Floor Statements

Mr. Speaker, I thank the gentleman from Washington (Mr. Inslee) for yielding me time on this important motion. I commend the gentleman for this motion and for his efforts on the prescription drug bill that we have before us tomorrow.

This motion speaks to a fundamental problem that has existed in rural America in particular for many, many years; and coming from western Wisconsin, the Third Congressional District that I represent, I have devoted a lot of my time to try to deal with the inadequacies of Medicare reimbursement that have adversely affected my rural hospitals.

This motion would ask for raising the average standardized amount for hospitals in rural areas, as well as raise the physicians' work geographic index. Why is this important? Well, rural hospitals have been suffering for a long time. Sixty percent of the rural hospitals in my district and throughout the country are not receiving adequate Medicare reimbursement to cover the costs of treating Medicare recipients. Over the last 25 years, we have lost 475 rural hospitals which have gone out of business, partly due to the fact of the inadequacy of the Medicare reimbursement formula.

On average, my rural hospitals receive about 25 percent less than the average Medicare reimbursement throughout the country. This is a serious issue that needs serious attention.

The bill before us tomorrow I feel has a very good provider aspect with it, but the provider aspect is paid for. There are offsets found in the budget in order to pay for that. One of the chief concerns I have with the Medicare bill that is going to come before us tomorrow is there is no cost containment, and these costs are going to explode in future years. As a way of dealing with the rising prices of prescription drugs, one is allowing generics to enter the market on a competitive basis when the patents on brand-names expire. Another is to allow the Federal Government to negotiate prices with the pharmaceutical companies, even though there is specific language in this bill that specifically prohibits any price negotiation. Finally, is to allow the reimportation of FDA-approved drugs in a country like Canada back into the United States, something that many of my seniors in Wisconsin are already doing.

Mr. Speaker, if we are concerned about the costs of this bill, we would implement these practical measures. The easiest thing to do in the world of politics is to pass a bill we do not pay for and stick it to our kids and our grandchildren in future years, and that is exactly going to be the outcome of this bill tomorrow if we do not come to grips with the cost factor of rising medications.

Mr. Speaker, on Monday, November 17, 2003, I was unable to record my vote on three resolutions under suspension of the rules, and one motion changing the hour of meeting. My unavoidable absence was due to the fact that I was hosting an important forum on Chronic Wasting Disease in Wisconsin with federal and state leaders.

Had I been able to vote, I would have voted the following:

Roll call #620: Yes, Roll call #621: Yes, Roll call #622: Yes, Roll call #623: Yes.

Mr. Speaker, I thank my friend and leader from Michigan for yielding me this time, and I appreciate and commend to him bringing this motion tonight. This is a very important

program in regards to higher education funding, and the gentleman from Michigan (Mr. Kildee) is someone who probably has more institutional knowledge in regard to the education programs and the funding of education programs than anyone else in the House of Representatives.

I think this is an important motion. It is a timely motion because of the trend that will be set here with the precedent being created in the next fiscal year as far as freezing the average Pell grant award given in this country. But just to be clear, the motion calls for not less than the House number that we should strive for in conference, and I appreciate the work the chairman has done in regard to the defense of education funding programs. He has been a champion in this issue. But what is being called for now is for the first time in over a decade freezing Pell grant awards at $4,050. If this goes through, this will affect adversely 86,000 more students who would normally qualify for Pell grants, but will be shut out of the system.

In Wisconsin, the State that I represent, we have 58,000 students who rely on Pell grants in order to go on to post-secondary education opportunities. There are five State universities in my congressional district alone. Thousands of students in Western Wisconsin rely on Pell grants in order to open up the doors to higher education.

Not only by underinvesting in this area will we have an adverse impact on future economic growth. I submit that it is going to have national security implications as well. I think this body would be well served to spend a little time studying the trends of places like China and India and the education infrastructure going on in those countries and the numbers of undergraduates that they are producing every year, which are going up year by year, including more engineering students being graduated in China and in India; and if we do not invest in the future of our country, our youth, we are going to leave them in a tough position to be able to compete in the global marketplace, not to mention perhaps slipping in regard to the technological edge and superiority that we now hold as a Nation compared to other nations that are investing in this area.

Just as an example, China yesterday announced that they are going to increase the fuel efficiency standards for the cars sold in China at higher standards than what exists here in the United States of America. Part of that is going to involve advances in technology to enable them to do it. It is an embarrassment that China is taking this unprecedented step, and we know in our gut that we should be doing it here as well.

When the original Pell grant program was passed many years back, it accounted for roughly 86 percent of the cost of a student with tuition and fees and room and board. Today, that slips below 50 percent. Now there is greater reliance on loans for students to finance their education.

Again, in my congressional district, the average student, when they do graduate from a 4-year university, is facing on average about $17,000 of debt coming out of school because of the greater reliance on loans as opposed to these grant programs. We are forcing them to dig a fiscal hole at a crucial time in their life when they are trying to start a career, have a family, have children, and this trend has been going on for some time.

