PUBLIC LAW 105-33 105TH REPORTS, PDFs...This 2-volume compilation contains historical documents...

BALANCED BUDGET ACT OF 1997

Volumes 1-2

H.R. 2015

PUBLIC LAW 105-33105TH CONGRESS

REPORTS, BILLS,DEBATES, AND ACT

Social Security Administration

Office of the Deputy Commissioner forLegislation and Congressional Affairs

PREFACE

This 2-volume compilation contains historical documents pertaining to P.L. 105-33,the "Balanced Budget Act of 1997." These books contain congressional debates and achronological compilation of documents pertinent to the legislative history of thepublic law.

Pertinent documents include:

o Differing versions of key billso Committee Reportso Excerpts from the Congressional Recordo The Public Lawo Legislative Bulletins

The books are prepared by the Office of the Deputy Commissioner for Legislation andCongressional Affairs and are designed to serve as helpful resource tools for thosecharged with interpreting laws administered by the Social Security Administration.

TABLE OF CONTENTS


Volume 1

House Action on H.R. 2015

A. Reported to House

Committee on the Budget reported bill (without amendments) committedto the Whole House--June 24, 1997 (excerpts)

House Report No. 105-149 (to accompany H.R. 2015)--June 23, 1997(excerpts)

B. H.Res. 174, Providing for Consideration of H.R. 2015

Committee on Rules Report on H.Res. 174--House Report No. 105-152--June 25, 1997

House Debate and Passage of H.Res. 174--Congressional Record--June 25, 1997 (excerpts)

C. House Debate on H.R. 2015--Congressional Record--June 25, 1997(excerpts)

D. House-Passed Bill

H.R. 2015 as received in the Senate--June 25, 1997 (excerpts)

II. Senate Action on S. 947/H.R. 2015

A. 5. 947 in the Senate of the United States (As Reported by the SenateCommittee on the Budget With No Written Report)--June 20, 1997(excerpts)

1 of 3

B. Senate Amendments to S. 947(Excerpts of SSI and Social Security-Related Provisions)

C. Senate debated and passed 5. 947, with amendments

Senate debated and passed H.R. 2015, after striking all after the enactingclause and inserting the text of 5. 947 (subsequently, 5. 947 wasindefmitely postponed)

Congressional Record--June 23, 24, and 25, 1997 (excerpts)

D. Senate-Passed Bill--June 25, 1997 (excerpts)

Volume 2

III. Conference Action

A. Senate insisted on its amendments, requested conference, and appointedconferees--Congressional Record--June 27, 1997

B. House disagreed to the Senate amendments, agreed to conference, andappointed conferees--Congressional Record--July 10, 1997

C. H.Res. 201, Waiving Same Day Consideration of Rule--CongressionalRecord--July 30, 1999

D. Conference Report Filed--July 29, 1997

House Report No. 105-217 (excerpts)

E. H.Res. 202 Approved, Rule Granted Allowing No Amendments toConference Report--Congressional Record--July 30, 1997

F. House Agreed to Conference Report--Congressional Record--July 30,1997 (excerpts)

2 of 3

G. Senate Began Consideration of Conference Report--CongressionalRecord--July 30, 1997 (excerpts)

Senate Agreed to Conference Report--Congressional Record--July 31,1997 (excerpts)

H. House Agreed to H.J.Res. 90, Waiving Enrollment Requirements WithRespect to H.R. 2015--Congressional Record--July 31, 1997

IV. Public Law

A. Public Law 105-33--lOSth Congress--August 5, 1997 (excerpts)

B. President Clinton's Signing Statement--August 5, 1997

C. President Clinton's Remarks and Special Message on Line Item Veto--August 11, 1997

APPENDIX

A. H.R. 2037, Budget Enforcement Act of 1997(H.R. 2037 Was Incorporated into H.R. 2015)

B. Comparison of Budget Reconciliation Human Resources Items--Conference Status--July 21, 1997 (excerpts)

C. Legislative Bulletin 105-4--June 12, 1997

D. Legislative Bulletin 105-6--August 1, 1997

E. Report on the Enrolled Bill, H.R. 2015

Letter to Franklin Raines, Director, Office of Management and Budget,from John J. Callahan, Acting Commissioner of Social Security--July 31,1997

3 of 3

lB

105TH CONGRESS1ST SEssioN

[Report No. 105—149]

To provide for reconciliation pursuant to subsections (b)(1) and (c) of section105 of the concurrent resolution on the budget for fiscal year 1998.

IN THE HOUSE OF REPRESENTATWES

JUNE 24, 1997

Mr. KASICH from the Committee on the Budget, reported the following bill;which was committed to the Committee of the Whole House on the Stateof the Union and ordered to be printed

A BILLTo provide for reconciliation pursuant to subsections (b)(1)

and (c) of section 105 of the concurrent resolution on

the budget for fiscal year 1998.

1 Be it enacted by the Senate and House of Representa-

2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the "Balanced Budget Act

5 of 1997".

2

1 SEC. 2. TABLE OF CONTENTS.

Title I—Committee on Agriculture.Title Il—Committee on Banking and Financial Services.Title Ill—Committee on Commerce—Nonmedicare.Title W—Committee on Commerce—Medicare.Title V—Committee on Education and the Workforce.Tittle VT—Committee on Government Reform and Oversight.Title WI—Committee on Transportation and Infrastructure.Title VTII—Committee on Veterans' Affairs.Title IX—Committee on Ways and Means—Nonmedicare.Title X—Committee on Ways and Means—Medicare.

184

TITLE 1V—COMMITTEE ON

2 COMMERCE—MEDICARE

185

CHAPTER 1—MEDIcAREPIUs PROGRAM

SUBCHAPTER A—MEDICAREPLUS PROGRAM

Sec. 4001. Establishment of MedicarePlus program.

"PART C—MEDICAREPLUS PROGRAM

"Sec. 1851. Eligibility, election, and enrollment."Sec. 1852. Benefits and beneficiary protections."Sec. 1853. Payments to MedicarePlus organizations."Sec. 1854. Premiums."Sec. 1855. Organizational and financial requirements for MedicarePlus

organizations; provider-sponsored organizations."Sec. 1856. Establishment of standards."Sec. 1857. Contracts with MedicarePlus organizations."Sec. 1859. Definitions; miscellaneous provisions.

Sec. 4002. Transitional rules for current medicare HMO program.Sec. 4003. Conforming changes in medigap program.

SUBCHAPTER B—SPECIAL RULES FOR MEDICAREPLUS MEDICAL SAVINGS

ACCOUNTS

Sec. 4006. MedicarePlus MSA.

SUBCHAPTER C—GME, IME, AND DSH PAYMENTS FOR MANAGED CARE

ENROLLEES

Sec. 4008. Graduate medical education and indirect medical education pay-ments for managed care enrollees.

Sec. 4009. Disproportionate share hospital payments for managed care enroll-ees.

CHAPTER 2—INTEGRATED LONG-TERM CARE PROGRAMS

SUBCHAPTER A—PROGRAMS OF ALL-INCLUSiVE CARE FOR THE ELDERLY

(PACE)

Sec. 4011. Reference to coverage of PACE under the medicare program.Sec. 4012. Reference to establishment of PACE program as medicaid State op-

tion.

SUBCHAPTER B—SOCIAL HEALTH MAINTENANCE ORGANIZATIONS (SHMOS)

Sec. 4015. Social health maintenance organizations (SHMOs).

SUBCHAPTER C—OTHER PROGRAMS

Sec. 4018. Orderly transition of municipal health service demonstrationprojects.

Sec. 4019. Extension of certain medicare community nursing organization dem-onstration projects.

CHAPTER 3—MEDICARE PAYMENT ADVISORY COMMISSION

Sec. 4021. Medicare Payment Advisory Commission.

CHAPTER 4—MEDIGAP PROTECTIONS

Sec. 4031. Medigap protections.Sec. 4032. Medicare prepaid competitive pricing demonstration project.

186

Subtitle B—Prevention Initiatives

Sec. 4101. Screening mammography.Sec. 4102. Screening pap smear and pelvic exams.Sec. 4103. Prostate cancer screening tests.Sec. 4104. Coverage of colorectal screening.Sec. 4105. Diabetes screening tests.Sec. 4106. Standardization of medicare coverage of bone mass measurements.Sec. 4107. Vaccines outreach expansion.Sec. 4108. Study on preventive benefits.

Subtitle C—Rural Initiatives

Sec. 4206. Informatics, telemedicine, and education demonstration project.

Subtitle D—Anti-Fraud and Abuse Provisions

Sec. 4301. Permanent exclusion for those convicted of 3 health care relatedcrimes.

Sec. 4302. Authority to refuse to enter into medicare agreements with individ-uals or entities convicted of felonies.

Sec. 4303. Inclusion of toll-free number to report medicare waste, fraud, andabuse in explanation of benefits forms.

Sec. 4304. Liability of medicare carriers and fiscal intermediaries for claimssubmitted by excluded providers.

Sec. 4305. Exclusion of entity controlled by family member of a sanctioned in-dividual.

Sec. 4306. Imposition of civil money penalties.Sec. 4307. Disclosure of information and surety bonds.Sec. 4308. Provision of certain identification numbers.Sec. 4309. Advisory opinions regarding certain physician self-referral provi-

sions.Sec. 4310. Nondiscrimination in post-hospital referral to home health agencies.Sec. 4311. Other fraud and abuse related provisions.

Subtitle E—Prospective Payment Systems

CHAPTER 2—PAYMENT UNDER PART B

SUBCHAPTER A—PAYMENT FOR HOSPITAL OUTPATIENT DEPARTMENT

SERVICES

Sec. 4411. Elimination of formula-driven overpayments (FDO) for certain out-patient hospital services.

Sec. 4412. Extension of reductions in payments for costs of hospital outpatientservices.

Sec. 4413. Prospective payment system for hospital outpatient department serv-ices.

SUBCHAPTER B—REHABILITATION SERVICES

Sec. 4421. Rehabilitation agencies and services.Sec. 4422. Comprehensive outpatient rehabilitation facilities (corf).

SUBCHAPTER C—AMBULANCE SERVICES

Sec. 4431. Payments for ambulance services.Sec. 4432. Demonstration of coverage of ambulance services under medicare

through contracts with units of local government.

187

CHAPTER 3—PAYMENT UNDER PARTS A AND B

Sec. 4441. Prospective payment for home health services.

Subtitle G—Provisions Relating to Part B Only

CHAPTER 1—PHYSICIANS' SERVICES

Sec. 4601. Establishment of single conversion factor for 1998.Sec. 4602. Establishing update to conversion factor to match spending under

sustainable growth rate.Sec. 4603. Replacement of volume performance standard with sustainable

growth rate.Sec. 4604. Payment rules for anesthesia services.Sec. 4605. Implementation of resource-based physician practice expense.Sec. 4606. Dissemination of information on high per admission relative values

for in-hospital physicians' services.Sec. 4607. No X-ray required for chiropractic services.Sec. 4608. Temporary coverage restoration for portable electrocardiogram

transportation.

CHAPTER 2—OTHER PAYMENT PROVISIONS

Sec. 4611. Payments for durable medical equipment.Sec. 4612. Oxygen and oxygen equipment.Sec. 4613. Reduction in updates to payment amounts for clinical diagnostic

laboratory tests.Sec. 4614. Simplification in administration of laboratory services benefit.Sec. 4615. Updates for ambulatory surgical services.Sec. 4616. Reimbursement for drugs and biologicals.Sec. 4617. Coverage of oral anti-nausea drugs under chemotherapeutic regimen.Sec. 4618. Rural health clinic services.Sec. 4619. Increased medicare reimbursement for nurse practitioners and clini

cal nurse specialists.Sec. 4620. Increased medicare reimbursement for physician assistants.Sec. 4621. Renal dialysis-related services.Sec. 4622. Payment for cochlear implants as customized durable medical equip-

ment.

CHAPTER 3—PART B PREMIUM

Sec. 4631. Part B premium.

Subtitle H—Provisions Relating to Parts A and B

CHAPTER 1—PROVISIONS RELATING TO MEDICARE SECONDARY PAYER

Sec. 4701. Permanent extension and revision 'of certain secondary payer provi-sions.

Sec. 4702. Clarification of time and filing limitations.Sec. 4703. Permitting recovery against third party administrators.

CHAPTER 2—HOME HEALTH SERVICES

Sec. 4711. Recapturing savings resulting from temporary freeze on payment in-creases for home health services.

Sec. 4712. Interim payments for home health services.Sec. 4713. Clarification of part-time or intermittent nursing care.

188

Sec. 4714. Study of definition of homebound.Sec. 4715. Payment based on location where home health service is furnished.Sec. 4716. Normative standards for home health claims denials,Sec. 4717. No home health benefits based solely on drawing blood.Sec. 4718. Making part B primary payor for certain home health services.

CHAPTER 3—BM3Y BOOM GENERATION MEDICARE COMMISSION

Sec. 4721. Bipartisan Commission on the Effect of the Baby Boom Generationon the Medicare Program.

CHAPTER 4—PROVISIONS RELATING TO DIRECT GRADUATE MEDICALEDUCATION

Sec. 4731. Limitation on payment based on number of residents and implemen-tation of rolling average FTE count.

Sec. 4732. Phased-in limitation on hospital overhead and supervisory physiciancomponent of direct medical education costs.

Sec. 4733. Permitting payment to non-hospital providers.Sec. 4734. Incentive payments under plans for voluntary reduction in number

of residents.Sec. 4735. Demonstration project on use of consortia.Sec. 4736. Recommendations on long-term payment policies regarding financ-

ing teaching hospitals and graduate medical education.Sec. 4737. Medicare special reimbursement rule for certain combined residency

programs.

CHAPTER 5—OTHER PROVISIONS

Sec. 4741.. Centers of excellence.Sec. 4742. Medicare part B special enrollment period and waiver of part B late

enrollment penalty and medigap special open enrollment periodfor certain military retirees and dependents.

Sec. 4743. Competitive bidding for certain items and services.

Subtitle I—Medical Liability Reform

CHAPTER 1—GENERAL PROVISIONS

Sec. 4801. Federal reform of health care liability actions.Sec. 4802. Definitions.Sec. 4803. Effective date.

CHAPTER 2—UMFoItrI STANDARDS FOR HEALTH CARE L!ILny ACTIONS

Sec. 4811. Statute of limitations.Sec. 4812. Calculation and payment of damages.Sec. 4813. Alternative dispute resolution.

403

10 Subtitle D—Anti-Fraud and Abuse11 Provisions

417

17 SEC. 4308. PROVISION OF CERTAIN IDENTIFICATION NUM-

18 BERS.

19 (a) REQUIREMENTS TO DISCLOSE EMPLOYER IDEN-

20 TIFICATION NUMBERS (EINS) AND SOCIAL SECURITY AC-

21 COUNT NUMBERS (SSNS).—Section 1124(a)(1) (42

22 U.S.C. 1320a—3(a)(l)) is amended by inserting before the

23 period at the end the following: "and supply the Secretary

24 with the both the employer identification number (as-

25 signed pursuant to section 6109 of the Internal Revenue

418

1 Code of 1986) and social security account number (as-

2 signed under section 205(c)(2)(B)) of the disclosing en-

3 tity, each person with an ownership or control interest (as

4 defined in subsection (a)(3)), and any subcontractor in

5 which the entity directly or indirectly has a 5 percent or

6 more ownership interest. Use of the social security account

7 number under this section shall be limited to identity ver-

8 ification and identity matching purposes only. The social

9 security account number shall not be disclosed to any per-

10 son or entity other than the Secretary, the Social Security

11 Administration, or the Secretary of the Treasury, In ob-

12 taming the social security account numbers of the disclos-

13 ing entity and other persons described in this section, the

14 Secretary shall comply with section 7 of the Privacy Act

15 of 1974 (5 U.S.C. 552a note)".

16 (b) OTHER MEDICARE PROVIDERS.—Section 1124A

17 (42 U.S.C. 1320a—3a) is amended—

18 (1) in subsection (a)—

19 (A) by striking "and" at the end of para-

20 graph (1);

21 (B) by striking the period at the end of

22 paragraph (2) and inserting "; and"; and

23 (C). by adding at the end the following new

24 paragraph:

419

1 "(3) including the employer identification num-

2 ber (assigned pursuant to section 6109 of the Inter-

3 nal Revenue Code of 1986) and social security ac-

4 count number (assigned under section 205(c)(2)(B))

5 of the disclosing part B provider and any person,

6 managing employee, or other entity identified or de-

7 scribed under paragraph (1) or (2)."; and

8 (2) in subsection (c) by inserting "(or, for pur-

9 poses of subsection (a)(3), any entity receiving pay-

10 ment)" after "on an assignment-related basis".

11 (c) VERIFICATION BY SoCJAI. SECURITY ADMINTS-

12 TRATION (SSA).—Section 1124A (42 U.S.C. 1320a—3a)

13 is amended—

14 (1) by redesignating subsection (c) as sub-

15 section (d); and

16 (2) by inserting after subsection (b) the follow-

17 ing new subsection:

18 "(c) VERIFICATION.—

19 "(1) TRANSMITTAL BY HHS.—The Secretary

20 shall transmit—

21 "(A) to the Commissioner of Social Secu-

22 rity information concerning each social security

23 account number (assigned under section

24 205(c)(2)(B)), and

HR2O15RH-- 14

420

1 "(B) to the Secretary of the Treasury in-

2 formation concerning each employer identifica-

3 tion number (assigned pursuant to section 6109

4 of the Internal Revenue Code of 1986),

5 supplied to the Secretary pursuant to subsection

6 (a)(3) or section 1124(c) to the extent necessary for

7 verification of such information in accordance with

8 paragraph (2).

9 "(2) VERIFICATION.—The Commissioner of So-

10 cial Security and the Secretary of the Treasury shall

11 veriiy the accuracy of, or correct, the information

12 supplied by the Secretary to such official pursuant

13 to paragraph (1), and shall report such verifications

14 or corrections to the Secretary.

15 "(3) FEES FOR VERIFICATION.—The Secretary

16 shall reimburse the Commissioner and Secretary of

17 the Treasury, at a rate negotiated between the Sec-

18 retary and such official, for the costs incurred by

19 such official in performing the verification and cor-

20 rection services described in this subsection.".

21 (d) R,EPORT.—Before this subsection shall be effec-

22 tive, the Secretary of Health and Human Services shall

23 submit to Congress a report on steps the Secretary has

24 taken to assure the confidentiality of social security ac-

25 count numbers that will be provided to the Secretary

421

1 under the amendments made by this section. If Congress

2 determines that the Secretary has not taken adequate

3 steps to assure the confidentiality of social security ac-

4 count numbers to be provided to the Secretary under the

5 amendments made by this section, the amendments made

6 by this section shall not take effect.

7 (e) EFFECTIVE DATES.—Subject to subsection (d)—

8 (1) the amendment made by subsection (a)

9 shall apply to the application of conditions of partici-

10 pation, and entering into and renewal of contracts

11 and agreements, occurring more than 90 days after

12 the date of submission of the report under sub-

13 section (d); and

14 (2) the amendments made by subsection (b)

15 shall apply to payment for items and services fur-

16 nished more than 90 days after the date of submis-

17 sion of such report.

717

13 TITLE IX—COMMITTEE ON WAYS14 AND MEANS—NONMEDICARE15 SEC. 9000. TABLE OF CONTENTS.

16 The table of contents of this title is as follows:

Sec. 9000. Table of contents.

Subtitle A—TANF Block Grant

Sec. 9001. Welfare-to-work grants.Sec. 9002. Limitation on amount of Federal funds transferable to title XX pro-

grams.Sec. 9003. Clarification of limitation on number of persons who may be treated

as engaged in work by reason of participation in vocationaleducational training.

Sec. 9004. Required hours of work; health and safety.Sec. 9005. Penalty for failure of State to reduce assistance for recipients refus-

ing without good cause to work.

Subtitle B—Supplemental Security Income

Sec. 9101. Requirement to perform childhood disability redeterminations inmissed cases.

Sec. 9102. Repeal of maintenance of effort requirements applicable to optionalState programs for supplementation of SSI benefits.

Sec. 9103. Fees for Federal administration of State supplementary payments.

718

Subtitle C—Child Support Enforcement

Sec. 9201. Clarification of authority to permit certain redisclosures of wage andclaim information.

Subtitle D—Restricting Welfare and Public Benefits for Aliens

Sec. 9301. Extension of eligibility period for refugees and certain other quali-fied aliens from 5 to 7 years for SSI and medicaid.

Sec. 9302. SSI eligibility for aliens receiving SSI on August 22, 1996.Sec. 9303. SSI eligibility foi permanent resident aliens who are members of an

Indian tribe.Sec. 9304. Verification of eligibility for State and local public benefits.Sec. 9305. Derivative eligibility for benefits.Sec. 9306. Effective date.

Subtitle E—Unemployment Compensation

Sec. 9401. Clarifring provision relating to base periods.Sec. 9402. Increase in Federal unemployment account ceiling.Sec. 9403. Special distribution to States from Unemployment Trust Fund.Sec. 9404. Interest-free advances to State accounts in Unemployment Trust

Fund restricted to States which meet funding goals.Sec. 9405. Exemption of service performed by election workers from the Fed-

eral unemployment tax.Sec. 9406. Treatment of certain services performed by inmates.Sec. 9407. Exemption of service performed for an elementary or secondary

school operated primarily for religious purposes from the Fed-eral unemployment tax.

Sec. 9408. State program integrity activities for unemployment compensation.

Subtitle F—Increase in Public Debt Limit

Sec. 9501. Increase in public debt limit,

761

i Subtitle B—Supplemental Security2 Income3 SEC. 9101. REQUIREMENT TO PERFORM CHILDHOOD DIS-

4 ABILITY REDETERMINATIONS IN MISSED

5 CASES.

6 Section 211(d)(2) of the Personal Responsibility and

7 Work Opportunity Reconciliation Act of 1996 (110 Stat.

8 2190) is amended—

9 (1) in subparagraph (A)—

10 (A) in the 1st sentence, by striking "1

11 year" and inserting "18 months"; and

12 (B) by inserting after the 1st sentence the

13 following: "Any redetermination required by the

14 preceding sentence that is not performed before

15 the end of the period described in the preceding

16 sentence shall be performed as soon as is prac-

17 ticable thereafter."; and

18 (2) in subparagraph (C), by adding at the end

19 the following: "Before commencing a redetermina-

20 tion under the 2nd sentence of subparagraph (A), in

21 any case in which the individual involved has not al-

22 ready been notified of the provisions of this para-

23 graph, the Commissioner of Social Security shall no-

24 ti1y the individual involved of the provisions of this

25 paragraph.".

762

1 SEC. 9102. REPEAL OF MAINTENANCE OF EFFORT RE-

2 QUIREMENTS APPLICABLE TO OPTIONAL

3 STATE PROGRAMS FOR SUPPLEMENTATION

4 OF SSI BENEFITS.

5 Section 1618 of the Social Security Act (42 U.S.C.

6 1382g) is repealed.

7 SEC. 9103. FEES FOR FEDERAL ADMINISTRATION OF STATE

8 SUPPLEMENTARY PAYMENTS.

9 (a) FEE SCHEDULE.-—

10 (1) OPTIoNu STATE SUPPLEMENTABY PAY-

11 MENTS.—

12 (A) IN GENERAL.—Section 1616(d)(2)(B)

13 of the Social Security Act (42 U.S.C.

14 1382e(d)(2)(B)) is amended—

15 (i) by striking "and" at the end of

16 clause (iii); and

17 (ii) by striking clause (iv) and insert-

18 ing the following:

19 "(iv) for fiscal year 1997, $5.00;

20 "(v) for fiscal year 1998, $6.20;

21 "(vi) for fiscal year 1999, $7.60;

22 "(vii) for fiscal year 2000, $7.80;

23 "(viii) for fiscal year 2001, $8.10;

24 "(ix) for fiscal year 2002, $8.50; and

25 "(x) for fiscal year 2003 and each succeeding

26 fiscal year—

763

1 "(I) the applicable rate in the preceding

2 fiscal year, increased by the percentage, if any,

3 by which the Consumer Price Index for the

4 month of June of the calendar year of the in-

5 crease exceeds the Consumer Price Index for

6 the month of June of the calendar year preced-

7 ing the calendar year of the increase, and

8 rounded to the nearest whole cent; or

9 "(II) such different rate as the Commis-

10 sioner determines is appropriate for the State.".

11 (B) CONFORMING AMENDMENT.—Section

12 1616(d)(2)(C) of such Act (42 U.S.C.

13 1382e(d)(2)(C)) is amended by striking

14 "(B)(iv)" and inserting "(B)(x)(II)".

15 (2) MANDATORY STATE SUPPLEMENTARY PAY-

16 MENTS.—

17 (A) IN GENERAL.—Section

18 212(b)(3)(B)(ii) of Public Law 93—66 (42

19 U.S.C. 1382 note) is amended—


21 subclause (III); and

22 (ii) by striking subclause (IV) and in-

23 serting the following:

24 "(IV) for fiscal year 1997, $5.00;

25 "(V) for fiscal year 1998, $6.20;

764

1 "(VI) for fiscal year 1999, $7.60;

2 "(VII) for fiscal year 2000, $7.80;

3 "(VIII) for fiscal year 2001, $8.10;

4 "(IX) for fiscal year 2002, $8.50; and

5 "(X) for fiscal year 2003 and each succeeding

6 fiscal year—

7 "(aa) the applicable rate in the preceding








15 "(bb) such different rate as the Commis-


17 (B) CONFORMING AMENDMENT.—SectiOn

18 212(b)(3)(B)(iii) of such Act (42 U.S.C. 1382

19 note) is amended by striking "(ii)(IV)" and in-

20 serting "(ii)(X)(bb)".

21 (b) USE OF NEW FEES To DEFRAY THE Soclith SE-

22 CURITY ADMINISTRATION'S ADMINISTRATWE Ex-

23 PENSES.—

24 (1) CREDIT TO SPECIAL FUND FOR FISCAL

25 YEAR 1998 AND SUBSEQUENT YEARS.—

765

1 (A) OPTIoNu STATE SUPPLEMENTARY

2 PAYMENT FEES.—Section 1616(d)(4) of the So-

3 ial Security Act (42 U.S.C. 1382e(d)(4)) is

4 amended to read as follows:

5 "(4)(A) The first $5 of each administration fee as-

6 sessed pursuant to paragraph (2), upon collection, shall

7 be deposited in the general fund of the Treasury of the

8 United States as miscellaneous receipts.

9 "(B) That portion of each administration fee in ex-

10 cess of $5, and 100 percent of each additional services

11 fee charged pursuant to paragraph (3), upon collection for

12 fiscal year 1998 and each subsequent fiscal year, shall be

13 credited to a special fund established in the Treasury of

14 the United States for State supplementary payment fees.

15 The amounts so credited, to the extent and in the amounts

16 provided in advance in appropriations Acts, shall be avail-

17 able to defray expenses incurred in carrying out this title

18 and related laws.".

19 (B) MANDATORY STATE SUPPLEMENTARY

20 PAYMENT FEES.—Section 212(b)(3)(D) of Pub-

21 lic Law 93—66 (42 U.S.C. 1382 note) is amend-

22 ed to read as follows:

23 "(D)(i) The first $5 of each administration fee as-

24 sessed pursuant to subparagraph (B), upon collection,

766

1 shall be deposited in the general fund of the Treasury of

2 the United States as miscellaneous receipts.

3 "(ii) The portion of each administration fee in excess

4 of $5, and 100 percent of each additional services fee

5 charged pursuant to subparagraph (C), upon collection for






11 able to defray expenses incurred in carrying out this sec-

12 tion and title XVI of the Social Security Act and related

13 laws.".

14 (2) LIMITATIONS ON AUTHORIZATION OF AP-

15 PROPRJATIONS.—From amounts credited pursuant

16 to section 1616(d)(4)(B) of the Social Security Act

17 and section 212(b)(3)(D)(ii) of Public Law 93—66 to

18 the special fund established in the Treasury of the

19 United States for State supplementary payment

20 fees, there is authorized to be appropriated an

21 amount not to exceed $35,000,000 for fiscal year

22 1998, and such sums as may be necessary for each

23 fiscal year thereafter.

767

11 Subtitle D—Restricting Welfare12 and Public Benefits for Aliens13 SEC. 9301. EXTENSION OF ELIGIBILITY PERIOD FOR REFU-

14 GEES AND CERTAiN OTHER QUALIFIED

15 ALIENS FROM 5 TO 7 YEARS FOR SSI AND

16 MEDICAID.

17 (a) SSI.—Section 402(a)(2)(A) of the Personal Re-

18 sponsibiity and Work Opportunity Reconciliation Act of

19 1996 (8 U.S.C. 1612(a)(2)(A)) is amended to read as fol-

20 lows:

21 "(A) TIME-LIMITED EXCEPTION FOR REF-

22 UGEES AND ASYLEES.—

23 "(i) SSI.—With respect to the speci-

24 Lied Federal program described in para-

768

1 graph (3)(A) paragraph 1 shall not apply

2 to an alien until 7 years after the date—

3 "(I) an alien is admitted to the

4 United States as a refugee under see-

5 tion 207 of the Immigration and Na-

6 tionality Acts

7 "(II) an alien is granted asylum

8 under section 208 of such Act; or

9 "(III) an alien's deportation is

10 withheld under section 243(h) of such

11 Act.

12 "(ii) FOOD STAMPS.—With respect to

13 the specified Federal program described in

14 paragraph (3)(B), paragraph 1 shall not

15 apply to an alien until 5 years after the

16 date—


18 United States as a refugee under sec-


20 tionality Act;





25 Act.".

769

1 (b) MEDICMD.—Section 402(b)(2)(A) of the Per-

2 sonal Responsibility and Work Opportunity Reconciliation

3 Act of 1996 (8 U.S.C. 1612(b)(2)(A)) is amended to read

4 as follows:



7 "(i) MEDICAID.—With respect to the

8 designated Federal program described in

9 paragraph (3)(C), paragraph 1 shall not


11 date—




15 tionality Act;





20 Act.

21 "(ii) OTHER DESIGNATED FEDERAL

22 PROGRAMS.—With respect to the des-

23 ignated Federal programs under paragraph

24 (3) (other than subparagraph (C)), para-

770

1 graph 1 shall not apply to an alien until 5

2 years after the date—




6 tionality Act;





11 Act.".

12 SEC. 9302. SSI ELIGIBILITY FOR ALIENS RECEWING SSI ON

13 AUGUST 22, 1996.

14 (a) IN GENERAL.—Section 402(a)(2) of the Personal

15 Responsibility and Work Opportunity Reconciliation Act

16 of 1996 (8 U.S.C. 1612(a)(2)) is amended by adding after

17 subparagraph (D) the following new subparagraph:

18 "(E) ALIENS RECEWING SSI ON AUGUST

19 22, 1996.—With respect to eligibility for bene-

20 fits for the program defined in paragraph

21 (3)(A) (relating to the supplemental security in-

22 come program), paragraph (1) shall not apply

23 to an alien who was receiving such benefits on

24 August 22, 1996.".

771

1 (b) STATUS OF CUBAN AND HAITIAN ENTRANTS AND

2 AMERASTAN PERMANENT IRESIDENT ALIENS.—For pur-

3 poses of section 402(a)(2)(E) of the Personal Responsibil-

4 ity and Work Opportunity Reconciliation Act of 1996, the

5 following aliens shall be considered qualified aliens:

6 (1) An alien who is a Cuban and Haitian en-

7 trant as defined in section 501(e) of the Refugee

8 Education Assistance Act of 1980.

9 (2) An alien admitted to the United States as

10 an Amerasian immigrant pursuant to section 584 of

11 the Foreign Operations, Export Financing, and Re-

12 lated Programs Appropriations Act, 1988, as con-

13 tamed in section 101(e) of Public Law 100-202,

14 (other than an alien admitted pursuant to section

15 584(b)(1)(C)).

16 (c) CONFORMING AMENDMENTS.—Section

17 402(a) (2) (D) of the Personal Responsibility and Work Op-

18 portunity Reconciliation Act of 1996 (8 U.S.C.

19 1612(a)(D)) is amended—

20 (1) by striking clause (i);

21 (2) in the subparagraph heading by striking

22 "BENEFITS" and inserting "FOOD STAMPS";

23 (3) by striking "(ii) FOOD STAMPS'.—';

24 (3) by redesignating subclauses (I), (II), and

25 (III) as clauses (i), (ii), and (iii).

HR2O15RH--25

772

1 SEC. 9303. SSI ELIGIBILITY FOR PERMANENT RESIDENT

2 ALIENS WHO ARE MEMBERS OF AN INDIAN

3 TRIBE.

4 Section 402(a) (2) of the Personal Responsibility and

5 Work Opportunity Reconciliation Act of 1996 (8 U.S.C.

6 1612(a)(2)) (as amended by section 9302) is amended by

7 adding after subparagraph (E) the following new subpara-

8 graph:

9 "(F) PERMANENT RESIDENT ALIENS WHO

10 ARE MEMBERS OF AN INDIAN TRIBE.—With re-

11 spect to eligibility for benefits for the program

12 defined in paragraph (3)(A) (relating to the

13 supplemental security income program), para-

14 graph (1) shall not apply to an alien who—

15 "(i) is lawfully admitted for perma-

16 nent residence under the Immigration and

17 Nationality Act; and

18 "(ii) is a member of an Indian tribe

19 (as defined in section 4(e) of the Indian

20 Self-Determination and Education Assist-

21 ance Act).".

22 SEC. 9304. VERIFICATION OF ELIGIBILITY FOR STATE AND

23 LOCAL PUBLIC BENEFITS.

24 (a) IN GENERAL.—The Personal Responsibility and

25 Work Opportunity Reconciliation Act of 1996 is amended

26 by adding after section 412 the following new section:

773

1 "SEC. 413. AUTHORIZATION FOR VERIFICATION OF ELIGI-

2 BILITY FOR STATE AND LOCAL PUBLIC BENE-

3 FITS.

4 "A State or political subdivision of a State is author-

5 ized to require an applicant for State and local public ben-

6 efits (as defined in section 411(c)) to provide proof of eli-

7 gibility.".

8 (b) CLERICAL AMENDMENT.—Section 2 of the Per-


10 Act of 1996 is amended by adding after the item related

11 to section 412 the following:

"Sec. 413. Authorization for verification of eligibility for state and local publicbenefits.".

12 SEC. 9305. DERIVATIVE ELIGIBILITY FOR BENEFITS.




16 "SEC. 436. DERIVATWE ELIGIBILITY FOR BENEFITS.

17 "(a) FooD STAMPs.—Notwithstanding any other

18 provision of law, an alien who under the provisions of this

19 title is ineligible for benefits under the food stamp pro-

20 gram (as defined in section 402(a)(3)(A)) shall not be eli-

21 gible for such benefits because the alien receives benefits

22 under the supplemental security income program (as de-

23 fined in section 402(a)(3)(B)).

774

1 "(b) MEDIcATD.—Notwithstanding any other provi-

2 sion of this title, an alien who under the provisions of this

3 title is ineligible for benefits under the medicaid program

4 (as defined in section 402(b)(3)(C)) shall be eligible for

5 such benefits if the alien is receiving benefits under the

6 supplemental security income program and title XIX of

7 the Social Security Act provides for such derivative eligi-

8 bility.".





"Sec. 436. Derivative eligibility for benefits.".

13 SEC. 9306. EFFECTiVE DATE.

14 Except as otherwise provided, the amendments made

15 by this subtitle shall be effective as if included in the en-

16 actment of title IV of the Personal Responsibility and

17 Work Opportunity Reconciliation Act of 1996.

783

1 TITLE X—COMMITTEE ON WAYS2 AND MEANS—MEDICARE3 SEC. 10000. AMENDMENTS TO SOCIAL SECURITY ACT AND

4 REFERENCES TO OBRA; TABLE OF CONTENTS

5 OF TITLE.

6 (a) AMENDMENTS TO Sociu SECURITY ACT.—Ex-

7 cept as otherwise specifically provided, whenever in this

8 title an amendment is expressed in terms of an amend-

9 ment to or repeal of a section or other provision, the ref-

10 erence shall be considered to be made to that section or

11 other provision of the Social Security Act.

12 (b) REFERENCES TO OBRA.—In this title, the terms

13 "OBRA—1986", "OBRA—1987", "OBRA—1989",

14 "OBRA—1990", and "OBRA—1993" refer to the Omnibus

15 Budget Reconciliation Act of 1986 (Public Law 99—509),

16 the Omnibus Budget Reconciliation Act of 1987 (Public

17 Law 100—203), the Omnibus Budget Reconciliation Act

18 of 1989 (Public Law 101—239), the Omnibus Budget Rec-

19 onciliation Act of 1990 (Public Law 101—508), and the

20 Omnibus Budget Reconciliation Act of 1993 (Public Law

21 103—66), respectively.

22 (c) TABLE OF CONTENTS OF TITLE.—The table of

23 contents of this title is as follows:

Sec. 10000. Amendments to Social Security Act and references to OBRA; tableof contents of title.

Subtitle A—MedicarePlus Program

784

CHAPTER 1—MEDICAREPLUS PROGRAM



"P1UT C—MEDICARE PLUS PROGRAM

"Sec. 1851. Eligibility, election, and enrollment."Sec. 1852. Benefits and beneficiary protections."Sec. 1853. Payments to MedicarePlus organizations."Sec. 1854. Premiums."Sec. 1855. Organizational and financial requirements for MedicarePlus




ACCOUNTS


CHAPTER 2—INTEGRATED LONG-TERM C PROGRAMS

SUBCHAPTER A—PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY(PACE)

Sec. 10011. Coverage of PACE under the medicare program.Sec. 10012. Establishment of PACE program as medicaid State option.Sec. 10013. Effective date; transition.Sec. 10014. Study and reports.

SUBCHAPTER B—SOCIAL HEALTFI MAINTENANCE ORGANIZATIONS




Sec. 10019. Extension of certain medicare community nursing organizationdemonstration projects.

CHAPTER 3—MEDICARE PAYMENT ADVISORY CoMMISSIoN




CHAPTER 5—TAX TREATMENT OF HOSPITALS PARTICIPATING IN PROVIDER-SPONSORED OROIZATIONS

Sec. 10041. Tax treatment of hospitals which participate in provider-sponsoredorganizations.

785




Sec. 10201. Rural primary care hospital program.Sec. 10202. Prohibiting denial of request by rural referral centers for reclassi-

fication on basis of comparability of wages.Sec. 10203. Hospital geographic reclassification permitted for purposes of dis-

proportionate share payment adjustments.Sec. 10204. Medicare-dependent, small rural hospital payment extension.Sec. 10205. Geographic reclassification for certain disproportionately large hos-

pitals.Sec. 10206. Floor on area wage index.Sec. 10207. Informatics, telemedicine, and education demonstration project.




Sec. 10303. Inclusion of toll-free number to report medicare waste, fraud, andabuse in explanation of benefits forms.




sions.Sec. 10310. Other fraud and abuse related provisions.


CHAPTER 1—PAYMENT UNDER PuT A

Sec. 10401. Prospective payment for skilled nursing facility services.Sec. 10402. Prospective payment for inpatient rehabilitation hospital services.

CHAPTER 2—PAYMENT UNDER PuT B

SUBCHAPTER A—PAYMENT FOR HOSPITAL OUTPATIENT DEPARTMENTSERVICES

Sec. 10411. Elimination of formula-driven overpayments (FDO) for certainoutpatient hospital services.

786

Sec. 10412. Extension of reductiGns in payments for costs of hospital out-patient services.

Sec. 10413. Prospective payment system for hospital outpatient departmentservices.


Sec. 10421. Rehabilitation agencies and services.Sec. 10422. Comprehensive outpatient rehabilitation facilities (corfl.

SUBCHAPTER C-—AMBULANCE SERVICES





Subtitle F—Provisions Relating to Part A

CHAPTER 1—PANT OF PPS HOSPITALS

Sec. 10501. PPS hospital payment update.Sec. 10502. Capital payments for PPS hospitals.Sec. 10503. Freeze in disproportionate share.Sec. 10504. Medicare capital asset sales price equal to book value.Sec. 10505. Elimination of IME and DSH payments attributable to outlier

payments.Sec. 10506. Reduction in adjustment for indirect medical education.Sec. 10507. Treatment of transfer cases.Sec. 10508. Increase base payment rate to Puerto Rico hospitals.

CHAPTER 2—PAYMENT OF PPS EXEMPT HOSPITALS

Sec. 10511. Payment update.Sec. 10512. Reductions to capital payments for certain PPS-exempt hospitals

and units.Sec. 10513. Cap on TEFRA limits.Sec. 10514. Change in bonus and relief payments.Sec. 10515. Change in payment and target amount for new providers.Sec. 10516. Rebasing.Sec. 10517. Treatment of certain long-term care hospitals.Sec. 1O518. Elimination of exemptions; report on exceptions and adjustments.

CHAPTER 3—PRoVISIONS RELATED TO HOSPICE SERVICES

Sec. 10521. Payments for hospice services.Sec. 10522. Payment for home hospice care based on location where care is fur-

nished.Sec. 10523. Hospice care benefits periods.See. 10524. Other items and services included in hospice care.Sec. 10525. Contracting with independent physicians or physician groups for

hospice care services permitted.Sec. 10526. Waiver of certain staffing requirements for hospice care programs

in non-urbanized areas.

787

Sec. 10527. Limitation on liability of beneficiaries for certain hospice coveragedenials.

Sec. 10528. Extending the period for physician certification of an individual'sterminal illness.

Sec. 10529. Effective date.

CHAPTER 4—M0DIFIcATI0N OF PuT A HOME HEALTH BENEFIT

Sec. 10531. Modification of part A home health benefit for individuals enrolledunder part B.


Sec. 10541. Reductions in payments for enrollee bad debt.Sec. 10542. Permanent extension of hemophilia pass-through.Sec. 10543. Reduction in part A medicare premium for certain public retirees.





growth rate.Sec. 10604. Payment rules for anesthesia services.Sec. 10605. Implementation of resource-based physician practice expense.Sec. 10606. Dissemination of information on high per discharge relative values


transportation.



laboratory tests.Sec. 10614. Simplification in administration of laboratory tests.Sec. 10615. Updates for ambulatory surgical services.Sec. 10616. Reimbursement for drugs and biologicals.Sec. 10617. Coverage of oral anti-nausea drugs under chemotherapeutic regi-

men.Sec. 10618. Rural health clinic services.Sec. 10619. Increased medicare reimbursement for nurse practitioners and clin-

ical nurse specialists.Sec. 10620. Increased medicare reimbursement for physician assistants.Sec. 10621. Renal dialysis-related services.

CHAPTER 3—PT B PREMIUM



CRAPTER 1—PROVISIONS RELATING TO MEDICARE SECONDARY PAYER

788

Sec. 10701. Permanent extension and revision of certain secondary payer provi-sions.



Sec. 10711. Recapturing savings resulting from temporary freeze on paymentincreases for home health services.

Sec. 10712. Interim payments for home health services.Sec. 10713. Clarification of part-time or intermittent nursing care.Sec. 10714. Study of definition of homebound.Sec. 10715. Payment based on location where home health service is furnished.Sec. 10716. Normative standards for home health claims denials,Sec. 10717. No home health benefits based solely on drawing blood.

CHAPTER 3—By BOOM GENERATION MEDICARE COMMISSION

Sec. 10721. Bipartisan Commission on the Effect of the Baby Boom Genera-tion on the Medicare Program.

CHAPTER 4—PROVISIONS RELATING TO DIRECT GRADUATE MEDICALEDUCATION

Sec. 10731. Limitation on payment based on number of residents and imple-mentation of rolling average FTE count.

Sec. 10732. Phased-in limitation on hospital overhead and supervisory physi-cian component of direct medical education costs.



ing teaching hospitals and graduate medical education.Sec. 10737. Medicare special reimbursement rule for certain combined resi-

dency programs.


Sec. 10741. Centers of excellence.Sec. 10742. Medicare part B special enrollment period and waiver of part B

late enrollment penalty and medigap special open enrollmentperiod for certain military retirees and dependents.

Sec. 10743. Protections under the medicare program for disabled workers wholose benefits under a group health plan.

Sec. 10744. Placement of advance directive in medical record.


CHAPTER 1—GENERAL PROVISIONS


CHAPTER 2—UNIFORM STANDARDS FOR HEALTH CARE LIABILITY ACTIONS

Sec. 10811. Statute of limitations.

789

Sec. 10812. Calculation and payment of damages.Sec. 10813. Alternative dispute resolution.

1030


1045

17 SEC. 10308. PROVISION OF CERTAIN IDENTIFICATION NTJM-

18 BERS.




22 U.S.C. 1320a—3(a)(1)) is amended by inserting before the




1046






6 more ownership interest".

7 (b) OTHER MEDICARE PROvIDERS.—Section 1124A




11 graph (1);



14 (C) by adding at the end the following new

15 paragraph:








23 (2) in subsection (e) by inserting "(or, for pur-



1047

1 (c) VERIFICATION BY SoCIAi SECURITY ADMINIS-

2 TRATION (SSA).—Sectjon 1124A (42 U.S.C. 1320a—3a) is

3 amended—


5 section (d); and









14 205(c)(2)(B)), and








22 paragraph (2).



25 verif& the accuracy of, or correct, the information

1048










10 (d) REPORT.—The Secretary of Health and Human

11 Services shall submit to Congress a report on steps the

12 Secretary has taken to assure the confidentiality of social

13 security account numbers that will be provided to the Sec-

14 retary under the amendments made by this section.

15 (e) EFFECTiVE DATES.-—

16 (1) The amendment made by subsection (a)





21 section (d).

22 (2) The amendments made by subsection (b)




Union Calendar No. 89lO5Tn CONGRESS

1ST SEssioN • •

[Report No. 105—149]

A BILLTo provide for reconciliation pursuant to sub-

sections (b)(1) and (c) of section 105 of the con-current resolution on the budget for fiscal year1998.

JUNE 24, 1997

Reported from the Committee on the Budget; committedto the Committee of the 'Whole House on the State ofthe Union and ordered to be printed

105m CONGRESS

}HOUSE OF REPRESENTATIVES

{1st Session

REPORTOF THE

COMMITTEE ON THE BUDGETHOUSE OF REPRESENTATiVES

TO ACCOMPANY

H.R. 2015

A BILL TO PROVIDE FOR RECONCILIATION PURSUANT TO SUB-SECTIONS (b)(1) AND (C) OF SECTION 105 OF THE CONCURRENTRESOLUTION ON THE BUDGET FOR FISCAL YEAR 1998

together with

ADDITIONAL AND MINORITY VIEWS

JuNE 24, 1997.—Committed to the Committee of the Whole House onthe State of the Union and ordered to be printed

REPORT

105—149


U.S. GOVERNMENT PRINTING OFFICE

41-479 WASHINGTON 1997

COMMITTEE ON THE BUDGET

DAVID L. HOBSON, Ohio,Speaker's Designee

CHRISTOPHER SHAYS, ConnecticutWALLY HERGER, CaliforniaJIM BUNNING, KentuckyLAMAR S. SMITH, TexasDAN MILLER, FloridaBOB FRANKS, New JerseyNICK SMITH, MichiganBOB INGLIS, South Carolina.SUSAN MOLINARI, New YorkJIM NUSSLE, IowaPETER HOEKSTRA, MichiganJOHN SHADEGG, ArizonaGEORGE P. RADANOVICH, CaliforniaCHARLES F. BASS, New HampshireMARK W. NEUMANN, WisconsinMIKE PARKER, MississippiBOB EHRLICH, MarylandGIL GTJTKNECHT, MinnesotaVAN HILLEARY, TennesseeKAY GRANGER, TexasJOHN E. SUNUNU, New HampshireJOSEPH PI11S, Pennsylvania

JOHN R. KASICH, Ohio, ChairmanJOHN M. SPRA11, Jr., South Carolina,

Ranking Minority MemberJIM McDERMOII', Washington,

Leadership DesigneeALAN B. MOLLOHAN, West VirginiaJERRY F. COSTELLO, IllinoisPATSY T. MINK, HawaiiEARL POMEROY, North DakotaLYNN C. WOOLSEY, CaliforniaLUCILLE ROYBAL-ALLARD, CaliforniaLYNN N. RWERS, MichiganLLOYD DOGGE11, TexasBENNIE G. THOMPSON, MississippiBENJAMIN L. CARDIN, MarylandDAVID MINGE, MinnesotaSCO'NY BAESLER, KentuckyKEN BENTSEN, TexasJIM DAVIS, FloridaBRAD SHERMAN, CaliforniaROBERT A. WEYGAND, Rhode IslandEVA M. CLAYTON, North Carolina

PROFESSIONAL Smi

Rzca&rw E. MAY, Staff DirectorTios S. K, Minority Staff Director and Chief Counsel

(II)

CONTENTS

LEGISLATWE LANGUAGE

Page

Title I—Committee on Agriculture 2Title Il—Committee on Banking and Financial Services 5Title Ill—Committee on Cominerce—NonMedicare 6Title IV—Committee on Commerce—Medicare 72Title V—Committee on Education and the Workforce 228Title VI—Committee on Government Reform and Oversight 263Title Vu—Committee on Transportation and Infrastructure 271Title Vull—Comnmittee on Veterans' Affairs 272Title IX—Committee on Ways and Means—NonMedicare 278Title X—Committee on Ways and Means—Medicare 303

REPORT LANGUAGE

Introduction 495Title I—Committee on Agriculture 505Title 11—Committee on Banking and Financial Services 524Title Ill—Committee on Ccmmerce—NonMedicare 529Title IV—Comnñttee on Commerce—Medicare 645Title V—Committee on Education and the Workforce 977Title Vu—Committee on Government Reform and Oversight 1091Title Vil—Committee on Transportation and Infrastructure 1125Title Vull—Cominittee on Veterans' Affairs 1135Title TX—Committee on Ways and Means—NonMedicare 1197Title X—Committee on Ways and Means—Medicare 1382Miscellaneous House Report Requirements 1619Additional and Minority Views 1625

(III)

105Th CONGRESS 'I I REPORT

1st Session j HOUSE OF REPRESENTATiVES 105—149

PROVIDING FOR RECONCILIATION PURSUANT TO SUB-SECTIONS (b)(1) AND (c) OF SECTION 105 OF THE CON-CURRENT RESOLUTION ON THE BUDGET FOR FISCALYEAR 1998

Ju 24, 1997.—Conmiitted to the Committee of the Whole House on the State ofthe Union and orde:red to be printed

Mr. KASICH, from the Committee on the Budget,submitted the following

REPORTtogether with

ADDITIONAL AND MINORITY VIEWS

•[To accompany H.R. 20151

[Including cost estimate of the Congressional Budget Office]

The Committee on the Budget, to whom reconciliation rec-ommendations were submitted pursuant to subsections (b)(1) and(c) of section 105 of House Concurrent Resolution 84, the concur-rent resolution on the budget for fiscal year 1998, having consid-ered the same, reports favorably thereon without amendment andrecommends that the bill do pass.SECTION 1. SHORT TITLE.

This Act may be cited as the "Balanced Budget Act of 1997".SEC. 2. TABLE OF CONTENTS.Title I—Committee on Agriculture.Title Il—Committee on Banking and Financial Services.Title Ill—Committee on Commerce—Nonmedicare.Title IV—Committee on Commerce—Medicare.Title V—Committee on Education and the Workforce.Title \rI-._-Commjttee on Government Reform and Oversight.Title VU—Committee on Transportation and Infrastructure.Title VIII—Committee on Veterans' Affairs.

2

Title IX—Committee on Ways and Means—Nonmedicare.Title X—Committee on Ways and Means—Medicare.

72

TITLE IV—COMMITTEE ONCOMMERCE—MEDICARE

SEC. 4000. AMENDMEN'I'S TO SOCIAL SECURITY ACT AND REFERENCESTO OBRA; TABLE OF CONTENTS OF TITLE.

(a) AMENDMENTS TO SocIAL SECURITY AcT.—Except as otherwisespecifically provided, whenever in this title an amendment is ex-pressed in terms of an amendment to or repeal of a section or otherprovision, the reference shall be considered to be made to that sec-tion or other provision of the Social Security Act.

(b) REFERENCES TO OBRA.—In this title, the terms "OBRA—1986", "OBRA—1987", "OBRA—1989", "OBRA—1990", and "OBRA—1993" refer to the Omnibus Budget Reconciliation Act of 1986 (Pub-lic Law 99—509), the Omnibus Budget Reconciliation Act of 1987(Public Law 100—203), the Omnibus Budget Reconciliation Act of1989 (Public Law 101—239), the Omnibus Budget Reconciliation Actof 1990 (Public Law 101—508), and the Omnibus Budget Reconcili-ation Act of 1993 (Public Law 103—66), respectively.

(c) TLE OF CONTENTS OF TITLE.—The table of contents of thistitle is as follows:Sec. 4000. Amendments to Social Security Act and references to OBRA; table of

contents of title.


CHAPTER 1—MEDICAREPLIJ5 PROGRAM

5UBCHAPTER A—MEDICAREPLIJ5 PROGRAM


"PT C—MEDICAREPLIJS PROGRAM

"Sec. 1851. Eligibility, election, and enrollment."Sec. 1852. Benefits and beneficiary protections."Sec. 1853. Payments to MedicarePlus organizations."Sec. 1854. Premiums."Sec. 1855. Organizational and financial requirements for MedicarePlus organi-

zations; provider-sponsored organizations."Sec. 1856. Establishment of standards."Sec. 1857. Contracts with MedicarePlus organizations."Sec. 1859. Definitions; miscellaneous provisions.


73

SUBCHAPTER B—SPECIAL RULES FOR MEDICAREPLUS MEDICAL SAVINGS ACCOUNTS


SUBCHAPTER C—GME, IME, AND DSH PAYMENTS FOR MANAGED CARE ENROLLEES

Sec. 4008. Graduate medical education and indirect medical education paymentsfor managed care enrollees.

Sec. 4009. Disproportionate share hospital payments for managed care enrollees.

CHAPTER 2—INTEGRXrED LONG-TERM CARE PROGEAMS

SUBCHAPTER A—PROGRAMS OF ALL-INCLUSWE CARE FOR THE ELDERLY (PACE)

Sec. 4011. Reference to coverage of PACE under the medicare program.Sec. 4012. Reference to establishment of PACE program as medicaid State option.

SUBCHAPTER B—SOCIAL HEALTH MA]INTENANCE ORGANIZATIONS (SHMOS)



Sec. 4018. Orderly transition of municipal health service demonstration projects.Sec. 4019. Extension of certain medicare community nursing organization dem-

onstration projects.

CHAPTER 3—MEDICARE PAYMENT ADVISORY CoMMISSIoN




Subtitle B—Prevention InitiativesSec. 4101. Screening mammography.Sec. 4102. Screening pap smear and pelvic exams.Sec. 4103. Prostate cancer screening tests.Sec. 4104. Coverage of colorectal screening.Sec. 4105. Diabetes screening tests.Sec. 4106. Standardization of medicare coverage of bone mass measurements.Sec. 4107. Vaccines outreach expansion.Sec. 4108. Study on preventive benefits.

Subtitle C—Rural InitiativesSec. 4206. Informatics, telemedicine, and education demonstration project.

Subtitle D—Anti-Fraud and Abuse ProvisionsSec. 4301. Permanent exclusion for those convicted of 3 health care related crimes.Sec. 4302. Authority to refuse to enter into medicare agreements with individuals

or entities convicted of felonies.Sec. 4303. Inclusion of toll-free number to report medicare waste, fraud, and abuse

in explanation of benefits forms.Sec. 4304. Liability of medicare carriers and fiscal intermediaries for claims sub-

mitted by excluded providers.Sec. 4305. Exclusion of entity controlled by family member of a sanctioned individ-

ual.Sec. 4306. Imposition of civil money penalties.Sec. 4307. Disclosure of information and surety bonds.Sec. 4308. Provision of certain identification numbers.Sec. 4309. Advisory opinions regarding certain physician self-referral provisions.Sec. 4310. Nondiscrimination in post-hospital referral to home health agencies.Sec. 4311. Other fraud and abuse related provisions.


CHAPTER 2—PAYMENT UNDER PART B

SUBCHAPTER A—PAYMENT FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES


74

Sec. 4412. Extension of reductions in payments for costs of hospital outpatient serv-ices.

Sec. 4413. Prospective payment system for hospital outpatient department services.






CHAPTER 3—PAYMENT UNDER PS A AND B



CI'rER 1—PHYSICIANS' SERVICES

Sec. 4601. Establishment of single conversion factor for 1998.Sec. 4602. Establishing update to conversion factor to match spending under sus-

tainable growth rate.Sec. 4603. Replacement of volume performance standard with sustainable growth

rate.Sec. 4604. Payment rules for anesthesia services.Sec. 4605. Implementation of resourcebased physician practice expense.Sec. 4606. Dissemination of information on high per admission relative values for

in-hospital physicians' services.Sec. 4607. No X-ray required for chiropractic services.Sec. 4608. Temporary coverage restoration for portable electrocardiogram transpor-

tation.

CaI'1tR 2—OTHER PAYMENT PROVISIONS

Sec. 4611. Payments for durable medical equipment.Sec. 4612. Oxygen and oxygen equipment.Sec. 4613. Reduction in updates to payment amounts for clinical diagnostic labora-

tory tests.Sec. 4614. Simplification in administration of laboratory services benefit.Sec. 4615. Updates for ambulatory surgical services.Sec. 4616. Reimbursement for drugs and biologicals.Sec. 4617. Coverage of oral anti-nausea drugs under chemotherapeutic regimen.Sec. 4618. Rural health clinic services.Sec. 4619. Increased medicare reimbursement for nurse practitioners and clinical

nurse specialists.Sec. 4620. Increased medicare reimbursement for physician assistants.Sec. 4621. Renal dialysis-related services.Sec. 4622. Payment for cochlear implants as customized durable medical equip-

ment.

CaItR 3—PART B PREMIUMSec. 4631. Part B premium.


CaI'1tR 1—PROVISIONS RELATING TO MEDICARE SECONDARY PAYER

Sec. 4701. Permanent extension and revision of certain secondary payer provisions.Sec. 4702. Clarification of time and filing limitations.Sec. 4703. Permitting recovery against third party administrators.

CaI'itR 2—Hor HEALTH SERVICESSec. 4711. Recapturing savings resulting from temporary freeze on payment in-

creases for home health services.Sec. 4712. Interim payments for home health services.Sec. 4713. Clarification of part-time or intermittent nursing care.Sec. 4714. Study of definition of homebound.Sec. 4715. Payment based on location where home health service is furnished.

75

Sec. 4716. Normative standards for home health claims denials,Sec. 4717. No home health benefits based solely on drawing blood.Sec. 4718. Making part B primary payor for certain home health services.

CRAI'FER 3—BY BOOM GENERATION MEDICARE CoxIssIoN

Sec. 4721. Bipartisan Commission on the Effect of the Baby Boom Generation onthe Medicare Program.

CHAPTER 4—PROVISIONS RELATING TO DIIcT GRADUATE MEDICAL EDUCATION

Sec. 4731. Limitation on payment based on number of residents and implementa-tion of rolling average FTE count.

Sec. 4732. Phased-in limitation on hospital overhead and supervisory physiciancomponent of direct medical education costs.

Sec. 4733. Permitting payment to non-hospital providers.Sec. 4734. Incentive payments under plans for voluntary reduction in number of

residents.Sec. 4735. Demonstration project on use of consortia.Sec. 4736. Recommendations on long-term, payment policies regarding financing

teaching hospitals and graduate medical education.Sec. 4737. Medicare special reimbursement rule for certain combined residency pro-

grams.

CHAPTER 5—OThER PROVISIONS

Sec. 4741. Centers of excellence.Sec. 4742. Medicare part B special enrollment period and waiver of part B late en-

rollinent penalty and medigap special open enrollment period for cer-tain military retirees and dependents.

Sec. 4743. Competitive bidding for certain items and services.


CHAPTER 1—GENERAL PROvIsIONS


CHAPTER 2—UNIFORM STANDARDS FOR Hm C LInITY Ac1IONS


157

Subtitle D—Anti-Fraud and AbuseProvisions

162

SEC. 4308. PROVISION OF CERTAIN mENTIFICATION NUMBERS.(a' REQUIREMENTS TO DISCLOSE EMPLOYER IDENTIFICATION NUM-

BERS (EINS) AND SocI. SECURITY ACCOUNT NUMBERS (SSNS).—Section 1124(a)(1) (42 U.S.C. 1320a—3(a)(1)) is amended by insert-

163

ing before the period at the end the following: "and supply the Sec-retary with both the employer identification number (assigned pur-suant to section 6109 of the Internal Revenue Code of 1986) andsocial security account number (assigned under section205(c)(2)(B)) of the disclosing entity, each person with an owner-ship or control interest (as defined in subsection (a)(3)), and anysubcontractor in which the entity directly or indirectly has a 5 per-cent or more ownership interest. Use of the social security accountnumber under this section shall be limited to identity verificationand identity matching purposes only. The social security accountnumber shall not be disclosed to any person or entity other thanthe Secretary, the Social Security Administration, or the Secretaryof the Treasury, In obtaining the social security account numbersof the disclosing entity and other persons described in this section,the Secretary shall comply with section 7 of the Privacy Act of 1974(5 U.S.C. 552a note)".

(b) OTHER MEDICARE PROvIDERS.—Section 1124A (42 U.S.C.1320a—3a) is amended—

(1) in subsection (a)—(A) by striking "and" at the end of paragraph (1);(B) by striking the period at the end of paragraph (2)

and inserting "; and"; and(C) by adding at the end the following new paragraph:

"(3) including the employer identification number (assignedpursuant to section 6109 of the Internal Revenue Code of 1986)and social security account number (assigned under section205(c)(2)(B)) of the disclosing part B provider and any person,managing employee, or other entity identified or describedunder paragraph (1) or (2)."; and

(2) in subsection (c) by inserting "(or, for purposes of sub-section (a)(3), any entity receiving payment)" after "on an as-signment-related basis".

(c) VERIFICATION BY SOCIAL SECURITY ADMINISTRATION (SSA).—Section 1124A (42 U.S.C. 1320a—3a) is amended—

(1) by redesignating subsection (c) as subsection (d); and(2) by inserting after subsection (b) the following new sub-

section:"(c) VERIFICATION.—

"(1) TRANSMITTAL BY HHS.—The Secretary shall transmit—"(A) to the Commissioner of Social Security information

concerning each social security account number (assignedunder section 205(c)(2)(B)), and

"(B) to the Secretary of the Treasury information con-cerning each employer identification number (assignedpursuant to section 6109 of the Internal Revenue Code of1986),

supplied to the Secretary pursuant to subsection (a)(3) or sec-tion 1124(c) to the extent necessary for verification of such in-formation in accordance with paragraph (2).

"(2) VERIFICATION.—The Commissioner of Social Securityand the Secretary of the Treasury shall verify the accuracy of,or correct, the information supplied by the Secretary to such of-ficial pursuant to paragraph (1), and shall report such verifica-tions or corrections to the Secretary.

164

"(3) FEEs FOR VERIFICATION.—The Secretary shall reimbursethe Commissioner and Secretary of the Treasury, at a rate ne-gotiated between the Secretary and such official, for the costsincurred by such official in performing the verification and cor-rection services described in this subsection.".

(d) REPORT.—Before this subsection shall be effective, the Sec-retary of Health and Human Services shall submit to Congress areport on steps the Secretary has taken to assure the confidential-ity of social security account numbers that will be provided to theSecretary under the amendments made by this section. If Congressdetermines that the Secretary has not taken adequate steps to as-sure the confidentiality of social security account numbers to beprovided to the Secretary under the amendments made by this sec-tion, the amendments made by this section shall not take effect.

(e) EFFECTIVE DATE5.—Subject to subsection (d)—(1) the amendment made by subsection (a) shall apply to the

application of conditions of participation, and entering into andrenewal of contracts and agreements, occurring more than 90days after the date of submission of the report under sub-section (d); and

(2) the amendments made by subsection (b) shall apply topayment for items and services furnished more. than 90 daysafter the date of submission of such report.

278

TITLE IX—COMMITTEE ON WAYS ANDMEANS—NONMEDICARE

SEC. 9000. TABLE OF CONTENTS.The table of contents of this title is as follows:



Sec. 9001. We'fare-to-work grants.Sec. 9002. Limitation on amount of Federal funds transferable to title )O( pro-

grams.Sec. 9003. Clarification of limitation on number of persons who may be treated as

engaged in work by reason of participation in vocational educationaltraining.

Sec. 9004. Required hours of work; health and safety.Sec. 9005. Penalty for failwe of State to reduce assistance for recipients refusing

without good cause to work.


Sec. 9101. Requirement to perform childhood disability redeterminations in missedcases.



Subtitle C—Child Support EnforcementSec. 9201. Clarification of authority to permit certain redisclosures of wage and

claim information.

279

Subtitle D—Restricting Welfare and Public Benefits for AliensSec. 9301. Extension of eligibility period for refugees and certain other qualified

aliens from 5 to 7 years for SSI and medicaid.Sec. 9302. SSI eligibility for aliens receiving SSI on August 22, 1996.Sec. 9303. SSI eligibility for permanent resident aliens who are members of an In-

-dian tribe.Sec. 9304. Verification of eligibility for State and local public benefits.Sec. 9305. Derivative eligibility for benefits.Sec. 9306. Effective date.

Subtitle E—Unemployment CompensationSec. 9401. Clarifying provision relating to base periods.Sec. 9402. Increase in Federal unemployment account ceiling.Sec. 9403. Special distribution to States from Unemployment Trust Fund.Sec. 9404. Interest-free advances to State accounts in Unemployment Trust Fund

restricted to States which meet funding goals.Sec. 9405. Exemption of service performed by election workers from the Federal

unemployment tax.Sec. 9406. Treatment of certain services performed by inmates.Sec. 9407. Exemption of service performed for an elementary or secondary school

operated primarily for religious purposes from the Federal unemploy-ment tax.


Subtitle F—Increase in Public Debt LimitSec. 9501. Increase in public debt limit.

294

Subtitle B—Supplemental Security IncomeSEC. 9101. REQUIREMENT TO PERFORM CHILDHOOD DISABILITY RE-

DETERMINATIONS IN MISSED CASES.Section 211(d)(2) of the Personal Responsibility and Work Oppor-

tunity Reconciliation Act of 1996 (110 Stat. 2190) is amended—(1) in subparagraph (A)—

(A) in the 1st sentence, by striking "1 year" and insert-ing "18 months"; and

(B) by inserting after the 1st sentence the following:"Any redetermination required by the preceding sentencethat is not performed before the end of the period de-scribed in the preceding sentence shall be performed assoon as is practicable thereafter."; and

(2) in subparagraph (C), by adding at the end the following:"Before commencing a redetermination under the 2nd sentenceof subparagraph (A), in any case in which the individual in-volved has not already been notified of the provisions of thisparagraph, the Commissioner of Social Security shall notify theindividual involved of the provisions of this paragraph.".

SEC. 9102. REPEAL OF MAINTENANCE OF EFFORT REQUIREMENTS AP-PLICABLE TO OPTIONAL STATE PROGRAMS FORSUPPLEMENTATION OF SSI BENEFITS.

Section 1618 of the Social Security Act (42 U.S.C. 1382g) is re-pealed.SEC. 9103. FEES FOR FEDERAL ADMINISTRATION OF STATE SUPPLE-

MENTARY PAYMENTS.(a) FEE SCHEDULE.—

(1) OPTIoNAL STATE SUPPLEMENTARY PAYMENTS.—(A) IN GENERAL.—Section 1616(d)(2)(B) of the Social Se-

curity Act (42 U.S.C. 1382e(d)(2)(B)) is amended—(i) by striking "and" at the end of clause (iii); and(ii) by striking clause (iv) and inserting the follow-

ing:"ir) for fiscal year 1997, $5.00;"(v) for fiscal year 1998, $6.20;

295

"(vi) for fiscal year 1999, $7.60;"(vii) for fiscal year 2000, $7.80;"(viii) for fiscal year 2001, $8.10;"(ix) for fiscal year 2002, $8.50; and"(x) for fiscal year 2003 and each succeeding fiscal year—

"(I) the applicable rate in the preceding fiscal year, in-creased by the percentage, if any, by which the ConsumerPrice Index for the month of June of the calendar year ofthe increase exceeds the Consumer Price Index for themonth of June of the calendar year preceding the calendaryear of the increase, and rounded to the nearest wholecent; or

"(II) such different rate as the Commissioner determinesis appropriate for the State.".

(B) CoNrom1ING AMENDMENT.—Section 1616(d)(2)(C) ofsuch Act (42 U.S.C. 1382e(d)(2)(C)) is amended by striking"(B)(iv)" and inserting "(B)(x)(II)".

(2) MANDATORY STATE SUPPLEMENTARY PAYMENTS.—(A) IN GENERAL.—Section 212(b)(3)(B)(ii) of Public Law

93-66 (42 U.S.C. 1382 note) is amended—(1) by striking "and" at the end of subclause (III);

and(ii) by striking subclause (N) and inserting the fol-

lowing:"(N) for fiscal year 1997, $5.00;"(V) for fiscal year 1998, $6.20;"(VI) for fiscal year 1999, $7.60;"(VII) for fiscal year 2000, $7.80;"(VIII) for fiscal year 2001 $8.10;"(LX) for fiscal year 2002, 8.50; and"(X) for fiscal year 2003 and each succeeding fiscal year—

"(aa) the applicable rate in the preceding fiscal year, in-creased by the percentage, if any, by which the ConsumerPrice Index for the month of June of the calendar year ofthe increase exceeds the Consumer Price Index for themonth of June of the calendar year preceding the calendaryear of the increase, and rounded to the nearest wholecent; or

"(bb) such different rate as the Commissioner deter-mines is appropriate for the State.".

(B) CONrOm1ING AMENDMENT.—Section 2 12(b)(3)(B)(iii)of such Act (42 U.S.C. 1382 note) is amended by striking"(ii)(N)" and inserting "(ii)(X)(bb)".

(b) USE OF NEW FEES To DEFRAY THE Socii SECURITY ADMINIS-TRATION'S ADMINISTRATIVE EXPENSES.—

(1) CREDIT TO SPECIAL FUND FOR FISCAL YEAR 1998 AND SUB-SEQUENT YEARS.—

(A) OPTIONAL STATE SUPPLEMENTARY PAYMENT FEES.—Section 1616(d)(4) of the Social Security Act (42 U.S.C.1382e(d)(4)) is amended to read as follows:

"(4)(A) The first $5 of each administration fee assessed pursuantto paragraph (2), upon collection, shall be deposited in the generalfund of the Treasury of the United States as miscellaneous re-ceipts.

296

"(B) That portion of each administration fee in excess of $5, and100 percent of each additional services fee charged pursuant toparagraph (3), upon collection for fiscal year 1998 and each subse-quent fiscal year, shall be credited to a special fund established inthe Treasury of the United States for State supplementary pay-ment fees. The amounts so credited, to the extent and in theamounts provided in advance in appropriations Acts, shall be avail-able to defray expenses incurred in carrying out this title and relat-ed laws.".

(B) MANDATORY STATE SUPPLEMENTARY PAYMENT FEES.—Section 212(b)(3)(D) of Public Law 93—66 (42 U.S.C. 1382note) is amended to read as follows:

"(D)(i) The first $5 of each administration fee assessed pursuantto subparagraph (B), upon collection, shall be deposited in the gen-eral fund of the Treasury of the United States as miscellaneous re-ceipts.

"(ii) The portion of each administration fee in excess of $5, and100 percent of each additional services fee charged pursuant tosubparagraph (C), upon collection for fiscal year 1998 and eachsubsequent fiscal year, shall be credited to a special fund estab-lished in the Treasury of the United States for State supple-mentary payment fees. The amounts so credited, to the extent andin the amounts provided in advance in appropriations Acts, shallbe available to defray expenses incurred in carrying out this sectionand title XVI of the Social Security Act and related laws.".

(2) LIMITATIONS ON AUTHORIZATION OF APPROPRIATIONS.—From amounts credited pursuant to section 1616(d)(4)(B) of theSocial Security Act and section 212(b)(3)(D)(ii) of Public Law93—66 to the special fund established in the Treasury of theUnited States for State supplementary payment fees, there isauthorized to be appropriated an amount not to exceed$35,000,000 for fiscal year 1998, and such sums as may be nec-essary for each fiscal year thereafter.

Subtitle D—Restricting Welfare and PublicBenefits for Aliens

SEC. 9301. EXTENSION OF ELIGIBIJUTY PERIOD FOR REFUGEES ANDCERTAIN OTHER QUALIFIED ALIENS FROM 5 TO 7 YEARSFOR SSI AND MEDICAID.

(a) SSI.—Section 402(a)(2)(A) of the Personal Responsibility andWork Opportunity Reconciliation Act of 1996 (8 U.S.C.1612(a)(2)(A)) is amended to read as follows:

297

"(A) TIME-LIMITED EXCEPTION FOR REFUGEES ANDASYLEES.—

"(i) SSI.—With respect to the specified Federal pro-gram described in paragraph (3)(A) paragraph 1 shallnot apply to an alien until 7 years after the date—

"(I) an alien is admitted to the United States asa refugee under section 207 of the Immigrationand Nationality Act;

"(II) an alien is granted asylum under section208 of such Act; or

"(III) an alien's deportation is withheld undersection 243(h) of such Act.

"(ii) FOOD STAMPS.—With respect to the specifiedFederal program described in paragraph (3)(B), para-graph 1 shall not apply to an alien until 5 years afterthe date—



"(III) an alien's deportation is withheld undersection 243(h) of such Act.".

(b) MEDICAID.—Section 402(b)(2)(A) of the Personal Responsibil-ity and Work Opportunity Reconciliation Act of 1996 (8 U.S.C.1612(b)(2)(A)) is amended to read as follows:

"(A) TIME-LIMITED EXCEPTION FOR REFUGEES ANDASYLEES.—

"(i) MEDICAID.—With respect to the designated Fed-eral program described in paragraph (3)(C), paragraph1 shall not apply to an alien until 7 years after thedate—



"(III) an alien's deportation is withheld undersection 243(h) of such Act.

"(ii) OTHER DESIGNATED FEDERAL PROGRAMS.—Withrespect to the designated Federal programs underparagraph (3) (other than subparagraph (C)), para-graph 1 shall not apply to an alien until 5 years afterthe date—



"(III) an alien's deportation is withheld undersection 243(h) of such Act.".

298

SEC. 9302. SSI ELIGIBILITY FOR ALIENS RECEIVING SSI ON AUGUST 22,1996.

(a IN GENERAL—Section 402(a)(2) of the Personal Responsibilityand Work Opportunity Reconciliation Act of 1996 (8 U.s.c.1612(a)(2)) is amended by adding after subparagraph (Di the fol-lowing new subparagraph:

"(E) ALIENS RECEIVING SSI ON AUGUST 22, 1996.—Withrespect to eligibility for benefits for the program defined inparagraph (3)(A (relating to the supplemental security in-come program), paragraph (1) shall not apply to an alienwho was receiving such benefits on August 22, 1996.".

Cb) STATUS OF cUBAN AND HAITIAN ENTRANTS AND AMERASIANPERMANENT RESIDENT ALIENS.—For purposes of section402(a)(2)(E) of the Personal Responsibility and Work OpportunityReconciliation Act of 1996, the following aliens shall be consideredqualified aliens:

(1) An alien who is a cuban and Haitian entrant as definedin section 501(e) of the Refugee Education Assistance Act of1980.

(2) An alien admitted to the United States as an Amerasianimmigrant pursuant to section 584 of the Foreign Operations,Export Financing, and Related Programs Appropriations Act.1988, as contained in section 101(e) of Public Law 100—202,(other than an alien admitted pursuant to section 584(b)C1)(c)).

(c CONFORMING AMENDMENTS.—Section 402(a(2)(D) of the Per-sonal Responsibility and Work Opportunity Reconciliation Act of1996 (8 u.S.c. 1612(a)(D)) is amended—

(1) by striking clause (i;(2) in the subparagraph heading by striking "BENEFITS" and

inserting 'FOOD STAMPS";(3) by striking "(ii FOOD STAMPS'.—;(4) by redesignating subclauses (I), (II), and (III) as clauses

(i), (ii), and (iii).SEC. 9303. SSI ELIGIBILITY FOR PERMANENT RESIDENT ALIENS WHO

ARE MEMBERS OF AN INDLAN TRIBE.Section 402(a)'2) of the Personal Responsibility and Work Oppor-

tunity Reconciliation Act of 196 (S u.s.c. i612(aX2) (as amendedby section 93O2 is amended by adding after subparagraph CE) thefollowing new subparagraph:

"(F) PERMANENT RESIDENT ALIENS WHO ARE MEMBERS OFAN INDIAN TRIBE.—With respect to eligibility for benefitsfor the program defined in paragraph (3)(A) (relating tothe supplemental security income program), paragraph (1)shall not apply to an alien wh

"(i) is lawfully admitted for permanent residenceunder the Immigration and Nationality Act; and

"(ii is a member of an Indian tribe (as defined insection 4(e) of the Indian Self-Determination and Edu-cation Assistance Act).'.

SEC. 9304. VERIFICATiON OF ELIGIBILITY FOR STATE AND LOCALPUBLIC BENEFITS

(a) IN GENERAL—The Personal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 is amended by adding after sec-tion 412 the following new section:

299

"SEC. 413. AUTHORIZATION FOR VERIFICATION OF ELIGIBILITY FORSTATE AND LOCAL PUBLIC BENEFiTS.

"A State or political subdivision of a State is authorized to re-quire an applicant for State and local public benefits (as defined insection 4 11(c)) to provide proof of eligibility.".

(b) CLERICAL AMENDMENT.—Section 2 of the Personal Respon-sibility and Work Opportunity Reconciliation Act of 1996 is amend-ed by adding after the item related to section 412 the following:"Sec. 413. Authorization for verification of eligibility for state and local public bene-

fits.".

SEC. 9305. DERIVATWE ELIGII3LLITY FOR BENEFITS.(a) IN GENERAL.—The Personal Responsibility and Work Oppor-

tunity Reconciliation Act of 1996 is amended by adding after sec-tion 435 the following new section:"SEC. 436. DER1VATWE ELIGIBILITY FOR BENEFITS.

"(a) FooD SmMPs.—Notwithstanding any other provision of law,an alien who under the provisions of this title is ineligible for bene-fits under the food stamp program (as defined in section4O2(a)(3)(A)) shall not be eligible for such benefits because the alienreceives benefits under the supplemental security income program(as defined in section 402(a)(3)(B)).

"(b) MEDICAID.—Notwithstanding any other provision of thistitle, an alien who under the provisions of this title is ineligible forbenefits under the medicaid program (as defined in section402(b)(3)(C)) shall be eligible for such benefits if the alien is receiv-.ing benefits under the supplemental security income program andtitle X1X of the Social Security Act provides for such derivative eli-gibility.".

(b) CLERICAL AMENDMENT.—Section 2 of the Personal Respon-sibility. and Work Opportunity Reconciliation Act of 1996 is amend-ed by adding after the item related to section 435 the following:'Sec. 436. Derivative eligibility for benefits.".

SEC. 9306. EFFECTWE DATE.Except as otherwise provided, the amendments made by this sub-

title shall be effective as if included in the enactment of title IV ofthe Personal Responsibility and Work Opportunity ReconciliationAct of 1996.

303

TiTLE X—COMINIITTEE ON WAYS AND?1IEANS—MEDTCARE

SEC. 10000. AMENDMENTS TO SOCIAL SECURITY ACT AND REF-ERENCES TO OBRA TABLE OF CONTENTS OF TITLE.

(a) AMENDMENTS TO Sociu SECURITY ACT.—Except as otherwisespecifically provided, whenever in this title an amendment is ex-pressed in terms of an amendment to or repeal of a section or otherprovision, the reference shall be considered to be made to that sec-tion or other provision of the Social Security Act.

(b) REFERENCES TO OBRA.—in this title, the terms "OBRA—1986", "OBRA—1987". "OBRA—1989'. "OBRA—1990", and "OBRA—1993" refer to the Omnibus Budget Reconciliation Act of 1986 (Pub-lic Law 99—509), the Omnibus Budget Reconciliation Act of 1987(Public Law 1OO—203, the Omnibus Budget Reconciliation Act of1989 (Public Law 10 1—239), tie Omnibus Budget Reconciliation Actof 1990 (Public Law 101—508), and the Omnibus Budget Reconcili-ation Act of 1993 (Public Law 103—66'. respectively.

(c) TABLE OF CONTENTS OF TITLE.—The table of contents of thistitle is as follows:Sec. 10000. Amendments to Social Security Act and references to OBRA; table of

contents of title.


CHAPTER 1—MEDICAREPLU5 PROGRAM

SUBCHAPTER A—MEDICAREPLU5 PROGRAM

Sec. 10001. Establishment or' MedicarePlus program.

"P.T C—MEDICAREPL.US PRccaI

"Sec. 1851. Eligibility, election, and enrollment."Sec. 1852. Benefits and beneficiary protections."Sec. 1853. Payments to MedicarePlus organizations."Sec. 1854. Premiums."Sec. 1855. Organizational and financial requirements for MedicarePlus organi-

zations; providersponsored organizations."Sec. 1856. Establishment of standards."Sec. 1857. Contracts with MedicarePlus organizations."Sec. 1859.. Definitions: miscellaneous provisions.


SUBCHAPTCR 8—SPECIAL RULES FOR MEDICAREPLUS MEDICAL SAVINGS ACCOUNTS

Sec. 10006: MedicarePlus MSA.

CHAPTER 2—INTEGRATED LONG-TIRM CAI PROGRAMS

SUBCHAPTER \—PROGRAMS OF ALL-INCLUSIVE CARE FOR TILE ELDERLY PACE

Sec. 10011. Coverage of PACE under the medicare program.Sec. 10012. Establishment of PACE program as medicaid State option.Sec. 10013. Effective date: transition.Sec. 10014. Study and reports.

SUBCHAPTER B—SOCIAL 1-f EALTU MAINTENANCE ORGANIZATIONS

Sec. 10015. Social health maintenance organizations SHMOs).

SUBCHAPTER C—OTHER PROG}tMS

Soc. 10018. Orderiy transition of municipal health service demonstration projects.Sec. 10019. Extension of certain medicare community nursing organization dem-

onstration projects.

304

CJtkP'rEr 3—MEDICARE P,mEcr ADVISORY COMi1Iss1oN


CHAII'ER 4—MEDIGAP PROTECTIONS


Ca&vrE1 5—T TREATMENT OF HOSPITALS PARTICIPATING IN PROVIDER-SPONSOREDORGANIZATIONS

Sec. 10041. Tax treatment of hospitals which participate in provider-sponsored or-gamzations.

Subtitle B—Prevention InitiativesSec. 10101. Screening mammography.Sec. 10102. Screening pap smear and pelvic exams.Sec. 10103. Prostate cancer screening tests.Sec. 10104. Coverage of colorectal screening.Sec. 10105. Diabetes screening tests.Sec. 10106. Standardization of medicare coverage of bone mass measurements.Sec. 10107. Vaccines outreach expansion.Sec. 10108. Study on preventive benefits.

Subtitle C—Rural InitiativesSec. 10201. Rural primary care hospital program.Sec. 10202. Prohibiting denial of request by rural referral centers for reclassifica-

tion on basis of comparability of wages.Sec. 10203. Hospital geographic reclassification permitted for purposes of dis-

proportionate share payment adjustments.Sec. 10204. Medicare-dependent. small rural hospital payment extension.Sec. 10205. Geographic reclassification for certain disproportionately large hos-


Subtitle D—Anti-Fraud and Abuse ProvisionsSec. 10301. Permanent exclusion for those convicted of 3 health care related

crimes.Sec. .10302. Authority to refuse to enter into medicare agreements with individuals

or entities convicted of felonies.Sec. 10303. Inclusion of toll-free number to report medicare waste, fraud, and

abuse in explanation of benefits forms.See. 10304. Liability of medicare carriers and fiscal intermediaries for claims sub-

mitted by excluded providers.Sec. 10305. Exclusion of entity controlled by family member of a sanctioned individ-

ual.Sec. 10306. imposition of civi money penalties.Sec. 10307. Disclosure of information and surety bonds.Sec. 10308. Provision of certain identification numbers.Sec. 10309. Advisory opinions regarding certaii physician self-referral provisions.Sec. 10310. Other fraud and abuse related provisions.


CHAPrER 1—PAYMENT UNDER PART A


CHAPrER 2—PAYMENT UNDER PART B

SUBCHAPTER A—PAYMENT FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES

Sec. 10411. Elimination of formula-driven overpavments (FDO for certain out-patient hospita' services.

Sec. 10412. Extension of reductions in payments for costs of hospital outpatientsewices.

Sec. 10413. Prospective payment system for hospital outpatient department serb'-ices.

305


Sec. 10421. Rehabilitation agencies and services.Sec. 10422. Comprehensive outpatient rehabilitation facilities (CORF).







CHAPTER 1—PAYMENT OF PPS HOSPITALS

Sec. 10501. PPS hospital payment update.Sec. 10502. Capital payments for PPS hospitals.Sec. 10503. Freeze in disproportionate share.Sec. 10504. Medicare capital asset sales price equal to book value.Sec. 10505. Elimination of IME and DSH payments attributable to outlier pay-

ments.Sec. 10506. Reduction in adjustment for indirect medical education.Sec. 10507. Treatment of transfer cases.Sec. 10508. Increase base payment rate to Puerto Rico hospitals.


Sec. 10511. Payment update.Sec. 10512. Reductions to capital payments for certain PPS-exempt hospitals and

units.Sec. 10513. Cap on TEFRA limits.Sec. 10514. Change in bonus and relief payments.Sec. 10515. Change in payment and target amount for new providers.Sec. 10516. Rebasing.Sec. 10517. Treatment of certain long-term care hospitals.Sec. 10518. Elimination of exemptions; report on exceptions and adjustments.

CHAPTER 3—PROVISIONS RELATED TO HOSPICE SERVICES


nished.Sec. 10523. Hospice care benefits periods.Sec. 10524. Other items and services inc'uded in hospice care.Sec. 10525. Contracting with independent physicians or physician groups for hos-

pice care services permitted.Sec. 10526. Waiver of certain staffing requirements for hospice care programs in

non-urbanized areas.Sec. 10527. Limitation on liability of beneficiaries for certain hospice coverage deni-

als.Sec. 10528. Extending the period for physician certification of an individual's termi-

nal illness.Sec. 10529. Effective date.

CHAFFER 4—MODIFICATION OF PART A HOME HEm BENEFIT


CHAPTER 5—OTHER PAYMENT PROvISIONS




Sec. 10601. Establishment of single conversion factor for 1998.

306

Sec. 10602. Establishing update to conversion factor to match spending under sus-tainable growth rate.

Sec. 10603. Replacement of volume performance standard with sustainable growthrate.

Sec. 10604. Payment rules for anesthesia services.Sec. 10605. Implementation of resource-based physician practice expense.Sec. 10606. Dissemination of information on high per discharge relative values for

in-hospital physicians' services.Sec. 10607. No X-ray required for chiropractic services.Sec. 10608. Temporary coverage restoration for portable electrocardiogram trans-

portation.

CHAPTER 2—O'riIER PAYMENT PRovisioNs

Sec. 10611. Payments for durable medical equipment.Sec. 10612. Oxygen and oxygen equipment.Sec. 10613. Reduction in updates to payment amounts for clinical diagnostic lab-

oratory tests.Sec. 10614. Simplification in administration of laboratory tests.Sec. 10615. Updates for ambulatory surgical services.Sec. 10616. Reimbursement for drugs and biologicals.Sec. 10617. Coverage of oral anti-nausea drugs under chemotherapeutic regimen.Sec. 10618. Rural health clinic services.Sec. 10619. Increased medicare reimbursement for nurse practitioners and clinical

nurse specialists.Sec. 10620. Increased medicare reimbursement for physician assistants.Sec. 10621. Renal dialysiE-related services.

CiAVrER 3—PART B PREMIUM





Sec. 10702. Clarification of time and filing limitations.Sec. 10703. Peniiitting recovery against third party administrators.




CIw'rER 3—BABY BOOM GENERATION MEDICARE COMMISsION

Sec. 10721. Bipartisan Commission on the Effect of the Baby Boom Generation onthe Medicare Program.

CHAPTER 4—PRovISIONs REL&TING TO DIRECT GinuA'rE MEDICAL EDUCATION

Sec. 10731. Limitation on payment based on number of residents and implementa-tion of rolling average FTE count.

Sec. 10732. Phased-in limitation on hospital overhead and supervisory phvsiciar.component of direct medical education costs.

Sec. 10733. Permitting payment to non-hospital providers.Sec. 10734. incentive payments under plans for voluntary reduction in number of

residents.Sec. 10735. Demonstration project on use of consortia.Sec. 10736. Recommendations on long-term payment policies regarding financing

teaching hospitals and graduate medical education.Sec. 10737. Medicare special reimbursement rule for certain combined residency

programs.

307

CHAPTER 5—OTHER PRovisioNs

Sec. 10741. Centers of excellence.Sec. 10742. Medicare part B special enrollment period and waiver of part B late en-

rollment penalty and medigap special open enrollment period for cer-tain military retirees and dependents.

Sec. 10743. protections under the medicare program for disabled workers who losebenefits under a group health plan.



CHAFFER 1—GENERAL PROVISIONS


CHAFFER 2—UNIFORM STANDARDS FOR Hm Ci Liiu'ry AcTIoNs


399


404

SEC. 10308. PROVISION OF CERTAIN IDENTIFICATION NUMBERS.(a) REQUIREMENTS TO DISCLOSE EMPLOYER IDENTIFICATION Nuivi-

BERS (EINS) A1TL) SOCIAL SECURITY ACCOUNT NUMBERS (SSNS).—Section 1124(a)(1) (42 U.S.C. 1320a—3(a)(1)) is amended by insert-

405

ing before the period at the end the following: "and supply the Sec-retary with both the employer identification number (assigned pur-suant to section 6109 of the Internal Revenue Code of 1986) andsocial security account number (assigned under section205(c)(2)(B)) of the disclosing entity, each person with an owner-ship or control interest (as defined in subsection (a)(3)), and anysubcontractor in which the entity directly or indirectly has a 5 per-cent or more ownership interest".

(b) OTHER MEDICARE PROVIDERS.—Section 1124A (42 U.S.C.1320a—3a) is amended—

(1) in subsection (a)—(A) by striking "and" at the end of paragraph (1);(B) by striking the period at the end of paragraph (2)

and inserting"; and"; and(C) by adding at the end the following new paragraph:

"(3) including the employer identification number (assignedpursuant to section 6109 of the Internal Revenue Code of 1986)and social security account number (assigned under section205(c)(2)(B)) of the disclosing part B provider and any person,managing employee, or other entity identified or describedunder paragraph (1) or (2)."; and

(2) in subsection (c) by inserting "(or, for purposes of sub-section (a)(3), any entity receiving payment)" after "on an as-signment-related basis".

(c) VERIFICATION BY SOCIAL SECURITY ADMINISTRATION (SSA).—Section 1124A (42 U.S.C. 1320a—3a) is amended—

(1) by redesignating subsection (c) as subsection.(d); and(2) by inserting after subsection (b) the following new sub-

section:"(c) VERIFICATION.—

"(1) T1ANSMIrrAL BY 11115.—The Secretary shall transmit—"(A) to the Commissioner of Social Security information

concerning each social security account number (assignedunder section 205(c)(2)(B)), and

"(B) to the Secretary of the Treasury information con-cerning each employer identification number (assignedpursuant to section 6109 of the Internal Revenue Code of1986),

supplied to the Secretary pursuant to subsection (a)(3) or sec-tion 1124(c) to the extent necessary for verification of such in-formation in accordance with paragraph (2).

"(2) VERIFICATION.—The Commissioner of Social Securityand the Secretary of the Treasury shall verify the accuracy of,or correct, the information supplied by the Secretary to such of-ficial pursuant to paragraph (1), and shall report such verifica-tions or corrections to the Secretary.

"(3) FEES FOR VERIFICATION.—The Secretary shall reimbursethe Commissioner and Secretary of the Treasury, at a rate ne-gotiated between the Secretary and such official, for the costsincurred by such official in performing the verification and cor-rection services described in this subsection.".

(d) REPORT.—The Secretary of Health and Human Services shallsubmit to Congress a report on steps the Secretary has taken to as-sure the confidentiality of social security account numbers that will

406

be provided to the Secretary under the amendments made by thissection.

(e) EFFECTIVE DATEs.—(1) The amendment made by subsection (a) shall apply to the

application of conditions of participation, and entering into andrenewal of contracts and agreements. occurring more than 90days after the date of submission of the reDort under sub-section (d).

(2) The amendments made by subsection (b) shall apply topayment for items and services furnished more than 90 daysafter the date of submission of such report.

STATEMENT OF THE HOUSE COMMITrEE ON THE BUDGET

ON THE BALANCED BUDGET ACT OF 1997

The Bipartisan Budget Agreement reached earlier this year rep-resents an historic achievement. It demonstrated that Congressand the administration could commit themselves to major reformsof government programs so that the Federal budget can be bal-anced in 2002. It also called for a substantial reduction in the taxburden for middle-income Americans.

This legislation—the Balanced Budget Act of 1997—reflects thegood faith efforts of House authorizing committees to fulfill thefirst part of that agreement through systemic, fundamental reformsof government entitlements. A second measure, called the RevenueReconciliation Act of 1997, provides approximately $85 billion innet tax relief over 5 years. Together, these twin bills respond to thereconciliation directives of the House Concurrent Resolution on theBudget for Fiscal Year 1998, (H. Con. Res. 84), which embraced theBipartisan Budget Agreement.

The underlying accomplishments of the budget agreement war-rant repeating. They include the following:

- It balances the Federal budget in 2002 and is projected to runsurpluses each year thereafter through 2002.

- It provides a total of $85 billion in net tax relief over the next5 years and $250 billion through 2007—the vast majority of itgoing to middle-income working families.

- It delays Medicare bankruptcy for 10 years.- It reduces total Federal spending to 18.9 percent of gross do-

mestic product [GDP] by 2002—the first time since 1974 thatFederal spending has been below 20 percent of GDP.

- It slows the growth of total Federal spending to 3 percent ayear for the next 5 years.

- It achieves roughly $182 billion in entitlement savings over thenext 5 years, and approximately $700 billion over the next 10years.

- It slows the growth of nondefense discretionary outlays to lessthan one-half of 1 percent a year over the next 5 years, com-pared with an average of 6 percent a year for the past 10years.

- It saves taxpayers approximately $13 billion over the next 5years, and $142 billion over the next 10 years, through lowerinterest payments.

(495)

49- It proves Congress and the administration can achieve common

goals without. cornDromising f'indarnenta] principles.Ye: as sweeping as these achievements are, they represent. only

the nrst step in what must be a long-term commitment to keepConress' flscai house order. T forthcoming retirement of thebaby boom generation will bring a massive new wave of challengesfor edera policymakers—chalienges that. if left unaddressed.cou'id overwhelm not only the Federal budget. but the entire econ-ornv a well.

Still, this budget agreement is an indispensable first step. Cor-gres snouid swiftly pass thiE Implementing legislation, and thePresident should sigr it, so that we can move on together to facethe cnallenges ahead.

HOUSE OF REPRESENTATWES,COMMITrEE ON COMMERCE,

Washington, DC, June 17, 1997.Hon. JoHN R. KASICH,Chairman, Committee on the Budget,Washington, DC.

DEAR MR. CHAIRMAN: I am transmitting herewith the rec-ommendations of the Committee on Commerce for changes in Medi-care laws within the jurisdiction, pursuant to the provisions of sec-tion 310 of the Congressional Budget Act of 1974 and H. Con. Res.84, the Concurrent Resolution on the Budget—Fiscal Years 1998—2002.

The enclosed recommendations were embodied in a CommitteePrint adopted by the Committee on June 12, 1997. Pursuant toyour instructions, the legislative language of this Committee Printhas been incorporated into Title IV—Committee on Commerce—Medicare.

Enclosed is the legislative language for Title IV, the accompany-ing report language, and the Minority Views. I have been informedthat the Legislative Counsel's Office has made arrangements withyour staff to submit the Ramsayer language for Title IV directly tothe Budget Committee to expedite your Committee's action.

If you have any questions concerning the Committee's rec-ommendations, or if I can be of any further assistance to you asyou proceed with the Committee's deliberations, please do not hesitate to contact me.

Sincerely,TOM BLILEY, Chairman.

TITLE W—COMMIrrEE ON COMMERCE—MEDICARE

PURPOSE AND SUMMARY

Recently, the Board of Trustees of the Federal Hospital Insur-ance Trust Fund and the Supplementary Medical Insurance TrustFund issued their annual reports which pointed to significantshort- and long-term financing crises in both Part A and Part B ofMedicare. With respect to the Hospital Insurance (HI) Trust Fund,the Trustees noted:

As we reported for the last several years, one of theMedicare Trust Funds, the Hospital Insurance Fund,would be exhausted in four years without legislation thataddresses its financial imbalance.

The Trustees also expressed very strong concerns regarding theSupplementary Medical Insurance (SMI) Trust Fund. Although theSMI Program is currently actuarially sound because it receivesmost of its funds from general revenues, the Trustees noted:

(645)

646

SMI benefits have been growing rapidly. Outlays haveincreased 45 percent over the past 5 years (33 percent ona per-beneficiary basis). During this period the programgrew about 14 percent faster than the economy as a whole,despite efforts to contro' SMI costs.

SMI expenditures are expected to continue to grow fast-er than the economy as a whole. SMI outlays were almost1 percent of the Gross Domestic Product (GDP) in 1996and are projected to grow about 2.5 percent in 2020.

We note with great concern the past and projected rapidgrowth in the cost of the program. Therefore, we urge theCongress to take appropriate steps to more effectively con-trol SMI costs. Prompt, effective, and decisive action isnecessary.

To address the twin financial crises facing Medicare, the Com-mittee on Commerce has adopted legislation which will place PartB of Medicare, the part of the program which is under the Commit-tee's primary jurisdiction, on a long-term sustainable growth path.

In addition to providing responsible and sustainable financing forMedicare, the Committe&s bill will provide Medicare beneficiarieswith the same choices in health delivery that younger Americansreceive from their employers. While Medicare enrollees will beguaranteed the right to remain in traditional fee-for-service Medi-care, they will now have the right to choose new and innovativehealth plans such as the following: (1) Provider Sponsored Organi-zations: (2) Health Care Maintenance Organizations with and with-out Point of Service options; (3) Medical Savings Accounts under anew demonstration authority; and (4) Preferred Provider Networks.

This legislation was developed after several months of publichearings by the Subcommittee on Health and the Environment.Testimony was received from dozens of witnesses including healthcare providers, hea).th care economists, actuaries, and other healthcare experts.

BACKGROUND ir NEED FOR LEGISLATION

Medicare is a Federal health insurance program for the aged andcertain disabled individuals. It consists of two parts: Part A is thehospital insurance (HI) program; and Part B is the supplementarymedical insurance (SMI) program. Most Americans age 65 or olderare automatically entitled to health coverage under Part A, where-as participation in Part B is voluntary. Also eligible, after a two-year waiting period, are people under age 65 who are receiving So-cial Security disability benefits.

The cost and scope of the Medicare program have placed its fu-ture financial viability in jeopardy. According to the 1997 report ofthe Board 01 Trustees. both Part A and Part B of the Medicare pro-gram require immediate attention if they are to remain a solventand integral component ir the health care coverage of America'sseniors. In light of the importance of the Medicare program to thelives of millions of Americans, the Medicare legislation was devel-oped to preserve, protect, and strengthen the program for the cur-rent and future generations of beneficiaries.

647

According to the Medicare Trustees, the Hospital Insurance (HI)Trust Fund is projected to run out of reseires in just four years.The Trustees also called for action to restructure the Supple-mentary Medical Insurance (SMI) program because the rate ofgrowth in this program is unsustainable. SMI growth directly af-fects Medicare beneficiary Part B Premiums as well as the overallFederal budget from which the largest share of SMI costs are fi-nanced.

Among the factors that initiated Congressional action on thiscritical issue is the fact that recent Medicare cost increases com-pare very unfavorably to those in the private health care market.According to data from the Congressional Budget Office, Medicarespending growth is more than two times greater than the increasein private health care costs.

For all of the above reasons. this legislation was developed topreserve, protect and strengthen the Medicare program. To achievethese objectives, the following criteria guided the Committee's re-form efforts:

(1) Policy improvements to make Medicare solvent for atleast 10 years, and ensure that Medicare continues to increasespending each year. However, Medicare spending will bebrought in line with the need to ensure Part B affordability,rather than permitting the program's uncontrolled spendinggrowth rates as in the past;

(2) Policy improvements desigied to create opportunities forbeneficiaries to choose more modern private coverage options,as well as for health care providers to reduce waste, eliminateabuse, and increase efficiency;

(3) Policy improvements that expand coverage for mammog-raphy screening (annual mammograms for all women ages 40and over; waiving of screening deductible); pap smear/pelvicscreening (pelvic screening every 3 years; yearly for high-riskwomen); prostate cancer screening (annually for men over 50;covers digital rectal exam or PSA); colorectal screening (menover 50; fecal-occult blood test, flexible sigmoidoscopy for high-risk individuals, and barium enema if recommended by theSecretary of Health and Human Services (the Secretary)), dia-betes screening (self-management training, glucose monitorsand testing strips); and vaccines (extension of influenza andpneumonia camDaigll through 2002); and

(4) The establishment of a Bipartisan Commission on the Ef-fect of the Baby Boom Generation on the Medicare Program tomake recommendations to the Congress on the reforms nec-essary to ensure the preservation of the program, in light ofanticipated demograDhic pressures on the program's financing.

HEARINGS

The Committee's Subcommittee on Health and Environment hasnot held hearings specifically on Title IV. However, the Subcommit-tee on Health and Environment has held a number of hearings inthe 105th Congress on the Medicare program and a variety of re-torm issues.

Testifying before the Subcommittee on February 12, 1997, on theDepartment of health and Human Services's Proposed Budget for

648

FY 1998, were: Dr. Bruce Vladeck, Administrator, Health Care Fi-nancing Administration; and Mr. Paul N. Van de Water, AssistantDirector for Budget Analysis, Congressional Budget Office.

Testifying before the Subcommittee on February 27, 1997, onMedicare Managed Care: Payment and Related Issues, were: Mr.Bruce M. Fried, Director, Office of Managed Care, Health Care Fi-nancing Administration; Jonathan Ratner, Ph.D., Associate Direc-tor, Health Financing Systems, Health, Education, and HumanServices, U.S. General Accounting Office; Donald A. Young, M.D.,Executive Director, Prospective Payment Assessment Commission;and Roger S. Taylor, M.D., M.P.A., Commissioner, Physician Pay-ment Review Commission.

Testifying before the Subcommittee on March 5, 1997, on Medi-care Home Health Care, were: Dr. Bruce Viadeck, Administrator,Health Care Financing Administration; Mr. Michael F. Mangano,Principal Deputy Inspector General, Department of Health andHuman Services; Mr. William Scanlon, Director, Health FinancingSystems, Health, Education, and Human Services, U.S. GeneralAccounting Office; Donald A. Young, M.D., Executive Director, Pro-spective Payment Assessment Commission; Ms. Margaret J.Cushman, President, VNA Health Care Inc., representing the Na-tional Association for Home Care; and James C. Pyles, Esq., Pow-ers, Pyles, Sutter, and Vervilie, representing the Home Health Pro-spective Payment Work Group.

Testifying before the Subcommittee on March 19, 1997, on Medi-care Provider Service •Networks, were: The Honorable James C.Greenwood, Member of Congress; The Honorable Charles W. Sten-holm, Member of Congress; Ms. Josephine Musser, President, Na-tional Association of Insurance Commissioners; William F. Bluhm,FSA, MAA, Vice President, Health, The American Academy of Ac-tuaries; The Honorable Bill Gradison, President, Health InsuranceAssociation of America; Ms. Mary Nell Lehnhard, Senior VicePresident Office of Policy and Representation, Blue Cross and BlueShield Association; Mr. Thomas R. Sobocinski, President and CEO,Physicians Plus Insurance Corporation representing the AmericanAssociation of Health Plans; Richard F. Corlin, M.D., Speaker ofthe House of Delegates, American Medical Association; Mr. John C.McMeekin, President and CEO Crozer-Keystone Heakh System,representing the American Hospita' Association; and RobertMargolis, M.D., Chairman, American Medica1 Group Association.

Testifying before the Subcommittee on April 11, 1997, on Medi-care Preventive Benefits and Quality Standards, were: The Honor-able Newt Gingrich, Speaker of the House, U.S. House of Rep-resentatives; The Honorable George R. Nethercutt, Jr., Member ofCongress; Ms. Bernice Steinhardt, Director Heakh Services Qualityand Public Health Issues, U.S. General Accounting Office; Mr. AlanAltschuler, Chairman of the Board, American Diabetes Association;Resa Levetan, M.D., Director of Diabetes, Medlantic Research In-stitute, Washington Hospital Center; Marvin M. Schuster, M.D.,President, Americar. College of Gastroenterology: James B. Regan.M.D., Assistant Professor of Surgery, Division of Urology, George-town University Medical Center representing the AmericanUrological Association, Inc.; Peter G. Taber, M.D., Chief of Gastro-enterology Division, University of Pennsylvania; and Robert Har-

649

mon, M.D., MPH Member, Board of Directors, Partnership for Pre-vention, representing the American Gastroenterological Associa-tion.

COMMITrEE CoNSIDE1TIoN

On June 10, 1997, the Subcommittee on Health and Environ-ment met in open session and approved for Full Committee consid-eration a Committee Print entitled "Title IV—Committee on Com-merce—Medicare," amended, by a roll call vote of 15 yeas to 11nays. On June 12, 1997, the Committee met in open session andordered the Committee Print entitled "Title N—Committee onCommerce—Medicare" transmitted to the House Committee on theBudget, amended, for inclusion in the 1997 Omnibus Budget Rec-onciliation Act, by a roll call vote of 30 yeas to 17 nays.

ROLL CALL VOTES

Pursuant to Clause 2(l)(2)(B) of rule Xi of the Rules of the Houseof Representatives, following are listed the recorded votes on themotion to order Title N transmitted to the House Committee onthe Budget, and on amendments thereto, including the names ofthose Members voting for and against.

716

SUBTITLE D—ANTI-FRAUD AND ABUSE PROVISIONS

71S

Section 3O6. Imposition of civil money penaltiesCurrent law. Section 1128A of the Social Security Act sets forth

a list of fraudulent activities relating to claims submitted for pay-ments for items of services under a Federa' health care program.Civil money penalties of up to $1OOOO for each item or service maybe assessed. In addition, the Secretary of HHS (or head of the de-partment or agency for the Federal heaith care program involved)may aiso exclude the person involved in the fraudulent activityfrom participation in a Federa' health care program, defined as anyprogram providing health benefits, whether directly or othevise,whici is funded directly, in whole or in part, by the United States

719

Government (other than the Federal Employees Health BenefitsProgram).

Explanation of provision. The provision would add a new civilmoney penalty for cases in which a person contracts with an ex-cluded provider for the provision of health care items or services,where the person knows or should know that the provider has beenexcluded from participation in a Federal health care program.

Section 4308. Provision of certain identification numbersCurrent law. Section' 1124 of the Social Security Act requires that

entities participating in Medicare, Medicaid and the Maternal andChild Health Block Grant programs (including providers, clinicallaboratories, renal disease faci]ities, health maintenance organiza-tions, carriers and fiscal intermediaries), provide certain informa-tion regarding the identity of each person with an ownership orcontrol interest in the entity, or in any subcontractor in which theentity has a direct or indirect 5 percent or more ownership interest.

720

Section 1124A of the Social Security Act requires that providersunder part B of Medicare also provide information regarding per-sons with ownership or control interest in a provider, or in anysubcontractor in which the provider has a direct or indirect 5 per-cent or more ownership interest.

Explanation of provision. The provision would require that allMedicare providers supply the Secretary with both the employeridentification number and social security account number of eachdisclosing entity, each person with an ownership or control inter-est, and any subcontractor in which the entity has a direct or indi-rect 5 percent or more ownership interest. The Secretary of HHSis directed to transmit to the Commissioner of Social Security infor-mation concerning each social security account number and to theSecretary of the Treasury information concerning each employeridentification number supplied to the Secretary for verification ofsuch information. Socia' security numbers would not be disclosedto other persons or entities, and use of such numbers would be lim-ited to verification and matching purposes only. The Secretarywould reimburse the Commissioner and the Secretary of the Treas-ury for costs incurred in performing the verification services re-quired by this provision. The Secretary of HHS would report toCongress on the steps taken to assure confidentiality of social secu-rity numbers to be provided to the Secretary under this section be-fore it becomes effective. This section's reporting requirementswould then become effective 90 days after submission of the Sec-retary's report to Congress on confidentiality of social securitynumbers.

754

CHANGES IN EXISTING LAW MADE BY TITLE IV

SOCIAL SECURITY ACT* * * * * *

TITLE Xi—GENER PROVISIONS, PEER REVIEW, ANDMINISTPTpE SIMPLIFICATION* * * * * * *

PART A—GENERAL PROVISIONS* * * * * * *

755

* * * * * * *

DISCLOSURE REQUIREMENTS FOR OTHER PROVIDERS UNDER PART B OFMEDICARE

SEc. 1124A. (a) DISCLOSURE REQUIRED TO RECEIvE PAYMENT.—No payment may be made under part B of title XVIII for items orse]rvices furnished by any disclosing part B provider unless suchprovider has provided the Secretary with full and complete infor-mation—

(1) on the identity of each person with an ownership or con-trol interest in the provider or in any subcontractor (as definedby the Secretary in regulations) in which the provider directlyor indirectly has a 5 percent or more ownership interest; [and]

(2) with respect to any person identified under paragraph (1)or any managing employee of the provider—

(A) on the identity of any other entities providing itemsor services for which payment may be made under titleXVIII with respect to which such person or managing em-ployee is a person with an ownership or control interest atthe time such information is supplied or at any time dur-ing the 3-year period ending on the date such informationis supplied, and

(B) as to whether any penalties, assessments, or exclu-sions have been assessed against such person or managingemployee under section 1128, 1128A, or 1128B[.]; and

(3) including the employer identification number (assignedpursuant to section 6109 of the Internal Revenue Code of 1986)and social security account number (assigned under section205(c)(2)(B)) of the disclosing part B provider and any person,managing employee, or other entity identified or describedunder paragraph (1) or (2).

* * * * * * *(c) VERIFICATIOM—

(1) TFiANSMI7TAL BY HHS.—The Secretary shall transmit—(A) to the Commissioner of Social Security information

concerning each social security account number (assignedunder section 205(c) (2) (B)), and

(B) to the Secretary of the Treasury information concern-ing each employer identification number (assigned pursu-ant to section 6109 of the Internal Revenue Code of 1986),

supplied to the Secretary pursuant to subsection (a)(3) or sec-tion 1124(c) to the extent necessary for verification of such infor-mation in accordance with paragraph (2).

756

(2) VERIFICATION.—The Commissioner of Social Security andthe Secretary of the Treasury shall verify the accuracy of, orcorrect, the information supplied by the Secretary to such offi-cial pursuant to paragraph (1), and shall report such verifica-tions or corrections to the Secretary.

(3) FEEs FOR VERIFIcATION.—The Secretary shall reimbursethe Commissioner and Secretary of the Treasury, at a rate nego-tiated between the Secretary and such official, for the costs in-curred by such official in performing the verification and cor-rection services described in this subsection.

[(c)] (d) DEFINITIONS.—For purposes of this section—(1) the term "disclosing part B provider" means any entity

receiving payment on an assignment-related basis (or, for pur-poses of subsection (a)(3), any entity receiving payment) for fur-nishing items or services for which payment may be madeunder part B of title XVIII, except that such term does not in-clude an entity described in section 1124(a)(2);

* * * * * * *

758

CIVIL MONETARY PENALTIES

SEc. 1128A. (a) Any person (including an organization, agency,or other entity, but excluding a beneficiary, as defined in sub-section (i)(5)) that—

(1) knowingly presents or causes to be presented to an offi-cer, employee, or agent of the United States, or of any depart-ment or agency thereof, or of any State agency (as defined insubsection (i)(1)), a claim (as defined in subsection (i)(2)) thatthe Secretary determines—(A)***

* * * * * * *

(D) is for a medical or other item or service furnished,ordered, or prescribed by such person during a period inwhich the person was excluded (pursuant to this title ortitle XVIII) from the program under which the claim wasmade [pursuant to a determination by the Secretary underthis section or under section 1128, 1156, 1160(b) (as in ef-fect on September 2, 1982), 1862(d) (as in effect on thedate of the enactment of the Medicare and Medicaid Pa-tient and Program Protection Act of 1987), or 1866(b) or asa result of the application of the provisions of section1842(j)(2), on,

(E) is for a medical or other item or service ordered orprescribed by a person excluded (pursuant to this title ortitle XVIII) from the program under which the claim wasmade, and the person furnishing such item or serviceknows or should know of such exclusion, or

[(E)] (F) is for a pattern of medical or other items orservices that a person knows or should know are not medi-cally necessary;

* * * * * * *

(4) in the case of a person who is not an organization, agen-cy, or other entity, is excluded from participating in a programunder title XVIII or a State health care program in accordancewith this subsection or under section 1128 and who, at thetime of a violation of this subsection—

(A) retains a direct or indirect ownership or control in-terest in an entity that is participating in a program undertitle XVIII or a State health care program, and who knowsor should know of the action constituting the basis for theexclusion; or

759

(B) is an officer or managing employee (as defined in sec-tion 1126(b)) of such an entity; [or]

(5) offers to or transfers remuneration to any individual eligi-ble for benefits under title XVIII of this Act, or under a Statehealth care program (as defined in section 1128(h)) that suchperson knows or should know is likely to influence such indi-vidual to order or receive from a particular provider, practi-tioner, or supplier any item or service for which payment maybe made, in whole or in part, under title XVIII, or a Statehealth care program (as so defined); or

(6) arranges or contracts (by employment or otherwise) withan individual or entity that the person knows or should knowis excluded from participation in a Federal health care program(as defined in section 1128B(f)), for the provision of items orservices for which payment may be made under such a pro-gram;

shall be subject, in addition to any other penalties that may be pre-scribed by law, to a civil money penalty of not more than $10,000for each item or service (or, in cases under paragraph (3), $15,000for each individual with respect to whom false or misleading infor-mation was given; in cases under paragraph (4), $10,000 for eachday the prohibited relationship occurs). In addition, such a personshall be subject to an assessment of not more than 3 times theamount claimed for each such item or service in lieu of damagessustained by the United States or a State agency because of suchclaim. In addition the Secretary may make a determination in thesame proceeding to exclude the person from participation in theFederal health care programs (as defined in section 1128B(f)(1))and to direct the appropriate State agency to exclude the personfrom participation in any State health care program.

* * * * * * *

(i) For the purposes of this section:(1) * * *

* * * * * * *

(6) The term "remuneration" includes the waiver of coinsur-ance and deductible amounts (or any part thereof), and trans-fers of items or services for free or for other than fair marketvalue. The term "remuneration" does not include—(A)***

(B) differentials in coinsurance and deductible amountsas part of a benefit plan design as long as the differentialshave been disclosed in writing to all beneficiaries, thirdparty payers, and providers, to whom claims are presentedand as long as the differentials meet the standards as de-fined in regulations promulgated by the Secretary not laterthan 180 days after the date of the enactment of theHealth Insurance Portability and Accountability Act of1996; [or]

(C) incentives given to individuals to promote the deliv-ery of preventive care as determined by the Secretary inregulations so promulgated[.]; or

760

(D) a reduction in the copayment amount for coveredOPD services under section 1833(t) (5) (B).

* * * * * * *

COMMITTEE ON WAYS D MEANS,HOUSE OF REPRESENTATIVES,

Washington, DC, June 13, 1997.Hon. JOHN KASICH,Chairman, Committee on the Budget,Washington, DC.

DEAR MR. CHAIRMAN: On June 10, 1997, the Committee on Waysand Means, pursuant to H. Con. Res. 84, the Concurrent Resolu-tion on the Budget of Fiscal Year 1998, ordered favorably reported,as amended, its budget reconciliation human resources rec-ommendations to the Committee on Budget by a recorded vote of21 to 18 with a quorum present. Accordingly, I am now transmit-ting these recommendations to you.

Pursuant to your letter dated May 30, enclosed are the legisla-tive language and explanatory report language.

Please feel free to contact me or Pete Singleton if you have anyquestions. With best personal regards,

Sincerely,BILL ARCHER, Chairman.

Enclosures.

SUMMARY TABLE—BY SUBTITLE, BY PROGRAM, FEDERAL BUDGETARY EFFECTS OF WAYS AND

MEANS RECONCILIATION PROPOSALS—TITLE IX

[By fiscal year. in millions of dollars. Estimates based on draft legislative language and clarifications specified byCommittee staff. Assumes enactment by Agst 15, 19971

1991 1998 1999 2000 2001 20021991-2002

total1998-2002

total

Subtitle A: Temporary

Assistance tar needy

Families BIkGrant,' Welfare to

Work Grants:

Budget Authority 0 750 1,250 1.000 0 0 3,000 3.000

OutIas 0 137 596 1,087 179 385 2.984 2,984

Subtitle B. Supple-mental Sunty In-come,23 SS

Budget Authority .. 0 (35) (70) (80) (90) (105) (380) (380)

Outlays — 0 (35) (70) (80) (90) (105) (380) (380)

Subtitle D: RestnctngWeitare and Public

Benefits fo Miens;

SS:Budget Au-

thority 200 1.900 1,650 1.525 1,150 1.175 7,600 7,400

Outlays 200 1.900 1,650 1,525 1.150 1.175 7,600 7.400

Food Stamp Pm-

gram:

Budget Au-

thority 0 0 0 0 0 0 0 0

(1169)

1170

SUMMARY TABLE—BY SUBTITLE, BY PROGRAM, FEDERAL BUDGETARY EFFECTS OF WAYS AND

MEANS RECONCILIATION PROPOSALS—TITLE IX—Continued

IBy fiscal year. in millions of dollars. Estimates based on draft legislative language and clarifications specified byCommittee staff. Assumes enactment by August 15, 1997]

iii 1997 1998 1999 2000 2001 20021997-2002 1998-2002

Outlays

Medicaid:

Budget Au-

thority

Outlays

Total Subtitle D:

Budget Authority ..

Outlays

Sub1itle: Unemployment

Compensation:

Budget Authority ..

Outlays

Total Direct Spending:

Budget Authority ..

Outlays

0

40

40

240

240

0

0

240

240

0

375

375

2,275

2,275

(341

134)

2,956

2,343

0

350

350

2,000

2,000

(36)

(36)

3,144

2,490

0

300

300

1.825

1825

(238)

(238)

2,507

2,594

0

.

275

275

1,425

1,425

(247)

(247)

1,088

1,867

0

275

275

1.450

1450

(257)

(257)

1,088

1,473

0

1,615

1,615

9,225

9.215

(814)

(8141

11,021

11,005

0

1,575

1.575

89758.975

(814)

1814)

10.781

10,765

REVENUES

Subtitle: Unemp(oyment

C 0 0 (11) 488 495 410 1,380 1,380

'This estimate assumes that states woutd use near'y aH of the $3 billion in welfare-to—work grants that would be established by the pro-posal. We are continuing to survey some states about their likelihood of using this money.

2The bill proposes to repeal the maintenance—of-effort requirement for state supplementation of federal SSI benefits found in section 1618of the Social Security Act. that repeal would have no direct effect on the federal budget. but it could have indirect effects. Assuming thatstates reduce their supplements in response to this provision, the princiDal indirect effects on federal outlays would be an increase in FoodStamp costs (as some beneficiaries' Food Stamps would rise to offset a Dart ot their lost supplements), and a decrease in Medicaid spending(as a few beneficiaries who gain coverage solely thr6ugh state supplements lose that coverage). CBO's best estimate is that these effectswould be roughly offsetting, so that no federal costs or savings are shown as a consequence of the repeal of Sec. 1618. the proposed legis-lation does not make clear whether the state of California's ability to 'cash out" Food Stamp benefits for 581 recipients, which is now basedon its relativSy high supplements and its compliance with the maintenance—of-effort requirement, would end. ("Cashout" means that a smallpail of the supplement is simply regarded as a substitute for Food Stamp benefits.) However. CBO's conclusion about federal budgetary im-pacts from the repeal of the maintenance—of-effort requirement is not very sensitive to assumptions about the continuation of California'scashout status.

3the bill would permit the proceeds from extra fees for federal administration of state supplements to be appropriated to help cover theadministrative expenses of the Social Security Administration, the bill does not, however, directly grant SSA authority to spend those proceeds.

a The unemployment benefit outlay savings shown assume an adjustment to the CBO March 1997 baseline to reflect increases due to theApril 4, 1997 decision by the Seventh Crrcuit U.S. Court of Appeals, which affirmed the iudgment of the district court in the case of Pen-nington v. Doherty.

Notes: Details may not add to totals because of rounding.

I. INTRODUCTION

A. PURPOSE kr Suivmwty

The budget agreement worked out between the Congress and theAdministration included several issues under the jurisdiction of theCommittee on Ways and Means. These items are items aboutwhich the Committee or its Subcommittee on Human Resourceshas held hearings and introduced legislation over the past twoyears (with one exception) are contained in the Committee's rec-onciliation recommendation to the Committee on the Budget.

Although the general purpose of this proposal is to balance thebudget within 5 years, each of the 23 provisions in the Committeerecommendation to the Committee on the Budget are good public

.policy and stand on their own merits. One set of proposals dealswith issues raised by last year's welfare reform legislation. Herethe Committee clarified work requirements and the number ofhours certain workfare participants may work, given the amount oftaxpayer-paid benefits they receive, while satisfying minimumwage reqirements. The Committee also, in accord with the budget

1171

agreement, creates a new $3 billion welfare-to-work grant aimed athelping the most disadvantaged and least job ready welfare recipi-ents obtain jobs.

Another set of proposals addresses the issue of welfare benefitsfor noncitizens. The Committee proposal includes about $9 billionin welfare benefits for noncitizens who were receiving benefitswhen the welfare reform law, enacted last August, restricted wel-fare benefits for noncitizens. this policy will provide SupplementalSecurity Income (SSI) and Medicaid benefits to about 500,000 non-citizens who would otherwise lose them no later than October 1,1997. The Committee proposal also extends from 5 years to 7 yearsthe time during which refugees, asylees, and those whose deporta-tion is being withheld can receive SSI and Medicaid, continues 551benefits for permanent resident alien members of Indian tribes liv-ing along the U.S.!Canada and U.S./Mexico border, and authorizesStates and localities to require applicants for welfare benefits toprovide proof of eligibility.

Since passage of the welfare reform law last year, the Committeehas closely followed implementation of the stricter eligibility guide-lines for children receiving SSI benefits. Because implementationfell behind schedule, the Committee proposal gives the Social Secu-rity Administration an additional 6 months to review cases in ap-plying the new guidelines. The proposal also clarifies that regard-less of when reviews are conducted, the new eligibility guidelinesmust be applied. In accordance with the budget agreement, the pro-posal requires the Social Security Administration to increase feesfor including State SSI supplements in the Federal benefit check.It also would repeal the maintenance of effort requirement thatStates must maintain their State SSI supplement at 1983 levels.

Finally, the Committee proposal, in reaction to the Pennington v.Doherty court decision by the Federal district court in Illinois, con-tains a proposal clarifying that States have complete authority insetting the base period for determining eligibility for unemploy-ment benefits. Consistent with the budget agreement, the proposalincreases the ceilings for the Federal unemployment compensationtrust funds, limits transfers from Federal to State accounts to $100million annually in the coming years, and authorizes specificamounts for unemployment compensation "integrity" activities de-signed to reduce overpayments. Given the recent concern withStates' maintaining adequate reserves in their unemployment trustfund accounts, the proposal would reward States that reach aState-specific criterion for high trust fund levels by granting theseStates interest-free loans if the necessity for borrowing from theFederal loan account should occur. Other provisions exclude certaininmates, poll workers, and employers of religious schools from eligi-bility for UI benefits.

Taken together, the Committee proposal both fulfills the spend-ing and savings terms of the budget agreement and reforms severalof the important social programs under the Committee's jurisdic-tion.

B. LEGISLATIVE HISTORY

The Subcommittee on Human Resources of the Committee onWays and Means held a hearing on February 13, 1997 on the

1172

President's Fiscal Year 1998 Budget and heard testimony from theHonorable Lamar Smith (TX), representatives of the Clinton Ad-ministration, and other interested parties.

On June 6, 1997, the Subcommittee on Human Resources or-dered favorably reported to the full Committee, as amended, budg-et reconciliation human resources recommendations by a recordedvote of 8 to 3 with a quorum present.

On June 10, 1997, the Committee on Ways and Means approvedand reported to the Committee on the Budget, as amended, budgetreconciliation human resources recommendations by a recordedvote of2l to 18.

II. EXPLANATION OF PROVISIONS

1179

SUBTITLE B—SIJPPLEMENTAL SECURITY INCOME

Section 9101. Requirement to perform childhood disability redeter-minations in missed cases

Present lawBy August 22, 1997 (one year after the date of enactment of P.L.

104—193), the Commissioner of the Social Security Administration(SSA) is expected to redetermine the eligibility of any child receiv-ing SSI benefits on August 22, 1996, whose eligibility may be af-fected by changes in childhood disability eligibility criteria, includ-ing the new definition of childhood disability and the eliminationof the individualized functional assessment. Benefits of current re-cipients will continue until the later of July 1, 1997 or a redeter-mination assessment. Should a child be found ineligible, benefitswill end following redetermination. Within 1 year of attainment ofage 18, SSA is expected to make a medical redetermination of cur-'rent SSI childhood recipients using adult disability eligibility cri-teria. For low birth weight babies, a review must be conductedwithin 12 months after the birth of a child whose low birth weightis a contributing factor to his or her disability.

Explanation of provisionThis provision extends from 1 year after the date of enactment

to 18 months after the date of enactment the period by which SSAmust redetermine the eligibility of any child receiving benefits onAugust 22, 1996 whose eligibility may be affected by changes inchildhood disability. The provision also specifies that any child sub-ject to an SSI redetermination under the terms of the welfare re-form law whose redetermination does not occur during the 18-month period following enactment (that is, by February 22, 1998)is to be assessed as soon as practicable thereafter using the neweligibility standards applied to other children under the welfare re-form law.

Reason for changeDue to delay in releasing implementing regulations, the Commit-

tee is extending from 12 months to 18 months the period of timefor SSA to redetermine the eligibility of any child receiving SSIbenefits on August 22, 1996 whose eligibility may be affected by

1180

changes in the childhood eligibility criteria. In addition, Congressintended that all children affected by the changes in P.L. 104—193would be redetermined using the new eligibility criteria and notthe medical improvement standard.

Effective dateAugust 22, 1996.

Section 9102. Repeal of maintenance of effort requirements applica-ble to optional state programs for supplementation of SSI bene-fits

Present lawSince the beginning of the SSI program, States have had the op-

tion to supplement the Federal SSI payment with State funds. Thepurpose of section 1618 of the Social Security Act was to encourageStates to pass along to SSI recipients the amount of any FederalSSI benefit increase. Under section 1618, a State that is found tobe not in compliance with the "pass along/maintenance of effort"provision is subject to loss of its Medicaid reimbursements. Section1618 allows States to comply with the "pass along/maintenance ofeffort" provision by either maintaining their State supplementarypayment levels at or above 1983 kvels or by maintaining total an-nual expenditures for supplementary payments (including any Fed-eral cost-of-living adjustment) at a level at least equal to the prior12-month period, provided that State was in compliance for thatperiod. In effect, section 1618 requires that once a State elects toprovide supplementary payments it must continue to do so.

Explanation of provisionThe maintenance of effort requirements applicable to optional

State programs for supplementation of SSI benefits are repealed.

Reason for changeIn nearly every social program in which States pay a substantial

portion of the benefits, States have the authority to establish bene-fit levels. However, in the Supplemental Security Income program,States that supplement the Federal benefit are required by Federallaw to maintain benefits at or above their 1983 level. The Commit-tee proposal, however, is based on the principle that States shouldbe able to establish and to change benefits levels in accordancewith the actions of elected State officials. Thus, the proposal over-turns the Federal freeze on State supplemental payments and al-lows States complete control in setting their own benefits.

Effective dateDate of enactment.

Sec. 9103. Fees for Federal Administration of State SupplementaryPayments

Present lawP.L. 103—66, the Omnibus Budget Reconciliation Act of 1993,

stiifttlated that part of the administrative cost of the SSI programwas to be funded through a user fee. Since fiscal year 1994, States

1181

have been required to pay a fee of Federal administration of Statesupplementary SSI payments. Thus, States that choose to havetheir supplementary SSI payments administered by the Social Se-curity Administration must pay the Commissioner or Social Secu-

• rity $5 per payment for fiscal year 1996 and each succeeding year,or a different rate deemed appropriate for the State by the Com-missioner (the rate per payment was $1.67 in fiscal year 1994 and$3.33 in fiscal year 1995).

Explanation of provisionThe administrative fee charged by the Federal government for in-

cluding State supplemental SSI payments with the Federal SSIcheck is increased as follows:

Adminis-Fiscal year trative

fee

1997 $5.001998 6.201999 7.602000 7.802001 8.102002 8.50

For 2003 and subsequent years, the rate from the previous yearis increased by the percentage by which the Consumer Price Indexincreased that year or a different amount established by the Com-missioner. Revenue attributed to the increase in fees (i.e., amountsin excess of $5.00) each year would, subject to the appropriationprocess, be available to defray the Social Security Administration'sadministrative costs.

Reason for changeThe basis for the 1993 Congressional decision to charge adminis-

trative fees against States that include their State supplement inthe Federal SSI check is that States are using Federal administra-tive resources to fulfill a State function. Given that the Federalgovernment is absorbing the cost of providing a service to States,it is reasonable to ask States to defray the Federal costs. The Com-inittee proposal simply extends this principle into the future by in-creasing the fee States must pay in rough correlation with inflationand other factors that cause Federal costs to increase.

Effective dateDate of enactment.

SUBTITLE C—CHILD SUPPORT ENFORCEMENT

Section 9201. Clarification of Authority to Permit Certain Redisclo-sures of Wage and Claim In formation

Present lawP.L. 104-193 gives the Department of Health and Human Serv-

ices (HHS) the authority to obtain information about the wages andunemployment compensation paid to individuals from State unem-ployment compensation agencies for the State Directory of NewHires. The State Directory of New Hires is then to furnish this

41.479 97—36

1182

wage and claim information, on a quarterly basis, to the NationalDirectory of New Hires. P.L. 104—193 also requires State unem-ployment compensation agencies to establish such safeguards asthe Secretary of Labor determines are necessary to insure that theinformation disclosed to the National Directory of New Hires isused only for the purpose of administering programs under Stateplans approved under the Child Support Enforcement program, theTemporary Assistance for Needy Families (TANF) block grant, andfor other purposes authorized in section 453 of the Social SecurityAct (as amended by P.L. 104—193).

Explanation of provisionAlthough the welfare reform law allowed HHS to disclose infor-

mation from the Directory of New Hires to the Social Security Ad-ministration and to the Internal Revenue Service, the wording ofa provision in the child support title of the legislation could be in-terpreted to contradict this policy. This wording is amended to clar-ify that HHS is authorized to share information from the Directoryof New Hires with the Social Security Administration and the In-ternal Revenue Service.

Reason for changeThis purely technical proposal is necessary to clarify current law

and allow the Office of Child Support Enforcement to share infor-mation collected from States with the Social Security Admimstra-tion and the Internal Revenue Service.


SUBTITLE D—RESTRICTING WELFARE AND PUBLIC BENEFITS FORALIENS

Section 9301. Extension of eligibility period for refugees and certainother qualified aliens from 5 to 7 years for SSI and Medicaid

Present lawCurrent law provides a 5-year exemption from: (1) the bar

against SSI and Food Stamps; and (2) the provision allowing Statesto deny "qualified aliens" access to Medicaid, TANF, and SocialServices Block Grant for three groups of aliens admitted for hu-mamtarian reasons. These groups are (1) refugees, for 5 years afterentry; (2) asylees, for 5 years after being granted asylum; and (3)aliens whose deportation is withheld on the grounds of likely perse-cution upon return, for 5 years after such withholding.

Explanation of provisionThis change would lengthen the period during which eligibility

for SSI and Medicaid is guaranteed to three groups (refugees,asylees, and aliens whose deportation has been withheld) from 5years to 7 years.

Reason for changeThe 5-year exception in the welfare law was designed to allow

refugees and asylees, who often arrive in the U.S. with few posses-

1183

sions, time to adjust to life here. However, because of delays in ad-justing to permanent resident status, mandatory residency require-ments before applying for citizenship, and recent increases in wait-ing times in the naturalization process, under the 5-year eligibilityperiod many would become ineligible for welfare benefits despitetheir attempting to naturalize at their earliest opportunity. By ex-tending the exception to allow these groups 7 instead of 5 years ofeligibility, these noncitizens would be given more time to naturalizewhile continuing to receive welfare benefits without interruption.


Section 9302. SSI eligibility for aliens receiving SSI on August 22,1996

Present lawSSI. The Personal Responsibility and Work Opportunity Rec-

onciliation Act of 1996 (P.L. 104—193) bars most "qualified aliens"from Supplemental Security Income (SSI) (sec. 402(a)). Current re-cipients must be screened for continuing eligibility during a 1-yearperiod after enactment of the welfare law (i.e., by Aug. 22, 1997).The pending fiscal year 1997 supplemental appropriations billwould extend this date until September 30, 1997.

Medicaid.—States may exclude "qualified aliens" who enteredthe United States before enactment of the welfare law (August 22,1996) from Medicaid beginning January 1, 1997 (sec. 402(b)). Addi-tionally, to the extent that legal immigrants' receipt of Medicaid isbased only on their eligibility for SSI, some will lose Medicaid be-cause of their ineligibility for SSI.

Definitions and exemptions.—"Qualified aliens" are defined byP.L. 104—193 (as amended by P.L. 104—208) as aliens admitted forlegal permanent residence (i.e., immigrants), refugees, aliens pa-roled into the United States for at least 1 year, aliens granted asy-um or related relief, and certain abused spouses and children.

Certain "qualified aliens" are exempted from the SSI ban and theState option to deny Medicaid, as well as from certain other restric-tions. These groups include: (1) refugees for 5 years after admissionand asylees 5 years after obtaining asylum: (2) aliens who haveworked, or may be credited with, 40 "qualifying quarters." As de-fined by P.L. 104- 193, a "qualifying quarter" is a 3-month work pe-riod with sufficient income to qualify as a social security quarterand, with respect to periods beginning after 1996, during which theworker did not receive Federal means-based assistance (sec. 435).The "qualifying quarter" test takes into account work performed bythe alien, the alien's parent while the alien was under age 18, andthe alien's spouse (provided the alien remains married to thespouse or the spouse is deceased); and (3) veterans, active dutymembers of the armed forces, and their spouses and unmarried de-pendent children.

Explanation of provisionLegal noncitizens who were receiving SSI benefits on August 22,

1996 (the date of enactment of the welfare reform law) would re-

1184

main eligible for SSI, despite underlying restrictions in the Per-sonal Responsibility and Work Opportunity Reconciliation Act. Thissection also specifies that Cuban and Haitian entrants andAmerasian immigrants are to be considered qualified aliens, there-by continuing the SSI and Medicaid eligibility of those who werereceiving SSI benefits on August 22, 1996.

Reason for changeThe new welfare law would restrict SSI and Food Stamp benefits

for noncitizens, with the exception of those who have worked for atleast 10 years or who have become naturalized citizens. However,to smooth the transition for those who were already receiving bene-fits, additional changes were sought to allow for continued cashand health care benefits. Under this change, Food Stamp benefitswould remain generally restricted to noncitizens, and noncitizensnot enrolled on SSI as of August 22, 1996 would remain ineligiblefor SSI benefits unless they naturalize or work for 10 or moreyears. For those in the U.S. when the President signed the newwelfare law but who were not then on SSI, special exceptions in thenaturalization process remain available to elderly noncitizens whohave resided in the U.S. for a number of years and also for individ-uals with disabilities that prevent their passing the language orcivics tests for naturalization. In addition, Medicaid is available atState option for all noncitizens residing in the U.S. on August 22,1996.


Section 9303. SSI eligibility for permanent resident aliens who aremembers of an Indian tribe

Present lawWith limited exceptions, the Personal Responsibility and Work

Opportunity Reconciliation Act of 1996 (P.L. 104—193) makes"qualified aliens," including aliens lawfully admitted for permanentresidence, ineligible for Supplemental Security Income (SSI). Thelimited exceptions to this bar do not include an exception based onmembership in an Indian tribe.

Though the immigration status of foreign-born Indians can, likethat of other aliens, vary from individual to individual, immigra-tion law does accord certain Indians entry rights that facilitatetheir residing here as legal permanent residents. Section 289 of theImmigration and Nationality Act of 1952 (INA) preserves the rightof free passage recognized in the Jay Treaty of 1794 by allowing"American Indians born in Canada" unimpeded entry and resi-dency rights if they "possess at least 50 per centum of blood of theAmerican Indian race." By regulation, individuals who enter theU.S. and reside here under this provision are regarded as lawfulpermanent resident aliens.

Entirely separate from immigration law, the Indian Self-Deter-mination and Education Assistance Act defines "Indian tribe" as atribe, band, nation, or other organized group that is recognized aseligible for special Indian programs and services. Recognition may

1185

be based on a treaty or statute, or may be drawn from the acknowl-edgment process. Not all Indian communities, nations, tribes, andother groups are Federally recognized.

Explanation of provisionPermanent resident Indians who are members of recognized

tribes are eligible for SSI, despite restrictions in the welfare law onnoncitizens' eligibility for benefits.

Reason for changeThis change is made to protect the longstanding entry rights and

access to benefits of members of certain Indian tribes residing inthe U.S. as lawful permanent residents.


Section 9304. Verification of eligibility for State and local publicbenefits

Present lawLast year's welfare reform law requires the Attorney General, in

consultation with the Secretary of Health and Human Services, topromulgate regulations requiring verification that persons applyingfor Federal public benefits are citizens or qualified aliens and eligi-ble for the benefits (sec. 432(a)). The law also requires that Statesadministering programs that provide a Federal benefit have a ver-ification system that complies with the regulation (sec. 432(b)).However, the law does not provide authority for State and localgovernments to verifr eligibility for State or local public benefits.

Explanation of provisionThis provision authorizes States or political subdivisions to re-

quire an applicant for State or local public benefits (as defined insection 4 11(c) of the Personal Responsibility and Work OpportunityReconciliation Act of 1996) to provide proof of eligibility.

Reason for changeThis change will allow States and local governments to require

proof of eligibility, including evidence pertaining to citizenship sta-tus, for individuals seeking welfare benefits. (See section 506 ofHouse Report 104—828.)


Section 9305. Derivative eligibility for benefits

Present lawStates may exclude "qualified aliens" who entered the United

States before enactment of the welfare law (August 22, 1996) fromMedicaid beginning January 1, 1997 (sec. 402(b)). Sec. 1902(a)(10)of the Social Secm.ity Act makes all individuals who are receivingSSI eligible for medical assistance under the Medicaid program.tinder the welfare law, most "qualified aliens" are ineligible for

1186

both SSI and Food Stamps. Under section 5(a) of the Food StampAct, households in which each member receives SSI benefits arealso eligible for Food Stamps.

Explanation of provisionThis section clarifies that legal noncitizens eligible for SSI under

the provisions of this subtitle are also eligible for Medicaid benefits.In addition, individuals made ineligible for Food Stamp benefits asa result of the welfare reform law are not to have their eligibilityfor Food Stamps restored as a result of the renewed eligibility forSSI.

Reason for changeThis section clarifies that individuals receiving SSI benefits on

August 22, 1996 (who under section 9302 of this subtitle wouldmaintain eligibility for SSI benefits) would also be assured of cov-erage under Medicaid, despite provisions in welfare reform lawthat allow States the option of restricting Medicaid benefits forqualified aliens in the U.S. on August 22, 1996. Food Stamp bene-fits would remain generally restricted for noncitizens, despite indi-viduals' continued eligibility for SSI.


Section 9306. Effective date

Present lawNo provision.

Explanation of provisionExcept as otherwise provided, the amendments made by this sub-

title shall be effective as if included in the enactment of title 1V ofthe Personal Responsibility arid Work Opportunity Act of 1996.

Reason for changeThis section clarifies that all provisions in this subtitle are to

apply as if included in the welfare reform law (whose effective datewas August 22, 1996).


1193

ifi. VOTES OF THE COMMITrEE.Fri compliance with clause 2(l)(2)(B) of rule XI of the Rules of the

House of Representatives, the following statements are made con-cerning the votes of the Committee on Ways and Means in its con-sideration of the Budget Reconciliation Human Resources Rec-ommendations:

Motion to report Budget Reconciliation Human Resources Rec-ommendations

The Committee on Ways and Means approved the reconciliationhuman resources provisions by a rollcail vote of 21 yeas to 18 nays(with a quorum being present). The vote was follows:

Representatives Yea Nay Representatives Yea Nay

Mr. Archer

Mr. Crane

Mr. Thomas

Mr. Shaw

X

X

X

X

X

Mr. Rangel

Mr. Stark

Mr. MatsuiMrs. Kennelly

Mr. Coyne

X

X

X

X

XMrs. Johnson

Mr. Bunning X Mr. Levin X

Mr. Houghton X Mr. Cardin X

Mr. Herger X Mr. McDennott X

Mr. McCrery

Mr. Camp

Mr. Ramstad

X

X

X

Mr. IeczhaMr. Lewis

Mr. Neal

X

X

X

Mr. Nussle X Mr. McNulty X

Mr. Johnson X Mr. Jefferson X

Ms. Dunn X Mr. Tanner X

Mr. Collins X Mr. Becerra X

Mr. Portman X Mrs. Thurman X

Mr. English X

Mr. Ensign X

Mr. Christensen X

Mr. Watkins X

Mr. Hayworth

Mr. Weller

X

X

XMr. Hulshof

Votes on amendmentsRollcall votes were conducted on the following amendments to

the Chairman's amendment in the nature of a substitute:An amendment by Mr. Tanner to Subtitle A, Section 9001, to

award bonuses to States for meeting specific performance goals wasdefeated by a rolicall vote of 16 yeas to 19 nays. The vote was asfollows:


Mr. Archer

Mr. Crane

Mr. Thomas

Mr. Shaw

Mrs. Johnson

Mr. BunningMr. Houghton

Mr. Herger

Mr. McCrery

Mr. Camp

Mr. RamstadMr. NusseMr. Johnson

Mr. Rangel

Mr. Stark

Mr. MatsulMrs. IennelIy

Mr. Coyne

Mr. Levin

Mr. Cardin

Mr. McDermott

Mr. IIeczkaMr. Lewis

Mr. Neal

Mr. McNulty

Mr. Jefferson

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

1194



Mr. Collins X Mr. Becerea X

Mr. Portman X Mrs. Thurman xMr. English X

Mr. Ensign X

Mr. Cheistensen x

Mr. Watkins xMr. Hsyworth xMr. Weller x

Mr. Hulshot x

An amendment by Mr. Stark to strike Section 9003, Subtitle A,which limits to 30 percent the number of families participating ineducational activities that may be counted towards the State'swork participation rate was defeated by a rollcall vote of 16 yeasto 21 nays. The vote was as follows:

Representatives Yea Nap Repeesentatives Yea Nap

Mr. Archer X Mt. Rangel X

Me. Crane X Mr. Stark X

Mr. Thomas Mr. Matsui X

Mr. Shsw X Mrs. Kennelly X

Mrs. Johnson X Mr. Coyne xMe. Banning X Mr. Levin X

Mr. Houghton X Me. Cardin xMr. Herger X Mr. McDermott X

Mt. McCrery X Mr. Klecotsa X

Mt.Csmp X Mt.Lewis X

Mt. Rsmstad Mr. Neal xMt. Nussle X Mr. McNulty X

Mr. Johnson X Mr. Jefferson X


Mr. Collins X Mr. Becerea X


Mr. English X

Mt. Ensign X

Mr. Christensen xMr. Watkins X

Mr. Hayworth xMr. Weller X

Mr. Hslshot X

An amendment by Mrs. Kennelly to Subtitle A, Section 9003, toremove teen parents from the 30 percent limitation on persons en-gaged in educational activities counting towards the participationrate was agreed to by a rollcall vote of 20 yeas to 17 nays. The votewas as follows:

Representatives Yea Nay Representatives Yea Nap

Mr. Archer

Mr. Crane

Mr. Thomas

Mr. Shaw

Mrs. Johnson

Mr. Banning

Mr. Hosghton -Mr. Herger

Mr. McCrety

Mr. CampMr. Ramstad . .. -Mr. Nsssle ..

Mr. Johnson

Mr. Rangel

Mr. StarkMr. MatssiMrs. Kennelly

Mr. Coyne

Mr. Lepin ..

Mr. CardinMr. McDermottMr. lUecuka ..

Mr. Lewis

Mr. Neal

Mr. McNsttyMr. Jefferson

x

xxx

x

xxxxxxxx

xxx

x

x

x

x

xx

x.x

1195

Representatives Vea Nay Representatives Vea Nay

Ms. Dunn .............................................................. X Mr. Tanner X

Mr. Collins X Mr. Becerra X

Mr. Poilman X Mrs. Thurman X

Mr. English X

Mr. Ensign X

Mr. Christensen X

Mr. Watkins X

Mr. layworth X

Mr. Weller X

Mr. Hotshot X

An amendment by Stark to strike Section 9004, Subtitle A, relat-ing to the allowable hours of work was defeated by a rollcall voteof 16 yeas to 22 nays. The vote was as follows:


Mr. Archer Mr. Rangel X

Mr. Crane X Mr. Stark ... X

Mr. Thomas

Mr. ShawX

X

X

Mr. MatsuiMrs. Kennelly

Mr. Coyne

X

X

XMrs. Johnson

Mr. Dunning X Mr. Levin X

Mr. Houghton X Mr. Cardin X

Mr. Herger X Mr. McDermott X

Mr. McCrery X Mr. Kleczka X

Mr. Camp X Mr. Lewis X

Mr. Ramstad X Mr. Neal X

Mr. Nussle X Mr. McNulty X

Mr. Johnson X Mr. Jetterson X


Mr. Collins X Mr. Decerra X


Mr. English X

Mr. Ensign X

Mr. Christensen X

Mr. Watkins X

Mr. Hayworth X

Mr. Weller X

Mr. Hulshof X

An amendment by Mr. Matsui to strike Section 9102, Subtitle B,on the repeal of the State SSI maintenance of effort requirement,was defeated by a roilcall vote of 16 yeas to 23 nays. The vote wasas follows:


Mr. Archer

Mr. Crane

Mr. Thomas

Mr. Shaw

Mrs. Johnson

Mr. Dunning

Mr. Houghton

Mr. Herger

Mr. McCrery

Mr. Camp

Mr. RamstadMr. Nussle

Mr. Johnson

Ms. Dunn

Mr. Collins

Mr. PortmanMr. English

Mr. Rangel

Mr. Stark

Mr. Matsui

Mrs. Kennelly

Mr. Coyne

Mr. Levin

Mr. Cardin

Mr. McDermott

Mr. Kteczka

Mr. Lewis

Mr. Neal

Mr. McNulty

Mr. Jetterson

Mr. Tanner

Mr. Decerra

Mrs. Thurman

x

x

x

x

x

x

x

x

x

x

x

xx

x

x

x

x

xx

x

x

x

x

x

x

x

x

x

x

xx

x

x

1196


Mr. Ensign . X

Mr. Christensen X

Mr. Watkins X

Mr. Haywnrth X

Mr. Weller X

Mr. Hulshot X

An amendment by Mr. Becerra to add a new Section 9305, Sub-title D, to allow legal immigrants present before August 22, 1996,but disabled after that date, to be eligible for SSI, was defeated bya rollcall vote of 19 yeas to 20 nays. The vote was as follows:


Mr. Archer X Mr. Rangel X

Mr. Crane X Mr. Stark X

Mr. Thnmas X Mr. Matsui X

Mr. Shaw X Mrs. Kennelly . K

Mrs. Jnhnsnn K Mr. Coyne K

Mr. Bunting K Mn. Levin K

Mr. Houghton K Mr. Cardin K

Mr. Herger K Mr. McDermott K

Mr. McCrery K Mr. Kleczka K

Mn.Camp K Mr.Lewrs K

Mr. Ramstad K Mn. Neal K

Mr. Nussle K Mr. McNulty K

Mr. Johnson K Mr. Jefferson K

Ms. Dunn K Mn. Tanner K

Mr. Collins K Mr. Becerra K

Mr. Portman K Mr. Thurman K

Mn. English K

Mr. Ensign K

Mr. Christensen K

Mr. Watkins K

Mn. Hayworth K

Mr. Weller K

Mr. Hulshot K

An amendment by Mr. Coyrie to strike Section 9401, Subtitle E,a provision clarifying State authority to determine base periods fordetermining eligibility for unemployment benefits was defeated bya rollcall vote of 17 yeas and 22 nays. The vote was as follows:


Mr. Archer

Mr. Crane

Mr. Thomas

Mr. Shaw

Mrs. Johnson

Mr. Bunting

Mr. Houghton

Mr. Herger

Mr. McCrery

Mr. CampMr. Ramstad

Mr. Nussle

Mr. Johnson

Ms. Dunn

Mr. Collins

Mr. Portman

Mr. English

Mr. Ensign ...,Mr. Christensen

K Mr. Rangel

K Mr. Stark

K Mr. Matsul

K Mrs. Konnelly

K Mr. Coyne

K Mr. Levin

K Mr. Cardin

K Mr. McDermott

K Mr. Kleczka

K Mr. tewisK Mr. Neal

K Mr. McNulty

K Mr. Jefferson

K Mr. Tanner

K Mr. Becerra

K Mrs. Thurman

K

K

K

K

K

K

K

K

K

K

K

K

K

K

K

K

K

K

K

1197

Representatives Yea Nay Representatwes Yea Nay

Mr. Watkins X

Mr. Ilayworth X

Mr. Weller X

Mr. uIshot X

IV. BUDGET EFFECTS OF THE BILLA. COMMITFEE ESTIMATE OF BUDGETARY EFFECTS

In compliance with clause 7(a) of Rule XIII of the Rules of theHouse of Representatives, the following statement is made:

The Committee agrees with the estimate prepared by the Con-gressional Budget Office (CBO) which is included below.

B. STATEMENT REGARD!G NEW BUDGET AUTHORITY AND TAXEXPENDITURES

In compliance with clause 2(l)(3)(B) of Rule XI of the House ofRepresentatives, the Committees states that the Committee rec-ommendations result in increased budget authority fir directspending programs relative to current law, and increased revenues.

C. COST ESTIMATE PREPARED BY THE CONGRESSIONAL BUDGET OFFICE

In compliance with clause 2(l)(3)(C) of Rule XI of the Rules of theHouse of Representatives requiring a cost estimate prepared by theCongressional Budget Office, the following report prepared by CBOis provided.

U.S. CONGRESS,CONGRESSIONAL BUDGET OFFICE,

Washington, DC, June 16, 1997.Hon. BILL ARCHER,Chairman, Committee on Ways and Means, House of Representa-

tives, Washington, DC.DEAR MR. CHAIRMAN: The Congressional Budget Office has pre-

pared the enclosed cost estimate for Title IX of the proposed rec-onciliation bill, containing the non-Medicare spending recommenda-tions of the Committee on Ways and Means.

The estimate shows the budgetary effects of the committee's pro-posals over the 1998—2007 period. CBO understands that the Com-mittee on the Budget will be responsible for interpreting how theseproposals compare with the reconciliation instructions in the budg-et resolution. The estimate assumes that the reconciliation bill willbe enacted by August 15; the estimate could change if the bill isenacted later.

If you wish further details on this estimate, we will be pleasedto provide them. The CBO staff contacts are Sheila Dacey, KathyRuffing, and Christina Hawley Sadoti for federal costs, and LeoLex and John Patterson, for state and local impacts.

Sincerely,JuNE E. O'NEILL, Director.

1198

ESTIMATED BUDGETARY IMPACT OF THE RECONCILIATION RECOMMENDATIONS OF THE COMMITTEE

ON WAYS AND MEANS

[Outlays by fiscal year, in millions of dollars)

Unemployment Insurance Revenues

Total

O 0 —11 488 495 410

DEFICIT

o 2,343 2.501 2106 1,284 1.028

I Fami'y support includes the Temporary Assistance for Needy Family block grant, federal administrative costs for child support enforcement.the Child Care block grant. certain researcn tunding enacted in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996(PRWORA). and residual outlays from several programs that were repealed by PRWORA.

2CBOs March 1997 baseline estimates tot Suppiemental Income and Medicaid have been adjusted upward by $200 million and $40 mil-lion, respectively, because of the supplemental appropriation signed by the President on June 12. 1997 (HR. 18711.

3CBO's Marcy 1997 baseláne estimates tor unemployment compensation have been adjusted to reflect increases due to the April 4, 1997,

decision of the even Circuit United States Court 01 Appeals, which affirmed the iudgment ot the District Court in the case of Pennington v.Doherty.

'Medicaid would also be affected by the reconciliation recommendations of the Committee on Commerce (Title III).

BASIs OF ESTIMATE

CBO's estimates assume that the bill would be enacted by Au-gust 15, 1997. The following sections describe only those sectionsof the bifl that are estimated to have significant budgetary effects.

SUBTITLE A, TEMPORARY ASSISTANCE FOR NEEDY FAMILIES

Section 9001 would establish welfare-to-work grants for statesand localities to help recipients of Temporary Assistance for NeedyFamilies (TANF) find jobs. Grants totaling up to $3 billion wouldbe awarded—$750 million in 1998, $1.25 billion in 1999, and $1billion in 2000. A small amount of the grant money would be setaside for special purposes: 1 percent for Indian tribes and 0.5 per-cent for evaluation of welfare-to-work programs. The remainingmoney would be divided evenly between non-competitive grants tostates and competitive grants to localities and private industrycouncils.

1997 1998 1999 2000 2001 2002

DIRECT SPENDING

Spending Under Current LaW

Family Support

Supplemental Security Income (lees)

Supplemental Security Income (spending)2

Medicaid2

Unemployment Compensation

Interest on UI loans to States

Proposed Changes

Family Support

Suppmental Security Income (lees)

Supplemental Security Income (spending)

Medicaid4



Total

Spending Under Title IX

Family Support

Supplemental Security Income (lees)

Supplemental Security Income (spending)

Medicaid



20,121 21,825 22,194 22,767 22,836 22,889

—155 —140 —145 —150 —155 —160

27.458 26,135 28,001 32,593 29,733 34.638

98,639 105,308 113,619 122,861 132,792 143.783

22,958 24,489 26,418 28,085 29,588 30,751

0 0 0 0 0 0

0 137 596 1,087 691 350

0 —35 —70 —80 —90 —105

0 1,900 1,650 1.525 1,150 1,175

0 375 350 300 275 275

0 —29 —31 —233 —242 —252

0 —5 —5 —5 —5 —5

0 2,343 2.490 2,594 1,779 1,438

20.121 21,962 22,790 23,854 23.527 23,239

—155 —175 —215 —230 —245 —265

27458 28,035 29.651 34,118 30,883 35,813

98.639 105,683 113,969 123,161 133,067 144058

22,958 24.460 26,387 27.852 29,346 30,499

REVENUES

1199

Non-competitive grants would be allocated to states based on aformula that equally considers states' shares of the iiâtionwidenumber of poor individuals, unemployed individuals, and adult re-cipients of TANF. States must match the federal funds, spendingone dollar of state money for every two dollars of federal money (a67 percent federal match rate). To be eligible for federal matching,the state spending must be in addition to the maintenance of effortspending for the TANF program (80 percent of a state's historicspending on Aid to Families with Dependent Children and relatedprograms.) States would be required to pass through 85 percent ofthe grant money to private industry councils and localities, whichwould have sole authority to spend the money after consulting withthe state agency that administers the grant. The state could retain15 percent of the money to fund welfare-to-work projects of thestate's choice.

Competitive grants would be awarded directly to local govern-ments and private industry councils and would not need to bematched by any state or local spending. The Secretary of Laborwould be required to give at least 65 percent of the funds to citiesthat are among the 100 cities in the United States with the highestnumber of poor residents and at least 25 percent of the funds torural areas.

Grantees could spend grant funds, either non-competitive or com-petitive, to help move recipients of TANF assistance into theworkforce by means of job creation, on-the-job training, job place-ment, job vouchers or job retention, and support services. Anyfunds that were not obligated by a state or locality by the end ofthe fiscal year would be reallocated in the following year. Anyfunds that were not expended after 3 years would be returned.

Based on conversations with officials in half a dozen large states,CBO believes that states would draw down most of the non-com-petitive grant money. The officials indicated that the 67 percentmatch rate would be very attractive to their states and that spend-ing on welfare-to-work programs is politically popular. CBO as-sumes most states would spend more than 80 percent of their his-toric level on benefit and work programs over this period undercurrent law, and thus could draw down the federal grant withoutspending any additional state money.

However, not all the state officials were confident that their statewould tap all the money available. Some states with particularlylow spending relative to their historic level would need to expandstate spending significantly in order to draw down the federalfunds. Also, the requirement to pass much of the money throughto private industry councils would make it less attractive for statesto spend match money. The estimate assumes that 30 percent ofthe grant funds available in 1998 and 20 percent of thee grantfunds available in 1999 would not be used in those years but wouldbe carried over to the immediately following years. The estimateassumes that 20 percent of the funds available in 2000 would notbe used but would not be redistributed in 2001 because the billdoes not allow grants to be made after 2000. States would spendthe grant funds they draw down more slowly in the start-up yearsof the program than in the later years.

1200

Because no match is required, CBO assumes that all of the com-petitive grant money would be spent. However, the competitivegrant funds would be spent a little more slowly than the non-com-petitive grant money because the process of awarding the grantswould delay spending.

Based on discussions with committee staff, the estimate assumesthat the legislative language will be changed to clarify that statespending that is used to match welfare-to-work grant dollars can-not also be used to match contingency fund dollars.

CBO estimates that only $137 million of the $750 million avail-able will be spent in 1998. This would increase to $1.1 billion by2000 and then decline to $350 million by 2002. In total, all but$139 million of the $3 billion would be spent.

SUBTITLE B, SUPPLEMENTAL SECURITY INCOME

Subtitle B would reduce the deficit by an estimated $0.4 billionover the 1998—2002 period by raising fees that the federal govern-ment charges some states in the Supplemental Security Income(SSI) program.

Increased Fees for Administration of State Supplements.—About6 million people now receive federal SSI benefits, which may be ashigh as $484 a month per person. Many states supplement thatfederal payment. As a convenience, states can request that the fed-eral government administer the state supplement, so that bene-ficiaries receive a single check. About 2.7 million people get statesupplements, of which 2.4 million are administered by the federalgovernment and the rest by the states. Under a law enacted in1993, the federal government charges states a fee of $5 per monthfor administering state supplements. Section 9103 of this bill wouldraise that in steps to $6.20 in fiscal year 1998 and to $8.50 in 2002.After 2002, the fee would be increased for inflation.

CBO assumed that the number of beneficiaries receiving feder-ally-administered state supplementation would inch up to abut 2.7million in 2002. Although states would be free under another provi-sion of the bill to cease their supplementation entirely, CBO as-sumed that relatively few would do so. Many may choose to paysmaller supplements than they would under current law, but thatchoice would not affect the federal government's proceeds from thefee, which depend on the number of supplements rather than ontheir size. CBO also assumed that few states would switch to state-administered supplementation to avoid the fee, because of the ad-ministrative headaches that would entail. Multiplying the numberof supplements by the additional fee yields estimated proceeds of$35 million in 1998 and $105 million in 2002.

Repeal of Maintenance-of-Effort Requirement. Section 9201 of thebill would repeal the requirement (Section 1618 of the Social Secu-rity Act) that states which supplement he incomes of SSI recipi-ents keep up that effort. States can choose between two methodsof compliance with Section 1618: a "maintenance of expenditures"method (spending at least as much on supplementation as in theprevious year) or "maintenance of payments" (maintaining per-cap-ita supplements at 1983 levels). Currently, a total of about $3.6 bil-lion in state supplements goes every year to approximately 2.7 mil-lior beneficiaries-figures that have changed little for several years.

1201

The principal effect of repealing this requirementS would be onstate budgets. Potential effects on the federal budget would besmall, and too speculative to estimate reliably. If states opt to trimtheir supplements, for example, the federal government wouldautomatically pay larger Food Stamp benefits in most states (withthe possible exception of California, as discussed below). On theother hand, a small number of people who participate in Medicaidsolely because of state supplements might lose that coverage, lead-ing to small savings in Medicaid.

California pays relatively generous supplements—accounting formore than half of the $3.6 billion paid nationwide, even though ithas only about one-sixth of the nation's SSI caseload—and has spe-cial permission to offer no food stamps to SSI recipients. Its supple-ments are decreed by federal law to represent a "cashout" of thesmall food stamp benefit that the recipient could otherwise get. Byrepealing section 1618, this title would leave the legal basis of thatcashout status tenuous; the issue would be left for the executivebranch and—very likely—the courts to decide. Even if Californialost its cashout status, however, CBO believes that the effects onfederal outlays would be fairly small. A large number of SSI bene-ficiaries in California would automatically become eligible for asmall Food Stamp benefit; administrative costs in the Food Stampprogram (which are split equally between the federal governmentand the state) would go up as a consequence; but a subset of recipi-ents-those who live in households that include non-SSI recipientsand whose income, for the first time, would begin to be countedwith the other members'—would cause a fairly steep drop in house-hold's food stamp benefit.

SUBTITLE D—NONCITIZENS

Last year's welfare reform law, the Personal Responsibility andWork Opportunity Reconciliation Act of 1996 (PRWORA) ended theeligibility of most legal aliens for SSI benefits. Specifically, legalaliens could not receive SSI unless they fell in one of the exemptedcategories—chiefly refugees during their first 5 years in the UnitedStates, and aliens who had worked for 10 years or more in thiscountry. (The same criteria were enacted for aliens seeking FoodStamp benefits.) The government stopped making new awards tolegal aliens immediately after PRWORA's enactment The approxi-mately half-million legal aliens who were on the rolls at thePRWORA's enactment and who do not fall in one of the exemptcategories faced the end of their SSI benefits in August or Septem-ber, after a one-year grace period provided by PRWORA. The cutoffdate was delayed to October 1, 1997, by the supplemental appro-priation signed by the President on June 12, at an estimated costun fiscal year 1997 of $0.2 billion.

