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[Page: S5823] GPO's PDF---
The ACTING PRESIDENT pro tempore. Under the previous order, the Senate will now resume consideration of H.R. 4577, which the clerk will report.
The bill clerk read as follows:
A bill (H.R. 4577) making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2001, and for other purposes.
Pending:
McCain amendment No. 3610, to enhance protection of children using the Internet.
Cochran amendment No. 3625, to implement pilot programs for antimicrobial resistance monitoring and prevention.
The ACTING PRESIDENT pro tempore. The Senator from Delaware.
Mr. ROTH. Mr. President, I had originally planned to come to the floor to voice my opposition to this bill and to offer a point of order that it violates rule XVI of the Standing Rules of the Senate. I intended to do so because of two serious failings in it.
First, this bill cuts the program that Congress passed in the 1997 Balanced Budget Act to help States provide health insurance to low-income children and could cost up to 2 million of them their health insurance. The State Children's Health Insurance Program, known by its acronym as S-CHIP, was designed to make health insurance coverage available, at State option, to lower-income, uninsured children.
[Page: S5824] GPO's PDF
More than 2 million children have been enrolled in S-CHIP--children who would otherwise lack access to the health insurance coverage that helps them grow and thrive.
When we designed S-CHIP in 1997, States were given specific allotments to cover eligible uninsured children. We designed the program so that those allotments were to be available to individual States for a period of 3 years. This was done to ensure that allotments didn't sit unused. At the end of 3 years, unspent allotments are to be reallocated to other States that have spent their full allotments. The basic idea is to effectively direct available S-CHIP dollars to States willing and able to use them to cover uninsured kids.
We are now coming up upon the first opportunity to reallocate unspent S-CHIP funds. Three years have elapsed since the program was first implemented.
But, instead of thinking through the ramifications of reallocation, today we confront an unexpected and far more fundamental challenge to the future of the S-CHIP program. The appropriations bill before us would cut $1.9 billion in S-CHIP funds from the program, with an unenforceable promise to restore the funds in 2003--a promise which is itself subject to a Budget Act point of order.
This cut represents a dramatic retreat from the commitment the Federal Government extended to uninsured children, their families, and to the States in 1997.
S-CHIP was designed to be a stable, guaranteed source of funding to States to cover lower-income, uninsured children. If States cannot count on the federal government to stand by its commitment, there will inevitably be an erosion of State support for participation in the program and aggressive enrollment strategies. As a result, fewer children will receive health insurance coverage.
We have to be very clear that what we are talking about today isn't a technical accounting gimmick that simply moves funds forward. We are talking about a concrete cut in a very real program upon which millions of children depend. The consequences will be no less real. If the provision in the appropriations bill is not removed, the National Governors' Association estimates that as many as 2 million children will be denied access to health insurance coverage.
For that reason, the National Governors' Association strongly and unambiguously opposes the S-CHIP cut included in this appropriations bill.
NGA is not alone in its opposition to the appropriations cut. The community of advocates who work on behalf of children strongly opposes it as well. In fact, all Senators should have received a letter signed by over 80 groups opposing the cut, including the Children's Defense Fund, Families USA, the American Hospital Association, and the American Medical Association. In addition, the Health Insurance Association of America has also written to express its opposition to S-CHIP cuts.
Second, this bill cuts three welfare programs by $1.4 billion. The title XX social services block grant is cut by a whopping 65 percent--from $1.7 billion in funding to $600 million. This is just a quarter of the level we promised to Governors during welfare reform in 1996.
The title XX block grant was enacted in 1981, during the Reagan administration, to provide States with a flexible source of social services funding. Today, title XX funds services to almost 6 million Americans, principally children, people with disabilities, and seniors. In Delaware, we use these funds for a broad range of programs--including helping abused and neglected children and for people who are blind, and for Meals-on-Wheels. These funds go to programs without adequate sources of support and to fill the gaps for the neediest citizens.
These title XX funds are essential. These funds cannot be easily replaced--by States or local governments, or by private charity.
The Labor-HHS-Education appropriations bill would cut these supplemental welfare grants to States by $240 million. In the 1996 welfare reform legislation States took a big, big risk. States exchanged an open-ended Federal entitlement--that is, guaranteed dollars for each person who qualified for welfare--for a fixed block grant.
To provide States with some modest protection, welfare reform contained a provision to provide States with a big population increase and high poverty rates with supplemental welfare grants. The Labor-HHS bill would cut these grants and break that promise.
These welfare program cuts violate the fundamental deal Congress made with the Governors during welfare reform. With these cuts, Congress reneges on its word.
Next year Congress will begin reauthorization of welfare reform. If Congress shows that it is not a dependable partner now, how can we expect States to have confidence in us next year?
