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This is a good bill. It goes to the heart of working men's needs and working women's needs for health care, for opportunities for pension savings, for jobs in our most debilitated urban areas and for Medicare for our seniors. Maybe it is not everything the President wants, but there is not anything in here that most Members have not already voted for. Do not let the politics
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PARLIAMENTARY INQUIRY
Mr. MOAKLEY. Mr. Speaker, I have a parliamentary inquiry.
The SPEAKER pro tempore. The gentleman will state it.
Mr. MOAKLEY. Mr. Speaker, is it proper for a Member to say that a Member is misleading the public by a statement he makes here on the floor?
The SPEAKER pro tempore. The rules of decorum in debate prohibit any descent to personalities.
Mr. MOAKLEY. So it is not in order for a Member to say that a Member intentionally misled someone by his statements?
The SPEAKER pro tempore. If it is an accusation of deceit, the gentleman is correct.
PARLIAMENTARY INQUIRY
Mr. LINDER. Mr. Speaker, I have a parliamentary inquiry.
The SPEAKER pro tempore. The gentleman will state it.
Mr. LINDER. Mr. Speaker, if a speaker on the floor makes a statement that is incorrect and someone corrects the statement, such as there is no money in here for school construction and in fact there is $15 billion, is that a statement of derision against the speaker or a correction of facts?
The SPEAKER pro tempore. The rules of the House would distinguish between deceit and mistake.
Mr. MOAKLEY. Mr. Speaker, I yield 3 minutes to the gentleman from New York (Mr. RANGEL), the ranking member of the Committee on Ways and Means.
(Mr. RANGEL asked and was given permission to revise and extend his remarks.)
Mr. RANGEL. Mr. Speaker, I am glad that the gentlewoman from Connecticut is on the floor with all of her candor. I would ask the gentlewoman from Connecticut to pay particular attention to what I am saying so that she might take down my words if they appear to mislead. Because I know that the President of these United States has written to the Republican leadership to say basically, Can we talk? Can we talk taxes? Can we talk about a $250 billion tax cut over 10 years?
I know that. I also know that the Republican leadership, rather than take these tax issues to the United States Congress, rather than take them to the House of Representatives, rather than take them to the committee which the gentlewoman from Connecticut and I are privileged to serve, sought not to take it to the Committee on Ways and Means. I would think the best way to deal with this is to leave the floor because the deception that is going on here today is that most people thought that when we adjourned yesterday, we adjourned yesterday.
I want my words taken down to say that it is a fraud on the American people to say that we adjourned yesterday 8 o'clock this morning in order to trick the American people into believing that yesterday is today. If you want to take my words down, we will go to the Parliamentarian and ask does that make any sense.
Does it make any sense to have a tax bill not come out of the tax committee? How dare them think that is what is best. The gentlewoman from Connecticut said that she and I had come to a state of mind in terms of a bill that has 230 cosponsors as to how we can modernize and how we can construct new schools.
[Time: 12:30]
Would Republican leadership talk with Democrats about how we could work out something, like the gentlewoman from Connecticut (Mrs. JOHNSON) and I have worked out? Would they call the White House and ask whether or not they can work out something?
For whatever reason, the Republicans are looking for a train wreck. They are asking for a veto, because each and every thing that the President has asked for they gave it to him, but put in a poison pill with each and every one of those things.
Sure, we want to improve the Medicaid and Medicare bill and give it back. Why is it you leave out hospitals and put in HMOs? There are things we can do, not as Democrats, not as Republicans, but as Members of Congress.
All of a sudden we are supposed to go home now and say we do not need the Congress. A handful of Republicans can ignore the President; a handful of Republicans. They do not go to the Republican committee members, they do not go to their Democrat counterparts, they do not go to the President of the United States. They just figure that they are going to get out of here and just are going to bring anything to the floor.
Well, it is not going to work that way. If we want to get out of here with some semblance of mutual respect, if we want to give credibility to the House of Representatives, we have to respect our committee system, and no one is going to tell us what to do and what to vote for and what to pass, and the President reserves the right to veto.
Mr. LINDER. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I would just like to make note that the letter the President sent us after we had passed this original bill in the spring of this year, the letter he sent us that asked could we sit down and talk about taxes, arrived yesterday.
Mr. Speaker, I reserve the balance of my time.
Mr. MOAKLEY. Mr. Speaker, I yield 1 minute to the gentleman from Mississippi (Mr. TAYLOR).
Mr. TAYLOR of Mississippi. Mr. Speaker, the citizens of America entrust us with running their Nation. We are going to be asked in less than 3 hours to vote on a 960-page document that was just delivered to the House. No one knows what is in it. There could be a tax on handguns; there could be a tax on cigarettes; they could bring back prohibition. Neither the Speaker of the House nor the gentleman from Georgia (Mr. LINDER) have any idea what is in this bill. But if the House votes for it and the Senate votes for it, it becomes the law of the land, until it is repealed. That could take 1 year, that could take 100 years.
