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Congress Reconvenes As President Clinton Delivers His Final State Of The Union Address
The House and Senate both convened the Second Session of the 106th Congress for what promises to be an important political year. Not only is the Presidential election already looming on the horizon, but also the elections for all House seats and a third of the Senate, which will, of course, determine whether Republicans continue their control of the Congress or whether Democrats regain control of either or both chambers.
As Congress returned to work, the first order of business was the President's final State of the Union address. In his address, Clinton called for Congress to seize this "Blessed Opportunity" of economic prosperity "to build a more perfect union of our founders' dreams." Clinton went on to call for a $350 billion tax cut that includes relief from the so-called marriage penalty tax and his new retirement savings account proposal. He also cited the need for new spending for domestic priorities including $4.5 billion for education programs and a ten-year $110 billion effort to obtain health care for low-income parents.
Chances for passage of comprehensive reform of Medicare in this election year are dim. However, financing projections for the Medicare trust fund have improved, indicating that the fund will be solvent through the year 2015.
Much of the debate this year will center on the establishment of prescription drug coverage for seniors. The Clinton administration is proposing the establishment of a prescription drug benefit under Medicare and several other plans have been introduced in the House and Senate.
The House GOP leadership has recently reacted to the popularity of a drug plan by creating a task force to develop legislation. However, it appears that their approach will not be broad-based. While congressional Democrats and President Clinton favor a plan that would cover all seniors under Medicare, House GOP leaders favor a plan that would only cover low-income seniors and that would operate outside of Medicare, possibly only through tax credits. Such a plan would fail to cover about one-third of Medicare recipients, no matter how large their prescription drug bills are. A plan limited to only low-income seniors would also create a dangerous precedent for the future, when Congress addresses comprehensive Medicare reform.
H.R. 979, the anti-prison privatization bill, enjoys strong bipartisan support in the House. The bill currently has 108 cosponsors -- 87 Democrats and 21 Republicans. AFSCME's goal is to garner the support of at least half of the members of the House of Representatives. Towards this end, AFSCME lobbyists are contacting all members of the House to ask them to sign onto the bill as cosponsors. Supplementing lobbyists' personal calls and congressional visits will be a field advocacy campaign designed to put constituent pressure on legislators and media exposure of the inherent danger of privatization to prison personnel and the general public.
Initially, emphasis will be placed on scheduling visits with members of the Congressional Correctional Officers Caucus (CCOC) who are not currently cosponsors. Please check the following list of CCOC members and the attached H.R. 979 cosponsor list to see if your member of Congress is on either list and ask them for their support.
CCOC members not cosponsors of H.R. 979:
Alan Boyd (D-FL)
Other scheduled events will be a field postcard mail-in campaign, targeted legislative department mailings, a Roll Call advertisement, legislative hearings, congressional prison field trip and a corrections officer legislative conference and reception in May. The conference will coincide with National Correctional Officers and Employees Week. Stopping Corrections Corporation of America (CCA), Wackenhut and other privateers from taking over more prisons and reversing this trend is AFSCME's top priority in the corrections area.
S. 1898 was introduced by Sen. Byron Dorgan (D-ND) to provide protection for the public in the interstate transportation of violent prisoners. This bill is in response to a high-profile escape of a North Dakota child molester and killer from a New Mexico truck stop. The private transporter was TransCor which is owned by CCA. The bill places heavy regulatory costs on prisoner transport companies such as: background checks and drug testing for employees, same qualifying standards for hiring as corrections officers, minimum standards for training, on-duty hour restrictions and staffing minimums.
Rep. John Sweeney (R-NY) is expected to introduce legislation this session that will ensure the privacy of corrections officers' official personnel records and personal information.
The Occupational Safety and Health Administration issued its long awaited ergonomics standard on November 23, 1999.
The ergonomics regulations seek to address injuries which are bought on by repeated motion. These injuries account for one-third of all serious workplace injuries, making repetitive motion injuries the number one workplace safety and health problem in the country. Each year, more than 600,000 American workers lose valuable time away from work because of repetitive motion injuries.
Truck drivers, nurses, assembly line workers, and computer operators are among the workers most at risk of developing conditions like carpal tunnel syndrome, back injuries and tendinitis. Women workers are especially at risk because they suffer a higher rate of repetitive motion injuries. These painful and oftentimes crippling injuries are costly and demonstrate the need for a standard that would prevent these injuries.