This bill would spare those aliens who were on the SSI rolls inAugust 1996 from losing their benefits after October 1. CBO esti-mates that the number who would benefit from this provision, whototaled about 500,000 in August 1996, would average about375,000 in fiscal year 1998 and 210,000 in 2002. That number fallsfor two reasons. First, the number would shrink naturally due todeath or (less frequently) financial improvement; second, many wholost benefits as a result of PRWORSA were assumed by CBO to re-

1202

turn to the rolls through naturalization. Multiplying the number ofaliens retaining 551 eligibility by an average benefit—assumed toequal about $425 in 1998 and $475 in 2002—yields outlays of $1.9billion and $1.2 billion in those two years. The extra outlays wouldtotal $7.4 billion over the 1998—2002 period.

This bill would also extend the window of SSI eligibility for refu-gees from 5 years to 7 years after their arrival in the UnitedStates. (Since aliens generally must live here 5 years before theycan become naturalized, this change would give more aged and dis-abled refugees a chance to complete the process without losing ben-efits.) Refugees; eligibility would remain at 5 years in the FoodStamp program. If the extension from 5 years to 7 years for refu-gees were enacted as a free-standing measure, it would cost ap-proximately $100 million a year in SSI. However, the extra costfrom the extension in this bill is negligible. Most of its cost in the1997—2002 period as associated with refugees already in the coun-try, and who have been here for more than 5 years or will soon hitthe 5-year mark; but most of those people would be spared by theproposed "grandfather" provision for aliens on the rolls in August1996.

Legal aliens who lost SSI would not necessarily have lost Medic-aid. PRWORA fundamentally left up to the states whether to pro-vide Medicaid coverage for aliens who were in the United Stateslegally in August 1996. (Much tougher rules, notably a ban on non-emergency Medicaid benefits for five years after entry, applied toimmigrants other than refugees who enter the country after August1996.) CBO assumed that, because most states provide Medicaidfor the aged and disabled who are "medically needy," only aboutone-quarter of aliens who lost SSI would have lost or stopped par-ticipating in Medicaid. Under this bill, they would retain Medicaid.Multiplying those participants by an assumed average Medicaidcost of about $4,000 in 1998—reflecting the fact that aliens areclustered in states with lower-than-average federal matching ratesand that, in the absence of regular Medicaid emergency Medicaidspending would have gone up—yields extra outlays of $0.3 billionin 1998 and gradually diminishing amounts thereafter.

SUBTITLE E—UNEMPLOYMENT COMPENSATION

Subtitle E would clarify that state base period determinationsare not administrative provisions, increase the federal unemploy-ment account ceiling, provide for a special distribution of $100 mil-lion to states in fiscal years 2000—2002, and restrict interest-freeadvances. In addition, Subtitle E would exempt from coverageunder the federal unemployment tax act (FUTA) certain workers,including teachers at church-run schools, temporary election work-ers, and inmates who work in private businesses as part of a coop-erative work program. The following table shows the budgetary ef-fect of each of these provisions.

[By fiscal year in millions ol doltarsi

199? 1998 1999 2000 2001 2002

DIRECT SPENDING

Section 9401: Base Period Determination —26 —28 —30 —31 33

Section 903: Special Distribution to States —200 —208 —216

1203

8y fiscal year in millions at dollarsi

1991 1998 999 2000 2001 2002

Section 9404 Interest on Advances —5 —5 —5 —5 —5

Sections 9405. 9406, and 9401: Eoemption from FUTA coverage ofCertain Workers —3 —3 —3 _3 —3

Total Changes —34 —36 —238 —247 —257

REVENUES

Section 9401 Base Period Determination

Section 9403 Special Distribution to States

Sections 9405, 9406. and 9407: Eoemption from FIJTA coverage ofCertain Workers

Total Changes

0 —8 —30 —36 —37

521 534 450

—3 —3 —3 —3

488 495 410

Base Period Determination.—Section 9401 would clarify that baseperiods, as defined under state law, are not considered methods ofadministration for purposes of section 303(a)(1) of the Social Secu-rity Act. Enacting this section would reduce federal outlays for un-employment compensation by $26 miilion for fiscal year 1998 andby $148 million over the 1998—2002 period. Payroll taxes would beadjusted in order to compensate for these reductions. These payrolltaxes are levied and collected by state governments but depositedwith the federal government in the Unemployment Trust Fund(UTF). CBO estimates that revenue from payroll taxes would fallby $111 million over the 1998—2002 period. As a result, the deficitwould be reduced by a total of $37 million over this five-year pe-riod. These savings assume that the CBO March 1997 baseline forunemployment benefit outlays and state deposit collections are ad-justed to reflect increases due to the April 4, 1997, decision by theSeventh Circuit U.S. Court of Appeals, which affirmed the judg-ment in the District Court in the case of Pennington v. Doherty.

Increase the Federal Unemployment Account Ceiling.—Section9402 would raise the statutory ceiling on the Federal Unemploy-ment Account in the UTF from 0.25 percent of covered wages to 0.5percent of covered wages beginning in fiscal year 2002. This changewould increase the ceiling from about $7 billion under current lawto about $14 billion. This increase would have no effect on revenuesor outlays during fiscal years 1998—2002 but would have sizeableimpacts on both outlays and revenues beginning in fiscal year2003.

Special Distribution to States.—Section 9403 would eliminate cer-tain transfers of UTF funds to states but allow for transfers of$100 million to take place in fiscal years 2000, 2001, and 2002.Current provisions of the Social Security Act require that when allof the federal accounts within the UTF reach their statutory limits,excess federal income is transferred to the state benefits accounts.CBO estimates that the federal accounts would reach these limitsat the end of fiscal year 1999 and that approximately $0.9 billionwould be transferred to the states and be available for expenditurebeginning in fiscal year 2000. Similar transfers would continuethroughout the baseline projection period. CBO estimated thatstates would spend about $300 million of these transfers each year,with slight adjustments for inflation.

1204

This section would effectively increase the ceiling, because itwould require amounts in excess of the ceiling, minus $100 million,to be held in the FUA regardless of the ceiling. This section wouldrestrict transfers to $300 million over fiscal years 2000—2002,thereby reducing net outlays by $624 million compared to the cur-rent law. In contrast to CBO's baseline estimate, where state reve-nues would drop because of the transfer effected by the currentFUA ceiling, CBO estimates that state tax rates would be main-tained at levels that would yield roughly $1.5 billion more in reve-nues than had been estimated under current law. Enacting thissection would reduce the federal deficit by about $2.1 billion overthe 1998—2002 period.

Restriction on Interest -Free Advances to State Accounts.—Section9404 would require states to meet certain criteria in order to be eli-gible to receive interest-free advances to their state benefit accountin the UTF. Under current law, states are not charged interest onadvances if they are repaid in full by September 30 of the calendaryear the advances were made, and if no other advances were madeduring that calendar year. This proposal would further require thatstates meet certain funding goals in four of the last five quartersbefore the quarter in which the advance was required.U.S.C.

Currently, most states have sufficient balances in their benefitaccounts and would not require advances in order to meet benefitpayments. A few states, however, do not have balances that wouldmeet the funding goal and could require advances within the pro-jection period. Section 9404 would require that these states becharged interest on their advances, even if they are paid back bySeptember 30.

In addition to intra-year borrowing due to timing of payroll taxreceipts, states may require advances when economic conditionswould cause outlays to increase or tax receipts to fall. Over thepast five years (1992—1996), about $140 million in interest on ad-vances was paid by the states. If this new policy had applied, inter-est payments would have been $20 million more than under cur-rent law. Assuming a 25 percent probability that similar conditionswould recur, CBO estimates that additional interest payments ofabout $5 million annually, on average, would be collected, for a netdeficit reduction of $25 million over fiscal years 1998—2002. Theseinterest payments are shown in the offsetting receipts account ofthe UTF in function 900.

Exemption of Service Performed by Election Workers from theFederal Unemployment Tax Act (FUTA).—Seciton 9405 would ex-empt from FUTA coverage work performed by approximately925,000 temporary election workers who staff polling places for oneto two days during a local, state, or federal election. CBO estimatesthat enacting this provision would reduce benefit outlays and reve-nues by $1 million a year.

Exemption of Service Performed for an Elementary or SecondarySchool Operated Primarily for Religious Purposes from the FederalUnemployment Tax.—Section 9406 would eliminate FUTA coveragefor approximately 71,000 elementary and secondary school teachersemployed by religious organizations. CBO estimates that enactingthis provision would reduce benefit outlays and revenues by $2 mil-lion a year.

1205

Treatment of Certain Services Performed by Inmates.—Section9407 would exempt from coverage under FUTA service performedby persons committed to penal institutions. Enactment of this sec-tion would reduce unemployment benefit outlays as well as FUTAand state employment tax revenues, but the amount is likely to beinsignificant.

Estimated impact on State, local, and tribal governments: Thistitle would impose no new intergovernmental mandates as definedunder the Unfunded Mandates Reform Act of 1995 (UMRA) andwould repeal an existing mandate under the Supplemental SecurityIncome (SSI) program. In addition, the title includes other provi-sions that would have a significant effect the budgets of state, local,and tribal governments.

Repeal of mandatory SSI supplementationCurrent law requires states to maintain their per-capita SSI sup-

plements at 1983 levels or maintain their total expenditures at thelevel from the previous year. Once a state elects to supplement SSI,federal law requires it to continue in order to remain eligible forMedicaid payments. Title IX would repeal this mandate.

States currently supplement SSI annually with about $3.6 billionof their own funds. Although some states supplement SSI beyondwhat is required, most of the $3.6 billion can be attributed to themandate to maintain spending levels. However, under the welfarereform law, most legal aliens will no longer be eligible for SSI orstate supplements after August 1997. (This title would allow manyof these legal aliens to remain eligible for SSI and supplements.)Based on data from the Social Security Administration, CBO esti-mates that the annual cost of the mandate will decrease to about$3.0 billion after August 1997 as a result of welfare reform. Eventhough this mandate would be repealed, CBO does not expect thatstates would cut their supplement programs significantly.

If the repeal of the maintenance-of-effort requirement results inCalifornia losing its cashout status, a large number of SSI bene-ficiaries in California would automatically become eligible for FoodStamps, and the state's share of the program's annual administra-tive costs would increase by $25 million to $50 million.

Other significant impactsWelfare to Work.—The title would provide states and tribal gov-

ernments with between $750 million and $1.25 billion annually forfiscal years 1998 through 2000 to move welfare recipients to work.In order to receive these funds, states would have to match eachfederal dollar with 50 cents of its own funds and also meet the 80percent maintenance of effort requirement under the TemporaryAssistance for Needy Families (TANF) program.

TANF Work Requirement.—The TANF work requirement (whichspecifies percentages of TANF families that must have a memberengaged in work activities) would be modified in ways that CBOestimates would likely increase the net costs of meeting the workrequirement. Such costs would not constitute a mandate as definedunder UMRA because under TANF states have the flexibility to off-set additional costs by tightening eligibility or reducing benefit 1ev-els.

1206

Fees for Administering SSI Supplements.—CBO estimates thatstates would spend an additional $105 million annually by 2002 be-cause of the increase in fees charged by the federal government toadminister SSI supplements. The higher fees do not constitute amandate because states contract voluntarily with the federal gov-ernment to provide these services.

Welfare and Public Benefits for Aliens.—Subtitle D would grand-father the eligibility of aliens receiving SSI on August 22, 1996, en-abling those aliens to continue receiving benefits. Assuming statescontinue to supplement SSI payments, the costs of these supple-ments would be approximately $400 million in 1998. Because Sec-tion 9102 of the subtitle eliminates the requirement for states tocomply with maintenance-of-effort requirements in the SSI pro-gram, continuing supplemental benefits for these aliens would notconstitute a mandate under UMRA.

The increased SSI eligibility that results from this subtitle wouldalso lead to an increase in state costs for their share of Medicaidpayments. These costs are estimated to total approximately $325million in 1998, decreasing to $250 million in 2002. Because stateshave the authority to make programmatic changes in the Medicaidprogram to offset these costs, they would not be considered man-dates under UMRA.

Unemployment Compensation.—This title contains a number ofprovisions that would affect states' costs under the federal Unem-ployment Compensation program. Because state participation inthis program is not required by federal law, the changes made bythis subtitle would not be considered mandates as defined byUMRA.

The provision clarifying the base period for determining the eligi-bility of an applicant for unemployment would preserve the abilityof states to define certain eligibility standards. The court decisionthat this provision would modify now applies to only three states(Illinois,Wisconsin, and Indiana). In the absence of this provision,however, 41 states could be required to adopt alteriiative base peri-ods at a cost of $400 million annually in additional unemploymentcompensation benefits, as well as administrative costs.

Provisions raising the FUA ceiling would reduce transfers tostate unemployment accounts by a total of about $2.5 billion fromfiscal year 2000 to fiscal year 2002.

Under current law, states may receive interest-free advances totheir state unemployment benefit accounts. Additional restrictionsimposed by this title would result in fewer states quaEfying forsuch loans. In total, CBO estimates that these restrictions wouldresult in additional costs to state goverilments totaling approxi-mately $5 million annua1ly beginning in fiscal year 1998.

Estimated impact on the private sector: This title contains noprivate-sector mandates as defined in the Unfunded Mandates Re-form Act of 1995.

Estimate prepared by: Federal Costs: Sheila Dacey, KathyRuffing, Christina Hawley Sadoti; Impact on State, Local, andTribal Governments: Leo Lex and John Patterson; Impact on thePrivate Sector: Ralph Smith.

Estimate approved by: Paul N. Van de Water, Assistant Directorfor qdget Analysis.

APPENDIX TABLE: FEDERAL BUDGETARY EFFECTS OF TITLE IX BY SUBTITLE

[By fiscal year, in millions of doHars]

1998 1999 2000 2001 2002 2003 20041998—

2005 2006 2007 2002Total

1998—2007Total

DIRECT SPENDING

SubtitIeA temporaly assistance for needy families block grant, weltare towork grants

Budget Authority

Outlays

Subtitle B supplemental security income, SSI

Budget Authority

Outlays

Subtiffe 0 restricting welfare and public benetits for aliens

SSI

Budget Authority 1.900 1.650 1525 1,150 1.175 1150 1,025 950 725 525 7,400 11,775Outlays 1900 1,650 1,525 1,150 1175 1,150 1,025 950 725 525 7,400 11,775

Medicaid

Budget Authority 375 350 300 275 275 275 250 226 200 160 1,675 2,675Outlays 375 350 300 275 275 275 250 226 200 150 1,575 2,675

Subtotal

Budget Authority 2,275 2,000 1,825 1.425 1,450 1,425 1,275 1.175 925 675 8,975 14,450Outlays 2.275 2.000 1,825 1,425 1.450 1425 1,275 1,175 925 675 8,975 14,450

Subtitle ( unemployment compensation

Budget Authority —34 —36 —238 —247 —267 —367 —377 —388 —398 —410 —813 —2,752Outlays —34 —36 —238 —247 —267 —367 —377 —388 —398 —410 —813 —2.752

Total

Budget Authority 2,956 3144 2,507 1,088 1,088 943 768 647 372 100 10.782 13,613Outlays 2343 2,490 2,594 1,779 1,438 943 768 647 372 100 10,643 13,474

REVENUES

SUBTiTL( ( UN(MPLOYM(NT COMPENSATION 0 — 11 488 495 410 358 292 209 143 59 1,380 2.442

Note: Details may not add to totall becaule of oundng.

750 1,250 1.000 0 0 0 0 0 0 0 3,000 3,000137 596 1,087 691 350 0 0 0 0 0 2,861 2,881

—35 —70 —80 —90 —105 —115 —130 —140 —155 —165 —380 —1.085—35 —70 —80 —90 —105 —115 —130 —140 —155 —165 —380 —1,085

1208

V. OTHER MATI'ERS REQUIRED To BE DISCUSSED UNDER THE RULESOF THE HOUSE

A. COMMITI'EE OVERSIGHT FINDINGS AND RECOMMENDATIONS

In compliance with clause 2(l)(3)(A) of Rule XI of the Rules of theHouse of Representatives, the Committee concludes that the ac-tions taken in this legislation are appropriate given its oversightactivities related to the human resources programs within its juris-diction.

B. SUMMARY OF FINDINGS AND RECOMMENDATIONS OF THEGOVERNMENT REFORM AND OVERSIGHT COMMITIEE

In compliance with clause 2(1)(3)(D) of Rule XI of the Rules of theHouse of Representatives, the Committee states that no oversightfindings and recommendations have been submitted to this Com-mittee by the Committee on Government Operations with respectto the provisions contained in this legislation.

C. CONSTITUTIONAL AUTHORITY STATEMENT

With respect to clause 2(l)(4) of rule XI of the Rules of the Houseof Representatives, relating to Constitutional Authority, the Com-mittee states that the Committee's action in reporting the bill isderived from Article I of the Constitution, Section 8 ("The Congressshall have power to lay and collect taxes, duties, imposts and ex-cises to pay the debts and to provide for * * * the general Welfareof the United States * * *")

CHANGES IN EXISTING LAW MADE BY TITLE IX OF THE BILL, ASREPORTED

In compliance with clause 3 of rule XIII of the Rules of the Houseof Representatives, changes in existing law made by the bill, as re-ported, are shown as follows (existing law proposed to be omittedis enclosed in black brackets, new matter is printed in italic, exist-ing law in which no change is proposed is shown in roman):

SOCIAL SECURITY ACT* * * * * * *

1227

* * * * * * *

TITLE XVI—SIJPPLEMENTAL SECURITY ThCOME FORTHE AGED, BLIND, AND DISABLED

* * * * * * *

OPTIONAL STATE SUPPLEMENTATION

SEC. 1616. (a) * * *

* * * * * * *(d)(1) Any State which has entered into an agreement with the

Commissioner of Social Security under this section which providesthat the Commissioner of Social Security will, on behalf of theState (or political subdivision), make the supplementary paymentsto individuals who are receiving benefits under this title (or whowould but for their income be eligible to receive such benefits),shall, at such times and in such installments as may be agreedupon between the Commissioner of Social Security and such State,pay to the Commissioner of Social Security an amount equal to theexpenditures made by the Commissioner of Social Security as suchsupplementary payments, plus an administration fee assessed inaccordance with paragraph (2) and any additional services feecharged in accordance with paragraph (3).

(2)(A) The Commissioner of Social Security shall assess eachState an administration fee in an amount equal to—

(i) * * *(B) As used in subparagraph (A), the term "applicable rate"

means—(i) for fiscal year 1994, $1.67;(ii) for fiscal year 1995, $3.33;(iii) for fiscal year 1996, $5.00; [and][(iv) for fiscal year 1997 and each succeeding fiscal year,

$5.00, or such different rate as the Commissioner of Social Se-curity determines is appropriate for the State.]

(iv) for fiscal year 1997, $5.00;(v) for fiscal year 1998, $6.20;(vi) for fiscal year 1999, $7.60;(vii) for fiscal year 2000, $7.80;(viii) for fiscal year 2001, $8.10;(ix) for fiscal year 2002, $8.50; and(x) for fiscal year 2003 and each succeeding fiscal year—

1228

(I) the applicable rate in the preceding fiscal year, in-creased by the percentage, if any, by which the ConsumerPrice Index for the month of June of the calendar year ofthe increase exceeds the Consumer Price Index for themonth of June of the calendar year preceding the calendaryear of the increase, and rounded to the nearest whole cent;or

(II) such different rate as the Commissioner determines isappropriate for the State.

(C) Upon making a determination under subparagraph [(B)(iv)](B)(x)(II), the Commissioner of Social Security shall promulgate thedetermination in regulations, which may take into account thecomplexity of administering the State's supplementary paymentprogram.

* * * * * * *

(d)(1) * * *

* * * * * * *

[(4) All administration fees and additional services fees collectedpursuant to this subsection shall be deposited in the general fundof the Treasury of the United States as miscellaneous receipts.]

(4)(A) The first $5 of each administration fee assessed pursuantto paragraph (2), upon collection, shall be deposited in the general/IL nd of the Treasury of the United States as miscellaneous receipts.

(B) That portion of each administration fee in excess of $5, and100 percent of each additional services fee charged pursuant toparagraph (3), upon collection for fiscal year 1998 and each subse-quent fiscal year, shall be credited to a special fund established inthe Treasury of the United States for State supplementary paymentfees. The amounts so credited, to the extent and in the amounts pro-vided in advance in appropriations Acts, shall be available to de-fray expenses incurred in carrying out this title and related laws.

*- * * * * * *

[oPERATIoN OF STATE SUPPLEMENTATION PROGRAMS

[SEc. 1618. (a) In order for any State which makes supple-mentary payments of the type described in section 1616(a) (includ-ing payments pursuant to an agreement entered into under section212(a) of Public Law 93—66), on or after June 30, 1977, to be eligi-ble for payments pursuant to title XIX with respect to expendituresfor any calendar quarter which begins—

[(1) after June 30, 1977, or, if later,[(2) after the calendar quarter in which it first makes such

supplementary payments,such State must have in effect an agreement with the Commis-sioner of Social Security whereby the State will—

[(3) continue to make such supplementary payments, and[(4) maintain such supplementary payments at levels which

are not lower than the levels of such payments in effect in De-cember 1976, or, if no such payments were made in thatmonth, the levels for the first subsequent month in which suchpayments were made.

1229

[(b)(1) The Commissioner of Social Security shall not find thata State has failed to meet the requirements imposed by paragraph(4) of subsection (a) with respect to the levels of its supplementarypayments for a particular month or months if the State's expendi-tures for such payments in the twelve-month period (within whichsuch month or months fall) beginning on the effective date of anyincrease in the level of supplemental security income benefits pur-suant to section 1617 are not less than its expenditures for suchpayments in the preceding twelve-month period.

[(2) For purposes of determining under paragraph (1) whether aState's expenditures for supplementary payments in the 12-monthperiod beginning on the effective date of any increase in the levelof supplemental security income benefits are not less than theState's expenditures for such payments in the preceding 12-monthperiod, the Commissioner of Social Security, in computing theState's expenditures, shall disregard, pursuant to a 1-time electionof the State, all expenditures by the State for retroactive supple-mentary payments that are required to be made in connection withthe retroactive supplemental security income benefits referred to insection 5041 of the Omnibus Budget Reconciliation Act of 1990.

l[(c) Any State which satisfies the requirements of this sectionsolely by reason of subsection (b) for a particular month or monthsin any 12-month period (described in such subsection) ending on orafter June 30, 1982, may elect, with respect to any month in anysubsequent 12-month period (so described), to apply subsection(a)(4) as though the reference to December 1976 in such subsectionwere a reference to the month of December which occurred in the12-month period immediately preceding such subsequent period.

[(d) The Commissioner of Social Security shall not find that aState has failed to meet the requirements imposed by paragraph(4) of subsection (a) with respect to the levels of its supplementarypayments for any portion of the period July 1, 1980, through June30, 1981, if the State's expenditures for such payments in thattwelve-month period were not less than its expenditures for suchpayments for the period July 1, 1976, through June 30, 1977 (or,if the State made no supplementary payments in the period July1, 1976, through June 30, 1977, the expenditures for the firsttwelve-month period extending from July 1 through June 30 inwhich the State made such payments).

[(e)(1) For any particular month after March 1983, a State whichis not treated as meeting the requirements imposed by paragraph(4) of subsection (a) by reason of subsection (b) shall be treated asmeeting such requirements if and only if—

[(A) the combined level of its supplementary payments (torecipients of the type involved) and the amounts payable (to oron behalf of such recipients) under section 16 11(b) of this Actand section 211(a)(1)(A) of Public Law 93—66, for that particu-lar month,

is not less than—[(B) the combined level of its supplementary payments (to

recipients of the type involved) and the amounts payable (to oron behalf of such recipients) under section 1611(b) of this Actand section 211(a)(1)(A) of Public Law 93—66, for March 1983,increased by the amount of all cost-of-living adjustments under

1230

section 1617 (and any other benefit increases under this title)which have occurred after March 1983 and before that particu-lar month.

[(2) In determining the amount of any increase in the combinedlevel involved under paragraph (1)(B) of this subsection, any por-tion of such amount which would otherwise be attributable to theincrease under section 1617(c) shall be deemed instead to be equalto the amount of the cost-of-living adjustment which would have oc-curred in July 1983 (without regard to the 3-percent limitation con-tained in section 215(i)(1)(B)) if section 111 of the Social SecurityAmendments of 1983 had not been enacted.

[(f) The Commissioner of Social Security shall not find that aState has failed to meet the requirements imposed by subsection(a) with respect to the levels of its supplementary payments for theperiod January 1, 1984, through December 31, 1985, if in the pe-riod January 1, 1986, through December 31, 1986, its supple-mentary payment levels (other than to recipients of benefits deter-mined under section 1611(e)(1)(B)) are not less than those in effectin December 1976, increased by a percentage equal to the percent-age by which payments under section 1611(b) of this Act and sec-tion 211(a)(1)(A) of Public Law 93—66 have been increased as a re-sult of all adjustments under section 16 17(a) and (c) which have oc-curred after December 1976 and before February 1986.

[(g) In order for any State which makes supplementary pay-ments of the type described in section 1616(a) (including paymentspursuant to an agreement entered into under section 2 12(a) of Pub-lic Law 93—66) to recipients of benefits determined under section1611(e)(1)(B), on or after October 1, 1987, to be eligible for pay-ments pursuant to title XIX with respect to any calendar quarterwhich begins—

[(1) after October 1, 1987, or, if later[(2) after the calendar quarter in which it first makes such

supplementary payments to recipients of benefits so deter-mined,

such State must have in effect an agreement with the Commis-sioner of Social Security whereby the State will—

[(3) continue to make such supplementary payments to re-cipients of benefits so determined, and

[(4) maintain such supplementary payments to recipients ofbenefits so determined at levels which assure (with respect toany particular month beginning with the month in which thissubsection is first effective) that—

[(A) the combined level of such supplementary paymentsand the amounts payable to or on behalf of such recipientsunder section 1611(e)(1)(B) for that particular month,

is not less than—[(B) the combined level of such supplementary payments

and the amounts payable to or on behalf of such recipientsunder section 1611(e)(1)(B) for October 1987 (or, if no suchsupplementary payments were made for that month, thecombined level for the first subsequent month for whichsuch payments were made), increased—

[(i) in a case to which clause (i) of such section1611(e)(1)(B) applies or (with respect to the individual

1231

or spouse who is in the hospital, home, or facility in-volved) to which clause (ii) of such section applies, by$5, and

[(ii) in a case to which clause (iii) of such section1611(e)(1)(B) applies, by $10.]

* * * * * * *

PERSONAL RESPONSIBILITY AND WORX OPPORTUNITYRECONCILIATION ACT OF 1996

SEC. 2. TABLE OF CONTENTS.The table of contents for this Act is as follows:

* * * * * * *

TITLE lY—RESTRICTING WELFARE AND PUBLIC BENEFITSFOR ALIENS

* * * * * * *

Subtitle B—Eligibility for State and Local Public BenefitsPrograms

Sec. 411. Aliens who are not qualified aliens or nonimmigrants ineligible for Stateand local public benefits.

* * * * *

Sec. 413. Authorization for verification of eligibility for state and local public bene-fits.

* * * * * *

Subtitle D—General ProvisionsSec. 431. Definitions.

* * * * *

Sec. 436. Derivative eligibility for benefits.* * * * * * *

TITLE IT—SUPPLEMENTAL SECURITYINCOME

SEC. 200. REFERENCE TO SOCIAL SECURITY ACT.Except as otherwise specifically provided, wherever in this title

an amendment is expressed in terms of an amendment to or repealof a section or other provision, the reference shall be considered tobe made to that section or other provision of the Social SecurityAct.

* * * * * * *

Subtitle B—Benefits for Disabled ChildrenSEC. 211. DEFINITION AND ELIGIBILITY RULES.

(a) * * *

* * * * *

1232

(d) EFFECTWE DATES, ETC.—(1) * * *(2) APPLICATION TO CURRENT RECIPIENTS.—

(A) ELIGIBILITY REDETERMINATIONS.—Durlng the periodbeginning on the date of the enactment of this Act andending on the date which is [1 year] 18 months after suchdate of enactment, the Commissioner of Social Securityshall redetermine the eligibility of any individual underage 18 who is eligible for supplemental security incomebenefits by reason of disability under title XVI of the So-cial Security Act as of the date of the enactment of this Actand whose eligibility for such benefits may terminate byreason of the provisions of, or amendments made by, sub-sections (a). and (b) of this section. Any redetermination re-quired by the preceding sentence that is not performed be-fore the end of the period described in the preceding sen-tence shall be performed as soon as is practicable there-after. With respect to any redetermination under this sub-paragraph—(i)***

* * * * * * *

(C) N0TICE.—Not later than January 1, 1997, the Com-missioner of Social Security shall notify an individual de-scribed in subparagraph (A) of the provisions of this para-graph. Before commencing a redetermination under the 2ndsentence of subparagraph (A), in any case in which the in-dividual involved has not already been notified of the pro-visions of this paragraph, the Commissioner of Social Secu-rity shall notify the individual involved of the provisions ofthis paragraph.

* * * * * * *

TITLE IV—RESTRICTING WELFARE ANDPUBLIC BENEFITS FOR ALIENS* * * * * * *

Subtitle A—Eligibility for Federal Benefits* * * * * * *

SEC. 402. LIMITED ELIGIBILITY OF QUALIFIED ALIENS FOR CERTAINFEDERAL PROGRAMS.

(a) LIMITED ELIGIBILITY FOR SPECIFIED FEDERAL PROGRAMS.—(1) * * *(2) ExCEPTIONS.—

[(A) TIME-LIMITED EXCEPTION FOR REFUGEES ANDASYLEES.—Paragraph (1) shall not apply to an alien until5 years after the date—

[(i) an alien is admitted to the United States as arefugee under section 207 of the Immigration and Na-tionality Act;

1233

[(ii) an alien is granted asylum under section 208 ofsuch Act; or

[(iii) an alien's deportation is withheld under section243(h) of such Act.]

(A) TIME-LIMITED EXCEPTION FOR REFUGEES ANDASYLEES.—

(i) SSI.—With respect to the specified Federal pro-gram described in paragraph (3)(A) paragraph 1 shallnot apply to an alien until 7 years after the date—

(I) an alien is admitted to the United States asa refugee under section 207 of the Immigrationand Nationality Act;

(II) an alien is granted asylum under section208 of such Act; or

(III) an alien's deportation is withheld undersection 243(h) of such Act.

(ii) FOOD STAMPS.—With respect to the specified Fed-eral program described in paragraph (3)(B), paragraph1 shall not apply to an alien until 5 years after thedate—




* * * * * *(D) TRANSITION FOR ALIENS CTJRRENTLY RECEWING [BEN-

EFITS] FOOD STAMPS.—[(i) SSI.

[(I) IN GENERAL—With respect to the specifiedFederal program described in paragraph (3)(A),during the period beginning on the date of the en-actment of this Act and ending on the date whichis 1 year after such date of enactment, the Com-missioner of Social Security shall redetermine theeligibility of any individual who is receiving bene-fits under such program as of the date of the en-actment of this Act and whose eligibility for suchbenefits may terminate by reason of the provisionsof this subsection.

[(II) REDETERMINATION CRITERIA.— With re-spect to any redetermination under subclause (I),the Commissioner of Social Security shall applythe eligibility criteria for new applicants for bene-fits under such program.

[(III) GRANDFATHER PROVISION.—The provisionsof this subsection and the redetermination undersubclause (I), shall only apply with respect to thebenefits of an individual described in subclause (I)for months beginning on or after the date of theredetermination with respect to such individual.

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[(IV) NOTICE—Not later than March 31, 1997,the Commissioner of Social Security shall notifyan individual described in subclause (I) of the pro-visions of this clause.]

[(ii) FOOD STAMPS.—][(I)] (i) IN GENERAL.—With respect to the specified

Federal program described in paragraph (3)(B), ineli-gibility under paragraph (1) shall not apply until April1, 1997, to an alien who received benefits under suchprogram on the date of enactment of this Act, unlesssuch alien is determined to be ineligible to receivesuch benefits under the Food Stamp Act of 1977. TheState agency shall recertify the eligibility of all suchaliens during the period beginning April 1, 1997, andending August 22, 1997.

[(II)] (ii) RECERTIFICATION CRITERIA.—With respectto any recertification under subclause (I), the Stateagency shall apply the eligibility criteria for applicantsfor benefits under such program.

[(III)] (iii) GRANDFATHER PROV!SION.—The provi-sions of this subsection and the recertification undersubclause (I) shall only apply with respect to the eligi-bility of an alien for a program for months beginningon or after the date of recertification, if on the date ofenactment of this Act the alien is lawfully residing inany State and is receiving benefits under such pro-gram on such date of enactment.

(E) ALIENS RECEIVING SSI ON AUGUST 22, 1996.—With re-spect to eligibility for benefits for the program defined inparagraph (3)(A) (relating to the supplemental security in-come program), paragraph (1) shall not apply to an alienwho was receiving such benefits on August 22, 1996.

(F) PERMANENT RESIDENT ALIENS WHO ARE MEMBERS OFAN INDIAN TPJBE.—With respect to eligibility for benefits forthe program defined in paragraph (3)(A) (relating to thesupplemental security income program), paragraph (1)shall not apply to an alien who—

(i) is lawfully admitted for permanent residenceunder the Immigration and Nationality Act; and

(ii) is a member of an Indian tribe (as defined in sec-tion 4(e) of the Indian Self-Determination and Edu-cation Assistance Act).

* * * * * * *

(b) LIMITED ELIGIBILITY FOR DESIGNATED FEDERALPROGRAMS.—

(1) * * *

(2) ExCEVrIONS.—Qualified aliens under this paragraph shallbe eligible for any designated Federal program.

[(A) TIME-LIMITED EXCEPTION FOR REFUGEES ANDASYLEES.—

[(i) An alien who is admitted to the United Statesas a refugee under section 207 of the Immigration andNationality Act until 5 years after the date of analien's entry into the United States.

1235

[(ii) An alien who is granted asylum under section208 of such Act until 5 years after the date of suchgrant of asylum.

[(iii) An alien whose deportation is being withheldunder section 243(h) of such Act until 5 years aftersuch withholding.]

(A) TIME-LIMITED EXCEPTION FOR REFUGEES ANDASYLEES.—

(i) MEDICAID.—With respect to the designated Fed-eral program described in paragraph (3)(C), paragraph1 shall not apply to an alien until 7 years after thedate—



(III) a.n alien's deportation is withheld undersection 243(h) of such Act.

(ii) OTHER DESIGNATED FEDERAL PROGI6AMS.—Withrespect to the designated Federal programs underparagraph (3) (other than subparagraph (C)), para-graph 1 shall not apply to an alien until 5 years afterthe date—




* * * * * * *

Subtitle B—Eligibility for State and LocalPublic Benefits Programs

* * * * * * *

SEC. 413. AUTHORIZATION FOR VERIFICATION OF ELIGIBILI1Y FORSTATE AND LOCAL PUBLIC BENEFITS.

A State or political subdivision of a State is authorized to requirean applicant for State and local public benefits (as defined in sec-tion 411(c)) to provide proof of eligibility.

* * * * * * *

Subtitle D—General Provisions* * * * * * *

SEC. 4,j• DEPJ VA Ti YE ELIGIBILITY FOR BENEFITS.(a) FOOD STAMPS.—Notwithstanding any other provision of law,

an alien who under the provisions of this title is ineligible for bene-fits under the food stamp program (as defined in section

1236

402(a) (3) (A)) shall not be eligible for such benefits because the alienreceives benefits under the supplemental security income program(as defined in section 402(a) (3) (B)).

(b) MEDIcAfD.—Notwithstanding any other provision of this title,an alien who under the provisions of this title is ineligible for bene-fits under the medicaid program (as defined in section 402(b)(3)(C))shall be eligible for such benefits if the alien is receiving benefitsunder the supplemental security income program and title XIX ofthe Social Security Act provides for such derivative eligibility.

* * * * * * *

SECTION 212 OF THE ACT OF JULY 9, 1973

AN ACT To extend the Renegotiation Act of 1951 for one year, and for otherpurposes.

MANDATORY MINIMUM STATE SUPPLEMENTATION OF SSI BENEFITSPROGRAM

SEC. 212. (a) * * *

(b)(1) * * *

* * * * * * *

(3)(A) * * *

(B)(i) The Secretary shall assess each State an administration feein an amount equal to—

(I) the number of supplementary payments made by the Sec-retary on behalf of the State under this subsection for anymonth in a fiscal year; multiplied by

(II) the applicable rate for the fiscal year.(ii) As used in clause Ci), the term "applicable rate" means—

(I) for fiscal year 1994, $1.67;(II) for fiscal year 1995, $3.33;(III) for fiscal year 1996, $5.00; [and][(IV) for fiscal year 1997 and each succeeding fiscal year,

$5.00, or such different rate as the Secretary determines is ap-propriate for the State, taking into account the complexity ofadministering the State's supplementary payment program.]

(IV) for fiscal year 1997, $5.00;(V) for fiscal year 1998, $6.20;(VI) for fiscal year 1999, $7. 60;(VII) for fiscal year 2000, $7.80;(VIII) for fiscal year 2001, $8.10;(IX) for fiscal year 2002, $8.50; and(X) for fiscal year 2003 and each succeeding fiscal year—

(aa) the applicable rate in the preceding fiscal year, in-creased by the percentage, if any, by which the ConsumerPrice Index for the month of June of the calendar year ofthe increase exceeds the Consumer Price Index for themonth of June of the calendar year preceding the calendaryear of the increase, and rounded to the nearest whole cent;or

(bb) such different rate as the Commissioner determinesis appropriate for the State.

1237

(iii) Upon making a determination under clause E(ii)(IV)1(iQ(X)(bb), the Secretary shall promulgate the determination in reg-ulations, which may take into account the complexity of adinin-istering the State's supplementary payment program.

(iv) All fees assessed pursuant to this subparagraph shall betransferred to the Secretary at the same time that amounts forsuch supplementary payments are required to be so transferred.

* * * * * * *

[CD) All administration fees and additional services fees collectedpursuant to this paragraph shall be deposited in the general fundof the Treasury of the United States as miscellaneous receipts.1

(D)(i) The first $5 of each administration fee assessed pursuant tosubparagraph (B), upon collection, shall be deposited in the generalfund of the Treasury of the United States as miscellaneous receipts.

• (ii) The portion of each administration fee in excess of $5, and 100percent of each additional services fee charged pursuant to subpara-graph (C), upon collection for fiscal year 1998 and each subsequentfiscal year, shall be credited to a special fund established in theTreasury of the United States for State supplementary payment fees.The amounts so credited, to the extent and in the amounts providedin advance in appropriations Acts, shall be available to defray ex-penses incurred in carrying out this section and title XV? of the So-cial Security Act and related laws.

* * * * * * *

COMMITTEE ON WAYS m MEANS,U.S. HOUSE OF REPRESENTATIVES,

Washington, DC, June 13, 1997.Hon. JOHN R. KASICH,Chairman, Committee on the Budget, U.S. House of Representa-

tives, Washington, DC.DE MR. C LAIRMAN: On June 9, 1997, the Committee on Ways

and Means, pursuant to H. Con. Res. 84, the Concurrent Resolu-tion on the Budget for fiscal Year 1998, ordered favorably reported,as amended, its budget reconciliation recommendations on healthitems, to the Committee on Budget by a recorded vote of 36 to 3.Accordingly, I am now transmitting these recommendations to you.

Enclosed are the legislative language, explanatory report lan-guage, estimates of the Congressional Budget Office and JointCommittee on Taxation and additional views. Under separate cov-ers, I am transmitting the Committee's recommendations onhuman resources items and revenue items.

Please feel free to contact me or Pete Singleton if you have anyquestions. With best personal regards,

Sincerely,BILL ARCHER, Chairman.

Enclosures

I. INTRODUCTION

A. PURPOSE AND SUMMARY

The goal of this legislation is to extend the financial life of theMedicare trust funds, to expand the private health plan choicesavailable to Medicare beneficiaries, and improve the quality ofMedicare coverage.

The Board of Trustees of the Medicare Hospital Insurance andSupplementary Medical Insurance trust funds have urged the Con-gress for many years to take action to curb the significant financialimbalance in the trust funds both in the short and long terms. Inresponse to these recommendations, the House of Representativespassed the Medicare Preservation Act of 1995 in the 104th Con-gress, and included that bill in the Balanced Budget Act of 1995which was passed by the Congress. This legislation would havekept the Medicare Hospital Insurance trust in balance to the ad-vent of the retirement of the baby boomer generation and stemmedthe unsustainable growth in the Supplementary Medical Insurancetrust fund. It would also have greatly expanded the private healthplan choices available to Medicare beneficiaries. Unfortunately, theAct was vetoed by the President. So, no substantive action regard-ing the challenges facing Medicare was taken in the 104th Con-gress.

(1241)

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This legislation would extend the life of the Medicare HospitalInsurance trust fund to 2007. More importantly, with the great in-crease in program cost that will accompany the retirement of thebaby boomer generation after 2010, this measure makes the struc-tural changes in the program that will provide a platform for meet-ing the longer term financial issues facing Medicare.

The legislation expands the private health plan options availableto beneficiaries, and will allow them to choose the type of coverageavailable tO them during their working lives. The increased use ofprivate health plans by beneficiaries will both improve coverage formost of those on Medicare, while offering them quality, cost-effec-tive health care.

Further, the legislation modernizes Medicare payment on the fee-for-service side of the program. Today, 89% of Medicare bene-ficiaries choose to remain in fee-for-service Medicare. Over timethat number will decline, but there will always be beneficiarieswho prefer traditional Medicare coverage. To keep that option cost-effective, it is critical that payment for services give providers theincentive to offer quality care at the best price for the program.This legislation achieve this objective by expanding the use of pro-spective payment in Medicare to home health, skilled nursing, out-patient hospital department, and other services.

Also, to help control costs, the legislation expands on the anti-fraud and abuse initiatives in the Health Insurance Portability andAccountability Act of 1996. The legislation gives the power to Medi-care to bar providers from the program who have been convictedof health care fraud, and requires certain new providers to post a$50,000 surety bond to assure that they will meet their obligationsin offering Medicare services.

The legislation further begins the process of improving the Medi-care benefit package through its prevention initiatives. It will en-courage more preventative screening and empower beneficiarieswith diabetes to better treat their disease.

This legislation achieves its objectives by improving the programand expanding opportunities for beneficiaries to seek and for pro-viders to give more cost effective, quality health care without in-creasing current costs of health to Medicare beneficiaries.

B. BACKGROUND AND NEED FOR LEGISLATION

As in past years, the Board of Trustees of the Medicare FederalHospital Insurance (HI) and Supplementary Medical Insurance(SMI) trust funds have called for action on the financial crisis fac-ing the Medicare program. The HI trust fund now spends moremoney than it receives in revenues from the payroll tax, and willrun out of reserves in 2001 according to the intermediate assump-tions of the Trustees report.

In the report for this year, the Board of Trustees urge action onthe HI trust fund:

"As we reported for the last several years, one of the Medicaretrust funds, the Hospital Insurance fund, would be exhausted infour years without legislation that addresses its financial imbal-ance. Any trust fund exhaustion can and should be avoided, as ithas been in the past."

1243

Additionally, they note the need to attend to the unsustainablecosts of the SMI trust fund:

"Costs of the Medical Supplementary Medical Insurance Programare rising rapidly and need to be addressed in the near term."

The short term imbalance in the Medicare Health Insurancetrust fund and the excessive growth in the Supplementary MedicalInsurance trust fund are fueled primarily by increasing health carecosts. This cost growth, depending on the service, is due to ever-increasing prices, use of services, intensity of care, and new tech-nologies. Once the baby boomer generation starts to retire, the ris-ing proportion of Americans entitled to Medicare will present a newchallenge and level of concern.

The Ways and Means Committee believes that the short termcost inflation problem faced by Medicare, as well as this longerterm demographic problem the retirement of the baby boomers, re-quires the attention of the Congress.

The Committee has undertaken an effort to meet this challengewith a legislative program that contends with the short term costinflation for both the HI and SM trust funds. This program keepsthe HI trust fund in balance to 2007. Further, the Committee takessteps to prepare the way for keeping Medicare in financial balancewhen it confronts the challenge of the baby boomer generationthrough the development of cost effective, private health plan op-tions under MedicarePlus and the development of payment reformin costly areas of the Medicare fee- for-service program.

Additionally, the Medicare benefits have not been changed sig-nificantly since the inception of the program in 1965. Over the lastthirty years, priorities in medical care have changed. There is nowmore emphasis given to disease prevention and health promotion,and most benefits packages in the private sector reflect thesetrends. Medicare still does not.

The Committee recognizes the need to modernize Medicare.Clearly life-extending and improving medical treatment is likely tobe more effective the earlier a disease can be discovered, and betterunderstanding of disease can empower beneficiaries with chronicillnesses to help take care of themselves.

Finally, the Committee continues to have concern with fraud andabuse of the Medicare program. The General Accounting Office hasreported over the years that as much as 10 percent of Medicare ex-penditures are lost to fraud and abuse. In the last Congress, theHealth Insurance Portability and Accountability Act took action tocurb these costs. The Act stiffened penalties and appropriated addi-tional funds to root out health care crime. However, more can bedone, and this legislation recognizes this need and provides furthersteps to get the "bad apples" among the health care providers outof Medicare and to keep them out.

The Committee is committed to preserving and protecting Medi-care as well as modernizing the program to expand the choices ofcoverage available to beneficiaries. This legislation has been devel-oped to assure all Americans that the Medicare program will con-tinue to improve with time and will be there for all those who ex-pect it in their retirement years or if they become disabled.

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C. LEGISLATIVE HISTORY

Committee recommendationsThe Committee's budget reconciliation health recommendations

to the House Committee on Budget were ordered favorably re-ported by the Committee on June 9, 1997, by a vote of 36 ayes and3 nays. These recommendations were initially developed by theSubcommittee on Health, which favorably reported them by aunanimous roll call vote of 13—0 on June 4, 1997.

These recommendations includes nine subtitles. Subtitle A pro-vides for the Medicare Plus program which will provide bene-ficiaries greater choice of health coverage. Subtitle B expands Med-icare coverage to increase health promotion and disease prevention.Subtitle C improves payment for certain rural hospitals. Subtitle Dincludes initiatives to reduce health care fraud and abuse. SubtitleE moderrnzes Medicare payment by placing many services under aperspective payment system. Subtitle F provides for refinements inpayment under Part A of Medicare and Subtitle G provides for re-finements in payment under Part B of medicare. Subtitle H con-cerns matter related to both Parts A and B of Medicare. SubtitleI provides for medical liability reform.

Committee actionThe Subcommittee on Health of the Committee on Ways and

Means held the following hearings in the 105th Congress relatedto the Subcommittee's 1997 Budget Reconciliation proposals:

February 13—Medicare Provisions in the President's BudgetFebruary 25—Medicare HMO Payment PoliciesMarch 4—Medicare Home Health Care, Skilled Nursing Fa-

cility, and other Post-Acute Care Payment PoliciesMarch 6—Medicare HMO Regulation and QualityMarch 11—Teaching Hospitals and Medicare Disproportion-

ateMarch 13—H.R. 15, the "Medicare Preventive Benefit Im-

provement Act of 1997"March 20—Recommendations Regarding Medicare Hospital

and Physician Payment PoliciesApril 10—Rehabilitation and Long-Term Care Hospitals Pay-

mentsApril 17—Medicare's Coverage PolicyApril 24—Medicare Provider-Sponsored OrganizationsApril 29—Coordinated Care Options for Seniors

On June 4, 1997 the Subcommittee on Health of the Committeeon Ways and Means favorably reported to the full Committee asamended, budget reconciliation health recommendations by a re-corded vote of 13 to 0 with a quorum present.

On June 9, 1997 the Committee on Ways and Means approved,as amended, budget reconciliation health recommendations by a re-corded vote of 36 to 3.

On June 13, 1997 the Committee on Ways and Means forwardedto the Committee on the Budget its budget reconciliation healthrecommendations.

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SUBTITLE D—ANTI-FRAUD AND ABUSE PROVISIONS ANDADMINISTRATIVE EFFICIENCIES

Chapter 1.—Fraud and Abuse Related Provisions

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Section 10306. Imposition of civil money penaltiesCurrent law. Section 1128A of the Social Security Act sets forth

a list of fraudulent activities relating to claims submitted for pay-ments for items of services under a Federal health care program.Civil money penalties of up to $10,000 for each item or service maybe assessed. In addition, the Secretary of HHS (or head of the de-partment or agency for the Federal health care program involved)may also exclude the person involved in the fraudulent activityfrom participation in a Federal health care program, defined as anyprogram providing health benefits, whether directly or otherwise,which is funded directly, in whole or in part, by the United StatesGovernment (other than the Federal Employees Health BenefitsProgram).

Explanation of provision. The provision would add a new civilmoney penalty for cases in which a person contracts with an ex-cluded provider for the provision of health care items or services,where the person knows or should know that the provider has beenexcluded from participation in a Federal health care program. Acivil money penalty is also added for cases in which a person pro-vides a service ordered or prescribed by an excluded provider,where that person knows or should know that the provider hasbeen excluded from participation in a Federal health care program.

Reason for change. This provision is intended to ensure thatMedicare contractors are vigilant in checking the eligibility ofhealth care providers for reimbursement. Currently, when erro-neous payments are made to excluded individuals, the Medicareand Medicaid programs incur the damages.

Effective date. The provision would apply to arrangements andcontracts entered into after the date of enactment of the Act.

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Section 10308. Provision of Certain Identification NumbersCurrent law. Section 1124 of the Social Security Act requires that

entities participating in Medicare, Medicaid and the Maternal andChild Health Block Grant programs (including providers, clinicallaboratories, renal disease facilities, health maintenance organiza-tions, carriers and fiscal intermediaries), provide certain informa-tion regarding the identity .of each person with an ownership orcontrol interest in the entity, or in any subcontractor in which theentity has a direct or indirect 5 percent or more ownership interest.Section 1124A of the Social Security Act requires that providersunder Part B of Medicare also provide information regarding per-sons with ownership or control interest in a provider, or in anysubcontractor in which the provider has a direct or indirect 5 per-cent or more ownership interest.

Explanation of provision. The provision would require that allMedicare providers supply the Secretary with both the employeridentification number and social security account number of eachdisclosing entity, each person with an ownership or control inter-est, and any subcontractor in which the entity has a direct or indi-rect 5 percent or more ownership interest. The Secretary of HHSis directed to transmit to the Commissioner of Social Security infor-mation concerning each Social Security number and to the Sec-retary of the Treasury information concerning each employer iden-tification number supplied to the Secretary for verification of suchinformation. The Secretary would reimburse the Commissioner andthe Secretary of the Treasury for costs incurred in performing the

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verification services required by this provision. The Secretary ofHHS would report to Congress on the steps taken to assure con-fidentiality of Social Security numbers to be provided to the Sec-retary of HHS under this section. This section's reporting require-ments would then become effective 90 days after submission of theSecretary's report to Congress on confidentiality of Social Securitynumbers.

Reason for change. This provision is intended to provide the Sec-retary of HHS with additional information necessary to determinewhether giving a provider number to a provider, physician, or sup-plier is in the best interest of beneficiaries. It also is intended toserve as a deterrent to individuals with past records of fraud andabuse who seek to provide services through the Medicare program.Because the Committee believes it is extremely important to pro-tect the privacy and confidentiality of physicians, the provisiondoes not take effect until the Administration provides a report tothe relevant committees of Congress to provide assurance thatthere are adequate measures in place to. protect the privacy of phy-sicians.

Effective date. The reporting requirements of this provision areapplicable to conditions of participation, entering and renewal ofcontracts, and payments for items and services furnished morethan 90 days after the submission of the report described above.

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VIII. CHANGES IN EXISTING LAW MADE BY THERECOMMENDATIONS AS REPORTED

In compliance with clause 3 of rule XIII of the Rules of the Houseof Representatives, changes in existing law made by the bill, as re-ported, are shown as follows (existing law proposed to the omittedis enclosed in black brackets, new matter is printed in italic, exist-ing law in which no change is proposed is shown in roman):

SOCIAL SECURITY ACT

* * * * * * *

TITLE XI—GENERAL PROVISIONS, PEER REVIEW, ANDADMINISTRATWE SIMPLIFICATION

* * * * * * *

PART A—GENERAL PROVISIONS* * * * * * *

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* * *• * * * *

DISCLOSURE REQUIREMENTS FOR OTHER PROVIDERS UNDER PART B OFMEDICARE

SEC. 1124A. (a) DIscLOsURE REQUIRED To RECEIVE PAYMENT.—No payment may be made under part B of title XVIII for items orservices furnished by any disclosing part B provider unless suchprovider has provided the Secretary with full and complete infor-mation—

(1) on the identity of each person with an ownership or con-trol interest in the provider or in any subcontractor (as definedby the Secretary in regulations) in which the provider directlyor indirectly has a 5 percent or more ownership interest; [and]

(2) with respect to any person identified under paragraph (1)or any managing employee of the provider—

(A) on the identity of any other entities providing itemsor services for which payment may be made under titleXVIII with respect to which such person or managing em-ployee is a person with an ownership or control interest atthe time such information is supplied or at any time dur-ing the 3-year period enthng on the date such informationis supplied, and

(B) as to whether any penalties, assessments, or exclu-sions have been assessed against such person or managingemployee under section 1128, 1128A, or 1128B[.]; and

(3) including the employer identification number (assignedpursuant to section 6109 of the Internal Revenue Code of 1986)and social security account number (assigned under section205(c)(2)(B)) of the disclosing part B provider and any person,managing employee, or other entity identified or describedunder paragraph (1) or (2).

* * * * * * *

(c) VEFUFIcATI0N.—(1) TRANSMITTAL BY HHS.—The Secretary shall transmit—

(A) to the Commissioner of Social Security informationconcerning each social security account number (assignedunder section 205(c) (2) (B)), and

(B) to the Secretary of the Treasury information concern-ing each employer identification number (assigned pursu-ant to section 6109 of the Internal Revenue Code of 1986),

supplied to the Secretary pursuant to subsection (a)(3) or section1124(c) to the extent necessary for verification of such informationin accordance with paragraph (2).

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(2) VERIFICATION.—The Commissioner of Social Security andthe Secretary of the Treasury shall verify the accuracy of; orcorrect, the information supplied by the Secretary to such offi-cial pursuant to paragraph (1), and shall report such verifica-tions or corrections to the Secretary.

(3) FEES FOR VERIFICATION.—The Secretary shall reimbursethe Commissioner and Secretary of the Treasury, at a rate nego-tiated between the Secretary and such official, for the costs in-curred by such official in performing the verification and cor-rection services described in this subsection.

[(c)] (d) DEFINITI0NS.—For purposes of this section—(1) the term "disclosing part B provider" means any entity

receiving payment on an assignment-related basis (or, for pur-poses of subsection (a)(3), any entity receiving payment) for fur-mshing items or services for which payment may be madeunder part B of title XVIII, except that such term does not in-dude an entity described in section 1124(a)(2);

* * * * * * *

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Dissenting Views of the Democratic Members of theCommittee on Ways and Means

on the Human Resource Provisionssubmitted by the Committee on Ways and Means

During discussions on the fiscal year 1998 budget reso'ution, theClinton Administration and Republican congressional leaders entered intogood faith negotiations on the steps that would be taken to eliminate thedeficit by 2002 and, at the same time, carry out important nationa'intiatives. The final budget agreement inc'uded only the following humanresource matters that fail within the jurisdiction of the Committee on Waysand Means:

Welfare-to-work.— A $3 blilion welfare-to-work initiative withcapped mandatory spending through 2001 to TANF, allocatedto States through a formula and targeted within a State to areaswith high poverty and unemployment. A share of funds wouldgo to cities/counties with large poverty populationscommensurate with the share of long-term welfare recipients inthose jurisdictions.

• Eligibility for legal immigrants.-- Restoration of SSI andMedicaid eigibiIity for ail disabled lega' immigrants who are orbecome disabled and who entered the U.S. prior to August 23,1996.

• Refugees and asylees.-- Lengthening the exemption forrefugees and asylees from the first 5 years in the country to 7years in order to provide SSI and Medicaid.

• SSI fees.-- An increase in the fees charged by the SocialSecurity Administration for administering State supplementalpayments.

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UI provisions.— An increase in the ceilings of the FederaLFUTA-funded accounts in the Unemployment Trust Fund toincrease trust fund solvency and an increase in fraud reductionfunds.

Unfortunately, the RepubLican majority, lead by SubcommftteeChairman Shaw and full Committee Chairman Archer, chose to violate thebudget agreement negotiated by their own leaders and deviate fromagreed to policy. The Committee report:

• Violates the budget agreement deal to restore SSI benefitsto certain legal immigrants. Claiming to have proposed abetter policy than the budget, the Committee report actuallyextends benefits to 75,000 fewer legal immigrants in 2002 thanthe budget agreement would. That's not good enough.

• Creates a subminimum wage, sending the message thatwelfare recipients who go to work don't deserve the minimumwage or other important labor protections — for them,apparently, a subminimum wage is good enough. It's not goodenough for us.

• Lets States cut back on the SSI benefits of as many as 2.8million elderly, blind, and disabled Americans, endingMedicaid for nearly 400,000 of them, even though no Federalsavings accrue from this policy. That is unconscionable.

There was one real attempt to be bipartisan n developing theCommittee's human resource provisions. This related to the welfare-to-work provisions carrying out the commitment to a $3 billion program for thispurpose. The bipartisan effort worked and needs only minor improvement.

The record of the Democratic Members of the Committee on Waysand Means on deficit reduction is irrefutable. We would like nothing betterthan to support a budget reconciliation bill that eliminates the deficit whilealso restoring benefits to needy legal immigrants. Such a biH would beeasy to draft. But this is not such a bill. We cannot support legislation that

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undermines our commitment to helping welfare recipients find and keep ajob, or one that trades one group of human beings for another. TheAmerican people expect better of us and they deserve it.

The remainder of these dissenting views explain, in detail, thereasons for our united opposition to this legislation.

The Committee Report Authorizes a Subminimum Wage — We CannotSupport It

The Committee bill violates the principle that work should pay adecent wage, under decent working conditions. If we want to signal thatwe expect welfare recipients to move into the workplace — and we must —we must demonstrate that it pays to work. Surely, the best way to do thatis to provide a liveable wage and decent working conditions, as wedemand for all other workers, not by giving welfare recipients moving towork the badge of second class citizenship. This was not part of thebudget agreement.

The old welfare law — known as Aid to Families with DependentChildren (AFDC) — made clear that only someone placed in a workfareposition (also known as community work experience, or CWEP) did notearn wages and could only be required to work in exchange for theirbenefit for the number of hours that resulted from dividing the welfarebenefit by the minimum wage. No mention was made of the Fair LaborStandards Act.

The new welfare law repealed all of AFDC — including the workfarerules — replacing it with the Temporary Assistance to Needy Families(TANF) program. The Department of Labor, as it does routinely, analyzedthe new law to determine how the Fair Labor Standards Act applied. In

large measure, that conclusion rests on whether or not the individual is an"employee." DOL concluded that any work activity (except for bona fidetraining) under TANF is covered by the labor protections of the Fair LaborStandards Act and, as a result, participants must receive the minimumwage for work performed.

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The Committee bill includes language designed to override DOL'sconclusion that the Fair Labor Standards Act applies. It states that:

• Welfare recipients in placements in the public and nonprofitsectors are not defined as employees.

• States may not require recipients to be employed by a public orprivate agency for a number of hours greater than the 'welfarebenefits package" divided by the minimum wage.

• The 'welfare benefits package" must include TANF and foodstamps, may include the value of housing, child care, andMedicaid, and may include time spent in education, trainingand job search activities. Two methods are specified forvaluing these benefits; States may count the actual valuereceived by the family, or may compute an average.

In our view, work is work. A worker is a worker. TheAdministration is not creating new policy, new rights, or new coverage. Allit is saying is that when workfare is work it must be treated as work andwelfare recipients treated as employees. That seems clear, simple, andfair.

Taking away basic legal protections from workfare workers is alicense to exploit the most vulnerable working women and families.Its a statement that some women should work for wages below theminimum wage, tolerate more discrimination and sexual harassment, andhave fewer safety protections on the job. If she refuses sexual advances,or dangerous work without proper safety equipment, she will have nowhereto turn — the fig leaf of extending health and safety standards to her is justthat, a fig leaf. The Committee bill does not restore to her the sameremedies for challenging workplace safety that protect every otherAmerican worker.

No other program has ever required workers to work atsubminimum wages. Counting child care, health insurance and foodstamps against wages means that no matter how many more hours these

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women work, their pay will never increase. Such services should keepworking families afloat, not drag them down.

And, it unfairly pits welfare recipients against the working poor, whoare better off but only marginally so. It opens the door for the conclusionthat employers should be permitted to subtract the cost of health benefitsfrom the minimum wage earnings of non-welfare workers or that employer-provided child care now count against the wages of the minimum wageworker not on welfare.

To illustrate the unfairness of the policy, let's consider how it wouldactually work. Consider two cities — one contracts out its parkmaintenance work to the private sector, the other pays city employees todo it. Under the Committee bill, a welfare recipient doing parkmaintenance in one city will get the minimum wage and all laborprotections and benefits, while the other welfare recipient does the samejob and works off her welfare, housing and Medicaid. How is thatequitable?

The Democratic Members of the Committee tried, in vain, to protectworkers from this subminimum wage. Rep. Pete Stark (D-CA) offered anamendment to strike the offending language. The Republican majorityrejected the Stark amendment, by a party-line vote of 16 to 22 (Rep. JerryWeller (R-IL) was absent).

If payment of a liveable wage is a threat to job placement as theparticipation requirements increase for States in the later years, we shouldaddress these issues through bipartisan discussions with Federal andState officials, not by an across-the-board swing at welfare recipients goingto work. Our Republican colleagues have often pointed out that decliningcaseloads have left most States with a windfall of finds, at least in the earlyyears. It is our view that States should be investing those funds inaggressive education, training and work activities now so that recipientsare prepared when time limits and tough participation rules take effect.

The Republican Bill Lets States Hurt the Low-Income Elderly and

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Disabled — We Cannot Support It

In the 1970's, when the Federal SSI program was created to provideincome support to poor elderly, blind, and disabled Americans, someStates already provided such benefits. To make certain that the aged,blind, and disabled received the full value of their SSI check — every year— Congress enacted a State maintenance-of-effort requirement, that madecertain that States passed on to all SSI recipients any Federal benefitincrease. Otherwise, each dollar that the Federal government intended togo into the pocket of the elderly, blind, and disabled would, instead, end upin State treasuries.

The Republican majority — at the urging of California Governor PeteWilson — decided State flexibility was more important than helping elderly,blind and disabled Americans avoid poverty, so they used the budgetreconciliation bill to propose a repeal of the SSI maintenance-of-effortrequirement. Worst case, 2.8 milUon SSI recipients are at risk of becomingpoorer from this provision; more than 350,000 of them could lose Medicaidentirely. Of course, that was not part of the budget agreement.

The American Association of Retired Persons (AARP) says it best, intheir etter to Members of the Committee opposing the Archer and Shawmarks on this point: "If the maintenance of effort requirement is repealed,many of our most vulnerable citizens who are &derly and disabled wou'dface serious and irreversible economic hardship. (Emphasis ours)

Probably the most remarkable aspect of this proposal is that it hasabsolutely no effect on the Federal budget — or the deficit. There are nofederal savings involved because there is no Federal spending on SSIsupplements. At issue is State spending — and the question of whetheror not Federal SSI benefit increases will actually reach the &derly anddisabled citizens for whom we authorized them, or wind up, instead, inState treasuries. And remember, all we are asking States to do ismaintain their SSI supplements at the level they paid in 1983— fourteenyears ago!

The Democratic Members of the committee, led by Rep. Bob Matsui

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(D-CA), proposed to protect SSI recipients from the potential loss of StateSSI supplements. The Republican majority rejected that amendment by astraight party-line vote of 16 to 23.

The Republican Bill Hurts Disabled Legal Immigrants — We CannotSupport It

A cornerstone of the bipartisan budget agreement was therestoration of benefits to certain legal immigrants made ineligible for SSIand Medicaid under the new welfare reform law. President Clinton madeclear when he signed the new law that he thought the cuts affecting legalimmigrants went too far and vowed to restore them.

The Committee bill violates the bipartisan budget agreement —accepted by House and Senate leaders of both parties — which explicitlystates that legal immigrants, who were in our country on August 22, 1996,would be eligible for SSI benefits regardless of when they becomedisabled.

Instead, Republicans have proposed to trade one group of humanbeings for another group, offering to "expand" coverage to all elderly legalimmigrants currently on SSI, in exchange for eliminating it for those whobecome disabled in the future. According to the Social SecurityAdministration, this results in the restoration of 75,000 fewer recipients inFY 2002 and 125,000 fewer by FY 2007 than the budget agreement policy.And, it means that any legal immigrants present by August 22 of last year,who qualify as disabled after that date, can never get benefits.

To correct this inequity, Rep. Xavier Becerra (D-CA) proposed toadd the so-caUed disabled after entry" to the Republican policy ofgrandfathering. The Republican majority rejected this amendment, by avote of 19 -20, even though the addition of this amendment left the wholelegal immigrants package within striking distance of the $9.7 billion allowedby the budget agreement. (Three Republicans — Reps. Thomas (R-CA),Johnson (R-CT) and Collins (R-GA) supported the Becerra amendment.)During deliberations by the Subcommittee on Human Resources, RankingMember Rep. Sandy Levin (D-MI) proposed to simply replace the Shaw

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legal immigrants policy with what was in the budget agreement. That toowas spurned by the Republican majority.

Education and Teen Parents — A Reasonable Middle Ground

There were a few brighter moments during consideration of thislegis'ation. After a spirited debate, the Democratic Members of theCommittee managed to convince a majority that it would be a mistake to pitteenagers on welfare who need to go to school against other welfarerecipients who haven't finished their basic high school education. TheChairman's mark had proposed to limit (to 30 percent of those subject tothe work requirements) the number of TANF recipients who can be invocational education and still meet the work requirement; teen parents —who everyone agrees need to go to school — would have been included inthat limitation, making it difficult for the 40 percent of all welfare recipientswho lack a high school degree to pursue that goal.

To correct this problem, the Committee adopted, with the support offour Republican Members — Mrs. Johnson, Mr. Bunning, Mr. Houghton,and Mr. Collins — and all 16 Democrats, an amendment by Rep. BarbaraKen nelly (D-CT) removing teen parents from the calculation of thevocational education limit.

It should be noted that the Repubhcan majority rejected, by a straightparty-line vote of 16 to 21 (Mr. Ramstad and Mr. Nussle were absent),what would have been the. best approach. Rep. Pete Stark (D-CA)proposed to strike the language of the bill and retain the present law limiton vocational education, which is 20 percent of the total TANF caseload.This would have given States the most flexibility, enabling them to tailortheir work requirements to the actuai needs of recipients. The NationalGovernors' Association, the National Conference of State Legislators, andthe American Public Welfare Association, all supported the two Democraticamendments.

A Bipartisan Welfare-to-Work Program

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The on'y bipartisan discussions in the human resource area occurredin drafting the welfare-to-work initiative. The budget agreement includesfunding for a $3 billion welfare-to-work program designed to help long-termwelfare recipients and those facing an imminent loss of benefits due to atime limit to find work.

To carry out this responsibility, the Democratic Members began bycrafting a set of principles by which we would evaluate legislativeproposals for the welfare-to-work funds. In summary, we concluded thefollowing:

Purpose.— The $3 billion in capped mandatory funds for a welfare-to-work initiative should be used only to expand the supply of jobs for low-skilled workers at high risk of reaching welfare time limits.

Eligible participants.-- For this grant program, eligible participantsshould be limited to those TANF recipients who have had no significantwork experience in the past 3 years, who have received cash assistancefor more than 36 months, and who have participated in a structured jobsearch program under TANF without securing employment. Our goal wasto assure that the program concentrated its resources to the hardest toemploy recipients.

Distribution of funds.-- Grants should be awarded by theDepartment of Labor, in consultation with the Departments of HHS andHUD, to both States and communities on the basis of merit to thoseproposing the most innovative and promising approaches to creating jobopportunities for hard to employ welfare recipients.

A substantial portion of all grants should be awarded to those areasof a State with the highest combination of poverty, unemployment, and jobshortage, without unnecessary duplication of effort between the State andcommunity grants. One percent of avaflable funds should be reserved forevaluation. The remaining funds should be awarded on merit to the entityin the State responsible for meeting the TANF work requirements, withauthority for that agency to contract for any allowable activity. Any unused

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funds should be reaflocated to qua'ified applicants and grantees.

Allowable activities.— Under these grants States and communitiesshould be permitted to offer any combination of the following activities (1)wage subsidies to expand the supply of private sector jobs; (2) job creationin private nonprofit or public agencies designed to address pressingcommunity needs; (3) contracts with job placement companies or publicjob placement programs; (4) job vouchers; and (5) job retention or supportservices for employment purposes. The program should include strongassurances of nondisplacement and nondiscrimination.

Performance bonuses.-- A portion of the funds should be set asidein later years for performance bonuses to States to reward placement andretention of long-term TANF/AFDC recipients in permanent jobs.

HHS role.-- Grants should be awarded to a State only if theDepartment of Health and Human Services determines that (1) the Statecannot meet its TANF work requirements without additional funds; (2) totalState spending on TANF work activities in the prior fiscal year exceededState spenthng on JOBS programs in fiscal year 1996; (3) the State hasmet 100 percent of its maintenance-of-effort requirements under TANF;and (4) the State has the ability and resources to carry out the proposedproject.

Nearly all of these Democratic goals were achieved in the version ofthe welfare-to-work program included in the Committee bill. At the urgingof the Administration and the Democratic Members, half the new fundswere reserved for competitive grants, the remainder to each State byformula, with instructions that the funds go to sub-State areas with highunemployment, poverty and welfare caseloads. The competitive fundswould be spent among rural areas and the 100 poorest cities.

The eligible population was carefully targeted to assure that thoseleast likely to find a job on their own will be a priority for these grant fundsand that the State and local TANF agencies and JTPA agencies worktogether to deliver on the job creation promise.

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Two important amendments were offered during Committeedeliberations on the budget reconciliation bill and should be noted here.

First, Rep. Ben Cardin (D-MD) offered an amendment whichextends to the new welfare-to-work grant the same basic labor protections,including anti-displacement language, that the House overwhelminglyapproved as part of its workforce bill. It was adopted by voice vote. It is

the view of the Democratic Members of the Committee that these sameprotections should be extended to all TANF recipients, whether or not theyparticipate in the welfare-to-work initiative. This would be the fairest andsimplest approach.

Second, Rep. John Tanner (D-TN) offered an amendment thatwould have created a performance bonus for the new welfare-to-workblock grant, making certain that extra funds are awarded to those projectsthat do the best job of placing, and retaining, welfare recipients. TheRepublican majority rejected this amendment, by a vote of 16 to 19 (Rep.Ensign (R-NV) voted for the Tanner amendment; Reps. Neal (D-MA),Thomas (R-CA), Nussle (R-IA), Johnson (R-TX) were absent).

We are especially troubled that the Republican majority would notestablish the principle of performance-based funding for this new grantprogram. Although we understand that it will be difficult to identify precisemeasures of performance and worry about skewing program designtowards those easiest to place and retain in jobs, we believe it is a mistaketo miss this opportunity to establish the principle that we expect results forour investment.

We know too little about what works and doesn't and even less aboutwhat needs to be done for the hardest to employ. Past programevaluations have usually focused on job retention measures of 18 months,or less, hardly enough time for us to judge placement of long-term welfarerecipients to be a true success. Even if the actual bonuses must wait untillater in the program, it would be much better, in our view, for work to beunderway on such measures now. With continuing scarce resources toinvest in these programs, it is all the more important that we be able todistinguish among the best.

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Mixed Signals to the Parents of SSI Disabled Kids

Finally, we would like to note that the Committee bill would extendthe effective date for the SSI disabled children provision in the 1996welfare legislation for 6 months, from August 22, 1997 until February 22,1998. This would give the Social Security Administration neededadditional time to do redeterminations of the eligibility of children affectedby the 1996 law. This extension received bipartisan support as a part theof Welfare Reform Technical Corrections Act of 1997.

However, the Committee bill also includes language which wouldeffectively eliminate this new February 22, 1998, effective date. Bypermitting SSA to review any case 'as soon as practicable" after theeffective date, the language allows SSA to ignore the date and reviewcases at any time in the future. This review process should not bepermitted to go on indefinitely. Not only does it relieve SSA of its duty tocomply with the law by the stated effective date, it leaves children and theirparents uncertain as to whether they might be cut off at any time in thefuture.

Parents and children do not know the basis on which they wereawarded benefits. Thus, they do not know whether SSA has not reviewedtheir case because: (1) they are in a category that SSA is not required toreview under the new law or (2) SSA has just "missed" their case. Withouta specific effective date, every SSI disabled child wifi be left in indefiniteuncertainty as to his or her status. This will include miHions of children whowould otherwise have nothing to worry about, but for the indefinite natureof this effective date.

Our Conclusion — This Bill is Tough on Women, the Elderly, andDisabled Legal Immigrants — We Cannot Support It

If the Republican majority had been wiVing to live within the budgetagreement it would have been an easy matter to craft a welfare-relatedbudget reconciliation bill that enjoyed broad bipartisan support. The

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provisions in the budget agreement with respect to the restoration ofbenefits for legal immigrants were clear and a bipartisan agreement amongour leaders had been reached.

Republicans and Democrats had worked together to design awelfare-to-work initiative that was carefufly targeted to those most in needand distributed to those areas of the country experiencing the highestpoverty, unemployment, and welfare receipt. Had the majority stoppedthere, we would have no need for these dissenting views.

But the Republican majority didn't stop there. Instead, they chose tounravel the budget agreement, leaving thousands of disabled legalimmigrants without SSI and Medicaid. They chose to reopen the minimumwage debate, establishing a subminimum wage for women on welfare andleaving them unprotected from sexual harassment. And, they chose to letStates reduce or eliminate their SSI supplemental payments, potentiallyleaving millions of elderly and disabled recipients — 60 percent of whomare women — poorer.

That's not what the American people mean when they teli us theywant us to balance the budget and reduce their taxes. Along the way, theyexpect us to also protect children, the elderly and the disabled. Based onthis experience, we conclude that the Republicans have abandoned thesebasic values. It was with a clear conscience that all 16 of us voted "no."We can — and should — do better.

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/Additional Views of Ranking Democrat John Spratt

Some Democrats supported and others opposed the budget resolution, but all agree that the

reconciliation bills should comply with the Bipartisan Budget Agreement. This bill does not.

it includes a number of provisions that directly viojate the Budget Agreement or were never

part of it and go welt beyond its scope. We will keep working on the floor ami in conference to

see that the majonty keeps its commitments and makes necessary changes to the bill. Those of

us who voted for the bill in committee made clear that our votes on the floor will rest on theresolution of numerous outstanding issues, preferably by a self-executing nile.

Among the provisions that Democrats object to are:

(a) LM: S1.5 billion must be included for Medicaid to ease the impact of Medicare

Part B premiums on low-income Medicare beneficiaries. These funds were provided

both in the Bipartisan Budget Agreement and the budget resolution. Thereconciliation bill provides only $0.5 billion for this purpose. This money isimportant to protect low income Medicare beneficiaries who will be paying higherPart B premiums when the cost of home health care is shifted to the Part B. We

understand that a satisfactory resolution to this issue will be included in the nile for

consideration of the reconciliation bill.

(b) Children's Health: The Children's Health Assistance Program is unacceptable in its

present form because there is no safeguard that the $14 billion the bill provides will

reach the beneficiaries it is intended to help: uninsured children. CBO estimates that

the committee bill would extend Medicaid and insurance coverage to 520,000 children

each year who otherwise have been uninsured and to about 345,000 who have beeninsured even without the reconciliation bill. This is far short of the target of 5 million

additional insured children set forth in the Budget Agreement. At a minimum thebill should stipulate that the children's health care block grant be used solely toprovide medical insurance to children under the age of 19 who would otherwise be

uninsured.

(c) FLSAIMinimum Wage: The sections affecting the Fair Labor Standards Act andrelated labor laws should be struck. When TANF (Temporary Assistance for Needy

Families) beneficiaries take part in workfare in public sector and non-profit agencyjobs, they should receive the minimum wage and the basic protections other American

workers cenjoy. The 1988 Family Support Act dealt with the status of workfareparticipants. Experience with its provisions has been uneventful and there is no reasonnot to carry forward its provisions. We have proposed, therefore, as an alternative tothe bill the Family Support Act's definition of workfare. requiring that workfare serve

a useful public purpose, connected with social services, health or environmentalprotection, urban or rural development, welfare, recreation, public facilities, publicsafety, and day care. All of the above was set forth in Section 482(f)(1)A) of theSocial Security Act until it was repealed by the welfare reform law. We have also

1709

proposed that the hours of workfare be Calculated by adding TANF cash assistanceand Food Stamps and dividing that sum by the minimum wage. This was Section482(f)(1)(B)(i) of the Social Security Act before it was repealed. It is not onlyunprecedented but unworkable to impute other benefits to income. We also proposethat oie the TANF recipient has satisfied all workfare hours, other activities (such aseducation, training, and job search) should count toward meeting the required hoursof participation. We proposed borrowing two work standards from Sections 484(1)and (3) of the Social Security Act: (i) that each work assignment take into account thephysical capacity, skills, experience, health and safety, and family responsibilities ofthe workfare participant, (ii) that participants not be discriminated against on thebasis of race, sex, national origin, religion, age, or handicapping condition, and thatthey have rights available under applicable federal, state, and local laws prohibitingdiscrimination. This reasonable proposal is drawn from provisions of law that havebeen shown to be feasible. These provisions should be made part of the reconciliationbill by a self-executing rule, replacing provisions of the current text of the bill that areunfair and unworkable.

(d) Medicaid Eligibility for Disabled Children: The bill should amend SupplementalSecurity Income (SSI) so that children who lose eligibility for SSI benefits as a resultthe welfare reform law will still retain Medicaid benefits. The cost is nominal ($100million over 5 years), and it can be paid for by deducting it from funds allocated tothe children's health block grant. The total for all childien's health programs wouldiemain $16 billion, as called for the Budget Agreement.

(e) SSIJState Maintenance of Effort: The provision repealing current SSI statemaintenance of effort requirements should be struck to protect individuals from losingtheir SSI and Medicaid benefits. Since federal SSI payments are not at issue, strikingthis provision will not reduce the savings in the bill. Yet under the bill, 2.7 millionAmericans could receive smaller state SSI supplemental payments. About 350,000receive only state supplements because their Social Security check is virtually thesame size as the federal SSI benefit. For them, losing the state supplement meanslosing their entire SSI benefit and thus Medicaid eligibility.

(f) Disabled Legal 1rnmigrant: Both the budget iesolution and Budget Agreementexplicitly provide that all legal immigrants who entered the United States beforeAugust 23, 1996, will be eligible for Medicaid and SSI if they later become disabled.President Clinton has sent Chairman Kasich a letter promising to veto thereconciliation bill unless its immigrant provisions conform to the Budget Agreementby extending SSI and Medicaid to such immigrants. We hope that Congress will heedthe President's warning.

(g) Food Stamp Work Slots: The budget resolution anticipated that up to 350,000 moreworkfare slots for people between age 18 and 50 would be created and allocated $1

1710

billion to this end. But the bill authorizes some of the funds to be used for purposesother than to create work slots. The bill should be clear that the extra $1 billion canbe used on'y to create workfare slots for these people and not to pay for state FoodStamp administration costs or any other purposes.

(h) Medicare Solvency: The cost of home health care after 100 visits per year should betransferred from Medicare Part A to Part B in or step. This transfer is called for inthe Budget Agreement as well as in the bill reported by Commerce, but Ways andMeans proposes to transfer home health care costs in phases. Making the transfermuned ate ensures solvency of the Part A Trust Fund for at least 10 years, adding atleast 2 more years of assured solvency than a phased transfer.

(i) Medicaid for D.C. and the territories The Budget Agreement and budget resolutioninclude an additional $919 million to fund a higher Federal Medicaid match rate forthe District of Columbia and $250 million for an inflation adjustment for medicaidprograms in Puerto Rico and the territories. The reconciliation bill contained nofunds for either purpose, and these funds should be added to meet commitmentsmade.

(j) Multi-Employer Welfare Associations (MEWAs'): This proposal is controversial, wasnever included in the Budget Agreement or discussed in the budget xgotiations, andshould be deleted. It supplants state health insurance regulation and replaces it with•inadequate solvency standards administered by a federal agency with little expertise inthe field.

(k) Medical Savings Accounts: MSAs are also controversial and were never part of theBudget Agreement. In addition, the 500,000 MSAs permitted by this bill will costMedicare $2 billion over the next five years, according to CBO. The Senate hasheeded CBO's warning and limited MSAs to a demonstration level of 100,000. Thisis sufficient to test their merit as a Medicare alternative, and the bill should go nofurther than this limited level.

(1) Medica' Malpractice: The bill preempts state law and provides a two-year statute oflimitations and a five-year statute of repose, a $250,000 cap on non-economicdamages, and limits on punitive damages. It also allows collateral beifits inevideie. The provisions apply to all medical malpractice actions, not just casesinvolving Medicare and Medicaid. These provisions were not considered by theJudiciary CojniniUee, the committee with primary jurisdiction. They weT not part ofthe Budget Agreement and should no be bobtailed onto this bill and considered in thismanner.

(m) Food Stamp/Medicaid Eligibility Ptivatization: The bill allows states to privañzeFood Stamp and Medicaid eligibility determinations. Delegating an importantgovernment function like benefit eligibility to the private sector raises public policyissues that call for debate and careful consideration-something wholly lacking in this

4 _a—.' -—

1711

omnibus bill.

(n) Adminitratiye Cost Allncatinn: The bill grants student loan guaranty agencies anAdministrative Cost Allowance" equal to 0.85 percent of new loan volume from themandatory loan administrative funding account. The bill also allows guarantyagencies to keep a higher portion of recoveries on consolidated defaulted loans. Ina time when mandatory spending keeps growing and discret!onary spending keepsbeing squeezed, we should be wary of new direct spending devices. Neither of theseproposals s necessary for the solvency of guaranty agencies. They do not helpbalance the budget, and if done at all, they should be done in another bill.

This is an illustrative list of our objections, issues that Democrats must have resolvedbefore this bill can be called a Bipartisan Budget Agreement."

105TH CONGRESS I REPORT1st Session J

HOUSE OF REPRESENTATWES 105-152

PROVIDING FOR CONSIDERATION OF H.R. 2015, THE BAL-ANCED BUDGET ACT AND H.R. 2014, THE TAXPAYER RE-LIEF ACT

JUNE 25 (legislative day, JUNE 24), 1997.—Referred to the House Calendar andordered to be printed

Mr. SOLOMON, from the Committee on Rules,submitted the following

REPORT[To accompany H. Res. 1741

The Committee on Rules, having had under consideration HouseResolution 174, by a record vote of 9 to 4, report the same to theHouse with the recommendation that the resolution be adopted.

BRIEF SUMMARY OF PROVISIONS OF RESOLUTION

The resolution provides for consideration of H.R. 2015, "the Bal-anced Budget Act" and waives all points of order against its consid-eration. The rule provides three hours of general debate equally di-vided and controlled by the chairman and ranking minority mem-ber of the Committee on the Budget. The rule considers the amend-ment printed in the Congressional Record and numbered 1, asadopted. The rule further waives all points of order against theprovisions of the bill, as amended by the rule. Finally, the rule pro-vides one motion to recommit H.R. 2015, with or without instruc-tions.

In addition, Section 2 of the rule provides for consideration ofH.R. 2014, "The Taxpayer Relief Act", and waives all points oforder against consideration of the bill and against its provisions, asamended by the rule. The rule further provides three hours of gen-eral debate equally divided and controlled by the chairman andranking minority member of the Committee on Ways and Means.The rule considers the amendment printed in the CongressionalRecord and numbered 2, as adopted in the House and in the Com-mittee of the Whole. The rule provides for consideration of the bill,as amended, as an original bill for the purposes of further amend-ment. Furthermore, the rule provides for the consideration of an

39—008

2

amendment printed in the Congressional Record and numbered 1,only if offered by Representative Rangel of New York or his des-ignee, which shall be debatable for one hour equally divided andcontrolled by the proponent and an opponent, and which shall notbe subject to amendment or to a demand for a division of the ques-tion in the House or in the Committee of the Whole. All points oforder are waived against this amendment. Finally, the rule pro-vides one motion to recommit H.R. 2014, with or without instruc-tions.

COMMYrrEE VOTES

Pursuant to clause 2(l)(2)(B) of House rule XI the results of eachrollcall vote on an amendment or motion to report, together withthe names of those voting for and against, are printed below:

Rules Committee Rollcall No. 43Date: June 24, 1997.Measure: Resolution providing for consideration of HR. 2015, the

"Balanced Budget Act" and HR. 2014, the "Taxpayer Relief Act".Motion by: Mr. Moakley.Summary of motion: Make in order the Ros-LehtinenfMeek en

bloc amendment to preserve SSI and Medicaid benefits for elderlyor disabled legal immigrants who were in the country on August22, 1996, but were not getting benefits; offset by requiring theStates to reimburse the Federal government for some of the costsof administering the SSI program.

Results: Defeated 5 to 8.Vote by Members: Dreier—Nay; Goss—Nay; Linder—Nay;

Pryce—Nay; Diaz-Balart—Yea; Mclnnis—Nay; Hastings—Nay;Myrick—Nay; Moakley—Yea; Frost—Yea; Hall—Yea; Slaughter—Yea; Solomon—Nay.


"Balanced Budget Act" and HR. 2014, the "Taxpayer Relief Act".Motion by: Mr. Moakley.Summary of motion: Make in order the Kennedy of Massachu-

setts amendment which alters the funding formula for child healthinsurance coverage to ensure that States that have enacted statelaws to provide insurance for its uninsured children are not penal-ized.


Pryce—Nay; Diaz-Balart—Nay; Mclnnis—Nay; Hastings—Nay;Myrick—Nay; Moakley—Yea; Frost—Yea; Hall—Yea; Slaughter—Yea; Solomon—Nay.


"Balanced Budget Act" and HR. 2014, the "Taxpayer Relief Act".Motion by: Mr. Frost.

3

Summary of motion: Make in order the Barton/Minge amend-ment which incorporates buget targets into law and holds thePresident and Congress accountable if the actual budget outcomesdo not meet the budget agreement goals. The amendment furtherrequires (1) the President to submit any necessary corrections and(2) the Congress to vote on a proposal to correct any violation ofthe agreement.



Rules Committee Rollcall No. 46Date: June 24, 1997.Measure: Resolution providing for consideration of H.R. 2015, the

"Balanced Budget Act" and H.R. 2014, the "Taxpayer Relief Act".Motion by: Mr. Frost.Summary of motion: Adopt an amendment to the rule striking

the spectrum provision from the manager's amendment self-exe-cuted in this rule.




"Balanced Budget Act" and H.R. 2014, the "Taxpayer Relief Act".Motion by: Mr. Frost.Summary of motion: Adopt amendment to the rule—self-executed

strike of the Agriculture and Commerce Committee provisions thatallow administrative determinations of Medicaid and food stampeligibility to be privatized.




"Balanced Budget Act" and H.R. 2014, the "Taxpayer Relief Act".Motion by: Mr. Frost.Summary of motion: Make in order the Taylor of Mississippi

amendment to give guaranteed health coverage to military retireeswhen they become Medicare-eligible.


Pryce—Nay; Diaz-Balart—Nay; Mclnnis—Nay; Hastings—Nay;

4

Myrick—Nay; Moakley—Yea; Frost—Yea; Hall—Yea; Slaughter—Yea; Solomon—Nay.


"Balanced Budget Act" and HR. 2014, the "Taxpayer Relief Act".Motion by: Mr. Hall.Summary of motion: Make in order three Brown of Ohio amend-

ments offered en bloc: reduces the number of medical savings ac-count demonstration policies from 500,000 to 100,000, and usesthat savings to cover co-payments for Medicare prevention serviceslike mammography; continues Medicaid eligibility for disabled chil-dren who lose their SSI benefits under welfare reform; and ensuresthat the child health insurance provided to the states may only beused for that purpose.




"Balanced Budget Act" and HR. 2014, the "Taxpayer Relief Act".Motion by: Mrs. Slaughter.Summary of motion: Make in order the McDermottlMatsui

amendment that strikes a provision in the bill which would permitemployers to reclassify their workers as independent contractors,thereby eliminating worker protections and pension benefits.


Pryce—Nay; Diaz-Balart—Nay; Mclnnis—Nay; Hastings—Nay;Myrick—May; Moakley—Yea; Frost—Yea; Hall—Yea; Slaughter—Yea; Solomon—Nay.


"Balanced Budget Act" and H.R. 2014, the "Taxpayer Relief Act".Motion by: Mr. Dreier.Summary of motion: Order the rule reported.Results: Adopted 9 to 4.Vote by Members: Dreier—Yea; Goss—Yea; Linder—Yea; Pryce—

Yea; Diaz-Balart—Yea; Mclnnis—Yea; Hastings—Yea; Myrick—Yea; Moakley—Nay; Frost—Nay; Hall—Nay; Slaughter—Nay; Solo-mon—Yea.

SUMMARY OF AMENDMENT CONSIDERED AS ADOPTED BY THE RULE TOH.R. 2015—THE BALANCED BUDGET ACT

This manager's amendment consists of changes from reconcili-ation legislation reported to the Committee on the Budget that willbe self-executed in the rule on reconciliation at the request of the

5

Chairman of the Committee on the Budget. The manager's amend-ment makes the following changes from the reported legislation:

Low-Income Medicare Premium Protections. Provides an addi-tional $1 billion for low-income Medicare premium protections,bringing the total to $1.5 billion over 5 years. The provision coversthe full Medicare Part B premium for seniors with incomes up to135 percent of poverty. For seniors with incomes between 135 per-cent and 175 percent of poverty, the assistance covers that portionof the Medicare Part B premium increase attributable to the homeheath spending transfer.

Minimum Wage/Welfare-to-Work Participant Protections. Con-tains the following changes from the reported legislation:

• Limits to no more than 40 hours per week the number of hoursparticipants in public sector or nonprofit workfare activities can berequired to work.

Counts only Temporary Assistance for Needy Families ETANF]and food stamp benefits as compensation under the minimum wagefor workfare participants.

Adopts the AFDC JOBS criteria for defining work experience andcommunity service jobs when States use workfare in the public ornonprofit sector to meet State work participation requirements,and uses the same criteria for determining whether participantsare "employees" under the terms of the Fair Labor Standards Act.

Adopts worker protection and nondiscrimination provisions (pre-venting discrimination based on age, race, gender, and disability),but provides for an independent nonfederal grievance resolutionprocedure.

Incorporates worker displacement language, which applies to allworkfare participants and which does not preempt stronger Statedisplacement laws.

Food Stamp Work Slots. Eliminated "job search" as a qualifiedactivity for additional food stamp work slot funds, and raises to 80percent (from 75 percent) the earmarked funds for people between18 and 50 years old who may lose food stamp benefits due to newwork requirements.

Medicaid. Drops language in Medicaid section that allows onlyphysicians to decide appropriate hospital stays. This language wasadded to bring the Committee on Commerce closer to compliancewith its reconciliation directives.

Children's Health Care. Modifies the children's health care blockgrant to ensure that it complies with the Bipartisan Budget Agree-ment's proposed spending $16 billion over the next 5 years.

Medicaid Coverage for SSI Children. Provides $100 million toallow States the option of maintaining Medicaid benefits for chil-dren currently on the Medicaid rolls who would otherwise loseMedicaid eligibility because of stricter SSI eligibility standards.

Spectrum Auctions. Increases from $9.7 billion to $20.3 billionover 5 years the receipts due to spectrum auctions. Drops or re-laxes numerous conditions specified in the Commerce Committee'sreported legislation that restricted the Federal CommunicationCommission's ability to auction spectrum. Also specifies additionalspectrum to be made available for auction.

Welfare to Work. Requires that all of $3 billion in welfare-to-workfunds be obligated by fiscal year 1999.

6

Multiple Employer Welfare Arrangements. Modifies language onMultiple Employer Welfare Arrangements to overcome jurisdic-tional issue between the Committees on Education and theWorkforce and Ways and Means.

Veterans' Medical Care. Allow veterans hospitals to retain, sub-ject to appropriations, medical care cost recovery receipts, so thatveterans' medical care remains a discretionary program.

Budget Enforcement. Budget process changes that are consistentwith the Bipartisan Budget Agreement (see attached summary).

SUMMARY OF BUDGET ENFORCEMENT CHANGES

Congressional Budget & Impoundment Control Act of 1974Permanently extends the requirement that budget resolutions

cover a five-year period.Similarly, extends indefinitely the enforcement of the five-year

spending and revenue levels set forth in budget resolutions throughpoints of order.

Simplifies and updates points of order that are used to enforcethe budget resolution's spending and revenue levels.

Provides for adjustments in the budget resolution levels for legis-lation appropriating funds for designated emergencies, arrearagesand the International Monetary Fund.

Eliminates the need to waive the Budget Act for a reported billthat violates the Act but is cured by a self-executing rule. In suchcases, the point of order no longer lies against the bill.

Amendments to the Balanced Budget and Emergency Deficit ControlAct of 1985

Adjusts and extends statutory discretionary spending limits,which are enforced through sequestration, through fiscal year 2002.

Provides for adjustments in the discretionary spending limits forappropriations for emergencies, arrearages, and the InternationalMonetary Fund.

Extends pay-as-you-go requirements, which provide that entitle-ment and tax legislation must be fully offset, through fiscal year2002.

Modifies baseline that is used to "score" legislation so that com-mittees get credit for eliminating entitlement programs.

Eliminates accrued paygo balance and savings from reconcili-ation to ensure that all savings are used for deficit reduction.

SUMMARY OF AMENDMENT CONSIDERED AS ADOPTED BY THE RULE TOH.R. 2014—THE TAXPAYER RELIEF ACT

I. Modifications to the child tax creditThe amendment would provide that in the case of lower- and

middle-income taxpayers, the otherwise allowable child tax creditis not reduced by one-half of the otherwise allowable dependentcare credit. Under the amendment, the reduction only applies totaxpayers above certain thresholds of modified adjusted gross in-come ("modified AGI"). For married taxpayers filing joint returns,the threshold is $60,000. For taxpayers filing single or head ofhousehold returns, the threshold is $33,000. For married taxpayersfiling separate returns, the threshold is $30,000. The reduction is

7

phased in over the first $10,000 ($5,000, in the case of single indi-viduals and $5,000, in the case of married individuals filing sepa-rate returns) of modified AGI above the threshold. The rules for de-termining a taxpayer's modified AGI and marital status under thebill remained unchanged. The effective date would be years begin-ning on or after January 1, 2000.

The amendment would provide that the Secretary of the Treas-ury shall submit notice to all taxpayers of the passage of the childtax credit. In addition, the amendment would direct the Secretaryof the Treasury to modify withholding tables for single taxpayersclaiming more than one exemption and for married taxpayersclaiming more than two exemptions to take account of the effectsof the child tax credit. The adjustments to the withholding tableswould apply to employees whose annualized wages from an em-ployer are expected to be at least $30,000, but not more than$100,000.

2. Estimated tax safe harborThe amendment would change the 110-percent-of-last-year's-li-

ability estimated tax safe harbor to a 105-percent-of-last-year's-li-ability safe harbor for 1998.3. Repeal alternative minimum tax depreciation adjustment

The amendment would direct the Secretary of the Treasury toconduct a study of whether the repeal of the depreciation adjust-ment for minimum tax purposes would have the result of permit-ting any corporation with taxable income from current year oper-ations to pay no Federal income tax and, if so, the policy implica-tions of that result. The study would be due no later than January1, 2001, to the House Committee on Ways and Means and the Sen-ate Committee on Finance.4. Airport and Airway Trust Fund excise taxes

The amendment would provide that the deposit rules with re-spect to the commercial air passenger excise taxes are modified topermit payment of these taxes that otherwise would have been re-quired to be deposited during the period July 1, 1998, through Sep-tember 30, 1998, to be deposited on October 13, 1998.

5. Modification to tax benefits for ethanol and renewable sourcemethanol

The amendment would delete those provisions in the bill relatingto a reduction in tax benefits for ethanol and renewable sourcemethanol.

6. Name of the actThe amendment would change the name of the Act from the

"Revenue Reconciliation Act of 1977" to the "Taxpayer Relief Act of1997".

7. Change in budgetary treatment of certain expiring provisionsThe amendment would amend the Balanced Budget and Emer-

gency Deficit Control Act of 1985 to provide that any preferentialrate (or any credit or refund) that is scheduled to expire and that,

8

under current scorekeeping conventions, is presumed to be ex-tended for purposes of determining the present-law revenue base-line shall, for budget scorekeeping purposes, be assumed to expireon the scheduled expiration date.

0

PROVIDING FOR CONSIDERATIONOF H.R. 2015, BALANCED BUDGETACT OF 1997, AND H.R. 2014, TAX-PAYER RELIEF ACT OF 1997Mr. SOLOMON. Mr. Speaker, by di-

rection of the Committee on Rules, Icall up House Resolution 174 and askfor its immediate consideration.

The Clerk read the resolution, as fol-lows:

H. RE5. 174Resolved, That upon the adoption of this

resolution it shall be in order without inter-vention of any point of order to consider inthe House the bill (H.R. 2015) to provide forreconciliation pursuant to subsections (b)(1)and (c) of section 105 of the concurrent reso-lution on the budget for fiscal year 1998. Thebill shall be considered as read for amend-ment. The amendment printed in the Con-gressional Record and numbered 1 pursuantto clause 6 of rule XXIII shall be consideredas adopted. All points of order against provi-sions in the bill, as amended, are waived. Theprevious question shall be considered as or-dered on the bill, as amended, to final pas-sage without intervening motion except: (1)three hours of debate equally divided andcontrolled by the chairman and ranking mi-nority member of the Committee on theBudget; and (2) one motion to recommit withor without instructions.

SEC. 2. At any time after the adoption ofthis resolution the Speaker may, pursuant toclause 1(b) of rule XXIII, declare the Houseresolved into the Committee of the WholeHouse on the state of the Union for consider-ation of the bill (HR. 2014) to provide for rec-onciliation pursuant to subsections (b) (2) and(d) of section 105 of the concurrent resolutionon the budget for fiscal year 1998. The firstreading of the bill shall be dispensed with.All points of order against consideration ofthe bill and against provisions in the bill, asamended by this resolution, are waived. Gen-eral debate shall be confined to the bill andshall not exceed three hours equally dividedand controlled by the chairman and rankingminority member of the Committee on the

CONGRESSIONAL RECORD — HOUSEWays and Means. After general debate thebill shall be considered for amendment underthe five-minute rule. The amendment print-ed in the Congressional Record and num-bered 2 pursuant to clause 6 of rule XXIIIshall be considered as adopted in the Houseand in the Committee of the Whole. The bill,as amended, shall be considered as the origi-nal bill for the purpose of further amend-ment and shall be considered as read. Noother amendment shall be in order exceptthe further amendment printed in the Con-gressional Record and numbered 1 pursuantto clause 6 of rule XXIII, which may be of-fered only by Representative Rangel of NewYork or his designee, shall be considered asread, shall be debatable for one hour equallydivided and controlled by the proponent andan opponent, shall not be subject to amend-ment, and shall not be subject to a demandfor division of the question in the House orin the Committee of the Whole. All points oforder against that amendment are waived.At the conclusion of consideration of thebill, as amended, for amendment the Com-mittee shall rise and report the bill, asamended, to the House with such furtheramendment as may have been adopted. Theprevious question shall be considered as or-dered on the bill, as amended, and any fur-ther amendments thereto to final passagewithout intervening motion except one mo-tion to recommit with or without instruc-tions.

The SPEAKER pro tempore (Mr.COMBEST). The gentleman from NewYork [Mr. SOLOMON] is recognized for 1hour.

Mr. SOLOMON. Mr. Speaker, for thepurposes of debate only, I yield 30 min-utes to the gentleman from Massachu-setts [Mr. MOAKLEY], pending which Iyield myself such time as I mayconsume. During consideration of theresolution, all time yielded is for thepurposes of debate only.

(Mr. SOLOMON asked and was givenpermission to revise and extend his re-marks and to include extraneous mate-rial.)

Mr. SOLOMON. Mr. Speaker, HouseResolution 174 is the customary struc-tured rule for the consideration of abudget reconciliation bill. In this case,the rule provides for the considerationof reconciliation legislation in twoparts, which reflects the bipartisanbudget agreement reached betweenCongress and the White House on May2, 1997.

Mr. Speaker, this rule first waives allpoints of order against the consider-ation of the legislation, the BalancedBudget Act. The rule provides 3 hoursof debate on the entitlement reformbill, equally divided and controlled bythe chairman and ranking member ofthe Committee on the Budget.

The rule also considers the amend-ment printed in the CONGRESSIONALRECORD and numbered 1 as adoptedupon the adoption of this rule. Thisamendment by the gentleman fromOhio [Mr. KASICH] reflects hours of ne-gotiations between Democrats and Re-publicans and between the White Houseand this Congress, both bodies of thisCongress.

This amendment attempts to resolvemany of the outstanding issues relatedto our bipartisan efforts to reform theNation's out-of-control entitlement

H4385spending. And we all know that it is to.tally out of control.

The rule further waives all points oforder against the provisions of the billas amended by the rule. After the con-clusion of the 3 hours of debate, therule provides for one motion to recom-mit, with or without instructions.

Yesterday, we informed the minoritymembers of the Committee on Rulesthat we were prepared to grant a ruleallowing one Democrat substitute to beoffered by the minority leader or hisdesignee. However, we were informedyesterday that such a substitute wouldnot be offered, even though we werewilling to make that amendment inorder.

0 1145In addition, section 2 of the rule pro-

vides for consideration of the secondpart of this reconciliation product, theTaxpayer Relief Act. The rule waivesall points of order against consider-ation of this bill and against its provi-sions as amended by the rule. The rulefurther provides another 3 hours ofgeneral debate on this tax cuttingmeasure, equally divided and con-trolled by the chairman and the rank-ing member of the Committee on Waysand Means. The rule also considers theamendment printed in the CONGRES-SIONAL RECORD and numbered 2 asadopted in the House and in the Com-mittee of the Whole. This amendment,drafted by the gentleman from Texas[Mr. ARCHER], reflects further negotia-tions between the various interestedparties involved in the implementationof the tax portion of this bipartisanagreement with the White House.

Furthermore, the rule provides forthe consideration of a substituteamendment printed in the CONGRES-SIONAL RECORD and numbered 1 only ifoffered by the gentleman from NewYork [Mr. RANGEL] or his designee.

Mr. Speaker, this amendment is de-batable for 1 hour equally divided andcontrolled by the proponent and an op-ponent, and is not subject to amend-ment or to a demand for a division ofthe question in the House or in theCommittee of the Whole and all pointsof order are waived against the amend-ment. This amendment, offered by thegentleman from New York [Mr. RAN-GEL], the ranking Democrat on theCommittee on Ways and Means, rep-resents the minority substitute to thetax bill.

Finally, the rule provides for one mo-tion to recommit, with or without in-structions.

Mr. Speaker, after hearing testimonyup in the Committee on Rules yester-day for more than 5 hours and frommore than 40 witnesses, the Committeeon Rules has produced a rule that isvery similar to that used on reconcili-ation bills going all the way back tothe 96th Congress, over two decades.Furthermore, after consultation withthe minority and our committee, weactually extended the total debatetime on the two bills from 5 hours to 7

June 25, 1997

H4386hours. We have made every effort tomake this a bipartisan rule to considerthis bipartisan balanced budget agree-ment. I would urge all my colleagues tosupport it.

Mr. Speaker, as to the contents ofthese bills, I can sum up their signifi-cance in two short statements:

First, the first balanced budget in 30years. Second, the first major tax cutin 16 years.

While these two bills before us con-tain a variety of provisions, I want tofocus on one in particular. In introduc-ing his tax cut plan to the Americanpeople back in 1962, then PresidentJohn F. Kennedy stated:

Prosperity is the real way to balance thebudget. By lowering taxes, by increasingJobsand incomes, we can expand tax revenuesand finally bring our budget into balance.

President Kennedy was right thenand the bill before us today representsthose truths.

Mr. Speaker, over the past two dec-ades, this Congress has held this samedebate over and over and over again.How can we reduce the tax burden, re-duce the deficit and balance the budgetat the same time? Today's budgetagreement is quite a different approachthan has been tried in previous budgetagreements. For instance, in 1990, Con-gress and the President, and at thattime the President was George Bush,negotiated a bipartisan budget agree-ment in an effort to reduce the deficitonly to result in a $100 billion tax in-crease and an unbalanced budget. Thatis what happened under a RepublicanPresident and a Democrat Congressback in 1990.

Three years later, in 1993, the Presi-dent, that is Bill Clinton, and congres-sional Democrats, who were in controlof this place at that time, gathered to-gether and negotiated another budgetdeal to reduce the deficit. This timethe result was a $200 billion tax in-crease, the largest tax increase in the

CONGRESSIONAL RECORD — HOUSE

history of this Nation, and still no bal-anced budget.

A year later, in 1994, the Americanpeople called on their government totry a new approach, to take a new lookat an old approach used in previousdecades under Presidents such as JohnF. Kennedy and Ronald Reagan. At thevery beginning of the 104th Congress,the new Republican majority, in fullagreement with President John F. Ken-nedy's assertion back in 1962, sought toprovide the American family withmeaningful tax cuts and a balancedbudget. We are all very familiar withthe extensive debates over tax relief inthe past Congress. Despite all the talk,the American family still remainsovertaxed and overburdened by its Gov-ernment. That is this Government thatwe stand in here today.

Some of my colleagues may chucklea little over this statement, exclaimingthere goes JERRY SOLOMON again withhis Reaganomics outlook on the world,but it is a fact that in the past 16years, this Congress has raised our Na-tion's taxes over 5 times and by hun-dreds of billions of dollars. We have notcut taxes, we have raised taxes righthere in this body. As a result, it is noexaggeration for me to say that theAmerican family pays a much higherpercentage of its hard-earned incomein taxes right now today than at anytime in recent history.

Today we have before us a budget billthat represents the first major tax cutin 16 years. Mr. Speaker, it is major.While we have had much larger tax re-lief packages before this House overthe past few years, the probability thatthis tax relief bill will receive biparti-san support and be signed into law ismuch, much higher than those pre-viously before us and that should berecognized here today. This is going tobecome law.

Furthermore, contrary to what weare going to hear from the other side

June 25, 1997

today, from some Members of the otherside because many Members on theDemocrat side are going to supportthis measure, the majority of this taxrelief, 72 percent of it, will go to mid-dle-income wage-earning families mak-ing between $20,000 and $70,000. Thiswill better enable all of America's fam-ilies to care for their children and theircommunities and represents a goodfirst step in rolling back the high levelof the Government's financial inter-ference in the lives of these hard-working families.

Finally, Mr. Speaker, it should benoted that these two bills before ustoday actually carry changes in the un-derlying laws that deliver the tax cutsand the spending cuts. This is very,very important, especially to some ofthe younger Members because in yearspast we have adopted budgets that putus on a glide path to a balanced budget,but when it came to making the hardvotes, we did not do it, we abandonedit, and that is why the deficits contin-ued. It is easy to vote for legislationthat actually calls for these cuts to bedone as we did in the budget agree-ment, and everybody sent out theirpress releases on it. It is quite some-thing different to actually vote forthese cuts. I urge all of the Membershere today to support these bills andthen follow through on the 13 appro-priation bills that will follow, becausethat is where it is going to count.

Members have my pledge that I amgoing to vote for every one of thesecuts represented in this agreementwith the Republicans and Democrats inthis House, with the Senate, and withthe President. These are the kind ofbills that actually make a difference. Iapplaud all of my colleagues on bothsides of the aisle.

Mr. Speaker, I include the followingextraneous material for the RECORD:

HOUSE RECONCILIATION RULES 1980—1996

Congress and year Bill No. Rule No, Terms of wle

96th (1980) H.R. 7765 H. Res. 776 10-hours general debate (1-). ea. To 8 comms.. 2-us. Ways and Means); 4 amendments aHowed; (1) BudgetComm.; (2) Stiike &ibtite; (3) Rep. Vanik (0); (4) Rep. Bauman (R); one mIon 10 recommit.

of amendment in the of substitute by chairman of Budget Comm.; 697th (1981) H.R. 3982 H. Res. 169 8-his. General debate, coffims. juris.;

amendments by Rep. latta; 1-hr.; one motion to recommit.C11m.; amendment in nature of substitute made in 1 amendment by thmn. Budget

98th (1983) HR. 4169 H. ReS. 344 1-If. gen. debate BudgetComm.; one motion to recommil. with or without Instnictions.

W&M C11m., 1Iy; (2) amend, by Rep. Pepp, 30-mins.; one98th (1984) HR. 5394 H. Res. 483 6-tws. gen. debate, Budget by

notion to recommit.Fazio, 30-mins.; Latta, 1-I1; (3) Rep.

99th (1985) HR. 3500 H. Res. 296 4-his. gen. debate, Budget Comm.; sell-exeQite (1) Rep. Rep.

Florto, 30-mins; one motIon 10 recommit.Rodino, 30-mins.: (2) Rep. Rodino, 30-mins.; (3)

99th (1986) H.R. 5300 H. Res. 558 3-In's. gen. debate, Budget C11m.; self-execute Rep.

Rep. ViIie, 3-mins.; one motion to recommit witiit inIUCtiS.Comm.; selfexecute amend.; (1) Rep Michel, 1-I1; one motion to recommit without in-

100th (1987) HR. 3545 H. Res. 296/298 3-his. gen. BudgetStflJCtiOns.

R—3), debate from 30-mins. 10 2-101st (1989) HR. 3299 H. Res. 2451249 6-his. gen. debate, Budget Ciim.; self-eiecute 10

Iws. ea. (varies by amendment); oe motion to recommit.amends.; (1) Rostenkowski, 1-IT.: one motion 10 reciimit

101st (1990) HR. 5835 H. Res. 509 3-his. gen. debate, Budgetwithjt instiuctions.

Kasich jbstItute. (290 pages). 1-IT.; one motion to103d (1993) HR. 2264 H. ReS. 186 2-tws. gen. debate; self-execute amend. (54 page); (1) Rep.

recommit without instructions.debate, Committee; self execute amend-

104th (1995) HR. 2491 H. ReS. 245 3-ITs. gen. debate (via. u.c. request); an additional 3-us. gen. Budgetment in the nature of a substitute; 1 substitute amendment if off&ed by the Mirwity Lead& or his designeedebatable for 1 how; one motion to recommit WtICh may contain instluctions if offed by the Minctity Leader((his designee.

Comm.; self amendment in natwe of substitute; 1 amendment if offed by104th (1996) HR. 3734 H. Res. 482 2-hrs. gen. debate. Budget

the chairman of the Budget Committee or his designee debatable for 20 minutes.; one motIon to recommLwith or without ins Vuctions.

June 25, 1997REPORT LAYOVER PERIOD FOR RECONCILIATION BILLS,

1980—1996

Congress and year Report

fliedBill con-sided

Layover

period(days)

Mr. Speaker, I reserve the balance ofmy time.

Mr. MOAKLEY. Mr. Speaker, I thankthe gentleman from New York [Mr.SOLOMON], the chairman of the Com-mittee on Rules, for yielding me thecustomary half-hour, and I yield my-self such time as I may consume.

Mr. Speaker, the reconciliation billswe are considering this week show veryclearly the difference between Demo-crats and Republicans. To put it sim-ply, on one hand, my Republican col-leagues want to help people who makeenormous amounts of money and in-herit more money on top of that. Onthe other hand, Mr. Speaker, myDemocratic colleagues and I want tohelp middle-class working families andsmall business owners.

When these bills come up for votes,we can take our pick. I think thechoice is obvious. More than half thetax cuts in the Republican tax bill arefor people making over $250,000 a year.Three-quarters of the tax cuts in theDemocratic alternative are for peoplemaking less than $58,000 a year.

The Republican tax bill helps onlyricher families send their kids to col-lege. The Democratic alternative givesa full $1,500 tax credit for college stu-dents. The Republican tax bill takesthe $500 per child credit away from low-income working families. The Demo-cratic alternative makes sure thatevery low- and middle-income workingfamily gets the $500 per child tax cred-it.

The Republican tax bill, Mr. Speaker,gives huge tax breaks to rich peoplewho sell stocks and bonds. The Demo-cratic alternative gives tax breaks tothe middle-class people who sell homes,who sell their farms or small busi-nesses.

The Republican bill also marks a se-rious departure from the budget agree-ment. My Republican colleagues didnot keep their word to provide the edu-cation tax credits they promised or topreserve the rights of legal immigrantsthat they also promised. The Repub-lican reconciliation bill hands the rich-est 1 percent an additional $27,000 each,while it takes $63 away from each fam-ily in the bottom 20 percent.

8ill no.


Mr. Speaker, the Republican bill willmean serious trouble to our teachinghospitals. The Boston teaching hos-pitals alone will lose more than $700million over a 5-year budget period.

Mr. Speaker, I do not know if ourteaching hospitals can survive thiskind of cut. They have already madehuge changes, drastic changes, under-gone complicated mergers and cutcosts to save money, but the fact re-mains that last year Boston MedicalCenter saw 58,000 patients for nothing,58,000 patients for free. Yet today myRepublican colleagues are asking hos-pitals to make do with even less, and itis the same for teaching hospitals allover the country.

Mr. Speaker, the United States islucky to have the best hospitals, thebest medical care in the entire world.Take it from me, personally, I knowthis.

Mr. Speaker, I believe we should bedoing all we can to keep Americanhealth care not only the best in theworld but also keep it accessible to ev-eryone. This bill does not do that.

In the Committee on Rules lastnight, my Republican colleagues re-

jected an amendment offered by thegentleman from Massachusetts [Mr.KENNEDY] to change the funding forchildren's health insurance so theStates with children's health care lawsalready on the books like Massachu-setts, like New York, like Florida arenot penalized.

Mr. Speaker, I urge my colleagues tojoin me in defeating the lirevious ques-tion to make in order 22 amendmentsthat were rejected in the Committee onRules last night, including the Barton-Minge amendment on enforcing thebudget agreement and the Tayloramendment to let veterans keep theirveterans health care regardless of howold they are. I want to add, Mr. Speak-er, that this veterans health issue hasbeen cosponsored by nine of my col-leagues on the Committee on Rules.

I urge my colleagues to defeat theprevious question.


Mr. SOLOMON. Mr. Speaker, I yieldmyself such time as I may consume,briefly to just repeat my favoritehero's line, Well, here we go again,"talking about the rich.

In the Hudson Valley where I live, itis about 200 miles long and 50 mileswide and has the Catskill Mountains onone end and the Adirondack Mountainson the other and a valley in between,there are very few rich people there.They are all hard-working people. Theyhave worked all their lives. They havesaved a little bit even under hardtimes.

Let me just give my colleagues oneexample, a couple I know that workedfor Sears Roebuck. They worked forSears Roebuck, both of them together,for 38 years. Sears Roebuck does notpay the highest salaries but they havea pretty good little pension plan andhave a great stock option plan for peo-

H4387ple that work for them. For these 38years, this couple has been taking ad-vantage of those options, living with awage scale much lower than theirpeers, but they managed to save themoney and buy that stock and theyhave had it now for 35, 40 years. Do mycolleagues know what that stock isworth today?

0 1200

It is a nest egg that they can now re-tire on. They can, if they want to,move out of the cold north countrywhere I live, and they can move toFlorida, and they can buy themselves alittle home, and they can live prettydecently for the rest of their lives.

Now my good friend the gentlemanfrom Massachusetts [Mr. MOAKLEY]thinks those people are rich becausethey are going to take advantage of thecapital gains tax cut. Well, I do notthink that is rich at all. Those peoplehave incomes of way under $70,000 com-bined, and they are going to be able totake advantage of this capital gainstax cut.

I also represent in that valley hun-dreds and hundreds of farmers; most ofthem are dairy farmers; and those peo-ple over the years have gotten up at 4o'clock in the morning when it was 30below zero.

I did a piece on public television lastyear in which we brought public tele-vision up there, and they saw thesepeople out there at 5 o'clock in themorning milking these cows when itwas 31 below zero. And, as my col-leagues know, those people have paidthe taxes on that farm, on those sev-eral hundred acres of land, and surethey are land rich, but they are cashpoor. And now, if they pass away andtheir sons or daughters have worked onthat same farm for all the time theywere growing up, when they were 4, 5,and 6-years-old up to maybe 20 or 25,and now when they die the FederalGovernment is going to make them sellthat land to pay the estate tax.

Mr. Speaker, that just is not right.As my colleagues know, they paidtaxes on that land, they paid the in-come taxes all those years, and nowthey are going to be penalized and theycannot keep that farm in the family. Itis happening all over Texas, it is hap-pening all over America, but especiallyup in the north country where I livewhere it is doggone tough to make aliving especially in the winter time.

So let us have enough of this richtalk, and let us get on to give meaning-ful tax cuts to all of the American peo-ple. That is what America is all about.

Mr. Speaker, having said that, I yieldsuch time as he may consume to thegentleman from Florida [Mr. Goss] oneof those northerners that moved toFlorida many years ago. He is thechairman of the Permanent SelectCommittee on Intelligence, but he isalso a very valuable member of theCommittee on Rules, and I yield to himto get some of his sage advice.

(Mr. GOSS asked and was given per-mission to revise and extend his re-marks.)

96th 1980 HR. 7765 7/21/80 9/4/80 4597th 1981 HR. 3982 6/19/81 6/25/81 698th 1983 HR. 4169 10/20/83 10/25/83 598th 1984 HR. 5394 (1) 4/12/84 NA99th 1985 HR. 3500 10/3/85 10/23/85 2099th 1986 HR. 5300 7/31/86 8/24/86 24100th 1987) HR. 3545 10/26/85 10/29/85 3101st 1989 HR. 3299 9/20/89 9/26/89 6101st 1990 HR. 5835 10/15/90 10/16/90 1

103rd 1993 HR. 2264 5/25/93 5/27/93 2104th 1995 HR. 2491 10/17/95 10/25/95 8104th 1996 HR. 3734 6/27/96 7/17/96 10

'Not reputed.

Notes: The dates of bill considation is the flrst day of consideration andis based on the date on which the rule was adopted. The Iayov period isbased on the assumption that the report was available to Members on therrrst day after the report was riled (which may t always have been thecase). Under clause 2(1)(6) of rule Xl, it is in ord to consid a bill on thethird day the report is available to Members. All recontiliation rules, how-eve, have routinely waived all points of ord against consideration of thebill even if the three-day availability requirement was complied with.

Sources: House Calendars.

H4388Mr. GOSS. Mr. Speaker, I thank the

distinguished gentleman from NewYork [Mr. SOLOMON] for yielding thistime to me, and I obviously rise instrong support of this fair and I thinkvery appropriate rule for what we areabout, which permits consideration of 2important measures, the BalancedBudget Act and the Taxpayer ReliefAct, in fact probably one of the mostimportant things we will do in this ses-sion of Congress.

Today, we take another major steptoward the first balanced budget inover a generation, as the gentlemanfrom New York [Mr. SOLOMON] said,and the first actual relief for Americantaxpayers in almost a generation. De-spite this indisputable progress, wecontinue to hear this same tired rhet-oric, we have already heard it, thisclass warfare from the defenders of thestatus quo. As usual they claim theyhave a study or they will get one thatproves that the majority of the taxcuts are going to go to the, quote, rich.Of course, they define rich to suit theirown purpose.

Mr. Speaker, if someone earns $40,000a year, the big Government crowd isgoing to consider them rich, and this ishow they are going to do it: artificiallyinflate their income through the addi-tion of their future pension as well asthe potential rental value of theirhome. I am sure this is going to benews to thousands of new-found richpeople in my district, and I imaginethey are going to be a little shocked byit, as the rest of America will be asthey discover they have been elevatedto rich.

Mr. Speaker, actually the definitionof rich is, 'If you're not on welfare,you're rich."

Given these partisan distortions it isimportant to let the American peopleknow that what we are doing today isimportant work and it is going to af-fect them, and it is going to affectthem positively.

We are taking the necessary steps tosave the Medicare Program, and it isfacing impending bankruptcy. But in-stead of resorting to the tax increasesand the draconian provider cutbacksthat we have talked about in the past,we achieve our savings through patientchoice. Americans want choice in theirmedical care, and we are providingchoice, and we are using free marketcompetition, and we believe Americanswill have better access, better choice,better medical service in the end, andwe think we will end up with a strong-er Medicare program as a result.

We are also providing overdue reliefto families through the child tax creditand reform of the punitive death tax. Ido not understand why we do not allunderstand that any American whoworks hard, saves little and wants toprovide for his wife and his kids afterhe is gone, or his grandkids, should beable to do that. Why should the Gov-ernment come in and take all of hishard work? After all I think what pro-pels a great amount of the work in this


country is the responsibility individ-uals have to go to work and provide fortheir families.

As a father of four I certainly feelthat way. I think most Americans do. Ithink I owe it to my family and to mycommunity and to my country to lookout for my family and provide forthem. I do not go for this new mantrathat Uncle Sam has been replaced byFather Government. Government isnot my daddy, and it is not anyoneelse's either. I think we need to getaway from that and remember that thepeople who work in this country workwith the sense of responsibility to theirfamily and should be able to providefor them after they are gone.

We will furnish responsible Ameri-cans with more ways to save for theirfuture by expanding IRA's, and we willpromote economic growth by slicingthe punitive capital gains tax.

But most important, today we willsend a message to our children and ourgrandchildren that their future is notgoing to be mortgaged for Washing-ton's profligate spending habits, andwe all know what they are. The lasttime this Congress balanced the budgetour national debt stood at $368 billion,and $368 billion is a lot of money.Today that national debt is at $54 tril-lion, trillion, and it is still climbing.With this package Congress has finallyacknowledged what most Americanhave known for a very, very long time:

Uncle Sam is obese, Uncle Sam needsa diet, and it is time.

Mr. Speaker, today is about historicprogress; slow and steady, yes, but it isprogress. This package is not perfect,but it is very good work, and it is bi-partisan, and it is multibranch. And,yes, there is more to do, and there al-ways will be if we are going to havejobs up here in Washington represent-ing the people of this country, and thatis the form of Government we have.

But above all this package representsa hard-earned victory, I think, for theAmerican taxpayer, the middle-incomeearner, the hard worker, the people outthere worrying about the future oftheir families and their kids. And Ithink it is a victory for our kids, too,because we are going to rein in taxingand not send the bill to them anymore.

I very passionately urge for a "yes"vote on this rule and for the importantreconciliation bills that it carries. Thisis the work we are about; this is whatwe are asked to do.

Mr. MOAKLEY. Mr. Speaker, I yield1 minute to the gentleman from NewJersey [Mr. PALLONE].

Mr. PALLONE. Mr. Speaker, I votedfor the balanced budget resolution, andI know that both Democrats and Re-publicans in this House believe strong-ly in a balanced budget. But this pro-posal the Republicans have put forwardtoday is not fair to working class, mid-dle-class, people; it is not fair to sen-iors, and it is not fair to children, andI want to tell my colleagues why.

These tax cuts that the Republicanshave proposed, they are for the

June 25, 1997

wealthy, wealthy individuals and cor-porations. They are not helping theworking middle class person. The per-son who needs that child tax credit inmany cases is not going to get it eventhough they are working, sometimestwo parents working. The person whoneeds that college credit, either a tui-tion tax deduction or a hope scholar-ship program, that money is not goingto be fulfilled. What the Presidentpromised is not in this. The Repub-licans have broken the deal, and theyare not giving middle-class and work-ing-class people that college tuitionbreak that they were expecting as partof this deal.

And Medicare, Medicare for seniors,we were promised this was going to besolvent and we were going to work to-ward the solvency. They have put in,the Republicans, provisions that willbreak the Medicare Program.

The SPEAKER pro tempore. The gen-tleman from New York [Mr. SOLOMON]has 12 minutes remaining, and the gen-tleman from Massachusetts [Mr. MOAK-LEY] has 24 remaining.

Mr. SOLOMON. Mr. Speaker, I re-serve the balance of my time.

Mr. MOAKLEY. Mr. Speaker, thegentleman from New York, Mr. SOLO-MON's, speech was so soothing andcharming, I did not realize he used allthat time.

Mr. Speaker, I yield 2 minutes to thegentleman from California [Mr. MIL-LER].

(Mr. MILLER of California asked andwas given permission to revise and ex-tend his remarks.)

Mr. MILLER of California. Mr.Speaker, today is the day when webegin the process where we rearrangethe priorities of this Nation, where werearrange the priorities of this Nationthat for many years has taken care ofthe senior citizens of this country byproviding them Medicare healthcarecoverage for their elderly years, wherewe rearrange the priorities of this Na-tion where we have tried to make surethat children had coverage of healthcare, where we have tried to providefamilies the means by which they couldpay for the college education of theirchildren.

What we now see in the budget planthat we will debate this afternoon andin the tax bill that we will debate to-morrow is that all of those goals, all ofthose ideals of this Nation, are threat-ened because we have to have a tax billthat gives $27,000 in relief to peoplemaking more than $250,000 a year.

Twenty-seven thousand dollars in taxrelief, which is more than many fami-lies make all year long, must go to thewealthiest 1 percent in this country,and how do we pay for it? We pay for itby reneging on the promise to providehealth care coverage for children. Inthe Senate they now talk about mak-ing 8 million elderly people who are be-tween the ages of 65 and 67 wait 2 moreyears before they would have Medicarecoverage by increasing the cost of theMedicare to those individuals.

June 25, 1997

As my colleagues know, the interest-ing thing is that after the vote we tookin 1993 where no Republicans voted forPresident Clinton's plan, we have dra-matically reduced the deficit. The defi-cit is on its way to a balanced budget.If we did nothing, the budget would bebalanced and we could take care of theproblems in Medicare and Medicaid.

But the Republicans have chosen an-other path. They have chosen the pathto try to again return to the dayswhere corporations that make millionsof dollars in profit every year, as theydid before 1986, would pay no taxes.They want to return to the days wherepeople who can clip coupons pay a 20percent tax rate while hard-workingAmericans pay a 28 percent tax rate.

It is not fair, it is not equitable, andit is not right.

Mr. MOAKLEY. Mr. Speaker, I yield2 minutes to the gentlewoman fromCalifornia [Ms. PELOSI].

Ms. PELOSI. Mr. Speaker, I thankthe gentleman for yielding.

Mr. Speaker, the Federal budgetshould be a statement of our nationalvalues. How we spend the public'smoney should reflect what is impor-tant to us in our country, and surelywe all agree that the health and well-being of our people should be a na-tional priority. Indeed the Americanpeople continue to believe that accessto quality health care should be a na-tional priority.

Unfortunately, the reconciliation billdoes not expand access to health insur-ance. Indeed, this bill makes access tohealth care more difficult. Why are wemoving toward covering fewer peoplethan more people?

Under this bill and actions taken bythe Senate, an American baby borntoday would not have access to qualityhealth care insurance until she is 67years old. The bill before us today doesnot live up to the promise of expandinghealth care insurance to 5 billion of the10 billion uninsured children in theUnited States. The way the Repub-licans have structured the bill, thechild health block grant, there is noguarantee that even one additionalchild will have health insurance cov-erage.

The Medicaid cuts in this bill threat-en childrens hospitals and other safetynet health care providers. Why wouldwe target children's hospitals andcounty hospitals caring for the unin-sured as a place to make an enormousspending cut to fund the tax breaks forthe wealthy? Forcing public hospitalsto close their doors will further reduceaccess to care, particularly for unin-sured children. When we combine thesechanges with provisions in the bill toexempt even more health care plansfrom State consumer guidelines, wehave a total package that weakens ac-cess to quality health care insurancefor all Americans.

The American people do not againwant us moving backward on access tohealth care.

Again, the Republican bill does notdeliver on the promise of health insur-


ance for uninsured children. Indeed,the Republican bill violates the goalsof the budget agreement. On that basisalone we should reject the rule and killthe bill.

Mr. MOAKLEY. Mr. Speaker, I yield1 minute to the gentleman from Michi-gan [Mr. LEVIN].

(Mr. LEVIN asked and was given per-mission to revise and extend his re-marks.)

Mr. LEVIN. Mr. Speaker, we aregoing to debate the tax bill tomorrow,and we will show how their bill on themajority side would blow a hole in thebudget, and we will show how they areusing phony figures. But today we aredebating the spending resolution.

I voted for the budget resolution.Trouble with this spending resolutionis it violates the budget agreement,purely and simply. It does so on legalimmigrants. It draws an irrational andinhumane line, contrary to what theyagreed to. It also goes beyond the budg-et agreement, and it withdraws frompeople moving from welfare to workthe protections of the Fair LaborStandards Act. All they put back is aminimum wage standard, but there isno Federal protection to be sure thatthat is paid, and they do not provideagainst sexual harassment and employ-ment discrimination.

Mr. Speaker, second class citizenshipis not the answer for people movingfrom welfare to work.

We ask the Committee on Rules togrant us amendments to cure these,they turned us down. We should turndown this budget resolution.

Mr. SOLOMON. Mr. Speaker, I yieldmyself such time as I might consume.

Mr. Speaker, I am somewhat con-fused. If my colleagues read this morn-ing's paper or if they talk to those thatattended a Democratic caucus, It isquite clear that the administration at-tended that Democratic caucus and isurging them to support this reconcili-ation bill that is before us today, thatmost of the problems that they hadwith, especially the 0MB Director, Mr.Raines, had been worked out, therewere some glitches, but they could besolved in conference.

U 1215

So I am really surprised to hear someof the statements being brought uphere today.

Mr. BARTON of Texas. Mr. Speaker,will the gentleman yield?

Mr. SOLOMON. I yield to the gen-tleman from Texas.

Mr. BARTON of Texas. Mr. Speaker,I thank the gentleman from New York[Mr. SOLOMON] chairman of the Com-mittee on Rules, for yielding.

I think the chairman understandsthat a number of us, on a bipartisanbasis for several years, have been try-ing to do something to put some en-forcement mechanism into the existingBudget Acts that govern our Nation.

We have a piece of legislation, H.R.2003, the bipartisan Budget Enforce-ment Act, that is pending before the

H4389Committee on Rules, the Committee onWays and Means, and the Committeeon the Budget. There have been a seriesof meetings and discussions this morn-ing.

It is my understanding that as chair-man of the Committee on Rules, thegentleman from New York [Mr. SOLO-MON] has agreed to an expedited proce-dure whereas this piece of legislation,perhaps as amended, will be brought tothe floor for an up or down vote nolater than July 24.

Is that the understanding of thechairman of the Committee on Rules?

Mr. SOLOMON. Mr. Speaker, re-claiming my time, yes, It is my under-standing, and that is an ad hoc agree-ment, which, after meeting with thegentleman from Texas [Mr. BARTON]and members of the gentleman's group,along with Members of the Republicanleadership, we have agreed that thethree committees of jurisdiction, theCommittee on Rules, the Committee onWays and Means, and the Committeeon the Budget, would have an oppor-tunity to look at the legislation.

Mr. BARTON of Texas. Mr. Speaker,the number is H.R. 2003, the bipartisanBudget Enforcement Act. The gen-tleman from Texas [Mr. STENHOLM] andthe gentleman from Minnesota [Mr.MINCE] and the gentleman from Indi-ana [Mr. VISCLOSKY] and several oth-ers.

Mr. SOLOMON. Mr. Speaker, cer-tainly the Committee on the Budgethas agreed, and so has the Committeeon Rules. Now the gentleman under-stands that the gentleman from Texas[Mr. ARCHER], who has jurisdiction aswell, will agree as long as he has timeto consider in his committee.

Ijust want to make this understand-ing clear, that the agreement in noway prejudices the ability of the Com-mittee on Rules and the Committee onthe Budget who share jurisdiction overbudget process to report a budget proc-ess reform bill on their own at a latertime.

Mr. BARTON of Texas. Mr. Speaker,that is my understanding. This doesnot fence off any other legislation onthe same subject, but It does committhe chairman of the Committee onRules, the Speaker of the House, themajority leader, the majority whip,and the chairmen of the committees ofjurisdiction to work in an expeditiousfashion to bring this particular bill,perhaps as amended, to the floor, andperhaps at the same time other billsthat deal with the same subject.

Mr. SOLOMON. Mr. Speaker, I thinkwe are in full agreement. Let me justsay to the gentleman I appreciate hisunderstanding.

As the gentleman knows, on the Re-publican side there were some 31 Mem-bers that had concerns with both thetax bill and the spending cut bill. Wehad asked them not to come before usand ask for changes to be made becauseit would disrupt the agreement that wemight have with the White House, andthere were a number of Democrats on

H4390the other side of the aisle requestingthe same thing. We did not allow them,as we did not allow the gentleman.

So the gentleman is being very rea-sonable and I appreciate it, and we arecommitted to bringing this to the floorby July 24.

Mr. BARTON of Texas. Mr. Speaker,I want to express my commitment tothe chairman of the Committee onRules that I will vote for this rule andI will encourage all of the RepublicanMembers who I have been discussingthis issue with to also vote for the rule,so that we can bring this reconciliationpackage to the floor.

Mr. SOLOMON. Mr. Speaker, I cer-tainly thank the gentleman for beingso reasonable.

Mr. CASTLE. Mr. Speaker, will thegentleman yield?

Mr. SOLOMON. I yield to the gen-tleman from Delaware.

Mr. CASTLE. Mr. Speaker, I wouldjust like to say that the leadership ofthe Republican Party in total was in-volved in this. I think that is very im-portant to understand. They were veryaccommodating.

It has always been agreed that if thiswere able to be passed on the floor ofthe House of Representatives, and bythe way, there is no commitment to ac-tually support this bill from any of theleadership, but if it did pass, It wouldbecome part of the House conferencepackage in terms of dealing with thereconciliation bill with the Senatewhich I think is important as well.

Mr. WAMP. Mr. Speaker, will thegentleman yield?

Mr. SOLOMON. I yield to the gen-tleman from Tennessee.

Mr. WAMP. Mr. Speaker, I commendall that have been involved in a verybipartisan way, and just for the peoplewhom I think we so adequately rep-resent here in this body across thecountry that are wondering maybewhat this is all about, this is a group ofa few Members on both sides of theaisle that have gotten together andsaid that the discipline needs to be in-tegrated into this budget agreement.There is a panacea out there that thisis a great thing, and I think It has thepotential of being a great thing if wefollow through on it, and if we do notallow certain predictions that are partof our assessment today that might notcome true to blow the thing apart lateron. That is what this is about, enforce-ment provisions.

Frankly, neither party has an exclu-sive on ideas or integrity, and much ofthis comes from the Blue Dog Coalitionon the other side and very accurately,they have assessed that we need somediscipline written into this agreement.and many on our side, led by the gen-tleman from Texas [Mr. BARTON] andthe gentleman from Delaware [Mr.CASTLE] and myself, have agreed tothis, and now our leadership is accom-modating our request that we have anopportunity to bring to this floor thedetails of how we need to enforce thisprovision as we go forward.


I think that is important for the peo-ple to know, and people who have sus-picion about this budget agreement canknow that we are working to improveit before we finally report it out.

I thank the gentleman for yielding.Mr. SOLOMON. Mr. Speaker, I thank

the gentleman for his comments.Mr. Speaker, I reserve the balance of

my time.Mr. MOAKLEY. Mr. Speaker, I yield

myself such time as I may consume.I would like to tell the gentleman

from Texas [Mr. BARTON] that wethought his amendment was a greatone and we brought it forward for avote, but we were outvoted. We haveanother chance, because if we defeatthe previous question, we are going toput the Barton amendment in. So thegentleman still has a chance to get hisamendment passed.

Mr. Speaker, I yield 1 minute to thegentleman from Texas [Mr. BENTSEN].

(Mr. BENTSEN asked and was givenpermission to revise and extend his re-marks.)

Mr. BENTSEN. Mr. Speaker, I votedfor this budget agreement and a num-ber of Members from 13 of the 50 Statesvoted for this budget agreement, but Ido not think they voted to agree thattheir States would be cut dispropor-tionately under the Medicaid program,under the Disproportionate Share Pro-gram that is in this bill.

This bill before us today, the spend-ing bill, will treat States like Texas,Colorado, Connecticut, Louisiana, Ten-nessee, that the gentleman just spokefrom, and several others twice as badlyas all the other States and 100 times asbadly as some of the other States.

This bill says that those 13 Stateswill have their disproportionate shareof funding cut by 40 percent by theyear 2002. That is not the budget agree-ment that this Member voted for and Ido not see how any Member from anyof those States could vote for this rule.

Now, if we defeat the previous ques-tion, included in the amendments thatthe gentleman from Massachusetts in-tends to offer is to correct this. We arenot talking about dollars, we are talk-ing about equity among the States.

Mr. SOLOMON. Mr. Speaker, I yield2½ minutes to the gentleman fromOhio [Mr. KASICH], the distinguishedchairman of the Committee on theBudget.

Mr. KASICH. Mr. Speaker, let mejust suggest that everybody in theHouse is concerned about the formulawhereby we help those hospitals thathave a disproportionate share of poorpeople who they attend to. It is inter-esting to note that Texas is one of thelargest recipients of DSH money andthey have a concern about how thisagreement is going to affect them,based on the formula that distributesthis money.

I have a concern about it not only asit applies to the State of Texas, but tothe State of Ohio, to the State of NewJersey and the State of New York andevery State in the country. Writing a

June 25, 1997

formula that affects the DSH pay-ments, the disproportionate share ofpayments, is going to be like, well, itwill be a rougher fight than Tyson-Holyfield this weekend.

The fact is that in the conferencecommittee we are going to have to cre-ate a new formula. We cannot write aformula on the House floor. We shouldnot even try to write a formula on theHouse floor. We should not want towrite a formula on the House floor.

What we should do, if I could be sopresumptuous to give this advice, is toindicate the fact that we do not have itright yet and that we should go to theconference committee and we ought toget it right, as right as we can. I canpromise my colleagues, it is just likereform of the IRS or the tax system, atthe end of the day, nobody is going tobe happy with the way we pay taxes,and at the end of the day, no one isgoing to be happy with the way inwhich we distribute money to help hos-pitals pay for the poor. But what we dointend to do is to get it as right ashuman beings can, representing 50States around the country.

So the point is, I feel your pain whenit comes to my colleagues' concernabout DSH payments. So the fact is,let us not try to say that we are tryingto shut somebody off or having a for-mula debate on the House floor. Wecannot fix it here. It would not be rightto fix it here. We would not get it righthere and we would end up hurting poorpeople in the final analysis.

So let us just stay cool, let us adoptthe rule, let us make an effort to getthe formula fixed in conference, and Iam willing to work with all of theMembers of the House to participate tocome up with something that is as fairand equitable as we can among the 50States.

Mr. MOAKLEY. Mr. Speaker, I yield1 minute to the gentleman from Indi-ana [Mr. VISCLOSKY].

Mr. VISCLOSKY. Mr. Speaker, Ithank the gentleman for yielding methis time.

Mr. Speaker, I rise today in strongopposition to the rule because it doesnot make in order an important bipar-tisan enforcement amendment pro-posed by our colleagues, the gentlemanfrom Texas [Mr. BARTON] and the gen-tleman from Minnesota [Mr. MINGE].The Barton-Minge takes a commonsense approach to enforcing the budgetreconciliation bill. It acknowledgesthat our best hope of actually bal-ancing the budget is to put every sec-tion of the budget on the table, includ-ing entitlements and revenues, andthat we must hold the President andthe Congress accountable.

Enforcement is important. The les-sons of previous budget resolutions isthat agreeing to a balanced budgetdoes not guarantee it will be. No fewerthan four times over the last 15 yearsCongress and Presidents have approvedbudget-balancing amendments, butthey have not led to a balanced budgetbecause they were not enforceable.

June 25, 1997We have been told repeatedly that

enforcement mechanisms should be ad-dressed. We have been told by the Com-mittee on the Budget, enforcementshould be addressed. We have been toldby the Committee on Rules, enforce-ment should be addressed. It has notbeen addressed in this rule.

Mr. Speaker, I rise today in strong opposi-tion to the rule because it does not make inorder an important bipartisan enforcementamendment proposed by our colleagues, Mr.BARTON and Mr. MINGE.

The Barton-Minge amendment takes a com-mon sense approach to enforcing the budgetreconciliation bill. It acknowledges that ourbest hope of actually balancing the budget isto put every section of the budget on thetable—including entitlements and revenues—and that we must hold the President and theCongress accountable if we do not live up tothe budget targets agreed to earlier thismonth.

While I voted for the budget resolution ear-lier this month, I did so with serious reserva-tions. One of my most serious concerns is thelack of meaningful enforcement procedures toensure that the budget is balanced as pro-jected by the year 2002.

The lesson of previous budget resolutions isthat agreeing to balance the budget does notguarantee that the budget will actually be bal-anced. No fewer than four times over the past15 years Congress has approved budgetagreements that were supposed to get us toa balanced budget, but failed to actually doso.

For example, in 1982, the budget reso'utioncalled for a balanced budget in 1984. Yet, thebudget was not balanced by that date. In

1985, under Gramm-Rudman I, we were toldthat the budget would be balanced in 1991. Itwas not.

In 1987, under Gramm-Rudman II, we weretold that the budget would be balanced in1993, but it was not. In 1990, under the Budg-et Enforcement Act, we were told that, finally,the budget would be balanced in 1994. Again,it was not.

The common thread in these failed atlemptsto balance the budget was the lack of a mean-ingful enforcement mechanism.

I would also like to point out that enforce-ment is not a new or transitory issue. In thelast two Congresses I sponsored importantlegislation designed to bring strong enforce-ment procedures to the budget process. Thislegislation, the Balanced Budget EnforcementAct, was originally introduced by then-chair-man of the Budget Commitlee Leon Panetlaand, after that, our former colleague from Min-nesota, Tim Penny.

I have appeared before both the RulesCommitlee and the Budget Commitlee askingthat comprehensive enforcement mechanismsbe included in the budget process. So far,however, no action has been taken by eithercommittee.

Leading up to consideration of the budgetreconciliation bill, we were told that enforce-ment would be addressed as part of the legis-lation. Unfortunately, however, the Rules Com-mitlee did not make the Barton-Minge enforce-ment amendment in order, and we again findourselves with a major budget bill that con-tains no serious enforcement language.

Mr. Speaker, I am extremely disappointedthat this rule does not make language onen-


forcement in order, and I urge my colleaguesto oppose it.

Mr. MOAKLEY. Mr. Speaker, I yield2 minutes to the gentleman from Texas[Mr. D0GGETr].

Mr. DOGGETT. Mr. Speaker, forthose of us who are truly committed toachieving a balanced budget that willremain balanced, this first effort to im-plement the balanced budget agree-ment represents a true setback. Theycall this bill that we have under con-sideration today the reconciliationbill. Really, it is the wreckonciliationbecause it wrecks this budget agree-ment, and the first area in which itwrecks the budget agreement is by nothaving an adequate enforcement provi-sion.

Mr. Speaker, there is nothing newabout promising a balanced budget inWashington. It is the guarantee of abalanced budget that really has somemeaning, and around here a promisenever seems to be a guarantee. We donot need more promises of a balancedbudget, we need a guarantee, and weneed it in this proposal. Rather thanwrecking the budget agreement, weought to be guaranteeing a truly bal-anced budget.

What does this reconciliation bill sayto the young American family that isout there struggling to make endsmeet? Well, if we listen to the Repub-licans here in Washington, it says tothat young American family, when youreach age 65, do not count on havingany health protection because yourMedicare coverage will not be there.We are going to escalate the age to 67before you ever get Medicare coverage.

Q 1230What does it say to the children of

that working American family, notpeople on welfare, but where perhapsboth parents are struggling to climb upthat economic ladder? It says no healthinsurance.

Surely this must be the only modernindustrialized country in the worldwhere we have 10 million children whohave no health insurance, and no hopefrom this reconciliation bill that it isgoing to get any better, from zero toage 67. No guarantee, is the goal of thisRepublican Congress for health insur-ance coverage.

It is time not to wreck the budgetagreement, deny enforcement provi-sions, and deny the guarantee of healthinsurance that so many people need intheir youngest age and in the oldestage. Vote "no" on this rule.

Mr. MOAKLEY. Mr. Speaker, I yield1 minute to the gentleman from Texas[Mr. STENHOLM].

Mr. STENHOLM. Mr. Speaker, I risein strong opposition to this rule, be-cause here we go again. Passage of areconciliation bill that is projected tobalance the budget by the year 2002does not guarantee the budget will ac-tually be balanced. Americans are tiredof Congress and the President makingunfulfilled promises about balancingour budget.

H4391Mr. Speaker, I appreciate the work

the gentleman from Texas [Mr. BAR-TON], the gentleman from Delaware[Mr. CASTLE], and the gentleman fromTennessee [Mr. WAMP] have done, but Iam a great believer that a bird in thehand is worth two in the bush. Today isthe time for us to deal with enforce-ment. I was sincerely disappointed thatthe Committee on Rules chose to re-port a rule that would not allow theHouse to consider the Barton-Mingebalanced budget agreement.

Our only request of the Committeeon Rules is that we be given a fair shotto offer our proposal for an up or downvote. Members from the left and rightoppose our amendment. Why not let itbe considered at the appropriate time,when we have the best chance of get-ting it done?

Whether Members support the bal-anced budget agreement and the rec-onciliation bill, which I do, I stronglyencourage all Members who are com-mitted to achieving a balanced budgetto vote against the rule. If we do notdeal with the matter today, it will notbe dealt with.

Mr. Speaker, I rise in strong opposition tothis rule. I do so as one who supports the bi-partisan budget agreement because this ruleprevents consideration of an amendment thatwould ensure that this budget agreement livesup to all the promises being made by those ofus who support the agreement. Joe Bartonand David Minge submitted an amendment onbehalf of a bipartisan group of more than twodozen members who believe that this budgetagreement must include strong budget en-forcement procedures to make this a crediblebalanced budget plan. Unfortunately, this ruledoes not make the Barton-Minge amendmentin order.

While passage of a reconciliation bill that isprojected to achieve balance by 2002 is a sig-nificant accomplishment, I would remind mycolleagues that history has taught us that pas-sage of a reconciliation bill that is projected tobalance the budget by 2002 does not guaran-tee that the budget will actuafly be balanced in2002. We need only look to the experience ofthe 1990 budget summit to be reminded howquickly a balanced budget plan can fall offcourse. Americans are tired of unfulfilledpromises about balancing our budget. TheBarton-Minge amendment will prevent thisbudget from repeating the failed promises ofpast balanced budget plans by putting teeth inthe budget agreement.

The Barton-Minge enforcement amendmentwould establish a comprehensive enforcementmechanism that would require Congress andthe President to ensure that actual spendingand revenues over the next 5 years meet thegoals of the budget agreement. It would en-force all portions of the budget—spending andrevenues—without exceptions to ensure thateveryone has a stake in keeping the budgeton a path to balance. Critics who complainabout the harmful effects of triggering sequestration or delaying the phase-in of tax cuts aremissing the point. The goal of any enforce-ment mechanism is to establish a hammerwith severe consequences to give Congressand the President the incentive to take actionimmediately when the budget falls off theglidepath to balance to avoid triggering en-forcement.

H4392The Barton-Minge amendment has biparti-

san support because enforcement would betargeted to the portion of the budget thatcauses a problem. Spending programs thatgrow faster than this budget assumes wouldbe sequestered; the phase-in of tax cutswould be delayed if revenues are lower thanassumed under this budget. Tax cuts will notbe affected because spending grows too fast;and spending will not be cut if taxes are belowprojections.

I was sincerely disappointed that the RulesCommittee chose to report a rule that wouldnot allow the House to consider the Barton-Minge balanced budget enforcement amend-ment. Our only request was that we be givena fair shot to offer our proposa' for an up ordown vote. I understand that many committeechairman oppose this effort to enforce thebudget agreement and that Members from theleft and right have concerns that our amend-ment is too strong and would vote against it.I welcome the opportunity to respond to thesecriticisms and debate the issue on the merits.Unfortunately, this rule prevents us from hav-ing that debate.

Whether or not you support the budgetagreement and the reconciliation bill that theHouse will consider today, I strongly encour-age all Members who are committed to actu-ally achieving a balanced budget to voteagainst this rule so that the House may con-sider legislation that makes this balancedbudget plan meaningful.

Mr. MOAKLEY. Mr. Speaker, I yield1 minute to the gentleman from Ten-nessee [Mr. TANNER].

Mr. TANNER. Mr. Speaker, I want tosecond what the gentleman from Texas[Mr. STENHOLM] and the gentlemanfrom Indiana [Mr. VIScLOSKY] said. Iam not interested in being a party to abalanced budget agreement that doesnot translate itself from an idea to areality.

There have been well-intentionedpeople in this town since 1980 who havetried mightily to balance the budget.This enforcement mechanism that wasdenied a vote on by this body, by theCommittee on Rules, itself I think war-rants a ' no" vote, because, Mr. Speak-er, this is the mechanism that trans-lates the idea of a balanced budget,which most of us embrace, to actual re-ality. Without it, we are, I think, goingdown the same path as those that werehere before us. We cannot afford thatpath again.

We are spending over $250 billion ayear in interest now. The future isbleak, indeed, for the young people ifwe do not put an enforcement mecha-nism in this agreement. I wish wewould vote "no" on the rule.

Mr. MOAKLEY. Mr. Speaker, I yield1 minute to the gentleman from Texas[Mr. TURNER].

Mr. TURNER. Mr. Speaker, I rise inopposition to the rule for the reasonthat the committee failed to acknowl-edge the importance of including en-forcement language in this budget rec-onciliation bill. The truth of the mat-ter is that the American people believethat when we, in great fanfare, just afew weeks ago announced a balancedbudget agreement, they believe the


balanced budget agreement is some-thing that has meaning to it, not anempty promise.

I think we in this Congress all needto tell the American people that abudget agreement resolution is nomore than a New Year's resolution, andit is no more than a promise that canbe broken without effective enforce-ment language put into the law.

The bipartisan Barton-Minge budgetenforcement amendment needs to be inthe budget reconciliation bill that thisCongress will adopt. A promise to con-sider it later is not enough. The Amer-ican people expect and deserve that wein the Congress will keep our promisesfor a balanced budget by 2002.

Mr. SOLOMON. Mr. Speaker, I yieldsuch time as he may consume to thegentleman from Pennsylvania [Mr.ENGLISH].

(Mr. ENGLISH of Pennsylvania askedand was given permission to revise andextend his remarks.)

Mr. ENGLISH of Pennsylvania. Mr.Speaker, I rise in support of the rule.

Mr. Speaker, I rise in strong support of sev-eral reconciliation changes contained in theproposed manager's amendment that will beself-executed in this rule.

The amendment contains an additional $1billion in relief for low-income seniors from thecost of their part B Medicare premiums. Thischange will further strengthen our bipartisanplan to save Medicare.

the amendment also provides credible pro-tections for participants in workfare programs.Specificafly, it would strengthen minimumwage requirements, clarify the 40-hour workweek, and adopt strong nondiscrimination pro-visions relating to age, race, gender, and dis-ability. It also protects other workers withstrong nondisplacement language.

The amendment contains other improve-ments, especially its designation of $100 mil-lion to empower states and extend Medicaidbenefits for children affected by Social Secu-rity eligibility changes. This is a useful and bal-anced amendment, and I urge adoption of therule.

Mr. MOAKLEY. Mr. Speaker, I yield2 minutes to the gentleman from Mis-sissippi [Mr. TAYLOR].

Mr. TAYLOR of Mississippi. Mr.Speaker, I urge a no vote on the rule.There is a crisis of faith in this coun-try. People every 2 years run for officeand ask for the privilege to serve inCongress. They say they are going todo things, and when the time comes todo those things, they find a reason tosee to it that they do not. All acrossthe country people ran for Congressand said, we are going to restore thepromise of lifetime health benefits tothose people who served in our militaryhonorably for 20, 25, 30 or more years.

There are 181 people who cosponsoreda bill to do Just that, including thechairman of the Committee on Rules:the gentlewoman from Ohio [Ms.PRYCE], the gentleman from Georgia[Mr. LINDER], the gentleman from Flor-ida [Mr. DIAZ-BALART], the gentlemanfrom Colorado [Mr. MCINNIS], and thegentleman from Washington [Mr.HASTINGS]. Yet, yesterday when the op-

June 25, 1997

portunity came before them to bringthis measure to the House floor so wecould restore that, so we could give theonly people in America who were prom-ised free health care for life, to fulfillthat promise for them, those peoplevoted against it.

They will not give the majority thechance to vote for it, to take care ofour military retirees, the same peoplewho went to Korea, the people whowent to Vietnam, the people who wentto the desert, the people who are in Co-lombia today. They said, these peopledo not count.

We ought to defeat this rule. Weought to vote 'no" on the previousquestion, and we ought to allow theHefley bill, which is cosponsored by 181Members of Congress, to fulfill thepromise of lifetime health care to ourmilitary retirees, to be voted on up-or-down, so we can see whether those peo-ple who went back home and said theywere for our military retirees reallyare, or whether it was just anotherempty promise.

Mr. Speaker, there is a crisis of faithin this country because people are notdoing what they said they would do.We have a chance to correct thattoday, we really do.

Mr. MOAKLEY. Mr. Speaker, I yield1 minute to the gentlewoman fromCalifornia [Mrs. TAUSCHER].

Mrs. TAUSCHER. Mr. Speaker, Ithank the gentleman for yielding timeto me.

Mr. Speaker, I rise in strong opposi-tion to the rule. I object to the decisionby the Committee on Rules to refuse toallow the Barton-Minge amendment, ofwhich I am an original cosponsor,which would add strong budget enforce-ment language to the legislation.While I strongly support this historicbudget agreement, I am concerned thatwithout proper enforcement mecha-nisms, spending will run out of controland tax cuts will balloon, thereby void-ing the balanced budget agreement.

A bipartisan group of Members hasdeveloped a proposed amendment toensure that, when actual spending ex-ceeds spending targets, Congress wouldhave to take action by December 15 orautomatic cuts would go into effect.Similarly, if revenues failed to meetthe expected level, any phase-in of taxcuts would be delayed.

There have been numerous attemptsto instill fiscal responsibility in thebudget process, but those attemptshave failed because they were unen-forceable. Let us not allow this agree-ment to fall prey to the same short-comings. I urge my colleagues to de-feat the rule.

Mr. MOAKLEY. Mr. Speaker, I yield1 minute to the gentleman from NewJersey [Mr. ANDREWS].

Mr. ANDREWS. Mr. Speaker, I thankthe ranking member for yielding timeto me.

Mr. Speaker, I rise in opposition tothe rule. I would say that there is nohigher purpose for those who have beencalled to this House than to stop the

June 25, 1997practice of borrowing money to run theU.S. Government and sending the billto our children.

I do not doubt for one minute thegood intentions of those who put thisbudget agreement together, but I suredo doubt what might happen as a resultof those intentions if we do not havethe enforcement language of the Bar-ton-Minge amendment.

Here is what it says without it. IfCongress spends more than we plannedunder this agreement, do Membersknow what happens? Nothing. If theTax Code does not bring in as muchmoney as we thought it would becauseof the tax cut, do Members know whathappens? Nothing. Without this amend-ment the deficit will rise, the balancedbudget will be in jeopardy, and we willcontinue the practice we all came hereto stop.

I urge my colleagues to oppose thisrule, and when we get a chance vote forthe Barton-Minge amendment when itcomes to the floor.

Mr. MOAKLEY. Mr. Speaker, I yield1 minute to the gentleman from Ohio[Mr. BROwN].

Mr. BROWN of Ohio. Mr. Speaker, Ithank the gentleman for yielding timeto me.

Mr. Speaker, I rise in opposition tothe rule. As the ranking member onthe Subcommittee on Health and theEnvironment of the Committee onCommerce, I, with my Democratic col-leagues, offered several amendments toimprove the Medicare-Medicaid andchildren's health care expansion provi-sions in the Budget Reconciliation Act.

Most important, perhaps, of thesewould have reduced the number of Med-icare MSA policies which could be is-sued from 500,000 to 100,000, thus savingapproximately $1 billion over 5 years.These savings would be used to coverthe copay for beneficiaries who will becovered for annual mammographies,bone mass testing, colorectal and pros-tate cancer screening, and a portion ofthe cost of test strips for diabetesunder Medicare.

Last week a similar bipartisanamendment was offered and passedbipartisanly in the Senate FinanceCommittee which would scale back thedemonstration project to 100,000 poli-cies. Unfortunately, Republicans onthe Committee on Rules neglected toallow us to offer this amendment, eventhough we only lost it in committee byone vote. It was part of the budgetagreement originally. It makes sense,Mr. Speaker.

I urge my colleagues to oppose therule when it comes before the House.

Mr. MOAKLEY. Mr. Speaker, I yield1 minute to the gentleman from Louis!-ana [Mr. JOHN].

Mr. JOHN. Mr. Speaker, I thank thegentleman from Massachusetts foryielding time to me.

Mr. Speaker, I rise in strong opposi-tion to the rule. What are we afraid of?Are we afraid of keeping our promises?That is what we are talking about. Weare talking about enforcing a balanced


budget agreement that only 2 weeksago everybody was praising. Everybodywas talking about how great it is. Butit is only worth the paper it is writtenon without some kind of enforcement.

What are the opponents of enforce-ment scared of? They are scared ofkeeping our promises? I would hopenot. I would hope that the Americanpeople will support us in putting en-forcement in a budget that could ex-plode if we are off on some of our eco-nomic figures.

Mr. SOLOMON. Mr. Speaker, I yield30 seconds to the distinguished gen-tleman from Texas [Mr. BARTON].

Mr. BARTON of Texas. Mr. Speaker,I strongly appreciate the support thatthe Barton-Minge amendment has onboth sides of the House, and I want topoint out that under the colloquyagreement, we will get that vote on en-forcement no later than July 24. If wewin on the floor, it will be in the rec-onciliation package in the conference.So I would hope we would vote for therule.

Mr. MOAKLEY. Mr. Speaker, I yieldmyself such time as I may consume.

Mr. Speaker, I cannot believe thegentleman from Texas would not voteagainst the previous question so he canget immediate recognition of this pro-vision.

Mr. Speaker, I yield 1 minute to thegentleman from Georgia [Mr. LEWIS],the minority whip.

Mr. LEWIS of Georgia. Mr. Speaker,I rise to urge my colleagues to defeatthis rule. This bill thatthe Repub-licans are bringing to this floor breaksthe budget deal the Republicans madewith the President. On issue after issuethis bill is in violation of the budgetagreement.

Mr. Speaker, how can the Presidentnegotiate if they will not deal in goodfaith, if they will not keep their word?On children's health care, this billbreaks the deal. On protecting disabledlegal immigrants, the bill breaks thedeal. On providing worker protectionfor people moving from welfare towork, this bill is not in keeping withthe spirit of the deal.

Mr. Speaker, this bill violates boththe spirit and the letter of a balancedbudget agreement. Defeat the rule, de-feat the bill. It is not the deal madewith the President. It is not the dealmade with the American people.

Mr. MOAKLEY. Mr. Speaker, I yield1 minute to the gentleman from Flor-ida [Mr. BOYD].

0 1245

Mr. BOYD. Mr. Speaker, I thank thegentleman for yielding me the time.

Mr. Speaker, I am a strong supporterof tax relief for American families thatis fair and fiscally responsible. I am astrong supporter of the balanced budg-et agreement. I voted for that. I risetoday in opposition to this rule becausethis bill that we are addressing todaydoes not meet the criteria that is nec-essary to see that we have both ofthose things.

H4393I am deeply concerned that this rec-

onciliation bill, as it is written withoutvery important necessary enforcementlanguage, that is, the Barton-Mingelanguage that should have been in-cluded, will blow a hole in the deficitpast the year 2002. Look back at his-tory and exactly what happened withthe other balanced budget plans thatthis U.S. Congress passed in the past.

We worked too hard to get this far.We have a unique opportunity to getthis budget balanced and establish aneconomic policy that will guaranteelong-term balance for the U.S. Govern-ment.

The tax cuts that we have in here, es-pecially indexing of capital gains andthe very long 10-year phase-in of estatetaxes, is bad. I implore Members tovote against the rule.

Mr. MOAKLEY. Mr. Speaker, I yieldmyself 2 minutes.

Mr. Speaker, I urge Members to de-feat the previous question. If that pre-vious question is defeated, I will offeran amendment to the rule which willmake in order 22 amendments, includ-ing the amendment by the gentle-women from Florida, Mrs. MEEK andMs. ROS-LEFrrINEN that would preserveSocial Security and Medicaid pay-ments for elderly or disabled legal im-migrants as amended by the gentlemanfrom Mississippi, Mr. TAYLOR, whichgives guaranteed health coverage tomilitary retirees when they becomeMedicare eligible, an amendment bythe gentleman from Texas, Mr. BAR-TON, and the gentleman from Min-nesota, Mr. MINCE, which incorporatesbudget targets into the law and holdsthe President and the Congress ac-countable if the actual budget out-comes do not meet the budget agree-ment goals.

Mr. Speaker, these are all very im-portant amendments and the Houseshould have an opportunity to considerthem. I urge no on the previous ques-tion and defeat the rule.

The SPEAKER pro tempore (Mr.COMBEST). The gentleman from Massa-chusetts [Mr. MOAKLEY] has 3 minutesremaining.

Mr. SOLOMON. Mr. Speaker, I yield 2minutes to the very distinguished gen-tlewoman from Columbus, OH [Ms.PRYCE], a member of the Committee onRules.

Ms. PRYCE of Ohio. Mr. Speaker, Ithank the distinguished chairman ofthe Committee on Rules for yieldingme the time.

I rise in strong support of this ruleand the reconciliation package and Iam very encouraged by the compromiseto address the enforcement issue.

Mr. Speaker, even without that inthis bill, boy, have we come a longway. Mr. Speaker, the growth in the1980's showed us what can happen whenwe give the American people the toolsthat they need to grow and prosper.The same is true today. Governmentdoes not create new jobs. Governmentdoes not build stable families. Ourchallenge is to restore growth and op-portunity and to sustain it for future

H4394generations. This reconciliation pack-age holds the beginning of an answer tothat challenge. Nobody calls it perfect,but it is a start and it is sure abouttime.

