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Also rural hospitals need additional help by passing re-basing of sole community provider status and also Medicare dependent hospital status, as we are both.
I will be glad to discuss this with you at any time concerning this very vital issue. If
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Sincerely,
George N. Miller, Jr.,
CEO/Administrator.
Mr. DIAZ-BALART. Mr. Speaker, I yield 5 1/2 minutes to the distinguished gentleman from California (Mr. THOMAS). Perhaps he has a copy of the stealth bill.
Mr. THOMAS. Mr. Speaker, I thank the gentleman from Florida for yielding me this time.
I do not have a copy of the bill that was introduced today. But if anyone wants to know what it contains, it would be a little bit like going to an editing room of a movie producer and picking up all the pieces that have been cut out of the movie on the floor and then stitching it together and calling it a movie, for example.
It is my understanding that, for hospitals, instead of the negotiated agreement, which was more generous for hospitals than was contained, for example, in the Committee on Ways and Means Subcommittee on Health bill in which all of the Democrats on the subcommittee voted unanimously, it says that hospitals should get a 2-year market basket update. Does that sound fair? Let them have a 2-year market basket update.
However, if one reviews the history of financing of hospitals, one will discover this, and I apologize for doing this, because, apparently, facts in history are supposed to be checked at the cloakroom door as we come to the floor of the House and simply make up whatever moves someone about dollar amounts or percentage payments. But for what it is worth, the last time hospitals got a 1-year market basket update was in 1985. The average over the last decade for market basket updates have been market basket minus 1.7.
So what is being provided in the bill that passed the floor is market basket the 1st year, so for the first time since 1985, and then an adjustment from current law, which is market basket 1.1. That is six-tenths of a point better than what they have averaged over the last decade. We cut that in half. So it is twice as good as current law in terms of the percentage adjustment. We continue that for 2 more years. The hospitals have said that is fine. They are comfortable.
Now, what I hear is one of the most amazing arguments one will ever hear anywhere. Well, but the providers would like our bill better. Well, if they thought it had a chance of becoming reality, they would. Who would turn down more money? The question that one really has to put to the providers: Do you want the bird in hand, or do you want try to get the bird in the bush? The answer is the providers are more than happy with what we have done.
However, what one really needs to do is take a look at the bill, when and if we get a copy in legislative language. I know it was introduced about 20 minutes ago. What one will find is, for example, our friends on the other side using arguments like a 2-year freeze on the graduate medical education . The phrase they use is from their notes: Provides help to the Nation's premier teaching and research hospitals.
Read that in New York City. New York City has ripped off the graduate medical education program for more than a decade, funding their basic welfare costs out of the Federal taxpayers. Last year, with the agreements of the gentleman from New York (Mr. RANGEL) and the Senator from New York, Mr. MOYNIHAN, that we would in the 1999 refinement bill make these modest adjustments to begin to create a more level playing field between all of our fine teaching hospitals; and this attempts to undo that agreement.
But when one reads on, one finds that, in fact, just last night, we defeated a motion to instruct to require Medicare+Choice programs to stay in an area for 3 years. Of course all the arguments made were the correct ones. But here we go. They lost last night, and guess what? Off of the cutting room floor is another little snippet picked up and folded back in, exactly the same thing.
But when one begins to read the fine print in terms of their reaching out to assist various groups, especially in the area of disabled children, who does not want to help disabled children? But while AL GORE points to Governor Bush and says he has a tax cut for the wealthiest 1 percent, what we have in this bill is a benefit for disabled children whose families, whose families have a 600 percent of poverty level. How ironic. The same 1 percent that AL GORE says are being benefited by George Bush's tax provision, they want to provide disabled children assistance, 600 percent of poverty. That is the kind of fine tuning they want for these government programs.
When one takes a look at this package, it is all of the snippets from the cutting room floor. There really is not anything about patient protections. There is not anything about prescription drugs. It is a clear attempt to run through programs that were brought up, voted down in committee, but desired nonetheless to produce a package that is conservatively in the $50 billion to $60 billion range. But of course we do not know for sure. We have not seen the language of the bill itself. Of course, the Congressional Budget Office has not scored it.
Mr. MOAKLEY. Mr. Speaker, I yield 3 1/2 minutes to the gentleman from Michigan (Mr. LEVIN).
(Mr. LEVIN asked and was given permission to revise and extend his remarks.)
Mr. LEVIN. Mr. Speaker, there is no mystery. There is nothing stealth about what we are doing. We are taking a bill that my colleagues put together, putting accountability into it for HMOs, and adding the provisions that many of us have been working for and the President laid out clearly in his veto message or the message which indicated he might veto it. There is nothing secretive about it.
The reason hospitals are in difficult shape the gentleman from California (Mr. THOMAS) talks about since the mid-1980s, is because, in 1997, behind closed doors, talking about a stealth procedure, there were cuts made in reimbursement provisions way beyond what anyone imagined. The impact of those cuts is way beyond, way beyond what anyone expected.