My colleagues on the other side are finally pointing to the graph and that, but they often neglect it was President Clinton that was forcing this investment in college education programs, why we saw the consistent trend line in the 1990s; but let us also remind ourselves that he was doing that in the context of balanced budgets and budget surpluses, because there is nothing easier to do in this place than to pass a bill that is not paid for, and this has been a consistent trend for the last few years: a $30 billion energy bill yesterday, perhaps a $400 billion prescription medication bill later on this week, not paid for, all deficit financing. That is easy politics to support, but when the Clinton administration was increasing Pell grant awards during the 1990s, we were doing it in an era of budget surpluses, with fiscal discipline and fiscal responsibility.

Hopefully, they are not crowing too loudly in regard to what was occurring in the 1990s versus the freeze now that we are seeing under one-party control here in Washington.

This is an important program. It does affect so many students. Again, by freezing not only the Pell Grant program but by freezing all campus- based student aid programs, college work study programs, SEOGs, Perkins' loans, the LEAP program, we are going to be forcing more and more students to have to build a debt route to finance their schooling, but more importantly closing the door of opportunity for many students who would otherwise qualify for higher education, but will not be able to afford it because of the lack of resources that are available.

So I hope that my colleagues support this motion. I commend the gentleman from Michigan for raising this issue in a timely basis. Again, I commend the work that has been done even on the other side, of the chairman in his defense of a lot of education funding in this fiscal year and also in past years. But this is important and we should not lose sight in regard to the crucial investments that have to be made for the future of our country, the youth of our Nation.

Mr. Speaker, will the gentleman yield?

Mr. Speaker, I would be happy to clarify my statement. By freezing the Pell Grant award in regard to the funding level that is established, there has been a score indicating that 86,000 more students who would otherwise qualify for Pell Grant funding will not qualify as a consequence. This is nationwide, not just in the State of Wisconsin.

Mr. Speaker, if the gentleman will continue to yield so that I can clarify myself, it is in the context of all the regulatory changes as well that the administration is proposing in the formula and the effect that that would have on the 86,000 students in this country that this side is very concerned about and we are hoping to engage our colleagues' support on the issue as well.

Mr. Speaker, as ranking member of the Subcommittee on Energy and Minerals Resources of the Committee on Resources, I rise in disappointed opposition to H.R. 6.

Like my friend and colleague, Mr. Dingell, I too was a conferee ``in name only'' on a bill that should have been--and could have been--a comprehensive and balanced plan for our Nation to meet its short and long term energy needs.

The centerpiece of this atrocious energy bill is a multi-billion dollar package of tax breaks and incentives designed to slant the market in favor of fossil fuel industries, and away from meaningful reform through the development of safe, clean and renewable alternatives. Should this bill pass, the Republican leadership will have locked the American economy into the old energy regime for most of the 21st century, with dire environmental and global security consequences.

Current provisions of the bill offer an inexcusably watered down version of the renewable energy production incentives program for solar, wind and geothermal energy, with meager and uncertain monetary incentives, barely reaching $5 million per year, providing little impetus for installing new capacity and unlikely to affect investments in renewable energy in any meaningful way. In addition, conservation efforts, such as mandating the reduction of one million barrels of oil per day by the year 2013, as the other body had approved on a vote of 99-1, was simply left out of the Republican planning.

The few good provisions of the bill, like the renewable fuel standards provision and its potential to aid our Nation's struggling family farmers, have been suffocated by the bloated excess and taxpayer-funded subsidies for some of our Nation's largest oil and gas companies.

Mr. Speaker, when the House considered the energy bill this past spring, I led an effort to stop the Federal Government from providing ``royalty relief'' for multi-billion dollar oil companies such as Exxon Mobil and Chevron Texaco operating on public lands and in coastal waters. This ``royalty holiday'' was once characterized as ``giving major oil companies a huge tax break'' by a candidate for the 2000 presidential election . . . No, not Al Gore but George W. Bush.

So what happened to that assessment? How can President Bush now support a bill that not only contains this very same taxpayer funded giveaway to some of the biggest oil companies in the world--already swimming in huge profits--but a bill that actually expands them?

Unfortunately, the House-passed oil and gas incentive provisions were scored by CBO and projected to reduce the Federal revenues by $20 billion over ten years. The total cost of this bill is $141 billion and it is not paid for. It will be added to historically larger budget deficits for many years.

Mr. Speaker, our Nation is facing huge structural budget deficits, escalating war costs and a sluggish economy. We simply cannot afford to open our checkbook and spend the American taxpayers' money to subsidize industries to do what their business plan would have them do anyway-- explore and produce domestic energy sources if it is cost effective to do so.

