E PL UR UM IB N U U S Congressional Record United States th of America PROCEEDINGS AND DEBATES OF THE 106 CONGRESS, SECOND SESSION

Vol. 146 WASHINGTON, THURSDAY, JUNE 29, 2000 No. 85 Senate The Senate met at 9:30 a.m. and was RECOGNITION OF THE ACTING minutes for closing remarks, with 5 called to order by the President pro MAJORITY LEADER minutes of that time to be under the tempore (Mr. THURMOND). The PRESIDING OFFICER. The Sen- control of the Senator from Arizona, ator from Pennsylvania is recognized. Mr. MCCAIN. PRAYER f The Senator from Arizona. The Chaplain, Dr. Lloyd John Mr. MCCAIN. Mr. President, I yield 2 Ogilvie, offered the following prayer: SCHEDULE minutes of my 5 minutes to the Sen- Gracious God, You are never reluc- Mr. SPECTER. Mr. President, on be- ator from Wisconsin, Mr. FEINGOLD. tant to bless us with exactly what we half of the leader, I have been asked to The PRESIDING OFFICER. The Sen- announce that we will resume consider- need for each day’s challenges and op- ator from Wisconsin. portunities. Sometimes we are stingy ation of H.R. 4762. Under the previous receivers who find it difficult to open order, there will be closing remarks on Mr. FEINGOLD. Mr. President, de- our tight-fisted grip on circumstances the bill with a vote on final passage to spite the claims in the press by some and receive the blessing that You have occur at approximately 9:40 a.m. and opponents of this measure, this bill is prepared. You know our needs before following that vote, a vote on or in re- fair and evenhanded. It affects groups we ask You, but You wait to bless us lation to the Frist amendment, which on both sides of the political spectrum. until we ask for help. We come to You is the Frist amendment to the Labor, It is not aimed at any particular group now honestly to confess our needs. HHS, and Education appropriations or players in the elections. It is aimed Lord, we need Your inspiration for our bill, will occur. at getting rid of secrecy. It is not an thinking, Your love for our emotions. I have been asked to announce that it attempt to silence anyone. It is an at- Your guidance for our wills, and Your is the leader’s intention to finish this tempt to give the American people in- strength for our bodies. We have bill by midafternoon and then to pro- formation. They are entitled to have learned that true peace and lasting se- ceed to the Interior appropriations bill. this information about the groups who renity results from knowing that You I note a smile by our distinguished Pre- flood the airwaves with negative ads have an abundant supply of resources siding Officer. He has the Interior bill. during an election campaign. to help us meet any trying situation, But that is what the script says. We I thank all my colleagues who sup- difficult person, or disturbing com- will be pushing as hard as we can to ac- ported the McCain-Feingold-Lieberman complish that and get that done. Our plexity, and so we say with the psalm- amendment on the Department of De- distinguished leader was in a perse- ist, ‘‘Blessed be the Lord, who daily fense bill. They can be proud of what vering, strong mood last night, and I loads us with benefits.’’—Psalm 68:19. they did. With that vote, they have assume he will be this morning as well. Amen. started in motion a process that has We want people who have amendments brought us to this day, when we will to come to the floor. We will work out quickly pass and send to the President f a schedule and work out time agree- for his signature a good, fair, bipar- ments so we can meet that demanding tisan bill that does the right thing for PLEDGE OF ALLEGIANCE schedule. the American people. I thank the Chair and yield the floor. The Honorable SLADE GORTON, a Sen- Mr. ROTH. Mr. President, I believe in f ator from the State of Washington, led full disclosure of who is funding polit- the Pledge of Allegiance, as follows: INTERNAL REVENUE CODE OF 1986 ical campaigns. The public has a right I pledge allegiance to the Flag of the AMENDMENT to know who is paying for the political United States of America, and to the Repub- The PRESIDING OFFICER. Under advertisements and direct mail that lic for which it stands, one nation under God, they see. While I think this bill may indivisible, with liberty and justice for all. the previous order, the Senate will now resume consideration of H.R. 4762, not go far enough in requiring disclo- sure of these groups, it is a first step f which the clerk will report. The legislative clerk read as follows: and that is why I support H.R. 4762. A bill (H.R. 4762) to amend the Internal H.R. 4762 requires disclosure for po- RESERVATION OF LEADER TIME Revenue Code for 1986 to require 527 organi- litical organizations which are tax ex- The PRESIDING OFFICER (Mr. GOR- zations to disclose their political activities. empt under section 527 of the Internal TON). Under the previous order, the The PRESIDING OFFICER. Under Revenue Code. 527 organizations which leadership time is reserved. the previous order, there will now be 7 directly advocate the election or defeat

∑ This ‘‘bullet’’ symbol identifies statements or insertions which are not spoken by a Member of the Senate on the floor.

S6041

. S6042 CONGRESSIONAL RECORD — SENATE June 29, 2000 of a particular candidate for federal of- the Ways and Means Committee bill in connection with a pressing public issue. fice are subject to federal election cam- were not incorporated in this bill. I The Court found that FECA’s disclosure pro- paign law disclosure obligations. How- fear that we will have to address these visions, as written, raised potential problems both of vagueness and overbreadth. ever, 527 organizations that do not di- technical issues in the future in order Under First Amendment ‘‘void for vague- rectly advocate for the election or de- to make the disclosure provisions work ness’’ jurisprudence, the government cannot feat of a particular candidate are not to effectively provide this information punish someone without providing a suffi- subject to these federal election cam- to the public. ciently precise description of what conduct paign laws and are not obligated to dis- Because this bill is a first step and is legal and what is illegal. A vague or im- close the names of their contributors that some disclosure is better than no precise definition of regulated political advo- nor how they send the contributions disclosure, I will vote for H.R. 4762. cacy might serve to ‘‘chill’’ some political they receive. This bill correctly adds Mr. President, I ask unanimous con- speakers who, although they desire to en- gage in pure ‘‘issue advocacy,’’ may be afraid disclosure requirements to these 527 or- sent that a letter from the Brennan that their speech will be construed as ganizations so that the activities per- Center for Justice expressing the view regulable ‘‘express advocacy.’’ Similarly, the formed and identity of contributors to that this bill requiring disclosure by overbreadth doctrine in First Amendment these previously undisclosed will be 527 organizations is constitutionally jurisprudence is concerned with a regulation available for public scrutiny, much sound be printed in the RECORD. that, however precise, sweeps too broadly like those 527 organizations that have There being no objection, the letter and reaches constitutionally protected to disclose under the federal election was ordered to be printed in the speech. Thus, a regulation that is clearly drafted, but covers both ‘‘issue advocacy’’ RECORD, as follows: laws. and ‘‘express advocacy’’ may be overbroad as I am also glad that this bill follows BRENNAN CENTER FOR JUSTICE, applied to certain speakers. the constitutional requirement that New York, NY, June 28, 2000. The Court’s vagueness and overbreadth revenue measures originate in the DEAR SENATOR: I am writing to express the analysis centered on two provisions in House of Representatives. If the rev- views of the Brennan Center for Justice at FECA—section 608(e), which adopted limits New York University School of Law on the on independent expenditures, and section enue measure did not originate in the constitutional validity of attempts to seek House, then any member could subject 434(e), which adopted reporting requirements disclosure from organizations covered by for individuals and groups. For these two the bill to a ‘‘blue slip,’’ thereby void- Section 527 of the Internal Revenue Code, as provisions, the Supreme Court overcame the ing the entire bill, not just the part of contained in the Lieberman-Levin-Daschle- vagueness and overbreadth issues by adopt- the bill that is a revenue measure. I op- McCain Bills (S.B. 2582 and 2583). ing a narrow construction of the statute that posed an amendment similar to this Senate Bill 2582 seeks to completely close limited its applicability to ‘‘express advo- bill a few weeks ago when it was of- the current Section 527 loophole, under cacy.’’ However, the Court made it abso- which some organizations are claiming that lutely clear that the ‘‘express advocacy’’ fered as an amendment to the Defense they exist for the purpose of influencing Authorization bill because adoption of limiting construction that it was adopting electoral outcomes for income tax purposes, for these sections did not apply to expendi- that amendment would have subjected but that they are not ‘‘political committees’’ tures by either candidates or political com- the Defense Authorization bill to such for purposes of federal election law. Senate mittees. According to the Court, the activi- a ‘‘blue slip’’ challenge. Since we are Bill 2582 clarifies that tax exemption under ties of candidates and political committees taking up a House-originated revenue Section 527 is available only to organizations are ‘‘by definition, campaign related.’’ Buck- measure, I do not have the concerns that are ‘‘political committees’’ under ley, 424 U.S. at 79. which forced me to vote against the FECA. Senate Bill 2583 is a more limited bill, The ‘‘express advocacy’’ limitation was in- which requires Section 527 organizations to tended by the Court to give protection to previous amendment. disclose their existence to the IRS, to file However, I do have some concerns speakers that are not primarily engaged in publicly available tax returns, and to file influencing federal elections. However, be- with this bill. First, this bill is a tax with the IRS and make public reports dis- cause candidates and political committees measure and tax measures should first closing large contributors and expenditures. have as their major purpose the influencing be addressed by this committee of ju- Both of these bills are constitutionally of elections, they are not entitled to the ben- risdiction, the Finance Committee. sound. Buckley v. Valeo, 424 U.S. 1 (1976), efit of the ‘‘express advocacy’’ limiting con- This we have not done. In fact, the Fi- clearly established that groups whose major struction. The Supreme Court never sug- ance Committee was scheduled to have purpose is influencing elections—the opera- gested, as no rational court would, that po- tive test under both the Federal Election a hearing on July 12, 2000 to review this litical candidates, political parties, or polit- Campaign Act (FECA) and under Section 527 ical committees can avoid all of FECA’s re- and other similar legislation dealing of the Internal Revenue Code—are appro- quirements by simply eschewing the use of with disclosure of political activity by priately subject to federal disclosure laws. A ‘‘express advocacy’’ in their communica- tax-exempt and other organizations. close textual analysis of Buckley reveals that tions. As discussed above, the Supreme Court This hearing will not happen now and the Supreme Court explicitly recognized the wanted to avoid trapping the unwary polit- we will not be able to have the Finance legitimacy of mandatory disclosure laws for ical speaker in the web of FECA regulation. Committee review how effective this organizations whose major purpose is influ- However, for political parties, political can- legislation will be. encing elections. didates, and political committees, which My second concern is that this bill UNDERSTANDING BUCKLEY’S DISCLOSURE have influencing electoral outcomes as their central mission, there is no fear that they may not do enough. By only focusing LIMITATIONS In Buckley v. Valeo, the Supreme Court will be unwittingly or improperly subject to on disclosure in one type of tax-exempt regulation. organization and not on others, we considered the constitutional