This Nation squanders $1 billion on interest on the debt. I hear my Republican colleagues say we finally turned a profit. We have an $8 billion surplus for the first time in 30 years. I would tell you that surplus compared to the debt is like a person who, for 30 years, has been charging things to his Visa card and finally breaks even at the end of 1 year and has $1,000 left, and says, ``Honey, let's go blow it,'' ignoring the fact that he is $686,000 in debt on his credit cards. That is the comparison of this year's surplus to the accumulated debt of $5.7 trillion.
Mr. MOAKLEY. Mr. Speaker, I yield 1 minute to the gentleman from Oregon (Mr. BLUMENAUER).
Mr. BLUMENAUER. Mr. Speaker, I appreciate the gentleman's courtesy.
Would that the rule that we are debating here today simply had given us a tax bill that somebody may be able to comprehend. As my colleague from Mississippi pointed out, there is nobody in this Chamber that knows exactly what they are voting on.
I look forward to the debate later today on the merits of the proposals that we have heard argued briefly before us. But this rule snuck in provisions that are extraneous to taxation.
I give you just one example: It does not just overturn Oregon's death with dignity law, the only such provision in the United States, but it would criminalize the critical doctor-patient relationship dealing with the management of pain.
This is something that is objected to by a number of medical societies around the country. Any thinking professional who considers the potential of criminalizing this sensitive relationship understands on this basis alone it calls for the rejection of the rule and the underlying bill.
Mr. MOAKLEY. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I urge a no vote on the previous question. Only by defeating the previous question will the House be allowed to vote on the Democratic alternative.
Our plan would include an increase in the minimum wage . Our plan would include targeted tax credits. It would provide $25 billion in real school construction and modernization financing with the prevailing wage protections. Our plan would improve Medicare, Medicaid, children's health benefits, and would include many, many other items.
Mr. Speaker, I include for the RECORD the text of my amendment.
Previous Question Amendment Conference Report on the Small Business Investment Act
At the end of the resolution insert the following;
``Sec. 2. Upon adoption of this resolution, the House shall be considered to have adopted a concurrent resolution introduced by Representative Gephardt on October 26, 2000, directing the Clerk of the House of Representatives to make corrections in the enrollment of the conference report on H.R. 2614 to amend the Small Business Investment Act to make improvements to the certified development company program, and for other purposes. The concurrent resolution deemed to have been adopted by the House shall consist of the Democratic alternative to the conference report including an increase in the minimum wage , targeted tax relief--including $25 billion in real school construction and modernization financing with prevailing wage protections--and Medicare, Medicaid and SCHIP benefit improvements and protections, and other matter.
Mr. Speaker, I yield back the balance of my time.
Mr. LINDER. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I include for the RECORD a list of 40 or 50 health care organizations, from the Federation of American Hospitals, American Cancer Society, et cetera, who are in support of this bill and the provisions in it.
FEDERATION OF AMERICAN HOSPITALS,
Washington, DC, October 19, 2000.
Hon. DENNIS
HASTERT,
Speaker of the U.S. House of Representatives, Washington,
DC.
Hon. TRENT LOTT,
Majority Leader of the U.S. Senate,
Washington, DC.
DEAR LEADER(s): On behalf of the nation's 1,700 privately-owned and managed hospitals, the Federation of American Hospitals is pleased to offer its strong support of the Medicare, Medicaid & S-CHIP Beneficiary Improvement & Protection Act of 2000. In the wake of the unintentionally negative impact of the Balanced Budget Act of 1997 (BBA), hospitals and health providers across the country have struggled financially, straining their ability to provide quality patient services. This legislation is a major step toward addressing some of the excesses in the BBA, and restoring stability to our health care delivery system.
By providing hospitals with a full inflation update for fiscal year 2001, Congress will allow us to be better prepared to meet the costs of delivering care to the millions of patients that we annually serve. By addressing excessive reductions in Medicaid, in Medicare Disproportionate Share payments, and in payments for indigent care, the bill targets its assistance at the precise payment policies that have so negatively impacted hospitals in recent years. Would hospitals like more relief, for a longer duration, including the restoration of our full inflation update for 2002? Certainly, but we appreciate the significant assistance of this bill. Above all, we want to ensure that the relief that is included in this package becomes low before Congress adjourns.
In addition to the broader provisions that impact all hospitals, the bill also includes significant provisions to assist rural hospitals, hundreds of whom are Federation members. Among numerous important rural provisions, the changes to the Medicare DSH program thresholds that will allow far more rural hospitals to participate, may be the most important. Many struggling hospitals in rural communities, serving predominantly low-income populations, will receive vital new assistance that will allow them to maintain services to poor Medicare patients.
Finally, this summer, after many years of development, hospitals moved to outpatient prospective payment (PPS). Despite improvements under the new outpatient PPS, beneficiary copayments remain high for some services due to historical design flaws in the program. This bill will significantly reduce many of those copayments, lowering costs to seniors.