Let me just mention the provisions that we are working for. The gentleman from California (Mr. ROHRABACHER), an hour ago, came to this floor in vain against illegal immigrants. I think he misshaped that argument saying we were trying to totally open the doors. No, we wanted equity for people who are here under the same circumstances as we granted amnesty to the gentleman from Florida (Mr. DIAZ-BALART) for those people that he represents.
Now we are arguing that legal immigrants, legal immigrants should be able, under State option, to receive Medicaid benefits. There is a letter here from three Governors urging that my colleagues grant it, including the Governor of the gentleman from Florida (Mr. DIAZ-BALART). He just gives it the back of his hand, no the gentleman from Florida (Mr. DIAZ-BALART) personally. Because we stood out on the grass here a month ago, or whenever it was, urging that the gentleman's party grant the States the right to cover children and pregnant women legal immigrants. His party says no to it.
Now, in terms of hospitals, look, all we are suggesting is, in the 2nd year, my colleagues not cut, because of the impact of the 1997 balanced budget agreement. There is nothing revolutionary. I know where my hospitals, the ones that I represent and in the metropolitan area are. They want something other than my colleagues have provided in this bill.
People with Lou Gehrig's Disease, they will not act. People who have other needs, other preventative conditions, they act on some, but they will not act on others. So we have been pleading with them to do so.
We have also asked, in terms of the Children's Health Initiative Program, for some assistance to the States so they will do better than Texas in terms of covering uninsured kids.
There is nothing stealth about this. It is very much in the open. We want a better bill than my colleagues have provided, a considerably better bill. Give us the chance. Their fear is, if we can bring it up, so many Members on their side will vote with us, we will pass it.
Mr. DIAZ-BALART. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I have no doubt that the gentleman from Michigan (Mr. LEVIN) has knowledge, has personal
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What I am saying when I say stealth legislation is that we do not have a copy, and it was filed 20 minutes ago. That is what I am saying. That cannot be denied.
So the reality of the matter is that we are debating here with regard to large figures and significant pieces of legislation which are included in a bill that has just been filed.
Mr. Speaker, I yield 3 minutes to the gentleman from California (Mr. THOMAS).
Mr. THOMAS. Mr. Speaker, I thank the gentleman for yielding me this time.
Mr. Speaker, I want just to briefly indicate, and I know the gentleman from Michigan (Mr. LEVIN) feels strongly about the issue, he referenced the current law of the land as having been written behind closed doors. Perhaps he was not in the room when I indicated that the gentleman from New York (Mr. RANGEL) and the Senator from New York, Mr. MOYNIHAN, were in the room when we dealt with the issues in the Refinement Act of 1999.
I believe the closed door session he was referring to was the one that produced the Balanced Budget Act of 1997 on which was voted on in the Committee on Ways and Means, passed 34 to 1, came to the floor, was passed overwhelmingly, and which the administration negotiated and requested reductions, further reductions in payments to hospitals and other health care providers.
In fact, the President's budget at that time said that the Medicare providers should be reduced by more than $125 billion over the 10 years. We fought the President. We thought it should not have been cut that much.
Yet, here we are being criticized for making sure that they were not cut as much as their President wanted to cut them, and it was not behind closed doors. In fact, it was participated in by the administration. The gentleman from Michigan (Mr. LEVIN) should be pleased that Republicans fought back against the President's $125 billion additional cuts so that the adjustments that we are making now are modest ones referred to both in the 1999 bill and in this one as refinements instead of massive needs to infuse if, in fact, the President's program had been agreed to.
We did not think it was right then. We do not think it is right now. The idea of a balanced modest refinement of about $30 billion is appropriate. This particular bill we believe is about $50 billion to $60 billion, consisting of all the items that were left on the cutting room floor when a reasonable and appropriate package were put together.
Mr. MOAKLEY. Mr. Speaker, may I again inquire as to the time remaining.
The SPEAKER pro tempore. The gentleman from Massachusetts has 8 1/2 minutes remaining. The gentleman from Florida (Mr. DIAZ-BALART) has 3 1/2 minutes remaining.
[Time: 13:30]
Mr. MOAKLEY. Mr. Speaker, I yield 2 minutes to the gentlewoman from Wisconsin (Ms. BALDWIN).
Ms. BALDWIN. Mr. Speaker, I come to the House floor today to urge a ``no'' vote on the previous question in order that we may bring up a clean minimum wage increase bill and a clean Medicare giveback bill. The resolution that we have before us today does not give us the opportunity to focus on what is one of the most important pieces of legislation before this Congress.
For 2 years, we have been hearing from constituents in the health care community about the dire need to restore funding cuts made in the Medicare program in 1997. The Medicare funding is vital to rural and teaching hospitals, home health agencies and others who were put in financial distress by those Medicare cuts of 1997 and literally could mean the difference between staying open and having to shut their doors.