validity of, among other things, various disclosure pro- * * * * * leave open the use of the other type of visions that Congress had enacted on federal The Buckley Court’s first invocation of the tax-exempt organizations by those who political activity. In general, the Court ‘‘express advocacy’’ standard appears in its want to hide their contributions and found mandatory disclosure requirements to discussion of the mandatory limitations im- activity behind the cloak of anonymity be the least restrictive means for achieving posed by FECA section 608(e) on independent that these tax-exempt organizations the government’s compelling interests in the expenditures. Section 608(e)(1) limited indi- provide. This view is shared by the campaign finance arena. However, the Court vidual and group expenditures ‘‘relative to a staff of the Joint Committee on Tax- believed that, while it was constitutionally clearly identified candidate’’ to $1,000 per permissible to require advocacy groups that year. The Court, in analyzing the constitu- ation. tional validity of the $1,000 limit to inde- Finally, I am concerned that this leg- ‘‘expressly advocate’’ for or against par- ticular federal candidates to comply with pendent expenditures by groups and individ- islation requires the Internal Revenue federal disclosure laws, advocacy groups that uals, focused first on the issue of unconstitu- Service to do things that it is not pre- engage in a mere discussion of political tional vagueness. The Court noted that al- pared to do with regard to disclosure. issues (so-called ‘‘issue advocacy’’) cannot be though the terms ‘‘expenditure,’’ ‘‘clearly For example, under the bill reported subjected to public disclosure. identified,’’ and ‘‘candidate’’ were all defined out of the Ways and Means Committee, The Supreme Court was concerned that in the statute, the term ‘‘relative to’’ a can- the IRS could partner with another FECA could become a trap for unwary polit- didate was not defined. Buckley, 424 U.S. at agency—most likely the Federal Elec- ical speakers. Advocacy groups or individ- 41. The Court found this undefined term to uals that participate in the national debate be impermissibly vague. Id. at 41. Due to the tion Commission—to provide that the about important policy issues might discover vagueness problem, the Court construed the results of the 527 disclosure to the pub- that they had run afoul of federal campaign phrase ‘‘relative to’’ a candidate to mean lic. Unfortunately, this and other tech- finance law restrictions simply by virtue of ‘‘advocating the election or defeat of’’ a can- nical matters that were addressed in their having mentioned a federal candidate didate. Id. at 42. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6043 Significantly, the Court did not adopt a rationale would no longer suffice. Id. at 76. campaign related, and legitimately subject limiting construction of the term ‘‘expendi- However, the Buckley Court concluded that to regulation under FECA. ture,’’ which appears in a definitional sec- section 434(e) was ‘‘not so intimately tied’’ This, of course, is the only sensible reading tion of the statute at section 591(f). Rather, to section 608(e) that it could not stand on of FECA. To suggest that political can- the Court narrowly construed only section its own. Id. at 76. Section 434(e), which pre- didates, political parties, or political com- 608(e). Id. at 44 (‘‘in order to reserve the pro- dated the enactment of section 608(e) by sev- mittees can escape FECA’s regulatory reach vision against invalidation on vagueness eral years, was an independent effort by Con- by merely eschewing the use of express grounds, § 608(e)(1) must be construed to gress to obtain ‘‘total disclosure’’ of ‘‘every words of advocacy, reduces the law to mean- apply only to expenditures for communica- kind of political activity.’’ Id. at 76. inglessness. It may be necessary, as the tions that in express terms advocate the The Court concluded that Congress, in its Court held, to give advocacy groups that are election or defeat of a clearly identified can- effort to be all-inclusive, had drafted the dis- not primarily engaged in campaign-related didate for federal office.’’). The limitations closure statute in a manner that raised activity a bright-line test that will enable under section 608(e) apply only to individuals vagueness problems. Id. at 76. Section 434(e) them to avoid regulatory scrutiny. But orga- and groups. Id. at 39–40. Political parties and required the reporting of ‘‘contributions’’ nizations whose very purpose is to influence federal candidates have separate expenditure and ‘‘expenditures.’’ These terms were de- federal elections need no such safety net, and limits that did not use the ‘‘relative to a fined in parallel FECA provisions in sections have not been given one. clearly identified candidate’’ language, see 431 (e) and (f) as using money or other valu- IMPLICATIONS FOR REGULATION OF SECTION 527 §§ 608(c) & (f), which was found to be problem- able assets ‘‘for the purpose of . . . influ- ORGANIZATIONS encing’’ the nomination or election of can- atic in section 608(e)(1). FECA’s definition of a ‘‘political com- didates for federal office. Id. at 77. The Court The Court, having solved the statute’s mittee’’ mirrors the Internal Revenue Serv- found that the phrase ‘‘for the purpose of vagueness problem, next turned to the ques- ice’s definition of a Section 527 ‘‘political or- . . . influencing’’ created ambiguity that tion of whether section 608(e)(1), as narrowly ganization.’’ Under FECA, a ‘‘political com- construed by the Court, nevertheless contin- posed constitutional problems. Id. at 77. In order to eliminate this vagueness prob- mittee’’ is, among other things, ‘‘any com- ued to impermissibly burden the speaker’s mittee, club, association, or other group of constitutional right of free expression. The lem, the Court then went back to its earlier discussions of ‘‘contributions’’ and ‘‘expendi- persons which . . . makes expenditures ag- Court found the government’s interest in gregating in excess of $1,000 during a cal- preventing corruption and the appearance of tures.’’ The Court construed the term ‘‘con- tribution’’ in section 434(e) in the same man- endar year.’’ 2 U.S.C. § 431(4)(A). The term corruption, although adequate to justify con- ‘‘expenditures’’ includes, among other tribution limits, was nevertheless inad- ner as it had done when it upheld FECA’s contribution limits. Id. at 78. It next consid- things, ‘‘any purchase, payment, distribu- equate to justify the independent expendi- tion, loan, advance, deposit, gift of money or ture limits. Therefore, the Court held section ered whether to adopt the same limiting con- struction of ‘‘expenditure’’ that it had adopt- anything of value, made by any person for 608(e)(1)’s limitation on independent expendi- the purpose of influencing any election for Fed- tures unconstitutional, even as narrowly ed when construing section 608(e)’s limits on independent expenditures by individuals and eral office.’’ 2 U.S.C. § 431(9)(A)(i) (emphasis construed. added). In sum, in this portion of its opinion, the groups. ‘‘When we attempt to define ‘expenditure’ Under the Internal Revenue Code, a Sec- Buckley Court did not adopt a new definition tion 527 political organization is defined as of the term ‘‘expenditure’’ for all of FECA. in a similarly narrow way we encounter line- drawing problems of the sort we faced in 18 ‘‘a party, committee, association, fund, or Rather, the Court held that the limits on other organization (whether or not incor- independent expenditures imposed on indi- U.S.C. § 608(e)(1) (1970 ed., Supp. IV). Al- though the phrase, ‘for the purpose of . . . in- porated) organized and operated primarily for viduals and groups should be narrowly con- the purpose of directly or indirectly accept- strued to apply only to ‘‘express advocacy,’’ fluencing’ an election or nomination, differs from the language used in § 608(e)(1), it ing contributions or making expenditures, or and that these limits were nevertheless un- both, for an exempt function.’’ 26 U.S.C. constitutional even as so limited. Because shares the same potential for encompassing both issue discussion and advocacy of a po- § 527(e)(1) (emphasis added). An ‘‘exempt the limits on independent expenditures in function’’ within the meaning of section 527 section 608(e) were ultimately struck down litical result. The general requirement that ‘political committees’ and candidates dis- ‘‘means the function of influencing or attempt- by the Court, the narrowing construction of ing to influence the selection, nomination, elec- that section became, in a practical sense, ir- close their expenditures could raise similar vagueness problems, for ‘‘political com- tion, or appointment of any individual to any relevant. Federal, State, or local public office of office in The only other portion of the Buckley deci- mittee’’ is defined only in terms of amount a political organization, or the election of sion that raises the ‘‘express advocacy’’ nar- of annual ‘‘contributions’’ and ‘‘expendi- Presidential or Vice-Presidential electors, rowing construction is the Court’s discussion tures,’’ and could be interpreted to reach whether or not such individual or electors of reporting and disclosure requirements groups engaged purely in issue discussion. are selected, nominated, elected, or ap- under FECA section 434(e). It is here that the The lower courts have construed the words pointed.’’ 26 U.S.C. § 527(e)(2) (emphasis Court makes it absolutely clear, in unambig- ‘‘political committee’’ more narrowly. To fulfill the purposes of the Act they need only added). uous language, that political committees and Thus, any organization that is a Section encompass organizations that are under the candidates are not entitled to the benefit of the 527 organization is, by definition, organized control of a candidate or the major purpose of narrowing ‘‘express advocacy’’ construction and operated primarily for the purpose of which is the nomination or election of a can- earlier discussed in section 608(e). ‘‘influencing or attempting to influence the The Court begins its discussion of report- didate. Expenditures of candidates and of ‘‘po- selection, nomination, election, or appoint- ing and disclosure requirements, by noting litical committees’’ so construed can be assumed ment of any individual’’ to public office. See that such requirements, ‘‘as a general mat- to fall within the core area sought to be ad- 26 U.S.C. § 527(e)(2). Such an organization sat- ter, directly serve substantial governmental dressed by Congress. They are, be definition, isfies the ‘‘major purpose’’ standard estab- interests.’’ Buckley, 424 U.S. at 68. After con- campaign related. lished by the Supreme Court in Buckley, and cluding that minor parties and independents ‘‘But when the maker of the expenditures may therefore be subject to reasonable pub- are not entitled to a blanket exemption from is not within these categories—when it is an lic disclosure of its sources of funding for its FECA’s reporting and disclosure require- individual other than a candidate or a group political activities. Buckley offered protec- ments, the Court moved on to a general dis- other than a political committee—the rela- tion to issue-oriented speakers and groups cussion of section 434(e). tion of the information sought to the pur- As introduced by the Court, ‘‘Section 434(e) poses of the Act may be too remote. To in- that are not organized for the explicit pur- requires ‘[e]very person (other than a political sure that the reach of § 434(e) is not pose of influencing election outcomes. Sec- committee or candidate) who makes contribu- impermissibly broad, we construe ‘‘expendi- tion 527 organizations, however, are subject tions or expenditures’ aggregating over $100 ture’’ for purposes of that section in the to reasonable mandatory public disclosure in a calendar year ‘other than by contribu- same way we construed the terms of § 608(e)— requirements by virtue of their central mis- tion to a political committee or candidate’ to reach only funds used for communications sion. to file a statement with the Commission.’’ that expressly advocate the election or de- CONCLUSION Id. 74–75 (emphasis added). The Court noted feat of a clearly identified candidate’’. Id. at There is no question that the Supreme that this provision does not require the dis- 79–80 (footnotes omitted) (emphasis added). Court in Buckley was concerned with pro- closure of membership or contribution lists; The Court in Buckley could not have been tecting the rights of advocacy groups and in- rather, it requires disclosure only of what a more clear. When applied to a speaker that is dividuals to engage in constitutionally pro- person or group actually spends or contrib- neither a political candidate nor a political tected ‘‘issue advocacy.’’ The Court was par- utes. Id. at 75. committee, the term ‘‘expenditure’’ in sec- ticularly concerned that the Federal Elec- The Buckley Court noted that the Court of tion 434(e) must be narrowly construed under tion Campaign Act, as written, would be- Appeals had upheld section 434(e) as nec- the ‘‘express advocacy’’ standard. However, come a trap for unwary or unsophisticated essary to enforce the independent expendi- when applied to organizations that have as a political speakers. However, the Court also ture ceiling discussed above—section 608(e). major purpose the nomination or election of recognized that there are some groups of Id. at 75. The Supreme Court, having just a candidate, the ‘‘express advocacy’’ limiting speakers—political candidates, political par- struck down these independent expenditure construction simply does not apply. The ac- ties, and political committees—whose major limits, concluded that the appellate court’s tivities of these groups are, by definition, purpose is engaging in electoral politics. For S6044 CONGRESSIONAL RECORD — SENATE June 29, 2000 these speakers, there is no danger of trap- Having been in the Senate over 20 in our elections and government are ping the unwary, and thus, the Court pro- years, now, I’ve witnessed how slow paying the price. vided them with no special constitutional and frustrating the legislative process Section 527 was created by Congress protection. The actions of political can- in the 1970’s to provide a category of didates, political parties, and political com- can be, and I’ve also witnessed how we mittees are assumed to be campaign-related, as an institution can come together tax exempt organizations for political and they are therefore appropriately subject quickly and directly when we see a parties and political committees. While to federal disclosure laws. compelling need to do so. Senators contributions to a political party or In order to qualify for tax exempt status LIEBERMAN, DASCHLE, MCCAIN, FEIN- political committee are not tax deduct- under Section 527 of the Internal Revenue GOLD and I introduced legislation in ible, Congress did provide for a tax ex- Code, an organization’s primary purpose the Senate, similar to H.R. 4762, in emption for money contributed and must be to influence election outcomes. Be- cause a Section 527 organization is, by defini- April of this year. With the upcoming spent on political activities by an orga- tion, primarily engaged in political activity, November elections we were ever aware nization created for the purpose of in- it satisfies the ‘‘major purpose’’ test promul- of the explosion in sham issue ad cam- fluencing elections. At the time Con- gated in Buckley. Thus, there is no constitu- paigns by anonymous contributors gress established the tax exemption, it tional impediment to subjecting Section 527 across the country that the public was assumed that such organizations would Committees to reasonable disclosure laws. going to experience this year without be filing with the FEC under the cam- The ‘‘express advocacy’’ protections that the Section 527 reform. We wanted to beat Supreme Court promulgated in order to pro- paign finance laws for the obvious rea- tect unwary political speaker, as the Court the clock and get this legislation in son that the language for both cov- itself explicitly recognized, have no applica- place in time to have an effect on this erage by the IRS and coverage by the bility in the context of an organization year’s campaigns. FEC were the same—‘‘influencing an whose primary purpose is engaging in elec- With the leadership of a committed election.’’ Consequently it was as- toral politics. Senate Bill 2582, which clari- group in the House, and a significant sumed that Section 527 didn’t need to fies that tax exemption under Section 527 is bipartisan majority supporting such re- require disclosure with the IRS, since available only to organizations regulated as form in the Senate, we have been able ‘‘political committees’’ under FECA, as well the FEC disclosure was considerably as the more limited Senate Bill 2583, which to do that. I commend the many dedi- more complete. simply requires public disclosure from Sec- cated House members and Senators The legislation before us would re- tion 527 organizations, will both withstand who worked to bring this vote about quire Section 527 organizations to file a constitutional scrutiny. over the past few weeks. The reforms tax return, something they are not re- Very truly yours, we are passing today will have a mean- quired to do now, and disclose the basic E. JOSHUA ROSENKRANZ, ingful effect on the campaigns being information about their organization President. run this year. as well as their contributors over $200. Mr. MOYNIHAN. Mr. President, The Section 527 loophole allows un- As good and important as this bill is, while I support the objectives of this disclosed, unlimited contributions. however, it does not stop the unlimited legislation, I regret that the Senate These are stealth contributions—tens aspect of these secret contributions, has chosen to rush ahead with a vote of millions of dollars of stealth con- nor the unlimited contributions per- on this matter without following the tributions that are off the campaign fi- mitted through the soft money loop- customary Senate procedure. This bill nance radar screen. How does that hap- hole. This victory today is but one bat- should have been referred to its com- pen—that an organization that tle in the overall campaign to enact mittee of jurisdiction, the Committee claims—on its own—to exist for the the McCain-Feingold bill, and I look on Finance, and that committee ought purpose of influencing an election can forward to continuing to work with my to have had the opportunity to con- receive unlimited contributions and colleagues to make that happen. sider all its implications. kept them secret? Well, it happens be- Mr. MCCAIN. Mr. President, I would In fact, Chairman ROTH and I agreed cause these organizations seeking a tax to schedule a hearing on this matter like to address an issue of importance exemption under Section 527 of the In- for July 12. We contacted election and with respect to the 527 disclosure de- ternal Revenue Service Code say one tax law experts to ask their opinions bate, and that is the constitutionality thing to the IRS to get the tax exemp- regarding fundamental questions sur- of H.R. 4762. I assert that the 527 disclo- rounding Section 527 organizations. tion and say the opposite to the Fed- sure legislation is Constitutional. As we thought, there are constitu- eral Election Commission to avoid hav- Among other things, the legislation tional questions, and the possibility of ing to register as a political com- requires 527 organizations claiming tax unintended consequences that might mittee. exempt status to disclose their mem- result from this or similar legislation. The Internal Revenue Service Code bers who make significant contribu- The careful examination that Senator defines an organization subject to a tax tions to support the 527’s political ad- ROTH and I had planned is going to be exemption under Section 527 as an or- vocacy. Some opponents maintain that cut short by our actions today. With- ganization, ‘‘influencing or attempting the legislation runs afoul of the Su- out that careful examination, we can to influence the selection, nomination, preme Court ruling in NAACP v. Ala- only hope that our conduct will with- election, or appointment of any indi- bama, where as most of you know, the stand judicial scrutiny and not create vidual to any Federal, State or local NAACP was protected from having to additional problems. public office . . .’’ The Federal Elec- disclose its membership list to the Ala- Mr. LEVIN. Mr. President, I am tion Campaign Act defines a political bama government pleased to join my colleagues Senators committee which is subject to regula- The 527 disclosure legislation com- MCCAIN, FEINGOLD and LIEBERMAN in tion by the FEC and that means disclo- plies with the Constitution’s protec- voting to send to the President H.R. sure as an organization that spends or tion of freedom of association upheld 4762, a bill that hopefully will lead to receives money ‘‘for the purpose of in- in NAACP v. Alabama. It does not re- closing one of the gaping loopholes in fluencing any election for Federal of- quire the disclosure of membership ros- our Federal campaign finance laws. I fice.’’ So people creating these organi- ters, per se, just the members who are use the words ‘‘lead to’’ because we zations are claiming, with a straight making politically related donations. aren’t closing the so-called 527 loophole face, that they are trying to influence More important, it does not constitute here today—we are forcing the disclo- an election in order to get the benefits a significant restraint on members’ sure of the contributors who use the of one agency while representing they rights to associate freely. loophole. Just as the disclosure of soft are not trying to influence an election It is important to note that the cir- money hasn’t yet ended the soft money in order to avoid the requirements of cumstances are different here than loophole, this disclosure won’t auto- another. We often say, ‘‘You can’t have those that surrounded the Alabama matically close the 527 loophole. Most it both ways,’’ but persons forming government’s treatment of the NAACP of our reform work lies ahead. But, our these organizations, Mr. President, during the 1950’s and 1960’s. The Su- action today will hopefully give us mo- turn that saying on its head. They are, preme Court recognized that the mem- mentum toward ending both the Sec- so far, having it both ways, and our bers of the NAACP had every right to tion 527 loophole and the soft money campaign finance system and the re- be concerned for their own and their loophole. spect and trust of the American people families’ safety if their identities were June 29, 2000 CONGRESSIONAL RECORD — SENATE S6045 publicly disclosed. The prospect of pub- to determine how many members there increased disclosure for other organiza- lic identification would have signifi- are in a 527. In the example I often cite, tions that engage in political activi- cantly discouraged people of color from there were only two contributors, each ties. And I couldn’t agree more. Be- joining the NAACP. While political funneling what appears to be at least cause the American people ought to contributors to 527 organizations may one million dollars into the accounts know who these groups are, their prefer to avoid public scrutiny, they to be used for campaign advocacy. major sources of funding, and where have no need to fear for their lives as While we may have no idea how many they are spending their money if they a result of that scrutiny. contributors there are in a 527, or how are working to influence a federal elec- That said, public safety is by no much each contributed, you can bet tion. It’s that simple. means the principal standard by which their favored candidates know. Prior to this vote on 527’s, we were the 527 disclosure legislation will be In a press conference announcing in- working on legislation that would do judged. In the NAACP v. Alabama deci- troduction of his bill, Senator MCCON- just that—a bipartisan, bicameral sion, the Supreme Court acknowledges NELL admits the ‘‘dubious constitu- measure that would satisfy the con- that a valid governmental purpose tionally’’ of his proposal. In order to cerns that have also been raised about must be weighed against the tendency regain the American public’s trust, it the scope of disclosure—that it not be for the disclosure requirement to is important that we support a pro- so broad as to cover all manner of ac- abridge an individual’s freedom of asso- posal we feel confident will withstand tivities that have nothing to do with ciation. The decision emphasized that the Court’s scrutiny. Thank you, Mr. elections. the governmental purpose for disclo- President. So we crafted a bill that was neither sure—in this case to prevent corrup- Ms. SNOWE. Mr. President, I rise overly broad or vague. We