It combines budget restraint withprogrowth tax policy. By preservingand strengthening Medicare, it honorsour commitment to older Americans.By including a child tax credit and newsavings incentives it will help familiesto keep more of their hard-earnedmoney to spend on things they needmost of their lives.

This package is an honest bipartisanattempt to help those who will createtomorrow's growth and prosperity, theearners, the savers, the taxpayers whowork hard; those people that get upearlier, stay at the office a little later,the ones that play by the rules, take afew risks and strive to build a betterfuture for their families and commu-nities.

Mr. Speaker, after years of unbal-anced budgets, deficit spending andhigh taxes, the chance to begin restor-ing the American dream is finallywithin our grasp. Let us seize it. Let usnot miss this historic opportunity togive our children and grandchildren thebright economic future they deserve. Iurge my colleagues to support this fair,this balanced rule and to vote for thisreconciliation package.

Mr. MOAKLEY. Mr. Speaker, I yield1 minute and 10 seconds to the gen-tleman from Oklahoma [Mr. C0BURN].

Mr. COBURN. Mr. Speaker, I thankthe gentleman from Massachusetts foryielding me this time.

I think it is important for people inthis country to know what this ruledoes. If you are poor and you are onMedicaid, this bill takes away the rightof your physician to determine whenyou should be discharged from the hos-pital. We put that in in committee. Wedid that on purpose, because you havea right to have quality care and theprofits of a health insurance industryshould not come above that. This ruledoes not take it out of Medicare. Weput it in Medicare, too.

But AARP is such a strong force thatwe did not have the courage to take itout in the Medicare portion of this bill.So if you are poor, you are blown away.If you are protected by Medicare, youare protected for right now. When itgets to conference, your ability to havequality medical care determining yourdischarge based on what is best foryour health is going to be eliminatedin conference. That is the plan.

So, America, wake up; this bill deter-mines your health care and your qual-ity not by your physician but by theinsurance company that is running themanaged care program.

I thank the gentleman very much foryielding me the time.

Mr. MOAKLEY. Mr. Speaker, will thegentleman yield? /

Mr. COBURN. I yield to tIie gen-tleman from Massachusetts.

Mr. MOAKLEY. Mr. Speaker, is thegentleman opposed to the rule?


Mr. COBURN. Mr. Speaker, I am notvoting for this rule.

Mr. MOAKLEY. Mr. Speaker, I thankthe gentleman.

Mr. Speaker, I yield the balance ofmy time to the gentlewoman from Con-necticut [Ms. DELAURO].

The SPEAKER pro tempore. The gen-tlewoman from Connecticut [Ms.DELAURO] is recognized for 2 minutes.

Ms. DELAURO. Mr. Speaker, I risetoday to urge my colleagues to voteagainst this rule. This bill breaks thebalanced budget agreement and ithurts average middle-class families inthis country. I voted for the balancedbudget agreement. This is not the billthat I voted for. I did not vote for a billthat hurts the middle class by denyingworking families help in providinghealth coverage for their kids. I did notvote for a bill that refuses to provideimportant basic worker protections inthis country, protections like familyand medical leave and protectionagainst sexual harassment. I did notvote for a bill that hurts children'shospitals in my State. I did not votefor a bill that infringes on a woman'sright to choose and I did not vote for abill that does not promise to protectlegal immigrants in this country.

Today's Republican bill violates thebudget agreement that was so carefullyput together and so hard that weworked on. And it shortchanges mid-dle-class American families so that to-morrow's Republican tax cut bill willbe able to provide the richest 5 percentof Americans in this country with thebiggest tax cuts in the bill. It is wrong.Working families are scrambling everysingle day, every day to pay their bills,to be able to send their kids to school,to protect themselves for a secure re-tirement and be able to have affordablehealth care coverage. The bill that wewill vote for today will deny those pro-tections to people. We should voteagainst this rule and tomorrow weshould vote against the Republican taxcut bill. I urge a "no" vote on the rule.

Mr. MOAKLEY. Mr. Speaker, I in-clude the following information for theRECORD:TEXT OF PIvIOus QUESTION AMENDMENT TO

H. RE5. 174, FY 98 BUDGET RECONCILIATIONAND TAX BILLSAt the end of the resolution add the follow-

ing new section:"Section 3. Notwithstanding any other

provision of this resolution, it shall be inorder without intervention of any point oforder to consider the following amendments:

The amendment offered by RepresentativeRos-Lehtinen and Representative Meek ortheir designee.

The amendment offered by RepresentativeBrown of Ohio or his designee.



The amendment offered by RepresentativeGekas and Representative Frost or their des-ignee.

The amendment offered by RepresentativeBarton and Representative Minge, or theirdesignee.

The amendment offered by RepresentativeTaylor of Mississippi or his designee.

June 25, 1997The amendment offered by Representative

Kennedy of Massachusetts or his designee.The amendment offered by Representative

McDermott and Representative Matsui ortheir designee.

The amendment offered by RepresentativeMcDermott or his designee.

The amendment offered by RepresentativeHinchey or his designee.

The amendment offered by RepresentativePeterson of Minnesota or his designee.

The amendment offered by RepresentativeNadler or his designee.

The amendment offered by RepresentativeNadler, Representative Maloney, and Rep-resentative Schumer or their designee.

The amendment offered by RepresentativeLevin or his designee.



The amendment offered by RepresentativeConyers or his designee.

The amendment offered by RepresentativeConyers or his designee.

The amendment offered by RepresentativeRoukema and Representative Pomeroy ortheir designee.

The amendment offered by RepresentativePallone or his designee.

The amendment offered by RepresentativeDavis and Representative Norton or theirdesignee.

The amendment offered by RepresentativeBerman or his designee.

The amendment offered by RepresentativeThurman or his designee.

The amendment offered by RepresentativeBecerra or his designee.

The amendment offered by RepresentativeEshoo and Representative Pallone or theirdesignee.

The amendment offered by RepresentativeBentsen or his designee.

H4402

AMENDMENTS TO H.R. 2015: BUDGETRECONCILIATION SPENDING ACT

AMENDMENT TO THE RECONCILIATION BILL, ASAPPROVED BY THE COMMITTEE ON WAYS ANDMEANS ON JUNE 10, 1991, OFFERED BY MRS.MEEK AND MS. ROS-LEHTINEN

In Section 9302 Strike subsection (a) and in-sert the following:

(a) IN GENERAL—Section 402(a)(2) of thePersonal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 8 U.S.C.l6l2(A)(2)) is amended by adding after sub-paragraph (D) the following new subpara-graph:

"(E) QUALIFIED ALIEN ON AUGUST 22, 1996.—With respect to eligibility for benefits forthe program defined in paragraph (3) (A) (re-lating to the supplemental security incomeprogram), paragraph (1) shall not apply to analien who on August 22, 1996, was a qualifiedalien.

AMENDMENT TO HR. — (RECONCILIATION)OFFERED BY MRS. MEEK OF FLORIDA

At the end of section 9103(a), add the fol-lowing:

(3) ADDITIONAL MANDATORY STATE PAY-MENTS.—

(A) DUTIES OF THE SOCIAL SECURITY ADMIN-ISTRATION—For each of fiscal years 1998through 2002, the Commissioner of Social Se-curity shall—

(i) estimate the difference between—(I) the total cost to the Federal Govern-

ment of providing to qualified aliens (as de-fined in section 431 of the Personal Respon-sibility and Work Opportunity Reconcili-ation Act of 1996) supplemental security in-come benefits under title XV! of the SocialSecurity Act and medical assistance benefitsunder title XIX of such Act; and

(H) $2300000000 for fiscal year 1998,$2100000000 for fiscal year 1999, $1800000000for fiscal year 2000, $1,400,000,000 for fiscalyear 2001, and $l500,000,000 for fiscal year2002; and

(ii) collect from each State (other than theCommonwealth of Puerto Rico, the VirginIslands, or Guam) an amount equal to—

(I) the ratio of the number of all persons inthe State receiving supplemental securityincome benefits under title XV! of the SocialSecurity Act to the number of all persons inthe United States receiving such benefits;multiplied by

(H) the difference estimated under clause(i).

(B) PAYMENT—In order for any State(other than the Commonwealth of PertoRico, the Virgin Islands, or Guam) to be eli-gible for payments pursuant to title XIXwith respect to expenditures for any quarterin fiscal year 1998 through 2002, the Stateshall pay to the Commissioner of Social Se-curity the amount required to be collectedfrom the State under subparagraph (A) (ii) forthe fiscal year.

(C) USE OF AMOUNTS COLLECTED—For fiscalyear 1998 and each subsequent fiscal year,the sums collected from each State pursuantto subparagraph (A)(ii) shall be credited to aspecial fund established in the Treasury ofthe United States for State administrativepayment fees. Amounts so credited, to theextent and in the amounts provided in ad-vance in appropriations Acts, shall be avail-able to defray expenses incurred in carryingOut title XV! of the Social Security Act andrelated laws.

CONGRESSIONAL RECORD — HOUSEAMENDMENT OFFERED BY MR. BROWN OF OHIO

TO THE MEDICARE RECONCILIATION PROVISIONSPage 8, line 6, strike 500,000" and insert

100,000".Page 131, after line 36, insert the following

new subsection (and redesignate the succeed-ing subsections accordingly):

(c) WAIVER OF COINSURANCE—Section1833(a)(1) (42 U.S.C. 13951(a)(1)) is amendedby—

(A) striking and" at the end of clause (0),and

(B) inserting before the semicolon at theend the following: ', and with respect toscreening mammography (as defined in sec-tion 1861W), the amount paid shall be 100percent of the fee schedule amount providedunder section 1848".

Page 132, line 7, before the period insertthe following:

except that the amendments made by sub-section (c) shall apply to items and servicesfurnished on or after January 1, 2000".

Page 133, after line 8, insert the followingnew subsection (and redesignate the succeed-ing subsections accordingly):

(c) WAIVER OF COINSURANCE—Section1833(a)(1) (42 U.S.C. 13951(a)(1)) is amendedby—

(A) striking 'and" at the end of clause (0),and

(B) inserting before the semicolon at theend the following: ', and with respect toscreening pap smear and screening pelvicexam (as defined in section 1861(nn)), theamount paid shall be 100 percent of the feeschedule amount provided under section1848".




(c) WAIVER OF COINSURANCE.—SectiOn1833(a)(1) (42 U.S.C. 13951(a)(1)) is amendedby—

(A) striking 'and" at the end of clause (0),and

(B) inserting before the semicolon at theend the following: ", and with respect toprostate cancer screening tests (as defined insection 1861(00)), the amount paid shall be100 percent of the fee schedule amount pro-vided under section 1848".

Page 134, line 31, before the period insertthe following:', except that the amendments made by sub-section (e) shall apply to items and servicesfurnished on or after January 1, 2000".


(e) WAIVER OF COINSURANCE.—SectiOn1833(a)(1) (42 U.S.C. 13951(a)(1) is amendedby—

(A) striking "and" at the end of clause (0),and

(B) inserting before the semicolon at theend the following: ', and with respect tocolorectal cancer screening test (as definedin section l86l(pp)), the amount paid shall be100 percent of the fee schedule amount pro-vided under section 1848".



Page 143, strike lines 24 through 30.Page 145, after line 22, insert the following

new subsection (and redesignate the succeed-ing subsection accordingly):

(c) WAIVER OF COINSURANCE—Section1833(a)(1) (42 U.S.C. 13951(a)1)) is amendedby—

June 25, 1997(A) striking "and" at the end of clause (0),

and(B) inserting before the semicolon at the

end the following:", and with respect to bonemass measurement (as defined in section1861(rr)), the amount paid shall be 100 per-cent of the fee schedule amount providedunder section 1848".



AMENDMENT OFFERED BY MR. BROWN OF OHIOTO THE CHILD HEALTH RECONCILIATION PROVI-SIONS

Add to the end the following new section:SEC. 3504. CONTINUATION OF MEDICAID ELIGI-

BILITY FOR DISABLED CHILDRENWHO LOSE SSI BENEFITS

(a) IN GENERAL—SectiOn1902(a)(10)(A)(i)(II) (42 U.S.C.1396 (a) (10) (A) (i) (II) is amended by inserting'or were being paid as of the date of enact-

ment of section 211(a) of the Personal Re-sponsibility and Work Opportunity Rec-onciliation Act of 1996 (P.L. 104—193) andwould continue to be paid but for enactmentof that section" after "title XV!".

(b) EFFECTIVE DATE—The amendmentmade by Sub-Section (a) applies to medicalassistance furnished on or after July 1, 1997.

AMENDMENT OFFERED BY MR. BROWN OF OHIOTO THE CHILD HEALTH RECONCILIATION PROVI-SIONS

(Page & line nos. refer to Committee Print of6/11/97, KIDCARE.006)

Page 2, amend lines 19 and 20 to read as fol-lows:

"(3) Other methods specified under theplan other than direct purchase of servicesfrom providers.

AMENDMENT TO H.R. —, AS REPORTED, OFFEREDBY MR. GEKAS OF PENNSYLVANIA AND MR.FROST OF TEXAS

Insert after section 966 of the bill the fol-lowing (and conform the table of contentsaccordingly):SEC. 967. EXEMPTION FROM REPORTING RE-

QUIREMENTS FOR CERTAINAMOUNTS PAID TO ELECTION OFFI-CIALS AND ELECTION WORKERS.

(A) IN GENERAL—SectiOn 6051 is amendedby adding at the end the following new sub-section:

"(g) EXCEPTION FOR CERTAIN AMOUNTS PAIDTO ELECTION OFFICIALS AND ELECTION WoRK-ERS.—Notwithstanding any other provisionof this title, the Secretary may not requirea statement described in this section to in-clude any amount paid as remuneration forservice performed by an election official orelection worker (within the meaning of sec-tion 3121(b)(F)(iv)) if it is reasonable to be-lieve that such remuneration is not subjectto tax under chapter 21 (relating to FederalInsurance Contributions Act)."

(b) EFFECTIVE DATE—The amendmentmade by this section shall apply to remu-neration paid after December 31, 1996, in tax-able years ending after such date.

AMENDMENT TO HR.—, AS REPORTEDOFFERED BY MR. BARTON OF TEXAS AND MR.

MINCEAt the end of the bill, add the following

new title:TITLE XI—BUDGET PROCESS

ENFORCEMENTSEC. 11001. SHORT TITLE AND TABLE OF CON-

TENTS.(a) SHORT TITLE—This title may be cited

as the "Balanced Budget Assurance Act of1997''.

June 25, 1997 CONGRESSIONAL RECORD — HOUSE H4403(b) TABLE OF CONTENTS.—

TITLE XI—BUDGET PROCESSENFORCEMENT

Sec. 11001. Short title and table of contents.Sec. 11002. Definitions.Subtitle A—Ensure That the Bipartisan Bal-

anced Budget Agreement of 1997 AchievesIts Goal

Sec. 11101. Timetable.Sec. 11102. Procedures to avoid sequestra-

tion or delay of new revenue re-ductions.

Sec. 11103. Effect on Presidents' budget sub-missions; point of order.

Sec. 11104. Deficit and revenue targets.Sec. 11105. Direct spending caps.Sec. 11106. Economic assumptions.Sec. 11107. Revisions to deficit and revenue

targets and to the caps for enti-tlements and other mandatoryspending.

Subtitle B—Enforcement ProvisionsSec. 11201. Reporting excess spending.Sec. 11202. Enforcing direct spending caps.Sec. 11203. Sequestration rules.Sec. 11204. Enforcing revenue targets.Sec. 11205. Exempt programs and activities.Sec. 11206. Special rules.Sec. 11207. The current law baseline.Sec. 11208. Limitations on emergency spend-

ing.SEC. 11002. DEFINITIONS.

For purposes of this title:(1) ELIGIBLE POPULATION.—The term "eligi-

ble population" shall mean those individualsto whom the United States is obligated tomake a payment under the provisions of alaw creating entitlement authority. Suchterm shall not include States, localities, cor-porations or other nonliving entities.

(2) SEQUESTER AND SEQUESTRATION—Theterms sequester" and sequestration' referto or mean the cancellation of budgetary re-sources provided by discretionary appropria-tions or direct spending law.

(3) BREACH—The term breach' means, forany fiscal year. the amount (if any) by whichoutlays for that year (within a category ofdirect spending) is above that category's di-rect spending cap for that year.

(4) BASELINE—The term "baseline" meansthe projection (described in section 11207) ofcurrent levels of new budget authority. Out-lays, receipts, and the surplus or deficit intothe budget year and the outyears.

(5) BUDGETARY RESOURCES—The termbudgetary resources" means new budget au-

thority. unobligated balances, direct spend-ing authority, and obligation limitations.

(6) DISCRETIONARY APPROPRIATIONS—Theterm 'discretionary appropriations" meansbudgetary resources (except to fund directspending programs) provided in appropria-tion Acts. If an appropriation Act alters thelevel of direct spending or offsetting collec-tions. that effect shall be treated as directspending. Classifications of new accounts oractivities and changes in classificationsshall be made in consultation with the Com-mittees on Appropriations and the Budget ofthe House of Representatives and the Senateand with CBO and 0MB.

(7) DIRECT SPENDING—The term "directspending" means—

(A) budget authority provided by law otherthan appropriation Acts, including entitle-ment authority:

(B) entitlement authority: and(C) the food stamp program.

If a law other than an appropriation Act a!-ters the level of discretionary appropriationsor offsetting collections, that effect shall betreated as direct spending.

(8) ENTITLEMENT AUTHORITY.—The term"entitlement authority" means authority(whether temporary or permanent) to make

payments (including loans and grants), thebudget authority for which is not providedfor in advance by appropriation Acts to anyperson or government if. under the provi-sions of the law containing such authority,the United States is obligated to make suchpayments to persons or governments whomeet the requirements established by suchlaw.

(9) CURRENT.—The term "current" means,with respect to 0MB estimates included witha budget submission under section 1105(a) oftitle 31 U.S.C.. the estimates consistent withthe economic and technical assumptions un-derlying that budget.

(10) ACCOUNT—The term 'account' meansan item for which there is a designated budg-et account designation number in the Presi-dent's budget.

(11) BUDGET YEAR.—The term "budgetyear" means the fiscal year of the Govern-ment that starts on the next October 1.

(12) CURRENT YEAR—The term 'currentyear" means, with respect to a budget year.the fiscal year that immediately precedesthat budget year.

(13) OUTYEAR.—The term outyear" means.with respect to a budget year, any of the fis-cal years that follow the budget year.

(14) 0MB—The term 0MB" means the Di-rector of the Office of Management andBudget.

(15) CBO.—The term CBO" means the Di-rector of the Congressional Budget Office.

(16) BUDGET OUTLAYS AND OUTLAYS—Theterms budget outlays" and "outlays" mean.with respect to any fiscal year. expendituresof funds under budget authority during suchyear.

(17) BUDGET AUTHORITY AND NEW BUDGETAUTHORITY.—The terms "budget authority"and new budget authority" have the mean-ings given to them in section 3 of the Con-gressional Budget and Impoundment ControlAct of 1974.

(18) APPROPRIATION ACT.—The term 'appro-priation Act" means an Act referred to insection 105 of title 1 of the United StatesCode.

(19) CONSOLIDATED DEFICIT—The termconsolidated deficit' means, with respect

to a fiscal year. the amount by which totaloutlays exceed total receipts during thatyear.

(20) SURPLUS—The term 'surplus" means.with respect to a fiscal year. the amount bywhich total receipts exceed total outlaysduring that year.

(21) DIRECT SPENDING CAPS—The term di-rect spending caps" means the nominal dol-lar limits for entitlements and other manda-tory spending pursuant to section 11105 (asmodified by any revisions provided for inthis Act).Subtitle A—Ensure That the Bipartisan Bal-


SEC. 11101. TIMETABLE.

On or before: Action to be completed:December 15 Presidential sequester

order or order delayingnew/additional reve-nues reductions sched-uled to take effect pur-suant to reconciliationlegislation enacted incalendar year 1997.

SEC. 11102. PROCEDURES TO AVOID SEQUESTRA-TION OR DELAY OF NEW REVENUEREDUCTIONS.

(a) SPECIAL MESSAGE—If the 0MB Analy-sis of Actual Spending Levels and Projec-tions for the Upcoming Year indicates that—

(1) deficits in the most recently completedfiscal year exceeded, or the deficits in thebudget year are projected to exceed the defi-cit targets in section 11104;

(2) revenues in the most recently com-pleted fiscal year were less than, or revenuesin the current year are projected to be lessthan, the revenue targets in section 11104; or

(3) outlays in the most recently completedfiscal year exceeded, or outlays in the cur-rent year are projected to exceed the caps insection 11104;the President shall submit to Congress withthe 0MB Analysis of Actual Spending Levelsand Projections for the Upcoming Year aspecial message that includes proposed legis-lative changes to—

(A) offset the net deficit or outlay excess;(B) offset any revenue shortfall: or(C) revise the deficit or revenue targets or

the outlay caps contained in this Act;through any combination of—

(i) reductions in outlays:(ii) increases in revenues; or(iii) increases in the deficit targets or ex-

penditure caps, or reductions in the revenuetargets, if the President submits a writtendetermination that, because of economic orprogrammatic reasons, none of the variancesfrom the balanced budget plan should be off-set.

(b) INTRODUCTION OF THE PRESIDENT'SPACKAGE—NOt later than November 15. themessage from the President required pursu-ant to subsection (a) shall be introduced as ajoint resolution in the House of Representa-tives or the Senate by the chairman of itsCommittee on the Budget. If the chairmanfails to do so. after November 15, the jointresolution may be introduced by any Mem-ber of that House of Congress and shall be re-ferred to the Committee on the Budget ofthat House.

(c) HOUSE BUDGET COMMIrFEE ACTION—TheCommittee on the Budget of the House ofRepresentatives shall, by November 15, re-port aj oint resolution containing—

(1) the recommendations in the President'smessage, or different policies and proposedlegislative changes than those contained inthe message of the President, to ameliorateor eliminate any excess deficits or expendi-tures or any revenue shortfalls, or

(2) any changes to the deficit or revenuetargets or expenditure caps contained in thisAct, except that any changes to the deficitor revenue targets or expenditure caps can-not be greater than the changes rec-ommended in the message submitted by thePresident.

(d) PROCEDURE IF THE COMMIrFEES ON THEBUDGET OF THE HOUSE OF REPRESENTATIVESOR SENATE FAILS TO REPORT REQUIRED RESO-LUTION.—

(1) AUTOMATIC DISCHARGE OF COMMITTEES ONTHE BUDGET OF THE HOUSE.—If the Committeeon the Budget of the House of Representa-tives fails, by November 20. to report a reso-lution meeting the requirements of sub-section (c), the committee shall be automati-cally discharged from further considerationof the joint resolution reflecting the Presi-dent's recommendations introduced pursuant

On or before:January 15

First Monday in Feb-ruary.

August 1August 15Not later than November

I (and as soon as prac-tical after the end ofthe fiscal).

November 1—December 15

December 15

Action to be completed:CBO economic and budg-

et update.Presidents budget up-

date based on new as-sumptions.

CBO and 0MB updates.Preview report.0MB and CBO Analyses

of Deficits. Revenuesand Spending Levelsand Projections for theUpcoming Year.

Congressional action toavoid sequestration.

0MB issues final (lookback) report for prioryear and preview forcurrent year.

H4404to subsection (a). and the Joint resolutionshall be placed on the appropriate calendar.

(2) CONSIDERATION OF DISCHARGE RESOLU-TION IN THE HOUSE—If the Committee hasbeen discharged under paragraph (1) above.any Member may move that the House ofRepresentatives consider the resolution.Such motion shall be highly privileged andnot debatable. It shall not be in order to con-sider any amendment to the resolution ex-cept amendments which are germane andwhich do not change the net deficit impactof the resolution.

(e) CONSIDERATION OF JOINT RESOLUTION INTHE HOUSE—Consideration of resolution re-ported pursuant to subsection (c) or (d) shallbe pursuant to the procedures set forth insection 305 of the Congressional Budget Actof 1974 and subsection (d).

(f) TRANSMITFAL TO SENATE—If ajoint res-olution passes the House of Representativespursuant to subsection (e), the Clerk of theHouse of Representatives shall cause the res-olution to be engrossed, certified, and trans-mitted to the Senate within 1 calendar dayof the day on which the resolution is passed.The resolution shall be referred to the Sen-ate Committee on the Budget.

(g) REQUIREMENTS FOR SPECIAL JOINT RESO-LUTION IN THE SENATE.—The Committee onthe Budget of the Senate shall report notlater than December 1—

(1) a joint resolution reflecting the mes-sage of the President; or

(2) theJoint resolution passed by the Houseof Representatives, with or without amend-ment; or

(3) a Joint resolution containing differentpolicies and proposed legislative changesthan those contained in either the messageof the President or the resolution passed bythe House of Representatives, to eliminateall or part of any excess deficits or expendi-tures or any revenue shortfalls, or

(4) any changes to the deficit or revenuetargets, or to the expenditure caps, con-tained in this Act, except that any changesto the deficit or revenue targets or expendi-ture caps cannot be greater than the changesrecommended in the message submitted bythe President.

(h) PROCEDURE IF THE SENATE BUDGET C0M-MIrFEE FAILS To REPORT REQUIRED RESOLU-TION.—

(1) AUTOMATIC DISCHARGE OF SENATE BUDG-ET COMMIrFEE.—In the event that the Com-mittee on the Budget of the Senate fails, byDecember 1, to report a resolution meetingthe requirements of subsection (g). the com-mittee shall be automatically dischargedfrom further consideration of the joint reso-lution reflecting the President's rec-ommendations introduced pursuant to sub-section (a) and of the resolution passed bythe House of Representatives, and both jointresolutions shall be placed on the appro-priate calendar.

(2) CONSIDERATION OF DISCHARGE RESOLU-TION IN THE SENATE.—(A) If the Committeehas been discharged under paragraph (1), anymember may move that the Senate considerthe resolution. Such motion shall be highlyprivileged and not debatable. It shall not bein order to consider any amendment to theresolution except amendments which aregermane and which do not change the netdeficit impact of the resolution.

(B) Consideration of resolutions reportedpursuant to subsections (c) or (d) shall bepursuant to the procedures set forth in sec-tion 305 of the Congressional Budget Act of1974 and subsection (d).

(C) If the joint resolution reported by theCommittees on the Budget pursuant to sub-section (c) or (g) or a joint resolution dis-charged in the House of Representatives orthe Senate pursuant to subsection (d)(1) or(h)(1) would eliminate less than—


(i) the entire amount by which actual orprojected deficits exceed, or revenues fallshort of. the targets in this Act; or

(ii) the entire amount by which actual orprojected outlays exceed the caps containedin this Act;then the Committee on the Budget of theSenate shall report a joint resolution, rais-ing the deficit targets or outlay caps, or re-ducing the revenue targets for any year inwhich actual or projected spending, revenuesor deficits would not conform to the deficitand revenue targets or expenditure caps inthis Act.

(k) CONFERENCE REPORTS SHALL FULLY AD-DRESS DEFICIT EXCESS—It shall not be inorder in the House of Representatives or theSenate to consider a conference report on ajoint resolution to eliminate all or part ofany excess deficits or outlays or to eliminateall or part of any revenue shortfall comparedto the deficit and revenue targets and the ex-penditure caps contained in this Act, un-less—

(1) the joint resolution offsets the entireamount of any overage or shortfall; or

(2) the House of Representatives and Sen-ate both pass the joint resolution reportedpursuant to subsection (J)(2).The vote on any resolution reported pursu-ant to subsection (J)(2) shall be solely on thesubject of changing the deficit or revenuetargets or the expenditure limits in this Act.SEC. 11103. EFFECT ON PRESIDENTS' BUDGET

SUBMISSIONS; POINT OF ORDER.(a) BUDGET SUBMISSION—Any budget sub-

mitted by the President pursuant to section1105(a) of title 31, United States Code, foreach of fiscal years 1998 through 2007 shall beconsistent with the spending, revenue, anddeficit levels established in sections 11104and 11105 or it shall recommend changes tothose levels

(b) POINT OF ORDER—It shall not be inorder in the House of Representatives or theSenate to consider any concurrent resolutionon the budget unless it is consistent with thespending. revenue, and deficit levels estab-lished in sections 11104 and 11105.SEC. 11104. DEFICIT AND REVENUE TARGETS.

(a) CONSOLIDATED DEFICIT (OR SURPLUS)TARGETS—FOr purposes of sections 11102 and11107, the consolidated deficit targets shallbe—

(1) for fiscal year 1998, $90,500,000,000;(2) for fiscal year 1999, $89,700,000,000;(3) for fiscal year 2000, $83,000,000,000;(4) for fiscal year 2001, $53,300,000,000; and(5) for fiscal year 2002, there shall be a sur-

plus of not less than $1,400,000,000.(b) CONSOLIDATED REVENUE TARGETS.—FOr

purposes of sections 11102, 11107, 11201, and11204, the consolidated revenue targets shallbe—

(1) for fiscal year 1998, $1,601,800,000,000;(2) for fiscal year 1999, $1,664,200,000,000;(3) for fiscal year 2000, $1,728,100,000,000;(4) for fiscal year 2001, $1,805,100,000,000; and(5) for fiscal year 2002, $1,890,400,000,000.

SEC. 11105. DIRECT SPENDING CAPS.(a) IN GENERAL—Effective upon submis-

sion of the report by 0MB pursuant to sub-section (c) direct spending caps shall applyto all entitlement authority except for un-distributed offsetting receipts and net inter-est outlays. For purposes of enforcing directspending caps under this Act, each separateprogram shown in the table set forth in sub-section (d) shall be deemed to be a category.

(b) BUDGET COMMITFEE REPORTS—Within30 days after enactment of this Act, theBudget Committees of the House of Rep-resentatives and the Senate shall file withtheir respective Houses identical reportscontaining account numbers and spendinglevels for each specific category.

(c) REPORT BY 0MB—Within 30 days afterenactment of this Act, 0MB shall submit to

June 25, 1997

the President and each House of Congress areport containing account numbers andspending limits for each specific category.

(d) CONTENTS OF REPORTS—All directspending accounts not included in these re-ports under separate categories shall be in-cluded under the heading Other Entitle-ments and Mandatory Spending". These re-ports may include adjustments among thecaps set forth in this Act as required below,however the aggregate amount availableunder the 'Total Entitlements and OtherMandatory Spending" cap shall be identicalin each such report and in this Act and shallbe deemed to have been adopted as part ofthis Act. Each such report shall include theactual amounts of the caps for each year offiscal years 1998 through 2002 consistent withthe concurrent resolution on the budget forFY 1998 for each of the following categories:

Earned Income Tax Credit,Family Support,Federal retirement:Civilian/other,Military,Medicaid,Medicare,Social security,Supplemental security income,Unemployment compensation,Veterans' benefits,Medicare,Other entitlements and mandatory spend-

ing, andAggregate entitlements and other manda-

tory spending.(e) ADDITIONAL SPENDING LIMITS—Legisla-

tion enacted subsequent to this Act may in-clude additional caps to limit spending forspecific programs. activities, or accountswith these categories. Those additional caps(if any) shall be enforced in the same manneras the limits set forth in such joint explana-tory statement.SEC. 11106. ECONOMIC ASSUMPTIONS.

Subject to periodic reestimation based onchanged economic conditions or changes ineligible population, determinations of the di-rect spending caps under section 11105, anybreaches of such caps, and actions necessaryto remedy such breaches shall be based uponthe economic assumptions set forth in thejoint explanatory statement of managers ac-companying the concurrent resolution onthe budget for fiscal year 1998 (House Con-current Resolution 84, 105th Congress).SEC. 11107. REVISIONS TO DEFICIT AND REVE-

NUE TARGETS AND TO THE CAPSFOR ENTITLEMENTS AND OTHERMANDATORY SPENDING.

(a) AUTOMATIC ADJUSTMENTS TO DEFICITAND REVENUE TARGETS AND TO CAPS FOR EN-TITLEMENTS AND OTHER MANDATORY SPEND-ING.—When the President submits the budgetunder section 1105(a) of title 31, UnitedStates Code, for any year, 0MB shall cal-culate (in the order set forth below), and thebudget and reports shall include, adjust-ments to the deficit and revenue targets, andto the direct spending caps (and those limitsas cumulatively adjusted) for the currentyear, the budget year, and each outyear, toreflect the following:

(1) CHANGES TO REVENUE TARGETS.—(A) CHANGES IN GROWTH—For Federal reve-

nues and deficits under laws and policies en-acted or effective before July 1, 1997, growthadjustment factors shall equal the ratio be-tween the level of year-over-year growthmeasured for the fiscal year most recentlycompleted and the applicable estimated levelfor that year as described in section 11105.

(B) CHANGES IN INFLATION—For Federalrevenues and deficits under laws and policiesenacted or effective before July 1, 1997, infla-tiOn adjustment factors shall equal the ratiobetween the level of year-over-year growthmeasured for the fiscal year most recently

June 25, 1997completed and the applicable estimated levelfor that year as described in section 11105.

(2) ADJUSTMENTS TO DIRECT SPENDINGCAPS.—

(A) CHANGES IN CONCEPTS AND DEFINI-TIONS.—The adjustments produced bychanges in concepts and definitions shallequal the baseline levels of new budget au-thority and outlays using up-to-date con-cepts and definitions minus those levelsusing the concepts and definitions in effectbefore such changes. Such changes in con-cepts and definitions may only be made inconsultation with the Committees on Appro-priations, the Budget, and Government Re-form and Oversight and Governmental Af-fairs of the House of Representatives and theSenate.

(B) CHANGES IN NET OUTLAYS—Changes innet outlays for all programs and activitiesexempt from sequestration under section11204.

(C) CHANGES IN INFLATION—For directspending under laws and policies enacted oreffective on or before July 1, 1997. inflationadjustment factors shall equal the ratio be-tween the level of year-over-year inflationmeasured for the fiscal year most recentlycompleted and the applicable estimated levelfor that years as described in section 11105(relating to economic assumptions). For di-rect spending under laws and policies en-acted or effective after July 1, 1997. thereshall be no adjustment to the direct spendingcaps (for changes in economic conditions in-cluding inflation, nor for changes in numbersof eligible beneficiaries) unless—

(i) the Act or the joint explanatory state-ment of managers accompanying such Actproviding new direct spending includes eco-nomic projections and projections of num-bers of beneficiaries; and

(ii) such Act specifically provides for auto-matic adjustments to the direct spendingcaps in section 11105 based on those projec-tions.

(D) CHANGES IN ELIGIBLE POPULATIONS—Fordirect spending under laws and policies en-acted or effective on or before July 1, 1997.the basis for adjustments under this sectionshall be the same as the projections underly-ing Table A—4, CBO Baseline Projections ofMandatory Spending, Including Deposit In-surance (by fiscal year. in billions of dol-lars). published in An Analysis of the Presi-dents Budgetary Proposals for Fiscal Year1998. March 1997, page 53. For direct spendingunder laws and policies enacted or effectiveafter July 1, 1997. there shall be no adjust-ment to the direct spending caps for changesin numbers of eligible beneficiaries unless—

(i) the Act or the joint explanatory state-ment of managers accompanying such Actproviding new direct spending includes eco-nomic projections and projections of num-bers of beneficiaries: and


(E) INTRA-BUDGETARY PAYMENTS.—FrOmdiscretionary accounts to mandatory ac-counts, The baseline and the discretionaryspending caps shall be adjusted to reflectthose changes.

(c) CHANGES TO DEFICIT TARGETS—The def-icit targets in section 11104 shall be adjustedto reflect changes to the revenue targets orchanges to the caps for entitlements andother mandatory spending pursuant to sub-section (a).

(d) PERMISSIBLE REVISIONS TO DEFICIT ANDREVENUE TARGETS AND DIRECT SPENDINGCAPS—Deficit and revenue targets and di-rect spending caps as enacted pursuant tosections 11104 and 11105 may be revised as fol-lows: Except as required pursuant to section11105(a), direct spending caps may only be


amended by recorded vote. It shall be a mat-ter of highest privilege in the House of Rep-resentatives and the Senate for a Member ofthe House of Representatives or the Senateto insist on a recorded vote solely on thequestion of amending such caps. It shall notbe in order for the Committee on Rules ofthe House of Representatives to report a res-olution waiving the provisions of this sub-section. This subsection may be waived inthe Senate only by an affirmative vote ofthree-fifths of the Members duly chosen andsworn.

Subtitle B—Enforcement ProvisionsSEC. 11201. REPORTING EXCESS SPENDING.

(a) ANALYSIS OF ACTUAL DEFICIT, REVENUE,AND SPENDING LEVELS—As soon as prac-ticable after any fiscal year, 0MB shall com-pile a statement of actual deficits, revenues,and direct spending for that year. The state-ment shall identify such spending by cat-egories contained in section 11105.

(b) ESTIMATE OF NECESSARY SPENDING RE-DUCTION.—Based on the statement providedunder subsection (a), the 0MB shall issue areport to the President and the Congress onDecember 15 of any year in which such state-ment identifies actual or projected deficits,revenues, or spending in the current or im-mediately preceding fiscal years in violationof the revenue targets or direct spendingcaps in section 11104 or 11105, by more thanone percent of the applicable total revenuesor direct spending for such year. The reportshall include:

(1) All instances in which actual directspending has exceeded the applicable directspending cap.

(2) The difference between the amount ofspending available under the direct spendingcaps for the current year and estimated ac-tual spending for the categories associatedwith such caps.

(3) The amounts by which direct spendingshall be reduced in the current fiscal year sothat total actual and estimated direct spend-ing for all cap categories for the current andimmediately preceding fiscal years shall notexceed the amounts available under the di-rect spending caps for such fiscal years.

(4) The amount of excess spending attrib-utable solely to changes in inflation or eligi-ble populations.SEC. 11202. ENFORCING DIRECT SPENDING CAPS.

(a) PURPOSE—This subtitle provides en-forcement of the direct spending caps on cat-egories of spending established pursuant tosection 11105. This section shall apply forany fiscal year in which direct spending ex-ceeds the applicable direct spending cap.

(b) GENERAL RULES.—(1) ELIMINATING A BREACH—Each non-ex-

empt account within a category shall be re-duced by a dollar amount calculated by mul-tiplying the baseline level of sequestrablebudgetary resources in that account at thattime by the uniform percentage necessary toeliminate a breach within that category.

(2) PROGRAMS. PROJECTS, OR ACTIVITIES.—Except as otherwise provided, the same per-centage sequestration shall apply to all pro-grams, projects and activities within a budg-et account.

(3) INDEFINITE AUTHORITY—Except as Oth-erwise provided, sequestration in accountsfor which obligations are indefinite shall betaken in a manner to ensure that obligationsin the fiscal year of a sequestration and suc-ceeding fiscal years are reduced, from thelevel that would actually have occurred, bythe applicable sequestration percentage orpercentages.

(4) CANCELLATION OF BUDGETARY RE-SOURCES—Budgetary resources sequesteredfrom any account other than an trust, spe-cial or revolving fund shall revert to theTreasury and be permanently canceled.

H4405(5) IMPLEMENTING REGULATIONS—Notwith-

standing any other provision of law, admin-istrative rules or similar actions implement-ing any sequestration shall take effect with-in 30 days after that sequestration.SEC. 11203. SEQUESTRATION RULES.

(a) GENERAL RULES—For programs subjectto direct spending caps:

(1) TRIGGERING OF SEQUESTRATIoN—Seques-tratiOn is triggered if total direct spendingsubject to the caps exceeds or is projected toexceed the aggregate cap for direct spendingfor the current or immediately preceding fis-cal year.

(2) CALCULATION OF REDUCTIONS—Seques-tratiOn shall reduce spending under each sep-arate direct spending cap in proportion tothe amounts each category of direct spend-ing exceeded the applicable cap.

(3) UNIFORM PERCENTAGES—In calculatingthe uniform percentage applicable to the se-questration of all spending programs or ac-tivities within each category, or the uniformpercentage applicable to the sequestration ofnonexempt direct spending programs or ac-tivities. the sequestrable base for directspending programs and activities is the totallevel of outlays for the fiscal year for thoseprograms or activities in the current lawbaseline.

(4) PERMANENT SEQUESTRATION OF DIRECTSPENDING—Obligations in sequestered directspending accounts shall be reduced in the fis-cal year in which a sequestration occurs andin all succeeding fiscal years. Notwithstand-ing any other provision of this section, afterthe first direct spending sequestration, anylater sequestration shall reduce direct spend-ing by an amount in addition to, rather thanin lieu of, the reduction in direct spending inplace under the existing sequestration or se-questrations.

(5) SPECIAL RULE—For any direct spendingprogram in which—

(A) outlays pay for entitlement benefits:(B) a current-year sequestration takes ef-

fect after the 1st day of the budget year;(C) that delay reduces the amount of enti-

tlement authority that is subject to seques-tration in the budget: and

(D) the uniform percentage otherwise ap-plicable to the budget-year sequestration ofa program or activity is increased due to thedelay;then the uniform percentage shall revert tothe uniform percentage calculated underparagraph (3) when the budget year is com-pleted.

(6) INDEXED BENEFIT PAYMENTS—If, underany entitlement program—

(A) benefit payments are made to personsor governments more frequently than once ayear; and

(B) the amount of entitlement authority isperiodically adjusted under existing law toreflect changes in a price index (commonlycalled "cost of living adjustments");sequestration shall first be applied to thecost of living adjustment before reductionsare made to the base benefit. For the firstfiscal year to which a sequestration applies,the benefit payment reductions in such pro-grams accomplished by the order shall takeeffect starting with the payment made at thebeginning of January following a final se-quester. For the purposes of this subsection,veterans' compensation shall be considered aprogram that meets the conditions of thepreceding sentence.

(7) LOAN PROGRAMS—For all loans made,extended, or otherwise modified on or afterany sequestration under loan programs sub-ject to direct spending caps—

(A) the sequestrable base shall be total feesassociated with all loans made extended orotherwise modified on or after the date of se-questration; and

H4406 CONGRESSIONAL RECORD — HOUSE June 25, 1997(B) the fees paid by borrowers shall be in-

creased by a uniform percentage sufficient toproduce the dollar savings in such loan pro-grams for the fiscal year or years of the se-questrations required by this section.Notwithstanding any other provision of law.in any year in which a sequestration is in ef-fect, all subsequent fees shall be increased bythe uniform percentage and all proceedsfrom such fees shall be paid into the generalfund of the Treasury.

(8) INSURANCE PROGRAMS—Any sequestra-tion of a Federal program that sells insur-ance contracts to the public (including theFederal Crop Insurance Fund, the NationalInsurance Development Fund, the NationalFlood Insurance fund, insurance activities ofthe Overseas Private Insurance Corporation,and Veterans' Life insurance programs) shallbe accomplished by increasing premiums oncontracts entered into extended or otherwisemodified, after the date a sequestrationorder takes effect by the uniform sequestra-tion percentage. Notwithstanding any otherprovision of law, for any year in which a se-questration affecting such programs is in ef-fect. subsequent premiums shall be increasedby the uniform percentage and all proceedsfrom the premium increase shall be paidfrom the insurance fund or account to thegeneral fund of the Treasury.

(9) STATE GRANT FORMULAS—For all Stategrant programs subject to direct spendingcaps—

(A) the total amount of funds available forall States shall be reduced by the amount re-quired to be sequestered; and

(B) if States are projected to receive in-creased funding in the budget year comparedto the immediately preceding fiscal year. se-questration shall first be applied to the esti-mated increases before reductions are madecompared to actual payments to States inthe previous year—

(i) the reductions shall be applied first tothe total estimated increases for all States;then

(ii) the uniform reduction shall be madefrom each State's grant; and

(iii) the uniform reduction shall apply tothe base funding levels available to states inthe immediately preceding fiscal year onlyto the extent necessary to eliminate any re-maining excess over the applicable directspending cap.

(10) SPECIAL RULE FOR CERTAIN PROGRAMS.—Except matters exempted under section 11204and programs subject to special rules setforth under section 11205 and notwithstand-ing any other provisions of law, any seques-tration required under this Act shall reducebenefit levels by an amount sufficient toeliminate all excess spending identified inthe report issued pursuant to section 11201,while maintaining the same uniform per-centage reduction in the monetary value ofbenefits subject to reduction under this sub-section.

(b) WITHIN-SESSION SEQUESTER—If a bill orresolution providing direct spending for thecurrent year is enacted before July 1 of thatfiscal year and causes a breach within anydirect spending cap for that fiscal year, 15days later there shall be a sequestration toeliminate that breach within that cap.SEC. 11204. ENFORCING REVENUE TARGETS.

(a) PURPOSE—This section enforces therevenue targets established pursuant to sec-tion 11104. This section shall apply for anyyear in which actual revenues were less thanthe applicable revenue target in the preced-ing fiscal year or are projected to be lessthan the applicable revenue target in thecurrent year.

(b) ESTIMATE OF NECESSITY TO SUSPENDNEW REVENUE REDUCTIONS—Based on thestatement provided under section 11201(a).

0MB shall issue a report to the Presidentand the Congress on December 15 of any yearin which such statement identifies actual orprojected revenues In the current or imme-diately preceding fiscal years lower than theapplicable revenue target in section 11104. asadjusted pursuant to section 11106. by morethan 1 percent of the applicable total reve-nue target for such year. The report shall in-clude—

(1) all laws and policies described in sub-section (c) which would cause revenues to de-cline in the calendar year which begins Jan-uary 1 compared to the provisions of law ineffect on December 15;

(2) the amounts by which revenues wouldbe reduced by implementation of the provi-sions of law described in paragraph (1) com-pared to provisions of law in effect on De-cember 15: and

(3) whether delaying implementation ofthe provisions of law described in paragraph(1) would cause the total for revenues in theprojected revenues in the current fiscal yearand actual revenues in the immediately pre-ceding fiscal year to equal or exceed thetotal of the targets for the applicable years.

(c) No CREDITS. DEDUCTIONS, EXCLUSIONS.PREFERENTIAL RATE OF TAX. ETC—If anyprovision of the Internal Revenue Code of1986 added by the Revenue ReconciliationAct of 1997 would (but for this section) firsttake effect in a tax benefit suspension year.such provision shall not take effect until thefirst calendar year which is not a tax benefitsuspension year.

(d) END OF SUSPENSION—If the 0MB reportissued under subsection (a) following a taxbenefit suspension year indicates that thetotal of revenues projected in the current fis-cal year and actual revenues in the imme-diately preceding year will equal or exceedthe applicable targets the President shallsign an order ending the delayed phase-in ofnew tax cuts effective January 1. Such ordershall provide that the new tax cuts shalltake effect as if the provisions of this sectionhad not taken effect.

(e) SUSPENSION OF BENEFITS BEING PHASEDIN—If, under any provision of the InternalRevenue Code of 1986. there is an increase inany benefit which would (but for this sec-tion) take effect with respect to a tax benefitsuspension year. in lieu of applying sub-section (c)—

(1) any increase in the benefit under suchsection with respect to such year and eachsubsequent calendar year shall be delayed 1calendar year. and

(2) the level of benefit under such sectionwith respect to the prior calendar year shallapply to such tax benefit suspension year.

(f) PERCENTAGE SUSPENSION WHERE FULLSUSPENSION UNNECESSARY TO ACHIEVE REVE-NUE TARGET—If the application of sub-sections (c). (d). and (e) to any tax benefitsuspension year would (but for this sub-section) cause revenues to decline in the cal-endar year which begins January 1 comparedto the provisions of law in effect on Decem-ber 15; subsections (c) (d) and (e) shall be ap-plied such that the amount of each benefitwhich is denied is only the percentage ofsuch benefit which is necessary to result inrevenues equal to such target. Such percent-age shall be determined by 0MB, and thesame percentage shall apply to such benefits.

(g) TAX BENEFIT SUSPENSION YEAR—Forpurposes of this section, the term tax bene-fit suspension year" means any calendaryear if the statement issued under sub-section (b) during the preceding calendaryear indicates that—

(1) for the fiscal year ending in such pre-ceding calendar year, actual revenues werelower than the applicable revenue target insection 11104. as adjusted pursuant to section11106. for such fiscal year by more than 1 per-cent of such target, or

(2) for the fiscal year beginning in suchpreceding calendar year. projected revenues(determined without regard to this section)are estimated to be lower than the applicablerevenue target in section 11104, as adjustedpursuant to section 11106, for such fiscal yearby more than 1 percent of such target.SEC. 11205. EXEMPT PROGRAMS AND ACTIVITIES.

The following budget accounts. activitieswithin accounts. or income shall be exemptfrom sequestration—

(1) net interest;(2) all payments to trust funds from excise

taxes or other receipts or collections prop-erly creditable to those trust funds;

(3) offsetting receipts and collections;(4) all payments from one Federal direct

spending budget account to another Federalbudget account;

(5) all intragovernmental funds includingthose from which funding is derived pri-marily from other Government accounts;

(6) expenses to the extent they result fromprivate donations. bequests. or voluntarycontributions to the Government:

(7) nonbudgetary activities, including butnot limited to—

(A) credit liquidating and financing ac-counts;

(B) the Pension Benefit Guarantee Cor-poration Trust Funds;

(C) the Thrift Savings Fund;(D) the Federal Reserve System; and(E) appropriations for the District of Co-

lumbia to the extent they are appropriationsof locally raised funds;

(8) payments resulting from Governmentinsurance, Government guarantees. or anyother form of contingent liability, to the ex-tent those payments result from contractualor other legally binding commitments of theGovernment at the time of any sequestra-tion;

(9) the following accounts. which largelyfulfill requirements of the Constitution orotherwise make payments to which the Gov-ernment is committed—

Bureau of Indian Affairs. miscellaneoustrust funds, tribal trust funds (14—9973—0—7—999);

Claims. defense;Claims, judgments and relief act (20—1895—0—

1—806):

Compact of Free Association. economic as-sistance pursuant to Public Law 99-658 (14—04 15—0—1—806);

Compensation of the President (11—0001—0—1—802);

Customs Service, miscellaneous permanentappropriations (20—9992—0—2—852);

Eastern Indian land claims settlementfund (14—2202—0—1—806);

Farm Credit System Financial AssistanceCorporation, interest payments (20—1850—0—1—351);

Internal Revenue collections of PuertoRico (20—5737—0—2—852);

Payments of Vietnam and USS Puebloprisoner-of-war claims (15—0104—0—1—153):

Payments to copyright owners (03—5175—0—2—376);

Salaries of Article III judges (not includingcost of living adjustments):

Soldier's and Airman's Home, payment ofclaims (84—8930—0—7—705);

Washington Metropolitan Area Transit Au-thority. interest payments (46—0300—0—1—401);

(10) the following noncredit special, revolv-ing, or trust-revolving funds—

Exchange Stabilization Fund (20-4444-0-3-155): and

Foreign Military Sales trust fund (1 1—82232—0—7—155).

(J) OPTIONAL EXEMPTION OF MILITARY PER-SONNEL.—

(1) The President may, with respect to anymilitary personnel account. exempt that ac-count from sequestration or provide for a

June 25, 1997lower uniform percentage reduction thatwould otherwise apply.

(2) The President may not use the author-ity provided by paragraph (1) unless he noti-fies the Congress of the manner in whichsuch authority will be exercised on or beforethe initial snapshot date for the budget year.SEC. 11206. SPECIAL RULES.

(a) CHILD SUPPORT ENFORCEMENT PRO-GRAM—Any sequestration order shall accom-plish the full amount of any required reduc-tion in payments under sections 455 and 458of the Social Security Act by reducing theFederal matching rate for State administra-tive costs under the program, as specified(for the fiscal year involved) in section 455(a)of such Act, to the extent necessary to re-duce such expenditures by that amount.

(b) COMMODITY CREDIT CORPORATION.—(1) EFFECTIVE DATE—For the Commodity

Credit Corporation, the date on which a se-questration order takes effect in a fiscal yearshall vary for each crop of a commodity. Ingeneral, the sequestration order shall takeeffect when issued, but for each crop of acommodity for which 1-year contracts are is-sued as an entitlement. the sequestrationorder shall take effect with the start of thesign-up period for that crop that begins afterthe sequestration order is issued. Paymentsfor each contract in such a crop shall be re-duced under the same terms and conditions.

(2) DAIRY PROGRAM.—(A) As the sole means of achieving any re-

duction in outlays under the milk price-sup-port program, the Secretary of Agricultureshall provide for a reduction to be made inthe price received by producers for all milkin the United States and marketed by pro-ducers for commercial use.

(B) That price reduction (measured incents per hundred-weight of milk marketed)shall occur under subparagraph (A) of sec-tion 201(d)(2) of the Agricultural Act of 1949(7 U.S.C. 1446(d) (2) (A)), shall begin on the dayany sequestration order is issued, and shallnot exceed the aggregate amount of the re-duction in outlays under the milk price-sup-port program, that otherwise would havebeen achieved by reducing payments madefor the purchase of milk or the products ofmilk under this subsection during that fiscalyear.

(3) EFFECT OF DELAY—For purposes of sub-section (b)(1), the sequestrable base for Com-modity Credit Corporation is the current-year level of gross outlays resulting fromnew budget authority that is subject to re-duction under paragraphs (1) and (2).

(4) CERTAIN AUTHORITY NOT TO BE LIMITED.—Nothing in this Act shall restrict the Cor-poration in the discharge of its authorityand responsibility as a corporation to buyand sell commodities in world trade, or limitor reduce in any way any appropriation thatprovides the Corporation with funds to coverits realized losses.

(c) EARNED INCOME TAX CREDIT.—(1) The sequestrable base for earned income

tax credit program is the dollar value of allcurrent year benefits to the entire eligiblepopulation.

(2) In the event sequestration is triggeredto reduce earned income tax credits, allearned income tax credits shall be reduced.whether or not such credits otherwise wouldresult in cash payments to beneficiaries, bya uniform percentage sufficient to producethe dollar savings required by the sequestra-tion.

(d) REGULAR AND EXTENDED UNEMPLOYMENTCOMPENSATION.—

(1) A State may reduce each weekly benefitpayment made under the regular and ex-tended unemployment benefit programs forany week of unemployment occurring duringany period with respect to which payments


are reduced under any sequestration order bya percentage not to exceed the percentage bywhich the Federal payment to the State is tobe reduced for such week as a result of suchorder.

(2) A reduction by a State in accordancewith paragraph (1) shall not be considered asa failure to fulfill the requirements of sec-tion 3304(a) (11) of the Internal Revenue Codeof 1986.

(e) FEDERAL EMPLOYEES HEALTH BENEFITSFUND.— For the Federal Employees HealthBenefits Fund, a sequestration order shalltake effect with the next open season. Thesequestration shall be accomplished by an-nual payments from that Fund to the Gen-eral Fund of the Treasury. Those annualpayments shall be financed solely by charg-ing higher premiums. The sequestrable basefor the Fund is the current-year level ofgross outlays resulting from claims paidafter the sequestration order takes effect.

(f) FEDERAL HOUSING FINANCE BOARD.—Any sequestration of the Federal HousingBoard shall be accomplished by annual pay-ments (by the end of each fiscal year) fromthat Board to the general fund of the Treas-ury, in amounts equal to the uniform seques-tration percentage for that year times thegross obligations of the Board in that year.

(g) FEDERAL PAY.—(1) IN GENERAL.— New budget authority to

pay Federal personnel from direct spendingaccounts shall be reduced by the uniformpercentage calculated under section11203(c) (3), as applicable, but no sequestra-tion order may reduce or have the effect ofreducing the rate of pay to which any indi-vidual is entitled under any statutory paysystem (as increased by any amount payableunder section 5304 of title 5, United StatesCode, or any increase in rates of pay whichis scheduled to take effect under section 5303of title 5, United States Code, section 1109 oftitle 37, United States Code, or any otherprovision of law.

(2) DEFINITIONS—For purposes of this sub-section—

(A) the term 'statutory pay system" shallhave the meaning given that term in section5302(1) of title 5, United States Code:term 'elements of military pay" means—

(i) the elements of compensation of mem-bers of the uniformed services specified insection 1009 of title 37, United States Code:

(ii) allowances provided members of theuniformed services under sections 403(a) and405 of such title; and

(iii) cadet pay and midshipman pay undersection 203(c) of such title: and

(B) the term "uniformed services" shallhave the same meaning given that term insection 101(3) of title 37, United States Code.

(h) MEDICARE.—(1) TIMING OF APPLICATION OF REDUCTIONS.—(A) IN GENERAL.— Except as provided in

subparagraph (B). if a reduction is made inpayment amounts pursuant to sequestrationorder, the reduction shall be applied to pay-ment for services furnished after the effec-tive date of the order. For purposes of theprevious sentence. in the case of inpatientservices furnished for an individual, the serv-ices shall be considered to be furnished onthe date of the individual's discharge fromthe inpatient facility.

(B) PAYMENT ON THE BASIS OF COST REPORT-ING PERIODS.— In the case in which paymentfor services of a provider of services is madeunder title XVIII of the Social Security Acton a basis relating to the reasonable cost in-curred for the services during a cost report-ing period of the provider. if a reduction ismade in payment amounts pursuant to a se-questration order, the reduction shall be ap-plied to payment for costs for such servicesincurred at any time during each cost re-porting period of the provider any part of

H4407which occurs after the effective date oforder, but only (for each such cost reportingperiod) in the same proportion as the frac-tion of the cost reporting period that occursafter the effective date of the order.

(2) No INCREASE IN BENEFICIARY CHARGES INASSIGNMENT-RELATED CASES—If a reductionin payment amounts is made pursuant to asequestration order for services for whichpayment under part B of title XVIII of theSocial Security Act is made on the basis ofan assignment described in section1842(b)(3)(B)(ii), in accordance with section1842(b)(6)(B), or under the procedure de-scribed in section 1870(f) (1) of such Act, theperson furnishing the services shall be con-sidered to have accepted payment of the rea-sonable charge for the services, less any re-duction in payment amount made pursuantto a sequestration order, as payment in full.

(3) PART B PREMIUMS—In computing theamount and method of sequestration frompart B of title XVIII of the Social SecurityAct—

(A) the amount of sequestration shall becalculated by multiplying the total amountby which Medicare spending exceeds the ap-propriate spending cap by a percentage thatreflects the ratio of total spending underPart B to total Medicare spending: and

(B) sequestration in the Part B programshall be accomplished by increasing pre-miums to beneficiaries.

(4) No EFFECT ON COMPUTATION OF AAPCC.—In computing the adjusted average per capitacost for purposes of section 1876(a)(4) of theSocial Security Act, the Secretary of Healthand Human Services shall not take into ac-count any reductions in payment amountswhich have been or may be effected underthis part.

(i) POSTAL SERVICE FUND.— Any sequestra-tion of the Postal Service Fund shall be ac-complished by annual payments from thatFund to the General Fund of the Treasury,and the Postmaster General of the UnitedStates and shall have the duty to makethose payments during the first fiscal yearto which the sequestration order applies andeach succeeding fiscal year. The amount ofeach annual payment shall be—

(1) the uniform sequestration percentage,times

(2) the estimated gross obligations of thePostal Service Fund in that year other thanthose obligations financed with an appro-priation for revenue forgone that year.

Any such payment for a fiscal year shall bemade as soon as possible during the fiscalyear, except that it may be made in install-ments within that year if the paymentschedule is approved by the Secretary of theTreasury. Within 30 days after the sequestra-tion order is issued, the Postmaster Generalshall submit to the Postal Rate Commissiona plan for financing the annual payment forthat fiscal year and publish that plan in theFederal Register. The plan may assume effi-ciencies in the operation of the Postal Serv-ice, reductions in capital expenditures, in-creases in the prices of services, or any com-bination, but may not assume a lower Fundsurplus or higher Fund deficit and shall fol-low the requirements of existing law govern-ing the Postal Service in all other respects.Within 30 days of the receipt of that plan.the Postal Rate Commission shall approvethe plan or modit it in the manner thatmodifications are allowed under current law.If the Postal Rate Commission does not re-spond to the plan within 30 days, the plansubmitted by the Postmaster General shallgo into effect. Any plan may be later revisedby the submission of a new plan to the Post-al Rate Commission, which may approve ormodify it.

H4408(J) POWER MARKETING ADMINISTRATIONS

AND T.V.A.— Any sequestration of the De-partment of Energy power marketing admin-istration funds or the Tennessee Valley Au-thority fund shall be accomplished by annualpayments from those funds to the GeneralFund of the Treasury, and the administra-tors of those funds shall have the duty tomake those payments during the fiscal yearto which the sequestration order applies andeach succeeding fiscal year. The amount ofeach payment by a fund shall be—

(1) the direct spending uniform sequestra-tion percentage, times

(2) the estimated gross obligations of thefund in that year other than those obliga-tions financed from discretionary appropria-tions for that year.Any such payment for a fiscal year shall bemade as soon as possible during the fiscalyear, except that it may be made in install-ments within that year if the paymentschedule is approved by the Secretary of theTreasury. Annual payments by a fund maybe financed by reductions in costs requiredto produce the pre-sequester amount ofpower (but those reductions shall not includereductions in the amount of power suppliedby the fund), by reductions in capital ex-penditures. by increases in tax rates, or byany combination, but may not be financedby a lower fund surplus. a higher fund defi-cit, additional borrowing, delay in repay-ment of principal on outstanding debt andshall follow the requirements of existing lawgoverning the fund in all other respects. Theadministrator of a fund or the TVA Board isauthorized to take the actions specified inthis subsection in order to make the annualpayments to the Treasury.

(k) BUSINESS-LIKE TRANSACTIONS—NOt-withstanding any other provision of law, forprograms which provide a business-like serv-ice in exchange for a fee, sequestration shallbe accomplished through a uniform increasein fees (sufficient to produce the dollar sav-ings in such programs for the fiscal year ofthe sequestration required by section11201(a)(2), all subsequent fees shall be in-creased by the same percentage, and all pro-ceeds from such fees shall be paid into thegeneral fund of the Treasury, in any year forwhich a sequester affecting such programsare in effect.SEC. 11207. THE CURRENT LAW BASELINE.

(a) SUBMISSION OF REpORTS.—CB0 and 0MBshall submit to the President and the Con-gress reports setting forth the budget base-lines for the budget year and the next ninefiscal years. The CB0 report shall be submit-ted on or before January 15. The 0MB reportshall accompany the President's budget.

(b) DETERMINATION OF THE BUDGET BASE-LINE.—(1) The budget baseline shall be basedon the common economic assumptions setforth in section 11106, adjusted to reflect re-visions pursuant to subsection (c)

(2) The budget baseline shall consist of aprojection of current year levels of budgetauthority, outlays. revenues and the surplusor deficit into the budget year and the rel-evant outyears based on current enactedlaws as of the date of the projection.

(3) For discretionary spending items, thebaseline shall be the spending caps in effectpursuant to section 601(a)(2) of the Congres-sional Budget Act of 1974. For years forwhich there are no caps, the baseline for dis-cretionary spending shall be the same as thelast year for which there were statutorycaps.

(4) For all other expenditures and for reve-nues, the baseline shall be adjusted by com-paring unemployment, inflation, interestrates, growth and other economic indicators-and changes ineligible population-for themost recent period for which actual data are

CONGRESSIONAL RECORD — HOUSEavailable, compared to the assumptions con-tained in section 11106.

(c) REVISIONS TO THE BASELINE—The base-line shall be adjusted for up-to-date eco-nomic assumptions when CBO submits itsEconomic and Budget Update and when 0MBsubmits its budget update, and by August 1each year, when CBO and OBM submit theirmidyear reviews.SEC. 11208. LIMITATIONS ON EMERGENCY SPEND-

ING.(a) IN GENERAL.—(1) Within the discre-

tionary caps for each fiscal year contained inthis Act. an amount shall be withheld fromallocation to the appropriate committees ofthe House of Representatives and of the Sen-ate and reserved for natural disasters andother emergency purposes.

(2) Such amount for each such fiscal yearshall not be less than 1 percent of total budg-et authority and outlays available withinthose caps for that fiscal year.

(3) The amounts reserved pursuant to thissubsection shall be made available for allo-cation to such committees only if—

(A) the President has made a request forsuch disaster funds;

(B) the programs to be funded are includedin such request; and

(C) the projected obligations for unforeseenemergency needs exceed the 10-year rollingaverage annual expenditures for existing pro-grams included in the Presidential requestfor the applicable fiscal year.

(4) Notwithstanding any other provision oflaw—

(A) States and localities shall be requiredto maintain effort and ensure that Federalassistance payments do not replace, subvertor otherwise have the effect of reducing reg-ularly budgeted State and local expendituresfor law enforcement, refighting, road con-struction and maintenance, building con-struction and maintenance or any other cat-egory of regular government expenditure (toensure that Federal disaster payments aremade only for incremental costs directly at-tributable to unforeseen disasters, and donot replace or reduce regular State and localexpenditures for the same purposes);

(B) the President may not take adminis-trative action to waive any requirement forStates or localities to make minimummatching payments as a condition or receiv-ing Federal disaster assistance and prohibitthe President from taking administrative ac-tion to waive all or part of any repayment ofFederal loans for the State or local matchingshare required as a condition of receivingFederal disaster assistance, and this clauseshall apply to all matching share require-ments and loans to meet matching share re-quirements under the Robert T. Stafford Dis-aster Relief and Emergency Assistance Act(42 U.S.C. 5121 et seq.) and any other Actspursuant to which the President may declarea disaster or disasters and States and local-ities otherwise qualify for Federal disasterassistance: and

(C) a two-thirds vote in each House of Con-gress shall be required for each emergency toreduce or waive the State matching require-ment of to forgive all or part of loans for theState matching share as required under theRobert T. Stafford Disaster Relief and Emer-gency Assistance Act.

(b) EFFECT BUDGET RESOLUTIONS.—(l) Allconcurrent resolutions on the budget (in-cluding revisions) shall specify the amountof new budget authority and outlays withinthe discretionary spending cap that shall bewithheld from allocation to the committeesand reserved for natural disasters, and a pro-cedure for releasing such funds for allocationto the appropriate committee. The amountwithheld shall be equal to 1 percent of thetotal discretionary spending cap for fiscalyear covered by the resolution, unless addi-tional amounts are specified.

June 25, 1997

(2) The procedure for allocation of theamounts pursuant to paragraph (1) shall en-sure that the funds are released for alloca-tion only pursuant to the conditions con-tained in subsection (a)(3)(A) through (C).

(c) RESTRICTION ON USE OF FUNDS—NOt-withstanding any other provision of law. theamount reserved pursuant to subsection (a)shall not be available for other than emer-gency funding requirements for particularnatural disasters or national security emer-gencies so designated by Acts of Congress.

(d) NEW POINT OF ORDER.—(1) Title IV ofthe Congressional Budget Act of 1974 isamended by adding at the end the followingnew section:

POINT OF ORDER REGARDING EMERGENCIES

"SEC. 408. It shall not be in order in theHouse of Representatives or the Senate toconsider any bill or joint resolution, oramendment thereto or conference reportthereon, containing an emergency designa-tion for purposes of section 251(b)(2)(D) or252(e) of the Balanced Budget and EmergencyDeficit Control Act of 1985 or of section 11207of the Balanced Budget Assurance Act of 1997if it also provides an appropriation or directspending for any other item or contains anyother matter, but that bill or joint resolu-tion, amendment, or conference report maycontain rescissions of budget authority or re-ductions of direct spending, or that amend-ment may reduce amounts for that emer-gency.".

(2) The table of contents set forth in sec-tion 1(b) of the Congressional Budget and Im-poundment Control Act of 1974 is amended byinserting after the item relating to section407 the following new item:

Sec. 408. Point of order regarding emer-gencies.".

AMENDMENT TO HR. 2015, AS REPORTEDOFFERED BY MR. TAYLOR OF MISSISSIPPI

At the end of title IV, add the followingnew subtitle:

Subtitle J—Uniformed Services MedicareSubvention

SEC. 4901. DEFINITIONS.For purposes of this subtitle:(1) MEDICARE-ELIGIBLE COVERED MILITARY

BENEFICIARY—The term medicare-eligiblecovered military beneficiary' means a bene-ficiary under chapter 55 of title 10, UnitedStates Code, who—

(A) is entitled to hospital insurance bene-fits under part A of title XVIII of the SocialSecurity Act (42 U.S.C. 1395c et seq.); and

(B) is enrolled in the supplementary medi-cal insurance program under part B of suchtitle (42 U.S.C. 1395j et seq.).

(2) TRICARE PROGRAM—The term'TRICARE program' means the managedhealth care program that is established bythe Secretary of Defense under the authorityof chapter 55 of title 10, United States Code,principally section 1097 of such title, and in-cludes the competitive selection of contrac-tors to financially underwrite the delivery ofhealth care services under the CivilianHealth and Medical Program of the Uni-formed Services,

(3) SUBVENTION PROGRAM—The term sub-vention program" means the program estab-lished under section 4902 to reimburse theDepartment of Defense, from the medicareprogram under title XVIII of the Social Se-curity Act (42 U.S.C. 1395 et seq.), for healthcare services provided to medicare-eligiblecovered military beneficiaries through themanaged care option of the TRICARE pro-gram.

(4) SECRETARIES—The term 'Secretaries"means the Secretary of Defense and the Sec-retary of Health and Human Services actingjointly.

June 25, 1997

SEC. 490Z. ESTABLISHMENT OF SUBVENTIONPROGRAM.

(a) ESTABLISHMENT REQUIRED—The Sec-retary of Defense and the Secretary ofHealth and Human Services shall jointly es-tablish a program to provide the Departmentof Defense with reimbursement, beginningOctober 1. 1997, in accordance with section4903, from the medicare program under titleXVIII of the Social Security Act (42 U.S.C.1395 et seq.) for health care services providedto medicare-eligible covered military bene-ficiaries who agree to receive the health careservices through the managed care option ofthe TRICARE program.

(b) VOLUNTARY ENROLLMENT—For purposesof the subvention program, enrollment ofmedicare-eligible covered military bene-ficiaries in the managed care option of theTRICARE program shall be voluntary, ex-cept that the total number of medicare-eligi-ble covered military beneficiaries so enrolledshall be subject to the capacity and fundinglimitations specified in section 4903.

(c) EFFECT OF ENROLLMENT—In the case ofa medicare-eligible covered military bene-ficiary who enrolls in the managed care op-tion of the TRICARE program, paymentsmay not be made under title XVIII of the So-cial Security Act (42 U.S.C. 1395 et seq.)other than under the subvention program forhealth care services provided through themanaged care option, except that the Sec-retaries may provide exceptions for emer-gencies or other situations as the Secretariesconsider appropriate.

(d) TRICARE PROGRAM ENROLLMENT FEEWAIVER—The Secretary of Defense shallwaive the enrollment fee applicable to anymedicare-eligible covered military bene-ficiary enrolled in the managed care optionof the TRICARE program for whom reim-bursement may be made under section 4903.

(e) MODIFICATION OF TRICARE CON-TRACTS—In carrying out the subvention pro-gram. the Secretary of Defense may amendexisting TRICARE program contracts asmay be necessary to incorporate provisionsspecifically applicable to medicare-eligiblecovered military beneficiaries who enroll inthe managed care option of the TRICAREprogram.

(f COST SHARING—The Secretary of De-fense may establish cost sharing require-ments for medicare-eligible covered militarybeneficiaries who enroll in the managed careoption of the TRICARE program and forwhom reimbursement may be made undersection 4903.

(g) EXPANSION OF SUBVENTION PROGRAM.—The Secretaries may expand the subventionprogram to incorporate health care servicesprovided to medicare-eligible covered mili-tary beneficiaries under the fee-for-serviceoptions of the TRICARE program if. in thereport submitted under section 713 of the Na-tional Defense Authorization Act for FiscalYear 1997 (Public Law 104—106; 110 Stat. 2591),the Secretaries determined that such expan-sion is feasible and advisable.SEC. 4903. DETERMINATION OF REIMBURSEMENT

AMOUNTS.(a) REIMBURSEMENT OF DEPARTMENT OF DE-

FENSE.—(1) BASIS OF pAYMENTS—Beginning October

1, 1997. monthly payments to the Departmentof Defense under the subvention programshall be made from the medicare programunder title XVIII of the Social Security Act(42 U.S.C. 1395 et seq.) on the basis that pay-ments are made under section 1876(a) of thesuch Act (42 U.S.C. 1395mm(a)).

(2) AMOUNT OF PAYMENTS—The Secretaryof Health and Human Services shall makepayments to the Department of Defense fromthe Federal Hospital Insurance Trust Fundand the Federal Supplementary Medical In-surance Trust Fund (allocated by the Sec-


retary of Health and Human Services be-tween each trust fund based on the relativeweight that each trust fund contributes tothe required payment) at a per capita rateequal to 93 percent of the applicable adjustedaverage per capita cost for each medicare-el-igible covered military beneficiary enrolledin the managed care option of the TRICAREprogram in excess of the number of suchbeneficiaries calculated under subsection (b)for the Department of Defense maintenanceof health care effort.

(b) MAINTENANCE OF DEFENSE HEALTH CAREEFFORT.—

(1) MAINTENANCE OF EFFORT REQUIRED.—The Secretary of Defense shall maintain theDepartment of Defense health care effortsfor medicare-eligible covered military bene-ficiaries so as to avoid imposing on the medi-care program those costs that the Depart-ment of Defense would be expected to incurto provide health care services to medicare-eligible covered military beneficiaries in theabsence of the subvention program.

(2) ESTIMATE OF PRIOR EFFORT—For thefirst fiscal year of the subvention program.the Secretaries shall estimate the amountexpended by the Department of Defense forfiscal year 1997 for providing health careitems and services (other than pharma-ceuticals provided to outpatients) to medi-care-eligible covered military beneficiaries.For subsequent fiscal years, the amount soestimated shall be adjusted for inflation. fordifferences between estimated and actualamounts expended, and for changes in theDepartment of Defense health care budgetthat exceed $100,000,000.

(3) TARGET FOR DEFENSE EFFORT—On thebasis of the estimate made under paragraph(2), the Secretaries shall establish monthlytargets of the number of medicare-eligiblecovered military beneficiaries for whom re-imbursement will not be provided to the De-partment of Defense under subsection (a).

(c) PROTECTION OF MEDICARE PROGRAMAGAINST INCREASED CoSTS.—

(1) PURPOSE—The purpose of this sub-section is to protect the medicare programagainst costs incurred under subsection (a)in connection with the provision of healthcare services to medicare-eligible coveredmilitary beneficiaries that would not havebeen incurred by the medicare program inthe absence of the reimbursement require-ment.

(2) REVIEW BY COMPTROLLER GENERAL—Notlater than December 31 of each year, theComptroller General shall determine andsubmit to the Secretaries and Congress a re-port on the extent, if any, to which the costsof the Secretary of Defense under theTRICARE program and the costs of the Sec-retary of Health and Human Services underthe medicare program have increased as a re-sult of the subvention program.

(3) ACTIONS TO PREVENT INCREASED COSTS.—If the Secretaries determine that the trustfunds under title XVIII of the Social Secu-rity Act (42 U.S.C. 1395 et seq.) still incur ex-cess costs as a result of the subvention pro-gram, the Secretaries shall take such stepsas may be necessary to offset those excesscosts (and prevent future excess costs), in-cluding suspension or termination of thesubvention program, adjustment of the pay-ment rate under subsection (a) (2), or an ad-justment of the maintenance of effort re-quirements of the Department of Defenseunder subsection (b).

AMENDMENT TO H.R. —, AS REPORTED. OFFEREDBY MR. KENNEDY OF MASSACHUSETrS.(Amendment to Child Health Budget

Reconciliation Provision)In section 3502, in the section 2103(b)(2) of

the Social Security Act as added by such sec-

H4409tion, insert before the period at the end thefollowing: plus the average number of low-income children who have such coverage inthe fiscal year, as estimated by the Sec-retary, only pursuant to a State-only fundedhealth coverage program or pursuant to anoptional expansion of coverage under theState's medicaid plan under title XIX.

AMENDMENT TO TAX RECONCILIATION PROVI-SIONS OFFERED BY MR. MCDERMOTr OF WASH-INGTON AND MR. MATSUI

Strike section 934 of the bill (relating tostandards for determining whether individ-uals are not employees).

AMENDMENT TO H.R.— AS REPORTED, OFFEREDBY MR. NADLER OF NEW YORK

(Offered to Medicare ReconciliationProvisions)

In section 3461(a)(3), in the paragraph(64) (A) (i) inserted by such section, by insert-ing before the semicolon at the end the fol-lowing: and so that coverage of services andtreatment is not denied if they are deter-mined to be medically necessary in the pro-fessional opinion of the treating health careprovider, in consultation with the individ-ual'.

In sections 4001 and 10001, in the section1852(d)(1) inserted by each such section,amend subparagraph (D) to read as follows:

(D) the organization provides coverage ofservices and treatment of appropriate pro-viders, including credentialed specialistswhen such treatment and services are deter-mined to be medically necessary in the pro-fessional opinion of the treating health careprovider, in consultation with the individual:and

AMENDMENT TO HR.—, AS REPORTED, OFFEREDBY MR. NADLER OF NEW YORK. MS. MALONEYOF NEW YORK. AND MR. SCHUMER

Strike section 7002 (relating to the sale ofGovernors Island. New York) and redesig-nate subsequent sections of title VII accord-ingly.

Subtitle B of title III is amended by addingat the end the following:SEC. 3102. SALE OF PETROLEUM PRODUCTS

FROM WEEKS ISLAND FACILITY.In fiscal year 2002, the Secretary of Energy

shall sell 73,000,000 barrels of petroleum prod-uct from the Weeks Island facility of theStrategic Petroleum Reserve.

AMENDMENT TO THE BUDGET RECONCILIATIONBILL OFFERED BY REPRESENTATIVE SANDERM. LEVIN

Strike subtitle D of title IX and insert thefollowing:


SEC. 9301. EXCEPTION FOR CERTAIN DISABLEDINDIVIDUALS FROM RESTRICTIONSON SUPPLEMENTAL SECURITY IN-COME AND MEDICAID PROGRAMPARTICIPATION BY QUALIFIEDALIENS.

(a) SSI EXCEPTION—Section 402(a) (2) of thePersonal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 is amendedby redesignating subparagraph (D) as sub-paragraph (E), and by inserting after sub-paragraph (C) the following new subpara-graph:

(D) SSI EXCEPTION FOR CERTAIN DISABLEDALIENS—With respect to the program speci-fied in paragraph (3)(A). paragraph (1) shallnot apply to a qualified alien—

'(i) who is blind or disabled within themeaning of section 1614(a) (2) or 1614(a) (3). re-spectively, of the Social Security Act: and

'(ii) who. prior to August 23, 1996, was law-fully admitted for permanent residence or

H4410had otherwise obtained an immigration Sta-tus included in the definition of 'qualifiedalien under section 431..

(b) MEDICAID EXCEpTION—Section 402(b) (2)of such Act is amended by redesignating sub-.paragraph (D) as subparagraph (E), and byinserting after subparagraph (C) the follow-ing new subparagraph:

(D) MEDICAID EXCEPTION FOR CERTAIN DIS-ABLED ALIENS—With respect to the programspecified in paragraph (3)(C). paragraph (1)shall not apply to a qualified alien who is anindividual described in subsection (a)(2)(D)..

(c) EFFECTIVE DATE.—The amendmentsmade by this section shall take effect asthough they had been included in the enact-ment of section 402 of the Personal Respon-sibility and Work Opportunity Reconcili-ation Act of 1996.SEC. 9302. 2-YEAR EXTENSION OF 5-YEAR EXCEP-

TIONS FOR REFUGEES AND CERTAINOTHER QUALIFIED ALIENS FROMBANS ON ELIGIBILITY FOR SSI ANDMEDICAID.

(a) SSI.—Section 402(a)(2)(A) of the Per-sonal Responsibility and Work OpportunityReconciliation Act of 1996 is amended in thematter preceding clause (i) by inserting ', inthe case of the Federal program specified inparagraph (3)(B). and 7 years, in the case ofthe Federal program specified in paragraph(3)(A).' after '5 years".

(b) MEDICAID—Section 402(b)(2)(A) of suchAct is amended in each of clauses (i). (ii). and(iii) by inserting '(or 7 years, in the case ofthe program specified in paragraph (3)(C))"after 5 years".

(c) EFFECTIVE DATE—The amendmentsmade by this section shall take effect asthough they had been included in the enact-ment of section 402 of the Personal Respon-sibility and Work Opportunity Reconcili-ation Act of 1996.SEC. 9303. EXEMPTIONS FROM RESTRICTIONS ON

SUPPLEMENTAL SECURITY INCOMEPROGRAM PARTICIPATION BY PER-MANENT RESIDENT ALIENS WHOARE MEMBERS OF AN INDIAN TRIBE.

(a) IN GENERAL.—

(1) SPECIAL RESTRICTION APPLICABLE TOSSI.—Section 402(a) (2) of the Personal Re-sponsibility and Work Opportunity Rec-onciliation Act of 1996 is amended by redesig-nating subparagraph (E) (as previously redes-ignated by section 9301(a) of this Act) as sub-paragraph (F), and by inserting after sub-paragraph (D) the following new subpara-graph:

(E) SSI EXCEPTION FOR PERMANENT RESI-DENT ALIENS WHO ARE MEMBERS OF AN INDIANTRIBE—With respect to the program speci-fied in paragraph (3)(A), paragraph (1) shallnot apply to any alien who is lawfully admit-ted to the United States for permanent resi-dence under the Immigration and National-ity Act and who is a member of an Indiantribe (as defined in section 4(e) of the IndianSelf-Determination and Education Assist-ance Act (25 U.S.C. 450b(e)).".

(2) FIVE-YEAR RESTRICTION APPLICABLE TONEW ENTRANTS—Section 403(b) of such Act isamended by adding at the end the followingnew paragraph:

(3) SSI EXCEPTION FOR PERMANENT RESI-DENT ALIENS WHO ARE MEMBERS OF AN INDIANTRIBE—An alien described in section402(a) (2) (E), but only with respect to the pro-gram specified in section 402(a) (3) (A).".

(b) EFFECTIVE DATE—The amendmentsmade by paragraphs (1) and (2) of subsection(a) shall take effect as though they had beenincluded in the enactment of sections 402 and403. respectively, of the Personal Respon-sibility and Work Opportunity Reconcili-ation Act of 1996.

CONGRESSIONAL RECORD — HOUSESEC. 9304. EXEMPTION FROM RESTRICTION ON

SUPPLEMENTAL SECURITY INCOMEPROGRAM PARTICIPATION BY CER-TAIN RECIPIENTS ELIGIBLE ON THEBASIS OF VERY OLD APPLICATIONS.

(a) IN GENERAL—Section 402(a)(2) of thePersonal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 is amendedby redesignating subparagraph (F) (as pre-viously redesignated by section 9303(a) (1) ofthis Act) as subparagraph (C). and by insert-ing after subparagraph (E) the following newsubparagraph:

(F) SSI EXCEPTION FOR CERTAIN RECIPIENTSELIGIBLE ON THE BASIS OF VERY OLD APPLICA-TIONS.—With respect to the program speci-fied in paragraph (3)(A), paragraph (1) shallnot apply to any individual (i) who is eligiblefor benefits under such program for monthsafter July 1996 on the basis of an applicationfiled before January 1. 1979. and (ii) with re-spect to whom the Commissioner lacks clearand convincing evidence that such individualis an alien ineligible for such benefits as aresult of the application of this section..

(b) EFFECTIVE DATE—The amendmentmade by subsection (a) shall take effect asthough it had been included in the enact-ment of section 402 of the Personal Respon-sibility and Work Opportunity Reconcili-ation Act of 1996.SEC. 9305. EXTENSION OF DEADLINES FOR SSI

REDETERMINATION PROVISIONS.(a) IN GENERAL—Section 402(a) (2) (C) (i) of

the Personal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 (as redesig-nated by section 9304(a) of this Act) isamended—

(1) in subclause (I). by striking the datewhich is 1 year after such date of enact-ment and inserting March 31. 1998 or. iflater, the date which is 255 days after thedate of the enactment of [INSERT SHORTTITLE OF THE ACT CONTAINING THISAMENDMENT]": and

(2) in subclause (III)—(A) by striking the date of the redeter-

mination with respect to such individualand inserting 'March 31. 1998 or, if later. thedate which is 255 days after the date of theenactment of [INSERT SHORT TITLE OFTHE ACT CONTAINING THIS AMEND-MENTI" and

(B) by inserting '. and the provisions ofsection 1614(a) (4) and clauses (i) and (ii) ofsection 1631(a)(7)(A) of the Social SecurityAct shall not apply to such individual" be-fore the period.

(b) EFFECTIVE DATE—The amendmentmade by subsection (a) shall take effect asthough they had been included in the enact-ment of section 402 of the Personal Respon-sibility and Work Opportunity Reconcili-ation Act of 1996.SEC. 9306. REALLOCATION OF DISABILITY DETER-

MINATION WORXLOADS RELATINGTO ALIENS.

In any State making disability determina-tions in accordance with section 221 of theSocial Security Act, the Commissioner ofSocial Security may, notwithstanding theprovisions of such section specitying the cir-cumstances under which the Commissionermay assume the disability determinationfunction in such State, elect to make the de-termination of disability with respect tosome or all of the individuals in such Statewho are described in section 402(a)(2)(D) ofthe Personal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 (as addedby section 9301(a) of this Act) or to transferresponsibility for such function to anotherState that the Commissioner determines iswilling and able to perform such function, ifthe Commissioner determines that such ac-tion is necessary to comply with the dead-line specified in section 402(a)(2)(G)(i)(I) ofthe Personal Responsibility and Work Oppor-

June 25, 1997

tunity Reconciliation Act of 1996 (as redesig-nated by section 9304(a) of this Act).SEC. 9307. PRESUMPTION OF DISABILITY FOR

PURPOSES OF THE SUPPLEMENTALSECURITY INCOME PROGRAM INTHE CASE OF CERTAIN QUALIFIEDALIENS RESIDING IN CERTAIN FA-CILITIES OR RECEIVING HOSPICECARE.

For the purpose of determining whether aqualified alien (as defined in section 431 ofthe Personal Responsibility and Work Oppor-tunity Reconciliation Act of 1996) meets therequirement contained in clause (i) of sec-tion 402(a) (2) (D) of such Act (as added by sec-tiOn 9301(a) of this Act), a qualified alien—

(1) who—(A) has attained the age of 65; and(B) resides in an institution (or distinct

part of an institution) that is primarily en-gaged in providing medical, custodial, orother care to residents who, because of theirmental or physical condition, require suchcare: or

(2) who is terminally ill and receiving hos-pice care,shall be presumed to be blind or disabledwithin the meaning of section 1614(a)(2) or1614(a)(3). respectively, of the Social Secu-rity Act. Such presumption may be rebuttedonly if the Commissioner of Social Securityreceives clear and convincing evidence to thecontrary.SEC. 9308. RELIANCE ON INFORMATION FROM

OTHER AGENCIES.(a) RELIANCE—Notwithstanding any other

provision of law, in determining whether aqualified alien (as defined in section 431 ofthe Personal Responsibility and Work Oppor-tunity Reconciliation Act of 1996) meets therequirement respecting blindness or disabil-ity contained in clause (i) of section402(a) (2) (D) of such Act (as added by section9301(a) of this Act), the Commissioner of So-cial Security may rely on information froma State or Federal agency respecting themedical condition of such individual in anycase where such information indicates to theCommissioner's satisfaction that such indi-vidual is blind or disabled within the mean-ing of section 1614(a)(2) or section 1614(a)(3).respectively. of the Social Security Act.

(b) PROVISION OF INFORMATION—Notwith-standing any other provision of law otherthan section 6103 of the Internal RevenueCode of 1986. the Department of Health andHuman Services. the Immigration and Natu-ralization Service. an agency of any State,or any other governmental agency may dis-close to the Social Security Administrationinformation respecting the medical condi-tion of an individual that the Commissionerof Social Security requests for the purpose ofmaking the determination described in sub-section (a).

(c) TEMPORARY EXEMPTION FROM COMPUTERMATCHING REQUIREMENTS.—The provisions ofsubsections (e)(12). (o). (p), (q), and (u) of sec-tion 552a of title 5, United States Code, shallnot apply to any computer matching pro-gram conducted during the one-year periodfollowing the date of the enactment of [IN-SERT SHORT TITLE OF THE ACT CON-TAINING THIS PROVISION] for the purposeof making the determinations described insubsection (a).SEC. 9309. TREATMENT OF CERTAIN AMERASIAN

IMMIGRANTS AS REFUGEES.(a) AMENDMENTS TO EXCEPTIONS FOR REFU-

GEES/ASYLEES.—(1) FOR PURPOSES OF SSI AND FOOD

STAMPS—Section 402(a) (2) (A) of the PersonalResponsibility and Work Opportunity Rec-onciliation Act of 1996 is amended—

(A) by striking ': or" at the end of clause(ii);

(B) by striking the period at the end ofclause (iii) and inserting '; or": and

June 25, 1997(C) by adding after clause (iii) the follow-

ing new clause:"(iv) an alien is admitted to the United

States as an Amerasian immigrant pursuantto section 584 of the Foreign Operations. Ex-port Financing, and Related Programs Ap-propriations Act. 1988, as incorporated intosection 101(e) of the Joint resolution makingfurther continuing appropriations for the fis-cal year 1988. Public Law 100-202. and amend-ed by the 9th proviso under Migration andRefugee Assistance in title II of the ForeignOperations. Export Financing, and RelatedPrograms Appropriations Act. 1991. PublicLaw 101—513.".

(2) FoR PURPOSES OF TANF. SSBG, AND MED-ICAID.—Section 402(b)(2)(A) of such Act isamended—

(A) by striking "; or" at the end of clause(ii):

(B) by striking the period at the end ofclause (iii) and inserting "; or"; and

(C) by adding after clause (iii) the follow-ing new clause:

"(iv) an alien described in subsection(a)(2)(A)(iv) until 5 years (or 7 years. in thecase of the program specified in paragraph(3)(C)) after the date of such alien's entryinto the United States.".

(3) FOR PURPOSES OF EXCEPTION FROM 5-YEAR LIMITED ELIGIBILITY OF QUALIFIEDALIENS—Section 403(b)(1) of such Act isamended by adding after subparagraph (C)the following new subparagraph:

"(D) An alien described in section402(a) (2) (A) (iv).".

(4) FOR PURPOSES OF CERTAIN STATE PRO-GRAMS—Section 412(b)(1) of such Act isamended by adding after subparagraph (C)the following new subparagraph:


(b) EFFECTIVE DATE.—The amendmentsmade by this section shall be effective withrespect to periods beginning on or after Oc-tober 1. 1997.SEC. 9310. 5-YEAR LIMITED ELIGIBILITY FOR

MEANS-TESTED PUBLIC BENEFITS:SPECIAL RULE FOR CUBAN AND HAI-TIAN ENTRANTS.

(a) CORRECTION OF REFERENCE—Section403(d) of the Personal Responsibility andWork Opportunity Reconciliation Act of 1996is amended by striking "section 501(e)(2)"and inserting "section 501(e)".

(b) EFFECTIVE DATE.—The amendmentmade by this section shall be effective withrespect to periods beginning on or after Oc-tober 1, 1997.

AMENDMENT TO H.R.—, AS REPORTED. OFFEREDBY MR. LEVIN OF MICHIGAN

Strike sections 5004 and 9004. and redesig-nate succeeding sections and amend thetable of contents. accordingly.

AMENDMENT TO HR.—, AS REPORTED. OFFEREDBY MR. LEVIN OF MICHIGAN

Strike section 9102. and redesignate suc-ceeding sections and amend the table of con-tents. accordingly.

AMENDMENT TO HR.—, AS REPORTED (RELATINGTO RECONCILIATION). OFFERED BY MR. CON-YERS OF MICHIGAN

In section 9004(a) (Committee on Ways andMeans print). and in section 5004(a) (Edu-cation and Labor print) strike the closemarks and the period at the end.

In section 407(J) of the Social Security Act,as amended by Section 9004(a) of the bill. andin section 407(k) of the Social Security Act,as amended by Section 5004 (a) of the bill. addthe following at the end:

"(6) RULE OF CONSTRUCTION—Nothing inthis title shall be construed to deny recipi-ents of assistance engaging in work. work


experience or community service under thistitle protection under title VII of the CivilRights Act of 1964."

AMENDMENT TO H.R.—, AS REPORTED, OFFEREDBY MR. CONYERS OF MICHIGAN (MALPRACTICE)

Strike sections 4801 through 4812 (Commit-tee on Commerce) and 10801 through 10812(Committee on Ways and Means), redesig-nate succeeding sections. and conform thetable of contents.

AMENDMENT OFFERED BY REPRESENTATIVEROUKEMA AND REPRESENTATIVE POMEROY

Strike sections 5301 through 5307 of sub-title D of Title V.

AMENDMENT OFFERED BY MR. WAXMAN TO THEMEDICAID RECONCILIATION PROVISIONS

At the end of the text, add the followingnew chapter:

CHAPTER 4—EXTENSION OF PREMIUMPROTECTION FOR LOW-INCOME MEDI-CARE BENEFICIARIESSEC. 3481. EXTENSION OF SLMB PROTECTION.

(a) IN GENERAL—Section 1902(a) (10) (E) (iii)(42 U.S.C. 1396a(a)(10)(E)(iii)) is amended bystriking "and 120 percent in 1995 and yearsthereafter" and inserting ", 120 percent in1995 through 1997. 130 percent in 1998, 140 per-cent in 1999. and 150 percent in 2000 and yearsthereafter".

(b) 100 PERCENT FMAP.—Section 1905(b) (42U.S.C. 1396d(b)) is amended by adding at theend the following: "Notwithstanding thefirst sentence of this section. the Federalmedical assistance percentage shall be 100percent with respect to amounts expended asmedical assistance for medical assistance de-scribed in section 1902(a) (10(E) (iii) for indi-viduals described in such section whose in-come exceeds 120 percent of the official pov-erty line referred to in such section".

"(ii) in the manner and through the writ-ten instrumentalities such MedicarePlus or-ganization deems appropriate. makes avail-able information on its policies regardingsuch service to prospective enrollees beforeor during enrollment and to enrollees within90 days after the date that the organizationor plan adopts a policy regarding such acounseling or referral service.

AMENDMENT OFFERED BY REPRESENTATIVEDAVIS OF VIRGINIA AND REPRESENTATIVENORTON OF THE DISTRICT OF COLUMBIA

The amendment consists of the text ofH.R. 1963.

AMENDMENT TO H.R. —, AS REPORTED (RELAT-ING TO RECONCILIATION) OFFERED BY MR.BERMAN OF CALIFORNIA

At an appropriate place, insert the follow-ing (and make such technical and conform-ing changes as may be appropriate):SEC. . AMENDMENT TO PRESERVE FOOD STAMP

ELIGIBILITY OF MIGRANT AND SEA-SONAL AGRICULTURAL WORKERS.

Subtitle D of title IV of the Personal Re-sponsibility and Work Opportunity Rec-onciliation Act of 1996 is amended by addingat the end the following:"SEC. 435. PRESERVATION OF ELIGIBILrrY OF MI-

GRANT AND SEASONAL AGRICUL-TURAL WORKERS TO RECEIVE FOODSTAMP BENEFITS.

"(a) EXCLUSION OF MIGRANT AND SEASONALAGRICULTURAL WORKERS—Notwithstandingany other provision of this title, a migrantor seasonal agricultural worker who is eligi-ble. as determined under the Food StampAct of 1977 (7 U.S.C. 2012(h)), to participate inthe food stamp program (as defined in sec-tion 3(h) of such Act) shall not be deter-mined. by reason of the operation of thistitle. to be ineligible to participate in suchprogram.

H4411'(b) DEFINITION—FOr purposes of sub-

section (a). the term 'migrant or seasonal ag-ricultural worker'—

"(1) has the meaning given the term 'mi-grant agricultural worker' in section 3(8) ofPublic Law 97—470 (29 U.S.C. 1802(8)), and

"(2) has the meaning given the term sea-sonal agricultural worker' in section 3(10) ofPublic Law 97—470 (29 U.S.C. 1802(10)).".

AMENDMENT TO H.R.—, AS REPORTEDOFFERED BY MRS. THURMAN OF FLORIDA[(Amendment to Medicare Reconciliation

Provisions)]At the end of subtitle D of title X (relating

to Anti-Fraud and Abuse Provisions), addthe following (and conform the table of con-tents of such title accordingly):SEC. 10311. EXTENSION OF SUBPOENA AND IN-

JUNCTION AUTHORITY.(a) SUBPOENA AUTHORiTY—Section

1128A(j)(1) (42 U.S.C. 1320a—7a(j)(1)) is amend-ed by inserting "and section 1128" after"with respect to this section".

(b) INJUNCTION AUTHORiTY—Section1128A(k) (42 U.S.C. 1320a-7a(k)) is amended byinserting "or an exclusion under section1128." after "subject to a civil monetary pen-alty under this section,".

(c) CLARIFYING AMENDMENTS—SectiOn1128A(j) (42 U.S.C. 1320a—7a(J)) is amended—

(1) in paragraph (1)—(A) by inserting ", except that, in so apply-

ing such sections any reference therein tothe Commissioner of Social Security or theSocial Security Administration shall be con-sidered a reference to the Secretary or theDepartment of Health and Human Services,respectively" after "with respect to title II":and

(B) by striking the second sentence and(2) in paragraph (2), to read as follows:"(2) The Secretary may delegate to the In-

spector General of the Department of Healthand Human Services any or all authoritygranted under this section or under section1128.''.

(d) CONFORMING AMENDMENT—SectiOn 1128(42 U.S.C. 1320a-7) is amended by adding atthe end the following new subsection:

"(j) REFERENCE TO LAWS DIRECTLY AFFECT-ING THIS SECTION—For provisions of law con-cerning the Secretary's subpoena and injunc-tion authority under this section. see section1128A(j) and (k).".SEC. 10312. KICKBACK PENALTIES FOR KNOWING

VIOLATIONS.Section 1128B(b) (42 U.S.C. 1320á—7b(b)) is

amended by striking "and willfully" eachplace it occurs.SEC. 10313. ELIMINATION OF EXCEPTION OF FED-

ERAL EMPLOYEES HEALTH BENE-FITS PROGRAM FROM DEFINITIONOF FEDERAL HEALTH CARE PRO-GRAM.

Section 1128B(f)(1) (42 U.S.C. 1320a—7b(f)(1))is amended by striking "(other than thehealth insurance program under chapter 89of title 5, United States Code)".SEC. 10314. LIABILITY OF PHYSICIANS IN SPE-

CIALTY HOSPITALS.Section 1867(d) (1) (B) (42 U.S.C.

1395dd(d) (1) (B)) is amended—(1) by inserting "or a physician working at

or on-call at a hospital that is subject to therequirements of subsection (g)," after "phy-sician on-call for the care of such an individ-ual."

(2) by striking "or" at the end of clause (i);and

(3) by adding after clause (ii) the followingnew clauses:

"(iii) fails or refuses to appear within areasonable time at a hospital subject to therequirements of subsection (g) in order toprovide an appropriate medical screening ex-amination as required by subsection (a), or

H4412necessary stabilizing treatment as requiredby subsection (b), or

(iv) fails or refuses to accept an appro-priate transfer of a patient to a hospital thathas specialized capabilities or facilities asdefined in subsection (g),".SEC. 10315. EXPANSION OF CRIMINAL PENALTIES

FOR KICKBACKS.

(a) APPLICATION OF CRIMINAL PENALTY AU-THORITY TO ALL HEALTH CARE BENEFIT PRO-GRAMS—Section 1128B(b) (42 U.S.C. 1320a-7b(b)) is amended by striking Federalhealth care program'S each place it appearsand inserting health care benefit program".

(b) AYI-ORNEY GENERAL'S AUTHORITY TOSEEK CIVIL PENALTIES—Section 1128B (42U.S.C. 1320a-7b) is further amended by add-ing at the end the following new subsection:

(g)(1) The Attorney General may bring anaction in the district courts to impose uponany person who carries Out any activity inviolation of this section with respect to aFederal health care program a civil penaltyof $25,000 to $50,000 for each such violation,and damages of three times the total remu-neration offered, paid, solicited, or received.

(2) A violation exists under paragraph (1)if one or more purposes of the remunerationis unlawful, and the damages shall be the fullamount of such remuneration.

"(3) The procedures for actions under para-graph (1) with regard to subpoenas, statuteof limitations, standard of proof, and collat-eral estoppel shall be governed by 31 U.S.C.3731, and the Federal Rules of Civil Proce-dure shall apply to actions brought underthis section.

(4) This provision does not affect theavailability of other criminal and civil rem-edies for such violations.".

(c) AYFORNEY GENERAL'S INJUNCTION AU-THORITY—Section 1128B (42 U.S.C. 1320a-7b)is further amended by adding at the end thefollowing new subsection:

(h) If the Attorney General has reason tobelieve that a person is engaging in conductconstituting an offense under subsection (b)or (g), the Attorney General may petition anappropriate United States district court foran order prohibiting that person from engag-ing in such conduct. The court may issue anorder prohibiting that person from engagingin such conduct if the court finds that theconduct constitutes such an offense. The fil-ing of a petition under this section does notpreclude any other remedy which is avail-able by law to the United States or any otherperson.".

(d) DEFINITION—Section 1128B(f) (42 U.S.C.1320a-7b(f)) is amended—

(1) by redesignating paragraphs (1) and (2)as subparagraphs (A) and (B);

(2) by striking (f)" and inserting (f)(1)";and

(3) by adding at the end the following newparagraph:

(2) For purposes of this section, the term'health care benefit program" has the mean-ing given such term in 18 U.S.C. 24(b).".

(e) CONFORMING AMENDMENTS.—(1) Section 1128A(a) (42 U.S.C. 1320a—7a(a))

is amended in the final sentence by striking1128B(f)(1)" and inserting 1128B(f)(1)(A)";

and(2) Section 24(a) of title 18 of the United

States Code is amended—(A) by striking the period at the end of

paragraph (2) and adding a semicolon; and(B) by adding after paragraph (2) the fol-

lowing new paragraph:(3) section 1128B of the Social Security

Act.'.SEC. 10316. REPEAL OF HIPAA ADVISORY OPIN-

ION AUTHORITY.

Section 1128D (42 U.S.C. 1320a—7d) is amend-ed by striking subsection (b).

CONGRESSIONAL RECORD — HOUSESEC. 10317. REPEAL EXPANDED EXCEPTION FOR

RISK-SHARING CONTRACT TO ANTI-KICKBACK PROVISIONS.

Section 1128B(b)(3) (42 U.S.C. 1320a—7b(b)(3)), as amended by section 216(a) of theHealth Insurance Portability and Account-ability Act of 1996, is amended—

(1) by adding and" at the end of subpara-graph (D);

(2) by striking and" at the end of sub-paragraph (E) and inserting a period; and

(3) by striking subparagraph (F).SEC. 10318. ADMINISTRATIVE FEES FOR MEDI-

CARE OVERPAYMENT COLLECTION.(a) ADMINISTRATIVE FEES FOR PROVIDERS OF

SERVICES UNDER PART A—Section 1815(d) (42U.S.C. 1395g(d)) is amended by inserting '(1)"after "(d)" and by adding at the end the fol-lowing new paragraph:

(2) (A) Except as provided in subparagraph(B), if the payment of the excess described inparagraph (1) is not made (or effected by off-set) within 30 days of the date of the deter-mination, an administrative fee of 1 percentof the outstanding balance of the excess(after application of paragraph (1)), or suchlower amount as an Administrative LawJudge may determine upon an appeal of theinitial determination of the excess, shall beimposed on the provider, for deposit into theTrust Fund under this part.

'(B) The administrative fee shall be im-posed under subparagraph (A) on a providerof services paid on a prospective basis only ifsuch provider's cost report with respect tothe payment determined to be in excess ofthe payment due under this part indicatesthat the provider's projected costs exceededits actual costs by 30 percent or more.".

(b) ADMINISTRATIVE FEES FOR PROVIDERS OFSERVICES OR OTHER PERSONS UNDER PARTB—Section 1833(J) (42 U.S.C. 13951(j)) isamended by inserting "(1)" after '(i)" and byadding at the end the following new para-graph:

(2) If the excess described in paragraph (1)is not made (or effected by offset) within 30days of the date of the determination, an ad-ministrative fee of 1 percent of the outstand-ing balance of the excess (after applicationof paragraph (1)), or such lower amount as anAdministrative Law Judge may determineupon an appeal of the initial determinationof the excess, shall be imposed on the pro-vider, or other person receiving the excess,for deposit into the Trust Fund under thispart.".

(c) EFFECTIVE DATE.—The amendmentsmade by this section shall apply to final de-terminations made on or after the date of en-actment of this Act.SEC. 10319. AUTOMATED PREPAYMENT SCREEN-

ING REQUIREMENT.(a) DETERMINATION BY ADMINISTRATOR—By

September 1 of each year (beginning with1998), the Administrator of the Health CareFinancing Administration, after consulta-tion with the Comptroller General of theUnited States, shall determine—

(1) the medical diagnoses by providers ofservices under title XVIII of the Social Secu-rity Act which frequently result in overpay-ments to such providers under such title; and

(2) the percentage of claims involving thediagnoses described in paragraph (1), that fis-cal intermediaries and carriers under suchtitle shall screen before payment is made inorder to avoid such overpayments.

(b) REQUIREMENT FOR FISCALINTERMEDIARIES AND CARRIERS—The Sec-retary of Health and Human Services shallnot enter into a contract with a fiscalintermediary or carrier under title XVIII ofthe Social Security Act (42 U.S.C. 1395 etseq.) unless the Secretary finds that suchintermediary or carrier will screen theclaims for payment. in accordance with sub-section (a), under such title.

June25, 1997

(c) NOTICE TO FISCAL INTERMEDIARIES ANDCARRIERS—The Secretary shall cause tohave published in the Federal Register, inthe last 15 days of October of each year, theresults of the determination made under sub-section (a).

AMENDMENT TO THE COMMIYFEE PRINTOFFERED BY MR. BECERRA OF CALIFORNIA

At the end of subtitle D of title IX (relat-ing to restricting welfare and public benefitsfor aliens) insert the following new section:SEC. 9305. SSI ELIGIBILITY FOR CERTAIN DIS-

ABLED ALIENS.Section 402(a)(2) of the Personal Respon-

sibility and Work Opportunity Reconcili-ation Act of 1996 (8 U.S.C. 1612(a)(12)) isamended by inserting after subparagraph (F)(as added by section 9303) the following newsubparagraph:

(G) SSI ELIGIBILITY FOR CERTAIN DISABLEDALIENS—With respect to the program speci-fied in paragraph (3) (A) (relating to the sup-plemental security income program), para-graph (1) shall not apply to a qualifiedalien—

(i) who is blind or disabled within themeaning of section 1614(a)(2) or 1614(a)(3), re-spectively, of the Social Security Act; and

"(ii) who on or before August 22, 1996, ob-tained a status within the meaning of theterm 'qualified alien'.".

AMENDMENT OFFERED BY MR. PALLONE, MS.ESHOO, AND MS. FURSE TO THE CHILD HEALTHRECONCILIATION PROVISIONS

Strike the entire text and insert the fol-lowing:Subtitle F—Child Health Insurance Initiative

Act of 1997SEC. 3500. SHORT TITLE OF SUBTITLE.

This subtitle may be cited as the 'ChildHealth Insurance Initiative Act of 1997".

CHAPTER 1—IMPROVED OUTREACHSEC. 3501. GRANT PROGRAM TO PROMOTE OUT-

REACH EFFORTS.(a) AUTHORIZATION OF APPROPRIATIONS.—

There are authorized to be appropriated, foreach fiscal year beginning with fiscal year1998 to the Secretary of Health and HumanServices, $25,000,000 for grants to States, lo-calities, and nonprofit entities to promoteoutreach efforts to enroll eligible childrenunder the medicaid program under title XIXof the Social Security Act (42 U.S.C. 1396 etseq.) and related programs.

(b) USE OF FUNDS—Funds under this sec-tion may be used to reimburse States, local-ities, and nonprofit entities for additionaltraining and administrative costs associatedwith outreach activities. Such activities in-clude the following:

(1) USE OF A COMMON APPLICATION FORM FORFEDERAL CHILD ASSISTANCE PROGRAMS —Im-plementing use of a single application form(established by the Secretary and based onthe model application forms developed undersubsections (a) and (b) of section 6506 of theOmnibus Budget Reconciliation Act of 1989(42 U.S.C. 701 note; 1396a note)) to determinethe eligibility of a child or the child's family(as applicable) for assistance or benefitsunder the medicaid program and under otherFederal child assistance programs (such asthe temporary assistance for needy familiesprogram under part A of title IV of the So-cial Security Act (42 U.S.C. 601 et seq.), thefood stamp program, as defined in section3(h) of the Food Stamp Act of 1977 (7 U.S.C.2012(h)), and the State program for fostercare maintenance payments and adoption as-sistance payments under part E of title IV ofthe Social Security Act (42 U.S.C. 670 etseq.)).

(2) EXPANDING OUTSTATIONING OF ELIGI-BILITY PERSONNEL—Providing for the sta-tioning of eligibility workers at sites. such

June 25, 1997

as hospitals and health clinics, at which chil-

dren receive health care or related services.(c) APPLICATION, ETC—Funding shall be

made available under this section only uponthe approval of an application by a State. lo-cality. or nonprofit entity for such fundingand only upon such terms and conditions asthe Secretary specifies.

(d) ADMINISTRATION—The Secretary mayadminister the grant program under this sec-tion through the identifiable administrativeunit designated under section 509(a) of theSocial Security Act (42 U.S.C. 709(a)) to pro-mote coordination of medicaid and maternaland child health activities and other childhealth related activities.CHAPTER 2—STRENGTHENING MEDICAID

PROGRAMSEC. 3521. STATE OPTION OF CONTINUOUS ELIGI-

BILITY FOR 12 MONTHS FOR CHIL-DREN UNDER THE MEDICAID PRO-GRAM.

(a) IN GENERAL—Section 1902(e) of the So-cial Security Act (42 U.S.C. 1396a(e)) isamended by adding at the end the followingnew paragraph:

(12) At the option of the State, the planmay provide that an individual who is underan age specified by the State (not to exceed19 years of age) and who is determined to beeligible for benefits under a State plan ap-proved under this title under subsection(a)(10)(A) shall remain eligible for those ben-efits until the earlier of—

(A) the end of a period (not to exceed 12months) following the determination; or

(B) the time that the individual exceedsthat age.".

(b) EFFECTIVE DATE—The amendmentmade by subsection (a) applies to medical as-sistance for items and services furnished onor after January 1, 1998.SEC. 3522. CLARIFICATION OF STATE OPTION TO

COVER ALL CHILDREN UNDER 19YEARS OF AGE.

Effective upon the date of the enactmentof this Act, section 1902(1) (1) (D) of the SocialSecurity Act (42 U.S.C. 1396a(l)(1)(D)) isamended by inserting (or. at the option of aState. after any earlier date)" after chil-dren born after September 30. 1983".

CHAPTER 3—MEDIKIDS PROGRAMSEC. 3531. STATE ENTITLEMENT TO PAYMENT

FOR MEDIKIDS PROGRAM.(a) IN GENERAL—Each State that has a

plan for a child health insurance program, orMediKids program, approved by the Sec-retary is entitled to receive, from amountsin the Treasury not otherwise appropriatedand for each fiscal year beginning with fiscalyear 1998, payment of the amounts providedunder section 3533.

(b) APPLICATION—The Secretary shall es-tablish a procedure for the submittal and ap-proval of plans for MediKids programs underthis chapter. The Secretary shall approvethe plan of a State for such a program if theSecretary determines that—

(1) the State is meeting the medicaid cov-erage requirements of section 3532(a). and

(2) the plan provides assurances satisfac-tory to the Secretary that the MediKids pro-gram will be conducted consistent with theapplicable requirements of section 3532.SEC. 3532. REQUIREMENTS FOR APPROVAL OF

MEDIKIDS PROGRAM.(a) ADEQUATE MEDICAID COVERAGE—The

medicaid coverage requirements of this sub-section are the following:

(1) COVERAGE OF PREGNANT WOMEN ANDCHILDREN AND INFANTS UP TO 185 PERCENT OFPOVERTY—The State has established 185 per-cent of the poverty line as the applicablepercentage under section 1902(l)(2)(A) of theSocial Security Act (42 U.S.C. 1396a(l)(2)(A)).

(2) COVERAGE OF CHILDREN UP TO 19 YEARSOF AGE—The State provides, either through


exercise of the option under section1902(l)(1)(D) of such Act (42 U.S.C.1396a(l)(1)(D)) or authority under section1902(r)(2) of such Act (42 U.S.C. 1396a(r)(2)) forcoverage under section 1902(l)(1)(D) of suchAct of individuals under 19 years of age, re-gardless of date of birth.

(3) MAINTENANCE OF EFFORT.—(A) MEDICAID—Subject to subparagraph

(B). the State—(i) has not modified the eligibility require-

ments for children under the State medicaidplan, as in effect on January 1. 1997 in anymanner that would have the effect of reduc-ing the eligibility of children for coverageunder such plan, and

(ii) will use the funds provided under thischapter to supplement and not supplantother Federal and State funds.

(B) WAIVER EXCEPTION—Subparagraph (A)shall not apply to modifications made pursu-ant to an application for a waiver under sec-tion 1115 of the Social Security Act (42U.S.C. 1315) submitted before January 1, 1997.

(b) COVERAGE OF UNINSURED CHILDREN.—(1) IN GENERAL—A MediKids program shall

not provide benefits for children who areotherwise covered for such benefits under amedicaid plan or under a group health plan,health insurance coverage, or other healthbenefits coverage, but may expend funds foroutreach and other activities in order to pro-mote coverage under such plans.

(2) CONSTRUCTION—NOthing in this sub-section shall be construed as requiring aMediKids plan of a State to provide coveragefor all near poverty level children describedin paragraph (1) who are residing in theState.

(c) MEDICAID-EQUIVALENT BENEFITS.—(1) IN GENERAL—Subject to subsection (d),

a MediKids program shall provide benefits toeligible children for the equivalent items andservices for which medical assistance isavailable (other than cost sharing) to chil-dren under the State's medicaid plan.

(2) CONSTRUCTION—NOthing in this sub-section shall be construed as limiting themethod under which a MediKids plan mayprovide benefits, including through purchaseof health insurance coverage, direct paymentfor covered services, or otherwise.

(d) PREMIUMS AND COST-SHARING—AMediKids program may—

(1) require the payment of premiums as acondition for coverage, but only for a cov-ered child whose family income exceeds thepoverty line;

(2) impose deductibles, coinsurance. copay-ments. and other forms of cost-sharing withrespect to benefits under the program; and

(3) vary the levels of premiums,deductibles, coinsurance. copayments. andother cost-sharing based on a sliding scalerelated to the family income of the coveredchild.SEC. 3533. PAYMENT AMOUNTS.

(a) TOTAL AMOUNT AVAILABLE—The totalamount of funds that is available for pay-ments under this chapter in any fiscal yearis $2000000000.

(b) ALLOTMENT AMONG STATES.—(1) IN GENERAL—The Secretary shall estab-

lish a formula for the allotment of the totalamount of funds available under subsection(a) among the qualif'ing States for each fis-cal year.

(2) BASIS—The formula shall be based uponthe Secretary's estimate of the number ofnear poverty level children in the State as aproportion of the total of such numbers forall the qualifying States.

(3) CARRYFORWARD.—If the Secretary doesnot pay to a State under subsection (c) in afiscal year the amount of its allotment inthat fiscal year under this subsection, theamount of its allotment under this sub-

H44 13section for the succeeding fiscal year shallbe increased by the amount of such shortfall.

(c) PAYMENTS.—(1) IN GENERAL—From the allotment of

each qualifying State under subsection (b)for a fiscal year. the Secretary shall pay tothe State for each quarter in the fiscal yearan amount equal to 75 percent of the totalamount expended during such quarter tocarry out the State's MediKids program.

(2) NOT COUNTING COST SHARING—For pur-poses of paragraph (1), if a MediKids programimposes premiums for coverage or requirespayment of deductibles, coinsurance, copay-ments. or other cost sharing, under rules ofthe Secretary, expenditures attributable tosuch premiums or cost sharing shall not betaken into account under paragraph (1).

(d) STATE ENTITLEMENT—This chapter con-stitutes budget authority in advance of ap-propriations Acts, and represents the obliga-tion of the Federal Government to providefor the payment to qualifying States ofamounts provided under this section.SEC. 3534. DEFINITIONS.

For purposes of this chapter:(1) The term child" means an individual

under 19 years of age.(2) The term medicaid plan" means the

plan of medical assistance of a State undertitle XIX of the Social Security Act.

(3) The term MediKids program" means achild health insurance program of a Stateunder this title.

(4) The term • near poverty level child"means a child the family income of which (asdefined by the Secretary) is at least 100 per-cent. but less than 300 percent, of the pov-erty line.

(5) The term poverty line" has the mean-ing given such term in section 673(2) of theCommunity Services Block Grant Act (42U.S.C. 9902(2)), including any revision re-quired by such section.

(6) The term qualifying State" means aState with a MediKids program for which aplan is submitted and approved under thistitle.

(7) The term Secretary" means the Sec-retary of Health and Human Services.

(8) The term State' means the 50 States,the District of Columbia, Puerto Rico, theVirgin Islands Guam, American Samoa, andthe Northern Mariana Islands.

CHAPTER 4—ASSURiNG CHILDREN'SACCESS TO HEALTH INSURANCE

SEC. 3441. GUARANTEED AVAILABILITY OF INDI-VIDUAL HEALTH INSURANCE COV-ERAGE TO UNINSURED CHILDREN.

(a) IN GENERAL—Title XXVII of the PublicHealth Service Act, as added by section111(a) of the Health Insurance Portabilityand Accountability Act of 1996, is amendedby inserting after section 2741 the followingnew section:"SEC. 2741A. GUARANTEED AVAILABILITY OF IN-

DIVIDUAL HEALTH INSURANCE COV-ERAGE TO UNINSURED CHILDREN.

•

• (a) GUARANTEED AVAILABILITY.—• (1) IN GENERAL—Subject to the succeed-

ing subsections of this section, each healthinsurance issuer that offers health insurancecoverage (as defined in section 2791(b)(1)) inthe individual market in a State, in the caseof an eligible child (as defined in subsection(b)) desiring to enroll in individual health in-surance coverage—

•

• (A) may not decline to offer such cov-erage to. or deny enrollment of, such child;

(B) either (i) does not impose any pre-existing condition exclusion (as defined insection 2701(b)(1)(A)) with respect to suchcoverage, or (ii) imposes such a preexistingcondition exclusion only to the extent suchan exclusion may be imposed under section2701 (a) in the case of an individual who is nota late enrollee; and

H4414(C) shall provide that the premium for the

coverage is determined in a manner so thatthe ratio of the premium for such eligiblechildren to the premium for eligible individ-uals described in section 274 1(b) does not ex-ceed the ratio of the actuarial value of suchcoverage (calculated based on a standardizedpopulation and a set of standardized utiliza-tion and cost factors) for children to such ac-tuarial value for such coverage for such eli-gible individuals.

(2) SUBSTITUTION BY STATE OF ACCEPTABLEALTERNATIVE MECHANISM.—The requirementof paragraph (1) shall not apply to health in-surance coverage offered in the individualmarket in a State in which the State is im-plementing an acceptable alternative mecha-nism under section 2744.

(b) ELIGIBLE CHILD DEFINED.—In this part.the term 'eligible child' means an individualborn after September 30. 1983. who has notattained 19 years of age and—

• (1) who is a citizen or national of theUnited States, an alien lawfully admitted forpermanent residence, or an alien otherwisepermanently residing in the United Statesunder color of law;

(2) who is not eligible for coverage under(A) a group health plan, (B) part A or part Bof title XVIII of the Social Security Act, or(C) a State plan under title XIX of such Act(or any successor program), and does nothave other health insurance coverage; and

"(3) with respect to whom the most recentcoverage (if any, within the 1-year periodending on the date coverage is sought underthis section) was not terminated based on afactor described in paragraph (1) or (2) of sec-tion 2712(b) (relating to nonpayment of pre-miums or fraud).For purposes of paragraph (2) (A). the termgroup health plan does not include COBRAcontinuation coverage.

(c) INCORPORATION OF CERTAIN PROVI-SIONS.—

(1) IN GENERAL.—SubJect to paragraph (2),the provisions of subsections (c), (d), (e) and(f) (other than paragraph (1)) of section 2741and section 2744 shall apply in relation to eli-gible children under subsection (a) in thesame manner as they apply in relation to eli-gible individuals under section 2741(a).

(2) SPECIAL RULES FOR ACCEPTABLE ALTER-NATIVE MECHANISMS.—With respect to apply-ing section 2744 under paragraph (1)—

'(A) the requirement in subsection(a)(1)(B) shall be applied instead of the re-quirement of section 2744(a) (1) (B);

(B) the requirement in subsection(a)(1)(C) shall be applied instead of the re-quirement of section 2744(a)(1)(D); and,

(C) any deadline specified in such sectionshall be 1 year after the deadline otherwisespecified.".

(b) EFFECTIVE DATE.—The amendmentmade by subsection (a) shall take apply 1year after the effective date for section 2741of the Public Health Service Act (as providedunder section 111(b) (1) of the Health Insur-ance Portability and Accountability Act of1996).

CHAPTER 5—APPROPRIATION FOR DATASEC. 3551. AUTHORIZATION OF APPROPRIATIONS.

In addition to any other amounts author-ized to be appropriated, there are authorizedto be appropriated $5,000,000 for the Bureauof the Census to refine the data on childrenin families with family incomes below 300percent of the applicable Federal povertylevel in each State.

AMENDMENT TO H.R. —. OFFERED BY MR.BENTSEN

Amend section 3471(b) to read as follows:(b) (1) ADJUSTMENT TO STATE DSH ALLOCA-

TIONS.—Subsection (f) of section 1923 (42U.S.C. 1396r-4) is amended to read as follows:

CONGRESSIONAL RECORD — HOUSE"(f) LIMITATION ON FEDERAL FINANCIAL

PARTICIPATION.—(1) IN GENERAL.—Subject to section

1903(x). payment under section 1903(a) shallnot be made to a State with respect to anypayment adjustment made under this sectionfor hospitals in a State (as defined in para-graph (3)(B)) for quarters in a fiscal year inexcess of the State disproportionate sharehospital (in this subsection referred to as'DSH') allotments for the year (as specifiedin paragraph (2)).

'(2) DETERMINATION OF STATE DSH ALLOT-MENTS.—

'(A) IN GENERAL.—The DSH allotment fora State is equal to its State 1995 DSH spend-ing minus—

'(i) for fiscal year 1998, 0;(ii) for fiscal year 1999, 15 percent of the

State multiplier; and(iii) for fiscal year 2000 and each succeed-

ing year, 25 percent of the State multiplier.(3) DEFINITIONS.—In this subsection:(A) STATE.—The term 'State means the

50 States and the District of Columbia.'(B) STATE 1995 DSH SPENDING.—The term—

State 1995 DSH spending means, with respectto a State. the total amount of payment ad-justments made under subsection (c) underthe State plan during fiscal year 1995 as re-ported by the State no later than January 1,1997, on HCFA Form 64.

(C) STATE MULTIPLIER.—The term Statemultiplier means, with respect to a State,the lesser of—

(i) the State 1995 DSH spending; or(ii) 12 percent of the total amount of ex-

penditures made under the State plan underthis title for medical assistance during fiscalyear 1995 as reported by the State no laterthan January 1, 1997 on HCFA Form 64.".

(2) EFFECTIVE DATE.—The amendmentmade by paragraph (1) shall apply to fiscalyears beginning with fiscal year 1998.

Mr. SOLOMON. Mr. Speaker, I yieldmyself the balance of my time.

Mr. Speaker, I smell a cop-out. I hearMembers standing up here finding allkinds of excuses to vote against thisrule because it does not have any en-forcement procedures. Let me show mycolleagues something.

Here are thousands of pages of Cuts,$182 billion in entitlement Cuts overthe next 5 years, $700 billion in locked-in spending Cuts. If you want some fis-cal sanity around here, do what yourPresident is asking us to do: he is call-ing your offices right now, saying sup-port the rule, support the bill. Let usget together. A deal is a deal.

Mr. Speaker, I yield back the balanceof my time, and I move the previousquestion on the resolution.

The SPEAKER pro tempore. Thequestion is on ordering the previousquestion.

The question was taken; and theSpeaker pro tempore announced thatthe noes appeared to have it.

Mr. SOLOMON. Mr. Speaker, I objectto the vote on the ground that aquorum is not present and make thepoint of order that a quorum is notpresent.

The SPEAKER pro tempore. Evi-dently a quorum is not present.

The Sergeant at Arms will notify ab-sent Members.

The vote was taken by electronic de-vice, and there were—yeas 222, nays204, not voting 8, as follows:

[Roll No. 2381YEAS—222

GibbonsGllchrestGlllmorGilmanGoodlingGossGrahamGrangerGreenwoodGutknechtHansenHastertHastings (WA)HayworthHefleyHergerHillHillearyHobsonHoekstraHornHostettlerHoughtonHulshofHunterHutchirisonHydeInglisIstookJenkinsJohnson (CT)Johnson, SamJonesKasichKellyKimKing (NY)KingstonKIugKnollenbergKolbeLaHoodLargentLathamLaTouretteLazioLeachLewis (CA)Lewis (KY)LinderLivingstonLoBiondoLucasManzulloMcCollumMcCreryMcDadeMclnnlsMcIntoshMcKeonMetcalfMicaMiller (FL)MolinariMoran (KS)MorellaMyrickNethercuttNeumannNeyNorthupNorwoodNussleOxley

NAYS—204Brown (CA)Brown (FL)Brown (OH)CappsCardinCarsonClayClaytonClementClyburnConditConyersCostelloCoyneCramerCummingsDannerDavis (FL)Davis (IL)DeFazio

June 25, 1997

AderholtArcherArmeyBachusBakerBallengerBarrBarrett (NE)BartlettBartonBassBatemanBereuterBilbrayBilirakisBlileyBluntBoehlertBoehnerBonillaBonoBradyBryantBunningBurrBurtonBuyerCallahanCalvertCampCampbellCanadyCannonCastleChabotChamblissChenowethChristensenCobleCoburnCollinsCombestCookCookseyCraneCrapoCubinCunninghamDavis (VA)DealDeLayDiaz-BalartDickeyDoolittleDreierDuncanDunnEhiersEhrlichEmersonEnglishEnsignEverettEwingFawellFoleyForbesFowlerFoxFranks (NJ)FrelinghuysenGalleglyGanskeGekas

AbercrombieAckermanAllenAndrewsBaeslerBaldacciBarciaBarrett (WI)BecerraBentsenBermanBerryBishopBlagojevichBlumenauerBoniorBorskiBoswellBoucherBoyd

PackardPappasParkerPaulPaxonPeasePeterson (PA)PetriPickeringPittsPomboPorterPortmanPryce (OH)QuinnRadanovichRamstadRedmondRegulaRiggsRileyRoganRogersRohrabacherRos-LehtlnenRoukemaRoyceRyunSalmonSanfordSaxtonScarboroughSchaefer, DanSchaffer. BobSensenbrennerSessionsShadeggShawShaysShimkusShusterSkeenSmith (MI)Smith (OR)Smith (TX)Smith, LindaSnowbargerSolomonSouderSpenceStearnsStumpSununuTalentTauzinTaylor (NC)ThomasThornberryThuneTiahrtUptonWalshWampWatkinsWatts (OK)Weldon (FL)Weldon (PA)WellerWhiteWhitfieldWickerWolfYoung (AK)Young (FL)

DeGetteDelahuntDeLauroDellumsDeutschDicksDingellDixonDoggettDooleyDoyleEdwardsEngelEtheridgeEvansFarrFattahFazioFilnerFlake

June 25, 1997 CONGRESSIONAL RECORD — HOUSE H4415Foglietta Lowey Rodriguez Cannon Hulshof Portman Kildee Mink ScottFord Luther Roemer Castle Hunter Pryce (OH) Kilpatrick Moakley SerranoFrank (MA) Maloney (CT) Rothman Chabot Hutchinson Quinn Kind (WI) Mollohan ShermanFrost Maloney (NY) Roybal-Allard Chambliss Hyde Radanovich Kleczka Murtha SisiskyFurse Manton Rush Chenoweth Inglis Ramstad Klink Nadler Skaggs

GeJdenson Markey Sabo Christensen Istook Redmond Kucinich Neal SkeltonGephardt Martinez Sanchez Coble Jenkins Regula LaFalce Oberstar SlaughterGonzalez Mascara Sanders Collins Johnson (CT) Riggs Lampson Obey Snyder

Goode Matsui Sandlin Combest Johnson, Sam Riley Lantos Olver SprattGordon McCarthy (MO) Sawyer Cook Jones Roemer Levin Ortiz StabenowGreen McCarthy (NY) Schumer Cooksey Kasich Rogan Lewis (GA) Owens StenholmGutierrez McDermott Scott Crane Kelly Rogers Lipinski Pallone Stokes

Hall (OH) McGovern Serrano Crapo Kim Rohrabacher Lofgren Pascrell StricklandHall (TX) McHale Sherman Cubin King (NY) Ros-Lehtinen Lowey Pastor StupakHamilton Mcintyre Sisisky Cunningham Kingston Royce Luther Payne TannerHarman McKinney Skaggs Davis (VA) KIug Ryun Maloney (CT) Pelosi Tauscher

Hastings (FL) McNulty Skelton Deal Knollenberg Salmon Maloney (NY) Peterson (MN) Taylor (MS)Hefner Meehan Slaughter DeLay Kolbe Sanford Manton Pickett Thompson

Hilliard Meek Smith, Adam Diaz-Balart LaHood Saxton Markey Pomeroy ThurmanHinchey Menendez Snyder Dickey Largent Scarborough Martinez Poshard TierneyHinojosa Millender- Spratt Doolittle Latham Schaefer, Dan Mascara Price (NC) TorresHolden McDonald Stabenow Dreier LaTourette Schaffer, Bob Matsui Rahall Towns

Hooley Miller (CA) Stark Duncan Lazio Sensenbrenner McCarthy (MO) Rangel TurnerHoyer Minge Stenholm Dunn Leach Sessions McCarthy (NY) Reyes Velazquez

Jackson (IL) Mink Stokes Ehlers Lewis (CA) Shadegg McDermott Rivers Vento

Jackson-Lee Moakley Strickland Ehrlich Lewis (KY) Shaw McGovern Rodriguez Visclosky(TX) Mollohan Stupak Emerson Linder Shays McHale Rothman Waters

Jefferson Moran (VA) Tanner English Livingstor Shimkus Mcintyre Roukema Watt (NC)

John Murtha Tauscher Everett LoBiondo Shuster McKinney Roybal-Allard Waxman

Johnson (WI) Nadler Taylor (MS) Ewing Lucas Skeen McNulty Rush Wexler

Johnson, E. B. Neal Thompson Fawell Manzullo Smith (Ml) Meehan Sabo Weygand

KanJorski Oberstar Thurman Foley McCollum Smith (NJ) Menendez Sanchez Wise

Kaptur Obey Tierney Forbes McCrery Smith (OR) Millender- Sanders Woolsey

Kennedy (MA) Olver Torres Fowler McDade Smith (TX) McDonald Sandlin Wynn

Kennedy (RI) Ortiz Towns Fox McHugh Smith, Adam Miller (CA) Sawyer

Kennelly Owens Traficant Franks (NJ) Mclnnis Smith. Linda Minge Schumer

Kildee Pallone Turner Frelinghuysen Mcintosh SnowbargerKilpatrick Pascrell Velazquez Gallegly McKeon Solomon —Kind (WI) Pastor Vento Ganske Metcalf Souder CoburnKleczka Payne Visclosky Gekas Mica Spence

Klink Pelosi Waters Gibbons Miller (FL) Stearns NOT VOTING5Kucinich Peterson (MN) Watt (NC) Gilchrest Molinari Stump Cox Schiff YatesLaFalce Pickett Waxman Gillmor Moran (KS) Sununu Meek StarkLampson Poshard Wexler Gilman Moran (VA) TalentLantos Price (NC) Weygand Goodlatte Morella Tauzin 0 1331Levin Rahall Wise Goodling Myrick Taylor (NC)Lewis (GA) Rangel Woolsey Goss Nethercutt Thomas So the resolution was agreed to.Lipinski Reyes Wynn Graham Neumann Thornberry The result of the vote was announcedLofgren Rivers Granger Ney Thune as above recorded.

Greenwood Northup TiahrtNOT VOTING8 Gutknecht Norwood Traficant A motion to reconsider was laid on

Cox McHugh Smith (NJ) Hall (TX) Nussle Upton the table.Eshoo Pomeroy Yates Hansen Oxley Walsh

Goodlatte Schiff Hastert Packard WampHastings (WA) Pappas Watkins

0 1313 Hayworth Parker Watts (OK)Hefley Paul Weldon (FL)

Mr. GONZALEZ and Mr. ADAM Herger Paxon Weldon (PA)

SMITH of Washington changed their Hill Pease WellerHilleary Peterson (PA) White

vote from yea to nay. Hobson Petri WhitfieldMr. GRAHAM changed his vote from Hoekstra Pickering Wicker

"nay' to "yea.' Horn Pitts Wolf

So the previous question was ordered.The result of the vote was announced

as above recorded. NAYS—200The SPEAKER pro tempore (Mr. Abercrombie Coyne Frost

COMBEST). The question is on the reso- Ackerman Cramer Furse

lution. Allen Cummings GeJdenson

The question was taken: and the BS1er Davis (FL) GonzalezSpeaker pro tempore announced that Barcia Davis (IL) Goode

the ayes appeared to have it. Barrett (WI) DeFazio Gordon

RE OR EBecerra DeGette GreenBentsen Delahunt Gutierrez

Mr. MOAKLEY. Mr. Speaker, I de- Berman DeLauro Hall (OH)

mand a recorded vote. Berry Dellums Hamilton

A recorded vote was ordered. Blagojevich Hastings (FL)The vote was taken by electronic de- Blumenauer Dingell Hefner

vice, and there were—ayes 228, noes 200, Bonior Dixon Hilliard

answered "present" 1, not voting 5, as Borski Doggett HincheyBoswell Dooley Hinojosa

follows: Boucher Doyle Holden[Roll No. 2391 Boyd Edwards Hooley

YEAS 228Brown (CA) Engel Hoyer

— Brown (FL) Ensign Jackson (IL)Aderholt Bass Brady Brown (OH) Eshoo Jackson-LeeArcher Bateman Bryant Capps Etheridge (TX)Armey Bereuter Bunning Cardin Evans JeffersonBachus Bilbray Burr Carson Farr JohnBaker Bilirakis Burton Clay Fattah Johnson (WI)Baldacci Bliley Buyer Clayton Fazio Johnson, E. B.Ballenger Blunt Callahan Clement Filner KanJorskiBarr Boehlert Calvert Clyburn Flake KapturBarrett (NE) Boehner Camp Condit Foglietta Kennedy (MA)Bartlett Bonilla Campbell Conyers Ford Kennedy (RI)Barton Bono Canady Costello Frank (MA) Kennelly

H4416 CONGRESSIONAL RECORD—HOUSE June 25, 1997BALANCED BUDGET ACT OF 1997Mr. KASICH. Mr. Speaker, pursuant

to House Resolution 174, I call up thebill (H.R. 2015) to provide for reconcili-ation pursuant to subsections (b) (1) and(c) of section 105 of the concurrent res-olution on the budget for fiscal year1998, and ask for its immediate consid-eration.

The Clerk read the title of the bill.The SPEAKER pro tempore (Mr.

DREIER). Pursuant to House Resolution174, the amendment printed in the CON-GRESSIONAL RECORD numbered 1 isadopted.

The text of H.R. 2015, as amended, isas follows:5ECTION 1. 5HORT TITLE.

This Act may be cited as the BalancedBudget Act of 1997'.SEC. 2. TABLE OF CONTENTS.Title I—Committee on Agriculture.Title H—Committee on Banking and Finan-

cial Services.Title IH—Committee on Commerce—Non-

medicare.Title IV—Committee on Commerce—Medi-

care.Title V—Committee on Education and the

Workforce.Tittle VI—Committee on Government Re-

form and Oversight.Title Vu—Committee on Transportation and

Infrastructure.Title VIlI—Committee on Veterans' Affairs.Title IX—Committee on Ways and Means—

Nonmedicare.Title X—Committee on Ways and Means—

Medicare.Title XI—Budget Enforcement.

H4434 CONGRESSIONAL RECORD — HOUSE June 25, 1997

TITLE IV—COMMfl,'EE ON COMMERCE_MED ICARE

SEC. 4000. AMENDMENTS TO SOCIAL SECURITYACT AND REFERENCES TO OBRA;TABLE OF CONTENTS OF TITLE.

(a) AMENDMENTS TO SOCIAL SECURITYACT_-Except as otherwise specifically pro-vided, whenever in this title an amendmentis expressed in terms of an amendment to orrepeal of a section or other provision, thereference shall be considered to be made tothat section or other provision of the SocialSecurity Act.

(b) REFERENCES TO OBRA.—In this title,the terms OBRA-1986", OBRA—1987"OBRA-1989' OBRA-iggO" and "OBRA-

1993" refer to the Omnibus Budget Reconcili-ation Act of 1986 (Public Law 99-509), theOmnibus Budget Reconciliation Act of 1987(Public Law 100-203) the Omnibus Budget

June 25, 1997Reconciliation Act of 1989 (Public Law 101—239), the Omnibus Budget Reconciliation Actof 1990 (Public Law 101-508), and the OmnibusBudget Reconciliation Act of 1993 (PublicLaw 103—66), respectively.

(c) TABLE OF CONTENTS OF TITLE.—Thetable of contents of this title is as follows:Sec. 4000. Amendments to Social Security

Act and references to OBRA;table of contents of title.

Subtitle A—MedicarePlus ProgramCHAPTER 1—MEDICAREPLUS PROGRAM

SUBCHAPTERA—MEDICAREPLUS PROGRAM

Sec. 4001. Establishment of MedicarePlusprogram.

'PART C—MEDICAREPLUS PROGRAM

"Sec. 1851. Eligibility, election, and en-rollment.

'Sec. 1852. Benefits and beneficiary pro-tections.

'Sec. 1853. Payments to MedicarePlusorganizations.

"Sec. 1854. Premiums.Sec. 1855. Organizational and financial

requirements for MedicarePlusorganizations; provider-spon-sored organizations.

Sec. 1856. Establishment of standards.Sec. 1857. Contracts with MedicarePlus

organizations.Sec. 1859. Definitions; miscellaneous

provisions.Sec. 4002. Transitional rules for current

medicare HMO program.Sec. 4003. Conforming changes in medigap

program.SUBCHAPTER B—SPECIAL RULES FOR

MEDICAREPLUS MEDICAL SAVINGS ACCOUNTS

Sec. 4006. MedicarePlus MSA.SUBCHAPTER C—GME, IME, AND DSH PAYMENTS

FOR MANAGED CARE ENROLLEES

Sec. 4008. Graduate medical education andindirect medical education pay-ments for managed care enroll-ees.

Sec. 4009. Disproportionate share hospitalpayments for managed care en-rollees.

CHAPTER 2—INTEGRATED LONG-TERM CAREPROGRAMS

SUBCHAPTER A—PROGRAMS OF ALL-INCLUSIVECARE FOR THE ELDERLY (PACE)

Sec. 4011. Reference to coverage of PACEunder the medicare program.

Sec. 4012. Reference to establishment ofPACE program as medicaidState option.

SUBCHAPTER B—SOCIAL HEALTH MAINTENANCEORGANIZATIONS (SHMOS)

Sec. 4015. Social health maintenance organi-zations (SHMOs).

SUBCHAPTER C—OTHER PROGRAMSSec. 4018. Orderly transition of municipal

health service demonstrationprojects.

Sec. 4019. Extension of certain medicarecommunity nursing organiza-tion demonstration projects.

CHAPTER 3—MEDICARE PAYMENT ADVISORYCOMMISSION

Sec. 4021. Medicare Payment Advisory Com-mission.


Sec. 4031. Medigap protections.Sec. 4032. Medicare prepaid competitive

pricing demonstration project.Subtitle B—Prevention Initiatives

Sec. 4101. Screening mammography.Sec. 4102. Screening pap smear and pelvic

exams.Sec. 4103. Prostate cancer screening tests.Sec. 4104. Coverage of colorectal screening.Sec. 4105. Diabetes screening tests.


Sec. 4106. Standardization of medicare cov-erage of bone mass measure-ments.

Sec. 4107. Vaccines outreach expansion.Sec. 4108. Study on preventive benefits.

Subtitle C—Rural InitiativesSec. 4206. Informatics, telemedicine, and

education demonstrationproject.


Sec. 4301. Permanent exclusion for thoseconvicted of 3 health care relat-ed crimes.

Sec. 4302. Authority to refuse to enter intomedicare agreements with indi-viduals or entities convicted offelonies.

Sec. 4303. Inclusion of toll-free number toreport medicare waste, fraud.and abuse in explanation ofbenefits forms.

Sec. 4304. Liability of medicare carriers andfiscal intermediaries for claimssubmitted by excluded provid-ers.

Sec. 4305. Exclusion of entity controlled byfamily member of a sanctionedindividual.

Sec. 4306. Imposition of civil money pen-alties.

Sec. 4307. Disclosure of information and sur-ety bonds.

Sec. 4308. Provision of certain identificationnumbers.

Sec. 4309. Advisory opinions regarding cer-tain physician self-referral pro-visions.

Sec. 4310. Nondiscrimination in post-hos-pital referral to home healthagencies.

Sec. 4311. Other fraud and abuse related pro-visions.

Subtitle E—Prospective Payment SystemsCHAPTER 2—PAYMENT UNDER PART B

SUBCHAPTER A—PAYMENT FOR HOSPITALOUTPATIENT DEPARTMENT SERVICES

Sec. 4411. Elimination of formula-drivenoverpayments (FDO) for certainoutpatient hospital services.

Sec. 4412. Extension of reductions in pay-ments for costs of hospital Out-patient services.

Sec. 4413. Prospective payment system forhospital outpatient departmentservices.


Sec. 4421. Rehabilitation agencies and serv-ices.

Sec. 4422. Comprehensive outpatient reha-bilitation facilities (corf).

SUBCHAPTER C—AMBULANCE SERVICESSec. 4431. Payments for ambulance services.Sec. 4432. Demonstration of coverage of am-

bulance services under medi-care through contracts withunits of local government.

CHAPTER 3—PAYMENT UNDER PARTS A AND BSec. 4441. Prospective payment for home

health services.Subtitle G—Provisions Relating to Part B

OnlyCHAPTER 1—PHYSICIANS SERVICES

Sec. 4601. Establishment of single conver-sion factor for 1998.

Sec. 4602. Establishing update to conversionfactor to match spending undersustainable growth rate.

Sec. 4603. Replacement of volume perform-ance standard with sustainablegrowth rate.

Sec. 4604. Payment rules for anesthesia serv-ices.

Sec. 4605. Implementation of resource- basedphysician practice expense.

H4435Sec. 4606. Dissemination of information on

high per admission relative val-ues for in-hospital physicians'services.

Sec. 4607. No X-ray required for chiropracticservices.

Sec. 4608. Temporary coverage restorationfor portable electrocardiogramtransportation.


Sec. 4611. Payments for durable medicalequipment.

Sec. 4612. Oxygen and oxygen equipment.Sec. 4613. Reduction in updates to payment

amounts for clinical diagnosticlaboratory tests.

Sec. 4614. Simplification in administrationof laboratory services benefit.

Sec. 4615. Updates for ambulatory surgicalservices.

Sec. 4616. Reimbursement for drugs andbiologicals.

Sec. 4617. Coverage of oral anti-nausea drugsunder chemotherapeutic regi-men.

Sec. 4618. Rural health clinic services.Sec. 4619. Increased medicare reimburse-

ment for nurse practitionersand clinical nurse specialists.

Sec. 4620. Increased medicare reimburse-ment for physician assistants.

Sec. 4621. Renal dialysis-related services.Sec. 4622. Payment for cochlear implants as

customized durable medicalequipment.


Sec. 4631. Part B premium.Subtitle H—Provisions Relating to Parts A

and BCHAPTER 1—PROVISIONS RELATING TO

MEDICARE SECONDARY PAYER

Sec. 4701. Permanent extension and revisionof certain secondary payer pro-visions.

Sec. 4702. Clarification of time and filinglimitations.

Sec. 4703. Permitting recovery against thirdparty administrators.


Sec. 4711. Recapturing savings resultingfrom temporary freeze on pay-ment increases for home healthservices.

Sec. 4712. Interim payments for home healthservices.

Sec. 4713. Clarification of part-time or inter-mittent nursing care.

Sec. 4714. Study of definition of homebound.Sec. 4715. Payment based on location where

home health service is fur-nished.

Sec. 4716. Normative standards for homehealth claims denials.

Sec. 4717. No home health benefits basedsolely on drawing blood.

Sec. 4718. Making part B primary payor forcertain home health services.

CHAPTER 3—BABY BOOM GENERATIONMEDICARE COMMISSION

Sec. 4721. Bipartisan Commission on the Ef-fect of the Baby Boom Genera-tion on the Medicare Program.

CHAPTER 4—PROVISIONS RELATING TO DIRECTGRADUATE MEDICAL EDUCATION

Sec. 4731. Limitation on payment based onnumber of residents and imple-mentation of rolling averageFTE count.

Sec. 4732. Phased-in limitation on hospitaloverhead and supervisory phy-sician component of direct med-ical education costs.

Sec. 4733. Permitting payment to non-hos-pital providers.

H4436 CONGRESSIONAL RECORD—HOUSE June 25, 1997Sec. 4734. Incentive payments under plans

for voluntary reduction in num-ber of residents

Sec. 4735. Demonstration project on use ofconsortia

Sec. 4736. Recommendations on long-termpayment policies regarding fi-nancing teaching hospitals andgraduate medical education

Sec. 4737. Medicare special reimbursementrule for certain combined resi-dency programs


Sec. 4741. Centers of excellenceSec. 4742. Medicare part B special enroll-

ment period and waiver of partB late enrollment penalty andmedigap special open enroll-ment period for certain mili-tary retirees and dependents

Sec. 4743. Competitive bidding for certainitems and services

Subtitle I—Medical Liability ReformCHAPTER 1—GENERAL PROVISIONS

Sec. 4801. Federal reform of health care li-ability actions

Sec 4802. DefinitionsSec 4803. Effective date.CHAPTER 2—UNIFORM STANDARDS FOR HEALTH

CARE LIABILITY ACTIONS

Sec. 4811. Statute of limitationsSec. 4812. Calculation and payment of dam-

agesSec. 4813. Alternative dispute resolution

June 25, 1997 CONGRESSIONAL RECORD — HOUSE H4457


SEC. 4308. PROVISION OF CERTAIN IDENTIFICA-TION NUMBERS.

(a) REQUIREMENTS TO DISCLOSE EMPLOYERIDENTIFICATION NUMBERS (EINS) AND SOCIALSECURITY ACCOUNT NUMBERS (SSNS).—Sec-


tion 1124(a)(l) (42 U.S.C. 1320a—3(a)(l)) isamended by inserting before the period atthe end the following: and supply the Sec-retary with the both the employer identifica-tion number (assigned pursuant to section6109 of the Internal Revenue Code of 1986) andsocial security account number (assignedunder section 205(c)(2)(B)) of the disclosingentity, each person with an ownership orcontrol interest (as defined in subsection(a)(3)), and any subcontractor in which theentity directly or indirectly has a 5 percentor more ownership interest. Use of the socialsecurity account number under this sectionshall be limited to identity verification andidentity matching purposes only. The socialsecurity account number shall not be dis-closed to any person or entity other than theSecretary, the Social Security Administra-tion, or the Secretary of the Treasury, In ob-taining the social security account numbersof the disclosing entity and other persons de-scribed in this section, the Secretary shallcomply with section 7 of the Privacy Act of1974 (5 U.S.C. 552a note)".

(b) OTHER MEDICARE PROVIDERS.—Section1124A (42 U.S.C. 1320a—3a) is amended—

(1) in subsection (a)—(A) by striking and" at the end of para-

graph (1);(B) by striking the period at the end of

paragraph (2) and inserting ; and'; and(C) by adding at the end the following new

paragraph:"(3) including the employer identification

number (assigned pursuant to section 6109 ofthe Internal Revenue Code of 1986) and socialsecurity account number (assigned undersection 205(c)(2)(B)) of the disclosing part Bprovider and any person, managing em-ployee, or other entity identified or de-scribed under paragraph (1) or (2).": and

(2) in subsection (c) by tnserting (or, forpurposes of subsection (a)(3), any entity re-ceiving payment)' after 'on an assignment-related basis".

(c) VERIFICATION BY SOCIAL SECURITY AD-MINISTRATION (SSA).—Section 1124A (42U.S.C. 1320a-3a) is amended—

(1) by redesignating subsection (c) as sub-section (d); and

(2) by inserting after subsection (b) the fol-lowing new subsection:

(c) VERIFICATION.—(1) TRANSMITFAL BY HHS.—The Secretary

shall transmit—(A) to the Commissioner of Social Secu-

rity information concerning each social se-curity account number (assigned under sec-tion 205(c) (2) (B)), and

(B) to the Secretary of the Treasury in-formation concerning each employer identi-fication number (assigned pursuant to sec-tion 6109 of the Internal Revenue Code of1986),

supplied to the Secretary pursuant to sub-section (a) (3) or section 1124(c) to the extentnecessary for verification of such informa-tion in accordance with paragraph (2).

(2) VERIFICATION.—The Commissioner ofSocial Security and the Secretary of theTreasury shall verify the accuracy of, or cor-rect, the information supplied by the Sec-retary to such official pursuant to paragraph(1), and shall report such verifications or cor-rections to the Secretary.

(3) FEES FOR VERIFICATION—The Sec-retary shall reimburse the Commissioner andSecretary of the Treasury, at a rate nego-tiated between the Secretary and such offi-cial, for the costs incurred by such official inperforming the verification and correctionservices described in this subsection.".

(d) REPORT—Before this subsection shallbe effective, the Secretary of Health andHuman Services shall submit to Congress areport on steps the Secretary has taken to

H4459assure the confidentiality of social securityaccount numbers that will be provided to theSecretary under the amendments made bythis section. If Congress determines that theSecretary has not taken adequate steps toassure the confidentiality of social securityaccount numbers to be provided to the Sec-retary under the amendments made by thissection, the amendments made by this sec-tion shall not take effect.

(e) EFFECTIVE DATES—Subject to sub-section (d)—

(1) the amendment made by subsection (a)shall apply to the application of conditionsof participation, and entering into and re-newal of contracts and agreements, occur-ring more than 90 days after the date of sub-mission of the report under subsection (d);and

(2) the amendments made by subsection (b)shall apply to payment for items and serv-ices furnished more than 90 days after thedate of submission of such report.

June 25, 1997

H4490 CONGRESSIONAL RECORD — HOUSE June 25, 1997Sec. 9005. State option to take account of

certain work activities of re-cipients with sufficient partici-pation in work experience orcommunity service programs.

Sec. 9006. Worker protections.Sec. 9007. Penalty for failure of State to re-

duce assistance for recipientsrefusing without good cause towork.

Subtitle B—Supplemental Security IncomeSec. 9101. Requirement to perform childhood

disability redeterminations inmissed cases.

Sec. 9102. Repeal of maintenance of effortrequirements applicable to op-tional State programs forsupplementation of SSI bene-fits.

Sec. 9103. Fees for Federal administration ofState supplementary payments.

Subtitle C—Child Support EnforcementSec. 9201. Clarification of authority to per-

mit certain redisclosures ofwage and claim information.


Sec. 9301. Extension of eligibility period forrefugees and certain otherqualified aliens from 5 to 7

years for SSI and medicaid.Sec. 9302. SSI eligibility for aliens receiving

SSI on August 22, 1996.Sec. 9303. SSI eligibility for permanent resi-

dent aliens who are members ofan Indian tribe.

Sec. 9304. Verification of eligibility forState and local public benefits.

Sec. 9305. Derivative eligibility for benefits.Sec. 9306. Effective date.

Subtitle E—Unemployment CompensationSec. 9401. Clarif'ing provision relating to

base periods.Sec. 9402. Increase in Federal unemployment

account ceiling.Sec. 9403. Special distribution to States

from Unemployment TrustFund.

Sec. 9404. Interest-free advances to State ac-counts in Unemployment TrustFund restricted to States whichmeet funding goals.

Sec. 9405. Exemption of service performed byelection workers from the Fed-eral unemployment tax.

Sec. 9406. Treatment of certain services per-formed by inmates.

Sec. 9407. Exemption of service performedfor an elementary or secondaryschool operated primarily forreligious purposes from theFederal unemployment tax.

Sec. 9408. State program integrity activitiesfor unemployment compensa-tion.

Subtitle F—Increase in Public Debt LimitTITLE IX—COMMITrEE ON WAYS AND Sec. 9501. Increase in public debt limit.

MEANS—NONMEDICARESEC. 9000. TABLE OF CONTENTS.

The table of contents of this title is as fol-lows:Sec. 9000. Table of contents.

Subtitle A—TANF Block GrantSec. 9001. Welfare-to-work grants.Sec. 9002. Limitation on amount of Federal

funds transferable to title XXprograms.

Sec. 9003. Clarification of limitation onnumber of persons who may betreated as engaged in work byreason of participation in voca-tional educational training.

Sec. 9004. Rules governing expenditures offunds for work experience andcommunity service programs.

June 25, 1997 CONGRESSIONAL RECORD—HOUSE H4493

Subtitle B—Supplemental Security IncomeSEC. 9101. REQUIREMENT TO PERFORM CHILD-

HOOD DISABILITY REDETERMINA-TIONS IN MISSED CASES.

Section 211(d)(2) of the Personal Respon-sibility and Work Opportunity Reconcili-ation Act of 1996 (110 Stat. 2190) is amended—

(1) in subparagraph (A)—(A) in the 1st sentence, by striking '1

year" and inserting "18 months": and(B) by inserting after the 1st sentence the

following: Any redetermination required bythe preceding sentence that is not performedbefore the end of the period described in thepreceding sentence shall be performed assoon as is practicable thereafter."; and

(2) in subparagraph (C), by adding at theend the following: Before commencing a re-determination under the 2nd sentence of sub-paragraph (A), in any case in which the indi-vidual involved has not already been notifiedof the provisions of this paragraph, the Com-missioner of Social Security shall notify theindividual involved of the provisions of thisparagraph."SEC. 9102. REPEAL OF MAINTENANCE OF EFFORT

REQUIREMENTS APPLICABLE TO OP-TIONAL STATE PROGRAMS FORSUPPLEMENTATION OF SSI BENE-FITS.

Section 1618 of the Social Security Act (42U.S.C. 1382g) is repealed.SEC. 9103. FEES FOR FEDERAL ADMINISTRATION

OF STATE SUPPLEMENTARY PAY-MENTS.

(a) FEE SCHEDULE.—(1) OPTIONAL STATE SUPPLEMENTARY PAY-

MENTS.—(A) IN GENERAL—Section 16l6(d)(2)(B) of

the Social Security Act (42 U.S.C.1382e(d) (2) (B)) is amended—

(i) by striking 'and" at the end of clause(iii); and

(ii) by striking clause (iv) and inserting thefollowing:

'(iv) for fiscal year 1997, $5.00;'(v) for fiscal year 1998, $6.20;"(vi) for fiscal year 1999, $7.60;'(vii) for fiscal year 2000, $7.80;"(viii) for fiscal year 2001, $8.10:'(ix) for fiscal year 2002, $8.50; and

(x) for fiscal year 2003 and each succeed-ing fiscal year—

"(I) the applicable rate in the precedingfiscal year. increased by the percentage, if

H4494any, by which the Consumer Price Index forthe month of June of the calendar year ofthe increase exceeds the Consumer PriceIndex for the month of June of the calendaryear preceding the calendar year of the in-crease, and rounded to the nearest wholecent; or

(II) such different rate as the Commis-sioner determines is appropriate for theState.".

(B) CONFORMING AMENDMENT.—Section1616(d) (2) (C) of such Act (42 U.S.C.1382e(d) (2) (C)) is amended by striking(B)(iv)" and inserting "(B)(x)(II)".(2) MANDATORY STATE SUPPLEMENTARY PAY-

MENTS.—(A) IN GENERAL—Section 212(b)(3)(B)(ii) of

Public Law 93—66 (42 U.S.C. 1382 note) isamended—

(i) by striking and' at the end of sub-clause (III); and

(ii) by striking subclause (IV) and insertingthe following:

(IV) for fiscal year 1997, $5.00;(V) for fiscal year 1998, $6.20;(VI) for fiscal year 1999, $7.60;(VII) for fiscal year 2000, $7.80;(VIII) for fiscal year 2001, $8.10;

'(IX) for fiscal year 2002, $8.50; and'(X) for fiscal year 2003 and each succeed-

ing fiscal year—(aa) the applicable rate in the preceding

fiscal year, increased by the percentage, ifany, by which the Consumer Price Index forthe month of June of the calendar year ofthe increase exceeds the Consumer PriceIndex for the month of June of the calendaryear preceding the calendar year of the in-crease, and rounded to the nearest wholecent; or

'(bb) such different rate as the Commis-sioner determines is appropriate for theState.".

(B) CONFORMING AMENDMENT—Section212(b)(3)(B)(iii) of such Act (42 U.S.C. 1382note) is amended by striking (ii) (IV)" andinserting "(ii) (X) (bb)".

(b) USE OF NEW FEES To DEFRAY THE SO-CIAL SECURITY ADMINISTRATION'S ADMINIS-TRATIVE EXPENSES.—

(1) CREDIT TO SPECIAL FUND FOR FISCALYEAR 1998 AND SUBSEQUENT YEARS.—

(A) OPTIONAL STATE SUPPLEMENTARY PAY-MENT FEES—Section 1616(d)(4) of the SocialSecurity Act (42 U.S.C. 1382e(d)(4)) is amend-ed to read as foows:

(4) (A) The first $5 of each administrationfee assessed pursuant to paragraph (2). uponcollection, shall be deposited in the generalfund of the Treasury of the United States asmiscellaneous receipts.

'(B) That portion of each administrationfee in excess of $5, and 100 percent of each ad-ditional services fee charged pursuant toparagraph (3), upon collection for fiscal year1998 and each subsequent fiscal year, shall becredited to a special fund established in theTreasury of the United States for State sup-plementary payment fees. The amounts socredited, to the extent and in the amountsprovided in advance in appropriations Acts,shall be available to defray expenses in-curred in carrying Out this title and relatedlaws.".

(B) MANDATORY STATE SUPPLEMENTARYPAYMENT FEES—Section 212(b)(3)(D) of Pub-lic Law 93-66 (42 U.S.C. 1382 note) is amendedto read as follows:

(D) (i) The first $5 of each administrationfee assessed pursuant to subparagraph (B).upon collection. shall be deposited in thegeneral fund of the Treasury of the UnitedStates as miscellaneous receipts.

'(ii) The portion of each administrationfee in excess of $5, and 100 percent of each ad-ditional services fee charged pursuant tosubparagraph (C), upon collection for fiscalyear 1998 and each subsequent fiscal year,

CONGRESSIONAL RECORD — HOUSEshall be credited to a special fund estab-lished in the Treasury of the United Statesfor State supplementary payment fees. Theamounts so credited, to the extent and in theamounts provided in advance in appropria-tions Acts, shall be available to defray ex-penses incurred in carrying out this sectionand title XVI of the Social Security Act andrelated laws.".

(2) LIMITATIONS ON AUTHORIZATION OF AP-PROPRIATIONS.—From amounts credited pur-suant to section 1616(d)(4)(B) of the SocialSecurity Act and section 212(b)(3)(D)(ii) ofPublic Law 93-66 to the special fund estab-lished in the Treasury of the United Statesfor State supplementary payment fees. thereis authorized to be appropriated an amountnot to exceed $35,000,000 for fiscal year 1998,and such sums as may be necessary for eachfiscal year thereafter.

Subtitle C—Child Support EnforcementSEC. 9201. CLARIFICATION OF AUTHORITY TO

PERMIT CERTAIN REDISCLOSURESOF WAGE AND CLAIM INFORMATION.

Section 303(h) (1) (C) of the Social SecurityAct (42 U.S.C. 503(h)(1)(C)) is amended bystriking 'section 453(i) (1) in carrying out thechild support enforcement program undertitle IV and inserting "subsections (i)(1),(i)(3), and U) of section 453".Subtitle D—Restricting Welfare and Public

Benefits for AliensSEC. 9301. EXTENSION OF ELIGIBILITY PERIOD

FOR REFUGEES AND CERTAINOTHER QUALIFIED ALIENS FROM 5TO 7 YEARS FOR SSI AND MEDICAID.

(a) SSI.—Section 402(a) (2) (A) of the Per-sonal Responsibility and Work OpportunityReconciliation Act of 1996 (8 U.S.C.1612(a)(2)(A)) is amended to read as follows:

(A) TIME-LIMITED EXCEPTION FOR REFU-GEES AND ASYLEES.—

(i) SSI.—With respect to the specifiedFederal program described in paragraph(3)(A) paragraph 1 shall not apply to an alienuntil 7 years after the date—

(I) an alien is admitted to the UnitedStates as a refugee under section 207 of theImmigration and Nationality Act;

(II) an alien is granted asylum under sec-tion 208 of such Act: or

(III) an alien's deportation is withheldunder section 243(h) of such Act.

(ii) FOOD STAMPS—With respect to thespecified Federal program described in para-graph (3)(B). paragraph 1 shall not apply toan alien until 5 years after the date—


'(II) an alien is granted asylum under sec-tion 208 of such Act; or

'(III) an alien's deportation is withheldunder section 243(h) of such Act.".

(b) MEDICAID—Section 402(b) (2) (A) of thePersonal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 (8 U.S.C.1612(b) (2) (A)) is amended to read as follows:

(A) TIME-LIMITED EXCEPTION FOR REFU-GEES AND ASYLEES.—

'(i) MEDICAID.—With respect to the des-ignated Federal program described in para-graph (3)(C), paragraph 1 shall not apply toan alien until 7 years after the date—


(II) an alien is granted asylum under sec-tion 208 of such Act; or

(III) an alien's deportation is withheldunder section 243(h) of such Act.

