REFINEMENTS TO THE BALANCED BUDGET ACT -- (House of Representatives - September 29, 1999)

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   The SPEAKER pro tempore. Under a previous order of the House, the gentleman from Minnesota (Mr. RAMSTAD) is recognized for 5 minutes.

   Mr. RAMSTAD. Mr. Speaker, today I rise in frustration, frustration with the government agency that may even be more unpopular than the IRS, if you can believe it. My friends on the Health Subcommittee of Ways and Means and many other colleagues on both sides of the aisle know exactly who I am talking about, the Healthcare Financing Administration, or HCFA.

   Mr. Speaker, on Friday of this week our Health Subcommittee will be holding a hearing on refinements to the Balanced Budget Amendment, or BBA. As we plan for this hearing, I hope the administration will not appear before us again in the subcommittee and insult our intelligence. I will be asking some tough questions about their handling of the Medicare program recently, and I hope I do not hear that the agency is unable to address the concerns we are hearing about from seniors across the Nation, and also from Medicare providers, because the agency's hands are completely tied by prescriptive BBA language. That is the constant refrain we get from HCFA, the agency's hands are completely tied by prescriptive BBA language.

   We hear these lines about prescriptive language and Congressional intent when the administration does not want to do things, but when it does want to act, when it does want to do something, it is perfectly comfortable with

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ignoring bill language or Congressional intent.

   Some of the problems we are hearing about in Medicare from health care providers are all results of actual BBA language. Yes, they are. The Health Subcommittee is planning to provide relief in those areas. But, as Senator ROTH and Chairman THOMAS have said recently, there is also a lot HCFA can do.

   The BBA gives HCFA significant power over how things are implemented. The risk adjuster for Medicare+Choice payments is a perfect example. Many of my colleagues and I have heard concerns about the risk adjuster the administration has designed. One very important concern is how this risk adjuster will impact some very special programs, especially innovative programs that seniors want and that the frail elderly seniors need so desperately.

   HCFA obviously understands the grave impact the interim risk adjuster will have on these programs. In fact, HCFA exempted them from the risk adjuster for the first year. But the argument which compelled the agency to exempt them for one year remains the same and just as powerful for all the years under the interim risk adjuster.

   Now, I might be just a plain Norwegian from Lake Woebegone, Mr. Speaker, but even I cannot understand why the agency is not exempting them for the entire interim period. That just makes good common Governor Jessie Ventura sense. If they have the authority to do it for 1 year, it seems they have the authority to do it for multiple years. Conversely, if they do not have authority for all the years, then how do they have the authority to do it for one?

   I see nothing in the BBA which prohibits the agency from exempting them for more than 1 year. Even if I were to accept HCFA's claim that only Congressional action allows a multiple-year exemption, that still would not allow me to understand why HCFA is not supporting the bill I introduced to provide the multiple exemption. They tell providers, well, we need Congress to pass a bill. So I introduced one. Then they come up with the multiple weak arguments against the bill.

   Mr. Speaker, I am offering to address any substantive concerns in a reasonable way, in a reasonable common-sense way, and I hope we will be having such an exchange on Friday in the Health Subcommittee. I invite the administration to join me for the sake of frail, eligible, elderly beneficiaries in Minnesota and across this Nation.

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