In my southern Wisconsin district, the additional payments are badly needed for providers like St. Clare Hospital in Baraboo and the Monroe Hospital and Clinics. It is time to stop playing politics with these vital issues that so strongly impact the lives and health of the people that we represent.
Mr. MOAKLEY. Mr. Speaker, I yield 2 minutes to the gentleman from Minnesota (Mr. LUTHER).
Mr. LUTHER. Mr. Speaker, I am here to highlight certain language that is in the Democratic alternative. The language I refer to was language that was introduced earlier this year by the gentlewoman from New Mexico (Mrs. WILSON) and myself. We introduced the legislation back in July of this year, and it was also included in the Medicare giveback bill that was reported out of the House Committee on Commerce. The language recognizes the great disparity that exists today between the costs and benefits of what seniors in States like Minnesota and New Mexico receive compared to what seniors in other States receive.
Our language will establish new minimum floor payments and provide relief to Minnesota seniors who are unfairly treated under the Medicare+Choice program. Unfortunately, health plans have been rapidly withdrawing from Medicare+Choice in Minnesota. Those that have remained in the program offer Minnesota seniors only minimal health care coverage, along with high premiums and copayments. However, in other States with high reimbursement rates, seniors enjoy Medicare benefits such as prescription drug coverage at no additional cost. This is unfair. Our legislation takes an important first step in rectifying that problem and in creating the right kind of incentives for an efficient health care delivery system in this country.
Mr. Speaker, I want to thank the sponsors of the Democratic alternative for including this language in the alternative.
Mr. MOAKLEY. Mr. Speaker, I yield myself such time as I may consume to urge my colleagues to vote ``no'' on the previous question, because only if the previous question is defeated will the House be permitted to correct the minimum wage and the Medicare giveback measures in a way that they can be enacted into law.
Mr. Speaker, if the previous question is defeated, I will offer a germane amendment to the rule to fix the small business bill so that the President will sign it.
Mr. Speaker, the text of my amendment is as follows:
Previous Question Amendment Conference Report on the Saint Croix Island Heritage Act
In the resolution, strike section 3 and insert the following:
``SEC. 3. The text specified in section 2 is as follows:
Resolved by the House of Representatives (the Senate concurring), That in the enrollment of the bill (H.R. 2614), to amend the Small Business Investment Act to make improvements to the certified development company program, and for other purposes, the Clerk of the House of Representatives shall make the following corrections:
(1) In section 1, insert before ``are hereby enacted into law'' the following: ``as modified in accordance with section 3,''.
(2) In section 2, insert before the period at the end the following: ``, modified in accordance with section 3''.
(3) Add at the end the following new section:
SEC. 3. MODIFICATION TO TEXT OF BILL ENACTED BY REFERENCE AND MODIFICATION OF A REFERENCE.
The modification referred to in sections 1 and 2 is to the text of the bill H.R. 5538, as referred to in section 1(1), and is as follows: The text of such bill is modified by striking all after the enacting clause and inserting the following:
``SECTION 1. SHORT TITLE.
``This Act may be cited as the `Minimum Wage Act of 2000'.
``SEC. 2. MINIMUM WAGE INCREASE.
``Paragraph (1) of section 6(a) of the Fair Labor Standards Act of 1938 (29 U.S.C. 206(a)) is amended to read as follows:
`` `(1) except as otherwise provided in this section. Not less than $5.15 an hour during the period ending December 31, 2000, not less than $5.65 an hour during the year beginning January 1, 2001, and not less than $6.15 an hour beginning January 1, 2002;'.''.
SEC. 2. CHANGE OF BILL NUMBER REFERRED TO IN CONFERENCE REPORT.
In the enrollment of the bill referred to in the first section of this resolution, the Clerk shall make the following correction: in section 1(3), strike ``H.R. 5543, as introduced on October 25, 2000'' and insert ``H.R. 5601, as introduced on October 30, 2000''.
Mr. MOAKLEY. Mr. Speaker, I yield back the balance of my time.
Mr. DIAZ-BALART. Mr. Speaker, I yield 1 minute to the gentleman from California (Mr. THOMAS) for a point he wants to make.
Mr. THOMAS. Mr. Speaker, I appreciate the gentleman yielding me this time.
I just want to remind all my colleagues on the other side of the aisle
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For all of my colleagues on the other side of the aisle who have been indicating they do not want money to go to the Medicare+Choice programs, I just do believe as a matter of honesty that they need to know that if they support the language in their bill, the Medicare+Choice payments will go up significantly, perhaps as much as $10 billion to $15 billion.
Mr. DIAZ-BALART. Mr. Speaker, I yield myself such time as I may consume to urge adoption of the rule and remind my colleagues that this is a vote on the minimum wage. It is a vote on the previous question and then the vote on the rule, but they are votes on the minimum wage.
Mr. RANGEL. Mr. Speaker, today, Representative DINGELL and I introduced a bill, H.R. 5601, to improve greatly the Medicare and Medicaid bill currently pending before the House and Senate.
The following outline describes how we would have significantly improved the nation's health care programs.
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