Bipartisan Commission on Medicaid Act of 2005
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Read twice and referred to the Committee on Finance.
February 9, 2005
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Introduced in Senate
February 9, 2005
Sponsor introductory remarks on measure. (CR S1208-1211)
February 9, 2005
Read twice and referred to the Committee on Finance.
February 9, 2005
Floor Debate
19 membersWhat members said about S. 338 on the floor
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Floor Debate
19 membersWhat members said about S. 338 on the floor
Mr. President, I ask unanimous consent that the order for the quorum call be rescinded. Mr. President, I rise in strong opposition to this budget. I believe it is a profound mistake for this country…
Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.
Mr. President, I rise in strong opposition to this budget. I believe it is a profound mistake for this country to stack additional debt upon already record levels of debt that I believe puts the long-term economic security of our country at risk.
The record is very clear. We now face record budget deficits, and we face them for as far as the eye can see. Those who have assured us repeatedly that deficits are being dealt with have failed the credibility test, and they have absolutely failed the test of fiscal responsibility. This budget bears no relationship to fiscal conservatism or fiscal responsibility, and this vote will be a defining vote on where Members stand with respect to fiscal responsibility for this country.
Here is the record on deficits. Since 2001 the deficits have soared to new records, levels we have never seen in the history of the country--$412 billion in 2004 and very little improvement anywhere in sight.
As we review back to 1980 the relationship between spending, here is what we see. The red line is the spending line of the United States, the green line is the revenue line. We can see spending has been brought down as a share of gross domestic product rather steadily until this administration. In fact, it is interesting, in the entire 8 years of the Clinton administration, spending came down steadily as a share of GDP. We have now had an increase, largely as a result of the attack of September 11 because 91 percent of this increase is defense, homeland security, aid to New York, and aid to the airlines.
Going forward, we see that spending will stay roughly at these levels going forward, with some slight additional increase as we get closer to the time when the baby boomers retire.
Look at the revenue line of the United States. Also during the Clinton administration, revenue rose each and every year so that finally we did away with deficits and, in addition, we actually stopped raiding the Social Security trust fund to use it for other purposes.
President Bush came to office, and the revenue side of the equation has collapsed. Last year, revenue was the lowest it has been as a share of GDP since 1959. The President said when revenue was high as a share of GDP, we must have tax cuts. Now that revenue is at a 50-year low, the President's answer is more tax cuts. The result is a huge ongoing gap between spending and revenue that means ever-increasing debt, and all of it at the worst possible time before the baby boomers retire.
Here is what the Comptroller General of the United States said in a speech to the National Press Club on February 2 of this year. He said:
The simple truth is that our Nation's financial condition
is much worse than advertised.
The Comptroller General of the United States had that exactly right. Our financial condition is far worse than advertised. In fact, my first chart showed the deficit at just over $400 billion in 2004, at $412 billion. But that is not how much was added to the debt that year. It was far more because the deficit understates the seriousness of our financial condition. So, too, does the budget that was sent to us by the President of the United States. The President told the American people that he is cutting the deficit in half over the next 5 years, but the only way he got there is just by leaving out things. He left out any war costs past September 30 of this year. Does anybody believe there is not going to be any war costs past September 30 of this year?
Here is what we have. The President sent up a supplemental. That passed the Senate and is in conference committee now. The supplemental is $82 billion for ongoing military operations in fiscal year 2005 but nothing past September 30. Look what the Congressional Budget Office tells us should be in the budget: $383 billion. That is their estimate of residual war costs.
Yes, I will be happy to.
It does not. We have this supplemental, as the Senator knows, that is going through the process. We passed it in the Senate. It is in conference committee now. It is $82 billion. Much of it will be spent this year; some of it will slop over to next year. This is what the Congressional Budget Office says should be in any realistic budget--not $82 billion, but $380 billion, and it is this gap which is part of the unrealistic nature of the budget that is before us and the budget the President sent us.
No, it really is not. I think any objective observer in reading this budget would have to say it is not
a realistic picture of our financial condition. It just leaves out things. In fact, when the President's people came to me and told me how they were going to cut the deficit in half, I said to them: Why don't you just leave out some more things and claim you balanced the budget because it would have about as much attachment to reality as this has.
There certainly are other items. One of the items that is left out is the true cost of the President's tax cut proposals because the President switched from 10-year budgeting to 5-year budgeting, and I think here is why. The dotted line shows the end of the 5 years, and this chart shows the cost of the President's tax cut proposals. As we can see, it is very interesting, right after the fifth year of this budget, the cost of the President's tax cut proposals takes off like a scalded cat. None of that is captured by the President's budget because his budget ends right here at this dotted line. But look what happens right past the dotted line. The revenue hemorrhage escalates dramatically, and it is not just there, but it is also with respect to the alternative minute tax, the old millionaire's tax that is rapidly becoming a middle-class tax trap.
Here is the trend line of the cost to fix the alternative minimum tax. It is straight up, and there is no funding in the President's budget to deal with it. So with 3 million people affected by the alternative minimum tax last year, 10 years from now it is going to be 40 million people a year. It costs $774 billion to fix. Last year, the President had 1 year of funding to deal with it. He has no funding in his budget this year to deal with it. And so, again, it is an unrealistic budget because it does not capture items we all know are going to have to be dealt with.
Perhaps most remarkably, the President's budget, as the budget before us, does not contain any money for the Social Security Program the President champions and that is championed by many on the other side of the aisle. There is no money. We know the President's proposal costs money. In fact, in the first 10 years, it costs $754 billion. There is no money in the budget. Over 20 years, the cost of the President's plan is $4.4 trillion--not a dime of it in the budget. This is not really a budget. It is a political statement, perhaps, but it is certainly not a budget.
When we go back and add back the items the President has left out, just the major items--the alternative minimum tax, the ongoing war costs, according to the Congressional Budget Office the cost of the President's privatization plan--instead of this trend line which the President is predicting, instead we see this hashed red line.
Over the next 10 years, this is where we see the deficits going under the President's plan. The budget before us has much the same pattern, exploding deficits for as far as the eye can see and at the worst possible time, right before the baby boomers retire.
As we see these deficits, we go back to this chart, and the President is saying they will be in the $200 billion range at the end of this 5-year period. We do not see that at all. As we can see, they will be in the $350 billion range. Of course, this, too, understates the real magnitude of our problem because it does not capture all that is being added to the debt.
Look where this goes the second 5 years--to deficits of $620 billion. In a moment I will get to how much is being added to the debt under this budget because I think that is critically important for people to understand. Our friends on the other side of the aisle talk a lot about deficits these days. They never talk about the debt. The debt is the accumulation of all the deficits.
Obviously we face a big demographic challenge going forward. I have indicated all of this is happening at a bad time because the baby boomers are about to retire. Here is what we see. We are going to go from about 40 million people eligible for Social Security and Medicare to 81 million eligible. That is a key reason we ought to be running more balanced budgets at this time.
The President told us back in 2002 that:
None of the Social Security surplus will be used to fund
other spending initiatives or tax relief.
That is what he told us. None of the Social Security money would be used to fund other spending initiatives or tax relief. Now we are able to have the benefit of several more years and we are able to look at the record and see what the President's budget will do going forward. The President said none of the Social Security surplus would be used for tax cuts, or other spending initiatives.
Under the budget that is before us from the President and under the budget before us by the majority party, every penny of the Social Security surplus is going to be used under the President's plan for the next 5 years and, by extension, the next 10 years, $2.5 trillion--$2.5 trillion of payroll tax money, which is supposed to be used to support Social Security, being used to pay for other things. In effect, it is being used to subsidize his massive income tax cuts for the wealthiest among us, and being used to pay for other things.
The irony of this is the President says Social Security is $3.7 trillion short over the next 75 years, but in his budget he is taking $2.5 trillion of Social Security money in the next 10 years alone and using it to pay for other things.
I think this whole picture becomes more clear if one puts it all together. This is the reason I so strongly oppose this budget that is on the floor. I say to my colleagues, anybody who votes for this budget should never make another campaign claim that they are fiscally responsible or fiscally conservative because this budget absolutely is a testimony to those who worship at the altar of debt. This budget builds debt on top of debt.
Going forward, this chart shows the Social Security trust fund surpluses, which are the green bars. The blue bars are the Medicare trust fund. The red bars are the President's tax cuts. What one sees is the Social Security and Medicare trust funds go cash negative at that very time the cost of the President's tax cuts explodes, driving us right over the cliff into massive deficit and debt. That is where this is all headed.
The President says Social Security is a problem and, of course, he is correct. The 75-year shortfall in Social Security is $4 trillion. The 75-year shortfall in Medicare is 7 times as much. The 75-year shortfall in Medicare is $29.6 trillion. This is according to the Social Security trustees.
One would say that is a big problem, that the President is not addressing this problem, not addressing these shortfalls. His proposals make it all worse. His proposals take more money out of Social Security. The budget that is before us takes $2.5 trillion of Social Security money over the next 10 years and uses it to pay for other things. Then the President comes with a proposal and says establish private accounts and divert more money out of Social Security, another $700 billion over the next 10 years. Over the next 20 years, he is talking about diverting over $4 trillion out of Social Security. That is real money. It is no wonder Social Security has a shortfall. The President is helping to create the shortfall.
The President told us in 2001:
. . . (M)y budget pays down a record amount of national debt.
We will pay off $2 trillion of debt over the next decade.
That will be the largest debt reduction of any country, ever.
Future generations shouldn't be forced to pay back money that
we have borrowed. . . .
These are not my words. These are the President's words. The President said:
. . . Future generations shouldn't be forced to pay back
money that we have borrowed. We owe this kind of
responsibility to our children and grandchildren.
Those are good words. The President was right to utter them. The problem is if one compares the record to the rhetoric, there is no connection.
I would be happy to yield.
That was made in March of 2001, when, the Senator will recall, he was assuring us we could afford to have a massive defense buildup,
deep tax cuts, that it would all add up and he would be able to protect Social Security and Medicare, not use the money for other purposes, and he would have maximum paydown of the debt. He was wrong on every single count. He was wrong by a country mile.
It is very interesting to compare this statement where the President says he is going to have ``the largest debt reduction of any country, ever. Future generations shouldn't be forced to pay back money that we have borrowed,'' but here is what has actually happened. There is no debt reduction. The debt is exploding. This is just the publicly held debt. The gross debt would be even a worse picture.
I have taken the debt that is the most restrained version of the debt of the United States. The President inherited $3.3 trillion in debt in 2001. Under his plan, we are headed for over $9 trillion of debt by 2015. Increasingly, this money is being borrowed from abroad.
I would be happy to.
The Senator is exactly correct. I think one of the things that is so disturbing about this is an increasingly large part of our budget is being consumed by interest costs to service this debt. It is going to do nothing but get worse. Part of the result of that is, not only are we borrowing money from ourselves but increasingly we are borrowing money from abroad. If we look at what we now owe abroad, here is what we see. These are stunning numbers, I might say, but this is the latest information we have on what we owe other countries.
We owe Japan over $700 billion. We owe China, now, almost $200 billion. We owe the United Kingdom over $171 billion. I am reading a book on George Washington. He would be turning in his grave to think our country owes Great Britain $171 billion. We owe the Caribbean Banking Centers over $100 billion. I don't know what the Caribbean Banking Centers constitute, or where they get their money, but we owe them over $100 billion. We owe South Korea over $67 billion.
The pattern that is so clear is the extraordinary increase in foreign holdings of our debt. The foreign holdings of our debt have increased almost 100 percent since President Bush took office. That is an utterly unsustainable course. Foreign holdings of our debt have gone up almost 100 percent since 2001.
Some people look at that and ask, what difference does it make? Isn't that just fine, someone is willing to loan us money? Shouldn't we take Japan's money? Shouldn't we take China's money? What is the difference it makes?
Here is the difference it makes: What happens when they decide to quit loaning us all this money? What happens if they decide they do not like the idea of loaning us this huge amount of money?
This was in the Financial Times in January of this year ``Central banks shun U.S. assets.'' ``Shifting reserves to eurozone will deepen Bush's difficulties in funding deficit.'' ``Actions likely to undermine dollar's value further.'' We can connect the dots.
Here is what has happened to the value of the dollar since 2002. Against the Euro, the dollar has declined 34 percent. If you were one of these countries holding all of these dollars and you see the value of the currency declining, might you get the idea it is time to put your money some other place? We have already seen the warning signs. South Korea, a month or so ago, indicated they might diversify out of dollar-dominated securities and the stock market went down 170 points. Weeks later, the Japanese Premier said they might diversify out of dollar-dominated securities and the dollar took a huge hit. In March of this year, perhaps the most successful American investor of our time, Warren Buffett, said he is going to bet against the American dollar again this year because of this pattern. The currency value is declining, and declining sharply. Warren Buffett tells us a key reason is these massive deficits we are running--trade deficit, budget deficit--are forcing us to borrow more and more money from abroad.
I say to those who might be listening, how does it make America stronger to borrow more and more money from abroad? How does that make us stronger?
Here we face these massive trade deficits. The trade deficit was over $600 billion last year. For the most recent month, after the dollar has declined dramatically, it is supposed to improve our trade situation. What happened to the trade deficit? Did it go down? No. In the most recent month, the trade deficit was $61 billion, the biggest ever. That is after the dollar has declined 34 percent. It makes our goods less expensive and makes foreign goods more expensive. That should have improved our trade position, and yet it did not.
We have a problem. The sooner we face up to it, the better. None of this adds up.
You can live beyond your means for a time. A family can do it. An individual can do it. A government can do it a lot longer because governments can print money. But there are consequences to that, as well.
Those who say deficits do not matter, go ask the German people about after World War I. Ask them whether they think deficits matter. We all know what happened in Germany after World War I. The currency collapsed because of their heavy foreign indebtedness after the war.
What did they do? You wanted to buy shoes? You filled a wheelbarrow full of the German currency because that is what it took to buy a pair of shoes.
We are not in that shape, and God forbid we ever get in that shape, but the trend lines are not favorable. They are not good.
Our foreign holdings of our debt have gone up almost 100 percent. In fact, that chart is a little out of date because the truth is, it is already over 100 percent. That is what has really happened. This debt is mushrooming every year, and under the budget that is before the Senate the debt of the United States is going to go up $600 billion a year each and every year of this budget.
They say they have the deficit going down, and yet the debt is going up. What kind of doubletalk is that? The deficit is going down, but the debt is
going up. It is going up $600 billion a year, every year. Anyone who votes for this budget is voting for it.
The budget before the Senate leaves out the full 10-year numbers because they know past the 5 years everything gets worse. It leaves out funding for the ongoing war beyond fiscal year 2006. It leaves out the alternative minimum tax reform. It leaves out the cost of Social Security privatization. When you add it all back, you get a very different result than our colleagues are showing the American people.
When you go back and create a real budget, here is what we find. Deficits, massive deficits each and every year going forward, never going below $572 billion. That is not the full increase in the debt. This leaves out things which we will get to in a moment.
Our friends on the other side say, well, we are reducing the deficit. In one meeting we had--in the conference committee Democrats were excluded, absolutely excluded from the negotiations on this budget. Let me repeat that: Democrats were not allowed or permitted to be in the room when these discussions were undertaken.
I am happy to.
Required by the rules.
That, in fact, is the case. We were excluded in every way. The only time we were included is at the meeting that is required by the rules. There is a requirement there be at least one meeting of the conference committee, and we were there. We made our statements. We were ushered out, and that was the end of the conversation. I said I do not think that is the way our Forefathers intended the process to work. One of our colleagues on the other side said: Well, our Forefathers never envisioned political parties. That is true; they did not envision political parties. But they did envision the abuse of power by a majority. That is one of the things that consumed them in writing the Constitution of the United States. They were deeply concerned that a majority would run roughshod over the rights of a minority. They did not see it in terms of political parties. They did see it in terms of majority power and minority rights. This majority has adopted the view that it is only about majority power. That is a mistake. That is not what the Founding Fathers intended.
Here are the results of that kind of mistake. When you look at the deficits, our colleagues say they are going to improve the deficit. But in fact, here, as shown on this chart, is a comparison of the budget conference report and the deficits it produces compared to what would happen if we put the Government of the United States on autopilot.
If we just used the CBO baseline, we would have lower deficits than is produced by the work of this conference committee and the majority. In fact, they have increased the deficits by $168 billion over 5 years, over the CBO baseline. So they have made the deficits worse by $168 billion in comparison to what would have happened if we would have just put the Government on autopilot. When our friends say they are going to cut the deficit in half over the next 5 years, here is the strongest answer in factual terms I know of. It is right here. This is the fiscal year 2006 budget resolution from the GOP conference report. This is their own document, their own calculation, of what is going to happen to the debt of the United States each and every year under this budget. Here is what it says. It is not my document. This is their document. They say that the debt is going to go up by $683 billion the first year, by $639 billion the next year, by $606 billion the third year, by $610 billion the fourth year, by $605 billion the fifth year.
Where is the deficit cut in half? Where is it? Every year the debt is going up by over $600 billion. Just visually, on this chart, this is what we see. They are building a wall of debt. Here is where the debt stood, debt subject to limit, and where it will stand at the end of this fiscal year in September. If this budget is adopted--and I pray it is not, for the good of this country. For the economic security of America, I hope this budget is not adopted. Why? Because it builds a wall of debt. Each year, each and every year, the debt climbs by another $600 billion under this budget resolution.
Anybody who votes for this budget ought never to again claim they are fiscally responsible or fiscally conservative because they are taking us on a path of deficits and debt and decline unparalleled in American economic history. That is where this is all headed.
I am happy to yield.
What is stunning here is who is it going to go to? It used to be America financed its own debt; that is, we borrowed the money from ourselves. Increasingly, we are borrowing the money from abroad. Increasingly, we are dependent on the decisions of foreign central bankers to finance our veracious appetite for foreign capital.
The Senator is exactly right. As the debt increases, even if interest rates remained unchanged, the interest cost would go up because of the increasing debt, the increasing borrowing that we are doing as a nation. On top of that, we know the increasing debt will put pressure to increase interest rates because people are going to keep making us these loans, especially when the value of our currency is declining.
The only way to offset that is to increase the interest rates. So then you get hit by a double whammy, the double whammy of increased interest because your debt has increased and also it is increased because interest rates are increasing.
Well, I was, in the sense that my colleagues chose me as a conferee, along with the distinguished senior Senator from Maryland, Mr. Sarbanes, as well as the senior Senator from Washington, Mrs. Murray, but we were not invited to any of the working sessions. We were not invited to any of the negotiations. We were not invited to be any part of any of the discussion, other than the one meeting that is required by rule. It was a public session of the conference committee in which we were permitted to make short statements, but we were not part of any negotiation or any discussion.
(Mr. ALLEN assumed the Chair.)
That would be the fact.
Here it is. This chart shows graphically precisely, according to their numbers--not my numbers; these are their numbers-- what they say their budget will do. It says they are going to increase the debt every year by $600 billion. They say they are going to cut the deficit in half over 5 years, but the debt goes up each and every year by over $600 billion. If that isn't doubletalk, I don't know what is. They say the deficit is going down, but the debt is going up. It is their own calculations. They are building a wall of debt that is unprecedented, and they are doing it right before the baby boomers begin to retire, and we all know what that means. They are going to present a future Congress and a future President with the most extraordinarily difficult choices that any Congress or any President has faced in this country's history because this is a complete lack of fiscal responsibility--deficits on top of deficits on top of debt, up, up, and away, no end in sight, and all of it at the worst possible time, before the baby boomers retire.
I say to my Republican colleagues: Any Republican colleague who votes for this budget ought to make a pledge here tonight that they will never again claim the mantle of fiscal responsibility, that they will never again claim to be fiscally conservative, because this is a borrow-and-spend budget of historic proportion. Our friends on the other side of the aisle have decided that the way to win elections is to borrow the money and use it to fund tax cuts and use it to fund spending and don't worry about anything adding up because they will be out of town before the bills come due.
In some ways, it is almost hard to place language on this document. The Senator says it has makeup. This isn't pretty with or without the makeup because the results of this are going to be a country that is deeper and deeper in debt, whose long-term economic security is put at risk, that more and more is dependent upon the decisions of foreign central bankers on our economic well-being. The harsh reality here is that you can live beyond your means for a while, but it catches up with you. And that is what this budget represents.
Our friends on the other side of the aisle want to spend money. Make no mistake about that. The spending is going up under this budget. They just don't want to pay for their spending. They prefer to borrow the money. They don't want to raise the taxes necessary to support their spending.
One could have more respect for their position if they did one of two things: if they either cut their spending to match their willingness to pay for it by raising revenue or if they were willing to raise the revenue to match their spending appetite. But our friends on the other side of the aisle are not willing to do either. They want to spend the money, but they don't want to raise the revenue to pay for it. Instead, their answer is, borrow the money. Borrow the money to fund tax cuts. Take the money from the Social Security trust fund, $2.5 trillion.
They say Social Security is short of money. So what is their answer? Their answer is to take $2.5 trillion out of it to pay for income tax cuts that go primarily to the wealthiest among us.
Here is the evidence of that because buried in this budget are additional tax cuts, dividends, capital gains that will give on average to those who are earning over $1 million a year in our society a $35,000 tax cut per year. For those who earn less than $50,000 a year, the vast majority of Americans, they will get $6 a year. This is our Republican friends' notion of a balanced plan--$35,000 a year for those who earn over $1 million a year, $6 for those who earn less than $50,000 a year. And for those who are fortunate enough to earn $50,000 to $200,000 a year, they would get $112. That is our Republican friends' notion of tax fairness.
It is.
Those who earn from $200,000 to $1 million a year get on average $1,480 under the tax cut plan that is contained here. Again, those who earn more than $1 million a year get, just on these tax provisions--by the way, these are just a couple of the tax provisions. This does not include the estate tax provisions that go overwhelmingly to the wealthiest among us. Just these two tax provisions would give $35,000 a year to those earning $1 million a year and $6 of tax cut to those who earn less than $50,000. It will give $112 to those who earn between $50,000 and $200,000.
I would just say that the priorities of this budget are also out of whack. This budget, in the year 2006, for those fortunate enough to earn over $1 million a year, the tax cuts going to that group of people will cost $32 billion in that year alone. That is the cost of the tax cuts for those earning over $1 million a year in that year alone: $32 billion. But they say there is not the money to restore the education cuts that are contained in this budget which would cost $4.8 billion. They say there is no money to do that. But there is eight times as much money to give tax cuts to those earning over $1 million a year. I guess one could say our Republican friends have said: It is seven times as important to give these tax cuts to those earning over $1 million a year as it is to restore these education cuts.
I don't share those priorities. I believe those are misplaced priorities. I don't think those are the priorities of the American people. They are profoundly wrong for the long-term economic strength of our country.
Yes.
That is for 1 year.
Actually, even more the next year.
It is very hard to understand this set of priorities. The Senator is exactly correct. This is the amount this budget would need to add to restore education programs to the 2005 level. It would require $4.8 billion. They say, no, they cannot do that because they have to give $32 billion of tax benefits to those earning over a million dollars a year. And it is not just with respect to education, although I argue that education is the clearest priority for our country. What is it that will allow us to compete in this global world economy? What is it that is going to allow us to compete and win? It is having the best-educated, the best-trained workforce, and having the most efficient system to disburse the resources we have, to employ them in the most competitive and effective way. That is what is going to make us dominant.
You can see we are slipping. We are running these massive trade deficits. Does anybody care? Is anybody paying attention? It is not just in education. It would cost $1.1 billion to maintain funding for law enforcement. But, no, they say you have to cut the COPS Program, shred the COPS Program. The COPS Program put 100,000 police on the street and helped reduce crime in this country. They say that has to go, we cannot afford it; but we can afford 30 times as much to give tax cuts to those earning over a million dollars a year.
A budget is a chance to make choices. That is what it is about. It is about priorities, about what is important. The choices that are being made by our friends on the other side are the choices to add to the debt, add to the deficits, take all the money from Social Security trust fund surpluses--every dime--and use it to pay for other things, including tax cuts that go overwhelmingly to the wealthiest among us.
Are those the priorities of the American people? You know, even wealthy people I talk to say these are not their priorities. I have had so many wealthy people say to me, ``I don't need another tax cut.'' A gentleman stopped me the other day--an enormously wealthy individual-- and he said: Look, what matters to me is how my country does. I have been very fortunate. I have done extremely well here. I want others to have the chance I had.
That means they have to have a chance to get a good education, and that means our country has to do well. I don't know of a country anywhere, ever, that has gotten stronger by becoming more dependent on borrowing from other countries. I would like some of our colleagues to come out here and tell me what country became stronger by borrowing more money from foreign countries. Where is it written in history that a country made itself powerful and strong by borrowing more and more money from other countries? You know, so many people have warned us we are on an unsustainable course. The Comptroller General of the United States warned us we are on an unsustainable course of deficits and debt. The Chairman of the Federal Reserve Board has warned us we are on an unsustainable course of deficits and debt. Another thing the Chairman of the Federal Reserve Board told us is, you ought to reinstitute the budget disciplines that helped this country in the past, those budget disciplines that apply to both the spending and the revenue side.
But this budget doesn't do that. This budget has pay-go provisions that apply on the spending side. Here is what Chairman Greenspan said:
A budget framework along the lines of the one that provided
significant and effective discipline in the past needs, in my
judgment, to be reinstated without delay. I am concerned
that, should the enforcement mechanisms governing the budget
process not be restored, the resulting lack of clear
direction and constructive goals would allow the inbuilt
political bias in favor of growing budget deficits to again
become entrenched.
He said that in 2003 before the Senate Banking Committee. The Chairman of the Federal Reserve Board was right about that matter. But that is not what our friends have done here. They have not restored the budget disciplines that worked in the past. No, no. They have taken half of the formula.
The New York Times ran an editorial on Wednesday: ``In Search of Budget Moderates.'' I would write a different headline. My headline would be: In Search of People Who Are Fiscally Responsible.
If you want to spend the money, raise the revenue to pay
for it. If you don't have the stomach for raising the revenue
to pay for it, cut your spending. Those are the choices that
were put before our Republican colleagues. They chose to do
neither. They chose instead to run up the debt of this
country, which is already at record levels, and they said:
Caution to the wind, let's add to the debt $600 billion a
year each and every year of this budget. That is what is
here. It is their own estimates. It is their own claims about
their own budget. It is not somebody else's calculations; it
is theirs and they are responsible. They will be held
accountable for their votes tonight.
Yes, I am happy to.
Yes, I will.
It is correct. Here we have a situation in which we are at war, and we have had very substantial tax cuts already. Last year the revenue was the lowest it has been as a share of gross domestic product since 1959. The deficits are at record levels. And the President's answer is spend more money and cut the tax base further, expanding the deficits, expanding the debt, and doing it all right before the baby boomers start to retire. It is truly a reckless course the President is taking us on. It is a reckless course. I hope at some point colleagues on both sides of the aisle will get serious about the long-term economic security of the country.
The Senator from Massachusetts has been extraordinarily patient. Mr. President, Senator Kennedy has very graciously offered to wait until the Senator from West Virginia has concluded his remarks. We certainly thank him for his consideration. I yield such time as the Senator from West Virginia may use.
How much time would the Senator like?
I am pleased to yield 30 minutes to the Senator from Massachusetts after the Senator from West Virginia has concluded.
Actually, we have Senator Akaka and then Senator Stabenow.
Can I suggest that Senator Hutchison had indicated to staff she would be more interested in a little later time slot.
If we went to Senator Akaka for 10 minutes and then Senator Stabenow for 15, we would then be very close to 9 o'clock.
Mr. President, I ask unanimous consent that notwithstanding the receipt of the House message and having the Senate papers at the desk, the Senate begin consideration of the conference report to…
Mr. President, I ask unanimous consent that notwithstanding the receipt of the House message and having the Senate papers at the desk, the Senate begin consideration of the conference report to accompany the budget resolution; provided further that the time from now until the arrival of the ranking member be under the control of the chairman; provided further that when the ranking member arrives, he be recognized to be in control of a like amount of time.
Mr. President, this order allows us to start opening statements on the budget. Senator Conrad should be available around 6 o'clock this evening, and his side will control the time after he arrives, which will be commensurate with the time we control, which I presume will be approximately an hour that we will use now until 6 o'clock.
Mr. President, we are now turning to the budget of the United States, which is pending in the House and being debated in the House. This obviously is a major item for us as a Congress. It is very hard to take the position that a government that spends $2.6 trillion should not have an outline as to how it is going to spend that money, should not have a proposal and a policy for spending that money. That is why a budget is important.
A budget doesn't get into the specifics of how the dollars are spent, but it does set out a very substantial and important blueprint as to how those dollars will be spent and what the policies are that will affect spending and taxes as we move into the future.
The budget that we bring today is a result of a lot of hard work. I want to especially thank my colleague from North Dakota, the Democratic ranking member of the committee, and his staff, who have been extremely courteous and extraordinarily professional in the way they have approached the process. Senator Conrad is someone I have enjoyed working with very much. We disagree, obviously, but the disagreements have been on policy, and certainly there has been nothing but a professional, cordial, and friendly relationship between us.
I also thank the majority leader and the assistant majority leader, Senator Frist and Senator McConnell, for their extraordinary effort. I especially thank members of my committee, all of whom have been very much engaged and who have been very involved in developing the budget.
In addition, I specifically thank Senator Smith from Oregon, who has been a critical player in developing what is one of the core issues of this budget, which I will get into in a few minutes.
Of course, I especially thank the staffs, both the majority staff and minority staff, and especially the staff on our side, led by Scott Gudes, and our colleagues across the aisle in the House who worked so hard to get us to this point.
The budget we are bringing forward today is the result of what I consider to be some serious public policy problems we confront as a nation, and they involve the amount of spending the Federal Government is doing in relationship to revenues, and specifically the rate of growth of our spending and the fact that we are confronting very significant deficits not only in the short term but in the long term.
