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We saw an opportunity this morning to offer this bill as an amendment to other legislation today, so it was assembled quickly, and I apologize for any technical errors or oversights. Basically, the bill takes the Republican-passed Medicare and Medicaid give-backs bill, cleans up some problems in their coverage and appeals area, and adds in the various items included in the Administration's letter explaining how the bill should be changed to avoid a veto (the Shalala-Lew letter).
Mr. Speaker, Democrats will keep trying to improve the Republican Medicare and Medicaid bill. We ask that the majority stop the stonewalling and negotiate with us so that we can mutually deliver a comprehensive improvement in these key social programs.
Defeat the Previous Question: Allow Democrats to Offer the Following Amendment
DEMOCRATS TAKE REPUBLICAN-PASSED MEDICARE/MEDICAID GIVE-BACKS BILL AND MAKE MAJOR IMPROVEMENTS
The alternative includes all the provisions which passed the House Thursday in HR 2614, and makes the following changes and additions:
Full hospital Prospective Payment System update for two years; The Republican bill had only a one year update, and cuts in the next two years. Hospitals reeling from BBA cuts need two years of full inflation adjustment.
Graduate Medical Education Payments, 2 year freeze at the 6.5 percent, compared to Republican-passed one year freeze, and a cut in the second year. Provides help to nation's premier teaching and research hospitals.
Rural Disproportionate Share Hospitals: in addition to the provisions in the Republican-passed bill, provides for a higher level of reimbursement for rural hospitals serving low income individuals.
Nursing Home staffing and quality: includes bipartisan proposals to provide an additional $1 billion/5 years to assist nursing homes on improving staffing. Recent studies show that many homes need to make major improvements in staffing levels.
Home health agencies: provides a 2 year delay in the 15 percent cut in payments instead of the Republicans 1-year delay.
Rural home health agencies, provide a 10 percent bonus for service in rural areas to compensate for the high cost of travel, lower volume of patients seen per hour.
Hospice, full two year update, in lieu of the Republicans one-year update. Hospices need increased payments to deal with soaring cost of pharmaceuticals.
Puerto Rico Hospitals, improved payments. The Democratic bill includes the Ways and Means Health Subcommittee and Senate Finance Committee proposal to increase Puerto Rican hospital payments, which was dropped in the Republican-only negotiations.
Medicare+Choice program: Retains the payment improvements in the Republican-passed bill, but provides increases only if the plan commits to stay in a community with a defined package of benefits for a three year period.
Medicare Coverage for Individuals with ALS (Lou Gherig's disease): Waives 24-month waiting period for individuals diagnosed with ALS so that they can become eligible for coverage under Medicare immediately. Because of the speed with which ALS progresses, these individuals would likely otherwise be dead before ever getting Medicare coverage. Capps bill cosponsored by 282 House Members.
Medicare Appeals provision: makes the provision in the Republican-passed bill workable and similar to the Patient Bill of Rights protections for Medicare beneficiaries.
Needlestick safety for workers in public hospitals.
Hospital-based SNF and Home Health Agency geographic reclassification (provision from Commerce Committee-reported bill.
MEDICAID AND CHIP PROVISIONS--FROM COMMERCE-PASSED BIPARTISAN PACKAGE
Medicaid Disproportionate Share Hospital (DSH) Increased Payments: Freeze Medicaid DSH cuts at 2000 levels. Annual update of DSH allotment for inflation beginning in 2001 and thereafter, and eliminates the ``cliff'' in FY 2003 allotments that was in the Republican bill.
Optional Coverage of Legal Immigrant Children and Pregnant Women in Medicaid and CHIP: States may extend coverage to legal immigrant children and pregnant women who have lawfully resided in the U.S. for 2 years. Sponsors of immigrants would not incur a debt for cost of Medicaid benefits provided and not asked to repay the value of medical care after the 2-year period had been met.
Improved/Expanded Outreach Sites for enrollment in Medicaid and CHIP: State option to allow additional entities to determine children ``presumptively eligible'' for health insurance in Medicaid or CHIP.