Altogether this bill cuts a children's health program and welfare programs by $3.3 billion. This is unquestionably a violation of sound policy.
In the interest of sound policy, in the interest of uninsured children, in the interest of welfare recipients, and in the interest of the States who are working with us to serve these vulnerable individuals, I had no choice but to oppose this bill.
I am not alone in recognizing these problems, Senator MOYNIHAN, Senator HATCH, Senator KENNEDY, Senator GRASSLEY, and Senator GRAHAM all joined me in a letter to our colleagues warning them against supporting this bill because of its inclusion of the provisions I oppose and have just outlined. I know that other Senators opposed them as well and I thank all of them for their support.
However, Mr. President, the Senator from Alaska, the distinguished chairman of the Appropriations Committee, has assured me that these cuts--specifically: (1) The $1.9 billion cut to the State Children's Health Insurance Program located in section 217 on pages 53 and 54 of the bill; (2) the $1.1 billion cut to the title XX social services block grant located in title 2, page 40 of the bill; (3) the $240 million cut to the Temporary Assistance to Needy Families, TANF, program, located in section 216, pages 52 to 53 of the bill; and (4) the $50 million cut to the Welfare-to-Work performance bonus program, located in section 104, pages 21 to 23 of the bill--will be eliminated in their entirety in this bill when it returns from conference.
The ACTING PRESIDENT pro tempore. The Chair is informed that there is supposed to be a vote at 9:45 on the Cochran amendment.
Mr. STEVENS. Mr. President, I ask unanimous consent the vote be postponed until the completion of my remarks; and I ask unanimous consent to proceed for 2 minutes.
The PRESIDING OFFICER. Without objection, it is so ordered.
The Senator from Alaska.
Mr. STEVENS. Mr. President, I am surprised at the comments made by the Senator from Delaware to this extent: The 1997 Budget Act puts limits on the amounts that can be appropriated under the pending bill, the Health and Human Services appropriations bill.
In order to have a technical offset against the additions that are in this bill over the 1997 limits, we provided these three technical provisions that give us the right to take the Health and Human Services bill across the floor to conference. We had no intention at all to ever suggest the Congress would enact those provisions. The Finance Committee knew that. All Members knew that. This is a technical situation where, in order to get the bill across the floor until we enact the military construction bill, which contains the waiver of the 1997 provisions with regard to the ceilings for our committee, we had to have this offset.
I assure the Senator that the bill will not come out of conference with these provisions in it. They were never intended to be enacted. No one on our committee supports the elimination of these provisions, and Senator SPECTER was very gracious in allowing us these provisions to comply with the 1997 act.
I assure the Finance Committee that this bill will not come out of committee with these provisions in it. They were never intended to be in it, as the Finance Committee knows.
Mr. ROTH. I thank the chairman of the Appropriations Committee and based on his assurances of these provisions' removal in conference, I withdraw my opposition to this bill. I believe that this is the best way to proceed: We not only protect the programs that I came to the floor to protect, but we also allow this funding bill for many other important programs to forward as well. I thank the Senator from
[Page: S5825] GPO's PDF
Mr. KENNEDY. Mr. President, I thank the chairman for his leadership in this area, and I commend Senator MOYNIHAN as well for his commitment to this important program. I believe the understanding we have reached is a satisfactory way to protect this program in conference.
The rescission of funds for children's health insurance would be a serious mistake. It would come at the expense of 12 million uninsured children in low income families across the nation.
It would override the reallocation system established with broad bipartisan support in the original law. It would use the funds to pay for other programs in this year's appropriations bill. While it does promise to restore in the year 2003 the funds taken away this year, the damage would be done long before 2003 arrives. In fact, more than 80 leading organizations have signed a letter urging rejection of this misguided policy.
Low-income working families should not be forced to pay the price for the budget pressures facing congress. Those pressures were created by the budget resolution, and its misguided priorities. The committee was operating under the budget instructions they were given. I believe they had good intentions. Unfortunately, however, this rescission robs needy children, and it is unacceptable.
Strong bipartisan support in the Senate created the Children's Health Insurance Program in 1997. We focused on guaranteeing health insurance to children in working families whose income was too high to be eligible for Medicaid, but too low to be able to afford private insurance. Estimates indicate that more than three-quarters of all uninsured children in the nation will be eligible for assistance through either CHIP or Medicaid in the near future.
This rescission would have established a devastating precedent at precisely the wrong time. The Children's Health Insurance Program is working. Every State is now participating.