(ii) OTHER DESIGNATED FEDERAL PRO-GRAMS—With respect to the designated Fed-eral programs under paragraph (3) (otherthan subparagraph (C)). paragraph 1 shallnot apply to an alien until 5 years after thedate—

June 25, 1997



'(III) an alien's deportation is withheldunder section 243(h) of such Act.".SEC. 9302. SSI ELIGIBILITY FOR ALIENS RECEIV-

ING SSI ON AUGUST 22, 1996.(a) IN GENERAL—Section 402(a)(2) of the

Personal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 (8 U.S.C.1612(a)(2)) is amended by adding after sub-paragraph (D) the following new subpara-graph:

(E) ALIENS RECEIVING SSI ON AUGUST 22,1996.—With respect to eligibility for benefitsfor the program defined in paragraph (3) (A)(relating to the supplemental security in-come program), paragraph (1) shall not applyto an alien who was receiving such benefitson August 22, 1996.".

(b) STATUS OF CUBAN AND HAITIAN EN-TRANTS AND AMERASIAN PERMANENT RESI-DENT ALIENS.—FOr purposes of section402(a) (2) (E) of the Personal Responsibilityand Work Opportunity Reconciliation Act of1996, the following aliens shall be consideredqualified aliens:

(1) An alien who is a Cuban and Haitian en-trant as defined in section 501(e) of the Refu-gee Education Assistance Act of 1980.

(2) An alien admitted to the United Statesas an Amerasian immigrant pursuant to sec-tion 584 of the Foreign Operations, ExportFinancing. and Related Programs Appropria-tions Act, 1988, as contained in section 101(e)of Public Law 100-202, (other than an alienadmitted pursuant to section 584 (b) (1) (C)).

(c) CONFORMING AMENDMENTS—SectiOn402(a) (2) (D) of the Personal Responsibilityand Work Opportunity Reconciliation Act of1996 (8 U.S.C. 1612(a)(D)) is amended—

(1) by striking clause (i);(2) in the subparagraph heading by striking

'BENEFITS' and inserting FOOD STAMPS";(3) by striking '(ii) FOOD STAMPS'.—':(3) by redesignating subclauses (I), (II). and

(III) as clauses (i), (ii), and (iii).SEC. 9303. SSI ELIGIBILITY FOR PERMANENT

RESIDENT ALIENS WHO ARE MEM-BERS OF AN INDIAN TRIBE.

Section 402(a)(2) of the Personal Respon-sibility and Work Opportunity Reconcili-ation Act of 1996 (8 U.S.C. 1612(a)(2)) (asamended by section 9302) is amended by add-ing after subparagraph (E) the following newsubparagraph:

(F) PERMANENT RESIDENT ALIENS WHO AREMEMBERS OF AN INDIAN TRIBE—With respectto eligibility for benefits for the program de-fined in paragraph (3) (A) (relating to the sup-plemental security income program). para-graph (1) shall not apply to an alien who—

'(i) is lawfully admitted for permanentresidence under the Immigration and Nation-ality Act; and

'(ii) is a member of an Indian tribe (as de-fined in section 4(e) of the Indian Self-Deter-mination and Education Assistance Act).SEC. 9304. VERIFICATION OF ELIGIBILITY FOR

STATE AND LOCAL PUBLIC BENE-FITS.

(a) IN GENERAL.—The Personal Responsibil-ity and Work Opportunity ReconciliationAct of 1996 is amended by adding after sec-tion 412 the following new section:SEC. 413. AUTHORIZATION FOR VERIFICATION

OF ELIGIBILITY FOR STATE ANDLOCAL PUBLIC BENEFITS.

"A State or political subdivision of a Stateis authorized to require an applicant forState and local public benefits (as defined insection 411(c)) to provide proof of eligi-bility.

(b) CLERICAL AMENDMENT.—SectiOn 2 of thePersonal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 is amended

June 25, 1997 CONGRESSIONAL RECORD — HOUSE H4495by adding after the item related to section412 the following:

Sec. 413. Authorization for verification ofeligibility for state and localpublic benefits.

SEC. 9305. DERIVATIVE ELIGIBILITY FOR BENE-FITS.

(a) IN GENERAL.—The Personal Responsibil-ity and Work Opportunity ReconciliationAct of 1996 is amended by adding after sec-tion 435 the following new section:SEC. 436. DERIVATIVE ELIGIBILITY FOR BENE-

FITS.'(a) FOOD STAMPs—Notwithstanding any

other provision of law, an alien who underthe provisions of this title is ineligible forbenefits under the food stamp program (asdefined in section 402(a)(3)(A)) shall not beeligible for such benefits because the alienreceives benefits under the supplemental se-curity income program (as defined in section402 (a) (3) (B)).

(b) MEDICAID—Notwithstanding anyother provision of this title, an alien whounder the provisions of this title is ineligiblefor benefits under the medicaid program (asdefined in section 402(b)(3)(C)) shall be eligi-ble for such benefits if the alien is receivingbenefits under the supplemental security in-come program and title XIX of the Social Se-curity Act provides for such derivative eligi-bility.

(b) CLERICAL AMENDMENT—SectiOn 2 of thePersonal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 is amendedby adding after the item related to section435 the following:"Sec. 436. Derivative eligibility for bene-

fits.'SEC. 9306. EFFECTIVE DATE.

Except as otherwise provided, the amend-ments made by this subtitle shall be effec-tive as if included in the enactment of titleIV of the Personal Responsibility and WorkOpportunity Reconciliation Act of 1996.

H4496

TITLE X—COMMIrrEE ON WAYS ANDMEANS—MEDICARE

SEC. 10000 AMENDMENTS TO SOCIAL SECURITYACT AND REFERENCES TO OBRA;TABLE OF CONTENTS OF TITLE.

(a) AMENDMENTS TO SOCIAL SECURITYACT—Except as otherwise specifically pro-vided, whenever in this title an amendmentis expressed in terms of an amendment to orrepeal of a section or other provision, thereference shall be considered to be made tothat section or other provision of the SocialSecurity Act.

(b) REFERENCES TO OBRA.—In this title,the terms OBRA—1986", "OBRA—1987",OBRA-1989", OBRA-1990", and OBRA-

1993" refer to the Omnibus Budget Reconcili-ation Act of 1986 (Public Law 99—509), theOmnibus Budget Reconciliation Act of 1987(Public Law 100-203), the Omnibus BudgetReconciliation Act of 1989 (Public Law 101—239), the Omnibus Budget Reconciliation Actof 1990 (Public Law 101-508), and the OmnibusBudget Reconciliation Act of 1993 (PublicLaw 103—66), respectively.

(c) TABLE OF CONTENTS OF TITLE—Thetable of contents of this title is as follows:Sec. 10000. Amendments to Social Security

Act and references to OBRA;table of contents of title.

Subtitle A—MedicarePlus ProgramCHAPTER 1—MEDICAREPLUS PROGRAM

SUBCHAPTER A—MEDICAREPLUS PROGRAMSec. 10001. Establishment of MedicarePlus

program.PART C—MEDICAREPLUS PROGRAM

Sec. 1851. Eligibility, election, and en-rollment.

Sec. 1852. Benefits and beneficiary pro-tections.

Sec. 1853. Payments to MedicarePlusorganizations.

Sec. 1854. Premiums.Sec. 1855. Organizational and financial

requirements for MedicarePlusorganizations: provider-spon-sored organizations.

Sec. 1856. Establishment of standards.'Sec. 1857. Contracts with MedicarePlus

organizations.Sec. 1859. Definitions; miscellaneous

provisions.Sec. 10002. Transitional rules for current

medicare HMO program.Sec. 10003. Conforming changes in medigap

program.SUBCHAPTER B—SPECIAL RULES FOR

MEDICAREPLU5 MEDICAL SAVINGS ACCOUNTSSec. 10006. MedicarePlus MSA.

CHAPTER 2—INTEGRATED LONG-TERM CAREPROGRAMS

SUBCHAPTER A—PROGRAMS OF ALL-INCLUSIVECARE FOR THE ELDERLY (PACE)

Sec. 10011. Coverage of PACE under the med-icare program.

Sec. 10012. Establishment of PACE programas medicaid State option.

Sec. 10013. Effective date; transition.Sec. 10014. Study and reports.

CONGRESSIONAL RECORD — HOUSESUBCHAPTER B—SOCIAL HEALTH MAINTENANCE

ORGANIZATIONSSec. 10015. Social health maintenance orga-

nizations (SHMOs).SUBCHAPTER C—OTHER PROGRAMS

Sec. 10018. Orderly transition of municipalhealth service demonstrationprojects.

Sec. 10019. Extension of certain medicarecommunity nursing organiza-tion demonstration projects.

CHAPTER 3—MEDICARE PAYMENT ADVISORYCOMMISSION

Sec. 10021. Medicare Payment AdvisoryCommission.

CHAPTER 4—MEDIGAP PROTECTIONSSec. 10031. Medigap protections.Sec. 10032. Medicare prepaid competitive

pricing demonstration project.CHAPTER 5—TAx TREATMENT OF HOSPITALS

PARTICIPATING IN PROVIDER-SPONSORED OR-GANIZATIONS

Sec. 10041. Tax treatment of hospitals whichparticipate in provider-spon-sored organizations.

Subtitle B—Prevention InitiativesSec. 10101. Screening mammography.Sec. 10102. Screening pap smear and pelvic

exams.Sec. 10103. Prostate cancer screening tests.Sec. 10104. Coverage of colorectal screening.Sec. 10105. Diabetes screening tests.Sec. 10106. Standardization of medicare cov-

erage of bone mass measure-ments.

Sec. 10107. Vaccines outreach expansion.Sec. 10108. Study on preventive benefits.

Subtitle C—Rural InitiativesSec. 10201. Rural primary care hospital pro-

gram.Sec. 10202. Prohibiting denial of request by

rural referral centers for reclas-sification on basis of com-parability of wages.

Sec. 10203. Hospital geographic reclassifica-tion permitted for purposes ofdisproportionate share paymentadjustments.

Sec. 10204. Medicare-dependent, small ruralhospital payment extension.

Sec. 10205. Geographic reclassification forcertain disproportionatelylarge hospitals.

Sec. 10206. Floor on area wage index.Sec. 10207. Informatics, telemedicine, and

education demonstrationproject.


Sec. 10301. Permanent exclusion for thoseconvicted of 3 health care relat-ed crimes.

Sec. 10302. Authority to refuse to enter intomedicare agreements with indi-viduals or entities convicted offelonies.

Sec. 10303. Inclusion of toll-free number toreport medicare waste, fraud,and abuse in explanation ofbenefits forms.

Sec. 10304. Liability of medicare carriers andfiscal intermediaries for claimssubmitted by excluded provid-ers.

Sec. 10305. Exclusion of entity controlled byfamily member of a sanctionedindividual.

Sec. 10306. Imposition of civil money pen-alties.

Sec. 10307. Disclosure of information andsurety bonds.

Sec. 10308. Provision of certain identifica-tion numbers.

Sec. 10309. Advisory opinions regarding cer-tain physician self-referral pro-visions.

June 25, 1997Sec. 10310. Other fraud and abuse related

provisions.Subtitle E—Prospective Payment Systems

CHAPTER 1—PAYMENT UNDER PART ASec. 10401. Prospective payment for skilled

nursing facility services.Sec. 10402. Prospective payment for inpa-

tient rehabilitation hospitalservices.

CHAPTER 2—PAYMENT UNDER PART BSUBCHAPTER A—PAYMENT FOR HOSPITAL

OUTPATIENT DEPARTMENT SERVICESSec. 10411. Elimination of formula-driven

overpayments (FDO) for certainoutpatient hospital services.

Sec. 10412. Extension of reductions in pay-ments for costs of hospital out-patient services.

Sec. 10413. Prospective payment system forhospital outpatient departmentservices.

SUBCHAPTER B—REHABILITATION SERVICESSec. 10421. Rehabilitation agencies and serv-

ices.Sec. 10422. Comprehensive outpatient reha-

bilitation facilities (corf).SUBCHAPTER C—AMBULANCE SERVICES

Sec. 10431. Payments for ambulance serv-ices.

Sec. 10432. Demonstration of coverage of am-bulance services under medi-care through contracts withunits of local government.

CHAPTER 3—PAYMENT UNDER PARTS A AND BSec. 10441. Prospective payment for home

health services.Subtitle F—Provisions Relating to Part ACHAPTER 1—PAYMENT OF PPS HOSPITALS

PPS hospital payment update.Capital payments for PPS hos-

pitals.Freeze in disproportionate share.Medicare capital asset sales price

equal to book value.Elimination of IME and DSH pay-

ments attributable to outlierpayments.

Sec. 10506. Reduction in adjustment for indi-rect medical education.

Sec. 10507. Treatment of transfer cases.Sec. 10508. Increase base payment rate to

Puerto Rico hospitals.CHAPTER 2—PAYMENT OF PPS EXEMPT

HOSPITALSSec. 10511. Payment update.Sec. 10512. Reductions to capital payments

for certain PPS-exempt hos-pitals and units.

Sec. 10513. Cap on TEFRA limits.Sec. 10514. Change in bonus and relief pay-

ments.Sec. 10515. Change in payment and target

amount for new providers.Sec. 10516. Rebasing.Sec. 10517. Treatment of certain long-term

care hospitals.Sec. 10518. Elimination of exemptions; re-

port on exceptions and adjust-ments.

CHAPTER 3—PRoVISIONS RELATED TO HOSPICESERVICES

Sec. 10521. Payments for hospice services.Sec. 10522. Payment for home hospice care

based on location where care isfurnished.

Sec. 10523. Hospice care benefits periods.Sec. 10524. Other items and services included

in hospice care.Sec. 10525. Contracting with independent

physicians or physician groupsfor hospice care services per-mitted.

Sec. 10526. Waiver of certain staffing re-quirements for hospice careprograms in non-urbanizedareas.

Sec. 10501.Sec. 10502.

Sec. 10503.Sec. 10504.

Sec. 10505.

June 25, 1997

Sec. 10527. Limitation on liability of bene-ficiaries for certain hospicecoverage denials.

Sec. 10528. Extending the period for physi-cian certification of an individ-ual's terminal illness.

Sec. 10529. Effective date.CHAPTER 4—MODIFICATION OF PART A HOME

HEALTH BENEFITSec. 10531. Modification of part A home

health benefit for individualsenrolled under part B.

CHAPTER 5—OTHER PAYMENT PROVISIONSSec. 10541. Reductions in payments for en-

rollee bad debt.Sec. 10542. Permanent extension of hemo-

philia pass-through.Sec. 10543. Reduction in part A medicare

premium for certain public re-tirees.

Subtitle C—Provisions Relating to Part BOnly

CHAPTER 1—PHYSICIANS SERVICESSec. 10601. Establishment of single conver-

sion factor for 1998.Sec. 10602. Establishing update to conver-

sion factor to match spendingunder sustainable growth rate.

Sec. 10603. Replacement of volume perform-ance standard with sustainablegrowth rate.

Sec. 10604. Payment rules for anesthesiaservices.

Sec. 10605. Implementation of resource-based physician practice ex-pense.

Sec. 10606. Dissemination of information onhigh per discharge relative val-ues for in-hospital physicians'services.

Sec. 10607. No X-ray required for chiroprac-tic services.

Sec. 10608. Temporary coverage restorationfor portable electrocardiogramtransportation.


Sec. 10611. Payments for durable medicalequipment.

Sec. 10612. Oxygen and oxygen equipment.Sec. 10613. Reduction in updates to payment

amounts for clinical diagnosticlaboratory tests.

Sec. 10614. Simplification in administrationof laboratory tests.

Sec. 10615. Updates for ambulatory surgicalservices.

Sec. 10616. Reimbursement for drugs andbiologicals.

Sec. 10617. Coverage of oral anti-nauseadrugs under chemotherapeuticregimen.

Sec. 10618. Rural health clinic services.Sec. 10619. Increased medicare reimburse-

ment for nurse practitionersand clinical nurse specialists.

Sec. 10620. Increased medicare reimburse-ment for physician assistants.

Sec. 10621. Renal dialysis-related services.CHAPTER 3—PART B PREMIUM

Sec. 10631. Part B premium.Subtitle H—Provisions Relating to Parts A

and BCHAPTER 1—PROVISIONS RELATING TO

MEDICARE SECONDARY PAYERSec. 10701. Permanent extension and revi-

sion of certain secondary payerprovisions.

Sec. 10702. Clarification of time and filinglimitations.

Sec. 10703. Permitting recovery againstthird party administrators.

CHAPTER 2—HOME HEALTH SERVICESSec. 10711. Recapturing savings resulting

from temporary freeze on pay-ment increases for home healthservices.


Sec. 10712. Interim payments for homehealth services.

Sec. 10713. Clarification of part-time orintermittent nursing care.

Sec. 10714. Study of definition of home-bound.

Sec. 10715. Payment based on location wherehome health service is fur-nished.

Sec. 10716. Normative standards for homehealth claims denials,

Sec. 10717. No home health benefits basedsolely on drawing blood.

CHAPTER 3—BABY BOOM GENERATIONMEDICARE COMMISSION

Sec. 10721. Bipartisan Commission on the Ef-fect of the Baby Boom Genera-tion on the Medicare Program.

CHAPTER 4—PROVISIONS RELATING TO DIRECTGRADUATE MEDICAL EDUCATION

Sec. 10731. Limitation on payment based onnumber of residents and imple-mentation of rolling averageFTE count.

Sec. 10732. Phased-in limitation on hospitaloverhead and supervisory phy-sician component of direct med-ical education costs.

Sec. 10733. Permitting payment to non-hos-pital providers.

Sec. 10734. Incentive payments under plansfor voluntary reduction in num-ber of residents.

Sec. 10735. Demonstration project on use ofconsortia.

Sec. 10736. Recommendations on long-termpayment policies regarding fi-nancing teaching hospitals andgraduate medical education.

Sec. 10737. Medicare special reimbursementrule for certain combined resi-dency programs.


Sec. 10741. Centers of excellence.Sec. 10742. Medicare part B special enroll-

ment period and waiver of partB late enrollment penalty andmedigap special open enroll-ment period for certain mili-tary retirees and dependents.

Sec. 10743. Protections under the medicareprogram for disabled workerswho lose benefits under a grouphealth plan.

Sec. 10744. Placement of advance directivein medical record.

Subtitle I—Medical Liability ReformCHAPTER 1—GENERAL PROVISIONS

Sec. 10801. Federal reform of health care li-ability actions.

Sec. 10802. Definitions.Sec. 10803. Effective date.CHAPTER 2—UNIFORM STANDARDS FOR HEALTH

CARE LIABILITY ACTIONS

Sec. 10811. Statute of limitations.Sec. 10812. Calculation and payment of dam-

ages.Sec. 10813. Alternative dispute resolution.

H4497

H4522 CONGRESSIONAL RECORD — HOUSE

SEC. 10308. PROVISION OF CERTAIN IDENTIFICA-TION NUMBERS.

(a) REQUIREMENTS TO DISCLOSE EMPLOYERIDENTWICATION NUMBERS (EINS) AND SOCIALSECURITY ACCOUNT NUMBERS (SSNS).—Sec-tion 1124(a)(1) (42 U.S.C. 1320a—3(a)(1)) isamended by inserting before the period atthe end the following: and supply the Sec-retary with the both the employer identifica-tion number (assigned pursuant to section6109 of the Internal Revenue Code of 1986) andsocial security account number (assignedunder section 205(c)(2)(B)) of the disclosingentity, each person with an ownership orcontrol interest (as defined in subsection(a)(3)), and any subcontractor in which theentity directly or indirectly has a 5 percentor more ownership interest

(b) OTHER MEDICARE PROVIDERS—Section1124A (42 U.S.C. 1320a—3a) is amended—

(1) in subsection (a)—(A) by striking "and ' at the end of para-

graph (1);(B) by striking the period at the end of

paragraph (2) and inserting and '; and(C) by adding at the end the following new

paragraph:"(3) including the employer identification

number (assigned pursuant to section 6109 ofthe Internal Revenue Code of 1986) and socialsecurity account number (assigned undersection 205(c)(2)(B)) of the disclosing part Bprovider and any person, managing em-ployee, or other entity identified or de-scribed under paragraph (1) or (2).'; and

(2) in subsection (c) by inserting "(or. forpurposes of subsection (a)(3). any entity re-ceiving payment) after "on an assignment-related basis".

(c) VERWICATION BY SOCIAL SECURITY AD-MINISTRATION (SSA).—Section 1124A (42 U.S.C.1320a-3a) is amended—

(1) by redesignating subsection (c) as sub-section (d); and

(2) by inserting after subsection (b) the fol-lowing new subsection:

'(c) VERIFiCATION.—"(1) TRANSMITrAL BY HHS.—The Secretary

shall transmit—"(A) to the Commissioner of Social Secu-

rity information concerning each social se-curity account number (assigned under sec-tion 205(c) (2) (B)), and

(B) to the Secretary of the Treasury in-formation concerning each employer identi-fication number (assigned pursuant to sec-tion 6109 of the Internal Revenue Code of1986),

supplied to the Secretary pursuant to sub-section (a)(3) or section 1124(c) to the extentnecessary for verification of such informa-tion in accordance with paragraph (2).

'(2) VERIFiCATION—The Commissioner ofSocial Security and the Secretary of theTreasury shall verify the accuracy of, or cor-rect. the information supplied by the Sec-retary to such official pursuant to paragraph(1), and shall report such verifications or cor-rections to the Secretary.

'(3) FEES OR VERIFiCATION—The Sec-retary shall reimburse the Commissioner andSecretary of the Treasury, at a rate nego-tiated between the Secretary and such offi-cial, for the costs incurred by such official inperforming the verification and correctionservices described in this subsection.".

(d) REPORT—The Secretary of Health andHuman Services shall submit to Congress areport on- steps the Secretary has taken toassure the confidentiality of social securityaccount numbers that will be provided to theSecretary under the amendments made bythis section.

H4524

June 25, 1997

(e) EECTIVE DATES.—(1) The amendment made by subsection (a)

shall apply to the application of conditionsof participation, and entering into and re-newal of contracts and agreements. occur-ring more than 90 days after the date of sub-mission of the report under subsection (d).

(2) The amendments made by subsection(b) shall apply to payment for items andservices furnished more than 90 days afterthe date of submission of such report.


H4523


TITLE X1—BUDGET ENFORCEMENTSEC. 11001. SHORT TITLE; TABLE OF CONTENTS.

(a) SHORT TITLE—This Act may be cited asthe Budget Enforcement Act of 1997".

(b) TABLE OF CONTENTS.—

TITLE XI—BUDGET ENFORCEMENTSec. 11001. Short title: table of contents.Subtitle A—Amendments to the Congres-

sional Budget and Impoundment ControlAct of 1974

Sec. 11101. Amendments to section 3.Sec. 11102. Amendments to section 201.Sec. 11103. Amendments to section 202.Sec. 11104. Amendment to section 300.Sec. 11105. Amendments to section 301.Sec. 11106. Amendments to section 302.Sec. 11107. Amendments to section 303.Sec. 11108. Amendment to section 305.Sec. 11109. Amendments to section 308.Sec. 11110. Amendments to section 310.Sec. 11111. Amendments to section 311.Sec. 11112. Amendment to section 312.Sec. 11113. AdJustments and Budget Com-

mittee determinations.Sec. 11114. Effect of self-executing amend-

ments on points of order in theHouse of Representatives.

Sec. 11115. Amendment of section 401 and re-peal of section 402.

Sec. 11116. Repeal of title VI.Sec. 11117. Amendments to section 904.Sec. 11118. Repeal of sections 905 and 906.Sec. 11119. Amendments to sections 1022 and

1024.Sec. 11120. Amendment to section 1026.Subtitle B—Amendments to the Balanced

Budget and Emergency Deficit Control Actof 1985

Sec. 11201. Purpose.Sec. 11202. General Statement and defini-

tions.Sec. 11203. Enforcing discretionary spending

limits.

H4547Sec. 11204. Violent crime reduction trust

fund.Sec. 11205. Enforcing pay-as-you-go.Sec. 11206. Reports and orders.Sec. 11207. Exempt programs and activities.Sec. 11208. General and special sequestration

rules.Sec. 11209. The baseline.Sec. 11210. Technical correction.Sec. 11211. Judicial review.Sec. 11212. Effective date.Sec. 11213. Reduction of preexisting balances

and exclusion of effects of thisAct from paygo scorecard.

Subtitle A—Amendments to the Congres-sional Budget and Impoundment ControlAct of 1974

SEC. 11101. AMENDMENTS TO SECTION 3.Section 3 of the Congressional Budget and

Impoundment Control Act of 1974 (2 U.S.C.622) is amended—

(1) in paragraph (2)(A), by striking "and"at the end of clause (iii), by striking the pe-riod and inserting ': and" at the end ofclause (iv), and by adding at the end the fol-lowing:

"(v) entitlement authority and the foodstamp program.": and

(2) in paragraph (9), by inserting butsuch term does not include salary or basicpay funded through an appropriation Act"before the period.SEC. 11102. AMENDMENTS TO SECTION 201.

(a) TERM OF OFFICE—The first sentence ofsection 201(a) (3) of the Congressional BudgetAct of 1974 is amended to read as follows:"The term of office of the Director shall befour years and shall expire on January 3 ofthe year preceding a Presidential election.".

(b) REDESIGNATION OF EXECUTED PROVI-SION.—Section 201 of the Congressional Budg-et Act of 1974 is amended by redesignatingsubsection (g) (relating to revenue esti-mates) as subsection (f).SEC. 11103. AMENDMENTS TO SECTION 202.

(a) ASSISTANCE TO BUDGET COMMITrEES.—The first sentence of section 202(a) of theCongressional Budget Act of 1974 is amendedby inserting 'primary" before 'duty".

(b) ELIMINATION OF EXECUTED PROVISION.—Section 202 of the Congressional Budget Actof 1974 is amended by striking subsection (e)and by redesignating subsections (f), (g), and(h) as subsections (e), (f), and (g), respec-tively.SEC. 11104. AMENDMENT TO SECTION 300.

The item relating to February 25 in thetimetable set forth in section 300 of the Con-gressional Budget Act of 1974 is amended bystriking "February 25" and inserting 'With-in 6 weeks after President submits budget".SEC. 11105. AMENDMENTS TO SECTION 301.

(a) TERMS OF BUDGET RESOLUTIONS—Sec-tion 301(a) of the Congressional Budget Actof 1974 is amended by striking ", and plan-ning levels for each of the two ensuing fiscalyears," and inserting and for at least eachof the 4 ensuing fiscal years".

(b) CONTENTS OF BUDGET RESOLUTIONS.—Paragraphs (1) and (4) of section 301 (a) of theCongressional Budget Act of 1974 are amend-ed by striking ", budget outlays, direct loanobligations, and primary loan guaranteecommitments" each place it appears and in-serting "and budget outlays".

(c) ADDITIONAL MATFERS.—Section 301(b) ofthe Congressional Budget Act of 1974 isamended by amending paragraph (7) to readas follows—

"(7) set forth pay-as-you-go procedures inthe Senate whereby committee allocations,aggregates, and other levels can be revisedfor legislation within a committee's Jurisdic-tion if such legislation would not increasethe deficit for the first year covered by theresolution and will not increase the deficit

June 25, 1997

H4548for the period of 5 fiscal years covered by theresolution:'.

(d) VIEWS AND ESTIMATES—The first sen-tence of section 301(d) of the CongressionalBudget Act of 1974 is amended by inserting'or at such time as may be requested by theCommittee on the Budget." after "Code,".

(e) HEARINGS AND REPORT—Section301(e)(2) of the Congressional Budget Act of1974 is amended by striking 'total directloan obligations total primary loan guaran-tee commitments,'.

(f) SOCIAL SECURITY CORRECTIONS—Section301 (i) of the Congressional Budget Act of 1974is amended by—

(1) inserting 'SOCIAL SECURITY POINT OFORDER.—" after '(i)"; and

(2) striking 'as reported to the Senate"and inserting "(or amendment, motion, orconference report on such a resolution)SEC. 11106. AMENDMENTS TO SECTION 302.

(a) ALLOCATIONS AND SUBALLOCATIONS.—Subsections (a) and (b) of section 302 of theCongressional Budget Act of 1974 are amend-ed to read as follows:

"(a) COMMITFEE SPENDING ALLOCATIONS.—'(1) ALLOCATION AMONG COMMITFEES.—The

Joint explanatory statement accompanying aconference report on a budget resolutionshall include allocations, consistent with theresolution recommended in the conferencereport, of the appropriate levels (for each fis-cil year covered by that resolution and atotal for all such years, except in the case ofthe Committee on Appropriations only forthe first such fiscal year) of—

(A) total new budget authority:"(B) total outlays; and'(C) in the Senate, social security outlays:

among each committee of the House of Rep-resentatives or the Senate that has jurisdic-tion over legislation providing or creatingsuch amounts.

"(2) NO DOUBLE COUNTING—In the House ofRepresentatives, any item allocated to onecommittee may not be allocated to anothersuch committee.

'(3) FURTHER DIVISION OF AMOUNTS—In theHouse of Representatives the amounts allo-cated to each committee for each fiscal year.other than the Committee on Appropria-tions, shall be further divided betweenamounts provided or required by law on thedate of filing of that conference report andamounts not so provided or required. Theamounts allocated to the Committee on Ap-propriations for each fiscal year shall be fur-ther divided between discretionary and man-datory amounts or programs, as appropriate.

'(4) AMOUNTS NOT ALLOCATED.—(A) In theHouse of Representatives, if a committee re-ceives no allocation of new budget authorityor outlays, that committee shall be deemedto have received an allocation equal to zerofor new budget authority or outlays.

"(B) In the Senate, if a committee receivesno allocation of new budget authority, Out-lays, or social security outlays, that com-mittee shall be deemed to have received anallocation equal to zero for new budget au-thority, outlays, or social security outlays.

'(5) SOCIAL SECURITY LEVELS IN THE SEN-ATE.—

'(A) IN GENERAL—For purposes of para-graph (1) (C), social security surpluses equalthe excess of social security revenues oversocial security outlays in a fiscal year oryears with such an excess and social securitydeficits equal the excess of social securityoutlays over social security revenues in a fis-cal year or years with such an excess.

"(B) TAX TREATMENT—For purposes ofparagraph (fl(C). no provision of any legisla-tion involving a change in chapter 1 of theInternal Revenue Code of 1986 shall be treat-ed as affecting the amount of social securityrevenues or outlays unless such provision


changes the income tax treatment of socialsecurity benefits.

"(6) ADJUSTING ALLOCATION OF DISCRE-TIONARY SPENDING IN THE HOUSE OF REP-RESENTATIVES.—(A) If a concurrent resolu-tion on the budget is not adopted by April 15,the chairman of the Committee on the Budg-et of the House of Representatives shall sub-mit to the House, as soon as practicable, anallocation under paragraph (1) to the Com-mittee on Appropriations consistent withthe discretionary spending limits containedin the most recently agreed to concurrentresolution on the budget for the second fiscalyear covered by that resolution.

'(B) As soon as practicable after an alloca-tion under paragraph (1) is submitted underthis section, the Committee on Appropria-tions shall make suballocations and prompt-ly report those suballocations to the Houseof Representatives.

"(b) SUBALLOCATIONS BY APPROPRIATIONCOMMITFEES.—As soon as practicable after aconcurrent resolution on the budget isagreed to, the Committee on Appropriationsof each House (after consulting with theCommittee on Appropriations of the otherHouse) shall suballocate each amount allo-cated to it for the budget year under sub-section (a) among its subcommittees. EachCommittee on Appropriations shall promptlyreport to its House suballocations made orrevised under this paragraph.".

(b) POINT OF ORDER—Section 302(c) of theCongressional Budget Act of 1974 is amendedto read as follows:

"(c) POINT OF ORDER—After the Commit-tee on Appropriations has received an alloca-tion pursuant to subsection (a) for a fiscalyear, it shall not be in order in the House ofRepresentatives or the Senate to considerany bill. Joint resolution, amendment, mo-tion. or conference report providing newbudget authority for that fiscal year withinthe Jurisdiction of that committee, untilsuch committee makes the suballocationsrequired by subsection (b).".

(c) ENFORCEMENT OF POINT OF ORDER.—(l)Section 302(0(1) of the Congressional BudgetAct of 1974 is amended by—

(A) striking "providing new budget author-ity for such fiscal year or new entitlementauthority effective during such fiscal year"and inserting "providing new budget author-ity for any fiscal year covered by the concur-rent resolution";

(B) striking 'appropriate allocation madepursuant to subsection (b) for such fiscalyear" and inserting "appropriate allocationmade under subsection (a) or any suballoca-tion made under subsection (b), as applica-ble, for the fiscal year of the concurrent res-olution or for the total of all fiscal yearscovered by the concurrent resolution"; and

(C) striking "of new discretionary budgetauthority or new entitlement authority tobe exceeded" and inserting "of new discre-tionary budget authority to be exceeded"

(2) Section 302(0(2) of the CongressionalBudget Act of 1974 is amended to read as fol-lows:

'(2) ENFORCEMENT OF COMMITFEE ALLOCA-TIONS AND SUBALLOCATIONS IN THE SENATE.—After a concurrent resolution on the budgetis agreed to, it shall not be in order in theSenate to consider any bill. Joint resolution.amendment. motion, or conference reportthat would cause—

(A) in the case of any committee exceptthe Committee on Appropriations, the appro-priate allocation of new budget authority oroutlays under subsection (a) to be exceeded;or

"(B) in the case of the Committee on Ap-propriations, the appropriate suballocationof new budget authority or outlays undersubsection (b) to be exceeded.".

June 25, 1997(d) SEPARATE ALLoCATIONS—Section 302(g)

of the Congressional Budget Act of 1974 isamended to read as follows:

"(g) SEPARATE ALLOCATIONS—The Com-mittees on Appropriations and the Budgetshall make separate allocations and sub-allocations under this section consistentwith the categories in section 251(c) of theBalanced Budget and Emergency DeficitControl Act of 1985."SEC. 11107. AMENDMENTS TO SECTION 303.

(a) IN GENERAL—Section 303 of the Con-gressional Budget Act of 1974 is amended toread as follows:"CONCURRENT RESOLUTION ON THE BUDGET

MUST BE ADOPTED BEFORE LEGISLATION PRO-VIDING NEW BUDGET AUTHORITY, NEW SPEND-ING AUTHORITY, OR CHANGES IN REVENUES ORTHE PUBLIC DEBT LIMIT IS CONSIDERED

"SEC. 303. (a) IN GENERAL.—It shall not bein order in either the House of Representa-tives or the Senate to consider any bill.Jointresolution, amendment. motion. or con-ference report as reported to the House orSenate which provides—

(1) new budget authority for a fiscal year;'(2) an increase or decrease in revenues to

become effective during a fiscal year;"(3) an increase or decrease in the public

debt limit to become effective during a fiscalyear;

"(4) in the Senate only, new spending au-thority (as defined in section 401(c)(2)) for afiscal year; or

"(5) in the Senate only. outlays,until the concurrent resolution on the budg-et for such fiscal year (or, in the Senate. aconcurrent resolution on the budget coveringsuch fiscal year) has been agreed to pursuantto section 301.

(b) EXCEPTIONS.—(l) In the House of Rep-resentatives, subsection (a) does not apply toany bill or resolution—

'(A) providing advance discretionary newbudget authority which first becomes avail-able in a fiscal year following the fiscal yearto which the concurrent resolution applies;or

"(B) increasing or decreasing revenueswhich first become effective in a fiscal yearfollowing the fiscal year to which the con-current resolution applies.After May 15 of any calendar year. sub-section (a) does not apply in the House ofRepresentatives to any general appropria-tion bill, or amendment thereto. which pro-vides new budget authority for the fiscalyear beginning in such calendar year.

"(2) In the Senate. subsection (a) does notapply to any bill or resolution making ad-vance appropriations for the fiscal year towhich the concurrent resolution applies andthe two succeeding fiscal years.

(b) CONFORMING AMENDMENT—The item re-lating to section 303 in the table of contentsset forth in section 1(b) of the CongressionalBudget and Impoundment Control Act of 1974is amended by striking "new credit author-ity.".SEC. 11108. AMENDMENT TO SECTION 305.

Section 305(a)(l) of the CongressionalBudget Act of 1974 is amended by inserting"when the House is not in session" after'holidays" each place it appears.

SEC. 11109. AMENDMENTS TO SECTION 308.Section 308 of the Congressional Budget

Act of 1974 is amended—(l)(A) in the side heading of subsection (a).

by striking "OR NEW CREDIT AUTHOR-ITY." and by striking the first comma andinserting "OR";

(B) in paragraphs (1) and (2) of subsection(a), by striking 'or new credit authority."each place it appears and by striking thecomma before new spending authority"each place it appears and inserting 'or";

June 25, 1997(2) in subsection (b)(l). by striking "or new

credit authority.' and by striking thecomma before 'new spending authority" andinserting "or";

(3) in subsection (c). by inserting 'and"after the semicolon at the end of paragraph(3). by striking "; and" at the end of para-graph (4) and inserting a period; and bystriking paragraph (5); and

(4) by inserting "Joint" before "resolution"each place it appears and, in subsection(b)(l). by inserting "Joint" before "resolu-tions".SEC. 11110. AMENDMENTS TO SECTION 310.

Section 310 of the Congressional BudgetAct of 1974 is amended by—

(1) in subsection (a)(l), by inserting "and"after the semicolon at the end of subpara-graph (B). by striking "subparagraphs (C)and (D), and by inserting after subparagraph(B) the following new subparagraph:

(C) direct spending (as defined in section250(c)(8) of the Balanced Budget and Emer-gency Deficit Control Act of 1985)"; and

(2) in subsection (c)(1)(A), by inserting "ofthe absolute value" after "20 percent" eachplace it appears.SEC. 11111 AMENDMENTS TO SECTION 311.

Section 311 of the Congressional BudgetAct of 1974 is amended to read as follows:'NEW BUDGET AUTHORITY, NEW SPENDING AU-

THORITY, AND REVENUE LEGISLATION MUSTBE WITHIN APPROPRIATE LEVELS"SEC 311. (a) ENFORCEMENT OF BUDGET AG-

GREGATES.—"(1) IN THE HOUSE OF REPRESENTATIVES,—

Except as provided by subsection (c). afterthe Congress has completed action on a con-current resolution on the budget for a fiscalyear, it shall not be in order in the House ofRepresentatives to consider any bill, Jointresolution, amendment, motion, or con-ference report providing new budget author-ity for such fiscal year or reducing revenuesfor such fiscal year. if—

"(A) the enactment of such bill or resolu-tIon as reported;

"(B) the adoption and enactment of suchamendment; or

(C) the enactment of such bill or resolu-tion in the form recommended in such con-ference report;would cause the appropriate level of totalnew budget authority or total budget Out-lays set forth in the most recently agreed toconcurrent resolution on the budget for suchfiscal year to be exceeded, or would causerevenues to be less than the appropriatelevel of total revenues set forth in such con-current resolution such fiscal year or for thetotal of all fiscal years covered by the con-current resolution, except in the case that adeclaration of war by the Congress is in ef-fect.

"(2) IN THE SENATE—After a concurrentresolution on the budget is agreed to. it shallnot be in order in the Senate to consider anybill, resolution, amendment, motion, or con-ference report that—

"(A) would cause the appropriate level oftotal new budget authority or total outlaysset forth for the first fiscal year in such reso-lution to be exceeded; or

"(B) would cause revenues to be less thanthe appropriate level of total revenues setforth for the first fiscal year covered by suchresolution or for the period including thefirst fiscal year plus the following 4 fiscalyears in such resolution.

"(3) ENFORCEMENT OF SOCIAL SECURITY LEV-ELS IN THE SENATE—After a concurrent reso-lution on the budget is agreed to, it shall notbe in order in the Senate to consider anybill, resolution. amendment. motion, or con-ference report that would cause a decrease insocial security surpluses or an increase in so-cial security deficits derived from the levels

CONGRESSIONAL RECORD — HOUSEof social security revenues and social secu-rity outlays set forth for the first fiscal yearcovered by the resolution and for the periodincluding the first fiscal year plus the fol-lowing 4 fiscal years in such resolution.

'(b) SOCIAL SECURITY LEVELS.—"(1) IN GENERAL—For the purposes of sub-

section (a)(3), social security surpluses equalthe excess of social security revenues oversocial security outlays in a fiscal year oryears with such an excess and social securitydeficits equal the excess of social securityoutlays over social security revenues in a fis-cal year or years with such an excess.

(2) TAX TREATMENT—For the purposes ofthis section, no provision of any legislationinvolving a change in chapter 1 of the Inter-nal Revenue Code of 1986 shall be treated asaffecting the amount of social security reve-nues or outlays unless such provisionchanges the income tax treatment of socialsecurity benefits.

(c) EXCEPTION IN THE HOUSE OF REP-RE5ENTATIVE5.—Subsection (a)(1) shall notapply in the House of Representatives to anybill, resolution, or amendment that providesnew budget authority for a fiscal year or toany conference report on any such bill orresolution. if—

"(1) the enactment of such bill or resolu-tion as reported;

"(2) the adoption and enactment of suchamendment; or

"(3) the enactment of such bill or resolu-tion in the form recommended in such con-ference report;would not cause the appropriate allocationof new budget authority made pursuant tosection 302(a) for such fiscal year, for thecommittee within whose Jurisdiction suchbill, resolution. or amendment falls. to beexceeded.'.SEC. 11112 AMENDMENT TO SECTION 312.

(a) IN GENERAL—Section 312 of the Con-gressional Budget Act of 1974 is amended toread as follows:

"POINTS OF ORDER

"SEC. 312. (a) BUDGET COMMITFEE DETER-MINATIONS.—For purposes of this title andtitle IV. the levels of new budget authority,budget outlays. spending authority as de-scribed in section 401(c)(2), direct spending,new entitlement authority. and revenues fora fiscal year shall be determined on the basisof estimates made by the Committee on theBudget of the House of Representatives orthe Senate. as the case may be.

'(b) DISCRETIONARY SPENDING POINT OFORDER IN THE SENATE.—

"(1) Except as otherwise provided in thissubsection, it shall not be in order in theSenate to consider any concurrent resolutionon the budget (or amendment, motion, orconference report on such a resolution) thatwould exceed any of the discretionary spend-ing limits in section 251(c) of the BalancedBudget and Emergency Deficit Control Actof 1985.

"(2) This subsection shall not apply if adeclaration of war by the Congress is in ef-fect or if a Joint resolution pursuant to sec-tion 258 of the Balanced Budget and Emer-gency Deficit Control Act of 1985 has beenenacted.

'(c) MAXIMUM DEFICIT AMOUNT POINT OFORDER IN THE SENATE—It shall not be inorder in the Senate to considerany concur-rent resolution on the budget for a fiscalyear under section 301, or to consider anyamendment to that concurrent resolution, orto consider a conference report on that con-current resolution—

"(1) if the level of total budget outlays forthe first fiscal year that is set forth in thatconcurrent resolution or conference reportexceeds the recommended level of Federalrevenues set forth for that year by an

H4549amount that is greater than the maximumdeficit amount, if any. specified in the Bal-anced Budget and Emergency Deficit ControlAct of 1985 for such fiscal year; or

"(2) if the adoption of such amendmentwould result in a level of total budget Out-lays for that fiscal year which exceeds therecommended level of Federal revenues forthat fiscal year, by an amount that is great-er than the maximum deficit amount, if any,specified in the Balanced Budget and Emer-gency Deficit Control Act of 1985 for such fis-cal year.

(d) TIMING OF POINTS OF ORDER IN THESENATE—A point of order under this Actmay not be raised against a bill. resolution,amendment, motion, or conference reportwhile an amendment or motion, the adoptionof which would remedy the violation of thisAct. is pending before the Senate.

"(e) POINTS OF ORDER IN THE SENATEAGAINST AMENDMENTS BETWEEN THEHOUSES—Each provision of this Act that es-tablishes a point of order against an amend-ment also establishes a point of order in theSenate against an amendment between theHouses. If a point of order under this Act israised in the Senate against an amendmentbetween the Houses. and the Presiding Offi-cer sustains the point of order. the effectshall be the same as if the Senate had dis-agreed to the amendment.

'(f) EFFECT OF A POINT OF ORDER ON A BILLIN THE SENATE—In the Senate, if the Chairsustains a point of order under this Actagainst a bill, the Chair shall then send thebill to the committee of appropriate jurisdic-tion for further consideration.".

(b) CONFORMING AMENDMENT—The item re-lating to section 312 in the table of contentsset forth in section 1(b) of the CongressionalBudget and Impoundment Control Act of 1974is amended by striking "Effect of point" andinserting "Point".SEC. 11113. ADJUSTMENTS AND BUDGET COMMIT-

TEE DETERMINATIONS,(a) IN GENERAL—Title III of the Congres-

sional Budget Act of 1974 is amended by add-ing at the end the following new section:

"ADJUSTMENTS"SEC. 314. (a) ADJUSTMENTS—When—"(l)(A) the Committee on Appropriations

reports an appropriation measure for fiscalyear 1998, 1999, 2000, 2001, or 2002 that speci-fies an amount for emergencies pursuant tosection 251(b)(2)(A) of the Balanced Budgetand Emergency Deficit Control Act of 1985 orfor continuing disability reviews pursuant tosection 251(b) (2) (C) of that Act;

"(B) any other committee reports emer-gency legislation described in section 252(e)of that Act;

"(C) the Committee on Appropriations re-ports an appropriation measure for fiscalyear 1998. 1999. 2000. 2001, or 2002 that in-cludes an appropriation with respect toclause (i) or (ii), the adjustment shall be theamount of budget authority in the measurethat is the dollar equivalent, in terms ofSpecial Drawing Rights, of—

(i) increases the United States quota aspart of the International Monetary FundEleventh General Review of Quotas (UnitedStates Quota); or

"(ii) increases the maximum amount avail-able to the Secretary of the Treasury pursu-ant to section 17 of the Bretton WoodsAgreement Act, as amended from time totime (New Arrangements to Borrow); or

"(D) the Committee on Appropriations re-ports an appropriation measure for fiscalyear 1998, 1999, or 2000 that includes an ap-propriation for arrearages for internationalorganizations, international peacekeeping,and multilateral development banks duringthat fiscal year, and the sum of the appro-priations for the period of fiscal years 1998

H4550through 2000 do not exceed $1,884,000,000 inbudget authority; or

(2) a conference committee submits a con-ference report thereon;the chairman of the Committee on the Budg-et of the Senate or House of Representativesshall make the adjustments referred to insubsection (c) to reflect the additional newbudget authority for such matter provided inthat measure or conference report and theadditional outlays flowing in all fiscal yearsfrom such amounts for such matter.

(b) APPLICATION OE ADJUSTMENTS—Theadjustments and revisions to allocations, ag-gregates. and limits made by the Chairmanof the Committee on the Budget pursuant tosubsection (a) for legislation shall only applywhile such legislation is under considerationand shall only permanently take effect uponthe enactment of that legislation.

(c) CONTENT o ADJUSTMENTS—The ad-justments referred to in subsection (a) shallconsist of adjustments, as appropriate, to—

• (1) the discretionary spending limits asset forth in the most recently agreed to con-current resolution on the budget;

(2) the allocations made pursuant to themost recently adopted concurrent resolutionon the budget pursuant to section 302(a); and

(3) the budgetary aggregates as set forthin the most recently adopted concurrent res-olution on the budget.

(d) REPORTING REVISED SUBALLOCA-TIONS.—Following the adjustments madeunder subsection (a). the Committees on Ap-propriations of the Senate and the House ofRepresentatives may report appropriatelyrevised suballocations pursuant to section302(b) to carry Out this subsection.

'(e) DEEINITIONS.—As used in subsection(a)(1)(A). when referring to continuing dis-ability reviews, the terms continuing dis-ability reviews', additional new budget au-thority', and additional outlays' shall havethe same meanings as provided in section251(b) (2) (C) (ii) of the Balanced Budget andEmergency Deficit Control Act of 1985.".

(b) CONEORMING AMENDMENTS.—(1) Sections302(g). 311(c). and 313(e) of the CongressionalBudget Act of 1974 are repealed.

(2) The table of contents set forth in sec-tion 1(b) of the Congressional Budget and Im-poundment Control Act of 1974 is amended byadding after the item relating to section 313the following new item:"Sec. 314. Adjustments.".

SEC. 11114. EFFECT OF SELF-EXECUTING AMEND-MENTS ON POINTS OF ORDER INTHE HOUSE OF REPRESENTATIVES.

(a) ELECT OE POINTS OE ORDER—Title IIIof the Congressional Budget Act of 1974 isamended by adding after section 314 the fol-lowing new section:• EEEECT OE SELE-EXECUTING AMENDMENTS ON

POINTS OE ORDER IN THE HOUSE OE REP-RESENTATIVES

SEC. 315. In the House of Representatives,if a provision of a bill. as reported. violatesa section of this title or title IV and a self-executing rule providing for consideration ofthat bill modifies that provision to eliminatesuch violation, then such point of order shallnot lie against consideration of that bill.".

(b) CONEORMING AMENDMENT—The table ofcontents set forth in section 1(b) of the Con-gressional Budget and Impoundment ControlAct of 1974 is amended by adding after theitem relating to section 314 the followingnew item:• Sec. 315. Effect of self-executing amend-

ments on points of order in thehouse of representatives.".

SEC. 11115. AMENDMENT OF SECTION 401 ANDREPEAL OF SECTION 402.

(a) SECTION 401.—Subsections (a) and (b) ofsection 401 of the Congressional Budget Actof 1974 are amended to read as follows:


BILLS PROVIDING NEW SPENDING AUTHORITYOR NEW CREDIT AUTHORITY

'SEC. 401. (a) CONTROLS ON LEGISLATIONPROVIDING SPENDING AUTHORITY OR CREDITAUTHORITY—It shall not be in order in eitherthe House of Representatives or the Senate

to consider any bill, joint resolution, amend-ment, motion, or conference report, as re-ported to its House which provides newspending authority described in subsection(c) (2) (A) or (B) or new credit authority, un-less that bill. resolution, conference report.or amendment also provides that such newspending authority as described in sub-section (c) (2) (A) or (B) or new credit author-ity is to be effective for any fiscal year onlyto such extent or in such amounts as are pro-vided in appropriation Acts.

(b) LEGISLATION PROVIDING ENTITLEMENTAUTHORITY—It shall not be in order in eitherthe House of Representatives or the Senate

to consider any bill, joint resolution, amend-ment, motion, or conference report, as re-ported to its House which provides newspending authority described in subsection(c) (2) (C) which is to become effective beforethe first day of the fiscal year which begins

during the calendar year in which such billor resolution is reported.".

(b) REPEALER Oi SECTION 402.—(l) Section402 of the Congressional Budget Act of 1974 isrepealed.

(2) CONEORMING AMENDMENTS.—(1) Sections403 through 407 of the Congressional BudgetAct of 1974 are redesignated as sections 402through 406. respectively.

(2) The table of contents set forth in sec-tion 1(b) of the Congressional Budget and Im-poundment Control Act of 1974 is amended bydeleting the item relating to section 402 andby redesignating the items relating to sec-tions 403 through 407 as the items relating tosections 402 through 406, respectively.SEC. 11116. REPEAL OF TITLE VI.

(a) REPEALER—Title VI of the Congres-sional Budget Act of 1974 is repealed.

(b) CONEORMING AMENDMENTS—The itemsrelating to title VI of the table of contentsset forth in section 1(b) of the CongressionalBudget and Impoundment Control Act of 1974are repealed.SEC. 11117. AMENDMENTS TO SECTION 904.

(a) CONEORMING AMENDMENT—Section904(a) of the Congressional Budget Act of 1974is amended by striking (except section 905)"and by striking "V. and VI (except section601(a))" and inserting 'and V'.

(b) WAIVERS—Section 904(c) of the Con-gressional Budget Act of 1974 is amended toread as follows:

(c) WAIVERS.—"(1) Sections 305(b)(2), 305(c)(4), 306,

310(d)(2), 313. 904(c), and 904(d) of this Actmay be waived or suspended in the Senateonly by the affirmative vote of three-fifths

of the Members. duly chosen and sworn.(2) Sections 301(i), 302(c), 302(f), 310(g),

311(a), and 315 of this Act and sections258(a)(4)(C), 258(A)(b)(3)(C)(I), 258(B)(f)(l),

258B(h)(l), 258(h)(3), 258C(a)(5), and

258(C)(b)(l) of the Balanced Budget andEmergency Deficit Control Act of 1985 maybe waived or suspended in the Senate only bythe affirmative vote of three-fifths of theMembers. duly chosen and sworn.".(c) APPEALS—Section 904(d) of the Con-

gressional Budget Act of 1974 is amended toread as follows:

• (d) APPEALS.—"(1) Appeals in the Senate from the deci-

sions of the Chair relating to any provisionof title III or IV of section 1017 shall, exceptas otherwise provided therein. be limited to1 hour, to be equally divided between, andcontrolled by. the mover and the manager ofthe resolution. concurrent resolution. rec-onciliation bill, or rescission bill, as the casemay be.

June 25, 1997(2) An affirmative vote of three-fifths of

the Members, duly chosen and sworn, shallbe required in the Senate to sustain an ap-peal of the ruling of the Chair on a point oforder raised under sections 305(b) (2), 305(c) (4),306, 310(d)(2), 313, 904(c). and 904(d) of thisAct.

(3) An affirmative vote of three-fifths ofthe Members. duly chosen and sworn. shallbe required in the Senate to sustain an ap-peal of the ruling of the Chair on a point oforder raised under sections 301(i), 302(c),302(f), 310(g). 311(a), and 315 of this Act andsections 258(a) (4) (C). 258(A) (b) (3) (C) (I),258(B)(f)(l). 258B(h)(l), 258(h)(3), 258C(a)(5),and 258(C)(b)(l) of the Balanced Budget andEmergency Deficit Control Act of 1985.".

(d) EXPIRATION OE SUPERMAJORITY VOTINGREQUIREMENTS—Section 904 of the Congres-sional Budget Act of 1974 is amended by add-ing at the end the following:

• (e) EXPIRATION OE CERTAIN SUPERMAJOR-ITY VOTING REQUIREMENTS.—Subsections(c) (2) and (d) (3) shall expire on September 30.2002.".SEC. 11118. REPEAL OF SECTIONS 905 AND 906.

(a) REpEALER—Sections 905 and 906 of the

Congressional Budget and ImpoundmentControl Act of 1974 are repealed.

(b) CONEORMING AMENDMENTS—The tableof contents set forth in section 1(b) of theCongressional Budget and ImpoundmentControl Act of 1974 is amended by strikingthe items relating to sections 905 and 906.SEC. 11119. AMENDMENTS TO SECTIONS 1022 AND

1024.(a) SECTION 1022.—Section 1022(b)(l)(F) of

Congressional Budget and ImpoundmentControl Act of 1974 is amended by striking"section 601" and inserting "section 251(c)the Balanced Budget and Emergency DeficitControl Act of 1985".

(b) SECTION 1024.—Section 1024(a)(l)(B) ofCongressional Budget and ImpoundmentControl Act of 1974 is amended by striking"section 601(a)(2)" and inserting section251(c) the Balanced Budget and EmergencyDeficit Control Act of 1985".SEC. 11120. AMENDMENT TO SECTION 1026.

Section 1026(7) (A) (iv) of the CongressionalBudget and Impoundment Control Act of 1974is amended by striking • 'and" and inserting

or".Subtitle B—Amendments to the Balanced

Budget and Emergency Deficit Control Actof 1985

SEC. 11201. PURPOSE.This subtitle extends discretionary spend-

ing limits and pay-as-you-go requirements.SEC. 11202. GENERAL STATEMENT AND DEFINI-

TIONS.(a) GENERAL STATEMENT.—Section 250(b) of

the Balanced Budget and Emergency DeficitControl Act of 1985 (2 U.S.C. 900(b)) is amend-ed by striking the first two sentences and in-serting the following: This part provides forthe enforcement of a balanced budget by fis-cal year 2002 as called for in House Concur-rent Resolution 84 (105th Congress. 1st ses-sion).".

(b) DEEINITIONS.—Section 250(c) of the Bal-anced Budget and Emergency Deficit ControlAct of 1985 is amended—

(1) by striking paragraph (4) and insertingthe following:

• (4) The term 'category' means defense,nondefense, and violent crime reduction dis-cretionary appropriations as specified in thejoint explanatory statement accompanying aconference report on the Balanced BudgetAct of 1997.":

(2) by striking paragraph (6) and insertingthe following:

"(6) The term 'budgetary resources' meansnew budget authority. unobligated balances,direct spending authority. and obligationlimitations.";

June 25, 1997

(3) in paragraph (9), by striking submis-sion of the fiscal year 1992 budget that arenot included with a budget submission" andinserting that budget submission that arenot included with it";

(4) in paragraph (14), by inserting first 4"before fiscal years" and by striking 1995"and inserting 2006";

(5) by striking paragraphs (17) and (20) andby redesignating paragraphs (18), (19), and(21) as paragraphs (17), (18), and (19), respec-tively;

(6) in paragraph (17) (as redesignated), bystriking Omnibus Budgtet ReconciliationAct of 1990 and inserting Balanced BudgetAct of 1997";

(7) in paragraph (20) (as redesignated), bystriking the second sentence; and

(8) by adding at the end the following newparagraph:

(20) The term consultation', when appliedto the Committee on the Budget of eitherthe House of Representatives or of the Sen-ate, means written communication with thatcommittee that affords that committee anopportunity to comment on the matter thatis the subject of the consultation before offi-cial action is taken on such matter.".SEC. 11203. ENFORCING DISCRETIONARY SPEND-

ING LIMITS.(a) EXTENSION THROUGH FISCAL YEAR

2002.—Section 251 of the Balanced Budgetand Emergency Deficit Control Act of 1985 isamended—

(I) in the side heading of subsection (a), bystriking 1991—1998" and inserting '1997—2002";

(2) in subsection (a) (7) by inserting (ex-cluding Saturdays, Sundays, or legal holi-days)" after 5 calendar days";

(3) in the first sentence of subsection (b)(l),by striking 1992, 1993, 1994, 1995, 1996, 1997 or

1998" and inserting 1997 or any fiscal yearthereafter through 2002" and by strikingthrough 1998" and inserting through 2002";(4) in subsection (b)(l), by striking the

following:" and all that follows through 'inconcepts and definitions" the first place itappears and inserting "the following: the ad-justments" and by striking subparagraphs(B) and (C);

(5) in subsection (b)(2), by striking 1991,1992, 1993, 1994, 1995, 1996, 1997, or 1998" andinserting 1997 or any fiscal year thereafterthrough 2002", by striking through 1998"and inserting through 2002", and by strik-ing subparagraphs (A), (B), (C), (E), and (G),and by redesignating subparagraphs (D), (F),and (H) as subparagraphs (A), (B), and (C), re-spectively;

(6) in subsection (b)(2)(A) (as redesignated),by striking (i)", by striking clause (ii), andby inserting fiscal" before years";

(7) in subsection (b) (2) (B) (as redesignated),by striking everything after the adjustmentin outlays" and inserting for a fiscal year isthe amount of the excess but not to exceed0.5 percent of the adjusted discretionaryspending limit on outlays for that fiscal yearin fiscal year 1997 or any fiscal year there-after through 2002; and

(8) by adding at the end of subsection (b) (2)the following new subparagraphs:

(D) ALLOWANCE FOR IMF.—If an appro-priations bill or joint resolution is enactedfor fiscal year 1998, 1999, 2000, 2001, or 2002that includes an appropriation with respectto clause (i) or (ii), the adjustment shall bethe amount of budget authority in the meas-ure that is the dollar equivalent, in terms ofSpecial Drawing Rights, of—

(i) an increase in the United States quotaas part of the International Monetary FundEleventh General Review of Quotas (UnitedStates Quota); or

'(ii) any increase in the maximum amountavailable to the Secretary of the Treasurypursuant to section 17 of the Bretton Woods

CONGRESSIONAL RECORD — HOUSEAgreement Act, as amended from time totime (New Arrangements to Borrow).

(E) ALLOWANCE FOR INTERNATIONAL AR-REARAGES.—

(i) ADJUSTMENTS—If an appropriationsbill or joint resolution is enacted for fiscalyear 1998, 1999, or 2000 that includes an ap-propriation for arrearages for internationalorganizations, international peacekeeping,and multilateral banks for that fiscal year,the adjustment shall be the amount of budg-et authority in such measure and the outlaysflowing in all fiscal years from such budgetauthority.

(ii) LIMITATIONS—The total amount ofadjustments made pursuant to this subpara-graph for the period of fiscla years 1998through 2000 shall not exceed $1,884,000,000 inbudget authority.".

(b) SHIFTING OF DISCRETIONARY SPENDINGLIMITS INTO THE BALANCED BUDGET ANDEMERGENCY DEFICIT CONTROL ACT OF 1985.—Section 251 of the Balanced Budget andEmergency Deficit Control Act of 1985 isamended by adding at the end the followingnew subsection:

(c) DISCRETIONARY SPENDING LIMIT—Asused in this part, the term 'discretionaryspending limit' means—

(1) with respect to fiscal year 1997, for thediscretionary category, the current adjustedamount of new budget authority and outlays;

'(2) with respect to fiscal year 1998—(A) for the defense category:

$269,000,000,000 in new budget authority and$266,823,000,000 in outlays;

(B) for the nondefense category:$252,357,000,000 in new budget authority and$282,853,000,000 in outlays; and

(C) for the violent crime reduction cat-egory: $5,500,000,000 in new budget authorityand $3,592,000,000 in outlays;

(3) with respect to fiscal year 1999—(A) for the defense category:

$271,500,000,000 in new budget authority and$266,518,000,000 in outlays; and

(B) for the nondefense category:$261,499,000,000 in new budget authority and$292,803,000,000 in outlays;

'(4) with respect to fiscal year 2000, for thediscretionary category: $537,193,000,000 in newbudget authority and $564,265,000,000 in Out-lays;

'(5) with respect to fiscal year 2001, for thediscretionary category: $542,032,000,000 in newbudget authority and $564,396,000,000 in Out-lays; and

(6) with respect to fiscal year 2002, for thediscretionary category: $551,074,000,000 in newbudget authority and $560,799,000,000 in Out-lays;as adjusted in strict conformance with sub-section (b).".SEC. 11204. VIOLENT CRIME REDUCTION TRUST

FUND.(a) SEQUESTRATION REGARDING VIOLENT

CRIME REDUCTION TRUST FUND—Section 251Aof the Balanced Budget and Emergency Defi-cit Control Act of 1985 is repealed.

(b) CONFORMING AMENDMENT—Section310002 of Public Law 103—322 (42 U.S.C. 14212)is repealed.SEC. 11205. ENFORCING PAY-AS-YOU-GO.

(a) EXTENSIoN—Section 252 (2 U.S.C. 902) isamended—

(I) by striking subsections (a) and (b) andinserting the following:

'(a) PURPOSE—The purpose of this sectionis to assure that any legislation enactedprior to September 30, 2002, affecting directspending or receipts that increases the defi-cit will trigger an offsetting sequestration.

(b) SEQUESTRATION.—'(1) TIMING—Within 15 calendar days after

Congress adjourns to end a session and onthe same day as a sequestration (if any)under sections 251 and 253, there shall be a

H455 1sequestration to offset the amount of anynet deficit increase in the budget yearcaused by all direct spending and receiptslegislation (after adjusting for any prior se-questration as provided by paragraph (2))plus any net deficit increase in the prior fis-cal year caused by all direct spending and re-ceipts legislation not reflected in the final0MB sequestration report for that year.

'(2) CALCULATION OF DEFICIT INCREASE.—0MB shall calculate the amount of deficitincrease, if any, in the budget year by add-ing—

(A) all applicable estimates of directspending and receipts legislation transmit-ted under subsection (d) applicable to thebudget year, other than any amounts in-cluded in such estimates resulting from—

(i) full funding of, and continuation ofthe deposit insurance guarantee commit-ment in effect on the date of enactment ofthis section; and

'(ii) emergency provisions as designatedunder subsection (e); and

(B) the estimated amount of savings in di-rect spending programs applicable to thebudget year resulting from the prior year'ssequestration under this section or section253, if any (except for any amounts seques-tered as a result of any deficit increase inthe fiscal year immediately preceding theprior fiscal year), as published in OMB's finalsequestration report for that prior year; and

(C) all applicable estimates of directspending and receipts legislation transmit-ted under subsection (d) for the current yearthat are not reflected in the final 0MB se-questration report for that year, other thanany amounts included in such estimates re-sulting from emergency provisions as des-ignated under subsection (e).":

(2) by amending subsection (c)l)(B), by in-serting and direct" after guaranteed";

(3) by amending subsection (d) to read asfollows:

'(d) ESTIMATES.—'(1) CBO ESTIMATES—As soon as prac-

ticable after Congress completes action onany direct spending or receipts legislation,CBO shall provide an estimate of the budg-etary effects of that legislation.

'(2) 0MB ESTIMATES—Not later than 5 cal-endar days (excluding Saturdays, Sundays,or legal holidays) after the enactment of anydirect spending or receipts legislation, 0MBshall transmit a report to the House of Rep-resentatives and to the Senate containing—

(A) the CBO estimate of the budgetary ef-fects of that legislation;

(B) an 0MB estimate of the budgetary ef-fects of that legislation using current eco-nomic and technical assumptions; and

(C) an explanation of any difference be-tween the two estimates.

'(3) SCOPE OF ESTIMATES—The estimatesunder this section shall include the amountof change in outlays or receipts, as the casemay be, for the current year (if applicable),the budget year, and each outyear.

(4) SCOREKEEPING GUIDELINES.—OMB andCBO, after consultation with each other andthe Committees on the Budget of the Houseof Representatives and the Senate, shall—

'(A) determine common scorekeepingguidelines; and

(B) in conformance with such guidelines,prepare estimates under this section."; and

(4) in subsection (e), by striking ', for anyfiscal year from 1991 through 1998," and bystriking through 1995".SEC. 11206. REPORTS AND ORDERS.

Section 254 of the Balanced Budget andEmergency Deficit Control Act of 1985 isamended—

(I) by striking subsection (c) and redesig-nating subsections (d) through (k) as (c)through (j), respectively;

H4552(2) in subsection (c) (2) (as redesignated), by

striking "1998" and inserting "2002' and(3)(A) in subsection (f)(2)(A) (as redesig-

nated), by striking "1998" and inserting"2002"; and

(B) in subsection (f)(3) (as redesignated), bystriking "through 1998".SEC. 11207. EXEMPT PROGRAMS AND ACTIVITIES.

(a) VETERANS PRoGRAMs—Section 255(b) ofthe Balanced Budget and Emergency DeficitControl Act of 1985 is amended as follows:

(1) In the item relating to Veterans Insur-ance and Indemnity, strike Indemnity andinsert Indemnities".

(2) In the item relating to Veterans' Can-teen Service Revolving Fund, strike Veter-ans".

(3) In the item relating to Benefits underchapter 21 of title 38, strike '(36—0131—0—1—

102)" and insert "(36—0120—0—1—101)".(4) In the item relating to Veterans' com-

pensation, strike Veterans' compensation"and insert Compensation".

(5) In the item relating to Veterans' pen-sions, strike ' Veterans' pensions" and insert"Pensions".

(6) After the last item, insert the followingnew items:

'Benefits under chapter 35 of title 38, Unit-ed States Code, related to educational assist-ance for survivors and dependents of certainveterans with service-connected disabilities(36—0131—0—1—102);

'Assistance and services under chapter 31of title 38, United States Code, relating totraining and rehabilitation for certain veter-ans with service-connected disabilities (36—0131—0—1—102);

"Benefits under subchapters I, II, and III ofchapter 31 of title 38, United States Code, re-lating to housing loans for certain veteransand for the spouses and surviving spouses ofcertain veterans Guaranty and IndemnityProgram Account (36—1119—0—1—104);

"Loan Guaranty Program Account (36-1025—0—1—104); and

"Direct Loan Program Account (36-1024-0-1—104).".

(b) CERTAIN PROGRAM BASES—Section255(f) of the Balanced Budget and EmergencyDeficit Control Act of 1985 is amended toread as follows:

'(f) OPTIONAL EXEMPTION OF MILITARY PER-SONNEL.—

(1) The President may, with respect toany military personnel account, exempt thataccount from sequestration or provide for alower uniform percentage reduction thanwould otherwise apply.

(2) The President may not use the author-ity provided by paragraph (1) unless he noti-fies the Congress of the manner in whichsuch authority will be exercised on or beforethe date specified in section 254(a) for thebudget year.".

(c) OTHER PROGRAMS AND AcTIvITIES.—(1)Section 255(g)(1)(A) of the Balanced BudgetEmergency Deficit Control Act of 1985 isamended as follows:

(A) After the first item, insert the follow-ing new item:

Activities financed by voluntary pay-ments to the Government for goods or serv-ices to be provided for such payments;".

(B) Strike "Thrift Savings Fund (26—8141—0—1--602);".

(C) In the first item relating to the Bureauof Indian Affairs, insert "Indian land andwater claims settlements and" after thecomma.

(D) In the second item relating to the Bu-reau of Indian Affairs, strike "miscellane-ous" and insert 'Miscellaneous" and strike

tribal trust funds".(E) Strike "Claims, defense (91—0102—0—1—

051);".


(F) In the item relating to Claims, judg-ments, and relief acts, strike '806" and in-sert "808".

(G) Strike "Coinage profit fund (20-5811-0-2-803)".

(H) Insert "Compact of Free Association(14—0415—0—1—808);" after the item relating tothe Claims,Judgments, and relief acts.

(I) Insert "Conservation Reserve Program(12—2319—0—1—302);" after the item relating tothe Compensation of the President.

(J) In the item relating to the CustomsService, strike '852" and insert "806".

(K) In the item relating to the Comptrollerof the Currency, insert ", Assessment funds(20—8413—0—8—313)' before the semicolon.

(L) Strike 'Director of the Office of ThriftSupervision;'.

(M) Strike "Eastern Indian land claimssettlement fund (14—2202—0—1—806);".

(N) After the item relating to the Ex-change stabilization fund, insert the follow-ing new items:

"Farm Credit Administration, Limitationon Administrative Expenses (18—4131—0—3—351);

"Farm Credit System Financial AssistanceCorporation, interest payment (20—1850—0—1—908);".

(0) Strike "Federal Deposit Insurance Cor-poration;".

(P) In the first item relating to the FederalDeposit Insurance Corporation, insert "(51—4064—0—3—313)" before the semicolon.

(Q) In the second item relating to the Fed-eral Deposit Insurance Corporation, insert"(51—4065—0—3—313)" before the semicolon.

(R) In the third item relating to the Fed-eral Deposit Insurance Corporation, insert"(51—4066—0—3—313)" before the semicolon.

(5) In the item relating to the FederalHousing Finance Board, insert "(95—4039—0—3—311)" before the semicolon.

(F) In the item relating to the Federal pay-ment to the railroad retirement account,strike "account" and insert "accounts

(U) In the item relating to the health pro-fessions graduate student loan insurancefund, insert "program account" after "fund"and strike "(Health Education AssistanceLoan Program) (15—4305—0—3—553)" and insert"(15—0340—0—1—552)".

(V) In the item relating to Higher edu-cation facilities, strike "and insurance".

(W) In the item relating to Internal reve-nue collections for Puerto Rico, strike "852"and insert "806".

(X) Amend the item relating to the Pan-ama Canal Commission to read as follows:

"Panama Canal Commission, PanamaCanal Revolving Fund (95-4061-0-3-403);".

(Y) In the item relating to the Medical fa-cilities guarantee and loan fund, strike "(15—4430—0—3—551)'' and insert ''(15—9931—0—3—550)''.

(Z) In the first item relating to the Na-tional Credit Union Administration, insert"operating fund (25—4056—0—3—313)" before thesemicolon.

(AA) In the second item relating to the Na-tional Credit Union Administration, strike"central" and insert "Central" and insert"(25—4410—0—3—313)" before the semicolon.

(BB) In the third item relating to the Na-tional Credit Union Administration, strike"credit" and insert "Credit" and insert "(25—4468—0—3—313)" before the semicolon.

(CC) After the third item relating to theNational Credit Union Administration, in-sert the following new item:

"Office of Thrift Supervision (20—4108—0—3—313);".

(DD) In the item relating to Payments tohealth care trust funds, strike "512" and in-sert "511'.

(EE) Strike "Compact of Free Association,economic assistance pursuant to Public Law99—658 (14—0415—0—1—806):'.

June 25, 1997(FF) In the item relating to Payments to

social security trust funds, strike "511" andinsert '651".

(GG) Strike "Payments to state and localgovernment fiscal assistance trust fund (20—2111—0—1—851);''.

(HH) In the item relating to Payments tothe United States territories, strike "852"and insert "806".

(II) Strike "Resolution Funding Corpora-tion;".

(JJ) In the item relating to the ResolutionTrust Corporation, insert "Revolving Fund(22—4055—0—3—313)" before the semicolon.

(KK) After the item relating to the Ten-nessee Valley Authority funds, insert the fol-lowing new items:

"Thrift Savings Fund;"United States Enrichment Corporation

(95—4054—0—3—211);

"Vaccine Injury Compensation (15-0320-0-1—55 1);

"Vaccine Injury Compensation ProgramTrust Fund (20—8115—0—1—551);".

(2) Section 255(g)(1)(B) of the BalancedBudget and Emergency Deficit Control Actof 1985 is amended as follows:

(A) Strike "The following budget" and in-sert "The following Federal retirement anddisability".

(B) In the item relating to Black lung ben-efits, strike "lung benefits" and insert"Lung Disability Trust Fund".

(C) In the item relating to the Court ofFederal Claims Court Judges' RetirementFund, strike "Court of Federal".

(D) In the item relating to Longshoremen'scompensation benefits, insert "Special work-ers compensation expenses," before "Long-shoremen's".

(E) In the item relating to Railroad retire-ment tier II, strike "retirement tier II" andinsert "Industry Pension Fund".

(3) Section 255(g)(2) of the Balanced Budgetand Emergency Deficit Control Act of 1985 isamended as follows:

(A) Strike the following items:"Agency for International Development,

Housing, and other credit guarantee pro-grams (12—4340—0—3—151);

"Agricultural credit insurance fund (12-.

4140—0—1—351);''.(B) In the item relating to Check forgery,

strike "Check" and insert "United StatesTreasury check'.

(C) Strike "Community development grantloan guarantees (86—0162—0—1—451);".

(D) After the item relating to the UnitedStates Treasury Check forgery insurancefund, insert the following new item:

"Credit liquidating accounts;".(E) Strike the following items:"Credit union share insurance fund (25-

4468—0—3—311);

"Economic development revolving fund(13—4406—0—3);

Export-Import Bank of the United States,Limitation of program activity (83—4021—0—1—155);

"Federal deposit Insurance Corporation(51—8419—0—8—311);

"Federal Housing Administration fund (86-4010—0—3—311);

"Federal ship financing fund (69—4301—0—3—403);

"Federal ship financing fund, fishing ves-sels (13—4411—0—3—316);

'Government National Mortgage Associa-tion, Guarantees of mortgage-backed securi-ties (86—4238—0—3—311);

"Health education loans (15—4301—0—3—553);"Indian loan guarantee and insurance fund

(14—4410—0—3—452);"Railroad rehabilitation and improvement

financing fund (69—4411—0—3—401);"Rural development insurance fund (12-

4155—0—3—452);

June 25, 1997Rural electric and telephone revolving

fund (12—4230—8—3—271);Rural housing insurance fund (12-4141-0-3-

37 1);

Small Business Administration. Businessloan and investment fund (73—4154—0—3—376);

Small Business Administration, Leaseguarantees revolving fund (73—4157—0—3—376)

Small Business Administration. Pollutioncontrol equipment contract guarantee re-volving fund (73—4147—0—3—376):

Small Business Administration. Suretybond guarantees revolving fund (73-4156-0-3-376);

Department of Veterans Affairs Loanguaranty revolving fund (36—4025—0—3—704);'.

(d) Low-INCOME PROGRAMS—Section 255(h)of the Balanced Budget and Emergency Defi-cit Control Act of 1985 is amended as follows:

(1) Amend the item relating to Child nutri-tion to read as follows:

State child nutrition programs (with theexception of special milk programs) (12—3539—0—1—605);'.

(2) Amend the item relating to the Women.infants, and children program to read as fol-lows:

Special supplemental nutrition programfor women, infants, and children (WIC) (12-3510—0—1—605).".

(e) IDENTIFICATION OF PROGRAMS—Section255(i) of the Balanced Budget and EmergencyDeficit Control Act of 1985 is amended toread as follows:

(i) IDENTIFICATION OF PROGRAMS—Forpurposes of subsections (b). (g). and (h). eachaccount is identified by the designated budg-et account identification code number setforth in the Budget of the United StatesGovernment 1996-Appendix, and an activitywithin an account is designated by the nameof the activity and the identification codenumber of the account.".

(f) OPTIONAL EXEMPTION OF MILITARY PER-SONNEL.—Section 255(h) of the BalancedBudget and Emergency Deficit Control Actof 1985 (relating to optional exemption ofmilitary personnel) is repealed.SEC. 11a08. GENERAL AND SPECIAL SEQUESTRA-

TION RULES.(a) SECTION HEADING.—(1) The section

heading of section 256 of the Balanced Budg-et and Emergency Deficit Control Act of 1985is amended by striking 'exceptions, limita-tions, and special rules' and inserting gen-eral and special sequestration rules".

(2) The item relating to section 256 in thetable contents set forth in section 250(a) ofthe Balanced Budget and Emergency DeficitControl Act of 1985 is amended to read as fol-lows:

Sec. 256. General and special sequestrationrules.".

(b) AUTOMATIC SPENDING INCREASES—Sec-tion 256(a) of the Balanced Budget and Emer-gency Deficit Control Act of 1985 is amendedby striking paragraph (1) and redesignatingparagraphs (2) and (3) as paragraphs (1) and(2). respectively.

(c) GUARANTEED AND DIRECT STUDENT LOANPROGRAMS—Section 256(b) of the BalancedBudget and Emergency Deficit Control Actof 1985 is amended to read as follows:

(b) STUDENT L0ANS.—(1) For all studentloans under part B or D of title IV of theHigher Education Act of 1965 made duringthe period when a sequestration order undersection 254 is in effect, origination fees undersections 438(c)(2) and 455(c) of that Act shallbe increased by a uniform percentage suffi-cient to produce the dollar savings in stu-dent loan programs (as a result of that se-questration order) required by section 252 or253, as applicable.

(2) For any loan made during the periodbeginning on the date that an order issuedunder section 254 takes effect with respect to


a fiscal year and ending at the close of suchfiscal year, the origination fees which areauthorized to be collected pursuant to sec-tions 4 38(c) (2) and 455(c) of such Act shall beincreased by 0.50 percent.".

(d) HEALTH CENTERS—SectiOn 256(e) (1) ofthe Balanced Budget and Emergency DeficitControl Act of 1985 is amended by strikingthe dash and all that follows thereafter andinserting '2 percent.'.

(e) FEDERAL PAY—Section 256(g) (1) of theBalanced Budget and Emergency DeficitControl Act of 1985 is amended by inserting

(including any amount payable under sec-tion 5303 or 5304 of title 5. United StatesCode)" after such statutory pay system'.

(f) TREATMENT OF FEDERAL ADMINISTRATIVEEXPENSES—SectiOn 256(h) (4) of the BalancedBudget and Emergency Deficit Control Actof 1985 is amended by striking subparagraphs(D) and (H). by redesignating subparagraphs(E), (F), (G). and (I). as subparagraphs (D).(E), (F), and (G). respectively, and by addingat the end the following new subparagraph:

(H) Farm Credit Administration.'.(g) COMMODITY CREDIT CoRPoRATIoN—Sec-

tion 256(J)(5) of the Balanced Budget andEmergency Deficit Control Act of 1985 isamended to read as follows:

(5) DAIRY PROGRAM—Notwithstandingother provisions of this subsection, as thesole means of achieving any reduction inoutlays under the milk price support pro-gram. the Secretary of Agriculture shall pro-vide for a reduction to be made in the pricereceived by producers for all milk producedin the United States and marketed by pro-ducers for commercial use. That price reduc-tion (measured in cents per hundred weightof milk marketed) shall occur under section201(d) (2) (A) of the Agricultural Act of 1949 (7U.S.C. 1446(d)(2)(A)), shall begin on the dayany sequestration order is issued under sec-tion 254. and shall not exceed the aggregateamount of the reduction in outlays under themilk price support program that otherwisewould have been achieved by reducing pay-ments for the purchase of milk or the prod-ucts of milk under this subsection during theapplicable fiscal year..

(h) EFFECTS OF SEQUESTRATION—Section256(k) of the Balanced Budget and Emer-gency Deficit Control Act of 1985 is amendedas follows:

(1) In paragraph (1), strike other than atrust or special fund account' and insertexcept as provided in paragraph (5)" beforethe period.

(2) Strike paragraph (4), redesignate para-graphs (5) and (6 as paragraphs (4) and (5).respectively, and amend paragraph (5) (as re-designated) to read as follows:

(5) Budgetary resources sequestered in re-volving. trust, and special fund accounts.and offsetting collections sequestered in ap-propriation accounts shall not be availablefor obligation during the fiscal year in whichthe sequestration occurs, but shall be avail-able in subsequent years to the extent other-wise provided in law.".SEC. 11a09. THE BASELINE.

Section 257 of the Balanced Budget andEmergency Deficit Control Act of 1985 isamended—

(1) in subsection (b) (2) by amending sub-paragraph (A) to read as follows:

"(A)(i) Except as provided in clause (ii), noprogram with estimated current year Out-lays greater than $50000000 shall be assumedto expire in the budget year or the outyears.

(ii) Clause (i) shall not apply to a programif legislation establishing or modifying thatprogram contains a provision stating Sec-tion 257(b)(2) of the Balanced Budget andEmergency Deficit Control Act of 1985 shallnot apply to the program specified in — ofthis Act. the blank space being filled in

H4553with the appropriate section or sections ofthat legislation.

(iii) No bill, resolution, amendment, mo-tion. or conference report shall be subject toa point of order under section 306 of the Con-gressional Budget Act of 1974 solely becauseit includes the provision specified in clause(ii).

(iv) Upon the expiration of the suspen-sions contained in section 171 of Public Law104-193 with regard to a program in such Actwith estimated fiscal year outlays greaterthan $50,000,000. that program shall be as-sumed to operate under that Act as in effectimmediately before reversion to the lawssuspended by such Act."

(2) by adding the end of subsection (b) (2)the following new subparagraph:

(D) If any law expires before the budgetyear or any outyear. then any program withestimated current year outlays greater than$50 million which operates under that lawshall be assumed to continue to operateunder that law as in effect immediately be-fore its expiration.';

(3) in the second sentence of subsection(c) (5), by striking national product fixed-weight price index and inserting domesticproduct chain-type price index"; and

(4) by striking subsection (e) and insertingthe following:

(e) ASSET SALES—Amounts realized fromthe sale of an asset other than a loan assetshall not be counted against legislation ifthat sale would result in a financial cost tothe Federal Government..SEC. IIIO. TECHNICAL CORRECTION.

Section 258 of the Balanced Budget andEmergency Deficit Control Act of 1985, enti-tled Modification of Presidential Order", isrepealed.SEC. hail. JUDICIAL REVIEW.

Section 274 of the Balanced Budget andEmergency Deficit Control Act of 1985 isamended as follows:

(1) Strike 252' or '252(b)' each place itoccurs and insert 254'.

(2) In subsection (d) (1) (A), strike '257(1) tothe extent that' and insert 256(a) if, strikethe parenthetical phrase, and at the end in-sert or'S.

(3) In subsection (d)(1)(B), strike 'newbudget" ad all that follows through spend-ing authority' and insert budgetary re-sources' and strike or" after the comma.

(4) Strike subsection (d) (1) (C).(5) Strike subsection (f) and redesignate

subsections (g) and (h) as subsections (0 and(g). respectively.

(6) In subsection (g) (as redesignated).strike 'base levels of total revenues andtotal budget outlays, as and insert fig-ures". and '251(a) (2) (B) or (c) (2)." and insert''254''.SEC. iiaia. EFFECTIVE DATE.

(a) EXpIRATION—Section 275(b) of the Bal-anced Budget and Emergency Deficit ControlAct of 1985 is amended—

(1) by striking Part C of this title, sec-tion' and inserting Sections 251. 253. 258B.and';

(2) by striking '1995" and inserting '2002';and

(3) by adding at the end the following newsentence: ' The remaining sections of part Cof this title shall expire September 30, 2006.'.

(b) EXPIRATIoN—Section 14002(c) (3) of theOmnibus Budget Reconciliation Act of 1993 (2U.S.C. 900 note) is repealed.SEC. hiai3. REDUCTION OF PREEXISTING BAL-

ANCES AND EXCLUSION OF EFFECTSOF THIS ACT FROM PAYGO SCORE-CARD.

Upon the enactment of this Act, the Direc-tor of the Office of Management and Budgetshall—

(1) reduce any balances of direct spendingand receipts legislation for any fiscal year

H4554under section 252 of the Balanced Budget andEmergency Deficit Control Act of 1985 tozero; and

(2) not make any estimates of changes indirect spending outlays and receipts undersubsection (d) of such section 252 for any fis-cal year resulting from the enactment of thisAct or the Revenue Reconciliation Act of1997.

The SPEAKER pro tempore. The gen-tleman from Ohio [Mr. KASICH] and thegentleman from South Carolina [Mr.SPRArr] each will be recognized for 90minutes.

The Chair recognizes the gentlemanfrom Ohio [Mr. KASICH].

Mr. KASICH. Mr. Speaker, I yieldmyself as much time as I mayconsume, and hopefully it will be short.

Let me just open the debate my mak-ing it very clear what we are about todo here today.

For those people who have watchedthe efforts to balance the budget overthe course of the last 10 to 12 years,and I want to direct my remarks to adegree to my friend from Indiana, therehas been great skepticism about anyplan to balance the budget becausewhat is involved is saying we will makethe savings later in exchange for someincreases or some tax increases today,and we will get around to it later.

What we are about to do today is toenact in permanent law the changesthat are necessary in the entitlementprograms that will accumulate the sav-ings that will allow us to balance thebudget over the course of the next 5years, and so what I want everyone inthis Chamber to understand is, as weenact the changes in permanent law,for example, that affect Medicare, wewill accumulate savings as long asthose changes in the law remain intact.In order for us to lose those savings, wewould have to change the law again.We are not going to do that. We are notonly going to do this in regard to Medi-care in an effort to save Medicare andextend the life of Medicare for 10 years,but we are doing it in all the entitle-ment programs.

So what we are about today is toenact into permanent law thosechanges that will result in the savingsof billions upon billions of dollars; overthe course of the next 10 years, ap-proximately a savings of $700 billion inmandatory savings, the largest in his-tory.

At the same time, in this bill we areputting in place spending caps for theoperations of Government. Thesespending caps mean that, if we spendmore than what we have budgeted for,then we have the Sword of Damoclescome down, and it just cuts all spend-ing above those caps. Those caps areenforceable. Real savings will resultfrom limiting the growth of the pro-grams which operate the Governmentto a growth of about half a percent ascompared to 6 percent over the last 10years.

So what we are about doing today isto pass the first real bill that willenact the permanent changes into lawthat will result in a balanced budget by


2002. It is not a wish, a prayer, a hope,a dream; it is reality.

Mr. ROEMER. Mr. Speaker, will thegentleman yield?

Mr. KASICH. I yield to the gen-tleman from the Hoosier State.

Mr. ROEMER. Mr. Speaker, I appre-ciate the gentleman directing hisevents across the aisle in a bipartisanway because I intend to vote for thisreconciliation package.

I would say that it is not only impor-tant to work in a bipartisan way tobalance the budget, but this is a defin-ing vote for the Democratic Party. It isa vote that, while working with ourDemocratic President and the majorityRepublican Party who control theHouse and the Senate, we have beenable to save over $700 billion that wewill not have to borrow over the next10 years, and at the same time thatmany of us Democrats believe in bal-ancing the budget, we believe in doingit in a fair, equitable and just manner.

Spending money on a brand-new ini-tiative for children's health, $16 billionover 5 years for uninsured children;that would not have happened withoutour input into this process.

The largest Pell grant increase in thehistory of the Pell grant program tohelp our struggling families get theirchildren a college education; thatwould not have happened without thePresident and the Democratic minori-ties in the Senate and the House work-ing with the Republican majority.

There are lots of things that we be-lieve very firmly will benefit the hard-working people of this country in thisbalanced budget proposal that we hopewill receive a number of Democraticvotes here on the floor, and I appre-ciate the hard work. And next door inthe Buckeye State, with the gentlemanfrom Ohio [Mr. KASICH], we oftentimeswork together on some of the budg-etary matters, and I am very anxiousto work with the President and withthe Senate, the other body, and im-prove this bill even further in con-ference.

Mr. KASICH. Mr. Speaker, I reclaimmy time and suggest that I think whateveryone should be very happy abouttoday is that what we are about to dohere again, so that there can be no con-fusion with our colleagues or the peo-ple who advise our colleagues, we areabout enacting the real savings thatwill accumulate to balance the budget.It is not based on some targets, it isnot based on some jerry-rigged mecha-nism. It is based on controlling thegrowth of entitlement programs in avariety of areas, and I want to com-mend the gentleman for being here andsupporting this effort today.

Let me also spend a few minutestalking about the Medicare portion ofthis. We have not only enacted the sav-ings that will preserve Medicare for 10years, but at the same time we havealso been able to offer a program thatwill give our senior citizens morechoice on health care.

Furthermore, it will permit physi-cians to group together to compete

June 25, 1997

against insurance companies. We thinkthat allowing physicians to be able togroup together to compete against in-surance companies will result in con-sumers having a leg up on the currentprocess. I am delighted it happened.

Furthermore, included in this issomething that is controversial, but Iwant to commend the minority for notdoing somersaults over this; it is theprogram to allow our senior citizens tohave more choice by being able to pur-chase medical savings accounts in thisproduct.

In addition to that, we have also gotsome control in the area of the homehealth care and skilled nursing facili-ties, which have been the most rapidlygrowing portion of Medicare. We arenow going to have an item called pro-spective payments where we do notjust turn the faucet on and let all thedollars run out. We want to hold peopleaccountable who deliver these services.

So we have a variety of things in thisprogram that, in fact, will empowerseniors, give them more choices, we be-lieve improve the quality of care, andat the same time save $115 billion overthe next 5 years which is very similarto what we had proposed 2 years ago.

So I think this is just a terrific ac-complishment. In the area of Medicaidwe have released the States from anumber of provisions designed by theFederal Government to tell States howto regulate the Medicaid program. Wehave decided that there are some rea-sonable provisions where the Governorsof our country ought to be given flexi-bility to manage their program betterso that they can provide more care tothose who are in need of it withoutmicromanaging the program fromWashington. We think it is terrific.

And we did make a few reforms inwelfare where we took a look at whatwe did last year, and we said if thereare some areas where perhaps we couldimprove the bill, make it more compas-sionate, we agreed to do it. But. we didnot walk away from the basic commit-ment that we made to the Americanpeople to end the entitlement program,to make sure that able-bodied peoplego to work and to make sure that thisprogram will be run at the State level.

Now I want to just suggest todaythat the ability to enact these pro-grams is really a huge step forward inbeginning to address the problem ofwhat can be generational warfare inthis country. We are by no means at anend. No one who watches this debateshould think that everything is nowcopasetic. It is not.

We are, in fact, going to have tocome back and give people more power,more flexibility, more control of theresources that they earn in their life-time to invest in their own retirement,in a retirement program called SocialSecurity where hopefully we can pre-serve that program and yet let peoplehave more flexibility to earn moremoney based on their earnings. Weknow that there has to be a majoroverhaul of the Social Security pro-gram that will preserve, protect and

June 25, 1997enhance Social Security. We are goingto have to work on a bipartisan basisin order to guarantee that our childrenare not consigned to spending all oftheir life working to pay our benefits.I think we can achieve it, and we aregoing to have to do it together becauseSocial Security is as American as theflag and apple pie, and we are going tostand behind it, but we are going tohave to improve it, and we are going tohave to innovate it.

In the area of Medicare it is veryclear that we are going to have tomove toward a greater voucher systemwhere senior citizens are going to holda check and the health care providersin this country are going to have tocompete for the right to provide qual-ity care to our senior citizens.

0 1345It is one of the answers that I believe

will help us be able to deal with thetremendous influx into the retirementprograms of our baby boomers, and inthe area of Medicaid, a lot more reformneeds to be done in Medicaid. Frankly,we have to wonder why we do not cre-ate a system where the baby boomersbegin to provide for their own long-term care.

The gentlewoman from Connecticutis intimately involved in trying to cre-ate a program to really move Medicaidto be a program for the disabled andthe children, and that we need to en-courage the baby boomers in this coun-try to buy long-term care insurance sothat we do not become a burden on ourchildren.

The fact is, we cannot afford agenerational war in this country. Whatwe have done is to take the first stepto show the country that we can, in aresponsible way, begin to get a handleon entitlement programs, balance thebudget, transfer power from this cityinto the hands of individuals who arethe recipients of these programs, bring-ing greater innovation, bringing great-er imagination to the effectiveness ofthese programs by transferring themout of a Washington model and puttingthem into the hands of people acrossthe country.

I think that if we can be successfulhere, we will gain some of the con-fidence of the American people that allof us know we must take to deal withthe problems of the next generation;we will gain confidence and credibilityfrom the public when we take that nextdifficult, but clearly exciting step topreserve many of these programs forthe American people.

So today we have so many thingsthat we can be proud of, so manythings that we can be excited about.But this is that step that will providefor a balanced budget in the year 2002in a real way.


Mr. SPRATT. Mr. Speaker, I askunanimous consent to yield 45 minutesto the gentlewoman from Connecticut[Ms. DELAuRO], and that she be allowedto control and yield that time.


The SPEAKER pro tempore (Mr.DREIER). Is there objection to the re-quest of the gentleman from SouthCarolina?

There was no objection.Mr. SPRATT. Mr. Speaker, I yield

myself such time as I may consume.I cannot pass up the opportunity to

observe, as I have before, why it is weare here at this moment. Five yearsago, the date I always pick as January13, 1993, just before George Bush left of-fice, his Economic Report of the Presi-dent came to the Congress and it mdi-cated, projected, that the deficit forthat year, fiscal year 1993, would be$332 billion. Within a few months, wepassed in the House and in the Senateand sent to the President a deficit re-duction plan, only with Democraticvotes, passed by the skin of its teeth,which sought to cut that deficit in halfover the next 5 fiscal years. The resultsare a matter of record.

The deficit fell in fiscal year 1993 to$255 billion, in fiscal 1994 to $203 billion,in fiscal year 1995 to $164 billion, andlast year, September 30, 1996, the defi-cit was $107.8 billion. Both 0MB andCB0 projected that the deficit will bewell below $75 billion on September 30,1997, when we close the books on thisfiscal year.

So we can credibly say that we arewithin reach of a balanced budget be-cause of what we did at some politicalexpense in 1993. This could be for manyof us, a sweet occasion, a very satisfy-ing moment. Instead, it is a little bit-tersweet.

Mr. Speaker, less than a month ago,we passed a budget agreement here inthe House, sent it to the other bodyand they passed it as well, that de-served the name bipartisan. Mr. Speak-er, 132 Democrats voted for that agree-ment, and today, 132 or more wouldcome back to the well of the House andvote for it again if the budget agree-ment we made a few weeks ago weresimply carried out, straightforwardlyimplemented in the bill that is beforeus.

Unfortunately, it is not. This billdoes not fully realize the goals that weset out in the balanced budget agree-ment. It is still a work in process, verymuch something that is yet to be real-ized. That is why the administrationrequested us in a letter they sent todayto pass a bill to move the process, notthat they are endorsing this bill, butthey endorse the process, because theirexpectation is that it can be perfectedin conference, which remains to beseen.

Here are just a few of the ways thatwe have fallen short. The philosophy ofour negotiation was that each side,Democrats and Republicans, wouldcome out of the negotiation with some-thing that each of us could claim wehad won, some distinct victory. Forour part we chose as a victory edu-cation, the President's request for edu-cation, and an initiative in the area ofchildren's health care, another step to-ward providing health care for the mil-lions of Americans who do not have it.

H4555The goal we set for ourselves was to

get at least 5 million children of the10.5 million children in working poorfamilies who do not have coverage cov-ered with health insurance. We setaside an earmark $16 billion of newspending resources in this bill in orderto accomplish that.

Unfortunately, the committee of ju-risdiction in its mark of this bill gaveus a block grant that provides us no as-surance that this $16 billion will reachthe children for whom it was intended.CBO has cast grave doubt as to whetherwe will even get a fraction of thosechildren. So we have fallen short of agoal that we all ostensibly shared andshould share, and that is, get at leasthalf of that 10 million children covered.That is why I say this bill needs im-provement.

Next, provisions were added to thebill that were never contemplated,never discussed in the course of thebudget negotiations. In dealing withwelfare to work and with workfare par-ticipants, provisions were added thatwould deny workfare participants theprotections of the Federal LaborStandards Act, deny them the right tobe called employees and all the rights,benefits and privileges pertinent there-to under Federal law.

In dealing with the food stamp provi-sion which now requires able-bodiedfood stamp beneficiaries between theages of 18 and 50 to work in order to gettheir food stamps, we have provided $1billion in order to see to it that 350,000workfare slots would be available sothat these food stamp participants, ifthey could not find a job, could at leastget workiare and continue to get theirfood stamps. We have not realized thatgoal in the bill before us.

Then in this bill, which is a must-pass piece of legislation, everybodyknows it is a moving vehicle and it isgoing on a fast track, some bitter pillswere added by people who are ardentproponents of various projects thathave nothing to do with reconciliation.This bill contains a new medical mal-practice code, a far-reaching innova-tion for the Federal Government. Ivoted for that before. I have actuallywritten the title, the Rowland-Bill-rakis bill that dealt with it, but thereare many Members on my side forwhom this is a bitter pill to swallow.The same goes for the Hyde amend-ment, which I voted for before, butmany Members on my side simplythink it has made the kids' care billsomething that they cannot supportuntil it is removed.

Go down the list; 500,000 MSA's, med-ical savings accounts, never discussedin our agreement, never contemplated,and scored by the Congressional Budg-et Office not to save money in a billwhere we are trying to shore up and re-store solvency to Medicare or shore upand eradicate the deficit; this will costthe Medicare Program $2 billion overthe next 5 years, an expensive experi-ment.

So all of this is hard to swallow forDemocrats. Some Democrats today, as

H4556a consequence, who could be countedon to come to the floor as they did in1993, as they did just a few weeks ago,and vote to eradicate the deficit andbalance the budget will be forced tovote no today. It is not because they donot want to balance the budget, it isbecause they think the deal that theysupported just a few weeks ago has notbeen upheld and has been actuallybreached.

Some, like me, will vote for thebudget reconciliation bill before us. Ivote for it for two strong and substan-tial reasons. First of all, as the billbegan to emerge from the pipeline ofthe different authorizing committees,and we began to note its problems thathad to be corrected and cleaned .up, thegentleman from Ohio [Mr. KASICH]worked in earnest and in good faithwith me to work off a list of thingsthat I thought we could correct here inthe House between the reporting of thebudget resolution and the rule that wasconsidered today. Much of that was ac-complished in the self-implementing,self-executing rule that we passed justa few minutes ago.

In that same spirit of good faith, Iam betting that that same cooperationwill continue into conference so thatwe can, through one means or another,negotiations with the Senate, thePresident's veto threat, whatever thedevice may be, we can take this workin progress and bring it back to what itwas just a few weeks ago. a bill that wecould call a balanced bill to balancethe budget, a bill that is truly biparti-san, one that we can all vote for.

It is in the hope that we can obtainthat objective that I will support thisbill, but I say to all Members of theHouse, Democrats and Republicansalike, it is still very much a work inprogress and it needs and requires a lotof work before final passage.


The SPEAKER pro tempore. Withoutobjection, the gentleman from Con-necticut LMr. SI-lAys] will control thetime of the gentleman from Ohio [Mr.KASICH].

There was no objection.Mr. SHAYS. Mr. Speaker, I yield 4

minutes to the gentlewoman fromTexas [Ms. GRANGER].

Ms. GRANGER. Mr. Speaker, I rise instrong support of the first balancedbudget since 1969, the year that NeilArmstrong walked on the moon. NeilArmstrong's giant leap for mankind isthe second thing I remember about1969. Mr. Speaker, 1969, the last yearthe budget was balanced, was also theyear my first child was born. I proudlywatched that young man walk downthe aisle to receive his doctor of juris-prudence just 3 weeks ago. That meansmy oldest son has not seen a balancedbudget since the year he was born. Mytwins, born 2 years later, have neverseen a balanced budget in their life-times.

Today we can change that. The legis-lation we consider today will balance


the budget by 2002, if not sooner. Ourplan will put the Federal budget intosurplus through the year 2007. This isthe most important thing we can do forour children's future.

But this plan does much more. In ad-dition to helping our children, this bal-anced budget downsizes Washington toreturn power, money, and decisionsback to families, neighborhoods, andcommunities. As the mayor of FortWorth, TX, I learned that local com-munities need more power and lessmandates from Washington. The bal-anced budget we will continue todaywill reduce Washington spending as apercentage of our economy to the low-est level since 1974.

This plan keeps our commitment toour parents and grandparents by pre-serving Medicare. This balanced budgetadds 10 years to the life of Medicare: itprovides our parents with more healthcare choices, the same health carechoices as their children and grand-children.

This plan keeps our commitment toeducation. I taught school for 9 yearsas a public school teacher, and Ilearned that there is nothing more im-portant than education. By eliminatingthe deficit, a balanced budget willlower the cost of a typical student loanby nearly $9,000. College education willbe more affordable to young men andwomen across this country.

This budget agreement keeps ourcommitment to future generations bybalancing the budget; to our parentsand grandparents by preserving Medi-care: and to America's future by mak-ing education for our children more af-fordable and available. Let us stand upfor America's children, its seniors andits students and its future and supportthis balanced budget agreement.

Ms. DELAURO. Mr. Speaker, I yield16 minutes to the gentleman fromMichigan [Mr. BONIOR].

Mr. BONIOR. Mr. Speaker, I thankmy distinguished colleague from Con-necticut for yielding me this time.

Mr. Speaker, this budget bill that wehave on the floor breaks the deal, andit does so not in one or two places, itdoes so in about 12 different areas,major areas of law.

0 1400

What it also does, this bill and thetax bill we will consider tomorrow thatthe Republicans are rushing throughthis Congress will spawn the worst eco-nomic inequality that Americans haveexperienced in the past century. We areexperiencing in this country today asituation in which those at the top aremoving further and further away fromthe rest of the country.

We can see it. We used to be first inwages and benefits. Now we are 13thamong Western developing countries.Eighty percent of the American peoplehave not had a raise in wages since1979. The top 20 percent are doing verywell. The difference between the CEOin 1960 and the average worker wasabout 12 times difference in salaries.

June 25, 1997

Today it is 209 times. They make 209times more than the average worker.Now we are codifying all of that intolaw today and tomorrow.

The Republican tax bill we are goingto deal with tomorrow gives more ben-efits to the richest 1 percent of Ameri-cans than to the bottom 60 percentcombined. The top 1 percent get morethan the 60 percent. Rollbacks in thecorporate minimum tax is a $232 billiongiveaway. Look at the chart here. Backin the early 1960's the corporationspaid roughly close to 25 percent of thetaxes in this country. It got down toabout 7 percent in 1982.

It was so embarrassing to the Repub-licans and the rest of the country, be-cause companies like Texaco andAT&T and Boeing were not paying anyFederal taxes, so we put together a cor-porate minimum tax. It started to goupjust a little bit since then.

This bill sends us this back down bygiving them a $22 billion break: whenwe add all of the breaks on capitalgains through inflation, $650 billioncosts over the period of outyears.

Another point I would like to makeis that the Republican tax bill actuallyraises taxes on the bottom 40 percentof Americans. It gives all these breaksto the people at the top, raises taxes onthe bottom 40 percent. If the Repub-licans were not writing this into law, Iwould call it robbery.

The second point, the tax and spend-ing bills give giant corporations thepower to create second-class citizenswho do not have the same rights as therest of us. I ask the Members, is it fairto deny some Americans their rightsunder the Family and Medical LeaveAct that we all worked so hard forhere, the Equal Pay Act, the CivilRights Protection Act, OSHA safetystandards?

Is it right to deny a person the abil-ity to defend themselves against sexualharassment? Is it fair to pay workerson a contract basis, denying them theminimum wage, health benefits, pen-sion benefits? This country was found-ed on the basic principle that we arecreated equal, but these bills today andtomorrow say that some people, mostlyfamilies struggling to raise their chil-dren, are less than equal, that they donot deserve the same rights as otherAmericans. That is not just a slipperyslope, that is a jagged cliff. If all Amer-icans do not share the same rights,then none of us have them.

The third point, the Republican taxand spending bills violate the biparti-san budget agreement. Three of themost important violations are that itreneges on a third of the promisedfunding for education, shortchangingparticularly students from workingfamilies. It also reneges on health carecoverage for 90 percent of the childrenwho will be covered under the originalagreement, and gives this funding toStates with no guarantee that they aregoing to spend it on kids for theirhealth insurance.

The agreement called for covering 5million children, but the spending bill

June 25, 1997covers only about 500000, and leavesout 4.5 million children. It also effec-tively slashes funding for children'shospitals serving children from poorand working class families perhapscausing some of these vital hospitals toshut down.

These bills punish working familiesand reward the wealthiest and big na-tionals. More benefits to the richest 1percent, and 60 percent of the rest ofthe folks, from zero to 60 percent, thosebenefits equal the top 1 percent. Is thatjust? Is that fair? We believe in a bal-anced budget, tax cuts for workingfamilies, and fairness. We will fight forthat.

Tomorrow, with our tax bill that tar-gets ours to working families, not thevery wealthy in this country, we willfight that, and we will fight that todaywhen we take on what the Republicanshave proposed here with respect towhat we believe is breaking the agree-ment.

Ms. DELAURO. Mr. Speaker, will thegentleman yield?

Mr. BONIOR. I yield to the gentle-woman from Connecticut.

Ms. DELAURO. Mr. Speaker, I thankthe gentleman from Michigan for yield-ing to me, and want to pick up a coupleof points he has laid out here.

I urge my colleagues to vote againstthis bill, because in fact it does violatethe bipartisan budget we passed earlierthis month. In particular one of theareas where it is an outrage is whatthey have done in the whole issue ofhealth care for children in this coun-try. It denies working families the helpthey need to provide health care fortheir children. They have violated thatvery basic tenet of this agreement.There is no assurance of coverage forat least half of the 10 million childrenin the Nation today who do not haveaccess to health insurance.

Children living without health carecoverage are hurt in so many ways inthis country. They are less likely tohave a family doctor, to receive pre-ventive care, and they are less likely tohave treatment for serious illnesses.They are less likely to grow up healthyand productive. The problem is notgoing away because every day in thiscountry another 3,300 kids lose theirhealth insurance.

Mr. BONIOR. That bears repeating;every day in this country 3,300 kids inthis country lose health insurance be-cause employers are cutting back thesebenefits. Where are the kids going togo? This plan does nothing, nothing forthem.

Ms. DELAURO. I might just add, Mr.Speaker, that the agreement clearlystates $16 billion would be spent tocover half the kids. It has been esti-mated by the Congressional Budget Of-fice that the bill would cover only520,000 of those 10 million kids. That iscoverage of less than 20 percent of thechildren who do not have access tohealth care today.

I might add that the children who donot have access to health care today


are the sons and the daughters of work-ing families. These are people whose fa-thers and mothers are working everysingle day in order to protect theirkids, and they are without health in-surance.

This bill offers no assurance thateven one additional child will receivehealth care insurance. But what myRepublican colleagues have done is in-stead they are going to send thismoney to the States with no require-ment at all that the funds be used togive kids the health care that theyneed. There is nothing that says thatthis money needs to be used to pay forhealth insurance for kids today.

The Republicans in fact are turningtheir back on working middle classfamilies today. They are going to notallow our youngsters to grow uphealthy and strong.

Mr. DOGGETT. Mr. Speaker, will thegentleman yield?

Mr. BONIOR. I yield to the gen-tleman from Texas.

Mr. DOGGETT. Mr. Speaker, I votedfor this balanced budget agreement.

Mr. BONIOR. I did, too. So did thegentlewoman from Connecticut [Ms.DELAURO].

Mr. DOGGETT. Really, is not themeasure what one would properly calla wreckonciliation bill, in that itwrecks the balanced budget agree-ment?

Mr. BONIOR. I agree 100 percent, inthat it wrecks it on a number of fronts,some of which we have just talkedabout.

Mr. DOGGETT. Indeed, when wetalked about getting a balanced budgetagreement that has true balance, I al-ways thought the idea was that therewould be shared sacrifice, shared bur-den, but it would appear that those atthe top of the economic ladder now getto share, and those that are trying toclimb up, they just get the burden.Does it appear that way to the gen-tleman?

Mr. BONIOR. Mr. Speaker, I thinkthe gentleman is absolutely correct.We can tell from this graph on the taxpiece that the multinational corpora-tions and giant corporations get a $22billion break. We are talking about, asI said earlier, the top 1 percent gettingas much in benefits as 60 percent of theAmerican people, working Americansin this country. Where is the justice?Where is the fairness there?

Mr. DOGGEIT If there is a familyout there, maybe both parents havingto try to work just to make ends meetand at the same time trying to createa good family environment for theirkids. If they work for someone thatdoes not provide health insurance, thisbill, this wreckonciliation bill, says tothem, you have to go forward with nohealth insurance, but it says to a giantmultinational corporation, can we cutyour taxes a little bit more?

Mr. BONIOR. Mr. Speaker, the gen-tleman is right, he has got it. That isexactly where we are headed on thisbill here. It is reneging on the promise

H4557that was made over the agreement. Itis inequitable, it is unfair, and puts theburden on those who can least afford tobear it.

Mr. DOGGETT. Indeed, for the ordi-nary young working families, does thisreconciliation bill really offer themmuch of anything?

Mr. BONIOR. It offers them virtuallynothing.

In terms of the budget, let me justtell my Republican colleagues andthose Members on the floor here, it wasin 1993, if we are talking about offeringpeople a balanced budget, it was Demo-crats on every single one of the votesthat passed that bill that reduced thedeficit from $300 billion.

It was in 1993 that we passed the bal-anced budget in this country. Thebudget was at about $300 billion. Thatbill, that was supported by Democratsonly, not a Republican in the Houseand Senate supported that bill, broughtthe deficit down from an annual $300billion deficit all the way down toroughly $60 billion this year.

What we are trying to do is maintainthat, maintain that progress, and makeit equitable in terms of working Amer-icans. This bill does not do it. It movesus back in the opposite direction, withhuge outyears, deficits in the outyears,because of what we will see tomorrowin the Republican bill on taxes by in-dexing capital gains. It does not dis-tribute the benefits fairly in this par-ticular bill, as we have discussed withchildren's health care, as we have dis-cussed with a variety of other issues interms of the workplace.

Mr. DEFAZIO. Mr. Speaker, will thegentleman yield?

Mr. BONIOR. I yield to the gen-tleman from Oregon.

Mr. DEFAZIO. Mr. Speaker, the gen-tleman just made the most salientpoint there. The cuts today are de-signed to cut taxes for the largest cor-porations in America and the wealthi-est. Some of these cuts are extraor-dinarily cruel. They cannot be deniedby my friends who will stand on theother side of the aisle: a 20-percent cutin home health oxygen benefits for sen-iors, and a freeze to the year 2002.

Let me just read from one constitu-ent, of the many letters I got: DixieMcNutt, Springfield, OR, my home-town. Dixie says, Having oxygen al-lows people like me to enjoy the com-forts of home and to feel as though weare still an active part of the family.Without this benefit, the choice seemsto be living at home without breathing,or spending our remaining days in thehospital, which would cost both Medi-care and the patient much more."

So today, Congress will cut $2 billionout of home health oxygen benefits forseniors and the disabled to pay for one-tenth of the repeal and the gutting ofthe alternative minimum tax for cor-porations, because it will be too much,too much to ask the largest corpora-tions in America to just pay maybe 5or 10 percent of their profits in taxes, afraction of what working Americans

H4558pay out of their paycheck every month.This is a travesty. It should not pass. Istand against this bill.

Mr. BONIOR. I thank my colleague.Mr. Speaker, what we have here is a

replay, really, of the last Congress.They are taking dollars out of chil-dren's hospitals, they are taking dol-lars that were intended for children'shealth insurance benefits, they aretaking benefits away from workers allover this country, and where are theyputting it? They are putting it intotaking care of the biggest corporationsin this country and the wealthiest indi-viduals in this country. It is indeed oneof the biggest transfers of wealth wewill see here in many a moon.

Mr. KENNEDY of Rhode Island. Mr.Speaker, will the gentleman yield?

Mr. BONIOR. I yield to the gen-tleman from Rhode Island.

Mr. KENNEDY of Rhode Island. Mr.Speaker, I think what this reconcili-ation bill really does is it shows wherethe majority party, the Republicanparty's, true priorities are. Clearly,their priorities are not with our Na-tions senior citizens, who are nowgoing to get the cold shoulder becauseof the MSA accounts that are providedfor in this bill, which basically allowsthe skimming to be done by insurancecompanies, so they can get the healthi-est and wealthiest who do not have topay the deductible, and be able to tar-get those very healthy and wealthypeople, leaving the poorest elderly, themost frail elderly, the ones that havethe most costs to bear with respect tothat.

In addition to that, the bill also, asthe gentleman said, makes sure thatwe do not provide the needed invest-ment for health insurance for children,making sure that all the children inthis country get the necessary healthcare that they need.

Finally, as the gentleman mentioned,all this does is shift the burden of ourtaxes from the top 1 percent of thiscountry to the bottom 60 percent. Ithink the gentleman pointed out cor-rectly that, is it not correct that thetax cut that this reconciliation billprovides for, including the tax bill, hasa tax cut larger for the top 1 percentthan for the aggregate of the bottom 60percent?

Mr. BONIOR. The gentleman hasstated it correctly. The top 1 percentgets as much as the bottom 60 percentin this country.

Mr. KENNEDY of Rhode Island.While the senior citizens do not get thenecessary health insurance, as my col-league, the gentleman from Oregon,just mentioned; while children do notget the necessary health insurancethey need, and while legal immigrantsstill go without SSI, based upon theRepublican discriminatory bill with re-spect to our legal immigrants notbeing provided adequate SSI coverage.

Mr. SANDERS. Mr. Speaker, will thegentleman yield?

Mr. BONIOR. I yield to the gen-tleman from Vermont.


Mr. SANDERS. Mr. Speaker, let usput this bill into the context of what ishappening in America today. Every-body knows what is happening. Therichest people are becoming richer, themiddle class is being squeezed, andmost of the new jobs being created arelow-wage jobs.

Given that context, what sense is itthat we have legislation under which 58percent of the benefits go to the top 5percent, corporations see a reductionin their tax burden, while the bottom40 percent of income earners see nobenefits at all? In other words, we havegot this thing completely backwards.We are helping those people who do notneed help, and we are not helping thosepeople who are in desperate need ofhelp. Furthermore, under this legisla-tion, Medicare will be cut $115 billionover a 5-year period.

The Vermont Association of Hos-pitals estimates that will be a $75 mil-lion cut from hospitals, rural hospitalsall over America who will be hurt,meaning there will be lower qualityhealth care for our senior citizens.

0 1415

Tax breaks for the rich and the peo-ple who do not need it, cuts in Medi-care and a reduction in the quality ofhealth care for our senior citizens,those people who do need help, I urge ano" vote on this absurd piece of legis-

lation.Mr. SHAYS. Mr. Speaker, I yield my-

self 1 minute, to say that tomorrow wewill be debating the tax bill. As the bi-partisan joint tax committee of Con-gress estimates, 76 percent of all thebenefit goes to people who make lessthan $75,000, totally contrary to thefacts that have been shouted out in thelast 20 minutes. Ninety-two percent ofthe benefits go to people making under$100,000.

We will be debating the tax bill to-morrow. It will be very, very clear whobenefits. We will realize the people whobenefit are the middle class in thiscountry. Today we are debating aspending bill, a spending bill that al-lows spending to go up 3 percent ayear, that allows Medicare to go up at7 percent a year each year, not a cut, asignificant increase.

Mr. Speaker, I yield 2 minutes to thegentleman from Florida [Mr. SHAWl.

Mr. SHAW. Mr. Speaker, I thank thegentleman for yielding me the time.

It is not necessary to stand here andyell when we have the facts with us.We definitely have the facts with us.

That is that 76 percent of the taxcuts that we are going to be talkingabout tomorrow, tax relief for Amer-ican families, goes to families earningless than $70,000.

Now, people listening to this debatewould wonder, where in the world arethese figures coming from that arebeing screamed and yelled on the floorand all of these graphs and all of thisyelling and signs that are going up? Ican tell my colleagues where theycame from. Treasury came up with an

June 25, 1997

archaic formula in which they deter-mine somebody's wealth by taking therental value of the home that they ownand add it to their income, the earn-ings of corporations in which theymight own a few shares of stocks andputting that upon them, the economicvalue of their resources such as theirautomobile. Come on.

Unless the Democrats are going tocome out and try to tax that, then thisis an absolutely absurd 'argument. Solet us get some truth here on the floor.Let us get to the situation where weare not yelling at each other, that weare simply talking facts. If we are put-ting that type of income on top ofsomebody when we start to try to comeup with all these figures that simplyare not true, I think that at that timewe owe it to the American people, wecertainly owe it to our colleagues toget up and say how did we determinethat income. We do it by simple mathand by the amount of earnings thatpeople have. The facts are very clear.

This is the first tax relief the Amer-ican people are getting in the last 16years. There are some Members thatare here on the floor debating thatjustcannot stand that idea. But I can tellmy colleagues, Democrats and Repub-licans alike are going to carry this dayand we are going to get the first tax re-lief for the American families in 16

years. That will vindicate this debate.Mr. SHAYS. Mr. Speaker, I yield 2

minutes to the gentleman from Ari-zona [Mr. HAYWORTH], who will pointout that taxes went up in 1993 and aregoing down in 1997.

Mr. HAYWORTH. Mr. Speaker, Ithank the gentleman from Connecticutfor yielding me this time.

I am pleased to follow my chairmanof the Subcommittee on Human Re-sources of the Committee on Ways andMeans. I have been listening, Mr.Speaker, with great interest to thecavalier fashion in which fear replacesfacts on the other side. It is sad to seethat happen.

I do not think the point can be madeoften enough that when you cook thebooks, as the liberal minority hasdone, in the process you fricassee thefacts.

Mr. Speaker, I do not know of any-one, including my friends on the mi-nority side, I do not know of anyonewho pays themselves rent to live in ahouse they own. Only in Washington,DC in the desperation of trying to con-coct fear rather than new ideas, ratherthan joining with us to decrease thetax burden on working Americans, de-crease the size of government, have alimited and effective government, onlyin Washington do we see this kind ofmath.

To hear the minority whip come upand talk about the balanced budgettaking shape in 1993, I was a privatecitizen. I know exactly what happenedin 1993, the largest tax increase inAmerican history. It took a new Con-gress cutting spending, it took a newCongress coming in and saying, let us

June 25, 1997reverse the culture of tax-and-spend totake the first fledgling steps in reduc-ing by $50 billion the size of govern-ment to make it limited and effective.

And the truth of this tax cut, Mr.Speaker, is the following: 76 percent ofthe tax cuts go to benefit middle-in-come families, families making be-tween $20,000 and $75,000 a year for, Mr.Speaker, we realize that those middle-income taxpayers are exactly that.They are not rich. They are workingAmericans. They deserve a break. Theywill get one.

Mr. SHAYS. Mr. Speaker, I yield 3minutes to the gentleman from Florida[Mr. MILLER].

Mr. MILLER of Florida. Mr. Speaker,let us get clear what we are voting ontoday in the Balanced Budget Act. Weare talking about the spending side ofthe equation. Tomorrow we are goingto talk about the tax side of the equa-tion. Because tomorrow we are goingto vote on massive amounts of middle-class tax relief. But today we are talk-ing about the spending side of theequation.

What we are talking about today isreining in the fiscal irresponsibilityand spending that takes place here inWashington. When I first ran in 1992, Iran because it was a moral issue to methat this Government was building upan obscene and immoral debt that wewere going to pass on to our childrenand grandchildren. It was wrong tobuild up a debt that today is over$19,000 for every man, woman, and childin the United States because we justoverspend in Washington. The way wego about solving that problem is rein-ing in the Federal Government.

I was pleased to be able to serve onthe Committee on the Budget with thegentleman from Ohio [Mr. KASICH]back in 1993 and 1994. As a minorityback then, we introduced a budget res-olution that was called cut spendingfirst because we recognized that iswhere the problem is. It is not that wetax too little in this country. It is be-cause we spend too much. And whatthis bill is today is $700 billion of enti-tlement savings over the next 10 years.It needs to be done in a bipartisan fash-ion.

That is the reason I congratulate thegentleman from South Carolina [Mr.SPRArr] and the gentleman from Indi-ana [Mr. ROEMER] earlier who have al-ways spoken in favor of this bill as astep in the direction for the final pas-sage ultimately next month. So wehave support on the other side of theaisle. It is too bad that the very liberalwing of the Democratic Party feels soadamant they need to demagogue thatissue because what we are doing is theright thing for America's children andgrandchildren of future generations toget the spending under control.

One of the very things I feel verypositive about in this bill is Medicare.What we have is a Medicare Programthat is going bankrupt. It will be bank-rupt in 4 more years. We need to ad-dress this in a bipartisan fashion,


which is exactly what has been done inthis committee. In fact, the Committeeon Ways and Means passed it with a 36to 3 vote. Only three Democrats votedagainst it. The majority of Democratsvoted for the Medicare position of thisbill, because Medicare has to be pre-served, has to be protected, has to besaved for our senior citizens.

In my district in Florida, Sarasota-Bradenton, Florida area, we have moreseniors than any district in the coun-try. So it is important to me for all theseniors in my district, I have an 87-year-old mother that is dependent onMedicare. So we need it for the seniors.But it is also a big jobs issue in my dis-trict with the hospitals and home careagencies and the doctors' offices, allneeding their jobs, depending on this.So we need to preserve that programand save that program.

How do we go about doing that inthis bill? What we do basically is weslow the rate of spending in Medicare.We slow the rate of spending so we aregoing to spend more money every yearin Medicare. Right now we are spend-ing about $5,200 per person on Medi-care. In 5 years we will be spending$6,900 per person on Medicare. What weare going to do is go after waste, fraud,and abuse and we are going to givemore choices to senior citizens.

It is a good program. I encourage mycolleagues to support this. I hope weget strong support on the other side ofthe aisle.

Ms. DELAURO. Mr. Speaker, howmuch time remains of my time?

The SPEAKER pro tempore [Mr.DREIER]. The gentlewoman from Con-necticut [Ms. DELAURO] has 29 minutesremaining, the gentleman from SouthCarolina [Mr. SPRArr] has 36 minutesremaining, and the gentleman fromConnecticut [Mr. SHAYS] has 68 min-utes remaining.

Ms. DELAURO. Mr. Speaker, I yield 1minute to the gentleman from Michi-gan [Mr. LEVIN].

Mr. LEVIN. Mr. Speaker, threepoints on taxes. I hope the Republicanswill listen. The 76 percent for familiesless than $70,000 is based on 5 years, ap-parently. We have never seen the anal-ysis. I challenge them, give us a 10-yearanalysis. They leave out the tax breaksthe second 5 years. Give it to us.

Second, Treasury, using the samemethods used by the Reagan Treasuryand the Bush Treasury, say two-thirdsof the tax cuts under your bill go tothe wealthy, the same method that wasused by previous administrations.

Third, they bust the budget in theoutyears. They bust it. So come herenot with phony figures. Come here withthe facts and we will debate them.

Mr. SHAYS. Mr. Speaker, I yield 3minutes to the gentleman from Ken-tucky [Mr. BUNNING], who is a memberof both the Committee on Ways andMeans and the Committee on the Budg-et.

Mr. BUNNING. Mr. Speaker, I wouldlike to say to my good friend fromMichigan, he knows full well that the

H4559numbers we use are adjusted gross in-come numbers and they are factual.And just because Ronald Reagan andGeorge Bush's Treasury Departmentsmade a mistake, it is no sign that theClinton administration has to continuemaking the same mistakes.

Mr. Speaker, I rise in strong supportof the Balanced Budget Act of 1997. Iam especially proud of the Medicare re-forms in this bill, about a 7-percent in-crease over the 5 years, each year.Since Republicans took control of Con-gress, we have been working very hardto preserve and strengthen and protectMedicare.

The bill before us today does saveMedicare from bankruptcy for at leastthe next 10 years and gives us time tofigure out a long-term fix for the prob-lem. But I think the most exciting partof this package is that it gives seniorsmore choices in picking the health careplan that best fits their needs.

I know some of the seniors like whatthey have right now. They do not wantto change a thing. Fine. They do nothave to move off Medicare part A orpart B. They can simply do what theyhave been doing. But if they want tochange, seniors will now be able toshop around for a PPO, an HMO, a med-ical savings account, another healthcare plan that covers something thatMedicare does not cover right now likeprescription drugs or eye glasses. Andit will be paid for by Medicare. Theymight even be able to choose a new pol-icy that allows them to get rid ofMedigap supplemental plans that theyare paying extra for right now.

In rural States like Kentucky, wherefolks sometimes do not have as manyhealth options, this bill enables doctorsand hospitals and other providers toband together to set up provider serv-ice networks to give seniors even morechoices. Letting seniors choose, forcinghealth care providers to compete fortheir business are the keys in this Med-icare reform package. This holds downthe cost and saves enough money tokeep Medicare going for years.

Of course, we also save a lot ofmoney by making other importantchanges like reforming the medicalmalpractice rules and cracking downon waste, fraud and abuse.

0 1430But by empowering seniors, by giving

them more choices, we take the biggeststrides towards reforming and savingMedicare. By exercising the power tochoose, seniors themselves will do mosttowards saving Medicare; they, not theWashington bureaucrats, will controltheir own futures.

I urge support of this bill and all thegood things in it.

Ms. DELAURO. Mr. Speaker, I yieldmyself 10 seconds. I think it bearsmerit to remember that it was the Re-publican majority in this House thatwanted to cut the Medicare Programby $270 billion to pay for a tax break,$245 billion for the richest people inthis country. It was the President andthe people of this country that said no.

H4560Mr. Speaker, I yield 2 minutes to the

gentlewoman from New York [Mrs.L0wEY].

Mrs. LOWEY. Mr. Speaker, I votedfor the budget agreement approved lastmonth because I do believe that ourNation must have a balanced budgetthat protects our priorities and re-spects our values. But, unfortunately,the Republican leadership did not evenwait for the ink to dry on the deal be-fore changing it.

In fact, the bill before us violates thebudget deal in several critical ways.First, it fails to provide basic assist-ance to legal immigrants, which meansthat 16,000 elderly and disabled legalimmigrants in New York will have thesafety net cut out from under them.

The bill cuts more than $12 billionfrom hospitals and other health careproviders in New York, and the chil-dren's health program fails to providecoverage for more than 4 million chil-dren. It denies American workers basicworkplace protections, and it will hurtseniors and their families who dependon quality nursing care.

And this bill violates the basic repro-ductive rights of American women.Tucked away in the fine print of thislegislation is an extreme provision, theHyde amendment, that would perma-nently, for the first time, prohibit theuse of Federal funds for abortion. Thispunitive prohibition would preventmillions of lower income women fromobtaining vital reproductive healthservices and would personally create atwo-tiered health care system.

We must not allow this to occur. Fed-eral health programs must cover thefull range of reproductive health careservices, including abortion. This abor-tion restriction was not in the budgetdeal, and it should not be in the budgetbill. We must not allow the Repub-licans to use the budget process toenact their radical anti-choice agenda.Again, the abortion restriction was notin the budget deal; and, therefore, itshould not be in this budget bill.

I urge a 'no' vote on this legislation.Mr. SHAYS. Mr. Speaker, it is my

pleasure to yield 3 minutes to the gen-tleman from Oklahoma, (Mr. J.C.WAITS].

Mr. WATTS of Oklahoma. Mr. Speak-er, I rise in support of the BalancedBudget Act of 1997. We have a historicopportunity to come together in a bi-partisan fashion and deliver on ourpromise to the American people tohave a balanced budget by the year2002.

As we debate this today, there aregoing to be people on the left and rightarguing and bickering about programsthat they want added or taken out, butwe cannot allow this to divert our at-tention from the big picture. This isthe first balanced budget in over 30years. And it is interesting, it is thefirst tax cut in 16 years; and it is evenmore interesting that Tiger Woods was5 years old the last time we had a taxcut.

We always hear, and we will continueto hear today, that the rich are getting


the tax breaks. Let me tell my col-leagues, as it has been said: 76 percentof our tax cut goes to people makingfrom $25,000 to $75,000 a year. Let metell my colleagues: Somebody making$75,000 a year in America that has twokids, they are working from paycheckto paycheck, trying to meet theirmonthly responsibilities.

We keep hearing that we are gettingtax cuts for the wealthy industries,wealthy businesses in America. Over 90percent of the businesses in the FourthDistrict of Oklahoma employ six peo-ple or less. These people are ravingabout this budget deal because theyknow they are going to get some relieffrom the ridiculous tax policies, theserepressive and aggressive tax policiesthat we passed over the last 25 or 30years.

When I came to Congress, I promisedthe people of the Fourth District ofOklahoma I would work to make Gov-ernment live within its means, justlike all the working families in Okla-homa and across the Nation must doevery month.

I have five kids who I am trying toteach how to be responsible, and Iknow they are always watching theirdad to try to see if he practices whathe preaches. So today, when I cast myvote for fiscal responsibility and bal-ancing the budget, I am showing mykids that I am serious.

Balancing the budget is the rightthing to do. And if every Member inthis Chamber does not vote to balancethe budget because it is the responsiblething to do, then do it for your chil-dren so they will not have to inherit anAmerica as pathetic as it is today,where you have got working familiespaying from 48 to 52 cents of every dol-lar they make in some Government taxor Government fee. Do it so the 5- and6-year-olds out there will not have tospend 80 to 84 cents of every dollar theymake in some type of Government taxor Government fee by the time theyare 25 years of age.

My father taught me at an early agethat you cannot spend out more moneythan you take in, and he said this: Ifyour outgo exceeds your income, thenyour uplift will come to a downfall.That is pretty good advice to remem-ber as we debate the balanced budgethere today. It is advice I must follow inteaching my kids.

Friends, I urge everyone to supportthis balanced budget. It helps controlrunaway Washington spending savesMedicare. Only in Washington, DCcould an increase be a cut. It savesMedicare. We increase Medicare spend-ing and provide much-needed tax relieffor working families.

Ms. DELAURO. Mr. Speaker, I yield 3minutes to the gentleman from Mis-souri [Mr. CLAY].

Mr. CLAY. Mr. Speaker, I am notsure that there is a term in the vocabu-lary adequate to describe my level ofdisgust with this bill. The Republicanmajority began this process with pro-posals reported out of the Committee

June 25, 1997

on Ways and Means and the Committeeon Education and the Workforce thatrepresented the most pernicious as-sault on the working poor I have wit-nessed as a 29-year Member of thisbody.

In response to the chorus of outragethat rang out against those proposals,the majority fabricated window dress-ing to make their proposals seem moremoderate. But this new managersamendment, rewritten by the Commit-tee on Rules late last night, remainsunfair, immoral and unconscionable.

Mr. Speaker, I have three fundamen-tal objections to this bill. First, it es-tablishes a new class of workers whowould be treated like indentured serv-ants without coverage under the land-mark worker protection and civilrights laws. Second, it concocts ascheme of watered-down grievance pro-cedures and remedies that wouldrender millions of workers unprotectedfrom discrimination and exploitation.And finally, Mr. Speaker, it endangersthe job security and financial well-being of millions of current public sec-tor employees by establishing a weakset of nondisplacement protections.

Here is why this proposal treats poorworkers like second-class Americans.It denies so-called community serviceparticipants employee status andpurports to use the old CWEP Programas precedent. But that program wasquite different from the workfare pro-gram established in this proposal.Whereas that program had a strongtraining element, the community serv-ice program established by this pro-posal is work, pure and simple.

Community service workers will beemployees in every sense of the term.They will sweat like other workers,their children will get sick just likethe children of other workers. Andthese workers have dreams and aspira-tions for their families just like otherworkers.

But this proposal says no, they arenot the same and they do not deservefull respect and dignity. Although theywill be employed to perform the sametasks performed by other workers,these welfare workers will be deniedthe protection of the Fair Labor Stand-ards Act, the Occupational Safety andHealth Act, the Family and MedicalLeave Act and the many other impor-tant Federal laws. And those employedby nonprofit private sector employerswill be denied the right to organize orbargain collectively.

The grievance procedures establishedin the rewritten proposal are a house ofcourts, substantially weaker than pro-tections adopted by the Republicans onthe Committee on Education and theWorkforce. There is no provision to en-sure that the grievances will be fairlyheard and adjudicated. In a real blowagainst due process, there is no appealfrom what may well turn out to be akangaroo court.

Here is an example of how outrageousthese grievance procedures are. A womanwho has been sexually harassed may be re-quired to seek redress from the very agency

June 25, 1997where the harassment occurred. Under thisproposal that woman would not be entitled toa fair hearing, or the right to appeal an ad-verse decision. What have poor women doneto deserve such indignity?

Finally, protections that were included in theeducation and work force proposal to ensurethat community service workers are not usedas pawns in a ploy to displace existing work-ers have been gutted by the managersamendment. As reported by the Committee onEducation and the Workforce, a welfare work-er could not be assigned to an equivalent jobif another individual was on layoff status. Thatprotection has now been effectively stripped.As reported by committee, a welfare workercould not be assigned to a job if a con-sequence of that assignment was the partial.displacement of an existing worker. Thoseprotections have also been deleted.

Mr. Speaker, this legislation is nothing shortof a bill of exploitation that will leave workersmore vulnerable to racism, sexism, and unsafeworkplaces. Rather than encouraging work,these provisions demean workers. I urge itsresounding defeat.

Mr. SHAYS. Mr. Speaker, I yield 3minutes to the gentleman from Texas[Mr. ARCHER], chairman of the Com-mittee on Ways and Means.

Mr. ARCHER. Mr. Speaker, I thankthe gentleman from Connecticut [Mr.SHAYS] for yielding me the time.

Mr. Speaker, today marks a greatand a historic day. We are poised tovote on a matter that unites Ameri-cans from all generations. We standready to vote on a bill that brings theAmerican people together like no otherlegislation before us.

With this vote, we can balance thebudget to save the next generationfrom the crushing burden of debt, andwe can save Medicare from bankruptcyso this generation of seniors can livetheir retirement years in peace, com-fort, and security. It is high time thatWashington put the needs of the Amer-ican people first, and that is what wewill do with this vote.

This legislation is bipartisan. Ourplan to save Medicare was supported inthe Committee on Ways and Means bya 36 to 3 vote. We came together, likethe American people want us to do. Wewill save Medicare by giving seniorschoices, by fighting fraud and abuse,and we even expand Medicare's benefitsto include new preventive programsthat seniors, particularly women, needand deserve.

We help people move from welfare towork by reinforcing the central mes-sage of last year's welfare reform law:If you are able to work, you shouldwork. Welfare should not be a way oflife. Yes, we made changes in lastyear's law. Many of the changes wererequested by the President. But I amproud to say we uphold our Nation'svalues by helping people earn a pay-check instead of a welfare check.

I am particularly pleased that withthis bill we will finally have a balancedbudget. My 12th grandson was born lastyear, a little 2-pound premature baby.And when I looked at him in that incu-bator, I realized that when he grows up,


his pro rata share on the national debtwould be $189,000 during his lifetime.

It is unconscionable for our genera-tion to leave that to our children andour grandchildren. And, for once, wewill finally move toward a balancedbudget and stop this continued in-crease in debt service charges for fu-ture generations.

Mr. Speaker, I yield back the balanceof my time.

Ms. DELAURO. Mr. Speaker, I yieldmyself 10 seconds. -

Mr. Speaker, the fact of the matter isthat this spending bill takes away hos-pitals and nursing homes, reasonableand adequate reimbursement. Medicaresolvency comes up 2 years short of thebudget agreement. And there are deepcuts in the disproportionate sharewhich adversely affect hospitals acrossthis country. We are not improving thehealth of people in this country.

Mr. Speaker, I yield 2 minutes to thegentlewoman from New York [Ms.VELAzQUEz].

(Ms. Velázquez asked and was givenpermission to revise and extend her re-marks.)

Ms. VELAZQUEZ. Mr. Speaker,today we will vote on the Republicanspending bill. The Republicans will saythat this is a middle-class budget. Donot believe it for a minute.

In fact, the Republicans are financingtax cuts for the rich by waging war onworking families and legal immigrants.And when they talk about a balancedbudget, they do not finish the sentence.They should add that they are bal-ancing the budget on the backs of legalimmigrants and working families inour country. Not only that, but theyare violating the terms of an agree-ment that they made to the President,the Democrats, and to the Americanpeople.

The Republican tax plan will give$27,000 in tax breaks to the wealthiest 1percent. At the same time, they wantto eliminate benefits to legal immi-grants who become disabled in the fu-ture. These are people who haveworked hard, raised families, and paidtaxes. These are American values andthey are values that immigrants tothis country hold dear to their hearts.

Disability benefits are not handouts.How many times do we have to saythis?

0 1445This is an issue of basic fairness. This

budget agreement creates a huge dou-ble standard that will permit immi-grants to be treated like second-classcitizens. Why? To pay for huge taxbreaks for the wealthy. Is that whatthis country is all about? Is that how ajust society treats its elderly who be-come disabled? Is that the message tosend to the rest of the world?

Mr. Speaker, this budget is really adisaster. It is cruel, it is unfair, andthe American people will not stand forit.

Mr. SHAYS. Mr. Speaker, I ask unan-imous consent to allow the gentleman

H4561from California [Mr. THOMAS] to con-trol and yield as he may choose thenext 12 minutes of our time.

The SPEAKER pro tempore [Mr.DREIER]. Is there objection to the re-quest of the gentleman from Connecti-cut?

There was no objection.Mr. THOMAS. Mr. Speaker, I yield

myself 2 minutes.Mr. Speaker, as we carry on what I

guess passes for normal debate aroundhere, I think we probably ought topause for just a moment and not letour partisan juices flow quite as freelyas they do sometimes, because quitefrankly, the Medicare provision in thisbill is remarkable. It is remarkable fora number of reasons, but I think pri-marily because it sets a standard forwhat I believe ought to be the way inwhich we work public policy.

The Medicare Program is as impor-tant as any policy that the FederalGovernment has. It is more importantthan cheap partisan shots. Trying toresolve one of the more difficult prob-lems that faces all of us and, more im-portantly, the seniors in this countryis important.

I think we have all come to the gen-eral agreement that people willconsume as much health care as otherpeople are willing to pay for. If in factthat is true, and I think we believe itis, our Medicare Program is clearly introuble. Bankruptcy was facing it:With an antiquated and out-of-date de-livery system, especially with the rapidchanges that are occurring in the pri-vate sector health care delivery systemand the fact that some of the programsthat we offer are as old as the bureauc-racy that structured it; that is, we waituntil people are sick before we dealwith the problem instead of moving ag-gressively into preventive care andwellness.

This measure, passed by the Commit-tee on Ways and Means and by the Sub-committee on Health, unanimously bythe Subcommittee on Health, moves, Ithink, aggressively in the area of pre-vention, aggressively in the area ofwellness, aggressively to address thequestion of bankruptcy, and aggres-sively to open up the system to achoice for seniors.

Mr. Speaker, I yield 2 minutes to thegentleman from California [Mr.STARK]), the ranking member of theSubcommittee on Health.

(Mr. STARK asked and was givenpermission to revise and extend his re-marks.)

Mr. STARK. Mr. Speaker, I want tosay on behalf of myself and many ofthe committee's Democrats that wewould like to commend the gentlemanfrom California [Mr. THOMAS], the fullcommittee, and the Subcommittee onHealth's staff director Chip Kahn foran open and consultative and biparti-san approach to the Medicare legisla-tion. It is really a model, I suspect, ofhow the legislation should be written.

I am not sure I can quite make my-self say that it is a model of legisla-tion, but it was done in a tradition of

H4562past Medicare bills. It extends the lifeof the Medicare trust fund to 2007, itmakes reforms in the way we pay pro-Vviders, and it indeed adds some bene-ficiary improvements. I do not intendto vote for the budget bill, but it is notbecause of the Medicare portion. Ifanybody was thinking of that, I woulddissuade them otherwise.

There are some things we shouldstrongly oppose and do differently. Weshould oppose the Senate's provision toraise the age to 67, which causes moreproblems I think than it solves. I thinkwe should oppose the Senate's copayprovisions because we already chargeTiger Woods on $10 million, $300,000 ayear for the same premium that some-body at $10,000 a year would pay $300for and get the same benefit. Why pun-ish Tiger Woods twice?

The managed care provisions needconsumer protections on emergencyappeals, and there are some antifraudprovisions that we should add. We aregoing to see a report in the next fewweeks that we are spending $20 billion,I think, on fraud. That needs to be im-proved. We can do that.

Mr. Speaker, I would urge my col-leagues to applaud the work that wasdone. I would not have picked $115 bil-lion as a cut, but that was the numbergiven to our subcommittee and, consid-ering that, they did a fair job of spread-ing those cuts to do the least amountof harm. Nobody liked it. If anybodyhad been smiling in the room, we prob-ably would have had the wrong bill.But it was a good job, and I commendthe chairman of the subcommittee forhis work.

Mr. THOMAS. Mr. Speaker, I yield 2minutes to the gentlewoman from Con-necticut [Mrs. JOHNSON], a valuablemember of the subcommittee.

Mrs. JOHNSON of Connecticut. Mr.Speaker, let me commend the gen-tleman from California [Mr. THOMAS]for bringing forth a very thoughtful,constructive and bipartisan bill out ofthe subcommittee. It meets the goalsof the budget resolution of extendingthe life of the Medicare Trust Funduntil 2007, but it also makes soundstructural changes to better controlcosts in the Medicare Program whichwill be especially important when thebaby boomer generation begins to re-tire in 2010.

It increases spending per Medicarebeneficiary from $5,480 this year to$6,911 in 2002. Most importantly, itgives Medicare recipients betterchoices of the kind of insurance cov-erage they want to select. It gives bet-ter choices and it gives better benefits.It has a good, solid preventive package,annual mammograms, comprehensivetesting opportunities for prostate can-cer. and adopts the prudent layperson'sstandard for emergency room care. Soit guarantees access to emergencyroom care.

It also guarantees seniors who wantto try a managed care plan that theycan go back to not only Medicare butto their MediGap policy, thereby guar-


anteeing them the opportunity to trythe kinds of plans that will provide farmore benefits for the Medicare dollar.

Finally, it strengthens the protectionfor those who choose Medicare bystrengthening the consumer protectionpackage that governs Medicare man-aged care plans, providing more timelyappeals procedures and in other waysstrengthening those benefits. Equallyimportantly, it provides the oppor-tunity for direct providers of services,doctors and hospitals, to get togetherand provide a managed care plan forthe seniors in their area, a plan inwhich the medical decision will be to-tally controlled by the medical provid-ers. This will guarantee better qualityin all managed care systems, whetherthey are provider sponsored or whetherthey are insurance company sponsored.This is a giant step forward for healthcare for seniors in America.

Mr. SPRATT. Mr. Speaker, I yield 3minutes to the gentleman from NewYork [Mr. RANGEL] the ranking mem-ber of the Committee on Ways andMeans.

(Mr. RANGEL asked and was givenpermission to revise and extend his re-marks.)

Mr. RANGEL. Mr. Speaker, this isone of the most important periods, Ithink, in our Nation's history, becauseit gives us an opportunity to reflectwho we are and what made this Nationso great. I think the test is, how do wewho are newcomers to this continenttreat those who are even more new? Aswe move into world trade, our greatestasset is the diversity, because with theexception of the Native American, wehave the benefit of all of the culturesof the entire world in this great coun-try, and I am fortunate to have a lot ofit in my great city of New York.

How many of my colleagues justenjoy thinking about how generationsago, from whatever country, whether itwas in Europe or some other country,we had relatives who came to thiscountry, many not with a lot of edu-cation or a lot of wealth but they camewith a lot of hope. Many of them cameillegally because we did not have thesophisticated way of checking. But weare not looking for them. Becausethose who came had on the docks peo-ple who came before them waving andscreaming saying that these people aregoing to make a contribution to thisgreat country. Even those of us whocame in chains are saying, 'This is agreat country." Even the Native Amer-icans are not asking to leave. It is agreat country.

But with each wave that came, therewas some group of people that wantedto hurt them. Ask the Jews, ask thePolish, ask the Irish. Ask the Italians.There was some group that came herethat said the next group was not goodenough. Because we Americans are sogood in our thinking, we do not askwho was that group that was stampingthe hands of those people who wereclimbing into America to become greatcitizens, but today the other side hasput for the record who they are.

June 25, 1997

We are now saying if you come tothis country, play by the rules, come inand you were working, coming in youhad a sponsor, you did everythingright, the sponsor died, you got old,you had an accident, we are saying,"You didn't come when our parents orgrandparents came, so now we'rechanging the rules.'

My colleagues are not changing therules by this Congress for the UnitedStates of America, and my President,who represents Republicans and Demo-crats, today's history and tomorrow'shistory, is going to say, "We're notgoing to change these rules to save acouple of dollars to throw into capitalgains indexing." What we are going todo is to make certain that anyone whowants to come to this great countrywill be able to come with the samerules and the same protections as forthose who came and made this Nationso great.

H4566 CONGRESSIONAL RECORD — HOUSE

Mr. SHAW. Mr. Speaker, I yield my-self 30 seconds.

Mr. Speaker, there have been severalspeakers who have come to the floor onthe other side of the aisle who have, Iam sure unintentionally, misstatedwhat this bill says. I would like to sayto them in the area of discriminationthat people coming off of welfare cer-tainly are not discriminated against.In fact, they are protected by title VIof the civil rights bill, which reads, andwhich is incorporated into the law,that "No person in the United Statesshall, on the ground of race, color, ornational origin, be excluded from par-ticipation in, be denied the benefits of,or be subjected to discrimination underany program or activity receiving Fed-eral financial assistance."

June 25, 1997

Mr. Speaker, I yield 3 minutes to thegentlewoman from Washington [Ms.DUNN], a member of the Committee onWays and Means.

Ms. DUNN. Mr. Speaker, I am pleasedto speak in support of the provisions inthe Balanced Budget Act thatstrengthen the welfare reform lawsigned into law last August by ourPresident. We have made several im-provements to our new welfare system,improvements that reinforce the valueof work, not the dependence on welfare.

These changes also reflect a good-faith compromise that was made withthe President on the transition fromwelfare to work for noncitizens. Ournew bill maintains our basic policy onthe matter of welfare and workfare fornoncitizens as a policy that is based onthe belief that taxpayer-funded assist-ance should be reserved for people whoare citizens of the United States.

The budget reaffirms that people whocome to America will be welcome topursue the opportunities of our greatNation, but not to go on welfare. Weencourage those individuals to seeksupport not from the taxpayer butfrom their relatives and their sponsors,as has long been the law in this Nation.

We came to a compromise, Mr.Speaker, on the issue of benefits for el-derly and for disabled noncitizens whowere already receiving assistance be-fore the welfare reform bill was passedlast August. To them this bill says:You will not be asked to play by dif-ferent rules. The rules of the game willbe the same. If you were in a nursinghome on August 22, 1996, you will re-tain that benefit. If you were receivingSSI last August 22, you will continueto receive that assistance.

We have set $9 billion aside, and Iwill make that loud and clear; nonciti-zens getting benefits on August 22, 1996,are grandfathered, period.

In the era of the minimum wage, weguarantee that those on workfare willreceive the minimum wage, but we alsobelieve in calculating this minimumwage that food stamps as well as cashbe considered. That total will deter-mine how many hours of work a personwill work.

The bill also includes a $3 billion wel-fare-to-work grant which specifically istargeted to the hardest hit. Thismoney will be provided to areas withthe highest concentrations of poverty,unemployment, and people on welfare.This grant truly will focus resources onthe areas most in need. This is newmoney since last year's bill was signed,and it is another effort to get welfaremoney to people who truly need thesedollars.

Mr. Speaker, I urge my colleagues tosupport this budget.

Mr. SPRATT. Mr. Speaker, I yield 2minutes to the gentleman from Florida[Mr. DAVIS].

Mr. DAVIS of Florida. Mr. Speaker, Irise in qualified support of the budgetresolution. As a member of the Com-mittee on the Budget, I have workedhard with the gentleman from South

June 25, 1997Carolina [Mr. SPRATT] and others totry to conform the budget resolution tothe budget agreement, and to strikethe balance between protecting our Na-tion's priorities and securing a reason-able approach toward a balanced budg-et. The budget agreement in fact did dothat.

Unfortunately, the agreement justbarely does that now. It still continuesto balance the budget, and I will votefor it today for that reason, because italso protects our most important prior-ities. We are dangerously close to un-raveling this agreement because ofmany extraneous matters that havebeen inserted in it, including sOme ofwhich were specifically agreed not tobe pursued as part of the budget agree-ment.

Let me share with the Members twoof the more egregious examples. One isthe alterations to the Federal LaborStandards Act that have been dis-cussed, that have the effect of reducingpeople who are moving from welfarefinto work to second-class citizens interms of some of the protections weotherwise afford to employees.

The second provision, which was spe-cifically agreed not to be included inthe budget agreement, was to treatlegal immigrants differently with re-spect to eligibility for disability bene-fits. These are two provisions thatmust be fixed in the conference com-mittee in order for this budget agree-ment, in order for the Budget Rec-onciliation Act, to pass.

I will vote for it today, but let us notrepeat the same mistakes we made onflood relief. Let us not load up whatotherwise could be a good bill with un-related matters that will have the ef-fect of forcing a veto and taking us offtrack.

Mr. Speaker, I rise in qualified support ofHR. 2015, the entitlement reform portion ofthe budget reconciliation package. I stronglysupported the budget agreement and the reso-lution we passed last month. I believe thatagreement represented a fair compromise anda good first step in restoring fiscal sanity toour Federal budget process. Now, a little overa month later, with the details of the plan filledin, there are serious questions whether certainprovisions in the bill before us today violateboth the spirit and the letter of the agreement.

Last Friday, I vote,d for this bill, in commit-tee, with the clear understanding that a man-ager's amendment would be offered to fixmany of the most egregious shortcomings inthe bill. Some of them, such as the protectionof low-income Medicare beneficiaries, the ex-pansion of children's health coverage, and theminimum wage security for participants inworkfare, have been modified. Unfortunately,critical differences have not yet been resolvedon a range of issues including the restorationof benefits for legal immigrants—which wasexplicitly included in the agreement—and theapplication of all Fair Labor Standards Act pro-tections to workfare participants.

am concerned that we are again set toplay politics and brinkmanship on an issue ofvital importance to the American people. Lastmonth, Congress loaded up the disaster sup-plemental appropriations bill with extraneous


provisions the President was certain to veto.After weeks of delays, causing serious prob-lems for the flood victims, we finally stoppedthe wars of rhetoric and posturing, and sentan appropriate bill to the President.

Now I am concemed that a similar mistakewill be made on the balanced budget agree-ment—trying to push the President into a cor-ner by adding extraneous items which have noplace in a deficit reduction package. For ex-ample, medical malpractice reform is a seriousissue which warrants serious considerationoutside of this reconciliation bill but which onlyjeopardizes the chances that this package wiltultimately be enacted into law.

Ultimately, I believe these issues will be ad-dressed in the conference committee, the nextstep for this bill, and I will support the packagetoday as a recommitment to the goals of thebipartisan budget agreement and in an effortto move this process forward to conference.My hope is that by the end of the conference,we will all be able to enthusiastically supportthe reconciliation bill representing both the let-ter and the spirit of the historic bipartisanagreement.

Mr. SHAW. Mr. Speaker, I yield 2minutes to the gentleman from Penn-sylvania [Mr. ENGLISH], a very valuablemember of the committee.

Mr. ENGLISH of Pennsylvania. Mr.Speaker, I thank the gentleman foryielding time to me.

Mr. Speaker, I rise in strong supportof the Balanced Budget Act, in part be-cause this legislation contains a vital$3 billion welfare-to-work grant pro-gram to create a path for long-termwelfare recipients to enter the workforce. For welfare reform to work, wehave to give the States and the local-ities the flexible tools they need toprovide a transition for people to leavewelfare, to escape the poverty trap, andto enter the mainstream of the Amer-ican economy. This program, developedin the Committee on Ways and Means,doesjust that.

Mr. Speaker, the focus of this fund-ing is on areas with the highest con-centrations of poverty, unemployment,and welfare enrollment, so resourceswill be available to those areas withthe greatest need. We know we do nothave sufficient programs for incentivescurrently to help welfare recipientswith little work experience success-fully enter the work force. This pro-gram, coupled with the expanded workopportunity tax credit and the newwelfare-to-work credit contained in thetax section of our budget, create realopportunities for the able-bodied poorto participate in the productive econ-omy. It will encourage State policycreativity in developing local solutionsto move people from welfare to work.

There is also a strong workfare provi-sion in this bill. Just to remind thefolks on the other side of the aisle, itcontains protections for minimumwage. It contains protections for the40-hour work week, for antidiscrimina-tion legislation, protections for healthand safety, protections for nondisplace-ment and a grievance procedure. To lis-ten to the speeches on the floor thismorning, we would think they have notread the bill.

H4567Mr. Speaker, I urge all of my col-

leagues on both sides of the aisle, espe-cially those representing depressedurban communities, to support thislegislation and provide the assistancetheir constituents need to get out ofthe welfare trap.

Mr. SPRATT. Mr. Speaker, I yield 2minutes to the gentleman from NorthDakota [Mr. POMEROY].

Mr. POMEROY. Mr. Speaker, I thankthe gentleman for yielding time to me.

Mr. Speaker, I intend to support thebill before us, although I find it to be adisappointingly close call. We are earlyin the legislative process on actuallycarrying through this historic balancedbudget agreement reached earlier be-tween congressional leaders and thePresident, and affirmed earlier by thisChamber in the budget resolution. Nowthat we get down to the actual businessof the legislating language, I find thatthe package before us substantiallycarries forward the agreement and theresolution, getting us on a balancedbudget footing. Unfortunately, it fallsshort of the guarantees explicitly thatare part of the agreement, like thecommitment to extend coverage tochildren.

In other areas, totally nonbudgetitems are jammed onto this bill, muchlike the nondisaster aid items that be-deviled us so in trying to get relief tothe flood-stricken areas for weeks.

An area here that I find most dis-turbing is the expansion of portabilityand health insurance coverage Act,known as EPHIC. It is the old multipleemployer welfare arrangement rejectedin the last Congress, that has againbeen jammed into this bill. This provi-sion, if ultimately enacted, would de-prive ultimately millions of people inthe workplace from their State-pro-vided consumer protections in dealingwith health insurance. Do we thinkthat is a good idea? I certainly do not.But it is an important concept that, atleast, would warrant debate.

When I went to the Committee onRules to seek, along with a Republicancolleague, a stand-alone debate on thisnonbudget item, in the context of thisact, we were not allowed it. It is a clas-sic case of taking a policy nugget unre-lated to the budget and jamming itinto the bill. As far as I am concerned,this is a deal-breaker, and I will voteagainst the bill coming out of con-ference committee if it looks like thebill before us.

But we are not at that point in time.It is important to keep the processmoving, and therefore, I urge a 'yes"vote.

Mr. SPRATT. Mr. Speaker, I yield 1minute to the gentleman from Min-nesota [Mr. MINGE].

Mr. MINGE. Mr. Speaker, the legisla-tion now moving through this body isunsettling to most of us. It is marketedby many as the path to balance thebudget. Indeed, it appears we are morelikely to balance the budget with thislegislation than without it. However, Iwould like to emphasize, it is a close

H4568call. We should be humble when wetalk about the legislation.

To move the process ahead to con-ference, to show support for the Presi-dent, to demonstrate bipartisanship, Iwill vote for the bill. But let me addsome caveats.

First, we need strong enforcementmechanisms in all legislation that af-fects the budget. Second, we must stopusing the Social Security trust fund tomask the size of the deficit, and recog-nize the long-term train wreck thatawaits us with the Social Security sys-tem if we do not aggressively move tofix it.

Finally, we must try harder. Wemust avoid exploding tax cuts, we mustnot give blank checks to programs, wemust limit our appetite for weaponssystems. This legislation is one smallstep in the political process. Let usmove the process ahead.

Mr. SHAW. Mr. Speaker, I yield 3minutes to the gentleman from Ari-zona [Mr. HAYWORTh], a valuable mem-ber of the Committee on Ways andMeans, and a member of the Sub-committee on Human Resources.

0 1545Mr. Speaker, I thank the subcommit-

tee chairman for yielding me the time.Mr. Speaker, I would invite those

who control the television cameraswhich broadcast these proceedingsfrom coast to coast and around theworld to take the proper perspective asI address in this well one of the dangerswe face from those who would opposethis reconciliation act, one of the dan-gers we face from those who continueto distort what is at stake for theAmerican people.

Mr. Speaker, I hold here H.R. 3734,one of the crowning achievements ofthe 104th Congress. Mr. Speaker, it isthis bill that took the important stepsin the 104th Congress to change welfareas we knew it, to move people fromwelfare to work.

Mr. Speaker, the danger in opposingthe provisions that the new majorityoffers in this act would have the effectof taking this important piece of legis-lation and throwing it away, droppingit into the trash can, radically chang-ing the intent of what transpires.

Good people can disagree. I will offera perspective that needs to be heard,Mr. Speaker, by the American peopleand especially those who continue tochampion the endless expansion of ben-efits and the destruction of welfare re-form. Let me offer a real story from areal State, the 48th State in this Na-tion, the one that I represent, Arizona.

Let me quote to my colleagues theperspective of the Arizona Departmentof Economic Security director, LindaBlessing, in talking about the old wel-fare programs, "The status quo was notcutting it," and to further quote fromher statement, 'We handcuffed peopleinto dependency."

Mr. Speaker, the facts are that wehave moved in a successful, deliberate,commonsense fashion to move people


from welfare to work. More than 38,000welfare recipients have dropped off theroles in Arizona since 1994, when theheight of the enrollment in our Statein that year was 195,000. The taxpayer-supported welfare program in Arizonahas helped 23,000 recipients find neededemployment training, placed 6,800 re-cipients in jobs, that is an increase of1,000 recipients from last year.

We need to continue the successfultrend, allow States like my home Stateof Arizona to work with the $3 billionwelfare-to-work grant to move yetmore families from welfare to work.What we provide for this, this legisla-tion does so because we have listenedto the Governors. We have improvedthe legislation. We have expanded edu-cational benefits. We have taken acommonsense approach. The FederalGovernment, along with State govern-ments, both made great strides withthe welfare reforms passed last year.Now is the time to provide those Stateand local governments with flexibility.Do not trash welfare reform; build onit. Adopt the resolution.

Mr. SPRATT. Mr. Speaker, I yield 30seconds to the gentlewoman fromTexas [Ms. JACKSON-LEE].

Ms. JACKSON LEE of Texas. Mr.Speaker, what my good friend from Ar-izona fails to acknowledge is that wel-fare reform in its best sense was bipar-tisan of Democrats and Republicans.What this spending bill does is takesthe rights away from working welfarepeople, does not provide them with pro-tections of fair labor standards laws,does not provide them with protectionagainst sexual harassment, does nottreat them as workers who get equalpay for equal work. That is why we areagainst this spending bill, because itdishes the welfare reform that we puttogether in a bipartisan Congress. I amashamed of what is coming about inthis pending bill.

Mr. SPRATT. Mr. Speaker, I yield 3minutes to the gentleman from Michi-gan [Mr. DINGELL] ranking member ofthe Committee on Commerce.

(Mr. DINGELL asked and was givenpermission to revise and extend his re-marks.)

Mr. DINGELL. Mr. Speaker, I com-mend my good friend for the fine workwhich he has done on this very impor-tant subject. I had voted for the priorresolutions on this matter. I regret Iwill not be able to do so.

This budget suffers from a number offatal defects, the most important ofwhich, it breaches agreements con-tained in the earlier budget resolutionand it will not achieve a balancedbudget. There are a number of defectswith regard to medical savings, withregard to moneys which should betterbe spent for preventive care such asmammographies, prostate cancerscreening, and more. The bill treats theyoung people of this country poorly. Itwill not achieve a balanced budget. TheCommittee on Rules put in sweepingamendments to the section on spec-trum auctions that have completely

June 25, 1997

gutted taxpayer protections that wereincluded in the Committee on Com-merce's recommendations.

Our committee made sure that thepublic's assets would not be sold at firesale prices by permitting spectrumauctions to be canceled if they did notraise a minimum amount of revenue.The policy changes included in this billwere rejected by the Committee onCommerce members, and for good rea-son: they do not protect American tax-payers. Indeed they do great harm tothem.

My colleagues need to know one issueof permanent and paramount impor-tance. A sizable portion of this budgetbill is held together by sham and fraudconsisting of phony revenue assump-tions about the value of spectrum auc-tions. We know that the revenue as-sumptions here are phony. We haveseen them before.

Last September Congress ordered aspectrum auction for the sole purposeof plugging a revenue gap. CBO esti-mated that the auction would raise $1.8billion. Instead the auction producedjust $13 million, less than one penny onthe dollar. One speculator won theright to serve four States for a total of$4. It appears that the Committee onthe Budget, like the Bourbons ofFrance, have learned nothing from thisand forget nothing also.

The evidence shows that the marketfor radio spectrum is saturated and de-mand is at an all-time low. Yet we are,under the aegis of the Committee onthe Budget, proceeding to rush forwardto sell out spectrum for pennies on thedollar under a pretense that it will bal-ance the budget. In fact, it will not.The money is not there and we arelooking at further deficits because ofthe fact that we have lied to ourselves,lied to each other, and lied to theAmerican people.

Even the FCC chairman says his en-gineers cannot identify where at leasthalf the spectrum will come from andthat they have no idea how this will beaccomplished. We have also learnedthat some of the spectrum identifiedfor auction in this bill is currentlyused by the FAA. We can be sure thenthat this proposal will jeopardize thehealth and the safety of the flying pub-lic.