narrowly tion of the American political system— today in support of the legislation sent and clearly defined political activities must be achieved in the most narrow to us by the House concerning disclo- as those that mention a candidate for manner possible. sure for so-called ‘‘Section 527 organi- office, targeted specifically to the can- Like our Congressional leaders, I be- zations’’. didate’s electorate, within a time lieve the more disclosure the better—as I want to thank the efforts of those frame near an election. And we only long as the associated requirements are involved in making this day a reality, targeted large-scale communications constitutional. Focusing narrowly on and that includes a bipartisan group so grassroots organizations will not be 527 organizations is one thing that sets from both sides of the aisle and both affected. H.R. 4762 apart from the Smith-McCon- sides of the Hill who have taken a lead- Our framework for this expanded dis- nell legislation, to ensure that the leg- ership role in working toward restoring closure drew from an amendment that islation survives a constitutional test. Americans’ faith in its election system. Senator JEFFORDS and I, along with I would like to submit a copy of the Senator MCCAIN’s herculean efforts and Senators MCCAIN, FEINGOLD, Smith-McConnell legislation, the Tax- leadership on this issue have made to- LIEBERMAN, and others, developed and Exempt Political Disclosure Act, into day’s vote possible. In addition, Sen- introduced in early 1998. Based on a the record. ator FEINGOLD’s leadership has been in- proposal developed and advanced by The Smith-McConnell legislation valuable, and Senators LIEBERMAN and constitutional scholars, our measure sweeps in business and labor organiza- JEFFORDS and Congressmen SHAYS, was designed to withstand constitu- tions. As I said, disclosing their polit- MEEHAN, and CASTLE, have worked very tional scrutiny, address some of the ical activities is a laudable goal. I have hard to ensure that this legislation was most egregious campaign abuses, and advocated a similar approach, but one both considered and passed. focus on areas where we know the Su- that would include bright line tests to I believe that disclosure of campaign preme Court has already allowed us to determine precisely when contribu- activities is the most fundamental go—like disclosure. tions and expenditures would have to component of campaign finance re- We’ve already been to the Senate be disclosed. Those bright line tests, form. On the one hand, proponents of floor twice with this language, and I’m such as limiting the disclosure require- measures like the McCain-Feingold bill proud to say that the constitutional ar- ment to a time period close to an elec- point to greater disclosure as part and guments made against our provision tion, are lacking in the Smith-McCon- parcel of additional reforms. On the quite simply didn’t hold water. And a nell bill. other hand, opponents have argued majority of the Senate went on record Unlike business and labor organiza- that, rather than more comprehensive in support of our provision. tions, which engage in activities com- reforms, what we really need is simply In short, the three major provisions pletely unrelated to elections, 527’s are more disclosure on what we already of the bill we were working on could be clearly political organizations. 527 or- have. So disclosure should be common summed up as follows—disclosure, dis- ganizations by law must have the func- ground where we can all come to- closure, and, finally, disclosure. That’s tion of influencing or attempting to in- gether, a point proved by the over- what we’re talking about here—sun- fluence elections. The Supreme Court whelming support for disclosure of 527 light, not censorship. Not speech ra- in the Buckley decision upheld federal organizations in the House on a vote of tioning, but information. disclosure laws for these types of orga- 385–39. I cannot emphasize enough that our nizations. When it comes to disclosure As we know, these organizations effort would not have prevented anyone laws for business and labor organiza- have incorporated under the 527 section from making any kind of communica- tions, concerns about vagueness and of the tax code to get tax exempt sta- tion at any time saying anything they overbreadth come into play. tus to influence federal elections, but want. All we said is, if you’re attempt- 527 organizations proliferated during then they argue to the Federal Elec- ing to influence a federal election, we the primary campaign season. Many tions Commission that for their pur- ought to know who you are, your major had obscure names that made it hard poses these organizations aren’t influ- sources of funding, and where you’re to guess even the types of members encing federal elections, simply be- spending your money. funding political advocacy on behalf of cause they don’t expressly advocate for As the Brennan Center for Justice each 527, much less their identities. the election or defeat of a particular stated to me in a letter I had included Contrary to the 527’s, most labor and candidate. in the RECORD in our first debate on business organizations have established Right now, they don’t have to dis- Snowe-Jeffords, and I quote, ‘‘As the identities, and clear-cut positions and close any of their activity—who they Supreme Court has observed, disclosure purposes that go beyond funding issue are, where they get their funding, and rules do not restrict speech signifi- ads. Since we have no window into the where they spend their money. Under cantly. For that reason, the Supreme world of 527’s, a disclosure requirement this legislation, they will have to dis- Court has made clear that rules requir- is more valid when compared with a close on all their activities, and be- ing disclosure are subject to less exact- disclosure requirement affecting labor cause political activities are all they ing constitutional strictures than di- and business organizations. do, that is as it should be. rect prohibitions on spending.’’ So if Unlike most, if not all, labor and It has also been expressed that if we the Congress is truly serious about in- business organizations, there is no way are to target 527’s, we should also have creased disclosure, there is no reason S6046 CONGRESSIONAL RECORD — SENATE June 29, 2000 why they should be able to support our under the bill reported by the Ways be voting for it because I do think the approach. and Means Committee. Is that under- constitutional law in this area is rath- The fact is, we all have to disclose as standing correct? er clear. But, ultimately, this is not a candidates, and we should. Is it unrea- Mr. FEINGOLD. That is correct. We spear worth falling on 4 months in ad- sonable when we know groups running want to allow the Internal Revenue vance of an election. This vote will in- ads or sending out mass mailings to Service to enforce these disclosure sulate them against absurd charges the public are influencing federal elec- rules with the assistance and coopera- that they are in favor of secret cam- tions to ask them to disclose as well? tion of the Federal Election Commis- paign contributions or Chinese money We know, for instance, that in the sion. or mafia money. 1995–1996 election cycle, the Annenberg Mr. MCCAIN. Mr. President, as spon- With regard to the few groups who Public Policy Center estimates that sor, I would like to make the final may be in the 527 area, they will have between $135 to $150 million was spent comments. a choice to make, either to no longer by outside groups not associated with Mr. MCCONNELL. Mr. President, this be organized under section 527 or to go candidates on television ads. In the debate has come a long way from the to court. And, these groups will have to last cycle, that number jumped to be- days of trying to regulate the speech of weigh the costs and make that choice. tween $275 to $350 million—more than politicians and other major players on Mr. President, I yield the floor. double. But what we don’t know is how the American political scene. Just a The PRESIDING OFFICER. The Sen- much is being spent on efforts like few years ago, folks on the other side ator from Arizona. mass mailings or phone banks, or who of the aisle were trying to get taxpayer Mr. MCCAIN. Mr. President, today, is funding them, and this legislation is funding for elections, spending limits indeed, marks a seminal day in the bat- designed to tell us. for campaigns, and regulation of any tle to reform our electoral system and As for those so-called issue ads, if group that mentioned a candidate in an restore the faith of the American citi- any doubt remains about the real in- ad two months before an election day. zenry that ours is a government of and tent of many of the broadcast ads we As recently as last year, there were for the people. This is a vote for cam- see, the Brennan Center recently re- measures being debated in the Senate paign finance reform. If the Senate ap- leased a report on television adver- that would have devastated the Repub- proves this legislation, it will be the tising in the 1998 congressional elec- lican Party in trying to compete with first campaign finance reform bill to tions. What did they find? When all the the Democrats and with well-funded become law in 21 long years. It will be ads were evaluated in terms of how outside groups who are almost wholly action that is long overdue. many within two months of the general and completely affiliated with the Whether we want to admit the fact or election were actually political ads and Democrats—groups such as the labor not, perception has an unfortunate how many were simply discussing unions, the plaintiffs’ lawyers, the Si- tendency to become reality. And the issues or legislation, 82 percent were erra Club, and the League of Conserva- American people perceive the Congress seen as campaign ads. Eighty-two per- tion Voters. as controlled by the monied special in- cent. There’s no question what these This particular bill before us will not terests. If we are to ensure the public’s ads are attempting to do—yet, under put Republicans at a disadvantage in faith in its Government, we must oblit- current law, they fly right under the this fall election. And, of course, it will erate that perception. This bill, al- radar screen. not put Democrats at any disadvantage though admittedly a very small step, is So, in short, our bipartisan approach because it doesn’t affect their political a step towards ending that perception. got at the largest abuses while answer- affiliates, the unions and the trial law- This is a step we should be proud to ing the critics who say that what’s yers. In fact, it’s hard to tell exactly take. good for the 527 organizations are good who will be put at a disadvantage by This bill will not solve what is wrong for other groups and unions and cor- this bill because there are so few with our campaign finance system. It porations as well. Unfortunately, we groups that will actually be impacted. will not do away with the millions of did not reach agreement with the So, in many respects, it is a relatively soft money dollars that are polluting House on such an approach this year— benign and harmless bill. our elections. We must yet undertake but our work generated momentum for But, let me be clear, there is an im- the task of doing away with soft money consideration and passage of this 527 portant constitutional principle at and make our Government more ac- bill. And we must look at this as a sig- stake here—even though it may only countable to the people we represent. nificant first step. Hopefully, we will affect a handful of groups in this coun- It will give the public information re- have the opportunity to build on this try. This bill takes us down the con- garding one especially pernicious weap- legislation with the broader approach stitutionally dubious path of disclosure on that is being used in modern cam- of Snowe-Jeffords. related to issue advocacy, which the paigns. It is an egregious and out- The passage of this bill should also Supreme Court has said, falls outside rageous insult to the very principles of make it that much more difficult for of the boundaries of government regu- how democracies function. those who supported it to now go back lation. In fact, the federal courts fol- The bill is fair. It affects both par- and say we shouldn’t have greater dis- lowing Buckley v. Valeo have routinely ties. It affects interests on both sides closure for other