Improving Welfare to Work Transition: Extends Transitional Medicaid Assistance (TMA) program for one additional year. (This program provides Medicaid health insurance for up to one year for families [up to 185 percent of poverty] who are transitioning from welfare to work.) Gives states the option to simplify requirements for reporting eligibility. Gives states that already cover individuals up to 185 percent the option to be exempt from TMA requirement.
Improved Outreach/Enrollment in Cost-Sharing Assistance Programs for Low-Income Medicare Beneficiaries: Secretary of HHS to consult with states, beneficiary groups to develop a simplified application form for applying for Qualified Medicare Beneficiary (QMB) and Specified Low-Income Medicare Beneficiary (SLMB) programs. Secretary would make form available in all Social Security offices, as well as other sites frequented by seniors within one year of enactment.
Health Insurance for Disabled Children: Democrats include the Family Opportunity Act which allows working families with incomes above the Social Security limit to buy-in to Medicaid coverage.
Medicaid recognition of physician assistant (PA) services.
Mr. POMEROY. Mr. Speaker, I rise in support of S. 2485, an act to develop a regional heritage center for the St. Croix Island International Historic Site in Calais, Maine.
As we prepare to celebrate the bicentennial of the historic Lewis and Clark expedition opening up the West, it is also important to note that the 400th anniversary of the first European settlements established in North America--including the St. Croix Island settlement established 396 years ago.
This site--the St. Croix Island--is a strikingly beautiful site in the St. Croix River, the river which forms the border between the United States and Canada. As such, it is a jointly operated site by the United States and Canada--the only internationally operated historic site in the entire park system.
I have been to the areas in each of the last 5 years and have found it to be a fascinating area to explore and learn about its rich history.
With the approaching anniversary, it is important to move now to get the infrastructure in place to facilitate those who will come to the area in the years ahead.
I am pleased to see the bill providing for the construction of a heritage center at Calais, Maine as part of this infrastructure. Calais is a delightful town in wonderful Washington County and is close to the island while being a crossroads for international traffic and tourism. It will enhance and increase tourist interest in this important historic site. I have become well acquainted with the people of Calais over the last several summers and have found them to be friendly and helpful to those visiting the area. They will be a great host for the center.
I commend Representative JOHN BALDACCI for his leadership in getting this matter brought to the floor for our action today. He is a great ambassador for his district and, as our legislative action on this matter represents, a very effective representative of the region in Congress.
Mr. DINGELL. Mr. Speaker, I rise in support of the Democratic amendment to be offered by Mr. MOAKLEY if the vote on the previous question is defeated. This amendment would make vast improvements over the legislation offered by the Republican leadership.
In my home state of Michigan and in every other state across the country, Medicare and Medicaid beneficiaries and providers are looking to Congress to address the program cuts enacted in 1997. The Republican leadership offered a bill last week that was woefully inadequate--it omitted key beneficiary protections, shortchanged providers, and dumped billions of dollars to HMOs without requiring any accountability.
The Democratic alternative includes the good provisions of the Republican bill, but makes up the difference where the Republican bill fell short. The Democratic amendment includes program improvements for seniors, the disabled, working families, pregnant women, and children. The bill improves outreach and enrollment for low-income seniors in cost-sharing assistance programs; allows families to
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The Democratic amendment also includes additional assistance to providers who are still reeling from the cuts they took in the 1997 Balanced Budget Act--providers like home health agencies, nursing homes, and hospitals that serve a disproportionate share of the low-income and uninsured.
I urge my colleagues on both sides of the aisle to support this amendment. Our providers and beneficiaries back home are counting on it.
Mr. DIAZ-BALART. Mr. Speaker, I yield back the balance of my time, and I move the previous question on the resolution.
The SPEAKER pro tempore (Mr. LAHOOD). The question is on ordering the previous question.
The question was taken; and the Speaker pro tempore announced that the ayes appeared to have it.
Mr. MOAKLEY. Mr. Speaker, I object to the vote on the ground that a quorum is not present and make the point of order that a quorum is not present.
The SPEAKER pro tempore. Evidently a quorum is not present.
Pursuant to clause 9 of rule XX, the Chair will reduce to a minimum of 5 minutes the period of time within which a vote by electronic device, if ordered, will be taken on the question of agreeing to the resolution.
The Sergeant at Arms will notify absent Members.