Beyond this, the GAO report says op-erations like Desert Storm could be se-verely impaired by the auction of radiofrequencies. Can the Committee on theBudget or the Committee on Rules as-sure members of this committee thatthe bill will not have a disastrous ef-fect on the viability of the Nation'smilitary operations? Put your exper-tise against the GAO, which says thatthis puts our national defense effort atsevere risk.

The losers here are going to be theAmerican taxpayers who are not onlybeing misled but who will continue toface a continued mounting budgetarydeficit because of a phony set of as-sumptions and a doomed-to-fail policyon spectrum auctions.

June 25, 1997Mr. SHAW. Mr. Speaker, I yield my-

self such time as I have remaining.The SPEAKER pro tempore (Mr.

DREIER). The gentleman from Florida[Mr. SI-lAw] is recognized for 4 minutes.

Mr. SHAW. Mr. Speaker, a year ago,approximately a year ago, I stood atthis microphone in support of welfarereform, a most historic bill.

The gentlewoman from Texas a fewmoments ago said that she supportedit. If we look at the voting records, shedid not. She voted against it.

Ms. JACKSON-LEE of Texas. Mr.Speaker, will the gentleman yield?

Mr. SHAW. No, I will not, Mr. Speak-er.

But I would like to give her the goodnews, that since welfare reform, since1995, in the State of Texas the welfarerolls are down 24 percent. That is un-heard of. It is unprecedented in the his-tory of this country. Welfare reformhas done more for the poor, the needy,than any piece of legislation that hasever come out of this Congress. And letthere be no mistake about it. Thosefigures are out there and they are na-tionwide. Nationwide. It has been a tre-mendous success.

When I stood here a year ago I saidthere was still much work to be done.There were corrections to be made. Iwant to do away with some of the rhet-oric and some of the misinformationthat has been on this floor today. Wedo not provide or allow for in this billany discrimination about people com-ing off of welfare. On unemployment,the people that are going into the pri-vate sector, they have all of the protec-tion that any of the workers in thiscountry have. Those that are workingfor their benefits, they have the protec-tion against discrimination. However,there are a few protections they do nothave. When their benefits run out, theycannot start collecting unemploymentcompensation. They do not have theFICA contributions. Those are thingsthat there is disagreement in this con-ference about. I recognize that, but Imust say to the Speaker and to my col-leagues that once they get into the pri-vate sector, there is no difference be-tween them and any other worker.

Ms. JACKSON-LEE of Texas. Mr.Speaker, will the gentleman yield?

Mr. SHAW. No, I will not.Mr. Speaker, I would ask the Chair to

admonish the gentlewoman from Texasnot to interrupt me.

The SPEAKER pro tempore. The gen-tleman from Florida [Mr. SI-lAw] con-trols the time.

Mr. SHAW. Mr. Speaker, there is alsoanother area that I think that there isgreat misunderstanding, there is thepart referring to SSI for noncitizens.We have a genuine disagreement withth President. We thought we came upwith a better solution. The President'splan would call for 60 percent of non-citizens, the elderly, to come off ofSSI. We did not want to do that. Sowhat we did, we grandfathered in all ofthe noncitizens that were receiving SSIon August 22, when the welfare bill was


signed. We thought that was much fair-er than pushing them out and thenhaving them come back and prove thatthey were disabled, knowing thatroughly half of them would never getback on and they would lose their Med-icaid as well as their SSI payments.

This is very important. We thoughtours was the more humane way to go.The President thought it was best totake the elderly off and exchange theirbenefits to allow people that were hereon August 22 that might become dis-abled, most of them will not, but thosethat did become disabled sometime inthe future could get onto SSI. It is adisagreement we have, but it I mightsay in the full committee, after wemade our argument, no one even of-fered the President's plan. No one of-fered the Presidents plan in the Com-mittee on Ways and Means. Why? Be-cause they did not want to hear the ar-gument that they were throwing theelderly off. I do not blame them. Iwould not have offered it either.

Another area that I would like to dis-cuss is the area of minimum wage. Inthis bill, in a very bipartisan manner,we adopted the President's definitionof minimum wage. We say in deter-mination of minimurti wage whenworking for your benefits that the onlything that will be included is the cashpayments and the food stamps.

This is what the President wanted.This is what we gave to the President.This is a bipartisan bill and we havetaken a bipartisan attitude in workingwith many of the Democrats. I hopethat we get a good vote. Vote "yes' onthe bill.

The SPEAKER pro tempore. Thetime of the gentleman from Florida[Mr. SHAW] has expired.

Mr. PALLONE. Mr. Speaker, I yield 2minutes to the gentleman from Michi-gan [Mr. LEvIN].

(Mr. LEVIN asked and was given per-mission to revise and extend his re-marks.)

Mr. LEVIN. Mr. Speaker, I speak assomeone who supported the reform ofAFDC and I very much continue tosupport it. Let me address two issues.

The Fair Labor Standards Act. Ifavor moving people off of welfare towork. They should not be treated assecond-class citizens, and you do that.You take away the protection of theFair Labor Standards Act, and thenyou go back in, the States must pay aminimum wage. They do not have theprotection of Federal law. There is noclear enforcement, and you take awaythe protection against sexual harass-ment. Why? What do you do that for?

People should move from welfare towork. They should not be second-classcitizens. Period.

In fact, our hope is the opposite, tomaintain the dignity and the integrityof work. Legal immigrants: look, wedid not offer the President's proposal.We offered something that built onthat. It was turned down by one vote,even though there was the money thereto pay for it. The gentlewoman from

H4569Washington said, well, everybodyshould play by the same rules. No, youare asking people who were here Au-gust of 1996, who became injured afterthat, to play by different rules. Theyare out in the cold. That is an irra-tional, inhumane line. We should notbe drawing it.

I am going to vote against this bill inpart because I am hoping that we willindeed have Mr. SI-lAw, whom I verymuch respect, in a bipartisan effort towork out these problems in conferencecommittee. Do not treat anybody inthis institution as a second-class citi-zen and do not renege on the budgetagreement regarding legal immigrants.They were here legally. We should notdifferentiate people according to whenthey were disabled.

H4572Mr. BLILEY. Mr. Speaker, I yield

such time as she may consume to thegentlewoman from New Jersey [Mrs.ROUKEMA].

(Mrs. ROUKEMA asked and wasgiven permission to revise and extendher remarks.)

Mrs. ROUKEMA. Mr. Speaker, I ac-knowledge the commitment of the gen-tleman from Ohio, Chairman KASICH,to working out the DSH payments inthis bill.

Mr. Speaker, I rise in support of H.R. 2015,the Balanced Budget Act with reservations.

We are on the verge of passing legislationthat, for the first time in more than a genera-tion, will set us on the trail toward a balancedbudget. This goal of a balanced budget is notan abstract exercise that some economists or'green-eyed shade types" thought-up in someivory tower. It is an essential economic tool toget the savings and capital investment wedesperately need for research and develop-ment, and new plant and equipment to rebuildthe American economy; keep us competitive inthe global economy and create the good jobsat good wages we need for this generationand those to come. For these reasons I be-lieve we must keep this progress going withthe full expectations that the final conferencereport will get strong endorsement.

Tomorrow, we will take up the legislationthat will implement a genuine "Save and In-vest" in America program. Today, we fulfill thepromise we made to our children and grand-children to make this Government live withinits means.

So this debate today is about priorities.While I will support this legislation in order tokeep this important legislative process movingforward, I want the people of New Jersey toknow of my priorities and the improvements Ibelieve we need.

Mr. Speaker, there is much to be proudabout in this bill. In addition to the real spend-ing cuts that will move our budget into bal-ance, this legislation contains a new $16-bil-lion initiative on children's health.

We are right to target $16 billion to help in-sure children who are not insured. The onlyquestion remains over what will be done withthis money to achieve the goal of providinghealth care to children.

I rise today to remind you not to forget chil-dren's mental health as well as their physicalhealth. Both are components of children'shealth that cannot be ignored.

Any health initiative must have parity treat-ment of mental health coverage. Yesterday, inthe other body, an amendment passed thatwould require that any plan that included men-tal health benefits would provide those bene-fits in a nondiscriminatory manner. This shouldremain a part of this budget package.

On the negative side, I recognize that wemust have genuine entitlement reform. Medi-care is going bankrupt and this bill restores itssolvency for another 10 years while we debatea long-term solution to this pressing problem.

This legislation moves in that direction. Butwithout question, this area of savings raisesthe most concern, and I must state my healthyskepticism about how much can, or should, beaccomplished in the near-term.

I am deeply concerned about the Com-merce Committee provision of this bill thatcuts $16 billion in Federal Medicaid matchingfunds from the disproportionate share hospital


[DSH] payments. This could amount to a 17-percent cut in New Jersey in a vitally impor-tant program that serves our neediest patients.I am encouraged by the statement made dur-ing debate on the rule on this legislation bythe chairman of the Budget Committee [Mr.KASIcH], that this formula is unfair to New Jer-sey and other States and should be revised.I am looking forward to reviewing those revi-sions when this House considers the con-ference report on this bill.

We in New Jersey are also deeply con-cerned about the reductions in Medicare pay-ments for high Medicare hospitals—many ofwhich can be found in New Jersey—and theprospective payment system freeze for nextyear. These two provisions present seriousburdens for New Jersey health care providersand could significantly affect the quality ofcare in our State.

Mr. Speaker, there is very little long-termMedicare reform in this bill. I, for one, supportthe establishment of a Bi-Partisan Blue RibbonMedicare Commission—modeled after thevery successful Greenspan Commission onSocial Security in the mid-1980's—to makerecommendations for preserving and protect-ing this vital program, which the Congressshould enact confident that there is not anyhidden 'political agenda" to the recommenda-tions.

Mr. Speaker, I am very troubled that thisreconciliation package includes provision thatallows associations to offer health careplans—the provision added in the EducationCommittee by my friend from Illinois, Mr. FA-WELL.

This section of the reconciliation packageraises two concerns. The first concern is thefact that budget reconciliation is a totally inap-propriate forum for bringing forth such expan-sive legislation without proper analysis andopen discussion of such important concernsas fiduciary standards.

This provision does not offer sufficient pro-tection against fraud and abuse and containssolvency standards that are substantiallyweaker than most State standards. This posesthe risk of significant losses for both plan par-ticipants and providers when plans fail.

We are being grossly irresponsible by in-cluding a major revision of ERISA law in thismassive reconciliation bill.

My second concern is that this proposaldoes not help the health care situation in thiscountry, but actually damages the integrity andhealth of group insurance coverage while re-ducing protections for patients.

We must carefutly weigh the benefits of al-lowing associations the protections of beingcovered by national laws with the benefits ofallowing State laws to determine consumerprotections. While we do want to encouragecompanies to provide health care benefits totheir employees and enlarge the prospects forsmall businesses to pool for insurance pur-poses, we must respect the right of each ofthe States to regulate the insurance industrywithin their boundaries. This proposal will driveus inextricably to national managed health in-surance standards.

In other words, this legislation is significant,complex and perhaps one whose time hascome but not in a reconciliation budget pack-age.

This is no way to run a railroad or a legisla-tive body. I will make every effort to ensurethat this provision will be dropped in con-ference.

June 25, 1997

I am equally concerned that this legislationdoes not contain the strong budget enforce-ment mechanism introduced by CongressmenBARTON and MINGE. However, I will rely on thecommitment from the Republican leadershipthat we will have a vote on this important leg-islation in July and that, if successful, this leg-islation will become part of the reconciliationprocess.

That process will not be without difficulty,but as we prepare to enact legislation that bal-ances the Federal budget we should not kidourselves into thinking that it will be easy todo. At the same time, we should acknowledgethe terrible cost to our Nation if we do nothing.

Balancing the Federal budget is essential toprotect our Nation's long-term financial health,and to ensure that the country our childrenand grandchildren inherit is as great as theone our parents gave us.

Mr. BLILEY. Mr. Speaker, I yield 1minute to the gentleman from Penn-sylvania [Mr. GREENWOOD].

Mr. GREENWOOD. Mr. Speaker, Ithank the gentleman from Virginia[Mr. BLILEY] for yielding me the time.

Mr. Speaker, I rise with great enthu-siasm to support this reconciliationpackage. This is why I came to Con-gress, to balance the budget. Today is ahistoric day for this Congress. But Iwant to specifically refer to the chil-dren's health care package.

The previous speaker somehow ar-gued that children will be left uncov-ered by this bill as we in the Commit-tee on Commerce have crafted it. Tothe contrary, what we have done is cre-ated the flexibility that the Statesneed to provide Medicaid coverage, toprovide direct health insurance pur-chases, and to provide direct services.And for those who criticize the provi-sion of direct services, we must remem-ber that if we did not provide childrenwith direct health care services, thosechildren would get no health carewhatsoever.

We need to trust our Governors, weneed to trust our State legislators andallow them to meet the health careneeds of their children in the way thatbest suits their States' realities. I sup-port this package enthusiastically andencourage my colleagues to do so, aswell.

0 1615Mr. SPRATT. Mr. Speaker, I yield

such time as he may consume to thegentleman from New York [Mr. ENGEL].

(Mr. ENGEL asked and was givenpermission to revise and extend his re-marks.)

Mr. ENGEL. Mr. Speaker, I thankthe gentleman for yielding me thistime.

Mr. Speaker, I rise to oppose theBudget Reconciliation Spending Act.

While this bill contains fewer cuts than thedrastic social spending reductions the Repub-licans have demanded in recent years, it stillgives short shrift to Ameca's seniors, work-ers, and immigrants.

Further, it violates several of the provisionsof the budget agreement we passed only afew weeks ago.

First, the legislation misguidedly permitsStates to turn over Medicaid and Food Stamp

June 25, 1997Programs to private companies, many ofwhich have demonstrated that they have notbeen able to efficiently administer other Gov-emment contracts.

An amendment in the Commerce Commit-tee would have fixed this problem, but it wasunwisely rejected by the Republican majority.

Second, the Medicare cuts are not as oner-ous as those of the 104th CongresI Stilt, theimpact of reduced payments to providers will,in the end, be absorbed by needy seniors, re-sulting in poorer health care and diminishedaccess to physicians.

P am further dismayed by the incorporationof the risky medical savings account propos'àlin the Medicare portion of the package.

This proposal will undermine the integrity ofthe Medicare Program by transferring criticalfunding away from the most needy bene-ficiares to the healthiest, wealthiest senior citi-zens.

Third, I am pleased that the bill restores SSIand Medicaid to those legal immigrants whowere receiving them when the welfare reformlegislation was enacted last August.

Unfortunately, the budget agreement doesnot go far enough. Those immigrants whowere here last August who only subsequentlyqualified for assistance, remain barred fromreceiving benefits. This is terribly unfair tothose who had a reasonable expectation thatthe U.S. Government would assist them.

Finally, the budget reconciliation spendingbill guts much of the minimum-wage increasewhich Congress passed last year, by exempt-ing those in workfare jobs from the minimum-wage protection.

This is outrageous. Not only will this pro-posal take good jobs away from workers mak-ing as little as the minimum wage, but it willdefeat the entire purpose behind workfare be-cause program participants will not be able toearn a living wage in their jobs.

Mr. Speaker, once again, this bifi representsan improvement over previous Republicanbudget cutting efforts. Unfortunately, it stillcuts too much and hetps too few.

I urge my colleagues to vote against thebudget reconciliation spending bill.

Mr. SPRATT. Mr. Speaker, I yield 2minutes to the gentlewoman fromNorth Carolina [Mrs. CLAYTON].

Mrs. CLAYTON. Mr. Speaker, Ithank the ranking member for yieldingme this time.

Mr. Speaker, I really wanted to votefor this bill. In fact, I voted for the bal-anced budget agreement in the Com-rnittee on the Budget and voted for iton the floor with reservations. I knewthere were things in there I had prob-lems with. One of the things I hadproblems with, there was not enoughfood and nutrition. There are greatneeds in terms of hunger. It was notthere. But in spite of that, it did havesome good things in it.

Some of those good things werearound children's health, around edu-cational opportunities and tax provi-sions that are in there. On balance itwas good to move for a balanced budg-et. But now we have an agreement thatdoes not conform to all of those agree-ments. Although I knew I had somereservaUon, I do not ever expect thateverything I want will be in the bill.

I can tell my colleagues, I am stilllooking forward to voting for a bal-


anced budget, but I am unable to dothat now. I want to tell my colleagueswhat I hope will be cleaned up after theconference. I hope indeed my col-leagues find the compassion, or thereasonableness of at least giving peoplethe work opportunity so they can havefood stamps, so they are not thrown offthe food stamp rolls. At least this richcountry should be above that. I hopewe will find in our hearts, and with alldue respect and I know the gentlemanfrom Florida [Mr. SI-lAw] is well-intend-ing, I think when we are protectingwelfare to work, age discrimination,sex discrimination generically and donot apply the same labor standardsthat are codified already in law, we aresupposing to create a new set of protec-tions for this group of people. It wouldbe so much easier if we would just sim-ply say the law that is already on thebooks and we would apply it to thesepeople just as we apply it to everyoneelse. I think that is a gross error, andI think we have made a tragic mistaketo create new provisions to speak tothe same issues.

For those reasons, Mr. Speaker, Icannot support this bill as it is. I hopewe will come back from the conferencewith an improved bill.

Mr. BLILEY. Mr. Speaker, I yield 1minute to the gentleman from Georgia[Mr. NoRwooD] a member of the com-mittee.

Mr. NOR WOOD. Mr. Speaker, I amvery pleased to support this bill formany reasons, but one of which is thatthe Committee on Commerce has donea marvelous job in trying to protectpatients in the health care field as wemove more and more from fee-for-serv-ice health care to managed care. I amextremely grateful to this committeefor doing the right things for Medicareand Medicaid, those things that wewant to do indeed for all the people ofthis country, but at this point we didget things into Medicare and Medicaid.

For example, for the first time we areactually going to allow the health caregiver, the physician and the patient, todetermine if they need a specialist, orthe physician and the patient will ac-tually determine if they need to be inthe hospital, not a health care bureau-crat or an accountant.

With that, I thank the gentlemanfrom Florida [Mr. BILIRAxls], the chair-man. I think we have a great bill, andI urge all Members to support it.

Mr. SPRATT. Mr. Speaker, I believethe provision the gentleman referred towas dropped in the manager's amend-ment.

Mr. Speaker, I yield 1'/2 minutes tothe gentleman from Illinois [Mr.EVANS].

Mr. EVANS. Mr. Speaker, I thankthe gentleman for yielding me thistime.

Mr. Speaker, H.R. 2015 would kill theefforts of the Department of VeteransAffairs from obtaining the resources itneeds to meet the health care needs ofour Nation's veterans.

Earlier this year the administrationproposed that appropriations for VA

H4573health care remain constant at $17 bil-lion a year for 5 years. Clearly the abil-ity of the VA to provide needed healthcare service to the Nation's veteranscould be seriouslyjeopardized if the re-sources required to provide that carewere fixed, while the costs of providingcare increased.

To offset the possible dire con-sequences of an appropriation freeze,the administration also proposed thatVA retain funds it collects from thirdparty payers, insurance companies forexample, for some treatment providedby VA to certain veterans. The VA isattempting to collect funds for thirdparty payments, but today those recov-ered funds are simply deposited by theVA into the General Treasury.

On a bipartisan basis the House Com-mittee on Veterans' Affairs rejectedthis proposal. Our committee believedit jeopardized VA's ability to meet vet-erans' health care needs and we said so.We told the Committee on the Budgetthat Congress should continue to fullyfund health care through the appro-priations process. The Committee onthe Budget, however, rejected our com-mittee's views and our recommenda-tions.

Under the Committee on the Budg-et's plan, appropriations for VA healthcare would not increase for 5 years andthird party collections would be re-tained by the VA to provide veteranshealth care. But now under H.R. 2015,the ability of the VA to provide veter-ans' health care has been further un-dermined, again ignoring the serviceprovisions in the bill. This bill nowmakes VA's third party collectionssubject to appropriations.

Mr. BLILEY. Mr. Speaker, I yield 1minute to the gentleman from Califor-nia [Mr. BILBRAY], a member of thecommittee.

(Mr. BILBRAY asked and was givenpermission to revise and extend his re-marks.)

Mr. BILBRAY. Mr. Speaker, thisafternoon we are hearing much talkabout what is not in this bill and whythey are finding excuses to voteagainst this bill. Let me give Membersa major reason to vote for this bill forpeople who say they want to protectthe most needy, the most disadvan-taged in our society.

Mr. Speaker, for decades this FederalGovernment has mandated that we pro-vide certain services across this coun-try, and over the last few years wehave mandated that poor working-classhospitals provide free emergencyhealth care to illegal aliens. At thesame time this Congress and otherCongresses have mandated that, theyhave walked away from the responsibil-ity to pay the bill for the emergencyhealth care to illegal aliens. This bill,Mr. Speaker, has in it a fund set asideto finally reimburse those working-Pclass hospitals that have been deniedthe reimbursement that they have de-served for so long.

I hope my colleagues who claim torepresent the poor, the needy, the dis-advantaged, the people that are not

H4574getting their fair share of health careand coverage, will stand up and say atleast, look, this bill does include some-thing that has been denied for muchtoo long. Support this bill and finallystart paying for the health care of theillegal aliens that we mandate to beserviced. Quit being a deadbeat dad.

Mr. SPRATT. Mr. Speaker, I yield 2minutes to the gentlewoman from Ha-waii [Mrs. MINK].

(Mrs. MINK of Hawaii asked and wasgiven permission to revise and extendher remarks.)

Mrs. MINK of Hawaii. I thank theranking member for yielding me thistime.

Mr. Speaker, I rise in opposition tothis bill. This is not a reconciliationbill. It contains many things which areextremely irrelevant to the budgetprocess. Many people have said, "Let'snot try to meddle with a welfare re-form bill that was only enacted lastAugust. Let's see if it's going to work."

Yet here we are today in a budgetreconciliation bill that severely cutsback on what I believe was intendedwhen we passed the Welfare ReformAct. We said welfare to work, becausework was an ethic we wanted to en-courage. Everybody who goes to workgets paid. Yet here in the Budget Rec-onciliation Act, we have a work re-quirement where there is no additionalcompensation. We are going to taketheir cash welfare check, we are goingto take their food stamps and we aregoing to add it together and say dividethat up to the minimum wage and thatis the amount of workfare you must dofor the Government or for a nonprofitagency, without one penny of addi-tional money.

Where is the work incentive that weare trying to build in the people thatwe were so-called trying to changetheir mode of life, getting them to goout and understanding the Joy of earn-ing additional money. That is abso-lutely taken away from them. The pro-tections of being a worker are denied.Many of the protections, such as occu-pational health and safety, sex dis-crimination, all the things that ordi-nary workers would have. Family med-ical leave. These people who are onwelfare that are being forced to go towork, forced to take workfare with noadditional compensation will not havethe protections of employees. They arenot workers. They are second-classcitizens in America.

We apologized for slavery over 100years ago. Who is going to stand up andapologize for the slavery that is incor-porated in this budget reconciliationbill? This is really degrading. I stood indefense of some of the rhetoric weheard in this Chamber about the im-portance of work. If my colleagues aregoing to require work, pay the peoplewhat they are entitled to receive.

Mr. Speaker, I rise to oppose the budgetreconciliation bill because it establishes prior-ities that ignore the needs and interests of themost vulnerable of our constituents—the poor,the disabled, the elderly, the young, and, yes,our legal immigrants.


BENEFITS FOR LEGAL IMMIGRANT5

I am happy to note that the reconciliation billexempts refugees and asylees from the SSIand Medicaid bans for 7 years.

Similarly, it is a positive sign that the Houseand Senate are making an attempt to restoreSSI and Medicaid benefits to legal immigrantswho were already on the rolls when the wel-fare law was enacted August 22, 1996.

However, this effort falls far short of restor-ing coverage in a meaningful way to elderlyand disabled noncitizens.

Much has been said about how the rec-onciliation bill fails to live up to the bipartisanbudget agreement. The budget agreementpledged to restore SSI and Medicaid for alllegal immigrants ion the country before August23, 1996, and who are now or later becomedisabled. Neither the House nor the Senatemeet this test.

The House plan grandfathered" in healthy,elderly noncitizens, but it fails to help legal im-migrants who are healthy today but who laterdevelop disabling conditions. It covers 75,000fewer people than the bipartisan budgetagreement.

The Senate budget plan was a little bit bet-ter, since it would let disabled noncitizens filefor SSI through the end of this fiscal year.Nevertheless, it still covers 55,000 fewer peo-ple than the budget agreement does.

We could do more to help this population,but we are failing to do so. During its delibera-tions, the House Ways and means Committeefound it had $2.3 billion left over. My colleagueMr. BECERRA proposed a $2.4 billion plan tocover all elderly and disabled legal immigrantsin the country, even those not already on theSSI roHs. The committee had a rare chance todo the right thing, but they let it slip away.Now it appears that they saved this moneysimply to cut the taxes of affluent Americanswho need it the least.

It is reprehensible to cut taxes for the rich,while leaving disabled and elderly legal immi-grants destitute. We should restore SSI andMedicaid benefits to all legal immigrants, notmerely those who were covered by the biparti-san budget agreement.

HEALTHcARE

The budget contains numerous cuts andpolicy changes that will have a devastating im-pact on the health of our most vulnerable pop-ulations. Medicare and Medicaid will be cut byalmost $130 billion over 5 years, while individ-ual rights to justice and State authority overthe health plans of small employers are elimi-nated.

The budget targets the most vulnerable pop-ulations cutting Medicare by $115 billion overthe next 5 years. Those in support of this leg-islation, both in the majority and minority, mustconstantly reassure themselves that thesecuts are acceptable because most of the cutsare achieved through "reduced payments todoctors and hospitals." Despite their reassur-ances, there can be no denying that paymentreductions to doctors and hospitals are passedon to Medicare beneficiaries. Medicare bene-ficiaries pay in decreased access to care anddecreased quality of care. Medicare bene-ficiaries are the losers.

How many Members of Congress have re-ceived letters from constituents protesting ex-tended waits for doctor's appointments be-cause their physician can only see a limitednumber of Medicare beneficiaries each month,or that their doctor has dropped Medicare pa-

June 25, 1997

tients entirely because they lose money everytime they see a Medicare patient? Do we ex-pect more physicians to accept Medicare pa-tients when payments are cut even further?Do we expect hospitals to make more roomfor Medicare patients when we are reducingpayments to hospitals? How do these cuts im-prove access to care? Have we improvedquality of care by turning physicians and hos-pitals into assembly line health care drivethrough windows?

The budget includes a demonstration projectto test how medical savings accounts wouldwork in the Medicare Program. We justpassed a medical savings account demonstra-tion project last year and we don't even knowif that will be a success. Why are we now im-plementing a MSA demonstration project In

Medicare?Medicare should be the 'ast place we

should be testing MSA's. Medical savings ac-counts will attract the healthiest and least ex-pensive to cover while the more expensivehigh risk individuals remain in traditional healthinsurance programs. With a greater density ofhigh risk individuals in the traditional healthplans, costs will rise creating additional strainon Medicare. Savings produced by medicalsavings accounts will be meager compared tothe higher costs to cover individuals in tradi-tional plans.

Meanwhile, Medicaid will be cut by $13.6billion. These cuts will predominantly comefrom reductions in payments to hospitals thatserve a disproportionate share of low incomepatients. Cuts to disproportionate share hos-pitals [DSH] will place enormous burdens onrural hospitals and hospitals in low-incomeareas. Why are we cutting from these areaswhen these are the populations that need ac-cess to care the most. Many facilities in low-income or rural areas will not be able to sur-vive.

Also concerning Medicaid, the budget re-peals the Boren amendment which requiresState Medicaid Programs to pay a reasonableand adequate rate for facilities and servicesprovided by hospitals and nursing homes.Once again, do we expect quality of care andaccess to care to improve by permitting StateMedicaid Programs to shortchange hospita'sand nursing homes? Beneficiaries will feel thecuts and beneficiaries will end up paying.

The budget bill attacks the rights of individ-uals in medical malpractice cases and attacksthe authority of States to regulate the healthplans of small employers.

This budget weakens individual protectionsfrom medical malpractice by capping non-economic damages in medical malpracticecases at $250,000. This is an egregious injus-tice. No matter how severe the hami causedby medical malpractice, noneconomic com-pensation is limited to $250,000. To place anarbitrary limitation on the damages an individ-ual can receive due to medical malpractice isan atrocity. This cap abolishes the rights fromevery American to receive just compensationfrom medical malpractice.

To top this off, this legislation puts a 2-yearstatute of limitation on medical liability cases,beginning on the date the injury occurred orshould have reasonably been discovered, andno legal action could begin more than 5 yearsafter the date of the alleged injury. Absolutelyabsurd.

Another disturbing provision included in thebudget is the Expansion of Portability and

June 25, 1997Health Insurance Coverage [EPHIC] Act of1997, which contrary to a popular theme thathas dominated the direction of this Congress,removes State authority to regulate the healthinsurance plans of small employers and trans-fers regulatory authority to the Federal Gov-ernment without adequate provisions andpreparations to manage the additional respon-sibility. States have spent years crafting lawsand regulations to govern the health insuranceplans of small employers. This bill will preemptmany carefully devised State provisions andassign authority to an unprepared FederalGovernment. Not only is this irresponsible butit is also a blatant disregard for the years ofwork done by State governments.

The budget agreement abandons the budg-et agreement with the President on children'shealth care. The budget fails to guaranteecoverage for children and gives excessivelygenerous authority to States. We must setminimum standards and requirements to in-sure that this funding is used efficiently and ef-fectively.

Additionally, the children's health State allo-cation formula is based on the State's share ofuninsured children. States that have workedthe hardest on covering their children andhave had the most success will get the leastamount of funding while States that have donelittle will get a windfall. This allocation systemrewards States that have done nothing whilepenalizing States that have made an extra ef-fort to cover children.

Moreover, this legislation permanently en-acts the Hyde amendment which in effect de-nies poor women their constitutional right toreproductive choice, and could jeopardize theiraccess to health services.

This budget exemplifies how this Congress'spriorities have deviated from fundamental prin-ciples and is a dishonorable failure of our re-sponsibility to care for America's elderly anddisabled.

WELFARE

Furthermore, Mr. Speaker, the most egre-gious provisions of this bill will allow States toplace welfare recipients in indentured ser-vitude by enacting a separate set of rules forwelfare recipients working in public and non-profit organizations.

These provisions were not part of the origi-nal budget agreement and they are not nec-essary to reach the budget savings called forin the budget resolution. It is simply anotherattempt to cast scorn on the poor of this coun-try and denigrate their status in our society.

Under the bill before us today, welfare re-cipients who are forced to go to work in publicservice agencies and nonprofit organizationsto work off their welfare benefits will not betreated as employees. The compensation theyreceive will not be considered wages or salaryand they will not be afforded the same rightsand protections under labor laws as other em-ployees in this Nation. Furthermore, States willbe able to count the combined TANF, formerlyAFDC, and food stamps benefits in calculatingwhether welfare workers in workfare or com-munity seMce jobs are receiving minimumwage.

What happened to equal work for equal pay,or does that just apply to the well-off in theNation—and not the poor?

I am frankly astounded that the majority hasadvocated these changes to the welfare lawbecause they are directly contrary to the em-pliasis of last year's bill, which was to em-


power welfare recipients with jobs, to promotethe value of work, and to promote self-suffi-ciency through experiencing the dignity ofwork.

How can one experience the dignity of workif they are treated differently than every otheremptoyee, not paid a wage, not protected bylabor laws, and relegated to a position mostvulnerable to discrimination and abuse?

Under this legislation, welfare recipients, vir-tuaHy all of whom are women, will not be pro-tected against sexual harassment and sex dis-crimination as in title VII of the Civil RightsAct. They will not be protected under OSHA,the Fair Labor Standards Act, nor the Familyand Medical Leave Act.

In short, welfare workers will be denied themost basic rights afforded every other personin the workplace. This is shameful, and a trag-ic step backward to a time when indenturedservitude and slavery was condoned in thiscountry.

Mr. BLILEY. Mr. Speaker, I yield 1minute to the gentleman from Michi-gan [Mr. UPTON], a member of the com-mittee.

(Mr. UPTON asked and was givenpermission to revise and extend his re-marks.)

Mr. UPTON. Mr. Speaker, I wouldlike to talk a little bit about why Con-gress should retain the States' optionto provide services as well as insurancecoverage with their child health assist-ance program grants.

The children's health provisions ofthis budget agreement state that 'theresources will be used in the most cost-effective manner to expand coverageand services for low-income and unin-sured children with a goal of up to 5million currently uninsured childrenbeing served."

Simply having a Medicaid card orprivate insurance plan is no guaranteeof access to health care services in themany medically underserved rural andinner-city areas of this country. Com-munity health centers are located inmedically underserved rural and urbanareas and may be the only source ofcare in many of those areas. These cen-ters serve one out of every six low-in-come American children and one out ofevery seven uninsured children in theUnited States. In addition to providinghealth care services, communityhealth centers are experienced in deal-ing with barriers to health care forchildren, such as transportation andlanguage and cultural differences.

Mr. BLILEY. Mr. Speaker, I yield 3minutes to the gentleman from Louisi-ana [Mr. TAuZIN], chairman of the Sub-committee on Telecommunications,Trade, and Consumer Protection.

Mr. TAUZIN. Mr. Speaker, let mefirst tell my colleagues that the Com-mittee on Commerce had an awesometask. Assigned to us in the budgetagreement was $2.2 trillion of budgetsavings over the period of time thatthis budget agreement is to operate.That was a huge undertaking. I thinkthe gentleman has correctly pointedwith pride to the work of every mem-ber of our committee in developing forthe Committee on Rules in this pack-

H4575age with the help of the Committee onthe Budget a package of reforms thatdoes in fact honorably meet thosegoals.

On the Subcommittee on Tele-communications, Trade, and ConsumerProtection, we had a particularly ardu-ous task of writing a section thatwould meet the Committee on theBudget's requirements of spectrumauctions and revenues to the govern-ment over the next 5 years in the faceof some very disturbing recent trends,the most recent of which was an auc-tion in April that yielded only one-halfof 1 percent of the amount of moneythat the Committee on the Budget hadearlier predicted that auction wouldyield for the Treasury.

Let me at first compliment the gen-tleman from Ohio [Mr. KASICH] and themembers of the Committee on theBudget for working so carefully withthe members of the Subcommittee onTelecommunications, Trade, andConsumer Protection in trying to re-solve that arduous task and those num-bers. What has been accomplished inthe course of the last few days throughnegotiations with the Committee onRules are provisions to help ensurethat the next round of spectrum auc-tions are conducted much more respon-sibly.

Number one, it is clear from the lan-guage that we are going to vote ontoday that spectrum auctions of addi-tional spectrum made available overthe next 5 years for public use will beconducted with several new directions:No. 1, those spectrum auctions will beconducted after a time has been al-lowed for the current round of spec-trum sales to clear the financial mar-kets. As my colleagues know in thelast successful auction, whereas we re-ceived bids of $23 billion, only about $11billion was actually paid in because ofdifficulties in getting that spectrumout.

The new bill provides, in effect, thatthe new auctions will give enough timefor bidders to know what is comingdown the pike and will give enoughtime for the market to clear. The newprovisions require in fact the FCC toexamine new computer models for auc-tioning, such as the ones carried out inCalifornia where block auctioning isactually attempted to yield higher re-sults for the Treasury. In short, thoseimprovements have been added to thebill.

We have retained in this bill thecommittee's mark that specifies thatthe FCC can permit the continued ana-log broadcast as long as more than 5percent of a community have not yetswitched over to digital as this digitaltransformation occurs.

0 1630We have retained the committee lan-

guage that there must be minimumbids in these auctions. No more shouldwe have bids on auction of a dollar atthe marketplace.

In short this is a good package. Iurge its adoption and commend thecommittee for its fine work.

H4576Mr. PALLONE. Mr. Speaker, based

on what was said before, it appearsthat the Republicans have significantlymore time, so I reserve the balance ofmy time.

Mr. SHAYS. Mr. Speaker, I yieldsuch time as he may consume to thegentleman from Michigan [Mr. SMITh].

(Mr. SMITH of Michigan asked andwas given permission to revise and ex-tend his remarks.)

Mr. SMITH of Michigan. Mr. Speak-er, my vote will be in favor of passageof this bill, and H.R. 2037, the budgetenforcement provisions, have beenmade part of this bill that will help usmake sure that we enforce the provi-sions of our intent to balance the budg-et and make these spending cuts.

CONGRESsIONAL BUDGET & IMPOUNDMENTcONTROL ACT OF 1974

Permanently extends the requirement thatbudget resolutions cover a five-year period.

Similarly, extends indefinitely the enforce-ment of the five-year spending and revenuelevels set forth in budget resolutionsthrough points of order.

Simplifies and updates points of order thatare used to enforce the budget resolutionsspending and revenue levels.

Provides for adjustments in the budget res-olution levels for legislation appropriatingfunds for designated emergencies, arrearagesand the International Monetary Fund.

Eliminates the need to waive the BudgetAct for a reported bill that violates the Actbut is cured by a self-executing rule. In suchcases, the point of order no longer liesagainst the bill.

AMENDMENTS TO THE BALANCED BUDGET ANDEMERGENCY DEFICIT CONTROL ACT OF 1985

Adjusts and extends statutory discre-tionary spending limits, which are enforcedthrough sequestration, through fiscal year2002.

Provides for adjustments in the discre-tionary spending limits for appropriationsfor emergencies, arrearages, and the Inter-national Monetary Fund.

Extends pay-as-you-go requirements,which provide that entitlement and tax leg-islation must be fully offset, through fiscalyear 2002.

Modifies baseline that is used to score"legislation so that committees get credit foreliminating entitlement programs.

Eliminates accrued paygo balance and sav-ings from reconciliation to ensure that allsavings are used for deficit reduction.

Mr. SHAYS. Mr. Speaker, I yield 2½minutes to the gentleman from Illinois[Mr. FAWELL].

(Mr. FAWELL asked and was givenpermission to revise and extend his re-marks.)

Mr. FAWELL. Mr. Speaker, I rise insupport of the balanced budget bill andin particular the provision of the billthat will expand affordable health in-surance to millions of workers, theirspouses and their children. By includ-ing the Expanded Portability andHealth Insurance Coverage Act, knownas EPHIC, in this reconciliation, we ad-vance bipartisan legislation which willmake insurance available to millionsof uninsured Americans.

The EPHIC legislation is consistentwith the budget agreement's goal of ex-panding coverage to uninsured chil-dren.

The problem of the uninsured, bothchildren and adults, is predominantly a


problem of small businesses lacking af-fordable health coverage. Over 80 per-Cent of the 40 million uninsured Ameri-cans live in families headed by a work-er, most often in a small business. Andover 80 percent of uninsured childrenare in a family headed by a worker,again, usually in a small business.

EPHIC addresses this problem by giv-ing franchise networks, union plans,and bona fide trade, business and pro-fessional associations the ability toform group health plans. EPHIC givesretailers, wholesalers, printers, agri-cultural workers, grocers, churches, or-ganizations such as the chambers ofcommerce and NFIB, the National Fed-eration of Independent Business, theeconomies of scale and affordable cov-erage that large businesses have hadfor 23 years under the Federal ERISAlaw. In other words, finally the littleguys will have what the big guys havehad for decades, and I refer to theeconomies of scale to be able to haveaffordable health insurance for theiremployees.

In hearings before my subcommittee,witnesses estimated that small busi-nesses could save between 30 and 60percent in overhead costs and that upto one-half of the 40 million uninsuredAmericans would find affordable cov-erage in the private market underEPHIC.

Mr. Speaker, this tremendous expan-sion of coverage can be realized with-out spending one single tax dollar,without any government subsidies orany government mandates.

EPHIC is supported by nearly 100 or-ganizations representing small busi-nesses, large businesses, the self-em-ployed, churches, hospitals, medicalgroups, agricultural, and rural inter-ests and insurance companies. The billcurrently has 152 Cosponsors, including23 Democrats.

Mr. Speaker, I think this is a soundidea whose time has come.

Mr. PALLONE. Mr. Speaker, I yieldmyself 5 minutes.

Mr. Speaker, the best way for me toillustrate the flaws that are containedin this bill is to focus on the harm itdoes to our Nation's children. Begin-ning with children's health care, a ma-jority of this House, myself included,voted for the balanced budget resolu-tion which promised $16 billion tocover five million of the 10 million un-insured children in America today. Buteven though most of us wanted tocover all 10 million, we felt that actingin good faith we could get to 5 millionnow and then address the remaininglater on. Well, gu2ss what, Mr. Speak-er, this bill does not even cover 1 mil-lion children. According to the Con-gressional Budget Office, the Repub-lican leadership's proposal would pro-vide coverage for about half a millionchildren. The CBO assumes that muchof the 16 billion will be passed on tohospitals and other providers who getshafted under this plan and basicallynot to purchase health insurance forchildren.

June 25, 1997

The Republican leadership, in effect,which is purporting to be the party offiscal Conservatism, takes $16 billionand, in my opinion, throws it away.The Democrats offered several alter-natives to this impotent policy. Firstwe sought to plug up the so-called di-rect services loophole that lets a Statespend its money on purposes otherthan insuring kids. The Republicansdefeated that amendment in the Com-mittee on Commerce. Then Democratsproposed to expand Medicaid and out-reach to cover more kids with an exist-ing health insurance program that al-ready works. We know that Medicaidworks, but the Republicans said no tothat too in the Committee on Com-merce.

And finally we put forward a proposalby the Democratic Caucus Health CareTask Force, a comprehensive approachto expand Medicaid, give States match-ing grants to cover kids above the in-come levels that qualify for Medicaidand require private insurance Compa-nies to provide kids only policies atreasonable costs, and the Republicansshot that down too in the Committeeon Commerce, and again in the Com-mittee on Rules when we proposed itthe other day.

We are considering a bill today whichviolates the balanced budget agree-ment and which I supported as didmost of my colleagues here. The bill weare considering today takes health caremoney away from children, it does notexpand health care, it takes it awayfrom children. This is not what we in-tended when we supported the balancedbudget agreement, so we will not sup-port this bill today. It is just anotherRepublican attempt to cost shift, andunfortunately, Mr. Speaker, the costshift is right on the backs of our Na-tion's children.

Mr. Speaker, I yield such time as hemay consume to the gentleman fromMassachusetts [Mr. KENNEDY].

Mr. KENNEDY of Massachusetts.First of all, Mr. Speaker, I appreciatethe gentleman from New Jersey yield-ing this time to me. I think we allought to recognize the fine work thatthe gentleman from New Jersey [Mr.PALLONE] and others in the caucushave done in trying to bring attentionto the fact that we have so many chil-dren in this Country who still do nothave basic health insurance.

Most people think that health insur-ance is provided as a matter of right tokids in America. The truth of the mat-ter is that amongst the very poor chil-dren, that is true under the MedicaidProgram. But again, working families,the children of taxicab drivers, thechildren of waiters and waitresses,working families simply do not havehealth insurance; and that is wherethis bill, I think, has had some dra-matic failures.

I wanted to point out to my friendfrom New Jersey, Mr. PALLONE, thatthere is an additional problem withthis language that is contained in thisbill. The way the actual funding for the

June 25, 1997The plan we are voting on today is

evidence that Washington is at last be-ginning to take its responsibility seri-ously. It reduces the growth of Govern-ment spending by nearly $1 trillionover the next 10 years. reversing thelegacy of bankruptcy that we are hand-ing off to our children. It saves Medi-care from bankruptcy, ensuring thatseniors of today, and tomorrow, willcontinue to have this vital programwell into the next century. It allowstax relief for families, and individuals,at every stage of their life so they willhave the freedom to save and plan fortheir future.

Mr. Speaker, the American peopleare the real winners in this plan. Bytaking this next step toward balancingthe budget for the first time in a gen-eration, we take another giant leap to-ward restoring their freedom to chasethe American dream. It is our respon-sibility to follow through on our prom-ises that we have made to them.

Mr. SHAYS. Mr. Speaker, I yield I

minute to the gentlewoman from NewJersey IMrs. ROUKEMA].

(Mrs. ROUKEMA asked and wasgiven permission to revise and extendher remarks.)

Mrs. ROUKEMA. Mr. Speaker, Iwould say that I do believe that weshould pass this program. Balancingthe Federal budget is absolutely essen-tial to protect the Nation's short-term,and long-term financial health and cer-tainly to ensure our children andgrandchildren a greater tomorrow.

I want to especially thank the chair-man of the committee for his workthat he is going to do, specifically men-tioning the needs of New Jersey withrespect to the Medicaid needs and theDSH formula.

I do want to say that I have a ques-tion and a reservation with respect tothe Small Business Association ERISAreforms of the bill. I will be moving tocorrect those reforms. In my opinion,they do not belong in this bill, theyreally should be separated out, and Iwould hope that we could work on thatin conference. But without reservation,we must support this as an ongoingprogram and assure that we are keep-ing our promise to the American peo-I)le.

Mr. PALLONE. Mr. Speaker, I yield1¼ minutes to the gentlewoman fromCalifornia [Ms. ESHOO].

0 1700Ms. ESHOO. Mr. Speaker, as the

American people listen to us this after-noon as we engage in this great and im-portant debate about our Nation'sbudget, it really is a statement of ourvalues. The President came to the Con-gress, and in his State of the UnionMessage delivered part of the message,there were 10 million uninsured chil-dren relative to health care in ourcountry.

The parties came together and said,this is a priority. We then went towrite in, to fill in the blank, of how wewould plan to insure the 10 million un-


insured children in our country. Thereis only one plan that has been ad-vanced that actually' works andreaches out to the majority of the chil-dren in our country. It has not createda new entitlement, there are no un-funded mandates, but neither is it agiveaway to our Nation's Governors. Itputs children first by building on thepublic system; by saying to the insur-ance companies, it says to the insur-ance companies that you can indeedoffer children-only insurance policies.It rewards States that are doing evenmore for children, and it is the onlyplan, according to the CBO. The CBOsays that the Republican plan willcover only 520,000. That is a deficit forour Nation.

I urge that we support this plan. Iwill not support the budget plan con-tingent upon this.

Mr. PALLONE. Mr. Speaker, I yield 1minute to the gentleman from Califor-nia IMr. WAXMAN].

Mr. WAXMAN. Mr. Speaker, I thankthe gentleman for yielding time to me.

Mr. Speaker, I will put a longerstatement in the RECORD on the healthaspects of this budget reconciliationbill, but I do want to point out that weare missing an opportunity to coverchildren as fully as we might in themost certain and effective way we can.

What we have in the bill is a goodstart. What we have in the budget is $16billion, but it would be most. effectiveif we were certain that the moneywould be spent to buy guaranteed cov-erage with the benefits that childrenneed.

We have a model for this and itworks. It is called Medicaid. We oughtto help States do a betterjob with thatprogram, and with the block grantmoney, we ought to be sure it is spenton what we intend, to buy health insur-ance coverage for uninsured children.It is not supposed to be a pot of moneyfor States to refinance their ownhealth services facilities. It is not sup-posed to be a replacement for DSH, itis supposed to help kids.

We can do better. In Medicaid andMedicare, while there are some posi-tive steps, it seems to me on balance Icannot endorse this legislation.

Mr. Speaker, we are missing an opportunitytoday to assure that we are extending cov-erage to millions of uninsured children in themost certain and effective way we can.

We have $16 billion to spend here. This isnot enough to cover all the uninsured children,but it is a good start.

And it will be most effective if we are certainthat the money is being spent to buy guaran-

•teed coverage, with the benefits that childrenneed.

We've got a model for this—and it works.It's called Medicaid. We ought to help Statesdo a better job with that program.

And with the block grant money, we oughtto be sure it's spent on what we intend: to buyhealth insurance coverage for uninsured chil-dren. It's not supposed to be a pot of funds forStates to refinance their own health service fa-cilities. It's not supposed to be a replacementfor DSH. It's supposed to help kids.

H4579We can do better.And the changes this bill makes in Medicaid

and Medicare are not acceptable.I recognize that these provisions are dra-

matically improved from those brought beforethis House in the last Congress. But beingbetter than something that was totally unac-ceptable is not good enough.

I also recognize that there are some thingsin this bill, particularly related to Medicare, thatare very positive. The preventive care benefitsadded to Medicare are long overdue, and willbe very helpful to Medicare beneficiaries.

But on balance, I cannot endorse this legis-lation.

I cannot vote in support of the establishmentof medical savings accounts [MSA's] in theMedicare Program. I know this is a dem-onstration—but it is a massive one. And it isa bad one.

MSA's cost Medicare money. They cost $2billion. This is money that should be left in theMedicare Trust Fund or spent on benefits thatall Medicare beneficiaries need. Instead, we'respending $2 billion to benefit people who arehealthier and wealthier. They leave the manyMedicare beneficiaries of moderate income,the ones whose health is more precarious,bearing the cost. That is wrong.

The changes n how managed care organi-zations will be paid by Medicare are also ex-treme. They will cause severe problems inhigher cost urban areas. An initial attempt torationalize payments became a free-for-all inwhich HMO's in urban areas, and the bene-ficiaries who are enrolled in them, are the los-ers.

And while this bill is better as a result of theamendment approved by rules in its protectionfor low-income Medicare beneficiaries, it doesnot meet the budget agreement terms of fullpayment of the Medicare premium for peoplebelow 150 percent of poverty.

Many of the changes this bill makes in Med-icaid are also not ones I can support. Put sim-ply, the cuts in the disproportionate share pro-gram are too large, and they are not designedto protect either the hospitals that serve verylarge populations of low-income people, orStates which have spent all of their DSH mon-eys on these kinds of hospitals.

I cannot vote for a proposal that will resultin a 20 percent cut of DSH dollars in my ownState of California by 2002. I cannot endorsea policy that leaves large public hospitals, chil-dren's hospitals and hospitals with low-incomeutilization rates of 25 percent or 30 percentwithout first call on the funds available.

I cannot support legislation that underminesa poor woman's right to choose.

Finally, I look at the bill currently being de-bated by our colleagues in the Senate, and Isee a number of provisions that will bebrought into conference that would make thisbill considerably worse.

It is not good enough now. It should bemade better. It must be made better before itwill have my support.

Mr. PALLONE. Mr. Speaker, I yield30 seconds to the gentlewoman fromTexas EMs. JACKSON-LEE].

(Ms. JACKSON-LEE of Texas askedand was given permission to revise andextend her remarks.)

Ms. JACKSON-LEE of Texas. Mr.Speaker, I acknowledge to the gen-tleman from Florida [Mr. SI-lAw], justas a correction, that I voted for the

H4580Deal amendment on welfare reform,which really worked, but I rise todaybecause I do not want to pit childrenagainst my hospitals in Texas. I do notwant to give a windfall to those Gov-ernors who may not focus on the needto insure the 10 million children whoare uninsured.

We have a real health plan that doesnot pit hospitals against children. It isextremely valuable that we move for-ward on a budget reconciliation thatprotects workers, protects children.and provides for the hospitals in theState of Texas.

Mr. Speaker, I rise today to express my ve-hement opposition to HR. 2015, the BudgetReconciliation Act. The problems with this billare almost too numerous to list. However, I

am compelled to report to the American peo-ple some of the most dismal aspects of thislegislation.

First, HR. 2015 contains a provision whichreduces Medicaid spending by $11.4 billion,primarily by reducing payments to hospitalsthat serve a disproportionate share of low-in-come patients. The Disproportionate ShareHospital [DSH] program was created to ensurehealth care for the elderly, the indigent andthe Nation's young people. It was specificallydesigned to reimburse hospitals that serve adisproportionate number of uninsured or indi-gent persons.

The DSH program is an integral part of theMedicaid Program in my home State of Texas.DSH is critical in providing quality health careto Texans who cannot otherwise afford it. Areduction in payments to these hospitals,therefore, discriminates against Texas be-cause it singles out high-DSH States for cuts.

Without DSH funding, many of Texas' ruralhospitals cannot continue to operate. Manycounties will lose access to a medical centerfor hospital, outpatient and physician-basedcare. When those hospitals which serve thelargest proportions of poor, low-income sen-iors and young persons suffer severe cuts inFederal funds, tens of thousands of low-in-come Americans will feel the pain.

Also included in this bill is a troubling provi-sion commonly referred to as the Hydeamendment. This discriminatory provisionwould permanently prohibit the use of funds topay for any abortion or to pay for any healthplan that covers abortion, except if the life ofthe woman would be endangered, or if thepregnancy was the result of rape or incest.The inclusion of this language in the budgetreconciliation bill would permanently write intoFederal law a ban on abortion funding for low-income women and thus deny them access tovital reproductive health services that areavailable to others. This places disadvantagedand poor women in a substandard health envi-ronment which says to them that we do notcare. This ban could force some women to re-sort to unsafe alternatives and others couldsuffer delays resulting in more risky proce-dures. One way or another, society will haveto bear the costs of providing medical andsupport services for the eligible recipientsunder this block grant who are not able to ter-minate crisis pregnancies.

Let me now turn my attention to our Na-tion's immigrants. HR. 2015 restores benefitsto those low-income legal immigrants whowere receiving SSI benefits when the welfarereform legislation was enacted last August and


lost those benefits. However, this is nothingmore than a Trojan Horse because the billdoes not provide SSI benefits to legal immi-grants who were in the country as of last Au-gust, were not receiving benefits in August,but who later became disabled despite the factthat this was part of the budget agreement.The President has threatened to veto the billbecause of the absence of these benefits. Weshould not allow this Trojan Horse to leave thefloor of the House.

Finally, the funding in HR. 2015 for a chil-dren's health care initiative is turned into ablock grant which even the CongressionalBudget Office estimates may only cover500,000 additional children—not the 5 milliongoal children agreed to in the budget negotia-tions. This seems to me to be obvious evi-dence that the concern some Republicanshave expressed for the 10 million childrenwithout health care in our country, is littlemore than lip service. If their concern wasdeeply-felt we would find that HR. 2015 pro-vided a sincere effort to reach as many ofthese children as possible. It does not.

Mr. Speaker, I, like many of my colleagueswould like nothing more than to vote for legis-lation that is a step toward bringing the na-tional budget into balance and eliminating thedeficit. I believe, however, that it is possible todo this in a manner that is balanced and com-passionate. HR. 2015 is neither and for thisreason I oppose it and urge my colleagues todo the same.

Mr. SPRATT. Mr. Speaker, I yieldthe balance of my time to the gen-tleman from Texas [Mr. STENHOLMI.

The SPEAKER pro tempore [Mr.DREIER]. The gentleman from Texas[Mr. STENHOLM] is recognized for 1/4minutes.

Mr. STENHOLM. Mr. Speaker, I risein support of this reconciliation bill.This bill takes another important steptoward achieving a balanced budget. Asone who believes that enactment of afair and responsible plan to balance thebudget by 2002 and beyond is critical tothe future of our country, I believe it isextremely important that the Housevote today to send this bill to con-ference and keep the process moving.

The efforts of President Clinton andCongress have resulted in 5 consecutiveyears of declining deficits and the low-est deficit since the Carter administra-tion. The agreement builds on this tre-mendous achievement, and continuesthe glidepath to a balanced budget.

I am gratified that in numerous in-stances this reconciliation bill reflectsthe influence of Blue Dog budgets. Thesavings levels and the policies for Med-icare and Medicaid and other programsare quite close to the savings levelsand policies we predicted would com-prise a reasonable compromise.

Anyone who has ever tried to leadknows there are a dozen attacks onwhy a plan is bad for every one sugges-tion of how it might be improved. I re-main solidly in the camp of those whowill work for a constructive com-promise.

In that vein, I congratulate thePresident and his staff, the gentlemanfrom Ohio [Mr. KASICH], the gentlemanfrom South Carolina [Mr. SPRNrr], and

June 25, 1997all of their staff for their hard laborswhich have brought us to this point.This has been a good-faith effort towork out the countless policy issuesthat need to be resolved for the budgetagreement to achieve a savings in afair and equitable manner.

I remain concerned about the impactof some of the policies of this reconcili-ation bill, and particularly I am veryconcerned about the impact that thepolicies for achieving the savings inthe Medicaid Disproportionate ShareProgram will have a harmful effect onsmall rural and inner-city hospitals.

However, we need to remember thatthis bill has a long way to go before itis enacted into law. The administrationwill continue to work with Republicansand Democrats to work out these re-maining problems. My primary concernis the lack of meaningful enforcement,but we will yet have another attemptat making that correction.

Mr. PALLONE. Mr. Speaker, I yieldthe balance of my time to the gen-tleman from California [Mr. FAzI0].

The SPEAKER pro tempore. The gen-tleman from California [Mr. FAzI0] isrecognized for 1½ minutes.

Mr. FAZIO of California. Mr. Speak-er, I am very disappointed at thispoint. I voted for the budget resolu-tion, and I looked forward to the bipar-tisan cooperation we saw then put inplace so we could vote today to sendthis bill to conference in the same bi-partisan manner.

But the bill comes up short. We donot need a provision to take the Hydelanguage on abortion and make it per-manent law. We need to pay more at-tention, for example, to the way inwhich we try to extend health care tothe 10 million kids in our society thatare not covered by insurance today.

First of all, we need an outreach pro-gram, because we know there are 3 mil-lion of them that are currently eligiblefor Medicaid who are not part of it. Weneed to expand the Medicaid programto try to broaden coverage throughoutour States. On top of that, we need in-surance reforms that will make it pos-sible for parents to buy insurance fortheir children if the children do not getit where they work, or if the childrenare not covered.

Most of all, we need to work with theStates to go after the kids of the work-ing-poor families who are not covered,but simply, to make a grant to theStates and tell them they can use it foralmost any purpose is going to do noth-ing more than supplant existing Statefunds. We need to expand affordable in-surance coverage and not simply gothrough a shell game with State andFederal dollars.

There are ways we can make this abetter bill. I hope I can support it whenit comes back from conference. I amoptimistic I can. I want to give creditto the gentleman from Ohio [Mr. KA-SICH], my good friend, and the gen-tleman from South Carolina [Mr.Spirr]. They have resolved a numberof problems before they came here

June 25, 1997today. They have not gone as far asthey must go.

The process should go forward, butthose of us who remain unhappy withthe progress we have made today needto keep before the President and thisCongress the pressure to do a betterjob. I look forward to voting for a bet-ter job, and I hope it can be accom-plished.

Mr. SHAYS. Mr. Speaker, I yield thebalance of my time to the chairman,the gentleman from Ohio, [Mr. JOHNKASICH], the gentleman who began thislong march toward a balanced budgetin 1989.

Mr. KASICH. Mr. Speaker, let mefirst of all compliment my colleagueand friend, the gentleman from SouthCarolina [Mr. SPRATF]. He has been ob-viously in a difficult position withsome of his very top leadership aggres-sively opposing the agreement. He hasalso been a party on a day-to-day basisto the difficulty of being able to writethis whole agreement, which has takena period now of about 6 months. I wantto thank him for his support. But Ithink the gentleman from South Caro-lina really is in a position to be able tounderstand what we have gone throughon this, and to understand the good-faith efforts that have been made by allsides.

First of all, if we want to have an ex-cuse to vote no, Members can come upwith anything they want. I am verydisappointed to see some of my friendsand colleagues on the other side of theaisle coming up with nothing morethan excuses to oppose this bill that isbefore us today, because the WhiteHouse supports it. The reason why theWhite House supports it is because wehave kept the spirit of this agreement.

Imagine this: about 4 or 5 months agowe started negotiating the entire oper-ation of the Federal Government in aneffort to balance the budget and comeup with tax cuts. We ended up reachingan agreement. We kept our word to ob-viously let this House vote on two sep-arate bills, the bills to cut spending tobalance the budget, and tomorrow abill to reduce the taxes and givesomemore power back to the American peo-ple.

We took this agreement, which waslaid out in many, many pages, and wewent to our committee chairmen, all ofwhom felt very strongly about the factthat they wanted to design some poli-cies the way they thought made moresense.

I will just give the Members one ex-ample. The gentleman from Florida[Mr. SI-lAw] decided that he thought itwas essential that we cover those peo-ple who are currently disabled whomight find themselves off the rolls in areview process, our noncitizens. He de-cided it was more compassionate tohelp those people than to help a groupof people who were here before the wel-fare bill was passed who might becomedisabled.

This was just an honest difference interms of how we can spend money to be


compassionate for people. It would bewrong, it would be unfair, and it wouldbe unjust to accuse the gentleman fromFlorida [Mr. SI-lAw] of trying to violatethe agreement. It was an honest dif-ference in terms of how we would besthelp people who were in need.

Furthermore, the gentleman fromFlorida is the chairman of a sub-committee. He has the right to carryout some legislation, and at times theSpeaker and I had to sit in rooms andwe had to direct a whole panoply of ac-tivity across our conference under thegrounds of making sure that thisagreement was carried out in terms ofits spirit.

Frankly, if Members take a look atthe efforts that have been made con-tained in this reconciliation bill, wehave done ajob that is unparalleled inthis House in modern times. The com-mittee chairmen, constructively, tomeet the agreement, they worked ag-gressively and with great bipartisan ef-fort to bring the other side to thisagreement, and at the end of the day Ithink we are pretty well there.

Let me just suggest one other thingthat I would like Members to thinkabout as they are in their offices, ifthey are a Democrat, when they wantto come over here. Think about theHouse, for once. This is a terrific op-portunity to join together to do some-thing that we have not done in 30years. We have a realistic chance. Ipredict, I believe, we will in fact havea bill. It will be signed into law. Wewill have a tax bill, it will pass, it willultimately be signed into law. We aregoing to have a balanced budget. Weare going to have tax cuts.

I think it represents a new oppor-tunity for this House to push aside thispartisan wrangling that we have beeninvolved in over the period of the lastseveral years and come together onsomething. This is just a matter ofcommon sense. Mr. Speaker, if we hadnot lived up to the spirit of this accord,the administration would not be sup-porting the passage of this bill.

I ask Members to listen to theirhearts and listen to their people. Donot listen to a bunch of people whowant to find an excuse to keep thisHouse divided, who want to find an ex-cuse to nitpick, who want to find anexcuse to downgrade the actions of ourchairman, who tried to reach acrossthe aisle and bring a document outhere that really made sense and couldreally represent bipartisan spirit.

Let us just get out here today, comeover here, give us a "yes" vote, movethis bill into conference. There will beadditional changes that will occur. ButI would like to say to the rest of theMembers in this House and to theirstaff and the people who watch this de-bate, it is a terrific day. We are goingto balance the budget. The Berlin Wallof big government has fallen. Therewill be tax cuts. It is all going to hap-pen because we stuck to principle. Webelieve in less government, we believein shifting power, money, and influence

H4581from this city, and it is no longer rhet-oric, Mr. Speaker, it is reality.

We are going to vote here today andwe are going to move this processalong, and at the end of the day, withthe process of further give and take,not deviating from our principles, wewill have signed into law before the endof this year the first balanced budgetsince man walked on the moon.

I think it gives the American peoplea little bit of hope that maybe some ofus can get it right here in town, but letus not be confused. There is a properrole for the Federal Government, butinto the future it will not be about thepower of Government. It will be aboutthe power of every man and everywoman and every boy and every girl inthis country to live their dreams, to becreative, innovative, be rewarded fortheir action, and to really, frankly, aswe head into this third millennium, beable to gain speed in terms of thepower of the United States to influencenot just our hemisphere but the entireworld, and to make a stand on whichall of mankind can be proud.

Mr. OWENS. Mr. Speaker, I rise in strongopposition to the Budget ReconciliationSpending Act (H.R. 2015). Nothing is more im-portant than the discussion of the budget. OurNation's values are all locked up into the wayit proceeds with its budget. What we reallycare about we should discover by watchingwhat is induded in the budget and under-standing that what is really important to thisNation should be reflected in its budget. H.R.2015 contains numerous modifications to enti-tlement programs—programs that are the lastresort for many of America's children, women,and families.

While Congress is moving forward in thebudget process, my colleagues must be re-minded that our starting point—the WhiteHouse-Republican budget agreement—was in-sufficient, especially in the area of education.We should have a budget which is not apolo-gizing for the amount of money in it for edu-cation. It is crucial that we bring 21st centurytechnology into our 19th century schools. TheGAO estimates that we need $135 billion torebuild our Nation's schools. My colleaguefrom New York, Representative LOwEY, intro-duced a bill to forward the President's $5 bil-lion initiative to stimulate funding to rebuildAmerica's schools. These funds were not in-cluded in the White House-Republican agree-ment. Without the school construction initiativeproposed by the President, many of theschools that have the greatest needs will nothave the buildings to provide a safe and de-cent place for children to learn. The secondarea, is Head Start. There are an estimated2.1 million children eligible for the Head StartProgram. According to an analysis by the Na-tional Education Association, $1 1 billion is re-quired to ensure that all of these children haveaccess to early childhood learning, a crucialcomponent in their developmental process.The funding necessary to serve these futureAmerican taxpayers again was not a part ofthe historic agreement. What message are wesending to the Nation by not funding this vitalprogram for children 4 years old and under?

Today, we enter the stage in the budgetprocess where permanent spending prioritiesare being proposed under H.R. 2015. The en-titlement programs with the largest reduction

H4582in this bill are Medicare—$115 billion—andMedicaid—$11 billion. Why do we continue tocut Medicare and Medicaid? We do need toaddress Medicare and Medicaid in a new way,and stop the assumption that these programsare where most of the money is, and thereforejustify proposals to cut Medicare and Medic-aid. The savings that Medicare will yield willcome from cutting payments to providers,$102 billion, mainly hospitals and health careplans, as well as $12.9 billion in increasedpremiums in Medicare part B to be paid by theMedicare beneficiaries.

That was yesterday's language. Today, theRepublicans tell us that the increased pre-miums will be paid by some beneficiaries.These beneficiaries are described by their in-come percentage of the poverty level. For ex-ample, beneficiaries with incomes between100 percent and 135 percent of the povertylevel will not have Medicare part B premiumincreases; but, for those with incomes be-tween 135 percent and 175 percent of thepoverty level, the measure will cover that por-tion of the premium that is attributable to thetransfer of home health services from Medi-care part A to part B. Who will decide whetherthose with income at the 135 percent of pov-erty level be considered in the free category orpremium increased category? Why are webeing forced to move in a way which wilt pe-nalize our elderly and our poor people?

The bill includes $16 billion over 5 years fora new child health assistance btock grant.While $16 billion is better than nothing, it isestimated that the plan is far short of reachingone-half of the 10 million children who arewithout health coverage. Why has this fundingfor children's health care been changed to ablock grant? Under the block grant concept,funds would be distributed to States based onthe State's share of uninsured children, andthen adjusted for the average cost of health.This appears to be a ball of confusion to me.We were grateful for the small step forwardwhen we asked for funds to insure one-half ofthe uncovered children. Yet, the Congres-sional Budget Office recently released figuresthat indicate as few as 500,000 children wouldbenefit from the block grant proposal. 500,000is a mere drop in the bucket and embarrass-ingly short of the dramatic health care needsof this country's children.

Just a week ago, I welcomed the joint reso-tution celebrating the end of slavery in theUnited States. I thought that it was a smallgesture. However, it is an important one for alot of Americans, both black and white, and I

was pleased to see that not a single Memberof the House of Representatives voted againstthis joint resolution introduced by the gen-tleman from Oklahoma (Mr. WATTS]. Buttoday, when I see certain provisions includedin the Welfare-to-Work Program, my pleasureis gone. The resolution that passed last weekwas simply a nonbinding, politically correct bill.Yet, today we are considering a bill that couldbecome permanent taw and would resort to adeclassification of workers in the WorkfareProgram. I see benefits that every American inthe workplace share not included in the wel-fare program. These workers, because theyreceive temporary assistance for needy fami-lies, would not be considered employees andwould be deprived of protections under theFair Labor Standards Act. These workers,both white and black, would be treated as sec-ond-class citizens. They would not be covered


by the Equal Pay Act, title VII civil rights pro-tection's SHA, or the family leave laws. Be-cause they receive temporary assistance forneedy families they are not protected againstsexual harassment as other workers. This reg-ulation states that women subject to sexualharassment on a welfare-to-work assignmentcould be required to seek redress from thevery agency that employed them." H.R. 2015contains no appeals rights, and no court re-dress for workfare participants. Where is thisNation going? Where are our values? Wehave laws that protect all other workers fromsexual harassment in the workplace. Are wesending the message that it is alright to sexu-ally harass poor or needy women? Thissounds like slavery all over again.

In direct breach of the so-called budgetagreement, H.R. 2015 would sanction the dis-crimination and gross mistreatment ofworkfare participants. Yesterday, the NewYork Times documented a tragedy in which a50-year-old Workfare participant in New Yorkdied on her job. Apparently, this individual suf-fered from coronary heart disease and wasnot able to work. Yet, the individual's well-doc-umented medical history was allegedly ig-nored. The Times revealed that manyworkfare workers have complained about gen-uine health problems, and were still forced towork in conditions inimical to their health. AndCongress' unconscionable answer to this is toensure that wronged workfare workers haveno Federal protections.

Moreover, H.R. 2015 reneges on the WhiteHouse-Republican budget agreement's prom-ise to restore benefits to legal, disabled immi-grants who face termination from the SSI pro-gram in October. H.R. 2015 would ensure thatthose immigrants who received SSI before thedate of the welfare reform bill's enactment,August 22, 1996, will continue to receivethem. However, no provisions are made forthose elderly, legal immigrants who were inthe country by August 22 and became dis-abled after this date. At best, the omission ofthis protection reveals a distorted understand-ing of an agreement. At worst, it indicates acareless, despicable disregard for our legalimmigrants who lack the ability to secure theresources needed to sustain a minimumstandard of living.

Undoubtedly, this bill still needs more work.This Nation's budget must reflect our values.Our values do not rob the poor and our chil-dren to provide for the rich. We must educateour children, all ages. We must build newschools. We must provide child health care forall needy children. We must keep freedomalive for all citizens. And we must do all of thiswithout cutting Medicare and Medicaid, there-by, penalizing our elderly and our poor. I urgemy colleagues to reject this shameful budgetbill and vote "no" against H.R. 2015.

Mrs. JOHNSON of Connecticut. Mr. Speak-er, today I rise in support of the BalancedBudget Act of 1997. Specifically, I stronglysupport the provision that will allow any per-manent resident who was receiving supple-mental security income ESSI] as of the enact-ment of last year's welfare bill, August 22,1996, to continue to do so.

I believe the noncitizen provisions in theBalanced Budget Act are compassionate andfair. By grandfathering everyone currently onSSI, it does not require anyone to undergo aneligibility redetermination process. I considerthis to be essential, since those on SSI are

June 25, 1997

some of our most vulnerable members of soci-ety—poor, elderly, and disabled. Imagine tell-ing an 85-year-old widow who qualified for SSIunder the elderly category that she may, ormay not, lose her benefits based on whetherthe SSI employees determine her to be dis-abled as well as elderly. The disability deter-mination process can be lengthy, detailed, andoften full of uncertainties, especially for thosewith a limited command of English. I did notsupport eliminating SSI for those noncitizensalready on the rolls last year, and I continueto oppose any efforts to take away benefits forthis group, of people. Subjecting 300,000 poor,elderly aliens to the SSI redetermination proc-ess is unjust.

I have been working closely with the Polishand Hispanic communities in my district to restore what I view as harmful cuts in benefitspassed as part of the welfare bill. I cannotthink of one group of people more vulnerablethan the elderly and disabled dependent onsupplementary security income. In addition tograndfathering all noncitizens on SSI as of lastAugust, I support efforts to provide a bridge tothose noncitizens who become disabled in thefuture. Legal permanent residents need to beaware of their options in the future, beforethey become disabled. If they work, or theirspouse works, for 40 quarters, serve in themilitary, or become a U.S. citizen, legal resi-dents will qualify for SSI. I am optimistic thatmost permanent residents will be prepared tomeet at least one of these criteria and so pro-tect themselves in case of a disabling acci-dent.

As a bridge, for legal residents not qualifiedfor SSI but who are borderline, I support atransition period so that noncitizens who cameto the United States under the old rules andwho are already borderline disabled or dis-abled but supported by family would be ableto receive help.

I urge my colleagues to join me in supportof the noncitizens provisions of the BalancedBudget Act of 1997.

Ms. CHRISTIAN-GREEN. Mr. Speaker, I

rise in strong opposition to the budget rec-onciliation bill because it will hurt everyonefrom children to low income workers to legalimmigrants.

Over 1 month ago, my colleagues on theother side of the aisle heralded the reachingan agreement with the President to balancethe Federal budget by the year 2002. How-ever, in an almost complete turnaround, thisspending bill before the House today reflectsa near complete repudiation of that agree-ment.

In addition to refusing to honor the budgetagreement on health-care coverage for low-in-come elderly and uninsured children, the billbefore us today makes deep cuts in the veryimportant Disproportionate Share Hospital Pro-gram and the SSI State maintenance-of-effort.

Of particular concern to me and my col-leagues who represent the over 4 million U.S.citizens in the U.S. territories and common-wealths, this spending bill completely elimi-nates all of the increments for inflation adjust-ments to the Medicaid Programs in theseareas, that was provided in the balancedbudget agreement. My constituents and thoseof my fellow congressional Delegates whosehealth care costs we cannot adequately meetat our present capped funding levels, werecounting on even this small increase in ourMedicaid payments.

June 25, 1997 CONGRESSIONAL RECORD — HOUSE H4583The territories are capped under current law

in the amount of Medicaid payments we canreceive and as a result, our current fundinglevel does not permit DSH payments to our a-ready struggling hospitals. This very punitivedecision not to provide this very needed in-crease in Medicaid payments for the territorieswill severely undermine the already fragilehealth-care delivery system and impact se-verely on children and the poor in the U.S. off-shore areas.

This reconciliation bill defiantly turns its backon a hard fought bipartisan balanced budgetagreement that reflected a compromise onmany important and controversial issues. Wemust insist that the majority live up to theagreement they reached with the President byvoting no on this deeply flawed bill.

Mr. FRELINGHUYSEN. Mr. Speaker, I risetoday in support of H.R. 2015, the Fiscal Year1998 Balanced Budget Act.

My priority as a Member of Congress hasbeen to work toward implementation of a bal-anced Federal budget. Over the course of thepast 3 years, the Republican Congress has re-duced the deficit and cut Government spend-ing by $43 billion. We have also raised thelevel of debate on this issue to the point thatwe are at today. It took Republican leadershipto get it to this point in history as we are aboutto vote on a proposal to balance the Federalbudget by 2002—the first balanced Federalbudget since 1969.

I am pleased to stand in support of takingthe next step forward towards ecuring a bet-ter future for our children and for our country.This budget sets reasonable priorities for Fed-eral Government spending. And, later thisweek, we will vote on another proposal 10 re-turn money to the pockets of hard-workingAmerican citizens.

This agreement balances our country's eco-nomic needs with our commitment to our vet-erans, seniors, students, and hard-workingtaxpayers, and allows generous spending onprograms that are important to them.

The package also contains important re-forms to the Medicare program, that serves somany older Americans in my District and mil-lions of Americans across the country. Underthis agreement, the Medicare part A trust fundwill be preserved and protected for at least 10years. We make these reforms while increas-ing spending on the program each year.

Seniors will be given greater choices in theirhealth care coverage. For the first time, bene-ficiaries will have the option of enrolling inmedical savings accounts. The range of pre-ventive benefits will be expanded to includemammography, diabetes, and prostate andcolorectal cancer screenings.

The budget reconciliation package makesother important changes to the delivery ofhealth care. States will be provided with great-er flexibility to manage the Medicaid Programand in turn, Federal outlays on Medicaid willbe reduced by approximately $11.4 billion overthe next 5 years. At the same time, States wiHshare a $16 billion block grant to providehealth insurance for currenfly uninsured chil-dren from low-income families.

H.R. 2015 also makes reasonable changesto existing welfare and immigration laws thatwere enacted in the 104th Congress. It main-tains the core reforms to welfare, SSI, and

H4593food stamps, yet restores benefits to a vulner-able group of legal immigrants, the aged anddisab'ed, who were receiving SSI at the timethe laws were signed.

As more and more Americans enroll in man-aged care, it is critical to address some con-cerns that have been raised about the man-agement of these programs. H.R. 2015 in-cludes a number of important consumer pro-tections for Medicare and Medicaid recipientsenrolled in managed care. Included are pro-posals to prohibit a managed care plan frompreventing a physician from advising a patient,and requires that the length of a Medicaid re-cipients hospital stay be determined by the pa-tent and doctor, instead of a health manage-ment organization.

For these, and many other reasons, I ampleased to support this budget that makescommonsense spending decisions, sets prior-ities, continues adequate levels of spendingon important Federal programs to protect ourhealth, safety, seniors, families, and children.This budget resolution is true to our commit-ment to ba'ance the Federal budget and livewithin our means. It assures fiscal disciplineand it takes power out of Washington and re-turns it to New Jersey and our neighborhoods.

The SPEAKER pro tempore. All timefor debate has expired.

Pursuant to House Resolution 174,the bill is considered as read foramendment, and the previous questionis ordered.

The question is on the engrossmentand third reading of the bill.

The bill was ordered to be engrossedand read a third time, and was read thethird time.

o 1715

MOTION TO RECOMMIT OFFERED BY MR. BROWNOF OHIO

Mr. BROWN of Ohio. Mr. Speaker, Ioffer a motion to recommit.

The SPEAKER pro tempore (Mr.DREIER). Is the gentleman opposed tothe bill?

Mr. BROWN of Ohio. In its currentform, I am, Mr. Speaker.

The SPEAKER pro tempore. TheClerk will report the motion to recom-mit.

The Clerk read as follows:MOTION TO RECOMMIT H.R. 2015 WITH

INSTRUCTIONS

OFFERED BY MR. BROWN OF OHIO

Mr. BROWN of Ohio moves to recommit thebill HR. 2015 to the Committee on the Budg-et with instructions to report the same backto the House forthwith with the followingamendment:

Strike subtitle F of title III and insert thefollowing:Subtitle F—Child Health Insurance Initiative

Act of 1997sEc. 3500. 5HORT TITLE OF SUBTITLE.

This subtitle may be cited as the ChildHealth Insurance Initiative Act of 1997'.

CHAPTER 1—IMPROVED OUTREACHSEC. 3501. GRANT PROGRAM TO PROMOTE our-


There are authorized to be appropriated, foreach fiscal year beginning with fiscal year1998 to the Secretary of Health and HumanServices. $25000000 for grants to States. 10-calities, and nonprofit entities to promoteoutreach efforts to enroll eligible childrenunder the medicaid program under title XIX

June 25. 1997 CONGRESSIONAL RECORD — HOUSE

H4594of the Social Security Act (42 U.S.C. 1396 etseq.) and related programs.

(b) USE OF FUNDS—Funds under this sec-tion may be used to reimburse States, local-ities. and nonprofit entities for additionaltraining and administrative costs associatedwith outreach activities. Such activities in-clude the following:

(1) USE OF A COMMON APPLICATION FORM FORFEDERAL CHILD ASSISTANCE PROGRAMS—Im-plementing use of a single application form(established by the Secretary and based onthe model application forms developed undersubsections (a) and (b) of section 6506 of theOmnibus Budget Reconciliation Act of 1989(42 U.S.C. 701 note; 1396a note)) to determinethe eligibility of a child or the child's family(as applicable) for assistance or benefitsunder the medicaid program and under otherFederal child assistance programs (such asthe temporary assistance for needy familiesprogram under part A of title IV of the So-cial Security Act (42 U.S.C. 601 et seq.), thefood stamp program, as defined in section3(h) of the Food Stamp Act of 1977 (7 U.S.C.2012(h)), and the State program for fostercare maintenance payments and adoption as-sistance payments under part E of title IV ofthe Social Security Act (42 U.S.C. 670 etseq.)).

(2) EXPANDING OUTSTATIONING OF ELIGI-BILITY PERSONNEL—Providing for the sta-tioning of eligibility workers at sites, suchas hospitals and health clinics, at which chil-dren receive health care or related services.

(c) APPLICATION, ETC.—Funding shall bemade available under this section only uponthe approval of an application by a State, lo-cality, or nonprofit entity for such fundingand only upon such terms and conditions asthe Secretary specifies.

(d) ADMINISTRATION—The Secretary mayadminister the grant program under this sec-tion through the identifiable administrativeunit designated under section 509(a) of theSocial Security Act (42 U.S.C. 709(a)) to pro-mote coordination of medicaid and maternaland child health activities and other childhealth related activities.

CHAPTER 2—MEDIKIDS PROGRAMSEC. 3521. STATE ENTITLEMENT TO PAYMENT


plan for a child health insurance program, orMediKids program, approved by the Sec-retary is entitled to receive, from amountsin the Treasury not otherwise appropriatedand for each fiscal year beginning with fiscalyear 1998, payment of the amounts providedunder section 3523.

(b) APPLICATION—The Secretary shall es-tablish a procedure for the submittal and ap-proval of plans for MediKids programs underthis chapter. The Secretary shall approvethe plan of a State for such a program if theSecretary determines that—

(1) the State is meeting the medicaid cov-erage requirements of section 3522(a), and

(2) the plan provides assurances satisfac-tory to the Secretary that the MediKids pro-gram will be conducted consistent with theapplicable requirements of section 3522.SEC. 3522. REQUIREMENTS FOR APPROVAL OF



(1) COVERAGE OF PREGNANT WOMEN ANDCHILDREN AND INFANTS UP TO 185 PERCENT OFPOVERTY—The State has established 185 per-cent of the poverty line as the applicablepercentage under section 1902(1) (2) (A) of theSocial Security Act (42 U.S.C. 1396a(l)(2)(A)).

(2) COVERAGE OF CHILDREN UP TO 19 YEARSOF AGE.—The State provides, either throughexercise of the option under section1902(1) (1) (D) of such Act (42 U.S.C.

CONGRESSIONAL RECORD — HOUSE1396a(l)(1)(D)) or authority under section1902(r) (2) of such Act (42 U.S.C. 1396a(r)(2)) forcoverage under section 1902(l)(1)(D) of suchAct of individuals under 19 years of age, re-gardless of date of birth.


(B), the State—(i) has not modified the eligibility require-

ments for children under the State medicaidplan, as in effect on January 1. 1997 in anymanner that would have the effect of reduc-ing the eligibility of children for coverageunder such plan, and


(B) WAIVER EXCEPTION—Subparagraph (A)shall not apply to modifications made pursu-ant to an application for a waiver under sec-tion 1115 of the Social Security Act (42U.S.C. 1315) submitted before January 1, 1997.

(b) COVERAGE OF UNINSURED CHILDREN.—(1) IN GENERAL—A MediKids program shall

not provide benefits for children who areotherwise covered for such benefits under amedicaid plan or under a group health plan,health insurance coverage, or other healthbenefits coverage, but may expend funds foroutreach and other activities in order to pro-mote coverage under such plans.

(2) CONSTRUCTION—Nothing in this sub-section shall be construed as requiring aMediKids plan of a State to provide coveragefor all near poverty level children describedin paragraph (1) who are residing in theState.

(c) MEDICAID-EQUIVALENT BENEFITS—Sub-ject to subsection (d), a MediKids programshall provide benefits to eligible children forthe equivalent items and services for whichmedical assistance is available (other thancost sharing) to children under the State'smedicaid plan.

(d) PREMIUMS AND COST-SHARING.—(1) IN GENERAL—Subject to paragraphs (2)

and (3), a MediKids program may—(A) require the payment of premiums as a

condition for coverage, but only for a cov-ered child whose family income exceeds thepoverty line;

(B) impose deductibles, coinsurance, co-payments, and other forms of cost-sharingwith respect to benefits under the program;and

(C) vary the levels of premiums,deductibles, coinsurance, copayments, andother cost-sharing based on a sliding scalerelated to the family income of the coveredchild.

(2) LIMITS ON PREMIUMS AND COST-SHAR-ING.—The Secretary shall establish limits onthe amount of cost-sharing expenses (includ-ing premiums, deductibles, coinsurance, co-payments, and any other required financialcontribution) that may be applied under theprogram. Such limits shall assure that totalcost sharing expenses for children participat-ing in such program are reasonable in rela-tion to the income of their family (and tak-ing into account the other types of expensesgenerally incurred by such families and fam-ily size) and that such cost sharing expensesdo not unreasonably reduce access to thecoverage or covered services provided undersuch program.

(3) No COST SHARING FOR PREVENTIVE SERV-ICES—A MediKids program may not imposedeductibles, coinsurance, copayments, orsimilar cost sharing for preventive services.SEC. 3523. PAYMENT AMOUNTS.

(a) TOTAL AMOUNT AVAILABLE.—(1) IN GENERAL—The total amount of funds

that is available for payments under thischapter in any fiscal year is the base amountspecified in paragraph (2) for the fiscal yearreduced by the amount specified under para-graph (3) for the fiscal year.

June 25, 1997

(2) BASE AMOUNT—The base amount speci-fied under this paragraph for fiscal year 1998and any subsequent fiscal year is$2,805,000,000.

(3) OFFSET FOR CERTAIN INCREASED MEDIC-AID EXPENDITURES.—

(A) IN GENERAL—Subject to subparagraph(B), the amount specified under this para-graph for a fiscal year is the amount of ag-gregate additional Federal expendituresunder made title XIX of the Social SecurityAct during the fiscal year that the Secretaryestimates, before the beginning of the fiscalyear, is attributable to imposition of theconditions described in section 3522(a). Forpurposes of applying the previous sentence,any Federal expenditures that result from anincrease in the applicable percentage undersection 1902(1) (2) (A) of the Social SecurityAct above the percentage in effect as of June25, 1997, or from any exercise of an option de-scribed in section 3522(a)(2) effected on orafter such date, shall be treated as addi-tional Federal expenditures attributable tothe imposition of the conditions described insection 3522(a).

(B) ADJUSTMENT TO REFLECT ACTUAL EX-PENDITURES.—After the end of each fiscalyear, the Secretary shall determine the ac-tual amount of the additional Federal ex-penditures described in subparagraph (A) forthe fiscal year. The Secretary shall adjustthe amount otherwise specified under sub-paragraph (A) for subsequent years to takeinto account the amount by which theamounts estimated for previous fiscal yearsunder such subparagraph were greater, orless than, the actual amount of the expendi-tures for such years.


lish a formula for the allotment of the totalamount of funds available under subsection(a) among the qualifying States for each fis-cal year.

(2) BASIS—The formula shall be based uponthe Secretary's estimate of the number ofnear poverty level children in the State as aproportion of the total of such numbers forall the qualifying States.

(3) CARRYFORWARD.—If the Secretary doesnot pay to a State under subsection (c) in afiscal year the amount of its allotment inthat fiscal year under this subsection, theamount of its allotment under this sub-section for the succeeding fiscal year shallbe increased by the amount of such shortfall.

(c) PAYMENTS.—(1) IN GENERAL.—FrOm the allotment of

each qualifying State under subsection (b)for a fiscal year, the Secretary shall pay tothe State for each quarter in the fiscal yearan amount equal to 75 percent of the totalamount expended during such quarter tocarry Out the State's MediKids program.

(2) NOT COUNTING COST SHARING—For pur-poses of paragraph (1), if a Med iKids programimposes premiums for coverage or requirespayment of deductibles, coinsurance, copay-ments, or other cost sharing, under rules ofthe Secretary, expenditures attributable tosuch premiums or cost sharing shall not betaken into account under paragraph (1).


For purposes of this chapter:(1) The term "child" means an individual

under 19 years of age.(2) The term "medicaid plan" means the


June 25, 1997

(3) The term MediKids program' means achild health insurance program of a Stateunder this title.

(4) The term "near poverty level childmeans a child the family income of which (asdefined by the Secretary) is at least 100 per-cent, but less than 300 percent, of the pov-erty line.

(5) The term poverty line has the mean-ing given such term in section 673(2) of theCommunity Services Block Grant Act (42U.S.C. 9902(2)), including any revision re-quired by such section.

(6) The term qualifying State' means aState with a MediKids program for which aplan is submitted and approved under thistitle.

(7) The term Secretary means the Sec-retary of Health and Human Services.

(8) The term State' means the 50 States.the District of Columbia, Puerto Rico. theVirgin Islands. Guam, American Samoa. andthe Northern Mariana Islands.CHAPTER 3—CONTINUATION OF MEDIC-

AID ELIGIBILITY FOR DISABLED CHIL-DREN WHO LOSE SSI BENEFITS

SEC. 3531. CONTINUATION OF MEDICAID ELIGI-BILITY FOR DISABLED CHILDRENWHO LOSE SSI BENEFITS.

(a) IN GENEIAL.—Section1902(a)(10)(A)(i)(II) of the Social Security Act(42 U.S.C. 1396a(a)(10)(A)(i)(II)) is amended byinserting (or were being paid as of the dateof enactment of section 211(a) of the Per-sonal Responsibility and Work OpportunityReconciliation Act of 1996 (P.L. 104—193)) andwould continue to be paid but for the enact-ment of that section after title XVI"

(b) EFFECTIVE DATE—The amendmentmade by subsection (a) applies to medical as-sistance furnished on or after July 1. 1997.

CHAPTER 4—ASSURING CHILDREN'SACCESS TO HEALTH INSURANCE

SEC. 3541. GUARANTEED AVAILABILITY OF INDI-VIDUAL HEALTH INSURANCE COV-ERAGE TO UNINSURED CHILDREN.

(a) IN GENEIAL.—Title XXVII of the PublicHealth Service Act, as added by section111(a) of the Health Insurance Portabilityand Accountability Act of 1996. is amendedby inserting after section 2741 the followingnew section:"SEC. 2741A. GUARANTEED AVAILABILITY OF IN-


'(a) GUARANTEED AVAILABILITY.—(1) IN GENERAL—Subject to the succeed-

ing subsections of this section. each healthinsurance issuer that offers health insurancecoverage (as defined in section 2791(b)(1)) inthe individual market in a State, in the caseof an eligible child (as defined in subsection(b)) desiring to enroll in individual health in-surance coverage—

(A) may not decline to offer such cov-erage to. or deny enrollment of. such child;

(B) either (i) does not impose any pre-existing condition exclusion (as defined insection 2701(b)(1)(A)) with respect to suchcoverage, or (ii) imposes such a preexistingcondition exclusion only to the extent suchan exclusion may be imposed under section2701 (a) in the case of an individual who is nota late enrollee; and

"(C) shall provide that the premium for thecoverage is determined in a manner so thatthe ratio of the premium for such eligiblechildren to the premium for eligible individ-uals described in section 2741(b) does not ex-ceed the ratio of the actuarial value of suchcoverage (calculated based on a standardizedpopulation and a set of standardized utiliza-tion and cost factors) for children to such ac-tuarial value for such coverage for such eli-gible individuals.

'(2) SUBSTITUTION BY STATE OF ACCEPTABLEALTERNATIVE MECHANISM—The requirement

CONGRESSIONAL RECORD — HOUSEof paragraph (1) shall not apply to health in-surance coverage offered in the individualmarket in a State in which the State is im-plementing an acceptable alternative mecha-nism under section 2744.

(b) ELIGIBLE CHILD DEFINED—In this part.the term 'eligible child' means an individualborn after September 30, 1983, who has notattained 19 years of age and—

"(1) who is a citizen or national of theUnited States, an alien lawfully admitted forpermanent residence, or an alien otherwisepermanently residing in the United Statesunder color of law;

"(2) who is not eligible for coverage under(A) a group health plan, (B) part A or part Bof title XVIII of the Social Security Act, or(C) a State plan under title XIX of such Act(or any successor program), and does nothave other health insurance coverage: and

"(3) with respect to whom the most recentcoverage (if any, within the 1-year periodending on the date coverage is sought underthis section) was not terminated based on afactor described in paragraph (1) or (2) of sec-tion 2712(b) (relating to nonpayment of pre-miums or fraud).For purposes of paragraph (2) (A). the term'group healthplan' does not include COBRAcontinuation coverage.

"(c) INCORPORATION OF CERTAIN PRO VI-SIONS.—

"(1) IN GENERAL—Subject to paragraph (2).the provisions of subsections (c), (d) (e) and(f) (other than paragraph (1)) of section 2741and section 2744 shall apply in relation to eli-gible children under subsection (a) in thesame manner as they apply in relation to eli-gible individuals under section 2741(a).

"(2) SPECIAL RULES FOR ACCEPTABLE ALTER-NATIVE MECHANISMS—With respect to apply-ing section 2744 under paragraph (1)—

"(A) the requirement in subsection(a)(1)(B) shall be applied instead of the re-quirement of section 2744(a) (1) (B);

"(B) the requirement in subsection(a)(1)(C) shall be applied instead of the re-quirement of section 2744(a)(1)(D); and

"(C) any deadline specified in such sectionshall be 1 year after the deadline otherwisespecified.".

(b) EFFECTIVE DATE.—The amendmentmade by subsection (a) shall take apply 1year after the effective date for section 2741of the Public Health Service Act (as providedunder section 111(b)(1) of the Health Insur-ance Portability and Accountability Act of1996).

AMENDMENT TO HR. —. AS REPORTED

OFFERED BY MR. BARTON OF TEXASAt the end of the bill, add the following

new title:TITLE XI—BUDGET PROCESS

ENFORCEMENTSEC. 11001. SHORT TITLE AND TABLE OF CON-

TENTS.(a) SHORT TITLE—This title may be cited

as the "Balanced Budget Assurance Act of1997".

(b) TABLE OF CONTENTS.—

TITLE XI—BUDGET PROCESSENFORCEMENT

Sec. 11001. Short title and table of contents.Sec. 11002. Definitions.Subtitle A—Ensure That the Bipartisan Bal-


Sec. 11101. Timetable.Sec. 11102. Procedures to avoid sequestra-

tion or delay of new revenue re-ductions.

Sec. 11103. Effect on Presidents' budget sub-missions: point of order.

Sec. 11104. Deficit and revenue targets.Sec. 11105. Direct spending caps.

H4595Sec. 11106. Economic assumptions.Sec. 11107. Revisions to deficit and revenue

targets and to the caps for enti-tlements and other mandatoryspending.

Subtitle B—Enforcement Provisions11201. Reporting excess spending.11202. Enforcing direct spending caps.11203. Sequestration rules.11204. Enforcing revenue targets.11205. Exempt programs and activities.11206. Special rules.11207. The current law baseline.11208. Limitations on emergency spend-

ing.SEC. 11002. DEFINITIONS.

For purposes of this title:(1) ELIGIBLE POPULATION—The term "eligi-

ble population" shall mean those individualsto whom the United States is obligated tomake a payment under the provisions of alaw creating entitlement authority. Suchterm shall not include States, localities, cor-porations or other nonliving entities.

(2) SEQUESTER AND SEQUESTRATION—Theterms 'sequester" and "sequestration" referto or mean the cancellation of budgetary re-sources provided by discretionary appropria-tions or direct spending law.

(3) BREACH—The term "breach" means, forany fiscal year. the amount (if any) by whichoutlays for that year (within a category ofdirect spending) is above that category's di-rect spending cap for that year.

(4) BASELINE—The term "baseline" meansthe projection (described in section 11207) ofcurrent levels of new budget authority, Out-lays, receipts, and the surplus or deficit intothe budget year and the outyears.

(5) BUDGETARY RESOURCES—The term'budgetary resources" means new budget au-

thority. unobligated balances, direct spend-ing authority, and obligation limitations.

(6) DISCRETIONARY APPROPRIATIONS—Theterm "discretionary appropriations" meansbudgetary resources (except to fund directspending programs) provided in appropria-tion Acts. If an appropriation Act alters thelevel of direct spending or offsetting collec-tions, that effect shall be treated as directspending. Classifications of new accounts oractivities and changes in classificationsshall be made in consultation with the Com-mittees on Appropriations and the Budget ofthe House of Representatives and the Senateand with CBO and 0MB.

(7) DIRECT SPENDING—The term "directspending" means—

(A) budget authority provided by law otherthan appropriation Acts, including entitle-ment authority;

(B) entitlement authority: and(C) the food stamp program.

If a law other than an appropriation Act al-ters the level of discretionary appropriationsor offsetting collections, that effect shall betreated as direct spending.

(8) ENTITLEMENT AUTHORITY—The term"entitlement authority" means authority(whether temporary or permanent) to makepayments (including loans and grants). thebudget authority for which is not providedfor in advance by appropriation Acts. to anyperson or government if. under the provi-sions of the law containing such authority,the United States is obligated to make suchpayments to persons or governments whomeet the requirements established by suchlaw.

(9) CURRENT.—The term "current" means,with respect to 0MB estimates included witha budget submission under section 1105(a) oftitle 31 U.S.C., the estimates consistent withthe economic and technical assumptions un-derlying that budget.

Sec.Sec.Sec.Sec.Sec.Sec.Sec.Sec.

H4596(10) ACCOUNT—The term account" means

an item for which there is a designated budg-et account designation number in the Presi-dent's budget.

(11) BUDGET YEAR.—The term "budgetyear' means the fiscal year of the Govern-ment that starts on the next October 1.

(12) CURRENT YEAR.—The term 'currentyear means, with respect to a budget year,the fiscal year that immediately precedesthat budget year.

(13) OUTYEAR.—The term 'outyear" means,with respect to a budget year, any of the fis-cal years that follow the budget year.

(14) 0MB—The term 0MB means the Di-rector of the Office of Management andBudget.

(15) CBO.—The term 'CBO" means the Di-rector of the Congressional Budget Office.

(16) BUDGET OUTLAYS AND OUTLAYS—Theterms budget outlays" and outlays" mean,with respect to any fiscal year. expendituresof funds under budget authority during suchyear.

(17) BUDGET AUTHORITY AND NEW BUDGETAUTHORITY—The terms 'budget authority"and new budget authority" have the mean-ings given to them in section 3 of the Con-gressional Budget and Impoundment ControlAct of 1974.

(18) APPROPRIATION ACT.—The term appro-priation Act" means an Act referred to insection 105 of title 1 of the United StatesCode.

(19) CONSOLIDATED DEFICIT—The term• consolidated deficit" means, with respectto a fiscal year, the amount by which totaloutlays exceed total receipts during thatyear.

(20) SURPLUS—The term surplus" means,with respect to a fiscal year, the amount bywhich total receipts exceed total outlaysduring that year.

(21) DIRECT SPENDING CAPS—The term di-rect spending caps" means the nominal dol-lar limits for entitlements and other manda-tory spending pursuant to section 11105 (asmodified by any revisions provided for inthis Act).Subtitle A—Ensure That the Bipartisan Ba!-


SEC. 11101. TIMETABLE.On or before:January IS

SEC. 11102. PROCEDURES TO AVOID SEQUESTRA-TION OR DELAY OF NEW REVENUEREDUCTIONS.

(a) SPECIAL MESSAGE—If the 0MB Analy-sis of Actual Spending Levels and Projec-tions for the Upcoming Year indicates that—

(1) deficits in the most recently completedfiscal year exceeded, or the deficits in thebudget year are projected to exceed, the defi-cit targets in section 11104;


(2) revenues in the most recently com-pleted fiscal year were less than, or revenuesin the current year are projected to be lessthan, the revenue targets in section 11104: or

(3) outlays in the most recently completedfiscal year exceeded, or outlays in the cur-rent year are projected to exceed, the caps insection 11104;the President shall submit to Congress withthe 0MB Analysis of Actual Spending Levelsand Projections for the Upcoming Year aspecial message that includes proposed legis-lative changes to—

(A) offset the net deficit or outlay excess;(B) offset any revenue shortfall; or(C) revise the deficit or revenue targets or

the outlay caps contained in this Act;through any combination of—

(i) reductions in outlays;(ii) increases in revenues; or(iii) increases in the deficit targets or ex-

penditure caps, or reductions in the revenuetargets if the President submits a writtendetermination that. because of economic orprogrammatic reasons. none of the variancesfrom the balanced budget plan should be off-set.

(b) INTRODUCTION OF THE PRESIDENT'SPACKAGE—NOt later than November 15, themessage from the President required pursu-ant to subsection (a) shall be introduced as ajoint resolution in the House of Representa-tives or the Senate by the chairman of itsCommittee on the Budget. If the chairmanfails to do so, after November 15, the jointresolution may be introduced by any Mem-ber of that House of Congress and shall be re-ferred to the Committee on the Budget ofthat House.

(c) HOUSE BUDGET COMMITtEE ACTION—TheCommittee on the Budget of the House ofRepresentatives shall, by November 15, re-port ajoint resolution containing—

(1) the recommendations in the President'smessage, or different policies and proposedlegislative changes than those contained inthe message of the President, to ameliorateor eliminate any excess deficits or expendi-tures or any revenue shortfalls. or

(2) any changes to the deficit or revenuetargets or expenditure caps contained in thisAct, except that any changes to the deficitor revenue targets or expenditure caps can-not be greater than the changes rec-ommended in the message submitted by thePresident.

(d) PROCEDURE IF THE COMMITtEES ON THEBUDGET OF THE HOUSE OF REPRESENTATIVESOR SENATE FAILS To REPORT REQUIRED RESO-LUTION.—

(1) AUTOMATIC DISCHARGE OF COMMITtEES ONTHE BUDGET OF THE HOUSE—If the Committeeon the Budget of the House of Representa-tives fails. by November 20, to report a reso-lution meeting the requirements of sub-section (c), the committee shall be automati-cally discharged from further considerationof the joint resolution reflecting the Presi-dent's recommendations introduced pursuantto subsection (a), and the joint resolutionshall be placed on the appropriate calendar.

(2) CONSIDERATION OF DISCHARGE RESOLU-TION IN THE HOUSE—If the Committee hasbeen discharged under paragraph (1) above,any Member may move that the House ofRepresentatives consider the resolution.Such motion shall be highly privileged andnot debatable. It shall not be in order to con-sider any amendment to the resolution ex-cept amendments which are germane andwhich do not change the net deficit impactof the resolution.

(e) CONSIDERATION OF JOINT RESOLUTION INTHE HOUSE—Consideration of resolution re-ported pursuant to subsection (c) or (d) shallbe pursuant to the procedures set forth insection 305 of the Congressional Budget Actof 1974 and subsection (d).

June 25, 1997

(f) TRANSMITtAL TO SENATE—If a joint res-olution passes the House of Representativespursuant to subsection (e), the Clerk of theHouse of Representatives shall cause the res-olution to be engrossed, certified, and trans-mitted to the Senate within 1 calendar dayof the day on which the resolution is passed.The resolution shall be referred to the Sen-ate Committee on the Budget.

(g) REQUIREMENTS FOR SPECIAL JOINT RESO-LUTION IN THE SENATE—The Committee onthe Budget of the Senate shall report notlater than December 1—

(1) a joint resolution reflecting the mes-sage of the President; or

(2) the joint resolution passed by the Houseof Representatives, with or without amend-ment; or

(3) a joint resolution containing differentpolicies and proposed legislative changesthan those contained in either the messageof the President or the resolution passed bythe House of Representatives, to eliminateall or part of any excess deficits or expendi-tures or any revenue shortfalls, or

(4) any changes to the deficit or revenuetargets, or to the expenditure caps, con-tained in this Act, except that any changesto the deficit or revenue targets or expendi-ture caps cannot be greater than the changesrecommended in the message submitted bythe President.

(h) PROCEDURE IF THE SENATE BUDGET C0M-MITtEE FAILS To REPORT REQUIRED RESOLU-TION.—

(1) AUTOMATIC DISCHARGE OF SENATE BUDG-ET COMMITtEE—In the event that the Com-mittee on the Budget of the Senate fails. byDecember 1, to report a resolution meetingthe requirements of subsection (g). the com-mittee shall be automatically dischargedfrom further consideration of the joint reso-lution reflecting the President's rec-ommendations introduced pursuant to sub-section (a) and of the resolution passed bythe House of Representatives and both jointresolutions shall be placed on the appro-priate calendar.

(2) CONSIDERATION OF DISCHARGE RESOLU-TION IN THE SENATE.—(A) If the Committeehas been discharged under paragraph (1), anymember may move that the Senate considerthe resolution. Such motion shall be highlyprivileged and not debatable. It shall not bein order to consider any amendment to theresolution except amendments which aregermane and which do not change the netdeficit impact of the resolution.

(B) Consideration of resolutions reportedpursuant to subsections (c) or (d) shall bepursuant to the procedures set forth in sec-tion 305 of the Congressional Budget Act of1974 and subsection (d).

(C) If the joint resolution reported by theCommittees on the Budget pursuant to sub-section (c) or (g) or a joint resolution dis-charged in the House of Representatives orthe Senate pursuant to subsection (d)(1) or(h) (1) would eliminate less than—

(i) the entire amount by which actual orprojected deficits exceed. or revenues fallshort of, the targets in this Act; or

(ii) the entire amount by which actual orprojected outlays exceed the caps containedin this Act;then the Committee on the Budget of theSenate shall report a joint resolution, rais-ing the deficit targets or outlay caps, or re-ducing the revenue targets for any year inwhich actual or projected spending. revenuesor deficits would not conform to the deficitand revenue targets or expenditure caps inthis Act.

(k) CONFERENCE REPORTS SHALL FULLY AD-DRESS DEFICIT ExCESS—It shall not be inorder in the House of Representatives or theSenate to consider a conference report on ajoint resolution to eliminate all or part of

First Monday in Feb-ruary.

August 1August 15Not later than November

I (and as soon as prac-tical after the end ofthe fiscal).

November I-December 15

December 15

December IS

Action to be completed:CBO economic and budg-

et update.President's budget up-

date based on new as-sumptions.

CBO and 0MB updates.Preview report.0MB and CBO Analyses

of Deficits, Revenuesand Spending Levelsand Projections for theUpcoming Year.

Congressional action toavoid sequestration.

0MB issues final (lookback) report for prioryear and preview forcurrent year.

Presidential sequesterorder or order delayingnew/additional reve-nues reductions sched-uled to take effect pur-suant to reconciliationlegislation enacted incalendar year 1997.

June 25, 1997any excess deficits or outlays or to eliminateall or part of any revenue shortfall comparedto the deficit and revenue targets and the ex-penditure caps contained in this Act, un-less—

(1) the Joint resolution offsets the entireamount of any overage or shortfall; or

(2) the House of Representatives and Sen-ate both pass the Joint resolution reportedpursuant to subsection (J)(2).The vote on any resolution reported pursu-ant to subsection (j)(2) shall be solely on thesubject of changing the deficit or revenuetargets or the expenditure limits in this Act.SEC. 11103. EFFECT ON PRESIDENTS' BUDGET

SUBMISSIONS; POINT OF ORDER.(a) BUDGET SUBMISSI0N.—Any budget sub-

mitted by the President pursuant to section1105(a) of title 31. United States Code, foreach of fiscal years 1998 through 2007 shall beconsistent with the spending, revenue, anddeficit levels established in sections 11104and 11105 or it shall recommend changes tothose levels

(b) POINT OF ORDER.—It shall not be inorder in the House of Representatives or theSenate to consider any concurrent resolutionon the budget unless it is consistent with thespending, revenue, and deficit levels estab-lished in sections 11104 and 11105.SEC. 11104. DEFICIT AND REVENUE TARGETS.

(a) CONSOLIDATED DEFICIT (OR SURPLUS)TARGETS—For purposes of sections 11102 and11107, the consolidated deficit targets shallbe—

(1) for fiscal year 1998, $90,500,000,000;(2) for fiscal year 1999, $89,700,000,000;(3) for fiscal year 2000, $83,000,000,000;(4) for fiscal year 2001, $53,300,000,000; and(5) for fiscal year 2002, there shall be a sur-

plus of not less than $1,400,000,000.(b) CONSOLIDATED REVENUE TARGETS—For

purposes of sections 11102, 11107, 11201, and11204, the consolidated revenue targets shallbe—

(1) for fiscal year 1998, $1,601,800,000,000;(2) for fiscal year 1999, $1,664,200,000,000;(3) for fiscal year 2000, $1,728,100,000,000;(4) for fiscal year 2001, $1,805,100,000,000; and(5) for fiscal year 2002, $1,890,400,000,000.

SEC. 11105. DIRECT SPENDING CAPS.(a) IN GENERAL—Effective upon submis-

sion of the report by 0MB pursuant to sub-section (c), direct spending caps shall applyto all entitlement authority except for un-distributed offsetting receipts and net inter-est outlays. For purposes of enforcing directspending caps under this Act. each separateprogram shown in the table set forth in sub-section (d) shall be deemed to be a category.

(b) BUDGET COMMITFEE REPORTS—Within30 days after enactment of this Act. theBudget Committees of the House of Rep-resentatives and the Senate shall file withtheir respective Houses identical reportscontaining account numbers and spendinglevels for each specific category.

(c) REPORT BY 0MB—Within 30 days afterenactment of this Act, 0MB shall submit tothe President and each House of Congress areport containing account numbers andspending limits for each specific category.

(d) CONTENTS OF REpORTS—All directspending accounts not included in these re-ports under separate categories shall be in-cluded under the heading Other Entitle-ments and Mandatory Spending". These re-ports may include adjustments among thecaps set forth in this Act as required below,however the aggregate amount availableunder the Total Entitlements and OtherMandatory Spending" cap shall be identicalin each such report and in this Act and shallbe deemed to have been adopted as part ofthis Act. Each such report shall include theactual amounts of the caps for each year offiscal years 1998 through 2002 consistent with

CONGRESSIONAL RECORD — HOUSEthe concurrent resolution on the budget forFY 1998 for each of the following categories:

Earned Income Tax Credit,Family Support,Federal retirement:Civilian/other,Military,Medicaid,Medicare,Social security,Supplemental security income,Unemployment compensation,Veterans' benefits,Medicare,Other entitlements and mandatory spend-

ing, andAggregate entitlements and other manda-

tory spending.(e) ADDITIONAL SPENDING LIMITS—Legisla-tion enacted subsequent to this Act may in-clude additional caps to limit spending forspecific programs. activities. or accountswith these categories. Those additional caps(if any) shall be enforced in the same manneras the limits set forth in such joint explana-tory statement.SEC. 11106. ECONOMIC ASSUMPTIONS.

Subject to periodic reestimation based onchanged economic conditions or changes ineligible population, determinations of the di-rect spending caps under section 11105, anybreaches of such caps, and actions necessaryto remedy such breaches shall be based uponthe economic assumptions set forth in thejoint explanatory statement of managers ac-companying the concurrent resolution onthe budget for fiscal year 1998 (House Con-current Resolution 84, 105th Congress).SEC. 11107. REVISIONS TO DEFICIT AND REVE-

NUE TARGETS AND TO THE CAPSFOR ENTITLEMENTS AND OTHERMANDATORY SPENDING.

(a) AUTOMATIC ADJUSTMENTS TO DEFICITAND REVENUE TARGETS AND TO CAPS FOR EN-TITLEMENTS AND OTHER MANDATORY SPEND-ING.—When the President submits the budgetunder section 1105(a) of title 31, UnitedStates Code. for any year, 0MB shall cal-culate (in the order set forth below), and thebudget and reports shall include. adjust-ments to the deficit and revenue targets, andto the direct spending caps (and those limitsas cumulatively adjusted) for the currentyear, the budget year, and each outyear, toreflect the following:

(1) CHANGES TO REVENUE TARGETS.—(A) CHANGES IN GROWTH.—For Federal reve-

nues and deficits under laws and policies en-acted or effective before July 1, 1997, growthadjustment factors shall equal the ratio be-tween the level of year-over-year growthmeasured for the fiscal year most recentlycompleted and the applicable estimated levelfor that year as described in section 11105.

(B) CHANGES IN INFLATION—For Federalrevenues and deficits under laws and policiesenacted or effective before July 1, 1997, infla-tion adjustment factors shall equal the ratiobetween the level of year-over-year growthmeasured for the fiscal year most recentlycompleted and the applicable estimated levelfor that year as described in section 11105.

(2) ADJUSTMENTS TO DIRECT SPENDINGCAPS.—

(A) CHANGES IN CONCEPTS AND DEFINI-TIONS.—The adjustments - produced bychanges in concepts and definitions shallequal the baseline levels of new budget au-thority and outlays using up-to-date con-cepts and definitions minus those levelsusing the concepts and definitions in effectbefore such changes. Such changes in con-cepts and definitions may only be made inconsultation with the Committees on Appro-priations, the Budget. and Government Re-form and Oversight and Governmental Af-fairs of the House of Representatives and theSenate.

H4597(B) CHANGES IN NET OUTLAYS—Changes in

net outlays for all programs and activitiesexempt from sequestration under section11204.

(C) CHANGES IN INFLATION—For directspending under laws and policies enacted oreffective on or before July 1, 1997, inflationadjustment factors shall equal the ratio be-tween the level of year-over-year inflationmeasured for the fiscal year most recentlycompleted and the applicable estimated levelfor that years as described in section 11105(relating to economic assumptions). For di-rect spending under laws and policies en-acted or effective after July 1, 1997, thereshall be no adjustment to the direct spendingcaps (for changes in economic conditions in-cluding inflation, nor for changes in numbersof eligible beneficiaries) unless—



(D) CHANGES IN ELIGIBLE POPULATION5.—Fordirect spending under laws and policies en-acted or effective on or before July 1, 1997,the basis for adjustments under this sectionshall be the same as the projections underly-ing Table A—4, CBO Baseline Projections ofMandatory Spending, Including Deposit In-surance (by fiscal year, in billions of dol-lars), published in An Analysis of the Presi-dent's Budgetary Proposals for Fiscal Year1998, March 1997, page 53. For direct spendingunder laws and policies enacted or effectiveafter July 1. 1997, there shall be no adjust-ment to the direct spending caps for changesin numbers of eligible beneficiaries unless—



(E) INTRA-BUDGETARY PAYMENT5.—Fromdiscretionary accounts to mandatory ac-counts. The baseline and the discretionaryspending caps shall be adjusted to reflectthose changes.

(c) CHANGES TO DEFICIT TARGETS—The def-icit targets in section 11104 shall be adjustedto reflect changes to the revenue targets orchanges to the caps for entitlements andother mandatory spending pursuant to sub-section (a).

(d) PERMISSIBLE REVISIONS TO DEFICIT ANDREVENUE TARGETS AND DIRECT SPENDINGCAPS—Deficit and revenue targets and di-rect spending caps as enacted pursuant tosections 11104 and 11105 may be revised as fol-lows: Except as required pursuant to section11105(a), direct spending caps may only beamended by recorded vote. It shall be a mat-ter of highest privilege in the House of Rep-resentatives and the Senate for a Member ofthe House of Representatives or the Senateto insist on a recorded vote solely on thequestion of amending such caps. It shall notbe in order for the Committee on Rules ofthe House of Representatives to report a res-olution waiving the provisions of this sub-section. This subsection may be waived inthe Senate only by an affirmative vote ofthree-fifths of the Members duly chosen andsworn.

H4598Subtitle B—Enforcement Provisions

SEC. 11201. REPORTING EXCESS SPENDING.(a) ANALYSIS OF ACTUAL DEFICIT, REVENUE,

AND SPENDING LEVELS—AS soon as prac-ticable after any fiscal year, 0MB shall com-pile a statement of actual deficits, revenues,and direct spending for that year. The state-ment shall identify such spending by cat-egories contained in section 11105.

(b) ESTIMATE OF NECESSARY SPENDING RE-DUCTION.—Based on the statement providedunder subsection (a), the 0MB shall issue areport to the President and the Congress onDecember 15 of any year in which such state-ment identifies actual or projected deficits,revenues, or spending in the current or im-mediately preceding fiscal years in violationof the revenue targets or direct spendingcaps in section 11104 or 11105. by more thanone percent of the applicable total revenuesor direct spending for such year. The reportshall include:

(1) All instances in which actual directspending has exceeded the applicable directspending cap.

(2) The difference between the amount ofspending available under the direct spendingcaps for the current year and estimated ac-tual spending for the categories associatedwith such caps.

(3) The amounts by which direct spendingshall be reduced in the current fiscal year sothat total actual and estimated direct spend-ing for all cap categories for the current andimmediately preceding fiscal years shall notexceed the amounts available under the di-rect spending caps for such fiscal years.

(4) The amount of excess spending attrib-utable solely to changes in inflation or eligi-ble populations.SEC. 11202. ENFORCING DIRECT SPENDING CAPS.

(a) PURPOSE—This subtitle provides en-forcement of the direct spending caps on cat-egories of spending established pursuant tosection 11105. This section shall apply forany fiscal year in which direct spending ex-ceeds the applicable direct spending cap.

(b) GENERAL RULES.—(1) ELIMINATING A BREACH—Each non-ex-

empt account within a category shall be re-duced by a dollar amount calculated by mul-tiplying the baseline level of sequestrablebudgetary resources in that account at thattime by the uniform percentage necessary toeliminate a breach within that category.

(2) PROGRAMS. PROJECTS, OR ACTIVITIES.—Except as otherwise provided, the same per-centage sequestration shall apply to all pro-grams, projects and activities within a budg-et account.

(3) INDEFINITE AUTHORITY—Except as oth-erwise provided, sequestration in accountsfor which obligations are indefinite shall betaken in a manner to ensure that obligationsin the fiscal year of a sequestration and suc-ceeding fiscal years are reduced, from thelevel that would actually have occurred, bythe applicable sequestration percentage orpercentages.

(4) CANCELLATION OF BUDGETARY RE-SOURCES—Budgetary resources sequesteredfrom any account other than an trust, spe-cial or revolving fund shall revert to theTreasury and be permanently canceled.

(5) IMPLEMENTING REGULATIONS—Notwith-standing any other provision of law, admin-istrative rules or similar actions implement-ing any sequestration shall take effect with-in 30 days after that sequestration.SEC. 11203. SEQUESTRATION RULES.

(a) GENERAL RULES—FOr programs subjectto direct spending caps:

(1) TRIGGERING OF SEQUESTRATION—Se-questration is triggered if total direct spend-ing subject to the caps exceeds or is pro-jected to exceed the aggregate cap for directspending for the current or immediately pre-ceding fiscal year.


(2) CALCULATION OF REDUCTIONS—Seques-tration shall reduce spending under each sep-arate direct spending cap in proportion tothe amounts each category of direct spend-ing exceeded the applicable cap.

(3) UNIFORM PERCENTAGES—In calculatingthe uniform percentage applicable to the se-questration of all spending programs or ac-tivities within each category, or the uniformpercentage applicable to the sequestration ofnonexempt direct spending programs or ac-tivities, the sequestrable base for directspending programs and activities is the totallevel of outlays for the fiscal year for thoseprograms or activities in the current lawbaseline.

(4) PERMANENT SEQUESTRATION OF DIRECTSPENDING —Obligations in sequestered directspending accounts shall be reduced in the fis-cal year in which a sequestration occurs andin all succeeding fiscal years. Notwithstand-ing any other provision of this section, afterthe first direct spending sequestration. anylater sequestration shall reduce direct spend-ing by an amount in addition to, rather thanin lieu of, the reduction in direct spending inplace under the existing sequestration or se-questrations.

(5) SPECIAL RULE—For any direct spendingprogram in which—

(A) outlays pay for entitlement benefits;(B) a current-year sequestration takes ef-

fect after the 1st day of the budget year;(C) that delay reduces the amount of enti-

tlement authority that is subject to seques-tration in the budget; and

(D) the uniform percentage otherwise ap-plicable to the budget-year sequestration ofa program or activity is increased due to thedelay;then the uniform percentage shall revert tothe uniform percentage calculated underparagraph (3) when the budget year is com-pleted.

(6) INDEXED BENEFIT PAYMENTS—If, underany entitlement program—

(A) benefit payments are made to personsor governments more frequently than once ayear; and

(B) the amount of entitlement authority isperiodically adjusted under existing law toreflect changes in a price index (commonlycalled 'cost of living adjustments"):sequestration shall first be applied to thecost of living adjustment before reductionsare made to the base benefit. For the firstfiscal year to which a sequestration applies,the benefit payment reductions in such pro-grams accomplished by the order shall takeeffect starting with the payment made at thebeginning of January following a final se-quester. For the purposes of this subsection,veterans' compensation shall be considered aprogram that meets the conditions of thepreceding sentence.

(7) LOAN PROGRAMS—For all loans made,extended, or otherwise modified on or afterany sequestration under loan programs sub-ject to direct spending caps—

(A) the sequestrable base shall be total feesassociated with all loans made extended orotherwise modified on or after the date of se-questration; and

(B) the fees paid by borrowers shall be in-creased by a uniform percentage sufficient toproduce the dollar savings in such loan pro-grams for the fiscal year or years of the se-questrations required by this section.Notwithstanding any other provision of law,in any year in which a sequestration is in ef-fect, all subsequent fees shall be increased bythe uniform percentage and all proceedsfrom such fees shall be paid into the generalfund of the Treasury.

(8) INSURANCE PROGRAMS—Any sequestra-tion of a Federal program that sells insur-ance contracts to the public (including theFederal Crop Insurance Fund, the National

June 25, 1997Insurance Development Fund, the NationalFlood Insurance fund, insurance activities ofthe Overseas Private Insurance Corporation,and Veterans' Life insurance programs) shallbe accomplished by increasing premiums oncontracts entered into extended or otherwisemodified, after the date a sequestrationorder takes effect by the uniform sequestra-tion percentage. Notwithstanding any otherprovision of law, for any year in which a se-questration affecting such programs is in ef-fect, subsequent premiums shall be increasedby the uniform percentage and all proceedsfrom the premium increase shall be paidfrom the insurance fund or account to thegeneral fund of the Treasury.

(9) STATE GRANT FORMULAS—For all Stategrant programs subject to direct spendingcaps—

(A) the total amount of funds available forall States shall be reduced by the amount re-quired to be sequestered; and

(B) if States are projected to receive in-creased funding in the budget year comparedto the immediately preceding fiscal year, se-questration shall first be applied to the esti-mated increases before reductions are madecompared to actual payments to States inthe previous year—

(i) the reductions shall be applied first tothe total estimated increases for all States;then

(ii) the uniform reduction shall be madefrom each State's grant; and

(iii) the uniform reduction shall apply tothe base funding levels available to states inthe immediately preceding fiscal year onlyto the extent necessary to eliminate any re-maining excess over the applicable directspending cap.

(10) SPECIAL RULE FOR CERTAIN PROGRAMS.—Except matters exempted under section 11204and programs subject to special rules setforth under section 11205 and notwithstand-ing any other provisions of law, any seques-tration required under this Act shall reducebenefit levels by an amount sufficient toeliminate all excess spending identified inthe report issued pursuant to section 11201.while maintaining the same uniform per-centage reduction in the monetary value ofbenefits subject to reduction under this sub-section.

(b) WITHIN-SESSION SEQUESTER—If a bill orresolution providing direct spending for thecurrent year is enacted before July 1 of thatfiscal year and causes a breach within anydirect spending cap for that fiscal year, 15days later there shall be a sequestration toeliminate that breach within that cap.SEC. 11204. ENFORCING REVENUE TARGETS.

(a) PURpOSE—This section enforces therevenue targets established pursuant to sec-tion 11104. This section shall apply for anyyear in which actual revenues were less thanthe applicable revenue target in the preced-ing fiscal year or are projected to be lessthan the applicable revenue target in thecurrent year.

(b) ESTIMATE OF NECESSITY TO SUSPENDNEw REVENUE REDUCTIONS—Based on thestatement provided under section 11201(a),0MB shall issue a report to the Presidentand the Congress on December 15 of any yearin which such statement identifies actual orprojected revenues in the current or imme-diately preceding fiscal years lower than theapplicable revenue target in section 11104, asadjusted pursuant to section 11106, by morethan 1 percent of the applicable total reve-nue target for such year. The report shall in-clude—

(1) all laws and policies described in sub-section (c) which would cause revenues to de-cline in the calendar year which begins Jan-uary 1 compared to the provisions of law ineffect on December 15;

(2) the amounts by which revenues wouldbe reduced by implementation of the provi-sions of law described in paragraph (1) com-pared to provisions of law in effect on De-cember 15; and

(3) whether delaying implementation ofthe provisions of law described in paragraph(1) would cause the total for revenues in theprojected revenues in the current fiscal yearand actual revenues in the immediately pre-ceding fiscal year to equal or exceed thetotal of the targets for the applicable years.

(c) No CREDITS, DEDUCTIONS. EXCLUSIONS.PREFERENTIAL RATE OF TAX, ETC.—If anyprovision of the Internal Revenue Code of1986 added by the Revenue ReconciliationAct of 1997 would (but for this section) firsttake effect in a tax benefit suspension year.such provision shall not take effect until thefirst calendar year which is not a tax benefitsuspension year.

END OF SUSPENSI0N.—If the 0MB report is-sued under section (a) following a tax benefitsuspension your indicates that the total ofrevenues projected in the current fiscal yearand actual revenues in he immediately pro-ceeding year will equal or exceed the appli-cable targets the President shall sign anorder ending the delayed phase-in of new taxcuts effective January 1. Such order shallprovide that the new tax cuts shall take ef-fect as if the provisions of this section hadnot taken effect.

(e) SUSPENSION OF BENEFITS BEING PHASEDIN.—If. under any provision of the InternalRevenue Code of 1986, there is an increase inany benefit which would (but for this sec-tion) take effect with respect to a tax benefitsuspension year. in lieu of applying sub-section (c)—

(1) any increase in the benefit under suchsection with respect to such year and eachsubsequent calendar year shall be delayed 1calendar year. and

(2) the level of benefit under such sectionwith respect to the prior calendar year shallapply to such tax benefit suspension year.

(0 PERCENTAGE SUSPENSION WHERE FULLSUSPENSION UNNECESSARY TO ACHIEVE REVE-NUE TARGET—If the application of sub-sections (c). (d). and (e) to any tax benefitsuspension year would (but for this sub-section) (1) all laws and policies described insubsection (c) which would cause revenues todecline in the calendar year which beginsJanuary 1 compared to the provisions of lawin effect on December 15; subsections (c). (d).and (e)shall be applied such that the amountof each benefit which is denied is only thepercentage of such benefit which is necessaryto result in revenues equal to such target.Such percentage shall be determined by0MB, and the same percentage shall apply tosuch benefits.

(g) TAX BENEFIT SUSPENSION YEAR—FOrpurposes of this section. the term "tax bene-fit suspnsion year" means any calendaryear if he statement issued under sub-section (b) during the preceding calendaryear indicates that—

(1) for çhe fiscal year ending in such pre-ceding caendar year. atual revenues werelower than èhe applicable revenue target insection 11104. as adjusted pursuant to section11106for such fiscal year by more than 1 per-cent of such target, or

(2) for the fiscal year beginning in suchpreceding calendar year. projected revenues(determined ithout regard to this section)areestimatéd obe lower than the applicablereveñqe taget fri section 11104. as adjustedpursuant to section 11106. for such fiscal yearby\more than 1 percent of such target.

CONGRESSIONAL RECORD — HOUSESEC. 11205. EXEMPT PROGRAMS AND ACTIVITIES.

The following budget accounts, activitieswithin accounts, or income shall be exemptfrom sequestration—

(1) net interest;(2) all payments to trust funds from excise

taxes or other receipts or collections prop-erly creditable to those trust funds;

(3) offsetting receipts and collections:(4) all payments from one Federal direct

spending budget account to another Federalbudget account;

(5) all intragovernmental funds includingthose from which funding is derived pri-marily from other Government accounts;

(6) expenses to the extent they result fromprivate donations, bequests, or voluntarycontributions to the Government;

(7) nonbudgetary activities. including butnot limited to—

(A) credit liquidating and financing ac-counts;

(B) the Pension Benefit Guarantee Cor-poration Trust Funds;

(C) the Thrift Savings Fund;(D) the Federal Reserve System; and(E) appropriations for the District of Co-

lumbia to the extent they are appropriationsof locally raised funds;

(8) payments resulting from Governmentinsurance, Government guarantees. or anyother form of contingent liability, to the ex-tent those payments result from contractualor other legally binding commitments of theGovernment at the time of any sequestra-tion;

(9) the following accounts, which largelyfulfill requirements of the Constitution orotherwise make payments to which the Gov-ernment is committed—

Bureau of Indian Affairs. miscellaneoustrust funds, tribal trust funds (14—9973—0—7—999);

Claims. defense;Claims, judgments and relief act (20—1895—0—

1—806);

Compact of Free Association. economic as-sistance pursuant to Public Law 99-658 (14—04 15—0—1—806);

Compensation of the President (11—0001—0—1—802)

Customs Service, miscellaneous permanentappropriations (20—9992—0—2—852);

Eastern Indian land claims settlementfund (14—2202—0—1—806);

Farm Credit System Financial AssistanceCorporation. interest payments (20—1850—0—1—351);

Internal Revenue collections of PuertoRico (20—5737—0—2—852)

Payments of Vietnam and USS Puebloprisoner-of-war claims (15—0104—0—1—153):

Payments to copyright owners (03—5175—0—2—376);

Salaries of Article III judges (not includingcost of living adjustments);

Soldier's and Airman's Home, payment ofclaims (84—8930_0—7—705);

Washington Metropolitan Area Transit Au-thority, interest payments (46—0300—0—1—401);

(10) the following noncredit special. revolv-ing, or trust-revolving funds—

Exchange Stabilization Fund (20-4444-0-3-155); and

Foreign Military Sales trust fund (1 1—82232—0—7—155).

(j) OPTIONAL EXEMPTION OF MILITARY PER-SONNEL.—

(1) The President may, with respect to anymilitary personnel account, exempt that ac-count from sequestration or provide for alower uniform percentage reduction thatwould otherwise apply.

(2) The President may not use the author-ity provided by paragraph (1) unless he noti-

H4599fies the Congress of the manner in whichsuch authority will be exercised on or beforethe initial snapshot date for the budget year.SEC. 11206. SPECIAL RULES.

(a) CHILD SUPPORT ENFORCEMENT PRO-GRAM.—Any sequestration order shall accom-plish the full amount of any required reduc-tion in payments under sections 455 and 458of the Social Security Act by reducing theFederal matching rate for State administra-tive costs under the program, as specified(for the fiscal year involved) in section 455(a)of such Act, to the extent necessary to re-duce such expenditures by that amount.

(b) COMMODITY CREDIT CORPORATION.—(1) EFFECTIVE DATE—For the Commodity

Credit Corporation. the date on which a se-questration order takes effect in a fiscal yearshall vary for each crop of a commodity. Ingeneral. the sequestration order shall takeeffect when issued. but for each crop of acommodity for which 1-year contracts are is-sued as an entitlement. the sequestrationorder shall take effect with the start of thesign-up period for that crop that begins afterthe sequestration order is issued. Paymentsfor each contract in such a crop shall be re-duced under the same terms and conditions.

(2) DAIRY PROGRAM.—(A) As the sole means of achieving any re-

duction in outlays under the milk price-sup-port program. the Secretary of Agricultureshall provide for a reduction to be made inthe price received by producers for all milkin the United States and marketed by pro-ducers for commercial use.

(B) That price reduction (measured incents per hundred-weight of milk marketed)shall occur under subparagraph (A) of sec-tion 201(d)(2) of the Agricultural Act of 1949(7 U.S.C. 1446(d) (2) (A)), shall begin on the dayany sequestration order is issued, and shallnot exceed the aggregate amount of the re-duction in outlays under the milk price-sup-port program. that otherwise would havebeen achieved by reducing payments madefor the purchase of milk or the products ofmilk under this subsection during that fiscalyear.

(3) EFFECT OF DELAY—For purposes of sub-section (b)(1). the sequestrable base for Com-modity Credit Corporation is the current-year level of gross outlays resulting fromnew budget authority that is subject to re-duction under paragraphs (1) and (2).

(4) CERTAIN AUTHORiTY NOT TO BE LIMITED.—Nothing in this Act shall restrict the Cor-poration in the discharge of its authorityand responsibility as a corporation to buyand sell commodities in world trade, or limitor reduce in any way any appropriation thatprovides the Corporation with funds to coverits realized losses.

(c) EARNED INCOME TAX CREDIT.—(1) The sequestrable base for earned income

tax credit program is the dollar value of allcurrent year benefits to the entire eligiblepopulation.

(2) In the event sequestration is triggeredto reduce earned income tax credits. allearned income tax credits shall be reduced.whether or not such credits otherwise wouldresult in cash payments to beneficiaries. bya uniform percentage sufficient to producethe dollar savings required by the sequestra-tion.

(d) REGULAR AND EXTENDED UNEMPLOYMENTCOMPENSATION.—

(1) A State may reduce each weekly benefitpayment made under the regular and ex-tended unemployment benefit programs forany week of unemployment occurring duringany period with respect to which paymentsare reduced under any sequestration order bya percentage not to exceed the percentage by

June 25, 1997

H4600 CONGRESSIONAL RECORD — HOUSE June 25, 1997

which the Federal payment to the State is tobe reduced for such week as a result of suchorder.

(2) A reduction by a State in accordancewith paragraph (1) shall not be considered asa failure to fulfill the requirements of sec-tion 3304 (a) (11) of the Internal Revenue Codeof 1986.

(e) FEDERAL EMPLOYEES HEALTH BENEFITSFUND.— For the Federal Employees HealthBenefits Fund, a sequestration order shalltake effect with the next open season. Thesequestration shall be accomplished by an-nual payments from that Fund to the Gen-eral Fund of the Treasury. Those annualpayments shall be financed solely by charg-ing higher premiums. The sequestrable basefor the Fund is the current-year level ofgross outlays resulting from claims paidafter the sequestration order takes effect.

(f) FEDERAL HOUSING FINANCE BOARD.—Any sequestration of the Federal HousingBoard shall be accomplished by annual pay-ments (by the end of each fiscal year) fromthat Board to the general fund of the Treas-ury, in amounts equal to the uniform seques-tration percentage for that year times thegross obligations of the Board in that year.

(g) FEDERAL PAY.—(1) IN GENERAL.— New budget authority to

pay Federal personnel from direct spendingaccounts shall be reduced by the uniformpercentage calculated under section111203(c)(3), as applicable, but no sequestra-tion order may reduce or have the effect ofreducing the rate of pay to which any indi-vidual is entitled under any statutory paysystem (as increased by any amount payableunder section 5304 of title 5. United StatesCode, or any increase in rates of pay whichis scheduled to take effect under section 5303of title 5, United States Code, section 1109 oftitle 37, United States Code, or any otherprovision of law.

(2) DEFINITIONS—FOr purposes of this sub-section—

(A) the term statutory pay system" shallhave the meaning given that term in section5302(1) of title 5, United States Code:term elements of military pay" means—

(i) the elements of compensation of mem-bers of the uniformed services specified insection 1009 of title 37, United States Code;

(ii) allowances provided members of theuniformed services under sections 403(a) and405 of such title; and

(iii) cadet pay and midshipman pay undersection 203(c) of such title; and

(C) the term uniformed services" shallhave the same meaning given that term insection 101(3) of title 37, United States Code.

(h) MEDICARE.—(1) TIMING OF APPLICATION OF REDUCTIONS.—(A) IN GENERAL.— Except as provided in

subparagraph (B), if a reduction is made inpayment amounts pursuant to sequestrationorder, the reduction shall be applied to pay-ment for services furnished after the effec-tive date of the order. For purposes of theprevious sentence, in the case of inpatientservices furnished for an individual, the serv-ices shall be considered to be furnished onthe date of the individual's discharge fromthe inpatient facility.

(B) PAYMENT ON THE BASIS OF COST REPORT-ING PERIODS.— In the case in which paymentfor services of a provider of services is madeunder titae XVIII of the Social Security Acton a basis relating to the reasonable cost in-curred for the services during a cost report-hig period of the provider, if a reduction Ismade in payment amounts pursuant to a se-questration order, the reduction shall be ap-plied to payment for costs for such servicesiiricurred at any time during each cost re-porting period of the provider any part ofwhich occurs after the effective date oforder, but only (for each such cost reporting

period) in the same proportion as the frac-tion of the cost reporting period that occursafter the effective date of the order.

(2) NO INCREASE IN BENEFICIARY CHARGES INASSIGNMENT-RELATED CASES—If a reductionin payment amounts is made pursuant to asequestration order for services for whichpayment under part B of title XVIII of theSocial Security Act is made on the basis ofan assignment described in section1842(b) (3) (B) (ii), in accordance with section1842(b)(6)(B), or under the procedure de-scribed in section 1870(0(1) of such Act, theperson furnishing the services shall be con-sidered to have accepted payment of the rea-sonable charge for the services, less any re-duction in payment amount made pursuantto a sequestration order, as payment in full.

(3) PART B PREMIUMS.—In computing theamount and method of sequestration frompart B of title XVIII of the Social SecurityAct—

(A) the amount of sequestration shall becalculated by multiplying the total amountby which Medicare spending exceeds the ap-propriate spending cap by a percentage thatreflects the ratio of total spending underPart B to total Medicare spending: and

(B) sequestration in the Part B programshall be accomplished by increasing pre-miums to beneficiaries.

(4) NO EFFECT ON COMPUTATION OF AAPCC.—In computing the adjusted average per capitacost for purposes of section 1876(a)(4) of theSocial Security Act, the Secretary of Healthand Human Services shall not take into ac-count any reductions in payment amountswhich have been or may be effected underthis part.

(i) POSTAL SERVICE FUND.— Any sequestra-tion of the Postal Service Fund shall be ac-complished by annual payments from thatFund to the General Fund of the Treasury,and the Postmaster General of the UnitedStates and shall have the duty to makethose payments during the first fiscal yearto which the sequestration order applies andeach succeeding fiscal year. The amount ofeach annual payment shall be—

(1) the uniform sequestration percentage,times

(2) the estimated gross obligations of thePostal Service Fund in that year other thanthose obligations financed with an appro-priation for revenue forgone that year.Any such payment for a fiscal year shall bemade as soon as possible during the fiscalyear. except that it may be made in install-ments within that year if the paymentschedule is approved by the Secretary of theTreasury. Within 30 days after the sequestra-tion order is issued, the Postmaster Generalshall submit to the Postal Rate Commissiona plan for financing the annual payment forthat fiscal year and publish that plan in theFederal Register. The plan may assume effi-ciencies in the operation of the Postal Serv-ice, reductions in capital expenditures. in-creases in the prices of services. or any com-bination, but may not assume a lower Fundsurplus or higher Fund deficit and shall fol-low the requirements of existing law govern-ing the Postal Service in all other respects.Within 30 days of the receipt of that plan,the Postal Rate Commission shall approvethe plan or modify it in the manner thatmodifications are allowed under current law.If the Postal Rate Commission does not re-spond to the plan within 30 days. the plansubmitted by the Postmaster General shallgo into effect. Any plan may be later revisedby the submission of a new plan to the Post-al Rate Commission, which may approve ormodify it.

(j) POWER MARKETING ADMINISTRATIONSAND T.V.A.— Any sequestration of the De-partment of Energy power marketing admin-istration funds or the Tennessee Valley Au-

thority fund shall be accomplished by annualpayments from those funds to the GeneralFund of the Treasury, and the administra-tors of those funds shall have the duty tomake those payments during the fiscal yearto which the sequestration order applies andeach succeeding fiscal year. The amount ofeach payment by a fund shall be—

(1) the direct spending uniform sequestra-tion percentage. times

(2) the estimated gross obligations of thefund in that year other than those obliga-tions financed from discretionary appropria-tions for that year.Any such payment for a fiscal year shall bemade as soon as possible during the fiscalyear, except that it may be made in install-ments within that year if the paymentschedule is approved by the Secretary of theTreasury. Annual payments by a fund maybe financed by reductions in costs requiredto produce the pre-sequester amount ofpower (but those reductions shall not includereductions in the amount of power suppliedby the fund). by reductions in capital ex-penditures, by increases in tax rates. or byany combination. but may not be financedby a lower fund surplus. a higher fund defi-cit, additional borrowing, delay in repay-ment of principal on outstanding debt andshall follow the requirements of existing lawgoverning the fund in all other respects. Theadministrator of a fund or the TVA Board isauthorized to take the actions specified inthis subsection in order to make the annualpayments to the Treasury.

(k) BUSINESS-LIKE TRANSACTIONS—Not-withstanding any other provision of law, forprograms which provide a business-like serv-ice in exchange for a fee, sequestration shallbe accomplished through a uniform increasein fees (sufficient to produce the dollar sav-ings in such programs for the fiscal year ofthe sequestration required by section11201(a)(2). all subsequent fees shall be in-creased by the same percentage. and all pro-ceeds from such fees shall be paid into thegeneral fund of the Treasury, in any year forwhich a sequester affecting such programsare in effect.SEC. 11207, THE CURRENT LAW BASELINE.

(a) SUBMISSION OF REPORTS.—CBO and 0MBshall submit to the President and the Con-gress reports setting forth the budget base-lines for the budget year and the next ninefiscal years. The CBO report shall be submit-ted on or before January 15. The 0MB reportshall accompany the President's budget.

(b) DETERMINATION OF THE BUDGET BASE-LINE.—(1) The budget baseline shall be basedon the common economic assumptions setforth in section 11106, adjusted to reflect re-visions pursuant to subsection (c).

(2) The budget baseline shall consist of aprojection of current year levels of budgetauthority, outlays. revenues and the surplusor deficit into the budget year and the rel-evant outyears based on current enactedlaws as of the date of the projection.

(3) For discretionary spending items, thebaseline shall be the spending caps in effectpursuant to section 601 (a) (2) of the Congres-sional Budget Act of 1974. For years forwhich there are no caps, the baseline for dis-cretionary spending shall be the same as thelast year for which there were statutorycaps.

(4) For all other expenditures and for reve-nues, the baseline shall be adjusted by com-paring unemployment. inflation. interestrates, growth and other economic indicators-and changes ineligible population-for themost recent period for which actual data areavailable, compared to the assumptions con-tained in section 11106.

(c) REVISIONS TO THE BASELINE—The base-line shall be adjusted for up-to-date eco-nomic assumptions when CBO submits its

June 25, 1997Economic and Budget Update and when 0MBsubmits its budget update, and by August 1each year. when CBO and OBM submit theirmidyear reviews.SEC. 11208. LIMITATIONS ON EMERGENCY SPEND-

ING.(a) IN GENERAL.—(1) Within the discre-

tionary caps for each fiscal year contained inthis Act, an amount shall be withheld fromallocation to the appropriate committees ofthe House of Representatives and of the Sen-ate and reserved for natural disasters andother emergency purposes.

(2) Such amount for each such fiscal yearshall not be less than 1 percent of total budg-et authority and outlays available withinthose caps for that fiscal year.

(3) The amounts reserved pursuant to thissubsection shall be made available for allo-cation to such committees only if—

(A) the President has made a request forsuch disaster funds:

(B) the programs to be funded are includedin such request: and

(C) the projected obligations for unforeseenemergency needs exceed the 10-year rollingaverage annual expenditures for existing pro-grams included in the Presidential requestfor the applicable fiscal year.

(4) Notwithstanding any other provision oflaw—

(A) States and localities shall be requiredto maintain effort and ensure that Federalassistance payments do not replace, subvertor otherwise have the effect of reducing reg-ularly budgeted State and local expendituresfor law enforcement, refighting. road con-struction and maintenance, building con-struction and maintenance or any other cat-egory of regular government expenditure (toensure that Federal disaster payments aremade only for incremental costs directly at-tributable to unforeseen disasters, and donot replace or reduce regular State and localexpenditures for the same purposes):

(B) the President may not take adminis-trative action to waive any requirement forStates or localities to make minimummatching payments as a condition or receiv-ing Federal disaster assistance and prohibitthe President from taking administrative ac-tion to waive all or part of any repayment ofFederal loans for the State or local matchingshare required as a condition of receivingFederal disaster assistance, and this clauseshall apply to all matching share require-ments and loans to meet matching share re-quirements under the Robert T. Stafford Dis-aster Relief and Emergency Assistance Act(42 U.S.C. 5121 et seq.) and any other Actspursuant to which the President may declarea disaster or disasters and States and local-ities otherwise qualify for Federal disasterassistance; and

(C) a two-thirds vote in each House of Con-gress shall be required for each emergency toreduce or waive the State matching require-ment of to forgive all or part of loans for theState matching share as required under theRobert T. Stafford Disaster Relief and Emer-gency Assistance Act.

(b) EFFECT BUDGET RESOLUTIONS.—(1) Allconcurrent resolutions on the budget (in-cluding revisions) shall specify the amountof new budget authority and outlays withinthe discretionary spending cap that shall bewithheld from allocation to the committeesand reserved for natural disasters, and a pro-cedure for releasing such funds for allocationto the appropriate committee. The amountwithheld shall be equal to 1 percent of thetotal discretionary spending cap for fiscalyear covered by the resolution, unless addi-tional amounts are specified.

(2) The procedure for allocation of theamounts pursuant to paragraph (1) shall en-sure that the funds are released for alloca-tion only pursuant to the conditions con-tained in subsection (a)(3)(A) through (C).

CONGRESSIONAL RECORD — HOUSE(c) RESTRICTION ON USE OF FUNDS—NOt-

withstanding any other provision of law, theamount reserved pursuant to subsection (a)shall not be available for other than emer-gency funding requirements for particularnatural disasters or national security emer-gencies so designated by Acts of Congress.

(d) NEW POINT OF ORDER.—(1) Title IV ofthe Congressional Budget Act of 1974 isamended by adding at the end the followingnew section:

'POINT OF ORDER REGARDING EMERGENCIES

"SEC. 408. It shall not be in order in theHouse of Representatives or the Senate toconsider any bill or joint resolution, oramendment thereto or conference reportthereon, containing an emergency designa-tion for purposes of section 251(b) (2) (D) or2 52(e) of the Balanced Budget and EmergencyDeficit Control Act of 1985 or of section 11207of the Balanced Budget Assurance Act of 1997if it also provides an appropriation or directspending for any other item or contains anyother matter. but that bill or joint resolu-tion, amendment. or conference report maycontain rescissions of budget authority or re-ductions of direct spending, or that amend-ment may reduce amounts for that emer-gency.".

(2) The table of contents set forth in sec-tion 1(b) of the Congressional Budget and Im-poundment Control Act of 1974 is amended byinserting after the item relating to section407 the following new item:"Sec. 408. Point of order regarding emer-

gencies.".Mr. BROWN of Ohio (during the read-

ing). Mr. Speaker, I ask unanimousconsent that the motion to recommitbe considered as read and printed inthe RECORD.

The SPEAKER pro tempore. Is thereobjection to the request of the gen-tleman from Ohio?

There was no objection.POINT OF ORDER

Mr. THOMAS. Mr. Speaker, I rise toa point of order that the amendment isnot germane to the bill.

The SPEAKER pro tempore. The gen-tleman will state his point of order.

Mr. THOMAS. Mr. Speaker, the budg-et process provisions prospectivelyamend another bill; that is, H.R. 2014,the Revenue Reconciliation Act of 1997,specifically section 11204(c). It suspendsprovisions in the Internal RevenueCode that are added by H.R. 2014 and is,therefore, beyond the scope.

The SPEAKER pro tempore. Does thegentleman from Texas [Mr. STENHOLM]wish to be heard on the point of order?

Mr. STENHOLM. Yes, Mr. Speaker.The SPEAKER pro tempore. The

Chair recognizes the gentleman fromTexas [Mr. STENHOLM].

Mr. STENHOLM. Mr. Speaker, in ris-ing to speak to the point of order, Iwill couple it with a parliamentary in-quiry. It was my understanding, sincethe item in question is the enforcementmechanisms of the budget, what thismotion to recommit includes is the en-tire Minge-Barton amendment thatwas denied an opportunity to be on thefloor under the rule.

In the colloquy that occurred thismorning, it was my understanding, andat least my friends on the other side ofthe aisle who acceded to this, that thiswould eventually be heard in a sepa-

H4601rate bill on the floor by July 24. In sodoing. it would then be coupled, assum-ing it passes. would be coupled with thereconciliation bill so that the finalconference report would include, if theHouse chooses to include this in thelanguage of the bill. would be votedupon.

My question, Mr. Speaker, if that isthe case. how can it be out of order forus to consider this amendment todaywhen it will be in order to consider iton July 24?

The SPEAKER pro tempore. TheChair would respond by saying that hecannot make a determination as towhat the legislative situation would beat some future date 3 weeks from now.

Mr. STENHOLM. Continuing myquestion as to the point of order, if itis the parliamentary judgment todaythat this is not in order to be heard asa motion to recommit. under what cir-cumstance could it be possible for us toconsider this at a later date?

The SPEAKER pro tempore. TheChair cannot anticipate what the con-ferees on this bill might do. That Issomething that will be considered at afuture date.

Mr. STENHOLM. So the judgment ofthe Speaker is that today it is out oforder but it might be in order at a laterdate?

The SPEAKER pro tempore. TheChair is not going to engage in somesort of hypothetical consideration as towhat might take place several weeksfrom now.

Does the gentleman wish to be heardfurther on the point of order?

Mr. STENHOLM. Mr. Speaker, Iwould say this is a very curious cir-cumstance, but I hope the entire Houseis listening because this is a very im-portant matter for a lot of us who aresupporting this entire budget process. Iam very worried to have this amend-ment as part of the recommittal beheld out of order and then have hopethat perhaps in the future it will be inorder. That bothers me, but I respectthe Chair's decision today.

The SPEAKER pro tempore. Does thegentleman from Ohio [Mr. BROWN] wishto be heard on the point of order?

Mr. BROWN of Ohio. No, Mr. Speak-er. We concede the point of order.

The SPEAKER pro tempore. The gen-tleman concedes the point of order?

Mr. BROWN of Ohio. We await theruling of the Chair, Mr. Speaker.

The SPEAKER pro tempore. The gen-tleman from California makes a pointof order that the amendment containedin the motion to recommit with in-structions is not germane to the bill.While the test of germaneness in thisinstance is measured against the bill aswhole, the Chair notes that a portionof the amendment makes provisions ofanother bill not presently before theHouse. namely, the Revenue Reconcili-ation Act of 1997, contingent on achiev-ing revenue targets in future fiscalyears.

As such, the amendment is a prospec-tive indirect change in a bill not yet

H4602considered by the House. The Chairholds that the amendment is thus notgermane to the bill, H.R. 2015. and sus-tains the point of order.

MOTION TO RECOMMIT OFFERED BY MR. BROWNOF OHiO

Mr. BROWN of Ohio. Mr. Speaker, Ioffer a motion to recommit.

The SPEAKER pro tempore. Is thegentleman still opposed to the bill?

Mr. BROWN of Ohio. Yes, Mr. Speak-er, I am, more so than when the Chairasked the last time.

The SPEAKER pro tempore. TheClerk will report the motion.

The Clerk read as follows:Mr. BROWN of Ohio moves to recommit the

bill H.R. 2015 to the Committee on the Budg-et with instructions to report the same backto the House forthwith with the followingamendment:

Strike subtitle F of title III and insert thefollowing:Subtitle F—Child Health Insurance Initiative

Act of 1997SEC. 3500. 5HORT TITLE OF SUBTITLE.

This subtitle may be cited as the 'ChildHealth Insurance Initiative Act of 1997".

CHAPTER 1—IMPROVED OUTREACHSEC. 3501. GRANT PROGRAM TO PROMOTE OUT-


There are authorized to be appropriated, foreach fiscal year beginning with fiscal year1998 to the Secretary of Health and HumanServices. $25,000,000 for grants to States, lo-calities, and nonprofit entities to promoteoutreach efforts to enroll eligible childrenunder the medicaid program under title XIXof the Social Security Act (42 U.S.C. 1396 etseq.) and related programs.

(b) USE OF FUNDS—Funds under this sec-tion may be used to reimburse States, local-ities, and nonprofit entities for additionaltraining and administrative costs associatedwith outreach activities. Such activities in-clude the following:

(1) USE OF A COMMON APPLICATION FORM FORVEDERAL CHILD ASSISTANCE PROGRAMS—Im-plementing use of a single application form(established by the Secretary and based onthe model application forms developed undersubsections (a) and (b) of section 6506 of theOmnibus Budget Reconciliation Act of 1989(42 U.S.C. 701 note; 1396a note)) to determinethe eligibility of a child or the child's family(as applicable) for assistance or benefitsunder the medicaid program and under otherFederal child assistance programs (such asthe temporary assistance for needy familiesprogram under part A of title IV of the So-cial Security Act (42 U.S.C. 601 et seq.), thefood stamp program, as defined in section3(h) of the Food Stamp Act of 1977 (7 U.S.C.2012(h)), and the State program for fostercare maintenance payments and adoption as-sistance payments under part E of title IV ofthe Social Security Act (42 U.S.C. 670 etseq.)).

(2) EXPANDING OUTSTATIONING OF ELIGI-BILITY PERSONNEL—Providing for the sta-tioning of eligibility workers at sites, suchas hospitals and health clinics, at which chil-dren receive health care or related services.

(c) APPLICATION. ETC—Funding shall bemade available under this section only uponthe approval of an application by a State, lo-cality. or nonprofit entity for such fundingand only upon such terms and conditions asthe Secretary specifies.

(d) ADMINISTRATION—The Secretary mayadminister the grant program under this sec-tion through the identifiable administrativeunit designated under section 509(a) of the


Social Security Act (42 U.S.C. 709(a)) to pro-mote coordination of medicaid and maternaland child health activities and other childhealth related activities.

CHAPTER 2—MEDIIUDS PROGRAMSEC. 35Z1. STATE ENTITLEMENT TO PAYMENT


plan for a child health insurance program, orMedikids program, approved by the Sec-retary is entitled to receive, from amountsin the Treasury not otherwise appropriatedand for each fiscal year beginning with fiscalyear 1998, payment of the amounts providedunder section 3523.

(b) APPLICATION—The Secretary shall es-tablish a procedure for the submittal and ap-proval of plans for Medikids programs underthis chapter. The Secretary shall approvethe plan of a State for such a program if theSecretary determines that—

(1) the State is meeting the medicaid cov-erage requirements of section 3522(a), and

(2) the plan provides assurances satisfac-tory to the Secretary that the Medikids pro-gram will be conducted consistent with theapplicable requirements of section 3522.SEC. 35ZZ. REQUIREMENTS FOR APPROVAL OF



(1) COVERAGE OF PREGNANT WOMEN ANDCHILDREN AND INFANTS UP TO 185 PERCENT OFPOVERTY.—The State has established 185 per-cent of the poverty line as the applicablepercentage under section 1902(l)(2)(A) of theSocial Security Act (42 U.S.C. 1396a(l)(2)(A)).

(2) COVERAGE OF CHILDREN UP TO 19 YEARSOF AGE.—The State provides, either throughexercise of the option under section1902(1) (1) (D) of such Act (42 U.S.C.1396a(l)(1)(D)) or authority under section1902(r) (2) of such Act (42 U.S.C. 1396a(r)(2)) forcoverage under section 1902(l)(1)(D) of suchAct of individuals under 19 years of age. re-gardless of date of birth.


(B), the State—(i) has not modified the eligibility require-

ments for children under the State medicaidplan. as in effect on January 1, 1997 in anymanner that would have the effect of reduc-ing the eligibility of children for coverageunder such plan, and


(B) WAIVER EXCEPTION.—Subparagraph (A)shall not apply to modifications made pursu-ant to an application for a waiver under sec-tion 1115 of the Social Security Act (42U.S.C. 1315) submitted before January 1, 1997.

(b) COVERAGE OF UNINSURED CHILDREN.—(1) IN GENERAL—A Medikids program shall

not provide benefits for children who areotherwise covered for such benefits under amedicaid plan or under a group health plan,health insurance coverage. or other healthbenefits coverage. but may expend funds foroutreach and other activities in order to pro-mote coverage under such plans.

(2) CoNSTRUCTION—Nothing in this sub-section shall be construed as requiring aMedikids plan of a State to provide coveragefor all near poverty level children describedin paragraph (1) who are residing in theState.

(c) MEDICAID-EQUIVALENT BENEFITS—Sub-ject to subsection (d). a Medikids programshall provide benefits to eligible children forthe equivalent items and services for whichmedical assistance is available (other thancost sharing) to children under the State'smedicaid plan.

(d) PREMIUMS AND COST-SHARING.—

June 25, 1997

(1) IN GENERAL—Subject to paragraphs (2)and (3). a Medikids program may—

(A) require the payment of premiums as acondition for coverage. but only for a cov-ered child whose family income exceeds thepoverty line;

(B) impose deductibles, coinsurance, co-payments, and other forms of cost-sharingwith respect to benefits under the program;and

(C) vary the levels of premiums,deductibles, coinsurance. copayments. andother cost-sharing based on a sliding scalerelated to the family income of the coveredchild.

(2) LIMITs ON PREMIUMS AND COST-SHAR-ING.—The Secretary shall establish limits onthe amount of cost-sharing expenses (includ-ing premiums. deductibles. coinsurance, co-payments, and any other required financialcontribution) that may be applied under theprogram. Such limits shall assure that totalcost sharing expenses for children participat-ing in such program are reasonable in rela-tion to the income of their family (and tak-ing into account the other types of expensesgenerally incurred by such families and fam-ily size) and that such cost sharing expensesdo not unreasonably reduce access to thecoverage or covered services provided undersuch program.

(3) No COST SHARING FOR PREVENTIVE SERV-IcEs—A Medikids program may not imposedeductibles. coinsurance. copayments, orsimilar cost sharing for preventive services.SEC. 35Z3. PAYMENT AMOUNTS.

(a) TOTAL AMOUNT AVAILABLE.—(1) IN GENERAL.—The total amount of funds

that is available for payments under thischapter in any fiscal year is the base amountspecified in paragraph (2) for the fiscal yearreduced by the amount specified under para-graph (3) for the fiscal year.

(2) BAsE AMOUNT.—The base amount speci-fied under this paragraph for fiscal year 1998and any subsequent fiscal year is$2,805,000,000.

(3) OFFSET FOR CERTAIN INCREASED MEDIC-AID EXPENDITURES.—

(A) IN GENERAL.—Subject to subparagraph(B), the amount specified under this para-graph for a fiscal year is the amount of ag-gregate additional Federal expendituresunder made title XIX of the Social SecurityAct during the fiscal year that the Secretaryestimates, before the beginning of the fiscalyear, is attributable to imposition of theconditions described in section 3522(a). Forpurposes of applying the previous sentence,any Federal expenditures that result from anincrease in the applicable percentage undersection 1902(l)(2)(A) of the Social SecurityAct above the percentage in effect as of June25, 1997, or from any exercise of an option de-scribed in section 3522(a)(2) effected on orafter such date. shall be treated as addi-tional Federal expenditures attributable tothe imposition of the conditions described insection 3522(a).

(B) ADJUSTMENT TO REFLECT ACTUAL EX-PENDITURES.—After the end of each fiscalyear, the Secretary shall determine the ac-tual amount of the additional Federal ex-penditures described in subparagraph (A) forthe fiscal year. The Secretary shall adjustthe amount otherwise specified under sub-paragraph (A) for subsequent years to takeinto account the amount by which theamounts estimated for previous fiscal yearsunder such subparagraph were greater. orless than. the actual amount of the expendi-tures for such years.


lish a formula for the allotment of the totalamount of funds available under subsection(a) among the qualifying States for each fis-cal year.

June 25, 1997(2) BASIS—The formula shall be based upon

the Secretary's estimate of the number ofnear poverty level children in the State as aproportion of the total of such numbers forall the qualifying States.

(3) CARRYFORWARD.—If the Secretary doesnot pay to a State under subsection (c) in afiscal year the amount of its allotment inthat fiscal year under this subsection, theamount of its allotment under this sub-section for the succeeding fiscal year shallbe increased by the amount of such shortfall.

(c) PAYMENTs.—(1) IN GENERAL—From the allotment of

each qualifying State under subsection (b)for a fiscal year, the Secretary shall pay tothe State for each quarter in the fiscal yearan amount equal to 75 percent of the totalamount expended during such quarter tocarry out the State's MediKids program.

(2) NOT COUNTING COST SHARING—For pur-poses of paragraph (1). if a MediKids programimposes premiums for coverage or requirespayment of deductibles, coinsurance. copay-ments. or other cost sharing, under rules ofthe Secretary, expenditures attributable tosuch premiums or cost sharing shall not betaken into account under paragraph (1).


For purposes of this chapter:(1) The term "child" means an individual

under 19 years of age.(2) The term "medicaid plan" means the


(3) The term "MediKids program" means achild health insurance program of a Stateunder this title.

(4) The term "near poverty level child"means a child the family income of which (asdefined by the Secretary) is at least 100 per-cent, but less than 300 percent, of the pov-erty line.

(5) The term "poverty line" has the mean-ing given such term in section 673(2) of theCommunity Services Block Grant Act (42U.S.C. 9902(2)), including any revision re-quired by such section.

(6) The term "qualifying State" means aState with a MediKids program for which aplan is submitted and approved under thistitle.

(7) The term "Secretary" means the Sec-retary of Health and Human Services.

(8) The term "State" means the 50 States,the District of Columbia, Puerto Rico, theVirgin Islands, Guam, American Samoa, andthe Northern Mariana Islands.

CHAPTER 3—CONTINUATION OF MEDIC-AID ELIGIBILITY FOR DISABLED CHIL-DREN WHO LOSE SSI BENEFITS

SEC. 3531. CONTINUATION OF MEDICAID ELIGI-BILITY FOR DISABLED CHILDRENWHO LOSE SSI BENEFITS.

(a) IN GENERAL—Section1902(a)(10)(A)(i)(II) of the Social Security Act(42 U.S.C. 1396a(a) (10) (A) (i) (II)) is amended byinserting "(or were being paid as of the dateof enactment of section 211(a) of the Per-sonal Responsibility and Work OpportunityReconciliation Act of 1996 (P.L. 104—193)) andwould continue to be paid but for the enact-ment of that section" after "title XVI".

(b) EFFECTIVE DATE.—The amendmentmade by subsection (a) applies to medical as-sistance furnished on or after July 1, 1997.

CONGRESSIONAL RECORD — HOUSECHAPTER 4—ASSURING CHILDREN'S

ACCESS TO HEALTH INSURANCESEC. 3541. GUARANTEED AVAILABILITY OF INDI-

VIDUAL HEALTH INSURANCE COV-ERAGE TO UNINSURED CHILDREN.

(a) IN GENERAL—Title XXVII of the PublicHealth Service Act, as added by section111(a) of the Health Insurance Portabilityand Accountability Act of 1996, is amendedby inserting after section 2741 the followingnew section:"SEC. 2741A. GUARANTEED AVAILABILITY OF IN-


(a) GUARANTEED AVAILABILITY.—'(1) IN GENERAL—Subject to the succeed-

ing subsections of this section, each healthinsurance issuer that offers health insurancecoverage (as defined in section 2791(b) (1)) inthe individual market in a State, in the caseof an eligible child (as defined in subsection(b)) desiring to enroll in individual health in-surance coverage—

"(A) may not decline to offer such cov-erage to, or deny enrollment of, such child;

"(B) either (i) does not impose any pre-existing condition exclusion (as defined insection 2701(b)(1)(A)) with respect to suchcoverage, or (ii) imposes such a preexistingcondition exclusion only to the extent suchan exclusion may be imposed under section2701 (a) in the case of an individual who is nota late enrollee; and

(C) shall provide that the premium for thecoverage is determined in a manner so thatthe ratio of the premium for such eligiblechildren to the premium for eligible individ-uals described in section 2741(b) does not ex-ceed the ratio of the actuarial value of suchcoverage (calculated based on a standardizedpopulation and a set of standardized utiliza-tion and cost factors) for children to such ac-tuarial value for such coverage for such eli-gible individuals.