groups engaging in struck down attempts to regulate of the aisle. It stifles no speech. It political activities when Snowe-Jef- speech that does not expressly advo- curbs no individual’s rights, and it is fords is introduced next year. In other cate the election or defeat of a federal clearly constitutional. If the Senate words, what we have done with this candidate. Just two weeks ago, the approves it today, it will become law, legislation is to throw a boulder in Second Circuit Court of Appeals struck and the American people will be well what has until this point been the still down the latest attempt to regulate served. and brackish pond of the campaign fi- issue advocacy as a clear violation of Before I close, I again thank the nance status quo, and the ripple effect the First Amendment. Nevertheless, I many who were involved with this will continue expanding ever outward. say to my Republican colleagues, par- issue. Many in the House courageously Again, I want to thank everyone in- ticularly those who are up for election fought to pass this legislation. I thank volved in this great victory and I hope this year, that is a pretty hard argu- and note again Congressmen CHRIS we will move forward to expand our ef- ment to explain in a political cam- SHAYS, MARTY MEEHAN, MIKE CASTLE, forts on campaign finance reform in paign. The constitutional distinction LINDSEY GRAHAM, and AMO HOUGHTON the next Congress. between issue advocacy and express ad- who all worked tirelessly on this legis- INTERNAL REVENUE SERVICE vocacy is complex and does not get re- lation. If it were not for their courage Mr. MOYNIHAN. I understand that duced to a campaign commercial very and tenacity, we would not have this this legislation would allow the Sec- easily. legislation before the Senate today. retary of the Treasury to partner with So in light of the limited impact of In the Senate, a bipartisan coalition other Federal agencies, principally the this relatively benign bill, I rec- of those who believe in reform refused Federal Election Commission, in a ommend to my Republican colleagues to relent on this matter: Senators manner similar to that contemplated that they vote for this bill. I will not SNOWE and LEVIN played key roles in June 29, 2000 CONGRESSIONAL RECORD — SENATE S6047 ensuring we move forward. Of course, I The PRESIDING OFFICER (Mr. the spirit of the original Senate must pay special note of all the work BUNNING). Are there any other Sen- amendment. done by Senators LIEBERMAN and FEIN- ators in the Chamber desiring to vote? Although disclosure is only part of GOLD. I am proud not only to call them The result was announced—yeas 92, the solution, the passage of H.R. 4762 friends but partners in this crusade to nays 6, as follows: ensures that the public understands return the Government to the people. I [Rollcall Vote No. 160 Leg.] what these committees are, who gives could be in no better company. YEAS—92 them their money, and how they spend As I noted last night to all those who Abraham Edwards Lugar that money to impact election out- believe in reform, today is only the Akaka Enzi McCain comes. This law, once signed by the first step, but it is a great first step Allard Feingold Mikulski President, will close a major loophole and it is, indeed, a great day for democ- Ashcroft Feinstein Moynihan and stop these stealth PACs from Baucus Fitzgerald Murkowski racy and a Government that is ac- Bayh Frist Murray skirting campaign finance require- countable to the governed. I urge my Bennett Gorton Reed ments, and I was pleased to vote in colleagues to support this legislation. Biden Graham Reid support of it. However, we still have Bingaman Gramm Robb Mr. President, I yield my remaining Bond Grams Roberts much to do. time to the Senator from Connecticut. Boxer Grassley Rockefeller We cannot, and must not, rest with The PRESIDING OFFICER. The Sen- Breaux Hagel Roth this vote today. Our campaign finance ator from Connecticut has 25 seconds Brownback Harkin Santorum system still needs major overhaul if we Bryan Hatch Sarbanes remaining. Bunning Hollings Schumer are going to reduce the influence of al- Mr. MCCAIN. I ask unanimous con- Burns Hutchinson Sessions most unlimited amounts of campaign sent that the Senator from Con- Byrd Hutchison Shelby cash on our electoral system. Until a necticut be allowed to speak for 2 min- Campbell Jeffords Smith (NH) Chafee, L. Johnson Smith (OR) majority of our citizens believe again utes. Cleland Kennedy Snowe that our government is ‘‘by and for’’ The PRESIDING OFFICER. Without Cochran Kerrey Specter the people, we cannot stop our battle objection, it is so ordered. The Senator Collins Kerry Stevens to reform this process. We need to pass Conrad Kohl Thomas from Connecticut. Craig Kyl Thompson a ban on soft money, reduce sky- Mr. LIEBERMAN. Mr. President, I Crapo Landrieu Thurmond rocketing campaign expectations, and thank my distinguished colleague from Daschle Lautenberg Torricelli return our electoral process to the peo- Arizona whom I have come to call our DeWine Leahy Voinovich Dodd Levin Warner ple, where it belongs. The power in our commanding officer in the war for Domenici Lieberman Wellstone country should rest with the vote, not campaign finance reform. I am proud Dorgan Lincoln Wyden with the purse. to serve under him. Durbin Lott f In this long struggle to cleanse our NAYS—6 THE DEPARTMENTS OF LABOR, campaign finance system, we are about Coverdell Inhofe McConnell to achieve a victory. In a campaign fi- Helms Mack Nickles HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED nance system that is wildly and dan- NOT VOTING—2 gerously out of control today, we are AGENCIES APPROPRIATIONS, 2001 about to draw a line. We are about to Gregg Inouye The PRESIDING OFFICER. Under establish some controls based on the The bill (H.R. 4762) was passed. the previous order, the Senate will now best of America’s national principles. Mr. REED. Mr. President, first, I resume consideration of H.R. 4577, The campaign finance reform adopt- commend my colleagues on both sides which the clerk will report. ed after the Watergate scandal had two of the aisle for their persistence in ne- The legislative clerk read as follows: fundamental principles: that contribu- gotiating a Section 527 disclosure bill A bill (H.R. 4577) making appropriations tions to political campaigns be limited, that has passed both chambers of Con- for the Departments of Labor, Health, and and that they be fully disclosed. gress. The overwhelming vote in both Human Services, and Education, and related These so-called 527 organizations to- the House and Senate in support of agencies for the fiscal year ending Sep- tally violate and undermine both of H.R. 4762, a bill mirroring a successful tember 30, 2001, and for other purposes. those principles. Individuals, corpora- amendment we made to the Defense Pending: tions, and associations can give unlim- Authorization bill several weeks ago, is Frist modified amendment No. 3654, to in- ited amounts to 527 organizations, and an important step in fixing our broken crease the amount appropriated for the those contributions are absolutely se- campaign finance reform system. Interagency Education Research Initiative. cret, unknown to the public. The con- Both parties have now acknowledged The PRESIDING OFFICER. Under tributors then audaciously enjoy a tax that some change in our campaign fi- the previous order, there are now 7 benefit for those contributions. Today, nance laws is warranted, the first such minutes of debate prior to a vote on we say no more of that. Unfortunately, legislative consensus on this issue the Frist amendment, with 5 minutes contributions will continue to be un- since technical changes were made in under the control of Senator FRIST. limited to 527 organizations, but at 1979 to the Federal Election Campaign The Senator from Tennessee is recog- least now the public will know. Act of 1974. nized. As Senator MCCAIN indicated, this is A majority has agreed that Section Mr. FRIST. Mr. President, my not the end of the effort to reform our 527 organizations need to both follow amendment fully funds the Department campaign finance system. It is only the federal campaign law and to file tax re- of Education’s share of the Interagency beginning, but it is a significant begin- turns. H.R. 4762, like our amendment to Education Research Initiative, IERI, ning. I urge my colleagues across the the Defense Authorization bill, re- which is a collaborative joint research aisle to support it. I thank the Chair. quires Section 527s to disclose any con- and development education effort be- Mr. MCCAIN. Mr. President, I ask for tributors who give more than $200, and tween the Department of Education the yeas and nays. report any expenditures of more than and the National Science Foundation The PRESIDING OFFICER. Is there a $500. Unlike our original amendment, it and the National Institute of Child sufficient second? requires a Section 527 organization Health and Human Development. There is a sufficient second. that fails to disclose contributions and Quality education depends on quality The question is, Shall the bill, H.R. expenditures to the IRS to pay a pen- research. We need to know the answers, 4762, pass? The clerk will call the roll. alty tax on the amounts it failed to if our goal is accountability and stu- The legislative clerk called the roll. disclose. The amendment we made to dent achievement, on what works and Mr. NICKLES. I announce that the the Defense Authorization bill would what does not work. As we all know, Senator from New Hampshire (Mr. have removed a Section 527’s tax ex- advances in education, as in other GREGG) is necessarily absent. empt status for the same violation. Al- fields, depend on knowing what works Mr. REID. I announce that the Sen- though not as severe a penalty, I be- and what doesn’t. If you look at our ator from Hawaii (Mr. INOUYE) is nec- lieve that this change in the House past investments in research in the essarily absent. version of this legislation does reflect field of education, pre-K through 12, S6048 CONGRESSIONAL RECORD — SENATE June 29, 2000 our efforts have been woefully inad- Hutchinson Lugar Schumer amendment. We are prepared, and have Hutchison Mack Sessions equate in terms of dollars and in the Inhofe McCain Shelby taken the quorum call off, on the as- quality of the research that has been Jeffords McConnell Smith (NH) surance that that opportunity will be produced in the past. Johnson Mikulski Smith (OR) present. This is a joint collaborative effort, Kennedy Moynihan Snowe I ask unanimous consent at this time Kerrey Murkowski Specter where we link three agencies together Kerry Murray Stevens there be 30 minutes of debate equally and demand accountability, credi- Kohl Nickles Thomas divided, and that at the end of 30 min- bility, good science, and the exactness Kyl Reed Thompson utes someone on our side will have an Landrieu Reid Thurmond opportunity, if he or she chooses, to of science in determining what works Lautenberg Robb Torricelli and what does not work. The primary Leahy Roberts Voinovich offer a second-degree amendment. objective of this joint program is to Levin Rockefeller Warner The PRESIDING OFFICER. Without support the research and development Lieberman Roth Wellstone objection, it is so ordered. Lincoln Santorum Wyden and the wide dissemination of research- Lott Sarbanes The minority leader. proven educational strategies that im- Mr. DASCHLE. Mr. President, I yield NOT VOTING—2 prove student achievement from pre-K myself such time as I may require. all the way through 12 in the key areas Gregg Inouye Mr. President, this week, we got our of reading, mathematics, and science. The amendment (No. 3654) was agreed first glimpse of the first rough draft of I urge my colleagues to support this to. the human genetic code. very worthwhile investment in our Mr. HARKIN. Mr. President, I move The public-private partnership children’s education. to reconsider the vote and I move to known as the Human Genome Project The PRESIDING OFFICER. The Sen- lay that motion on the table. is the genetic equivalent of putting ator from Pennsylvania is recognized. The motion to lay on the table was man on the moon. By decoding our genetic makeup, re- Mr. SPECTER. Mr. President, I com- agreed to. searchers may soon discover how to mend the Senator from Tennessee for The PRESIDING OFFICER. The Sen- cure and even prevent heart disease, this amendment. It is a worthwhile ator from Georgia. cancer, birth defects, and