Comments on the proposal are due February 1, 2000 and informal hearings around the country will begin on February 22, 2000. Copies of the proposed regulatory text, the introduction and public participation sections and relative materials are available on OSHA's website at http://www.osha-slc.gov/ergonomics-standard/index.html.
Last August, Rep. William Goodling (R-PA), Chairman of the House Education and the Workforce Committee, pushed legislation through the House on a 217-209 vote to delay the new rules. The bill would put off issuance of the regulations until the National Academy of Sciences completes a study in January 2001 of whether work habits cause injuries. But the measure has stalled in the Senate.
In November, the Institute of Medicine released a report on the sizable number of medical errors in health care settings, resulting from errors in medication and procedure. According to the report, an estimated 44,000 to 98,000 deaths occur in hospitals each year as a result of medical errors. At 44,000, deaths from medical errors represent the eighth leading cause of death, exceeding deaths attributable to motor vehicle accidents (43,458), breast cancer (42,297) or AIDS (16,516).
The report made a number of recommendations, including the establishment of a national mandatory reporting system for the collection of information by state governments about errors in health care settings which result in death or serious harm. Currently, about one-third of the states have some type of mandatory reporting system, including New York, California, Pennsylvania, New Jersey, Florida, and Ohio.
There has been considerable interest in the report in Congress. Sen. Arlen Specter (R-PA), Chairman of the Senate Labor, HHS and Education Appropriations Subcommittee, held a hearing on the report in mid-December. The Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing this week and plans to hold two more during the next several weeks. Sen. Edward M. Kennedy (D-MA) has announced that he plans to introduce legislation on medical errors and is attempting to draft a bipartisan bill with Sen. James Jeffords (R-VT), Chairman of the HELP Committee. If a bipartisan bill cannot be worked out, Kennedy plans to introduce his own bill.
In the House, hearings have not been scheduled, but Rep. John Dingell (D-MI), Ranking Democrat on the House Commerce Committee, plans to introduce a bill with Democratic colleagues. Thus far, there has been little interest in the issue from House Republicans.
Because of the strong interest in this issue, it appears that legislation has a chance of being passed in this session of Congress. AFSCME's efforts are aimed at preventing language that simply blames health care workers in lieu of addressing systemic problems that increase the likelihood of errors. We are also looking at the opportunity of using this legislation to address related issues such as implementing whistleblower protections for health care workers, increasing staffing levels in health care facilities and preventing needlestick injuries.
Rules to protect the confidentiality of the medical records of patients are currently proceeding on both a regulatory and legislative track. In late October, the U.S. Department of Health and Human Services (HHS) issued proposed regulations on protecting the privacy of medical records. Legislation on privacy was introduced last year but did not proceed very far in either the House or Senate. It is likely that Congress will renew its push for legislation, which would take the place of the HHS regulations.
AFSCME has several interests in regulations and legislation. The Department of Legislation has been working closely with Public Policy on the HHS regulations in an effort to address whistleblower protections for health care workers who reveal protected patient information in order to raise quality problems to appropriate bodies. We have also been working to protect the ability of AFSCME local leaders and staff to have access to patient records when needed for representational purposes, such as representing a health care worker in a grievance procedure.
We are also watching how workers' compensation records are treated under the regulations and in legislation. It is unlikely that HHS regulations will protect medical records accumulated as the result of workers' compensation claims because the existing legislative authority to create regulations does not clearly state that these records must be protected. Therefore, the activity in Congress will be important in addressing this issue.
Federal Budget Projections
Kicking off the fiscal year 2001 budget debate, the Congressional Budget Office (CBO) has already issued its latest projections for the budget surplus over the next 10 years. CBO's estimate of the budget surplus from all tax revenues, excluding the Social Security payroll tax revenues, over the next decade was one trillion dollars more then had been estimated just six months ago. Driven by the strong U.S. economy, CBO now estimates that the federal budget surplus will surge to as much as $1.9 trillion.
The CBO actually issued three separate estimates. The first, based on adhering to the 1997 budget caps through 2002 and increasing government spending thereafter at the rate of inflation, is estimated to produce a $1.92 trillion surplus over the next decade. The second, assuming the federal defense and domestic budgets are frozen at fiscal year 2000 levels, would yield $1.86 trillion over the same period. And the third, based on increasing spending by the rate of inflation starting this year, produces the smallest estimate, $0.84 trillion over the next 10 years.