"(2) SUBSTITUTION BY STATE OF ACCEPTABLEALTERNATIVE MECHANISM—The requirementof paragraph (1) shall not apply to health in-surance coverage offered in the individualmarket in a State in which the State is im-plementing an acceptable alternative mecha-nism under section 2744.

"(b) ELIGIBLE CHILD DEFINED—In this part,the term 'eligible child' means an individualborn after September 30, 1983, who has notattained 19 years of age and—

"(1) who is a citizen or national of theUnited States. an alien lawfully admitted forpermanent residence, or an alien otherwisepermanently residing in the United Statesunder color of law;

"(2) who is not eligible for coverage under(A) a group health plan, (B) part A or part Bof title XVIII of the Social Security Act. or(C) a State plan under title XIX of such Act(or any successor program). and does nothave other health insurance coverage; and

"(3) with respect to whom the most recentcoverage (if any. within the 1-year periodending on the date coverage is sought underthis section) was not terminated based on afactor described in paragraph (1) or (2) of sec-tion 2712(b) (relating to nonpayment of pre-miums or fraud).For purposes of paragraph (2) (A), the term'group health plan' does not include COBRAcontinuation coverage.

'(c) INCORPORATION OF CERTAIN PROVI-SIONS.—

"(1) IN GENERAL—Subject to paragraph (2),the provisions of subsections (c). (d). (e) and(f) (other than paragraph (1)) of section 2741and section 2744 shall apply in relation to eli-gible children under subsection (a) in thesame manner as they apply in relation to eli-gible individuals under section 2741 (a).

"(2) SPECIAL RULES FOR ACCEPTABLE ALTER-NATIVE MECHANISMS—With respect to apply-ing section 2744 under paragraph (1)—

H4603(A) the requirement in subsection

(a) (1) (B) shall be applied instead of the re-quirement of section 2744(a) (1) (B);

"(B) the requirement in subsection(a)(1)(C) shall be applied instead of the re-quirement of section 2744 (a) (1) (D) and

'(C) any deadline specified in such sectionshall be 1 year after the deadline otherwisespecified.".

(b) EFFECTIVE DATE.—The amendmentmade by subsection (a) shall take apply 1year after the effective date for section 2741of the Public Health Service Act (as providedunder section 111(b)(1) of the Health Insur-ance Portability and Accountability Act of1996).

Mr. BROWN of Ohio (during the read-ing). Mr. Speaker, I ask unanimousconsent that the motion to recommitbe considered as read and printed inthe RECORD.

The SPEAKER pro tempore. Is thereobjection to the request of the gen-tleman from Ohio?

There was no objection.Mr. BROWN of Ohio. Mr. Speaker,

the Republican children's health careexpansion proposal in the Budget Rec-onciliation Act before us today will notensure real health insurance coveragefor the maximum number of children inthe most cost-effective manner. I amdeeply concerned because the Repub-lican plan does not offer a real guaran-tee of health care coverage for childrenor a real benefits package.

The Republican block grant containsa so-called direct services loopholewhich could mean that not a singletaxpayer penny is used to providehealth insurance for our Nation's 10million uninsured children.

States would be free to divert Fed-eral children's health care expansionfunds from directly providing healthcare coverage for uninsured children toinstead providing direct payments tohospitals who will suffer under the dis-proportionate share cuts in this bill.Just as many States misused the DSHprogram in the early 1990s to pay forhighway repairs and other related pro-grams, I fear that States will use theseFederal funds to plug holes in shrink-ing State budgets. We surely shouldhave learn our lesson.

I believe there are several superiorprograms to help extend coverage foruninsured children. Bipartisan legisla-tion introduced by the gentleman fromMichigan [Mr. DINGELL], the gentle-woman from New Jersey [Mrs. ROU-KEMA], me, and others would providechildren with a guaranteed, real healthcare benefits package which includespreventive care, hearing and visionservices, and routine doctor visits.

The Democratic Caucus proposal, an-other plan which is part of this motionto recommit, would promote more ef-fective outreach for Medicaid-eligiblechildren who are not enrolled, allow forvoluntary expansion of Medicaid cov-erage, establish a State grant programto fund innovative kids' health initia-tives and require the issuance of afford-able kids-only health insurance poli-cies.

The Republican plan, Mr. Speaker,will cost too much, waste too many tax

H4604dollars, and fail to insure America's 10million uninsured children.

Mr. Speaker, I yield to the gentlemanfrom New Jersey [Mr. PALLONE].

Mr. PALLONE. Mr. Speaker, I wantto commend my colleague for what hesaid about the reason we need to pro-pose this Democratic alternative is be-cause the Republicans have offered justa straight block grant. It does notmandate that these funds go to thechildren who need it. It gives too muchdiscretion to the Governors who mightuse this money to fund other huge gapscreated by this bill, like the unfair cutsto disproportionate share hospitalsalso known as DSH hospitals.

The Democratic Health Care TaskForce has a plan, an alternative thatcontains four elements:

First, incentives for States to coverchildren under 19 years of age in fami-lies with less than $24,000 in incomeand pregnant women and infants infamilies with incomes up to $30,000through an enhanced Medicaid match.

Second, we have a Medikids grant forStates to help middle- and low-incomefamilies to purchase private insuranceor participate in a State-sponsored ex-panded Medicaid package.

Third, we improve outreach efforts toensure that nearly 3 million childreneligible for Medicaid that are not en-rolled in the program sign up forhealth insurance coverage.

And, fourth, insurance reforms to re-quire private insurance companies toprovide health care policies for chil-dren at reasonable premiums.

This four-pronged approach takeswhat we feel are the most positive as-pects in Medicaid matching grants andprivate insurance reforms. It assistsmiddle- and low-income families byproviding affordable health insurancefor their children. It assures that chil-dren are covered by an adequate bene-fits package and it provides that properbalance of State flexibility with publicaccountability.

I urge my colleagues to support themotion to recommit so that this Househas a real opportunity to address theneeds of the 10 million uninsured chil-dren in our country.

The SPEAKER pro tempore. Doesany Member rise in opposition to themotion to recommit?

Mr. THOMAS. Mr. Speaker, I rise inopposition to the motion to recommit.

Mr. Speaker, we heard all day, speak-er after speaker on the other side ofthe aisle go into the well and say thatthe provisions that the Republicanshad structured were outside the scopeof the budget agreement, that we hadnot lived up to the budget agreement,that oh, my goodness, how could younot live up to the budget agreement.

Mr. Speaker, this motion to recom-mit, guess what, does not live up to thebudget agreement. It clearly states inthe budget agreement that there aretwo areas where money can be spentfor children's health care. One is inMedicaid. The other one is in blockgrants. Other possibilities are available


if mutually agreeable. Mutually agree-able.

The fact of the matter is, this motionto recommit has mandatory languagerequiring private insurers to carry outthe wish, yes, the demands of theDemocrats. It is clearly beyond thebudget agreement. How in the worldcan you folks spend all day telling usthat provision after provision is unac-ceptable because it is outside the budg-et agreement and yet you offer a mo-tion to recommit which is one, subjectto a point of order, it is not germane,and, two, the entire rest of the contextis outside of the budget agreement?Why do you not live up to what youpreach.

I would simply tell, my colleagues,the simple answer is to vote no on themotion to recommit.

Mr. Speaker, I yield to the gentlemanfrom Virginia [Mr. BLILEY], chairmanof the Committee on Commerce, whohas the specific jurisdiction of thismatter, which is outside the scope ofthe budget agreement.

Mr. BLILEY. Mr. Speaker, I thankthe gentleman for yielding to me.

Here we go again. All day, speakerafter speaker on this side of the aislecomplaining about their Governors get-ting cut with the DSH payments andnot going to be able to meet the tar-gets. Well, in the Committee on Com-merce we gave $16 billion for kid careand we said to the Governors, you fur-nish the health and you furnish theservices and we did not restrict it andthey are made pretty much whole fortheir Medicare budgets.

But what this recommit motionwould do would require States to phasein all children up to age 19 in the Med-icaid Program and would requireStates to increase their mandatory lev-els of eligibility for certain eligibilitygroups. These are costly changes. ManyStates do not have the budgetary re-sources to do them. That means theseStates will not be eligible or able toparticipate in kid care and the unin-sured children in those States would bedenied the coverage and services theyneed. It would require States to pro-vide only the Medicaid benefits pack-ages to children served by kid care.

This package is so expensive thatStates would not be able to afford tocover millions of children who wouldotherwise receive coverage under ourplan. It would eliminate the ability ofStates to provide uninsured childrenthe health services they need. This is aviolation of the budget agreement, asthe distinguished chairman of the Sub-committee on Health of the Committeeon Ways and Means pointed out, whichprovided for coverage and services touninsured low-income children.

In addition, it would mean that serv-ices would be denied to the 2.6 millionchildren that CBO estimates would re-ceive health care services under ourplan.

Mr. THOMAS. Mr. Speaker, I yield tothe gentleman from Illinois [Mr.HASTERT].

June 25, 1997

Mr. HASTERT. Mr. Speaker, biggergovernment, more bureaucrats, morerestrictions on the States. As a matterof fact, we create more loopholes forthe States to jump through and whatwe do is deny the States providing kidcare for kids. So those 2.6 million chil-dren who were going to benefit fromthis program all of a sudden will nothave States providing health care forthem.

D 1730

Too much bureaucracy, too muchextra cost, too many new hoops tojump through. The States are notgoing to do it. The States are not goingto follow this. And I think it is a badidea at a bad time.

The SPEAKER pro tempore (Mr.DRELER). All time has expired.

PARLIAMENTARY INQUIRY

Mr. BROWN of Ohio. Mr. Speaker,parliamentary inquiry.

The SPEAKER pro tempore. The gen-tleman will state his parliamentary in-quiry.

Mr. BROWN of OhiO. Mr. Speaker, isthe language to which the gentlemanfrom California [Mr. THOMAS] and thegentleman from Illinois [Mr. HASTERT]and the gentleman from Virginia [Mr.BLILEY] are referring the State op-tional program on the——

The SPEAKER pro tempore. The gen-tleman is not presenting a parliamen-tary inquiry.

Without objection, the previous ques-tion is ordered on the motion to recom-mit.

There was no objection.The SPEAKER pro tempore. The

question is on the motion to recommit.The question was taken; and the

Speaker pro tempore announced thatthe noes appeared to have it.

Mr. BROWN of Ohio. Mr. Speaker, Iobject to the vote on the ground that aquorum is not present and make thepoint of order that a quorum is notpresent.

The SPEAKER pro tempore. Evi-dently a quorum is not present.

The Sergeant at Arms will notify ab-sent Members.

The vote was taken by electronic de-vice, and there were—yeas 207, nays223, not voting 4, as follows:

[Roll No. 2401YEAS—207

Abercrombie Brown (FL) DeLauroAckerman Brown (OH) DellumsAllen Capps DeutschAndrews Cardin DicksBaesler Carson DingellBaldacci Clay DixonBarciaBarrett (WI)

ClaytonClement

DoggettDooley

Becerra Clyburn DoyleBentsen Condit EdwardsBerman Conyers EngelBerry Costello EshooBishopBlagojevich

CoyneCramer

EtheridgeEvans

BlumenauerBonior

CummingsDanner

FarrFattah

Borski Davis (FL) FazioBoswell Davis (IL) FilnerBoucher DeFazio FlakeBoyd DeGette FogliettaBrown (CA) Delahunt Ford

June 25, 1997 CONGRESSIONAL RECORD—HOUSE H4605Frank (MA) Maloney (CT) Rodriguez Ney Rohrabacher Spence Goss Maloney (CT) SaxtonFrost Maloney (NY) Roemer Northup Ros-Lehtinen Stearns Graham Manzullo ScarboroughFurse Manton Rothman Norwood Roukema Stump Granger Martinez Schaefer, DanGejdenson Markey Roybal-Allard Nussle Royce Sununu Greenwood McCarthy (MO) Schaffer, BobGephardt Martinez Rush Oxley Ryun Talent Gutknecht McCollum SensenbrennerGonzalez Mascara Sabo Packard Salmon Tauzin Hall (OH) McCrery SessionsGoode Matsui Sanchez Pappas Sanford Taylor (NC) Hamilton McDade ShadeggGordon McCarthy (MO) Sanders Parker Saxton Thomas Hansen McHale ShawGreen McCarthy (NY) Sandlin Paul Scarborough Thornberry Harman McHugh ShaysGutierrez McDermott Sawyer Paxon Schaefer, Dan Thune Hastert Mclnnls ShimkusHall (OH) McGovern Schumer Pease Schaffer, Bob Tiahrt Hastings (WA) McIntyre ShusterHall (TX) McHale Scott Peterson (PA) Sensenbrenner Upton Hayworth McKeon SisiskyHamilton McIntyre Serrano Petri Sessions Walsh Hefley Mica SkeenHarman McKinney Sherman Pickering Shadegg Wamp Herger Miller (FL) SkeltonHastings (FL) McNulty Sisisky Pitts Shaw Watkins Hill Minge Smith (Ml)Hefner Meehan Skaggs Pombo Shays Watts (OK) Hilleary Molinari Smith (NJ)Hilliard Meek Skelton Porter Shimkus Weldon (FL) Hobson Moran (VA) Smith (OR)Hinchey Menendez Slaughter Portman Shuster Weldon (PA) Hoekstra Morella Smith (TX)Hinojosa Millender- Smith, Adam Pryce (OH) Skeen Weller Holden Myrick Smith, AdamHolden McDonald Snyder Quinn Smith (Ml) White Hooley Nethercutt Smith, LindaHooley Miller (CA) Spratt Radanovich Smith (NJ) Whitfield Horn Neumann SnowbargerHoyer Minge Stabenow Ramstad Smith (OR) Wicker Hostettler Ney SnyderJackson (IL) Mink Stark Redmond Smith (TX) Wolf Houghton Northup SolomonJackson-Lee Moakley Stenholm Regula Smith, Linda Young (AK) Hulshof Norwood Souder

(TX) Mollohan Stokes Riley Snowbarger Young (FL) Hunter Nussle SpenceJefferson Moran (VA) Strickland Rogan Solomon Hutchinson Oxley SprattJohn Murtha Stupak Rogers Souder Hyde Packard StenholmJohnson (WI) Nadler Tanner Inglis Pappas StumpJohnson, E. B. Neal Tauscher NOT VOTING4 Istook Parker SununuKanjorski Oberstar Taylor (MS) Chenoweth Schiff Jenkins Paxon TalentKaptur Obey Thompson Cox Yates John Pease TannerKennedy (MA) Olver Thurman Johnson (CT) Peterson (PA) TauscherKennedy (RI) Ortiz Tierney 0 1748 Johnson, Sam Petri TauzinKennelly Owens Torres Jones Pickering Taylor (MS)Kildee Pallone Towns Mr. HOSTETI'LER and Mr. Kasich Pitts Taylor (NC)Kilpatrick Pascrell Traficant LARGENT changed their vote from Kelly Pombo ThomasKind (WI) Pastor Turner "yea' to 'nay." Kennelly Pomeroy ThornberryKleczka Payne Velazquez Kim Porter ThuneKlink Pelosi Vento Mr. LIPINSKI and Ms. WOOLSEY Kingston Portman ThurmanKucinich Peterson (MN) Visclosky changed their vote from 'nay" to Kleczka Pryce (OH) TiahrtLaFalce Pickett Waters "yea." KIug Quinn TraficantLampson Pomeroy Watt (NC) So the motion to recommit was re- Knollenberg Radanovich TurnerLantos Poshard Waxman Kolbe Ramstad UptonLevin Price (NC) Wexler jected. LaHood Redmond ViscloskyLewis (GA) Rahall Weygand The result of the vote was announced Lampson Regula WalshLipinski Rangel Wise as above recorded. Largent Riggs WampLofgren Reyes Woolsey Latham Riley WatkinsLowey Riggs Wynn The SPEAKER pro tempore (Mr. LaTourette Roemer Watts (OK)Luther Rivers DREJER). The question is on the passage Lazio Rogan Weldon (FL)

of the bill. Leach Rogers Weldon (PA)NAYS223 The question was taken; and the Lewis (CA) Rohrabacher Weller

Lewis (KY) Ros-Lehtinen WhiteAderholt Deal Houghton Speaker pro tempore announced that Linder Roukema WhitfieldArcher DeLay Hulshof the ayes appeared to have it. Livingston Royce WickerArmey DIaz-Balart Hunter LoBiondo Ryun WolfBachus Dickey Hutchinson RECORDED VOTE Lucas Sanchez Young (AK)Baker Doolittle Hyde Mr. BONIOR. Mr. Speaker, I demand Luther Sanford Young (FL)Ballenger Dreier Inglis a recorded vote.Barr Duncan Istook NOES—162Barrett (NE) Dunn Jenkins A recorded vote was ordered.

Abercrombie Farr LevinBartlett Ehlers Johnson (CT) The vote was taken by electronic de- Ackerman Fattah Lewis (GA)Barton Ehrlich Johnson, Sam vice, and there were—ayes 270, noes 162, Allen Fazio LipinskiBass Emerson JonesBateman English Kasich not voting 3, as follows: Andrews Filner Lofgren

Baldacci Flake LoweyBereuter Ensign Kelly [Roll No. 241J Barrett (WI) Foglietta Maloney (NY)Bilbray Everett KimAYES—270 Becerra Ford MantonBilirakis Ewing King (NY)

Berman Frank (MA) MarkeyBliley Fawell Kingston Aderholt Callahan DoolittleBlunt Foley KIug Archer Calvert Doyle

Berry Frost MascaraBoehlert Forbes Knollenberg Armey Camp Dreier Blagojevich Furse MatsuiBoehner Fowler Kolbe Bachus Campbell Duncan

Blumenauer GeJdenson McCarthy (NY)Bonior Gephardt McDermottBonilla Fox LaHood Baesler Canady Dunn Borski Gonzalez McGovernBono Franks (NJ) Largent Baker Cannon Edwards Boucher Green McIntoshBrady Frelinghuysen Latham Ballenger Capps Ehlers Brown (CA) Gutierrez McKinneyBryant Gallegly LaTourette Barcia Castle Ehrlich

Bunning Ganske Lazio Barr Chabot Emerson Brown (FL) Hall (TX) McNultyBurr Gekas Leach Barrett (NE) Chambliss English Brown (OH) Hastings (FL) Meehan

Cardin Hefner MeekBurton Gibbons Lewis (CA) Bartlett Chenoweth Ensign Carson Hilliard MenendezBuyer Gilchrest Lewis (KY) Barton Christensen Etheridge Clay Hinchey MetcalfCallahan Gillmor Linder Bass Clement EverettCalvert Gilman Livingston Bateman Coble Ewing Clayton HinoJosa Millender-Camp Goodlatte LoBiondo Bentsen Coburn Fawell Clyburn Hoyer McDonaldCampbell Goodling Lucas Bereuter Collins Foley Conyers Jackson (IL) Miller (CA)Canady Goss Manzullo Bilbray Combest Forbes Costello Jackson-Lee MinkCannon Graham McCollum Bilirakis Condit Fowler Coyne (TX) MoakleyCastle Granger McCrery Bishop Cook Fox

Cummings Jefferson MollohanChabot Greenwood McDade Bliley Cooksey Franks (NJ) Davis (IL) Johnson (WI) Moran (KS)

DeFazio Johnson, E. B. MurthaChambliss Gutknecht McHugh Blunt Cramer Frelinghuysen DeGette Kanjorski NadlerChristensen Hansen Mclnnls Boehlert Crane Gallegly Delahunt Kaptur NealCoble Hastert McIntosh Boehner Crapo GanskeCoburn Hastings (WA) McKeon Bonilla Cubin Gekas DeLauro Kennedy (MA) OberstarCollins Hayworth Metcalf Bono Cunningham Gibbons

Dellums Kennedy (RI) Obey

Combest Hefley Mica Boswell Danner Gilchrest Deutsch Kildee OlverCook Herger Miller (FL) Boyd Davis (FL) Gillmor

Dicks Kilpatrick OrtizCooksey Hill Molinari Brady Davis (VA) Gilman

Dingell Kind (WI) OwensCrane Hilleary Moran (KS) Bryant Deal Gingrich Dixon King (NY) PalloneCrapo Hobson Morella Bunning DeLay Goode

Doett Klink PascrellCubin Hoekstra Myrick Burr Diaz-Balart Goodlatte

Engel Kucinich PastorCunningham Horn Nethercutt Burton Dickey Goodling

Eshoo LaFalce PaulEvans Lantos PayneDavis (VA) Hostettler Neumann Buyer Dooley Gordon

H4606 CONGRESSIONAL RECORD—HOUSE June 25, 1997I'elosi Sanders ThompsonI'eterson (MN) Sandlin TierneyI'ickett Sawyer TorresPoshard Schumer TownsPrice (NC) Scott VelazquezRahall Serrano VentoRangel Sherman WatersReyes Skaggs Watt (NC)Rivers Slaughter WaxmanRodriguez Stabenow WexlerRothman Stark WeygandRoybal-Allard Stearns WiseRush Stokes WoolseySabo Strickland WynnSalmon Stupak

NOT VOTING—3Cox Schiff Yates

0 1809The Clerk announced the following

pairs: on this vote:Mr. Schiff for, with Mr. Yates against.Messrs. GORDON, WELDON of Flor-

ida, and BARR of Georgia changedtheir vote from no" to aye."

So the bill was passed.The result of the vote was announced

as above recorded.A motion to reconsider was laid on

the table.

THANKING MEMBERS FOR A COUR-TEOUS AND DIGNIFIED DEBATEON THE BILL JUST PASSED(Mr. KASICH asked and was given

permission to address the House for 1minute.)

Mr. KASICH. Mr. Speaker, I justwanted to take a moment to thank theHouse Members on both sides of theaisle for the kind of courtesies and dig-nity with which we conducted that last3 hours worth of debate, and I want tothank the House for the opportunity tomove this bill forward.

I had the sense out here on the flooras we wrapped up the debate, Mr.Speaker, that while there may be dif-ferences, may be there is a little icemelting here in our ability to be ableto get along, to have differences andyet still maintain a good spirit aboutthings, and I think that is nothing butgood for the future of this House.

II

105TH CONGRESS1ST SEssioN

IN THE SENATE OF THE UNITED STATES

JUNE 25, 1997

Received

AN ACTTo provide for reconciliation pursuant to subsections (b)(1)

and (c) of section 105 of the concurrent resolution onthe budget for fiscal year 1998.



2



3 of 1997".

4 SEC. 2. TABLE OF CONTENTS.

Title I—Committee on Agriculture.Title Il—Committee on Banking and Financial Services.Title UI—Committee on Commerce—Nonmedicare.Title IV—Committee on Commerce—Medicare.Title V—Committee on Education and the Workforce.Tittle VI—Committee on Government Reform and Oversight.Title Vu—Committee on Transportation and Infrastructure.Title VIll—Committee on Veterans' Affairs.Title TX—Committee on Ways and Means—Nonmedicare.Title X—Committee on Ways and Means—Medicare.Title XI—Budget Enforcement.

181

20 TITLE W—COMMITTEE ON21 COMMERCE—MEDICARE

401

io Subtitle D—AntiFraud and Abuse11 Provisions

415

17 SEC. 4308. PROVISION OF CERTAIN IDENTIYICATION NUM-

18 BERS.


20 TIFICATION NUMBERS (EINS) AND SOCIAl4 SECURITY Ac-



23 period at the end the following: "and suppiy the Secretary



416






6 more ownership interest. Use of the social security account

7 number under this section shall be limited to identity ver-

8 ification and identity matching purposes only. The social

9 security account number shall not be disclosed to any per-

10 son or entity other than the Secretary, the Social Security

11 Administration, or the Secretary of the Treasury, In ob-

12 taming the social security account numbers of the disclos-

13 ing entity and other persons described in this section, the

14 Secretary shall comply with section 7 of the Privacy Act

15 of 1974 (5 U.S.C. 552a note)".

16 (b) OTHER MEDICARE PROVJDERS.—Section 1124A




20 graph (1);




24 paragraph:

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1 "(3) including the employer, identification num-










11 (c) VERIFICATION BY Soci SECURITY ADMTNIS-

12 TRATION (SSA).—Section 1124A (42 U.S.C. 1320a—3a)

13 is amended—


15 section (d); and


17 ing new subsection: -


19 "(1) TRsIflTTAL BY irns.—The Secretary





24 205(c)(2)(B)), and

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8 paragraph (2).



11 verlly the accuracy of, or correct, the information










21 (d) REPORT.—Before this subsection shall be effec-

22 tive, the Secretary of Health and Human Services shall

23 submit to Congress a report on steps the Secretary has

24 taken to assure the confidentiality of social security ac-

25 count numbers that will be provided to the Secretary

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1 under the amendments made by this section. If Congress

2 determines that the Secretary has not taken adequate

3 steps to assure the confidentiality of social security ac-

4 count numbers to be provided to the Secretary under the

5 amendments made by this section, the amendments made

6 by this section shall not take effect.

7 (e) EFFECTwE DATES.—Subject to subsection (d)—

8 (1) the amendment made by subsection (a)





13 section (d); and

14 (2) the amendments made by subsection (b)




714

9 TITLE IX—COMMITTEE ON WAYS10 AND MEANS—NONMEDICARE11 SEC. 9000. TABLE OF CONTENTS.

12 The table of contents of this title is as follows:



Sec.. 9001. Welfare-to-work grants.Sec. 9002. Limitation on amount of Federal funds transferable to title XX pro-

grams.Sec. 9003. Clarification of limitation on number of persons who may be treated

as engaged in work by reason of participation in vocationaleducational training.

Sec. 9004. Rules governing expenditures of funds for work experience and com-munity service programs.

Sec. 9005. State option to take account of certain work activities of recipientswith sufficient participation in work experience or communityservice programs.

Sec. 9006. Worker protections.Sec. 9007. Penalty for failure of State to reduce assistance for recipients refus-

ing without good cause to work.


Sec. 9101. Requirement to perform childhood disability redeterminations inmissed cases.



Subtitle C—Child Support Enforcement

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Sec. 9201. Clarification of authority to permit certain redisciosures of wage and

claim information.

Subtitle D—Restrictmg Welfare and Public Benefits for Aliens

Sec. 9301. Extension of eligibility period for refugees and certain other quali-fied aliens from 5 to 7 years for SSI and medicaid.

Sec. 9302. SSI eligibility for aliens receiving SSI on August 22, 1996.

Sec. 9303. SSI eligibility for permanent resident aliens who are members of an

Indian tribe.Sec. 9304. Verification of eligibility for State and local public benefits.

Sec. 9305. Derivative eligibility for benefits.Sec. 9306. Effective date.

Subtitle E—Unemployment Compensation

Sec. 9401. Clarifying provision relating to base periods.Sec. 9402. Increase in Federal unemployment account ceiling.Sec. 9403. Special distribution to States from. Unemployment Trust Fund.Sec. 9404. Interest-free advances to State accounts in Unemployment Trust

Fund restricted to States which meet funding goals.Sec. 9405. Exemption of service performed by election workers from the Fed-

eral unemployment tax.Sec. 9406. Treatment of certain services performed by inmates.Sec. 9407. Exemption of service performed for an elementary or secondary

school operated primarily for religious purposes from the Fed-eral unemployment tax.


Subtitle F—Increase in Public Debt Limit

Sec. 9501. Increase in public debt limit.

752

1 Subtitle B—Supplemental Security2 Income3 SEC. 9101. REQUIREMENT TO PERFORM CHILDHOOD DIS-

4 ABIIJrrY REDETERMINATIONS IN MISSED

5 CASES.

6 Section 211(d)(2) of the Personal Responsibility and

7 Work Opportunity Reconciliation Act of 1996 (110 Stat.

8 2190) is amended—


10 (A) in the 1st sentence, by striking "1

11 year", and inserting "18 months"; and

12 (B) by inserting after the 1st sentence the

13 following: "Any redetermination required by the

14 preceding sentence that is not performed before

15 the end of the period described in the preceding

16 sentence shall be performed as soon as is prac-

17 ticable thereafter."; and

18 (2) in subparagraph (C), by adding at the end

19 the following: "Before commencing a redetermina-

20 tion under the 2nd sentence of subparagraph (A), in

21 any case in which the individual involved has not al-

22 ready been notified of the provisions of this para-

23 graph, the Commissioner of Social Security shall no-

24 tify the individual involved of the provisions of this

25 paragraph.".

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1 SEC. 9102. REPEAL OF MAINTENANCE OF EFFORT RE-

2 QUIREMENTS APPLICABLE TO OPTIONAL

3 STATE PROGRAMS FOR SUPPLEMENTATION

4 OF SSI BENEFITS.

5 Section 1618 of the Social Security Act (42 U.S.C.

6 1382g) is repealed.

7 SEC. 9103. FEES FOR FEDERAL ADMINISTRATION OF STATE

8 SUPPLEMENTARY PAYMENTS.

9 (a) FEE SCHEDULE.—

10 (1) OPTIoN STATE SUPPLEMENTARY PAY-

11 MENTS.—

12 (A) IN GENERAL.—Section 1616(d)(2)(B)

13 of the Social Security Act (42 U.S.C.

14 1382e(d)(2)(B)) is amended—


16 clause (iii); and

17 (ii) by striking clause (iv) and insert-

18 ing the following:

19 "(iv) for fiscal year 1997, $5.00;

20 "(v) for fiscal year 1998, $6.20;

21 "(vi) for fiscal year 1999, $7.60;

22 "(vii) for fiscal year 2000, $7.80;

23 "(viii) for fiscal year 2001, $8.10;

24 "(ix) for fiscal year 2002, $8.50; and

25 "(x) for fiscal year 2003 and each succeeding

26 fiscal year—

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1 "(I) the applicable rate in the preceding





6 the month of Juiie of the calendar year preced-



9 "(II) such different rate as the Conimis-



12 1616(d)(2)(C) of such Act (42 U.S.C.

13 1382e(d)(2)(C)) is amended by striking

14 "(B)(iv)" and inserting "(B)(x)(ll)".

15 (2) MANDATORY STATE STJPPLEMENTABY PAY-

16 MENTS.—

17 (A) IN GENERAL—Section

18 212(b)(3)(B)(ji) of Public Law 93—66 (42

19 U.S.C. 1382 note) is amended—


21 subclause (III); and

22 (ii) by striking subclause (W) and in-


24 "(IV) for fiscal year 1997, $5.00;

25 "(V) for fiscal year 1998, $6.20;

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1 "(VI) for fiscal year 1999, $7.60;

2 "(VII) for fiscal year 2000, $7.80;

3 "(VIII) for fiscal year 2001, $8.10;

4 "(IXI) for fiscal year 2002, $8.50; and

5 "(X) for fiscal year 2003 and each succeeding

6 fiscal year—

7 "(aa) the applicable rate in the preceding








15 "(bb) such different rate as the Comrnis-



18 212(b)(3)(B)(iii) of such Act (42 U.S.C. 1382

19 note) is amended by striking "(ii)(IV)" and in-

20 serting "(ii)(X)(bb)".

21 (b) USE OF NEW FEES To DEFRAY THE Soci SE-

22 CURITY ADMINISTRATION'S ADMINISTRATWE Ex-

23 PENSES.—

24 (1) CREDIT TO SPECIAL FUND FOR FISCAL

25 YEAR 1998 AN]) SUBSEQUENT YEARS.—

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1 (A) OPTIoN STATE SUPPLEMENTARY

2 PAYMENT FEES.—Section 1616(d)(4) of the So-

3 cia! Security Act (42 U.S.C. 1382e(d)(4)) is

4 amended to read as follows:

5 "(4)(A) The first $5 of each administration fee as-

6 sessed pursuant to paragraph (2), upon collection, shall

7 be deposited in the genera! fund of the Treasury of the

8 United States as miscellaneous receipts.

9 "(B) That portion of each administration fee in ex-

10 cess of $5, and 100 percent of each additional services

11 fee charged pursuant to paragraph (3), upon collection for

12 fisca! year 1998 and each subsequent fisca! year, shall be


14 the United States for State supp!ementary payment fees.



17 able to defray expenses incurred in carrying out this tit!e

18 and re!ated !aws.".

19 (B) MANDATORY STATE SUPPLEMENTARY

20 PAYMENT FEES.—Section 212(b)(3)(D) of Pub

21 ljc Law 93—66 (42 U.S.C. 1382 note) is amend-

22 ed to read as follows:

23 "(D)(i) The first $5 of each administration fee as-

24 sessed pursuant to subparagraph (B), upon collection,

.HR 2015 EH

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1 shall be deposited in the general fund of the Treasury of

2 the United States as miscellaneous receipts.

3 "(ii) The portion of each administration fee in excess

4 of $5, and 100 percent of each additional services fee

5 charged pursuant to subparagraph (C), upon collection for






11 able to defray expenses incurred in carrying out this sec-

12 tion and title XVI of the Social Security Act and related

13 laws.".

14 (2) LIMITATIoNs ON AUTHORIZATION OF AP-

15 PR0PRIATI0NS.—From amounts credited pursuant

16 to section 1616(d)(4)(B) of the Social Security Act

17 and section 212(b)(3)(D)(ii) of Public Law 93—66 to

18 the special fund established in the Treasury of the

19 United States for State supplementary payment

20 fees, there is authorized to be appropriated an

21 amount not to exceed $35,000,000 for fiscal year

22 1998, and such sums as may be necessary for each

23 fiscal year thereafter.

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11 Subtitle D—Restricting Welfare12 and Public Benefits for Aliens13 SEC. 9301. EXTENSION OF ELIGIBILITY PERIOD FOR REFU-

14 GEES AND CERTAIN OTHER QUALIFiED

15 ALiENS FROM 5 TO 7 YEARS FOR SSI AND

16 MEDICAID.

17 (a) SSI.—Section 402(a)(2)(A) of the Personal Re-

18 sponsibility and Work Opportunity Reconciliation Act of


20 lows:

21 "(A) TIME-LIMETED EXCEPTION FOR REF-


23 "(i) SSI.—With respect to the speci-

24 fled Federal program described in para-

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6 tionality Act;





11 Act.





16 date—




20 tionality Act;





25 Act.".

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1 (b) MEDICArn.—Section 402(b)(2)(A) of the Per-



4 as follows:


6 TJGEES AND ASYLEES.—





11 date—




15 tionality Act;





20 Act.


22 PROGRAMS.—With respect to the des-



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6 tionality Act;




10 withheld under section 243(h) of sueh

11 Act.".

12 SEC. 9302. SSI ELIGIBILITY FOR ALIENS RECEIVING SSI ON

13 AUGUST 22, 1996:

14 (a) IN GENERAi.—Section 402(a)(2) of the Personal




18 "(E) ALIENS RECEWING 551 ON AUGUST

19 22, 1996.—With respect to eligibility for bene-

20 fits for the program defined in paragraph


22 come program), paragraph (1) shall not apply

23 to an alien who was receiving such benefits on

24 August 22, 1996.".

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1 (b) STATUS OF CUBAN AND HAITIAN ENTRANTS AND

2 AMERASIAN PERMANENT RESIDENT ALIENS.—For pur-

3 poses of section 402(a)(2)(E) of the Personal Responsibil-

4 ity and Work Opportunity Reconciliation Act of 1996, the

5 following aliens shall be considered qualified aliens:

6 (1) An alien who is a Cuban and Haitian en-

7 trant as defined in section 501(e) of the Refugee

8 Education Assistance Act of 1980.

9 (2) An alien admitted to the United States as

10 an Amerasian immigrant pursuant to section 584 of

11 the Foreign Operations, Export Financing, and Re-

12 lated Programs Appropriations Act, 1988, as con-

13 tamed in section 101(e) of Public Law 100-202,

14 (other than an alien admitted pursuant to section

15 584(b)(l)(C)).


17 402(a)(2)(D) of the Personal Responsibility and Work Op-

18 porturiity Reconciliation Act of 1996 (8 U.S.C.





23 (3) by striking "(ii) FOOD STAMPS'.—';



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1 SEC. 9303. SSI ELIGIBILITY FOR PERMANENT RESJDENT

2 ALIENS WHO ARE MEMBERS OF AN INDIAN

3 TRIBE.

4 Section 402(a)(2) of the Personal Responsibility and



7 adding after subparagraph (E) the following new subpara-

8 graph:













21 ance Act).".

22 SEC. 9304. VERIFICATION OF ELIGIBILITY FOR STATE AND

23 LOCAL PUBLIC BENEFITS.




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1 "SEC. 413. AUTHORIZATION FOR VERIFICATION OF ELIGI-

2 BILITY FOR STATE AND LOCAL PUBLIC BENE-

3 FITS.

4 "A State or political subdivision of a State is author-

5 ized to require an applicant for State and local public ben-

6 efits (as defined in section 411(c)) to provide proof of eli-

7 gibiity.".





"Sec. 413. Authorization for verification of eligibility for state and local public

benefits.".

12 SEC. 9305. DER1VATWE ELIGIBILiTY FOR BENEFflS.




16 "SEC. 436. DER1VATWE ELIGIBILiTY FOR BENEFITS.

17 "(a) FOOD STAMPs.—Notwithstanding any other

18 provision of law, an alien who under the provisions of this

19 title is ineligible for benefits under the food stamp pro-

20 gram (as defined in section 402(a)(3)(A)) shall not be eli-

21 gible for such benefits because the alien receives benefits

22 under the supplemental security income program (as de-

23 fined in section 402(a)(3)(B)).

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1 "(b) MEDICArn.—Notwithstanding any other provi-

2 sion of this title, an alien who under the provisions of this

3 title is ineligible for benefits under the medicaid program

4 (as defined in section 402(b)(3)(C)) shall be eligible for

5 such benefits if the alien is receiving benefits under the

6 supplemental security income program and title XIX of

7 the Social Security Act provides for such derivative eligi-

8 bility.".






13 SEC. 9306. EFFECTiVE DATE.


15 by this subtitle shall be effective as if included in the en-



774

1 TITLE X—COMMITTEE ON WAYS2 AND MEANS—MEDICARE3 SEC. 10000. AMENDMENTS TO SOCIAL SECURITY ACT AND


5 OF TITLE.

6 (a) AMENDMENTS TO Socij. SECURITY ACT.—Ex-







13 "OBRA—1986", "OBRA—1987", "OBRA—1989",




17 Law 100—203), the Omnibus Budget Reconciliation Act


19 onciliation Act of 1990 (Public Law 10 1—508), and the


21 103—66), respectively.

22 (c) TABLE OF CONTENTS OF TITLE.—The table of

23 contents of this title is as follows:

Sec. 10000. Amendments to Social Security Act and references to OBRA tableof contents of title.


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CHAPTER 1—MEDICAREPLUS PROGRAM



"PA1T C—MEDICAREPLUS PROGRAM

"Sec. 1851. Eligibility, election, and enrollment."Sec. 18.52. Benefits and beneficiary protections."Sec. 1853. Payments to MedicarePlus organizations."Sec. 1854. Premiums."Sec. 1855. Organizational and financial requirements for MedicarePlus




ACCOUNTS


CHAPTER 2.—INTEGRATED LONG-TERM Cu PROGRAMS

SUBCHAPTER A—PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY

(PACE)

Sec. 10011. Coverage of PACE under the medicare program.Sec. 10012. Establishment of PACE program as medicaid State option.Sec. 10013. Effective date; transition.Sec. 10014. Study and reports.

SUBCHAPTER B—SOCIAL HEALTH MAINTENANCE ORGANIZATIONS




Sec. 10019. Extension of certain medicare community nursing organizationdemonstration projects.

CHAPTER 3—MEDICARE PAYMENT ADVISORY COMMISSION




CHAPTER 5—TAX TREATMENT OF HOSPITALS PARTICIPATING IN PrtOvmER-SPONSORED ORoiu.uzATIONS

Sec. 10041. Tax treatment of hospitals which participate in provider-sponsoredorganizations.

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Subtitle G—Rural Initiatives

Sec. 10201. Rural primary care hospital program.Sec. 10202. Prohibiting denial of request by rural referral centers for reclassi-

fication on basis of comparability of wages.Sec. 10203. Hospital geographic reclassification permitted for purposes of dis-

proportionate share payment adjustments.Sec. 10204. Medicare-dependent, small rural hospital payment extension.Sec. 10205. Geographic reclassification for certain disproportionately large hos-





Sec. .10303. Inclusion of toll-free number to report medicare waste, fraud, andabuse in explanation of benefits forms.




sions.Sec. 10310. Other fraud and abuse related provisions.


CHAPTER 1—PAyNT UNDER PiuT A


CHAPTER 2—PAYMENT UNDER PiuT B

SUBCHAPTER A—PAYMENT FOR HOSPITAL OUTPATIENT DEPARTMENTSERVICES

Sec. 10411. Elimination of formula-driven overpayments (FDO) for certainoutpatient hospital services.

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Sec. 10412. Extension of reductions in payments for costs of hospital out-patient services.


SUBCHAPTER B—REHABrLITATION SERVICES



Sec. 10431. Payments for ambulance services.Sec. 10432. Demonstration of. coverage of ambulance services under medicare


CHAPTER 3—PAYMENT UNDER PARTS A 1) B



CHAPTER 1—PAYMENT OF PPS HOSPITAJJS

Sec. 10501. PPS hospital payment update.Sec. 10502. Capital payments for PPS hospitals.Sec. 10503. Freeze in disproportionate share.Sec. 10504. Medicare capital asset sales price equal to book value.Sec. 10505. Elimination of IME and DSH payments attributable to outlier

payments.Sec. 10506. Reduction in adjustment for indirect medical education.Sec. 10507. Treatment of transfer cases.Sec. 10508. Increase base payment rate to Puerto Rico hospitals.

CHAPTER 2—PAYMENT OF PPS EXEMPT HOSPITAJJS


and units.Sec. 10513. Cap on TEFRA limits.Sec. 10514. Change in bonus and relief payments.Sec. 10515. Change in payment and target amount for new providers.Sec. 10516. Rebasing.Sec. 10517. Treatment of certain long-term care hospitals.Sec. 10518. Elimination of exemptions; report on exceptions and adjustments.

CHAPTER 3—PRovISIoNS RELATED TO HOSPICE SERVICES


nished.Sec. 10523. Hospice care benefits periods.Sec. 10524. Other items and services included in hospice care.Sec. 10525. Contracting with independent physicians or physician groups for


in non-urbanized areas.

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Sec. 10527. Limitation on liability of beneficiaries for certain hospice coveragedenials.

Sec. 10528. Extending the period for physician certification of an individual'sterminal illness.

Sec. 10529. Effective date.

CHAPTER 4—MODIFICATION OF PT A Ho HEALTH BE'rT








growth rate.Sec. 10604. Payment rules for anesthesia services.Sec. 10605. Implementation of resource-based physician practice expense.Sec. 10606. Dissemination of information on high per discharge relative values


transportation.



laboratory tests.Sec. 10614. Simplification in administration of laboratory tests.Sec. 10615. Updates for ambulatory surgical services.Sec. 10616. Reimbursement for drugs and biologicals.Sec. 10617. Coverage of oral anti-nausea drugs under chemotherapeutic regi-

men.Sec. 10618. Rural health clinic services.Sec. 10619. Increased medicare reimbursement for nurse practitioners and clin-

ical nurse specialists.Sec. 10620. Increased medicare reimbursement for physician assistants.Sec. 10621. Renal dialysis-related services.





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CHAPTER 2—HoME HEALTH SERVICES

Sec. 10711. Recapturing savings resulting from temporary freeze on paymentincreases for home health services.


CHAPTER 3—BABy BOOM GENBRATION MEDICARE COMMISSION

Sec. 10721. Bipartisan Commission on the Effect of the Baby Boom Genera-tion on the Medicare Program.

CHAPTER 4—PROVISIONS RELATING TO DIRECT GR.ADUATE MEDICAL

EDUCATION

Sec. 10731. Limitation on payment based on number of residents and imple-mentation of rolling average FTE count.

Sec. 10732. Phased-in limitation on hospital overhead and supervisory physi-cian component of direct medical education costs.



ing teaching hospitals and graduate medical education.Sec. 10737. Medicare special reimbursement rule for certain combined resi-

dency programs.


Sec. 10741. Centers of excellence.Sec. 10742. Medicare part B special enrollment period and waiver of part B

late enrollment penalty and medigap special open enrollmentperiod for certain military retirees and dependents.

Sec. 10743. Protections under the medicare program for disabled workers wholose benefits under a group health plan.



CHAPTER 1—GENBRAL PROVISIONS


CHAPTER 2—UNu'O1i STAI'rnAJWS FOR HEALTH CARE Lirury ACTIONS

Sec. 10811. Statute of limitations.

780

Sec. 10812. Calculation and payment of damages.Sec. 10813. Alternative dispute resolution.

1021


1036


18 BERS.








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7 (b) OTHER MEDICARE PR0WDERS.—Section 1124A




11 graph (1);




15 paragraph:




19 count number (assigned under section 205(c) (2) (B))







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1 (c) VERIFICATION BY SoCiAJ SECURITY ADMINIS-

2 TRATION (SSA).—Section 1124A (42 U.S.C. 1320a—3a) is

3 amended—


5 section (d); and









14 205(c)(2)(B)), and








22 paragraph (2).



25 verify the accuracy of, or correct, the information

.HR 2015 EH

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7 retaiy and such official, for the costs incurred by






13 security account numbers that will be provided to the Sec-

14 retaiy under the amendments made by this section.

15 (e) EFFECTIVE DATES.—

16 (1) The amendment made by subsection (a)





21 section (d).

22 (2) The amendments made by subsection (b)




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20 TITLE XI—BUDGET21 ENFORCEMENT22 SEC. 11001. SHORT TITLE; TABLE OF CONTENTS.

23 (a) SHORT TITLE.—ThiS Act may be cited as the

24 "Budget Enforcement Act of 1997".

25 (b) TABLE OF CONTENTS.—

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TITLE XI—BUDOET ENFORCEMENT

Sec. 11001. Short title; table of contents.

Subtitle A—Amendments to the Congressional Budget and ImpoundmentControl Act of 1974

Sec. 11101. Amendments to section 3.Sec. 11102. Amendments to section 201.Sec. 11103. Amendments to section 202.Sec. 11104. Amendment to section 300.Sec. 11105. Amendments to section 301.Sec. 11106. Amendments to section 302.Sec. 11107. Amendments to section 303.Sec. 11108. Amendment to section 305.Sec. 11109. Amendments to section 308.Sec. 11110. Amendments to section 310.Sec. 11111. Amendments to section 311.Sec. 11112. Amendment to section 312.Sec. 11113. Adjustments and Budget Committee determinations.Sec. 11114. Effect of self-executing amendments on points of order in the

House of Representatives.Sec. 11115. Amendment of section 401 and repeal of section 402.Sec. 11116. Repeal of title VT.Sec. 11117. Amendments to section 904.Sec. 11118. Repeal of sections 905 and 906.Sec. 11119. Amendments to sections 1022 and 1024.Sec. 11120. Amendment to section 1026.

Subtitle B—Amendments to the Balanced Budget and Emergency DeficitControl Act of 1985

Sec. 11201. Purpose.Sec. 11202. General statement and definitions.Sec. 11203. Enforcing discretionary spending limits.Sec. 11204. Violent crime reduction trust fund.Sec. 11205. Enforcing pay-as-you-go.Sec. 11206. Reports and orders.Sec. 11207. Exempt programs and activities.Sec. 11208. General and special sequestration rules.Sec. 11209. The baseline.Sec. 11210. Technical correction.Sec. 11211. Judicial review.Sec. 11212. Effective date.Sec. 11213. Reduction of preexisting balances and exclusion of effects of this

Act from paygo scorecard.

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1 Subtitle A—Amendments to the2 Congressional Budget and Im-3 poundment Control Act of 19744 SEC. 11101. AMENDMENTS TO SECTION 3.

5 Section 3 of the Congressional Budget and Impound-

6 ment Control Act of 1974 (2 U.S.C. 622) is amended—

7 (1) in paragraph (2)(A), by striking "and" at

8 the end of clause (iii), by striking the period and in-

9 serting "; and" at the end of clause (iv), and by

10 adding at the end the following:

11 "(v) entitlement authority and the

12 food stamp program."; and

13 (2) in paragraph (9), by inserting ", but such

14 term does not include salary or basic pay funded

15 through an appropriation Act" before the period.

16 SEC. 11102. AMENDMENTS TO SECTION 201.

17 (a) TERM OF OFFICE.—The first sentence of section

18 201(a)(3) of the Congressional Budget Act of 1974 is

19 amended to read as follows: "The term of office of the

20 Director shall be four years and shall expire on January

21 3 of the year preceding a Presidential election.".

22 (b) REDESIGNATION OF EXECUTED PROVISION.—

23 Section 201 of the Congressional Budget Act of 1974 is

24 amended by redesignating subsection (g) (relating to reve-

25 nue estimates) as subsection (f).

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2 (a) ASSISTANCE TO BUDGET COMMITTEES.—The

3 first sentence of section 202(a) of the Congressional

4 Budget Act of 1974 is amended by inserting "primary"

5 before "duty".

6 (b) ELIMINATION OF EXECUTED PROVISION.—Sec-

7 tion 202 of the Congressional Budget Act of 1974 is

8 amended by striking subsection (e) and by redesignating

9 subsections (f), (g), and (h) as subsections (e), (f), and

10 (g), respectively.

11 SEC. 11104. AMENDMENT TO SECTION 300.

12 The item relating to February 25 in the timetable

13 set forth in section 300 of the Congressional Budget Act

14 of 1974 is amended by striking "February 25" and insert-

15 ing "Within 6 weeks after President submits budget".


17 (a) TERMS OF BUDGET IRESOLUTIONS.—Section

18 301(a) of the Congressional Budget Act of 1974 is amend-

19 ed by striking ", and planning levels for each of the two

20 ensuing fiscal years," and inserting "and for at least each

21 of the 4 ensuing fiscal years".

22 (b) CONTENTS OF BUDGET RESOLUTIONS.—Para-

23 graphs (1) and (4) of section 301(a) of the Congressional

24 Budget Act of 1974 are amended by striking ", budget

25 outlays, direct loan obligations, and primary loan guaran-

•HR 2015 EH

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1 tee commitments" each place it appears and inserting

2 "and budget outlays".

3 (c) ADDITIONAL MATTERS.—Section 301(b) of the

4 Congressional Budget Act of 1974 is amended by amend-

5 ing paragraph (7) to read as follows—

6 "(7) set forth pay-as-you-go procedures in the

7 Senate whereby committee allocations, aggregates,

8 and other levels can be revised for legislation within

9 a committee's jurisdiction if such legislation would

10 not increase the deficit for the first year covered by

11 the resolution and will not increase the deficit for

12 the period of 5 fiscal years covered by the resolu-

13 tion;".

14 (d) ViEws iNI) ESTIMATES.—The first sentence of

15 section 301(d) of the Congressional Budget Act of 1974

16 is amended by inserting "or at such time as may be re-

17 quested by the Committee on the Budget," after "Code,".

18 (e) HEARINGS AND REPORT.—Section 301(e)(2) of

19 the Congressional Budget Act of 1974 is amended by

20 striking "total direct loan obligations, total primary loan

21 guarantee commitments,".

22 (f) 5ocii SECURITY CORRECTIONS.—Section 301(i)

23 of the Congressional Budget Act of 1974 is amended by—

24 (1) inserting "SoCJ1 SECURITY POINT OF

25 ORDER.—" after "(i)"; and

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1 (2) striking "as reported to the Senate" and in-

2 serting "(or amendment, motion, or conference re-

3 port on such a resolution)".


5 (a) ALLOCATIONS AND SUBAJJLOCATIONS.—SUb-

6 sections (a) and (b) of section 302 of the Congressional

7 Budget Act of 1974 are amended to read as follows:

8 "(a) COMMITTEE SPENDING ALLOCATIONS.—

9 "(1) ALLOCATION AMONG COM1VHTTEES.—The

10 joint explanatory statement accompanying a con-

11 ference report on a budget resolution shall include

12 allocations, consistent with the resolution rec-

13 ommended in the conference report, of the appro-

14 priate levels (for each fiscal year covered by that res-

15 olution and a total for all such years, except in the

16 case of the Committee on Appropriations only for

17 the first such fiscal year) of—

18 "(A) total new budget authority;

19 "(B) total outlays; and

20 "(C) in the Senate, social security outlays;

21 among each committee of the House of Representa-

22 tives or the Senate that has jurisdiction over legisla-

23 tion providing or creating such amounts.

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1 "(2) No DOUBLE COUNTING.—In the House of

2 Representatives, any item allocated to one committee

3 may nOt be allocated to another such committee.

4 "(3) FURTHER DIVISION OF AMOUNTS.—In the

5 House of Representatives, the amounts allocated to

6 each committee for each fiscal year, other than the

7 Committee on Appropriations, shall be further cli-

8 vided between amounts provided or required by law

9 on the date of filing of that conference report and

10 amounts not so provided or required. The amounts

11 allocated to the Committee on Appropriations for

12 each fiscal year shall be further divided between dlis-

13 cretionary and mandatory amounts or programs, as

14 appropriate.

15 "(4) AMOUNTS NOT ALLOCATED.—(A) In the

16 House of Representatives, if a committee receives no

17 allocation of new budget authority or outlays, that

18 committee shall be deemed to have received an allo-

19 cation equal to zero for new budget authority or out-

20 lays.

21 "(B) In the Senate, if a committee receives no

22 allocation of new budget authority, outlays, or social

23 security outlays, that committee shall be deemed to

24 have received an allocation equal to zero for new

25 budget authority, outlays, or social security outlays.

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1 "(5) SoCiAI SECURITY LEVELS IN THE SEN-

2 ATE.—

3 "(A) IN GENERAL.—For purposes of para-

4 graph (1)(C), social security surpluses equal the

5 excess of social security revenues over social se-

6 curity outlays in a fiscal year or years with

7 such an excess and social security deficits equal

8 the excess of social security outlays over social

9 security revenues in a fiscal year or years with

10 such an excess.

11 "(B) TAx TREAT1V[ENT.—For purposes of

12 paragraph (1)(C), no provision of any legisla-

13 tion involving a change in chapter 1 of the In-

14 ternal Revenue Code of 1986 shall be treated as

15 affecting the amount of social security revenues

16 or outlays unless such provision changes the in-

17 come tax treatment of social security benefits.

18 "(6) ADJUSTING ALLOCATION OF DISCRE-

19 TIONARY SPENIING IN THE HOUSE OF REPRESENT-

20 ATWES.—(A) If a concurrent resolution on the

21 budget is not adopted by April 15, the chairman of

22 the Committee on the Budget of the House of Rep-

23 resentatives shall submit to the House, as soon as

24 practicable, an allocation under paragraph (1) to the

25 Committee on Appropriations consistent with the

•HR 2015 EH

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1 discretionary spending limits contained in the most

2 recently agreed to concurrent resolution on the

3 budget for the second fiscal year covered by that res-

4 olution.

5 "(B) As soon as practicable after an allocation

6 under paragraph (1) is submitted under this section,

7 the Committee on Appropriations shall make sub-

8 allocations and promptly report those suballocations

9 to the House of Representatives.

10 "(b) SUBALLOCATIONS BY APPROPRIATION CoIT-

11 TEES.—As soon as practicable after a concurrent resolu-

12 tion on the budget is agreed to, the Connnittee on Appro-

13 priations of each House (after consulting with the Com-

14 mittee on Appropriations of the other House) shall sub-

15 allocate each amount allocated to it for the budget year

16 under subsection (a) among its subcommittees. Each Com-

17 mittee on Appropriations shall promptly report to its

18 House suballocations made or revised under this para-

19 graph.".

20 (b) POINT OF ORDER.—Section 302(c) of the Con-

21 gressional Budget Act of 1974 is amended to read as fol-

22 lows:

23 "(c) POINT OF ORDER.—After the Committee on Ap-

24 propriations has received an allocation pursuant to sub-

25 section (a) for a fiscal year, it shall not be in order in

.HR 2015 EH

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1 the House of Representatives or the Senate to consider

2 any bifi, joint resolution, amendment, motion, or con-

3 ference report providing new budget authority for that fis-

4 cal year within the jurisdiction of that committee, until

5 such committee makes the suballocations required by sub-

6 section (b).".

7 (c) ENFORCEMENT OF POINT OF ORDER.—(1) Sec-

8 tion 302(f)(1) of the Congressional Budget Act of 1974

9 is amended by—

10 (A) striking "providing new budget authority

11 for such fiscal year or new entitlement authority ef-

12 fective during such fiscal year" and inserting "pro-

13 viding new budget authority for any fiscal year coy-

14 ered by the concurrent resolution";

15 (B) striking "appropriate allocation made pur-

16 suant to subsection (b) for such fiscal year" and in-

17 serting "appropriate allocation made under sub-

18 section (a) or any suballocation made under sub-

19 section (b), as applicable, for the fiscal year of the

20 concurrent resolution or for the total of all fiscal

21 years covered by the concurrent resolution"; and

22 (C) striking "of new discretionary budget au-

23 thority or new entitlement authority to be exceeded"

24 and inserting "of new discretionary budget authority

25 to be exceeded".

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1 (2) Section 302(f)(2) of the Congressional Budget

2 Act of 1974 is amended to read as follows:

3 "(2) ENFORCEMENT OF COMMITTEE ALLOCA-

4 TIONS AND SUBALLOCATIONS IN THE SENATE.—

5 After a concurrent resolution on the budget is

6 agreed to, it shall not be in order in the Senate to

7 consider any bill, joint resolution, amendment, mo-

8 tion, or conference report that would cause—

9 "(A) in the case of any committee except

10 the Committee on Appropriations, the appro-

11 priate allocation of new budget authority or

12 outlays under subsection (a) to be exceeded; or

13 "(B) in the case of the Committee on Ap-

14 propriations, the appropriate suballocation of

15 new budget authority or outlays under sub-

16 section (b) to be exceeded.".

17 (d) SEPARATE ALLOCATIONS.—Section 302(g)

18 of the Congressional Budget Act of 1974 is amended

19 to read as follows:

20 "(g) SEPARATE ALLOCATIONS.—The Committees on

21 Appropriations and the Budget shall make separate alloca-

22 tions and suballocations under this section consistent with

23 the categories in section 251(c) of the Balanced Budget

24 and Emergency Deficit Control Act of 1985."

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1284


2 (a) IN GENERAL.—Section 303 of the Congressional

3 Budget Act of 1974 is amended to read as follows:

4 "CONCURRENT RESOLUTION ON THE BUDGET MUST BE

5 ADOPTED BEFORE LEGISLATION PROVIDING NEW

6 BUDGET AUTHORITY, NEW SPENDING AUTHORITY,

7 OR CHANGES IN REVENUES OR THE PUBLIC DEBT

8 LIMIT IS CONSIDERED

9 "SEC. 303. (a) IN GENERAL.—It shall not be in order

10 in either the House of Representatives or the Senate to

11 consider any bill, joint resolution, amendment, motion, or

12 conference report as reported to the House or Senate

13 which provides—

14 "(1) new budget authority for a fiscal year;

15 "(2) an increase or decrease in revenues to be-

16 come effective during a fiscal year;

17 "(3) an increase or decrease in the public debt

18 limit to become effective during a fiscal year;

19 "(4) in the Senate only, new spending authority

20 (as defined in section 401(c)(2)) for a fiscal year; or

21 "(5) in the Senate only, outlays,

22 until the concurrent resolution on the budget for such fis-

23 cal year (or, in the Senate, a concurrent resolution on the

24 budget covering such fiscal year) has been agreed to pur-

25 suant to section 301.

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1 "(b) ExCEPTIONS.—(1) In the House of Representa-

2 tives, subsection (a) does not apply to any bill or resolu-

3 tion—

4 "(A) providing advance discretionary new budg-

5 et authority which first becomes available in a fiscal

6 year following the fiscal year to which the concur-

7 rent resolution applies; or

8 "(B) increasing or decreasing revenues which

9 first become effective in a fiscal year following the

10 fiscal year to which the concurrent resolution ap-

11 plies.

12 After May 15 of any calendar year, subsection (a) does

13 not apply in the House of Representatives to any general

14 appropriation bill, or amendment thereto, which provides

15 new budget authority for the fiscal year beginning in such

16 calendar year.

17 "(2) In the Senate, subsection (a) does not apply to

18 any bill or resolution making advance appropriations for

19 the fiscal year to which the concurrent resolution applies

20 and the two succeeding fiscal years.

21 (b) CONFORMING AMENDMENT.—The item relating

22 to section 303 in the table of contents set forth in section

23 1(b) of the Congressional Budget and Impoundment Con-

24 trol Act of 1974 is amended by striking "new credit au-

25 thority,".

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2 Section 305(a)(1) of the Congressional Budget Act

3 of 1974 is amended by inserting "when the House is not

4 in session" after "holidays" each place it appears.


6 Section 308 of the Congressional Budget Act of 1974

7 is amended—

8 (1)(A) in the side heading of subsection (a), by

9 striking "OR NEW CREDIT AUTHORITY," and

10 by striking the first comma and inserting "OR";

11 (B) in paragraphs (1) and (2) of subsection (a),

12 by striking "or new credit authority," each place it

13 appears and by striking the comma before "new

14 spending authority" each place it appears and in-

15 serting "or";

16 (2) in subsection (b)(1), by striking "or new

17 credit authority," and by striking the comma before

18 "new spending authority" and inserting "or";

19 (3) in subsection (c), by inserting "and" after

20 the semicolon at the end of paragraph (3), by strik-

21 ing "; and" at the end of paragraph (4) and insert-

22 ing a period; and by striking paragraph (5); and

23 (4) by inserting "joint" before "resolution"

24 each place it appears and, in subsection (b)(1), by

25 inserting "joint" before "resolutions".

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3 is amended by—

4 (1) in subsection (a)(1), by inserting "and"

5 after the semicolon at the end of subparagraph (B),

6 by striking "subparagraphs (C) and (D), and by in-

7 serting after subparagraph (B) the following new

8 subparagraph:

9 "(C) direct spending (as defined in section

10 250(c)(8) of the Balanced Budget and Emer-

11 gency Deficit Control Act of 1985),"; and

12 (2) in subsection (c)(1)(A), by inserting "of the

13 absolute value" after "20 percent" each place it ap-

14 pears.



17 is amended to read as follows:

18 "NEW BUDGET AUTHORITY, NEW SPENDING AUTHORITY,

19 AND REVENUE LEGISLATION MuST BE WIITfflN AP-

20 PROPRJATE LEVELS

21 "SEc. 311. (a) ENFORCEMENT OF BUDGET AGGRE-

22 GATES.—

23 "(1) IN TIlE HOUSE OF REPRESENTATIVES.—

24 Except as provided by subsection (c), after the Con-

25 gress has completed action on a concurrent resolu-

26 tion on the budget for a fiscal year, it shall not be

.HR 2015 EH

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1 in order in the House of Representatives to consider

2 any bill, joint resolution, amendment, motion, or

3 conference report providing new budget authority for

4 such fiscal year or reducing revenues for such fiscal

5 year, if—

6 "(A) the enactment of such bill or resolu-

7 tion as reported;

8 "(B) the adoption and enactment of such

9 amendment; or

10 "(C) the enactment of such bill or resolu-

11 tion in the form recommended in such con-

12 ference report;

13 would cause the appropriate level of total new budg-

14 et authority or total budget outlays set forth in the

15 most recently agreed to concurrent resolution on the

16 budget for such fiscal year to be exceeded, or would

17 cause revenues to be less than the appropriate level

18 of total revenues set forth in such concurrent resolu-

19 tion such fiscal year or for the total of all fiscal

20 years covered by the concurrent resolution, except in

21 the case that a declaration of war by the Congress

22 is in effect.

23 "(2) IN THE SENATE.—After a concurrent reso-

24 lution on the budget is agreed to, it shall not be in

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1 order in the Senate to consider any bill, resolution,

2 amendment, motion, or conference report that—

3 "(A) would cause the appropriate level of

4 total new budget authority or total outlays set

5 forth for the first fiscal year in such resolution

6 to be exceeded; or

7 "(B) would cause revenues to be less than

8 the appropriate level of total revenues set forth

9 for the first fiscal year covered by such resolu-

10 tion or for the period including the first fiscal

11 year plus the following 4 fiscal years in such

12 resolution.

13 "(3) ENFORCEMENT OF SOCIAL SECURITY LEV-

14 ELS IN THE SENATE.—After a concurrent resolution

15 on the budget is agreed to, it shall not be in order

16 in the Senate to consider any bill, resolution, amend-

17 ment, motion, or conference report that would cause

18 a decrease in social security surpluses or an increase

19 in social security deficits derived from the levels of

20 social security revenues and social security outlays

21 set forth for the first fiscal year covered by the reso-

22 lution and for the period including the first fiscal

23 year plus the following 4 fiscal years in such resolu-

24 tion.

25 "(b) SOCIAL SECURITY LEVELS.—

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1 "(1) IN GENERAL.—For the purposes of sub-

2 section (a)(3), social security surpluses equal the ex-

3 cess of social security revenues over social security

4 outlays in a fiscal year or years with such an excess

5 and social security deficits equal the excess of social

6 security outlays over social security revenues in a

7 fiscal year or years with such an excess.

8 "(2) TAx TREATMENT.—FOr the purposes of

9 this section, no provision of any legislation involving

10 a change in chapter 1 of the Internal Revenue Code

11 of 1986 shall be treated as affecting the amount of

12 social security revenues or outlays unless such provi-

13 sion changes the income tax treatment of social se-

14 curity benefits.

15 "(c) EXCEPTION IN THE HOUSE OF REPRESENTA-

16 TWES.—Subsection (a)(1) shall not apply in the House

17 of Representatives to any bill, resolution, or amendment

18 that provides new budget authority for a fiscal year or

19 to any conference report on any such bill or resolution,

20 if—

21 "(1) the enactment of such bill or resolution as

22 reported;

23 "(2) the adoption and enactment of such

24 amendment; or

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1 "(3) the enactment of such bill or resolution in

2 the form recommended in such conference report;

3 would not cause the appropriate allocation of new budget

4 authority made pursuant to section 302(a) for such fiscal

5 year, for the committee within whose jurisdiction such bill,

6 resolution, or amendment falls, to be exceeded.".


8 (a) IN GENERAL.—Section 312 of the Congressional


10 "POINTS OF ORDER

11 "SEc. 312. (a) BUDGET COMMITTEE DETERMINA-

12 TIONS.—For purposes of this title and title IV, the levels

13 of new budget authority, budget outlays, spending author-

14 ity as described in section 401(c)(2), direct spending, new

15 entitlement authority, and revenues for a fiscal year shall

16 be determined on the basis of estimates made by the Com-

17 mittee on the Budget of the House of Representatives or

18 the Senate, as the case may be.

19 "(b) DISCRETIONARY SPENDING POINT OF ORDER IN

20 THE SENATE.—

21 "(1) Except as otherwise provided in this sub-

22 section, it shall not be in order in the Senate to con-

23 sider any concurrent resolution on the budget (or

24 amendment, motion, or conference report on such a

25 resolution) that would exceed any of the discre-

26 tionary spending limits in section 251(c) of the Bal-.HR 2015 EH

1292

1 anced Budget and Emergency Deficit Control Act of

2 1985.

3 "(2) This subsection shall not apply if a dec-

4 laration of war by the Congress is in effect or if a

5 joint resolution pursuant to section 258 of the Bal-


7 1985 has been enacted.

8 "(c) MAXIMUM DEFICIT AMOUNT POINT OF ORDER

9 IN THE SENATE.—It shall not be in order in the Senate

10 to consider any concurrent resolution on the budget for

11 a fiscal year under section 301, or to consider any amend-

12 ment to that concurrent resolution, or to consider a con-

13 ference report on that concurrent resolution—

14 "(1) if the level of total budget outlays for the

15 first fiscal year that is set forth in that concurrent

16 resolution or conference report exceeds the rec-

17 ommended level of Federal revenues set forth for

18 that year by an amount that is greater than the

19 maximum deficit amount, if any, specified in the

20 Balanced Budget and Emergency Deficit Control

21 Act of 1985 for such fiscal year; or

22 "(2) if the adoption of such amendment would

23 result in a level of total budget outlays for that fiscal

24 year which exceeds the recommended level of Fed-

25 eral revenues for that fiscal year, by an amount that

.HR 2015 EU

1293

1 is greater than the maximum deficit amount, if any,

2 specified in the Balanced Budget and Emergency

3 Deficit Control Act of 1985 for such fiscal year.

4 "(d) TIMING OF POINTS OF ORDER IN THE SEN-

5 ATE.—A point of order under this Act may not be raised

6 against a bill, resolution, amendment, motion, or con-

7 ference report while an amendment or motion, the adop-

8 tion of which would remedy the violation of this Act, is

9 pending before the Senate.

10 "(e) POINTS OF ORDER IN THE SENATE AGAINST

11 AMENDMENTS BETWEEN THE HOUSES.—Each provision

12 of this Act that establishes a point of order against an

13 amendment also establishes a point of order in the Senate

14 against an amendment between the Houses. If a point of

15 order under this Act is raised in the Senate against an

16 amendment between the Houses, and the Presiding Officer

17 sustains the point of order, the effect shall be the same

18 as if the Senate had disagreed to the amendment.

19 "(f) EFFECT OF A POINT OF ORDER ON A BILL IN

20 THE SENATE.—In the Senate, if the Chair sustains a

21 point of order under this Act against a bill, the Chair shall

22 then send the bill to the committee of appropriate jurisdic-

23 tion for further consideration.".

24 (b) CONFORMING AMENDMENT.—The item relating

25 to section 312 in the table of contents set forth in section

'ER 2015 EH

1294

1 1(b) of the Congressional Budget and Impoundment Con-

2 trol Act of 1974 is amended by striking "Effect of point"

3 and inserting "Point".

4 SEC. 11113. ADJUSTMENTS AND BUDGET COMMITTEE DE-

5 TERMINATIONS.

6 (a) IN GENERAL.—Title III of the Congressional

7 Budget Act of 1974 is amended by adding at the end the

8 following new section:

9 "ADJUSTMENTS

10 "SEc. 314. (a) ADJUSTMENTS.—When—

11 "(1)(A) the Committee on Appropriations re-

12 ports an appropriation measure for fiscal year 1998,

13 1999, 2000, 2001, or 2002 that specifies an amount

14 for emergencies pursuant to section 251(b)(2)(A) of

15 the Balanced Budget and Emergency Deficit Control

16 Act of 1985 or for continuing disability reviews pur-

17 suant to section 251(b)(2)(C) of that Act;

18 "(B) any other committee reports emergency

19 legislation described in section 252(e) of that Act;

20 "(C) the Committee on Appropriations reports

21 an appropriation measure for fiscal year 1998, 1999,

22 2000, 2001, or 2002 that includes an appropriation

23 with respect to clause (i) or (ii), the adjustment

24 shall be the amount of budget authority in the meas-

25 ure that is the dollar equivalent, in terms of Special

26 Drawing Rights, of—

.HR 2015 EH

1295

1 "(i) increases the United States quota as

2 part of the International Monetary Fund Elev-

3 enth General Review of Quotas (United States

4 Quota); or

5 "(ii) increases the maximum amount avail-

6 able to the Secretary of the Treasury pursuant

7 to section 17 of the Bretton Woods Agreement

8 Act, as amended from time to time (New Ar-

9 rangements to Borrow); or

10 "(D) the Committee on Appropriations reports

11 an appropriation measure for fiscal year 1998, 1999,

12 or 2000 that includes an appropriation for arrear-

13 ages for international organizations, international

14 peacekeeping, and multilateral development banks

15 during that fiscal year, and the sum of the appro-

16 priations for the period of fiscal years 1998 through

17 2000 do not exceed $1,884,000,000 in budget au-

18 thority; or

19 "(2) a conference committee submits a con-

20 ference report thereon;

21 the chairman of the Committee on the Budget of the Sen-

22 ate or House of Representatives shall make the adjust-

23 ments referred to in subsection (c) to reflect the additional

24 new budget authority for such matter provided in that

25 measure or conference report and the additional outlays

•HR 2015 EH

1296

1 flowing in all fiscal years from such amounts for such mat-

2 ter.

3 "(b) APPLICATION OF AIJUSTMENTS.—The adjust-

4 ments and revisions to allocations, aggregates, and limits

5 made by the Chairman of the Committee on the Budget

6 pursuant to subsection (a) for legislation shall only apply

7 while such legislation is under consideration and shall only

8 permanently take effect upon the enactment of that legis-

9 lation.

10 "(c) CONTENT OF AIJUSTMENTS.—The adjustments

11 referred to in subsection (a) shall consist of adjustments,

12 as appropriate, to—

13 "(1) the discretionary spending limits as set

14 forth in the most recently agreed to concurrent reso-

15 lution on the budget;

16 "(2) the allocations made pursuant to the most

17 recently adopted concurrent resolution on the budget

18 pursuant to section 302(a); and

19 "(3) the budgetary aggregates as set forth in

20 the most recently adopted concurrent resolution on

21 the budget.

22 "(d) REPORTING REVISED SUBALLOCATIONS.—F01-

23 lowing the adjustments made under subsection (a), the

24 Committees on Appropriations of the Senate and the

25 House of Representatives may report appropriately revised

.HR 2015 EH

1297

1 suballocations pursuant to section 302(b) to carry out this

2 subsection.

3 "(e) DEFINTTIONS.—AS used in subsection (a)(1)(A),

4 when referring to continuing disability reviews, the terms

5 'continuing disability reviews', 'additional new budget au-

6 thority', and 'additional outlays' shall have the same

7 meanings as provided in section 251(b)(2)(C)(ii) of the

8 Balanced Budget and Emergency Deficit Control Act of

9 1985.".

10 (b) CONFORMING AMENDMENTS.—(1) Sections

11 302(g), 3 11(c), and 3 13(e) of the Congressional Budget

12 Act of 1974 are repealed.

13 (2) The table of contents set forth in section 1(b) of

14 the Congressional Budget and Impoundment Control Act

15 of 1974 is amended by adding after the item relating to

16 section 313 the following new item:

"Sec. 314. Adjustments.".

17 SEC. 11114. EFFECT OF SELF-EXECUTING AMENDMENTS ON

18 POINTS OF; ORDER IN TILE HOUSE OF REP

19 RESENTATWES.

20 (a) EFFECT OF POINTS OF ORDER.—Title III of the

21 Congressional Budget Act of 1974 is amended by adding

22 after section 314 the following new section:

•HR 2015 Ell

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1 "EFFECT OF SELF-EXECUTING AMENDMENTS ON POINTS

2 OF ORDER IN THE HOUSE OF REPRESENTATIVES

3 "SEC. 315. In the House of Representatives, if a pro-

4 vision of a bill, as reported, violates a section of this title

5 or title IV and a self-executing rule providing for consider-

6 ation of that bill modifies that provision to eliminate such

7 violation, then such point of order shall not lie against

8 consideration of that bill.".

9 (b) CONFORMING AMENDMENT.—The table of con-

10 tents set forth in section 1(b) of the Congressional Budget

11 and Impoundment Control Act of 1974 is amended by

12 adding after the item relating to section 314 the following

13 new item:

"Sec. 315. Effect of self-executing amendments on points of order in the houseof representatives.".

14 SEC. 11115. AMENDMENT OF SECTION 401 AND REPEAL OF

15 SECTION 402.

16 (a) SECTION 401.—Subsections (a) and (b) of section

17 401 of the Congressional Budget Act of 1974 are amended


19 "BILLS PROVIDING NEW SPENI)ING AUTHORITY OR NEW

20 CREDIT AUTHORITY

21 "SEC. 401. (a) CONTROLS ON LEGISLATION PROVID-

22 ING SPENDING AUTHORITY OR CREDIT AUTHORITY.—It

23 shall not be in order in either the House of Representa-

24 tives or the Senate to consider any bill, joint resolution,

.ER 2015 EH

1299

1 amendment, motion, or conference report, as reported to

2 its House which provides new spending authority de-

3 scribed in subsection (c)(2)(A) or (B) or new credit au-

4 thority, unless that bill, resolution, conference report, or

5 amendment also provides that such new spending author-

6 ity as described in subsection (c)(2) (A) or (B) or new

7 credit authority is to be effective for any fiscal year only

8 to such extent or in such amoimts as are provided in ap-

9 propriation Acts.

10 "(b) LEGISLATION PROVIDING ENTITLEMENT Au-

11 THORITY.—It shall not be in order in either the House

12 of Representatives or the Senate to consider any bill, joint

13 resolution, amendment, motion, or conference report, as

14 reported to its House which provides new spending author-

15 ity described in subsection (c)(2)(C) which is to become

16 effective before the first day of the fiscal year which begins

17 during the calendar year in which such bill or resolution

18 is reported.".

19 (b) REPEALER OF SECTION 402.—(1) Section 402 of

20 the Congressional Budget Act of 1974 is repealed.

21 (2) CONFORMING AMENDMENTS.—(1) Sections 403

22 through 407 of the Congressional Budget Act of 1974 are

23 redesignated as sections 402 through 406, respectively.

24 (2) The table of contents set forth in section

25 1(b) of the Congressional Budget and Impoundment

.HR 2015 EH

1300

1 Control Act of 1974 is amended by deleting the item

2 relating to section 402 and by redesignating the

3 items relating to sections 403 through 407 as the

4 items relating to sections 402 through 406, respec-

5 tively.

6 SEC. 11116. REPEAL OF TITLE VI.

7 (a) REPEALER.—Title VI of the Congressional Budg-

8 et Act of 1974 is repealed.

9 (b) CONFORMING AMENDMENTS.—The items relating

10 to title VI of the table of contents set forth in section 1(b)

11 of the Congressional Budget and Impoundment Control

12 Act of 1974 are repealed.


14 (a) CONFORMING AMENDMENT.—Section 904(a) of

15 the Congressional Budget Act of 1974 is amended by

16 striking "(except section 905)" and by striking "V, and

17 VT (except section 601(a))" and inserting "and V".

18 (b) WMvIRs.—Section 904(c) of the Congressional


20 "(c)WMVERS.—

21 "(1) Sections 305(b)(2), 305(c)(4), 306,

22 310(d)(2), 313, 904(c), and 904(d) of this Act may

23 be waived or suspended in the Senate only by the af-

24 firmative vote of three-fifths of the Members, duly

25 chosen and sworn.

.HR 2015 EH

1301

1 "(2) Sections 301(i), 302(c), 302(f), 3l0(g),

2 311(a), and 315 of this Act and sections

3 258(a)(4) (C), 258(A) (b) (3) (C) (I), 258(B) (f) (1),

4 258B(h)(1), 258(h)(3), 258C(a)(5), and

5 258(C)(b)(1) of the Balanced Budget and Emer-

6 gency Deficit Control Act of 1985 may be waived or

7 suspended in the Senate only by the affirmative vote

8 of three-fifths of the Members, duly chosen and

9 sworn.".

10 (c) APPEAI4S.—Section 904(d) of the Congressional


12 "(d) APPEALS.—

13 "(1) Appeals in the Senate from the decisions

14 of the Chair relating to any provision of title III or

15 IV of section 1017 shall, except as otherwise pro-

16 vided therein, be limited to 1 hour, to be equally di-

17 vided between, and controlled by, the mover and the

18 manager of the resolution, concurrent resolution,

19 reconciliation bill, or rescission bill, as the case may

20 be.

21 "(2) An affirmative vote of three-fifths of the

22 Members, duly chosen and sworn, shall be required

23 in the Senate to sustain an appeal of the ruling of

24 the Chair on a point of order raised under sections

.HR 2015 EH

1302

1 305(b)(2), 305(c)(4), 306, 310(d)(2), 313, 904(c),

2 and 904(d) of this Act.

3 "(3) An affirmative vote of three-fifths of the

4 Members, duly chosen and sworn, shall be required

5 in the Senate to sustain an appeal of the ruling of

6 the Chair on a point of order raised under sections

7 301(i), 302(c), 302(f), 310(g), 311(a), and 315 of

8 this Act and sections 258(a)(4)(C),

9 258(A)(b)(3)(C)(I), 258(B)(f)(1), 258B(h)(1),

10 258(h)(3), 258C(a)(5), and 258(C)(b)(1) of the Bal-


12 1985.".

13 (d) ExIIRATION OF SuPER1VIAJORITY VOTING RE-

14 QuIREMENTs.—Section 904 of the Congressional Budget

15 Act of 1974 is amended by adding at the end the follow-

16 ing:

17 "(e) EXPIRATION OF CERTAIN SUPERMAJORITY VOT-

18 ING REQuIREMENTS.—Subsections (c)(2) and (d)(3) shall

19 expire on September 30, 2002.".

20 SEC. 11118. REPEAL OF SECTIONS 905 AND 906.

21 (a) REPEALER—Sections 905 and 906 of the Con-

22 gressional Budget and Impoundment Control Act of 1974

23 are repealed.

24 (b) CONFORMING AMENDMENTS.—The table of con-

25 tents set forth in section 1(b) of the Congressional Budget

.HR 2015 EH

1303


2 striking the items relating to sections 905 and 906.

3 SEC. 11119. AMENDMENTS TO SECTIONS 1022 AND 1024.

4 (a) SECTION 1022.—Section 1022(b)(1)(F) of Con-

5 gressional Budget and Impoundment Control Act of 1974

6 is amended by striking "section 601" and inserting "sec-

7 tion 251(c) the Balanced Budget and Emergency Deficit

8 Control Act of 1985".

9 (b) SECTION 1024.—Section 1024(a)(1)(B) of Con-

10 gressional Budget and Impoundment Control Act of 1.974

11 is amended by striking "section 601(a)(2)" and inserting

12 "section 251(c) the Balanced Budget and Emergency Def-

13 icit Control Act of 1985".


15 Section 1026(7)(A)(iv) of the Congressional Budget


17 striking "and" and inserting "or".

18 Subtitle B—Amendments to the19 Balanced Budget and Emer-20 gency Deficit Control Act of21 198522 SEC. 11201. PURPOSE.

23 This subtitle extends discretionary spending limits

24 and pay-as-you-go requirements.

•RR 2016 EH

1304

1 SEC. 11202. GENERAL STATEMENT AND DEFINITIONS.

2 (a) GENERAL STATEMEN'r.—Section 250(b) of the


4 1985 (2 U.S.C. 900(b)) is amended by striking the first

5 two sentences and inserting the following: "This part pro-

6 vides for the enforcement of a balanced budget by fiscal

7 year 2002 as called for in House Concurrent Resolution

8 84 (105th Congress, 1st session).".

9 (b) DEFINrrIONS.—Section 250(c) of the Balanced

10 Budget and Emergency Deficit Control Act of 1985 is

11 amended—

12 (1) by striking paragraph (4) and inserting the

13 following:

14 "(4) The term 'category' means defense, non-

15 defense, and violent crime reduction discretionary

16 appropriations as specified in the joint explanatory

17 statement accompanying a conference report on the

18 Balanced Budget Act of 1997.";

19 (2) by striking paragraph (6) and inserting the

20 following:

21 "(6) The term 'budgetary resources' means new

22 budget authority, unobligated balances, direct spend-

23 ing authority, and obligation limitations.";

24 (3) in paragraph (9), by striking "submission of

25 the fiscal year 1992 budget that are not included

•HR 2015 EH

1305

1 with a budget submission" and inserting "that budg-

2 et submission that are not included with it";

3 (4) in paragraph (14), by inserting "first 4" be-

4 fore "fiscal years" and by striking "1995" and in-

5 serting "2006";

6 (5) by striking paragraphs (17) and (20) and

7 by redesignating paragraphs (18), (19), and (21) as

8 paragraphs (17), (18), and (19), respectively;

9 (6) in paragraph (17) (as redesignated), by

10 striking "Omnibus Budgtet Reconciliation Act of

11 1990" and inserting "Balanced Budget Act of

12 1997";

13 (7) in paragraph (20) (as redesignated), by

14 striking the second sentence; and

15 (8) by adding at the end the following new

16 paragraph:

17 "(20) The term 'consultation', when applied to

18 the Committee on the Budget of either the House of

19 Representatives or of the Senate, means written

20 communication with that committee that affords

21 that committee an opportunity to comment on the

22 matter that is the subject of the consultation before

23 official action is taken on such matter.".

.HR 2015 EH

1306

1 SEC. 11203. ENFORCING DISCRETIONARY SPENDING LIM-

2 ITS.

3 (a) ExTENSION TmouGH FISCAL YEAIt 2002.—Sec-

4 tion 251 of the Balanced Budget and Emergency Deficit

5 Control Act of 1985 is amended—

6 (1) in the side heading of subsection (a), by

7 striking "1991—1998" and inserting "1997—2002";

8 (2) in subsection (a)(7) by inserting "(excluding

9 Saturdays, Sundays, or legal holidays)" after "5 cal-

10 endar days";

11 (3) in the first sentence of subsection (b)(1), by

12 striking "1992, 1993, 1994, 1995, 1996, 1997 or

13 1998" and inserting "1997 or any fiscal year there-

14 after through 2002" and by striking "through

15 1998" and inserting "through 2002";

16 (4) in subsection (b)(1), by striking "the follow-

17 ing:" and all that follows through "in concepts and

18 definitions" the first place it appears and inserting

19 "the following: the adjustments" and by striking

20 subparagraphs (B) and (C);

21 (5) in subsection (b)(2), by striking "1991,

22 1992, 1993, 1994, 1995, 1996, 1997, or 1998" and

23 inserting "1997 or any fiscal year thereafter through

24 2002", by striking "through 1998" and inserting

25 "through 2002", and by striking subparagraphs (A),

26 (B), (C), (E), and (G), and by redesignating sub-

•HR 2015 EH

1307

1 paragraphs (D), (F), and (H) as subparagraphs (A),

2 (B), and (C), respectively;

3 (6) in subsection (b)(2)(A) (as redesignated),

4 by striking "(i)", by striking clause (ii), and by in-

5 serting "fiscal" before "years";

6 (7) in subsection (b)(2)(B) (as redesignated),

7 by striking everything after "the adjustment in out-

8 lays" and inserting "for a fiscal year is the amount

9 of the excess but not to exceed 0.5 percent of the

10 adjusted discretionary spending limit on outlays for

11 that fiscal year in fiscal year 1997 or any fiscal year

12 thereafter through 2002; and

13 (8) by adding at the end of subsection (b)(2)

14 the following new subparagraphs:

15 "(D) ALLOWANCE FOR IMF.—If an appro-

16 priations bill or joint resolution is enacted for

17 fiscal year 1998, 1999, 2000, 2001, or 2002

18 that includes an appropriation with respect to

19 clause (i) or (ii), the adjustment shall be the

20 amount of budget authority in the measure that

21 is the dollar equivalent, in terms of Special

22 Drawing Rights, of—

23 "(i) an increase in the United States

24 quota as part of the International Mone-

•RR 2015 Eli

1308

1 tary Fund Eleventh General Review of

2 Quotas (United States Quota); or

3 "(ii) any increase in the maximum

4 amount available to the Secretary of the

5 Treasury pursuant to section 17 of the

6 Bretton Woods Agreement Act, as amend-

7 ed from time to time (New Arrangements

8 to Borrow).

9 "(E) ALLOWANCE FOR INTERNATIONAL

10 ARREARGES.—

11 "(i) ADJUSTMENTS.—If an appropria-

12 tions bill or joint resolution is enacted for

13 fiscal year 1998, 1999, or 2000 that in-

14 cludes an appropriation for arrearages for

15 international organizations, international

16 peacekeeping, and multilateral banks for

17 that fiscal year, the adjustment shall be

18 the amount of budget authority in such

19 measure and the outlays flowing in all fis-

20 cal years from such budget authority.

21 "(ii) LIMITATIONS.—The total

22 amount of adjustments made pursuant to

23 this subparagraph for the period of fiscla

24 years 1998 through 2000 shall not exceed

25 $1,884,000,000 in budget authority.".

.HR 2015 EU

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1 (b) SHIFTING OF DISCRETIONARY SPENDING LIMITS

2 INTO THE BALANCED BUDGET AND EMERGENCY DEFICIT

3 CONTROL ACT OF 1985.—Section 251 of the Balanced


5 amended by adding at the end the following new sub-

6 section:

7 "(c) DISCRETIONARY SPENDING LIMIT.—A.s used in

8 this part, the term 'discretionary spending limit' means—

9 "(1) with respect to fiscal year 1997, for the

10 discretionary category, the current adjusted amount

11 of new budget authority and outlays;

12 "(2) with respect to fiscal year 1998—

13 "(A) for the defense category:

14 $269,000,000,000 in new budget authority and

15 $266,823,000,000 in outlays;

16 "(B) for the nondefense category-:


18 $282,853,000,000 in outlays; and

19 "(C) for the violent crime reduction cat-

20 egory: $5,500,000,000 in new budget authority

21 and $3,592,000,000 in outlays;

22 "(3) with respect to fiscal year 1999—

23 "(A) for the defense category:


25 $266,518,000,000 in outlays; and

•HR 2015 EH

1310

1 "(B) for the nondefense category:


3 $292,803,000,000 in outlays;


5 discretionary category: $537,193,000,000 in new

6 budget authority and $564,265,000,000 in outlays;




10 and




14 as adjusted in strict conformance with subsection (b).".

15 SEC. 11204. VIOLENT CRIME REDUCTION TRUST FUND.

16 (a) SEQUESTRATION REGARDING VIOLENT CRIME

17 REDUCTION TRUST FUND.—Section 251A of the Bal-

18 anced Budget and Emergency Deficit Control Act of 1985

19 is repealed.

20 (b) CONFORMING AMENDMENT.—SectiOn 310002 of

21 Public Law 103—322 (42 U.S.C. 14212) is repealed.

22 SEC. 11205. ENFORCING PAY-AS-YOU-GO.

23 (a) ExTENSION.—Section 252 (2 U.S.C. 902) is

24 amended—

.HR 2015 EH

1311

1 (1) by striking subsections (a) and (b) and in-


3 "(a) PURPOSE.—The purpose of this section is to as-

4 sure that any legislation enacted prior to September 30,

5 2002, affecting direct spending or receipts that increases

6 the deficit will trigger an offsetting sequestration.

7 "(b) SEQUESTRATION.—

8 "(1) TIMING.—Within 15 calendar days after

9 Congress adjourns to end a session and on the same

10 day as a sequestration (if any) under sections 251

11 and 253, there shall be a sequestration to offset the

12 amount of any net deficit increase in the budget

13 year caused by all direct spending and receipts legis-

14 lation (after adjusting for any prior sequestration as

15 provided by paragraph (2)) plus any net deficit in-

16 crease in the prior fiscal year caused by all direct

17 spending and receipts legislation not reflected in the

18 final 0MB sequestration report for that year.

19 "(2) CALCULATION OF DEFICIT INCREASE.—

20 0MB shall calculate the amount of deficit increase,

21 if any, in the budget year by adding—

22 "(A) all applicable estimates of direct

23 spending and receipts legislation transmitted

24 under subsection (d) applicable to the budget

.HR 2015 EH

1312

1 year, other than any amounts included in such

2 estimates resulting from—

3 "(i) full funding of, and continuation of, the de-

4 posit insurance guarantee commitment in effect on

S the date of enactment of this section; and

6 "(ii) emergency provisions as designated under

7 subsection (e); and

8 "(B) the estimated amount of savings in

9 direct spending programs applicable to the

10 budget year resulting from the prior year's se-

11 questration under this section or section 253, if

12 any (except for any amounts sequestered as a

13 result of any deficit increase in the fiscal year

14 immediately preceding the prior fiscal year), as

15 published in OMB's final sequestration report

16 for that prior year; and

17 "(C) all applicable estimates of direct

18 spending and receipts legislation transmitted

19 under subsection (d) for the current year that

20 are not reflected in the final 0MB sequestra-

21 tion report for that year, other than any

22 amounts included in such estimates resulting

23 from emergency provisions as designated under

24 subsection (e).";

.HR 2015 EH

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1 (2) by amending subsection (c)(1)(B), by in-

2 serting "and direct" after "guaranteed";

3 (3) by amending subsection (d) to read as fol-

4 lows:

5 "(d) ESTIMATES.—

6 "(1) CBO ESTIMATES.—As soon as practicable

7 after Congress completes action on any direct spend-

8 ing or receipts legislation, CBO shall provide an esti-

9 mate of the budgetary effects of that legislation.

10 "(2) 0MB ESTIMATES.—Not later than 5 cal-

11 endar days (excluding Saturdays, Sundays, or legal

12 holidays) after the enactment of any direct spending

13 or receipts legislation, 0MB shall transmit a report

14 to the House of Representatives and to the Senate

15 containing—

16 "(A) the CBO estimate of the budgetary

17 effects of that legislation;

18 "(B) an 0MB estimate of the budgetary

19 effects of that legislation using current eco-

20 nomic and technical assumptions; and

21 "(C) an explanation of any difference be-

22 tween the two estimates.

23 "(3) SCOPE OF ESTIMATES.—The estimates

24 under this section shall include the amount of

25 change in outlays or receipts, as the case may be,

•HR 2015 EH

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1 for the current year (if applicable), the budget year,

2 and each outyear.

3 "(4) SCOREKEEPING GuIDELINEs.—OMB and

4 CBO, after consultation with each other and the

5 Committees on the Budget of the House of Rep-

6 resentatives and the Senate, shall—

7 "(A) determine common scorekeeping

8 guidelines; and

9 "(B) in conformance with such guidelines,

10 prepare estimates under this section."; and

11 (4) in subsection (e), by striking ", for any fis-

12 cal year from 1991 through 1998," and by striking

13 "through 1995".

14 SEC. 11206. REPORTS AND ORDERS.

15 Section 254 of the Balanced Budget and Emergency

16 Deficit Control Act of 1985 is amended—

17 (1) by striking subsection (c) and redesignating

18 subsections (d) through (k) as (c) through (j), re-

19 spectively;

20 (2) in subsection (c)(2) (as redesignated), by

21 striking "1998" and inserting "2002"; and

22 (3)(A) in subsection (f)(2)(A) (as redesignated),

23 by striking "1998" and inserting "2002"; and

24 (B) in subsection (f)(3) (as redesignated), by

25 striking "through 1998".

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1 SEC. 11207. EXEMPT PROGRAMS AND ACTIVITIES.

2 (a) VETERANS PROGRAMS.—Section 255(b) of the


4 1985 is amended as follows:

5 (1) In the item relating to Veterans Insurance

6 and Indenmity, strike "Indemnity" and insert "In-

7 demnities".

8 (2) In the item relating to Veterans' Canteen

9 Service Revolving Fund, strike "Veterans".

10 (3) In the item relating to Benefits under chap-

11 ter 21 of title 38, strike "(36—0137—0—1—702)" and

12 insert "(36—0120—0—1—701)".

13 (4) In the item relating to Veterans' compensa-

14 tion, strike "Veterans' compensation" and insert

15 "Compensation".

16 (5) In the item relating to Veterans' pensions,

17 strike "Veterans' pensions" and insert "Pensions".

18 (6) After the last item, insert the following new

19 items:

20 "Benefits under chapter 35 of title 38,

21 United States Code, related to educational as-

22 sistance for survivors and dependents of certain

23 veterans with service-connected disabilities (36—

24 0137—0—1—702);

25 "Assistance and services under chapter 31

26 of title 38, United States Code, relating toHR 2015 RDS —— 42

1316

1 training and rehabilitation for certain veterans

2 with service-connected disabilities (36—0137—0—

3 1—702);

4 "Benefits under subchapters I, II, and III

5 of chapter 37 of title 38, United States Code,

6 relating to housing loans for certain veterans

7 and for the spouses and surviving spouses of

8 certain veterans Guaranty and Indemnity Pro-

9 gram Account (36—1119—0—1—704);

10 "Loan Guaranty Program Account (36—

11 1025—0—1—704); and

12 "Direct Loan Program Account (36—1024--

13 0—1—704).".

14 (b) CERTAIN PROGRAM BASES.—Section 255(f) of

15 the Balanced Budget and Emergency Deficit Control Act

16 of 1985 is amended to read as follows:

17 "(f) OPTIONAL EXEMPTION OF MILITARY PERSON-

18 NEL.—

19 "(1) The President may, with respect to any

20 military personnel account, exempt that account

21 from sequestration or provide for a lower uniform

22 percentage reduction than would otherwise apply.

23 "(2) The President may not use the authority

24 provided by paragraph (1) unless he notifies the

25 Congress of the manner in which such authority will

.RR 2015 ER

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1 be exercised on or before the date specified in see-

2 tion 254(a) for the budget year.".

3 (c) OTHER PROGRAMS AND ACTwITIES.—(1) Section

4 255(g)(1)(A) of the Balanced Budget Emergency Deficit

5 Control Act of 1985 is amended as follows:

6 (A) After the first item, insert the following

7 new item:

8 "Activities financed by voluntary payments

9 to the Government for goods or services to be

10 provided for such payments;".

11 (B) Strike "Thrift Savings Fund (26—8141—0—

12 7—602);".

13 (C) In the first item relating to the Bureau of

14 Indian Affairs, insert "Indian land and water claims

15 settlements and" after the comma.

16 (D) In the second item relating to the Bureau

17 of Indian Affairs, strike "miscellaneous" and insert

18 "Miscellaneous" and strike ", tribal trust funds".

19 (E) Strike "Claims, defense (97—0102—0—1—

20 051);".

21 (F) In the item relating to Claims, judgnients,

22 and relief acts, strike "806" and insert "808".

23 (G) Strike "Coinage profit fund (20-5811-0-2-

24 803)".

•HR 2015 EH

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1 (H) Insert "Compact of Free Association (14—

2 0415—0—1—808);" after the item relating to the

3 Claims, judgments, and relief acts.

4 (I) Insert "Conservation Reserve Program (12—

5 2319—0—1—302);" after the item relating to the

6 Compensation of the President.

7 (J) In the item relating to the Customs Service,

8 strike "852" and insert "806".

9 (K) In the item relating to the Comptroller of

10 the Currency, insert ", Assessment funds (20—8413—

11 0—8—373)" before the semicolon.

12 (L) Strike "Director of the Office of Thrift Su-

13 pervision;".

14 (M) Strike "Eastern Indian land claims settle-

15 ment fund (14—2202—0—1—806);".

16 (N) After the item relating to the Exchange

17 stabilization fund, insert the following new items:

18 "Farm Credit Administration, Limitation

19 on Administrative Expenses (78—4131—0—3—

20 351);

21 "Farm Credit System Financial Assistance

22 Corporation, interest payment (20—1850—0—1—

23 908);".

24 (0) Strike "Federal Deposit Insurance Cor-

25 poration;".

.HR 2015 EH

1319

1 (P) In the first item relating to the Federal De-

2 posit Insurance Corporation, insert "(51—4064—0—3—

3 373)" before the semicolon.

4 (Q) In the second item relating to the Federal

5 Deposit Insurance Corporation, insert "(51—4065—


7 (R) In the third item relating to the Federal

8 Deposit Insurance Corporation, insert "(51—4066—


10 (S) In the item relating to the Federal Housing

11 Finance Board, insert "(95—4039—0—3—371)" before

12 the semicolon.

13 (T) In the item relating to the Federal payment

14 to the railroad retirement account, strike "account"

15 and insert "accounts".

16 (U) In the item relating to the health profes-

17 sions graduate student loan insurance fund, insert

18 "program account" after "fund" and strike

19 "(Health Education Assistance Loan Program) (75—

20 4305—0—3—553)" and insert "(75—0340—0—1—552)".

21 (V) In the item relating to Higher education fa-

22 cilities, strike "and insurance".

23 (W) In the item relating to Internal revenue

24 collections for Puerto Rico, strike "852" and insert

25 "806".

.0k 2015 ER

1320

1 (X) Amend the item relating to the Panama

2 Canal Commission to read as follows:

3 "Panama Canal Commission, Panama

4 Canal Revolving Fund (95—406 1—0--3—403);".

5 (Y) In the item relating to the Medical facilities

6 guarantee and loan fund, strike "(75—4430—0—3—

7 551)" and insert "(75—9931—0—3—550)".

8 (Z) In the first item relating to the National

9 Credit Union Administration, insert "operating fund

10 (25—4056—0—3—373)" before the semicolon.

11 (AA) In the second item relating to the Na-

12 tional Credit Union Administration, strike "central"

13 and insert "Central" and insert "(25—4470—0—3—

14 373)" before the semicolon.

15 (BB) In the third item relating to the National

16 Credit Union Administration, strike "credit" and in-

17 sert "Credit" and insert "(25—4468—0—3—373)" be-

18 fore the semicolon.

19 (CC) After the third item relating to the Na-

20 tional Credit Union Administration, insert the fol-

21 lowing new item:

22 "Office of Thrift Supervision (20—4108—0—

23 3—373);".

•HR 2015 EH

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1 (DD) In the item relating to Payments to

2 health care trust funds, strike "572" and insert

3 "571".

4 (EE) Strike "Compact of Free Association, eco-

5 nomic assistance pursuant to Public Law 99—658

6 (14—0415—0—1—806);".

7 (FF) In the item relating to Payments to social

8 security trust funds, strike "571" and insert "651".

9 (GG) Strike "Payments to state and local gov-

10 ernment fiscal assistance trust fund (20—2111—0—1—

11 851);".

12 (1111) In the item relating to Payments to the

13 United States territories, strike "852" and insert

14 "806".

15 (II) Strike "Resolution Funding Corporation;".

16 (JJ) In the item relating to the Resolution

17 Trust Corporation, insert "Revolving Fund (22—

18 4055—0—3—373)" before the semicolon.

19 (KK) After the item relating to the Tennessee

20 Valley Authority funds, insert the following new

21 items:

22 "Thrift Savings Fund;

23 "United States Enrichment Corporation

24 (95—4054—0—3—271);

.HR 2015 EH

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1 "Vaccine Injury Compensation (75—0320—

2 0—1—551);

3 "Vaccine Injury Compensation Program

4 Trust Fund (20—8175—0—7—551);".

5 (2) Section 255(g)(1)(B) of the Balanced Budget and

6 Emergency Deficit Control Act of 1985 is amended as fol-

7 lows:

8 (A) Strike "The following budget" and insert

9 "The following Federal retirement and disability".

10 (B) In the item relating to Black lung benefits,

11 strike "lung benefits" and insert "Lung Disability

12 Trust Fund".

13 (C) In the item relating to the Court of Federal

14 Claims Court Judges' Retirement Fund, strike

15 "Court of Federal".

16 (D) In the item relating to Longshoremen's

17 compensation benefits, insert "Special workers com-

18 pensation expenses," before "Longshoremen's".

19 (E) In the item relating to Railroad retirement

20 tier II, strike "retirement tier II" and insert "Indus-

21 try Pension Fund".

22 (3) Section 255(g)(2) of the Balanced Budget and

23 Emergency Deficit Control Act of 1985 is amended as fol-

24 lows:

25 (A) Strike the following items:

'HR 2015 EH

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1 "Agency for International Development,

2 Housing, and other credit guarantee programs

3 (72—4340—0—3—151);

4 "Agricultural credit insurance fund (12—

5 4140—0—1—351);".

6 (B) In the item relating to Check forgery,

7 strike "Check" and insert "United States Treasury

8 check".

9 (C) Strike "Community development grant loan

10 guarantees (86—0162—0—1—451);".

11 (D) After the item relating to the United States

12 Treasury Check forgery insurance fund, insert the

13 following new item:

14 "Credit liquidating accounts;".

15 (E) Strike the following items:

16 "Credit union share insurance fund (25—

17 4468—0—3—371);

18 "Economic development revolving fund

19 (13—4406—0—3);

20 "Export-Import Bank of the United

21 States, Limitation of program activity (83—

22 4027—0—1—155);

23 "Federal deposit Insurance Corporation

24 (51—8419—0—8—371);

'HR 2015 EH

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1 "Federal Housing Administration fund

2 (86—4070—0—3—371);

3 "Federal ship financing fund (69—4301—0—

4 3—403);

5 "Federal ship financing fund, fishing yes-

6 sels (13—4417—0—3—376);

7 "Government National Mortgage Associa-

8 tion, Guarantees of mortgage-backed securities

9 (86—4238—0—3—371);

10 "Health education loans (75—4307—0—3—

11 553);

12 "Indian loan guarantee and insurance fund

13 (14—4410—0—3—452);

14 "Railroad rehabilitation and improvement

15 financing fund (69—4411—0—3—401);

16 "Rural development insurance fund (12—

17 4155—0—3—452);

18 "Rural electric and telephone revolving

19 fund (12—4230—8—3—271);

20 "Rural housing insurance fund (12—4141—

21 0—3—371);

22 "Small Business Administration, Business

23 loan and investment fund (73—4154—0—3—376);

24 "Small Business Administration, Lease

25 guarantees revolving fund (73—4157—0—3—376);

.HR 2015 EH

1325

1 "Small Business Administration, Pollution

2 control equipment contract guarantee revolving

3 fund (73—4147—0—3—376);

4 "Small Business Administration, Surety

5 bond guarantees revolving fund (73—4156—0—3—

6 376);

7 "Department of Veterans Affairs Loan

8 guaranty revolving fund (36—4025—0—3—704);".

9 (d) Low-INco1n PROGRAMS.—Section 2 55(h) of the


11 1985 is amended as follows:

12 (1) Amend the item relating to Child nutrition


14 "State. child nutrition programs (with the

15 exception of special milk programs) (12—3539—

16 0—1—605);".

17 (2) Amend the item relating to the Women, in-

18 fants, and children program to read as follows:

19 "Special supplemental nutrition program

20 for women, infants, and children (WIC) (12—

21 3510—0—1—605).".

22 (e) IDENTIFICATION OF PROGRAMS.—Section 255(i)

23 of the Balanced Budget and Emergency Deficit Control

24 Act of 1985 is. amended to read as follows:

•HR 2015 EU

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1 "(i) IDENTIFICATION OF PROGRAMS.—For purposes

2 of subsections (b), (g), and (h), each account is identified

3 by the designated budget account identification code num-

4 ber set forth in the Budget of the United States Govern-

5 ment 1996—Appendix, and an activity within an account

6 is designated by the name of the activity and the identi-

7 fication code number of the account.".

8 (f) OPTIONAL EXEMPTION OF MILITARY PERSON-

9 NEL.—Section 255(h) of the Balanced Budget and Emer-

10 gency Deficit Control Act of 1985 (relating to optional ex-

11 emption of military personnel) is repealed.

12 SEC. 11208. GENERAL AND SPECIAL SEQUESTRATION

13 RULES.

14 (a) SECTION HEADING.—.-(1) The section heading of

15 section 256 of the Balanced Budget and Emergency Defi-

16 cit Control Act of 1985 is amended by striking "EXCEP-

17 TIONS, LIMITATIONS, AND SPECIAL RULES" and in-

18 serting "GENERAL AN]) SPECIAL SEQUESTRATION

19 RULES".

20 (2) The item relating to section 256 in the table con-

21 tents set forth in section 250(a) of the Balanced Budget

22 and Emergency Deficit Control Act of 1985 is amended


"Sec. 256. General and special sequestration rules.".

24 (b) AUTOMATIC SPENDING INCREASES.—Section

25 256(a) of the Balanced Budget and Emergency Deficit

.HR 2015 Eli

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1 Control Act of 1985 is amended by striking paragraph (1)

2 and redesignating paragraphs (2) and (3) as paragraphs

3 (1) and (2), respectively.

4 (c) GUARANTEED AND DIRECT STUDENT LoAN PRO-

5 GRAMS.—Section 256(b) of the Balanced Budget and

6 Emergency Deficit Control Act of 1985 is amended to

7 read as follows:

8 "(b) STUDENT LoANs.—(1) For all student loans

9 under part B or D of title IV of the Higher Education

10 Act of 1965 made during the period when a sequestration

11 order under section 254 is in effect, origination fees under

12 sections 438(c)(2) and 455(c) of that Act shall be in-

13 creased by a uniform percentage sufficient to produce the

14 dollar savings in student loan programs (as a resuilt of

15 that sequestration order) required by section 252 or 253,

16 as applicable.

17 "(2) For any loan made during the period beginning

18 on the date that an order issued under section 254 takes

19 effect with respect to a fiscal year and ending at the close

20 of such fiscal year, the origination fees which are author-

21 ized to be collected pursuant to sections 438(c)(2) and

22 455(c) of such Act shall be increased by 0.50 percent.".

23 (d) HEALTH CENTERS.—Section 256(e)(1) of the

24 Balanced. Budget and Emergency Deficit Control Act of

•HR 2015 EH

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1 1985 is amended by striking the dash and all that follows

2 thereafter and inserting "2 percent.".

3 (e) FEDERAL PAY.—Section 256(g)(1) of the Bal-

4 anced Budget and Emergency Deficit Control Act of 1985

5 is amended by inserting "(including any amount payable

6 under section 5303 or 5304 of title 5, United States

7 Code)" after "such statutory pay system".

8 (f) TREATMENT OF FEDERAL ADMINISTRATWE Ex-

9 PENSES.—Section 256(h)(4) of the Balanced Budget and

10 Emergency Deficit Control Act of 1985 is amended by

11 striking subparagraphs (D) and (H), by redesignating

12 subparagraphs (E), (F), (G), and (I), as subparagraphs

13 (D)., (E), (F), and (G), respectively, and by adding at the

14 end the following new subparagraph:

15 "(H) Farm Credit Administration.".

16 (g) CoivrioDITY CREDIT CORPO1TION.—Section

17 256(j)(5) of the Balanced Budget and Emergency Deficit

18 Control Act of 1985 is amended to read as follows:

19 "(5) DAIRY PROGRAM.—Notwithstanthng other

20 provisions of this subsection, as the sole means of

21 achieving any reduction in outlays under the milk

22 price support program, the Secretary of Agriculture

23 shall provide for a reduction to be made in the price

24 received by producers for all milk produced in the

25 United States and marketed by producers for com-

'HR 2015 EH

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1 mercial use. That price reduction (measured in cents

2 per hundred weight of milk marketed) shall occur

3 under section 201(d)(2)(A) of the Agricultural Act

4 of 1949 (7 U.S.C. 1446(d)(2)(A)), shall begin on the

5 day any sequestration order is issued under section

6 254, and shall not exceed the aggregate amount of

7 the reduction in outlays under the milk price sup-

8 port program that otherwise would have been

9 achieved by reducing payments for the purchase of

10 milk or the products of milk under 'this subsection

11 during the applicable fiscal year.".

12 (h) EFFECTS OF SEQuESTRATION.—Section 256(k)

13 of the Balanced Budget and Emergency Deficit Control

14 Act of 1985 is amended as follows:

15 (1) In paragraph (1), strike "other than a trust

16 or special fund account" and insert ", except as pro-

17 vided in paragraph (5)" before the period.

18 (2) Strike paragraph (4), redesignate para-

19 graphs (5) and (6) as paragraphs (4) and (5), re-

20 spectively, and aknend paragraph (5) (as redesig-

21 nated) to read as follows:

22 "(5) Budgetary resources sequestered in revolv-

23 ing, trust, and special fund accounts, and offsetting

24 collections sequestered in appropriation accounts

25 shall not be available for obligation during the fiscal

.HR 2015 EH

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1 year in which the sequestration occurs, but shall be

2 available in subsequent years to the extent otherwise

3 provided in law.".

4 SEC. 11209. THE BASELINE.


6 Deficit Control Act of 1985 is amended—

7 (1) in subsection (b)(2) by amending subparagraph

8 (A) to read as follows:

9 "(A)(i) Except as provided in clause (ii), no

10 program with estimated current year outlays greater

11 than $50,000,000 shall be assumed to expire in the

12 budget year or the outyears.

13 "(ii) Clause (i) shall not apply to a program if

14 legislation establishing or modifying that program

15 contains a provision stating 'Section 257(b)(2) of

16 the Balanced Budget and Emergency Deficit Control

17 Act of 1985 shall not apply to the program specified

18 in

____

of this Act.', the blank space being filled in

19 with the appropriate section or sections of that legis-

20 lation.

21 "(iii) No bill, resolution,. amendment, motion, or

22 conference report shall be subject to a point of order

23 under section 306 of the Congressional Budget Act

24 of 1974 solely because it includes the provision spec-

25 ified in clause (ii).

.HR 2016 EH

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1 "(iv) Upon the expiration of the suspensions

2 contained in section 171 of Public Law 104—193

3 with regard to a program in such Act with estimated

4 fiscal year outlays greater than $50,000,000, that

5 program shall be assumed to operate under that Act

6 as in effect immediately before reversion to the laws

7 suspended by such Act."

8 (2) by adding the end of subsection (b)(2) the

9 following new subparagraph:

10 "(D) If any law expires before the budget year

11 or any outyear, then any program with estimated

12 current year outlays greater than $50 million which

13 operates under that law shall be assumed to con-

14 tinue to operate under that law as in effect imme-

15 diately before its expiration.";

16 (3) in the second sentence of subsection (c)(5),

17 by striking "national product fixed-weight price

18 index" and inserting "domestic product chain-type

19 price index"; and

20 (4) by striking subsection (e) and inserting the

21 following:

22 "(e) ASSET SA1ES.—Amounts realized from the sale

23 of an asset other than a loan asset shall not be counted

24 against legislation if that sale would result in a financial

25 cost to the Federal Government.".

'HR 2015 ER

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1 SEC. 11210. TECHNICAL CORRECTION.


3 Deficit Control Act of 1985, entitled "Modification of

4 Presidential Order", is repealed.

5 SEC. 11211. JUDICIAL REVIEW.


7 Deficit Control Act of 1985 is amended as follows:

8 (1) Strike "252" or "252(b)" each place it oc-

9 curs and insert "254".

10 (2) In subsection (d)(1)(A), strike "257(1) to

11 the extent that" and insert "256(a) if", strike the

12 parenthetical phrase, and at the end insert "or".

13 (3) In subsection (d)(1)(B), strike "new budg-

14 et" and all that follows through "spending author-

15 ity" and insert "budgetary resources" and strike

16 "or" after the comma.

17 (4) Strike subsection (d) (1) (C).

18 (5) Strike subsection (f) and redesignate sub-

19 sections (g) and (h) as subsections (f) and (g), re-

20 spectively.

21 (6) In subsection (g) (as redesignated), strike

22 "base levels of total revenues and total budget out-

23 lays, as" and insert "figures", and "251(a)(2)(B) or

24 (c)(2)," and insert "254".

•HR 2015 EH

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1 SEC. 11212. EFFECTIVE DATE.

2 (a) ExPI1TIoN.—Section 275(b) of the Balanced


4 amended—

5 (1) by striking "Part C of this title, section"

6 and inserting "Sections 251, 253, 258B, and";

7 (2) by striking "1995" and inserting "2002";

8 and

9 (3) by adding at the end the following new sen-

10 tence: "The remaining sections of part C of this title

11 shall expire September 30, 2006.".

12 (b) EXPIRATION.—Section 14002(c)(3) of the Omni-

13 bus Budget Reconciliation Act of 1993 (2 U.S.C. 900

14 note) is repealed.

15 SEC. 11213. REDUCTION OF PREEXISTING BALANCES AND

16 EXCLUSION OF EFFECTS OF THIS ACT FROM

17 PAYGO SCORECARD.

18 Upon the enactment of this Act, the Director of the

19 Office of Management and Budget shall—

20 (1) reduce any balances of direct spending and

21 receipts legislation for any fiscal year under section

22 252 of the Balanced Budget and Emergency Deficit

23 Control Act of 1985 to zero; and

24 (2) not make any estimates of changes in direct

25 spending outlays and receipts under subsection (d)

26 of such section 252 for any fiscal year resulting

•HR 2015 EH

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1 from the enactment of this Act or the Revenue Rec-

2 onciliation Act of 1997.

Passed the House of Representatives June 25, 1997.

Attest: ROBIN H. CARLE,Clerk.

.HR 2015 RDS

II

Calendar No. 91105TH CONGRESS

1ST SEssioN

To provide for reconciliation pursuant to section 104(a) of the concurrentresolution on the budget for fiscal year 1998.

IN THE SENATE OF THE UNITED STATES

JUNE 20, 1997

Mr. DOMENICI, from the Committee on the Budget, reported the followingoriginal bill; which was read twice and placed on the calendar

A BILLTo provide for reconciliation pursuant to section 104(a) of

the concurrent resolution on the budget for fiscal year 1998.





5 of 1997".

6 SEC. 2. TABLE OF TITLES.

7 The table of titles for this Act is as follows:

PageTitle I. Committee on Agriculture, Nutrition, and Forestry 2

Title II. Committee on Banking, Housing, and Urban Affairs 11Title III. Committee on Commerce, Science, and Transportation 92

2

Title IV. Committee on Energy and Natural Resources 129Title V. Committee on Finance 130Title VI. Committee on Governmental Affairs 1027Title VII. Committee on Labor and Human Resources 1049Title VIII. Committee on Veterans' Affairs 1056

130

10 TITLE V—COMMITTEE ON11 FINANCE12 SEC. 5000. AMENDMENTS TO SOCIAL SECURITY ACT AND


14 OFTITLE.

15 (a) AMENDMENTS TO SociAL SECURITY ACT.—Ex-







22 "OBRA—1986", "OBRA—1987", "OBRA—1989",




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131

1 Law 100—203), the Orrmibus Budget Reconciliation Act


3 onciliation Act of 1990 (Public Law 101—508), and the


5 103—6 6), respectively.

6 (c) TABLE OF CONTENTS.—The table of contents of

7 this title is as follows:

TITLE V—COMMITTEE ON FINANCE

Sec. 5000. Amendments to Social Security Act and references to OBRA; tableof contents of title.

DWISION 1—MEDICARE

Subtitle A—Medicare Choice Program

CHAPTER 1—MEDIcu CHOICE PROGRAM

SUBCHAPTER A—MEDICARE CHOICE PROGRAM

Sec. 5001. Establishment of Medicare Choice program.

"PT C—MEDICARE CHOICE PROGRAM

"Sec. 1851. Eligibility, election, and enrollment."Sec. 1852. Benefits and beneficiary protections."Sec. 1853. Payments to Medicare Choice organizations."Sec. 1854. Premiums."Sec. 1855. Organizational and financial requirements for Medicare Choice

organizations; provider-sponsored organizations."Sec. 1856. Establishment of standards."Sec. 1857. Contracts with Medicare Choice organizations."Sec. 1859. Definitions; miscellaneous provisions.

Sec. 5002. Transitional rules for current medicare HMO program.Sec. 5003. Conforming changes in Medigap program.

SUBCHAPTER B—SPECIAL RULES FOR MEDICARE CHOICE MEDICAL SAVINGSACCOUNTS

Sec. 5006. Medicare Choice MSA.

CHAPTER 2—INTEGRATED LONG-TERM Cai PIooIIS

SUBCHAPTER A—PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY

(PACE)

Sec. 5011. Coverage of PACE under the medicare program.Sec. 5012. Effective date; transition.See. 5013. Study and reports.

S947PCS--5

132

SUBCHA?1'ER B—SOCIAL HEALTH MAINTENANCE ORGANIZATIONS




CHAPTER 3—CoMMissioNs

Sec. 5021. National Bipartisan Commission on the Future of Medicare.Sec. 5022. Medicare Payment Advisory Commission.


Sec. 5031. Medigap protections.Sec. 5032. Addition of high deductible Medigap policy.

CHAPTER 5—DEMONSTRATIONS

SUBCHAPTER A—MEDICARE CHOICE COMPETITWE PRICING DEMONSTRATION

PROJECT

Sec. 5041. Medicare Choice competitive pricing demonstration project.Sec. 5042. Determination of annual Medicare Choice capitation rates.Sec. 5043. Benefits and beneficiary premiums.

SUBCHAPTER B—OTHER PROJECTS

Sec. 5045. Medicare enrollment demonstration project.Sec. 5046. Medicare coordinated care demonstration project.Sec. 5047. Establishment of medicare reimbursement demonstration projects.

CHAPTER 6—TAX TREATMENT OF HOSPITALS PARTICIPATING IN PROVIDER-SPONSORED ORGANIZATIONS

Sec. 5049. Tax treatment of hospitals which participate in provider-sponsoredOrganizations.


Sec. 5101. Annual screening mammography for women over age 39.

Sec. 5102. Coverage of colorectal screening.Sec. 5103. Diabetes screening tests.Sec. 5104. Coverage of bone mass measurements.


Sec. 5151. Sole community hospitals.Sec. 5152. Medicare-dependent, small rural hospital payment extension.Sec. 5153. Medicare rural hospital flexibility program.Sec. 5154. Prohibiting denial of request by rural referral centers for reelassi-

fication on basis of comparability of wages.Sec. 5155. Rural health clinic services.Sec. 5156. Medicare reimbursement for telehealth services.Sec. 5157. Telemedicine, informatics, and education demonstration project.

Subtitle D—Anti-Fraud and Abuse Provisions and Improvements inProtecting Program Integrity

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133

CHAPTER 1—REVISIONS TO SANCTIONS FOR FRAUD AND ABUSE



Sec. 5203. Imposition of civil money penalties.

CHAPTER 2—IMPROVEMENTS IN PROTECTING PROGRAM INTEGRITY

Sec. 5211. Disclosure of information, surety bonds, and accreditation.Sec. 5212. Provision of certain identification numbers.Sec. 5213. Application of certain provisions of the bankruptcy code.Sec. 5214. Replacement of reasonable charge methodology by fee schedules.Sec. 5215. Application of inherent reasonableness to all part B services other

than physicians' services.Sec. 5216. Requirement to furnish diagnostic information.Sec. 5217. Report by GAO on operation of fraud and abuse control program.Sec. 5218. Competitive bidding.

CHAPTER 3—CLARIFICATIONS AND TECHMCAL CHANGES

Sec. 5221. Other fraud and abuse related provisions.


CHAPTER 1—PROVISIONS RELATING TO PART A

Sec. 5301. Prospective payment for inpatient rehabilitation hospital services.Sec. 5302. Study and report on payments for long-term care hospitals.

CHAPTER 2—PROVISIONS RELATING TO PART B

SUBCHAPTER A—PAYMENT FOR HOSPITAL OUTPATIENT DEPARTMENT

SERVICES




SUBCHAPTER B—AMBULANCE SERVICES

Sec. 5321. Payments for ambulance services.

CHAPTER 3—PROVISIONS RELATING TO PARTS A ANt) B

SUBCHAPTER A—PAYMENTS TO SKILLED NURSING FACILITIES

Sec. 5331. Basing updates to per diem limits effective for fiscal year 1998 oncost limits effective for fiscal year 1997.

Sec. 5332. Prospective payment for skilled nursing facility services.

SUBCHAPTER B—HOME HEALTH SERVICES AND BENEFITS

PART I—PAYMENTS FOR HOME HEALTH SERVICES

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134


Sec. 5342. Interim payments for home health services.Sec. 5343. Prospective payment for home health services.Sec. 5344. Payment based on location where home health service is furnished.

PART Il—HOME HEALTH BENEFITS


Sec. 5362. Imposition of $5 copayment for part B home health services.Sec. 5363. Clarification of part-time or intermittent nursing care.Sec. 5364. Study on definition of homebound.Sec. 5365. Normative standards for home health claims denials.Sec. 5366. Inclusion of cost of service in explanation of medicare benefits.


CHAPTER 1—PAYMENT OF PPS HOSPITALS

Sec. 5401. PPS hospital payment update.Sec. 5402. Capital payments for PPS hospitals.

CHAPTER 2—PAYMENT OF PPS EXEMP'r HOSPITALS


and units.Sec. 5423. Cap on TEFRA limits.Sec. 5424. Change in bonus and relief payments.Sec. 5425. Target amounts for rehabilitation hospitals, long-term care hos-

pitals, and psychiatric hospitals.Sec. 5426. Treatment of certain long-term care hospitals located within other

hospitals.Sec. 5427. Elimination of exemptions; report on exceptions and adjustments.Sec. 5428. Technical correction relating to subsection (d) hospitals.Sec. 5429. Certain cancer hospitals.

CHAPTER 3—GRADUATE MEDICAL EDUCATION PAYMENTS

SUBCHAPTER A—DIRECT MEDICAL EDUCATION

Sec. 5441. Limitation on number of residents and rolling average FTE count.Sec. 5442. Permitting payment to nonhospital providers.

SUBCHAPTER B—INDIRECT MEDICAL EDUCATION

Sec. 5446. Indirect graduate medical education payments.

SUBCHAPTER C—GRADUATE MEDICAL EDUCATION PAYMENTS FOR MANAGED

CARE ENROLLEES

Sec. 5451. Direct and indirect medical education payments to hospitals formanaged care enrollees.

Sec. 5452. Demonstration project on use of consortia.

CHAPTER 4—OTHER HOSPITAL PAYMENTS

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135

Sec. 5461. Disproportionate share payments to hospitals for managed care andMedicare Choice enrollees.

Sec. 5462. Reform of disproportionate share payments to hospitals serving vul-nerable populations.

Sec. 5463. Medicare capital asset sales price equal to book value.Sec. 5464. Elimination of IME and DSH payments attributable to outlier pay-

ments.Sec. 5465. Treatment of transfer cases.Sec. 5466. Reductions in payments for enrollee bad debt.Sec. 5467. Floor on area wage index.Sec. 5468. Increase base payment rate to Puerto Rico hospitals.Sec. 5469. Permanent extension of hemophilia pass-through.Sec. 5470. Coverage of services in religious nonmedical health care institutions

under the medicare and medicaid programs.

CHAPTER 5—PAYMENTS FOR HOSPICE SERVICES

Sec. 5481. Payment for home hospice care based on location where care is fur-nished.

Sec. 5482. Hospice care benefits periods.Sec. 5483. Other items and services included in hospice care.Sec. 5484. Contracting with independent physicians or physician groups for


in non-urbanized areas.Sec. 5486. Limitation on liability of beneficiaries for certain hospice coverage

denials.Sec. 5487. Extending the period for physician certification of an individual's

terminal illness.Sec. 5488. Effective date.


CHAPTER 1—PAYMENTS FOR PHYSICIANS AND OTHER HEALTH CAREPROVIDERS



growth rate.Sec. 5504. Payment rules for anesthesia services.Sec. 5505. Implementation of resource-based physician practice expense.Sec. 5506. Increased medicare reimbursement for nurse practitioners and clini-

cal nurse specialists.Sec. 5507. Increased medicare reimbursement for physician assistants.Sec. 5508. Chiropractic services coverage demonstration project.


Sec. 5521. Reduction in updates to payment amounts for clinical diagnosticlaboratory tests; study on laboratory services.

Sec. 5522. Improvements in administration of laboratory services benefit.Sec. 5523. Payments for durable medical equipment.Sec. 5524. Oxygen and oxygen equipment.Sec. 5525. Updates for ambulatory surgical services.Sec. 5526. Reimbursement for drugs and biologicals.

.S 947 PCS

136

CHAPTER 3—PiUT B PREMIUM AND RELATED PROVISIONS

Sec. 5541. Part B premium.Sec. 5542. Income-related reduction in medicare part B deductible to reflect re-

capture of part B subsidy.


CHAPTER 1—SEcoImuw PAYOR PROVISIONS

Sec. 5601. Extension and expansion of existing requirements.Sec. 5602. Improvements in recovery of payments.

CHAPTER 2—OTmR PROVISIONS

Sec. 5611. Conforming age for eligibility under medicare to retirement age forsocial security benefits.

Sec. 5612. Increased certification period for certain organ procurement organi-zations.

DWISION 2—MEDICAID AND CHILDREN'S HEALTH INSURANCEINITIAT WE S

Subtitle I—Medicaid

CHAPTER 1—MEDICAID SAVINGS

SUBCHAPTER A—MANAGED CARE REFORMS

Sec. 5701. State option for mandatory managed care.

"PART B—PROVISIONS RELATING TO MANAGED Ciu

"Sec. 1941. Beneficiary choice; enrollment."Sec. 1942. Beneficiary access to services generally."Sec. 1943. Requirements for access to emergency care."Sec. 1944. Other beneficiary protections."Sec. 1945. Assuring quality care."Sec. 1946. Protections for providers."Sec. 1947. Assuring adequacy of payments to medicaid managed care or-

ganizations and entities."Sec. 1948. Fraud and abuse."Sec. 1949. Sanctions for noncompliance by managed care entities."Sec. 1950. Definitions; miscellaneous provisions."

Sec. 5702. Primary care case management services as State option withoutneed for waiver.

Sec. 5703. Additional reforms to expand and simplitr managed care.

SUBCHAPTER B—MANAGEMENT FLEXIBILITY REFORMS

Sec. 5711. Elimination of Boren amendment requirements for provider pay-ment rates.

Sec. 5712. Medicaid payment rates for qualified medicare beneficiaries.Sec. 5713. No waiver required for provider selectivity.

SUBCHAPTER C—REDUCTION OF DISPROPORTIONATE SHARE HOSPITAL (DSH)

PAYMENTS

Sec. 5721. Disproportionate share hospital (DSFI) payments.

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137

CHAPTER 2—ExPANSIoN OF MEDICAID ELIGIBILITY

Sec. 5731. State option to permit workers with disabilities to buy into medicaid.Sec. 5732. 12-month continuous eligibility for children.

ChAPTER 3—PRoGIIs OF ALL-INCLUSIVE CARE FOR THE ELDERLY

(PACE)

Sec. 5741. Establishment of PACE program as medicaid State option.Sec. 5742. Effective date; transition.Sec. 5743. Study and reports.

CHAPTER 4—MEDICAID MANAGEMENT AND PROGRAM REFORMS

Sec. 5751. Elimination of requirement to pay for private insurance.Sec. 5752. Elimination of obstetrical and pediatric payment rate requirements.Sec. 5753. Physician qualification requirements.Sec. 5754. Expanded cost-sharing requirements.Sec. 5755. Penalty for fraudulent eligibility.Sec. 5756. Elimination of waste, fraud, and abuse.Sec. 5757. Study on EPSDT benefits.Sec. 5758. Study on effectiveness of managed care entities in meeting the needs

of enrollees with special health care needs.

CHAPTER 5—MISCELLANEOUS

Sec. 5761. Increased FMAPs.Sec. 5762. Increase in payment caps for territories.Sec. 5763. Community-based mental health services.Sec. 5764. Optional medicaid coverage of certain CDC-screened breast cancer

patients.Sec. 5765. Treatment of State taxes imposed on certain hospitals that provide

free care.Sec. 5766. Treatment of veterans pensions under medicaid.Sec. 5767. Effective date.

Subtitle J—Children's Health Insurance Initiatives

Sec. 5801. Establishment of children's health insurance initiatives.

"TITLE XXI—CHILD HEALTH INSURANCE INITIATIVES

"Sec. 2101. Purpose."Sec. 2102. Definitions."Sec. 2103. Appropriation."Sec. 2104. Program outline."Sec. 2105. Distribution of funds."Sec. 2106. Use of funds."Sec. 2107. State option for the purchase or provision of children's health

insurance."Sec. 2108. Program integrity."Sec. 2109. Annual reports."

DiVISION 3—INCOME SECURITY AND OTHER PROVISIONS

Subtitle K—Income Security, Welfare-to-Work Grant Program, and OtherProvisions

•S 947 PCS

138

CHAPTER 1—INCOME SECURITY

Sec. 5811. SSI eligibility for aliens receiving SSI on August 22, 1996.Sec. 5812. Extension of eligibility period for refugees and certain other quali-

fied aliens from 5 to 7 years for SSI and medicaid.Sec. 5813. SSI eligibility for permanent resident aliens who are members of an

Indian tribe.Sec. 5814. SSI eligibility for disabled legal aliens in the United States on Au-

gust 22, 1996.Sec. 5815. Exemption from restriction on supplemental security income pro-

gram participation by certain recipients eligible on the basis ofvery old applications.

Sec. 5816. Reinstatement of eligibility for benefits.Sec. 5817. Exemption for children who are legal aliens from 5-year ban on

medicaid eligibility.Sec. 5818. Effective date.

CHAPTER 2—WELFA1u-To-WoRK GRANT PROGRAM

Sec. 5821. Welfare-to-Work grants.Sec. 5822. Enrollment flexibility.Sec. 5823. Clarification of a State's ability to sanction an individual receiving

assistance under TANF for noncompliance.

CHAPTER 3—UNEMPLOYMENT COMPENSATION

Sec. 5831. Increase in Federal unemployment account ceiling.Sec. 5832. Special distribution to States from unemployment trust fund.Sec. 5833. Clarilying provision relating to base periods.Sec. 5834. Treatment of certain services performed by inmates.

DWISION 4—EARNED INCOME CREDIT AND OTHER PROVISIONS

Subtitle L—Earned Income Credit and Other Provisions

CHAPTER 1—ENED INCOME CREDIT

Sec. 5851. Restrictions on availability of earned income credit for taxpayerswho improperly claimed credit in prior year.

CHAPTER 2—INCREASE IN PUBLIC DEBT LIMIT



Sec. 5871. Sense of the Senate regarding the correction of cost-of-living adjust-ments.

Subtitle M—Welfare Reform Technical Corrections

Sec. 5900. Short title of subtitle.

CHAPTER 1—BLOCK GRANTS FOR TEMPORA1Y ASSISTANCE TO NEEDYFIuaEs

Sec. 5901. Amendment of the Social Security Act.Sec. 5902. Eligible States; State plan.Sec. 5903. Grants to States.

.S 947 PCS

139

Sec. 5904. Use of grants.Sec. 5905. Mandatory work requirements.Sec. 5906. Prohibitions; requirements.Sec. 5907. Penalties.Sec. 5908. Data collection and reporting.Sec. 5909. Direct funding and administration by Indian tribes.Sec. 5910. Research, evaluations, and national studies.Sec. 5911. Report on data processing.Sec. 5912. Study on alternative outcomes measures.Sec. 5913. Limitation on payments to the territories.Sec. 5914. Conforming amendments to the Social Security Act.Sec. 5915. Other conforming amendments.Sec. 5916. Modifications to the job opportunities for certain low-income individ-

uals program.Sec. 5917. Denial of assistance and benefits for drug-related convictions.Sec. 5918. Transition rule.Sec. 5919. Effective dates.

CHAPTER 2—SUPPLEMENTAL SECURITY INCOME

Sec. 5921. Conforming and technical amendments relating to eligibility restric-tions.

Sec. 5922. Conforming and technical amendments relating to benefits for dis-abled children.

Sec. 5923. Additional technical amendments to title XVI.Sec. 5924. Additional technical amendments relating to title XVLSec. 5925. Effective dates.

CHAPTER 3—CHiLD SUPPORT

Sec. 5935. State obligation to provide child support enforcement services.Sec. 5936. Distribution of collected support.Sec. 5937. Civil penalties relating to State directory of new hires.Sec. 5938. Federal Parent Locator Service.Sec. 5939. Access to registry data for research purposes.Sec. 5940. Collection and use of social security numbers for use in child sup-

port enforcement.Sec. 5941. Adoption of uniform State laws.Sec. 5942. State laws providing expedited procedures.Sec. 5943. Voluntary paternity acknowledgement.Sec. 5944. Calculation of paternity establishment percentage.Sec. 5945. Means available for provision of technical assistance and operation

of Federal Parent Locator Service.Sec. 5946. Authority to collect support from Federal employees.Sec. 5947. Definition of support order.Sec. 5948. State law authorizing suspension of licenses.Sec. 5949. International support enforcement.Sec. 5950. Child support enforcement for Indian tribes.Sec. 5951. Continuation of rules for distribution of support in the case of a

title IV—E child.Sec. 5952. Good cause in foster care and food stamp cases.Sec. 5953. Date of collection of support.Sec. 5954. Administrative enforcement in interstate cases.Sec. 5955. Work orders for arrearages.Sec. 5956. Additional technical State plan amendments.Sec. 5957. Federal case registry of child support arders.

.S 947 PCS

140

Sec. 5958. Full faith and credit for child support orders.Sec. 5959. Development costs of automated systems.Sec. 5960. Additional technical amendments.Sec. 5961. Effective date.

CHAPTER 4—RESTRICTING WELFARE AND PUBLIC BENEFITS FOR ALIENS

SUBCHAPTER A—ELIGIBILITY FOR FEDERAL BENEFITS

Sec. 5965. Alien eligibility for Federal benefits: limited application to medicareand bencfits under the Railroad Retirement Act.

Sec. 5966. Exccptions to benefit limitations: corrections to reference concerningalicns whose deportation is withheld.

Sec. 5967. Veterans exception: application of minimum active duty service re-quirement; extension to unremarried surviving spouse; ex-

panded definition of veteran.Sec. 5968. Correction of reference concerning Cuban and Haitian entrants.Sec. 5969. Notification concerning aliens not lawfully present: correction of ter-

minology.Sec. 5970. Freely associated States: contracts and licenses.Sec. 5971. Congressional statement regarding benefits for Hmong and other

Highland Lao veterans.

SUBCHAPTER B—OENERAL PROVISIONS

Sec. 5972. Detcrmination of treatmcnt of battered aliens as qualified aliens; in-clusion of alicn child of battered parent as qualified alien.

Sec. 5973. Verification of eligibility for benefits.Sec. 5974. Qualifying quarters: disclosure of quartcrs of coverage information;

correction to assure that crediting applies to all quartersearned by parents b'fore child is 18.

Sec. 5975. Statutory construction: benefit eligibility limitations applicable onlywith respect to aliens present in the United States.

SUBCHAPTER C—MISCELLANEOUS CJERICAL AND TECHNICAL AMENDMENTS;

EFFECTIVE DATE

Sec. 5976. Correcting miscellaneous clerical and technical errors.Sec. 5977. Effective date.

CHAPTER 5—CHILD PROTECTION

Sec. 5981. Conforming and technical amendments relating to child protection.Sec. 5982. Additional technical amendments relating to child protection.Sec. 5983. Effective date.

CHAPTER 6—CHILD C

Sec. 5985. Conforming and technical amendments relating to child care.Sec. 5986. Additional conforming and technical amendments.Sec. 5987. Repeals.Sec. 5988. Effective dates.

CHAPTER 7—ERISA AMENDMENTS RELATING TO MEDICAL CHILD SUPPORTORDERS

Sec. 5991. Amendments relating to section 303 of the Personal Responsibilityand Work Opportunity Reconciliation Act of 1996.

141

Sec. 5992. Amendment relating to section 381 of the Personal Responsibilityand Work Opportunity Reconciliation Act of 1996.

Sec. 5993. Amendments relating to section 382 of the Personal Responsibilityand Work Opportunity Reconciliation Act of 1996.

443

1 Subtitle D—Anti-Fraud and Abuse2 Provisions and Improvements in3 Protecting Program Integrity

449

15 CHAPTER 2—IMPROVEMENTS IN

16 1ROTECTING PROGRAM INTEGRITY

455

5 SEC. 5212. PROVISION OF CERTAIN mEN'rDICATIoN NUM-

6 BERS.

7 (a) REQUIREMENTS To DIscLOsE EMPLOYER IDEN-

8 TIFICATION NUMBERS (EINS) SOCIAL SECURITY Ac-


10 U.S.C. 1320a—3(a)(1)) is athènded by inserting before the










20 (b) OTHER MEDICARE PROVIDERS.—Section 1124A



23 (A) in paragraph (1), by striking "and" at

24 the end;

456

1 (B) in paragraph (2), by striking the pe-

2 nod at the end and inserting "; and"; and

3 (C) by adding at the end the following:







10 scribed, under paragraph (1) or (2)."; and

11 (2) in subsection (c)(1), by inserting "(or, for

12 purposes of subsection (a)(3), any entity receiving

13 payment)" after "on an assignment-related basis".

14 (c) VERIFICATION BY SOCIAL SECtJRITY ADMINTS-

15 TRATION (SSA) .—Section 112 4A (42 U.S.C. 132 Oa—3a),

16 as amended by subsection (b), is amended—


18 section (d); and


20 ing:


22 "(1) TRANSMITTAL BY ims.—The Secretary




.S 947 PCS

457


2 205(c)(2)(B)), and








10 'paragraph (2).



13 verify the accuracy of, or correct, the information













.S 947 PCS

458

1 security account numbers that will be provided to the See-

2 retary under the amendments made by this section.

3 (e) EFFECTWE DATES.—

4 (1) DISCLOSURE REQTJIREMENTS.—The amend-

5 ment made by subsection (a) shall apply to the ap-

6 plication of conditions of participation, and entering

7 into and renewal of contracts and agreements, oc-

8 curring more than 90 days after the date of submis-

9 sion of the report under subsection (d).

10 (2) OTHER PROVLDERS.—The amendments

11 made by subsection (b) shall apply to payment for

12 items and services furnished more than 90 days

13 after the date of submission of such report.

865

3 DWISION 3—INCOME SECURITY4 AND OTHER PROVISIONS5 Subtitle K—Income Security, Wel-6 fare-to-Work Grant Program,7 and Other Provisions8 CHAPTER 1—INCOME SECURITY

9 SEC. 5811. SSI ELIGIBILITY FOR ALIENS RECEWING 55! ON

10 AUGUST 22, 1996.

11 (a) IN GENERAi.—Section 402(a)(2) of the Personal




15 "(E) ALIENS RECEIVING SSI ON AUGUST

16 22, 1996.—With respect to eligibility for benefits

17 for the program defined in paragraph (3)(A)

18 (relating to the supplemental security income

19 program), paragraph (1) shall not apply to an

20 alien who is lawfully residing in any State and

21 who was receiving such benefits on August 22,

22 1996.".

23 (b) STATUS OF CUBAN AND HAITIAN ENTRANTS.—

24 For purposes of section 402(a)(2)(E) of the Personal Re-


•SD47PCS

866

1 1996 (8 U.S.C. 1612(a)(2)(E)), an alien who is a Cuban

2 and Haitian entrant, as defined in section 50 1(e) of the

3 Refugee Education Assistance Act of 1980, shall be con-

4 sidered a qualified alien.


6 402(a)(2)(D) of the Personal Responsibility and Work Op-






12 (3) by striking "(ii) FOOD STAMPS"; and



15 SEC. 5812. EXTENSION OF ELIGIBILITY PERIOD FOR REFU.

16 GEES AND CERTAIN OTHER QUALIFIED


18 MEDICAiD.

19 (a) 551.—Section 402(a)(2)(A) of the Personal Re-



22 lows:



.S 947 PCS

867

1 "(i) SSI.—With respect to the sped-

2 fled Federal program described in para-






8 tionality Act;





13 Act.





18 date—




22 tionality Act;



S947PCS--28

868



3 Act.".

4 (b) MEDICiUD.—Section 402(b)(2)(A) of the Per-



7 as follows:







14 date—




18 tionality Act;





23 Act.


25 PROGRAIVIS.—With respect to the des-

.S 947 PCS

869








8 tionality Act;





13 Act.".

14 (c) STATUS OF CUBAN AND HAITIAN ENTRANTS.—

15 For purposes of sections 402(a)(2)(A) and 402(b)(2)(A)

16 of the Personal Responsibility and Work Opportunity Rec-

17 onciiation Act of 1996 (8 U.S.C. 1612(a)(2)(A),

18 (b) (2) (A)), an alien who is a Cuban and Haitian entrant,

19 as defined in section 501(e) of the Refugee Education As-

20 sistance Act of 1980, shall be considered a refugee.

21 SEC. 5813. 55! ELIGIBILITY FOR PERMANENT RESIDENT

22 ALIENS WHO ARE MEMBERS OF• AN INDIAN

23 TRIBE.



..S 947 PCS

870















15 ance Act).".

16 SEC. 5814. SSI ELIGiBILITY FOR DISABLED LEGAL ALIENS

17 IN THE UNITED STATES ON AUGUST 22, 1996.





22 "(G) DISABLED ALIENS LAWFULLY RESID-

23 ING IN THE UNITED STATES ON AUGUST 22,

24 1996.—With respect to eligibility for benefits for

25 the program defined in paragraph (3)(A) (relat-

•S 947 PCS

871

1 ing to the supplemental security income pro-

2 gram), paragraph (1) shall not apply to an

3 alien who—

4 "(i) is lawfully residing in any State

5 onAugust22, 1996; and

6 "(ii) is disabled, as defined in section

7 1614(a)(3) of the Social Security Act (42

8 U.S.C. 1382c(a)(3)),

9 but only if the alien applies for benefits under

10 such program on or before September 30,

11 1997.".

12 SEC. 5815. EXEMPTION FROM RESTRICTION ON SUPPLE-

13 MENTAL SECURITY INCOME PROGRAM PAR-

14 TICIPATION BY CERTAIN RECIPIENTS ELIGI-

15 BLE ON THE BASIS OF VERY OLD APPLICA-

16 TIONS.





21 "(II) Ssi EXCEPTION FOR CERTAIN RE-

22 CIPIENTS ON THE BASIS OF VERY OLD APPLICA-

23 TIONS.—With respect to eligibility for benefits

24 for the program defined in paragraph (3)(A)

25 (relating to the supplemental security income

.S 947 PCS

872

1 program), paragraph (1) shall not apply to any

2 individual—

3 "(i) who is receiving benefits under

4 such program for months after July 1996

5 on the basis of an application filed before

6 January 1, 1979; and

7 "(ii) with respect to whom the Com-

8 missioner of Social Security lacks clear and

9 convincing evidence that such individual is

10 an alien ineligible for such benefits as a re-

11 sult of the application of this section.".

12 SEC. 5816. REINSTATEMENT OF ELIGIBILITY FOR BENE-

13 rrS14 (a) FOOD STAMIS.—The Personal Responsibility and



17 "SEC. 436. DERWATWE ELIGIBILITY FOR BENEFITS.

18 Notwithstanding any other provision of law, an alien

19 who under the provisions of this title is ineligible for bene-

20 fits under the food stamp program (as defined in section

21 402(a)(3)(A)) shall not be eligible for such benefits be-

22 cause the alien receives benefits under the supplemental

23 security income program (as defined in section

24 402(a)(3)(B)).".

.S 947 PCS

873

1 (b) MEDICMD.—Section 402(b)(2) of the Personal


3 of 1996 (8 U.S.C. 1612(b)(2)) is amended by adding at

4 the end the following:

5 "(E) MEDICAID EXCEPTION FOR ALIENS

6 RECEIVING 551.—An alien who is receiving ben-

7 efits under the program defined in subsection

8 (a)(3)(A) (relating to the supplemental security

9 income program) shall be eligible for medical

10 assistance under a 5tate plan under title XIX

11 of the Social 5ecurity Act (42 U.S.C. 1396 et

12 seq.) under the same terms and conditions that

13 apply to other recipients of benefits under the

14 program defined in such subsection.".

15 (c) CLERICAL AMENDMENT.—Section 2 of the Per-





19 SEC. 5817. EXEMPTION FOR CHILDREN WHO ARE LEGAL

20 ALIENS FROM 5-YEAR BAN ON MEDICAID ELI-

21

22 5ection 403 of the Personal Responsibility and Work

23 Opportunity Reconciliation Act of 1996 (8 U.S.C. 1613))

24 is amended by adding at the end the following:

.S 947 PCS

874

1 "(e) MEDICMD ELIGIBILITY EXEMPTION FOR CrnL-

2 DREN.—The limitation under subsection (a) shall not

3 apply to any alien who has not attained age 19 and is

4 lawfully residing in any State, but only with respect to

5 such alien's eligibility for medical assistance under a State

6 plan under title XIX of the Social Security Act (42 U.S.C.

7 1396 et seq.).".


9 The amendments made by this chapter shall take ef-

10 fect as if they were included in the enactment of title IV


12 onciliation Act of 1996 (Public Law 104—193; 110 Stat.

13 2260).

915

7 CHAPTER 3—MISCELLANEOUS

8 SEC. 5871. SENSE OF THE SENATE REGARDING THE COR-

9 RECTION OF COST-OF-LWING ADJUSTMENTS.

10 (a) FINDINGS.—The Senate makes the following

11 findings:

12 (1) The final report of the Senate Finance

13 Committee's Advisory Commission to Study the

14 Consumer Price Index, chaired by Professor Michael

15 Boskin, has concluded that the Consumer Price

16 Index overstates the cost of living in the United

17 States by 1.1 percentage points.

18 (2) Dr. Alan Greenspan, Chairman of the

19 Board of Governors of the Federal Reserve System,

20 has testified before the Senate Finance Committee

21 that "the best available evidence suggests that there

22 is virtually no chance that the CPI as currently pub-

23 lished understates" the cost of living and that there

24 is "a very high probability that the upward bias

'S 947 PCS

916

1 ranges between 1/2 percentage point per year and

2 11/2 percentage points per year".

3 (3) The overstatement of the cost of living by

4 the Consumer Price Index has been recognized by

5 economists since at least 1961, when a report noting

6 the existence of the overstatement was issued by a

7 National Bureau of Economic Research Committee,

8 chaired by Professor George J. Stigler.

9 (4) Congress and the President, through the in-

10 dexing of Federal tax brackets, Social Security bene-

11 fits, and other Federal program benefits, have un-

12 dertaken to protect taxpayers and beneficiaries of

13 such programs from the erosion of purchasing power

14 due to inflation.

15 (5) Congress and the President intended the in-


17 fits, and other Federal program benefits to accu-

18 rately reflect changes in the cost of living.

19 (6) The overstatement of the cost of living in-

20 creases the deficit and undermines the equitable ad-

21 ministration of Federal benefits and tax policies.

22 (b) SENSE OF THE SENATE.—It is the sense of the

23 Senate that all cost-of-living adjustments required by stat-

24 ute should accurately reflect the best available estimate

25 of changes in the cost of living.

.8 947 PCS

917

1 Subtitle M—Welfare Reform2 Technical Corrections3 SEC. 5900. SHORT TITLE OF SUBTITLE.

4 This subtitle may be cited as the "Welfare Reform

5 Technical Corrections Act of.1997".

960

4 CHAPTER 2—SUPPLEMENTAL SECURITY

5 INCOME

6 SEC. 5921. CONFORMING AND TECHNICAL AMENDMENTS

7 RELATING TO ELIGIBILITY RESTRICTIONS.

8 (a) DENiAI OF SSI BENEFITS FOR FUGITWE FEL-

9 ONS AND PROBATION AND PAiOLE VIOLATORS.—Section

10 1611(e)(6) (42 U.S.C. 1382(e)(6)) is amended by insert-

11 ing "and section 1106(c) of this Act" after "of 1986".

12 (b) TREATMENT OF PRISONERS.—Section

13 1611(e)(1)(I)(i)(II) (42 U.S.C. 1382(e)(1)(I)(i)(II)) is

14 amended by striking "inmate of the institution" and all

15 that follows through "this subparagraph" and inserting

16 "individual who receives in the month preceding the first

17 month throughout which such individual is an inmate of

18 the jail, prison, penal institution, or correctional facility

19 that furnishes information respecting such individual pur-

20 suant to subclause (I), or is confined in the institution

21 (that so furnishes such information) as described in sec-

22 tion 202(x)(1)(A)(ii), a benefit under this title for such

23 preceding month, and who is determined by the Commis-

24 sioner to be ineligible for benefits under this title by rea-

961

1 son of confinement based on the information provided by

2 such institution".

3 (c) CORRECTION OF REFERENCE.—Section

4 1611(e)(1)(I)(i)(I) (42 U.S.C. 1382(e)(1)(I)(i)(I)) is

5 amended by striking "paragraph (1)" and inserting "this

6 paragraph".

7 SEC. 5922. CONFORMING AND tECHNICAL AMENDMENTS

8 RELATiNG TO BENEFITS FOR DISABLED

9 CHiLDREN.

10 (a) ELIGIBILITY REDETERMINATIONS FOR CURRENT

11 RECIPIENTS.—Section 211(d)(2)(A) of the Personal Re-


13 1996 (42 U.S.C. 1382c note) is amended by striking "1

14 year" and inserting "18 months".

15 (b) ELIGIBILITY REDETERMINATIONS AND CONTINTJ-

16 ING DISABILITY REVIEWS.—

17 (1) DISABILITY ELIGIBILITY REDETERMINA-

18 TIONS REQUIRED FOR SSI RECIPIENTS WHO ATTAIN

19 18 YEARS OF AGE.—Section 1614(a)(3)(H)(iii) (42

20 U.S.C. 1382c(a)(3)(H)(iii)) is amended by striking

21 subclauses (I) and (II) and all that follows and in-


23 "(I) by applying the criteria used in determin-

24 ing initial eligibility for individuals who are age 18

25 or older; and

.S 947 PCS

962

1 "(II) either during the 1-year period beginning

2 on the individual's 18th birthday or, in lieu of a con-

3 tinuing disability review, whenever the Commissioner

4 determines that an individual's case is subject to a

5 redetermination under this clause.

6 With respect to any redetermination under this clause,

7 paragraph (4) shall not apply.".

8 (2) CoNTINUING DISABILITY REVIEW REQUIRED

9 FOR LOW BIRTH WEIGHT BABIES.—Section

10 1614(a)(3)(H)(iv) (42 U.S.C. 1382c(a)(3)(H)(iv)) is

11 amended—

12 (A) in subclause (I), by striking "Not" and

13 inserting "Except as provided in subclause (VI),

14 not"; and

15 (B) by adding at the end the following:

16 "(VI) Subclause (I) shall not apply in the case of an

17 individual described in that subclause who, at the time of

18 the individual's initial disability determination, the Com-

19 missioner determines has an impairment that is not ex-

20 pected to improve within 12 months after the birth of that

21 individual, and who the Commissioner schedules for a con-

22 tinuing disability review at a date that is after the individ-

23 ual attains 1 year of age.".

.8 947 PCS

963

1 (c) ArDITIoNAL ACCOUNTABILITY REQUIRE-

2 MENTS.—Section 1631(a)(2)(F) (42 U.s.c.

3 1383(a)(2)(F)) is amended—

4 (1) in clause (ii)(III)(bb), by striking "the total

5 amount" and all that follows through "1613(c)" and

6 inserting "in any case in which the individual know-

7 ingly misapplies benefits from such an account, the

8 Conissioner shall reduce future benefits payable to

9 such individual (or to such individual and his

10 spouse) by an. amount equal to the total amount of

11 such benefits so misapplied"; and

12 (2) by striking clause (iii) and inserting the fol-

13 lowing:

14 "(iii) The representative payee may deposit into the

15 account established under clause (i) any other funds rep-

16 resenting past due benefits under this title to the eligible

17 individual, provided that the amount of such past due ben-

18 efits is equal to or exceeds the maximum monthly benefit

19 payable under this title to an eligible individual (including

20 5tate supplementary payments made by the commissioner.

21 pursuant to an agreement under section 1616 or section

22 212(b) of Public Law 93—66).".

23 (d) REDUCTION IN CASH BENEFITS PAYABLE TO IN-

24 STITUTIONALIZED INDWJDUALS WHOSE MEDICAL COSTS

S947PCS--31

964

1 ARE COVERED BY PRIVATE INSURANCE .—Section

2 1611(e) (42 U.S.C. 1382(e)) is amended—

3 (1) in paragraph (1)(B)—

4 (A) in the matter preceding clause (i), by

5 striking "hospital, extended care facility, nurs-

6 ing home, or intermediate care facility" and in-

7 serting "medical treatment facility";

8 (B) in clause (ii)—

9 (i) in the matter preceding subclause

10 (I), by striking "hospital, home or"; and

11 (ii) in subclause (I), by striking "hos-

12 pital, home, or";

13 (C) in clause (iii), by striking "hospital,

14 home, or"; and

15 (D) in the matter following clause (iii), by

16 striking "hospital, extended care facility, nurs-

17 ing home, or intermediate care facility which is

18 a 'medical institution or nursing facility' within

19 the meaning of section 1917(c)" and inserting

20 "medical treatment facility that provides serv-

21 ices described in section 1917(c) (1) (C)";

22 (2) in paragraph (1)(E)—

23 (A) in clause (i)(ll), by striking "hospital,

24 extended care facility, nursing home, or inter-

.8 047 PCS

965

1 mediate care facility" and inserting "medical

2 treatment facility"; and

3 (B) in clause (iii), by striking "hospital,



6 treatment facility";

7 (3) in paragraph (1)(G), in the matter preced-

8 ing clause (i)—

9 (A) by striking "or which is a hospital, ex-

10 tended care facility, nursing home, or inter-

11 mediate care" and inserting "or is in a medical

12 treatment"; and

13 (B) by inserting "or, in the case of an in-

14 dividual who is a child under the age of 18,

15 under any health insurance policy issued by a

16 private provider of such insurance" after "title

17 XIX"; and

18 (4) in paragraph (3)—

19 (A) by striking "same hospital, home, or

facility" and inserting "same medical treatment

facility"; and

(B) by striking "same such hospital, home,

or facility" and inserting "same such facility".

(e) ComEcTIoN OF U.S.C. CITATI0N.—Section

5 2 11(c) of the Personal Responsibility and Work Oppor-

.8 947 PCS

966

1 tunity Reconciliation Act of 1996 (Public Law 104—193;

2 110 Stat. 2189) is amended by striking "1382(a)(4)" and

3 inserting "1382c(a)(4)".

4 SEC. 5923. ADDITIONAL TECHNICAL AMENDMENTS TO

5 TITLE XVI.

6 Section 1615(d) (42 U.S.C. 1382d(d)) is amended—

7 (1) in the first sentence, by inserting a comma

8 after "subsection (a)(1)"; and

9 (2) in the last sentence, by striking "him" and

10 inserting "the Commissioner".

11 SEC. 5924. ADDITIONAL TECHNICAL AMENDMENTS RELAT-

12 ING TO TiTLE XVI.

13 Section 1110(a)(3) (42 U.S.C. 1310(a)(3)) is amend-

14 ed—

15 (1) by inserting "(or the Commissioner, with

16 respect to any jointly financed cooperative agree-

17 ment or grant concerning title XVI)" after "Sec-

18 retary" the first place it appears; and

19 (2) by inserting "(or the Commissioner, as ap-

20 plicable)" after "Secretary" the second place it ap-

21 pears.

22 SEC. 5925. EFFECTiVE DATES.

23 (a) IN GENERAL—Except as provided in subsection

24 (b), the amendments made by this part shall take effeci

25 as if included in the enactment of title II of the Persona

.8 947 PCS

967


2 of 1996 (Public Law 104—193; 110 Stat. 2185).

3 (b) EXCEPTION.—The amendments made by section

4 5925 shall take effect as if included in the enactment of

5 the Social Security Independence and Program Improve-

6 ments Act of 1994 (Public Law 103—2 96; 108 Stat.

7 1464).

978

3 SEC. 5940. COLLECTION AND USE OF SOCIAL SECURITY

4 NUMBERS FOR USE IN C1ITLD SUPPORT EN-

5 FORCEMENT.

6 Section 466(a)(13) (42 U.S.C. 666(a)(13)) is amend-

7ed—


9 (A) by striking "commercial"; and

10 (B) by inserting "recreational license,"

11 after "occupational license,"; and

12 (2) in the matter following subparagraph (C),

13 by inserting "to be used on the face of the document

14 while the social security number is kept on file at

15 the agency" after "other than the social security

16 number".

1000

3 CHAPTER 4—RESTRICTING WELFARE AND

4 PUBLIC BENEFITS FOR ALIENS

5 Subchapter A—Eligibility for Federal

6 Benefits

7 SEC. 5965. ALIEN ELIGIBILITY FOR FEDERAL BENEFITS:

8 LIMITED APPLICATION TO MEDICARE AND

9. BENEFITS UNDER THE RAILROAD RETIRE-

10 MENT ACT.

11 (a) LIMITED APPLICATION TO MEDICARE.—Section

1.2 40 1(b) of the Personal Responsibility and Work Oppor-

13 tunity Reconciliation Act of 1996 (8 U.S.C. 1611(b)) is

14 amended by adding at the end the following:

15 "(3) Subsection (a) shall not apply to any bene-

16 fit payable under title XVIII of the Social Security

17 Act (relating to the medicare program) to an alien

18 who is lawfully present in the United States as de-

19 termined by the Attorney General and, with respect

20 to benefits payable under part A of such title, who

21 was authorized to be employed with respect to any

22 wages attributable to employment which are counted

23 for purposes of eligibility for such benefits.".

24 (b) LIMITED APPLICATION TO BENEFITS UNDER

25 THE RAILROAD RETIREMENT ACT.—Section 401(b) of the

•S 947 PCS

1001

1 Personal Responsibility and Work Opportunity Reconcili-

2 ation Act of. 1996 (8 U.S.C. 1611(b)) (as amended by sub-

3 section (a)) is amended by inserting at the end the follow-

4 ing:


6 fit payable under the Railroad Retirement Act of

7 1974 or the Railroad Unemployment Insurance Act

8 to an alien who is lawfully present in the United

9 States as determined by the Attorney General or to

10 an alien residing outside the United States.".

11 SEC. 5966. EXCEPTIONS TO BENEFIT LIMITATIONS: COR-

12 RECTIONS TO REFERENCE CONCERNING

13 ALIENS WHOSE DEPORTATION IS WITHHELD.

14 Sections 402(a)(2)(A)(i)(III), 402(a)(2)(A)(ii)(III),

15 402(b)(2)(A)(iii), 403(b)(1)(C), 412(b)(1)(C), and

16 431(b)(5) of the Personal Responsibility and Work Oppor-

17 tunity Reconciliation Act of 1996 (8 U.S.C.

18 1612(á)(2)(A)(iii), 1612(b)(2)(A)(iii), 1613(b)(1)(C),

19 1622(b)(1)(C), and 1641(b)(5)) are each amended by

20 striking "section 243(h) of such Act" each place it ap-

21 pears and inserting "section 243(h) of such Act (as in ef-

22 fect immediately before the effective date of section 307

23 of division C of Public Law 104—208) or section 241(b)(3)

24 of such Act (as amended by section 305(a) of division C

25 of Public Law 104—208)".

.S 947 PCS

1002

1 SEC. 5967. VETERANS EXCEPTION: APPLICATION OF MINI-

2 MUM ACTWE DUTY SERVICE REQUIREMENT;

3 EXTENSION TO UNREMARRIED SURVWING

4 SPOUSE; EXPANDED DEFINITION OF VET-

5 ERAN.

6 (a) APPLICATION OF MIMMUM ACTIVE Du'ry SERV-

7 ICE REQUIREMENT .—Sections 402(a) (2) (C) (i),

8 402(b)(2)(C)(i), 403(b)(2)(A), and 412(b)(3)(A) of the


10 ation Act of 1996 (8 U.S.C. 1612(a)(2)(C)(i),

11 1612(b)(2)(C)(i), 1613(b)(2)(A), and 1622(b)(3)(A)) are

12 each amended by inserting "and who fulfifis the minimum

13 active-duty service requirements of section 5303A(d) of

14 title 38, United States Code" after "alienage".