other serious amendment. It is a relatively small Mr. COVERDELL. Mr. President, I medical conditions. sum of money. We are prepared to ac- ask unanimous consent that a Helms We have every reason to be hopeful cept it, as we have accepted a number amendment regarding school facilities about this breakthrough. But we also of amendments where the funds are not be included in the amendment se- have some reason to be concerned, be- too high, and where we can offset it quence following the Dorgan amend- cause genetic information—used im- against administrative costs. I believe ment. properly—can also cause great harm. this one can be held in conference. I The PRESIDING OFFICER. Without objection, it is so ordered. Improvements in genetic testing can can’t make an absolute commitment determine whether a person has an in- because we are going to have to bal- The Senator from Iowa. AMENDMENT NO. 3688 creased chance of developing breast ance this along with many others on cancer, or colon cancer, or some other (Purpose: To prohibit health insurance com- the administrative cost line. But I serious illness—years before symptoms think it is meritorious. We are trying panies from using genetic information to discriminate against enrollees, and to pro- even appear. to meet the leader’s deadline of final In the right hands, that information passage by midafternoon, and in the in- hibit employers from using such informa- tion to discriminate in the workplace) could save your life. In the wrong terest of time and the value of the Mr. HARKIN. Mr. President, I call up hands, that same information could be amendment, we are prepared to accept amendment No. 3688 and ask for its used to deny you insurance, a mort- it. consideration. gage, or even a job. Mr. FRIST. Mr. President, I yield The PRESIDING OFFICER. The We need to make sure this new re- back my remaining time. clerk will report. search—which has been funded largely The PRESIDING OFFICER. The The assistant legislative clerk read by American taxpayers—is used to help question is on agreeing to the amend- as follows: America’s families, not hurt them. ment of the Senator from Tennessee. The Senator from Iowa [Mr. HARKIN], for That is the goal of this amendment. The yeas and nays have been ordered. Mr. DASCHLE, for himself, Mr. KENNEDY, Mr. Francis Collins probably knows more The clerk will call the roll. HARKIN, and Mr. DODD, proposes an amend- about the potential of genetic testing The assistant legislative clerk called ment numbered 3688. than anyone in the world. He is the the roll. Mr. HARKIN. Mr. President, I ask head of the international research Mr. NICKLES. I announce that the unanimous consent that the reading of team that makes up the Human Ge- Senator from New Hampshire (Mr. the amendment be dispensed with. nome Project. GREGG) is necessarily absent. The PRESIDING OFFICER. Without Listen to what Dr. Collins said on Mr. REID. I announce that the Sen- objection, it is so ordered. Monday, the day the results of the first ator from Hawaii (Mr. INOUYE) is nec- (The text of the amendment is print- phase of the Human Genome Project essarily absent. ed in today’s RECORD under ‘‘Amend- were unveiled: The PRESIDING OFFICER. Are there ments Submitted.’’) Genetic discrimination in insurance and any other Senators in the Chamber de- Mr. COVERDELL. Mr. President, we the workplace is wrong and it ought to be siring to vote? just received the amendment. I am prevented by effective federal legislation. The result was announced—yeas 98, going to suggest the absence of a He added: nays 0, as follows: quorum for the moment so we can look If we needed a wake-up call to say that it’s [Rollcall Vote No. 161 Leg.] at it. I suggest the absence of a time to do this, isn’t today the wake-up call? YEAS—98 quorum. Dr. Collins is right. It would be an Abraham Byrd Edwards The PRESIDING OFFICER. The absolute travesty if a test that could Akaka Campbell Enzi clerk will call the roll. save your life ends up costing you your Allard Chafee, L. Feingold The assistant legislative clerk pro- job or your financial security. Ashcroft Cleland Feinstein ceeded to call the roll. Genetic discrimination isn’t just a Baucus Cochran Fitzgerald Bayh Collins Frist Mr. SPECTER. Mr. President, I ask theoretical possibility. It isn’t just Bennett Conrad Gorton unanimous consent that the order for something that might happen in the fu- Biden Coverdell Graham the quorum call be rescinded. ture. It is already happening—even Bingaman Craig Gramm Bond Crapo Grams The PRESIDING OFFICER. Without without the information the human ge- Boxer Daschle Grassley objection, it is so ordered. nome promises to uncover. Breaux DeWine Hagel Mr. SPECTER. Mr. President, we It is already happening to people like Brownback Dodd Harkin have just had a discussion, and it may Terri Seargent. Bryan Domenici Hatch Bunning Dorgan Helms be that someone on our side of the aisle Terri was a model employee who was Burns Durbin Hollings will want to offer a second-degree moving up the corporate ladder—until June 29, 2000 CONGRESSIONAL RECORD — SENATE S6049 the day a test revealed that she carried our understanding of the humane ge- ance companies from raising premiums a gene that might—here I emphasize nome will be in vain. or denying patients health care cov- ‘‘might’’—make her more susceptible A CNN/Time Poll released earlier erage based on the results of genetic to a potentially fatal pulmonary condi- this week, found that a full 80 percent tests, and prohibit insurers from re- tion. of the respondents said genetic infor- quiring such tests as a condition of Before her employers saw those test mation should not be available to in- coverage. In the workplace, the amend- results, they used to give Terri glowing surance companies. ment would outlaw the use of pre- job performance reviews. But after And almost half of all Americans be- dictive genetic information for hiring, they saw the results, they asked her to lieve there will be negative con- advancement, salary, or other work- resign. She did, because she had no sequences from the Human Genome place rights and privileges. And, be- choice, because genetic discrimination Project. I think we ought to prove cause a right without a remedy is no is not clearly prohibited—in the work- today that they are wrong. right at all, this important measure place, or anywhere else. Let us make sure that Americans are would provide persons who have suf- The solution is obvious. Dr. Collins is not afraid to take advantage of break- fered genetic discrimination in either right. Our laws must keep pace with throughs in genetic testing. Dramatic arena with the right to seek redress advances in science and technology. No scientific advances should not have through legal action. one should suffer discrimination solely negative consequences for our health In too many cases, the hopeful prom- because of his or her genetic makeup. care. ise of genetic discoveries is squandered, Last year, the President signed an We have an historic opportunity to because patients rightly fear that in- executive order outlawing genetic dis- preempt this problem. Today, Congress formation about their genes will be crimination in the workplace for Fed- should expand the scope of its anti- used against them in the workplace or eral employees. It is now time to ex- discrimination laws to include a ban on the health system. That fear is clearly pand these important protections to all genetic discrimination. I hope that my well-founded. Today, employers and in- Americans. colleagues will join me in supporting surers can and do use this information That is why I am offering, along with this important amendment. to deny health coverage, refuse a pro- my colleagues—Senators KENNEDY, Mr. President, I yield the floor and motion, or reject a job applicant—all DODD, and HARKIN—the Genetic Non- reserve the remainder of my time. in the absence of any symptoms of dis- discrimination in Health Insurance and The PRESIDING OFFICER (Mr. AL- ease. Employment Act as an amendment to LARD). The Senator from Massachu- Although many genetic discoveries this bill. setts. and technologies are new, the problems Our bill has three major components: Mr. KENNEDY. Mr. President, ear- they raise with respect to discrimina- First, it forbids employers from dis- lier this week, as the leader has point- tion in insurance and in employment criminating in hiring, or in the terms ed out, scientists announced the com- have been with us for decades. and conditions of employment, on the pletion of a task that once seemed un- It was clear in 1973 that new develop- basis of genetic information; imaginable; and that is, the deci- ments in genetics had the potential for Second, it forbids health insurers phering of the entire DNA sequence of enormous good, as well as significant from discriminating against individ- the human genetic code. This amazing harm. That’s why I worked with the uals on the basis of genetic informa- accomplishment is likely to affect the scientific community to bring together tion; and 21st century as profoundly as the in- legal scholars, medical professionals, Third, it prevents the disclosure of vention of the computer or the split- and scientists at the Asilomar Con- genetic information to health insurers, ting of the atom affected the 20th cen- ference Center to assess the risks and health insurance data banks, employ- tury. I believe that the 21st century benefits of genetics. That conference ers, and anyone else who has no legiti- will be the century of life sciences, and formed the basis for laws and estab- mate need for information of this kind. nothing makes that point more clearly lished procedures for the use of genetic Discrimination based on genetic fac- than this momentous discovery. It will technology that helped create today’s tors is just as unacceptable as that revolutionize medicine as we know it thriving biotechnology industry. based on race, national origin, religion, today. It was clear in 1993 and 1996 that ge- sex or disability. In each case, people Already, genetic tests can be used to netic tests and information had the po- are treated unfairly, not because of identify and help those who are at risk tential not only to help patients, but their inherent abilities but solely be- for disease, and those who are already also to harm them. That’s why we in- cause of irrelevant characteristics. diagnosed. Scientists are using new cluded protections against genetic dis- Genetic discrimination, like other knowledge gained from the genetic crimination in the Health Security Act forms of discrimination, hurts us all. It code to design better treatments for of 1993 and the Kassebaum-Kennedy hurts our economy by keeping talented cancer, AIDS, depression, and many Act of 1996. While the Health Security people out of the workforce and dimin- other conditions and diseases. Act did not become law, Kassebaum- ishes us as a people. We cannot take Tragically, the vast potential of ge- Kennedy did. Its protections were an one step forward in science but two netic knowledge to improve health important step forward, but were far steps back in civil rights. care will go unfulfilled it patients fear from complete. Insurers can still use And we will all pay the price in in- that information about their genetic genetic information to outright deny creased health care costs if we allow characteristics will be used as the basis coverage or charge outrageous rates to employers or insurers to use genetic in- for job discrimination or other preju- individuals who are currently healthy, formation to discriminate. If fear of dices. To realize the unprecedented op- but may have a genetic pre-disposition discrimination stops people from get- portunities presented by these new dis- to a particular disease or condition. ting genetic tests, early diagnosis and coveries, we must guarantee that pri- And, with this week’s announcement, preventative treatments, they may suf- vate medical information remains pri- it is more clear than ever before that fer much more serious and more expen- vate and that genetic information can- in the year 2000 the American people sive health problems in the long run. not be used for improper purposes. need strong federal laws to protect And we all have to pay for that, as I commend our leader, Senator them against the malicious misuse of well. DASCHLE, for offering this important genetic data. The century may have Finally, genetic discrimination un- amendment that would do just that. It changed, but the