Mr. Speaker, I rise today to honor the work of Sister Leclare Beres from La Crosse, Wisconsin, in recognition of her retirement. Sister Leclare has worked tirelessly for many years as a nurse and a nun, aiming to provide all people with access to healthcare.

Sister Leclare grew up in Elroy, Wisconsin. Living on a farm, surrounded by her large family, she learned early the importance of hard work and compassion to others. In the early 90s, Sister Leclare saw the medical needs of refugee immigrants and called upon the four area hospitals to sponsor a free clinic. The Indochinese Screening Clinic later became the St. Clare Health Mission. As the director of the St. Clare Health Mission, Sister Leclare has been a leader in providing health services to the poor in the La Crosse, Wisconsin area. In addition, she has worked in Guam and Jamaica as well as with organizations such as Place of Grace and the Salvation Army.

Moreover, after she retires this fall, her dedication to the poor will live on as she plans to volunteer at the St. Clare Health Mission where she has served as its only director for ten years. I am pleased that her efforts and giving spirit have earned her multiple honors, including the Pope John XXIII Award from Viterbo College, the YWCA Tribute to Outstanding Women in the Medical Field, and the 2002 La Crosse Tribune Person of the Year.

Aside from her amazing gifts in working with persons who are poor and sick, Sister Leclare has impressive organizational talents. She would regularly coordinate the 200 plus medical professionals and community volunteers who came each Tuesday and Thursday evening to serve at the St. Clare Health Mission. In this feat, Sister Leclare was able to bring together a community to address the needs of its neighbors and sought a solution to the limited access to healthcare that many Americans face.

Mr. Speaker and my fellow Members of Congress, I ask that you join me in honoring the dedication and service of Sister Leclare Beres as she retires. She is a role model of service, compassion, and generosity, and we could all learn from her dedication.

Thus, I would like to leave you with the words of Sister Leclare's successor, Sister Dawn Kutt. ``Sister Leclare's compassion for the poor and underserved dwells deep within her heart's desire. Her service to the poor is undertaken with joy and tender love as her gentle presence reflects God's love for each of them. She certainly brings the richness out of the poorest of God's poor.''

Mr. Speaker, I thank my friend for yielding me time.

Mr. Speaker, I rise in reluctant opposition to this martial rule. I do not understand why we cannot follow regular process around here to give this body a chance to actually look at the supplemental, $87 billion, the largest in our Nation's history, so we know the details that are contained in it.

Just a couple of weeks ago, I had the opportunity to visit Iraq and visit our troops in the field. They are doing an incredible job under very difficult and dangerous circumstances. And, of course, this body is going to do everything we can to make sure they have the tools and the resources they need so they can do their mission safely and return home soon. But this process is out of order, and we are derelict in our duty in regard to the accountability to the American taxpayer.

We do need accountability, and that is why earlier the gentleman from Maryland (Mr. Cardin) and I offered an amendment with this bill that would have slashed the reconstruction funds in half, requiring the administration to come back to account for how the money is being used and to justify the need for more.

Instead, we are giving them $20 billion when the World Bank just released a report indicating that Iraq cannot absorb more than $6 billion in the next year anyway for reconstruction.

But I am also concerned that these conference committees are becoming the black hole of the democratic process. The will of the House and the will of the Senate go in, but it never comes out. Specifically, in both the House and the Senate with wide bipartisan majorities, it was determined that we wanted to provide half the reconstruction funds in grants and the other half in loans, recognizing Iraq is sitting on the second largest oil reserve in the world, but also it would give us some bargaining position with the rest of the nations holding debt over Iraq to hopefully get them to forgive the debt. But any loan in this has been vanished in the conference committee; and, instead, the administration wants to just gift outright the $20 billion, requiring our children and grandchildren to pick up the tab for many years to come.

We want to do right in Iraq. We do not have the luxury of cutting and running. We must succeed, but this process is not the way to do it.

Mr. Chairman, I offer an amendment.

Mr. Chairman, I yield myself 2\1/2\ minutes.

Mr. Chairman, last week I had the opportunity to travel to Iraq visiting our troops in the field, and they are doing an incredible job under difficult and dangerous circumstances. Clearly, our Nation is paying a very high price in both lives and money due to the unilateral action that was taken in Iraq. Their high level of sacrifice, quite frankly, has not been met by the high level of planning that is required for this mission. I believe we have been derelict in our duty in Congress in demanding more accountability and more justification in regards to the expenditure and the use of the funds that are before us today and have been appropriated earlier this year.

That is why the gentleman from Maryland (Mr. Cardin) and I are offering this amendment which could be titled The Enhanced Accountability and Detailed Accounting Amendment, which would slash the reconstruction funds by one-half, not because we do not believe in the mission, but because we believe the administration should come before Congress to justify in a detailed fashion what current funds are being used for and what future funds are being requested and for what purpose.