I want to go through a few charts to explain the parameters of the problem. I think it is critical that people understand that and understand how this budget was developed. We received testimony in the committee from the Comptroller General of the United States that there are on the books today obligations of the Federal Government that exceed projected revenues of the Federal Government amounting to approximately $44 trillion. Now, a trillion dollars is an incomprehensible amount of money for anybody to understand. I will try to
put it into context. This means we already have obligations that we have committed to as a government that we have not figured out how we are going to pay for, which in their total add up to $44 trillion, which amount of money compared, for example, to all of the taxes collected by the United States since we became a nation--all of the taxes collected during that time, over 200 years, total $38 trillion. So we actually have on the books more in obligation than we have collected in taxes in the history of the Nation.
To try to put it in another context, if you take all the net worth of everybody in this country--everybody's car, house, savings account, stock, every asset that everybody has in this country--and add it all together, it adds up to about $47 trillion.
This chart reflects the problem. The chart here is $44 trillion in outstanding obligations of the Federal Government. Over here we have the present net worth of the United States, which is $47 trillion. The amount collected since the beginning of the country is $38 trillion. The larger part of the chart reflects $44 billion, calculated on the actuarial life of these programs. The larger part of the chart is what the cost would be if you projected these programs out into infinity, which would be 100 years, which is about $84 trillion.
So you can see that we are confronting a massive fiscal problem as a nation. The effects of this problem will be that somebody is going to have to pay this bill. Our generation is running up the bill and we are passing it on to our children, and our children will have to bear a huge cost in order to pay off this $44 trillion in debt that we have added up. To pay that off, basically, their quality of life is going to have to be reduced, unless we get started on addressing this problem now.
Where does the $44 trillion come from? What are the obligations that created this huge number? This chart reflects it. It is entirely almost what is known as entitlements, or mandatory spending; it is the orange line. If you look at the mandatory spending, these are programs on the books that say, if you are a citizen and you have certain physical or demographic or income characteristics, you have a right to payment by the Federal Government. The majority of these entitlements, the mandatory spending is Social Security, Medicare, and Medicaid. These three items make up the vast majority of the cost of the $44 trillion, which is unpaid for. In fact, Medicare and Medicaid--the health care items of those three entitlements--represents about $27 trillion of the total of $44 trillion--$27 trillion of unfunded liabilities. That means after taking all of the taxes you pay, your HI tax--the hospital tax which you pay out of your payroll every week--there is still a debt, an obligation on top of those taxes of $27 trillion--a huge amount of money.
Well, now, some would represent that if we raise taxes, we can solve this problem. But we cannot. I want to explain why and the next chart does that.
Historically, the Federal Government has spent about 20 percent of the gross national product. That is what we spend as a Federal Government. We take the gross national product--20 percent of it--and spend it to govern. That has been in our history for quite a while, since the 1960 period. That is the blue line that runs across the chart. If you take the top three--Social Security, Medicare and Medicaid--just the cost of that, as projected out into the future, you will see that by about 2028, 2031--depending on what happens around here--the cost of those three programs to pay the benefits that have been committed under those three programs will exceed 20 percent of the gross national product.
What is the practical effect of that? It is that if that were allowed to occur, you would have no money available to pay for national defense, education, environmental protection, the building of roads, or for anything other than those three programs. It gets worse. The line keeps going straight up--this is where the $44 trillion comes in--as those programs continue to demand more and more in order to support them because of the obligations that are on the books. So you can raise taxes almost endlessly and never catch up with the spending that we have on the books.
That is the point. You cannot tax your way out of this problem. You simply cannot do it. You have to address these major programs and try to control their rate of growth so they are affordable, while still maintaining a benefit structure that is fair, especially to low-income Americans. If you don't do it, the practical effect would be that you will have to double the taxes on our children in the area of withholding in order to keep up with these costs during the period 2020 to 2040. That would mean our children, instead of being able to buy a house, a car, expand their education, or send their kids to college, they will have to pay a radically increased tax burden in order to support our generation. What is causing this huge explosion in costs? It is the fact that the baby boom generation is so large, the demographic shift is so huge, when our generation starts to retire because we go from a generation that has changed the culture of America throughout our lifetime to when we retire we will change the dynamics of the demand on the Federal Government; we shift that so radically that we put all these new costs on our children and our children's children to support our generation when we retire.
People have heard me say this before. These retirement systems-- Medicare, Medicaid, Social Security--were structured on the concept that there would always be a pyramid, many more people paying into the system than taking out. In 1950, 16 people were paying into the system for every one person that was taking out. That is the pyramid concept, the genius of Franklin Roosevelt. Today, there are 3\1/2\ people paying into the system, and it is still affordable. But as we head into this next century and as this huge baby boom generation of which I am a member retires, there will only be two people paying into the system for every one person taking out. So we go from a pyramid to a rectangle, and you simply cannot support the system as it is structured.
The taxes on our children will far exceed their capacity to pay them in order to support the benefit structure. So how do we address this? Well, one way is to bury our heads in the sand and say it is not a problem and hope our children can handle the tax burden increase. But that is not acceptable. As leaders and as people charged with the responsibility of public policy in this country, we need to get ahead of this issue before we get to the problem. And that is where this budget comes into play.
The President sent us a budget which for the first time in 7 years stepped on the sacred ground of trying to address the entitlement costs of the Federal Government. Independent of the budget, of course, he has tried to address the Social Security issue. By law, the Budget Committee is not allowed to address Social Security. So that one is taken off the table for us as a committee. But we do have the capacity as a Budget Committee to step forward and try to do something about the issue of entitlements beyond Social Security, and that is what we are going to try to do in this budget. We are going to try to begin the process of relieving the pressure that is going to be put on the next generation.
This budget does three basic things. In the short term, it reduces the deficit in half over 4 years. It does this by aggressively controlling the rate of growth of discretionary spending that is nondefense. Specifically, we freeze it for 3 years. That is a very aggressive position. Nondefense discretionary spending is frozen for 3 years. But more importantly, we reestablish enforcement mechanisms known as spending caps. Members can come to the floor, and if a bill exceeds that freeze, they can make a point of order against that bill, and it will take 60 votes in the Senate to pass that bill. That is an important change, a very important change--not a change but a reinstitution of budget discipline.
What happened? Why don't we have caps today? We do, but they are very much at the margin. The problem is that because we did not pass a budget last year and because 2 out of the last 4 years we have not passed a budget, we have lost most of the really effective enforcement mechanisms or are on the verge of losing most of those enforcement mechanisms in the next budget cycle. So it is critical we get a budget to put those enforcement mechanisms back into place so we can control in the short term the rate of growth of a number of accounts but especially the discretionary accounts.
We put in place a budget which moves us toward reducing the deficit in half over 4 years. That is one deficit issue. More importantly, the big issue, which I have just discussed, which is this long-term fiscal catastrophe we are headed toward as a nation unless we do something about it, we begin to address that. We do not do radical steps in that direction. This is going to be a long and arduous process. It is difficult, and it is going to be a bumpy road, but what we do is we take some very significant steps down that road toward reintroducing fiscal restraint into the entitlement accounts that we have under our control and that we are willing to address.
We do this in two specific accounts that are critical: Medicaid and something called the Pension Benefit Guaranty Corporation. We can look at these three accounts--Social Security, Medicare, and Medicaid--as being the primary drivers of our problem, but there are other issues out there that are very significant in driving our fiscal problems, and one of them is the Pension Benefit Guaranty Corporation. It is a corporation that makes sure, if you have a pension, a defined benefit plan, and your company goes under, the Federal Government guarantees that pension.
The taxpayers end up with a bill for doing that, by the way. Mismanagement on a corporation's behalf, excessive benefits structure, poor management in the marketplace, a company goes under, and the taxpayers end up with the bill. That projected liability out there today, the contingent liability of the taxpayers of the United States for the Pension Benefit Guaranty Corporation, is estimated to be $25 billion to $30 billion, and it may be radically higher than that, to be very honest.
So we need to reform that system, and the budget we are addressing today begins that process. We try to address that niche issue of significant fiscal problems we have as a nation, which is correcting the Pension Benefit Guaranty Corporation.
Equally and even more important is we step forward on one of three entitlement accounts. We only have jurisdiction over two of the three, as I mentioned earlier. We step forward on the Medicaid issue, and we put in place--Senator Smith basically orchestrated this, and he is going to talk about it--a process to move to get substantive reform in the Medicaid accounts so they are affordable and continue to deliver a quality service to kids in need and people who have to go into nursing homes and cannot afford it, but at the same time they are affordable.
What we do is have an advisory committee or a commission set up which will study the issue. It must report by September 1. We have a reconciliation instruction which says the committee of jurisdiction has to come back and reduce the rate of growth of Medicaid by $10 billion. I will get back to that. And we limit that action on the $10 billion reduction, so we delay it a year. So there is a year to get ready to do that.
I want to put this $10 billion in context because this is a major savings item of the budget in the area of entitlement reform. Over the next 5 years, we are going to spend $1.12 trillion, a huge amount of money, on Medicaid. This budget is suggesting that we reduce that rate of spending over the next 5 years by $10 billion; $10 billion on a $1.12 trillion base, approximately 1 percent. One would think we were scorching the Earth when we initially proposed this. Obviously not.
The practical effect of this is we are taking a program that is going to grow at 41 percent over the next 5 years and reducing its rate of growth to 39 percent. We can do that. If we are halfway decent as managers of the tax dollars of Americans, we can do that, reduce 1 percent off a program that is growing so quickly, reduce its rate of growth from 41 percent back to 39 percent.
In fact, we can do that, and we can actually give more services to more kids and more people who are deserving of it. The reason is that Medicaid, unfortunately, has some problems right now in the way it is functioning. There is a fair amount of Medicaid money which is being shifted from the delivery of service to needy children and to people who need help going into nursing homes over to simply the general operation of State government. That should not happen anymore, and we can end that.
Unfortunately, there is a lot of abuse, where people are spending down in order to qualify for Medicaid and hiding assets and transferring over to the taxpayers costs which they should fairly bear.
There are significant savings which can occur in the way we purchase pharmaceuticals under Medicaid. There is a whole list of items which Governors are willing to consider in order to accomplish savings. But what the Governors need is more flexibility. We give the Governors more flexibility and a little less rate of growth in this program, and they are going to deliver more services to more people at less cost. It is that simple. A good Governor will do that, and there are a lot of Governors out there willing to try.
So there has been a compromise we reached on Medicaid which has been orchestrated and energized by Senator Smith of Oregon. I congratulate him for it. It is a good compromise because it will start us on the path toward looking at public policy which will start to address--it is not going to resolve the problem--will start to address the issue of this element of the entitlement problem, the Medicaid element of this chart, and it is one of the three major items.
In addition, as I mentioned, we have taken up the PBGC issue. This is the first budget in 7 years which has stepped on the sacred ground of entitlements and tried to manage them at least marginally. The total amount of entitlement for reconciliation savings--not all of it is entitlement--but the total amount of reconciliation savings in this bill is approximately $35 billion. That is a very reasonable number. That is a 5-year number. So it is something that can certainly be accomplished.
The third thing that this budget does is it continues to energize economic growth. When the President came into office, he was confronted with a very severe recession as a result of the burst of the Internet bubble. That was compounded, of course, by the attack of 9/11, which caused our economy to stumble severely as a result of the adjustment to what was a new world. Then we had to dramatically expand our commitment to national defense and homeland security in order to participate aggressively in finding the people who were responsible for this horrific act of 9/11 and making sure that we are as well prepared as possible in avoiding another attack.
So the President was confronted with an unfortunate set of facts relative to the economy, and there was a recession. But that recession's severity was significantly reduced because this President had the foresight to reduce the tax burden on America's workers early so that people were allowed to keep their money and there was incentive for entrepreneurship, an incentive to go out and work harder, and an incentive to create jobs. The recession was shallowed out as a result of that. Now we are seeing a dramatic turnaround in the amount of revenues the Federal Government is receiving because of that.
Revenues dropped precipitously, everyone knows that, but they dropped because we were in a recession and because we were attacked. The tax cut that was put in place has essentially helped us recover in the revenues area because people have gone out and they have become more productive as they have been willing to work harder, earn more, and create more jobs because the tax burden has been reduced. The function of that is that more incentive is created to be productive.
We are seeing the results. Last year, tax revenues grew at 9 percent. This year, they are going to grow around 7 percent or maybe even faster. The month of April, which has not been formally reported yet, looks like it is going to be one of the highest collection months as far as revenue goes in the history of the country, a dramatic jump in revenues as a result of the tax cut. For the foreseeable future it is expected under this budget, and I think under all economic assumptions, that tax revenues are going to continue to compound at a rate of about 6 to 6\1/2\ percent as a result of a strong economy, driven by a good tax policy.
We continue that tax policy in this bill. This bill does not assume any new tax cuts, but it does assume that tax
cuts that are on the books, that are very constructive, and which people use in their day-to-day life will be continued--tax cuts such as the R&D tax cut, the research and experimentation tax cut, the deduction for teachers' classroom expenses, the deduction for qualified education expenses, the deduction for State and local taxes, the welfare-to-work tax credit. These are tax credits that are continued.
We hear a lot of talk from the other side of the aisle that, oh, there are just not enough tax increases in this bill; we have to raise taxes. Which one of these deductions which is about to expire does the other side of the aisle want to allow to expire and put more burden on American workers? I doubt there are very many that would fall into that category that are on this list, and that is what this bill assumes-- that we will continue in place tax proposals which encourage people to be more productive, such as the R&D tax cut, or give people a benefit they deserve, such as teachers being allowed to expense classroom costs, and that are popular. So we will continue a tax policy under this bill which will continue to energize economic growth.
As we have brought this budget forward, it puts us on a path to accomplishing positive steps in the area of fiscal responsibility and fiscal restraint. It is a budget which reflects the President's initial budget which was a commitment to trying to begin to address the deficits in the short run and, more importantly, the long-term issue of the fiscal problems we confront because of the demographic boom which I mentioned, which is coming at us. For that reason, it is a very positive budget.
I wish to make one more point about the budget before I yield to the Senator from Oregon, whose thoughts are very important here because he is one of the key players in addressing this critical issue of Medicaid. This budget is critical because it also puts back in place and actually energizes new initiatives in the area of enforcement mechanisms. These are procedural things, yes, and they are arcane things, yes. Most people do not understand what they are, that is true. But it was interesting, when Alan Greenspan testified before the Budget Committee last week, he said the most significant thing that had happened in the area of disciplining Federal spending was that we had budget enforcement mechanisms in place through the late 1990s and early 2000 period and we needed to reinitiate those initiatives. By law, we cannot pick them all up because this is a resolution, not a law. The way this works, we cannot pick them all up. But to the extent that the budget resolution can put back in place and strengthen enforcement mechanisms to allow this Congress to be disciplined in the way it spends money, this resolution does that in an extraordinarily aggressive way.
So this is a good resolution. It is a positive step. It takes us on the right direction toward fiscal discipline. I certainly hope my colleagues will support us in moving it forward.
Now I yield to the Senator from Oregon such time as he may consume.
Mr. President, I thank the Senator from Oregon. His efforts have been immense. Quite honestly, the budget would not be on the floor and we would not have a chance if it were not for the Senator's courtesy and efforts. He had strong points and made them very effectively. As a result, we will make progress here not only on the entire budget but on what I consider to be the core element of this exercise, which is trying to get a reasonable approach to one of the major entitlement accounts.
I congratulate the Senator. He has had a huge impact. The Senator knows how to get things done around here. I appreciate his courtesy to me.
Mr. President, the time until Senator Conrad arrives will be charged to my account. When Senator Conrad arrives, he will take an equal amount of time to what we have used. That was the unanimous consent we entered into. After that, I ask unanimous consent time spent in quorum calls during the consideration of the bill be counted equally against both sides, the majority and the minority, for debate time.
Mr. President, the Senator from Oregon has made the point very well, but what is important is important to the majority, specifically, the essence of governance. You cannot govern unless you are willing to set out the principles by which you govern, especially the blueprint which is going to guide you in the governance activity.
Obviously, one of the most significant things done when you are the majority party and you have the presence, you make the decisions, basic decisions as to how the country's finances will be managed and how moneys will be spent and that they will be shepherded well.
These are tax dollars. People work hard. Every day people are putting in a full day's work and the Federal Government, every day, comes along and says, You worked all day long, we will take ``X'' percentage of the money you earned. We will take it right out of your pocket and we will spend it on a series of things.
What is important is that the American people first know what we are going to spend it on and how we will spend it--that is where a budget comes into play--and that we be good shepherds of those dollars and use them effectively so people can retain as much money as possible in their pockets to spend on what they know is important in their lives, and the Government does not take it and spend it for them and tell them how their money should be spent, and that we function in a way we get the type of government that delivers the services that are critical to making sure we can defend ourselves and take care of the less fortunate in this Nation, make sure we have strong education, make sure we have good health systems, that we can continue as a nation to have a vibrant and a strong economy.
This all starts with a budget. It is that simple. This is not the end of the product. This is the beginning of the exercise. If you do not have that blueprint in place, it makes the rest of the process extremely complicated and much more difficult.
It is critical we pass this resolution. I strongly believe this resolution is a responsible effort to try to bring our fiscal house in order and to make strides in the area of controlling the rate of growth in spending so it is affordable for our taxpayers, but, more importantly, so it is affordable for the next generations who will have to pay the burden we put on the books today.
It does, for the first time, take that step in the area of entitlement or mandatory spending which has become 59 percent of the Federal Government. A lot of people say, what about the appropriations bills? Appropriations bills are the discretionary side of the budget. They represent less than 30 percent of Federal spending. Half of that is defense, which we have to do today in a very aggressive way because we have been attacked and are at war and people are out there who want to harm us. I held a hearing this morning on terrorists relative to their desire to use biological and chemical weapons against us. It is very sobering, to say the least, but we have to defend ourselves and it will take a lot of money to do that.
Of about 30 percent, half is defense, and the other part goes to nondefense discretionary so it is not the large part of the budget, of the appropriations bills that come through. The most significant part of the budget is the part
of the entitlement accounts which never come across the Senate as individual spending items such as appropriations bills do. They simply are on automatic pilot. Absolutely the only way we can address policy effectively in mandatory accounts is through something called the reconciliation process.
To quickly explain, that allows for the committees that have jurisdiction over these entitlement programs that are already in place and that have grown radically over the years to take another look at those programs and see if they are working as well as they could work. Medicaid is a classic example of a program that needs another look, where if we adjust it so Governors have more flexibility, we have a slower rate of growth in dollars, they can probably do a lot more for a lot more people if we give Governors the type of powers they need to accomplish that.
Reconciliation is the only avenue for effectively doing that type of a review of the mandatory side of the ledger which represents 59 percent of Federal spending today. The reason it is the only effective way is because we all know nothing can go through this Congress--we have been shown that in the last few weeks--nothing goes through this Congress that is controversial without 60 votes. We also know any sort of mandatory change is going to be controversial. Reconciliation gives the opportunity to use a majority rather than a supermajority to review these programs and to make progress in restraining their rate of growth and making them more effective in delivering services. That is why this budget is a unique budget.
It is the first budget we have a shot at passing in the last 2 years. The last 4 years we have only passed a budget twice. More importantly, since 1997, there has not been a budget which is a step forward to try to address the very critical element of where the Federal Government stands and how it spends money in the area of mandatory entitlement accounts which represent 59 percent of Federal spending.
With that, I reserve our time, recognizing it is going to run against our side of the aisle, with the understanding the ranking member, Senator Conrad, will be here probably around 6 o'clock at which time I will yield the floor to Senator Conrad.
I suggest the absence of a quorum with the understanding the time will run against our side.
Mr. President, I yield to the Senator from Tennessee such time as he may consume or such time until the Senator from North Dakota gets here.
Mr. President, as I understand the Senator from North Dakota, Senator Sarbanes wishes to speak for 10 minutes. I would suggest that Senator Sarbanes speak for 10 minutes, then we to go Senator Grassley for 15 minutes, then we go to Senator Stabenow; however you want. We will go back to your side for a half or so, and then we will come back over here. The next speaker on our side, after we go from Senator Sarbanes to Senator Grassley to--
We may want to put Senator Hutchison between Senators Akaka and Stabenow. But if not, we will go with that sequence.
Yes, around 9. But I assume we will hit that hour by that time.
Why don't we plan to do it that way. Then move to Senator Hutchison. With that being the general lay of the land, let's proceed.
Mr. President, I thank the Senator for his generosity, but I look forward to listening to the Senator from West Virginia. I know we are going back and forth. I ask unanimous consent to proceed after…
Mr. President, I thank the Senator for his generosity, but I look forward to listening to the Senator from West Virginia. I know we are going back and forth. I ask unanimous consent to proceed after the Senator from West Virginia.
I was asking for recognition after the Senator from West Virginia. I withhold.
If I could have a half an hour.
Mr. President, do I have it correct, I will have the opportunity for recognition after the Senator from West Virginia?
I believe I have up to 30 minutes; is that right?
Mr. President, I first want to congratulate the Senator from North Dakota and my two other colleagues, my old friend and colleague from Maryland, Senator Sarbanes, and Senator Dorgan, for their excellent presentation in terms of the budgetary impact of this budget.
I think they have explained very clearly, eloquently, and passionately the severe risks that this budget puts in terms of the economic future of this country and its relationships and dependency on other countries throughout the world.
I would like to address another aspect of this budget, and that is with regard to domestic priorities that are front and center for most families in this country. First, I would like to discuss the priority of education, and then, second, the budget cuts in Medicaid, which is a lifeline to millions of children and disabled people and women in our society, and third, the further undermining of our whole pension system, which has been included as part of this budget as well. We are having a great national debate on the issues of Social Security and the integrity of the Social Security fund. Under the provisions of this budget, we are going to find that the availability and the assurance of pensions is going to be seriously undermined and threatened as well.
But as an initial matter, I ask unanimous consent that an excellent statement by the Episcopal Church, the Evangelical Lutheran Church, the Presbyterian Church, the United Church of Christ, and the United Methodist Church, with regard to this budget, be printed in the Record.
I will just read a few lines from this statement.
We believe our federal budget is a moral document and
should reflect our historic national commitment for those in
our own country who suffer from hunger, lack of education,
jobs, housing, and medical care, as well as concern for our
global community. . . .
As we view the FY 2006 Federal Budget through our lens of
faith, this budget, on balance, continues to ask our nation's
working poor to pay the cost of a prosperity in which they
may never share. We believe this budget remains unjust. It
does not adequately address the more than 36 million
Americans living below the poverty line, the 45 million
without health insurance, or the 13 million hungry children .
. . Therefore, we ask Congress to reject this budget and
begin anew.
Mr. President, with a budget we have a chance to make a difference. We have a chance to make a difference for working families and for millions of Americans who work hard every day, who care for their families, who want the best for their children, their communities, and their country. This budget should make a difference for them. It should be a budget for America, a fair budget that improves the lives of average Americans. That is not this budget.
President Bush and the Republican Congress had a chance to make a difference and they failed. In this budget, they choose instead to lavish more tax breaks on the wealthy at the expense of poor Americans who rely on Medicaid and at the expense of parents who want to send their children to college. It is Medicaid, strike one; education, strike two; and this budget is strike three. We ought to throw it out.
Here is how this budget harms education in America. Education is the golden door to opportunity for our citizens. Parents know that education makes the American dream possible for their children. Education is essential to our future competitiveness and our strength as a nation. We cannot compete in the world without skilled workers. We cannot maintain a strong defense without a skilled and dedicated military.
The budget proposed by the President and the Republican leadership in Congress fails our future. It fails American families struggling to pay for their children's college education. It fails American workers seeking to improve their skills and secure better jobs to support their families. It fails our companies looking for the best workers. It fails our military looking for the brightest recruits. It weakens America as we strive to compete in the global economy and maintain our security in a dangerous world.
American workers are being battered by the tidal wave of globalization and this budget does nothing for them. Nothing. Since this administration has been in office, 2.8 million manufacturing jobs have been lost. By the year 2015, 3.4 million jobs are at risk of being sent overseas.
This chart demonstrates, according to Forrester Research, one of the most authoritative analytical groups in terms of jobs being outsourced, the job
outsourcing projections we are facing. Do you think there was any effort at all in this budget conference to take into consideration this flow line, to be able to take the remedial steps by providing additional skills to our workers, such as training, increasing vocational schools, commitment in terms of adult education, continuing the upgrading of our skills? Absolutely not.
The wages of average workers are going down at a time when the cost of living is going up. At the same time, other nations are producing increased numbers of workers with advanced skills. China, today, is graduating 300,000 engineers; India, 200,000 engineers; the United States of America, 50,000 engineers. Better than half of those foreign nationals who graduate in the sciences from American universities are going back overseas. How are we going to be able to maintain national security? How are we going to be able to maintain our economy with these flow lines?
Look at what has happened since 1975 with regard to American production of scientists and engineers. The United States in 1975 was third in the world. The United States today is 15th in the world and we are in a downward slide.
This Senate said we were going to change that flow line. This Senate went on record by supporting, Republicans and Democrats alike, $5.4 billion to make sure we were going to be able to graduate 50,000 to 60,000 more engineers and scientists a year.
What did this conference do? They said, no, no. Did they say, we will give you 15,000 or 20,000 engineers? No. Or 10,000? No. Or 5,000? No. Or 1,000? No. Zero. Effectively, they zeroed that amendment out that had Democratic and Republican support alike not only with regard to math and science but also with regard to the TRIO Program, the Upward Bound Program, the GEAR UP program, the vocational education program, adult literacy programs, all the programs that provide additional training and help and assistance.
For the first time in a decade, this budget cuts the education budget. Page 34 of this budget, two-thirds of the way down, are the projections of 2005 through 2010. It is cutting our education commitment by some $15 billion over the next 5 years--not increasing it, not even holding its own--cutting education. Rejecting the Senate amendment that added $5.4 billion, the conferees instead cut $15 billion in the discretionary education budget.
If our country is to remain strong in this rapidly changing world, if our economy must work for everyone, every American must have an equal chance at the American dream.
No Child Left Behind is not just a political slogan; it is a solemn pledge to every parent and every child in America. But this budget leaves 3 million children behind. In 2006, 3 million children are left behind. Remember our commitment, that all children were going to reach proficiency over the period of the next 12 years? Under this budget, by 2013, we will be leaving 4.8 million children behind on the projections we have.
This budget cuts student aid, helping young people who would be able to go to college. Where do we find that in this budget? In the reconciliation part, it talks about $13.6 billion in cuts; $7 billion will come from the student aid program and $6.6 billion will come from pensions. That means the companies are going to have an increased tax. Companies will have to pay more into the Pensions Benefit Guaranty Corporation, big companies and small companies. That will discourage companies from maintaining their pension programs. That is what the administration wanted.
We had offsets for our amendment of $5.4 billion. What were the offsets? Closing corporate tax loopholes. Imagine the Republican majority saying all right, Senator Kennedy, maybe you will close the tax loopholes you have identified, but not ours. But that is not the case. Those tax loophole closure provisions already had passed virtually unanimously in the Senate previously. The Senate voted for them and then did not use them, did not close them completely previously. Corporate tax loopholes to pay for education and training: That was the choice for the Budget Committee. And they said no to education, no to training, and yes to the corporate loopholes.
This budget with regard to education, is important not only for those who are going to college but for those who are trying to make it through K-12. Every child and every parent ought to understand the judgment made at the instigation of the leadership of the Republican Party--and this President--to make a reduction of $15 billion in education for the K-12 education; $13 billion in terms of higher education and the pension program; and the elimination of the $5.4 billion. We could have added funding for education. Instead this budget cuts education.
Money is not everything, but it is a clear indication of a country's priorities. What we are talking about with these investments, we were enhancing the Pell grant which would be available to 5.3 million young Americans who are qualified, are talented, and able to go to school but are having hard times making ends meet, and help and assistance to working families. That is what we were interested in doing. That is what was turned down.
I yield.
The Senator is absolutely correct. That was passed and accepted by Republicans and Democrats alike on previous legislation and was never incorporated, never utilized, as we say around here. So there had been an agreement that these were the most egregious loopholes and, therefore, we used that as an offset for the increase of the $5.4 billion in education funding.
The conference came back and said, no, we want those loopholes back and we are going to cut education for the neediest children, the TRIO Program, the Upward Bound Program, vocational education, and cut back on scholarship programs for the sons and daughters of working families in middle America. That is what is in this budget in education.
I was listening to the Senator's comments earlier about the foreign policy implications of debt. He has been active in areas of education. He knows from his own experience in the Foreign Relations Committee, the Banking Committee, the Joint Economic Committee, what is happening in the other countries.
What we saw on the front page of the Washington Post last week was that China was reducing their overall numbers in their military. What they are doing is enhancing their research and development and education and training programs because they are going to go smaller in terms of the total numbers of people in the military and go more into high-tech military equipment which require high level training and high skills.
Would the Senator not agree with me? They are graduating 300,000 engineers, and India is graduating 200,000 engineers. And General Electric has just moved its top research center over to--where? to Maryland or to Massachusetts? no--to India. And DEC, one of the leading, innovative companies in this country, has just opened their new research facility, hiring 3,000 Indian engineers. We are not just exporting jobs, we are seeing the export of research and technology. And what is our response? Cutting back on training young Americans and giving more tax breaks to individuals.
I say to the Senator, who has been here for years as a member of the Foreign Relations Committee, isn't he
troubled by these flow lines, not only with regard to our national security but in terms of our ability to be competitive?
The Senator is----
The Senator is correct.
Well, the Senator is exactly correct. If we think we are going to have the technological advantage in another 20 years, either commercially or militarily, with these kinds of flow lines, then we are dreaming dreams that never will exist. This is absolutely preposterous.
We have had an excellent presentation on the overall economic implications of this conference report, but we are talking about the human investment that makes the difference for us to be No. 1 competitively, both militarily and commercially.
