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I view the bill we are introducing today as a discussion draft. Our goal is to hear from a wide range of experts on government and management. I look

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   I look forward to working with Senators THOMPSON, BROWNBACK, ROTH and VOINOVICH on this important legislation.

   By Mr. DORGAN (for himself, Mr. DASCHLE, Mr. BAUCUS, Mr. JOHNSON, and Mr. HARKIN):

   S. 2307. A bill to amend the Communications Act of 1934 to encourage broadband deployment to rural America, and for other purposes; to the Committee on Commerce, Science, and Transportation.

   RURAL BROADBAND ENHANCEMENT ACT

   Mr. DORGAN. Mr. President, today I am, along with Senator DASCHLE, Senator BAUCUS and Senator JOHNSON, introducing the Rural Broadband Enhancement Act to deploy broadband technology to rural America. As the demand for high speed Internet access grows, numerous companies are responding in areas of dense population. While urban America is quickly gaining high speed access, rural America is--once again--being left behind. Ensuring that all Americans have the technological capability is essential in this digital age. It is not only an issue of fairness, but it is also an issue of economic survival.

   To remedy the gap between urban and rural America, this legislation gives new authority to the Rural Utilities Service to make low interest loans to companies that are deploying broadband technology to rural America. Loans are made on a company neutral and a technology neutral basis so that companies that want to serve these areas can do so by employing technology that is best suited to a particular area. Without this program, market forces will pass by much of America, and that is unacceptable.

   This issue is not a new one. When we were faced with electrifying all of the country, we enacted the Rural Electrification Act. When telephone service was only being provided to well-populated communities, we expanded the Rural Electrification Act and created the Rural Utilities Service to oversee rural telephone deployment . The equitable deployment of broadband services is only the next step in keeping America connected, and our legislation would ensure that.

   If we fail to act, rural America will be left behind once again. As the economy moves further and further towards online transactions and communications, rural America must be able to participate. Historically, our economy has been defined by geography, and we in Congress were powerless to do anything about it. Where there were ports, towns and businesses got their start. Where there were railroad tracks, towns and businesses grew up around them. The highway system brought the same evolution.

   But the Internet is changing all of that. No longer must economic growth be defined by geographic fiat. Telecommunications industries and policy-makers are proclaiming, ``Distance is dead!'' But, that's not quite right: Distance will be dead, as long as Congress ensures that broadband services are available to all parts of America, urban and rural.

   I look forward to working with Senator DASCHLE, Senator BAUCUS, Senator JOHNSON and my other colleagues in the Senate to pass this legislation and give rural America a fair chance to survive.

   By Mr. MOYNIHAN (for himself, Mr. GRAHAM, and Mrs. FEINSTEIN):

   S. 2308. A bill to amend title XIX of the Social Security Act to assure preservation of safety net hospitals through maintenance of the Medicaid disproportionate share hospital program; to the Committee on Finance.

   THE MEDICAID SAFETY NET HOSPITAL ACT OF 2000

   Mr. MOYNIHAN. Mr. President, today, I join with my colleagues, Senators GRAHAM and FEINSTEIN, in introducing legislation to ensure that our safety net hospitals continue to be able to care for the poor and the uninsured.

   The Medicaid Disproportionate Share Hospital (DSH) program provides vital funding to safety net hospitals that primarily serve Medicaid and uninsured patients. The Balanced Budget Act of 1997 placed declining state-specified ceilings on federal Medicaid DSH spending from 1998-2002. In 2003, the limits will begin to be adjusted upwards for inflation. The Medicaid Safety Net Hospital Act of 2000 would freeze the state-specific caps at this year's limits (thereby preventing further declines in the limits) and adjust them for inflation beginning in 2002.

   It is essential to provide much-needed support to our safety net hospitals. The number of uninsured in the United States increases every year, in part because of declining Medicaid enrollment as a result of welfare reform. There are now 44 million Americans without health insurance who have no choice but to turn to the emergency rooms of safety net hospitals for care. Yet, even as demands on safety net hospitals increase, DSH spending per State is being further reduced. The Medicaid Safety Net Hospital Act of 2000 would maintain significant savings achieved by prior reductions but would protect safety net hospitals from further DSH cuts. As a result, hospitals would have access to the financing they need for achieving their social mission.

   Mr. President, Congress should act now to preserve the financial ability of our safety net hospitals to provide health care to the poor and uninsured/

   I ask unanimous consent that the text of the bill be printed in the RECORD.

   There being no objection, the bill was ordered to be printed in the RECORD, as follows:

    Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

   SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicaid Safety Net Hospital Act of 2000''.

   SEC. 2. FREEZING MEDICAID DSH ALLOTMENTS FOR FISCAL YEAR 2001 AT LEVELS FOR FISCAL YEAR 2000.