The World Bank and IMF released a report last week that indicated that for the next year in Iraq, we cannot spend, more than $5 billion without running into difficulty, and yet we have a $20 billion reconstruction request before us today.

As a member of the Committee on the Budget, it has been very frustrating trying to get detailed listings of the amount of money being spent and for what purpose. Mr. Zakheim, Comptroller for Defense, indicated yesterday before us that it was the administration's intent to keep coming to Congress for future supplemental requests which do not have to be offset, which will result in more deficit financing, instead of budgeting it in the normal budget process.

We think it should be budgeted with future requests. I also believe by slashing funds by one-half, we would encourage greater savings and cost efficiencies.

I met with Kuwaiti officials last week who indicated that they did not understand what the administration was doing in Iraq. They were sitting on multiple 3,000 megawatt generators not being used and not being requested by the United States for use in Iraq. They are also sitting on multiple desalinization machines that could be used in Iraq to help with clean water difficulties; but again, they were not being asked to contribute.

General Petraeus of the 101st Airborne, when he discovered from U.S. engineers that it was going to cost somewhere between $15-$20 million to restore a cement factory in northern Iraq went out and talked to local Iraqi officials and was able to get the job done for $80,000.

I believe this Congress has an obligation to the American taxpayer, an obligation to our children and to our grandchildren to ask questions and to demand accountability in regards to the use of these reconstruction funds, and I would encourage support for my amendment.

Mr. Chairman, I yield the balance of my time to the gentleman from Maryland (Mr. Cardin), one of the most fiscally responsible Members of this Congress.

Mr. Chairman, I demand a recorded vote.

Mr. Chairman, I thank my friend and colleague, the gentleman from Wisconsin (Mr. Obey) for yielding me this time.

Last week I had the opportunity and the privilege to travel to Iraq. We met with troops on the ground, military command, the civilian administration with CPA. And nothing has made me more proud to be an American than the opportunity to visit our troops in the field, whether it has been in Bosnia, Kosovo or now in Iraq. They are doing a tremendously good job under very difficult and dangerous circumstances.

And I believe General Zinni was right when he said that the high level of sacrifice that our troops and their families have made for this mission has not been met by the high level of planning that was required for this mission.

But whether one agrees with the merits on the methodology of going into Iraq, now that we are there, I believe that we must succeed. Failure is not an option. We do not have the luxury of cutting and running right now. But what we do from this point on can make all the difference.

That is why I stand in support of the Obey substitute, which I think is a commonsense, practical approach of leveraging the limited funds that we have available to put in Iraq through the World Bank, but also diversifying the many resources for our troops and enhancing the quality of life issues that are so important to them in their performance, and also by asking another segment of our country to contribute something as well, the upper 1 percent of the wealthy in this Nation, who if they were to postpone or freeze their tax cut would pay for this entire supplemental along with additional

funds in the future which will be needed. It's the right thing to do for the sake of our children.

I believe we need to internationalize this. And, hopefully, the U.N. unanimous vote today will help bring us closer to sharing the burden and bringing legitimacy to the process with other lay nations who can contribute troops and resources in a meaningful way. Thus far, we are paying a very high price in both lives and money due to the unilateral action in Iraq.

But I also believe we must work simultaneously on empowering the Iraqi people themselves to take control of their own destiny and have control of their own fate. Because, at the end of the day, it is going to be the attitude of the Iraqi people themselves that will determine the future of their country.

So I beseech my colleagues to give it due consideration and to support the Obey substitute which addresses so many of these issues in a practical and commonsense fashion. We can support our troops and the goals in Iraq, but we can do it in a fiscally responsible manner or we will build upon the legacy of debt that our children and grandchildren will inherent.

Mr. Chairman, I thank my friend from Indiana for bringing this amendment and discussing a very important issue in tonight's debate.

This was an amendment that I intended to offer myself because it made sense, one-half grant, one-half loan. Grant money can go out the door right away to keep continuity of the reconstruction effort which is important, but the loan aspect is a fundamental recognition that the Iraqis are sitting on a $7 trillion oil reserve, the second largest in the world, but also, it may leverage our negotiator's position going into Madrid next week that they have $10 billion to put on the table to get other countries to give up the loans that they currently have. It also addresses an issue in regard to whether fiscal responsibility is going to seep into this debate.

We can continue the gifts and the grants to the Iraqi people but continue leaving this tremendous legacy of debt for our children and grandchildren to inherit, or we can try making a statement that it is this generation's obligation to pay the ongoing obligations that we have incurred, not our children and not our grandchildren. That is why this amendment makes sense, and I commend my friend from Indiana for raising this issue this evening.

Mr. Speaker, on Tuesday October 7, and Wednesday October 8, 2003, I was overseas on an official congressional delegation trip to Iraq and unable to have my vote recorded on the House floor.