In related budgetary news, House Speaker J. Dennis Hastert (R-IL) announced he has ruled out as "not realistic" a potential budget strategy of freezing fiscal 2001discretionary spending at this year's level. Hastert also suggested that the spending caps imposed by the 1997 balanced budget law (PL 105-33) are becoming irrelevant in view of expected budget surpluses. "Those caps are somewhat by the side, and we have to face the reality of what we have today," Hastert said.
Although long-term budget projections have proven to be highly unreliable before, they will be used by both parties, the White House and the Congress, to debate how to best allocate the expanded resources -- tax cuts, increased investment for education, Medicare, kids and other vital domestic needs, or reducing the debt. Regardless of the precise estimates and assumptions, the bottom line is crystal clear. There will be an enormous budget surplus which AFSCME believes should be used to fund public investment needs so that working people benefit, and not squandered on tax cuts for the wealthy.
Patients' Bill Of Rights
While the House-Senate conference committee was appointed in November to reconcile differences in managed care reform legislation passed by each house, Republican leaders have so far resisted efforts to begin conference negotiations on the legislation. After nearly three months, not a single meeting of Democratic and Republican staff or members on the conference has yet taken place. The conference committee is dominated by House and Senate Republicans who oppose the strong protections in the Norwood-Dingell bill (H.R. 2723), passed by the House in October. The conference may very well become deadlocked, unable to produce a bill strong enough to win passage in the House and weak enough to win passage in the Senate. But deadlock is not the only possible outcome.
While the House passed the Norwood-Dingell bill with the support of many Republicans, it is likely that the GOP leadership will lean heavily on these members to accept a conference bill which looks like the deeply flawed legislation approved by the Senate last summer. The pressure on Republican members will be strong to neutralize an election issue by passing some sort of managed care reform bill, however flawed, in order to claim that they have addressed the issue. It is also possible that if medical errors legislation moves forward, GOP leaders might scuttle managed care reform altogether and attempt to define medical errors as patients' rights legislation.
Physician Collective Bargaining
The Quality Health Care Coalition Act (H.R. 1304) has been scheduled for mark-up on March 8 in the House Judiciary Committee. While Speaker Hastert originally promised to allow a floor vote in the week following mark-up, it is not clear whether a floor vote will be scheduled soon after March 8. The bill has over 170 cosponsors from both parties.
Needlestick Protection Bill
A bill (H.R. 1899) which would require the use of safety-designed needles and sharps, introduced by Reps. Pete Stark (D-CA) and Marge Roukema (R-NJ), continues to collect sponsors from both parties in the House. There are over 155 cosponsors, including more than 25 Republicans. However, the GOP leadership of the House Education and Workforce Committee, which has primary jurisdiction for the bill, continues to strongly oppose it.
In the Senate, the companion bill (S. 1140) introduced by Sens. Barbara Boxer (D-CA) and Harry Reid (R-NV) still lacks a Republican cosponsor. Sen. James Jeffords (R-VT) indicated in October that he would draft another bill for introduction in the Senate, however, he has yet to do so.
On January 24, 2000, President Clinton unveiled a $27 million Equal Pay Initiative in his FY 2001 budget to help fight wage discrimination. The Initiative includes $10 million for the Equal Employment Opportunity Commission (EEOC) to: (1) bolster the ability of the EEOC to identify and respond to wage discrimination; (2) teach employers how to meet legal requirements; and (3) launch an equal pay public service announcement campaign to inform employers and employees alike of their rights and responsibilities.
The President also called for passage of the "The Paycheck Fairness Act," introduced by Sen. Tom Daschle (D-SD) and Rep. Rosa DeLauro (D-CT), to strengthen laws prohibiting wage discrimination (S. 74/H.R. 541). The highlights of this legislation include a new data collection provision; increased penalties under the Equal Pay Act (EPA); a non-retaliation provision; and a provision for increased training, research, and a pay equity award.
Rep. Goode To Caucus With GOP
Rep. Virgil H. Goode Jr. (I-VA) not only announced he was leaving the Democratic party but also has said he will join the Republican Conference for organizing purposes within the Congress. In exchange, GOP leaders announced he would be given a seat on the Appropriations Committee that had been held open since Michael P. Forbes (NY) switched to the Democratic Party last July. His defection leaves the House roster at 211 Democrats, 222 Republicans and two independents (Bernard Sanders (I-VT) sides with the Democrats).