15 (b) EXCEPTION APPLICABLE TO UNREMARRIED SUR-

16 VWING SPOUsE.—Section 402(a)(2)(C)(iii),

17 402(b)(2)(C)(iii), 403(b)(2)(C), and 412(b)(3)(C) of the


19 ation Act of 1996 (8 U.S.C. 1612(a)(2)(C)(iii),

20 1612(b)(2)(C)(iii), 1613(b)(2)(C), and 1622(b)(3)(C)) are

21 each amended by inserting before the period "or the

22 unremarried surviving spouse of an individual described

23 in clause (i) or (ii) who is deceased if the marriage fulfills

24 the requirements of section 1304 of title 38, United States

25 Code".

•S 947 PCS

1003

1 (c) EXPANDED DEFINITION OF VETERAN.—Sections

2 402(a)(2)(C)(i), 402(b)(2)(C)(i), 403(b)(2)(A), and

3 412(b)(3)(A) of the Personal Responsibility and Work Op-


5 1612(a)(2)(C)(i), 1612(b)(2)(C)(i), 1613(b)(2)(A), and

6 1622(b)(3)(A)) are each amended by inserting ", 1101,

7 or 1301, or as described in section 107" after "section

8 101".

9 SEC. 5968. CORRECTION OF REFERENCE CONCERNING

10 CUBAN AND HAITIAN ENTRANTS.

11 Section 403(d) of the Personal Responsibility and


13 1613(d)) is amended—

14 (1) by striking "section 501 of the Refugee"

15 and insert "section 50 1(a) of the Refugee"; and

16 (2) by striking "section 501(e)(2)" and insert-

17 ing "section 01(e)".

18 SEC. 5969. NOTIFICATION CONCERNING ALIENS NOT LAW-

19 FULLY PRESENT: CORRECTION OF TERMI-

20 NOLOGY.

21 Section 1631(e)(9) of the Social Security Act (42

22 U.S.C. 1383(e)(9)) and section 27 of the United States

23 Housing Act of 1937, as added by section 404 of the Per-


25 Act of 1996, are each amended by striking "unlawfully

.S 947 PCS

1004

1 in the United States" each place it appears and inserting

2 "not lawfully present in the United States".

3 SEC. 5970. FREELY ASSOCIAIED STATES: CONTRACTS AND

4 LICENSES.

5 Sections 401(c)(2)(A) and 411(c)(2)(A) of the Per-


7 Act of 1996 (8 U.S.C. 1611(c)(2)(A) and 1621(c)(2)(A))

8 are each amended by inserting before the semicolon at the

9 end ", or to a citizen of a freely associated state, if section

10 141 of the applicable compact of free association approved

11 in Public Law 99—239 or 99—658 (or a successor provi-

12 sion) is in effect".

13 SEC. 5971. CONGRESSIONAL STATEMENT REGARDING BEN-

14 EFITS FOR HMONG AND OTHER HIGHLAND

15 LAO VETERANS.

16 (a) FINDINGS.—The Congress makes the following

17 findings:

18 (1) Hmong and other Highland Lao tribal peo-

19 ples were recruited, armed, trained, and funded for

20 military operations by the United States Department

21 of Defense, Central Intelligence Agency, Department

22 of State, and Agency for International Development

23 to further United States national security interests

24 during the Vietnam conflict.

'S 947 PCS

1005

1 (2) Hmong and other Highland Lao tribal

2 forces sacrificed their own lives and saved the lives

3 of American military personnel by rescuing downed

4 American pilots and aircrews and by engaging and

5 successfully fighting North Vietnamese troops.

6 (3) Thousands of Hmong and other Highland

7 Lao veterans who fought in special guerilla units on

8 behalf of the United States during the Vietnam con-

9 flict, along with their families, have been lawfully ad-

10 mitted to the United States in recent years.

11 (4) The Personal Responsibility and Work Op-

12 portunity Reconciliation Act of 1996 (Public Law

13 104—193), the new national welfare reform law, re-

14 stricts certain welfare benefits for noncitizens of the

15 United States and the exceptions for noncitizen vet-

16 erans of the Armed Forces of the United States do

17 not extend to Hmong veterans of the Vietnam con-

18 flict era, making Hmong veterans and their families

19 receiving certain welfare benefits subject to restric-

20 tions despite their military service on behalf of the

21 United States.

22 (b) CONGRESSIONAL STATEMENT.—It is the sense of

23 the Congress that Hmong and other Highland Lao veter-

24 ans who fought on behalf of the Armed Forces of the Unit-

25 ed States during the Vietnam conflict and have lawfully

.S 947 PCS

1006

1 been admitted to the United States for permanent resi-

2 dence should be considered veterans for purposes of con-

3 tinuing certain welfare benefits consistent with the excep-

4 tions provided other noncitizen veterans under the Per-


6 Actof 1996.

7 Subchapter B—General Provisions

8 SEC. 5972. DETERMINATION OF TREATMENT OF BAFERED

9 ALIENS AS QUALIFIED ALIENS; INCLUSION

10 OF ALIEN CHILD OF BATTERED PARENT AS

11 QUALIFIED ALIEN.

12 (a) DETERMINATION OF STATUS BY AGENCY PRO-

13 VIDING BENEFITS.—Section 431 of the Personal Respon-

14 sibility and Work Opportunity Reconciliation Act of 1996

15 (8 U.S.C. 1641) is amended in subsections (c)(1)(A) and

16 (c)(2)(A) by striking "Attorney General, which opinion is

17 not subject to review by any court)" each place it appears

18 and inserting "agency providing such benefits)".

19 (b) GUIDANCE ISSUED BY ATTORNEY GENERAL.—

20 Section 431(c) of the Personal Responsibility and Work

21 Opportunity Reconciliation Act of 1996 (8 U.S.C.

22 1641(c)) is amended by adding at the end the following

23 new undesignated paragraph:

24 "After consultation with the Secretaries of Health

25 and Human Services, Agriculture, and Housing and

.S 947 PCS

1007

1 Urban Development, the Commissioner of Social Security,

2 and with the heads of such Federal agencies administering

3 benefits as the Attorney General considers appropriate,

4 the Attorney General shall issue guidance (in the Attorney

5 General's sole and unreviewable discretion) for purposes

6 of this subsection and section 421(f), concerning the

7 meaning of the terms 'battery' and 'extreme cruelty', and

8 the standards and methods to be used for determining

9 whether a substantial connection exists between battery or

10 cruelty suffered and an individual's need for benefits

11 under a specific Federal, State, or local program.".

12 (c) INCLUSION OF ALIEN CmLD OF BATTERED PAR-

13 ENT AS QUALIFIED ALIEN.—Section 43 1(c) of the Per-


15 Act of 1996 (8 U.S.C. 1641(c)) is amended—

16 (1) at the end of paragraph (1)(B)(iv) by strik-

17 ing "or";

18 (2) at the end of paragraph (2)(B) by striking

19 the period and inserting "; or"; and

20 (3) by inserting after paragraph (2)(B) and be-

21 fore the last sentence of such subsection the follow-

22 ing new paragraph:

23 "(3) an alien child who—

24 "(A) resides in the same household as a

25 parent who has been battered or subjected• to

'S 947 PCS

1008

1 extreme cruelty in the United States by that

2 parent's spouse or by a member of the spouse's

3 family residing in the same household as the

4 parent and the spouse consented or acquiesced

5 to such battery or cruelty, but only if (in the

6 opinion of the agency providing such benefits)

7 there is a substantial connection between such

8 battery or cruelty and the need for the benefits

9 to be provided; and

10 "(B) who meets the requirement of sub-

11 paragraph (B) of paragraph (1).".

12 (d) INCLusION OF ALIEN CHILD OF BATTERED PAI-

13 ENT UNDER SPECIAL RULE FOR ATTRIBUTION OF IN-

14 COME.—Section 421(f)(1)(A) of the Personal Responsibil-

15 ity and Work Opportunity Reconciliation Act of 1996 (8

16 U.S.C. 1631(f)(1)(A)) is amended—

17 (1) at the end of clause (i) by striking "or";

18 and

19 (2) by striking "and the battery or cruelty de-

20 scribed in clause (i) or (ii)" and inserting "or (iii)

21 the alien is a child whose parent (who resides in the

22 same household as the alien child) has been battered

23 or subjected to extreme cruelty in the United States

24 by that parent's spouse, or by a member of the

25 spouse's family residing in the same household as

.S 947 PCS

1009

1 the parent and the spouse consented to, or acqui-

2 esced in, such battery or cruelty, and the battery or

3 cruelty described in clause (i), (ii), or (iii)".

4 SEC 5973. VERIFICATION OF ELIGIBILITY FOR BENEFITS.

5 (a) REGULATIONS AND GUIDANCE.—Section 432(a)

6 of the Personal &sponsibility and Work Opportunity &c-

7 onciliation Act of 1996 (8 U.S.C. 1642(a)) is amended—

8 (1) by inserting at the end of paragraph (1) the

9 following: "Not later than 90 days after the date of

10 the enactment of the Welfare Reform Technical Cor-

11 rections Act of 1997, the Attorney General of the

12 United States, after consultation with the Secretary

13 of Health and Human Services, shall issue interim

14 verification guidance."; and

15 (2) by adding after paragraph (2) the following

16 new paragraph:

17 "(3) Not later than 90 days after the date of the en-

18 actment of the Welfare &form Technical Corrections Act

19 of 1997, the Attorney General shall promulgate regula-

20 tions which set forth the procedures by which a State or

21 local government can verify whether an alien applying for

22 a State or local public benefit is a qualified alien, a non-

23 immigrant under the Immigration and Nationality Act, or

24 an alien paroled into the United States under section

25 212(d)(5) of the Immigration and Nationality Act for less

.S 947 PCS

1010

1 than 1 year, for purposes of determining whether the alien

2 is ineligible for benefits under section 411 of this Act.".

3 (b) DISCLOSURE OF INFORMATION FOR VERIFICA-

4 TION.—Section 3 84(b) of the Illegal Immigration Reform

5 and Immigrant Responsibility Act of 1996 (division C of

6 Public Law 104—208) is amended by adding after para-

7 graph (4) the following new paragraph:

8 "(5) The Attorney General is authorized to dis-

9 close information, to Federal, State, and local public

10 and private agencies providing benefits, to be used

11 solely in making determinations of eligibility for ben-

12 efits pursuant to section 431(c) of the Personal Re-

13 sponsibility and Work Opportunity Reconciliation

14 Act of 1996.".

15 SEC. 5974. QUALWYING QUARTERS: DISCLOSURE OF QUAR-

16 TERS OF COVERAGE INFORMATION; CORREC-

17 TION TO ASSURE THAT CREDITING APPLIES

18 TO ALL QUARTERS EARNED BY PARENTS BE-

19 FORE CHILD IS 18.

20 (a) DISCLOSURE OF QUARTERS OF COVERAGE IN-

21 FORMATION.—Section 435 of the Personal Responsibility

22 and Work Opportunity Reconciliation Act of 1996 (8

23 U.S.C. 1645) is amended by adding at the end the follow-

24 ing: "Notwithstanding section 6103 of the Internal Reve-

25 nue Code of 1986, the Commissioner of Social Security

.S 947 PCS

1011

1 is authorized to disclose quarters of coverage information

2 concerning an alien and an alien's spouse or parents to

3 a government agency for the purposes of this title.".

4 (b) CORRECTION To ASSURE THAT CREDITING AP-

5 PLIES TO ALL QUARTERS EARNED BY PARENTS BEFORE

6 CHILD IS 18.—Section 435(1) of the Personal Respon-


8 (8 U.S.C. 1645(1)) is amended by striking "while the alien

9 was under age 18," and inserting "before the date on

10 which the alien attains age 18,".

11 SEC. 5975. STATUTORY CONSTRUCTION: BENEFIT ELIGI-

12 BILITY LIMITATIONS APPLICABLE ONLY

13 WITH RESPECT TO ALIENS PRESENT IN THE

14 UNITED STATES.

15 Section 433 of the Personal Responsibility and Work

16 Opportunity Reconciliation Act of 1996 (8 U.S.C. 1643)

17 is amended—

18 (1) by redesignated subsections (b) and (c) as

19 subsections (c) and (d); and

20 (2) by adding after subsection (a) the following

21 new subsection:

22 "(b) BENEFIT ELIGIBILITY LIMITATIONS APPLICA-

23 BLE ONLY WITH RESPECT TO ALIENS PRESENT IN THE

24 UMTED STATES.—Notwithstanding any other provision

25 of this title, the limitations on eligibility for benefits under

.8 947 PCS

1012

1 this title shall not apply to eligibility for benefits of aliens

2 who are not residing, or present, in the United States with

3 respect to—

4 "(1) wages, pensions, annuities, and other

5 earned payments to which an alien is entitled result-

6 ing from employment by, or on behalf of, a Federal,

7 State, or local government agency which was not

8 prohibited during the period of such employment or

9 service under section 274A or other applicable provi-

10 sion of the Immigration and Nationality Act; or

11 "(2) benefits under laws administered by the

12 Secretary of Veterans Affairs.".

13 Subchapter C—Miscellaneous Clerical and

14 Technical Amendments; Effective Date

15 SEC. 5976. CORRECTING MISCELLANEOUS CLERICAL AND

16 TECHNICAL ERRORS.

17 (a) INFORMATION REPORTING UNDER TITLE IV OF

18 THE SocIAi SEcuRITY AcT.—Effective July 1, 1997, sec-

19 tion 408 of the Social Security Act (42 U.S.C. 608), as

20 amended by section 5903, and as in effect pursuant to

21 section 116 of the Personal Responsibility and Work Op-

22 portunity Reconciliation Act of 1996, and as amended by

23 section 5906(e) of this Act, is amended by adding at the

24 end the following new subsection:

oS 947 PCS

1013

1 "(f) STATE REQUIRED To PROVIDE CERTAIN INFOR-

2 MATION.—Each State to which a grant is made under sec-

3 tion 403 shall, at least 4 times annually and upon request

4 of the Immigration and Naturalization Service, furnish the

5 Immigration and Naturalization Service with the name

6 and address of, and other identifying information on, any

7 individual who the State knows is not lawfully present in

8 the United States.".

9 (b) MISCELLANEOUS CLERICAL AND TECHNICAL

10 CORRECTIONS.—

11 (1) Section 411(c)(3) of the Personal Respon-

12 sibility and Work Opportunity Reconciliation Act of

13 1996 (8 U.S.C. 1621(c)(3)) is amended by striking

14 "4001(c)" and inserting "401(e)".

15 (2) Section 422(a) of the Personal Responsibil-

16 ity and Work Opportunity Reconciliation Act of

17 1996 (8 U.S.C. 1632(a)) is amended by striking

18 "benefits (as defined in section 412(c))," and insert-

19 ing "benefits,".

20 (3) Section 412(b)(1)(C) of the Personal Re-

21 sponsibiity and Work Opportunity Reconciliation

22 Act of 1996 (8 U.S.C. 1622(b)(1)(C)) is amended by

23 striking "with-holding" and inserting "withholding".

24 (4) The subtitle heading for subtitle D of title

25 IV of the Personal Responsibility and Work Oppor-

1014

1 tunity Reconciliation Act of 1996 is amended to

2 read as follows:

1015



3 by this chapter shall be effective as if included in the en-



Calendar No. 91

105Th CONGRESS1ST SESSION

A BILLTo provide for reconciliation pursuant to section

104(a) of the concurrent resolution on the budgetfor fiscal year 1998.

Jur. 20, 1997Read twice and placed on the calendar

S6100 CONGRESSIONAL RECORD — SENATE June 23, 1997

DODD AMENDMENT NO. 425(Ordered to lie on the table.)Mr. DODD submitted an amendment

• intended to be proposed by him to thebill, S. 947, to provide for reconciliationpursuant to section 104(a) of the con-current resolution on the budget forfiscal year 1998; as follows:

On page 874, between lines 7 and 8. insertthe following:sEC. 5817A. CONTINUATION OF MEDICAID ELIGI-

BILITY FOR DISABLED CHILDRENWHO LO5E SSI BENEFITS.

(a) IN GE'4ERAL.—SectiOn 1902(a) (10(A) (i) (II)(42 U.S.C. 396a(a)(10(A)(i)(II)) is amended byinserting (or were being paid as of the dateof enactment of section 211(a) of the Per-sonal Resnsibility and Work OpportunityAct of 1996 (Public Law 104—193: 110 Stat. 2188)and would continue to be paid but for the en-actment of that section)' after "title XVI".

(b) EFFECTIVE DATE.—The amendmentmade by subsection (a) applies to medical as-sistance furnished on or after July 1, 1997.

S6251

HUTCHISON (AND SANTORUM)AMENDMENT NO. 446

Mrs. HUTCHISON (for herself andMr. SANTORUIvI) proposed an amend-ment to the bill, 5. 947, supra; as fol-lows:

At the end of title I. add the following:SEC. 1O_. DENIAL OF FOOD STAMPS FOR PRIS-

ONERS.(a) STATE PLANS.—(1) IN GENERAL—Section 11(e) of the Food

Stamp Act of 1977 (7 U.S.C. 2020(e)) is amend-ed by striking paragraph (20) and insertingthe following:

(20) that the State agency shall establisha system and take action on a periodicbasis—

'(A) to verify and otherwise ensure that anindividual does not receive coupons in morethan I jurisdiction within the State; and

'(B) to verify and otherwise ensure that anindividual who is placed under detention in aFederal, State, or local penal, correctional,or other detention facility for more than 30days shall not be eligible to participate inthe food stamp program as a member of anyhousehold, except that—

(i) the Secretary may determine that ex-traordinary circumstances make it imprac-ticable for the State agency to obtain infor-mation necessary to discontinue inclusion ofthe individual; and

'(ii) a State agency that obtains informa-tion collected under section 1611(e)(1)(I)(i)(I)of the Social Security Act (42 U.S.C.1382(e)(1)(I)(i)(I)) through an agreementunder section 1611(e)(1)(I)(ii)(II) of that Act(42 U.S.C. 1382(e)(1)(I)(ii)(II)), or under an-other program determined by the Secretaryto be comparable to the program carried Outunder that section, shall be considered incompliance with this subparagraph.".

(2) LIMITs ON DISCLOSURE AND USE OF INFOR-MATION.—Section 11(e)(8)(E) of the FoodStamp Act of 1977 (7 U.S.C. 2020(e)(8)(E)) isamended by striking "paragraph (16)" andinserting 'paragraph (16) or (20)(B)".

(3) EFFECTIVE DATE.—(A) IN GENERAL—Except as provided in

subparagraph (B), the amendments made bythis subsection shall take effect on the datethat is 1 year after the date of enactment ofthis Act.

(B) EXTENSION—The Secretary of Agri-culture may grant a State an extension oftime to comply with the amendments madeby this subsection, not to exceed beyond thedate that is 2 years after the date of enact-ment of this Act, if the chief executive offi-cer of the State submits a request for the ex-tension to the Secretary—

(i) stating the reasons why the State is notable to comply with the amendments madeby this subsection by the date that is 1 yearafter the date of enactment of this Act;

(ii) providing evidence that the State ismaking a good faith effort to comply withthe amendments made by this subsection assoon as practicable; and

(iii) detailing a plan to bring the State intocompliance with the amendments made by

this subsection as soon as practicable andnot later than the date of the requested ex-tension.

(b) INFORMATION SHARING—Section 11 ofthe Food Stamp Act of 1977 (7 U.S.C. 2020) isamended by adding at the end the following:

"(q) DENIAL OF FOOD STAMPS FOR PRIS-ONERS.—The Secretary shall assist States, tothe maximum extent practicable, in imple-menting a system to conduct computermatches or other systems to prevent pris-oners described in section 11(e)(20)(B) fromreceiving food stamp benefits.".SEC. 1O. NUTRITION EDUCATION.

Section 11(f) of the Food Stamp Act of 1977(7 U.S.C. 2020(f)) is amended—

(1) by striking '(f) To encourage" and in-serting the following:

(f) NUTRITION EDUCATION.—'(1) IN GENERAL—To encourage' and(2) by adding at the end the following:"(2) GRANTS.—

(A) IN GENERAL—The Secretary shallmake available not more than $600,000 foreach of fiscal years 1998 through 2001 to paythe Federal share of grants made to eligibleprivate nonprofit organizations and Stateagencies to carry Out subparagraph (B).

'(B) ELIGIBILITY—A private nonprofit or-ganization or State agency shall be eligibleto receive a grant under subparagraph (A) ifthe organization or agency agrees—

(i) to use the funds to direct a collabo-rative effort to coordinate and integrate nu-trition education into health, nutrition, so-cial service, and food distribution programsfor food stamp participants and other low-in-come households; and

'(ii) to design the collaborative effort toreach large numbers of food stamp partici-pants and other low-income householdsthrough a network of organizations, includ-ing schools, child care centers, farmers' mar-kets, health clinics, and outpatient edu-cation services.

(C) PREFERENCE—In deciding between 2or more private nonprofit organizations orState agencies that are eligible to receive agrant under subparagraph (B), the Secretaryshall give a preference to an organization oragency that conducted a collaborative effortdescribed in subparagraph (B) and receivedfunding for the collaborative effort from theSecretary before the date of enactment ofthis paragraph.

'(D) FEDERAL SHARE.—'(i) IN GENERAL—Subject to subparagraph

(E), the Federal share of a grant under thisparagraph shall be 50 percent.

'(ii) NO IN-KIND CONTRIBUTIONS—The non-Federal share of a grant under this para-graph shall be in cash.

'(iii) PRIVATE FUNDS—The non-Federalshare of a grant under this paragraph mayinclude amounts from private nongovern-mental sources.

'(E) LIMIT ON INDIVIDUAL GRANT—A grantunder subparagraph (A) may not exceed$200,000 for a fiscal year.".

AMENDMENTS SUBMITTED

THE BALANCED BUDGET ACT OF1997

S6254

DURBIN (AND OTHERS)AMENDMENT NO. 450

Mr. DURBIN (for himself, Mr.WELLSTONE, and Mrs. BOxER) proposedan amendment to the bill, S. 947, supra:as follows:

At the end of title I, add the following:SEC. 10 . FOOD 5TAMP BENEFIT5 FOR CHILD IM-

MIGRANTS.

(a) IN GENERAL—Section 402(a)(2) of thePersonal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 (8 U.S.C.1612(a)(2)) is amended by adding at the endthe following:

'(E) CHILD IMMIGRANTS—In the case of theprogram specified in paragraph (3)(B), para-graph (1) shall not apply to a qualified alienwho is under 18 years of age.

(b) ALLOCATION OF ADMINISTRATIVECOSTS—SectiOn 408(a) of the Social SecurityAct (42 U.S.C. 608(a)) is amended by adding atthe end the following:

(12) DEsIGNATION OF GRANTS UNDER THISPART AS PRJMARY PROGRAM IN ALLOCATING AD-MINISTRATIVE COSTS.—

'(A) IN GENERAL_Notwithstanding anyother provision of law, a State shall des-ignate the program funded under this part asthe primary program for the purpose of allo-cating costs incurred in serving families eli-gible or applying for benefits under the Stateprogram funded under this part and anyother Federal means-tested benefits.

(B) ALLOCATION OF COSTS.—(i) IN GENERAL.—The Secretary shall re-

quire that costs described in subparagraph(A) be allocated in the same manner as the

CONGRESSIONAL RECORD — SENATE

costs were allocated by State agencies thatdesignated part A of title IV as the primaryprogram for the purpose of allocating admin-istrative costs before August 22, 1996.

(ii) FLEXIBLE ALLOCATION—The Secretarymay allocate costs under clause (i) dif-ferently if a State can show good cause foror evidence of increased costs, to the extentthat the administrative costs allocated tothe primary program are not reduced bymore than 33 percent.

(13) FAILURE TO ALLOCATE ADMINISTRATIVECOSTS TO GRANTS PROVIDED UNDER THISPART.—If the Secretary determines that,with respect to a preceding fiscal year, aState has not allocated administrative costsin accordance with paragraph (12), the Sec-retary shall reduce the grant payable to theState under section 403(a) (1) for the succeed-ing fiscal year by an amount equal to—

'(A) the amount the Secretary determinesshould have been allocated to the programfunded under this part in such preceding fis-cal year; minus

(B) the amount that the State allocatedto the program funded under this part insuch preceding fiscal year.

June 24, 1997

MCCAIN (AND KERRY)AMENDMENT NO. 461

Mr. DOMENICI (for Mr. MCCAIN, forhimself and Mr. KERRY) proposed anamendment to the bill, S. 947. supra: asfollows:

On page 874, between lines 7 and 8, insertthe following:SEC. 5817A. TREATMENT OF CERTAIN AMERASIAN


GEES/ASYLEES(1) FOR PURPOSES OF SSI AND FOOD

STAMPS—Section 402(a) (2) (A) of the PersonalResponsibility and Work Opportunity Rec-onciliation Act of 1996 (8 U.S.C. 1612(a)(2)(A))is amended—

(A) by striking "; or at the end of clause(ii):

(B) by striking the period at the end ofclause (iii) and inserting ': or"; and

(C) by adding at the end the following:"(iv) an alien who is admitted to the Unit-

ed States as an Amerasian immigrant pursu-ant to section 584 of the Foreign Operations,Export Financing, and Related Programs Ap-propriations Act, 1988 (as contained in sec-tion 101(e) of Public Law 100-202 and amend-ed by the 9th proviso under MIGRATION ANDREFUGEE ASSISTANCE in title II of the ForeignOperations, Export Financing, and RelatedPrograms Appropriations Act, 1989, PublicLaw 100-461, as amended).'.

(2) FOR PURPOSES OF TANF, SSBG, AND MED-ICAID—Section 402(b) (2) (A) of the PersonalResponsibility and Work Opportunity Rec-onciliation Act of 1996 (8 U.S.C. 1612(a) (2) (A))is amended—

(A) by striking "; or' at the end of clause(ii);

(B) by striking the period at the end ofclause (iii) and inserting '; or"; and

(C) by adding at the end the following:"(iv) an alien described in subsection

(a) (2) (A) (iv) until 5 years after the date ofsuch alien's entry into the United States.'.

(3) FOR PURPOSES OF EXCEPTION FROM 5-YEAR LIMITED ELIGIBILITY OF QUALIFIEDALIENS—Section 403(b)(1) of the Personal Re-sponsibility and Work Opportunity Rec-onciliation Act of 1996 (8 U.S.C. 1613(b)(1)) isamended by adding at the end the following:


(4) FOR PURPOSES OF CERTAIN STATE PRO-GRAMS—Section 412(b) (1) of the Personal Re-sponsibility and Work Opportunity Rec-onciliation Act of 1996 (8 U.S.C. 1622(b)(1)) isamended by adding at the end the followingnew subparagraph:



(b) F'UNDING.—(1) LEVY OF FEE—The Attorney General

through the Immigration and NaturalizationService shall levy a $150 processing fee uponeach alien that the Service determines—

(A) is unlawfully residing in the UnitedStates;

(B) has been arrested by a Federal law en-forcement officer for the commission of a fel-ony: and

(C) merits deportation after having beendetermined by a court of law to have com-mitted a felony while residing illegally inthe United States.

(2) COLLECTION AND USE—In addition toany other penalty provided by law, a courtshall impose the fee described in paragraph(1) upon an alien described in such paragraphupon the entry of a Judgment of deportationby such court. Funds collected pursuant tothis subsection shill be credited by the Sec-retary of the Treasury as offsetting in-creased Federal outlays resulting from theamendments made by section 5817A of theBalanced Budget Act of 1997.

(c) EFFECTIVE DATE—The amendmentsmade by this section shall be effective withrespect to the period beginning on or afterOctober 1, 1997.

S6257

BROWNBACK (AND KOHL)AMENDMENT NO. 464

Mr. DOMENICI (for Mr. BROwNBACK,for himself and Mr. KOHL) proposed anamendment to the bill, S. 947, supra: asfollows:

At the end of the _, add the following:TITLE —BUDGET CONTROL

SEC. _O1. SHORT TITLE; PURPOSE.(a) SHORT TITLE—This title may be cited

as the "Bipartisan Budget Enforcement Actof 1997'.

(b) PURPOSE—The purpose of this title is—(1) to ensure a balanced Federal budget by

fiscal year 2002:(2) to ensure that the Bipartisan Budget

Agreement is implemented: and(3) to create a mechanism to monitor total

costs of direct spending programs. and, inthe event that actual or projected costs ex-ceed targeted levels, to require the Presidentand Congress to address adjustments in di-rect spending.SEC. _O2, ESTABLISHMENT OF DIRECT SPEND-

ING TARGETS.(a) IN GENERAL—The initial direct spend-

ing targets for each of fiscal years 1998through 2002 shall equal total outlays for alldirect spending except net interest as deter-mined by the Director of the Office of Man-agement and Budget (hereinafter referred toin this title as the 'Director') under sub-section (b)

(b) INITIAL REPORT BY DIRECTOR.—(1) IN GENERAL—Not later than 30 days

after the date of enactment of this title, theDirector shall submit a report to Congresssetting forth projected direct spending tar-gets for each of fiscal years 1998 through 2002.

(2) PROJECTIONS AND ASSUMPTIONS—TheDirector's projections shall be based on legis-lation enacted as of 5 days before the reportis submitted under paragraph (1). The Direc-tor shall use the same economic and tech-nical assumptions used in preparing the con-current resolution on the budget for fiscalyear 1998 (H.Con.Res. 84).SEC. _03. ANNUAL REVIEW OF DIRECT SPEND-

ING AND RECEIPTS BY PRESIDENT.As part of each budget submitted under

section 1105(a) of title 31, United StatesCode, the President shall provide an annualreview of direct spending and receipts, whichshall include—

(1) information on total outlays for pro-grams covered by the direct spending tar-gets, including actual outlays for the priorfiscal year and projected outlays for the cur-rent fiscal year and the 5 succeeding fiscalyears; and

(2) information on the major categories ofFederal receipts, including a comparison be-tween the levels of those receipts and thelevels projected as of the date of enactmentof this title.SEC. _04. SPECIAL DIRECT SPENDING MES-

SAGE BY PRESIDENT.(a) TRIGGER—If the information submitted

by the President under section _03 indi-cates—

June 24, 1997

(1) that actual outlays for direct spendingii the prior fiscal year exceeded the applica-ble direct spending target; or

(2) that outlays for direct spending for thecurrent or budget year are projected to ex-ceed the applicable direct spending targets.the President shall include in his budget aspeciaR direct spending message meeting therequirements of subsection (b).

(b) CONTENTS.—(1) INCLUSIONS—The special direct spend-

ing message shall include—(A) an analysis of the variance in direct

spending over the direct spending targets;and

(B) the President's recommendations foraddressing the direct spending overages. ifany, in the prior, current, or budget year.

(2) ADDITIONAL MATrERS.—The President'srecommendations may consist of any of thefollowing:

(A) Proposed legislative changes to recoupor eliminate the overage for the prior, cur-rent, and budget years in the current year,the budget year. and the 4 outyears.

(B) Proposed legislative changes to recoupor eliminate part of the overage for theprior, current, and budget year in the cur-rent year. the budget year, and the 4 out-years, accompanied by a finding by thePresident that. because of economic condi-tions or for other specified reasons, onlysome of the overage should be recouped oreliminated by outlay reductions or revenueincreases, or both.

(C) A proposal to make no legislativechanges to recoup or eliminate any overage.accompanied by a finding by the Presidentthat. because of economic conditions or forother specified reasons. no legislativechanges are warranted.

(c) PROPOSED SPECIAL DIRECT SPENDINGRESOLUTION—If the President recommendsreductions consistent with subsection(b)(2)(A) or (B), the special direct spendingmessage shall include the text of a specialdirect spending resolution implementing thePresidents recommendations through rec-onciliation directives instructing the appro-priate committees of the House of Represent-atives and Senate to determine and rec-ommend changes in laws within their Juris-dictions. If the President recommends no re-ductions pursuant to (b) (2) (C) the special di-rect spending message shall include the textof a special resolution concurring in thePresident's recommendation of no legislativeaction.

CONGRESSIONAL RECORD — SENATESEC. _06. RELATIONSHIP TO BALANCED BUDG-

ET AND EMERGENCY DEFICIT CON-TROL ACT.

Reductions in outlays or increases in re-ceipts resulting from legislation reportedpursuant to section _05 shall not be takeninto account for purposes of any budget en-forcement procedures under the BalancedBudget and Emergency Deficit Control Actof 1985.SEC. _07. ESTIMATING MARGIN.

For any fiscal year for which the overageis less than one-half of 1 percent of the directspending target for that year, the proceduresset forth in sections 04 and _05 shallnot apply.SEC. _08. EFFECTIVE DATE.

This title shall apply to direct spendingtargets for fiscal years 1998 through 2002 andshall expire at the end of fiscal year 2002.

June 24, 1997

SEC. _05. REQUIRED RESPONSE BY CONGRESS.

(a) IN GENEL.—It shall not be in order inthe House of Representatives or the Senateto consider a concurrent resolution on thebudget unless that concurrent resolutionfully addresses the entirety of any overagecontained in the applicable report of thePresident under section __04 through rec-onciliation directives.

(b) WAIVER AND SUSPENSION—This sectionmay be waived or suspended in the Senateonly by the affirmative vote of three-fifthsof the Members, duly chosen and sworn. Thissection shall be subject to the provisions ofsection 258 of the Balanced Budget andEmergency Deficit Control Act of 1985.

(c) APPEALS—Appeals in the Senate fromthe decisions of the Chair relating to anyprovsion of this section shall be limited to 1hour, to be equally divided between. and con-trolled by, the appellant and the manager ofthe bill or joint resolution. as the case maybe. An affirmative vote of three-fifths of theMembers of the Senate, duly chosen andsworn, shall be required in the Senate to sus-tain an appeal of the ruling of the Chair ona point of order raised under this section.

S6262

LAUTENBERG AMENDMENT NO. 475Mr. LAUTENBERG proposed an

amendment to the bill, S. 947. supra: asfollows:

AMENDMENT NO. 415

(Purpose: to ensure that certain legal immi-grants who become disabled are eligible fordisability benefits)On page 8971, strike line 9—11.


Act (42 U.S.C. 608(a)) is amended by adding atthe end the following:

'(12) DESIGNATION OF GRANTs UNDER TI-115PART A5 PRIMARY PROGRAM IN ALLOCATING AD-MINI5TRATIVE COSTS——

'(A) IN GENERAL—Notwithstanding anyother provision of law, a State shall des-ignate the program funded under this part asthe primary program for the purpose of allo-cating costs incurred in serving families eli-gible or applying for benefits under the Stateprogram funded under this part and anyother Federal means-tested benefits.

(B) ALLOCATION OF COSTS.—-—(i) IN GENERAL—The Secretary shall re-

quire that costs described in subparagraph(A) be allocated in the same manner as thecosts were allocated by State agencies thatdesignated part A of title IV as the primaryprogram for the purpose of allocating admin-istrative costs before August 22, 1996.

• (iii) FLEXIBLE ALLOCATION—The Sec-retary may allocate costs under clause (i)differently, if a State can show good causefor or evidence of increased costs, to the ex-tent that the administrative costs allocatedto the primary program are not reduced bymore than 33 percent.

'(13) FAILURE TO ALLOCATE ADMINISTRATIVECOSTS TO GRANTS PROVIDED UNDER TI-US

PART—If the Secretary determines that,with respect to a preceding fiscal year. aState has not allocated administrative costsin accordance with paragraph (12). the Sec-retary shall reduce the grant payable to theState under section 403(a) (1) for the succeed-ing fiscal year by an amount equal to——


'(B) the amount that the State allocatedto the program funded under this part insuch preceding fiscal year.".

June 24, 1997

sponsibility and Work Opportunity Act of1996 (Public law 104—193; 110 Stat. 2188) andwould continue to be paid but for the enact-ment of that section )" after title XVI".

(b) OFFSET—Section 2103(b) of the SocialSecurity Act (as added by section 5801) isamended——

(1) in paragraph (2), by striking 'and" andat the end;

(2) in paragraph (3), by striking the periodand inserting ; and"; and

(3) by adding at the end the following:(4) the amendment made by section

5817A(a) of the Balanced Budget Act of 1997(relating to continued eligibility for certaindisabled children).'.

(c) EFFECTIVE DATE—The amendmentmade by subsection (a) applies to medical as-sistance furnished on or after July 1, 1997.

DURBIN (AND OTHERS)AMENDMENT NO. 477

Mr. LAUTENBERG (for Mr. DURBIN,for himself, Mr. WELLSTONE, and Mrs.BoxER) proposed an amendment to thebill, 5. 947, supra; as follows:

At the end of title I. add the following:SEC. 10. FOOD STAMP BENEFITS FOR CHILD IM-

MIGRANTS.(a) IN GENERAL—SectiOn 402(a)(2) of the

Personal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 (8 U.S.C.1612(a)(2)) is amended by adding at the endthe following:

(E) CHILD IMMIGRANTS—In the case of theprogram specified in paragraph (3) (B), para-graph (1) shall not apply to a qualified alienwho is under 18 years of age.".

(b) ALLOCATION OF ADMINISTRATIVECOSTS—Section 408(a) of the Social Security

DODD AMENDMENT NO. 479Mr. LAUTENBERG (for Mr. DODD)

proposed an amendment to the bill, S.947, supra; as follows:

On page 874, between lines 7 and 8, insertthe following:SEC. 5817A. CONTINUATION OF MEDICAID ELIGI-

BILITY FOR DISABLED CHILDRENWHO LOSE SSI BENEFITS.

(a) IN GENERAL—Section1902(a)(10)(A)(i)(II) (42 U.S.C.1396a(a) (10) (A) (i) (II)) is amended by inserting'(or were being paid as of the date of enact-ment of section 2 11(a) of the Personal Re-

June 24, 1997 CONGRESSIONAL RECORD — SENATE S6265tion 5801, insert the following: The benefitsshall include additional benefits to meet theneeds of children with special needs, includ-ing—

'(A) rehabilitation and habilitation serv-ices, including occupational therapy, phys-ical therapy, speech and language therapy,and respiratory therapy services;

'(B) mental health services;'(C) personal care services;"(D) customized durable medical equip-

ment, orthotics, and prosthetics, as medi-cally necessary; and

case management services."With respect to FEHBP-equivalent chil-dren's health insurance coverage, servicesotherwise covered under the coverage in-volved that are medically necessary to main-tain, improve, or prevent the deteriorationof the physical, developmental, or mentalhealth of the child may not be limited withrespect to scope and duration, except to thedegree that such services are not medicallynecessary. Nothing in the preceding sentenceshall be construed to prevent FEHBP-equiva-lent children's health insurance coveragefrom utilizing appropriate utilization reviewtechniques to determine medical necessityor to prevent the delivery of such servicesthrough a managed care plan.".

AMENDMENT No. 493

On page 874, between lines 7 and 8, insertthe following:SEC. 5817A. SSI ELIGIBILITY FOR SEVERELY DIS-

ABLED ALIENS.Section 402(a)(2) of the Personal Respon-

sibility and Work Opportunity Reconcili-ation Act of 1996 (8 U.S.C. 1612(a)(2)), asamended by section 5815, is amended by add-Ing at the end the following:

"(I) SSI EXCEPTION FOR SEVERELY DISABLEDALIENS—With respect to eligibility for bene-fits for the program defined in paragraph(3) (A) (relating to the supplemental securityincome program), paragraph (1), and the Sep-tember 30, 1997 application deadline undersubparagraph (G), shall not apply to anyalien who is lawfully present in the UnitedStates and who has been denied approval ofan application for naturalization by the At-torney General solely on the ground that thealien is so severely disabled that the alien isotherwise unable to satisfy the requirementsfor naturalization.

KENNEDY AMENDMENTS NOS. 492-493

Mr. LAUTENBERG (for Mr. KEN-NEDY) proposed two amendments to thebill, 5. 947, supra; as follows:

AMENDMENT No. 492

At the appropriate place in section 2102(5)of the Social Security Act as added by sec-

CONRAD AMENDMENT NO. 494Mr. LAUTENBERG (for Mr. CONRAD)

proposed an amendment to the bill, S.947, supra; as follows:

On page 874, between lines 7 and 8, insertthe following:SEC. 5817A. CONTINUATION OF MEDICAID ELIGI-


(a) IN GENEJL.—5ection1902(a)(10)(A)(i)(II) (42 U.S.C.1396a(a)(10)(A)(i)(II)) is amended by inserting"(or were being paid as of the date of enact-ment of section 211(a) of the Personal Re-sponsibility and Work Opportunity Act of1996 (Public Law 104—193; 110 Stat. 2188) andwould continue to be paid but for the enact-ment of that section)' after "title XVI'.

(b) OFF5ET.—Section 2103(b) of the SocialSecurity Act (as added by section 5801) isamended—

(1) in paragraph (2), by striking "and" atthe end:

(2) in paragraph (3), by striking the periodand inserting "; and" and

(3) by adding at the end the following:"(4) the amendment made by section

5817A(a) of the Balanced Budget Act of 1997(relating to continued eligibility for certaindisabled children).'.

S6266(c) EFFECTIVE DATE.—The amendment

made by subsection (a) applies to medical as-sistance furnished on or after July 1, 1997.


DOMENICI AMENDMENT NO. 499Mr. DOMENICI proposed an amend-

rient to the bill, S. 947, Supra; as fol-lows:

Strike sections 5811 through 5814 and insertthe following:SEC. 5812. EXTENSION OF ELIGIBILITY PERIOD


(a) SSI.—Section 402(a)(2)(A) of the Per-sonal Responsibility and Work OpportunityReconciliation Act of 1996 (8 U.S.C.1612(a) (2) (A)) is amended to read as follows:

"(A) TIME-LIMITED EXCEPTION FOR REFU-GEES AND ASYLEES.—

'(i) SSI.—With respect to the specifiedFederal program described in paragraph(3) (A) paragraph 1 shall not apply to an alienuntil 7 years after the date—

(I) an alien is admitted to the UnitedStates as a refugee under section 207 of theImmigration and Nationality Act:

"(II) an alien is granted asylum under sec-tion 208 of such Act; or

'(III) an alien's deportation is withheldunder section 243(h) of such Act.

'(ii) FOOD STAMPS—With respect to thespecified Federal program described in para-graph (3)(B), paragraph 1 shall not apply toan alien until 5 years after the date—

"(I) an alien is admitted to the UnitedStates as a refugee under section 207 of theImmigration and Nationality Act;


"(III) an alien's deportation is withheldunder section 243(h) of such Act.".

June 24, 1997(b) MEDICAID—Section 402(b)(2)(A) of the

Personal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 (8 U.S.C.1612(b) (2) (A)) is amended to read as follows:

'(A) TIME-LIMITED EXCEPTION FOR REFU-GEES AND ASYLEES.—

'(i) MEDICAID—With respect to the des-ignated Federal program described in para-graph (3) (C), paragraph 1 shall not apply toan alien until 7 years after the date—



'(HI) an alien's deportation is withheldunder section 243(h) of such Act.

'(ii) OTHER DESIGNATED FEDERAL PRO-GRAMS—With respect to the designated Fed-eral programs under paragraph (3) (otherthan subparagraph (C)). paragraph 1 shallnot apply to an alien until 5 years after thedate—


"(II) an alien is granted asylum under sec-tion 208 of such Act: or

"(III) an alien's deportation is withheldunder section 243(h) of such Act.".

(c) STATUS OF CUBAN AND HAITIAN EN-TRANTS—For purposes of sections402(a) (2) (A) and 402(b) (2) (A) of the PersonalResponsibility and Work Opportunity Rec-onciliation Act of 1996 (8 U.S.C. 1612(a)(2)(A),(b)(2)(A)), an alien who is a Cuban and Hai-tian entrant, as defined in section 501(e) ofthe Refugee Education Assistance Act of1980, shall be considered a refugee.SEC. 5813. SSI ELIGIBILITY FOR PERMANENT


Section 402(a)(2) of the Personal Respon-sibility and Work Opportunity Reconcili-ation Act of 1996 (8 U.S.C. 1612(a)(2)) (asamended by section 5811) is amended by add-ing at the end the following:

"(F) PERMANENT RESIDENT ALIENS WHO AREMEMBERS OF AN INDIAN TRIBE—With respectto eligibility for benefits for the program de-fined in paragraph (3)(A) (relating to the sup-plemental security income program), para-graph (1) shall not apply to an alien who—

'(i) is lawfully admitted for permanentresidence under the Immigration and Nation-ality Act: and

'(ii) is a member of an Indian tribe (as de-fined in section 4(e) of the Indian Self-Deter-mination and Education Assistance Act).".SEC. 5811. SSI ELIGIBILITY FOR DISABLED LEGAL

ALIENS IN THE UNITED STATES ONAUGUST 22, 1996.

(a) Section 402(a)(2) of the Personal Re-sponsibility and Work Opportunity Rec-onciliation Act of 1996 (8 U.S.C. 1612(a)(2)) (asamended by section 5813) is amended by add-ing at the end the following:

"(C) SsI ELIGIBILITY FOR DISABLEDALIENS.—With respect to eligibility for bene-fits for the program defined in paragraph(3)(A) (relating to the supplemental securityincome program), paragraph (1) shall notapply—

'(i) to an alien who—"(I) is lawfully residing in any State on

August 22. 1996; and'(H) is disabled, as defined in section

1614(a)(3) of the Social Security Act (42

U.S.C. 1382c(a)(3)); or'(i) to an alien who—

(I) is lawfully residing in any State aftersuch date;

'(II) is disabled (as so defined): and"(III) as of June 1, 1997, is receiving bene-

fits under such program.".(b) Funds shall be made available for not

to exceed 2 years for elderly SSI recipientsmade ineligible for benefits after August 22,1996.

SENATE DEBATE

JUNE 23, 1997


BALANCED BUDGET ACT OF 1997The PRESIDING OFFICER. The Sen-

ate will now proceed to the consider-ation of 5. 947, which the clerk will re-port.

The legislative clerk read as follows:A bill (S. 947) to provide for reconciliation

pursuant to section 104(a) of the concurrentresolution on the budget for the fiscal year1998.

The Senate proceeded to consider thebill.

The PRESIDING OFFICER. The Sen-ator from Alabama.

Mr. SESSIONS. Mr. President, I sug-gest the absence of a quorum, and I askthat the time be equally divided.

The PRESIDING OFFICER. Withoutobjection, it is so ordered.

The clerk will call the roll.The legislative clerk proceeded to

call the roll.Mr. DOMENICI. Mr. President, I ask

unanimous consent that the order forthe quorum call be rescinded.


Mr. DOMENICI. Parliamentary in-quiry, Mr. President. I understand weare on the reconciliation bill?

The PRESIDING OFFICER. That iscorrect.

Mr. DOMENICI. Time has been run-ning?

The PRESIDING OFFICER. The Sen-ator is correct.

Mr. DOMENICI. How much time hasrun?

The PRESIDING OFFICER. Thirtyminutes.

Mr. DOMENICI. I understand thatthe leadership has indicated there willbe no votes today, which does not meanthere will not be amendments offered.We hope that we will take a fewamendments and debate them and thenput them over in some stacked regimefor tomorrow.

I also understand there are 20 hoursof debate equally divided on this bill. Isthat correct?

The PRESIDING OFFICER. That iscorrect.

June 23, 1997

Mr. DOMENICI. And that there isalso an agreement between the leadersthat we will use 10 hours of that 20today before we recess. So I think thatsort of sets the stage for those who areinterested in attempting to modify thebill before us.

I have a couple of technical consents.Mr. President, I ask unanimous con-

sent that the presence and use of smallelectronic computers be permitted onthe floor during the debate and discus-sions on this measure.


PRIVILEGE OF THE FLOOR

Mr. DOMENICI. Mr. President, I askunanimous consent that the followingstaff of the Budget Committee be per-mitted to remain on the Senate floorduring consideration of 5. 947 and thelist be printed in the RECORD. This listcontains both the majority and minor-ity staff.


The list is as follows:MAJORITY STAFF

Victor Block, Scott Burnison, Amy Call,Jim Capretta, Lisa Cieplak, Kay Davies,Kathleen M. Dorn, Beth Felder, Alice Grant,Jim Hearn, Bill Hoagland, Carole McGuire,Anne Miller, Mieko Nakabayashi, CheriReidy, Ricardo Rel, Karen Ricoy, BrianRiley, Mike Ruffner, Andrea Shank, AmySmith. Austin Smythe, Bob Stevenson, Don-ald Marc (Javits) Sumerlin, Winslow Wheel-er.

MINORITY STAFFAmy Peck Abraham, Matt Greenwald, Phil

Karsting. Bruce King, Jim Klumpner, SanderLurie. Daniela Mays. Martin S. Morris, SueNelson, Jon Rosenwasser. Barry Strumpf.Mitchell S. Warren.

Mr. DOMENICI. In addition, we havetwo others we want to have full accessto the floor. I ask unanimous consentthe privilege of the floor be granted toAustin Smythe and Anne Miller duringthe pendency of 5. 947 on the day ofMonday, June 23.


Mr. DOMENICI. Mr. President, mightI inquire, am I correct in assumingthat Senator Rom and Senator Moy-NIHAN intend to come to the floor earlythis afternoon with a modification, anamendment?

Mr. LAUTENBERG. We have heardthat Senator M0mIHAr'I will be here, aswill, I assume, Senator Rom, at about1:30.

Mr. DOMENICI. That might be thefirst matter we take up, I understand,since it is the chairman and rankingmember.

Mr. LAUTENBERG. That could bevery well the case.

Mr. DOMENICI. What I would like todo is make a few opening remarks,yield to my friend and colleague Sen-ator LAUTENBERG, and see where itturns out.

Today the Senate begins consider-ation of 5. 947, the Balanced BudgetAct of 1997. Some people wonder, whenwe had the debate and told the Amer-


ican people that we finally had reachedan agreement, 5 years in duration, thatwould get us to a balanced budget,some people wanted us to tell themprecisely what the agreement con-templated when, as a matter of fact,the agreement covered only a portionof what must be done by Congress.Then, in addition, a budget resolutionwas taken up on the Senate floor. Dur-ing the discussion of that budget reso-lution, people would ask questions like,What changes are there going to be in

Medicare to make it solvent for the 10years that are being promised?" Theymight ask the question, "What is goingto happen to Medicaid under this budg-et proposal and this agreement?"

Frankly, for the most part, we toldthem what we knew and we told themthat, in due course, a piece of legisla-tion would be coming through thatwould change various laws of the landand would accomplish the goals, thesavings required over the first 5 yearsand estimated over 10. And now, today,to put it into perspective and so theprocess is understood better, the com-mittees that were charged under thatbudget resolution to do things—for themost part to decrease the cost of pro-grams within their jurisdiction, withintheir authority; in a couple of in-stances they were asked to increaseslightly, the expenditures—essentiallythose committees, eight in number,have done their work and now what wehave is a law, what could be a law, thatis a bill, not a budget resolution.

The bill before us is a very specialbill. It is called a reconciliation bill.That is significant in the U.S. Senate,more significant than in the House, be-cause in the U.S. Senate this proposedbill, this reconciliation bill, is grantedsome very powerful immunity from therules of the Senate. The biggest one isthe bill cannot be filibustered. So yousee right off, when I asked the ques-tion, is it not correct that there are 20hours of debate on this bill?—and theParliamentarian answered yes—that isby law. In other words, we came alongand said these bills should not be de-layed. They are part of getting you thebudget changes you need, and they de-serve a privilege of being immune fromfilibusters. So the law set down howmuch time would be used for debate.

In addition, you will hear throughoutthe next 2 days some interesting ver-biage. We will talk about amendmentsto the bill. Again, this bill is not an or-dinary bill. Either by the statute thatcreated the process or by subsequentenactment of the Congress, we havesaid that it is very difficult to amendthis bill. So, essentially almost any-thing you try to do to this bill thatchanges matters of real substance thatare in it are generally subject to apoint of order and require 60 votes, ifthe point of order is made on a waiver.to make them germane and thus sub-ject to being added to this bill.

In the meantime, since that law, weadopted another rule for ourselves. Themore we did these the more we found

S6059that Senators found ways to get aroundwhat was contemplated. So, what wedid, with the cooperation and assist-ance of the distinguished Senator fromWest Virginia, Senator BYRD, weadopted a rule for ourself about thisbill and we have now named it after theSenator. It is called the Byrd rule. Es-sentially what it says is that matterswithin this bill or matters attemptedto be added to this bill that do not sub-stantially decrease the deficit—that is,if you introduce them, for instance, todo away with a commission, but itreally isn't there to save money—thenthe Parliamentarian will rule that ittakes 60 votes to pass them.

This is very different from an ordi-nary bill that comes before this body,which is the most generous parliamen-tary body in the world in terms of per-mitting Members to make amendmentsand argue what one might even call ir-relevant matters to a bill pending. So,as an example, you can have a bill com-ing through here on education andsomebody can get up and say, "I wouldlike to debate the troops in Bosnia."They would get up and they could in-troduce a resolution or a statute onthat education bill that says we aregoing to be out of Bosnia in 6 months.Frankly, it is debatable for as long asthe Senate wants to debate it and itcannot be stricken for germaneness orrelevance because, under the Jeffer-sonian rules that we adopted and par-liamentary interpretations, we are freeto offer nongermane, extraneousamendments to the bill.

In any event, Members now are fa-miliar enough that they do go ask forsome assistance before they up andoffer an amendment tojust change thisreconciliation bill and do things theirway. On the other hand, they may offerthem even if they are not germane andsubject to the Byrd rule, and everybodyknows they are apt to be defeated be-cause it requires 60 votes to concur intheir adoption.

So that is about where we are. Again,getting back to where we are, this leg-islation is the first reconciliation billthat was instructed by that budget res-olution that we talked to the Americanpeople about, in terms of getting tobalance. It was about 2 weeks ago weadopted that resolution. It told theseeight committees of the U.S. Senate todo some work to change some laws. Ina sense, this represents the first leg ofa three-legged stool that must be con-structed to implement the balancedbudget, and the bipartisan budgetagreement that attended it, that theSpeaker of the House and the majorityand minority leaders of the Senateagreed and concurred on on May 15.

I characterize this as the first leg, be-cause that historic agreement, to befully implemented, requires changesboth to entitlement spending, that isthis first reconciliation bill; changes toour tax laws, that is the second rec-onciliation bill; and then, in duecourse, there will be 13 appropriationsbills that are annual spending of

S6060money that will have to be kept withinthe limits prescribed in this agreementand also will have to provide some pri-ority items that were agreed to be-tween the President and Congress formatters that pertain to crime, edu-cation, and about 13 different items.Some are small, some are large. Wehave to try to put those in their appro-priate place in the appropriations bills.So, I characterize this as the first legbecause the historic agreement, to befully implemented, requires changes inboth the entitlement spending andchanges to our tax laws and, also, lim-its on the annual appropriations spend-ing account.

Obviously, it is complex. I do notknow if we could get anywhere nearwhere we are if we did not have thesebills, which are privileged, as I indi-cated, for many of them would go on indebate for 3 or 4 weeks and many ofthem would be so burdened down withamendments that you would not recog-nize the bill when you finished. So, weare ready to take the cumbersome na-ture of it all and work as hard as wecan so that by September 1 we have allthree legs completed and perhaps theprocedural changes that we must get toenforce it, which will come along hereshortly, and thus be where we ought tobe to reconfirm to the public we are ona path to a balanced budget.

Last week these committees of theCongress completing this bill, this firstleg, were quietly adopting spendinglimits established in the agreement forthe upcoming fiscal year. Later in thedebate on this reconciliation bill, I willoffer an amendment, hopefully with myranking member, Senator LAUTENBERG,to establish appropriation limits forthe next 5 years as required by theagreement. I understand Senator LAU-TENBERG is concerned about one aspectof that. We will try to work togetheron that.

So, before the week is out, the Sen-ate, in rapid succession, will have builtthe three legs of the stool necessary tocarry out the bipartisan agreementwhich we negotiated over a period, gen-erally now understood to be as long as5 months of negotiating. Among thosethree legs, first the entitlement spend-ing bill is before us today and, I repeat,immediately after it the second leg,the tax reduction bill, will follow, andthen in due course the appropriations.When completed into law and signed bythe President—and I am hopeful thetwo reconciliation bills will be, and Iam hopeful that before September 1 ar-rives we will have passed all the appro-priations bills, thus enabling Govern-ment to operate for another year—what we will have is we will have setabout to balance the Federal budget by2002.

If that works, and I have no reason tobelieve it will not, it will be the firstsuch accomplishment since 1969. Re-ducing Federal spending compared tocurrent Federal spending projections,spending will slow by nearly $290 bil-lion over the next 5 years. And if the


reform policies we adopt this week con-tinue unchanged, we will have reducedFederal spending by nearly $1.1 trillionover the next 10 years, counting thedebt service that we will not have tomake because of reduced borrowing.Changing the scope of spending meas-ured by the size of a growing economyresulting from this balanced budgetplan, Federal spending will declinefrom 20.8 percent in 1996 to 18.9 percentin 2002.

Frankly, when I started, in 1974, as amember of the Budget Committee, Ireally was skeptical as to whether wewould ever break this 20 or 21 percentof spending versus the gross domesticproduct. We will be down to 18.9 whenthis budget agreement is fully imple-mented. Again, that will be the lowestlevel since 1974, and, more important,52 percent of the 5-year savings will bederived from reduced entitlementgrowth, particularly through the re-forms and changes made to Medicareand Medicaid Programs and, in particu-lar, on Medicare, to avoid the bank-ruptcy of that program.

Funding priority programs willachieve balance in 2002, and the agree-ment does assume some directing ofour limited Federal resources to prior-ity programs, such as children's health,assistance to disabled citizens, edu-cation, environment, transportation,crimefighting, and international af-fairs.

Reducing Federal taxes. When wecomplete the second reconciliation bill,the agreement will have been achievedto reduce taxes on American familiesand businesses to provide incentives,savings and investments and to providerelief for families with education ex-penses.

Enforcing the agreement, when we fi-nally complete work this week, will beextended and strengthened because weare going to add to the Budget Enforce-ment Act of 1990 and give the Americanpeople assurances—as sure as we can—that we will live by these decisions, be-cause to break any of these caps overthe next 5 years will require a waiverof this agreement and will require asupermajority of 60 votes.

So, Mr. President, I say to fellowSenators, in short, this could turn outto be a very busy and, hopefully, a verysuccessful week. It will be a week inwhich the fiscal policy decisions wemake will resonate for many years tocome. As it relates to the immediatebill before us, I thank the eight com-mittees, their chairmen and rankingmembers, for acting as quickly as theydid to report to the Budget Committeetheir legislative pieces which willcarry out the agreement.

The legislation before us is, in verylarge part, consistent with the agree-ment. However, in a few areas, the leg-islation does not comport with theagreement. An argument can be madethat certain provisions are inconsist-ent with the agreement. Obviously, wewill work on those over the next 2days. Under the Budget Act, the Budg-

June 23, 1997

et Committee could only bundle theeight committees and the languagegiven to us for this report, and I quotefrom the statute, "without any sub-stantive revision.

It falls to the leadership and us inthe full Senate to attempt, where nec-essary, and to the extent the rules ofthe Senate permit, to make changesthat might result in it being mademore consistent with the agreementand, I also want to mention, to the ex-tent it is not totally inconsistent insome areas. There is one additional op-portunity to fix it, and that will bewhen we go to conference with theHouse. They will be working on theirbills simultaneous with this, and theywill be off the mark in a few areas.When we go to conference, we will at-tempt to reconcile those differencesand make them as consistent with theagreement as possible.

I remind all Senators and theirstaffs, again, that this bill is on a spe-cial fast track, as I have alluded to. Itis actually the paramount special fast-track legislation provided for in thelaws and rules of the Senate. Soamending can be tricky. I have alreadyindicated that germaneness and notbeing extraneous are very important,and you can violate those standardsonly with 60 votes.

So over the next 20 hours allowed onthis legislation, I anticipate we willhave four broad areas of amendments,and not all will be germane and prob-ably many will be extraneous, butnonetheless, we will need to consider,first, as I mentioned earlier, the agree-ment calls for enforcement under thestrict rules of the reconciliation budgetprocess. Enforcement could not be con-sidered in the committee. Any enforce-ment legislation similar to 1990 and1993 will need to be considered on thefloor. The joint Budget Committeestaffs and the administration officialshave been preparing such an amend-ment, and other Senators will probablyalso offer their amendments to enforcethe agreement.

Second, there will be a group ofamendments that may need to be con-sidered to bring legislative languageinto compliance. I will work with theleadership and the affected committeechairmen and ranking members tomake sure that these amendments arenecessary and consistent with theagreement.

Third, the legislation before us fallsshort of the deficit reduction target as-sumed in the agreement. It may be nec-essary to consider some amendmentthat would bring the legislation beforeus into compliance, or modifications tothe agreement will have to be consid-ered.

Finally, the legislation before us in-cludes provisions on which the agree-ment was silent. Some of these in theMedicare area have been controversial,such as means testing of the Medicaredeductible or gradually increasing theage when individuals will be eligiblefor Medicare. I am sure we will have

June 23, 1997some hearty discussions about theseprovisions, and there will, obviously,be amendments to them.

So now, Mr. President, the Senatebusiness and work lies before us. It isimportant work for the countrys fiscalfuture. After nearly 2 years of debatewith the administration on how toachieve a balanced budget, it is workthat, once completed, I think, will be-come law and will balance the budget.It has been way too long in coming. Ilook forward to closing a chapter inthe Senate at the end of this week, per-haps as late as Saturday, and imme-diately upon return from the Fourth ofJuly recess, to reconcile with theHouse our differences and get this com-pleted as early alter the Fourth of Julyas possible.

I thank the Chair, and I thank theSenators for listening. I yield the floorat this point.

Mr. LAUTENBERG addressed theChair.

The PRESIDING OFFICER. TheChair recognizes the Senator from NewJersey.

Mr. LAUTENBERG. I thank theChair. I want to say, Mr. President,this is my first year as ranking mem-ber on the Budget Committee to proc-ess the budget resolution, and it hasbeen an interesting experience. It is afairly complicated process. I had a lotof learning to do. I still feel that I amplaying catchup in some areas, but itwas largely through the good work ofSenator D0MENICI that the processmoved fairly expeditiously. We workwell together. The relationship, on apersonal basis, is excellent. We dis-agreed without being disagreeable, andwe completed this arduous task. It hasgone on for several months and I thinkprobably will be a milestone mark inthe way a budget is developed becauseof the target that it has, a balancedbudget in the year 2002, 5 years hence.There will be enormous change as wego along.

Mr. President, I have to point outthat this comes at a time when thingsare pretty good. Since President Clin-ton has been in office, we have seendramatic changes in our fiscal condi-tion. For instance, the annual deficitcame down from $290 billion, in roundterms, in 1992, to an expected $70 bil-lion level for the year 1997.

So we have had dramatic declines inthe deficits. Our unemployment is at alow point in decades. America is verycompetitive. We are sending out thekind of high-valued products that welike to see being shipped to other coun-tries, in terms of international com-merce. We have the lowest deficit toGDP among all countries of the world,running around 1.5 percent, the envy ofalmost every nation on this globe. Ourratio of taxes to GDP is the lowest ofany nation on the globe. We are talk-ing about large societies, advanced so-cieties.

We just saw completion of the gath-ering of the heads of government inDenver, eight countries, including


ours, in which I guess America boasteda little bit because we have been lead-ing the way. Countries that were soenvied for so many years, like Ger-many and Japan, are trying to figureout how we did it and with a tax basethat enables people certainly to suç-ceed, acquire, in some cases, incrediblefortunes, fortunes far larger than weever dreamed possible.

There used to be a time in Americawhen if someone was a billionaire, thatwas a stand-out person. It is not all in-flation, but today they are countingbillionaires and multibillionaires.There is success after success of peoplegoing into the corporate world, fromwhence I came, and work a few yearswith a company and walk out with $20million, $50 million, some people beingpaid $25 million a year on a regularroutine.

It is quite incredible and quite dif-ferent, by the way, than the guy whoworks hard every day and tries to sup-port his family and thinks about wherehe is, whether his kids are going to beable to get an education so they canmove up the economic ladder. He wor-ries about his old age, "Will my pen-sion be there when I am ready to re-tire?" "Will I be able to give a hand tomy mother if she falls sick beyond thecapacity of the system as it is pres-ently designed to take care of her?""Will I be able to continue to live on alittle plot of land and maintain myhome, our home?" Or, 'Will my wifeand I have to work shifts so that shecan be home when I am not, and viceversa, to take care of our kids?"

That is the picture we see in Americatoday, with all the good results. Peopleat the top are doing very, very well,and people at the bottom are doingslightly better but still very worried.The price of a college education, theopportunity for the kind of jobs thatcan sustain a family—it is quite dif-ferent in the levels of income.

So, Mr. President, when we look at abill like this which we will be consider-ing very soon, the tax consequences ofour deliberation—and we will be run-ning into some difficult discussionshere, because I know a lot of my col-leagues are worried about tax breaksfor those who don't need them and taxopportunities for those who do.

Today, we are talking about the firstof the two reconciliation bills, this onecalled the spending reconciliation bill.Senator DOMENICI went through someexplanatory statements to let peopleunderstand what it is about this arcanesystem of ours—frankly, it is a mys-tery to most and to many even insidethis place—about the budget resolu-tion, the reconciliation, enforcement,and all of the terminology that be-comes routine when you are workingwith it every day, and talking aboutgermaneness and relevance. Aroundhere, relevance, to steal a phrase, whenthey talk about beauty in the eyes ofthe beholder, relevance here is in theeyes of the bellower. That is whereoften debate comes about—relevance.

S6061But we have a process by which we de-termine whether or not something isrelevant. So that will be considered aswe go along.

So, Mr. President, I want to just sayonce again that I commend the chair-man of the Budget Committee for hishard work and cooperative attitudeover the past many months. We havespent long days in tight quarters work-ing on this—by the way, no longersmoke-filled; that's out, as we see nowwith the tobacco legislation in front ofus.

Senator D0MENICI is one of the mostcompetent, serious, hard-working Sen-ators in this body. I enjoyed, as I saidearlier, working with him over thesepast few months. The reconciliationbill before us includes provisions thathave been, as the chairman noted, re-viewed and developed by eight differentauthorizing committees. Our col-leagues on those committees deservereal credit for moving fairly quickly toput these pieces together. I commendthem for their hard work.

When I look at the final product,there is much in this legislation to bepleased with. It makes some improve-ments in Medicare solvency and ex-tending the trust fund. It restores someimportant benefits to legal immi-grants. It includes $3 billion to movepeople from welfare to work. We wantthat to happen. And it softens the lawthat denies food stamps to those whotry but are unable to find work.

Despite these positive elements, Mr.President, I have serious concernsabout this legislation in its currentform. It is blatantly inconsistent inparts with the bipartisan budget agree-ment. Once again, I have to say thatwe labored long and hard and honestly,I believe, in trying to establish agree-ments. They did not always go downeasy. Some of these were bitter pills toswallow. But we inched our way at firstto get there, and finally it evolved intoa consensus that we felt we could livewith.

The bipartisan budget agreement hadsome problematic provisions that nowwe are seeing—frankly, I would have touse the word "attacked"—in someways. I want to touch on a few exam-ples.

First, I think this bill does challengeor violate the provision in the budgetagreement that protects senior citizenswith modest incomes from increases inMedicare premiums. The bipartisan ne-gotiators set aside $1.5 billion specifi-cally for this purpose. But the FinanceCommittee has refused to allocate thismoney. Now, this must be fixed. I un-derstand they are considering it evenas we speak.

Second, the bill violates the provi-sion in the budget agreement that pro-tects those who have come into ourcountry legally, paid taxes, played bythe rules, who suffer at a future timefrom a disability, accident, sickness, orotherwise. The budget agreementclearly requires that these innocent

S6062victims be protected. However, the Fi-nance Committee has refused to in-clude that in their agreement and in-cluded only a temporary restoration ofbenefits. This, too, must be fixed.

Third, the bill fails to provide Medic-aid coverage for the 30,000 children whoare losing SSI benefits under lastyear's welfare bill. This runs counterto the goal of ensuring that America'schildren have health care coverage. Itis another blatant violation of the bi-partisan budget agreement.

Mr. President, it is up to the congres-sional leadership, not the leadership ofthe committees, to correct these prob-lems and to bring the reconciliationbill back into compliance with thebudget agreement. Senators LoTr andDASCHLE have agreed in writing to dothis through bipartisan leadershipamendments. I am confident that thiscommitment is going to be fulfilled.But as I mentioned earlier, Mr. Presi-dent, I am concerned about other pro-visions as well in this reconciliationbill that go beyond the bipartisanbudget agreement. I want to outlinesome of these.

First, the bill changes the age for eli-gibility in Medicare from 65 to 67. Mr.President, that may be a worthwhilesubject, but not here, not in this bill.There is no legislation to protect theseniors who will be aged 65 and 66 asthey wait for eligibility going from oneplace to another. For many companies,for many situations, the retirement pe-riod is age 65. It is common. I do notthink it is right to be in here. Theissue was never discussed during thenegotiations on the budget agreement.So while there may be an argument forconsidering related proposals as part ofa broad review of health care and enti-tlements, this is not something that weought to be doing now on a fast-trackreconciliation bill. Our senior citizensdeserve more than that, or one day tobe senior citizens.

Nor, Mr. President, should we be con-sidering a fundamental change in theuniversal nature of the Medicare Pro-gram as part of a fast-track bill? Thislegislation would introduce means test-ing to Medicare. Again, I realize thatthere are Senators here who supportthis proposal. But the long-term impli-cations for this move are enormous.They deserve much more thorough de-bate than is possible in this legislation.

Mr. President, the bill before us alsoincludes several other provisions thatgo beyond the bipartisan budget agree-ment that are of concern.

The bill would increase the financialburdens on some of our most vulner-able senior citizens, poor people, peopleimpoverished by establishing a new co-payment for home health visits.

It would authorize medical savingsaccounts, a new approach to Medicarethat could, in my view, harm its long-term viability, harm the viability ofthe whole Medicare Program, becauseit would give people choices outsidethe system and perhaps would pull outthose who are in good health and leave


the rest to those who are not quite upto snuff. It would make excessive bur-dens for them. It cuts the Medicaidpayments. The hospitals also would becurtailed, and they serve a dispropor-tionate share of poor and uninsured pa-tients.

So, Mr. President, these and otherproblematic provisions should not be ina reconciliation bill—again, I remindyou, fast track; this will be done some-time tomorrow—that is designed to im-plement a bipartisan budget agree-ment. I hope that many of these thingscan be eliminated before the Senatehas to vote on final passage of the leg-islation.

I want, Mr. President, to caution mycolleagues that they are to get herewith their amendments because thetime continues to pass. As Senator Do-MENICI has said, at some point the 20hours that is allocated for the debatewill be consumed by just wasting time.If that is the case, those who haveamendments that they care about willbe here in the final moments of thetime that we have allocated to this de-bate and they will not be able to bringthem up. They may be able to intro-duce them and get a vote on them, butthey are not going to be able to discussthem, they are not going to be able toargue the merits. I think that is some-thing that people ought to pay a lot ofattention to if they are serious aboutthe amendments that they are propos-ing.

So, I plead with our colleagues, getover here, get your amendments in.The fact that there will be no votestoday does not have anything to dowith the time schedule. If these issuesare going to be voted upon, theseamendments, that can be done tomor-row, but the debate will have to be heldbefore we run out of time.

So I conclude, Mr. President, by say-ing this to my friend and colleague, thechairman of the Budget Committee,that despite the various controversiesthat have pitted our two partiesagainst each other, we have managedto maintain a spirit of bipartisanshipin our efforts to balance the budget inthe proper way. I believe that we willmaintain that cooperative approach.But if we are going to do it, many ofthese problems will have to be ad-dressed before this legislation is sentto President Clinton. I look forward toworking with Senator DOMENICI andwith the leadership on both sides of theaisle to make it happen.

Let us get a bill that we can livewith, a consensus bill, much in themanner that we shook hands on; maybewith a grimace or two across the table,but we did it. We arrived at a consen-sus. I need not go to such elementaryteachings to say a consensus really re-flects a give-up by all parties to a dis-cussion. A consensus is not I win, youlose; it is we both win a little and weboth lose a little. That is what we didto get to where we are. Therefore, I ex-press some disappointment in thechanges that have been made in the

June 23, 1997

process of reconciliation and hope thatwe will be able to change the changesand get on with this bipartisan budgetagreement that we concluded here onthe floor not too long ago.

I yield the floor.Mr. POMENICI addressed the Chair.The PRESIDING OFFICER. The

Chair recognizes the Senator from NewMexico.

Mr. DOMENICI. I just want to thankSenator LAUTENBERG for his observa-tions and his comments. Whateverwords he had to say about me, I appre-ciate.

I say, I have just an evaluation thatis mildly different. I think, consideringthe great bulk of things the commit-tees had to do—and, you know, we hadan agreement for the first time thattold them they had to do certainthings; before it was a very vague in-struction—I think they did fairly well.I mean, I think we can count on thefingers of our hands—probably even ifwe did not have all five fingers, wecould even on less than five—the areasthat they did not comply with. I thinkthey are going to work with us to tryto get those done.

Obviously, there is one that is dif-ficult that has to do with the radio andtelevision spectrum. That is a littlemore difficult. The administration toldus we could get a lot of money and, ifwe did not go that far, it would notlast. It turns out it is very hard to dothat. But we are working on that, in abipartisan fashion also.

I say to Senator WELLSTONE, youhave been here for a while. SenatorJUID Gpcc has indicated that it wasall right with you if he proceeded.

Mr. WELLSTONE. That is correct.Ijust want to ask the managers—it is

fine with me if Senator GREGG pro-ceeds. It is my understanding that Sen-ator MOYNIHAN will be coming to thefloor seeking a modification.

Is that correct?Mr. DOMENICI. Yes. He and Senator

ROTH or somebody.Mr. WELLSTONE. When do we ex-

pect them to come to the floor?Mr. DOMENICI. I thought it was 1:30

to 2 o'clock. I think we will have sometime for statements before that if youwant to make a statement before that.

Mr. WELLSTONE. I say to both mycolleagues, I potentially am ready todo an amendment or two. But I wouldrather wait until after some discus-sions with other Senators. Also, Sen-ator MOyNJHJ' and Senator ROTh willbe here.

I thank the Senator for his courtesy.Mr. DOMENICI. I say to Senator

GREGG, how much time would you like?Mr. GREGG. Fifteen minutes.Mr. DOMENICI. I will yield the Sen-

ator 20 minutes.I wonder if you could do me a favor.

I am going to sneak out and get some-thing to eat. Would you manage thefloor for about 15 minutes?

Mr. GREGG. Certainly.Mr. DOMENICI. I thank the Senator.I yield the floor.

June 23, 1997The PRESIDING OFFICER. The

Chair recognizes the Senator from NewHampshire for 20 minutes.

Mr. GREGG. First, I rise to congratu-late the Senator from New Mexico andthe Senator from New Jersey, thechairman and ranking member of theBudget Committee, for getting us tothis point where we are in the processof voting on and hopefully reaching aconclusion on two very important rec-onciliation bills which deal with thecritical elements of how we manage en-titlement spending and how we managetax policy here at the Federal level,and which lead, hopefully, to a conclu-sion that we can say with certaintythat the balanced budget agreementwhich was reached has been met andthat we will therefore have a balancedbudget which our children can look toas a benefit and which we can look toas a success.

I want to speak specifically abouttwo elements of the reconciliation billwhich I consider to be important, twodifferent bills, the one that deals withthe spending, the entitlement bill, andthe one that deals with tax policy, andtalk about the Medicare Choice Pro-gram, reform program, and the pensionlanguage within these two bills, be-cause I think these bills have madegiant strides in both these areas to-ward addressing some fundamentalpublic policy needs.

I commend Senator RoTh and the Fi-nance Committee for including theseimportant provisions on both Medicareand on pension reform.

Earlier this year I introduced 5. 246,the Choice care bill. It was essentiallysimilar to legislation that I had intro-duced in the last Congress, which wasincluded in the Balanced Budget Actthat year, which unfortunately was ve-toed by the President. The Medicaresavings achieved in this reconciliationbill represent only a tentative start,however, toward placing the Medicaresystem on a path toward long-term sol-vency. But they are an importantstart. There are still trillions of dollarsof unfunded Medicare liability await-ing us, and this legislation does not ad-dress it all, but it does get us off on theright foot.

I am pleased we have taken this op-portunity to enact some of the struc-tural reforms that are key to real sub-stantive Medicare reform and the sta-bilization of the Medicare trust funds.In my Choice care bill and in the provi-sions contained in this legislation, sen-iors will be able to choose from a largevariety of health care purchasing op-tions. They can remain in their tradi-tional Medicare plan, they could in-stead buy an HMO, or they could buyfrom a competing medical plan pro-vided that it meets the benefit stand-ards of the present Medicare system.So seniors will have a wide variety ofnew and exciting choices.

When we offer seniors this greatarray of choices, we benefit not onlythe seniors but the system as a wholeby bringing it into the marketplace.


Traditional Medicare must then effec-tively compete for the right for sen-iors' health care spending in the mar-ketplace and the people in the market-place who are willing to give other op-tions to seniors. Suppose, for example,there are plans that can deliver serv-ices more effectively and more effi-ciently than Medicare in a particularregion of this Nation. If they can dothat, then they can offer a more sub-stantial package of benefits for thesame costs, and, therefore, seniors willhave an incentive to buy from theseplans.

Take, for example, if a plan was ableto offer the seniors not only the basicMedicare benefit but also maybe aneyeglass benefit or a prescription drugbenefit. That option is now going to beavailable to the seniors. This benefitsthe health of the system because, atthe same time, this legislation gainscontrol over the rate of growth of theper capita spending in the MedicareProgram. So whenever seniors moveinto these plans that can offer them abetter benefits package, the entire sys-tem will save money because the Medi-care system will be spending lessmoney per capita on these seniors thanit would under the traditional Medi-care system.

If they are getting a stronger pack-age, you might say, how can that be? Itis called the marketplace, it is calledcapitalism, it is called what is happen-ing in the private sector today, in thehealth care system generally. But, un-fortunately, it is not helping Medicare,which was designed for a 1960's healthcare delivery system, which simply isnot operable in the 1990's or as we gointo the year 2000.

This legislation begins to flatten thewide disparity in reimbursement levelsthat exist between geographic regionsin this country by gradually blendingover time local and national reim-bursement rates. If we do this, then wemake spending patterns in Medicaremore fair and reward those regions ofthe country that have already donewell in holding down costs. The dispar-ity between regions is really excessive.For example, in some parts of thiscountry, like New Hampshire and Or-egon, and I suspect in Wyoming, wherethe Presiding Officer is from, the costsof Medicare benefits are significantlylower than in areas like Staten Island.In fact, it is lower by almost $500 amonth.

It is imperative we include such re-form as a component of the MedicareChoice Program because only by doingso can we be sure that seniors in low-cost areas will ultimately have accessto a wide array of benefit packages. Aslong as reimbursement rates in someparts of the country are unfairly low,it will be difficult to entice plans intothose regions to compete for seniors'dollars even though the health carebenefits in those areas today are beingmaintained at a high level.

I believe we should have increasedthe incentives available to seniors to

S6063become cost conscious by offeringthem opportunities to save money inthe manner in which they buy Medi-care. That is the incentive that trulymoves shoppers, and I believe thatMedicare Choice would be a greatlystrengthened reform if we had includeda cash-rebate incentive. Under myoriginal bill, 5. 246, every time a seniorbought from a less expensive plan, eventhough the benefit package in thatplan had to meet the same benefitpackage or exceed the benefit packageof the present Medicare system, if theplan costs less because of competitionand efficiencies within that plan, then75 percent of the savings would havegone to the individual, and the remain-ing 25 percent would have been depos-ited in the trust fund. Thus, the trustfund would never lose money due tosuch rebates.

On the contrary, the trust fund wouldreceive money every time a senior seesthis incentive to make a cost-consciousdecision. Unfortunately, this languagewas left out of this bill, and, in fact,there is some language in this billwhich undermines the ability to createincentives in the Medicare systemunder the Medicare Choice plan. I ex-pect I will be offering an amendment tocorrect this, an amendment to strikethat section which limits the ability tooffer incentives, because lacking thatimportant incentive we cannot, in myopinion, create the huge marketplaceforces which we need in order to sig-nificantly control the costs of healthcare and to create marketplace forceswithin the health care systems.

Even considering that, this packagestill offers the incentive to seniors thatwhere their plan can be more efficient,they will be offered an enhanced pack-age of benefits. That is a significant in-centive. While perhaps not as powerfula purchasing incentive as an actualcash rebate, for example, it is my hopethat the prospect of strengthened bene-fits will prove a powerful enticementthat allows seniors to move more com-fortably into buying Medicare Choiceplans.

I am reminded of the old saying thatyou begin a trip, a long journey, withone small step. Well, this package thathas been brought forth by the FinanceCommittee is a series of small steps. Ithas gotten us well into the journey. Ithas not gotten us to the end, but it hasgotten us down the road by giving sen-iors more choices and more opportuni-ties in the way they purchase theirhealth care.

At the same time that the FinanceCommittee has made significantstrides in the area of Medicare by mak-ing Choice care available to them inthe Choice care plan which I intro-duced, it is also contained in the taxresolution which will be coming for-ward later in the week, a significantincentive to increase retirement sav-ings. I congratulate, again, and thankSenator Rom, the chairman of the Fi-nance Committee, for including somany of the ideas and initiatives which

S6064I was able to participate in pulling to-gether as chairman of the RetirementTask Force. I also want to particularlythank Senator BOB GRAHAM and othermembers of the bipartisan workinggroup for their aggressiveness in pro-moting pension reform which will pro-mote savings.

Some months ago, I was asked byMajority Leader TRENT Lorr to chairthe Republican task force on retire-ment security, and in that capacity Iworked with Senator ROTh and the restof the task force to develop a packageof proposals introduced a week ago asSenate bill 5. 883.

I will not use this time here to de-scribe again the dire circumstances ofthis Nation with respect to retirementsavings. When we introduced 5. 883, wedetailed the vast gap between our Na-tion's retirement income and the inad-equate amount of funding we are cur-rently putting aside to meet those re-tirement needs. Approximately $7 tril-lion of unfunded liability sits in ourdifferent retirement accounts. I amvery pleased to note that no fewer than13 of the provisions, 13 of the provisionsof 5. 883 have been included in someform in this budget reconciliationpackage. While many of them are smallor technical corrections without sig-nificant revenue impacts, enactingthese reforms will do much to improvethe prospects for expanding pensioncoverage and retirement savings.

Because time is limited, let me listonly a few of the reforms that havecome to be included in this packagewhich I think are positive for encour-aging people to save for their retire-ment.

This budget reconciliation packageincludes the first title of the WISE bill,5. 260. This part of the WISE bill—theWISE bill being a bill directed at giv-ing more equity to women in the areaof being able to save for their retire-ment—strengthens the homemakerIRA. I, personally, have placed a higherpriority on this provision than on anyother of our task force savings initia-tives, so I am particularly pleased tosee it was included. This provision re-ceived the active support of a biparti-san group of Senators, including, mostnotably, Senator COL MOSELEY-BRAUN from the other side of the aisle.

This provision, Mr. President, willsever the link between the home-maker's ability to make a fully tax de-ductible contribution to IRA and allowher to make that contribution whetheror not her husband or her spouse who isin the workplace has a pension plan.This is an important provision not onlybecause it will stimulate additionalsavings but because it will enablehomemakers, especially women, togenerate additional savings in theirown name. It is about time we do that.I especially want to congratulate, ofcourse, Senator Rom, the chairman ofthe Finance Committee, who has beena tireless advocate for this idea.

This reconciliation bill also willgradually raise the income limits on


the tax deductible contributions toIRA's. Our Republican task force en-dorsed the Roth-Breaux legislationthat would have completely phased outthe income limits so that every Amer-ican will be eligible to fully deducttheir IRA contributions. I believe thatFinance Committee Chairman Rom ex-erted every effort to achieve as muchas he could in this area, and I ampleased he included at least a versionof the language from the task forcebill, gradually phasing up the incomelimits, doubling them by the year 2004.This will do a tremendous amount tospur savings in our marketplace and aspeople head toward retirement.

This budget reconciliation packagealso includes the backloaded IRA, animportant new option in retirementsavings in which the contributions arenot tax deductible and the tax advan-tagés come up upon withdrawal. Thisexpands the capacity of individuals totake advantage of retirement incen-tives in a way that works best forthem. It also limits the revenue loss inthe short term from IRA expansion, be-cause the contributions today will betaxed when they are made. I knowmany individuals will wish to use thisalternative backloaded-IRA structure,and thus this will be an important in-centive for additional long-term sav-ings.

Mr. President, one thing we must doas a nation is simply make it easierand more convenient for people to save.The fact is that if we do not do this, weas a nation are going toface bank-ruptcy as a result of the costs of ourpension systems as the postwar baby-boom generation fully retires in theyear 2010 and beyond. One reason whythe thrift savings plan worked so wellfor Federal employees is that it has thefeature of automatic deduction fromones payroll, automatic investment,automatic savings. I am pleased thatthe Finance Committee has also in-cluded the provision to allow for auto-matic payroll deductions into IRA ac-counts. This will also stimulate addi-tional retirement savings simply bymaking IRA investment easier.

I am also pleased this reconciliationpackage recognizes we must continueto do more to stimulate retirementsavings not only through individualsavings but also through employer-pro-vided pensions. I have long been trou-bled by the limitations that have beenplaced on employer funding of futurepension liabilities. Employers mustfund these liabilities sooner or later,and it is good policy to put more of thefunding upfront to allow that fundingto be invested and to use thecompounding interest to increase theinvestment and to assure an adequateamount of funds when people retire.

The reconciliation package picks upmost of the provisions authored by thetask force to raise the limits on fullfunding by 5 percent every 2 years. Ibelieve that our Nation's workers willbe more secure by their pension bene-fits being funded more fully. This is a

June 23, 1997

critical point because so many of ourpension benefits are underfunded. Thecapacity of the employer to be able tofully fund the pension benefits at anearlier time in the cycle is critical toassure people will have a pension whenthey retire.

Some of the technical changes madeby this bill are very significant. Thisreconciliation bill would exempt Stateand local government plans from thecumbersome nondiscrimination rules.This was a prime example of how manyof our pension laws and regulationshave been unduly complicated. Non-discrimination rules were not createdto apply to Government plans, where itis difficult to find exactly who the em-ployer is and thus to compare employerand employee benefits. This type ofcommonsense change will make it easi-er for States and local governments toplan for functions around the country.

Another task force-endorsed reformpicked up by the reconciliation billwill do much to help small business.Until now, the matching contributionsmade by the self-employed were treat-ed differently under tax law than thematching contributions made by em-ployers. By straightening out the dis-crepancy, we will remove another ob-stacle from among the many that detersmall business owners from providingpension coverage. As we all know,small business is where we most needto increase participation in pensionplans.

There is not time, Mr. President, todiscuss every reform that was insertedinto this reconciliation bill in the pen-sion area. But I am pleased that thisbill draws from reform initiatives in avariety of areas. In the area of port-ability—I am talking now about thetax bill coming to us after we completethe bill on spending—this bill will addextra protection to defined benefitplans that accept rollovers, protectingthem from disqualification if they dofacilitate that kind of portability.Moreover, the bill includes a few provi-sions that will streamline the paper-work process. The bill will facilitatethe use of new technologies to replaceold paperwork filing, and also elimi-nate some paperwork requirementsthat should no longer be required. Fi-nally, various technical inconsistencieswithin the law will be eliminated if weretain those provisions in conference.

Let me close by thanking ChairmanROTH for his extraordinary effort andfor his willingness to include so manyprovisions to promote pension reformand Medicare Choice in both reconcili-ation bills, as well as several other Fi-nance Committee Senators, IncludingSenators BOB GRAaM, CHUCK GRAss-LEY, OiRtN HATCH, JIM JEFFORDS, andothers. Although I am not on the Fi-nance Committee, I was certainlypleased to be able to work with thisgroup to advance efforts to increase re-tirement savings. Savings incentivesare an effective and important use oftax relief—one of the very best thingsthat we can do with our opportunity

June 23, 1997this year to relieve the tax burden onAmerican taxpayers. I do hope and ex-pect that we can retain these criticalprovisions in these two bills.

Now let me express one area that Ihave concern about, and that is thearea of how we handle the Medicaid ex-pansion, or the new program for thepurposes of assisting child health. Ihave read the bill. I understand thatStates have the right to choose be-tween a capped grants program and theexpansion of the Medicaid Program. Itis not, however, clear to me what therequirements are relative to coverage,and how demanding the Federal Gov-ernment is going to be on each State asto how and what must be covered oneach child. I would have serious res-ervations if we have created a new en-titlement program. This would be amistake, at a time when we are tryingto control the rate of growth of theFederal Government and growth of themost explosive side of the Federal Gov-ernment, the entitlement accounts ofthis Government; it would be a seriouserror for us to embark on a new enti-tlement program.

It is not clear to me, after havingread this, whether or not we have donethat. It is clear to me that there wasan intention not to do that. At least, inthe language of the bill, and in the ex-planation of the bill, statements weremade that it was not the intention ofthe committee to move down the roadof a new entitlement program. Whetheror not the operable language in factcreates such an event, demanding thatcertain action be taken, that certainexpenditures be made and not fundingthose, or creating a situation wherepeople can come in and demand thoseexpenditures in a way that creates anentitlement or a mandatory program isnot absolutely clear. As we go forwardwith this debate, I hope we will getclarification on this point. Should itturn out that this is a new entitlementprogram, I hope we will change that,either here on the floor or in con-ference, so that the intent of the lan-guage is clear, which is to create agrant program to benefit children andtheir health needs.

Mr. President, I yield the floor.I suggest the absence of a quorum.The PRESIDING OFFICER. The

clerk will call the roll.The assistant legislative clerk pro-

ceeded to call the roll.Mr. GREGG. Mr. President, I ask

unanimous consent that the order forthe quorum call be rescinded.


Mr. GREGG. Mr. President, is thetime being controlled?

The PRESIDING OFFICER. Yes. TheSenator would need time yielded tohim to speak, but could offer anamendment that would then be debatedfor 2 hours equally divided.

Mr. DOMENICI. How much timewould the Senator need?

Mr. GREGG. I would need about 15minutes.


Mr. DOMENICI. Would the Senatorbe agreeable at a later date, in thestacking process, to rearrange theorder of his amendment if the Commit-tee on Finance wants to have anamendment before it?

Mr. GREGG. Absolutely. I wouldagree to a unanimous consent to placemy amendment behind whateveramendments are offered by the chair-man and ranking members of the com-mittee.

Mr. DOMENICI. Would the Senatoralso agree that it can be sequenced ina manner that helps the manager workthis bill through? It won't take a longtime. But it may be second or third.

Mr. GREGG. As long as it is noteliminated.

Mr. DOMENICI. Right.

S6070

Mr. GRAMM addressed the Chair.The PRESIDING OFFICER (Ms. COL-

LINS). The Senator from Texas.Mr. GRAMM. Mr. President, I want

to join our distinguished colleaguefrom New York in commending thechairman of the Finance Committee.


The PRESIDING OFFICER. If theSenator would suspend.

The Chair would like to know whoyields time to the Senator.

Mr. ROTH. I yield to the distin-guished Senator 10 minutes.

The PRESIDING OFFICER. The Sen-ator is recognized for 10 minutes.

Mr. GRAMM. Mr. President, I wantto join our colleague from New York incommending our chairman of the Fi-nance Committee for his excellentwork and leadership. I think it is agreat testament to his leadership thatwe have before us a bill that will spendless money on Medicare than anotherbill we debated 2 years ago which wasdeemed to be a partisan effort whichruptured the bipartisan nature of ourwork on health care.

Today we have before us a bill that issuperior in virtually every way to thatbill. And this bill that is now before uspassed the Finance Committee on aunanimous vote and was strongly sup-ported and praised by every member ofthe Finance Committee.

I think it is a testament to the lead-ership and fairness of the chairmanthat we have achieved this goal. I cansay, as a person who has watched nowmany chairmen work, both in theHouse and the Senate, I have neverseen anybody be fairer to every singlemember of the committee from themost senior member to the most juniormember than Senator ROTh was.

I think it is a lesson to all of us. Thatis, when you have heavy lifting to do, ifyou give people an opportunity tospeak their mind, to have a fair hear-ing for their ideas, in the end they area lot more willing to be part of that ef-fort than if they feel you are trying toram it down their throat or treat themunfairly. We have all heard, from ourteenage years, if you want me with youon the landing, you need to have methere on the takeoff. But we often for-get it in real life. And I think ourchairman has reminded us of it againhere.

We have before us a very thick billwhich is the composite of all of the so-called reconciliation bills that are sup-posed to save money. I want to notethat there is only one bill in here thatsaves any real money, and that is thebill that we are talking about today,the bill that came out of the FinanceCommittee.

Now, lest someone jump up and saythe Commerce Committee savedmoney, what the Commerce Committeedid was to sell spectrum, the right tobroadcast. We had the AgricultureCommittee that was actually orderedto spend $1.5 billion, and remarkablythey had no trouble doing it. But theFinance Committee portion of the billthat is before us saves $100 billion witha Sb" dollars. And it does it in some ofthe most sensitive programs of theFederal Government. I want to talkvery briefly about some of thesechanges because they are important.

We are going to have a lot of debatehere in the Senate tomorrow when we

June 23, 1997

start shooting real bullets and starthaving amendments offered about Med-icare. We are going to have questionsabout the need for long-term reform. Iam proud to say that the bill before usis the most dramatic reform of Medi-care in the history of the program, and,in fact, if you combine all of the otherreforms in Medicare that we haveadopted in the last 32 years into onepackage, it is relatively insignificantas compared to this bill.

I know there will be those who ques-tion the need for this dramatic reform,but I just want to remind my col-leagues that over the next 10 yearsMedicare will be a $1.6 trillion drain onthe Federal Treasury. If you take allthe money we collect in payroll taxesand you compare that to how muchmoney we are going to spend on Medi-care over the next 10 years, we aregoing to fail to pay for the program bya cumulative total of $1.6 trillion.

We have an unfunded liability inMedicare under the best of cir-cumstances. With all the right reforms,if they could be made and done imme-diately, we still have an unfunded li-ability bigger than the current infla-tion adjusted costs of winning WorldWar II. We have promised Medicare totwo succeeding generations and wehave set no money aside to pay forthose benefits. As the baby-boomergeneration—79 million people strong—begins to go into retirement 11 yearsfrom now, we are going to go from 5.9workers to 3.9 workers to 2.2 workersper retiree, and the impact of it isgoing to be cataclysmic on the Federalbudget.

That is why this bill is so importantbecause it takes the first step towardsaving Medicare. I believe if we cansave these reforms not just in the Sen-ate but through the House and to thePresident with his signature, thatevery Member of the Congress will beable to say of this bill that they trulydid something worthy of being remem-bered.

Now, let me outline some of themajor components of the bill that Ithink are important. First of all, thisbill gives our seniors who qualify forMedicare a broad range of choices.Today they have two choices. They canstay in the old fee-for-service Medicarepolicy or they can go into a massiveall-encompassing HMO. What we do isfill in all the areas in between by giv-ing our seniors the same kind of com-petitive choices that are available inprivate medicine today. I think this isa dramatic reform. I think it is a re-form that is going to enhance the qual-ity of health care. It is certainly goingto expand freedom. Since we knowcompetition has an impact on healthcare costs because the competition ofthe last 8 years in the private sectorhas driven the medical price index thatmeasures inflation in medicine belowthe Consumer Price Index which meas-ures the costs of all goods and servicesin the economy, we are confident that

June 23, 1997expanded choice, expanded competi-tion, and the efficiency that it will ul-timately bring will benefit every Medi-care beneficiary and will benefit the110 million people that are paying Med-icare taxes.

This is a very important reform. It isa reform that now, I think, we can beproud to say, is virtually non-controversial.

One thing we have done in the billwhich I say that had it been left up tome I would not have done is we havetransferred home health care out of thetrust fund into general revenue. Thosewho have wanted to be unkind havesaid It is a phony reform; not only arethey unkind, they are correct. In fact,when we initially debated this so-called reform I said that you can buy 10years of solvency in Medicare by tak-ing the fastest growing item in Medi-care out of the trust fund and puttingit in general revenue and not countingit as part of Medicare anymore as partof the part A trust fund. If that is realreform, I can save Medicare for 100years by simply taking hospital careout of the trust fund and putting itinto general revenue and not countingit as part A Medicare, but would any-body believe that I had done anythingwhen I did it?

So, one part of this bill which wasdictated by the budget agreement isthe transfer of home health care. Butthere are two things that we have doneas part of this transfer which reallyrepresents an accounting gimmick, buttwo things we have done are real. No. 1,we are going to build over time 25 per-cent of the cost of home health careinto the Medicare premium that peoplepay for part B services or physicianservices after retirement; and also forthe first time in this bill we have a $5copayment for home health care. Now Iknow that there will be an amendmentoffered and that people will scream andholler that this $5 copayment rep-resents the end of the world. But Iwant to remind my colleagues thathome health care now spends moremoney than the National Institutes ofHealth. It now spends more moneythan the space program. This is a mas-sive uncontrolled program.

Some of you probably saw the big ar-ticle in the Wall Street Journal abouthow people have gotten out of the gar-bage collection business and gone intohome health care and become instantmillionaires, how fraudulent much ofthis program is in terms of people whowere providing services and overbillingand how the whole system is comapletely out of control. We are trying tobegin to tighten up on that but there isnothing that will be better for tighten-ing up on It than asking for a smallnominal payment so that people willlook at the cost, so that people willmake rational choices. So It is a smallcopayment. But if we know anythingabout the world we live in, it is thatsmall costs affect behavior on a sub-stantial basis.

We have very important long-termreform in this bill. The reform has al-


ready been denounced by most of themajor special interest groups in thecountry that tend to speak out onthese issues, and I want to talk aboutthe two long-term reforms. The firstreform has to do with retirement age. Iremind my colleagues that we changedthe retirement age in 1983 for SocialSecurity. I remind you of the cir-cumstances. We were on the verge ofhaving Social Security go bankrupt.We were down to the point where wecould not have sent out the Julychecks. We had a commission that hadnot reached any kind of conclusion,and under the leadership of RonaldReagan we were ultimately able to geta recommendation to make somechanges. The only real substantivechange that the commission made andCongress adopted was changing the re-tirement age. They set out to changethe retirement age over a 35-year pe-riod where, as we recognize that peopleare living longer, as we are healthier,as we are working longer, that ulti-mately Social Security had to change.

People forget that when Social Secu-rity went into effect in 1935 the averageAmerican worker did not have a life ex-pectancy that was high enough thatthey would ever receive any benefitsfrom Social Security. It was the excep-tional person who lived longer thannormal who ever got a penny out of So-cial Security. Our lifetimes, thankGod, have grown tremendously since1935 due to improvements in publichealth, due to improvements in medi-cal care, due to improvements in nutri-tion, and due to the improvements thatwould come as income has risen withour strong free-enterprise economy andwe have all been able to do a better jobtaking care of ourself and our children.

But we raised the retirement age to67 for Social Security—that will be-come effective in the year 2027—but wedid not raise the eligibility date forMedicare. In this bill we make the con-forming changes so that Social Secu-rity and Medicare will again bebrought together. What it means is forpeople who were born in 1960 and whoare, therefore, 37 years old today, theywill know, with 30 years to plan for it,that they are not going to qualify forSocial Security and for Medicare untilthey are 67. So they have 30 years toplan for that change. In my case, I wasborn in 1942. So I know that if this billis adopted, along with the changes thathave already been made in Social Secu-rity, that I will not be eligible to retireuntil I am 65 years and 10 months old.So I have 11 years to adjust to the factthat under this bill I am going to be re-quired and can expect to work 10months longer.

Now, we have a lot of people who aresaying that this is unreasonable, out-rageous, that the end of the world isgoing to come as a result of it, but thisis the reality of the world we live in.We are healthier, we are workinglonger, and we are living longer. So ifthis program that we all depend on isgoing to be there to serve us, this is a

S6071change that needs to be made. I intendto defend it vigorously.

The second change that was madehad to do with asking very high-in-come retirees to pay the full cost of thevoluntary part of this program. Somepeople will recall that the part A of thetrust fund, the hospital part, you payfor during your working life by paying2.9 percent of your wages into a trustfund, and that pay is for part A. Actu-ally it is a long way from paying for itbut that is the system. The part A sec-tion of Medicare which pays for hos-pital care, you do not pay for while youare working, you pay 25 percent of thecosts of the part B premium. When theprogram was started in 1965 it wasgoing to be 50 percent of the costs.

What we do under this bill is ask ourhigh-income seniors, who as individ-uals, make between $50,000 and $100,000a year and as couples from $75,000 to$125,000, to phase up that part B pre-mium from that 25 percent of the costwhich is $526 a year to approximately$2,100 a year of costs, which is the fullcost of that voluntary program.

Now, again, some people will say thisis an outrage, but the plain truth isthis is a voluntary program. It is stilla better buy than anybody can get inthe marketplace. Nobody paid for thisprogram during their working life. Itmakes no sense for my son in the labormarket and 21 years old to be payingtaxes to subsidize voluntary insurancefor a senior who is making $125,000 ayear. It is just not right. This is a goodGovernment program. I note that thesavings from this higher part B pre-mium for very high-income seniors andfrom the retirement age change, thatthe savings from those two programswe do not even count them in this bill.They are not counted for budget pur-poses. We are not using them to bal-ance the budget. We are not using themto fund tax cuts. We are simply doingthem and dedicating all the savings tothe Medicare trust fund to keep thesystem solvent. No one has ever doneanything like this before in the nameof trying to save Medicare.

Finally, we did have a provision thatwould have used the higher costs forvery high-income seniors as a deduct-ible instead of as a payment. We havehad so many questions raised about itthat I have decided, along with others,to go ahead and simply charge the pre-mium and then do a study and a test ofusing the deductible instead of the pre-mium. I will submit for the RECORDtwo letters, one from the American En-terprise Institute and one from theHeritage Foundation, explaining whydoing it where we would raise the de-ductible instead of the premium wouldbe better and would save more moneyand would improve the efficiency of thesystem. The logic which seems to es-cape many people is that if I am ahigh-income retiree and I pay $1,577more for an insurance policy, once Ipaid that, then the cost of medical carethat I would then buy with that policyis totally unchanged.

S6072So all the Government did that

helped Medicare was it got $1,577 out ofmy pocket and pu it into the trustfund to help keep the program alive—good work, important work, but bydoing it as a deductible, which I hopesome day we can do when people under-stand it, you are going to get high in-come seniors who will be more costconscious because they will be payingthe first $2,100 as a deductible, and sothey will actually be consuming medi-cal care more efficiently, getting outtheir bills and reading them, and re-porting when somebody over chargesthem. They will actually be shoppingaround for the best buy. That is whatwe want people to do. But this wholeidea is so important, I don't want anew idea to threaten it.

So I will submit these two letters forthe RECORD. I ask unanimous consentthat they be printed in the RECORD.

There being no objection, the mate-rial was ordered to be printed in theREcORD, as follows:

THE HERITAGE FOUNDATION,June 20, 1991

Hon. PHIL GRAMM,Russell Senate Office Building,Washington, DC.

DEAR SENATOR GRAMM: I was delighted tohear that your amendment concerning theMedicare Part B deductible was added to theFinance Committee bill.

We have long argued, as you have, thatraising the Part B deductible for upper-in-come Americans is wise policy. Moreover,given the choice between raising the deduct-ible and raising premiums, increasing the de-ductible makes far more sense. While raisingthe premium for upper-income retirees, likeraising the deductible, would reduce the tax-payer-financed subsidy now going to peoplewho do not need it, raising the deductiblewould have the added advantage of also sig-nificantly changing patient incentives. Thatwould lay the groundwork for long termstructural reform of Medicare.

I should add that the criticisms leveled atyour amendment are quite remarkable. At atime when Medicare is increasingly incapa-ble of promising continued service to lower-income retirees, it seems incredible thatsome liberal members and organizations aredefending a huge subsidy to the rich. And itis almost amusing to hear the claim that theamendment is unworkable. We have beenmeans-testing programs for the poor formany years, but now we are told that design-ing an income-adjusted Medicare deductiblefor the rich is beyond the capability of thehuman mind.

Keep up the good work, Senator!Sincerely,

STUART BUTLER, Ph.D.,Vice President, Director of

Domestic and Economic Policy Studies.


per capita health care costs, it would todaybe about $1,200.

75 percent of Part B is now financed fromgeneral revenues. This means that each Med-icare recipient receives a subsidy from othertaxpayers of about $1,700 per year. It is high-ly appropriate that higher income Medicarerecipients pay a higher portion of the cost oftheir insurance coverage.

The long-term reform of Medicare is notJust a matter of raising more revenue frompayroll taxes or premiums. It will require re-forms that give recipients incentives to seekmore cost-effective providers when they needcare and to avoid using medical care unlessit is actually needed. Higher deductibles area useful first step on the long road to reformsince they will give those with the greatestability to pay an incentive to use medicalcare more carefully. You will not get thesebehavioral effects from higher premiums.

Since Medigap policies impose extra costsof approximately $1000 per beneficiary onthe Medicare program and reduce the behav-ioral effects of deductibles and co-payments,I urge the Congress to investigate and even-tually pass reforms affecting the Medigap in-surance market.

The views expressed here are my own anddo not necessarily reflect the views of theAmerican Enterprise Institute or any of mycolleagues.

Sincerely yours,ROBERT B. HELMS,

Resident Scholar,Director of Health Policy Studies.

Mr. GRAMM. Madam President, Iyield the floor.

Mr. ASHCROFT addressed the Chair.The PRESIDING OFFICER. The Sen-

ator from Missouri is recognized.Mr. ASHCROFT. Madam President, I

ask unanimous consent that I be al-lowed to yield 20 minutes from the ma-jority time for purposes of making re-marks.

The PRESIDING OFFICER. Is thereobjection?

Without objection, it is so ordered.

June 23, 1997

AMERIcAN ENTERPRISE INSTITUTEFOR PUBLIC POLICY RESEARCH,

Washington, DC, June 20, 1997.Hon. PHIL GRAMM,U.S. Senate,Washington, DC.

DEAR SENATOR GRAMM: I would like to con-gratulate the Senate Finance Committee onits recent action to introduce income-relateddeductibles into the Medicare program. Inmy personal view, this proposed change islong overdue for the following reasons:

The original Part B deductible was $50.After over 30 years, it has only been allowedto increase to $100. If it had been indexed to

SENATE DEBATE

JUNE 24, 1997

Zongrzziona1 RecordUnited States

of America PROCEEDINGS AND DEBATES OF THElO5

CONGRESS, FIRST SESSION

Vol. 143 WASHINGTON, TUESDAY, JUNE 24, 1997 No. 90

Senate

BALANCED BUDGET ACT OF 1997The PRESIDING OFFICER. The Sen-

ate will now resume consideration of S.947, which the clerk will report.

The assistant legislative clerk readas follows:

A bill (S. 947) to provide for reconciliationpursuant to section 104(a) of the concurrentresolution on the budget for fiscal year 1998.

The Senate resumed consideration ofthe bill.

Pending:Gregg modified amendment No. 426. to pro-

vide for terms and conditions of imposingMedicare premiums.

Harkin amendment No. 428. to reducehealth care fraud, waste, and abuse.

Kennedy/Wellstone amendment No. 429. tostrike the provision relating to th imposi-tion of a copayment for part B home healthservices.

Motion to waive a point of order that sec-tion 5611 of the bill violates section313(b)(1)(A) of the Congressional Budget Actof 1974.

AMENDMENT NO. 426

The PRESIDING OFFICER. Therewill now be 15 minutes of debate prior

to a vote on or in relation to the Greggamendment No. 426.

Mr. DOMENICI. Parliamentary in-quiry. Is it not time for the proponentand opponents to share some timeequally in reference to the Greggamendment?

The PRESIDING OFFICER. That iscorrect. There are now 15 minutesequally divided on the Gregg amend-ment No. 426.

Mr. DOMENICI. I yield the floor toSenator GREGG.

Mr. GREGG. Mr. President, I am notsure who rises in opposition to thisamendment. I understand there aresome concerns that have been raised.Let me review the amendment so peo-ple understand what it does.

Essentially, this amendment createsa marketplace, creates competition,and it gives seniors the opportunity togo into the marketplace, be thoughtfulpurchasers, and the result of beingthoughtful purchasers is getting an ac-tual return, a monetary return, forbeing thoughtful purchasers.

What the amendment does is strikethe language in the bill which saysthat there can be no cash incentivestied to any sort of Choice plan. Now, inthe original bill as it was presented bymyself, the original Choice bill, thevast majority of which has been incor-porated in this bill, we had a sectionwhich said that if a senior was able topurchase a plan at less dollars, thenthe senior would be allowed to keep 75percent of the savings, and 25 percentof the savings would go into the part Atrust fund. Under the bill as it is pres-ently structured, the practical effectwas it created more marketplaceforces. It meant seniors would be morethoughtful purchasers of health care.This is important.

Second, it meant that the health careprovider groups like HMO's, PPOs andthe PSO's who are now being empow-ered to compete for senior dollars,those groups would have a reason todeliver the same benefit structure as

• This "bullet" symbol identifies statements or insertions which are not spoken by a Member of the Senate on the floor.

0 Printed on recycled paper containing 100% post consumer waste

S6105

S6106Medicare gives today at the same qua!-ity but deliver it at less cost. It iscalled capitalism. It is called a market-place force. It is what we are trying toput in place to try to control the costof health care and Medicare, and it iswhat is working in the private sector.

Under the bill as it is presentlystructured that opportunity would beeliminated. Now, we are not suggestingthat opportunity has to be pursued. Weare just saying let's leave open that op-portunity under HCFA's guidance, andby the way, if it was determined thismight be a way to create better com-petition and better health care deliv-ery, it would be available.

Now, I cannot speak for the opposi-tion, but what I have heard from theopposition is that there is a feelingthat this cash rebate may in some wayaffect the Treasury. Well, it does not.Under the present law as it is struc-tured in this bill, if there is no cash re-bate, the only beneficiaries of more ef-ficiency are the provider groups. Theyget to keep the money. They get tokeep the money. They do not rebate itto the seniors. They get to keep it, toquote Jerry McGuire.

Then I heard another comment, 'Ba-sically what we want to do is encour-age the provider groups to supply morebenefits, not to supply a financial re-bate to senior citizens." I think thatmakes sense. I think that should be anoption. I think provider groups likePPO's that can deliver the services forless might want to throw in eyeglasscare, might want to throw in prescrip-tion care. I think it is a good publicpolicy decision to encourage that. Butat the same time I bet you there aresome provider groups today, becausewe pay so much in insurance for Medi-care, who could pay the cost of eye-glass care and some percentage of pre-scription drug care and still be deliver-ing that service for considerably lessthan what the basic premium is todaythat we pay in Medicare. Who is goingto keep that difference? The providergroups. They will keep it in profit.

Now, I do find it ironic that peoplewould oppose the concept that we wantto open it up to competition in a waythat allows the senior citizen to benefitfrom the cost savings, by putting somepressure on those provider groups tohave to say, "We are going to make$100 extra on this contract. Maybe webetter return $50 to the senior citizenbecause, if we do not, our competitordown the street will make that $100and they will return that $50 and theywill get this client."

Right now this is an issue. I under-stand there are some undercurrents ofopposition to this. I am appreciative ofthat. The fact is that this is an at-tempt to open the marketplace to morecompetition and create more cost-con-scious purchasers and buyers, and as aresult I think it is a good approach. Itdoes not demand that that occur. Itdoes not even allow that to occur inthe first instance. It simply makesthat additional avenue of competition


available by giving HCFA the author-ity to do it rather than banning HCFAfrom having the authority to do it.

I reserve the remainder of my time.The PRESIDING OFFICER. The Sen-

ator from New Jersey controls 71/2 min-utes.

Mr. LAUTENBERG. Mr. President, Iwill yield myself such time as neededto respond with my opposition to theamendment of the Senator from NewHampshire and rise in support of theprovision in the reconciliation packagethat was developed by Senator ROThand Senator MOYNIHAN and other mem-bers of the Finance -Committee.

Mr. President, the reconciliation billestablishes a new program known asMedicare Choice, which will give Medi-care beneficiaries more options for thetype of health care that they will re-ceive in the program. Seniors will beable to choose from HMO's, PPO's, andmedical savings accounts, among sev-eral other options. The committee'sproposal is intended to increase Choicefor seniors. At the same time, it ismeant to avoid the risk that the Medi-care Program would move toward atwo-tiered or multitiered system inwhich some seniors, especially thehealthier and wealthier, enjoy benefitsnot available to the others.

Under the. committee-reported bill,providers of different services are paida set amount. They then can competefor the consumers based on the qualityand types of benefits they provide. If,for example, one HMO can operatemore efficiently, it can plow the result-ing savings into providing services thatother less-efficient HMO's could not.This type of system is intended to en-sure that seniors get the best qualitycare for each Federal dollar that getsspent. I think that makes sense.

The Finance Committee also wantedto avoid a situation in which providerslimit their benefit package to attractthose who are healthy and who there-fore could take advantage of a cheaperplan that offers fewer benefits. Thiscould ultimately lead to a Medicaresystem that segregates the healthyfrom the ill and that forces sicker peo-ple to pay more to get the health carethey need.

Mr. President, I am going to stickwith the Finance Committee's proposalon this. Let's give seniors more choicebut let's make sure that the choicesoffer the type of quality health carethey need and deserve.

When I think of plans that may offerpremiums—maybe they offer theatertickets or baseball games or what haveyou—to seduce or induce people to gotheir way, I think that is a terribleidea. It can provide a large providerwith a monopoly of opportunities.Spend your money now, you will get

it back." You will have these peoplelocked into your service, so spend it upfront. It is a calculated marketingcost. Frankly, I hate to see our seniorcitizens get caught up in a scheme likethat.

Mr. President, I hope we will be ableto muster the support that is required

June 24, 1997

here for the Finance Committee. Onceagain, this is now a new proposal. It al-ters the bill as originally developed. Ido not think we ought to be doing it atthis time.

I reserve the remainder of my time.Mr. GREGG. I appreciate the com-

ments of the Senator from New Jersey,but they are inaccurate. This does notcreate a two-tier system.

Under the law, the basic benefitspackage of the Medicare system has tobe supplied by all providers. Therefore,any provider that comes forward andproduces a less costly system is goingto be producing a system that stillmeets the basic benefits package of theMedicare system. The added benefitsmight be eyeglasses or prescriptiondrugs, but those are benefits which arenot presently covered by Medicare any-way. So there is no opportunity for atwo-tiered system.

What the Senator from New Jerseysaid that was accurate is that efficientsuppliers of health care will end up cre-ating a savings. What I am pointingout is that savings then flows to thesupplier of the health care, the HMO orthe PPO. You are basically underwrit-ing the big health care companies atthe disadvantage of seniors becauseseniors get none of that savings unlessthere is a benefit added that they maynot want. They may not want eye-glasses. They may not want prescrip-tion drugs. They may have that underanother system. Why not make this op-tion available?

However, I have been asked by thechairman of the committee to with-draw the amendment at this time. Ihave great respect for the chairman ofthe committee and will acquiesce tohis request. I understand his concern. Ibelieve this is bad policy as it is pres-ently structured. It is not in the Housebill, and I hope it will be straightenedout in Congress because I think weought to give seniors this chance.

I ask unanimous consent to vitiatethe yeas and nays and withdraw theamendment.


The amendment (No. 426) was with-drawn.

Mr. NICKLES. Mr. President, I willbe brief. I want to compliment my col-league from New Hampshire for offer-ing this amendment.

He mentioned this prohibition is notin the House bill. I hope to have some-thing to do with the conference. Ithink he has brought out a very goodpoint. We should allow some of thesesavings to go to the participants. So Iappreciate his examination of the bill.That fact proves he has done his home-work. I, for one, think he has pointedout a good option that we should allowto be available. I appreciate my col-league's attention in this matter. I willbe happy to work with him to see if wecan't come up with a good provision inconference.

Mr. ROTH addressed the Chair.The PRESIDING OFFICER. The Sen-

ator from Delaware is recognized.

June 24, 1997Mr. ROTH. Mr. President, I, too

want to join the distinguished Senatorfrom Oklahoma in thanking our friendfrom New Hampshire and withdrawingthe amendment. I think he has articu-lated the reason for the change. I thinkthere is considerable merit to the idea,but I do appreciate the fact that he haswithdrawn the amendment. I don'tthink it is appropriate at this time. Welook forward to working with him.

Mr. DOMENICI addressed the Chair.The PRESIDING OFFICER. The Sen-

ator from New Mexico.Mr. DOMENICI. Mr. President, I, too,

want to join in saying to the distin-guished Senator from New Hampshirethat I saw this as a Choice proposal, anexpansion of Choice. It wasn't a man-date. I thought it was a pretty goodthing that we keep as much choice andpotential for choice in the Medicare re-form. I am sure this will be revisited atsome point.

As the manager for the majority, Iwould like to talk a little bit with theSenate about where we are. Could I in-quire, none of the amendments areautomatically up at this point, arethey? Am I mistaken on that? Aren'tthey subject to a management decisionon which ones come next?

The PRESIDING OFFICER. Thequestion would recur on No. 429, theKennedy-Wellstone amendment to S.947.

Mr. DOMENICI. I thank the Chair.Might I then enquire, under the ordi-nary rules of amendments, how muchtime is left on the Kennedy-Wellstoneamendment, if it were all to be used?

The PRESIDING OFFICER. TheChair will check on that.

Mr. DOMENICI. That is fine. Is thereany reason we should not go to theKennedy-Wellstone amendment? I amsure Senator Rom has a substantialamount of time on the amendment. Iwant to yield the entire time in opposi-tion to the amendment to the distin-guished chairman of the Finance Com-mittee. I may need a few minutes later.I will yield the Senator the time thatis left. Can the Senator manage that?

Mr. ROTH. Yes, I can manage that.The PRESIDING OFFICER. To an-

swer the question of the Senator fromNew Mexico as to the time remainingon the Kennedy-Wellstone amendment,Senator KENNEDY has 15 minutes andthe Senator from New Mexico has 45minutes.

Mr. DOMENICI. I will yield the 45minutes to Senator ROTh.

Let me indicate to the Senate, sothere won't be any misunderstanding,that what I am trying to do is get timeused up or get time agreements. Wedon't intend to vote on the Kennedy-Wellstone amendment until early inthe afternoon. So we can finish the de-bate and go to another one. I wanted toindicate that to the Senate at thispoint.

Mr. LAUTENBERG. Mr. President, ifI might just add a note here for all ofour colleagues who are interested inamendments, or talking on the bill.


Time is flying and we will be finishedat about 7:30 tonight, I think it is, withno more time left. And then should anyamendments be offered, they will be of-fered without debate or discussion andjust voted upon.

So I say to all of our colleagues with-in earshot, or through the staff, if youhave amendments, you better get themhere because pretty soon the time willhave expired and you won't have an op-portunity to do so.

I thank the Chair.The PRESIDING OFFICER. The Sen-

ator from Delaware is recognized for 45minutes.

S6107

June 24, 1997 CONGRESSIONAL RECORD—SENATE S6117

Mr. GRAMM. Mr. President, whenSocial Security started in the mid-1930's, the average person paying intoSocial Security, given the lifespan pro-jections, was not projected to live longenough to get any of the benefits. Infact, we forget that when Social Secu-rity started, the average life expect-ancy of Americans was substantiallyless than 65.

By 1983, Social Security had becomeinsolvent. We were in danger, in thespring, of not being able to send outJuly checks. We had a crisis in SocialSecurity, so we instituted a series ofreforms to try to pull Social Securityback in the black. One of those reformswas raising the retirement age begin-ning in the year 2003. Then over the en-suing 24 years it would be raised insmall increments up to 67. We did itunder crisis circumstances. I rememberthe vote. I was a young Member of theHouse at the time. It was adopted on abipartisan vote. Nobody liked it, buteverybody recognized that it had to bedone.

We did not make a similar change forMedicare then because Medicare was inthe black. Today, our circumstanceswith Medicare are very, very different.If you look at this chart behind me, wecurrently are in this last small part ofblue. Medicare is now in the process,very rapidly, of going bankrupt and theMedicare part A trust fund, which pays

S6118for hospital care, within 4 years will beinsolvent. We expect Medicare, basedon everything that exists now, to be adrain on the Federal Treasury of $1.6trillion over the next 10 years.

Our problem is not only explodingcosts, but the fact that we have a babyboomer generation that was born im-mediately after the war which madeMedicare possible as all these babyboomers came into the labor marketbeginning in 1965. But 14 years fromtoday, the first baby boomer retires.We will go from 200,000 people retiringa year to 1.6 million people retiring ayear. The number does not change for20 years. We go from 5.9 workers per re-tiree in 1965, to 3.9 workers per retiree,to 2.2 workers per retiree. We are fac-ing a very great crisis in Medicare.

We also face a timing crisis. Every-body knows we are going to have toraise the retirement age for qualifyingfor Medicare as we did for Social Secu-rity. Everybody knows it is going tohave to be done. If we do it today, weare going to have time for it to phasein. But if we wait another 3 or 4 years,the phase-in for Social Security willhave started and we are going to beforced to tell people who have plannedfor retirement that their Social Secu-rity benefits and their Medicare cov-erage are not going to cut in when theyplan to retire.

If we make this change today, peoplewill have time to adjust. For example,I was born in 1942. If we pass this billtoday, I will know that if I plan to re-tire at 65, that my Social Security ben-efits and my Medicare coverage willnot cut in until I am 65 years 10months of age. So I have 11 years, if Iwere looking forward to that retire-ment, to plan for it. If we keep waiting,knowing we are going to have to dothis, we are going to end up having toforce change on people when they arenot ready. The advantage of doingwhat we have done is that it phases inbetween now and the year 2027, andpeople have time to plan for it.

It is the ultimate paradox that wehave a point of order against this pro-vision because we did this provisionwithout claiming any savings for thebudget. We made this change to saveMedicare. We dedicate every penny ofsavings to the Medicare trust fund, wedon't count a penny of the savings to-ward balancing the budget or fundingtax cuts, and now we have a point oforder against the amendment becausewe are not claiming savings.

So we try to answer the charge thatis often made on the other side of theaisle that you are cutting Medicare tobalance the budget or you are cuttingMedicare to cut taxes. We try to re-spond to that by taking a long-termview of saving Medicare. We do notcount it toward reducing the deficit,we don't let any of it be spent, and wedon't let any of it be used for tax cuts.We simply are trying to do somethingthat is fundamentally important.

Medicare is going broke. We have anunfunded liability for Medicare todayof $2.6 trillion.


The PRESIDING OFFICER (Mr. SES-SIONS). The Senator has spoken for 5minutes.

Mr. GRAMM. May I have 1 additionalminute?


Mr. GRAMM. The plain truth is wehave guaranteed two generations ofAmericans benefits under Medicare,and we have not set any money asideto pay for it. We have an outstandingliability of $2.6 trillion. If we wait 10years to do something about it, it willbe $3.9 trillion. If we wait 20, it will bebigger than the entire national debt ofthe country at $6.1 trillion. The Fi-nance Committee, in an extraordinaryact of courage, decided to make thischange and not count any of it towardbalancing the budget and not countany of it to pay for the tax cut but tosimply do it so we will never have tocall up senior citizens and tell themMedicare went broke today.

I supported this provision because Ihave an 83-year-old mother who de-pends on Medicare, and I don't want topick up the phone someday and say,Mama, Medicare went broke today. I

knew it was going broke, but I did nothave courage enough to do anythingabout it.'

We have an opportunity over thenext 30 years to phase up the eligibilitydate for Medicare to conform to SocialSecurity, something we have alreadyhad to do under crisis circumstances.Let's not wait until the house is on fireto do something about the problem.

I urge this point of order be waived.The PRESIDING OFFICER. Who

yields time?The PRESIDING OFFICER. The Sen-

ator from Illinois.Mr. DURBIN. Mr. President, I don't

know if I need permission from SenatorLAUTENBERG on our side, but I amgoing to presume there is no objectionto speak on behalf of our side in rela-tion to this motion to waive. I see Sen-ator LAUTENBERG on the floor now.

Mr. LAUTENBERG. I yield so muchtime, up to 10 minutes, as the Senatorfrom Illinois requires.

Mr. DURBIN. I thank my colleaguefor making this legitimate.

The PRESIDING OFFICER. The Sen-ator from Illinois is recognized.

Mr. DURBIN. Mr. President, what isthis all about? Well, you say the word'Medicare' and senior citizens start

listening. "Medicare, wait a minute,that is my mother's health insuranceprotection, it is my grandfather'shealth insurance. What are they doingto Medicare?"

Let me tell you for a moment, if youare 65 years old or older, listen with in-terest; if you are 59 years old or young-er, listen to this debate with great in-terest. It is about you and when youwill be able to retire. It is whether ornot you will have the protection ofhealth insurance In your old age.

This is the committee print for thebill we are considering, a very interest-ing document. There is a provision in

June 24, 1997

here that we are now debating whichyou might overlook, but it is so impor-tant that virtually everyone under theage of 59 years in the United States ofAmerica, because of a handful of sen-tences here, may have to change theirplans as to when they are going to re-tire. That is how important this debateis, that is how important this issue is,because buried in this committee printon page 161 at the bottom of the page isa Texas two-step for America's work-ing families. A Texas two-step—step,step, slide, slide, and guess what? Itraises the eligibility age for Medicarefrom 65 to 67.

What does that mean? It means ifyou were counting on retiring at age65, taking your Social Security, takingyour Medicare, guess what? You nowhave to wait a couple of years, or atleast retire without the protection ofMedicare.

Is that important to people? I thinkit is very important. Do you know howmany people now at the age of 65 havehealth insurance in America? Thirtypercent; 70 percent do not. They arepeople who count on Medicare to pro-tect them. And the Senator from Texasoffers an amendment which says, "Oh,you can count on Medicare to protectyou, just wait 2 years, wait 2 years, andthen we will start protecting you."

What if you should retire at age 60,what if your employer says to you,• Oh, take your retirement, we'll giveyou health insurance protection,' andchanges his mind? Have you ever heardthat story? I have heard it plenty. Peo-ple who retired say, "I'm taken care of,the company I work for gave me awatch, they gave me a health insur-ance plan, this is going to be great, I'mgoing fishing. Then what happens?The company is sold two or threetimes, a couple mergers, a couple cut-backs, and the next thing you know,they are saying, "Sorry we have tosend you a letter and tell you the badnews. No more health insurance, Mr.Retiree. Thanks for working for us for35 years." And there you sit at age 61without health insurance.

What does it cost you? I know whatit costs in Chicago because we checked.About $6,000 a year if you are healthy.If you are not healthy and in your six-ties, 10,000 bucks a year. Did you counton that when you decided to retire? Idon't think so. And if you get stuck inthat position, you know what you startdoing? You start counting the days towhen you will be eligible for Medicare.How many more months before I reachage 65 and Medicare is going to come inand protect me and my family and mysavings? You count the days.

The Senator from Texas, who offersthis amendment, wants you to keepcounting for 24 months more, wantsyou to hang on until you are 67. Thenhe says we should make you eligible forMedicare.

I think that there is some questionas to the statement in the committeeprint about its voracity. I know we arenot supposed to say that, but let me

June 24, 1997just tell you why I say that. The com-mittee says we are changing Medicareso that it tracks Social Security and,in their words, they say, "The commit-tee provision will establish a consist-ent national policy on eligibility forboth Social Security, old age pensionbenefits and Medicare."

Let us concede the obvious. The ageto retire under Social Security in thenext century is going to go up from 65to 67. This is true. It is the basis forthis amendment. But it is not thewhole story, I say to my friends. Thewhole story is this. You can draw So-cial Security at age 62. You won't getas much, but that is your option. "Iwill take a lower retirement, I'm leav-ing at 62, that's it." But you cant dothat on Medicare. You can't draw Med-icare benefits at age 62. Right now youwait until you are age 65, unless youare disabled, and the Senator fromTexas wants you to keep on waiting for2 more years to the age of 67. I dontthink that is an accurate statementwhen they say they are going to trackSocial Security. They dont track So-cial Security.

The Senator argues this gives peopletime to adjust. He talks about compas-sion and courage. How much couragedoes it take to say to a senior citizenwho now has developed a serious heartproblem, "Keep drawing out of yoursavings accounts to pay for your healthinsurance."

You know what will be compas-sionate and courageous, not raising theage to 67. What would be compas-sionate and courageous is universalhealth care. To say no matter how oldyou are, rich or poor, where you live,black or white, regardless of your eth-nic background, you are insured inAmerica. You are not going to be stuckin the situation we are creating withthis bill, you are not going to be stuckin the position with a terrible medicalproblem at age 62 and no health insur-ance, waiting and praying for the daywhen you are eligible for Medicare.That would be compassion and courage.That would be responsive to the 40 mil-lion Americans stuck today withouthealth insurance.

Let me tell my friends, my opposi-tion to this provision to raise the eligi-bility age for Medicare comes, ofcourse, from the, Democratic side, but Ihave some interesting allies in thisbattle. Eighty different corporationshave written to the Members of theSenate and said, "Please, do not dothis, do not accept Senator Grammsproposal to raise the eligibility age forMedicare to 67." Among them, the Na-tional Association of Manufacturersand the U.S. Chamber of Commerce.

What is a Democrat doing arguingthe position of the U.S. Chamber ofCommerce here? I will tell you why.These companies and their associationsnow offer to their employees health in-surance protection until they are eligi-ble for Medicare. That is written in thecontract. If you make eligibility forMedicare age 67 instead of 65, these


companies have a new liability thathas been dumped in their laps by theTexas two-step, and it is a disincentivefor any other company to offer thisbenefit to their employees. They knowit costs more, and they don't knowwhat the Senate is likely to do nextyear when it comes to Medicare eligi-bility. That is what this battle is allabout.

When I look at the number of peoplecurrently covered by health insuranceat age 60 and 65 in America, it is clear.Fewer companies are offering protec-tion. More people are on their own. Theexpense of health insurance when youreach age 60 goes through the roof,even without any kind of medical prob-lem. That is what this debate is allabout.

You want to save Medicare? Thereare lots of things we need to do on a bi-partisan basis. There is a Commissioncreated by this bill to study thoseways, to make sure that we do it in asensible, fair, compassionate way. Butinstead, my colleague from Texas andhis friends on the committee have de-cided, let's just take a flier, let's throwone of them out there. And the firstone they throw out there does not im-pose any new liability on health careproviders, it imposes a new burden onseniors in years to come.

Those who retire after the year 2003have to start waiting longer and longerand longer. I say to my friends, I dontthink that is what Medicare is allabout. Many of the people who pro-posed this, frankly, don't care much forMedicare. That came out in the lastcampaign. Some of the candidatesstood up and said, "Yeah, I votedagainst it, and I'd do it again." I amnot one of them. I didn't have the op-portunity, the rare opportunity, tovote for this program. But I will tellyou this, I am going to vote to protectit. I am going to vote to protect it be-cause of what it has meant to my fam-ily. Medicare has meant to my familythat you can retire not only with thedignity with Social Security, but withthe protection of Medicare.

Parents don't want to be burdens ontheir children. They want to live inde-pendently, enjoy their lives becausethey played by the rules and they havepaid in. To change the rules at thispoint, to say we are going to raise theretirement age for Medicare really re-neges on a promise that was made over30 years ago. It is the wrong way to go.We can make Medicare solvent in thelong term, and we can do it in a sen-sible way.

At this point, I yield, for purposes ofdebate, to my colleague from Califor-nia, Senator BOXER.

Mr. LAUTENBERG. Mr. President, Iask how much time does the Senatorfrom Illinois have remaining that Igave him?

The PRESIDING OFFICER. The Sen-ator has spoken for 10 minutes.

Mr. LAUTENBERG. He has spokenfor 10 minutes.

Mr. GRAMM addressed the Chair.

S6119The PRESIDING OFFICER. The Sen-

ator from Texas.Mr. GRAMM. Mr. President, I yield

myself 4 minutes.The PRESIDING OFFICER. The Sen-

ator from Texas is recognized.Mr. GRAMM. Mr. President, let me

first point out that when our colleaguetalks about people waking up and find-ing that age of eligibility is changed by2 years, let me say that those peopleare 37 years old today. It will be be-tween now and the year 2027 that thisretirement age will phase up.

One of the reasons we want to do thisnow is we dont want people to wake upand discover that this has happenedand they have not had time to plan onit. By doing it now, this will affect thefull 2-year increase; it will affect onlypeople born after 1960. That is, they aregoing to have 30 years in which tochange their life's plan in order to ac-commodate this change.

Our colleague acts as if tomorrowthey are going to wake up and discoverthat the eligibility has changed.

Let me remind my colleague, unlessthe note I have been passed is incor-rect, that in 1983, on March 24, our col-league voted to raise the retirementage for Social Security, is that correct?

Mr. DURBIN. Will the Senator yield?Mr. GRAMM. I yield for an answer to

that question.Mr. DURBIN. The amendment offered

was the Pickle-Pepper amendment inthe House of Representatives. I votedwith Mr. Pepper and against raisingthe retirement age.

Mr. GRAMM. You voted for final pas-sage on the bill on March 24. My pointis, we are going to have to do this. Ev-erybody knows we are going to have todo it. Should we wait until there is acrisis so that we will literally do whatthe Senator from Illinois says andmake the change so it will go into ef-fect immediately?

That is what is going to happen whenyou look at the exploding deficit ofMedicare. We will have a $1.6 trillionloss to the Treasury in trying to main-tain the program in the next 10 yearsalone.

Our colleagues are not telling us thatby the year 2025 when we will be goinginto the final phase up, we will have totriple the payroll tax—triple the pay-roll tax—to pay for Medicare if wedont begin to make changes. They arenot proposing today to triple the pay-roll tax. They are simply saying,"Don't act now, wait until there's acrisis; wait until Medicare is flat on itsback and then make the change.'

Let me tell you why we can't do that.We can't do it because the phase in isalready underway in Social Security,something that both Houses of Con-gress approved, and the Presidentsigned. It was voted for on a bipartisanbasis raising the effective retirementage for full retirement benefits to 67.That is already the law of the land, andthat phase up begins very slowly, amatter of months each year, very slow-ly, but it begins in the year 2003.


If we wait, we are going to end updoing what our colleague accuses us oftoday. But the truth is, by doing itnow, for those who will have to wait anadditional 2 years, they will have 30years to adjust. This is the responsibleway to do it. It is the way it should bedone, and I hope it will be done. If wedon't do it, we will be back here in 3 or4 years doing it under crisis cir-cumstances and doing it immediately.

The PRESIDING OFFICER. The timeof the Senator from Texas has expired.

Mr. ROTH addressed the Chair.The PRESIDING OFFICER. The Sen-

ator from Delaware.Mr. ROTH. Mr. President, I ask unan-

imous consent that we set aside tempo-rarily the motion before us to considera technical amendment that has beencleared on both sides.


AMENDMENT NO. 431

(Purpose: To provide for managers'amendments)

S6144 CONGRESSIONAL RECORD—SENATE JUne 24, 1997

UNANIMOUS-CONSENT AGREEMENT

Mr. LOTT. Mr. President, we haveagain conferred with the Democraticleadership, and I believe we have thisunanimous-consent agreement ap-proved.

I ask unanimous consent that all re-maining amendments in order to 5. 947must be offered prior to the close ofbusiness today and any votes orderedwith respect to those amendmentsoccur beginning at 9:30 a.m. on Wednes-day, in a stacked sequence, with 2 min-utes equally divided between each vote.


Mr. LOTT. I ask unanimous consentthat when the Senate reads 5. 947 forthe third time, the Senate proceed tovote on passage of the balanced budgetreconciliation bill, all without inter-vening action or debate, and when theSenate receives the House companionbill, the Senate proceed to its imme-diate consideration and all after theenacting clause be stricken and the

June 24, 1997 CONGRESSIONAL RECORD — SENATE S6145

text of 5. 941, as amended, be inserted,the bill be immediately considered ashaving been read for a third time andpassed and the motion to reconsider belaid upon the table, all without furtheraction or debate.


Mr. LOTT. Mr. President, we can an-nounce that that would be the last re-corded vote tonight. We will begin ourstacked votes in the morning at 9:30.We are ready to go with the remainingdebate and amendments that will be of-fered.

I yield the floor.Mr. GRAMM. I yield to the Senator

from Illinois for a unanimous-consentrequest, without losing my right to thefloor.

Ms. MOSELEY-BRAUN. I thank myfriend, the Senator from Texas.


AMENDMENT NO. 446

(Purpose: To require States to verify thatprisoners are not receiving food stamp ben-efits)Mrs. HUTCHISON. Mr. President, I

send an amendment to the desk andask for its immediate consideration.

The PRESIDING OFFICER. Theclerk will report the amendment.

The bill clerk read as follows:The Senator from Texas (Mrs. HUTCHI5ONJ,

for herself and Mr. SANTORUM, proposes anamendment numbered 446.

Mrs. HUTCHISON. Mr. President, Iask unanimous consent that reading ofthe amendment be dispensed with.


The amendment is as follows:At the end of title I, add the following:

SEC. 1O_. DENIAL OF FOOD STAMPS FOR PRIS-ONERS.

(a) STATE PLANs.—(1) IN GENERAL—Section 11(e) of the Food

Stamp Act of 1977 (7 U.S.C. 2020(e)) is amend-ed by striking paragraph (20) and insertingthe following:

'(20) that the State agency shall establisha system and take action on a periodicbasis—

•'(A) to verify and otherwise ensure that anindividual does not receive coupons in morethan 1 jurisdiction within the State; and

'(B) to verify and otherwise ensure that anindividual who is placed under detention in aFederal, State, or local penal, correctional,or other detention facility for more than 30days shall not be eligible to participate inthe food stamp program as a member of anyhousehold, except that—

S6147'(i) the Secretary may determine that ex-

traordinary circumstances make it imprac-ticable for the State agency to obtain infor-mation necessary to discontinue inclusion ofthe individual; and

'(ii) a State agency that obtains informa-tion collected under section 1611(e)(1)(I)(i)(I)of the Social Security Act (42 U.S.C.1382(e)(1)(I)(i)(I)) through an agreementunder section 161P(e)(1)(I)(ii)(II) of that Act(42 U.S.C. 1382(e)(1)(I)(ii)(II)), or under an-other program determined by the Secretaryto be comparable to the program carried Outunder that section, shall be considered incompliance with this subparagraph.".

(2) LIMITs ON DISCLOSURE AND U5E OF INFOR-MATION—Section 11(e) (8) (E) of the FoodStamp Act of 1977 (7 U.S.C. 2020(e)(8)(E)) isamended by striking "paragraph (16)" andinserting "paragraph (16) or (20)(B)".

(3) EFFECTIVE DATE.—(A) IN GENERAL—Except as provided in

subparagraph (B), the amendments made bythis subsection shall take effect on the datethat is 1 year after the date of enactment ofthis Act.

(B) EXTENSION—The Secretary of Agri-culture may grant a State an extension oftime to comply with the amendments madeby this subsection, not to exceed beyond thedate that is 2 years after the date of enact-ment of this Act, if the chief executive offi-cer of the State submits a request for the ex-tension to the Secretary—

(i) stating the reasons why the State is notable to comply with the amendments madeby this subsection by the date that is 1 yearafter the date of enactment of this Act;

(ii) providing evidence that the State ismaking a good faith effort to comply withthe amendments made by this subsection assoon as practicable; and

(iii) detailing a plan to bring the State intocompliance with the amendments made bythis subsection as soon as practicable andnot later than the date of the requested ex-tension.

(b) INFORMATION SHARING—Section 11 ofthe Food Stamp Act of 1977 (7 U.S.C. 2020) isamended by adding at the end the following:

(q) DENIAL OF FOOD STAMPS FOR PRI5-ONERS.—The Secretary shall assist States, tothe maximum extent practicable, in imple-menting a system to conduct computermatches or other systems to prevent pris-oners described in section 11(e)(20)(B) fromreceiving food stamp benefits.".

SEC. 1O_. NUTRITION EDUCATION.

Section 11(f) of the Food Stamp Act of 1977(7 U.S.C. 2020(f)) is amended—

(1) by striking (f) To encourage" and in-serting the following:

(f) NUTRITION EDUCATION.—(1) IN GENERAL—To encourage"; and

(2) by adding at the end the following:'(2) GRANTS.—"(A) IN GENERAL—The Secretary shall

make available not more than $600,000 foreach of fiscal years 1998 through 2001 to paythe Federal share of grants made to eligibleprivate nonprofit organizations and Stateagencies to carry out subparagraph (B).

"(B) ELIGIBILITY.—A private nonprofit or-ganization or State agency shall be eligibleto receive a grant under subparagraph (A) ifthe organization or agency agrees—

(i) to use the funds to direct a collabo-rative effort to coordinate and integrate nu-trition education into health, nutrition, so-cial service, and food distribution programsfor food stamp participants and other low-in-come households; and

(ii) to design the collaborative effort toreach large numbers of food stamp partici-pants and other low-income households

June 24, 1997

S6148through a network of organizations. includ-ing schools, child care centers, farmers' mar-kets, health clinics, and outpatient edu-cation services.

'(C) PREFERENCE—In deciding between 2or more private nonprofit organizations orState agencies that are eligible to receive agrant under subparagraph (B), the Secretaryshall give a preference to an organization oragency that conducted a collaborative effortdescribed in subparagraph (B) and receivedfunding for the collaborative effort from theSecretary before the date of enactment ofthis paragraph.

(D) FEDERAL SHARE.—(i) IN GENERAL—Subject to subparagraph

(E). the Federal share of a grant under thisparagraph shall be 50 percent.

'(ii) No IN-KIND CONTRIBUTIONS—The non-Federal share of a grant under this para-graph shall be in cash.

(iii) PRiVATE FUNDS—The non-Federalshare of a grant under this paragraph mayinclude amounts from private nongovern-mental sources.

(E) LIMIT ON INDIVIDUAL GRANT—A grantunder subparagraph (A) may not exceed$200,000 for a fiscal year.".

The PRESIDING OFFICER. The Sen-ator from Texas.

Mrs. HUTCHISON. Mr. President, Iunderstand this has been Cleared byboth sides. This is an amendment thatI offer. It is an amendment that passedon a record vote of 409 to zero in theHouse. It basically closes a loophole inthe Food Stamp Program.

The GAO did a study and determinedthat the Federal Government is losingnearly $4 million a year to provide foodstamps for prisoners who obviously donot need food stamps. Prisoners do notqualify for food stamps because, ofcourse, they are being fed in prison.But nevertheless, there is food stampabuse going on where someone in ahousehold claims a prisoner to add tothe food stamp benefits.

Mr. President, I am very pleased thatthis amendment is going to be acceptedbecause I think it is very importantthat the States do a basic check oftheir prison rolls with their food stamprolls to make sure that the food stampsare being used for the purpose forwhich they were intended.

Food stamps are an entitlement, asthey should be. They are given to any-one who is in need. But I think it is notfair to double dip, and we can save $4million. In fact, that $4 million will gointo some of the other very importantprograms that will be covered by thisreconciliation bill.

So I am very pleased that we areclosing this loophole, and I am verypleased that we are also adding anotherpart that provides nutrition educationfor the low-income households througha network of social service organiza-tions. This is something that SenatorRICK SANTORUM has been a leader indoing. and he is a cosponsor of thisamendment. I think we can do a lot ofgood.

So I thank the managers of the billfor accepting this amendment. I urgeadoption of the amendment and askthat we have a voice vote.

The PRESIDING OFFICER. Is therefurther debate?


Mr. HARKIN addressed the Chair.The PRESIDING OFFICER. The Sen-

ator from Iowa.Mr. HARKIN. I just wonder if I could

ask—I was just informed of this amend-ment as ranking member on authoriza-tion. Ijust want to make sure I under-stand it fully. I would ask the Senatorfrom Texas to yield for a question.

Mrs. HUTCHISON. Yes, I would behappy to yield for a question.

Mr. HARKIN. As I understand, whatthe Senator is saying is that right nowunder the food stamp rolls, if there is aperson in the household who is incar-cerated, that you just want to ensurethat the changes are made to reflectthat there is one less person in thathousehold for purposes of food stampeligibility and food stamp allotment?

Mrs. HUTCHISON. I think what theSenator is asking is, is this going to af-fect the rest of the family? The answeris no. It is just that the prisoner wouldbe taken out of the equation.

Mr. HARKIN. That is a good amend-ment.

Mr. DOMENICI. That had been ac-cepted. We had failed to tell you wehad already agreed.

Mr. HARKIN. I appreciate that. It isa good amendment.

Mrs. HUTCHISON. I thank the Sen-ator from Iowa for accepting theamendment. I ask unanimous consentthat it be adopted.

The PRESIDING OFFICER. Withoutobjection, the amendment is agreed to.

The amendment (No. 446) was agreedto.

Mrs. HUTCHISON. Mr. President, Iwill send another amendment to thedesk and ask for its immediate consid-eration. Then I want it to be set asidefor future consideration.

The PRESIDING OFFICER. Theclerk will report.

Mr. DOMENICI. Is this being submit-ted pursuant to the unanimous consentthat it would be taken care of tomor-row?

Mrs. HUTCHISON. This is an amend-ment that we are placing—it is on theDSH" issue, and we are going to do a

place-holder amendment, but it wassuggested I go ahead and put it in.

Mr. DOMENICI. It was on the list.Could you send it to the desk?

Mrs. HUTCHISON. Ijust want to for-mally submit the amendment.

AMENDMENT NO. 447

(Purpose: To modify the reductions fordisproportionate share hospital payments)

June 24, 1997

AMENDMENT NO. 450

(Purpose: To provide food stamp benefits tochild immigrants)

Mr. DURBIN. Mr. President, I sendan amendment to the desk and ask forits immediate consideration.


The bill clerk read as follows:The Senator from Illinois [Mr. DURBINI for

himself, Mr. WELLSTONE, and Mrs. BOXERproposes an amendment numbered 450.

Mr. DURBIN. Mr. President, I askunanimous consent that reading of theamendment be dispensed with.


The amendment is as follows:At the end of title I. add the following:

SEC. 10 . FOOD STAMP BENEFIT5 FOR CHILD IMMIGRANTS.

(a) IN GENERAL—SeCtiOn 402(a)(2) of thePersonal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 (8 U.S.C.l6l2(a)(2)) is amended by adding at the endthe following:

(E) CHILD IMMIGRANTS—In the case of theprogram specified in paragraph (3) (B), para-graph (1) shall not apply to a qualified alienwho is under 18 years of age.

(b) ALLOCATION OF ADMINISTRATIVECosTs—Section 408(a) of the Social SecurityAct (42 U.S.C. 608(a)) is amended by adding atthe end the following:

(12) DESIGNATION OF GRANTS UNDER THISPART AS PRIMARY PROGRAM IN ALLOCATING AD-MINISTRATIVE COSTS.—

(A) IN GENERAL—Notwithstanding anyother provision of law, a State shall des-ignate the program funded under this part asthe primary program for the purpose of allo-cating costs incurred in serving families eli-gible or applying for benefits under the Stateprogram funded under this part and anyother Federal means-tested benefits.

(B) ALLOCATION OF COSTS.—(i) IN GENERAL—The Secretary shall re-

quire that costs described in subparagraph(A) be allocated in the same manner as thecosts were allocated by State agencies thatdesignated part A of title IV as the primaryprogram for the purpose of allocating admin-istrative costs before August 22, 1996.

(ii) FLEXIBLE ALLOCATION—The Secretarymay allocate costs under clause (i) dif-ferently, if a State can show good cause foror evidence of increased costs, to the extentthat the administrative costs allocated tothe primary program are not reduced bymore than 33 percent.

(13) FAILURE TO ALLOCATE ADMINISTRATIVECOSTS TO GRANTS PROVIDED UNDER THISPART—If the Secretary determines that,with respect to a preceding fiscal year, aState has not allocated administrative costsin accordance with paragraph (12), the Sec-retary shall reduce the grant payable to theState under section 403(a) (1) for the succeed-ing fiscal year by an amount equal to—

(A) the amount the Secretary determinesshould have been allocated to the programfunded under this part in such preceding fis-cal year: minus

(B) the amount that the State allocatedto the program funded under this part insuch preceding fiscal year.".

The PRESIDING OFFICER. The Sen-ator from Illinois.

Mr. DURBIN. Mr. President, I knowthe hour is late but the subject is veryimportant and in a few moments Iwould like my colleagues to consider

S6151what this amendment would do. Duringthe course of passing the welfare re-form bill, we made many changes inmany programs in an effort to movepeople from welfare to work. Therewere several aspects of that bill—eventhough I supported the bill in its en-tirety—there were several aspects ofthat bill which were troubling, not theleast of which was the reduction in nu-tritional assistance for children in theUnited States. The purpose of thisamendment is to correct what I con-sider to be a very serious error and aserious problem in this legislation, be-cause with this amendment we will re-store food stamps for the children oflegal immigrants.

Keep in mind that I have said legalimmigrants. These are children legallyin the United States who are in pov-erty and have been denied the protec-tion and sustenance of the Food StampProgram. It is a significant problemnationwide. Over 4000 immigrant chil-dren in Illinois have lost their foodstamps because of this welfare reformbill; over 283,000 nationwide. Accordingto the Food Research Action Councilsurvey of families living below 185 per-cent of poverty, hungry children sufferfrom two to four times as many indi-vidual health problems such as fre-quent colds and headaches, fatigue, un-wanted weight loss, inability to con-centrate and so on.

These children—hungry children—areoften absent from school. They canhave a variety of medical problemsarising from nutritional deficiencies,not the least of which is anemia. Hun-gry children are less likely to interactwith other people, explore and learnfrom their surroundings, and it has anegative impact on the ability of chil-dren to learn. We should be focusing onhealthy children in America, not hun-gry children in America.

This amendment seeks to correctthat problem by giving to these chil-dren the basic protection of foodstamps.

Just a month or so ago, I visited theCook County Juvenile Detention Cen-ter, a facility which, unfortunately, isdoing quite a large business in juvenilecrime. I spoke to the psychologist atthat center and asked him what traitsthese kids who committed crime had incommon. I would like to focus on onewhich he said was very common, alearning disability, a neurological defi-cit.

I said, Where does that come from?"He said it can come from improper

prenatal nutrition, improper infant nu-trition. These kids get a bad start, andwith that bad start, they don't learn aswell, they become frustrated, they fallbehind, they become truant, they dropout, they become statistics, crime andwelfare statistics which haunt us inthis Chamber as we consider all of theramifications of a child's failed life.

June 24, 1997 CONGRESSIONAL RECORD — SENATE

S6152Many times we overlook the basics. I

am happy that my colleagues tonighthave addressed children's health. Ithink that is something that should bea given in America, that we providebasic health care protection to all chil-dren. But can we then argue that chil-dren should go hungry at the sametime? The children that would be pro-tected by this bill would now be quali-fying for food stamps. In my State ofIllinois, many of the soup kitchens andother food providers have experienced adramatic increase in demand for serv-ices by children since enactment of thewelfare reform bill.

The Reverend Gerald Wise of theFirst Presbyterian Church in Chicagorecently came to tell me that the pan-try at the First Presbyterian in the ex-tremely distressed Woodlawn neighbor-hood and the Pine Avenue United Pres-byterian Church in the Austin neigh-borhood are stretched beyond capacity.

Fifty-two percent of the cities par-ticipating in the U.S. Conference ofMayors' 1995 survey reported emer-gency food assistance facilities wereunable to provide necessary resources,and that is before the welfare reformbill.

This amendment, which I have beenjoined in offering by SenatorWELLSTONE and Senator BOXER, re-stores food stamp benefits to legal im-migrant families with children 18 yearsand under. According to the CBO, itwould cost the Treasury $750 millionover 5 years.

We have established an offset in thisbill from the administrative moneysbeing given to the Governors so thatthey can administer the new welfarereform bill, food stamps and other pro-grams. Our amendment tries to ensurethat Federal dollars are being used effi-ciently to make sure that direct bene-fits are given to needy children.

I am going to stop at this point, as Iknow some of my colleagues are wait-ing to offer an amendment and othershave been here a long time. I hope to-morrow when this amendment comesto the floor that my colleagues on bothsides of the aisle will join in a biparti-san spirit to help the children of legalimmigrants. These children are likelyto become naturalized citizens inAmerica. We want them to be healthy,productive citizens, good studentsmaking this a better nation in whichto live. If we are pennywise and poundfoolish and cut these children shortwhen it comes to one of the basic ne-cessities of life, food itself, we may endup paying the price for decades andgenerations to come.

Let us do the right thing, the com-passionate thing, yes, the Americanthing. Let us make sure that hungrychildren are provided for.

Mr. President, I yield the floor.The PRESIDING OFFICER. Is there

further debate on the amendment?Mr. DOMENICI. Mr. President, I have

nothing other than we will take ourminute tomorrow. Again, if thisamendment is subject to a point of


order, we have not waived the point oforder tonight.

The PRESIDING OFFICER. The Sen-ator is correct.

Mr. D'AMATO addressed the Chair.The PRESIDING OFFICER. The Sen-

ator from New York.

June 24, 1997

AMENDMENT NO. 461

(Purpose: To provide for the treatment ofcertain Amerasian immigrants as refugees)On page 874, between lines 7 and 8, insert

the following:SEC. 5817A. TREATMENT OF CERTAIN AMERASIAN


GEES/ASYLEES.—(1) FOR PURPOSES OF SSI AND FOOD

STAMPS.—-Section 402(a) (2) (A) of the PersonalResponsibility and Work Opportunity Rec-onciliation Act of 1996 (8 U.S.C. 1612(a)(2)(A))is amended—

(A) by striking or" at the end of clause(ii):

(B) by striking the period at the end ofclause (iii) and inserting or": and

(C) by adding at the end the following:(iv) an alien who is admitted to the Unit-

ed States as an Amerasian immigrant pursu-ant to section 584 of the Foreign Operations,Export Financing, and Related Programs Ap-propriations Act. 1988 (as contained in sec-tion 101(e) of Public Law 100-202 and amend-ed by the 9th proviso under MIGRATION ANDREFUGEE ASSISTANCE in title II of the ForeignOperations. Export Financing, and RelatedPrograms Appropriations Act, 1989, PublicLaw 100-461, as amended).".

(2) FOR PURPOSES OF TANF, SSBG. AND MED-ICAID.—Section 402(b) (2) (A) of the PersonalResponsibility and Work Opportunity Rec-onciliation Act of 1996 (8 U.S.C. 1612(a) (2) (A))is amended—

(A) by striking ': or' at the end of clause(ii):

(B) by striking the period at the end ofclause (iii) and inserting or" and

(C) by adding at the end the following:(iv) an alien described in subsection

(a)(2)(A)(iv) until 5 years after the date ofsuch alien's entry into the United States.".


(3) FOR PURPOSES OF EXCEPTION FROM 5-YEAR LIMITED ELIGIBILITY OF QUALIFIEDALIENS—Section 403(b) (1) of the Personal Re-sponsibility and Work Opportunity Rec-onciliation Act of 1996 (8 U.S.C. 1613(b)(1)) isamended by adding at the end the following:

(D) An alien described in section402(a) (2) (A) (iv).".

(4) FOR PURPOSES OF CERTAIN STATE PRO-GRAMS.—Section 4 12(b) (1) of the Personal Re-sponsibility and Work Opportunity Rec-onciliation Act of 1996 (8 U.S.C. 1622(b)(1)) isamended by adding at the end the followingnew subparagraph:

(D) An alien described in section402(a) (2) (A)(iv).".

(b) FUNDING.—(1) LEVY OF FEE.—The Attorney General

through the Immigration and NaturalizationService shall levy a $100 processing fee uponeach alien that the Service determines—

(A) is unlawfully residing in the UnitedStates:

(B) has been arrested by a Federal law en-forcement officer for the commission of a fel-ony: and

(C) merits deportation after having beendetermined by a court of law to have com-mitted a felony while residing illegally inthe United States.

(2) COLLECTION AND USE.—In addition toany other penalty provided by law, a courtshall impose the fee described in paragraph(1) upon an alien described in such paragraphupon the entry of a Judgment of deportationby such court. Funds collected pursuant tothis subsection shall be credited by the Sec-retary of the Treasury as offsetting in-creased Federal outlays resulting from theamendments made by section 5817A of theBalanced Budget Act of 1997.

(c) EFFECTIVE DATE—The amendmentsmade by this section shall be effective withrespect to the period beginning on or afterOctober 1, 1997.

Mr. MCCAIN. Mr. President, I risetoday to offer an amendment to S. 947,

the Budget Reconciliation Act, thatwill redress what I assume to be an in-adVertent omission in a section of thisbill that discriminates againstAmerasian children of U.S. militarypersonnel who served in Vietnam.

My amendment will add a new provi-sion to section 5817 to includeAmerasian children to the category oflegal aliens eligible for Medicaid. ThePersonal Responsibility and Work Op-portunity Reconciliation Act of 1996excluded from eligibility these childrenof American soldiers because they areadmitted as refugees under section 584of the Foreign Operations, Export Fi-nancing, and Related Programs Act of1988, rather than section 207 of the Im-migration and Nationality Act, underwhich refugees are excepted from theWelfare Region legislation's ban onMedicaid, SSI, and other forms of as-sistance. This amendment correctsthat oversight.

Because there is a cost associatedwith this amendment, I propose to off-set it by mandating that the AttorneyGeneral of the United States, actingthrough the Immigration and Natu-ralization Service, impose a $150 proc-essing fee on each illegal alien de-ported from the United States whocommitted a felony while in this coun-try. According to CBO, this will gen-erate the revenue necessary to offsetthe cost of my amendment over the 5-

S6169year period for which the welfare billexcludes aliens from Medicaid eligi-bility.

I hope that I can count on my col-leagues' support for this worthwhileamendment.

AMENDMENT NO. 464

(Purpose: To establish procedures to ensure abalanced Federal budget by fiscal year 2002)At the end of the

___.

add the following:

June 24, 1997

S6170TITLE —BUDGET CONTROL

SEC. _O1. SHORT TITLE; PURPOSE.(a) SHORT TITLE—This title may be cited

as the 'Bipartisan Budget Enforcement Actof 1997'.

(b) PURPOSE—The purpose of this title is—(1) to ensure a balanced Federal budget by

fiscal year 2002;(2) to ensure that the Bipartisan Budget

Agreement is implemented: and(3) to create a mechanism to monitor total

costs of direct spending programs, and, inthe event that actual or projected costs ex-ceed targeted levels, to require the Presidentand Congress to address adjustments in di-rect spending.SEC. _OZ. ESTABLISHMENT OF DIRECT SPEND-

ING TARGETS.(a) IN GENERAL.—The initial direct spend-

ing targets for each of fiscal years 1998

through 2002 shall equal total outlays for alldirect spending except net interest as deter-mined by the Director of the Office of Man-agement and Budget (hereinafter referred toin this title as the Director') under sub-section (b).

(b) INITIAL REPORT BY DIRECTOR.—(1) IN GENERAL—Not later than 30 days

after the date of enactment of this title, theDirector shall submit a report to Congresssetting forth projected direct spending tar-gets for each of fiscal years 1998 through 2002.

(2) PROJECTIONS AND ASSUMPTIONS.—TheDirector's projections shall be based on legis-lation enacted as of 5 days before the reportis submitted under paragraph (1). The Direc-tor shall use the same economic and tech-nical assumptions used in preparing the con-current resolution on the budget for fiscalyear 1998 (H.Con.Res. 84).SEC. _03. ANNUAL REVIEW OF DIRECT SPEND-

ING AND RECEIPTS BY PRESIDENT.As part of each budget submitted under

section 1105(a) of title 31, United StatesCode, the President shall provide an annualreview of direct spending and receipts, whichshall include—

(1) information on total outlays for pro-grams covered by the direct spending tar-gets, including actual outlays for the priorfiscal year and projected outlays for the cur-rent fiscal year and the 5 succeeding fiscalyears; and

(2) information on the major categories ofFederal receipts, including a comparison be-tween the levels of those receipts and thelevels projected as of the date of enactmentof this title.SEC. _04. SPECIAL DIRECT SPENDING MES-

SAGE BY PRESIDENT.(a) TRIGGER—If the information submitted

by the President under section ._.03 indi-cates—

(1) that actual outlays for direct spendingin the prior fiscal year exceeded the applica-ble direct spending target: or

(2) that outlays for direct spending for thecurrent or budget year are projected to ex-ceed the applicable direct spending targets.the President shall include in his budget aspecial direct spending message meeting therequirements of subsection (b)

(b) CONTENTS.—(1) INCLUSIONS—The special direct spend-

ing message shall include—(A) an analysis of the variance in direct

spending over the direct spending targets:and

(B) the Presidents recommendations foraddressing the direct spending overages. ifany. in the prior, current, or budget year.

(2) ADDITIONAL MATTERS.—The President'srecommendations may consist of any of thefollowing:

(A) Proposed legislative changes to recoupor eliminate the overage for the prior, cur-rent, and budget years in the current year,the budget year, and the 4 outyears.


(B) Proposed legislative changes to recoupor eliminate part of the overage for theprior, current. and budget year in the cur-rent year, the budget year, and the 4 out-years, accompanied by a finding by thePresident that, because of economic condi-tions or for other specified reasons, onlysome of the overage should be recouped oreliminated by outlay reductions or revenueincreases, or both.

(C) A proposal to make no legislativechanges to recoup or eliminate any overage.accompanied by a finding by the Presidentthat. because of economic conditions or forother specified reasons, no legislativechanges are warranted.

(c) PROPOSED SPECIAL DIRECT SPENDINGRESOLUTION —If the President recommendsreductions consistent with subsection(b)(2)(A) or (B), the special direct spendingmessage shall include the text of a specialdirect spending resolution implementing thePresident's recommendations through rec-onciliation directives instructing the appro-priate committees of the House of Represent-atives and Senate to determine and rec-ommend changes in laws within their juris-dictions. If the President recommends no re-ductions pursuant to (b) (2) (C) the special di-rect spending message shall include the textof a special resolution concurring in thePresident's recommendation of no legislativeaction.SEC. _05. REQUIRED RESPONSE BY CONGRESS.

(a) IN GENERAL—It shall not be in order inthe House of Representatives or the Senateto consider a concurrent resolution on thebudget unless that concurrent resolutionfully addresses the entirety of any overagecontained in the applicable report of thePresident under section _04 through rec-onciliation directives.

(b) WAIVER AND SUSPENSION—This sectionmay be waived or suspended in the Senateonly by the affirmative vote of three-fifthsof the Members. duly chosen and sworn. Thissection shall be subject to the provisions ofsection 258 of the Balanced Budget andEmergency Deficit Control Act of 1985.