These are just a few of the many positive provisions that have been included in this legislation to help patients and their health care providers. As a result, the Federation strongly supports the Medicare, Medicaid & S-CHIP Beneficiary Improvement & Protection Act of 2000. We will work with Congress and the President to encourage its swift enactment.
We look forward to working with Congress and the Administration to further educate our leaders on the difficulties facing our health providers. Both the President and Congress have shown a significant appreciation for the reimbursement problems facing our hospitals, and we hope that we can continue this dialogue. Only with a sustained bipartisan dialogue can our hospitals, and our biggest insurer--the government--continue to provide the world's finest health care in an increasingly complex fiscal environment.
Sincerely,
THOMAS A. SCULLY,
President & CEO.
--
NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS, INC.,
Washington, DC, October 18, 2000.
Hon. TRENT
LOTT,
Majority Leader, U.S. Senate, United States Capitol Building,
Washington, DC.
Hon. J. DENNIS HASTERT,
Speaker, U.S.
House of Representatives, United States Capitol Building, Washington, DC.
DEAR MAJORITY LEADER LOTT AND SPEAKER HASTERT: On behalf of the National Association of Community Health Centers (NACHC), thank you for your efforts to protect health care access for more than 11.5 million medically underserved Americans by including the Medicaid prospective payment system for Federally qualified health centers in the final version of BBA relief legislation.
As you know, the BBA eliminated a fundamental underpinning of America's health center safety net by phasing-out and eventually terminating the Medicaid cost-based reimbursement system for Federally qualified health centers. Health centers believe that your efforts to include a new prospective payment system for health centers in your BBA relief legislation is essential to their continued survival and will ensure that they remain a viable part of America's health care safety net.
Thank you again for your commitment to protecting health centers through your BBA relief legislation. Enactment of this prospective payment system is essential to protect the struggling health care safety net and will ensure the place of health centers in providing access to care for millions of uninsured Americans. We stand ready to work with you to make meaningful BBA relief for health centers a reality.
Please feel free to contact me if there is anything that I can do for you.
Sincerely,
Thomas J. Van Coverden,
President and CEO.
--
AMERICAN MEDICAL REHABILITATION
PROVIDERS ASSOCIATION,
Washington, DC, October 19, 2000.
Hon. WILLIAM V.
ROTH, Jr.,
Chairman, Committee on Finance, Dirksen Senate Office
Building, Washington, DC.
DEAR CHAIRMAN ROTH: The American Medical Rehabilitation Providers Association (AMRPA) thanks you for your leadership in securing passage of the ``Medicare Medicaid and SCHIP Beneficiary Protection Improvement Act of 2000.'' This legislation will provide crucial and immediate relief to Medicare providers adversely affected by cuts imposed by the Balanced Budget Act of 1997 (BBA 97). We strongly support its immediate passage.
In particular, we would like to thank you for ensuring inclusion of two provisions addressing concerns of the rehabilitation hospital industry. Section 305 of the Act will eliminate, for FY 2002, a two percent cut on overall rehabilitation spending imposed by BBA 97. This provision will help shore up the financial strength of the industry as we begin the transition to a prospective payment system (PPS). Section 305 of the Act also gives rehabilitation facilities which are ready to proceed immediately to full PPS reimbursement the opportunity to do so, rather than requiring them to gradually transition over a two-year period as in BBA 97. Fully funding this provision helps to ensure the ability of rehabilitation providers to provide high quality, cost-effective care during the PPS transition.
As indicated in MedPac's June 1999 report citing the decrease in rehabilitation hospital margins to 1.8%, rehabilitation hospitals nationwide have been hurt substantially by funding cuts under the Balanced Budget Act of 1997. If additional funding becomes available for short-term relief for providers, we respectfully request that you consider making the 2% restoration effective July 1, 2001 and extending the psych hospital provision in Section 306 to include rehabilitation hospitals and units.
Please know that your leadership is appreciated by the rehabilitation hospital industry, and by hundreds of thousands of rehabilitation patients served by rehabilitation hospitals nationwide. We hope we can count on Congressional intervention for future additional financial relief for rehabilitation hospitals. Thank you again.
Sincerely,
Edward A. Eckenhoff,
Chairman.
--
HEALTH SOUTH,
Birmingham, AL, October 19, 2000.
Hon. JIM
MCCRERY,
U.S. House of Representatives, Washington, DC.
DEAR REPRESENTATIVE MCCRERY: Please accept this as my sincere thanks and appreciation for all of your efforts with the ``Medicare Refinement and Benefits Improvement Act of 2000.'' It is because of men such as yourself that give their attention to matters of concern to all people that we are able to make progress in much needed areas.
Rehabilitation hospitals across the nation will benefit from this legislation but greater still will be the benefit to the patients. Your help and continued support of this issue is again deeply appreciated.
Best regards,
Richard m. Scrushy,
Chairman of the Board &
Chief Executive Officer.
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