problem of discrimi- dercuts the Human Genome Project’s would give the American people the nation hasn’t—and neither has my fundamental purpose of promoting pub- protections against genetic discrimina- commitment to protect the American lic health. Investing resources in the tion they need and deserve. people from discrimination in all its Human Genome Project is justified by The amendment would prohibit ugly forms. Discrimination is discrimi- the benefits of identifying, preventing health insurers and employers from nation whether it’s done at the ballot and developing effective treatments for using predictive genetic information to box, on a job application, or in the of- disease. But if fear of discrimination discriminate in the health care system fice of an insurance underwriter who deters people from genetic diagnosis, and the workplace. It would bar insur- denies an otherwise healthy patient S6050 CONGRESSIONAL RECORD — SENATE June 29, 2000 the health care they need based solely testified before the Joint Economic quire this information use it in hiring on the result of a genetic test or med- Committee that genetic discrimination decisions. ical history of a family member. is ‘‘the biggest barrier against having a President Clinton recognized the This is the same form of discrimina- real medical revolution based on this need for employees to be protected tion that would be evident on the ques- tremendous new scientific informa- from the dangers of genetic discrimina- tion of race. Individuals have virtually tion.’’ tion. In an action of great vision and no kind of control over their genetic Without strong protections, the wisdom, President Clinton signed an makeup. What we are saying now is, health and welfare of large numbers of Executive order on February 8 of this without these kinds of protections, it our fellow citizens will be unfairly at year to ban any use of predictive ge- will be permissible for insurance com- risk. Last week, I was proud to stand netic information as a basis for hiring, panies or for employers to say: I am with Terri Seargeant, a woman who firing, promotion or any other condi- not going to hire that person because carries a genetic trait that can—if un- tion of employment in the federal of the genetic makeup they have, be- treated—lead to a lung disease often workplace. With the stroke of a pen, cause it may mean they are going to called ‘‘Alpha-1 deficiency.’’ Let me the President instituted for federal get sicker over time and cost me in the emphasize that this trait only carries workers the types of protections that workplace. Therefore, I am going to the potential to develop the lung dis- this amendment would provide for all deny that person. On the other hand, it ease. If persons at risk for the disorder workers and all patients. will require workers to take the test as take a simple genetic test and are ap- Our amendment is strongly sup- a condition for employment. And then propriately treated, they can prevent ported by leading patient groups, med- if they find that their genetic makeup development of the disease. ical professional societies, and sci- demonstrates some kind of proclivity Terri Seargent is such a person. She entists. The need for these kinds of to acquire this kind of disease, they received a genetic test that revealed protections has been clearly and re- won’t hire them. That is what is hap- her risk for this disease, and took the peatedly endorsed by the two leaders of pening. They are going to find out that preventive measures needed to avoid the genome sequencing project and by the workers are not going to take the the onset of symptoms. She worked experts in law, medicine, and science. test, which is increasingly the case, be- hard at her job and received consist- A host of editorial boards have written cause they don’t want to risk not being ently positive performance reviews and in favor of congressional action to pro- hired in a particular employment situ- salary increases. Nonetheless, her em- tect people in this area. ation. ployer—who had access to her medical In many respects, people’s genetic What happens is, they put themselves files and the records of her genetic composition is essentially a blueprint at greater risk of getting the disease tests—decided to terminate this hard- of their medical past and a crystal ball because they deny themselves all the working, healthy employee. What are of the possibilities for their medical fu- preventive health care that could keep we to conclude except that she had ture. It is difficult to imagine more them healthy and avoid getting sick been fired on the basis of her genetic personal and more private information. and being more useful and valuable potential for disease? This powerful information should be citizens in the community. And for every Terri Seargent, who shared between patients and their doc- Fear of genetic discrimination causes has suffered actual discrimination, tors—not their employer and their co- patients to go without needed medical there are millions of men and women workers. tests. The Journal of the American across the nation who are either at The threat of genetic discrimination Medical Association reported that 57 risk of genetic discrimination or fear faces every American, because every percent of women at risk for breast or getting tested because of possible re- American carries unique genetic char- ovarian cancer had refused to take a prisals in the workplace or health sys- acteristics that indicate risk of dis- genetic test that could have identified tem. ease. This is not about Terri Seargent. their risk for cancer and assisted them National Human Genome Research This is about each and every one of us, in receiving medical treatment to pre- Institute, ‘‘Already, with but a handful and everyone we know. vent the onset of these diseases be- of genetic tests in common use, people The vote cast today in this Chamber cause they feared reprisals for doing so. have lost their jobs, lost their health will help determine whether the secrets As the potential for discrimination insurance, and lost their economic well of our DNA will be used for beneficial increases, more and more Americans being because of the misuse of genetic or for harmful purposes. Congress are becoming concerned about the dan- information.’’ should give the American people the ger that employers and insurers will Make no mistake: The potential for strong and comprehensive protection misuse and abuse genetic information. genetic discrimination is growing. Al- from genetic discrimination that they Just this week, in the aftermath of the ready DNA ‘‘chips’’ are available that need and deserve. I urge my colleagues historic completion of the genome se- can determine a person’s genetic traits to vote for this amendment. quencing project, a new CNN-Time in only a few minutes. In the near fu- The PRESIDING OFFICER. The Sen- magazine survey found that 46 percent ture, genetic tests will become even ator’s time has expired. of Americans believe that sequencing cheaper and more widely available Mr. KENNEDY. Mr. President, as I the genome would have harmful re- than they re today. If we do not pass understand, it is the purpose of the sults. legislation to ban genetic discrimina- Senator from Pennsylvania now to Surely, using genetic information as tion, it may become commonplace for send a second-degree amendment to the a basis for discrimination would be one an employer to require such tests, and desk. of the most harmful consequences of to use the results of these tests to de- The PRESIDING OFFICER. The Sen- this remarkable scientific accomplish- cide which employees to hire or pro- ator from Pennsylvania. ment. Experts in genetics are virtually mote and which to deny such advance- Mr. SPECTER. Mr. President, has unanimous in calling for strong protec- ment, based in whole or in part on time expired for the other side? tions to prevent such a misuse of their perceived risk for disease. The PRESIDING OFFICER. It has. science. Secretary Shalala’s advisory Even now, some employers require Mr. SPECTER. Mr. President, we panel on genetic testing—consisting of information about a person’s genetic have asked people on our side who have experts in the fields of law, science, inheritance as a condition of employ- worked on this in the HELP Com- medicine, and business—has rec- ment or part of the job application mittee to come over. We believe this ommended unambiguously that ‘‘Fed- process. A recent American Manage- amendment addresses important con- eral legislation should be enacted to ment Association survey of more than siderations and the objectives are very prohibit discrimination in employment 2,000 companies showed that more than valid: to stop discrimination in em- and health insurance based on genetic 18 percent of companies require genetic ployment and in health coverage. information.’’ tests or family medical history data What we would like to do is have an Dr. Craig Venter, the president of the from employees or job applicants. Ac- opportunity to propose a second-degree company that led the privately-fi- cording to the same survey, more than amendment and then to arrange an or- nanced genome sequencing effort, has 26 percent of the companies that re- derly debate and have the votes. That June 29, 2000 CONGRESSIONAL RECORD — SENATE S6051 is going to take a few minutes for us to The PRESIDING OFFICER. Without able occurrence, one that has been her- accomplish. In the interim, it is our objection, it is so ordered. alded, and properly so, for giving us the hope that we can move along and get a Mr. KENNEDY. Mr. President, as I ability to understand ourselves better. short time agreement on the Ashcroft understand it, CBO says the cost im- I applaud the remarkable work done by amendment, to present that and con- pact of this proposal on business is neg- the NIH and Celera. clude it. By that time, our people will ligible but a destructive impact on in- Why is it important to offer this be in a position to present the second- dividuals and society of the failure to amendment today in the context of degree amendment. We can figure out a act will be immense. this bill? As we have seen with all the time agreement and move ahead. On the part of this proposal that advances in technology, generally—and The PRESIDING OFFICER. The Sen- deals with employment, without this it has been a remarkable decade in that ator from Nevada. kind of amendment, those who have sense, with the Internet and commu- Mr. REID. Mr. President, the Senator been responsible for the breakthrough nications technology—there is a great from Pennsylvania is absolutely right. in terms of the sequencing of the gene unease in the country about how much We need to move on with this issue. understand very well, and have stated information people have about us as in- However, there are a number of people repeatedly, we are going to have a new dividuals. who have come to the floor. We believe form of discrimination in employment. We pride ourselves, I suppose, on the it is appropriate they be allowed to We want to avoid that. Two, from a notion that we protect privacy in this complete their statements. It may take health point of view, if people don’t be- country. It goes back to the founding a little bit of time. Senator DASCHLE lieve they are going to be secure either days of our Republic. The right of pri- has agreed at the appropriate time to in employment or in getting health in- vacy is as deeply rooted in the Amer- move on this and to go to something surance, they are not going to take the ican conscience as almost any other else. But Senator KENNEDY would like tests and they are going to, therefore, principle I can think of. Yet, there is to finish his statement. There are oth- deny themselves the kind of treatment this uneasy sense that with the explo- ers who want to speak on this issue. We that is going to be available to them in sion of technology, too many people would like to stay on this issue for a order to remain healthy. So we ought have too much information about us while. to take these steps that this amend- that they ought not to have—at least The PRESIDING OFFICER. The Sen- ment includes; it is essential. without our permission. The idea that ator from Pennsylvania has the floor. We already know from what is hap- people can peer into our financial Mr. SPECTER. Mr. President, might pening today that a number of people records and our medicine cabinets and I inquire of the Senator from Nevada aren’t taking these