The other point I want to mention to the Senator is that the loopholes we closed were the loopholes that were tax incentives for corporations to move jobs overseas. Do we understand? We, as a country, are concerned or should be concerned about outsourcing, sending jobs overseas. Now we are seeing that not only the jobs are going overseas, the research is going overseas, the education advantage is going overseas, the debt control is going overseas. And we are seeing the incentives to move those jobs overseas with the tax loopholes we closed.
But did the Republican budget conference keep the loopholes closed? No. They restored them. They restored them. They are back, now available to companies to go ahead and outsource American jobs. This is a performance that just defies reason--we heard over the course of the campaign, which was not all that long ago, how everyone was talking about--Republicans and Democrats--what we were going to do about outsourcing. They have given their answer, and they have given it to us tonight.
Yes.
That is correct. It is exactly right. And we had those agreed on, Republican and Democrat alike. I think it was by 76 votes here in the Senate on the FSC-ETI legislation.
So we had the offset of incentives that were moving jobs overseas. We were closing that loophole and investing in able, capable young Americans in higher education, in training teachers for math and science, of which we are in desperate need. No Child Left Behind has the guarantee that we are going to have a well-qualified teacher in every classroom by the year 2006. We are far behind. This would have given us an opportunity to meet that goal.
But most importantly, we would have given the helping hand to many other young people in the TRIO Programs and the Upward Bound Programs and the rest.
Mr. President, over 160 organizations representing students and educators supported our amendment. They generated thousands of calls to their legislators. Just in Massachusetts, I received more than 1,000 letters from adult education students and teachers urging that this amendment be retained, telling their stories about how adult education is changing their lives for the better. We have letters from colleges and universities across the country urging Congress to increase the Pell grants, to save the Perkins Loans Program. We have letters from students, counselors, and young adults urging us to save college preparation programs for first-generation students, such as TRIO and GEAR UP. Over 600,000 students have sought more information about this amendment.
On their own, five Republican Senators wrote the budget conference committee to tell them this President should support this amendment and the conference committee should support this amendment, and that the education and Pell grants needed their support. Yet this conference rejected all those pleas and cut education.
Now, the Republican leadership and the White House decided it was more important to maintain the loopholes to reward corporations that send jobs overseas rather than invest in our own young people here at home.
Our amendment embraced the hopes and dreams of millions of Americans. All parents want their children to have lives of fulfillment and opportunity, to raise strong and healthy families, and afford to live comfortably in safe neighborhoods.
When we first debated this resolution a little over a month ago, a majority in the Senate said no to the President's cuts in education. Today, a majority of the Senate should say no again. We should stop the raid on student aid and pass a budget that strengthens, not weakens, America.
Now, Mr. President, on another subject, just last month the Senate made it clear that cuts to the Medicaid Program were unacceptable. In a bipartisan vote, we agreed to not make any cuts until a bipartisan commission had time to examine the Medicaid Program and recommend possible reforms based on sound policy. Just this week, in an overwhelming, bipartisan vote, the House instructed the budget conferees not to cut Medicaid.
Yet the budget we will be voting on shortly not only cuts Medicaid-- despite consensus in both the House and Senate against cuts--its cuts to the program are almost as deep as those we voted down in March. The Senate rejected the $15 billion in cuts to the Finance Committee. Yet this budget report that was drafted in the dark of night behind closed doors forces the Finance Committee to cut $10 billion.
If these cuts were not bad enough, the bipartisan Medicaid Commission has turned into a partisan commission that the administration can stack with members they know will recommend the cuts they have determined. Instead of a real examination of the Medicaid Program so that we can modernize the program with needed reforms, we will have a commission whose agenda will be to recommend cuts.
It is not just Medicaid that is at risk. What does it say about Republican priorities if this Republican budget cuts a program that provides health care for 53 million low-income Americans--children, parents, the elderly, and the disabled--in order to provide large, new tax cuts for the wealthy?
Republicans say they are for a culture of life, but Medicaid sustains that life. One-third of all the births in America are covered by Medicaid. Medicaid sustains life for a third of our mothers and our babies. But this budget says the lives of poor mothers and poor children are not that important after all. Under this budget, tax breaks for the rich are more important than life itself.
I want to show you what has happened with regard to low-income children. Since 1997, 23 percent of children in America were not covered. Now we have reduced that to 15 percent. We are making very important progress in terms of providing some insurance for
children. But now with this budget, we are going to see this line go back up because of the following.
If you look at this chart, you will see what is happening to children and also to low-income parents. The total number of low-income children has increased by 6.7 percent and 5.5 percent in terms of low-income parents who have lost their health insurance. We have seen a 1.7- percent growth in the Medicaid Program and an increase of 8 percent to cover low-income children. So we are making some progress, but not with this budget.
This budget takes away those gains for children. Take them away from the elderly. Take them away from the services for expectant mothers who are delivering. That is what this budget does, and that is what is so incredibly wrong in terms of this budget.
We know the harmful consequences of the lack of access to health care. In the early 1960s, President Kennedy commissioned a study to find out why half of our young military draftees were rejected for service. The study, which was released in 1964 and provided the basis for Medicaid coverage policy for children, found these young men had physical and mental developmental problems that were highly treatable if they had had access to health care as children. As a result, the Medicaid program was set up. That is the basis for it. And we have made enormous progress. Now we are going to see the undermining of that program.
Finally, Mr. President, the budget also includes a reserve fund for the Grassley-Kennedy bill to provide health coverage for families with disabled children. The bill is titled the ``Family Opportunity Act.''
For the last 5 years, Senator Grassley and I have been fighting to get this legislation passed.
The Family Opportunity Act allows families of children with severe disabilities to buy health care coverage under the Medicaid program, without becoming poor, staying poor, or giving up custody of your child. It is legislation cosponsored by more than half of the United States Senate and over 200 disability, health care and other organizations.
Almost one in ten children in America has significant disabilities. But many do not have access to even the most basic health services they need because the private health insurance won't cover them.
In every one of these plans you read numerous exclusions that hurt children with disabilities--no coverage for hearing aids, for special health needs, for assistive technology, for services at school, and on and on and on.
These families aren't looking for a hand-out--just a helping hand. All they want is the opportunity to buy affordable coverage, because the private health insurance market won't offer it to them.
More than any other investment we can make in this budget, we should secure funding for these families who struggle everyday to afford the health care their children need to live healthy and successful lives.
I hope that we can finally see this profamily bill enacted into law this year.
The budget sets up a reserve fund for Senate action to bring the benefits of information technology to our inefficient health care system. Unfortunately, a similar reserve fund is not available for House action.
Information technology has revolutionized virtually every industry in America--only health care lags behind.
IT is critical to our efforts to bring costs down and improve quality. It can provide for more efficient delivery of care, and it can reduce errors and increase quality. HHS estimates that widespread use of IT can save as much as $140 billion a year.
The VA has implemented the most advanced IT system in the country over the past few years. The results have been remarkable. Since 1996, VA costs per patient have actually decreased 7 percent, while private sector costs per patient have increased by 62 percent. During this period, the VA has been widely recognized for improving its quality of care.
Obviously, not all of these successes have been due to information technology--but the VA system thinks that much of it has.
We have a tremendous opportunity to improve the ability of IT to make a real difference in the quality and efficiency of health care--but we have to act now.
I commend Senator Gregg and Senator Conrad for working with the chairman of our Health Committee, Senator Enzi, and me as well as Senator Grassley and Senator Baucus on the Finance Committee--to include this fund in the budget.
The fund is a small step in the right direction, but it will be a wasted step unless Congress enacts legislation to improve the use of health IT in America.
The two key components of any legislation, in my view are incentives for hospitals and health care providers to use IT to improve quality and in acquiring IT. Part of this effort is developing technical standards in partnership with the private sector to ensure that the money is spent on systems that really enhance quality.
Our economic competitors in Europe and elsewhere are making the investments needed to improve their health IT systems. The British are investing over $15 billion, yet we in this country continue to delay.
IT can cut costs in many ways. Our fragmented and uncoordinated health care system imposes high costs in duplication and waste. Patients with multiple chronic illnesses see as many as fourteen doctors a year.
Doctors repeat tests that have already been performed. Residents take histories that have already been taken. Patients show up for doctors' appointments that are essentially a waste of time because tests have been performed but the results have not been delivered.
It has been estimated that one in seven hospitalizations could be avoided if complete medical records were available for the patient. One out of five laboratory tests are duplicative of ones that have already been performed. This adds up to immense amounts of money. IT can reduce this needless duplication.
We as a nation cannot afford to miss this opportunity to make the investments needed to improve health care and cut costs.
My time is about up, but I must comment on how this budget resolution also attacks our defined benefits system. Pensions are more important than ever. We know of the assault that is on the very nature Social Security. Separate from Social Security, the number of secured, defined benefit plans is going down. This particular budget increases the premium tax on employers with a heavy burden on manufacturing companies. It will hurt small businesses. These premium increases will obviously hurt many workers and retirees, and it will also jeopardize long-term retirement stability. Pensions are important. They are a part of the quality of life for working American families. This budget does a disservice for them as well.
I hope this budget will be rejected.
Mr. President, Medicaid provides a critical safety net for 53 million Americans--low-income children, parents, disabled and elderly citizens who have nowhere else to turn for health care. Medicaid…
Mr. President, Medicaid provides a critical safety net for 53 million Americans--low-income children, parents, disabled and elderly citizens who have nowhere else to turn for health care. Medicaid now provides health care for 1 in every 5 children. It pays for one-third of all births in this country, almost 40 percent of all long-term care expenses, a sixth of all drug costs, and half of the States' mental health services. It also is the largest payer of services for AIDS patients.
What does it say about the leadership of this Senate that it proposes to cut $15 billion from Medicaid? That program provides health care for 25 million children, 13 million low-income adults, and 15 million disabled and elderly Americans. These cuts are proposed at the very same time the budget once again proposes large new tax cuts tilted toward higher income households. Our colleagues say they have no choice but to make these cuts to Medicaid because of the large deficit. But the large deficit was created by the large tax breaks for the rich, not by Medicaid.
The budget is a blueprint of Congress' priorities for the Nation. This Congress once again shows that it cares more about those who have the most than it does about those who have the least. How can we possibly continue to give tax breaks each year to the wealthy, and reduce health benefits for the poor to pay for them. Those are not the values we stand for.
In fact, the budget cuts in the Senate resolution are even deeper than the cuts proposed in the administration budget. Even if the Finance Committee adopts every cut the President proposed to Medicaid, they will still need to come up with an additional $7 billion in cuts to meet the target in this bill.
We need to maintain the Federal commitment to medical care for the poorest of the poor. If we weaken the Federal commitment, these men, women, and children will go without care, or show up at the emergency room door. We know that lack of access to care causes harmful consequences. We cannot abandon our responsibility to provide for those among us who are less fortunate.
This budget will force the States to pick up costs that the Federal Government should be covering. It will result in a massive shift of responsibility from the Federal Government to the States. We already have shifted much of the cost of the elderly to the States, costs that should be covered by Medicare. More than 40 percent of all Medicaid expenditures are used to fill the gaps in Medicare. Medicaid pays for their long-term care, their prescription drugs, and their cost-sharing.
Medicaid is the largest source of long-term care today. The more than 7 million persons who are eligible for both Medicare and Medicaid are among the most vulnerable. Seventy percent of them have incomes below $10,000. Nearly one in four live in long-term care facilities. They are twice as likely to have Alzheimer's disease, and more likely to have diabetes and stroke than others on Medicare beneficiaries. They are a small proportion of the Medicaid population, but their costs are among the highest. Medicare will start paying for prescription drugs for the dually eligible next January, but the states will see little or no relief. In fact, because of the so-called ``clawback'' formula in the prescription drug law, many states will end up sending the federal government more money for picking up these drug costs than they would have spent without the drug bill. What kind of relief is that?
We can all agree that we need to improve Medicaid. We have an opportunity to improve the program, but that is not what this budget does. This budget is not driven by policy--it is driven by an arbitrary number that was picked by the leadership as their deficit reduction target. The Federal Government needs to maintain its commitment to health care, not try to weaken it and dump the costs on the states. We need to help the states provide health care, not cut federal funding and put a bigger burden on them. But that is exactly what this budget does.
Some on the other side describe these cuts as minor, or as reductions in growth, or as necessary Medicaid reforms. Don't believe a word of that. Nothing is further from the truth. There are no policy reasons for these cuts. They are large, harmful cuts that are being made so that they can say they are reducing the deficit. But if you look at the numbers, this budget doesn't reduce the deficit--it increases it over the next 5 years. Despite these harmful cuts in Medicaid, they add yet another round of tax breaks. Where is the fairness in that? It is Robin Hood in reverse steal from the poor to give to wealthy.
Our colleagues say we need to cut Medicaid because it is growing too fast. The reason is obvious. It is growing because over the past 4 years, more people are losing their jobs and their health care, falling into poverty, and finding themselves with no option but Medicaid. That is what is responsible for Medicaid's growth.
Over the past 4 years, the number of uninsured has climbed from 40 million to 45 million, and it is expected to continue growing for the foreseeable future. The number of uninsured would have been much greater without Medicaid. During the same time period that the number of uninsured increased by 5 million, the number of Americans on Medicaid grew by 9 million. If Medicaid had not been available to them, we would be facing 54 million uninsured. Is that the kind of policy the Nation wants to promote?
Medicaid enrollment grew 40 percent over the past 5 years, and it is projected to grow another 5 percent this year. Enrollment growth is causing Medicaid's rising cost, not inefficiencies, or fraud, or abuse. In fact, the cost of private employer-sponsored health insurance has grown at twice the rate of Medicaid. The percentage of Americans with employer-sponsored health insurance fell, but the number of Americans on Medicaid grew, and that growth was largely caused by the bad economy, the continuing decline of employer health insurance, and the soaring cost of prescription drugs.
Cutting costs is the wrong prescription for Medicaid. This amendment will give us time to assess Medicaid fairly, and base any changes on sound policy, not arbitrary budget cuts. These cuts will have a real impact on real people. Millions may lose their only hope for health care if we allow these cuts to stand. Emergency rooms will have more and more patients with nowhere else to turn, and the Nation's health care safety net will continue to fray. That is not the kind of budget we ought to be approving.
I urge my colleagues to vote for the Smith-Bingaman amendment. Our goal on Medicaid is to improve it, not dismantle it.
Mr. President, I strongly support the Sarbanes amendment, which will prevent one the greatest failings of this President's Budget--its elimination of more than $2 billion
from critically needed economic development and social service programs and the proposed consolidation of 18 valuable Federal programs into a single block grant under the so-called ``Strengthening America's Communities Initiative.''
I am heartened that so many of my colleagues have come together in opposition to these cuts--55 Senators wrote to the Budget Committee in an important show of bipartisanship 2 weeks ago.
Under the President's plan most American cities can expect at least a 35 percent cut in assistance from the Federal Government to help secure investment, house the poor, provide health care to the uninsured, and counsel the abused.
If the administration dislikes helping cities, they should have the decency to say so, instead of this charade where they try to hide massive cuts under the cloak of streamlining.
Their proposal insults the intelligence of mayors, community development officials, and social service agencies across the country-- by cynically suggesting that somehow these cuts are going to make life better and be helpful to cities across America.
What makes these cuts so objectionable is they come at a time of great stress and difficulty for Americans who live in poverty. 1We are the wealthiest nation on earth. We are blessed with great abundance. Yet despite our great wealth, too many of our fellow citizens remain in the shadows, the prisoners of persistent and increasing urban and rural poverty.
The numbers are alarming. Today, nearly 36 million Americans live in poverty, and 3 million more working Americans live in hunger or on the verge of hunger today than in 2000. One out of five American children goes to bed hungry each night. We have it in our power to eliminate so much of this poverty.
At the very least, we shouldn't do anything to make it worse which is exactly what this ``Strengthening America's Communities'' plan from the White House would do. In the powerful words of the Gospel, ``To whom much is given, much is required.''
We need to pass the Sarbanes amendment, so that the work of tens of thousands of public officials, health officials, educators, community development experts toiling to improve living conditions in our cities isn't made any more difficult.
Mayors across the country on the front lines every day are struggling to create new jobs and attract capital investment. They are struggling to educate and house the children of the poor, and they are not fooled by this administration's misleading slogan ``Strengthening America's Communities,'' because they know it is the exact opposite.
My friend, Mayor Clare Higgins of Northampton isn't fooled. She recently wrote me urging Congress to save Community Development Block Grants, one of the very few tools she has to meet Northampton's needs and one of the biggest programs on the President's chopping block.
Most recently, Northampton invested $300,000 of these Federal funds to acquire the Interfaith Cold Weather Emergency Homeless shelter--the only cold weather shelter serving Hampshire County. It is a collaborative effort between area church groups and ServiceNet Inc., a local human service provider. Without these funds, there would be no cold weather shelter in Hampshire County.
Mayor Higgins wrote:
Without CDBG funds, the City will be unable to develop a
planned senior center, public services that provide emergency
food, homeless services, child care and after school
programming, literacy skills and health care would not be
funded; the City's ability to promote and develop affordable
housing will be severely limited, parks and playgrounds will
not be improved, and the City's ability to provide funding
for the redevelopment of the former Northampton State
Hospital will cease.
Mayor Tom Menino of Boston--the former head of the U.S. Conference of Mayors--isn't fooled. He knows what's at stake and recently conducted an analysis of the budget cuts on his city.
Since 1998 alone--
Mayor Menino stated at a recent press conference--
the City of Boston has permitted almost 5,000 new units of
affordable housing and permitted more than 12,000 other
units. We have invested a total of $7.8 million in CDBG funds
in 19 large developments that have created a total of 1,175
apartments including 517 units for the formerly homeless.
He went on to say that this budget for housing, community development, and social services threatens to ``throw the nation into the dark ages.''
That doesn't sound like he believes his community will be ``strengthened'' by the Bush administration's cuts.
Mayor Menino believes the President's budget will mean the loss of $8 million in Community Development Block Grant funding for Boston and the loss of $5.5 million in Community Services Block Grant funding.
On any given night in the City of Boston, there are nearly 6,000 homeless men, women, and children in the city. Shelters in Massachusetts have been overflowing for 6 straight years, with 4 beds available for every 5 adults.
Yet the very support he has relied on to help build 133 units of affordable housing for homeless people, to help 500 low-income homeowners rehabilitate their properties, and to provide 130 first-time homebuyers with their down payments is now in grave danger.
How exactly is the mayor supposed to strengthen Boston when the support he needs to do it is getting the axe under this budget?
Other local officials tell the same story.
A letter I recently received from Elizabeth Cohen, Executive Director of Rape Crises Services of Greater Lowell, says:
Dear Senator Kennedy:
We need your help . . . We use CDBG Funds to support
multilingual sexual assault support services. We are the only
program in the Greater Lowell area and the only agency to
have certified rape crisis counselors who speak Spanish and
Khmer. With the elimination of this funding, we will have to
cut back on these services, which will result in 100 Khmer-
speaking clients being unable to have a counselor in their
language . . .
As you know, immigrants and refugees already have many
struggles when they move to a new city or new country. Having
to deal with the trauma of sexual violence on top of the
difficulties in housing, education, food and school can
paralyze a family . . . Please don't let the President take
away this funding for Lowell.
I ask the Senate, does this sound like we are strengthening communities with this budget?
In Lawrence--one of Massachusetts' and the Nation's poorest cities-- CDBG funds have been used to amazing effect to leverage nearly $110 million of investment in the remedation and redevelopment of an abandoned industrial brownfield site known as the Lawrence Gateway Project.
The city has invested nearly $6 million of its CDBG funds in the project and formed a model partnership with GenCorp, a private company that has invested $75 million so far in the redevelopment.
Today, Lawrence is continuing to use its CDBG funds to meet debt service payments on loans made to clean the properties.
Without these Federal funds, the partnership with GenCorp could not exist, and the City would not be able to do anything about this 15- acre, fenced-in, desolate property, which would stand as a stark reminder of the city's industrial past rather than as a symbol of the kind of innovative development needed to build a stronger future for the city.
How will we be strengthening Lawrence by eliminating one of the best ways they have to create investment partnerships with private businesses?
In addition to the community development block grant, the Sarbanes amendment will also preserve the community services block grant. These funds strengthen communities by funding local agencies, which provide services such as literacy, child health care, after school activities, low-income housing, food stamps, emergency shelter, and other support.
In Worcester, Patsy Lewis of the Worcester Community Action Council sent me a letter on just how devastating the President's plans to eliminate this program are.
Simply put, Patsy wrote, they would have to reduce or close their GED classes and partnerships for at-risk students in the public schools. The agency may even be forced to close.
Perhaps the President can explain how a community can be ``strengthened'' by eliminating GED programs.
Another person who isn't fooled about the effect of the President's devastating ``Strengthening America's
Communities,'' budget cuts is Steve Teasdale, executive director of the Main South Community Development Corporation in Worcester, which is doing incredible work attacking poverty in one of Massachusetts most economically distressed neighborhoods.
The Main South Community Development Corporation was formed in 1986, when concerned citizens came together to revitalize the neighborhood surrounding Clark University, which was reeling from the economic and social devastation wrought by the loss of Worcester's industrial base.
The obstacles in Main South's path are considerable:
Between 1960 and 2000, the population of the neighborhood fell 35 percent from 5,600 to 3,700. The housing stock fell by 29 percent.
Over 40 percent of the population lives below the poverty line--and 17 percent have incomes lower than 50 percent of the poverty level.
At 11.4 percent, unemployment is double the city's rate of 6.3 percent. Over half of neighborhood households are headed by single parents.
The challenges confronting the community are great, and Federal funds made available through the community services block grant, the community development block grant, and HUD's section 108 loan program have been absolutely essential to the extraordinary successes of Main South in recent years.
CDBG funds were used at the outset to match a challenge grant from the Ford Foundation that provided for the creation of the entity, and enabled Main South to attract outside investment. The result is numerous accomplishments for the neighborhood.
Since 1988, Main South has acquired and rehabilitated 246 units of low and moderate income housing--137 of which had been abandoned, and 78 of which were fire-damaged, many from arson. The new homes added $500,000 annually to Worcester's tax rolls.
In addition, as a direct result of Main South's housing rehabilitation, over $20 million of investment has flowed back into the community. Three ongoing private developments represent another $40 million of capital brought into the area.
Because of this Federal support, Main South has been able to be a true partner to Clark University, providing greater educational opportunity to neighborhood families--through a homework center, computer training classes, and career placement services.
In fact, because of the success of the partnership, Clark University lets neighborhood high school students take college classes and provides full tuition to neighborhood students who make the grade academically. This is extraordinary.
All of this has been made possible by the commitment and dedication of concerned community leaders--and the relatively modest sums of Federal support that are in danger with this budget before us.
Now Main South is taking on its greatest project, the Kilby-Gardner- Hammond Neighborhood Project.
This partnership between the Boys and Girls Club, the City, Clark University, and Main South will revitalize 30 acres of distressed industrial property consisting of over 40 vacant, trash-strewn lots.
It aims to transform the neighborhood through the construction of a $7 million new Boys and Girls Club, between 70 to 80 affordable housing units, and a new outdoor track and field complex for Clark University students and neighborhood children alike.
It is a transformative project, with a total investment impact of $30 million, much of that made possible by Section 108 loan guarantees that this budget would eliminate.
Without Section 108, Teasdale and Main South would never have been able to acquire the properties to put this project together. This fact alone should cause us to reject the administration's ``strengthening communities'' proposal--because it will do nothing of the sort.
The question has to be asked, [Teasdale recently wrote] is
what would happen in these neighborhoods if such funding was
severely restricted or cut back. The answer can only be
assumed to be that the current problems in these areas would
get worse as capital investment once again withdraws to safer
havens and the social service needs of the resident
populations are stripped away. Crime, substance abuse, lack
of recreational and educational opportunities for the youth
of these areas and the incidence of poverty can all be
expected to increase if CDBG funding is no longer available.
The long-term social and financial costs associated with
such cut backs would be deeply damaging and although the
immediate impact would be most severely felt in our poorer
urban communities the resulting social distress would
eventually affect everyone.
Steve Teasdale and the leadership of the Main South Community Development Corporation know more about the day-to-day challenges affecting our poorer urban communities and the difficulties associated with urban economic revitalization than any of us, because they live it every day.
I ask my colleagues to consider his words and vote for the Sarbanes amendment, so we can save these critically important poverty prevention and economic development programs.
The Senate has a moral obligation not to make it harder for communities to solve the complicated issues of poverty and community development they face. Without the Sarbanes amendment, that is exactly what the Senate will allow to happen.
Will the Senator yield for a question, and I will give him a minute to answer it? Does this amendment raise taxes to pay for the $15 billion that would be called for to put in this budget, or does it…
Will the Senator yield for a question, and I will give him a minute to answer it?
Does this amendment raise taxes to pay for the $15 billion that would be called for to put in this budget, or does it increase the deficit with more spending?
To reclaim the time, the Senator did not answer the question. Maybe he is not familiar with the answer, but the answer is that this amendment increases the deficit by $15 billion.
Mr. President, I had the great good fortune when I went to college to be taught by one of the historically strongest history professors in our Nation, a man named David Truman. He went on to be president of Mount Holyoke. He wrote probably the definitive treatise on American Government. One chapter in that treatise was dedicated to committees and commissions. He said that the commission is the place where you send issues when you do not want to have to deal with them, when you want to ignore them, when you want to obfuscate the issue, and when you want to basically kick the can down the road.
He was a brilliant professor and usually right, and in this case obviously totally correct.
This amendment, if it is adopted, will guarantee that the issue of Medicaid is not addressed. That is a guarantee in this decade. It does not kick the can down the road, it kicks the can down the road a decade because we will not do reconciliation again for a long time, I suspect. Next year is an election year, and Congresses are not inclined to make tough choices in election years. It has been 10 years since we did the last reconciliation bill, so it is unlikely reconciliation will occur again. And we are not going to pass in this Congress a bill which reforms a significant program on the entitlement side without using reconciliation because the courage simply is not here.
So let's talk about why it is absolutely critical that this year we address the Medicaid issue and why it is not going to impact any children and why all this ``wearing your heart on the sleeve'' language we heard around here is a large amount of puffery.
We had some very disturbing testimony--and I believe that is the term used by the Senator from North Dakota, and it is accurate--from the Comptroller of the Currency as we talked about the liabilities already on the books that our children are going to have to pay because our generation put them on the books. They add up now to $44 trillion. That is ``trillion'' dollars. Mr. President, $44 trillion of liabilities is already on the books.
This chart shows that, $44 trillion. To try to put that in perspective because a trillion dollars is something nobody can understand. If you take all the taxes paid in America since the Revolution, it adds up to $38 trillion. So we have on the books more liabilities today than taxes paid in this country in the history of this country.
In fact, if you take the entire net worth of the United States today, and every American adds up all their net worth--all their houses, all their cars, all their jewelry, whatever they have, stocks, bonds, assets, real estate, it comes to $47 trillion. So we have on the books almost as much obligation as we have net worth.
The practical effect of that is that we are overwhelming the next generation with obligations which they will have to pay. Our children and our grandchildren are going to have to pay the taxes to support that $44 trillion worth of obligations we put on the books. So it is important that we look at from where those obligations come.
They come primarily from what is known as entitlement accounts, specifically three major accounts: Social Security, Medicare, and Medicaid. In fact, the vast majority of them do not come from Social Security, they come from Medicare and Medicaid. Health care represents $27 trillion of that $44 trillion of costs that are on the books that our children are going to have to pay because we have already committed them to do that to support the baby boom generation when it retires.
It is entitlements that are the issue. My colleagues have come forward and said: But we do not have to deal with Social Security, even though the President has been willing to discuss it. We do not have to deal with it, no; stiff arm Social Security. OK, that is off the table.
The President says he just amended the Medicare law, so he does not want to move on Medicare this year. OK, that is off the table.
That leaves one issue, one major program that should be looked at this year at least, and that, of course, is Medicaid.
The other side of the aisle and three speakers this morning have already said you can just address this problem by raising taxes. I note--it does not appear to be anybody has focused on this at all--but the amendment before us does not raise taxes, it raises the deficit. We heard all of yesterday, the day before, and the day before that how the other side of the aisle did not want to raise the deficit; they wanted to be the party that was opposed to deficit spending. Today they come forward and the vast majority of the people sponsoring and supporting the program, the bill before us, which dramatically raises the deficit by $14 billion in the 5-year period, something like $60 billion in the 10-year period.
But even if you accept the fact that they want to raise taxes to pay for it, the issue is, Could you solve this problem, this outyear liability that is caused by all these entitlement accounts, Medicare, Medicaid, and Social Security, by raising taxes?
You cannot do it. This chart shows it so clearly. The cost of Medicare, Medicaid, and Social Security is the red line here. The blue line is the historical amount that the Federal Government spends, 20 percent of GDP. That is what we have historically spent, since World War II, essentially. You can see that the red line crosses the blue line in about the year 2029, 2028, in that period. These three programs--Social Security, Medicare, and Medicaid--will actually cost the Federal Government more than 20 percent of the gross national product.
What does that mean in practical terms? It means you wouldn't be able to spend any money on education, any money on roads, any money on national defense, because the entire Federal Government would be absorbed by paying for these three programs. Or, alternatively, you could take the approach the other side wants to take, which is raise taxes.
If you did that, you would have to double the tax rate on Americans in order to pay for this program. Working Americans, young Americans, these pages who are here today and are going to get a job, would find their ability to have a decent lifestyle would be dramatically reduced because they would have to pay twice as much in taxes as our generation has paid in order to support these Federal programs which are already on the books.
You cannot tax your way out of this. I don't care if you confiscate all the income of the two top brackets, you cannot get this system under control through taxes. You have to address the other side of the ledger, which is spending responsibly on these programs. That is what this bill tries to do. That is what the budget tries to do.
In a most minor way, a minuscule way, almost, we suggest in this budget we want to save $15 billion in the rate of growth--not cuts--in the rate of growth of Medicaid over the next 5 years; $15 billion. You say $15 billion is a lot of money. It is a lot of money, but you have to put it in context. Over the next 5 years, the Medicaid system is going to spend $1.12 trillion--that is trillion with a ``t''--and $15 billion on that amount is 1 percent, essentially. What we are actually trying to save in this bill is $14 billion.