The vote was taken by electronic device, and there were--yeas 189, nays 169, not voting 74, as follows:
Aderholt
Armey
Bachus
Baker
Baldacci
Ballenger
Barrett (NE)
Bartlett
Barton
Bass
Bereuter
Biggert
Bilbray
Bilirakis
Bliley
Blunt
Boehlert
Boehner
Bonilla
Bono
Bryant
Burr
Burton
Buyer
Callahan
Calvert
Camp
Canady
Cannon
Castle
Chabot
Chambliss
Chenoweth-Hage
Coble
Coburn
Collins
Combest
Cook
Cox
Cubin
Cunningham
Davis (VA)
Deal
DeLay
DeMint
Diaz-Balart
Doolittle
Dreier
Duncan
Dunn
Ehlers
Ehrlich
Emerson
English
Ewing
Fletcher
Foley
Fossella
Frelinghuysen
Gallegly
Ganske
Gekas
Gibbons
Gilchrest
Gillmor
Gilman
Goode
Goodlatte
Goodling
Goss
Graham
Granger
Green (WI)
Greenwood
Gutknecht
Hall (TX)
Hansen
Hastings (WA)
Hayes
Hayworth
Herger
Hill (MT)
Hilleary
Hobson
Hoekstra
Horn
Hostettler
Houghton
Hunter
Hutchinson
Hyde
Isakson
Istook
Jenkins
Johnson (CT)
Johnson, Sam
Jones (NC)
Kelly
Kingston
Knollenberg
Kuykendall
LaHood
Largent
Latham
LaTourette
Leach
Lewis (CA)
Lewis (KY)
Linder
LoBiondo
Lucas (OK)
Manzullo
McCrery
McHugh
McKeon
Miller (FL)
Miller, Gary
Moran (KS)
Morella
Myrick
Nethercutt
Ney
Northup
Norwood
Nussle
Packard
Paul
Pease
Peterson (MN)
Peterson (PA)
Petri
Pickering
Pitts
Pombo
Porter
Portman
Pryce (OH)
Quinn
Ramstad
Regula
Reynolds
Rogan
Rogers
Rohrabacher
Ros-Lehtinen
Roukema
Royce
Ryan (WI)
Ryun (KS)
Salmon
Sanford
Saxton
Schaffer
Sensenbrenner
Sessions
Shadegg
Sherwood
Shimkus
Simpson
Skeen
Smith (MI)
Smith (NJ)
Smith (TX)
Souder
Spence
Stump
Sununu
Sweeney
Tancredo
Tauzin
Terry
Thomas
Thornberry
Thune
Tiahrt
Toomey
Traficant
Upton
Vitter
Walden
Walsh
Wamp
Watts (OK)
Weldon (PA)
Weller
Wicker
Wilson
Young (AK)
Young (FL)
Andrews
Baca
Baird
Baldwin
Barcia
Barrett (WI)
Becerra
Bentsen
Berkley
Berman
Berry
Bishop
Blagojevich
Blumenauer
Bonior
Borski
Boswell
Boyd
Brady (PA)
Capps
Capuano
Cardin
Carson
Clay
Clayton
Clement
Clyburn
Condit
Costello
Coyne
Cramer
Cummings
Davis (FL)
DeFazio
DeGette
DeLauro
Deutsch
Dicks
Dingell
Dixon
Doggett
Dooley
Doyle
Edwards
Engel
Eshoo
Etheridge
Evans
Farr
Filner
Ford
Frost
Gejdenson
Gephardt
Gonzalez
Gordon
Green (TX)
Gutierrez
Hall (OH)
Hill (IN)
Hinchey
Hinojosa
Hoeffel
Holden
Holt
Hooley
Hoyer
Inslee
Jackson (IL)
Jackson-Lee (TX)
Jefferson
John
Kennedy
Kildee
Kilpatrick
Kind (WI)
Kleczka
Kucinich
Lampson
Larson
Lee
Levin
Lewis (GA)
Lofgren
Lowey
Lucas (KY)
Luther
Maloney (CT)
Markey
Matsui
McCarthy (NY)
McDermott
McGovern
McIntyre
McKinney
McNulty
Meehan
Meek (FL)
Meeks (NY)
Menendez
Millender-McDonald
Miller, George
Minge
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