Had I been able to vote I would have voted the following: Rollcall No. 532: ``yes''; Rollcall No. 533: ``yes''; Rollcall No. 534: ``no''; Rollcall No. 535: ``yes''; Rollcall No. 536: ``yes''; Rollcall No. 537: ``yes''; Rollcall No. 538: ``yes''; Rollcall No. 539: ``yes.''

Mr. Chairman, I offer an amendment.

Mr. Chairman, I yield myself such time as I may consume.

Let me thank my friend, the gentleman from Tennessee (Mr. Duncan), for the courtesy and consideration that he is showing in allowing this brief discussion.

It is my intent that after a brief debate on this amendment I will ask unanimous consent to withdraw and we will go to final passage at this time.

Mr. Chairman, let me first of all commend the work that the Committee on Transportation and Infrastructure has done on this important piece of legislation. I think it is a good bill. It is a bill that can be made better. I think there has been important progress in a variety of areas, especially the provisions relating to the Corps of Engineers reform.

Mr. Chairman, I believe that the inclusion of these critical Corps reform measures demonstrate a critical recognition that reforms are necessary in how the Corps of Engineers conducts their projects throughout the country and accomplish many of the goals that I set forth nearly 4 years ago when I introduced the Army Corps of Engineer Reform Act of 2000.

These efforts are an important first step towards assuring that the Corps properly plans, constructs, and operates projects and provides Congress with accurate information.

My amendment, Mr. Chairman, briefly would build on the committee's efforts to improve the Corps record on mitigation of civil works projects. The committee took an important step in requiring the Corps to include critical information in its mitigation plans. Unfortunately, I do not think it goes quite far enough.

I am hoping that we can keep an open mind as the Senate begins their work on WRDA and as we enter the

conference committee that perhaps some more improvements can be made with the Corps reforms that are recommended in this base bill.

The Corps track record on mitigation certainly needs improvement. In May 2002, the General Accounting Office reported that the Corps had proposed no mitigation for almost 70 percent of its projects. In addition, despite the existing requirement that the Corps carry out its mitigation concurrently with project construction, the GAO also reported that the Corps has not done so for over 80 percent of the projects where mitigation is supposed to occur.

Mr. Chairman, failure to properly mitigate has real implications for the Nation's health and economic well-being. For example, when wetlands losses are not mitigated, water quality is harmed, water supplies are strained, flood damage increases, and wildlife is harmed. Wetlands filter pollutants from water, absorb and slow the release of storm runoff, recharge aquifers, provide crucial wildlife habitat for millions of migrating waterfowl, shore birds, and other species and provide recreation and enjoyment to millions of Americans who visit wetlands areas throughout the year. We must correct this situation and quickly.

My amendment to section 2030 would do so by requiring the Corps to first fully mitigate habitat loss from the construction of Corps projects by replacing at a minimum each acre of damaged habitat with an equivalent or superior acre of habitat.

Second, complete at least 50 percent of mitigation before construction begins with the remainder to be completed when the project construction is complete wherever it is physically possible.

Third, to prepare detailed mitigation plans that have a high likelihood of successfully replacing loss values and that require monitoring to ensure success.

I wish to emphasize that these recommendations are not mine alone but are also those from a panel of experts of the National Academies of Research Council. Speaking to the specific issue of compensating for wetland loss, the NRC's Water Science and Technology Board recommended, ``Restoration and creation of wetlands should occur simultaneously or before the filling of the natural wetland and according to established design criteria that are better monitored and enforced.''

Again, I would reiterate that hopefully we can keep an open mind as we move forward with the work of the Senate and begin work on the conference report whenever that might occur so we can improve upon, I think, significant improvements that have been made in the area of Corps reform and perhaps produce a better bill at the end of the day for the protection of wetlands and habitats throughout our country.

Mr. Chairman, I reserve the balance of my time.

Mr. Chairman, I yield 2 minutes to the gentleman from Oregon (Mr. Blumenauer).

Mr. Chairman, I yield myself such time as I may consume, and again I want to thank my friend from Tennessee for the courtesy he has shown and my colleagues for their patience.

Mr. Chairman, I ask unanimous consent to withdraw my amendment.

Mr. Speaker, I offer a motion to instruct.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, what this motion to instruct basically states is asking for some fairness and some equity in regards to the rural health care providers during the Medicare reform conference discussions that are taking place right now.

Mr. Speaker, rural America is often called the backbone of our country, and rightly so. It is rural America where so many of our parents and grandparents grew up, and it is to rural America that many of our veterans, teachers, and farmers retire.

There are 9 million Medicare beneficiaries in rural communities, and these seniors tend to be older. They tend to be sicker. They tend to have a little less money than those in urban communities. Rural seniors are in great need, and we must be sure that any Medicare bill does not leave these citizens out in the cold.