This chart shows it. Medicaid spending will go up dramatically. It will go up by 39 percent. It will not go up by 41 percent. That is what it would do. It would go up by 41 percent if this bill doesn't go into place, but if this bill goes into place, it will go up by 39 percent. A 39-percent rate of growth in this program is what we are planning.
We have heard people come down here, especially the Senator from Oregon, and say if this language passes, lives will be lost. I think he said that. Children will be lost. That is absurd, misleading, inaccurate, and a total gross exaggeration. I wish the Senator had been a Governor because he would know that the Medicaid system today does not benefit children as much as he thinks it does. There is a large chunk of the Medicaid system today which is being gamed out of the system by States and being used in the general operations by the States to build roads, to put police officers on the road--a large chunk of it. That could be saved.
There is a large chunk of the Medicaid system today which is going to pharmaceuticals to pay dramatically more than what we pay under any other program for pharmaceutical products. That could be saved.
There is a large chunk of the Medicaid system today which is going to people who are gaming the system by what is known as spending down. That is when you, in a rather fraudulent way, get rid of your assets-- give them to your kids or give them to somebody else in your family so that you can then come to the Government and say, Support me in a nursing home. So all the other Americans in this country who are playing by the rules end up supporting people who are breaking the rules and who are gaming the system through spending down. Huge amounts of dollars are pouring out of the system under those accounts.
A lot of money is being lost in this system simply because it is inefficiently run, because the Governors do not have the flexibility they need in order to get more service because they know how to deliver it, but instead they are hamstrung by all sorts of rules and regulations which make no sense to them and which undermine their capacity to deliver the service efficiently.
The President and innumerable Governors, responsible Governors in this country, have come forward and said you give more flexibility to the Governors and they can take a little less rate of increase in spending and deliver much more service to many more kids. So this concept that you cannot get to this 1-percent savings, that you cannot live on a 39-percent rate of growth in Medicaid without having children lose their lives and be not able to go to the emergency room for care, is scare tactics. Not only that, it is not right. Because if you cannot step up--especially as a Republican who supposedly is committed to fiscal responsibility, because that is what our party is supposed to be committed to--and say that you can deliver better service with more flexibility, then you are probably not a very good Governor. I doubt there are any Republican Governors, at least, and I suspect there are not a lot of Democratic Governors who don't believe they can do more with a lot more flexibility.
The President has listed seven or eight--actually, Governor Leavitt has--seven or eight different proposals, none of which impact services one iota and, in fact, some of which would significantly expand services to children, which could be accomplished if we reform the program and would slow the rate of growth in this program along the lines projected here.
So it is unconscionable that people would claim a $14 billion reduction in the rate of growth when you are having a $1.1 trillion expenditure, a reduction which represents 1 percent over 5 years, could not be accomplished in the context of a program where there are obviously so many problems which need to be addressed and which could deliver more efficient and more effective service.
It gets back to this point, of course. If we do not do this now, we are not going to do it. This is not an amendment to set up a commission, the purpose of which is to resolve the problem. This is an amendment to set up a commission to make sure the problem is never resolved. It is irresponsible because of that.
I do think it is important to note how this budget has been structured. A lot of people say this Federal budget is pretty meaningless and it is sort of a process we go through here. Of course, 2 out of the last 4 years we didn't even have one. To some degree they are correct, I regret to say.
We have in this budget three basic elements: discretionary spending, entitlement spending, and the other is taxes. On the discretionary side we set a discretionary cap. We have already seen 24 amendments or so offered on the floor that will affect that cap--in other words, Members not willing to accept the spending levels of this budget. They have to put money into this program or that program. We have another hundred or so amendments also pending which do exactly the same. So the willingness to discipline the discretionary side of the ledger is, to say the least, tepid. One would suspect there are going to be a lot of games played with that cap even if it gets into place before we get to the appropriations
process. But it does, hopefully, limit the rate of growth and it does have some impact. But regrettably I have to admit it is at the margin.
Then there is a tax side. Most of the taxes, in this budget at least, are taxes which most people are going to vote for. That point was made yesterday--whether there are reconciliation instructions, most of these tax cuts are going to be extended. They are very popular: R&D, spousal stuff, tuition tax stuff.
No, the essence of this budget is whether we are going to address the fastest growing function of the Federal Government, the function of the Federal Government which is going to bankrupt our children and give them much less of a quality of life than we have had; whether our generation, the baby boom generation, which is now the generation that governs, is going to be willing to stand up and admit that we put too much on the books for our children to bear. That is the essence of this amendment. This amendment knocks out the only significant effort--well, there is one other dealing with the PBGC--the only significant effort to bring under control the rate of growth in the Federal Government in the outyears; the major piece of fiscal discipline.
In the short term you can argue the discretionary caps may help. But in the long term, which is where our big problem is and where we all acknowledge it to be, the only thing that is going to address that is if we reconcile the Medicaid number. If we do not do it this year, it is not going to be done. That is why I find this amendment to be so pernicious, because it is put forward as if the people who support it are for fiscal discipline when in fact its practical implication is to gut the only thing in this budget which actually will generate fiscal discipline. And it is being done by Republicans. You have to ask yourself how they get up in the morning and look in the mirror.
In any event, that is where we stand. I am not going to deny that this isn't a crucial vote. This is a crucial vote. If the Medicaid language is passed, if it is knocked out of the bill, I think I put in context the effect it has on this budget. More important, I hope I have put in context the effect it is going to have on our kids and our grandkids, because we will have said that in none of the three areas where the explosive growth is occurring--in none of these three areas where we are headed to this disaster, where our children are not going to be able to afford the costs that we have stuck them with--that in none of these three areas is this Congress willing to act. That would be more than an unfortunate event.
I reserve the remainder of my time.
Do I have any time?
Mr. President, I reserve that time and yield the floor. I yield the remainder of the time on my side to the Senator from Mississippi.
I appreciate the appropriate comments of the Senator from Mississippi.
Madam President, I send an amendment to the desk.
Madam President, I ask unanimous consent that reading of the amendment be dispensed with.
I yield back such time as I have.
Madam President, what is the time?
Madam President, this amendment increases spending by $2.5 billion, exceeding the cap, and it increases taxes by the same amount of money. It is a tax-and-spend amendment. Therefore, I would oppose it. There are a lot of other reasons I would oppose it, but I wanted to give the Senator from Missouri an opportunity to say a couple of words on something else.
I yield to the Senator from Missouri, and I yield the remainder of my time on this amendment.
What is the time situation on Senator Sarbanes' amendment?
We do not have any time on this side.
We yield back.
Show 8 more
Mr. President, will the Senator yield for a question on that chart? As I understand it, the President's budget, and this budget resolution, do not provide anything for the long-term costs of Iraq,…
Mr. President, will the Senator yield for a question on that chart?
As I understand it, the President's budget, and this budget resolution, do not provide anything for the long-term costs of Iraq, Afghanistan, and the continuing war on terror?
So the budget is not really presenting a true picture of what we can anticipate in terms of expenditures; is that correct?
Are there other items they have left out besides the costs of Iraq and Afghanistan?
What would the deficits be if all of these things are included?
Would the Senator yield for a question?
When did the President make that statement?
Grievously wrong. I gather we will probably see the true picture of what has happened over the succeeding 4 years, but we continue to run these deficits and we are getting deeper into debt all the time. Is that not correct?
If the debt keeps running up, then the carrying charge on the debt goes up every year. So more and more of the annual budget is consumed in order to pay the interest charge on the debt that was built up because deficits have been run before, is that correct?
Mr. President, that is the question I wanted to put to my colleague.
As I understand what is happening, we are becoming increasingly dependent economically on countries abroad. We are losing control over our own economic destiny.
They say, well, they are still willing to lend us this money. That may be, but in the course of doing it, we become more and more dependent upon them. They can continue to give us the money, we get deeper and deeper into the hole, which then raises the prospect that if they shift their policy, we can take a very serious hit. There is no commentator I have read who believes we can continue on this path indefinitely. At some time there will be a reckoning.
What has happened is the United States has become dependent on the kindness of strangers. We say we are No. 1, that we have the world's strongest economy. Yet we are in hock to everyone around the world.
The Senator showed the figures of the holdings of other countries. The China figures, which are still well short of Japan, are going up on an ascending trend that is almost breathtaking in terms of how much deeper we get into hock.
I ask the Senator, not only does that have serious economic implications, but doesn't it also reduce our ability to deal on important political and security issues when we are this indebted and this dependent on others in economic terms? They are in a position to give a real jolt to our economy if they choose to do so, which then, it seems to me, restricts our ability to deal on a whole range of other issues we may have with one or another of these countries.
Will the ranking member yield on that point?
Would the Senator agree with me that is an outrageous departure from the traditional practice in terms of how conference committees ought to operate? Traditionally, conference committees have met, both parties have been included in the conference committee, debate has taken place, issues have been raised, and decisions made. The majority may be able to impose their decisions because that is how it gets decided, but there is an opportunity to try to shape the debate and have an influence on what is decided.
In this instance, the Democratic members of the conference committee were completely excluded, except for one show-and-tell meeting that was held, a pro forma meeting.
Yes. Which had to be done; otherwise, presumably, it never would have happened. All these decisions were made by--and only by--the Republican members of the conference committee from the House and the Senate.
Now, it is an abuse of power, in my opinion. It is another reflection of an arrogance of power in terms of how the institution ought to operate. I think it is very important to register the point that this is what transpired. The American people need to understand that this budget resolution was not the consequence of a give-and-take in the normal legislative way. This was done by the majority simply imposing their will.
Will the Senator yield for a question?
As this wall of debt is built up, I want to come back again to the carrying cost on that debt. It has to be understood, in each annual budget, there is going to be a larger and larger amount to cover the interest charge on this expanding debt that is being built up year to year. Furthermore, if we run a risk that other countries are not going to want to hold our paper, as they are doing, we are probably going to have to raise our interest rates. In fact, interest rates are already on the way up, in any event. If you have to raise them even more, to get others to continue to hold our paper, the carrying charge is going to go up.
So the carrying charge is going to go up because the debt is going up, and it is also going to go up because the interest rates will be going up. So there will be a double blow dealt to the American economy, and a bigger and bigger chunk of each year's budget will be eaten up in paying the interest charges on this enormous debt. Isn't that correct?
Will the Senator yield?
The number of people in this country who earn over $200,000 a year is less than 1 percent of all taxpayers, is it not?
It is a tiny group. So this tiny group under this chart will be receiving the overwhelming proportion of this tax cut that is included in this budget resolution.
Is the $32 billion--the cost of the tax cut that goes to those making over a million dollars, is that just for 1 year?
So, presumably, in the following year it will cost another $32 billion?
That gives you a clear picture of what the priorities are in this budget. The priorities are to give $32 billion in tax cuts to millionaires, and yet to cut the education programs to almost below what they were in 2005; is that correct?
Mr. President, will the Senator yield for a final question?
The Senator has spoken in a very articulate way about fiscal responsibility. My own understanding is, looking back at history, when we have gone to war, as the President took us to war in Iraq, we have usually raised taxes to help cover the cost of the war or at least cover part of the cost of the war in an effort to be fiscally responsible.
In this administration, we went to war and, if I am not mistaken, at the same time the administration was pushing for tax cuts. So we were again being hit doubly. The cost of the war was being imposed on the budget affecting our deficit and debt situation, and at the same time they were seeking tax cuts--in other words, diminishing revenues--which also affected negatively our deficit and debt situation, and that is contrary to fiscal responsibility and contrary to what has happened in previous war engagements; is that not correct?
Would the Senator yield the floor?
Wasn't the money in order not to do this to education contained in the Senator's amendment coming from closing corporate tax loopholes that had previously been passed by an overwhelming majority in this Senate?
Isn't it a dramatic demonstration of a choice in priorities, that rather than choosing to fund education, to give young people these opportunities which have been paid for, what they now say is, we had to cut the programs because we have a deficit problem?
The very able Senator from Massachusetts took that into consideration when he proposed his amendment because he wasn't going to add to the deficit. He was going to cover the costs of the amendment by closing these egregious loopholes in corporate taxes. They came along and cut the education programs and allowed the egregious tax loopholes to continue. It is a dramatic demonstration of the priorities of this Republican budget.
Absolutely. And the Senator from Massachusetts has been sounding this clarion call. I make reference to the chart the Senator showed earlier, which shows what is happening in terms of our young people going into math and science and engineering as a percent of the 24-year-olds who could go into those fields to develop that kind of competence which we need in the so-called global economy.
Now, as I understand this chart, in 1975, the United States was third in the world, as shown over on the left side of the chart; is that correct?
In 1975, we were third in the world; is that correct?
We are talking now about math, science, and engineering. Everyone talks about technology, the competition we are engaged in, and so forth. How do you compete in that world if you do not train the people and have the professionals with the skills to do it? We went from being third in the world as to the percentage of our young people going into math, science, and engineering, to where now, as of the year 2000, we are 15th in the world, as I read over on the right side of that chart.
We have slipped all the way back; there are 14 countries ahead of us worldwide in terms of the people they are putting into math, science, and engineering.
Will the Senator yield on that point?
I want to make sure I understand the Senator on this very point. As I understand it, the tax loopholes, or at least some of the tax loopholes the Senator was closing in order to be able to fund education, were incentives or inducements in the Tax Code to encourage American corporations to move their investment and operations out of the United States and send them overseas. Is that correct?
Mr. President, I commend my very able colleague from
Massachusetts for a very powerful statement about the priorities in this budget. He is absolutely right.
The budget resolution is the single most important document we deal with in the Congress because it contains within it thousands of decisions that are critical to our national life, all of which reflect our choices about priorities.
As the Senator pointed out, this budget resolution makes it a priority to keep tax loopholes for large corporations, many of which induce them to send jobs overseas, rather than closing those loopholes--which have been overwhelmingly supported by the Senate, both Republicans and Democrats--in order to fund education. It is a clear example of the wrong set of priorities. I thank the Senator, first for his leadership in the Senate which got that amendment adopted, which would have done something for education in this country, and for articulating so well what is at stake here as we move ahead.
The budget presents very fundamental questions to us. What do we establish as priorities? Which programs are important? How do we balance programs with tax cuts, with deficit reduction? In my view, this budget does not reflect the right answers. It contains substantial cuts in a number of important domestic programs, including Medicaid, education, affordable housing--the list goes on and on.
The justification for these cuts is that we have a deficit problem to deal with. If you ask, why are you cutting these programs which we so desperately need, the answer that is given is: Well, we have a big deficit.
But the question that needs to be asked and understood is: Where did this deficit come from to begin with? When President Bush came into office in 2001, he inherited a surplus in the Federal budget. The projection was that we would run a $5.6 trillion surplus over the next 10-year period. Those were the projections.
In his first budget proposal, which included, in my view, an excessive tax cut, primarily for those at the top of the income scale, he said: We can proceed with tax relief without fear of budget deficits. That is what the President said: We can proceed with tax relief without fear of budget deficits.
The following year, with the budget already in deficit, having moved from surplus to deficit, the President advocated for another tax cut while promising, and I quote him:
Our budget will run a deficit that will be small and short-
term.
In fact, the President's budget that year stated that deficits would be so short-term that by today, by now, the Government would be back in surplus. How wrong he was.
Instead of the $5.6 trillion 10-year surplus projected when the President took office, the projections now are for a deficit over the same period of $3.7 trillion. When you factor in, as my able colleague from North Dakota stated earlier in the debate, some of the costs we know are coming, such as the continuing cost of the war in Iraq, the cost of reforming the alternative minimum tax, the cost of some of the President's proposals to make tax cuts permanent, that is a deterioration in our fiscal position of over $9 trillion.
There are a number of reasons for this fiscal reversal. Spending to recover from the attacks of September 11, to pay for operations in Iraq and Afghanistan have played a part. But the deficits are not primarily the result of increased spending by the Congress. By far the greatest factor contributing to the return of deficits and these disastrous projections is on the revenue side, and the primary reason on the revenue side is the President's tax cuts.
We are now living with the consequence of those tax cuts: deficits and debt as far as the eye can see. The architects of this budget claim that to deal with these deficits, we must have serious cuts in domestic programs. At the same time these serious cuts in education, health care, and housing are being made, this budget resolution contains billions of dollars in additional tax cuts for the wealthiest Americans. In fact, as my able colleague from North Dakota, Senator Conrad, pointed out, in 2006 alone, the President's tax cuts are scheduled to give $32 billion to those making over $1 million a year. So for millionaires, there is going to be $32 billion in tax cuts in 2006.
The New York Times, in an editorial earlier this week, recognized that this budget is skewed toward the wealthy. Let me quote from that editorial:
Congress is likely to approve a budget blueprint this week
that manages to be profligate and mean-spirited at the same
time. . . . It calls for generous tax cuts for investors, who
hardly need more help, and for harsh spending cuts for the
needy, who certainly do.
The Times hoped there would be pressure on the drafters of this budget sufficient to ``inject some common sense and human kindness into the process.''
Regrettably, that appears to have been a vain hope. This budget resolution contains $70 billion in tax cuts that are given fast-track procedural protection at the same time there are very deep cuts in a number of domestic programs.
There are those who seek to defend the spending cuts by saying that they are necessary in order to rein in the deficit. I want to say to them that these cuts are not about reducing the deficit; these cuts are about making room for tax breaks for wealthy people.
As the Washington Post reported, ``the cost of those tax cut extensions would more than nullify the savings from the spending cuts.'' Let me repeat that. ``The cost of those tax cut extensions would more than nullify the savings from the spending cuts.''
There are Medicaid cuts--so important to providing health care for our people--and education cuts, which set us back in the effort to fund our schools and undertake educational initiatives, which may well be the best investment America can make in its future strength.
We are failing to face up to the global competition in which we find ourselves, and we are making choices in this budget that are directly contrary to strengthening our economy and strengthening our Nation. Make no mistake about it, the argument that is made that we must cut these programs that are so essential to our people in order to address the deficit misses entirely the point that room is being made in this budget for further tax cuts for very wealthy people.
So the choice of priorities is the tax cuts on the one hand--more tax cuts, excessive tax cuts, for the very top of the income scale on the one hand--and cutting back on education and health care, the environment, and housing. As the Post pointed out and I quoted, the cost of those tax cut extensions would more than nullify the savings from the spending cuts.
These are the wrong priorities, the wrong choices. I urge my colleagues to vote against this disastrous budget resolution.
I yield the floor.
Madam President, I have an amendment I send to the desk for immediate consideration. I ask unanimous consent that the reading of the amendment be dispensed with. Madam President, let me express my…
Madam President, I have an amendment I send to the desk for immediate consideration.
I ask unanimous consent that the reading of the amendment be dispensed with.
Madam President, let me express my thanks to my colleague from Maryland, Senator Sarbanes, for his work on this issue and for his leadership in the Senate. We serve together on the Foreign Relations Committee. It is a great honor. He brings great compassion, great respect, great dignity to the committee, to the institution, and his service is greatly appreciated. It is my honor as a relatively new Senator to be working on an issue that is so important to him as it is to me and to the folks I represent, both as a Senator from Minnesota, but as I represented as mayor in the city of St. Paul.
My amendment is simple. It says no cuts to the Community Development Block Grant Program. It says no moving CDBG, no to program changes that limit CDBG's effectiveness.
I share the President's goal of reducing the deficit and bringing fiscal accountability to Washington. But like so many things in Washington, the devil is in the details. In the case of CDBG, the details in the budget need to be reworked quite a bit.
I have a simple philosophy: Don't kill those things that build the economy and help cut deficits. I strongly supported tax cuts that create investment and grow jobs. CDBG grows jobs. Community development block grants grow communities.
When I talk to the folks back in Minnesota, whether they are city administrators or mayors or county commissioners, they all say the same thing: The Community Development Block Grant Program is the lifeblood of community development. That is why I am offering this amendment to fully fund CDBG along with the Community Service Block Grant Program, the Brownfield Redevelopment Program, and the Rural Housing and Economic Development Program, to name a few. These are things that work. Let's change and reshape things that do not work. But when you go home and folks say across the board--big town, small town, urban, rural--that it works, work with it.
CDBG was enacted in 1974 and has been assisting America's communities for 30 years. It is a program that helps State and local government tap their most serious community development challenges, including infrastructure, housing, and economic development. Over the first 25 years, it has created 2 million jobs and contributed in excess of $129 billion to the Nation's gross domestic product.
CDBG and public-private partnerships are the cornerstone of the economic revitalization across the country and in many of our cities in recent years. They have provided the tools to provide economic opportunity and hold jobs.
When you deal with the budget, there is a question of fiscal responsibility. Does the program work? Fair question. Is it cost effective? Fair question. What does it achieve?
I know CDBG works because when I was mayor, before coming to Washington, I worked with it. In coming here, my hope was to be Minnesota's mayor in Washington. I always take pride in the fact that a mayor's focus is on getting things done. They are at the bottom of the political food chain but really responsive. That was the bottom line. It was getting things done. If streets were unplowed in the city of St. Paul, I heard about it. So as a former mayor I know something about fiscal responsibility, about having to reduce needless bureaucracy, about turning deficits into surpluses, and setting money aside for a rainy day, all while submitting budgets that contained no tax increases in 8 years. Part of my ability to do that was the growth I saw in my communities and the public-private partnerships that CDBG created and shaped and was a part of. Community centers and crime prevention, affordable housing, and business and economic development--the heart and soul of Federal help to our cities.
The Presiding Officer serves the great State of Alaska, which has challenges. They are not awash in a surplus of cash. The Presiding Officer understands, as I understand, we have to support those things that grow our communities.
The fact is, jobs in St. Paul's economy have not grown without CDBG. We used CDBG to revitalize neighborhoods, and it is through this effort we were successful.
I can personally testify that dollar for dollar there is no better initiative to help States and localities renew and rebuild our cities and create economic growth and jobs than the Community Development Block Grant Program.
As Minnesota's mayor in Washington, I still believe that Government is beholden to the people; that individuals, with the help of their local representatives, can plan their lives better than bureaucrats in some distant capital.
That is what I like, and the idea behind CDBG, a very conservative idea that we should not have 1,500 command and control programs rush out of Washington trying to micromanage the needs of communities. Instead, we should help communities meet those needs and priorities through one block grant. With all the unfunded mandates coming from Washington, CDBG is a way we help communities across the country meet some very critical priorities. CDBG is a fiscally responsible program that exponentially produces more than it costs and is a truly conservative initiative enabling local leaders to meet local needs.
CDBG works. Last year, the Office of Management and Budget celebrated CDBG under the theme ``performance counts.'' Since then, the Office of Management and Budget may have changed its mind, but America hasn't.
Let me state what CDBG means to my home State in Minnesota. When I became mayor of St. Paul, we got businesses and jobs growing. But not all St. Paul was benefiting from the turnaround. An area around Ames Lake on the east side of St. Paul, one of my toughest neighborhoods, needed help, needed growth. They could not take part in the surrounding economic boom because the buildings were in total disrepair and businesses were looking to move out, not move in. It would have been an impossible situation if not for CDBG. But thanks to CDBG, we were able to leverage Federal funds to attract millions of private dollars to improve infrastructure and replace the blight of city sprawl with green space, and build a community center to keep kids off the street.
I was at the League of City meetings the other day and talking to the member who represents the east side of St. Paul. In that community, they had a shopping center that was blighted, with nothing there. Reeds grew up through the concrete. We figured out the Good Lord was saying there was a wetland in the heart of the city. We got rid of the shopping center, got rid of the concrete, and created wetlands. Now he is telling me we have housing in the worst areas of St. Paul; the most blighted areas are growing and prospering. Again, CDBG was an important part of it.
In other words, thanks to CDBG, Ames Lake is now moving in the right direction. St. Paul is located within Ramsey County. And like all counties with a big city, Ramsey County struggles with sort of a split identity. On one hand, it has suburbs that are doing well compared to parts of the big city. Within the city is land intense with industrial projects such as car parks and truck sites that big cities need. Now these projects are great to have when they are up and running, but when they shut down, they are so large they take whole communities with them that is happened with the Glendenning Truck site.
It was in bad condition, and local officials knew something had to be done about it. Using CDBG, they were able to replace a dilapidated truck site with thriving businesses and jobs.
Ramsey County also used CDBG to transform the Vadnais Highlands apartment complex into safe, attractive and affordable housing.
I give another example of how community development becomes economic development. There is a town of 502 people in Minnesota called Brewster. In 1997, Brewster was awarded a one time community development block grant. This grant allowed Brewster to renew and rejuvenate its infrastructure by tearing down its dilapidated structures and replacing them with 40 homes. As a result of this investment, when Minnesota Soybean Processors was looking for a new home, there was no better place than Brewster.
The relocation of Minnesota Soybean Processors immediately created 40 jobs. In fact, that CDBG grant is still creating jobs as Minnesota Soybean Processors are now opening a biodiesel division which will employ 10 more people.
In another example, the city of Rochester, MN, used CDBG to fund the Aldrich Memorial Nursery School, providing pre-school kids with a safe place to be while mom and dad are working.
The city of Minneapolis uses CDBG to improve housing, stimulate job growth, improve public infrastructure, provide public health services, and school readiness programs.
A reduction in CDBG could hinder the city's current efforts to help 200 moms and dads to find jobs; efforts to develop 150 multifamily homes; efforts to acquire and demolish 110 vacant and boarded up houses; efforts to provide capital improvements to child care facilities, and efforts to reduce lead hazards in 70 homes and provide youth employment training to 300 kids. That is a lot of bang for the buck.
Minneapolis is a big city, but community development block grants are just as important to our rural communities. As you may know, America's rural communities often lack the resources to improve their infrastructure and housing.
The town of Detroit Lakes is located in Becker County, MN, and has about 7,500 residents. It is the heart of Lake Country in the land of 10,000 lakes. If you have not visited there, you should. Spend some money there while enjoying the lakes. The beach is right in town. At 119 Pioneer Street is the Graystone Hotel.
Built in 1916 to accommodate the region's growing tourism industry, the Graystone Hotel had since fallen on hard times. Its once grand exterior had degenerated into an unsightly mess, and its rooms all but abandoned. In short, what was once one of Detroit Lakes' flagship buildings, was now its biggest detraction.
Using CDBG along with private funding, the Graystone Hotel now includes 41 residential units and a variety of businesses and nonprofit enterprises ranging from Lakeland Medical Health Center to Godfather's Pizza.
St. Louis County, which is located in northern Minnesota and is one of the more rural areas in Minnesota, has also used CDBG. Since 1993, CDBG has helped create 560 jobs in St. Louis County; it has provided 2,900 residents of St. Louis County with business training resulting in 159 new start-up businesses; 450 homes were improved through local housing rehabilitation programs in the county.
Hundreds of first-time home buyers participated in a first-time home buyer program, resulting in the purchase of 600 single family homes.
In St. Louis County, CDBG also helps fund community soup kitchens, emergency shelters, child daycare projects, programs combating domestic violence, and a number of infrastructure improvements such as the water treatment facility in Aurora. St. Louis County has been able to leverage $5 in private dollars for every dollar they received through the CDBG program.
CDBG works, but don't take my word for it, just 1 ask the folks in Detroit Lakes, St. Paul, or St. Louis County.
I was pleased to work with Senator Patrick Leahy in leading a bipartisan coalition of 57 Senators in sending a message to the Senate Budget Committee signifying our strong commitment to CDBG and reminding folks that cities from Montpelier to Minneapolis need CDBG to create economic opportunity and to grow jobs.
I also ask unanimous consent to have printed in the Record a letter of support for the community development block grant program from the U.S. Conference of Mayors, the National Governors Association, the National Community Development Association, National Association of Counties, the National League of Cities, the Council of State Community Development Agencies, the Local Initiatives Support Corporation, the Enterprise Foundation, the National Association of Housing and Redevelopment Officials, the National Association of Local Housing Finance Agencies, the National Council of State Housing Agencies, and the National Congress for Community Economic Development.
I urge my colleagues to adopt my amendment and show their support for these community leaders by fully funding the community development block grant program, keeping it at HUD, and rejecting any harmful changes.
Mr. President, I first compliment the chairman of the committee, Senator Gregg, for his outstanding work in getting a budget before the Senate because that didn't happen last year. I am so glad we…
Mr. President, I first compliment the chairman of the committee, Senator Gregg, for his outstanding work in getting a budget before the Senate because that didn't happen last year. I am so glad we have a budget because it is discipline for the Congress, and anybody knows, when it comes to spending money, Congress needs discipline. So I urge my colleagues to support this conference report.
Of course, a budget resolution is more or less a blueprint. It sets the overall level of spending and also for revenue of the Federal Government. The budget itself does not change any law. As I said, it is a blueprint, ground rules, for all of the other spending and revenue legislation that will be considered in the Senate yet this year.
Under the Senate rules, any bill that exceeds the level set in the budget may be subject to a point of order that would require a 60-vote supermajority. That is where the discipline comes--when people want to spend more money without raising taxes or taking the money from some other program, then they would be beyond the budget, and consequently a point of order could be raised. It is very difficult to get a 60-vote supermajority in this body. Consequently, it keeps spending within the budget. So it is budget discipline that Congress needs.
By imposing the supermajority requirement, the budget encourages the Senate to stay within these overall limits that are in the document we are going to vote on tonight, while at the
same time providing the opportunity to exceed those limits if a supermajority can be gotten. And when there are extenuating circumstances, you have to assume extenuating circumstances get that sort of a vote in the Senate.
The annual budget process is often the subject of much controversy, as I think you can tell from the debate tonight. I want to take a moment and focus on a number of specific provisions as they relate to the committee that I chair, the Senate Finance Committee, which has the responsibility for all of the legislation that affects Medicaid and Medicare, as well as everything dealing with the raising of taxes or the decreasing of taxes involved with the income tax code.