(c) APPEALS—Appeals in the Senate fromthe decisions of the Chair relating to anyprovision of this section shall be limited to 1hour, to be equally divided between, and con-trolled by, the appellant and the manager ofthe bill or joint resolution, as the case maybe. An affirmative vote of three-fifths of theMembers of the Senate, duly chosen andsworn, shall be required in the Senate to sus-tain an appeal of the ruling of the Chair ona point of order raised under this section.SEC. _06. RELATIONSHIP TO BALANCED BUDG-

ET AND EMERGENCY DEFICIT CON-TROL ACT.

Reductions in outlays or increases in re-ceipts resulting from legislation reportedpursuant to section 05 shall not be takeninto account for purposes of any budget en-forcement procedures under the BalancedBudget and Emergency Deficit Control Actof 1985.SEC. _07. ESTIMATING MARGIN.

For any fiscal year for which the overageis less than one-half of 1 percent of the directspending target for that year. the proceduresset forth in sections _04 and ___05 shallnot apply.SEC. _08. EFFECTIVE DATE.

This title shall apply to direct spendingtargets for fiscal years 1998 through 2002 andshall expire at the end of fiscal year 2002.

June 24, 1997

S6172

AMENDMENTS NO. 475 THROUGH 498

Mr. LAUTENBERG. Mr. President,we have one amendment that is stillbeing considered.

Otherwise, I ask unanimous consentthat it be in order to send 25 amend-ments to the desk on behalf of myDemocratic colleagues, that theamendments be considered as read andlaid aside to be voted on in sequence.


The amendments are as follows:AMENDMENT NO. 475

(Purpose: to ensure that certain legal immi-grants who become disabled are eligible fordisability benefits)On page 8971, strike line 9—11.

CONGRESSIONAL RECORD — SENATE(A) be allocated in the same manner as thecosts were allocated by State agencies thatdesignated part A of title IV as the primaryprogram for the purpose of allocating admin-istrative costs before August 22, 1996.

(ii) FLEXIBLE ALLOcATION—The Secretarymay allocate costs under clause (i) dif-ferently, if a State can show good cause foror evidence of increased costs, to the extentthat the administrative costs allocated tothe primary program are not reduced bymore than 33 percent.

(13) FAILURE TO ALLOCATE ADMINISTRATIVECOSTS TO GRANTS PROVIDED UNDER THISPART—If the Secretary determines that,with respect to a preceding fiscal year. aState has not allocated administrative costsin accordance with paragraph (12), the Sec-retary shall reduce the grant payable to theState under section 403(a) (1) for the succeed-ing fiscal year by an amount equal to—


"(B) the amount that the State allocatedto the program funded under this part insuch preceding fiscal year.

June 24, 1997

SENATE AMENDMENT 476

(Purpose: To enhance taxpayer value in auc-tions conducted by the Federal Commu-nications Commission)

SECTION . RESERVE.In any auction conducted or supervised by

the Federal Communications Commission(hereinafter the Commission) for any license,permit or right which has value, a reason-able reserve price shall be set by the Com-mission for each unit in the auction. the re-serve price shall establish a minimum bid forthe unit to be auctioned. If no bid is receivedabove the reserve price for a unit, the unitshall be retained. The Commission shall re-assess the reserve price for that unit andplace the unit in the in the next scheduled ornext appropriate auction.

AMENDMENT NO. 477

(Purpose: To provide food stamp benefits tochild immigrants)

At the end of title I. add the following:SEC. 1O_. FOOD STAMP BENEFITS FOR CHILD

IMMIGRANTS.(a) IN GENERAL.—SectiOn 402(a)(2) of the

Personal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 (8 U.S.C.1612(a)(2)) is amended by adding at the endthe following:

(E) CHILD IMMIGRANTS—In the case of theprogram specified in paragraph (3)(B), para-graph (1) shall not apply to a qualified alienwho is under 18 years of age.

(b) ALLOCATION OF ADMINISTRATIVECOSTS.—Section 408(a) of the Social SecurityAct (42 U.S.C. 608(a)) is amended by adding atthe end the following:

'(12) DESIGNATION OF GRANTS UNDER THISPART AS PRIMARY PROGRAM IN ALLOCATING AD-MINISTRATIVE COSTS.—

"(A) IN GENERAL—Notwithstanding anyother provision of law, a State shall des-ignate the program funded under this part asthe primary program for the purpose of allo-cating costs incurred in serving families eli-gible or applying for benefits under the Stateprogram funded under this part and anyother Federal means-tested benefits.

"(B) ALLOCATION OF COSTS.—'(i) IN GENERAL—The Secretary shall re-

quire that costs described in subparagraph

AMENDMENT NO. 479

(Purpose: To provide for medicaid eligibilityof disabled children who lose SSI benefits)On page 874, between lines 7 and 8. insert

the following:SEC. 5817A. CONTINUATION OF MEDICAID ELIGI-


(a) IN GENERAL—Section1902(a)(10)(A)(i)(II) (42 U.S.C.1396a(a) (10) (A) (i) (II)) is amended by inserting'(or were being paid as of the date of enact-ment of section 2 11(a) of the Personal Re-sponsibility and Work Opportunity Act of1996 (Public Law 104—193; 110 Stat. 2188) andwould continue to be paid but for the enact-ment of that section)" after "title XVI.

(b) OFFsET—Section 2 103(b) of the SocialSecurity Act (as added by section 5801) isamended—

(1) in paragraph (2), by striking 'and" atthe end;

(2) in paragraph (3), by striking the periodand inserting "; and': and


5817A(a) of the Balanced Budget Act of 1997(relating to continued eligibility for certaindisabled children).".

(c) EFFECTIVE DATE.—The amendmentmade by subsection (a) applies to medical as-sistance furnished on or after July 1, 1997.

June 24, 1997 CONGRESSIONAL RECORD—SENATE S6175

AMENDMENT NO. 493(Purpose: To exempt severely disabled aliens

from the ban on receipt of supplemental se-curity income)On page 874, between lines 7 and 8, insert

the following:SEC. 5817A. SSI ELIGIBILITY FOR SEVERELY DIS-

ABLED ALIENS.Section 402(a) (2) of the Personal Respon-

sibility and Work Opportunity Reconcili-ation Act of 1996 (8 U.S.C. 1612(a)(2)), asamended by section 5815, is amended by add-ing at the end the following:

(I) SSI EXCEPTION FOR SEVERELY DISABLEDALIENS.—With respect to eligibility for bene-fits for the program defined in paragraph

S6176(3) (A) (relating to the supplemental securityIncome program), paragraph (1), and the Sep-tember 30. 1997 application deadline undersubparagraph (G) shall not apply to anyalien who is lawfully present in the UnitedStates and who has been denied approval ofan application for naturalization by the At-torney General solely on the ground that thealien is so severely disabled that the alien isotherwise unable to satisfy the requirementsfor naturalization.'.

AMENDMENT NO 494

(Purpose: To provide for Medicaid eligibilityof disabled children who lose SSI benefits)On page 874, between lines 7 and 8, insert

the following:SEC. 5817A CONTINUATION OF MEDICAID ELIGI-

BILITY FOR DISABLED CHILDRENWHO LOSE SSI BENEFiTS.

(a) IN GENERAL—Section1902(a) (10) (A) (i) (II) (42 U.S.C.1396a(a) (10) (A) (i) (II)) is amended by inserting"(or were being paid as of the date of enact-ment of section 211(a) of the Personal Re-sponsibility and Work Opportunity Act of1996 (Public Law 104-193; 110 Stat. 2188) andwould continue to be paid but for the enact-ment of that section)" after "title XVI'.

(b) OFFSET—Section 2103(b) of the SocialSecurity Act (as added by section 5801) isamended—

(1) in paragraph (2), by striking 'and" atthe end;

(2) in paragraph (3), by striking the periodand inserting "; and"; and


5817A(a) of the Balanced Budget Act of 1997(relating to continued eligibility for certaindisabled children).".

(c) EFFECTIVE DATE.—The amendmentmade by subsection (a) applies to medical as-sistance furnished on or after July 1, 1997.

AMENDMENT NO. 495

(Purpose: To establish a process to permit anurse aide to petition to have his or hername removed from the nurse aide registryunder certain circumstances)On page 844, between lines 7 and 8, insert

the following:SEC. . REMOVAL OF NAME FROM NURSE AIDE

REGISTRY.(a) MEDICARE—Section 1819(g)(1)(C) of the

Social Security Act (42 U.S.C. 1395i-3(g)(1)(C)) is amended—

(1) in the first sentence by striking "TheState" and inserting '(i) The State"; and

(2) by adding at the end the following:'(ii)(I) In the case of a finding of neglect,

the State shall establish a procedure to per-mit a nurse aide to petition the State tohave his or her name removed from the reg-istry upon a determination by the Statethat—

"(aa) the employment and personal historyof the nurse aide does not reflect a pattern ofabusive behavior or neglect; and

"(bb) the neglect involved in the originalfinding was a singular occurrence.

"(II) In no case shall a determination on apetition submitted under clause (I) be madeprior to the expiration of the 1-year periodbeginning on the date on which the name ofthe petitioner was added to the registryunder this subparagraph.".

(b) MEDICAID—SectiOn 1919(g)(1)(C) of theSocial Security Act (42 U.S.C. 1396r(.g)(1)(C))is amended—

(1) in the first sentence by striking 'TheState" and inserting (i) The State'; and

(2) by adding at the end the following:'(ii) (I) In the case of a finding of neglect,

the State shall establish a procedure to per-mit a nurse aide to petition the State tohave his or her name removed from the reg-


istry upon a determination by the Statethat—

(aa) the employment and personal historyof the nurse aide does not reflect a pattern ofabusive behavior or neglect; and

"(bb) the neglect involved in the originalfinding was a singular occurrence.

"(II) In no case shall a determination on apetition submitted under clause (I) be madeprior to the expiration of the 1-year periodbeginning on the date on which the name ofthe petitioner was added to the registryunder this subparagraph..

(c) RETROACTIVE REVIEW—The proceduresdeveloped by a State under the amendmentsmade by subsection (a) and (b) shall permitan individual to petition for a review of anyfinding made by a State under section1819(g) (1) (C) or 1919(g)(1)(C) of the Social Se-curity Act (42 U.S.C. 1395i—3(g)(1)(C) or1396r(g) (1) (C)) after January 1, 1995.

(d) STUDY AND REPORT.—(1) STUDY—The Secretary of Health and

Human Services shall conduct a study of—(A) the use of nurse aide registries by

States, including the number of nurse aidesplaced on the registries on a yearly basis andthe circumstances that warranted theirplacement on the registries;

(B) the extent to which institutional envi-ronmental factors (such as a lack of ade-quate training or short staffing) contributeto cases of abuse and neglect at nursing fa-cilities; and

(C) whether alternatives (such as a proba-tional period accompanied by additionaltraining or mentoring or sanctions on facili-ties that create an environment that encour-ages abuse or neglect) to the sanctions thatare currently applied under the Social Secu-rity Act for abuse and neglect at nursing fa-cilities might be more effective in minimiz-ing future cases of abuse and neglect.

(2) REPORT—NOt later than 2 years afterthe date of enactment of this Act, the Sec-retary of Health and Human Services shallprepare and submit to the appropriate com-mittees of Congress, a report concerning theresults of the study conducted under para-graph (1) and the recommendation of theSecretary for legislation based on suchstudy.

AMENDMENT NO. 496

(Purpose: To strike the limitation on thecoverage of abortions)

On page 860, strike all matter after line 10and before line 15, and the following:

(d) USE LIMITED TO STATE PROGRAM Ex-PENDITURES.—Funds provided to an eligibleState under this title shall only be used tocarry out the purpose of this title.

AMENDMENT NO. 497

(Purpose: To clarify that risk solvencystandards established for managed care en-tities under the Medicaid program shallnot preempt any State standards that aremore stringent)On page 743, line 6, strike the period and

insert '(but that shall not preempt anyState standards that are more stringent thanthe standards established under this sub-paragraph. •' .

AMENDMENT NO. 498

(Purpose: To allow funds provided under thewelfare-to work grant program to be usedfor the microloan demonstration programunder the Small Business Act)On page 888, between lines 22 and 23, insert

the following:"(VI) Technical assistance and related

services that lead to self-employmentthrough the microloan demonstration pro-gram under section 7(m) of the Small Busi-ness Act (15 U.S.C. 636(m))

June 24, 1997

Mr. LAUTENBERG. Again, the firstamendment on that list, Mr. President,is the Lautenberg amendment.

Mr. CONRAD addressed the Chair.The PRESIDING OFFICER. The Sen-

ator recognizes the Senator from NorthDakota.

Mr. LAUTENBERG. May we finishthis up?

Mr. DOMENICI. I need to finish thiswork, if you don't mind.

Senator, I understand you did submitan amendment with reference to the il-legal aliens.

Mr. LAUTENBERG. Legal.Mr. DOMENICI. Legal aliens

AMENDMENT NO. 499

(Purpose: To provide SSI eligibility fordisabled legal aliens)

Mr. DOMENICI. Mr. President, I sendan amendment to the desk.


The legislative clerk read as follows:The Senator from New Mexico IMr. DOMEN-

IcIl proposes an amendment numbered 499.Mr. DOMENICI. Mr. President, I ask

unanimous consent that reading of theamendment be dispensed with.


The amendment is as follows:Strike sections 5811 through 5814 and insert

the following:SEC. 5812. EXTENSION OF ELIGIBILITY PERIOD


(a) SSI.—Section 402(a)(2)(A) of the Per-sonal Responsibility and Work OpportunityReconciliation Act of 1996 (8 U.S.C.1612 (a) (2) (A)) is amended to read as follows:

"(A) TIME-LIMITED EXCEPTION FOR REFU-GEES AND ASYLEES.—

'(i) SSI.—With respect to the specifiedFederal program described in paragraph(3)(A) paragraph 1 shall not apply to an alienuntil 7 years after the date—




(ii) FooD STAMPS—With respect to thespecified Federal program described in para-graph (3) (B), paragraph 1 shall not apply toan alien until 5 years after the date—

"(I) an alien is admitted to the UnitedStates as a refugee under section 207 of theImmigration and Nationality Act:


"(III) an alien's deportation is withheldunder section 243(h) of such Act..

(b) MEDIcAID—Section 402(b) (2) (A) of thePersonal Responsibility and Work Oppor-tunity Reconciliation Act of 1996 (8 U.S.C.1612(b) (2) (A)) is amended to read as follows:

'(A) TIME-LIMITED EXCEPTION FOR REFU-GEES AND ASYLEES.—

'(i) MEDICAID—With respect to the des-ignated Federal program described in para-graph (3) (C), paragraph 1 shall not apply toan alien until 7 years after the date—

"(I) an alien is admitted to the UnitedStates as a refugee under section 207 of theImmigration and nationality Act:



June24, 1997 CONGRESSIONAL RECORD — SENATE S6177(ii) OTHER DESIGNATED FEDERAL PRO-

GRAMS—With respect to the designated Fed-eral programs under paragraph (3) (otherthan subparagraph (C)), paragraph 1 shallnot apply to an alien until 5 years after thedate—



'(III) an alien's deportation is withheldunder section 243(h) of such Act.".

(c) STATUS OF CUBAN AND HAITIAN EN-TRANTS—For purposes of sections402(a) (2) (A) and 402(b) (2) (A) of the PersonalResponsibility and Work Opportunity Rec-onciliation Act of 1996 (8 U.S.C. 1612(a)(2)(A),(b)(2)(A), an alien who is a Cuban and Hai-tian entrant, as defined in section 501(e) ofthe Refugee Education Assistance Act of1984, shall be considered a refugee.SEC. 5813. SSI ELIGIBILITY FOR PERMANENT


Section 402(a) (2) of the Personal Respon-sibility and Work Opportunity Reconcili-ation Act of 1966 (8 U.S.C. 1612(a)(2)) (asamended by section 5311) is amended by add-ing at the end the following:

(F) PERMANENT RESIDENT ALIENS WHO AREMEMBERS OF AN INDIAN TRIBE—With respectto eligibility for benefits for the program de-fined in paragraph (3) (A) (relating to the sup-plemental security income program), para-graph (1) shall not apply to an alien who—

(i) is lawfully admitted for permanentresidence under the Immigration and Nation-ality Act; and

(ii) is a member of an Indian tribe (as de-fined in section 4(e) of the Indian Self-Deter-mination and Education Assistance Act).".SEC. 5814. SSI ELIGIBILITY FOR DISABLED LEGAL

ALIENS IN THE UNITED STATES ONAUGUST 22, 1996.

(a) Section 402(a)(2) of the Personal Re-sponsibility and Work Opportunity Rec-onciliation Act of 1996 (8 U.S.C. 1612(a)(2) (asamended by section 5813) is amended by add-ing at the end the following:

(C) SSI ELIGIBILITY FOR DISABLEDALIENS.—With respect to eligibility for bene-fits for the program defined in paragraph(3)(A) (relating to the supplemental securityincome program), paragraph (1) shall notapply—

(i) to an alien who—(I) is lawfully residing in any State on

August 22, 1996; and(II) is disabled, as defined in section

1614(a)(3) of the Social Security Act (42U.S.C. 1382c(a)(3)); or

(ii) to an alien who—(I) is lawfully residing in any State and

after such date;'(II) is disabled (as so defined and"(III) as of June 1, 1997, is receiving bene-

fits under such program.".(b) Funds shall be made available for not

to exceed 2 years for elderly SSI recipientsmade ineligible for benefits after August 22,1996.

Mr. DOMENICI. I wonder if the Sen-ator from Delaware would mind takingover for me. We are only going to beanother 10 minutes, and he can close it.I would appreciate that.

Senator LAUTENBERG, I will see youin the morning.

Mr. LAUTENBERG. I look forward tothat.

Mr. DOMENICI. Have we run out oftime under the bill?

The PRESIDING OFFICER. My un-derstanding is that the time runs outat 9:15.

Mr. DOMENICI. You have plenty oftime, Senator.

Several Senators addressed theChair.

Mr. CONRAD. Mr. President, I yield-ed to the distinguished Republicanmanager. I would like to reclaim mytime at this point.

Mr. DOMENICI. I didn't know youhad an amendment.

Mr. CONRAD. I have a point of orderthat I would like to raise.

Mr. DOMENICI. I wonder if we couldfinish this part of getting them in.

Mr. CONRAD. Yes. I would be happyto yield for that purpose.

POINT OF ORDER

Mr. CONRAD. I rise to make a pointof order that section 5822 of this bill isextraneous and violates section

313(b)(1)(D) of the Budget Act, the so-called Byrd rule.

Mr. President, I urge my colleaguesto join me in opposing what amountsto a $2 billion blank check for oneState, the State of Texas.

The bill before us would require theSecretary of Health and Human Serv-ices to approve the privatization of allFederal and State health and humanservices benefit programs in the Stateof Texas without any hearings andwithout any opportunity to review theproposal or ensure that the goals ofthese programs are furthered by theproposal -

Mr. President, this is truly unprece-dented. If we look at the potential im-pact from this one State waiver, we seethat it affects 2.35 million Medicaidbeneficiaries, 2.1 million food stamp re-cipients, 10 percent of all the foodstamp recipients in the United States,nearly 1 million WIC recipients, and20,000 children who are up for adoptionor qualify for foster care assistance.

The Texas waiver amounts to a $2billion blank check without the benefitof one hearing and without the benefitof any Senator knowing what is in theproposal, because this is a proposalthat has not been revealed to the U.S.Senate. There has been no waiver sub-mitted.

We hear a lot of talk that it is awaiver. There has been no waiver sub-mitted. This is a procurement docu-ment which, by law, is confidential andcannot be reviewed by the U.S. Senate.There have been no public hearings onthis proposal—not one. Not a singleMember here has had privy to whatthis procurement document involves.There are serious unanswered ques-tions about whether taxpayers are pro-tected from liability, mismanagementor fraud.

Mr. President, let me go to the nextchart. The contracting of human serv-ices has a very checkered record. I haveproduced reviews ofjust four situationswhich have occurred around the coun-try, because I think before we leap offthis precipice, we ought to know whatis in this agreement. What is in thisproposal? None of us have been privy towhat is here.

Let me just review with my col-leagues what we have seen in otheragreements like this around the coun-try. In California, an agreement withLockheed Martin for a child supportenforcement contract, harshly criti-cized in the California Assembly, slat-ed to cost $99 million, now projected tocost $260 million, cost overrun of 163percent. The State of Californiastopped payment in February of 1997;limited contractor liability of only $44million. Taxpayers have to pick up therest—a disaster in California.

Do we want this to be repeated inTexas? Some will say, well, it won'thappen in Texas. On what basis do theysay that? Not a single Senator knowswhat is in that procurement document—not a single one—because it is con-fidential.

S6178Virginia: Electronic Data Systems, a

Medicaid contract. By the way, this isthe same company that seeks to pri-vatize all—let me emphasis—every sin-gle Federal and State program in theState of Texas. The same company isinvolved in this Virginia matter.

This is a Medicaid contract in Vir-ginia. The contract has been canceled;20 months behind schedule; error rateof more than 50 percent—error rate ofmore than 50 percent—alleged sweet-heart deal; EDS selected over competi-tor whose bid was 50 percent less; al-leged conflict of interest; company woncontract after making revolving-doorhire of a senior Virginia Medicaid offi-cial.

Texas: Anderson Consulting, a childsupport system contract; 559 percentover the budget; over 4 years behindschedule; design errors result in inabil-ity to handle changes in Federal regu-lations; taxpayers to foot more than 78percent of the project cost—anotherdisaster.

Mr. President, before we do this, weought to know what is in this procure-ment document. We shouldn't be hand-ing a blank check to Texas, or anyother State. I wouldn't advocate thisfor my State—a blank check that couldblow up on the taxpayers like these ex-amples have blown up.

Let me just conclude with the Flor-ida Unisys contract, a Medicaid con-tract. Unisys employees arrested forgrand theft; one pleaded guilty tofraud, forgery and money-laundering;two others charged with racketeering;more arrests expected: use of tem-porary employees, one of whom stolealmost a quarter of a million dollars.

And we are getting ready to approvethis kind of deal for the State of Texaswithout any hearing, without any re-view, without a single Senator know-ing what is in the proposed agreement?

Mr. President, we ought to thinkvery carefully before we go down thispath.

In Florida, authorities investigatingalleged Medicaid theft of $20 million.

Boy, if the warning lights aren't outon this one, I don't know what it willtake.

Mr. President, we ought to reviewthis circumstance, have a chance to re-view it, have hearings, and make a de-termination if it makes any sense forus to proceed on this basis. I thinkthere are serious and legitimate ques-tions surrounding this proposed pro-curement document.

The Texas waiver has serious unan-swered questions. How do we preventthe massive cost overruns and higherror rates that plague similar projectsin other States?

How do we protect against revolving-door hiring, kickbacks, or other fraud?

Will the taxpayers be liable if a con-tractor fails to enroll eligible individ-uals?

You know, this is a fundamental re-sponsibility of Government to makecertain that those who are eligible getthe benefits to which they are entitled.


Who pays for it if they enroll peoplewho are not eligible?

What happens to vulnerable Ameri-cans who need these programs for basicsurvival if the contractor has financialincentives to minimize enrollment,even of those who have every legalright to be qualified?

Mr. President, I would like to quotean editorial from the Salt Lake Trib-une of April 27th. This is what the SaltLake Tribune said on April 27 of thisyear:

Certain elements of a welfare program lendthemselves well to contracting, vouchers, orother forms of privatization

I think we all agree with that:But when it comes to deciding who will re-

ceive public assistance or who should losecustody of a child, the private sector has itslimits. If a private group's primary missionis to make profits . . . services may be re-duced . . . Government employees, on theother hand, are subject to more public scru-tiny and are expected to promote the publicgood within constitutional protections forindividuals.

Mr. President, let's not fix what isn'tbroken.

Virtually every State is currently op-erating, developing, or planning the de-velopment of an integrated, automatedeligibility and enrollment system forTANF, food stamps, and Medicaid.Thirty-eight States with Federally cer-tified systems; three States installing:five States developing; two Statesplanning: three States with State-de-veloped systems.

Let's not throw the baby out withthe bathwater.

I urge my colleagues to support thiswell-taken point of order.

I thank the Chair. I yield the floor.Mr. ROTH. Mr. President, I move to

waive the point of order.The PRESIDING OFFICER. The Sen-

ator from Delaware.MOTION TO WAIVE THE BUDGET ACT

Mr. ROTH. I move to waive the pointof order.

Mr. CONRAD. Mr. President, par..liamentary inquiry.

The PRESIDING OFFICER. State theinquiry.

Mr. CONRAD. Parliamentary in-quiry. The motion to waive the point oforder has been raised. Will this bestacked in votes tomorrow? Would thatbe the intention of the Chair?

Mr. ROTH. That would be the intentof the chairman.

Mr. CONRAD. That would be the in-tent of the chairman.

Mr. President, would that be the in-tent?

The PRESIDING OFFICER. Thatwould be the procedure.

Mr. CONRAD. I ask for the yeas andnays.

The PRESIDING OFFICER. Is there asufficient second?

There is a sufficient second.The yeas and nays were ordered.Mr. CONRAD. I thank the Chair.Mr. LAUTENBERG addressed the

Chair.The PRESIDING OFFICER. The

Chair recognizes the Senator from NewJersey.

June 24, 1997

Mr. LAUTENBERG. Mr. President, Ican't let this moment pass withoutcommending——

Mr. ROTH. Could the Senator yieldso I can send this amendment to thedesk for consideration?

Mr. LAUTENBERG. Yes, of course. Iwould be happy to yield to the chair-man of the Finance Committee. But Iexpect to regain the floor.

AMENDMENT NO. 502

Mr. ROTH. Mr. President, I submitan amendment on behalf of SenatorD'AMATO on Medicare, on the duplica-tion provision for consideration tomor-row.


The legislative clerk read as follows:The Senator from Delaware IMr. ROTHJ for

Mr. D'AMATo, proposes an amendment num-bered 502.

The amendment is as follows:Section 1. In 42 U.S.C. §1395ss(d)(3)(A)(v),

insert '(a)' before "For', and after the firstsentence insert:

(b) For purposes of this subparagraph, ahealth insurance policy (which may be a con-tract with a health maintenance organiza-tion) is not considered to "duplicate healthbenefits under this title or title XIX or underanother health insurance policy if it—

(I) provides comprehensive health carebenefits that replace the benefits providedby another health insurance policy,

(II) is being provided to an individual enti-tled to benefits under Part A or enrolledunder Part B on the basis of section 226(b),and

(III) coordinates against items and servicesavailable or paid for under this title or titleXIX, provided that payments under this titleor title XIX shall not be treated as paymentsunder such policy in determining annual orlifetime benefit limits.

Section 2. In 42 U.S.C. §1395ss(d)(3)(A)(v),insert "(c) before "For purposes of thisclause".

The PRESIDING OFFICER. The Sen-ator from New Jersey.

POINT OF ORDER

Mr. LAUTENBERG. Mr. President, Iwant to commend our friend and col-league from North Dakota for beingaware of what is potentially takingplace here.

Mr. President, this is a small exam-ple of the kind of document that youmight have that has all kinds of badgoodies in here. One of the things thatyou have to do around here is to makecertain that everybody is on the alertto the fact that some things get intothese bills without being discussed,without being formally introduced. Ithas a way of sneaking in there. Thereis an osmosis process in which they falldown from the sky and get in there.This is one that is really kind of sky-high.

I express very serious concerns aboutthe provision in this bill, that it willallow, as the Senator from North Da-kota said, in this case Texas, but anyState—to have private companies de-termine the eligibility for low-incomebenefits like Medicaid, WIC and foodstamps.

Mr. President, this is a budget rec-onciliation bill, not a Government

June 24, 1997management reform bill. In my view,the privatization provision does not be-long in fast-track legislation—fasttrack, that means to get it throughhere as quickly as you can—that is de-signed primarily to implement thebudget resolution. This provision hasno real impact on the deficit except topotentially make it worse in the yearsahead, and it would represent a signifi-cant policy change with broad-rangingimplications.

I also note that this provision is outside of the bipartisan budget agree-ment. It was never discussed at anyone of the negotiating sessions becauseI personally sat there at every one ofthem, and it never appeared in anyearly drafts of the budget agreement.

This provision raises some very im-portant policy questions. For example,will these private companies have anincentive, as the Senator from NorthDakota pointed out in his chart, to ex-clude people that they would rathernot carry from low-income programs.Will they receive bonuses for doing so?Will they feel inclined to do so in orderto win other State government con-tracts?

Now, Mr. President, I kind of gr.ewup, if I can say, in the compiter busj-ness, and we have seen some of the fin-est companies in the world make mis-takes. We have seen it here with theFAA contract, a fairly complicatedpiece of business, and it was pointedout that it was Unisys and EDS andnames that are very well known in thecomputer field. Mistakes are made andsometimes these things run wayoverthe original cost estimate, as dem-.onstrated in the example we saw, so wecannot afford to put all of our citizenssubject to what might go awry hereand spend $2 billion to take care of anarrangement, whatever that arrange-ment is. Ask every citizen here wheth-er they would feel like kicking intothis thing, and I am sure that given aproper questionnaire they would say;"Heck, no." This is not for us and noState ought to be so privileged as toget that kind of an advantage.

Mr. President, the Department ofHealth and Human Services reportsthat there may be 3 million children el-igible for Medicaid who are not en-rolled in the program. It is a seriousproblem and I feel could even get worseunder a privatization program. If pri-vate companies are put in charge of en-rolling more children for Medicaid,would they really conduct aggressiveoutreach programs to enroll children,to encourage people to bring them ineven if it meant that the State's Med-icaid costs would go up? I would notbet on it.

I want to be clear. I am not nec-essarily opposed to privatization ofsome Government services. However, itmust be considered very carefully, es-pecially when the lives of vulnerableAmericans are at stake. This proposalreally breaks new ground. For the firsttime, private interests would be handedcomplete power to make benefit deci-


sions that are of critical importance topeople with low incomes.

It is like turning our military over toprivate hands and letting them designwhat conflicts we are going to get in-volved with. The fact is that much ofthe allure of privatization is to savemoney, and there is. a place for that.For example, Congress has to decide tohave private companies operate someof its cafeterias and do some of itscleaning, and perhaps that translatesinto more savings and better servicefor congressional employees. But Con-gress has wisely limited the roll of pri-vate companies in many functions ofGovernment. Private companies arenot allowed to operate our military in-stallations, nor do we have privatecompanies administer our Social Secu-rity system. We draw the line at somepoint.

I am concerned that privatizing deci-sions about benefits far low-income in-dividuals may go over this line. Atleast, at the very least, It needs carefuland thorough study. Yet, I understandthat the Finance Committee has notreviewed the details of the Texas waiv-er, has never seen the full proposal, andsince the Senator from North Dakotais also a member of the Finance Com-mittee and talks about the secret na-ture of this agreement, that furtherconfirms what the rest of us who arenot on the Finance Committee mightnot know and that is that it has neverhad appropriate scrutiny, never had ap-propriate review.

Mr. CONRAD. Will the Senator yieldon that?

Mr. LAUTENBERG. I would be de-lighted.

Mr. CONRAD. Is the Senator awarethat the proposal before us forces theSecretary of Health and Human Serv-ices to approve without comment or re-view any proposal submitted by theState of Texas which includes provi-sions to contract out for eligibility de-terminations? Was the Senator soaware?

Mr. LAUTENBERG. Not aware. I can-not even believe it would be suggested,because that is such a dereliction ofduty that I think everybody would beembarrassed if something like thistook place. What do you mean? That aSecretary has no right to review theconditions under which we are spend-ing the taxpayers' money?

Mr. CONRAD. If we think about this,these are programs with respect to foodstamps and WIC that are 100 percentfederally funded. The Medicaid Pro-gram is over 50 percent federally fund-ed.

Mr. LAUTENBERG. The rest of it isState funded.

Mr. CONRAD. The rest of it is Statefunded. We would be in a position toendorse any proposal the State ofTexas sent up here without any review,without any comment by the Secretaryof Health and Human Services. That isthe situation we are in with the pro-posal in the underlying legislation. Ijust ask the Senator, has he ever heardof such a proposal before the Senate?

S6 179

Mr. LAUTENBERG. Never, not evenin the years that I spent in the privatesector, and I ran a pretty good-sizedcompany with 16,000 employees when Ileft. It did better after I left. It nowhas 30,000 employees.

Never have I seen It. Never, when oneworks with Government, have I seenthis kind of an arrangement that has apeculiar odor, and It is not Chanel No.5. The fact is that to give away Govern-ment funds in a program as sensitive asthis to take care of the poor—listen, allof us have seen the abuses of privatesector companies that have taken overhealth care and things of that nature.

It just blows one's mind when you seethat the president of a company that isin the health care business made $22million in a single year and meanwhileis squeezing down because that iswhere the profits are going to comefrom, from cutting conditions. Theyare cutting programs that are supposedto take care of people's health.

Well, do you want to have someoneup there whose bonus, whose stock op-tions, whose salary depends on makingsure that they service as few people aspossible, reduce expenses as much aspossible when, in fact, the WIC Pro-gram is designed to take care of peoplewho are really impoverished, peoplewho need the nutrition that comesthrough the program to sustain them?So do you want to have some executivesitting at some remote place—and Iliked that executive life when I wasthere, but it was never at the Govern-ment's expense—at Government ex-pense. We see constant reference tocases being tried, investigations beingconducted where programs were turnedover to the private sector. I talk aboutthings like jails—we have tried that inNew Jersey—which were dismal fail-ures because they could not protect theguards sufficiently in these jails be-cause they did not hire the right kindof people. They did not provide themwith the right kind of tools. The facili-ties were not built enough to makesure the inmates incarcerated wereproperly cared for.

So we see this time and time again,and here we walk in and say, 'OK, hereis a bunch of poor people. You takecare of them. Do the best you can atthe best price you can." What an out-rage.

Mr. CONRAD. Will the Senator yieldfor a final question?

Mr. LAUTENBERG. Sure.Mr. CONRAD. Is the Senator aware

that under the proposal in the underly-ing legislation, we could have a privatecompany decide the custody of a child?That this is so far-reaching withoutany limits we could be in a drcumstance in which a private concernhas the authority to determine the cus-tody of a child? How does that strikethe Senator from New Jersey?

Mr. LAUTENBERG. I will tell theSenator how it strikes me. I say thankGod that the Senator from North Da-kota has brought this to the attentionof the Senate and to the public.


My friend has done a real service indoing this. The notion that an individ-ual working for a private living, per-haps their salary dependent upon theirability to curtail services, is hardly theway you want to treat a sick patient inthe hospital. That is hardly the wayyou want to treat a family problem.That is hardly the way you want toprotect a mother who has been bat-tered. That is hardly the way we wantto do things in a society with the con-science this country has.

I am delighted, again, that the Sen-ator introduced it. I am concerned thatprivatization like this is not going todo the job. Before we go ahead with ap-proval of a waiver, we ought to at leasthold a hearing and review the details.Mr. President, Congress has establishedthese safety net programs for people inour society who are truly in need, im-poverished. They are designed to easesuffering, to provide nutritional assist-ance to help children, help strugglingpeople get into the work force to getthemselves off welfare, to do whateverthey can to sustain themselves. Theseprograms can literally mean the dif-ference between homelessness andindependence, and we ought not to rushto hand them over to a private interestat this time, perhaps never, but wesure ought not to do it in the hastymanner that this is being undertaken.We can always revisit this issue, Mr.President, without constraints of a rec-onciliation bill.

I fully support the action being pro-posed by the Senator from North Da-kota and commend him for it, I musttell you.

Mr. CONRAD. I thank the Senatorfrom New Jersey. If I could just take amoment to further point out—I wantto rivet this point—there have been nohearings, not a hearing in the FinanceCommittee, not a hearing in the Agri-culture Committee. Members have notbeen granted the opportunity to ques-tion witnesses, experts, company, oradvocates on the merits of privatizingeligibility determinations, protectionsagainst cost overruns or protectionsfor recipients.

I really believe this is a totally un-precedented proposal that is buried inthis very large document that sets aprecedent that I believe is truly alarm-ing. I hope my colleagues will supportthe point of order when we vote on ittomorrow. This is, I think, a cir-cumstance in which a very broad pro-posal is being attempted, being madeto ram it through Congress as part ofprivileged legislation. That is wrong.That is simply wrong. The issue de-serves public hearings and full debate.

I thank the Chair, yield the floor,and I thank very much the Senatorfrom New Jersey.

AMENDMENT NO. 503

(Purpose: To extend premium protection forlow-Income medicare beneficiaries underthe medicaid program)

June 24, 1997 CONGRESSIONAL RECORD — SENATE S6287

ORDERS FOR WEDNESDAY, JUNE25, 1997

Mr. ROTH. Mr. President, I ask unan-imous consent that when the Senatecompletes its business today, it standin adjournment until the hour of 9:20a.m. on Wednesday, June 25. I furtherask unanimous consent that onWednesday, immediately following theprayer, the routine requests throughthe morning hour be granted, and Sen-ator STEVENS be recognized for up to 10minutes as if in morning business; thatfollowing Senator STEVENS' remarks,

S6288the Senate then immediately resumeconsideration of the budget reconcili-ation bill and begin voting on or in re-lation to the pending amendments inthe order in which they were offered inalternating sequence between each sideof the aisle.


PROGRAMMr. ROTH. For the information of all

Senators, tomorrow morning SenatorSTEVENS will be recognized for up to 10minutes. Following the remarks bySenator STEVENS, the Senate will re-sume consideration of the reconcili-ation bill. At 9:30 a.m. the Senate willproceed to a series of back-to-backrollcall votes on or in relation to a


number of amendments which havebeen offered this evening, beginningwith Senator GRAMM's amendment No.444 and ending with final passage of S.947 as previously ordered.

Also, by consent there will be 2 min-utes of debate equally divided on eachamendment prior to each vote. There-fore, Members can expect a lengthy se-ries of back-to-back rollcall votes asthe Senate disposes of all the amend-ments in order to the budget reconcili-ation bill.

Following final passage of 5. 947, theSenate is expected to proceed to theconsideration of 5. 949, the Tax Fair-ness Act. All Senators wishing to offeramendments to 5. 949 should be pre-pared to offer them during Wednesday'ssession of the Senate. Furthermore,Members can be expected to vote on

June 24, 1997amendments offered to the Tax Fair-ness Act beginning Wednesday after-noon. As previously announced, thenext couple of evenings will be lateones as the Senate works to completeaction on the Budget Act prior to theJuly 4 recess.

SENATE DEBATE

JUNE 25, 1997

S6290

BALANCED BUDGET ACT OF 1997The PRESIDING OFFICER (Mr.

ENzI). The Senate will now resume con-sideration of 5. 947, which the clerkwill report.

The assistant legislative clerk readas follows:

A bill (S. 947) to provide for reconciliationpursuant to section 104 (a) of the concurrentresolution on the budget for the fiscal year1998.

The Senate resumed the consider-ation of the bill.

Pending:Harkin amendment No. 428. to reduce

health care fraud, waste, and abuseGramm amendment No. 444, to provide

waiver authority for penalties relating tofailure to satisfy minimum participationrate.

Reed amendment No. 445, in the nature ofa substitute.

Hutchison amendment No. 447, to modifythe reductions for disproportionate sharehospital payments.

Chafee/Rockefeller/Jeffords amendmentNo. 448. to clarify the standard benefitspackage and the cost-sharing requirementsfor the children's health initiative.

DurbinIWellstone amendment No. 450, toprovide food stamp benefits to child immi-grants.

D'Amato/Harkin amendment No. 451. toimprove health care quality and reducehealth care costs by establishing a NationalFund for Health Research.

Domenici (for Murkowski) amendment No.455. to confirm Title IV, Energy Title, to theprovisions of the bill. with respect to the useof underutilized Strategic Petroleum Re-serve facilities.

Domenici (for Abraham/Levin) amendmentNo. 456. to extend the moratorium regardingHealthSource Saginaw until December 31.2002.

Domenici (for Helms) amendment No. 458,to provide for inclusion of Stanly County,North Carolina in a large urban area underthe Medicare program.

Domenici (for Helms) amendment No. 459,to provide for inclusion of Stanly County.North Carolina in a large urban area underthe Medicare program.

Domenici (for McCainIWyden) amendmentNo. 460, to provide for the continuation ofcertain State-wide medicaid waivers.


Domenici (for McCain) amendment No. 461,to provide for the treatment of certainAmerasian immigrants as refugees.

Domenici (for Jeffords) amendment No.462. to require the Secretary of Health andHuman Services to provide medicare bene-ficiaries with notice of the medicare cost-sharing assistance available under the med-icaid program for specified low-income medi-care beneficiaries.

Domenici (for Jeffords) amendment No.463. to provide for the evaluation and qualityassurance of the children's health insuranceinitiative.

Domenici (for Brownback) amendment No.464. to establish procedures to ensure a bal-anced Federal budget by fiscal year 2002.

Domenici (for Allard) amendment No. 465.to expand medical savings accounts to fami-lies with uninsured children.

Domenici (for Chafee) amendment No. 466.to extend the authority of the Nuclear Regu-latory Commission to collect fees throughSeptember 30. 2002.

Domenici (for Grassley) amendment No.467, to preserve religious choice in long-termcare.

Domenici (for Kyl) amendment No. 468, toallow medicare beneficiaries to enter intoprivate contracts for services.

Domenici (for Specter) amendment No. 469.to extend premium protection for low-in-come medicare beneficiaries under the med-icaid program.

Domenici (for Specter) amendment No. 470.to strike the limitations on DSH paymentsto institutions for mental diseases under themedicaid program.

Domenici (for Specter) amendment No. 471,to strike the limitations on Indirect Grad-uate Medical Education payments to teach-ing hospitals.

Domenici (for Burns) amendment No. 472,to provide that information contained in theNational Directory of New Hires be deletedafter 6 months.

Domenici (for Hutchinson) amendment No.473. to clarify the number of individuals thatmay be treated as engaged in work for pur-poses of the mandatory work requirementfor TANF block grants.

Domenici (for McCain) amendment No. 474.to provide for the extension and expansion ofspectrum auction authority and to providefor the flexible use of electromagnetic spec-trum.

Lautenberg amendment No. 475. to ensurethat certain legal immigrants who becomedisabled are eligible for disability benefits.

Lautenberg (for Kerrey) amendment No.476. to enhance taxpayer value in auctionsconducted by the Federal CommunicationsCommission.

Lautenberg (for Durbin) amendment No.477. to provide food stamp benefits to childimmigrants.

Lautenberg (for Rockefeller) amendmentNo. 478. to require balance billing protec-tions for individuals enrolled in fee-for-serv-ice plans under the Medicare Choice programunder part C of title XVIII of the Social Se-curity Act.

Lautenberg (for Dodd) amendment No. 479.to provide for medic aid eligibility of disabledchildren who lose SSI benefits.

Lautenberg (for Murray) amendment No.480, to clarify the family violence optionunder the temporary assistance to needyfamilies program.

Lautenberg (for Dodd) amendment No. 481.to amend the provision with regard to trans-fer cases.

Lautenberg (for Levin) amendment No. 482,to allow vocational educational training tobe counted as a work activity under the tem-porary assistance for needy families programfor 24 months.

Lautenberg (for Wyden) amendment No.483, to provide for the continuation of cer-tain State-wide medicaid waivers.

June 25, 1997Lautenberg (for Harkin) amendment No.

484. to make community action agencies,community development corporations andother non-profit organization eligible forwelfare-to-work grants.

Lautenberg (for Feinstein) amendment No.485. to provide that the hospital length ofstay with respect to an individual shall bedetermined by the attending physician.

Lautenberg (for Feinstein) amendment No.486. to provide additional funding for Stateemergency health services furnished to un-documented aliens.

Lautenberg (for Feinstein) amendment No.487, to provide for the application of dis-proportionate share hospital-specific pay-ment adjustments with respect to California.

Lautenberg (for Wellstone) amendment No.488, to provide for actuarially sufficient re-imbursement rates for providers.

Lautenberg (for Mikulski) amendment No.489. to reinstate the requirements for pro-vider payment rates.

Lautenberg (for Kennedy) amendment No.490, to improve the provisions relating to theHigher Education Act of 1965.

Lautenberg (for Baucus) amendment No.491, to prohibit cost-sharing for children infamilies with incomes that are less than 150percent of the poverty line.

Lautenberg (for Kennedy) amendment No.492. to ensure the provision of appropriatebenefits for uninsured children with specialneeds.

Lautenberg (for Kennedy) amendment No.493, to exempt severely disabled aliens fromthe ban on receipt of supplemental securityincome.

Lautenberg (for Conrad) amendment No.494, to provide for medicaid eligibility of dis-abled children who lose SSI benefits.

Lautenberg (for Conrad) amendment No.495, to establish a process to permit a nurseaide petition to have his or her name re-moved from the nurse aide registry undercertain circumstances.

Lautenberg (for Kerrey) amendment No.496. to strike the limitation on the coverageof abortions.

Lautenberg (for Kohl) amendment No. 497.to clarify that risk solvency standards estab-lished for managed care entities under themedicaid program shall not preempt anyState standards that are more stringent.

Lautenberg (for Harkin) amendment No.498. to allow funds provided under the wel-fare-to-work grant program to be used forthe microloan demonstration program underthe Small Business Act.

Domenici amendment No. 499, to provideSSI eligibility for disabled legal aliens.

Domenici (for Chafee/Rockefeller) amend-ment No. 500. to require that any benefitspackage offered under the block grant optionfor the children's health initiative includeshearing and vision services.

Domenici (for Chafee/Rockefeller) amend-ment No. 501, to require that nay benefitspackage offered under the block grant optionfor the children's health initiative includeshearing and vision services.

Roth (for D'Amato) amendment No. 502, toestablish a Medicare anti-duplication provi-sion.

Lautenberg (for Rockefeller) modifiedamendment No. 503. to extend premium pro-tection for low-income medicare bene-ficiaries under the medicaid program.

Lautenberg (for Kennedy) amendment No.504. to immediately transfer to part B cer-tain home health benefits.

Roth (for Lott) amendment No. 505 (toamendment No. 448), to improve the chil-dren's health initiative.

Roth amendment No. 506, to make tech-nical corrections and revisions.

Roth (for Lott) amendment No. 507 (toamendment No. 501). in the nature of a sub-stitute.

June 25, 1997 CONGRESSIONAL RECORD—SENATE S6291Roth (for Lott) amendment No. 508 (to

amendment No. 500), in the nature of a sub-stitute.

Roth (for Lott) amendment No. 509 (toamendment No. 492), in the nature of a sub-stitute.

Lautenberg (for Rockefeller) amendmentNo. 510, to require that any benefits packageoffered under the block grant option for thechildren's health initiative includes hearingand vision services.

Roth amendment No. 511, to provide a sub-stitute for the children's health insuranceinitiatives.

Chafee amendment No. 512 (to amendmentNo. 511), to clarify the standard benefitspackage and the cost-sharing requirementfor the children's health initiative.

Roth (for Lott) amendment No. 513 (toamendment No. 510), in the nature of a sub-stitute.

Roth (for DeWine) amendment No. 427, tocontinue full-time-equivalent resident reim-bursement for an additional one year undermedicare for direct graduate medical edu-cation for residents enrolled in combined ap-proved primary care medical residency train-ing programs.

Motion to waive a point of order that Sec-tion 5822 of the bill violates section313(b)(1)(A) of the Congressional Budget Act.

Motion to waive section 310(d) of the Con-gressional Budget Act with respect to con-sideration of Reed amendment No. 445, listedabove.

Motion to waive section 305(b)(2) of theCongressional Budget Act with respect toconsideration of D'Amato amendment No.451, listed above.

The PRESIDING OFFICER. Therewill now be a series of votes on or in re-lation to the amendments not yet dis-posed of, in the order they were offeredbut alternating between parties.

Mr. STEVENS. Mr. President, I sug-gest the absence of a quorum until thefloor leader arrives.

The PRESIDING OFFICER. Theclerk will call the roll.

The assistant legislative clerk pro-ceeded to call the roll.• Mr. STEVENS. Mr. President, I askunanimous consent that the order forthe quorum call be rescinded.


Mr. STEVENS. What is the pendingbusiness, Mr. President?

AMENDMENT NO. 428

The PRESIDING OFFICER. Thequestion is on agreeing to the Harkinamendment No. 428.

The amendment (No. 428) was agreed

AMENDMENT NO. 450

The PRESIDING OFFICER. Thequestion now is on amendment No. 450.

Mr. DOMENICI. Mr. President, Imake a point of order that the Durbinamendment is not germane.

Mr. BREAUX. I have a unanimousconsent. I ask unanimous consentMichelle Prejean, a member of mystaff, be allowed floor privileges today.


Mr. DOMENICI. I make a point oforder that the Durbin amendment No.450 is out of order, is not germane.

Mr. DURBIN. Mr. President, I objectto that.

First, I make a unanimous-consentrequest.

Mr. President, I ask unanimous con-sent that Anne Marie Murphy be al-lowed privileges of the floor during thedebate.


Is the Senator from Illinois movingto waive?

Mr. DURBIN. Mr. President, I ammoving to waive the provisions of theBudget Act for consideration of thisamendment, and I ask for the yeas andnays after the debate on this amend-ment.

The PRESIDING OFFICER. Is there asufficient second? There is a sufficientsecond.

The yeas and nays were ordered.There are 2 minutes equally divided.

The Senator from Illinois.Mr. DURBIN. Mr. President, I might

say to my colleagues in the Senate thisamendment seeks to right a wrong. Itseeks to provide food stamp coveragefor the children of legal immigrants tothe United States. The welfare reformbill cut off food stamp protection forchildren—deserving qualified chil-dren—and really relegated over 200,000children across the United States intoa position where they do not have ade-quate nutrition.

It does not do our Nation a bit ofgood to deny these children food at amoment in their lives when it is impor-tant to their development. These kidsare likely to become American citi-zens. They are likely to be our neigh-bors. They are likely to be our futureworkers.

Let us resolve that although we aretrying to eradicate welfare as we knowit, we will not take it out on the kids.The money that is used to pay for thefood stamps for the children of theselegal immigrants is an offset thatcomes from the administrative costssent to the States. This is money thatshould be dedicated for the better pur-pose of feeding hungry, deserving chil-dren.

I ask my friends, regardless of yourposition on welfare reform, to makesure that we are dedicated in Americato healthy children, not hungry chil-

June 25, 1997dren. I hope you will consider voting towaive the provisions of the Budget Actand approval of this amendment.

The PRESIDING OFFICER. The Sen-ator from New Mexico.

Mr. DOMENICI. Mr. President, theagreement that was put together withthe President contains some foodstamp changes. They have been adopt-ed by the committees. We have neveragreed on this one. In fact, it was noteven brought up by the administration.

This amendment amends the welfarereform bill of last year by requiringfood stamp benefits to child immi-grants, paid for with State administra-tive moneys.

I yield remaining time on our side.VOTE ON MOTION TO WAIVE THE BUDGET ACTThe PRESIDING OFFICER. The

question is on agreeing to the motionof Senator DURBIN to waive the BudgetAct for the consideration of amend-ment No. 450.

The yeas and nays have been ordered.The clerk will call the roll.

The legislative clerk called the roll.The PRESIDING OFFICER. Are there

any other Senators in the Chamber de-siring to vote?

The yeas and nays resulted—yeas 48,nays 52, as follows:

YEAS—48Akaka Durbin LeahyBaucus Feingold LevinBiden Feinstein LiebermanBingaman Ford MikuiskiBoxer Glenn Moseley-BraunBreaux Graham MurrayBryan Harkin ReedBumpers Hollings ReidChafee lnouye RobbCleland Johnson RockefellerCollins Kennedy SarbanesConrad Kerrey SnoweDAmato Kerry SpecterDaschle Kohl TorricelliDodd Landrieu WellstoneDorgan Lautenberg Wyden

NAYS—52Abraham Gorton McConnellAllard Gramm MoynihanAshcroft Grams MurkowskiBennett Grassley NicklesBond Gregg RobertsBrownback Hagel RothBurns Hatch SantorumByrd Helms SessionsCampbellCoats

HutchinsonHutchlsdn

ShelbySmith (NH)

Cochran Inhofe Smith (OR)Coverdell Jeffords StevensCraig Kempthorne ThomasDeWine Kyl ThompsonDomenici Lott ThurmondEnzi Lugar WarnerFaircloth MackFrist McCaIn

The PRESIDING OFFICER. On thisvote the yeas are 48, the nays are 52.

Three-fifths of the Senators duly cho-sen and sworn not having voted in theaffirmative, the motion is rejected.

The point of order is sustained andthe amendment falls.

S6292 CONGRESSIONAL RECORD — SENATE

S6294 CONGRESSIONAL RECORD — SENATE

AMENDMENT NO. 499 WITHDRAWN

Mr. DOMENICI. Mr. President, Iwithdraw my amendment No. 49 re-garding the subject matter of the Lau-tenberg amendment. It is amendment499, excuse me. It is 49 on our list. No.499.

The PRESIDING OFFICER. Withoutobjection, the amendment is with-drawn.

The amendment (No. 499) was with-drawn.

AMENDMENT NO. 415

Mr. DOMENICI. We have agreed toaccept the Lautenberg amendment andtaking it to conference. We think it isthe best way to resolve this issuewhich is between the two Houses andthe White House. We all have different

June 25, 1997

versions. And we agree to accept theamendment. I yield to him now for hisminute.

The PRESIDING OFFICER. The Sen-ator from New Jersey.

Mr. LAUTENBERG. I thank theChair. I thank the chairman of thecommittee for accepting this.

The purpose of the amendment isvery simple. It is to provide fairness forpeople who come to this country le-gally, who paid their taxes in goodfaith and played by the rules, and thenperhaps suffer from a serious disabilitycaused by an accident or a serious ill-ness.

Whatever the cause, they are here atour invitation, left unable to work andunable to support themselves. And so,Mr. President, the budget agreementincludes a very specific provision to en-sure that these people get help. Unfor-tunately, the bill before us providesfunding for only 1 year of these bene-fits. I hope we will be able to hold thisamendment. It is very important. Ithink it establishes our attitude aboutthose who have come here at our invi-tation, and we say, pay your taxes, doyour work, and then we want to takethem out of the protection stream.

So I hope that this amendment,which will restore them personally,will take care of it.

The PRESIDING OFFICER. Withoutobjection, the amendment is agreed to.


Mr. DOMENICI. Mr. President, Imove to reconsider the vote.

Mr. LAUTENBERG. I move to laythat motion on the table.

The motion to lay on the table wasagreed to.

AMENDMENT NO. 461Mr. DOMENICI. The amendment we

are going to is amendment No. 461, theMcCain amendment.

Might we proceed to amendment 461?We have just received a unanimousconsent to set this aside.

The PRESIDING OFFICER. Whoyields time on the McCain amendment?

Mr. DOMENICI. I do.The PRESIDING OFFICER. The Sen-

ator from New Mexico.Mr. DOMENICI. Mr. President, this is

going to be accepted. This amendmentwill reclassify certain Amerasian im-migrants as refugees to exempt themfrom the restrictions on receiving ben-efits under the welfare reform bill. Itcosts about $1 million and has been ac-cepted on both sides.

Mr. LAUTENBERG. We have no ob-jection.

Mr. BYRD. Mr. President, we cannothear the explanation by the distin-guished manager.

S6295The PRESIDING OFFICER. The Sen-

ator is correct. The Senate be in order.The Senator from New Jersey?Mr. LAUTENBERG. Mr. President, I

was saying we have no objection. Weought to move on, move this along.

Mr. DOMENICI. We yield any timewe have.

Mr. BYRD. Mr. President, will thedistinguished Senator repeat the state-ment? There is so much noise and con-fusion that I for one could not under-stand what Senator DOFvIENIcI was say-ing.

Mr. DOMENICI. This McCain amend-ment would reclassify certainAmerasian immigrants as refugees.Thus, they would be entitled to bene-fits of people similarly situated. Theamendment costs about $1 million peryear, and those on our side who handlethese matters have indicated they arewilling to accept it. I understand theminority is willing to accept it.

Mr. LAUTENBERG. We have no ob-jection.

THE PRESIDING OFFICER. If therebe no further debate, the question is onagreeing to the amendment.



Mr. LAUTENBERG. I move to laythat motion on the table.


AMENDMENT NO. 479

The PRESIDING OFFICER. Thequestion occurs on the Dodd amend-ment, No. 479. The Senator from Con-necticut.

Mr. DODD. Mr. President, I hope thisamendment will be agreed to. This isan amendment I think all of our col-leagues can support. I am offering it onbehalf of myself and the Senator fromNorth Dakota, Senator CONRAD. It willpreserve the Medicaid coverage forsome 30,000 children who, if we do noth-ing else, are going to lose it. These arethe most severe disabled children inthe country. This was a slip, more thananything else, I think, when we passedthe welfare reform law last year. Welearned these children might lose theirMedicaid coverage as a consequence oflosing their SSI. Since then there hasbeen a broad agreement we should stepin and try to preserve health care forthe most needy of all children. In fact,the bipartisan budget agreement calledfor continued Medicaid coverage forthese children. So, this amendmentmerely plugs that gap that we had allagreed on. It simply honors the agree-ment. Its cost is modest. It is about$100 million over 5 years.

I can argue if we can find $16 billionto provide insurance for kids who lackit, surely we could set aside a fractionof that to provide insurance for chil-dren who stand to lose it. That is whatwe are faced with. If we do not do this,these 30,000 severely disabled childrenwould be cut off.

Mr. LAUTENBERG. Mr. President, Irise in support of this amendment to

June 25, 1997 CONGRESSIONAL RECORD — SENATE

S6296restore Medicaid coverage for childrenwho were removed from the SSI rolls inlast year's welfare bill.

Mr. President, last year's welfare billsignificantly restricted the types ofdisabilities that enable a child to qual-ify for the Supplemental Security In-come Program. In some cases, the samedisability that will qualify an adult forSSI now will be insufficient to qualitya child. Among the children most like-ly to lose benefits are those who sufferfrom multiple problems, no one ofwhich is severe enough to meet themore restrictive legal criteria, but thecombined effect of which is substan-tial.

The Social Security Administrationestimates that 135,000 low-income dis-abled children will be removed fromthe SSI as a result of the new law. Oth-ers put the number much higher.

In any case, since SSI eligibility islinked to Medicaid eligibility, many ofthese children will be terminated fromthe Medicaid Program, unless theyqualify on other grounds. The adminis-tration believes that, in the end, about30000 disabled children from low in-come families will lose Medicaid cov-erage.

Mr. President, the loss of Medicaidcoverage is likely to create seriousproblems for these families. Private in-surance will be very difficult to findAnd even it it's available, the costswill reflect the conditions that thesechildren have.

Compounding matters; these familiesalso will be suffering large incomelosses because of the loss of their chil-dren's SSI benefits.

Mr. President, these families had lowincomes even before these benefitswere withdrawn. And now they are fac-ing severe financial hardships. Allow-ing these to keep Medicaid coverage isthe right thing to do. Otherwise, we arelikely to see even more children be-come uninsured.

Mr. President, one of the core prin-ciples of the bipartisan budget agree-ment was to provide health care cov-erage for as many as 5 million unin-sured children. And it was my under-standing that the budget negotiatorsagreed to restore Medicaid for theseroughly 30,000 SSI kids. Not as part ofthe $16 billion child health initiative,but as a separate, binding commit-ment. That is clearly the understand-ing of the administration, as well.

Unfortunately, Mr. President, Sen-ator DOMENtCt has a different recollec-tion of what was agreed to, and I knowhe holds that view in good faith. So wehave an honest disagreement.

But regardless of whose recollectionis more accurate, Mr. President, Iwould urge my colleagues to protectthese vulnerable children and theirfamilies.

Mr. President, I know that Senatorson both sides of the aisle share a com-mitment to covering all of America'schildren. And so I hope that thisamendment will win broad support.

Keep in mind that that these chil-dren don't just come from low-income


families. They are disabled, eventhough they don't meet the new eligi-bility standards for SSI. And many ofthem will be become completely unin-sured if we do not Correct this problem.

I also want to make sure that Sen-ators understand that this amendmentwould not restore any SSI benefits. Allit would do is restore Medicaid cov-erage for these children. But thatwould greatly ease the hardships facingmany of these families, and reduce thenumber of children who otherwisewould join the ranks of the uninsured.

So, Mr. President, I hope my col-leagues will stand with these 30,000 dis-abled children and their families, andwill support this amendment.

The PRESIDING OFFICER. The timeof the Senator has expired. The Sen-ator from New Mexico.

Mr. DOMENICI. Mr. President, firstof all let me say it is the position ofthe committee of jurisdiction thatthese children are covered under the$16 billion child care provisions of thebill. Since that is the case, I firstwould ask the Senator if he would liketo withdraw the amendment and con-firm that. If not, I would make a pointof order against the amendment and hewould have to get 60 votes to pass it.

Mr. DODD. I realize we are runningout of time. Let me, on the Senator'stime—I raised this earlier, I say to thedistinguished chairman of the BudgetCommittee. We are not convinced thatis the case. I understood that was theargument made to me and that has notbeen confirmed. So we are running therisk here, if it is not the case. I wouldrather adopt the amendment. If itturns out it is OK, then we protectedthese children. If you do not do it, it'snot part of the $16 billion, 30,000 dis-abled children lose their Medicaid ben-efits. We have to do it by law, and Iwould rather err on that side than erron the other side.

Mr. DOMENICI. I do greatly respectthe Senator. I respect all Senators. Butwe really are operating on a 1-minuterule for each side. I think if we aregoing to speak longer we ought to getconsent of the Senate to do that, and Ido not address that just to SenatorDODD.

We contend they are covered. I makea point of order under section 310 of theBudget Act.

Mr. DODD. I move to waive that.Mr. President, I ask for the yeas and

nays.The PRESIDING OFFICER. Is there a

sufficient second?There is a sufficient second.The yeas and nays were ordered.VOTE or MOTIOr TO WAIVE THE BUDGET ACT

The PRESIDING OFFICER. Thequestion is on agreeing to the motionto waive the Budget Act, section 310.The yeas and nays have been ordered.The clerk will call the roll.

The bill clerk called the roll.The yeas and nays resulted—yeas 49,

nays 51, as follows:

AkakaBaucus

FeingoldFeinstein

LevinLieberman

Biden Ford MlkulsklGlenn Moseley-BraunBingaman

Boxer Graham MoynihanBreaux Harkin MurrayBryanBumpers

Hollingslnouye

ReedReid

CampbellChafee

JeffordsJohnson

RobbRockefellerSarbanes

ConradDAmatoDaschle

KennedyKerreyKerryKohl

SpecterTorricelliWellstone

Dodd Landrleu WydenDorgan LautenbergDurbin Leahy

NAYS—51

AbrahamAllard

FristGorton McConnell

Ashcroft Gramm MurkowsklBennett Grams NJlcklesBond Grassley RobertsBrownbackBurns

GreggHagel

RothSantorum

Byrd Hatch SessionsCoats Helms ShelbyCochran Hutchinson Smith (NH)Collins Hutchison Smith (OR)Coverdell Inhofe Snowe

Kempthorne StevensCraigDeWine Kyl ThomasDomenici Lott ThompsonEnzl Lugar ThurmondFalrcloth Mack Warner

The PRESIDING OFFICER. On thisvote, the yeas are 49, the nays are 51.Three-fifths of the Senators duly cho-sen and sworn not having voted in theaffirmative, the motion is rejected.The point of order is sustained, and theamendment falls.

Mr. DOMENICI addressed the Chair.The PRESIDING OFFICER. The Sen-

ator from New Mexico.Mr. DOMENICI. May I have the at-

tention of the Senate for just a mo-ment?

The PRESIDING OFFICER. The Sen-ate will be in order.

The Senator from New Mexico.Mr. DOMENICI. Could I ask the

clerk, how long have we been taking interms of time on the rollcalls on theamendments?

The PRESIDING OFFICER. Votes aretaking approximately 15 minutes.

Mr. DOMENICI. We are on 10-minuterollcall votes, I say to the Senators.The longer we take for these, thelonger we go into the evening tonight.I really urge you to do your best to gethere quickly so we can wrap them up in10 minutes. I understand 10 to 11 is suf-ficient. I thank the Senate.

BALANCED BUDGET ACT OF 1997Mr. DOMENICI. Parliamentary in-

quiry. Is it not time to return to con-sideration of the bill?

The PRESIDING OFFICER. Underthe previous agreement, the Senate re-sumes consideration of 5. 947. The Sen-ator is correct.

The Senate continued with the con-sideration of the bill.

June 25, 1997

S6301

S6302

AMENDMENT NO. 493Mr. DOMENICI. Senator KENNEDY

has an amendment, No. 493, Kennedy-Lautenberg. Senator LAUTENBERG in-troduced it for Senator KENNEDY, to ex-empt severely disabled aliens from theban on receipt of supplemental income.It is at the desk. I indicate from our


side that there is no objection. I under-stand from the Democratic side thereis no objection.

Senator KENNEDY, is that correct?Mr. KENNEDY. That is correct. I

thank the chairman of the committeefor his consideration. It is a seriousissue and a heartrending issue formany different individuals. The will-ingness to accept this amendment issomething we are very, very appre-ciative of. If I might just say a fewwords about it.

Under the budget reconciliation bill,legal immigrants who are already inthis country can keep their SSI bene-fits. But for those who come in the fu-ture, SSI is only for citizens. Theyhave to become citizens to qualify inthe future, so your sponsor must takecare of you until then.

This amendment creates a small ex-ception to that rule. It enables immi-grants who are too disabled to qualifyfor citizenship to retain their SSI eligi-bility.

Some immigrants and refugees—though not many—become too disabledto qualify for citizenship. Under thisbill, their sponsors have to care forthem for life. If they dont have spon-sors, they have nowhere to turn.

One example is Vien Vu. His familyfled Vietnam after years of servingside-by-side with the United StatesArmed Forces. But Vien Vu has Downssyndrome. He is 34 years old. The restof his family has become Americancitizens but Vien will never qualify forcitizenship. His family needs SSI tocare for him for the rest of his life.

Mendel Tsadovich is a Latvian Holo-caust survivor who is too mentally re-tarded to qualify for naturalization. In1992, he and his family escaped as refu-gees from the anti-Semitism of theformer Soviet Union. He is now 61 andliving in New York. He is the only sur-viving member of his family, and de-pends on SSI for assistance. He has nosponsor.

Vien and Mendel are the lucky ones.They arrived before passage of lastyear's welfare law. So the reconcili-ation bill will continue their SSI cov-erage. But what about the Viens andMendels who arrive in the future?

With the passage of the Lautenbergamendment this morning, my amend-ment costs almost nothing. CBO scoresit as having little budget impact. So,we can help all those like Vien andMendel and still balance the budget by2002.

The number of immigrants thisamendment affects is small, perhapsonly a few thousand people a year. Butthese immigrants often depend on SSIbenefits for their survival. If they donot have the ability to become citizens,Congress should not deny them the SSIbenefits they need.

Mr. DOMENICI. Mr. President, I havea couple of seconds. I want to say,some may ask why I accepted this. Ac-tually, it's a very tiny group of people.It covers those who are so seriouslydisabled that the disability disqualifies

June 25, 1997

them from completing their natu-ralization process. Therefore, they can-not become citizens. They are nonciti-zens, but legal. As a result, they are de-nied benefits described in the Kennedyamendment for only that reason. So Iagree to accept that.

THE PRESIDING OFFICER. If therebe no further debate, the question is onagreeing to the amendment.



Mr. KENNEDY. I move to lay thatmotion on the table.


S6320

POINT OF ORDER

Mr. DASCHLE. Mr. President, pursu-ant to section 313 of the CongressionalBudget Act, I make a point of orderthat the following sections of the pend-ing bill are extraneous to the reconcili-ation instructions of the respectivecommittee ofjurisdiction: section 5713,section 5833, and section 5987.

The PRESIDING OFFICER. TheChair sustains the points of order.

Mr. ROBB. Mr. President, I risetoday to discuss 5. 947, the BalancedBudget Act of 1997. I'm pleased thatwe've come together in a bipartisanway—both sides of the aisle, both sidesof the Capitol, and both ends of Penn-sylvania Avenue—to craft a plan thatbrings us a step closer to fiscal sanity.

The good news, Mr. President, is thatthe bill before us realizes roughly $137billion in savings over the next 5 years.And that's good news for our countryand for our children and our grand-children.

5. 947 provides additional years ofsolvency to the Medicare hospital trustfund, reforms payment methodologies


for skilled nursing facilities, homehealth, and outpatient entities, and in-cludes greater choice—and expandedpreventive benefits—for millions ofMedicare beneficiaries. As a cosponsorof the original Chafee-Rockefeller childhealth bill, I'm delighted that this billcontains $16 billion to expand access tohealth care for America's children,most of whom live in the home of anAmerican worker.

Someday, our children will be grate-ful for the $16 billion we invested intheir health care, Mr. President. Andthey will be grateful that we succeededtoday in saving $137 billion in futuredebt—debt we will not ask them topay.

But our children will not be gratefulif we don't take this opportunity inthis budget to tackle long-term enti-tlement reform in a systemic way.

We all know the statistics. While en-titlements and interest on the nationaldebt represented just 30 percent of ourbudget in 1963, they will absorb 70 per-cent by the year 2002. And even morealarmingly, if we don't make changesin the way we do business around here,entitlements and interest on the debtwill absorb the entire Federal revenuebase by the year 2012. How then can weresponsibly invest in our children? Howcan we sustain the transportation in-frastructure needed to support a thriv-ing economy in the next century? Howdo we pay our soldiers, repair our subsand carriers, and invet in the tech-nology we need to remain the lastgreat superpower on Earth?

Mr. President, despite the fact thatthe vast majority of economists havetold us that we need to adjust theconsumer price index to accurately re-flect inflation, we have no legislativeCPI adjustment in this package. Oppo-nents say that since we don't need alegislative CPI adjustment to balancethe budget in 5 years, it's not in thisplan. But what about when the babyboom generation retires, Mr. President,when just three workers—and thentwo—will support each Social Securitybeneficiary?

The Finance Committee had thecourage to include a provision in thisbill to gradually increase the eligi-bility age for Medicare from 65 todayto 67 by the year 2027. This provisionhas been under assault—and will con-tinue to be—from many sides. Somewho oppose it argue that this is not thetime. And while I'm committed toidentifying methods to provide accessfor those who may encounter a lapse incoverage—and this bill creates a bi-partisan commission that will look atthe feasibility of a Medicare buy-inprogram—when will the time be right?We had a good vote in support of thiseligibility increase in the Senate andwe have to fight to retain it in con-ference.

Finally, the home health copay andthe affluence testing for wealthy sen-iors which were included in the com-mittee mark and which were supportedby the majority of the Senate during

June 25, 1997

two rollcall votes held yesterday willlikely not survive conference as well,Mr. President. These provisions are indanger even though we all know wehave to find responsible ways to reducethe Federal cost of Medicare. While af-fluence testing of part B premiums is apolitical lightning rod, it is good publicpolicy. It is simply indefensible to re-quire lower income families, many whocannot afford health insurance fortheir own children today, to continueto help subsidize 75 percent of the Med-icare premiums of wealthy seniors.

We have much to do, Mr. President,to fulfill our obligation to leave ourchildren a strong economic future anda quality of life equal to the one we in-herited from our own parents. The firststep is to balance our budget—and Ihope the bill before us accomplishesthat goal. The next step—and it is anessential one—is to tackle long term,systemic entitlement reform that willprotect both the solvency of Medicareand Social Security and the economicsecurity of the generations that followus.

I hope the conferees will not makethose goals even harder to achieve inthe future.

With that plea Mr. President, I yieldthe floor.

THE BUDGET RECONCILIATION BILL MU5TPROTECT LEGAL IMMIGRANTs

Mr. KENNEDY. Mr. President, I con-tinue to be concerned about actions byCongress that hurt legal immigrants.

Last year, Congress passed a so-called welfare reform bill. This harshbill cut off legal immigrants from mostFederal assistance programs for thefirst time in history. It permanentlybanned legal immigrants from SSI andfood stamps. It banned them for 5 yearsfrom AFDC, Medicaid, and other pro-grams. And, it gave the States the op-tion of permanently banning themfrom these programs.

We quickly saw the effect of these ex-treme provisions. Panic spread throughthe immigrant community. The SocialSecurity Administration sentnotices tolegal elderly and disabled immigrantsthat they would soon lose their SSIbenefits. Numerous reports in the presstold of legal immigrants who would beturned out of nursing homes, or cut offfrom disability payments. Some legalimmigrants took their own lives, rath-er than burden their families. Thank-fully, many Members of Congress real-ized that these provisions went too far.

This budget reconciliation bill cor-rects many of those mistakes. Membersof the Finance Committee and BudgetCommittee showed impressive leader-ship in developing this bill. They rec-ognized that the immigrants affectedby last year's harsh cuts are individ-uals and families who came here le-gally. By and large, they are familymembers—mothers, fathers, and sons,daughters—of American citizens. Theyplay by the rules, pay their taxes, andserve in the Armed Forces. They can bedrafted. They can volunteer. We havehundreds of them in Bosnia today.

June 25, 1997They are future citizens trying tomake new lives for themselves andtheir families in this country. I com-mend the committees for working sohard to come up with a bipartisan pro-posal.

This bill allows legal immigrantswho are already receiving SSI to con-tinue their SSI payments. It preservesSSI coverage for immigrants already inthe United States who become disabledin the future, and for future immi-grants who are too severely disabled togo through the process of naturaliza-tion to become citizens. It extends theexemption for refugees from 5 to 7

years. It exempts children from the 5-year ban on Medicaid eligibility.

There is still much more to be doneto correct the problems created for im-migrants by last year's welfare reformlaw. But, overall, this bill makesworthwhile progress toward restoring asafety net for immigrants who fall onhard times. I hope that Senators willdo all they can to see that the immi-grant provisions in this bill are re-tained In the Senate-House conferenceand final bill.

MEDICARE REFORMMr. GRAMS. Mr. President, I rise

today in support of some very impor-tant Medicare reforms made within thereconciliation package before us. Spe-cifically, I am pleased the committeeincluded reforms to the formula usedto determine the reimbursement ratefor health plans under the MedicareProgram to make it fairer and more eq-uitable for States like Minnesota andother parts of rural America, changesto ensure better access to emergencymedical services, and an expansion ofMedical Savings Accounts.

Reform of the Adjusted Average PerCapita Cost formula has been neededfor years because the formula has dis-criminated against seniors who chooseto live and retire in rural communities.It has penalized States like Minnesotawhich are efficient in delivering healthcare services, and in doing so, discour-aged quality health care. Since beingelected to the Senate in 1994, I havemade restoring fairness and equity toMedicare recipients in Minnesota andother parts of rural America a top pri-ority.

Mr. President, we are all aware of thefact that the current Medicare reim-bursement formula discriminatesagainst Minnesota by giving our Statethe second-lowest payment rates in theNation. Not one county in the entireState of Minnesota, or in 15 otherStates, receives the national average of$467 in AAPCC payment per month.

Because of these low reimbursementrates, managed care organizations havebeen discouraged from offering our sen-ior citizens many of the alternativehealth plans available in other parts ofthe country, plans which offer addi-tional benefits such as eyeglasses andprescription drugs. Clearly, this is aproblem which should have been ad-dressed long ago.

In February, several of my colleaguesand I introduced 5. 359, the Medicare


Payment Equity Act, which wouldhave established a floor of 80 percent ofthe national adjusted capitation ratefor the year and made the AAPCC for-mula more equitable by blending thenational and county specific percent-age. More recently, I cosponsored S.862, authored by Senator GRASSLEY,which followed the same lines of re-form and even more closely resembleswhat was ultimately passed by the Fi-nance Committee. Under the leadershipof Finance Chairman RoTh and throughthe tireless efforts of Senators THOMAS,BURNs GRASSLEY, and ROBERTS, wehave succeeded in beginning to fix theMedicare formula to make it fairer forMinnesota's seniors and right some ofthe wrongs against us.

The AAPCC reforms contained in thereconciliation bill are a very importantstep in restoring fairness and providinggreater choices for Medicare recipientswho live in Minnesota, particularly inrural communities. This truly rep-resents a great victory for Minnesota'ssenior citizens as we close the long-standing gap of inequity in the Medi-care Program.

Mr. President, this legislation alsoaddresses another important issue inwhich I have been deeply involved. InJanuary, Senator GRAHAM of Floridaand I introduced 5. 238, the EmergencyMedical Services Efficiency Act, to es-tablish a reasonable standard for deter-mining Medicare reimbursement forEMS services. Our bill would ensurethat EMS providers would be reim-bursed based upon a prudent laypersonstandard, rather than the ultimate di-agnosis of a physician. This revised def-inition will ensure that EMS providersare prepared to meet the challengesfacing them as they work to improvetheir services.

All of us depend daily on the readi-ness, efficiency, and immediate re-sponse of our emergency medical sys-tem. And while many of us take it forgranted, we all want it to work wellwhen we need it. Many of the men andwomen who risk their lives deliveringemergency care have told me the sys-tem can be improved, yet their desireto improve the services they providehas rarely been recognized by Congress.This provision in the reconciliation billis the first step in helping EMS provid-ers help themselves become more effi-cient. I would like to thank SenatorGRAI-LAM for his efforts in the FinanceCommittee to see that this importantissue was included in the package.

Finally, I would like to thank Chair-man RoTh for his efforts to include anexpansion of Medical Savings Ac-counts. In developing a MedicareChoice Program modeled on the Fed-eral Employee Health Benefits plan1this will offer, for the first time, a realchoice to America's seniors.

Again, I commend and thank Chair-man ROTH and his Finance Committeecolleagues for including these impor-tant changes in the reconciliationspending package.

S6321BIPARTI5AN BUDGET AGREEMENT ITEM5 TO BE

ACHIEVED IN APPROPRIATIONS PROCE55Mr. DOMENICI. Mr. President, I rise

to address some concerns expressed bythe administration with regard to twoitems they believe should be in thisreconciliation bill. I would like to clar-ify what we assumed in the 1998 budgetresolution for those items.

The bipartisan budget agreement didinclude assumptions on additionalfunding for unemployment insurancebenefits integrity and on extension offees for SSI State supplemental benefitadministration. In both instances, thebudget resolution assumed that theseproposals would be implemented by theAppropriations Committee, and there-fore the authorizing committees werenot instructed to achieve these savingsin reconciliation. The budget resolu-tion is the basis for scoring congres-sional action and cannot be changed inan ad hoc manner, that is, withoutpassing another concurrent resolutionto change it.

I would ask the chairman of the Ap-propriations Committee if it is not alsohis understanding that these proposalsare to be considered by his committee?

Mr. STEVENS. As chairman of theAppropriations Committee, I am com-mitted to working with the chairman,and the administration regarding thelevels of funding assumed in the bipar-tisan budget agreement that are withinpurview of the Appropriations Commit-tee. It is my understanding that theSubcommittee on Labor, Health andHuman Services, and Education hasbeen working with the Office of Man-agement and Budget with regard to theproposals you have mentioned.

Mr. DOMENICI. I thank the Senatorfor helping clarify this matter.

FINAL REGULATIONS ON SOCIAL SECURITYINSURANCE DETERMINATIONS FOR CHILDRENMr. JEFFORDS. Mr. President, dur-

ing the consideration of this importantbill, I would like to bring to your at-tention developments regarding the ad-ministration's recently released SSIregulations for children. Through sec-tions 211 and 212 of Public Law 104-193,the Personal Responsibility and WorkOpportunity Act of 1996, Congress es-tablished a new eligibility test requir-ing that children show the presence of


marked and severe functional limita-tions" to become eligible for Supple-mental Security Income (SSI] disabil-ity benefits. Additionally, under thesenew rules up to 300,000 children who arecurrently eligible for SSI will undergoa redetermination assessment over thenext several months.

On February 11, 1997, in an attemptto implement these provisions, the So-cial Security Administration issued in-terim final regulations that require alevel of disability that meets or equalsthe listings of impairments criteria. Asstated in a letter written by nine of mycolleagues and me to the President inApril, I believe this regulation estab-lishes an overly severe standard thatmisinterprets the intent of Congress toreform the SSI program for childrenwith disabilities. SSA's test would re-move up to 135,000 SSI disabled chil-dren this year alone. Thus, thousandsof severely disabled children would facea loss of needed SSI benefits—contraryto the will of Congress.

I believe the Social Security Admin-istration should establish a comprehen-sive functional test at a stricter sever-ity level than the former individualizedfunctional assessment test, but onethat does not harm children with seri-ous disabilities. A test protecting chil-dren with severely disabling condi-tions—including those with onemarked and one moderate condition—would accurately reflect the intent ofCongress. The administration has esti-mated this test would terminate 45,000children this year, and close to 250,000over 6 years.

Mr. President, I have already heardfrom constituents in my State of Ver-mont whose children will soon losetheir SSI benefits. These families havenowhere else to turn. Such predica-ments present troubling moral andbudgetary questions—how to providefor those families who are shut off fromdesperately needed SSI benefits, andwhether these regulations will simplyshift the costs of providing for childrenwith disabilities from SSI to otherFederal entitlement programs, or tothe States as communities react tothese troubling cases. Such cost shift-ing would eliminate any significantsavings gained. Additionally, the lossof SSI benefits will force families tomove their children to costly out-of-home placement, as parents would nolonger have the financial support tostay at home and care for the disabledchild.

This is a matter that I will be pursu-ing with the Administration with theintent of reconciling the Administra-tion's interpretation with the regula-tions passed by Congress during thewelfare debate last fall.

S6331

S6323

Mr. DOMENICI. Mr. President, let metake 1 minute, and then we are goingto final passage. I want to thank every-body for their cooperation. Under avery difficult process and procedure, Ithink we did very well. On a number ofissues, there was great bipartisan sup-port. I thank those on the other side ofthe aisle who have supported this over-all package, and I hope the vote isoverwhelming. Tonight we complete

June 25, 1997

S6332the first step of three legs. The threelegs are to get the deficit down by re-ducing spending; second is for us to geta good tax bill for all Americans; thirdis to do the appropriations bills in amanner that is consistent with theagreement and which doesn't violatethe Budget Act.

I believe this is a historic beginning,and I am very pleased to be part of it.I thank everyone here for their role. Ithank all eight committees that as-sumed their burden and produced theirreconciliation package. Mostly, Ithank Senator RoTh, the chairman ofthe Finance Committee, and SenatorMOYNn-iArJ, his Democratic manager,and all those on the Finance Commit-tee who worked to produce a bipartisanbill.

The lesson learned is that we can getthings done that are difficult but goodfor the American people in a bipartisanway if we just work at it. I believe thebest example we have of that is the Fi-nance Committee this year. All theother committees had lesser respon-sibilities, but they provided their sav-ings without rancor and with almostunanimity and, if not, a unanimity ofspirit. I believe there is no process thatwould have let us in the U.S. Senateget this much work done. If this billwere freestanding and the tax bill werefreestanding without the protections ofthe Budget Act, I just ask you todream about what might happen. First,I think each bill could take 4 or 5weeks, I think the amendments couldrun into the hundreds, and the billcould look like something completelydifferent by the time we finished thanwhat we started with. So we take somebad with the good in this difficult proc-ess called the reconciliation bill.

I thank the ranking member of theBudget Committee not only for thework here on the floor, but actually aswe moved through the last 3½ months,Senator LAUTENBERG has been verygood to work with, and we produced agood package, which will show up herein a bipartisan vote tonight. I thankthe Senator. We produced a good bill.

Mr. LAUTENBERG addressed theChair.

The PRESIDING OFFICER. The Sen-ator from New Jersey is recognized.

Mr. LAUTENBERG. Mr. President, Iwill be brief. I sense that everybodywould like to hear a long speech, but Iam going to disappoint them. I justwant to say, Mr. President, that I, too,enjoyed my work with the distin-guished chairman of the Budget Com-mittee. We managed to resolve all ofour problems without too much dis-pute, without any confrontation. Therewasn't a moment that we walked outon anything. This reconciliation bill isconsistent with that. We did, as it wasappropriately noted, rush throughsome things. But that does not at all,in my view, suggest that we rushedthrough and didn't have the appro-priate knowledge or review of theitems that we were processing.

I thought it was ajob very well done.I must say, if we didn't have some time

I want to thank the staff of the Pol-icy Committee, but particularly mysenior staff here—Bruce King, SanderLurie, Nell Mays, Marty Morris, AmyAbraham, John Cahill, Jodi Grant,Matt Greenwald, Phil Karsting, SueNelson, Jon Rosenwasser, JimKlumpner, and Mitch Warren—who dida terrific job, as I know Bill Hoaglandand his team did. I won't go throughthe names, but I will say that I havegotten to know them and respect themand admire the work they have done. Ithank everybody for their cooperation,particularly my colleagues on this side.

Mr. DOMENICI. Mr. President, Sen-ator GRAMM would like 30 seconds.

The PRESIDING OFFICER. The Sen-ator from Texas is recognized.

Mr. GRAMM. Mr. President, I haveheard a lot of people speak in my 13years in the Senate, but I don't think Ihave ever seen anybody do a better jobof taking complicated issues and ex-plaining them in a very short time asSenator DOMENIcI has done in the last2 days. I think we have made historyon this bill, and I think the Senatorfrom New Mexico has been a very im-portant part of that.

Mr. DOMENICI. I ask for the yeasand nays on final passage.

The PRESIDING OFFICER. Is there asufficient second?

There is a sufficient second.The yeas and nays were ordered.The PRESIDING OFFICER. The

question is on the engrossment andthird reading of the bill.

The bill was ordered to be engrossedfor a third reading and was read thethird time.

The PRESIDING OFFICER. The billhaving been read the third time, thequestion is. Shall the bill pass?

The yeas and nays have been orderedand the clerk will call the roll.

The legislative clerk called the roll.The PRESIDING OFFICER. Are there

any other Senators in the Chamber de-siring to vote?

The result was announced—yeas 73,nays 27. as follows:

Hutchison Mccain Smith (NH)lnhofe Mcconnell Smith (OR)Jeffords Moseley-Braun SnoweKempthorne Moynihan SpecterKerrey Murkowski StevensKohl Nickles ThomasKyl Robb ThompsonLandrieu Roberts ThurmondLeahy Rockefeller WarnerLieberman Roth WydenLott SantorumLugar Sessions

NAYS—27Akaka Iaircloth LautenbergBingaman Grams LevinBoxer Harkin MikulskiBumpers Helms MurrayByrd Hollings ReedDaschle lnouye ReidDodd Johnson SarbanesDorgan Kennedy TorricelliDurbin Kerry Wellstone

The bill (5. 947), as amended, waspassed.

(The text of the bill will be printed ina future edition of the RECORD.)

Mr. ROTH. Mr. President, I move toreconsider the vote by which the billwas passed.

Mr. MOYNIHAN. I move to lay thatmotion on the table.


Mr. ROTH. Mr. President, in myopening statement, I thanked my goodfriend and colleague, Senator MOY-NIHAN, my colleague on the FinanceCommittee, and our staff for their ex-cellent work. I would be remiss, how-ever, if I failed to conclude withoutagain expressing my appreciation forthese diligent professionals—men andwomen who work into the wee, weehours, late nights, early mornings, andweekends to help us craft a bill thatcould find the kind of success that thishas found on the Senate floor.

I would like to particularly thankthe following majority and minoritystaff of the Finance Committee whoworked so hard on this bill, includingLindy Paull, Frank Polk, Julie James,Dennis Smith, Gioia Bonmartini, Alex-ander Vachon, Dee Dee Spitznagel,Joan Woodward. Brig Gulya, Mark Pat-terson, David Podoff, Faye Drummond,Kristen Testa, Doug Steiger, Rick Wer-ner, and Rakesh Singh.

Again, I am grateful for the out-standing work that they did. And I be-lieve that it merits the thanks andgratitude of all of us.


constraint on this, Heaven knows howlong we would all be here. We would seesummer come and go and we wouldstill be debating.

Again, I enjoyed the process and myfirst time at bat with the Budget Com-mittee in the position that I have. Ithoroughly enjoyed it. I hope that Sen-ator DOMENICI will, as my rankingmember in the not-too-distant future,also enjoy it. I promise to be coopera-tive.

June 25, 1997

AbrahamAllardAshcroftBaucusBennettBidenBondBreauxBrownbackBryanBurnscampbell

[Rolicall Vote No. 130 Leg.1YEAS—73

chafee IeingoIdcleland IeInsteincoats Iordcochran Iristcollins Glennconrad Gortoncoverdell Grahamcraig GrammDAmato GrassleyDeWine GreggDomenici HagelEnzi Hatch

S6386 CONGRESSIONAL RECORD—SENATE June 25, 1997

MEASURE INDEFINITELYPOSTPONED—S. 947

Mr. GRASSLEY. I further ask con-sent that 5. 947 be indefinitely post-poned.


II

June 26, 1997

Ordered to be printed as passed

In the Senate of the United States,June 25, 1997.

Resolved, That the bill from the House of Representa-tives (H.R. 2015) entitled "An Act to provide for reconcili-

ation pursuant to subsections (b)(1) and (c) of section 105of the concurrent resolution on the budget for fiscal year1998.", do pass with the following

AMENDMENT:

Strike out all after the enacting clause and insert:



3 of 1997".

4 SEC. 2. TABLE OF TITLES.

5 The table of titles for this Act is as follows:

Title I. Committee on Agriculture, Nutrition, and Forestry.Title II. Committee on Banking, Housing, and Urban Affairs.Title III. Committee on Commerce, Science, and Transportation.Title IV Committee on Energy and Natural Resources.Title V. Committee on Finance.Title VI. Committee an Governmental Affairs.Title VII. Committee on Labor and Human Resources.Title VIII. Committee on Veterans' Affairs.

122

4 TITLE V—COMMITTEE ON5 FINANCE6 SEC. 5000. AMENDMENTS TO SOCIAL SECURITY ACT AND

7 REFERENCES TO OBRA, TABLE OF CONTENTS

8 OF TITLE.

9 (a) AMENDMENTS TO SOCIAL SECURITY ACT.—Except

10 as otherwise specifically provided, whenever in this title an

11 amendment is expressed in terms of an amendment to or

12 repeal of a section or other provision, the reference shall

13 be considered to be made to that section or other provision

14 of the Social Security Act.


16 "OBRA—i 986", "OBRA—i 987", "OBRA—i 989", "OBRA—

17 1990", and "OBRA—1993" refer to the Omnibus Budget

18 Reconciliation Act qf 1986 (Public Law 99—509), the Omni-

19 bus Budget Reconciliation Act of' 1987 (Public Law 100—

20 203), the Omnibus Budget Reconciliation Act of 1989 (Pub-

21 lic Law 101—239), the Omnibus Budget Reconciliation Act

22 of 1990 (Public Law 101—508), and the Omnibus Budget

23 Reconciliation Act of 1993 (Public Law 103—66), respec-

24 tively.

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(c) TABLE OF GONTENTS.—The table of contents of this

2 title is as follows:

TITLE V—COMMITTEE ON FINANCE

Sec. 5000. Amendments to Social Security Act and references to OBRA; table ofcontents of title.

Sec. 5000A. Extension of moratorium.

DIVISION 1—MEDICARE

Subtitle A—Medicare Choice Program

CHAPTER 1—MEDICARE CHOICE PROGRAM

SUBCHAPTER A—MEDICARE CHOIG'E PROGRAM

Sec. 5001. Establishment of Medicare Choice program.

"PT J—MEDIARE CHOICE PROGRAM

"Sec. 1851. Eligibility, election, and enrollment."Sec. 1852. Benefits and beneficiary protections."Sec. 1853. Payments to Medicare Choice organizations."Sec. 1854. Premiums."Sec. 1855. Organizational and financial requirements for Medicare Choice

organizations; provider-sponsored organizations."Sec. 1856. Establishment of standards."Sec. 1857. Contracts with Medicare Choice organizations."Sec. 1859. Definitions; miscellaneous provisions.

Sec. 5002. Transitional rales for current medicare HIWO program.Sec. 5003. Conforming changes in Medigap program.

SUBCHAPTER B—SPECIAL RULES FOR MEDICARE CHOICE MEDICAL SAVINGS

ACCOUNTS

Sec. 5006. Medicare Choice MSA.

CHAPTER 2—INTEGRATED LONG- TERM CARE PROGRAMS

SUBCHAPTER A—PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)

Sec. 5011. Coverage of PACE under the medicare program.Sec. 5012. Effective date; transition.Sec. 5013. Study and reports.

SUB CHAPTER B—SOCIAL HEALTH MAJNTEN4NCE ORGANIZATIONS

Sec. 5015. Social health maintenance organizations (SHJliOs,.

SUBG'HAPTER C—OTHER PROGRAMS


CHAPTER 3—COMMISSIaVs

Sec. 5021. National Bipartisan Commission on the Future of Medicare.Sec. 5022. Medicare Payment Advisory Commission.

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Sec. 5031. Medqap protections.Sec. 5032. Addition of high deductible Medigap policy.

CHAPTER 5—DEMONSTRATIONS

SUBCHAPTER A—MEI)ICARE CHOICE COMPETITIVE PRICING I)EMONSTRATION

PROJECT

PART I—IN GENERAL

Sec. 5041. Medicare Choice competitive pricing demonstration project.Sec. 5042. Determination of annual Medicare Choice capitation rates.Sec. 5043. Benefits and beneficiary premiums.

PART Il—INFORMATION ANI) QUALITY STtvw1RI)s

SUBPART A—INFORMATION

Sec. 5044. Information requirements.

SUBPART B—QUALITY IN I)EMONSTRATION PLiINS

Sec. 5044A. Definitions.Sec. 5044B. Quality Advisory Institute.Sec. 5044C. Duties of Director.Sec. 5044D. Cnnpliance.Sec. 5044E. Payments for value.Sec. 5044F. Certification requirement.Sec. 5044G. Licensing of certificatirn entities.Sec. 5044H. Certification criteria.Sec. 50441. Grievance and appeals.

SUBJHAPTER B—OTHER PROJECTS

Sec. 5045. Medicare enrollment demonstration project.Sec. 5046. Medicare coordinated care demonstration project.Sec. 5047. Establishment of medicare reimbursement demonstration projects.

CHAPTER 6—T4x TREATMENT OF HOSPITALS PARTWIPATING IN PROVIDER-SPONSORED ORGANIZATIONS

Sec. 5049. Tax treatment of hospitals which participate in provider-sponsored or-ganizations.


Sec. 5101. Annual screening mammography for women over age 39.Sec. 5102. Coverage of colorectal screening.Sec. 5103. Diabetes screening tests.Sec. 5104. Coverage of bone mass measurements.Sec. 5105. Study on 'medical nutrition therapy services.


Sec. 5151. Sole community hospitals.Sec. 5152. Medicare-dependent, small raral hospital payment extension.Sec. 5153. Medicare rural hospital flexibility program.

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Sec. 5154. Prohibiting denial of request by rural referral centers for reclassifica-tion on basis of comparability of wages.

Sec. 5155. Rural health clinic services.Sec. 5156. Medicare reimbursement for telehealth services.Sec. 5157. Tele'medicine, informatics, and education demonstration project.

Subtitle D—Anti-Fraud and Abuse Provisions and Improvements in ProtectingProgram Integrity

CHAPTER 1—REVISIONS TO SvcTIONs FOR FRAuJ ANJ) ABUSE

Sec. 5201. Authority to refuse to enter into medicare agreements with individualsor entities convicted of felonies.

Sec. 5202. Exclusion of entity controlled by family member of a sanctioned indi-vidual.

Sec. 5203. Imposition of civil money penalties.

CHAPTER 2—IMPROVEMENTS IN PROTECTING PROGRAM INTEGRITY

Sec. 5211. Disclosure of information, surety bonds, and accreditation.Sec. 5212. Provision of certain identification numbers.Sec. 5213. Application of certain provisions of the bankruptcy code.Sec. 5214. Replacement of reasonable charge methodology by fee schedules.Sec. 5215. Application of inherent reasonableness to all part B services other than

physicians' services.Sec. 5216. Requirement to furnish diagnostic information.Sec. 5217. Report by GAO on operation of fraud and abuse control program.Sec. 5218. Competitive bidding.Sec. 5219. Improving information to medicare beneficiaries.Sec. 5220. Prohibiting unnecessa?y and wasteful medicare payments for certain

items.Sec. 5221. Reducing excessive billings and utilization for certain items.Sec. 5222. Improving information to medicare beneficiaries.Sec. 5223. Prohibiting unnecessary and wastefiLl medicare payments for certain

items.Sec. 5224. Reducing excessive billings and utilization for certain items.Sec. 5225. Improved carrier authority to reduce excessive 'medicare payments.Sec. 5226. Itemization of surgical dressing hills submitted by home health agen-

cies.

CHAPTER 3—CLARIFICATIONS ANJ) TECHNICAL CHANGES

Sec. 5231. Other fraud and abuse related provisions.


CHAPTER 1—PROvISIONS RELATING TO PART A

Sec. 5301. Prospective payment for inpatient rehabilitation hospital services.Sec. 5302. Study and report on payments for long-term care hospitaLs.

CHAPTER 2—PROVISIOA RELATING TO PT B

SUBCHAPTER A—PAYMENT FOR HOSPITAL OUTPATIENT 1)EPARTMENT SERVICES

Sec. .5311. Elimination of formula-driven overpayments (FDO) for cerai'n out-patient hospital services.

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Sec. 5313. Prospective payment system for hospital outpatient depathnent serv-ices.

SUBCHAPTER B—AMBULAMJE SERVICES

Sec. 5321. Payments for ambulance services.

CHAPTER 3—PRovISIoNS RELATING TO PARTS A AYD B

SUBCHAPTER A—PAYMENTS TO SKILLED NURSING FACILITIES

Sec. 5331. Extension of cost limits.Sec. 5332. Prospective payment for skilled nursing facility services.

SUBCHAPTER B—HOME HEAL TI! SRR VICES AND BENEFITS

Pu?T I—PAYMENTS FOR HOME HEALTH SERVICES


Sec. 5342. Interim payments for home health services.Sec. 5343. Prospective payment for home health services.Sec. 5344. Payment based on location where hrnne health service is furnished.

Pu?T 11—HOME HEALTH BENEFITS


Sec. 5362. Imposition of $5 copayment for part B home health services.Sec. 5363. Clarification of part-time or intermittent nursing care.Sec. 5364. Study on definition of homebound.Sec. 5365. Normative standards for home health claims denials.Sec. 5366. Inclusion of cost of service in explanation of medicare benefits.


ChAPTER 1—PAYMENT OF PPS HOSPITALS

Sec. 5401. PPS hospital payment update.Sec. 5402. Capital payments for PPS hospitals.


Sec. 5421. Payment update.Sec. 5422. Reductions to capital payments for certain PPS-exempt hospitals and

units.Sec. 5423. Cap on TEFRA limits.Sec. 5424. Change in bonus and relief payments.Sec. 5425. Target amounts for rehabilitation hospitals, longterin care hospitals,

and psychiatric hospitals.Sec. 5426. Treatment of certain long-term care hospitals located within other iws-

pitals.Sec. 5426A. Rebasi'ng.Sec. 5427. Elimination of exenptions, report on exceptions and adjustments.Sec. 5428. Technical correction relating to subsection (d) hospitals.Sec. 5429. Certain cancer hospitals.

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CHAPTER 3—GRADUATE MEDICAL EDUCATION PAYMENTS

SUBCHAPTER A—DIRECT MEDICAL EI)UCATION

Sec. .5441. Limitation on number of residents and rolling average FTE count.Sec. 5442. Permitting payment to nonhospital providers.Sec. 5443. Medicare special reimbursement ride for primary care combined resi-

dency programs.

SUBCHAPTER B—INDIRECT MEI)ICAL EI)UCATION

Sec. 5446. Indirect graduate 'medical education payments.

SUBCHAPTER C—GRM)UATE MEDIcaL EI)UCATION PAYMENTS FOR MAXAGED

CARE ENROLLEES

Sec. 5451. Direct and indirect 'medical education payments to hospitaLs for man-aged care enrollees.

Sec. 5452. Demonstration project on use of consortia.

CHAPTER 4—OTHER HOSPITAL P1YMENTs

Sec. 5461. Disproportionate share payments to hospitaLs for managed care andMedicare Choice enrollees.

Sec. 5462. Reform of disproportionate share payments to hospitaLs serving vulner-able populations.

Sec. 5463. Medicare capital asset sales price equal to book value.Sec. 5464. Elimination of IME and DSH payments attributable to outlier pay-

inents.Sec. 546.5. Treatment of transfer cases.Sec. 5466. Reductions in payments for enrollee had debt.Sec. 5467. Floor on area wage index.Sec. 5468. Increase base payment rate to Puerto Rico hospitals.Sec. 5469. Permanent extension of hemophilia pass-through.Sec. 5470. Coverage of services in religious nonmedical health care institutions

under the medicare and medicaid programs.

CHAPTER 5—PAYMENTS FOR HOSPICE SERVICES

Sec. 5481. Payment for home hospice care based on location where care is fizr-nished.

Sec. 5482. Hospice care benefits periods.Sec. 5483. Other items and services included in hospice care.Sec. 5484. Contracting with independent physicians or physician groups for hos-

pice care services permitted.Sec. 5485. Waiver of certain staffing requirements for hospice care programs in

non—urbanized areas.Sec. 5486. Limitation on liability of beneficiaries for certain hospice coverage de-

'nials.Sec. 5487. Extending the period for physician cerlification of an individual's ter-

'minal illness.Sec. 5488. Effective date.


CHAPTER 1—PAYMENTS FOR PIn'sICI\s AND OTHER HEALTH CAREPROVIDERS

Sec. 5501. Establishment of si?qle conversion factor for 1998.

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Sec. 5502. Establishing update to conversion factor to match spending under sus-tainable growth rate.

Sec. 5503. Replacement of volume performance standard with sustainable growthrate.

Sec. 5504. Payment rules for anesthesia services.Sec. 5505. Implementation of resource-based methodologies.Sec. 5506. Increased medicare reimbursement for nurse practitioners and clinical

nurse specialists.Sec. 5507. Increased medicare reimbursement for physician assistants.

CHAPTER 2—OTHER PAYMENT PRovIsIoNs

Sec. 5521. Reduction in updates to payment amounts for clinical diagnostic lab-oratory tests; study on laboratory services.

Sec. 5522. Improvements in administration of laboratory services benefit.Sec. 5523. Payments for durable medical equipment.Sec. 5524. Oxygen and oxygen equipment.Sec. 5525. Updates for ambulatory surgical services.Sec. 5526. Reimbursement for drugs and hiologicals.

CHAPTER 3—PT B PREMIUM AJTI) RELATED PROVISIONS

Sec. 5541. Pare B premium.Sec. 5542. Income-related reduction in medicare subsidy.Sec. 5543. Demonstration project on income-related pare B deductible.Sec. 5544. Low-income medicare beneficiary block grant program.


CHAPTER 1—SEcoNDY PAYOR PROVISIONS

Sec. 5601. Extension and expansion of existing requirements.Sec. 5602. Improvements in recovery of payments.


Sec. 5611. Conforming age for eligibility under medicare to retirement age for so-cial security benefits.

Sec. 5612. Increased cert'fication period for certain organ procurement organiza-tions.

Sec. 5613. Facilitating the use of private contracts under the medicare program.

Subtitle I—Miscellaneous Provisions

Sec. 5651. Inclusion of Stanly County, N.C. in a large urban area under medi-care program.

Sec. 5652. Medicare anti-duplication provision.

DIVISION 2—MEDICAID AND CHILDREN'S HEALTH INSURANCEINITIATIVES

Subtitle I—Medicaid

CHAPTER 1—MEI)ICAII) SAVINGS

SUBCHAPTER A—MANAGED C.4RE REFORMS

Sec. 5701. State option for mandatory managed care.

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"P1j?T B—PRovIsIoivS RELATING To MANAGED Cu?E

"Sec. 1941. Beneficianj choice; enrollment."Sec. 1942. Beneficiary access to services generally."Sec. 1943. Requirements for access to emergency care."Sec. 1944. Other beneficiary protections."Sec. 1945. Assuring quality care."Sec. 1946. Protections for providers."Sec. 1947. Assuring adequacy of payments to medicaid managed care orga-

nizations and entities."Sec. 1948. Fraud and abuse."Sec. 1949. Sanctions for noncompliance by managed care entities."Sec. 1950. Definitions; miscellaneous provisions. ".

Sec. 5702. Primary care case management sen'ices as State option without needfor waiver.

Sec. 5703. Additional reforms to expand and simplify managed care.

SUBCHAPTER B—MANAGEMENT FLEXIBILITY REFORMS

Sec. 5711. Elimination of Boren amendment requirements for provider paymentrates.

Sec. 5712. Medicaid payment rates for qualified medicare beneficiaries.

SUBCHAPTER C—REDUCTION OF DISPROPORTIONATE SHARE HOSPITAL (DSH)

PAYMENTS

Sec. 5721. Disproportionate share hospital (DSH) payments.

CHAPTER 2—ExPANSION OF MEDICAID ELIGIBILITY

Sec. 5731. State option to permit workers with disabilities to buy into medicaid.Sec. 5732. 12-month continuous eligibility for children.

CHAPTER 3—PROGRAMS OF ALL-INJLUSIVE CARE FOR THE ELDERLY (PACE)

Sec. 5741. Establishment of PACE program as medicaid State option.Sec. 5742. Effective date; transition.Sec. 5743. Study and reports.

CHAPTER 4—MEDICAID MANAGEMENT AND PROGRAM REFORMS

Sec. 5751. Elimination of requirement to pay for private insurance.Sec. 5752. Elimination of obstetrical and pediatric payment rate requirements.Sec. 5753. Physician qualification requirements.Sec. 5754. Expanded cost-sharing requirements.Sec. 5755. Penalty for fraudulent eligibility.Sec. 5756. Elimination of waste, fraud, and abuse.Sec. 5757. Study on EPSDT benefits.Sec. 5758. Study and guidelines regarding managed care organizations and indi-

viduals with special health care needs.


Sec. 5761. Increased FMAPs.Sec. 5762. Increase in payment caps for territories.Sec. 5763. Community-based mental health services.Sec. 5764. Optional medicaid coverage of certain CDC-screened breast cancer pa-

tients.

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Sec. 5765. Treatment of State taxes imposed on certain hospitals that provide freecare.

Sec. 5766. Treatment of veterans pensions under medicaid.Sec. 5767. Removal of name from nurse aide registry.Sec. 5768. Waiver of certain provider tax provisions.Sec. .5769. Continuation of State-wide section 1115 medicaid waivers.Sec. 5770. Effective date.

Subtitle J—Children 's Health Insurance Initiatives

Sec. 5801. Establishment of children's health insurance initiatives.

"TITLE XXI—CHILD HEALTH INSURANCE INITIATIVES

"Sec. 2101. Purpose."Sec. 2102. Definitions."Sec. 2103. Appropriation."Sec. 2104. Program outline."Sec. 2105. Distribution of funds."Sec. 2106. Use of funds."Sec. 2107. State option for the purchase or provision of children's health

insurance."Sec. 2108. Program integrity."Sec. 2109. Annual reports. ".

DIVISION 3—INCOME SECURITY AND OTHER PROVISIONS

Subtitle K—Income Security, Welfare-to-Work Grant Program, and OtherProvisions

CHAPTER 1—LvCo1IE SECURITY

Sec. 5811. SSI eligibility for aliens receiving SSI o August 22, 1996.Sec. 5812. Extensi(yn of eligibility period for refugees and certain other qualified

aliens from S to 7 years for SSI and medicaid.Sec. 5813. Exceptions for certain Indians from limitation on eligibility for sup-

pleinental security income and medicaid benefits.Sec. 5814. SSI eligibility for disabled legal aliens in the United States o August

22, 1996.Sec. 5815. Exemption from restriction on supplemental security income program

participation by certain recipients eligible on the basis of veryold applications.

Sec. 5816. Reinstatement of eligibility for benefits.Sec. 5817. Exemption for children who are legal aliens from 5-year ban on med-

icaid eligibility.Sec. 5818. Treatment of certain Amerasian immigrants as refiLgees.Sec. 5819. SSI eligibility for severely disabled aliens.Sec. 5820. Effective date.

CHAPTER 2—WELFARE-TO-WORK GRANT PROGRAM

Sec. 5821. Welfare-to-work grants.Sec. 5822. Clarification of a State's ability to sanction an individual receiving

assistance under TAIVF for noncompliance.

CHAPTER 3—UNEMPLOYMENT COMPENSATION

Sec. 5831. Increase in Federal unemployment account ceiling.

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Sec. 5832. Special distribution to States from unemployment trust fund.Sec. 5833. Treatment of certain services performed by inmates.

DIVISION 4—EARNED INCOME CREDIT AND OTHER PROVISIONS

Subtitle L—Earned Income Credit and Other Provisions

CHAPTER 1—EARNED INCOME CREDIT

Sec. 5851. Restrictions on availability of earned income credit for taxpayers whoimproperly claimed credit in prior year.

CHAPTER 2—INCREASE IN PUBLIC DEBT LIMIT



Sec. 5871. Sense of the Senate regarding the correction of cost-of-living adjust-ments.

Subtitle M—Welfare Reform Technical Corrections

Sec. 5900. Short title of subtitle.

CHAPTER 1—BLOCK GRANTS FOR TEMPORARY ASSISTANCE TO NEEDY

FAMILIES

Sec. 5901. Amendment of the Social Security Act.Sec. 5902. Eligible States; State plan.Sec. 5903. Grants to States.Sec. 5904. Use of grants.Sec. 5905. Mandatory work requirements.Sec. 5906. Prohibitions; requirements.Sec. 5907. Penalties.Sec. 5908. Data collection and reporting.Sec. 5909. Direct funding and administration by Indian tribes.Sec. 5910. Research, evaluations, and national studies.Sec. 5911. Report on data processing.Sec. 5912. Study on alternative outcomes measures.Sec. 5913. Limitation on payments to the territories.Sec. 5914. Conforming amendments to the Social Security Act.Sec. 5915. Other conforming amendments.Sec. 5916. Modifications to the job opportunities for certain low-income individ-

uals program.Sec. 591 7. Denial of assistance and benefits for drug-related convictions.Sec. 5918.. Transition rule.Sec. 5919. Protecting victims of family violence.Sec. 5920. Effective dates.

CHAPTER 2—SUPPLEMENTAL SECURITY INCOME

Sec. 5921. Conforming and technical amendments relating to eligibility restric-tions.

Sec. 5922. Conforming and technical amendments relating to benefits for disabledchildren.

Sec. 5923. Additional technical amendments to title XVI.Sec. 5924. Additional technical amendments relating to title XVI.

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Sec. 5925. Effective dates.

CHAPTER 3—CHILD SUPPORT

Sec. 5935. State obligation to provide child support enforcement services.Sec. 5936. Distribution of collected support.Sec. 5937. Civil penalties relating to State directory of new hires.Sec. 5938. Federal Parent Locator Service.Sec. 5939. Access to registry data for research purposes.Sec. 5940. Collection and use of social security numbers for use in child support

enforcement.Sec. 5941. Adoption of uniform State laws.Sec. 5942. State laws providing expedited procedures.Sec. 5943. Voluntary paternity acknowledgement.Sec. 5944. Calculation of paternity establishment percentage.Sec. 5945. Means available for provision of technical assistance and operation of

Federal Parent Locator Service.Sec. 5946. Authority to collect support from Federal employees.Sec. 5947. Definition of support order.Sec. 5948. State law authorizing suspension of licenses.Sec. 5949. International support enforcement.Sec. 5950. Child support enforcement for Indian tribes.Sec. 5951. Continuation of rules for distribution of support in the case of a title

TV—E child.

Sec. 5952. Good cause in foster care and food stamp cases.Sec. 5953. Date of collection of support.Sec. 5954. Administrative enforcement in interstate cases.Sec. 5955. Work orders for arrearages.Sec. 5956. Additional technical State plan amendments.Sec. 5957. Federal case registry of child support orders.Sec. 5958. Full faith and credit for child support orders.Sec. 5959. Development costs of automated systems.Sec. 5960. Additional technical amendments.Sec. 5961. Effective date.

CHAPTER 4—RESTRICTING WELFARE AND PUBLIC BENEFITS FOR ALIENS

SUBCHAPTER A—ELIGIBILITY FOR FEDERAL BENEFITS

Sec. 5965. Alien eligibility for Federal benefits: Limited application to medicareand benefits under the Railroad Retirement Act.

Sec. 5966. Exceptions to benefit limitations: Corrections to reference concerningaliens whose deportatim is withheld.

Sec. 5967. Veterans exception: Application of minimum active duty service re-quirement; extension to unremarried surviving spouse; expandeddefinition of veteran.

Sec. 5968. Correction of reference concerning Cuban and Haitian entrants.Sec. 5969. Notification concerning aliens not lawfully present: Correction of ter-

minology.Sec. 5970. Freely associated States: Contracts and licenses.Sec. 5971. Congressional statement regarding benefits for Hmong and other High-

land Lao veterans.

SUBCHAPTER B—GENERAL PROVISIOMS

Sec. 5972. Determination of treatment of battered aliens as qualified aliens; in-clusion of alien child of battered parent as qualified alien.

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Sec. 5973. Venfication of eligibility for benefits.Sec. 5974. Qualifying quarters: Disclosure of quarters of coverage information;

correction to assure that crediting applies to all quarters earnedby parents before child is 18.

Sec. 5975. Statutory constructioii: Benefit eligibility limitations applicable onlywith respect to aliens present in the United States.

SUBCHAPTER C—MISCELLANEOUS CLERICAL AND TECHNICAL AMENDMENTS;

EFFECTIVE DATE

Sec. 5976. Correcting miscellaneous clerical and technical errors.Sec. 5977. Effective date.

CHAPTER 5—CHILD PROTECTION

Sec. 5981. Conforming and technical amendments relating to child protection.Sec. 5982. Additional technical amendments relating to child protection.Sec. 5983. Effective date.

CHAPTER 6—CHILD iUE

Sec. 5985. Conforming and technical amendments relating to child care.Sec. 5986. Additional conforming and technical amendments.Sec. 5987. Effective dates.

CHAPTER 7—ERISA AMENDMENTS RELATING TO MEDICAL CHILD SUPPORTORDERS

Sec. 5991. Amendments relating to section 303 of the Personal Responsibility andWork Opportunity Reconciliation Act of 1996.

Sec. 5992 Amendment relating to section 381 of the Personal Responsibility andWork Opportunity Reconciliation Act of 1996.

Sec. 5993. Amendments relating to section 382 of the Personal Responsibility andWork Opportunity Reeoiiciliation Act of 1996.

453

3 Subtitle D—Anti-Fraud and Abuse4 Provisions and Improvements in5 Protecting Program Integrity

459

18 CHAPTER 2—IMPROVEMENTS IN

19 PROTECTING PROGRAM INTEGRITY

465


4 BERS.

5 (a) REQUIREMENTS To DISCLOSE EMPLOYER IDENTI-

6 FlCA TION NUMBERS (EINS) AJVD SOCIAL SECURITY AC-

7 COUNT NUMBERS (SSNS).—Section 1124(a) (1) (42 U.S.C.

8 1320a—3(a)(1)) is amended by inserting before the period

9 at the end the following: "and supply the Secretary with

10 the both the employer identification number (assigned pur-

11 suant to section 6109 of the Internal Revenue Code of 1986)

12 and social security account number (assigned under section

13 205(c) (2) (B)) of the disclosing entity, each person with an

14 ownership or control interest (as defined in subsection

15 (a) (3)), and any subcontractor in which the entity directly

16 or indirectly has a 5 percent or more ownership interest".

17 (b) OThER MEDICARE PROvIDERS.—Section 1124A

18 (42 U.S.C. 132 Oa—3a) is amended—


20 (A) in paragraph (1), by striking "and" at

21 the end;

22 (B) in paragraph (2), by striking the period

23 at the end and inserting "; and"; and


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2 ber (assigned pursuant to section 6109 of the Internal

3 Revenue Code of 1986) and social security account

4 number (assigned under section 205(c) (2) (B)) of the

5 disclosing part B provider and any person, managing

6 employee, or other entity identified or described under

7 paragraph (1) or (2)."; and

8 (2) in subsection (c) (1), by inserting "(or, for

9 purposes of subsection (a) (3), any entity receiving

10 payment)" after "on an assignment-related basis".

11 (c) VERIFICATION BY SoCIAL SECuRITY ADMINISTRA-

12 TION (SSA).—Section 1124A (42 U.S.C. 1320a—3a), as

13 amended by subsection (b), is amended—

14 (1) by redesignating subsection (c) as subsection

15 (d); and

16 (2) by inserting after subsection (b) the folkw-

17 ing:




21 "(A) to the Commissioner of Social Security

22 information concerning each social security ac-

23 count number (assigned under section

24 205(c) (2) (B)), and

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1 "(B) to the Secretary of the Treasury infor-

2 mation concerning each employer identification

3 number (assigned pursuant to section 6109 of the

4 Internal Revenue Code of 1986),




8 paragraph (2).

9 "(2) VERIFIGATION.—The Commissioner of So-


11 verify the accuracy oj or correct, the information

12 supplied by the Secretary to such official pursuant to

13 paragraph (1), and shall report such venfications or

14 corrections to the Secretary.

15 "(3) FEEs FOR VERIFIGATION.—The Secretary



18 retary and such official, for the costs incurred by such

19 official in performing the verification and correction

20 services described in this subsection. ".

21 (d) REPORT.—Th€ Secretary of Health and Human

22 Services shall submit to Congress a report on steps the Sec-

23 retary has taken to assure the confidentiality of social secu-

24 rity account numbers that will be provided to the Secretary

25 under the amendments made by this section.

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1 (e) EFFECTIVE DATES. —

2 (1) DIScLoSuRE REQUIREMENTS .—The amend-

3 ment made by subsection (a) shall apply to the appli-

4 cation of conditions of participation, and entering

5 into and renewal of contracts and agreements, occur-

6 ring more than 90 days after the date of submission

7 of the report under subsection (d).

8 (2) OTHER PRO VIDERS.—The amendments made

9 by subsection (b) shall apply to payment for items

10 and services furnished more than 90 days after the

11 date of submission of such report.

897

1 DIVISION 3—INCOME SECURITY2 AND OTHER PROVISIONS3 Subtitle K—Income Security, Wel-4 fare-to-Work Grant Program,5 and Other Provisions6 CHAPTER 1—INCOME SECURITY

7 SEC. 5811. SSI ELIGIBILITY FOR ALIENS RECEEVING SSI ON

8 AUGUST22, 1996.

9 (a) IN GENERAL—Section 402(a) (2) of the Personal

10 Responsibility and Work Opprtunity Reconciliation Act

11 of 1996 (8 U.S.C. 1612(a) (2)) is amended by adding after


13 "(E) ALIENS RECEIVING 551 ON A UGUST 22,


15 the program defined in paragraph (3) (A) (relat-


17 gram), paragraph (1) shall not apply to an alien

18 who is lawfully residing in any State and who

19 was receiving such benefits on August 22, 1996.".

20 (b) STATUS OF CUBAN AND HAITIAN ENTRANTS .—For

21 purposes of section 402(a) (2) (E) of the Personal Respon-


23 (8 U.S.C. 1612(a) (2) (E)), an alien who is a Cuban and

24 Haitian entrant, as defined in section 501(e) of the Refugee

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1 Education Assistance Act of 1980, shall be considered a

2 qualified alien.

3 (c) CONFORMING AMEND MENTS.—Section

4 402(a) (2) (D) of the Personal Responsibility and Work Op-

5 portunity Reconciliation Act of 1996 (8 U.S.C. 1612(a)(D))

6 is amended—




10 (3) by striking "('ii) FOOD STAMPS"; and



13 SEC. 5812. EXTENSION OF ELIGIBILITY PERIOD FOR REFU-

14 GEES AND CERTAIN OTHER QUALIFIED


16 MEDICAID.

17 (a) 881.—Section 402(a)(2)(A) of the Personal Re-


19 1996 (8 U.S.C. 1612(a) (2) (A)) is amended to read as fol-

20 lows:

21 "(A) TIME-LIMITED EXCEPTION FOR REFU-

22 GEES AND ASYLEES.—

23 "(i) 881.—With respect to the specified

24 Federal program described in paragraph

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1 (3)(A) paragraph 1 shall not apply to an

2 alien until 7 years after the date—




6 tionality Act;





11 Act.





16 date—




20 tionality Act;





25 Act. ".

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1 (b) MEDIa4iD.—Section 402(b) (2) (A) of the Personal


3 of 1996 (8 U.S. C. 1612(b) (2) (A)) is amended to read as fol-

4 lows:

5 "(A) TIME-LIMITED EXCEPTION FOR REFU-

6 GEES AND ASYLEES.—



9 paragraph (3) (C), paragraph 1 shall not


11 date—




15 tionality Act;





20 Act.


22 PROGRAMS.—With respect to the designated

23 Federal programs under paragraph (3)

24 (other than subparagraph (C)), paragraph

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1 1 shall not apply to an alien until 5 years

2 after the date—




6 tionality Act;





11 Act.".

12 (c) STATUS OF CUBAN AND HAITIAN ENTRANTS .—For

13 purposes of sections 402(a)(2)(A) and 402(b)(2)(A) of the


15 ation Act of 1996 (8 U.S.C. 1612(a) (2) (A), (b)(2)(A)), an

16 alien who is a Cuban and Haitian entrant, as defined in

17 section 501 (e) of the Refugee Education Assistance Act of

18 1980, shall be considered a refugee.

19 SEC. 5813. EXCEPTIONS FOR CERTAIN INDIANS FROM LIMI-

20 TATION ON ELIGIBILITY FOR SUPPLEMENTAL

21 SECURITY INCOME AND MEDICAID BENEFITS.

22 (a) EXCEPTION FROM LIMITATION ON 551 ELIGI-

23 BILITY.—Section 402(a) (2) of the Personal Responsibility


25 U.S.C. 1612(a) (2)) is amended—

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1 (1) by redesignating subparagraph (D) and sub-

2 paragraph (F); and

3 (2) by inserting after subparagraph (C) the fol-

4 lowing:

5 "(D) 551 EXCEPTION FOR CERTAIN INDI-

6 ANS.—With respect to eligibility for benefits for



9 gram), paragraph (1) shall not apply to any in-

10 dividual—

11 "(i) who is an American Indian born

12 in Canada to whom the provisions of sec-

13 tion 289 of the Immigration and National-

14 ity Act (8 U.S.C. 1358) apply; or

15 "(ii) who is a member of an Indian

16 tribe (as defined in section 4(e) of the In-

17 dian Self-Determination and Education As-

18 sistance Act (25 U.S.C. 450b(e)). ".

19 (b) EXCEPTION FROM LIMITATION ON MEDICAID ELI-

20 GIBILITY.—Section 402 (b) (2) of the Personal Responsibility


22 U.S. C. 1612(b) (2)) is amended—

23 (1) by redesignating subparagraph (D) and sub-

24 paragraph (F); and

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1 (2) by inseriing after subparagraph (C) the fol-

2 lowing:

3 "(D) MEDICAID EXCEPTION FOR CERTAIN

4 INDIANS.—With respect to eligibility for benefits

5 for the program defined in paragraph (3) (A) (re-

6 lating to the medicaid program), paragraph (1)

7 shall not apply to any individual described in

8 subsection (a)(2)(D).".

9 (c) 881 AND MEDICAID EXCEPTIONS FROM LIMITA-

10 TION ON ELIGIBILITY OF NEW ENTRANTS.—Section 403(b)


12 onciliation Act of 1996 (8 U.S.C. 1613(b)) is amended by


14 "(3) 881 AND MEDICAID EXCEPTION FOR CER-

15 TAIN INDIANS.—An individual described in section

16 402(a) (2) (D), but only with respect to the programs

17 specified in subsections (a) (3) (A) and (b)(3) (C) of sec-

18 tion 402.".

19 (d) EFFECTIVE DATE. —

20 (1) SECTION 402.—The amendments made by

21 subsections (a) and (b)shall take effect as though they

22 had been included in the enactment of section 402 of

23 the Personal Responsibility and Work Opportunity

24 Reconciliation Act of 1996.

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1 (2) SECTION 403.—The amendment made by

2 subsection (c) shall take effect as though they had been

3 included in the enactment of section 403 of the Per-

4 sonal Responsibility and Work Opportunity Eec-

5 onciliation Act of 1996.

6 SEC. 5814. SSI ELIGIBILITY FOR DISABLED LEGAL ALIENS

7 IN THE UNITED STATES ON AUGUST 22, 1996.


9 Work Opportunity Reconciliation Act of 1996 (8 U.S. C.



12 "(0) DISABLED ALIENS LAWFULLY RESID-

13 ING IN THE UNITED STATES ON A UGUST 22,




17 gram), paragraph (1) shall not apply to an alien

18 who—

19 "(i) is lawfully residing in any State

20 on August 22, 1996; and

21 "(ii) is disabled, as defined in section

22 1614(a)(3) of the Social Security Act (42

23 U.S.C. 1382c(a)(3)).".

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1 SEC. 5815. EXEMPTION FROM RESTRICTION ON SUPPLE-

2 MENTAL SECURITY INCOME PROGRAM PAR-

3 TICIPATION BY CERTAIN RECIPIENTS ELIGI-

4 BLE ON THE BASIS OF VERY OLD APPLICA-

5 TIONS.



8 1612(a) (2)) (as amended by section 5814) is amended by


10 "(H) Ssi EXCEPTION FOR CERTAIN RECIPI-

11 ENTS ON THE BASIS OF VERY OLD APPLICA-

12 TIONS.—With respect to eligibility for benefits

13 for the program defined in paragraph (3) (A) (re-

14 lating to the supplemental security income pro-

15 gram), paragraph (1) shall not apply to any in-

16 dividual—

17 "(i) who is receiving benefits under

18 such program for months after July 1996

19 on the basis of an application filed before

20 January 1, 1979; and

21 "(ii) with respect, to whom the Com-

22 missioner of Social Security lacks clear and

23 convincing evidence that such individual is

24 an alien ineligible for such benefits as a re-

25 sult of the application of this section. ".

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1 SEC. 5816. REINSTATEMENT OF ELIGIBILITY FOR BENEFITS.

2 (a) FOOD STAMPS.—The Personal Responsibility and



5 "SEC. 436. DERIVATIVE ELIGIBILITY FOR BENEFITS.

6 Notwithstanding any other provision of law, an alien

7 who under the provisions of this title is ineligible for bene-

8 fits under the food stamp program (as defined in section

9 402(a)(3)(A)) shall not be eligible for such benefits because

10 the alien receives benefits under the supplemental security

11 income program (as defined in section 402(a)(3)(B)). ".

12 (b) MEDICAID.—Section 402(b) (2) of the Personal Re-


14 1996 (8 U.S.C. 1612(b) (2)) is amended by adding at the

15 end the following:

16 "(E) MEDICAID EXCEPTION FOR ALIENS RE-

17 CEIVING 221.—An alien who is receiving benefits

18 under the program defined in subsection

19 (a) (3) (A) (relating to the supplemental security

20 income program) shall be eligible for medical as-

21 sistance under a State plan under title XIX of

22 the Social Security Act (42 U.S.C. 1396 et seq.)

23 under the same terms and conditions that apply

24 to other recipients of benefits under the program

25 defined in such subsection. ".

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1 (c) CLERICAL AMENDMENT.—Section 2 of the Personal


3 of 1996 is amended by adding after the item related to sec-

4 tion 435 the following:

"Sec. 436. Derivative eligibility for benefits. ".

5 SEC. 5817. EXEMPTION FOR CHILDREN WHO ARE LEGAL

6 ALIENS FROM 5-YEAR BAN ON MEDICAID ELI-

7 GIBILITY.


9 Opportunity Reconciliation Act of 1996 (8 U.S.C. 1613))

10 is amended by adding at the end the following:

11 "(e) MEDICAID ELIGIBILITY EXEMPTION FOR CHIL-

12 DREN.—The limitation under subsection (a) shall not apply

13 to any alien who has nt attained age 19 and is lawfully

14 residing in any State, but only with respect to such alien's

15 eligibility for medical assistance under a State plan under

16 title XIX of the Social Security Act (42 U.S.C. 1396 et

17 seq.).".

18 SEC. 5818. TREATMENT OF CERTAIN AMERASIAN IMMI-

19 GRANTS AS REFUGEES.

20 (a) AMENDMENTS TO EXCEPTIONS FOR REFUGEES!

21 ASYLEES.—

22 (1) FOR PURPOSES OF SSI AJVD FOOD STAMPS.—

23 Section 402(a)(2)(A) of the Personal Responsibility


25 U.S.C. 1612(a) (2) (A)) is amended—

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1 (A) by striking "; or" at the end of clause

2 (ii);


4 clause (iii) and inserting "; or"; and


6 "(iv) an alien who is admitted to the

7 United States as an Amerasian immigrant

8 pursuant to section 584 of the Foreign Op-

9 erations, Export Financing, and Related

10 Programs Appropriations Act, 1988 (as

11 contained in section 101(e) of Public Law

12 100—202 and amended by the 9th proviso

13 under MIGRATION AND REFUGEE ASSIST-

14 ANCE in title II of the Foreign Operations,

15 Export Financing, and Related Programs

16 Appropriations Act, 1989, Public Law 100—

17 461, as amended).".

18 (2) FOR PURPOSES OF TANF, SSBG, AND MEDIC-

19 AJD.—Section 402(b)(2)(A) of the Personal Respon-


21 1996 (8 U.S.C. 1612(a) (2) (A)) is amended—

22 (A) by striking "; or" at the end of clause

23 (ii);


25 clause (iii) and inserting "; or"; and

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2 "(iv) an alien described in subsection

3 (a) (2) (A) (iv) until 5 years after the date of

4 such alien's entry into the United States.".

5 (3) FOR PURPOSES OF EXCEPTION FROM 5-YEAR

6 LIMITED ELIGIBILITY OF QUALIFIED ALIENS.—Section

7 403(b)(1) of the Personal Responsibility and Work

8 Opportunity Reconciliation Act of 1996 (8 U.S.C.

9 1613(b) (1)) is amended by adding at the end the fol-

10 lowing:

11 "(D) An alien described in section

12 402 (a) (2) (A) (iv). ".

13 (4) FOR PURPOSES OF CERTAIN STATE PRO-

14 GRAMS.—Section 412(b)(1) of the Personal Respon-


16 1996 (8 U.S.C. 1622 (b) (1)) is amended by adding at

17 the end the following new subparagraph:

18 "(D) An alien described in section

19 402 (a) (2) (4) (iv). ".

20 (b)FUNDING.—

21 (1) LEvY OF FEE.—The Attorney General

22 through the Immigration and Naturalization Service

23 shall levy a $100 processing fee upon each alien that

24 the Service determines—

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1 (A) is unlawfully residing in the United

2 States;

3 (B) has been arrested by a Federal law en-

4 forcement officer for the commission of a felony;

5 and

6 (C) merits deportation after having been de-

7 termined by a court of law to have committed a

8 felony while residing illegally in the United

9 States.

10 (2) COLLECTION AND USE.—In addition to any

11 other penalty provided by law, a court shall impose

12 the fee described in paragraph (1) upon an alien de-

13 scribed in such paragraph upon the entry of a judg-

14 ment of deportation by such court. Funds collected

15 pursuant to this subsection shall be credited by the

16 Secretary of the Treasury as offsetting increased Fed-

17 eral outlays resulting from the amendments made by

18 section 581 7A of the Balanced Budget Act of 1997.

19 (c) EFFECTIVE DATE.—The amendments made by this

20 section shall be effective with respect to the period beginning

21 on or after October 1, 1997.

22 SEC. 5819. SSI ELIGIBILITY FOR SEVERELY DISABLED

23 ALIENS.



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1 1 612(a) (2)), as amended by section 5815, is amended by


3 "(I) Ssi EXCEPTION FOR SEVERELY DIS-

4 ABLED ALIENS.—With respect to eligibility for

5 benefits for the program defined in paragraph


7 come program), paragraph (1), and the Septem-

8 ber 30, 1997 application deadline under sub-

9 paragraph (G), shall not apply to any alien who

10 is lawfully present in the United States and who

11 has been denied approval of an application for

12 naturalization by the Attorney General solely on

13 the ground that the alien is so severely disabled

14 that the alien is otherwise unable to satisfy the

15 requirements for naturalization.".


17 The amendments made by this chapter shall take effect

18 as if they were included in the enactment of title IV of the


20 ation Act of 1996 (Public Law 104—1 93; 110 Stat. 2260).

949

7 CHAPTER 3—MISCELLANEOUS

8 SEC. 5871. SENSE OF THE SENATE REGARDING THE COR-

9 RECTION OF COST-OF-LTVING ADJUSTMENTS.

10 (a) FINDINGS.—Th Senate makes the following find-

11 ings:

12 (1) The final report of the Senate Finance Corn-

13 mittee's Advisory Commission to Study the Consumer

14 Price Index, chaired by Professor Michael Boskin, has

15 concluded that the Consumer Price Index overstates

16 the cost of living in the United States by 1.1 percent-

17 age points.

18 (2) Dr. Alan (Ireenspan, Chairman of the Board

19 of Governors of the Federal Reserve System, has testi-

20 fied before the Senate Finance Committee that "the

21 best available evidence suggests that there is virtually

22 no chance that the CPI as currently published under-

23 states" the cost of living and that there is "a very

24 high probability that the upward bias ranges between

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1 1/2 percentage point per year and 11/2 percentage

2 points per year".

3 (3) The overstatement of the cost of living by the

4 Consumer Price Index has been recognized by econo-

5 mists since at least 1961, when a report noting the

6 existence of the overstatement was issued by a Na-

7 tional Bureau of Economic Research Committee,

8 chaired by Professor George J. Stigler.

9 (4) Congress and the President, through the in-


11 fits, and other Federal program benefits, have under-

12 taken to protect taxpayers and beneficiaries of such

13 programs from the erosion of purchasing power due

14 to inflation.

15 (5) Congress and the President intended the in-


17 fits, and other Federal program benefits to accurately

18 reflect changes in the cost of living.

19 (6) The overstatement of the cost of living in-

20 creases the deficit and undermines the equitable ad-

21 ministration of Federal benefits and tax policies.

22 (b) SENSE OF THE SENATE.—It is the sense of the Sen-

23 ate that all cost-of-living adjustments required by statute

24 should accurately reflect the best available estimate of

25 changes in the cost of living.

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1 Subtitle M—Welfare Reform2 Technical Corrections3 SEC. 5900. SHORT TITLE OF SUBTITLE.

4 This subtitle may be cited as the "Welfare Reform

5 Technical Corrections Act of 1997".

998

7 CHAPTER 2—SUPPLEMENTAL SECURITY

8 INCOME


10 RELATING TO ELIGIBILITY RESTRICTIONS.

11 (a) DENIAL OF 551 BENEFITS FOR FUGITIVE FELONS

12 AND PROBATION AND PAROLE VIOLATORS.—Section

13 1611 (e)(6) (42 U.S.C. 1382 (e) (6)) is amended by inserting

14 "and section 1106(c) of this Act" after "of 1986".

15 (b) TREATMENT OF PRISONERS.—Section

16 1611 (e)(1)(I)(i)(II) (42 U.S.C. 1382(e)(1)(I)(i)(II)) is

17 amended by striking "inmate of the institution" and all

18 that follows through "this subparagraph" and inserting

19 "individual who receives in the month preceding the first

20 month throughout which such individual is an inmate of

21 the jail, prison, penal institution, or correctional facility

22 that furnishes information respecting such individual pur-

23 suant to subclause (I), or is confined in the institution (that

24 50 frrnishes such information) as described in section

25 202(x)(1)(A)(ii), a benefit under this title for such preced-

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1 ing month, and who is determined by the Commissioner to

2 be ineligible for benefits under this title by reason of con-

3 finement based on the information provided by such institu-

4 tion".

5 (c) CORRECTION OF REFERENCE.—Section

6 1611(e)(1)(I)(i)(I) (42 U.S.C. 1382(e)(1)(I)(i)(I)) is

7 amended by striking "paragraph (1)" and inserting "this

8 paragraph".


10 RELATING TO BENEFITS FOR DISABLED CHIL-

11 DREN.

12 (a) ELIGIBILITY REDETERMINATIONS FOR CURRENT

13 RECIPIENTs.—Section 211(d) (2) (A) of the Personal Re-


15 1996 (42 U.S.C. 1382c note) is amended by striking "1

16 year" and inserting "18 months".

17 (b) ELIGIBILITY REDETERMINATIONS AND CONTINU-

18 ING DIsILITY REVIEWS.—

19 (1) DISAJ3ILITY ELIGIBILITY REDETERMINATIONS

20 REQUIRED FOR 881 RECIPIENTS WHO ATTAIN 18

21 YEARS OF AGE.—Section 1614(a) (3) (H) (iii) (42

22 U.S.C. 1382c(a) (3) (H) (iii)) is amended by striking

23 subclauses (I) and (II) and all that follows and in-


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1 "(I) by applying the criteria used in determin-

2 ing initial eligibility for individuals who are age 18

3 or older; and

4 "(II) either during the 1-year period beginning

5 on the individual's 18th birthday or, in lieu of a con-

6 tinuing disability review, whenever the Commissioner

7 determines that an individual's case is subject to a re-

8 determination under this clause.

9 With respect to any redetermination under this clause,

10 paragraph (4) shall not apply.".

11 (2) CONTINUING DISABILITY REVIEW REQUIRED

12 FOR LOW BIRTH WEIGHT BABIES.—Section

13 1614(a)(3)(H)(iv) (42 U.S.C. 1382c(a)(3)(H)(iv)) is

14 amended—

15 (A) in subclause (I), by striking "Not" and

16 inserting "Except as provided in subclause (VI),

17 not"; and

18 (B) by adding at the end the following:

19 "(VI) Subclause (I) shall not apply in the case of an

20 individual described in that subclause who, at the time of

21 the individual's initial disability determination, the Com-

22 missioner determines has an impairment that is not ex-

23 pected to improve within 12 months after the birth of that

24 individual, and who the Commissioner schedules for a con-

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1 tinuing disability review at a date that is after the individ-

2 ual attains 1 year of age.".

3 (c) ADDITIONAL ACCOUNTABILITY REQUIREMENTS.—

4 Section 1631(a) (2) (F) (42 U.s.c. 1383(a) (2) (F)) is amend-

5 ed—

6 (1) in clause (ii) (III) (bb), by striking "the total

7 amount" and all that follows through "1 613(c)" and

8 inserting "in any case in which the individual know-

9 ingly misapplies benefits from such an account, the

10 commissioner shall reduce future benefits payable to

11 such individual (or to such individual and his

12 spouse) by an amount equal to the total amount of

13 such benefits so misapplied'j and

14 (2) by striking clause (iii) and inserting the fol-

15 lowing:

16 "(iii) The representative payee may deposit into the

17 account established under clause (i) any other funds rep-

18 resenting past due benefits under this title to the eligible

19 individual, provided that the amount of such past due bene-

20 fits is equal to or exceeds the maximum monthly benefit

21 payable under this title to an eligible individual (including

22 State supplementary payments made by the commissioner

23 pursuant to an agreement under section 1616 or section

24 212(b) of Public Law 93—66).".

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1 (d) REDUCTION IN CASH BENEFITS PAYABLE TO IN-

2 STITUTIONALIZED INDIVIDUALS WHOSE MEDICAL COSTS

3 AjiE COVERED BY PRIVATE INSURANCE.—Section 1611(e)

4 (42 U. S. C. 1382(e)) is amended—

5 (1) in paragraph (1)(B)—

6 (A) in the matter preceding clause (i), by

7 striking "hospital, extended care facility, nursing

8 home, or intermediate care facility" and insert-

9 ing "medical treatment facility";

10 (B) in clause (ii)—

11 (i) in the matter preceding subclause

12 (I), by striking "hospital, home or"; and

13 (ii) in subclause (I), by striking "hos-

14 pital, home, or";

15 (C) in clause (iii), by striking "hospital,

16 home, or"; and

17 (D) in the matter following clause (iii), by

18 striking "hospital, extended care facility, nursing

19 home, or intermediate care facility which is a

20 'medical institution or nursing facility' within

21 the meaning of section 1917(c)" and inserting

22 "medical treatment facility that provides services

23 described in section 1917(c) (1) (C) ";

.4 (2) in paragraph (1)(E,)—

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1 (A) in cktuse (i) (II), by striking "hospital,



4 treatment facility"; and

5 (B) in clause (iii), by striking "hospital, ex-

6 tended care facility, nursing home, or inte'rmedi-

7 ate care facility" and inserting "medical treat-

8 ment facility";

9 (3) in paragraph (1) (G), in the matter preceding

10 cktuse (i)—

11 (A) by striking "or which is a hospital, ex-

12 tended care facility, nursing home, or intermedi-

13 ate care" and inserting "or is in a medical

14 treatment"; and

15 (B) by inserting "or, in the case of an mdi-

16 vidual who is a child under the age of 18, under

17 any health insurance policy issued by a private

18 provider of such insurance" after "title XIX";

19 and

20 (4) in paragraph (3)—

21 (A) by striking "same hospital, home, orfa-

22 cility" and inserting "same medical treatment

23 facility"; and

24 (B) by striking "same such hospital, home,

25 or facility" and inserting "same such facility".

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1 (e) CORRECTION OF U.S.C. CITATION.—Section 211(c)

2 of the Personal Responsibility and Work Opportunity Eec-

3 onciliation Act of 1996 (Public Law 104—193; 110 Stat.

4 2189) is amended by striking "1382(a) (4)" and inserting

5 "1382c(a) (4)".

6 SEC. 5923. ADDITIONAL TECHNICAL AMENDMENTS TO

7 TITLE XVL

8 Section 1615(d) (42 U.S. C. 1 382d(d)) is amended—

9 (1) in the first sentence, by inserting a comma

10 after "subsection (a)(1)"; and

11 (2) in the last sentence, by striking "him" and

12 inserting "the Commissioner".

13 SEC. 5924. ADDITIONAL TECHNICAL AMENDMENTS RELAT.

14 ING TO TITLE XVL

15 Section 1110(a)(3) (42 U.S.C. 1310(a) (3)) is amend-

16 ed—

17 (1) by inserting "(or the Commissioner, with re-

18 spect to any jointly financed cooperative agreement or

19 grant concerning title XVI)" after "Secretary" the

20 first place it appears; and

21 (2) by inserting "(or the Commissioner, as ap-

22 plicable)" after "Secretary" the second place it ap-

23 pears.

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1 SEC. 5925. EFFECTIVE DATES.

2 (a) IN GENERAL.—EXCept as provided in subsection

3 (b), the amendments made by this part shall take effect as

4 if included in the enactment of title II of the Personal Re-


6 1996 (Public Law 104—193; 110 Stat. 2185).

7 (b) EXGEPTION.—The amendments made by section

8 5925 shall take effect as f included in the enactment of

9 the Social Security Independence and Program Improve-

10 ments Act of 1994 (Public Law 103—296; 108 Stat. 1464).

11 CHAPTER 3—CHILD SUPPORT

1016

1 SEC. 5940. COLLECTION AND USE OF SOCIAL SECURITY

2 NUMBERS FOR USE IN CHILD SUPPORT EN-

3 FORCEMENT.

4 Section 466(a)(13) (42 U.S.C. 666(a) (13)) is amend-

5 ed—


7 (A) by striking "commercial"; and

8 (B) by inserting "recreational license," after

9 "occupational license, "; and

10 (2) in the matter following subparagraph (C), by

11 inserting "to be used on the face of the document

12 while the social security number is kept on file at the

13 agency" after "other than the social security num-

14 ber".

1038

1 CHAPTER 4—RESTRICTING WELFARE AND

2 PUBLIC BENEFITS FOR ALIENS

3 Subchapter A—Eligibility for Federal Benefits

4 SEC. 5965. ALIEN ELIGIBILITY FOR FEDERAL BENEFITS:

5 LIMITED APPLICATION TO MEDICARE AND

6 BENEFITS UNDER THE RAILROAD RETIRE-

7 MENT ACT.

8 (a) LIMITED APPLICATION TO MEDICARE .—Section

9 401(b) of the Personal Responsibility and Work Oppor-

10 tunity Reconciliation Act of 1996 (8 U.S.C. 1611(b)) is

11 amended by adding at the end the following:


13 fit payable under title XVIII of the Social Security

14 Act (relating to the medicare program) to an alien

15 who is lawfully present in the United States as deter-

16 mined by the Attorney General and, with respect to

17 benefits payable under part A of such title, who was

18 authorized to be employed with respect to any wages

19 attributable to employment which are counted for

20 purposes of eligibility for such benefits. ".

21 (b)LIMITED APPLICATION TO BENEFITS UNDER THE

22 RAILROAD RETIREMENT ACT.—Section 401 (b) of the Per-


24 Act of 1996 (8 U.S.C. 1611(b)) (as amended by subsection

25 (a)) is amended by inserting at the end the following:

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2 fit payable under the Railroad Retirement Act of

3 1974 or the Railroad Unemployment Insurance Act to

4 an alien who is lawfully present in the United States

5 as determined by the Attorney General or to an alien

6 residing outside the United States. ".

7 SEC. 5966. EXCEPTIONS TO BENEFIT LIMITATIONS: COR-

8 RECTIONS TO REFERENCE CONCERNING

9 ALIENS WHOSE DEPORTATION IS WITHHELD.

10 Sections 402(a) (2) (A) (i) (III), 402(a) (2) (A) (ii) (III),

11 402(b) (2) (A) (iii), 403(b) (1) (C), 412(b) (1) (C), and 431(b) (5)


13 onciliation Act of 1996 (8 U.S.C. 1612(a) (2) (A) (iii),

14 1612(b) (2) (A) (iii), 1613(b) (1) (C), 1622(b) (1) (C), and

15 1641(b)(5)) are each amended by striking "section 243(h)

16 of such Act" each place it appears and inserting "section

17 243(h) of such Act (as in effect immediately before the effec-

18 tive date of section 307 of division C of Public Law 104—

19 208) or section 241(b) (3) of such Act (as amended by section

20 305(a) of division C of Public Law 104—208)".

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1 SEC. 5967. VETERANS EXCEPTION: APPLICATION OF MINI-

2 MUM ACTIVE DUTY SERVICE REQUIREMENT;

3 EXTENSION TO UNREMARRIED SURVIVING

4 SPOUSE; EXPANDED DEFINITION OF VET-

5 ERA

6 (a) APPLICATION OF MINIMUM ACTIVE DUTY SERVICE

7 REQUIREMENT.—SeCtiOnS 402(a) (2) (C) (i), 402(b) (2) (C) (i),

8 403(b) (2) (A), and 412(b) (3) (A) of the Personal Responsibil-


10 U.S.C. 1612(a)(2)(C)(i), 1612(b)(2)(C)(i), 1613(b)(2)(A),

11 and 1622(b) (3) (A)) are each amended by inserting "and

12 who fufills the minimum active-duty service requirements

13 of section 5303A(d) of title 38, United States Code" after

14 "alienage".

15 (b)EXCEPTION APPLICABLE TO UNREMARRIED S UR-

16 VIVING SPOUsE.—Section 402(a) (2) (C) (iii),

17 402(b)(2)(C)(iii), 403(b)(2)(C), and 412(b) (3) (C) of the


19 ation Act of 1996 (8 U.S.C. 1612(a) (2) (C) (iii),

20 1612(b) (2) (C) (iii), 1613(b) (2) (C), and 1622(b)(3)(C)) are

21 each amended by inserting before the period "or the

22 unremarried surviving spouse of an individual described in

23 clause (i) or (ii) who is deceased if the marriage fulfills

24 the requirements of section 1304 of title 38, United States

25 Code".

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1 (c) EXPANDED DEFINITION OF VETERAN.—Sections

2 402(a)(2)(C)(i), 402 (b) (2) (C) (i), 403 (b) (2) (A), and

3 412(b)(3)(A) of the Personal Responsibility and Work Op-


5 1612(a) (2) (C) (i), 1 612(b) (2) (C) (i), 1613(b) (2) (A), and

6 1622(b) (3) (A)) are each amended by inserting ", 1101, or

7 1301, or as described in section 107" after "section 101".

8 SEC. 5968. CORRECTION OF REFERENCE CONCERNING

9 CUBAN AND HAITIAN ENTRANTS.

10 Section 403(d) of the Personal Responsibility and


12 1613(d)) is amended—

13 (1) by striking "section 501 of the Refugee" and

14 insert "section 501(a) of the Refugee"; and

15 (2) by striking "section 501(e) (2)" and inserting

16 "section 501(e)".

17 SEC. 5969. NOTIFICATION CONCERNING ALIENS NOT LAW-

18 FULLY PRESENT: CORRECTION OF TERMINOL-

19 OGY.

20 Section 1631(e) (9) of the Social Security Act (42

21 U.S.C. 1383(e)(9)) and section 27 of the United States

22 Housing Act of 1937, as added by section 404 of the Per-


24 Act of 1996, are each amended by striking "unlawfully in

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1 the United States" each place it appears and inserting "not

2 lawfully present in the United States".

3 SEC. 5970. FREELY ASSOCIATED STATES: CONTRACTS AND

4 LICENSES.

5 Sections 401 (c) (2) (A) and 411(c) (2) (A) of the Personal


7 of 1996 (8 U.S. C. 1611(c) (2) (A) and 1621(c) (2) (A)) are

8 each amended by inserting before the semicolon at the end

9 ", or to a citizen of a freely associated state, if section 141

10 of the applicable compact of free association approved in

11 Public Law 99—239 or 99—658 (or a successor provision)

12 is in effect".

13 SEC. 5971. CONGRESSIONAL STATEMENT REGARDING BENE-

14 FITS FOR HMONG AND OTHER HIGHLAND LAO

15 VETERANS.

16 (a) FINDINGS.—The Congress makes the following

17 findings:

18 (1) Hmong and other Highland Lao tribal peo-

19 ples were recruited, armed, trained, and funded for

20 military operations by the United States Department

21 of Defense, Central Intelligence Agency, Department

22 of State, and Agency for International Development

23 to further United States national security interests

24 during the Vietnam conflict.

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1 (2) Hmong and other Highland Lao tribal forces

2 sacrificed their own lives and saved the lives of Amer-

3 ican military personnel by rescuing downed Amer-

4 ican pilots and aircrews and by engaging and suc-

5 cessfully fighting North Vietnamese troops.

6 (3) Thousands of Hmong and other Highland

7 Lao veterans who fought in special guerilla units on

8 behalf of the United States during the Vietnam con-

9 flict, along with their families, have been lawfully ad-

10 mitted to the United States in recent years.

11 (4) The Personal Responsibility and Work Op-

12 portunity Reconciliation Act of 1996 (Public Law

13 104—193), the new national welfare reform law, re-

14 stricts certain welfare benefits for noncitizens of the

15 United States and the exceptions for noncitizen veter-

16 ans of the Armed Forces of the United States do not

17 extend to Hmong veterans of the Vietnam conflict era,

18 making Hmong veterans and their families receiving

19 certain welfare benefits subject to restrictions despite

20 their military service on behalf of the United States.

21 (b) CONGRESSIONAL STATEMENT.—It is the sense of

22 the Congress that Hmong and other Highland Lao veterans

23 who fought on behalf of the Armed Forces of the United

24 States during the Vietnam conflict and have lawfully been

25 admitted to the United States for permanent residence

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1 should be considered veterans for purposes of continuing

2 certain welfare benefits consistent with the exceptions pro-

3 vided other noncitizen veterans under the Personal Respon-

4 sibility and Work Opportunity Reconciliation Act of 1996.

5 Subchapter B—General Provisions

6 SEC. 5972. DETERMINATION OF TREATMENT OF BATTERED

7 ALIENS AS QUALIFIED ALIENS; INCLUSION OF

8 ALIEN CHILD OF BATTERED PARENT AS

9 QUALIFIED ALIEN.

10 (a) DETERMINATION OF STATUS BY AGENCY PROvID-

11 ING BENEFITS.—Section 431 of the Personal Responsibility


13 U. S. C. 1641) is amended in subsections (c) (1) (A) and

14 (c) (2) (A) by striking "Attorney General, which opinion is

15 not subject to review by any court)" each place it appears

16 and inserting "agency providing such benefits)".

17 (b) GUIDANCE ISSUED BY ATTORNEY GENERAL.—Sec-

18 tion 431 (c) of the Personal Responsibility and Work Oppor-

19 tunity Reconciliation Act of 1996 (8 U.S.C. 1641(c)) is

20 amended by adding at the end the following new undesig-

21 nated paragraph:

22 "After consultation with the Secretaries of Health and

23 Human Services, Agriculture, and Housing and Urban De-

24 velopment, the Commissioner of Social Security, and with

25 the heads of such Federal agencies administering benefits

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1 as the Attorney General considers appropriate, the Attorney

2 General shall issue guidance (in the Attorney General's sole

3 and unreviewable discretion) for purposes of this subsection

4 and section 421 (f), concerning the meaning of the terms

5 'battery' and 'extreme cruelty', and the standards and meth-

6 ods to be used for determining whether a substantial connec-

7 tion exists between battery or cruelty suffered and an mdi-

8 vidual's need for benefits under a specific Federal, State,

9 or local program. ".

10 (c) INCLUSION OF ALIEN CHILD OF BATTERED PAR-

11 ENT AS QUALIFIED ALIEN.—Section 431 (c) of the Personal


13 of 1996 (8 U.S.C. 1641(c)) is amended—

14 (1) at the end of paragraph (1) (B) (iv) by strik-

15 ing "or";

16 (2) at the end of paragraph (2) (B) by striking

17 the period and inserting "; or"; and

18 (3) by inserting after paragraph (2) (B) and be-

19 fore the last sentence of such subsection the following

20 new paragraph:

21 "(3) an alien child who—

22 "(A) resides in the same household as a par-

23 ent who has been battered or subjected to extreme

24 cruelty in the United States by that parent's

25 spouse or by a member of the spouse's family re-

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1 siding in the same household as the parent and

2 the spouse consented or acquiesced to such bat-

3 tery or cruelty, but only if (in the opinion of the

4 agency providing such benefits) there is a sub-

5 stantial connection between such battery or cru-

6 elty and the need for the benefits to be provided;

7 and

8 "(B) who meets the requirement of subpara-

9 graph (B) of paragraph (1). ".

10 (d) INCLUSION OF ALIEN CHILD OF BATTERED PAR-

11 ENT UNDER SPECIAL RULE FOR ATTRIBUTION OF IN-

12 COME.—Section 421(f) (1) (A) of the Personal Responsibility


14 U. S. C. 1631 (f) (1) (A)) is amended—

15 (1) at the end of clause (i) by striking "or"; and

16 (2) by striking "and the battery or cruelty de-

17 scribed in clause (i) or (ii)" and inserting "or (iii)

18 the alien is a child whose parent (who resides in the

19 same household as the alien child) has been battered

20 or subjected to extreme cruelty in the United States

21 by that parent's spouse, or by a member of the

22 spouse's family residing in the same household as the

23 parent and the spouse consented to, or acquiesced in,

24 such battery or cruelty, and the battery or cruelty de-

25 scri bed in clause (i), (ii), or (iii)".

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1 SEC. 5973. VERIFICATION OF ELIGIBILITY FOR BENEFITS.

2 (a) REGULATIONS AND GUIDANCE.—Section 432(a) of

3 the Personal Responsibility and Work Opportunity Rec-

4 onciliation Act of 1996 (8 U.S.C. 1642(a)) is amended—

5 (1) by inserting at the end of paragraph (1) the

6 following: "Not later than 90 days afler the date of

7 the enactment of the Welfare Reform Technical Cor-

8 rections Act of 1997, the Attorney General of the

9 United States, after consultation with the Secretary of

10 Health and Human Services, shall issue interim ver-

11 ification guidance. "; and

12 (2) by adding afler paragraph (2) the following

13 new paragraph:

14 "(3) Not later than 90 days afler the date of the enact-

15 ment of the Welfare Reform Technical Corrections Act of

16 1997, the Attorney General shall promulgate regulations

17 which set forth the procedures by which a State or local

18 government can verify whether an alien applying for a

19 State or local public benefit is a qualified alien, a non-

20 immigrant under the Immigration and Nationality Act, or

21 an alien paroled into the United States under section

22 212(d) (5) of the Immigration and Nationality Act for less

23 than 1 year, for purposes of determining whether the alien

24 is ineligible for benefits under section 411 of this Act. ".

25 (b) DISCLOSURE OF INFORMATION FOR VERIFICA-

26 TION.—Section 384(b) of the illegal Immigration Reform

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1 and Immigrant Responsibility Act of 1996 (division C of

2 Public Law 104—208) is amended by adding after para-

3 graph (4) the following new paragraph:

4 "(5) The Attorney General is authorized to dis-

5 close information, to Federal, State, and local public

6 and private agencies providing benefits, to be used

7 solely in making determinations of eligibility for ben-

8 efits pursuant to section 431 (c) of the Personal Re-

9 sponsibility and Work Opportunity Reconciliation

10 Act of 1996.".

11 SEC. 5974. QUALIFYING QUARTERS: DISCLOSURE OF QUAR-

12 TERS OF COVERAGE INFORMATION; CORREC-

13 TION TO ASSURE THAT CREDITING APPLIES

14 TO ALL QUARTERS EARNED BY PARENTS BE-

15 FORE CHILD IS 18.

16 (a) DISCLOSURE OF QUARTERS OF COVERAGE INFOR-

17 MATION.—Section 435 of the Personal Responsibility and


19 1645) is amended by adding at the end the following: "Not-

20 withstanding section 6103 of the Internal Revenue Code of

21 1986, the Commissioner of Social Security is authorized to

22 disclose quarters of coverage information concerning an

23 alien and an alien's spouse or parents to a government

24 agency for the purposes of this title. ".

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1 (b) CORRECTION To ASSURE THAT CREDITING Ap-

2 PLIES TO ALL QUARTERS EARNED BY PARENTS BEFORE

3 CHILD IS 18.—Section 435(1) of the Personal Responsibil-


5 U. S. C. 1645(1)) is amended by striking "while the alien

6 was under age 18," and inserting "before the date on which

7 the alien attains age 18, ".

8 SEC. 5975. STATUTORY CONSTRUCTION: BENEFIT ELIGI-

9 BILITY LIMITATIONS APPLICABLE ONLY WITH

10 RESPECT TO ALIENS PRESENT IN THE UNIT-

11 ED STATES.


13 Opportunity Reconciliation Act of 1996 (8 U.S.C. 1643)

14 is amended—

15 (1) by redesignated subsections (b) and (c) as

16 subsections (c) and (d); and

17 (2) by adding after subsection (a) the following

18 new subsection:

19 "(b) BENEFIT ELIGIBILITY LIMITATIONS APPLICABLE

20 ONLY WITH RESPECT TO ALIENS PRESENT IN THE UNITED

21 STATES.—Notwithstanding any other provision of this title,

22 the limitations on eligibility for benefits under this title

23 shall not apply to eligibility for benefits of aliens who are

24 not residing, or present, in the United States with respect

25 to—

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1 "(1) wages, pensions, annuities, and other

2 earned payments to which an alien is entitled result-

3 ing from employment by, or on behalf of; a Federal,

4 State, or local government agency which was not pro-

5 hibited during the period of such employment or serv-

6 ice under section 274A or other applicable provision

7 of the Immigration and Nationality Act; or

8 "(2) benefits under laws administered by the

9 Secretary of Veterans Affairs. ".

10 Subchapter C—Miscellaneous Clerical and11 Technical Amendments; Effective Date

12 SEC. 5976. CORRECTING MISCELLANEOUS CLERICAL AND

13 TECHNICAL ERRORS.

14 (a) INFORMATION REPORTING UNDER TITLE IV OF

15 THE SOCIAL SECURITY ACT.—Effective July 1, 1997, sec-

16 tion 408 of the Social Security Act (42 U. S.C. 608), as

17 amended by section 5903, and as in effect pursuant to sec-

18 tion 116 of the Personal Responsibility and Work Oppor-

19 tunity Reconciliation Act of 1996, and as amended by sec-

20 tion 590 6(e) of this Act, is amended by adding at the end

21 the following new subsection:

22 "(f) STATE REQUIRED To PROVIDE CERTAIN INFOR-

23 MATION.—Each State to which a grant is made under sec-

24 tion 403 shall, at least 4 times annually and upon request

25 of the Immigration and Naturalization Service, furnish the

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1 Immigration and Naturalization Service with the name

2 and address of; and other identifying information on, any

3 individual who the State knows is not lawfully present in

4 the United States. ".

5 (b) Mis CELJ VEoS CLERICAL AND TECHNICAL C0R-

6 RECTIONS.—

7 (1) Section 411(c)(3) of the Personal Respon-


9 1996 (8 U. S. C. 1621(c) (3)) is amended by striking

10 "4001(c)" and inserting "401(c)".

11 (2) Section 422(a) of the Personal Responsibility


13 U.S.C. 1632 (a)) is amended by striking "benefits (as

14 defined in section 412(c))," and inserting "benefits,".

15 (3) Section 412(b) (1) (C) of the Personal Respon-


17 1996 (8 U. S.C. 1622(b) (1) (C)) is amended by striking

18 "with-holding" and inserting "withholding".

19 (4) The subtitle heading for subtitle D of title IV

20 of the Personal Responsibility and Work Opportunity

21 Reconciliation Act of 1996 is amended to read as fol-

22 lows:

23 "Subtitle D—General Provisions".24 (5) The subtitle heading for subtitle F of title IV

25 of the Personal Responsibility and Work Opportunity

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1 Reconciliation Act of 1996 'is amended to read as fol-

2 lows:

3 "Subtitle F—Earned Income Credit4 Denied to Unauthorized Employ-5 ees".6 (6) Section 431 (c) (2) (B) of the Personal Respon-


8 1996 (8 U. S. C. 1641(c) (2) (B)) is amended by striking

9 "clause (ii) of subparagraph (A)" and inserting "sub-

10 paragraph (B) of paragraph (1)".

11 (7) Section 431 (c) (1) (B) of the Personal Respon-


13 1996 (8 U.S.C. 1641(c)(1)(B)) is amended—

14 (A) 'in clause (iii) by striking ", or" and

15 inserting "(as in effect prior to April 1, 1997),";

16 and

17 (B) by adding after clause (iv) the following

18 new clause:

19 "(v) cancellation of removal pursuant

20 to section 240A(b)(2) of such Act;".



23 by this chapter shall be effective as if included in the enact-

24 ment of title 117 of the Personal Responsibility and Work

25 Opportunity Reconciliation Act of 1996.

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