Yesterday, the House voted on an identical motion offered by my good friend the gentleman from Texas (Mr. Stenholm). Unfortunately, the motion was defeated, 202 to 213, with 19 Members absent. We are hoping to give those absent Members another chance to come and vote and participate in this discussion, and hopefully then have the votes to prevail on this motion to instruct.

There are many Members on both sides of the aisle, Mr. Speaker, that come from rural areas, from rural districts. I do not for the life of me understand why a Member from a rural area would oppose a motion to instruct on this basis. I think it makes a lot of sense.

This is not an ideological or partisan issue, this is a geographic issue, and we are asking for some fundamental fairness and some equity in dealing with rural health care providers.

I believe Medicare recipients deserve a prescription drug plan under Medicare, and I believe that all seniors, regardless of their location, should have access to affordable, stable drug benefits. H.R. 1, however, lacks a guarantee that seniors living in rural areas will have access to such a plan.

Rather than gaining a drug benefit under Medicare, seniors would have to join a managed care plan or purchase a private drug-only plan. For rural seniors, only 19 percent of whom had access to a Medicare-managed plan in 2003, this could be disastrous. In effect, seniors in rural areas would be subsidizing prescription drugs for others, but would not get a drug benefit plan of their own.

I am not prepared to tell seniors in my district in western Wisconsin that some seniors will be getting a drug benefit, when they will not.

The Senate Medicare bill, recognizing the instability of private plans in rural areas, provides a fallback, meaning that traditional Medicare would offer its own prescription drug plan to areas with fewer than two private plans available to Medicare recipients. I urge the conferees to recognize the importance of offering prescription drug plans to all Medicare enrollees and to accept the Senate provisions.

Yesterday, some of my colleagues on the other side of the aisle argued that the instructions in this motion would lead to greater spending and higher deficits. I am committed to being fiscally responsible at all times and reducing the deficit, and this motion does not call for exceeding the budget limit of $400 billion allotted for this Medicare reform bill. Rather, this motion instructs the conferees to carefully assess their priorities in allocating the $400 billion. I hope that this dispels any confusion over the costs advocated by this motion, and I hope that my colleagues across the aisle will be able to join in supporting it.

We have seen too many rural hospitals close, over 470 in the last 25 years alone, and rural hospitals all over the country are in danger of being forced to shut their doors forever. Currently hospitals receive full inflation or market basket payments for inpatient and outpatient services. H.R. 1 would reduce hospital payment updates

for the next 3 years, which the CBO estimates would lead to a $12 billion loss to hospitals over the next decade.

Currently over 57 percent of hospitals in America lose money when serving Medicare patients. We cannot ask hospitals to continue to accept Medicare payments that are below the cost of delivering the care they provide. The Senate bill makes no such cuts to the market basket payments and would keep rural hospitals in business. I urge the conferees to reject the House provision and accept the Senate provisions.

Geographic disparities in Medicare reimbursements disproportionately affect rural providers. In my State of Wisconsin, providers are paid 25 percent less on average per Medicare beneficiary. The motion encourages the conferees to adopt the best-world provisions in both bills. These provisions go a long way to reduce geographic disparities.

Physicians and specialists are scarce in rural areas. In fact, less than 10 percent of physicians practice in nonmetropolitan counties. It is not surprising, given that rural providers consistently receive lower reimbursement rates than providers in the rest of the country.

These providers who do deal with the unique challenges presented by health care in rural areas are the pillars of our communities, and fair payments to rural providers mean quality health care for our Nation's seniors.

Physicians in rural communities see a large percent of Medicare patients. This motion instructs conferees to include the best provisions of the Senate and House bill. We must insist that rural providers and beneficiaries are protected and that critical-access hospitals are maintained and improved.

I would be disappointed if my colleagues on the other side of the aisle did not join in voting for this motion and supporting providers in their communities. Yesterday's close vote on a motion identical to this one shows that many of us are concerned about the crisis of health care in rural areas. By again offering this motion, and by dispelling the myth that these instructions would lead to a more expensive Medicare bill, I hope that those Members who were absent yesterday, as well as those Members who truly do care about the state of rural health care in our country, will cast a vote in favor of this motion.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, that large government-run program is called Medicare, a very successful and highly popular program for seniors throughout the country.

Mr. Speaker, I yield 4 minutes to my friend the gentleman from Texas (Mr. Stenholm).

Mr. Speaker, I yield 4 minutes to the gentleman from Ohio (Mr. Brown), a true champion of rural health care providers and rural health care patients.

Mr. Speaker, I yield 3 minutes to the gentlewoman from Oregon (Ms. Hooley), a true champion of seniors in rural America and in her congressional district.

Mr. Speaker, I yield myself such time as I may consume.

I am sure the gentleman from New Jersey must realize that the conference and negotiations are ongoing and that these very decisions have yet to be made. I am surprised by the rhetoric on the other side that they do not recognize that 39 Republican Senators recently voted for a Medicare prescription drug fallback provision. They had to have known what they were doing on that vote.