The budget resolution conference report provides reconciliation instruction--in other words, mandating that the Finance Committee, like it mandates other committees to do similar things in their jurisdiction, to achieve $10 billion in program savings and $70 billion in tax relief.
While these instructions do not actually require the Finance Committee to enact any specific policy--that is our option how we meet these goals--there are a number of policies that are assumed and I think realistic within the numbers that are provided in the budget resolution.
The budget provides for $10 billion in savings from the Finance Committee, and I surely and confidently commit the Finance Committee to make every effort to work in a bipartisan fashion where we keep in mind principles that guide us in producing a better Medicaid Program.
The Finance Committee will look at proposed savings that will be shared equally--I should not say equally but shared proportionately between the Federal Government and the States because the Medicaid Program is a Federal-State partnership.
States are in trouble. We want to help them. We want to emphasize flexibility for the States through voluntary options that States can exercise to get more bang for the Medicaid dollar and even save money in the process, maybe in some instances, through flexibility, even serving a larger population than they now serve but with a more efficient expenditure of that money. The Finance Committee will do this while making a commitment not to eliminate coverage for Medicaid beneficiaries.
I look forward to taking action to improve Medicaid. Doing nothing is far worse for Medicaid. If we do not eliminate wasteful practices, if we do not provide States with this necessary flexibility, if we do not provide States the relief they are asking for, they are simply going to cut whole groups of people off the rolls to make their budget ends meet within their State legislative prerogative.
I recall reading in the paper a couple of months ago, I think it was the State of Mississippi found itself in a position where it could not afford everything the Federal Government mandated on Medicaid, and they just dropped 55,000 people from the rolls. They should not have to do that, they do not want to do that, and we can help them not to do that by giving more flexibility to the States.
That is why I say doing nothing is far worse for Medicaid beneficiaries than what we are going to attempt to do in the next few months through this reconciliation instruction to provide a rational, reasoned approach to protecting and strengthening the Medicaid Program. That is what we will do in meeting our instructions.
I am going to leave Medicaid now and go to the tax relief portions in this budget and comment on two aspects: The amount of relief for the budget period--that is the next 5 years--and the use of reconciliation to bring about the tax relief that a majority of this Senate is going to say we need.
Before I start with the numbers, I want to put in context the revenue side of the budget. Some have argued, and particularly we have heard this even tonight, that bipartisan tax relief has gutted the revenue base permanently, and that is hogwash. They argue that this change is a reason to raise taxes. People want to raise taxes, can you believe that, Mr. President, instead of not extending the tax relief that was voted in 2001, 2003, and I guess some in 2004?
The facts, according to the Congressional Budget Office--and remember, they work for everybody, Republicans and Democrats; they are not Republican or Democrat, they are professionals. Their statistics show otherwise.
I want to put a chart up and have my colleagues concentrate on Congressional Budget Office data, and this covers the period of time from 1960 to 2015, so we get a historical response to people who are saying we have permanently gutted the tax base.
This chart shows the volatility of revenue and its relationship to economic performance. When we suffer economically--and that is the green line on the chart--as related to the ups and downs in the growth of the economy, the gross domestic product, it shows that we suffered economically. You can see the red lines going up and down being revenue coming into the Federal Treasury in relationship to the growth or the sinking of the economy over this historical period of time. Then we also see when the economy grows, revenues go up. When the economy sinks, obviously, revenue coming into the Federal Government goes down.
We have heard so much about what this administration has done to the revenue base of the country. What we see in the first 4 years of the Bush administration--so you have to look at the years 2001 to 2005--you will remember we inherited a recession. I hope people on the other side of the aisle realize that the NASDAQ lost 50 percent of its value in the year 2000. I hope people remember that this economy started in a recession 3 months before President Bush was ever sworn in for the first time. So the bubble broke. We had those corporate scandals that date back to the midnineties becoming public in the year 2001. And then we can see from the chart that the uptick in the economy started late in the Bush administration and continues today.
The Congressional Budget Office shows, as we can see, revenue is coming back. So let's not confuse cause and effect. The tax reduction we voted on in 2001 and 2003 has helped the economy recover and the Federal Treasury is benefiting. So we have to look at what is projected out, starting this year and into the future.
We see the economy fairly stable for the next few years, and we see the revenue base high above the growth of the economy. So let's be clear, undertaxation of the American people is not the source of our budget problems. And all the people over here who think we ought to raise taxes, I wonder when they have their town meetings how many people in their town meetings say: I am undertaxed; I want to pay more taxes. I do not have people coming to my town meeting saying that. I think what the American people are saying is that Congress overspends, and this budget is all about discipline in spending. Undertaxation, I hope my colleagues understand over there, is not the source of our problems.
Now, let's start with a basic number. When the Senate Budget Committee considered the resolution a few weeks ago, Republicans laid out our plan for reconciled tax relief. This plan was a product of discussion with members of the Republican caucus, just like I presume the Democrats have discussions about tax policy among their people.
Our objective now is to preserve current law, levels of tax relief that were voted in 2001 and 2003, and anybody who says you should eliminate the tax cuts of 2001 and 2003, they are not saying eliminate the tax cuts, they are saying raise your taxes. That is what they are saying.
Our plan centers on a seamless extension of tax relief provisions that began in 2001. It is critical that these provisions be rationalized in a commonsense way. Assuring taxpayers of the continuity of promised tax benefits should be one of our highest priorities.
Taxpayers should not face a reversal of the level of tax relief we have delivered. Certainty of tax policy is absolutely necessary for economic growth, and economic growth is absolutely necessary for creating jobs. This objective is critical with respect to the widely applicable provisions dealing with capital gains and dividends, small business expensing, low-income savings, the alternative minimum tax, and college tuition deductibility.
Do those people over there who say we ought to eliminate the tax cuts of
2001 and 2003 think we ought to eliminate the college tuition deductibility? I do not think so. But that is where they would take us. Millions of taxpayers from all walks of life have come to rely upon these tax relief provisions, and they are going to expire if we do not do something about it. They are going to get an automatic tax increase without even a vote of Congress if we do not do something. We should have guts enough to vote for tax increases if we want to, not just sit idly by and let taxes go up.
Some on the other side have been critical of the $70 billion in reconciled tax relief that is in this budget resolution, as was Social Security reform. At my hearing this week we heard a lot of complaining about so-called Social Security reform, but we do not get a lot of answers from the other side on Social Security or on taxes. We do not get problem solving. We do not get any constructive dialogue.
Where is the Democratic plan for tax relief? Has anyone seen it? All we hear are criticisms. How many times have we heard about AMT? Answer: We have heard we ought to be doing something about AMT plenty of times. There is an AMT problem. I have a couple of charts that tell the story. I would like to have my colleagues look at the baseline.
I ask unanimous consent for an additional 5 minutes.
Mr. President, Senator Smith and I have worked together successfully on several issues within the last year to defend and improve our Nation's health care safety, including on an amendment to the…
Mr. President, Senator Smith and I have worked together successfully on several issues within the last year to defend and improve our Nation's health care safety, including on an amendment to the Medicare prescription drug bill addressing community health center payments within Medicare that passed by a vote of 94-1. However, none of these initiatives have been more important than the legislation that we are introducing together today, along with a list of 13 other senators--7 Republicans, 5 Democrats, and 1 Independent, 7 of which serve on the Senate Finance Committee--to create a Bipartisan Commission on Medicaid.
Joining Senator Smith and I as original cosponsors are: Senators Snowe, Jeffords, Santorum, Kerry, DeWine, Durbin, Chafee, Lincoln, Collins, Nelson of Nebraska, Voinovich, Corzine, and Coleman.
I will not go into the specifics of the legislation, as Senator Smith has explained how the Commission would be formed and would operate. Instead, I will take the time to explain why it is that the formation of commission is so important.
Medicaid is a critically important health care safety net program that provides health care services to over 50 million low-income children, pregnant women, seniors, and people with disabilities.
In New Mexico, Medicaid is the single largest payor for health care. All told, Medicaid covers the health care costs of more than 400,000 New Mexicans--nearly one-quarter of our State's population.
Although the least expensive to cover, those who benefit most from Medicaid are nearly 300,000 of New Mexico's children. Of the various populations covered, children represent almost two-thirds of all our State's beneficiaries, which is the highest ratio in the Nation according to data from the Kaiser Family Foundation.
However, Medicaid is much more than just a safety net program for children from low-income families. It also serves low-income adults and pregnant women. It also serves senior citizens and people with disabilities who receive the bulk of their health care through Medicare but who still rely on Medicaid for a substantial share of their benefits and cost-sharing assistance. Medicaid also provides critically needed funding to support our Nation's safety net providers, including disproportionate share hospitals.
In the President's budget that was just released, the administration has proposed cutting Medicaid by $60 billion over the next 10 years. Secretary Leavitt recently testified in the Senate Finance Committee that he believes ``Medicaid is flawed and inefficient.''
There are others that believe Medicaid is not working and that costs are spiraling out of control and so the program needs dramatic overhaul.
In contrast. there are also those that will attest that there is absolutely nothing wrong with Medicaid. I firmly believe neither point of view is correct.
First, Medicaid is far from broken. The cost per person in Medicaid rose just 4.5 percent per year from 2000 to 2004. That compares to a 12 percent rise in the annual cost of premiums in the private sector. If that is the comparison, Medicaid seems to be about the most efficient health care program around, even more so than Medicare.
The overall cost of Medicaid is going up largely, not because the program is inefficient, but because more and more people find themselves depending on this safety net program for their health care during a recession. When nearly 5 million people lost employer coverage between 2000 and 2003, Medicaid added nearly 6 million to its program. Costs rose in Medicaid precisely because it is working--and working well--as our Nation's safety net program.
Consequently, as noted previously, Medicaid now provides health care to over 50 million low-income Americans, including one-quarter of all New Mexicans.
This is precisely why I so strongly oppose block grants or any arbitrary caps on Federal spending for Medicaid. If we had caps in 2000 and Medicaid could not have responded to the economic downturn, we would have 50 million uninsured today. Medicaid is a Federal-State partnership and an arbitrary cap of the Federal share to States is nothing more than the Federal Government trying to shift all risk to States.
On the other hand, it is also not true that Medicaid is not in need of improvement. The administration is rightly concerned about certain State efforts to provide ``enhanced payments'' to institutional providers as a significant factor in driving Medicaid costs. Secretary Leavitt, in a speech to the World Health Care Congress on February 1, 2005, referred to State efforts to maximize Federal funding as ``the Seven Harmful Habits of Highly Desperate States.'' As a result, he called for ``an uncomfortable, but necessary, conversation with our funding partners, the States.''
Unfortunately, Medicaid reform driven by a budget reconciliation process is not a dialogue or conversation. It is a one-way mechanism for the Federal Government to impose its will on the States. The administration's budget calls for $60 billion in cuts to Medicaid, including $40 billion that would directly harm States.
Where is the conversation in that? In fact, the States have a fair amount of complaint with Federal cost shifting to the States. While I certainly do not speak for the National Governors' Association or National Conference of States Legislatures, some of those grievances are rather obvious and I share them.
For example, according to data from Kaiser Family Foundation, 42 percent of the costs in Medicaid are due to Medicare dual eligible beneficiaries. These dual eligibles are also a major driver of health costs in Medicare and this is a prime example of where better coordination between Medicare and Medicaid could improve both programs. States have been calling for better coordination for years to no avail.
In the Medicare prescription drug bill that was passed by the Congress in 2003, the Federal Government imposed what is referred to as a ``clawback'' mechanism which forces the States to help pay for the Federally-passed Medicare prescription drug benefit. Although States will derive a financial windfall from moving dual eligibles from Medicaid coverage to Medicare, some of the States believe the ``clawback'' will cost them more than if they continued to provide prescription drug coverage themselves.
The prescription drug bill also impacted States financially in a host of other ways that went largely unnoticed, including those that increased Medicaid costs for dual eligibles as a result of increases in the Medicare Part B deductible and increased payments to the new Medicare Advantage plans. The law also required States to help enroll low-income Medicare beneficiaries into the low-income drug benefit.
In fact, the Congressional Budget Office, or CBO, estimated that States had $5.8 billion in added enrollment of dual eligibles in Medicaid due to what they refer to as a ``woodworking'' effect on dual eligibles trying to sign up for the low-income drug benefit discovering they are also eligible for Medicaid benefits. CBO further estimated that States had $3.1 billion in new administrative and other costs added by the prescription drug legislation.
States had no ability to ``have a conversation'' with the Federal Government about the imposition of such costs on them when the Medicare prescription1rrug drug bill was passed, but they should have and will have in our Bipartisan Commission on Medicaid.
Furthermore, due to a recent rebenchmarking done by the Department of Commerce's Bureau of Economic Affairs with respect to the calculation of per capita income in the States and the application of that data by the Centers for Medicare and Medicaid Services, or CMS, the Medicaid Federal Medical Assistance Percentage, or FMAP, many States, including New Mexico, will see a rather dramatic decline in their Federal Medicaid matching percentage. In fact, due to the rebenchmarking and other factors, 29 states will lose Medicaid funding in 2006 by an amount of in excess of $800 million. Again, this occurred with no dialogue or conversation.
Mr. President, I agree with Secretary Leavitt that there should be a conversation among all the stakeholders about the future of Medicaid and about what are the fair division of responsibilities between the Federal Government, States, local governments, providers, and the over 50 million people served by Medicaid. It is for this reason that the Bipartisan Commission on Medicaid includes all of those stakeholders at the table to have a full discussion and debate about the future of Medicaid.
It is our intent that the recommendations would not be focused on cutting costs but about improving health care delivery to our Nation's most vulnerable citizens. However, they are not mutually exclusive. In fact, both can and should be done.
There are those that will argue that a commission may not reach a consensus to make recommendations to
improve the Medicaid program and so is not worth the effort. I would strongly disagree and point to the fact that the National Academy for State Health Policy recently convened a workgroup they called Making Medicaid Work for the 21st Century that included many of the Medicaid stakeholders and came forth with a 78-page report with numerous recommendations with respect to eligibility, benefits, and financing. According to the report entitled Improving Health and Long-Term Care Coverage for Low-Income Americans, the workgroup attempted to ``assess areas where it would be most productive to focus on improvement in the program, and to develop consensus around recommendations for reform.'' I would underscore the emphasis of the workgroup on ``improving'' Medicaid and health coverage. This should be the primary and overriding goal of the Bipartisan Commission on Medicaid that we are introducing today.
Before closing, I once again thank Senator Smith, the other 12 Senate cosponsors, and the various stakeholders--State and local governments, providers, and consumers that have endorsed this legislation--in an effort, not to cut Medicaid, but to make it more efficient and effective in the delivery of care to our Nation's most vulnerable citizens.
I ask unanimous consent to have a copy of the Fact Sheet accompanying this legislation printed in the Record.
Mr. President, Senator Smith and I have worked together successfully on several issues within the last year to defend and improve our Nation's health care safety, including on an amendment to the…
Mr. President, Senator Smith and I have worked together successfully on several issues within the last year to defend and improve our Nation's health care safety, including on an amendment to the Medicare prescription drug bill addressing community health center payments within Medicare that passed by a vote of 94-1. However, none of these initiatives have been more important than the legislation that we are introducing together today, along with a list of 13 other senators--7 Republicans, 5 Democrats, and 1 Independent, 7 of which serve on the Senate Finance Committee--to create a Bipartisan Commission on Medicaid.
Joining Senator Smith and I as original cosponsors are: Senators Snowe, Jeffords, Santorum, Kerry, DeWine, Durbin, Chafee, Lincoln, Collins, Nelson of Nebraska, Voinovich, Corzine, and Coleman.
I will not go into the specifics of the legislation, as Senator Smith has explained how the Commission would be formed and would operate. Instead, I will take the time to explain why it is that the formation of commission is so important.
Medicaid is a critically important health care safety net program that provides health care services to over 50 million low-income children, pregnant women, seniors, and people with disabilities.
In New Mexico, Medicaid is the single largest payor for health care. All told, Medicaid covers the health care costs of more than 400,000 New Mexicans--nearly one-quarter of our State's population.
Although the least expensive to cover, those who benefit most from Medicaid are nearly 300,000 of New Mexico's children. Of the various populations covered, children represent almost two-thirds of all our State's beneficiaries, which is the highest ratio in the Nation according to data from the Kaiser Family Foundation.
However, Medicaid is much more than just a safety net program for children from low-income families. It also serves low-income adults and pregnant women. It also serves senior citizens and people with disabilities who receive the bulk of their health care through Medicare but who still rely on Medicaid for a substantial share of their benefits and cost-sharing assistance. Medicaid also provides critically needed funding to support our Nation's safety net providers, including disproportionate share hospitals.
In the President's budget that was just released, the administration has proposed cutting Medicaid by $60 billion over the next 10 years. Secretary Leavitt recently testified in the Senate Finance Committee that he believes ``Medicaid is flawed and inefficient.''
There are others that believe Medicaid is not working and that costs are spiraling out of control and so the program needs dramatic overhaul.
In contrast. there are also those that will attest that there is absolutely nothing wrong with Medicaid. I firmly believe neither point of view is correct.
First, Medicaid is far from broken. The cost per person in Medicaid rose just 4.5 percent per year from 2000 to 2004. That compares to a 12 percent rise in the annual cost of premiums in the private sector. If that is the comparison, Medicaid seems to be about the most efficient health care program around, even more so than Medicare.
The overall cost of Medicaid is going up largely, not because the program is inefficient, but because more and more people find themselves depending on this safety net program for their health care during a recession. When nearly 5 million people lost employer coverage between 2000 and 2003, Medicaid added nearly 6 million to its program. Costs rose in Medicaid precisely because it is working--and working well--as our Nation's safety net program.
Consequently, as noted previously, Medicaid now provides health care to over 50 million low-income Americans, including one-quarter of all New Mexicans.
This is precisely why I so strongly oppose block grants or any arbitrary caps on Federal spending for Medicaid. If we had caps in 2000 and Medicaid could not have responded to the economic downturn, we would have 50 million uninsured today. Medicaid is a Federal-State partnership and an arbitrary cap of the Federal share to States is nothing more than the Federal Government trying to shift all risk to States.
On the other hand, it is also not true that Medicaid is not in need of improvement. The administration is rightly concerned about certain State efforts to provide ``enhanced payments'' to institutional providers as a significant factor in driving Medicaid costs. Secretary Leavitt, in a speech to the World Health Care Congress on February 1, 2005, referred to State efforts to maximize Federal funding as ``the Seven Harmful Habits of Highly Desperate States.'' As a result, he called for ``an uncomfortable, but necessary, conversation with our funding partners, the States.''
Unfortunately, Medicaid reform driven by a budget reconciliation process is not a dialogue or conversation. It is a one-way mechanism for the Federal Government to impose its will on the States. The administration's budget calls for $60 billion in cuts to Medicaid, including $40 billion that would directly harm States.
Where is the conversation in that? In fact, the States have a fair amount of complaint with Federal cost shifting to the States. While I certainly do not speak for the National Governors' Association or National Conference of States Legislatures, some of those grievances are rather obvious and I share them.
For example, according to data from Kaiser Family Foundation, 42 percent of the costs in Medicaid are due to Medicare dual eligible beneficiaries. These dual eligibles are also a major driver of health costs in Medicare and this is a prime example of where better coordination between Medicare and Medicaid could improve both programs. States have been calling for better coordination for years to no avail.
In the Medicare prescription drug bill that was passed by the Congress in 2003, the Federal Government imposed what is referred to as a ``clawback'' mechanism which forces the States to help pay for the Federally-passed Medicare prescription drug benefit. Although States will derive a financial windfall from moving dual eligibles from Medicaid coverage to Medicare, some of the States believe the ``clawback'' will cost them more than if they continued to provide prescription drug coverage themselves.
The prescription drug bill also impacted States financially in a host of other ways that went largely unnoticed, including those that increased Medicaid costs for dual eligibles as a result of increases in the Medicare Part B deductible and increased payments to the new Medicare Advantage plans. The law also required States to help enroll low-income Medicare beneficiaries into the low-income drug benefit.
In fact, the Congressional Budget Office, or CBO, estimated that States had $5.8 billion in added enrollment of dual eligibles in Medicaid due to what they refer to as a ``woodworking'' effect on dual eligibles trying to sign up for the low-income drug benefit discovering they are also eligible for Medicaid benefits. CBO further estimated that States had $3.1 billion in new administrative and other costs added by the prescription drug legislation.
States had no ability to ``have a conversation'' with the Federal Government about the imposition of such costs on them when the Medicare prescription1rrug drug bill was passed, but they should have and will have in our Bipartisan Commission on Medicaid.
Furthermore, due to a recent rebenchmarking done by the Department of Commerce's Bureau of Economic Affairs with respect to the calculation of per capita income in the States and the application of that data by the Centers for Medicare and Medicaid Services, or CMS, the Medicaid Federal Medical Assistance Percentage, or FMAP, many States, including New Mexico, will see a rather dramatic decline in their Federal Medicaid matching percentage. In fact, due to the rebenchmarking and other factors, 29 states will lose Medicaid funding in 2006 by an amount of in excess of $800 million. Again, this occurred with no dialogue or conversation.
Mr. President, I agree with Secretary Leavitt that there should be a conversation among all the stakeholders about the future of Medicaid and about what are the fair division of responsibilities between the Federal Government, States, local governments, providers, and the over 50 million people served by Medicaid. It is for this reason that the Bipartisan Commission on Medicaid includes all of those stakeholders at the table to have a full discussion and debate about the future of Medicaid.
It is our intent that the recommendations would not be focused on cutting costs but about improving health care delivery to our Nation's most vulnerable citizens. However, they are not mutually exclusive. In fact, both can and should be done.
There are those that will argue that a commission may not reach a consensus to make recommendations to
improve the Medicaid program and so is not worth the effort. I would strongly disagree and point to the fact that the National Academy for State Health Policy recently convened a workgroup they called Making Medicaid Work for the 21st Century that included many of the Medicaid stakeholders and came forth with a 78-page report with numerous recommendations with respect to eligibility, benefits, and financing. According to the report entitled Improving Health and Long-Term Care Coverage for Low-Income Americans, the workgroup attempted to ``assess areas where it would be most productive to focus on improvement in the program, and to develop consensus around recommendations for reform.'' I would underscore the emphasis of the workgroup on ``improving'' Medicaid and health coverage. This should be the primary and overriding goal of the Bipartisan Commission on Medicaid that we are introducing today.
Before closing, I once again thank Senator Smith, the other 12 Senate cosponsors, and the various stakeholders--State and local governments, providers, and consumers that have endorsed this legislation--in an effort, not to cut Medicaid, but to make it more efficient and effective in the delivery of care to our Nation's most vulnerable citizens.
I ask unanimous consent to have a copy of the Fact Sheet accompanying this legislation printed in the Record.
Mr. President, over the last several years as the economy came down from the high of the 1990s, we have seen how devastating it can be for workers when their companies declare bankruptcy. From the…
Mr. President, over the last several years as the economy came down from the high of the 1990s, we have seen how devastating it can be for workers when their companies declare bankruptcy. From the enormous Enron bankruptcy at the end of 2001 to the bankruptcies of Wheeling-Pitt and then Weirton Steel in my own home State, every bankruptcy has brought heartache for workers who had dedicated themselves to their employers. In many cases, employees and retirees have very limited ability to recover the wages, severance, or benefits they are due when their companies seek protection from creditors.
Workers deserve better. So today I am introducing the Bankruptcy Fairness Act to strengthen workers' rights in bankruptcy and to provide greater authority to bankruptcy courts to ensure a fair distribution of assets. I am very pleased that Senator Leahy, the distinguished ranking Democrat on the Senate Judiciary Committee is an original cosponsor of this bill.
Specifically, the bill will do three things. It will ensure that retirees whose promised health insurance is taken away receive at least some compensation for their lost benefits. Second, my legislation would allow employees to recover more of the back-pay or other compensation that is owed to them at the time of the bankruptcy. And lastly, it would provide bankruptcy courts the authority to recover company assets in cases where company managers flagrantly paid excessive compensation to favored employees just before declaring bankruptcy.
I first introduced this legislation in the 108th Congress. I am reintroducing
it because this issue is as important in West Virginia today as it has ever been. I am hopeful that as Congress considers any changes to bankruptcy law we will debate how we can better protect workers whose companies file for bankruptcy. I do not pretend to have all the answers. But I do know that we must do a better job of easing the burden that bankruptcy imposes on employees and retirees. And I believe that we can do so in creative ways that do not make it more difficult for companies to successfully reorganize and emerge from bankruptcy. I look forward to the ideas and suggestions of my colleagues.
In the simplest economic terms, employees sell their labor to their companies. They toil away in offices, plants, factories, mills, and mines, because they are promised that at the end of the day they will receive certain compensation. One of the most important types of compensation that workers earn is the right to enjoy certain benefits when they retire. Pensions, life insurance, or health care coverage are earned by workers in addition to their weekly paychecks. Yet, sadly we have seen many companies in the last few years abandon these promises when they declare bankruptcy.
More and more we see companies taking the easy road to profitability by abandoning commitments that they made to workers. For retirees who have planned for their golden years based on the benefits they have earned, losing health insurance can be a devastating blow. Retirees must have the right to reasonable compensation if the company seeks to break its promise to provide health insurance. Under current law, these retirees receive what is called a general unsecured claim for the value of the benefits they lost. As any creditor will tell you, a general unsecured claim is essentially worthless in most bankruptcies. It means you are at the end of the line, and there are not enough assets to go around. This law allows companies to essentially rescind compensation that retirees have earned with virtually no cost to the company. Of course that is a great deal for the company, but it is spectacularly unfair to the retirees.
Recognizing that so-called legacy costs are often an impossible burden for a company that is trying to emerge from bankruptcy, my legislation would still allow companies in some circumstances to alter the health coverage offered to retirees. However, it would require that the company pay a minimum level of compensation to retirees. Under this bill, each retiree would be entitled to a payment equal to the cost of purchasing comparable health insurance for a period of 18 months. Of course, 18 months of health insurance coverage is a lot less than many of these retirees are losing, but it can ease the transition as retirees make alternative plans, and it will discourage companies from thinking that terminating retiree health coverage is an easy solution. The retirees would still be entitled to a general unsecured claim for the value of the benefits lost in excess of this one time payment. This change would ensure that retirees, while still not being made whole on lost benefits, will at least receive some compensation for the broken promises.
Many active workers, too, have a difficult time recovering what is owed to them by their employer when the company files bankruptcy. Under current law, employees are entitled to a priority claim of up to $4,925. But that figure is usually not enough to cover the back-wages, vacation time, severance pay, or benefit payments that the employees are owed for work done prior to the bankruptcy. Congress needs to update the amount of the priority claim to ensure that more workers are able to receive what is rightfully theirs. The Bankruptcy Fairness Act would establish a priority claim for the first $15,000 of compensation owed to an employee.
In most cases, employees have been working their hardest to help the company avoid the nightmare of bankruptcy, only to find that they will not be compensated for their services as promised. As we saw so clearly with the Enron case, employees are often left holding the bag when their company declares bankruptcy. In that case, employees were owed an average of $35,000 in back-wages, severance, and other promised compensation. They deserved to recover more than a mere $4,925 of what was owed them. Let me be clear, this bill does not establish any new obligation for a company to pay severance or other compensation to employees caught up in a company's bankruptcy. It merely ensures that employees can recover more of what is already owed to them through the bankruptcy process.
I understand that many creditors or investors are not able to recover what is rightfully owed to them in bankruptcy, but employees deserve protection that recognizes the unique nature of their dependence on their employer. Any smart investor diversifies his or her portfolio so that a bankruptcy at one company does not bankrupt the investor. Likewise, suppliers and creditors that do business with a company typically have many other clients. This is not the case with workers. They cannot diversify away the risk of working for a bankrupt company, and the financial hardship a bankruptcy brings is more devastating to the average worker than the average creditor or supplier.
Now, I know that some of my colleagues listening to this may be worrying that this legislation is insensitive to the needs of companies that are trying to reorganize in order to emerge from bankruptcy and go forward as successful businesses. I am fully aware that sometimes, too often in the real world, the bankruptcy process can help companies stay open and maintain jobs by restructuring obligations to creditors. Too many companies in West Virginia have had to go through the painful process of Chapter 11 reorganization. I completely understand the need to keep the factories open. And I have always worked side by side with companies to help them recover.
I will continue that important work, and I have included a provision in this bill to help bankrupt companies that are struggling to survive to recover assets that have been pilfered from the corporate coffers. In too many cases, company executives reward themselves even as their companies careen toward bankruptcy. The most egregious recent example is at Enron in 2001. In the days and weeks leading up to the bankruptcy filing, executives granted large bonuses to themselves and their favored employees. Millions of dollars were paid to a select group of employees just before the company declared bankruptcy. It is unconscionable that executives would grant themselves undeserved bonuses and then weeks later claim that the company did not have the resources to pay its rank and file employees.
My legislation provides bankruptcy courts greater authority to recover excessive compensation that was paid just prior to the bankruptcy filing. If the court finds that compensation was out of the ordinary course of business or was unjust enrichment, the court can recover those assets for the bankrupt company, ensuring that more creditors, employees, and retirees can receive what is rightfully owed to them by the company.
The reforms I have outlined are modest. They will not take the sting out of bankruptcy. By definition a bankruptcy is a failure, and it is painful for the company's employees, retirees, and business partners. But the Bankruptcy Fairness Act I am introducing today would make progress toward ensuring that bankruptcies are more fair to the workers who gave their time and energy and sweat to the company in exchange for certain promised compensation. And by helping a company recover assets that should not have been paid out as undeserved bonuses just before bankruptcy the bill ensures that more of a company's assets are paid to the employees, retirees, and creditors who are rightfully owed.
It is my hope that this legislation will receive serious consideration from my colleagues, and that this can open an important debate about how workers and retirees can be better protected from the ugly side of prolonged economic downturns. I ask unanimous consent that the text of the legislation be printed in the Record.