    Section 1923(f) of the Social Security Act (42 U.S.C. 1396r-4(f)) is amended--

    (1) in paragraph (2)--

    (A) in the heading, by striking ``2002'' and inserting ``2001'';

    (B) in the matter preceding the table, by striking ``2002'' and inserting ``2001 (and the DSH allotment for a State for fiscal year 2001 is the same as the DSH allotment for the State for fiscal year 2000, as determined under the following table)''; and

    (C) by striking the columns in the table relating to FY 01 and FY 02 (fiscal years 2001 and 2002); and

    (2) in paragraph (3)--

    (A) in the heading, by striking ``2003'' and inserting ``2002''; and

    (B) in subparagraph (A), by striking ``2003'' and inserting ``2002''.

   Mrs. FEINSTEIN. Mr. President, I rise today in support of the Medicaid Safety Net Hospital Act of 2000, a bill that would freeze Medicaid Disproportionate Share Hospital (DSH) payments to hospitals at their 2000 level for Fiscal Year 2001 and 2002. I hope the Senate can act promptly on this bill.

   The number of people in our nation who have no medical insurance has hit some 44 million. This is tragic. More than 100,000 people join the ranks of the uninsured monthly. We cannot continue to reduce payments to hospitals that provide care for the uninsured. We cannot balance the budget on the backs of poor people who show up at emergency rooms with no insurance or on the backs of the hospitals that tend to them.

   California bears a disproportionate burden of uncompensated care. Twenty-four percent of our population is uninsured. Nationwide, the rate is 17 percent. Currently, over 7 million Californians are uninsured. During the past few months, I have met with many California health care leaders. They fear that the Medicaid cuts contained in the Balanced Budget Act of 1997 have undermined the financial stability of California's health care system, which many believe to be on the verge of collapse.

   As a result of Medicaid reductions in the Balanced Budget Act of 1997, California's Medicaid Disproportionate

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   Without this bill, for example, by Fiscal Year 2002 Los Angeles County- University of Southern California Medical Center will lose $13.5 million. San Francisco General will lose $5.2 million. Fresno Community Hospital will lose $10.5 million. Over 132 California hospitals, representing rural and urban communities, depend on Medicaid DSH payments. Under this bill, millions of dollars will be restored to California public hospitals.

   Public hospitals carry a disproportionate share of caring for the poor and uninsured. Forty percent of all California uninsured hospital patients were treated at public hospitals in 1998, up from 32 percent in 1993. The uninsured as a share of all discharges from public hospitals grew from 22 percent in 1993 to 29 percent in 1998. While overall public hospital discharges declined from 1993 to 1999 by 15 percent, discharges for uninsured patients increased by 11 percent. Large numbers of uninsured add huge uncompensated costs to our public hospitals.

   The uninsured often choose public hospitals and frequently wait until their illnesses or injuries require emergency treatment. This makes their care even more costly. California's emergency rooms are strained to the breaking point. Last week at a California State Senate hearing, Dr. Dan Abbott, an emergency room physician at St. Jude Hospital in Fullerton, California said: ``We feel that emergency care in California is overwhelmed, it's underfunded and at times, frankly, it is out-and-out dangerous.'' Statewide, 19 emergency rooms have closed since 1997 despite an increase in the number of uninsured requiring care. The burden to provide care is put on those hospitals who have managed to remain open, and many of those hospitals are currently facing financial problems of their own.

   California's health care system, in the words of a November 15th Wall Street Journal article, is a ``chaotic and discombobulated environment.'' It is stretched to the limit:

   Thirty-seven California hospitals have closed since 1996, and up to 15 percent more may close by 2005.

   Earlier this month, Scripps Memorial Hospital East County closed its doors due in part to reimbursement problems.

   Eighty-six California hospitals operated in the red in 1999.

   Academic medical centers, which incur added costs unique to their mission, are facing margins reduced to zero and below.

   Sixty-two percent of California hospitals are now losing money. Due to the large number of Medicare and Medicaid patients, sixty-nine percent of California's rural hospitals lost money in 1998, according to the California Healthcare Association.

   Hospitals have laid off staff, limited hours of operation, and discontinued services.

   California physician groups are failing at the rate of one a week, with 115 bankruptcies or closures since 1996.

   In short, restoring Medicaid cuts is crucial to stabilizing California's health delivery system.

   Circumstances have changed since 1997 when we passed the Balanced Budget Act. We have eliminated the federal deficit. Because we have a robust economy, lower inflation, higher GDP growth and lower unemployment, we also have lowered Medicaid spending growth more than anticipated. This climate provides us an opportunity to revisit the reductions contained in the Balanced Budget Act of 1997 and to strengthen the stability of health care services, a system that in my State is on the verge of unraveling.