Mr. Speaker, I yield 6 minutes to the gentleman from Alabama (Mr. Davis), one of the youngest and brightest minds of the United States Congress.

Mr. Speaker, I yield myself such time as I may consume.

Just quickly in response to the previous speaker, no one is trying to politicize this. We are just trying to work to produce the best product at the end of the day, especially for many of our rural seniors whom we represent in this body.

Mr. Speaker, I yield 5 minutes to the gentleman from Texas (Mr. Sandlin), the foremost expert on the impact medical malpractice has on health care costs in this Chamber.

Mr. Speaker, I would ask passage of this motion.

Mr. Speaker, on that I demand the yeas and nays.

Mr. Speaker, I ask unanimous consent to claim the time of the gentleman from Ohio (Mr. Brown).

Mr. Speaker, a person once told me that only silly people have heroes in their lives. If that is true, then this silly person rises today to congratulate and thank a hero in my life, my high school basketball coach, Tom Manchester, who is being inducted into the Wisconsin Basketball Coaches Association Hall of Fame.

Coach Manchester is a native of Racine, Wisconsin, and played basketball and baseball at Wartburg College, Iowa. Fortunately, for many of us northsiders, kids who grew up on the northside of La Crosse, Wisconsin, Coach Manchester accepted a teaching position at Logan High School and became the head basketball coach in 1977. He coached from 1977 to 1997, and finished with a 224-209 record and many city titles and Big Rivers Conference Championships.

I had the pleasure of playing for him starting in my sophomore year in high school in 1978 and finishing in 1981. I was a member of his team when we struggled to be competitive my sophomore year, and then saw the remarkable transformation the next 2 years when we won back-to- back city championships, and also won our conference and became one of the top-ranked teams in the State of Wisconsin.

He must have seen something in me that I did not at the time because he plucked me off the streets and made me a starting guard my sophomore year even though it was obvious that I was wet behind the ears and qualified as a ``work in progress.''

I will never forget one of my first games with Coach Manchester. I took the in-bounds pass to break a full-court press, asked for my teammates to clear out the second half of the court so I could break the press by myself, and then proceeded to dribble off my heel when I went between my legs on a dribble. The whistle blew when the ball went out of bounds. The buzzer sounded for a substitution. I ran to the bench assuming I was going to be replaced, only to have Coach Manchester ask me what I was doing. The substitute was for someone else, and he told me to get back out there and get used to making some mistakes because we had some learning to do.

Basketball for Coach Manchester was more than winning and losing. Everyone likes to win, but I never had the impression playing for him that all that mattered was the score at the end of the game. He was always first and foremost concerned about his players, not only how we were playing, but how school was going and whether things were going well in our lives.

For many of us growing up on the north side of La Crosse, which was considered the wrong side of the railroad tracks in town, presented us with some unique challenges and some choices to make. We could, if we wanted to, hang out on the street corners and run with the wrong crowd, getting into trouble and disappointing our parents, or we could find another channel for our energies and focus. That channel for many of us was in sports and in school, and Coach Manchester knew this. The gym became our safe haven and the team our extended family. There was no greater feeling of comfort and security than walking into that dark, cold,

smelly gym on a weekend winter night for practice before a big game and having Coach Manchester check on our personal lives and get us prepared for the next contest.

His wife, Jan, must have been very understanding to allow him leave from his family to spend as much time as he did with us kids. But we were not always alone. His young son Paul was the classic gym rat, dribbling and shooting off in another corner while the rest of us were practicing. Paul would later grow up to enjoy a spectacular high school career playing for his father at Logan, and then a terrific collegiate career at the University of Platteville and then the University of La Crosse. I cannot imagine the pride Coach Manchester must have felt coaching his son and watching him grow up to be the person he is today.

It has been said that great teachers enjoy a form of immortality because their influence never stops radiating. If true, then Coach Manchester is immortal. That influence can be seen today in so many of us kids who had the pleasure to play for and learn from one of the finest coaches in the State of Wisconsin. I am glad the Wisconsin Basketball Coaches Association is recognizing that by inducting him into their Hall of Fame.

I just hope Coach Manchester realizes the impact he has made on so many of our lives. Young kids need guidance. They need role models, people in their lives to teach them right and wrong and how to be good citizens. They also need from time to time a hero to look up to. I found one of mine, and whether it is silly or not, I do not mind saying that it is Coach Tom Manchester of Logan High School.

I congratulate the coach and thank him for all he has done.

Mr. Speaker, subject to rule XXII, clause 7(c), I hereby announce my intention to offer a motion to instruct on H.R. 1, the Medicare Prescription Drug and Modernization Act of 2003.