Mr. President, I thank the chairman of the Budget Committee, Senator Gregg, for yielding time but much more for his patience with all of his colleagues--and I suppose myself primarily-- during what…
Mr. President, I thank the chairman of the Budget Committee, Senator Gregg, for yielding time but much more for his patience with all of his colleagues--and I suppose myself primarily-- during what has been a very difficult and grueling period of time for the majority and even some in the minority who are focused on this issue.
I also want to express my appreciation to Bill Frist, the majority leader, and Mitch McConnell, the whip, who have come at this responsibility of producing a budget with determination and understanding that without a budget, we have considerable chaos in this Chamber. To the general public it probably looks as if we are in chaos all the time, but they have seen nothing until they have seen us without a budget.
As I have approached this budget, two things have been apparent to me. No. 1, that we had to have a budget. I understand the institutional responsibility the majority carries when it comes to advancing the legislative work of the American people. I have also been mindful for some time that Medicaid needs reform, restructuring, and, in my view, restructuring not unlike what the State of Oregon has done with the Oregon health plan, to make sure that those intended to be served and covered, those legitimate and truly eligible, find access to this essential strand in America's safety net.
Each one of us in this Chamber comes from their own perspectives and with their own sense of responsibility, their own history from their States. In my case, I come from a State that prides itself on pioneering in many ways, not the least of which is in the area of health care. One of the crown jewels of that pioneering is the Oregon health plan, which was an effort on the part of one of our former Governors, John Kitzhaber, to find a way, with the resources available through the Federal match with State resources, to cover more people more effectively with preventive medicine and essential services in a way that gets the most bang for the medical buck.
Clearly, America will come to a point when more people of the baby boom generation come on to Medicaid where such a model or something similar will be necessary for our country to both afford it and to provide it. So as I approached this budget, it was with caution, especially caution due to the people who are covered by Medicaid. These are the elderly, the poor, the disabled, the unusually vulnerable in our society, who when they are thrown off of Medicaid are thrown into emergency rooms, where the cost of their medicine is simply shifted over time on to the escalating costs of private plans which many small businesses struggle today to continue to provide to their employees.
When we came to this debate, I was very mindful that the House of Representatives had passed a reconciliation number which, in the case of their Chamber, I believe was $18.5 billion over 5 years to the Ways and Means Committee and $20 billion to the House Commerce Committee, a total of $38.5 billion over 5 years. That is a very large number, and the programs to be affected were not Social Security. It was announced that Medicare would not be touched. That leaves, on the list of programs, very few.
So it was my feeling--despite my high regard for the budget chairman, Senator Gregg--that I needed to engage and, if I could, to take out the Senate number, which was $14 billion. He and others were honest enough to say it was to Medicaid. So the Senate went to zero.
Then comes the clash of institutional responsibility, the ability to do the Nation's business without in any way, in my view, putting such undue pressure upon Medicaid as a class of people that should not be borne in haste, or done in haste, by putting a budget number ahead of sound policy.
I know that the people in the medical community who are counting on us want us to do this right, if we do it at all. I know many of them would have liked a budget with a number that remained at zero. That has not been possible. But the minimum number that I was told, necessary to get a budget, was $10 billion over 5 years, with no cuts required in the first year. That also was coupled with the creation of a commission. You will look through this budget and you will not find a commission in it because that is not the kind of thing you put in a budget. A commission is something that Congress could create, but it can more quickly be created through an executive decision, with resources currently allocated, so that work can begin in a more timely way.
I want to make it also clear that the Secretary of Health and Human Services, the former Governor of Utah, Mike Leavitt, is a person in whom I have implicit confidence. He is a man of integrity. He is a man of his word. He is a man who understands that his reputation and mine are on the line in constructing the kind of commission that is inclusive, that is bipartisan, that is academic in its nature, and is charged with the responsibility to produce a Medicaid program--not just short term but long term--that is a system that we can be proud of and that will serve the people who need its coverage.
It is the strong desire of the Senate, and I do not speak for my Democratic colleagues, but my partner in this effort, Senator Jeff Bingaman of New Mexico, he and I and our staffs have been working across the aisle to create
the kind of credible structure to recommend to the Secretary. Ideally, and it is my strong urge and plea, this commission will be conducted by the Institute of Medicine. They will be charged to provide to us, by early September, their recommendations of what ways the Senate Finance Committee and the House Commerce Committee can respond to the reconciliation number. I will not prejudge what they will say, but I know they will say it in a way that will be acceptable to Republican and Democratic ears and will give this the kind of academic focus it truly deserves.
But that is a work in progress. Ultimately, you have to trust people to be good, to live up to the public statements they make. The President's administration has made it clear that they approve of the creation of this commission. The majority leader, Senator Frist, has also assured me of a colloquy that will be part of this budget to the Senate, how we will proceed. Ultimately, the work of the commission will go to the Senate Finance Committee, and there we will take up deciding what should be done under reconciliation.
The Senate Finance Committee is composed of thoughtful people, all of whom, with few exceptions, are anxious to do this right and to serve the people that ought to be served. I hope that everyone will understand this has not been easy, but I think much has been achieved in terms of checks and balances as we proceed.
No one can deny that the awful arithmetic of American demographics confronts future Congresses with a demographic tsunami, and we have to find ways to keep our safety net strong without bankrupting our taxpayers and particularly our children and grandchildren. I think they would want us to do this carefully, to do it right, to do it on the basis of good policy instead of numbers which may, in some cases, be arrived at arbitrarily. But we are going to begin now because this budget should pass. I would say to all of my colleagues who are wondering, as I have, whether to vote for this budget: I have yet to vote for a budget with which I found myself in agreement with everything. I have never voted on a perfect piece of legislation.
But I also remember the time when my party was briefly in the minority and the majority party at the time was unable to come up with a budget at all, and we truly had a chaotic situation. We cannot have that if people are sincere about managing spending and setting this country on a path of promise-keeping, not just to those served, but also to today's and tomorrow's taxpayers.
So I ask my colleagues, particularly those who voted with me to remove the $14 billion, to now vote in good faith for this budget that Senator Gregg has brought to the floor. It has been a difficult process, and again I say I believe our leaders are to be credited. They have dealt in good faith. They have a tough job to do, and each of us in this Chamber has principles that we are trying to defend. But this is not the final number. The final number is done in the authorizing committees--in the House Commerce Committee and in the Senate Finance Committee. There is a long way to go. So to those who care about Medicaid, to those who are served by Medicaid: Be engaged and know that my office, my heart, my mind are open to you in order to do this right and not just to do it fast. But, having said that, it is necessary for us to go beyond where we are now, which is operating without a budget at all, because appropriations need to be made, important legislation has to pass, and a budget is the cornerstone of making all this work begin to proceed.
I thank Chairman Gregg for the time, for his understanding, and for his coming to the Senate and bringing the best budget we can produce under all the competing interests and demands.
This is, while not perfect--and I have a long list of things I would rather not be there--this is a beginning and not an ending. But we do not get to the end until we finish this budget.
I announce my support for it and urge all of my colleagues to join in approving it this evening.
I yield the floor.
Mr. President, I ask unanimous consent that the order for the quorum call be rescinded. Is it in order for me to take about 7 or 8 minutes to speak on a subject other than the budget? Mr. President,…
Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.
Is it in order for me to take about 7 or 8 minutes to speak on a subject other than the budget?
Mr. President, I thank the distinguished chairman. I am here to talk about President Bush's nominee to be our next permanent representative to the United Nations, John Bolton. I am privileged to be a member of the Foreign Relations Committee. A few weeks ago at Mr. Bolton's first day of hearing, I heard what I expected to hear. In fact, I was unusually impressed by what I heard. I listened to a man who has been confirmed four times by the Senate, who in the last 4 years has been Under Secretary of State for Arms Control and International Security, Assistant Secretary for International Organizations under the first President Bush, under whom I served, a person who graduated summa cum laude from Yale, received his JD from Yale, a person who helped repeal resolution 3379 equating Zionism with racism.
I listened very carefully. And while we have had a number of distinguished U.N. ambassadors, I rarely have seen anyone who had such a good grasp of diplomacy, of the United Nations, its resolutions, and its history. And during a period of about 7 hours, he handled himself well, and there were tough questions asked. I was impressed with the fact that he had been endorsed by five former Secretaries of State and by more than 50 former ambassadors. I was with one of those former ambassadors over the weekend, the former majority leader of this body, Howard Baker, with whom I and other Members had lunch Sunday. He remarked about how he had dealt with Secretary Bolton over the last 4 years in Tokyo. He liked him. He was impressed with him. He said he spoke frankly, that he would be a good ambassador.
The second day of hearings was a little different. I was surprised and disappointed by what I heard. There was a man named Carl Ford, who was well respected by members of the committee, who presented evidence that John Bolton had ``chewed out,'' to use colloquial words, intelligence analysts in the State Department. Mr. Ford, to his credit, didn't like that because those persons were down the line.
Mr. Ford was a pretty good witness because he didn't overstate his case. He acknowledged that it wasn't unusual for policy people and intelligence analysts to argue, for policy people to hope for intelligence that supported their positions. He just didn't like the fact that in this case he had heard about--he wasn't there, he had heard about--that Mr. Bolton in effect chewed out one of Mr. Ford's employees and Mr. Ford didn't like it. He told Mr. Bolton so and they exchanged words. That is what he said.
There have been some other things said about Mr. Bolton. I have had the privilege of being confirmed by the Senate and going through a hearing. I am surprised the number of things they can find to say about you when you go through a thing like that. I see the Senator from Massachusetts over there. He was chairman of the committee when I went through the nomination process, and the Democrats were in the majority at that time. So it is a good airing of about anything you can do and anything people can say about you. It serves a purpose.
There were some other things said. It was suggested that Mr. Bolton was misusing intelligence, compromising intelligence. But Mr. Ford himself said:
In this particular case--
The one he was led there to complain about--
there wasn't politicization [of the intelligence].
So that wasn't the case.
A little later, someone called up to say that Mr. Bolton had chased a USAID contractor around a Moscow hotel to stop her from damaging his client. This was when he was in the private sector. But then others, including the employer of that complaining person, disputed the complainer's account, and others did as well. So it boils down to the fact that the credible charge of Mr. Ford was that Mr. Bolton was rude to staff members below him in the bureaucracy.
I imagine Mr. Bolton is embarrassed by those charges. I didn't like to hear them. And perhaps he deserves to be embarrassed by the charges and perhaps he has learned a lesson. But what I heard doesn't change my vote, even though I hope it might change some of Mr. Bolton's ways of dealing with people with whom he works.
How significant is this charge that he was rude to people in the bureaucracy? As has been mentioned by others, if that were the standard for remaining in the Senate, we would have a hard time getting a quorum. There are regularly occasions when busy Senators, eager to make their own point, are rude to their staff and even shout at one another. In fact, the shouting was so loud in the Foreign Relations Committee room by some of the Senators, I could barely hear the charges about Mr. Bolton. That is not attractive, and I don't endorse it. It even caused me to think back about times that I may have become angry or impatient or startled in dealing with a staff member or another person, and made me redouble my efforts to make sure I swallow my pride and think about what I say and not do that anymore. It is not good business.
As I heard Senator Voinovich, who has a long reputation of caring for civil servants and caring about those things,
my guess is that was on his mind as well.
How significant is this? Here is what former Secretary of State Larry Eagleburger had to say about it Sunday in the Washington Post. This deserves special attention. Larry Eagleburger was Secretary of State for the first President Bush, but in a way he was more than that. He had 27 years in the foreign service. We hear about a football player is a football player's player or a man is a man's man or a woman is a woman's woman. Larry Eagleburger is a foreign service officer's Secretary of State. He had and has enormous respect from all those men and women who put their lives on the line around the world and in the United States in support of our diplomacy and foreign policy. Here is what he said:
As to the charge that Bolton has been tough on
subordinates, I can say only that in more than a decade of
association with him in the State Department I never saw or
heard anything to support such a charge. Nor do I see
anything wrong with challenging intelligence analysts on
their findings. They can, as recent history demonstrates,
make mistakes. And they must be prepared to defend their
findings under intense questioning. If John pushed too hard
or dressed down subordinates, he deserves criticism, but it
hardly merits a vote against confirmation when balanced
against his many accomplishments.
That is where I am. I think the benefit of hearing Mr. Ford's testimony might be a little bit of a lesson to Mr. Bolton and a reminder to the rest of us of how unattractive it is to shout at an associate or unnecessarily dress down a staff member. I agree with Secretary Eagleburger. John Bolton has a distinguished background and record. He has dedicated himself to improving our country's foreign policy. His action toward subordinates might have been inappropriate. Perhaps he has learned a lesson, but it doesn't cause me to change my vote. I am glad to support him.
This is a critical time for the United Nations. Even the Secretary General acknowledges it is in need of reform. Billions of dollars filtered from the U.N. coffers to Saddam Hussein's pockets in the oil- for-food scandal. Top human rights abusers such as Sudan sit on the Human Rights Commission. United Nations peacekeepers in Africa have been found to rape and pillage. Just today, the United Nations appointed Zimbabwe to the Human Rights Commission.
Now the United Nations has many important roles in the world. I am glad we have it. I want it to work, but I believe the President is right in his thinking, that we need to take action to help the U.N. reform itself, and that a frank-talking, experienced diplomat named John Bolton is an excellent candidate for that commission. I intend to vote for him in committee and on the floor. It is my hope that when we come back after the recess, we will have the long hearing as we usually do, and all the Senators will have a chance to say what they have to say--hopefully without shouting at one another--and that we will report it to the floor and the Senate will approve Mr. Bolton's nomination and give him a chance to go to work in reforming the U.N.
I yield the floor and I suggest the absence of a quorum.
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Mr. President, I am pleased to join with a number of my colleagues in cosponsoring the Bipartisan Commission on Medicaid and the Medically Underserved Act of 2005, which Senator Smith and Senator…
Mr. President, I am pleased to join with a number of my colleagues in cosponsoring the Bipartisan Commission on Medicaid and the Medically Underserved Act of 2005, which Senator Smith and Senator Bingaman are introducing today.
The Medicaid program provides essential medical services to low- income and uninsured children and their families, pregnant women, senior citizens, individuals with disabilities, and others. Last year, nearly 55 million Americans were enrolled in Medicaid, including more than 300,000 in Maine where one in five people now receive health care services through MaineCare, our State's Medicaid program.
Individuals who rely upon Medicaid-funded health services have no other option. Without Medicaid, they would join the ever growing ranks of the uninsured in this country, which now numbers an all-time high of more than 45 million Americans who lacked health coverage at some point last year. These two groups represent a total of 100 million Americans who would have no health insurance were it not for Medicaid coverage which reaches just over half of them. And to the extent that the Federal Government reduces its support for Medicaid funding, the numbers of uninsured Americans will rise at an even faster rate.
As Congress begins to consider the administration's Fiscal Year 2006 Budget, I believe we must take a balanced approach that is both fiscally responsible and reflects our long-standing commitments to provide health care for many of the low-income and uninsured through the Medicaid program. Although we face growing budget deficits and ever tightening Federal budgets, the Federal Government cannot simply abandon its responsibility to help states provide health care access to our most vulnerable citizens.
Today, Medicaid is the fastest growing component of State budgets, according to the most recent survey of the National Governors Association. Total Medicaid spending nationwide now averages 22 percent of State budgets, while State spending on all healthcare functions is approximately 31 percent. However, although its costs are increasing, the annual growth in Medicaid spending on a per capita basis is growing more slowly, at 4.5 percent a year, than the private sector where health insurance premiums have increased an average of 12.5 percent a year for the last 3 years.
The economic downturn which State economies experienced several years ago, and from which many States are only now emerging, has continued to leave many families jobless and without health insurance, forcing them to turn to Medicaid. This has put an enormous strain on the states already strapped with budget scarcities. Many States reduced Medicaid benefits last year and even more restricted Medicaid eligibility in an effort to satisfy their budgetary obligations.
In fact, the Chairman of the National Governors Association, Governor Warner of Virginia, and the Vice Chairman, Governor Huckabee of Arkansas, recently warned Congress that if Federal spending for Medicaid were capped and the number of Medicaid recipients increased sharply, States would face dire fiscal consequences. According to the Governors, total costs for State Medicaid programs are growing at an annual rate of 12 percent, and total Medicaid expenditures now exceed that of Medicare, due primarily to factors beyond States' control, especially the costs of long-term care: Medicaid now accounts for 50 percent of all State long-term care spending and pays for the care of 70 percent of those in nursing homes.
At this time, therefore, it is crucial that we continue to provide sufficient Federal funding for Medicaid, which has worked so well since it began providing care for some of our most vulnerable populations 40 years ago. We must proceed cautiously before making any significant changes in the program, and the Medicaid Commission established by this bill will ensure that necessary deliberative approach.
The concept of a commission to undertake a comprehensive review of the Medicaid program and recommend possible changes is similar to the commission which Congress established in the late 1990s, the Bipartisan Commission on the Future of Medicare. That commission examined various aspects of
the Medicare program to determine areas that should be modernized and later recommended a number of changes, including a prescription drug benefit. Those recommendations initiated the process of congressional debate and consideration of reforming the Medicare program, culminating in the Medicare Prescription Drug, Improvement, and Modernization Act which passed in 2003 and, among other reforms, included the new prescription drug benefit for seniors which will take effect next year.
The new Medicare prescription drug benefit will have a major impact on Medicaid since it will shift Federal expenditures for drug benefits currently provided by Medicaid for the ``dual eligible'' population-- those who are eligible for both Medicaid and Medicare--to Medicare. However, this will not lift most of the financial responsibility and burden of prescription drug costs from the States. Recent estimates by the National Governors Association show that currently 42 percent of all Medicaid dollars are spent on ``dual eligible'' Medicare beneficiaries, although they comprise only a small percentage of Medicaid cases, and they are covered by Medicare for other services.
The new prescription drug program includes a provision known as the ``claw-back'' which will require States to remit funds to the Federal Government, based on their inflation-adjusted 2003 per person Medicaid expenditures for prescription drugs for these beneficiaries. Although the percentage share of drug costs that States must pay for the dual eligibles will decline over time, from 90 percent to 75 percent, States will continue to pay the lion's share of dual eligibles' prescription drug costs. Many States are just now recognizing this fact and are looking for ways to accommodate these ongoing costs.
Unanswered questions like these remain concerning the ultimate impact of the Medicare drug program on State budgets and Medicaid programs. One of the primary duties of the Medicaid Commission would be to review and make recommendations on the interaction of Medicaid with Medicare and other Federal health programs.
Moreover, the formula for calculating the Federal matching rate, known as the Federal Medical Assistance Percentage, FMAP, which determines the Federal Government's share of a State's expenditures for Medicaid each year, has also contributed to the Medicaid problems that States are facing. The FMAP formula is designed so that the Federal Government pays a larger portion of Medicaid costs in States with a per capita income lower than the national average. However, the formula looks back 3 years, to points in time that are not necessarily reflective of a State's current financial situation.
In fiscal year 2003, for example, the FMAP for that year was calculated in 2001 for the fiscal year beginning October 2002. The FMAP for FY 2003 was determined on the basis of State per capita income over the 3-year period of 1998 through 2000, when State economies were growing significantly. Yet in 2003, when this matching rate was in effect, a serious economic downturn was affecting many State budgets, and that downturn has contributed greatly to the growth of Medicaid for several years now.
We recognized this situation in the last Congress and provided for State fiscal relief by providing a temporary increase in the Federal Medicaid matching rate, which provided $10 billion in fiscal relief to States during fiscal 2003 and 2004, when we passed the Jobs and Growth Tax Relief Reconciliation Act of 2003. But that fiscal relief has sunset.
One of the duties of the Medicaid Commission would be to make recommendations on how to make Federal matching payments more equitable with respect to the States and the populations they serve, as well as how to make them more responsive to changes in States' economic conditions.
The fact is, Medicaid and Medicare have complex responsibilities, financing, and interrelationships and that is why a Medicaid Commission is vital for the future state budgets and the Medicaid program as a whole.
I urge my colleagues to join us supporting this legislation to help sustain and improve this critical health care safety net for our most vulnerable Americans.
Mr. President, I am pleased to join with a number of my colleagues in cosponsoring the Bipartisan Commission on Medicaid and the Medically Underserved Act of 2005, which Senator Smith and Senator…
Mr. President, I am pleased to join with a number of my colleagues in cosponsoring the Bipartisan Commission on Medicaid and the Medically Underserved Act of 2005, which Senator Smith and Senator Bingaman are introducing today.
The Medicaid program provides essential medical services to low- income and uninsured children and their families, pregnant women, senior citizens, individuals with disabilities, and others. Last year, nearly 55 million Americans were enrolled in Medicaid, including more than 300,000 in Maine where one in five people now receive health care services through MaineCare, our State's Medicaid program.
Individuals who rely upon Medicaid-funded health services have no other option. Without Medicaid, they would join the ever growing ranks of the uninsured in this country, which now numbers an all-time high of more than 45 million Americans who lacked health coverage at some point last year. These two groups represent a total of 100 million Americans who would have no health insurance were it not for Medicaid coverage which reaches just over half of them. And to the extent that the Federal Government reduces its support for Medicaid funding, the numbers of uninsured Americans will rise at an even faster rate.
As Congress begins to consider the administration's Fiscal Year 2006 Budget, I believe we must take a balanced approach that is both fiscally responsible and reflects our long-standing commitments to provide health care for many of the low-income and uninsured through the Medicaid program. Although we face growing budget deficits and ever tightening Federal budgets, the Federal Government cannot simply abandon its responsibility to help states provide health care access to our most vulnerable citizens.
Today, Medicaid is the fastest growing component of State budgets, according to the most recent survey of the National Governors Association. Total Medicaid spending nationwide now averages 22 percent of State budgets, while State spending on all healthcare functions is approximately 31 percent. However, although its costs are increasing, the annual growth in Medicaid spending on a per capita basis is growing more slowly, at 4.5 percent a year, than the private sector where health insurance premiums have increased an average of 12.5 percent a year for the last 3 years.
The economic downturn which State economies experienced several years ago, and from which many States are only now emerging, has continued to leave many families jobless and without health insurance, forcing them to turn to Medicaid. This has put an enormous strain on the states already strapped with budget scarcities. Many States reduced Medicaid benefits last year and even more restricted Medicaid eligibility in an effort to satisfy their budgetary obligations.
In fact, the Chairman of the National Governors Association, Governor Warner of Virginia, and the Vice Chairman, Governor Huckabee of Arkansas, recently warned Congress that if Federal spending for Medicaid were capped and the number of Medicaid recipients increased sharply, States would face dire fiscal consequences. According to the Governors, total costs for State Medicaid programs are growing at an annual rate of 12 percent, and total Medicaid expenditures now exceed that of Medicare, due primarily to factors beyond States' control, especially the costs of long-term care: Medicaid now accounts for 50 percent of all State long-term care spending and pays for the care of 70 percent of those in nursing homes.
At this time, therefore, it is crucial that we continue to provide sufficient Federal funding for Medicaid, which has worked so well since it began providing care for some of our most vulnerable populations 40 years ago. We must proceed cautiously before making any significant changes in the program, and the Medicaid Commission established by this bill will ensure that necessary deliberative approach.
The concept of a commission to undertake a comprehensive review of the Medicaid program and recommend possible changes is similar to the commission which Congress established in the late 1990s, the Bipartisan Commission on the Future of Medicare. That commission examined various aspects of
the Medicare program to determine areas that should be modernized and later recommended a number of changes, including a prescription drug benefit. Those recommendations initiated the process of congressional debate and consideration of reforming the Medicare program, culminating in the Medicare Prescription Drug, Improvement, and Modernization Act which passed in 2003 and, among other reforms, included the new prescription drug benefit for seniors which will take effect next year.
The new Medicare prescription drug benefit will have a major impact on Medicaid since it will shift Federal expenditures for drug benefits currently provided by Medicaid for the ``dual eligible'' population-- those who are eligible for both Medicaid and Medicare--to Medicare. However, this will not lift most of the financial responsibility and burden of prescription drug costs from the States. Recent estimates by the National Governors Association show that currently 42 percent of all Medicaid dollars are spent on ``dual eligible'' Medicare beneficiaries, although they comprise only a small percentage of Medicaid cases, and they are covered by Medicare for other services.
The new prescription drug program includes a provision known as the ``claw-back'' which will require States to remit funds to the Federal Government, based on their inflation-adjusted 2003 per person Medicaid expenditures for prescription drugs for these beneficiaries. Although the percentage share of drug costs that States must pay for the dual eligibles will decline over time, from 90 percent to 75 percent, States will continue to pay the lion's share of dual eligibles' prescription drug costs. Many States are just now recognizing this fact and are looking for ways to accommodate these ongoing costs.
Unanswered questions like these remain concerning the ultimate impact of the Medicare drug program on State budgets and Medicaid programs. One of the primary duties of the Medicaid Commission would be to review and make recommendations on the interaction of Medicaid with Medicare and other Federal health programs.
Moreover, the formula for calculating the Federal matching rate, known as the Federal Medical Assistance Percentage, FMAP, which determines the Federal Government's share of a State's expenditures for Medicaid each year, has also contributed to the Medicaid problems that States are facing. The FMAP formula is designed so that the Federal Government pays a larger portion of Medicaid costs in States with a per capita income lower than the national average. However, the formula looks back 3 years, to points in time that are not necessarily reflective of a State's current financial situation.
In fiscal year 2003, for example, the FMAP for that year was calculated in 2001 for the fiscal year beginning October 2002. The FMAP for FY 2003 was determined on the basis of State per capita income over the 3-year period of 1998 through 2000, when State economies were growing significantly. Yet in 2003, when this matching rate was in effect, a serious economic downturn was affecting many State budgets, and that downturn has contributed greatly to the growth of Medicaid for several years now.
We recognized this situation in the last Congress and provided for State fiscal relief by providing a temporary increase in the Federal Medicaid matching rate, which provided $10 billion in fiscal relief to States during fiscal 2003 and 2004, when we passed the Jobs and Growth Tax Relief Reconciliation Act of 2003. But that fiscal relief has sunset.
One of the duties of the Medicaid Commission would be to make recommendations on how to make Federal matching payments more equitable with respect to the States and the populations they serve, as well as how to make them more responsive to changes in States' economic conditions.
The fact is, Medicaid and Medicare have complex responsibilities, financing, and interrelationships and that is why a Medicaid Commission is vital for the future state budgets and the Medicaid program as a whole.
I urge my colleagues to join us supporting this legislation to help sustain and improve this critical health care safety net for our most vulnerable Americans.
Mr. President, I strongly support the Smith-Bingaman- Coleman amendment to strike the reconciliation instruction to the Finance Committee to cut Medicaid by $15 billion. Some say this amendment is…
Mr. President, I strongly support the Smith-Bingaman- Coleman amendment to strike the reconciliation instruction to the Finance Committee to cut Medicaid by $15 billion. Some say this amendment is not important because the budget is just a blueprint and the Finance Committee would never make these cuts. That is just not true. A vote for this budget is a vote for cuts, plain and simple. If the reconciliation instruction is to cut, the Finance Committee is under instruction to cut.
Once we pass this budget, the reconciliation instructions are binding. The Finance Committee would be bound to find the $15 billion in savings. Although it would be difficult for the committee to reach agreement on these cuts, the committee would make the cuts. The Finance Committee has never failed to comply with reconciliation instructions. I do not believe that it would start this year. Those who say it is just a blueprint, that is a smokescreen. It is not accurate.
The administration says we need to address waste and abuse in Medicaid. They say these cuts will end the abuse of intergovernmental transfers. I urge my colleagues to not be swayed by these allegations. The administration has been negotiating reform of intergovernmental transfers on a State-by-State basis for the past 2 years. They have already squeezed significant savings through this new policy, and there will not be much further savings if Congress goes down this road. How do I know this? Because Montana is one of the States that was required to revise its intergovernmental program to comply with new State rules last year.
Keep in mind that the change in policy has never been published. There has been no notice, no invited comments, no rulemaking--never; no State Medicaid director's letter, none.
So how much in savings remains in reform of intergovernmental transfers? The Congressional Budget Office says zero, no savings. So let's not fool ourselves into thinking we are really cutting fraud and abuse in Medicaid with these cuts. Rather, these cuts will hurt people. In fact, in Montana, the proposed cuts would mean a loss of health coverage for 2,800 seniors or more than 12,000 children.
These cuts are definitely shortsighted. If Congress simply starts cutting Medicaid without considering the overall effects, it would force people to seek care in emergency rooms, and even higher spending would result, or even more people could lose coverage altogether.
Some say these are small and represent only a 1-percent cut in the program's growth over 5 years. But the President's $45 billion net Medicaid cut over 10 years is more than the $39 billion Congress has allocated to CHIP coverage for millions of uninsured children during the 10-year lifetime of that program.
I applaud the leadership of Senators Bingaman, Smith, and Coleman. I urge my colleagues to join me in supporting this important amendment.
This is important. I strongly urge our colleagues to do what is right, to not make these cuts. It is going to directly affect people. Support the Smith amendment.
Mr. President, I rise to speak in support of the amendment of my friend and to express my support of the Community Development Block Grant Program, the Economic Development Administration, and the 16 other economic and community development programs that are dramatically underfunded in this budget. It is no surprise to see this amendment coming from my distinguished colleague from Maryland. I thank him for his work on this issue, both now and in the past. Throughout his career in the Senate he has been a powerful advocate for CDBG and similar community development programs.
The CDBG Program has for 31 years provided vital funding to communities all over the United States and throughout my home State of Montana. CDBG is especially valuable to economically distressed communities that often lack basic public infrastructure. It funds a diverse range of projects. Just last year, CDBG dollars helped fund head start facilities in Havre and Kalispell, and money to help Dodson modernize their wastewater system.
A CDBG grant helped Big Horn County renovate Memorial Hospital. In Anaconda, where we have a Jack Nicklaus-designed golf-course, a CDBG loan helped renovate the Old Works Hotel, dramatically improving the region's tourism industry.