   We need to pass this bill. Without it, we could have a more severe health care crisis on our hands, especially in California. I urge my colleagues to join me in passing this bill.

   By Mr. DASCHLE:

   S. 2309. A bill to establish a commission to assess the performance of the civil works function of the Secretary of the Army; to the Committee on Environment and Public Works.

   CORPS OF ENGINEERS CIVIL WORKS INDEPENDENT INVESTIGATION AND REVIEW ACT

   Mr. DASCHLE. Mr. President, over the last couple of months the Washington Post has published a number of very troubling articles about the operations of the U.S. Army Corps of Engineers.

   These stories expose the existence of independent agendas within the Corps. They suggest cost-benefit analyses rigged to justify billion dollar projects; disregard for environmental laws, and a pattern of catering to special interests.

   The actions described in the Post articles raise serious questions about the accountability of the Corps. And they present a compelling case for a thorough review of the agency's operations and management.

   And it is not only the Post articles that cause me to believe this.

   The Corps' current effort to update the Missouri River Master Control Manual--the policy document that governs the Corps' management of the river from Montana to Missouri--illustrates not only that the Corps can be indifferent to the environment. Too often, it actually erects institutional barriers that make achieving certain critical ecological goals difficult or impossible.

   This ought to be a concern to all Americans. It is a deep concern to South Dakotans. The Missouri runs down the center of our state and is a major source of income, recreation and pride for us.

   More than 40 years ago, the Corps built dams up and down the Missouri River in order to harness hydroelectric power. In return, it promised to manage the river wisely and efficiently.

   That promise has not been kept.

   Silt has built up, choking the river in several spots.

   In recent years, studies have been done to determine how to restore the river to health. An overwhelming amount of scientific and technical data all point to the same conclusion.

   The flow of the river should more closely mimic nature. Flows should be higher in the spring, and lower in the summer--just as they are in nature.

   Yet the Corps proposes to continue doing largely what it has been doing all these years--knowing the consequences, knowing exactly what the practices have produced now for the last 50-plus years.

   The agency's refusal to change will further jeopardize endangered species. And, it will continue to erode the recreational value of the river, which is 12 times more important to the economy than its navigational value.

   Why does the Corps insist--despite all the evidence--on this course?

   It does it to protect the barge industry--a $7 million-a-year industry that American taxpayers already spend $8 million a year to support. $8 million. That's how much American taxpayers pay each year for channel maintenance, to accommodate the barge industry.

   The Washington Post suggests that the Corps handling of the Missouri River Master Manual is not an isolated case.

   The Post articles contain allegations by a Corps whistleblower who says that a study of proposed upper-Mississippi lock expansions was rigged to provide an economic justification for that billion-dollar project.

   In response to these allegations, the Corps' own Office of Special Counsel concluded that the agency--quote-- ``probably broke laws and engaged in a gross waste of funds.''

   In my own dealings with the Corps of Engineers, I too have experienced the institutional problems recorded so starkly in the Post series.

   In South Dakota, where the Corps operates four hydroelectric dams, we have fought for more than 40 years to force the agency to meet its responsibilities under the 1958 Fish and Wildlife Coordination Act and mitigate the loss of wildlife habitat resulting from the construction of those dams.

   For 40 years, the Corps has failed to meet those responsibilities.

   That is why I have worked closely with the Governor of my state, Bill Janklow, and with many other South Dakotans, to come up with a plan to transfer of Corps lands back to the state of South Dakota and two Indian tribes.

   Unfortunately, instead of attempting to work with us, the Corps is fighting us.

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   The litany of excuses, scare tactics and misinformation the Corps employed to try to defeat our proposal is outrageous. It appears Corps officials are not nearly as concerned with preserving the river as they are with preserving their own bureaucracy.

   After the legislation was enacted, the Chief of the Engineers, General Joseph Ballard continued to resist its implementation. In fact, my own experiences with the Corps, and the experiences of other members, repeatedly demonstrates General Ballard's unwillingness to follow civilian direction and ensure the faithful implementation of the law.

   When considered in the context of the litany of problems that have come to light in the Post series, Congress has no choice but to consider seriously moving the responsibilities of the Corps from the Army and placing them within the Department of the Interior. Too much power now is concentrated in the hands of the Chief of the Engineers, and that power too often has been abused.

   General Ballard's lack of responsiveness to the law, to meeting environmental objectives and to civilian direction, has serious consequences for individual projects.

   Beyond that, it raises very troubling questions about the lack of meaningful civilian control over this federal agency.

   In a democracy, institutions of government must be held accountable. That is the job of Congress--to hold them responsible.

   The existence of separate agendas within the Corps bureaucracy cannot be tolerated if our democracy is to succeed in representing the will of the people. Its elected representatives and the civil servants appointed by them must maintain control of the apparatus of government.

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