The form of the motion is as follows:

Mr. Kind moves that the managers on the part of the House

at the conference on the disagreeing votes of the two Houses

on the Senate amendment to the bill H.R. 1 be instructed as

follows:

(1) The House recede to the Senate on the provisions to

guarantee access to prescription drug coverage under section

1860D-13(e) of the Social Security Act, as added by section

101(a) of the Senate amendment.

(2) To reject the provisions of section 501 of the House

bill.

(3) The House recede to the Senate on the following

provisions of the Senate amendment to improve rural health

care:

(A) Section 403 (relating to inpatient hospital adjustment

for low volume hospitals).

(B) Section 404 (relating to medicare disproportionate

share adjustment for rural areas), but with the effective

date applicable under section 401(b) of the House bill.

(C) Section 404A (relating to MedPAC report on medicare

disproportionate share hospital adjustment payments).

(D) The following provisions of section 405 (relating to

critical access hospital improvements):

(i) Subsection (a), but with the effective date applicable

under section 405(f)(4) of the House bill.

(ii) Subsection (b), but with the effective date applicable

under section 405(c)(2) of the House bill.

(iii) Subsections (e), (f), and (g).

(E) Section 414 (relating to rural community hospital

demonstration program).

(F) Section 415 (relating to critical access hospital

improvement demonstration program).

(G) Section 417 (relating to treatment of certain entities

for purposes of payment under the medicare program).

(H) Section 420 (relating to conforming changes relating to

Federally qualified health centers).

(I) Section 420A (relating to increase for hospitals with

disproportionate indigent care revenues).

(J) Section 421 (relating to establishment of floor on

geographic adjustments of payments for physicians' services).

(K) Section 425 (relating to temporary increase for ground

ambulance services), but with the effective date applicable

under the amendment made by section 410(2) of the House bill.

(L) Section 426 (relating to appropriate coverage of air

ambulance services under ambulance fee schedule).

(M) Section 427 (relating to treatment of certain clinical

diagnostic laboratory tests furnished by a sole community

hospital).

(N) Section 428 (relating to improvement in rural health

clinic reimbursement).

(O) Section 444 (relating to GAO study of geographic

differences in payments for physicians' services).

(P) Section 450C (relating to authorization of

reimbursement for all medicare part B services furnished by

Indian hospitals and clinics).

(Q) Section 452 (relating to limitation on reduction in

area wage adjustment factors under the prospective payment

system for home health services).

(R) Section 455 (relating to MedPAC study on medicare

payments and efficiencies in the health care system).

(S) Section 459 (relating to increase in medicare payment

for certain home health services).

(T) Section 601 (Increase in medicaid DSH allotments for

fiscal years 2004 and 2005).

(4) The House insist upon the following provisions of the

House bill:

(A) Section 402 (relating to immediate establishment of

uniform standardized amount in rural and small urban areas).

(B) Section 403 (relating to establishment of essential

rural hospital classification).

(C) Subsections (a), (b), (d), and (e) of section 405

(relating to improvements to critical access hospital

program).

(D) Section 416 (relating to revision of labor-related

share of hospital inpatient pps wage index).

(E) Section 417 (relating to medicare incentive payment

program improvements).

(F) Section 504 (relating to wage index classification

reform).

(G) Section 601 (relating to revision of updates for

physician services).

(H) Section 1001 (relating to medicaid disproportionate

share hospital (DSH) payments).

Mr. Speaker, I am pleased to support H.R. 49, the Internet Tax Non-Discrimination Act. This bill would make permanent the national moratorium on Internet access taxes and multiple and discriminatory taxes on e-commerce.

The United States has made great strides in the goal of achieving Internet access for all Americans. As I travel throughout my district in western Wisconsin, I am constantly amazed to see the continued use of the Internet in public libraries, schools and hospitals, as well as individual homes and businesses. As the telephone did 100 years ago, the Internet is improving our lives and bringing us closer together as a world community.

Mr. Speaker, the previous legislation dealing with Internet taxation grandfathered existing laws in 10 states, including Wisconsin that imposed taxes on Internet access. The revenue from the taxes was used to pay for police officers, firefighters, hospital personnel, and elementary and secondary school teachers.

In these times of tight state budgets and fiscal uncertainty, every tax dollar is crucial to deliver needed services to citizens throughout the country. However, when the Federal Government unilaterally removes tax revenue by superceding state laws, state budgets take the hit. Congress must take state government needs and budget schedules when passing laws that supercede state taxation laws.

Mr. Speaker, the language in the Senate version of this bill includes a provision providing for a 3-year delay in the implementation of the law in those states with previous Internet access tax laws. This provision will afford those states the opportunity to plan for the loss of revenue from H.R. 49.

I am voting for H.R. 49 because I believe it is important to keep Internet access affordable so all Americans across the economic spectrum. However, I think it is only fair to state governments that they have proper notice about the lost of tax revenue dollars. Thus, I will be urging conferees to adopt the Senate language allowing for a 3- year delay of this law in those 10 states with Internet access tax laws.