These CDBG investments leveraged millions of State and local dollars. In Montana, CDBG dollars are primarily administered at the State level, so local officials can direct the funding to the areas of greatest need. CDBG is a program that works. It is a good investment of taxpayer money that communities leverage to fund vital
projects they could not complete on their own.
And the CDBG Program has been supporting community development for the past 30 years with great success. Providing small infusions of Federal funding to jumpstart projects, CDBG has touched hundreds of Montana communities, and thousands of lives.
Unfortunately, CDBG isn't the only program on the chopping block. The Economic Development Administration is a small but crucial program that invests to help communities--particularly economically distressed communities--get ready for new businesses. EDA has a documented record of success. Since its inception in 1964, the EDA has created more than 4 million jobs and leveraged more than $18 billion in private sector investment in thousands of communities all across the country.
EDA investments in Montana have helped Montana farmers, suffering from years of draught. The Bear Paw economic development district in northern Montana used an EDA planning grant to help farmers study the feasibility of growing carrots and other vegetables in a region dominated by wheat growth for more than a century. The study demonstrated the viability of these crops, and farmers are excited to have a variety of crops to choose amongst.
Why, then, does this budget propose to eliminate it? At a time when it is critical for our country to maintain competitiveness in the global economy a proposal to eliminate a successful catalyst for economic growth is a mistake.
The growing budget deficit is a concern. But continued economic growth is central to everyone's plan to reduce the deficit. Why then are we cutting programs that spur economic growth? EDA creates jobs, more than 4 million in its history. It is essential that we preserve this job creating agency.
Our economy is in recovery, and as this recovery continues, EDA is working to make sure that all of America recovers. EDA targets its funding at economically disadvantaged communities. Areas that have recently experienced a factory closure, or a military base closure. The people who benefit the most from EDA are those who have been hurt the most by outsourcing.
States, counties, and cities are experiencing ever greater demands on their budgets. The choices they make, just like the choices we make here in the Senate, are tough, and getting tougher. The rising costs of health care, education, and other investments programs are straining local budgets to the breaking point. In some communities they have been forced to raise local taxes so high the benefits from recent tax cuts are all but gone.
We are robbing Peter to pay Paul. And it doesn't make sense to do it with agencies that have the ability to leverage their funds and ripple through their communities. For us here in Washington to eliminate Federal programs like the CDBG and EDA would devastate communities.
Cities will be forced to choose between school for our children or housing for our seniors, between improving decaying infrastructure needed to create new jobs and providing health coverage for our children. This amendment doesn't solve all of these problems, but it is a giant step to improving our communities.
Once again, I thank my colleague from Maryland, as well as all of our other cosponsors. I urge my colleagues to support this amendment. These programs create jobs and improve lives and communities all over our country. Let's not shortchange our communities that need this help the most.
I rise today in support of Senator Sarbanes' amendment to the Budget resolution that would restore funding to the Community Development Block Grant, CDBG, program and 17 other community and economic…
I rise today in support of Senator Sarbanes' amendment to the Budget resolution that would restore funding to the Community Development Block Grant, CDBG, program and 17 other community and economic development programs proposed to be eliminated.
These programs are vital to our Nation's low and moderate income neighborhoods, as these are the communities who need these programs the most.
Despite the proven results of the CDBG program and the other 17 community and economic development programs, the fiscal year 2006 budget proposes to consolidate these programs into a single Commerce Department program, resulting in a $1.89 billion cut.
In fiscal year 2005, the total budget for all 18 community and economic development programs proposed to be consolidated, including CDBG, was $5.6 billion.
The administration's proposal only provides $3.7 billion for all 18 programs, leading to a $1.89 billion cut in community development funds.
This major reduction would have a devastating impact on our Nation's neediest communities and families who rely on these programs.
The loss of funds would also impact our Nation's economy, affecting small businesses who receive loans to finance projects that lead to the creation and retention of jobs.
The Sarbanes' amendment would restore the proposed $1.89 billion cuts to the CDBG program and 17 other community and economic development programs, such as the Community Development Loan Guarantees Program and Community Development Financial Institutions Fund; retain the administration of these important programs at their current agencies. For example, the CDBG program would remain at HUD and not be transferred to the Department of Commerce; accomplish this by closing tax loopholes that an overwhelming majority of Senators voted to close in the last Congress.
While the vote to close tax loopholes was not enacted, it offers us a bipartisan way to save community and economic development programs.
The Community Development Block Grant Program is one of the most effective Federal domestic programs to revitalize urban and rural communities.
Over the past 30 years, cities, counties, and States have used more than $105 billion in CDBG funds.
Over 95 percent of CDBG funds have gone to projects and activities principally benefiting low- and moderate-income individuals and families such as housing development, recreation centers, clinics, day- care facilities, and job creation and training.
According to HUD's ``Highlights of Fiscal Year 2004 CDBG Accomplishments,'' CDBG funding led to the creation and retention of more than 90,000 jobs and 85,000 individuals received employment training nationwide in the last year alone.
In 2004, CDBG funds also helped with the rehabilitation of over 130,000 rental units and single family homes, and allowed more than 11,000 Americans to achieve the American Dream and become homeowners.
Additionally, nearly 700 crime prevention and awareness programs were
funded and child care services were provided to 100,065 children in 205 communities across the country.
In my State of California, CDBG grants are critical to both urban and rural cities who rely on these funds to serve many low-income neighborhoods.
In fiscal year 2005, California received over $526 million in CDBG funds, accounting for 12.8 percent of the total $4.1 billion grant program.
Of these funds, for example, California cities and counties received $82.8 million to the city of Los Angeles and $34.6 million to Los Angeles County; $24.6 million to the city of San Francisco; $11.5 million to Riverside County; $8.4 million to San Bernardino County; and $5.5 million to Fresno County.
Over the past 5 years, the diverse use of CDBG funds have allowed Los Angeles County to develop almost 9,000 affordable housing units, to create and preserve over 2,000 jobs, to remove over 32 million square feet of graffiti, and to provide loans and technical assistance to over 5,000 businesses among other programs.
Cuts to the CDBG program would greatly hurt Los Angeles County's low income residents, the primary beneficiaries of CDBG-funded services.
According to 2000 Census data, 17.9 percent of Los Angeles County residents had incomes below the poverty level, a far higher poverty rate than the 12.4 percent national average.
CDBG funds have not only benefited large urban counties like Los Angeles, but rural counties and cities in California as well. Here are a few examples:
The city of Porterville in the Central Valley, which has a population of over 39,000 and an unemployment rate of 12.3 percent, has utilized CDBG funds to rehabilitate over 50 homes and assist more than 200 first time homebuyers purchase their first home. Many of these first time homebuyers are farm worker families.
The city of Victorville, located in San Bernardino County, served over 2,900 senior citizens, youth, homeless, disabled, victims of domestic violence, and low-income families in 2004 with CDGB funds. Over $551,550 in CDBG grants were provided to low-income senior and disabled homeowners to rehabilitate their homes, ensuring that Victorville citizens have a safe place to live.
As you can see, CDBG funds are crucial to closing the disparity between rich and poor in so many communities in California and throughout the country.
As a former mayor, I know that CDBG resources are the most flexible dollars within city government, making them extremely valuable to the economic vitality of local communities.
We cannot allow these funds to be cut.
To do so would send the wrong message to our country's neediest communities and families who rely on these funds the most.
Although CDBG is one of the main community development programs slated for consolidation and cuts in the fiscal year 2006 budget, there are 17 other important programs that would be impacted as well.
Specifically, I would like to touch on a few of the following programs that have had a substantial benefit to counties and cities:
Community Development Loan Guarantees, section 108 loan program, funded at $7 million in fiscal year 2005, is used often with CDBG funds to finance the construction of new facilities and economic development activities such as business loans.
Through the section 108 Loan Program, the city of San Francisco has been able to construct 13 new childcare facilities which created 599 new slots for children of low-income families, and created 200 new jobs through 8 business start ups and expansions.
Brownfields Economic Development Initiative, which received $24 million in fiscal year 2005, used with the section 108 loan program, helps finance the redevelopment of seriously contaminated sites.
Cities throughout California and the Nation have received assistance through these funds to conduct environmental engineering assessments for site cleanup activities.
This amendment would also restore funding for the Community Development Financial Institutions, CDFI, which provides private sector investors with tax credits to raise money for hard to finance development projects in low-income areas, as well as other economic development programs. CDFI received $55 million in funding this year.
These community and economic development programs proposed to be cut in the fiscal year 2006 budget put Federal dollars where they are needed most by funding projects that are unique to the problems they address.
The proposed cuts to the CDBG program and 17 other programs would result in higher unemployment, diminish business creation and retention, increase the number of blighted buildings, and the number of homeless people who cannot find affordable housing.
The loss of these dedicated funds would profoundly affect our country's low and moderate income communities and residents.
We must not allow this to happen.
I urge my colleagues to vote for the Sarbanes amendment to restore funding for CDBG and the 17 other community and economic development programs proposed to be eliminated.
I thank the Chair. First I say to our esteemed colleague who chairs the Budget Committee, I think, as I have said before, he has done an excellent job on the committee and the floor in allowing…
I thank the Chair.
First I say to our esteemed colleague who chairs the Budget Committee, I think, as I have said before, he has done an excellent job on the committee and the floor in allowing important discussions and input. We all know this is about choices and priorities. We last year passed the tax loophole closings, as they have been called, some $23 billion in a business tax bill, a tax bill that I supported that did not end up becoming law. We have already joined saying there are dollars we believe would better be spent in other ways, in fairness from a tax standpoint that tax loopholes should be closed, and those equal more than what we are talking about here in terms of health care for our most vulnerable citizens.
We also, as my colleague from New Jersey has said, have choices in this country about where everyone will contribute to the quality of life, what it means to be an American, to the strength of America, to what we are proud of and our best values, or whether only some people will do that. This is a debate about values and choices. That is what a budget resolution is. It is a picture of who we are. It is a picture of our values. I can't think of anything that is worse in this budget resolution than the picture that says for the most vulnerable children, the poorest children, or poorest seniors in the country, we are going to take away health care for them. That doesn't fit with what I know about my faith and beliefs about helping the least of these. It does not reflect what the people of Michigan believe about what is important in supporting each other in community and caring about each other.
In a way it balances priorities. Obviously, we want dollars that are spent efficiently and effectively, and we want to give the States flexibility. In my home State, I am very proud of what they have been able to do in bulk purchasing for prescription drugs under Medicaid and working with other States and saving dollars, and we certainly know we want flexibility for them under Medicaid. But we also know that Medicaid is the single greatest provider of health insurance, covering over 21 million children, our future; 800,000 children in Michigan, our future. How many times do we say children are our future?
Well, this budget does not reflect that. It does not reflect that as it relates to funding their future skills and technology and education, and it certainly doesn't reflect their future if you are a poor child whose parents do not have health care.
Let me speak about a couple of people in Michigan. Betty Counts, who lives in Detroit with her daughter Yvette, who has mental and physical handicaps, is quoted in the Detroit News as saying, ``It's getting more frustrating trying to get the services I need and the help my daughter needs.'' And the budget cuts will certainly make things worse for her.
Ask Jimia Williams how much Medicaid means to her. She lives in Flint and has a 19-month-old son who has seizures and asthma. She works 35 to 40 hours a week--and most of the people we are talking about are people who are working; 80 percent of the uninsured are working 1 job, 2 jobs, 3 jobs that do not provide health insurance--but her only source of health insurance right now is Medicaid. Medicaid pays for her young son to see a neurologist and get treatments for his seizures and his asthma, and it also pays for his medication, inhalers for both of them. She said, ``Without Medicaid I would not be able to pay for my son's medical needs.''
I could go on to so many different situations, but the bottom line of this vote is about our values and our choices.
This amendment reflects what is best about America. I urge its adoption.
Mr. President, will my friend from Oregon yield for a moment?
Mr. President, I rise to thank the Senator from Oregon for his leadership. He and the Senator from New Mexico, Mr. Bingaman, have led an effort I am proud to cosponsor. His eloquence is meaningful. This is an opportunity for us to work in a bipartisan way, to lay out a process to achieve what we all want in terms of efficiencies, but to do it in a way that is thoughtful, caring, and appropriate, and to allow us to make the best decisions without hurting the most vulnerable people in this country.
I thank the Senator for his leadership.
Madam President, I appreciate very much having an opportunity to support this amendment and to be a cosponsor. I thank my colleague from Maryland for his leadership.
This is a small way in which we support local communities to create jobs, revitalize neighborhoods, support infrastructure, water, sewer, roads--those things that help create jobs.
From the highlights of the 2004 CDBG accomplishments, they show very specifically that they created or had the retention of more than 90,000 jobs last year. In a State like Michigan, this is incredibly important. Over 130,000 rental units and single-family homes were rehabbed, 85,000 individuals received employment training, 1.5 million children were served with afterschool enrichment programs, childcare services were provided to over 100,000 children and their families, 700 crime prevention and awareness programs, and 11,000 Americans became homeowners.
What is more important to each of us as parents than to be able to make sure we have shelter and a home for our children?
These are partnerships with local communities, small amounts of revenue that we bring together with our communities to make major impacts on the quality of life. That is what we are about--to partner with our local communities.
I urge the support of the amendment.
As the cosponsor with my colleague from Missouri, I would appreciate a couple of minutes to speak on the Talent-Stabenow amendment before proceeding with the other amendments.
I ask for 2 minutes off the resolution.
To my colleagues, I rise to speak in support of the Talent-Stabenow amendment. It is very simple, as my colleague indicated. It is extremely important as the Senate begins the work of SAFETEA transportation legislation.
As in past resolutions, the current budget resolution in the reserve fund section allows the budget chairman to make adjustments to the surface transportation allocation. However, this budget resolution as written ties the hands of the Finance Committee and restricts the transportation funding options available to them such as using interest from the highway trust fund and drawing down the trust fund balance.
All the Talent-Stabenow amendment would do is modify the language to put all the funding options on the table. This change would be identical to the provision in the current House budget resolution and what has been included in past House and Senate budget resolutions.
We all know how critical SAFETEA is. Transportation issues in each of our States are absolutely critical. The transportation bill creates jobs. It supports communities. It uplifts all of our roads and highways and bridges in a critically important way. I am hopeful this amendment will receive strong bipartisan support so we can pass a strong safety bill with all the options on the table and make sure we have the options available to make it the very best bill we possibly can, given all of the concerns regarding funding.
Mr. President, I rise today to discuss devastating cuts to Medicaid included the fiscal year 2006 budget we are now debating. Medicaid has been the most successful health care safety net program our…
Mr. President, I rise today to discuss devastating cuts to Medicaid included the fiscal year 2006 budget we are now debating. Medicaid has been the most successful health care safety net program our nation has ever established, protecting low-income children, the elderly and the disabled from being uninsured. Fifty-two million people count on this program and without it, these individuals would be forced to seek out care in our emergency rooms, and would likely mean that many low-income seniors in nursing homes would not have appropriate care in older age.
As you know, the budget before us includes $14 billion in cuts to the Medicaid program over the next 5 years. This is a startling number and represents the single largest cut to any program in this budget. Fourteen billion in cuts is almost as large as the entire State Health Insurance Program or SCHIP budget for the next 3 years, and equal to Federal Medicaid spending in six mid-sized States or 18 small States. If we allow this reconciliation instruction to move forward, it will have very harmful effects for those most in need all across America. These reductions will force states to cut services as well as cut access entirely for certain populations.
In my home State of South Dakota, it is estimated that these Medicaid cuts could cause a loss of coverage for 800 elderly people. These are largely individuals with severe chronic illnesses that require nursing home care. It will also cut coverage for 4,000 children in South Dakota by the end of 2010; children who would have otherwise been covered under the program if the Federal dollars would continue. These are the most vulnerable citizens in my State whose families have likely sold the farm and exhausted all of their resources just to pay for health care. They are the sickest and the poorest, and this budget tells them that we do not care.
Beyond the devastating effect on those most in need, the budget cuts will inappropriately shift the entire burden of care to cash-strapped States that are already struggling with growing health care costs and will not be able to afford these additional burdens. More than half of all States will see their Federal matching rates decline in 2006 and they will also be required to start making payments back to the Federal Government to finance the new Medicare drug coverage for dual eligibles or those people eligible for both Medicare and Medicaid. Additional Medicaid burdens are of great concern to me and the majority of Governors have also expressed their opposition to the current Medicaid budget.
These budget cuts not only mean that many South Dakotans will lose State coverage, but it also means that the State will have to cut services for those who are lucky enough not to be dropped from the Medicaid program. Cuts in services may mean that people on Medicaid will no longer be able to obtain health services such as breast cancer treatment, rehabilitative care or prescription drugs. The impact of these cuts in care will not just go away because Medicaid stops paying for treatment. Hospitals, health centers and other providers will wind up treating those patients in our emergency rooms and as charity care patients, absorbing those costs. Also, individuals who lose coverage will not have access to preventive care and will likely delay treatment until hospital care is needed. This increases the costs to the system, since a trip to the hospital is going to be much more expensive than if they would have had coverage to go to the doctor or get a prescription drug before getting sick.
Costs within the program are rising, but this is not because the Medicaid program is inefficient. The driving force behind rising costs is the result of many things. The surge in costs are due in part to Congress having failed to deal with the millions of low-income workers who are uninsured, and that Medicare does not pay for long-term nursing home care. Census data has revealed that there were 5.1 million more people uninsured in 2003 than in 2000. An unstable economy has left workers with lower incomes and employers dropping health coverage. Statistics show that two-thirds of those losing coverage are in low- income jobs. Because of these access to coverage problems, Medicaid is filling a critical gap that most in our nation support--ensuring kids have basic medical care, providing low-income working families with health coverage that keeps them healthy and productive, and making sure that seniors have the care they need in old age. These factors do not make the case for cuts to Medicaid, but rather indicate that we should be doing more to expand the program for those who lack coverage. The SCHIP program was a great example of that, and we should be doing more to pull those that are low-income and uninsured under this umbrella.
The overall rise in health care costs are also contributing to the increased expenses in Medicaid. New technologies and the skyrocketing costs of prescription drugs are sending all health care costs through the roof. Under these circumstances, Medicaid's spending per enrollee has actually been more efficient than other health care payors. The program spending has increased more slowly than private insurance spending and Medicare.
More and more poor people will need programs like Medicaid if the trends continue as they have in recent years. We should be working on solutions to reduce the costs of health care in the United States, but cutting Medicaid is not the answer. We need to closely examine our care system broadly and reduce costs by promoting the use of information technology in health, emphasizing prevention techniques that keep people healthy, and reducing the costs of prescription drugs. It will also be crucial that we closely examine our long-term care system, which accounts for almost one-third of Medicaid spending and will likely increase as our senior population increases in numbers. This is where the discussion must turn to, rather than placing the blame on the Medicaid program which has been a cost efficient, successful program ensuring coverage for millions of Americans most in need.
We will be voting soon on an important amendment offered by Senators Smith and Bingaman, as well as many others, that will strike the reconciliation instructions to the Finance Committee for Medicaid, and strike the function that directs that committee to cut the $14 billion for that program. In its place, the amendment will create a $1.5 million reserve fund to create a Medicaid Commission. I am pleased to be a cosponsor of this amendment. We do have a need to address the skyrocketing costs of our Federal health care programs and health care in general, and I think the establishment of a commission on Medicaid is a smart way to begin to find solutions. I will support this amendment and I urge all of my colleagues to do the same. We need to get our priorities straight with this budget. A budget that proposes to cut billions in health care coverage for our most vulnerable citizens while at the same time including $23 billion in tax cuts for capital gains and dividends is not a budget that represents my values or the values of the American people.
Amendment No. 204
Mr. President, I rise to introduce the Taxpayer Abuse Prevention Act. Earned income tax credit, EITC, benefits intended for working families are significantly reduced by the use of refund…
Mr. President, I rise to introduce the Taxpayer Abuse Prevention Act. Earned income tax credit, EITC, benefits intended for working families are significantly reduced by the use of refund anticipation loans, RALs, which typically carry triple digit interest rates.
According to the Brookings Institution, an estimated $1.9 billion intended to assist low-income families was received by commercial tax preparers and affiliated national banks to pay for tax assistance, electronic filing of returns, and high-cost refund loans in 2002. Fifty-seven percent of consumers who received RALs in 2003 earned the EITC. The Children's Defense Fund recently conducted a review of EITC refunds in eight states and the District of Columbia. In Texas, it is estimated that EITC families lost an estimated $251 million in tax preparation fees and high interest loans. EITC families had an estimated $82.6 million diverted to tax preparers in Ohio.
The interest rates and fees charged on RALs are not justified because of the short length of time that these loans are outstanding and the minimal risk they present. These loans carry little risk because of the Debt Indicator program.
The Debt Indicator, DI, is a service provided by the Internal Revenue Service, IRS, that informs the lender whether or not an applicant owes Federal or state taxes, child support, student loans, or other Government obligations, which assists the tax preparer in ascertaining the applicant's ability to obtain their full refund so that the RAL is repaid. The Department of the Treasury should not be facilitating these predatory loans that allow tax preparers to reap outrageous profits by exploiting working families.
Unfortunately too many working families are susceptible to predatory lending because they are left out of the financial mainstream. Between 25 and 56 million adults are unbanked, or not using mainstream, insured financial institutions. The unbanked rely on alternative financial service providers to obtain cash from checks, pay bills, send remittances, utilize payday loans, and obtain credit. Many of the unbanked are low- and moderate-income families that can ill afford to have their earnings unnecessarily diminished by their reliance on these high-cost and often predatory financial services. In addition, the unbanked are unable to save securely to prepare for the loss of a job, a family illness, a down payment on a first home, or education expenses.
My bill will protect consumers against predatory loans, reduce the involvement of the Department of the Treasury in facilitating the exploitation of taxpayers, and expand access to opportunities for saving and lending at mainstream financial services.
My bill prohibits refund anticipation loans that utilize EITC benefits. Other Federal benefits, such as Social Security, have similar restrictions to ensure that the beneficiaries receive the intended benefit.
My bill also limits several of the objectionable practices of RAL providers. It will prohibit lenders from using tax refunds to collect outstanding obligations for previous RALs. In addition, mandatory arbitration clauses for RALs that utilize Federal tax refunds would be prohibited to ensure that consumers have the ability to take future legal action if necessary.
I am deeply troubled that the Department of the Treasury plays such a prominent role in the facilitation and subsequent promotion of refund anticipation loans. In 1995, the use of the DI was suspended because of massive fraud in e-filed returns with RALs. After the program was discontinued, RAL participation declined. The use of the DI was reinstated in 1999, according to H&R Block, to ``assist with screening for electronic filing fraud and is also expected to substantially reduce refund anticipation loan pricing.'' Although RAL prices were expected to go down as a result of the reinstatement of the DI, this has not occurred. Use of the Debt Indicator should once again be stopped. The DI is helping tax preparers make excessive profits from low- and moderate-income taxpayers who utilize RALs. The IRS should not be aiding efforts that take the earned benefit away from low-income families and allow unscrupulous preparers to take advantage of low- income taxpayers. My bill terminates the DI program. In addition, this bill removes the incentive to meet congressionally mandated electronic filing goals by facilitating the exploitation of taxpayers. My bill would exclude any electronically filed tax returns resulting in tax refunds distributed by refund anticipation loans from being counted towards the goal established by the IRS Restructuring and Reform Act of 1998, which is to have at least 80 percent of all returns filed electronically by 2007.
Mr. President, my bill also expands access to mainstream financial services. Electronic Transfer Accounts, ETA, are low-cost accounts at banks and credit unions intended for recipients of certain Federal benefit payments. Currently, ETAs are provided for recipients of other Federal benefits such as Social Security payments. My bill expands the eligibility for ETAs to include EITC benefits. These accounts will allow taxpayers to receive direct deposit refunds into an account without the need for a refund anticipation loan.
Furthermore, my bill would mandate that low- and moderate-income taxpayers be provided opportunities to open low-cost accounts at federally insured banks or credit unions via appropriate tax forms. Providing taxpayers with the option of opening a bank or credit union account through the use of tax forms provides an alternative to RALs and immediate access to financial opportunities found at banks and credit unions.
I thank my colleagues, Senators Bingaman, Sarbanes, Dayton, and Durbin for cosponsoring this legislation. I also thank Representative Jan Schakowsky for introducing the companion legislation in the other body.
I ask unanimous consent that the text of the Taxpayer Abuse Prevention Act, support letters and an accompanying fact sheet from the Association of Community Organizations for Reform, the Children's Defense Fund, the Consumer Federation of America, Consumers Union, the National Consumer Law Center, the Center for Responsible Lending, and the text of the national summary of the refund anticipation studies done by the Children's Defense Fund be printed in the Record.
I urge my colleagues to support this important legislation that will restrict predatory RALs and expand access to mainstream financial services.
Mr. President, I thank Senator Gregg for the leadership he provided at the Budget Committee. This is never an easy job. I worked with Senator Pete Domenici when he was chairman, and we had this vote-…
Mr. President, I thank Senator Gregg for the leadership he provided at the Budget Committee. This is never an easy job. I worked with Senator Pete Domenici when he was chairman, and we had this vote- arama and critical votes year after year. We got it done every year except for 2 out of the last 3 years. We need this blueprint in place so we can go forward, so we can have some modicum of controlling ourselves, controlling spending.
I don't like everything in this resolution, particularly. I think right now the aggregate of money for a State is too much; the aggregate amount of money for Treasury and IRS is too much. I would like to have more in agriculture, education, transportation. But if each one of us picks our issue where, ``Oh, no, we can't have any restraint here,'' we will never have any.
I enjoy listening to my colleagues on both sides of the aisle get up and give these great speeches about how we have a problem with the deficit, we have to have restraint, and then when it comes time to have restraint, to do things to help the economy grow, or control spending in any area, we all say: No, not my area.
We have to do it across the board. We know that the problem in the Federal Government is not on the discretionary side. It is not how much we are going to be spending on highways or education. The growth there has been relatively restrained. That is true in most of these categories. The problem is in the mandatory area. Frankly, I have never liked mandatory areas. What does mandatory mean, you get it no matter what? Then a Governor or legislature can keep adding people, keep adding people, perhaps for good reason, perhaps political reasons.
All of a sudden, you have a program that grows like topsy-turvy, totally out of control. It is going to bust State budgets. It already has. It will have a huge impact on the Federal budget.
These mandatory programs are going to cause situations where we cannot continue to afford to spend what we are spending in the future, what we committed to on Social Security, Medicare, and Medicaid.
Do I think this is a great program? Yes. I personally know what they mean. I have benefited from them. I have seen what they don't do. When my father was killed in an automobile accident after 30 years of paying into Social Security, because of the marital situation and my age, our family got nothing out of it.
I would like to have some sort of system where people pay and they have an opportunity for their families to benefit, if they so choose.
Medicare--I know what it means to people who are aged and have health problems. I think what we did on the prescription drug issue was a huge mistake. We didn't have real reforms. In fact, we put more burdens on Medicare, and we are not going to be able to afford what we have gotten into on Medicare. But Medicaid is the subject for discussion. My State has wrestled with this. Over the past few years, we kept adding people and programs to it until it was not a problem for a while, but for the last 2 years it is absolutely totally out of control, and my poor State of Mississippi, there is a $270 million hole. The Governor and legislature fought about it, cussed about it, struggled with it. Finally, last Sunday night at midnight they came up with an agreement.
What was the agreement? They couldn't figure out any way to pay for it or to cut it, and they borrowed the money from the tobacco trust fund, and said: Don't worry, we will pay it back later. Excuse me? I don't think that is a very good or permanent solution. The States need help. We need to be thoughtful in how we reform Medicaid to make sure those we are committed to giving help really do get it, and that it is done in a controllable, reasonable way.
The Federal Government is part of the problem. We have to match the funds.
The President made a very small recommendation of some savings in the Medicaid area. Then the Senator from New Hampshire took that, and actually he took some of the savings and added some of it back in areas where it was badly needed, for a net savings of only $14 billion in this resolution over 5 years. If we cannot support that, we might as well fold our tent.
Let me say to my colleagues here, too, that we are going to have to do this. We are going to have to do it now and later.
When we come back out of conference, we are going to have serious reforms, or a way to get to reforms and some savings in the Medicaid area because we cannot continue down this road.
I am sorry. I am embarrassed to say that Democrats seem to not want to have any kind of restraint, and, unfortunately, some of my Republicans colleagues, too.
This is an important vote. It is not the only important vote. It is not one that will destroy the whole process, but it is going to tell a whole lot about who we are.
I don't see how anybody who votes for this amendment to knock out this little, tiny savings can ever raise their voice again and say they are worried about deficits and Federal Government spending to go on too long. I realize I am talking in very broad terms and not going into any specificity.
This is an important vote. I plead with my colleagues, show some restraint. We have shown so little restraint for several years. We have all been a part of that. But now we are paying the price. We have these deficits which we have to cut. It is estimated this resolution would cut the
deficit about half over the next 5 years. I believe that is right. It is probably not enough. We probably should do more.
The red line and the red ink on the chart in these entitlement programs is going to swamp us. Some people say we can do that later. Can we do it better later? No. Every year we wait, it gets worse. It makes the reforms and the necessary savings more difficult and larger.
I just wanted to urge my colleagues to support the Budget Committee's action and support this resolution. Don't vote to take out the tiny savings in Medicaid that is included here. The States have to be doing some of that. They show a lot more restraint and leadership than we do on them. They have one thing that is different: they have to have balanced their budgets every year. It is in their constitutions. My poor State does. Maybe someday we will still have to come back to that at the Federal level.
I thank Senator Gregg for his leadership, and I thank him for yielding.