Between 1998 and 1999, enrollment numbers doubled from just under 1 million children to 2 million. States, advocacy groups and other leaders are undertaking and planning impressive outreach efforts in the states. Last year, back-to-school campaigns helped dramatically increase enrollment. A month ago, the Governor of Mississippi announced a new campaign to cover all children in that State. We have every reason to expect that this trend will continue, as the programs become more established and States begin to do all they can to enroll eligible children.
If the rescission were enacted, it would penalize needy children in the States that have most actively sought and enrolled eligible children. States could be forced to halt enrollment until more funds are available. That's wrong.
The reallocation mechanism in the original legislation is designed to ensure that dollars remain targeted to uninsured children, regardless of location. Next year is the first year that the reallocation fund would be available. Senators should know that no State loses under current law. All States have the right to their allocations for three years. We have encouraged all States to take advantage of their funds. But, it a State cannot spend all its money, the excess dollars should be used by States that can.
If the Senate were to adopt this rescission, States would be
reluctant to expand their programs or actively enroll more children if they feel that future State allotments are unreliable. The National Governors Association has sent us two letters--one just last week--expressing their unified strong opposition for this reason.
We shouldn't second guess the original policy. It was well designed to direct money where it is most clearly needed. The policy was strongly supported when we enacted CHIP, and States have acted in good faith to implement it. It would be wrong for us to change the ground rules now, when so much progress is being made.
We know that lack of insurance is the seventh leading--and most preventable--cause of death in America today. That fact is a national scandal.
The majority of uninsured children with asthma--and one in three uninsured children with recurring ear infections--never see a doctor during the year. That's wrong. No child should have to be hospitalized for an acute asthma attack that could have been avoided. We know that uninsured children are 25 percent more likely to miss school. Children who cannot see the blackboard well or hear their teacher clearly miss lessons even when they are at school. That's wrong. No child should suffer permanent hearing loss and developmental or educational delays because of an untreated infection.
Every child deserves a healthy start in life, and the health security that comes with insurance. And under CHIP and Medicaid, every child will have a legitimate opportunity for health insurance.
Congress should do everything in its power to shore-up these programs, not undermine them. I welcome today's agreement, and I look forward to the continuing effective implementation of this worthwhile program to guarantee good health care for all children.
I ask unanimous consent to print in the RECORD the letter to which I earlier referred and another related correspondence.
There being no objection, the letters were ordered to be printed in the RECORD, as follows:
June 9, 2000.
DEAR SENATOR: We are writing to express our opposition to the taking of $1.9 billion of fiscal year 1998 Children's Health Insurance Program (CHIP) funds by the Senate Appropriations Committee to help fund the fiscal year 2001 Labor, Health and Human Services, and Education Appropriations bill. In effect, the Senate committee action takes unspent funds that would be reallocated to states to provide health insurance to uninsured children and instead promises to restore those funds in fiscal year 2003. While we are appreciative of the efforts of the Senate Appropriations Committee efforts to increase funding for important programs in the Labor, Health and Human Services, and Education Appropriations bill, the use of CHIP funds for this purpose breaches the integrity of the CHIP program and the commitment it represents to the nation's uninsured children.
This taking of CHIP funds is troubling for several reasons. First, the taking of these funds will deprive some states of the funding needed soon to insure children through the program. Second, states have made decisions on how many children they expect to insure through the CHIP program based on the federal funding commitment in the 1997 CHIP legislation. The Senate Appropriations Committee action, if enacted, calls into question the commitment of Congress to this program. Third, states are rapidly increasing enrollment of uninsured children in CHIP but may become reluctant to continue aggressive outreach and enrollment if Congress starts playing budget shell games with the program funds.
We urge, in the strongest possible terms, that Congress restore the funds to the CHIP program that were removed by the Senate Appropriations Committee. We believe that Congress should refrain from looking to this program, designed to serve uninsured children, to alleviate the fiscal difficulties faced by the House and Senate Appropriations as they fund critical programs.
Sincerely,
AIDS Action.
Alliance for Children and Families.
Alliance to End Childhood Lead Poisoning.
American Academy of Pediatrics.
American Association of University Affiliated Programs for Persons with Developmental Disabilities.
American Association on Mental Retardation.
American College of Osteopathic Pediatricians.
American Dental Hygienists' Association.
American Federation of State, County and Municipal Employees (AFSCME).
American Friends Service Committee.
American Hospital Association.
American Medical Association.
American Music Therapy Association.
American Network of Community Options and Resources.
American Occupational Therapy Association.
American Psychiatric Association.
American Psychological Association.
American Public Health Association.
Association of Community Organizations for Reform Now (ACORN)
Association of Jewish Family and Children's Agencies.
Association of Maternal and Child Health Programs.
Bazelon Center of Mental Health Law.
Camp Fire Boys and Girls.
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