Mr. President, I rise today to talk about Medicaid, a program that is very important to my home State of West Virginia. Over the past few days I have listened to my colleagues characterize the $15…
Mr. President, I rise today to talk about Medicaid, a program that is very important to my home State of West Virginia. Over the past few days I have listened to my colleagues characterize the $15 billion in Medicaid cuts contained in this budget as marginal, minor, and not a big deal. I want to remind my colleagues that this budget isn't simply about numbers. It is about the policies behind the numbers that have an impact on real people who would not have access to health care in the absence of Medicaid.
Medicaid is the absolute bedrock of our nation's health care system. It is the fulfillment of the promise the Federal Government has made to our Nation's most vulnerable citizens that they will have access to affordable health care when times get tough.
It finances nearly 40 percent of all births in the United States. Without it, many pregnant women would forego the prenatal visits and pregnancy-related care that are vital for a child's healthy start. Medicaid provides coverage for one in five of our Nation's children, many of whom would otherwise be uninsured. It pays for half of all nursing home care and is the largest single purchaser of long-term care services in the country.
In every State throughout our Nation, Medicaid keeps hospitals, doctors, nursing homes, and clinics operating in our communities. And, more importantly, it provides our most vulnerable citizens--pregnant women, children, the elderly, and the disabled--with access to meaningful and affordable health care.
The $15 billion in Medicaid cuts being proposed by this administration matter to the more than 50 million children, pregnant women, seniors, and disabled individuals who rely on Medicaid to meet their health care needs. Some of my colleagues would have you believe that these cuts will have no impact at all on the number of kids covered by Medicaid or the number of people who can access care in nursing homes. They even argue that these cuts will lead to Medicaid expansions because Governors will have greater flexibility over the use of their dollars.
Well, these statements simply are not true. Fewer dollars do not equal
greater flexibility. Fewer dollars mean that States, medical providers, and individual beneficiaries are going to have to shoulder more of the burden of rapidly rising health care costs. Cost-shifts of this magnitude will undoubtedly lead to eligibility restrictions, benefit reductions, increased beneficiary cost-sharing, and provider payment cuts or freezes.
States are already struggling with the numerous unfunded mandates that the Federal Government has passed down in recent years. Twenty- nine states, including my home state of West Virginia, are facing a drop in their Federal medical assistance percentage, FMAP, next year because of a change in the statutory formula used to compute FMAP.
When the Medicare drug benefit starts on January 1, 2006, states will be required to finance a significant portion of the cost. This will be the first time since the enactment of Medicare and Medicaid in 1965 that a specific Medicare benefit will be financed in significant part by state payments. The Congressional Budget Office, CBO estimates that, at a minimum, states will pay $48 billion toward the Medicare prescription drug benefit in the first 5 years. These costs could be much greater if more dual eligibles sign up for prescription drug coverage or if States have to cover the costs of drugs for dual eligibles that private drug plans do not cover.
West Virginia is scheduled to lose $36 million in Federal Medicaid matching funds in 2006. And, it is still unclear how much implementation of the Medicare prescription drug law will cost. The additional cuts proposed by the President could result in West Virginia losing as much as $100 million in Federal Medicaid matching funds next year alone. The hospitals, doctors, nursing homes and clinics in my State cannot afford to absorb cuts of this magnitude.
This budget isn't about reducing the Federal deficit. Otherwise, we would have eliminated the $70 billion in tax cuts that are contained this budget. We would have taken an objective look at entitlement spending, and not just focused on the program that provides health benefits to the working poor. We would have reined in excessive overpayments to private plans under Medicare and found ways to lower Medicare prescription drug costs.
This budget isn't about reforming the Medicaid program for the better. Otherwise, it would have addressed the real reasons Medicaid cost are going up: significant decreases in employer-sponsored health coverage and Medicare's gaps in long-term care coverage. Otherwise, the administration would have provided specific policy proposals for strengthening Medicaid for the future, instead of vague ideas that even the Congressional Budget Office could not score. If this budget were truly about improving Medicaid, then the administration would not be attempting to shoehorn sweeping changes to the program into an arbitrary budget number. Instead, Medicaid policy would determine the budget number.
I would like to say to my colleagues that Democrats are happy to discuss strengthening the Medicaid program for the future. We are happy to work toward reforming the program for the better. However, the prescription for Medicaid must adequately address the larger problems with our health care system that have an impact on the program. This is clearly not the case with this budget.
The bottom line is that this budget is about choices, and this administration has chosen to unfairly target low-income working families. This budget robs the most vulnerable in our society, while simultaneously giving greater tax breaks to the rich. This is unacceptable. The Federal Government has a responsibility to maintain its commitment to Medicaid in order to protect access to health care for working Americans.
That is why I oppose the $15 billion in Medicaid cuts included in the budget and will vote for the Smith-Bingaman amendment to strike these cuts from the budget resolution.
Mr. President, I thank the distinguished Senator from North Dakota and I thank the distinguished Senator from Massachusetts. The Senator from Massachusetts has been waiting prior to my arrival on the…
Mr. President, I thank the distinguished Senator from North Dakota and I thank the distinguished Senator from Massachusetts. The Senator from Massachusetts has been waiting prior to my arrival on the floor. I have no problem with waiting until he is recognized.
I thank the Chair. Mr. President, I thank again my friend from Massachusetts. I will try to be brief so that I do not impose on the Senator from Massachusetts.
Mr. President, in his book, ``Profiles in Courage,'' John F. Kennedy recalls the tale told by Lucius Quintus Cincinnatus Lamar, a U.S. Senator from the State of Mississippi. And I read from John F. Kennedy's book:
Lamar, in the company of other prominent military and
civilian officers of the Confederacy, was on board a blockade
runner making for Savannah harbor. Although the high-ranking
officers after consultation had decided it was safe to go
ahead, Lamar related, the Captain had sent Sailor Billy
Summers to the top mast to look for Yankee gunboats in the
harbor, and Billy said he had seen ten. That distinguished
array of officers knew where the Yankee fleet was, and it was
not in Savannah; and they told the Captain that Billy was
wrong and the ship must proceed ahead. The Captain refused,
insisting that while the officers knew a great deal more
about military affairs, Billy Summers on the top mast with a
powerful glass had a much better opportunity to judge the
immediate situation at hand.
``Profiles'' quotes Senator Lamar:
Thus it is, my countrymen, you have sent me to the topmost
mast, and I tell you what I see. If you say I must come down,
I will obey without a murmur, for you cannot make me lie to
you; but if you return me, I can only say that I will be true
to love of country, truth, and God . . .
So ends the quote from John F. Kennedy's book, ``Profiles in Courage.''
Mr. President, I have been to the topmost mast. As the senior member of the Appropriations Committee that must implement this budget, as a Senator from a State that will suffer under this budget, as a taxpayer who must bear the debt burden of this budget, I see herein calamity, tragedy, and callous indifference.
Budget deficits, we now know, are not short-term aberrations emanating from an economic recession or the attacks of September 11, as some have long maintained. They are the inevitable result--the inevitable result--of structural imbalances embedded deep within this administration's failed fiscal policies.
From $158 billion 3 years ago, to $375 billion 2 years ago, to $413 billion last year, to $427 billion this year, this administration proposes record deficits for today, for tomorrow, and for the indefinite future. So this talk about cutting the deficit in half is fiction, nothing else but fiction. This budget excludes the long-term costs of military operations in Iraq. It excludes the costs of Social Security reform.
It looks no further than 5 years down the road, effectively concealing the consequences of the administration's proposals for more tax cuts. The American people must think Congress is out of its mind to believe that a budget that proposes such enormous deficits, while excluding so much, could serve as an example of tough decisions. Well it ``ain't'' so. Rising deficits suggest just the opposite--an inability to make tough decisions. For that matter, cheap shots at programs for the elderly and poor and for rural America hardly represent tough choices.
The administration has been clear that despite the deteriorating budget, it will not sacrifice its political priorities. The sacrifice, it insists, must come from others, must come from somebody else, must come from somewhere else; from veterans, who need health care; yes, from families who cannot afford to heat their homes; yes, from students who require Federal loans; oh, yes, from our police and firefighters who need training and equipment to cope with new dangers.
In my State of West Virginia, this budget will result in tens of millions of dollars in cuts for our schools, tens of millions of dollars in cuts in nutritional childcare and family services for lower income families. It will eviscerate economic development programs, likely resulting in half a billion dollars in cuts for the State and its localities over 5 years. Yes, let them suffer the cuts. It requires cuts in Medicaid. It requires cuts in other programs that will deny affordable health care to seniors and to families across the States. All together, the cuts included in this budget amount to nickels and dimes within the context of the $2.5 trillion budget. They do not fix the deficit problem. Talk about cutting the budget deficit in half, they do not fix the deficit problem. Even with these cuts, this budget will worsen the deficit by $33 billion this year. Think about that. The Congress is proposing to cut investments that are essential to the care of our seniors, essential to our veterans, essential to our schoolchildren, and the result is a $33 billion increase in the budget deficit.
Our constituents must wonder for what they are being asked to sacrifice. A few simple phrases describe this budget: High deficits and debt, more tax cuts for the wealthy that we cannot afford, more cuts to programs for the elderly, more cuts to programs for veterans, more cuts to programs for the schoolchildren, and not a dime to ensure the solvency of the Social Security and Medicare Programs.
I think highly of the Senator from New Hampshire. I am very fond of him. I admire him greatly. He has done yeoman's work as chairman of the Budget Committee. I cannot support this budget. I defer to that great Senator's expertise on many budgetary matters. He is absolutely superb as a chairman, but the only right vote that I can see from the topmost masts that I have climbed is a vote against this budget.
I again thank my friend from Massachusetts, Senator Kennedy. I yield the floor.
Mr. President, today many Americans in communities across the Nation are being left behind in our economy. Federal community and economic development programs, such as Community Development Block…
Mr. President, today many Americans in communities across the Nation are being left behind in our economy. Federal community and economic development programs, such as Community Development Block Grants, Community Development Financial Institutions, and Economic Development Administration grants, have a history of ``being there'' for communities--providing funding for housing rehabilitation, job creation, and infrastructure. I thank Senator Sarbanes for offering his amendment to save these important programs from elimination, and I am glad to be a cosponsor. Senator Sarbanes' amendment will restore funding to these vital programs by closing tax loopholes that the majority of the Senate supported closing in the FSC/ETI bill.
The President's Strengthening America's Communities Initiatives, SACI, would fundamentally change Federal economic and community development programs serving our communities. The President's fiscal year 2006 budget eliminates 18 successful programs serving low-income urban, rural, and Native American communities. It reduces the Federal commitment to funding community development by 33 percent, cutting funding from $5.6 billion to $3.71 billion. And the President's proposal will also reduce the number of communities served. A program that serves fewer Americans with less resource can only place more families and low-income neighborhoods at risk, rather than create vibrant and strong economies as CDBG, CDFI, EDA, the Brownfields Economic Development Initiative and Section 108 loan guarantees are doing.
The real issue with federal community development assistance is the lack of financial resources for the thousands of communities struggling to remain economically competitive, not the current structure of the existing programs. While the budget resolution includes funding for tax loopholes that the Senate voted to close last year, it fails to adequately fund programs that provide affordable housing to American workers, programs that create or retain jobs in the economy, and programs that provide vital public services to our senior citizens.
In fiscal year 2003, the economy lost 486,000 jobs. CDBG projects created or retained 108,700 jobs for Americans. CDBG also has a strong record in business retention. While businesses have left American shores for other countries, CDBG ensured that over 80 percent of the businesses assisted through this program were still in operation after 3 years.
There is overwhelming opposition to the Strengthening America's Community Initiative. Mayors, local and State community development agencies, housing assistance agencies, and others from Rhode Island to Utah, and from Michigan to Texas, have written letters to Congress and to the administration opposing these devastating cuts and changes to Federal economic and community development assistance. They know that CDBG, CDFI, and EDA programs are the foundation of strong communities-- these programs are literally the building blocks of community development. A unified grant program, as proposed by the administration, will leave gaping holes in community and economic development assistance.
CDBG is the glue that holds other Federal programs serving low-income communities together. On the 30th Anniversary of CDBG in 2004, HUD Deputy Secretary Roy Bernardi said the following about the program:
HUD has a long history of 'being there' and providing help
for people, particularly those with the greatest needs--our
lower income constituents. CDBG has certainly been there,
during boom years and most importantly in times of tightening
budgets, which place greater demands on existing services. We
must continue to support and build upon programs that work,
those that have a proven record of flexibility and the
ability to fit in with locally determined needs. CDBG is such
a program and ranks among our nation's oldest and most
successful programs. It continues to set the standard for all
other block grant programs.
I want to tell my colleagues about CDBG's history of ``being there.'' In Rhode Island, CDBG was there when the West Elmwood Housing Development Corporation, a not-for-profit community based organization, needed to build and renovate affordable homes. CDBG gave Rhode Island families, who would otherwise be unable to achieve the American dream of homeownership, the chance to own their own home. In Florida, Congress turned to CDBG to provide relief after last year's devastating hurricane season, and in New York City, CDBG helped the city rebuild after the September 11 tragedy. In New Hampshire, CDBG is there for the Concord Area Trust for Community Housing to layer with Low-Income Housing Tax Credits to build affordable housing. In Ohio, Community Development Financial Institutions are there for communities across the State helping to finance businesses and microenterprises that support new jobs in the economy. And EDA was there to provide planning and technical assistance to help save 466 existing jobs and
create 78 new jobs near Billings, MT. There are no other Federal programs or tax loophole that have the history of ``being there'' like CDBG, CDFI, and EDA.
Senator Sarbanes' amendment to restore funding to these programs deserves the full support of my Senate colleagues, whether Republican or Democratic, representing an urban state such as Rhode Island or a rural state such as Montana. I hope my colleagues will join me in voting for Senator Sarbanes' amendment so that all workers, families, neighborhoods, and communities can participate in our Nation's economic growth.
Bill Text
Latest available legislative text
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 338 Introduced in Senate (IS)]
109th CONGRESS
1st Session
S. 338
To provide for the establishment of a Bipartisan Commission on
Medicaid.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
February 9, 2005
Mr. Smith (for himself, Mr. Bingaman, Ms. Snowe, Mr. Jeffords, Mr.
Santorum, Mr. Kerry, Mr. DeWine, Mr. Durbin, Mr. Chafee, Mrs. Lincoln,
Ms. Collins, Mr. Nelson of Nebraska, Mr. Voinovich, Mr. Corzine, and
Mr. Coleman) introduced the following bill; which was read twice and
referred to the Committee on Finance
_______________________________________________________________________
A BILL
To provide for the establishment of a Bipartisan Commission on
Medicaid.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Bipartisan Commission on Medicaid
Act of 2005''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) The medicaid program under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.) (in this Act referred to
as ``Medicaid'') provides essential health care and long-term
care coverage to low-income children, pregnant women and
families, individuals with disabilities, and senior citizens
constituting 1 in 6 Americans.
(2) State participation in Medicaid is voluntary, and all
States have elected to participate, administering the program
within broad Federal guidelines.
(3) The Federal Government matches the costs of delivering
covered services by participating providers to individuals
entitled to benefits that are incurred by State Medicaid
programs at rates ranging from 50 percent to 77 percent,
depending upon a State's per capita income.
(4) Medicaid pays for health care services for over \1/4\
of America's children, including children who live in poverty.
(5) Medicaid is America's largest single purchaser of
maternity care, paying for over \1/3\ of all the births in the
Nation each year.
(6) Although low-income children and their parents make up
\3/4\ of the recipients of benefits under Medicaid, they
account for only 30 percent of Medicaid spending.
(7) Medicaid is America's single largest purchaser of
nursing home services and other long-term care, covering the
majority of nursing home residents.
(8) Medicaid is an essential supplement to the medicare
program under title XVIII of the Social Security Act (42 U.S.C.
1395 et seq.) (in this Act referred to as ``Medicare'') for
over 6,000,000 low-income elderly and disabled Medicare
beneficiaries, assisting them with their Medicare premiums and
co-insurance and, in most cases, the costs of nursing home care
that Medicare does not cover.
(9) The elderly and individuals with disabilities comprise
\1/4\ of the recipients of benefits under Medicaid and 70
percent of Medicaid spending on services.
(10) States will be required, beginning in 2006, to
contribute billions of dollars to the Federal Government to
help finance the Medicare prescription drug benefit established
under part D of title XVIII of the Social Security Act.
(11) Medicaid pays for personal care and other supportive
services necessary to enable individuals with disabilities to
remain in the community, to work, and to maintain independence.
(12) Medicaid is the single largest source of revenue for
the Nation's safety net hospitals and health centers and is
critical to the ability of these providers to continue to serve
medicaid enrollees and uninsured Americans.
(13) Medicaid is the single largest Federal grant-in-aid
program to the States, accounting for over 40 percent of all
Federal grants to States.
(14) Medicaid serves a major role in ensuring that the
number of Americans without health insurance, approximately
45,000,000, is not substantially higher.
(15) Medicaid finances services for many special health
care needs populations, providing health care for 55 percent of
all individuals living with HIV/AIDS and 60 percent of all
public mental health care for people with severe mental
illnesses.
(16) Medicaid's multiple roles present financial challenges
for Federal, and State governments that warrant a comprehensive
review in light of the increasing number of uninsured Americans
and the increasing number of low-income Americans in need of
long-term care services.
SEC. 3. BIPARTISAN COMMISSION ON MEDICAID.
(a) Establishment.--There is established a commission to be known
as the Bipartisan Commission on Medicaid (in this section referred to
as the ``Commission''). The Commission shall locate its headquarters in
the District of Columbia.
(b) Membership.--
(1) Appointment.--The Commission shall be composed of 23
members to be appointed as follows:
(A) One member shall be appointed by the President.
(B) Three members shall be appointed by the
majority leader of the Senate of whom--
(i) one shall be a Member or former Member
of Congress;
(ii) one shall be an advocate for
populations who are served by Medicaid; and
(iii) one shall be a health care provider
that provides a disproportionate share of care
to recipients of benefits under Medicaid or a
representative of an organization that
represent such providers.
(C) Three members shall be appointed by the
minority leader of the Senate of whom--
(i) one shall be a Member or former Member
of Congress;
(ii) one shall be an advocate for
populations who are served by Medicaid; and
(iii) one shall be a health care provider
that provides a disproportionate share of care
to recipients of benefits under Medicaid or a
representative of an organization that
represent such providers.
(D) Three members shall be appointed by the Speaker
of the House of Representatives of whom--
(i) one shall be a Member or former Member
of Congress;
(ii) one shall be an advocate for
populations who are served by Medicaid; and
(iii) one shall be a health care provider
that provides a disproportionate share of care
to recipients of benefits under Medicaid or a
representative of an organization that
represent such providers.
(E) Three members shall be appointed by the
minority leader of the House of Representatives of
whom--
(i) one shall be a Member or former Member
of Congress;
(ii) one shall be an advocate for
populations who are served by Medicaid; and
(iii) one shall be a health care provider
that provides a disproportionate share of care
to recipients of benefits under Medicaid or a
representative of an organization that
represent such providers.
(F) Two members shall be appointed by the National
Governors Association and shall be chief executive
officers of a State who are not of the same political
party.
(G) Two members shall be appointed by the National
Conference of State Legislatures and shall be members
of a State legislature who are not of the same
political party.
(H) Two members shall be appointed by the National
Association of State Medicaid Directors and shall be
chief officials responsible for administering Medicaid
in a State who are not of the same political party.
(I) Two members shall be appointed by the National
Association of Counties and shall be officials of a
local government involved in Medicaid financing or that
directly provides medical services to Medicaid
beneficiaries and uninsured individuals who are not of
the same political party.
(J) Two members shall be appointed by the
Comptroller General of the United States and shall be
health policy experts with special expertise regarding
Medicaid or the populations served by Medicaid who are
not of the same political party.
(2) Qualifications.--The members of the Commission
appointed under paragraph (1), shall reflect--
(A) a broad geographic representation; and
(B) a balance between urban and rural
representation.
(3) Deadline for appointment.--Members of the Commission
shall be appointed by not later than the 60th day after the
date of enactment of this Act.
(c) Duties of Commission.--
(1) In general.--The Commission shall--
(A) review and make recommendations with respect to
each of Medicaid's major functional responsibilities,
including being--
(i) a source of coverage for low-income
children, pregnant women, and some parents;
(ii) a payer for a complex range of acute
and long-term care services for the frail
elderly and individuals with disabilities,
including the medically needy;
(iii) the source of wrap-around coverage or
assistance for low-income seniors and
individuals with disabilities on Medicare,
including coverage of additional benefits and
assistance with Medicare premiums and
copayments; and
(iv) the primary source of funding to
safety net providers that serve both Medicaid
patients and the 45,000,000 uninsured;
(B) review and make recommendations for a clearer
delineation of--
(i) the Federal and State roles and
responsibilities under Medicaid; and
(ii) the interaction of Medicaid with
Medicare and other Federal health programs;
(C) review and identify issues that either threaten
or could improve the long-term financial condition of
Medicaid, including forthcoming demographic changes,
Federal and State revenue options, private sector
health coverage, and health care information;
(D) review the Federal matching payments and
requirements under Medicaid, and issues related to such
payments and requirements, and make recommendations on
how to make such payments more equitable with respect
to the populations served and the States, and on how to
improve the program's responsiveness to changes in
economic conditions;
(E) review and make recommendations with respect to
health care for individuals dually eligible for both
Medicare and Medicaid, including issues related to
Federal, State, provider, and beneficiary
responsibilities, coordination, and outcomes;
(F) review research and data with respect to health
disparities for populations served by Medicaid,
particularly with respect to individuals with
disabilities or special health care needs, and make
recommendations on how to improve health quality,
coordination of services and providers, and access to health care for
vulnerable populations, including the implementation of managed care
protections for Medicaid enrollees with special health care needs;
(G) review Federal and State policies for
enrollment (including enrollment sites), income
eligibility (including methodology and length of
eligibility periods), outreach, and documentation with
respect to Medicaid and Medicare and make
recommendations on how to simplify such policies and
improve enrollment and retention in such programs and
coordination with other Federal and State programs to
improve service delivery and coverage;
(H) review the operation and effectiveness of
Medicaid premium assistance programs, including the
payment of premiums under section 1906(a)(3) of the
Social Security Act (42 U.S.C. 1396e(a)(3)) and payment
waivers under section 1115 of such Act (42 U.S.C.
1315), and the adequacy of covered benefits,
affordability of cost-sharing and premiums, and access
to care under such programs;
(I) review and make recommendations regarding
payment policies under Medicaid, including the adequacy
of such policies with respect to--
(i) managed care plans (including payment
policies for single benefit managed care
arrangements, such as managed behavioral health
and dental care);
(ii) providers in managed care, fee-for-
service, long-term care, and primary care case
management settings; and
(iii) measures to assure and reward quality
and access to care for Medicaid enrollees;
(J) review how Medicare payment policies impact
Medicaid and make recommendations on ways to address
specific payment problems that such policies may create
in service delivery to populations typically not
covered by Medicare, such as children and pregnant
women;
(K) review payments to safety net providers,
including a review of--
(i) the adjustments to payments under
Medicaid--
(I) under section 1923 of the
Social Security Act (42 U.S.C. 1396r-4)
for inpatient hospital services
furnished by disproportionate share
hospitals; and
(II) under section 1902(bb) of such
Act (42 U.S.C. 1396a(bb)) for payments
to federally-qualified health centers
and rural health clinics; and
(ii) other payments that impact the
capacity of the health care safety net to care
for uninsured individuals, recipients of
benefits under Medicaid, and other vulnerable
populations;
(L) review interstate payment, enrollment, access,
and quality concerns with respect to recipients of
benefits under Medicaid that are served by interstate
providers, and make recommendations on ways to improve
interstate health care delivery;
(M) review and make recommendations with respect to
financing and other issues impacting Commonwealth and
territorial programs as compared to other States; and
(N) review and make recommendations on such other
matters related to Medicaid as the Commission deems
appropriate.
(2) Analysis of effect of each recommendation.--Each
recommendation required under paragraph (1) shall include an
analysis of the effect of the recommendation under Medicaid
and, if applicable, Medicare and other Federal health programs,
on--
(A) Federal and State expenditures;
(B) provider payment rates;
(C) beneficiary out-of-pocket expenditures;
(D) beneficiary access to covered items and
services; and
(E) coverage of items and services.
(3) Expert advice.--The Comptroller General of the United
States and the Director of the Congressional Research Service
shall advise the Commission on the methodology to be used in
identifying problems and analyzing potential solutions in
accordance with the duties of the Commission described in
paragraph (1).
(d) General Administrative Provisions.--
(1) Terms of appointment.--The members of the Commission
shall be appointed for the life of the Commission.
(2) Vacancies.--A vacancy on the Commission shall be
filled, not later than 30 days after the date on which the
Commission is given notice of the vacancy, in the same manner
in which the original appointment was made.
(3) Chairperson and vice chairperson.--The Commission shall
designate 2 of its members to serve as the chairperson and vice
chairperson of the Commission.
(4) Meetings.--The Commission shall meet at the call of the
chairperson of the Commission.
(5) Quorum.--Twelve members of the Commission shall
constitute a quorum for purposes of voting, but a lesser number
of members may meet and hold hearings.
(6) Compensation and expenses.--
(A) Compensation.--Except as provided in
subparagraph (B), members of the Commission shall
receive no additional pay, allowances, or benefits by
reason of their service on the Commission.
(B) Expenses.--While away from their homes or
regular places of business in the performance of
services for the Commission, members of the Commission
shall be allowed travel expenses, including per diem in
lieu of subsistence, at rates authorized for employees
of agencies under subchapter I of chapter 57 of title
5, United States Code.
(7) Ethical disclosure.--The Comptroller General of the
United States shall establish and implement a system for public
disclosure of financial and other potential conflicts of
interest by members of the Commission.
(e) Staff and Support Services.--
(1) Executive director.--The chairperson and vice-chair
shall appoint an executive director of the Commission.
(2) Staff.--With the approval of the Commission, the
executive director may appoint such personnel as the executive
director determines to be appropriate.
(3) Applicability of civil service law; etc.--The executive
director and staff of the Commission shall be appointed without
regard to the provisions of title 5, United States Code,
governing appointment in the competitive service, and shall be
paid without regard to chapter 51 and subchapter III of chapter
53 of title 5, United States Code, relating to classification
of positions and General Schedule pay rates, except that the
rate of pay for the executive director and other personnel may
not exceed the rate payable for level V of the Executive
Schedule under section 5316 of such title.
(4) Experts and consultants.--With the approval of the
Commission, the executive director may procure temporary and
intermittent services under section 3109(b) of title 5, United
States Code.
(5) Federal agencies.--
(A) Staff of other federal agencies.--Upon the
request of the Commission, the head of any Federal
agency may detail, without reimbursement, any of the
personnel of such agency to the Commission to assist in
carrying out the duties of the Commission. Any such
detail shall not interrupt or otherwise affect the
civil service status or privileges of the Federal
employee.
(B) Technical assistance.--Upon the request of the
Commission, the head of a Federal agency shall provide
such technical assistance to the Commission as the
Commission determines to be necessary to carry out its
duties.
(6) Other resources.--The Commission shall have reasonable
access to materials, resources, statistical data, and other
information from the Library of Congress and agencies and
elected representatives of the executive and legislative
branches of the Federal Government. The chairperson or vice-
chair of the Commission shall make requests for such access in
writing when necessary.
(7) GAO services.--
(A) Physical facilities.--The Administrator of
General Services shall locate suitable office space for
the operation of the Commission. The facilities shall
serve as the headquarters of the Commission and shall
include all necessary equipment and incidentals
required for the proper functioning of the Commission.
(B) Administrative support services.--Upon the
request of the Commission, the Administrator of General
Services shall provide to the Commission, on a
reimbursable basis, such administrative support
services as the Commission may request.
(f) Powers of the Commission.--
(1) Hearings.--The Commission shall conduct public hearings
or forums at the discretion of the Commission, at any time and
place the Commission is able to secure facilities and
witnesses, for the purpose of carrying out the duties of the
Commission.
(2) Studies or investigations.--Upon the request of the
Commission, the Comptroller General of the United States, the
Medicare Payment Advisory Commission, or the Director of the
Congressional Research Service shall conduct such studies or
investigations as the Commission determines to be necessary to
carry out its duties.
(3) Cost estimates.--The Director of the Congressional
Budget Office, the Chief Actuary of the Centers for Medicare &
Medicaid Services, the Medicare Payment Advisory Commission, or
all three, shall provide to the Commission, upon the request of
the Commission and without reimbursement, such cost estimates
as the Commission determines to be necessary to carry out its
duties.
(4) Gifts.--The Commission may accept, use, and dispose of
gifts or donations of services or property.
(5) Mails.--The Commission may use the United States mails
in the same manner and under the same conditions as Federal
agencies.
(g) Report.--
(1) In general.--Not later than 14 months after the date of
enactment of this Act, the Commission shall prepare and submit
a report that contains a detailed statement of the
recommendations, findings, and conclusions of the Commission
(as determined in accordance with paragraph (3)) to each of the
following:
(A) The President.
(B) The Committee on Finance of the Senate.
(C) The Committee on Energy and Commerce of the
House of Representatives.
(D) The chief executive officer of each State.
(2) Availability.--The report shall be made available to
the public.
(3) Recommendations, findings, and conclusions.--The
recommendations, findings, and conclusions of the Commission
shall be included in the report under paragraph (1) only if--
(A) each member of the Commission has had an
opportunity to vote on such recommendation, finding, or
conclusion;
(B) the results of the vote are printed in the
report, including a record of how each member voted;
and
(C) at least 14 of the 23 members of the Commission
voted in favor of such recommendation, finding, or
conclusion.
(h) Authorization of Appropriations.--There is authorized to be
appropriated to the Commission such sums as may be necessary to carry
out this section.
(i) Definition of State.--In this Act, the term ``State'' has the
meaning given such term for purposes of title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.).
(j) Termination.--The Commission shall terminate on the date that
is 30 days after the date on which the Commission submits the report
under subsection (g) to the President, Congress, and the chief
executive officer of each State.
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