genetic tests be- that information can be disseminated how long he would like to stay on it— cause they fear genetic discrimination. to broad audiences, violating our sense for 15 more minutes? This is one of the most important of privacy, is of great concern. And the Mr. REID. I think it will take a little health issues we are going to face in genome breakthrough raises similar more time than that. this century. It has been identified by issues. Mr. KENNEDY. I could just take 2 those on the cutting edge of progress in Let me share with you one anecdote. more minutes to conclude. terms of the sequencing of the gene. We Last year I visited Yale University to Mr. REID. The Senator from Con- should take their advice and counsel hear about some of the genetics re- necticut. and accept the Daschle amendment. search that is being conducted there. Mr. SPECTER. What I would like to I yield the floor. One of the studies is attempting to de- do would be to establish a parameter. The PRESIDING OFFICER. The Sen- termine the likelihood of certain This is the kind of subject which we ator from Connecticut is recognized. women developing breast cancer by could usefully debate for several days. Mr. DODD. Mr. President, I want to studying twin girls. They are getting I would like to see what our amend- address this amendment, but first I to the point where they can determine ment is on this side. We can compare want to speak to another issue. I know almost at the birth, the possibility of them. Then we are in a position to people are meeting on the conference individuals contracting breast cancer have a discussion as to how long we report on the emergency supplemental. as adults. It is incredible information ought to spend. If we are to finish this One of the provisions being considered to have. Imagine parents of a newborn bill this afternoon or even today, we is whether to add the Nethercutt lan- baby knowing, because of the genetic are going to have to move through this guage in the House supplemental. makeup of that child, that the baby amendment. We have other com- I care deeply about a lot of provisions has a possibility of contracting breast plicated amendments coming up. in the supplemental, including the Co- cancer. All of a sudden, diets change Mr. REID. That is very appropriate. lombian aid package, but I want to let and lifestyles change. Prevention The Senator from Massachusetts de- my colleagues know I will use what- measures can be taken. These are the sires another 5 minutes; the Senator ever parliamentary procedure is avail- kinds of things the deciphering of the from Connecticut, 15 minutes; the Sen- able to me if that language comes over genome is going to be able to do for us. ator from North Dakota, 10 minutes. on the emergency supplemental. I It is wonderful to be able to have Senator HARKIN also wishes to speak. know we all want to get out of here in that kind of information. But imagine Mr. SPECTER. We just had an offer the next few days. I care about the bill, just that the information Yale Medical of 10 minutes. but I also care about that language. I School is uncovering becomes avail- Mr. REID. Senator KENNEDY, 5; the think it is wrong for it to be included able, as that child gets older, to an em- Senator from Connecticut. in the bill. I want people to know I am ployer or to an insurance company— Mr. SPECTER. Did my colleague say serious about this. I will use whatever not information that the person has 5 for Senator DORGAN? procedures are available to me when it contracted the disease—but just that Mr. REID. Senator DORGAN wishes 7 comes to the supplemental if the they might possibly do so. Just that minutes. Nethercutt language is included. I am predisposition for a certain illnesses Mr. SPECTER. So we have a total of going to meet with members of the can have a devastating impact on 22 minutes—10, 7, and 5. conference shortly and express that whether than individual gets insurance Mr. REID. Yes, with the under- view there as well. or keeps their job. standing that we will come back for I strongly support what Senator This amendment says that when it further debate on this issue at a subse- DASCHLE is proposing in his amend- comes to that information—the pro- quent time. ment on genetic discrimination. The pensity for acquiring these problems— Mr. SPECTER. Mr. President, I ask world received wonderful news this we ought to be able to protect people in unanimous consent that there be an past week that the genetic code had their jobs and in their ability to re- additional 22 minutes, at which point been deciphered. This discovery is ceive or get health insurance. we will return to the Ashcroft amend- breathtaking in scope, and I suspect This need not be a partisan issue. ment. After that, we will present a sec- over the next 50 years we are going to Senator DOMENICI and I, 3 years ago, ond-degree amendment and work see it change the nature of medicine in introduced legislation similar to this through the time sequence. this country. So it is really a remark- bill. We thought it was critical to bring S6052 CONGRESSIONAL RECORD — SENATE June 29, 2000 up and address both insurance and em- Washington Post describes this legis- Another major farm group has just ployment discrimination. Two years lator from Florida who opposes elimi- come out in opposition to it, saying ago, many colleagues joined our col- nating sanctions. She said the agree- this doesn’t solve the problem; let’s league from Maine, Senator SNOWE, ment will make it as difficult as pos- fight to solve the problem. The prob- who also offered strong legislation pro- sible for such sales to take place with lem is that we include medicine and tecting patients from genetic discrimi- respect to Cuba. Why? Because they food as part of our sanctions. nation in insurance. We have an oppor- prohibit private financing of the sale of The solution is that this country tunity today, with the breakthroughs food to Cuba. What is that about? It should not include food and medicine announced on Monday of this week, to has nothing to do with good or com- in sanctions that we impose on these really say as a body—Republicans and mon sense. They are not trying to get countries. We should not use food as a Democrats across the board—this is an rid of sanctions. It has everything to weapon. area where we are going to, early on, do with the irrational notion about It is a very simple proposition. Sev- establish some ground rules when it Cuba, and that if we can somehow re- enty Senators have already weighed in comes to the use of genetic informa- strict the food and medicine going to in the Senate saying let’s stop it. If tion. Cuba, we will enhance America’s for- they would allow a vote in the House, I see that time has expired in terms eign policy. It is crazy. It doesn’t make they would get 70 percent in the House of my few minutes. any sense at all. of Representatives as well. I want our colleagues to know how Here is where we have sanctions: I hope we will not decide to cave in important this amendment is, and I Cuba, Iran, Iraq, Libya, North Korea, on this issue. Let’s not make the per- urge them to support it when the vote and Sudan. These countries are coun- fect the enemy of the good. But let us occurs. tries that our Government has decided at least continue to fight. We have The PRESIDING OFFICER. The Sen- are not behaving properly. I support some more months in this legislative ator from North Dakota. slapping them with economic sanc- session. We have a provision coming to Mr. DORGAN. Mr. President, am I to tions. I do not support including food the floor of the Senate in about 3 be recognized for 7 minutes? Is that the and medicine in those sanctions. weeks that includes a real effort to order? I do not support using food as a weap- stop using food and medicine as part of The PRESIDING OFFICER. The Sen- on. We are trying very hard to get rid our sanctions. Let’s fight for that. ator from North Dakota is recognized of this practice of using food as a weap- Let’s not let a couple of people who run for 7 minutes. on. Seventy Senators voted last year to the other body decide for us at 3 a.m. Mr. DORGAN. Mr. President, I had stop using food as a weapon. in the morning what we were going to intended to speak about this amend- We have a provision in the Senate ag- do in this circumstance. ment. But I am compelled to speak riculture appropriations committee Let’s stand up and fight for family about the point that the Senator from bill that will come to the floor of the farmers, and let’s fight for the moral Connecticut discussed at the start of Senate within several weeks that in- principles that this country ought to his comments because it is so impor- cludes an approach that will eliminate hold dear. We should not use food and tant, and it is timely. the use of food and medicine as part of medicine as a weapon any longer. This At this moment, I understand there our sanctions. is not about Republicans and Demo- I think we ought not give up here. We are meetings going on right now some- crats. ought to fight on behalf of our family Both administrations in recent years where in this building by a small group farmers and others to say that we want have used this approach, and they were of people who are dealing with a piece to abolish the use of sanctions that in- wrong. of legislation that was cobbled to- clude food and medicine. The Senate was right last year with gether around 3 o’clock in the morning The proposition that was cobbled to- 70 votes that said let us stop it. a couple of days ago dealing with the gether over in the House at 2 o’clock or And what was put together over in issue of imposing sanctions on food and 3 o’clock in the morning by some peo- the House is now billed as some sort of medicine around the world, and wheth- ple who really do not want to do this, a compromise. It is not a compromise er that will be added to the supple- have made it seem as if they have made at all. It falls far short of what we mental bill that will be considered per- progress in this area. But, in fact, they ought to expect. Those of us who are haps later today or tomorrow. If that is have lost ground in a couple of cases, clearheaded enough believe we should added, in my judgment, it is going to and especially with respect to Cuba in not use food and medicine as part of cause significant trouble. a couple of other circumstances. There economic sanctions in this country. Here is why: The House leaders have will be no U.S. sales of food to Cuba. Mr. DODD. Mr. President, will my done what I am reminded of as the Canadian farmers can sell to Cuba. Eu- colleague yield? ‘‘Moon walk’’. You know the Moon ropean farmers can sell to Cuba. Ven- Mr. DORGAN. Yes. walk Michael Jackson used to do. It ezuelan farmers can sell to Cuba. Mr. DODD. I urge people to read the looked like he was walking forward, Seventy Members of the Senate said bill. Unfortunately, a lot of people do but he was actually going backward. we ought to get rid of sanctions on the not read the legislation. But if you That is what they have done with re- shipment of food and medicine—yes, to read this legislation, section 808 im- spect to this issue of sanctions. all countries, including Cuba. But now poses a prohibition on financing U.S. Senator DODD from Connecticut, my- we have cobbled together a deal some- assistance. One part of this says no self, and others are saying we ought to time early in the morning by a group more sanctions. Then it says no more end the use of sanctions on food and of people who are going to apparently sanctions, except—‘‘Notwithstanding medicine anywhere in the world where put it on a supplemental bill so we will any of the provisions of this law, the it exists. This country has imposed have a circumstance where we don’t export of agricultural commodities, sanctions on the shipment of food and solve this problem. The proposal that medicine, and medical devices to the medicine. It is wrong. When we take fails to solve this problem was not de- government of a country’’—as of June aim at dictators, we hit poor people bated in the House. It was not debated 1, 2000. and hungry people and sick people. It is in the Senate. But it was concocted at These are the countries that have not the best of what America stands 3 a.m. in the morning and apparently been termed by the Secretary of State for. was stuck on a supplemental appro- to be ‘‘terrorist states.’’ Those are the We ought to end all sanctions on food priations bill. It is the wrong way to do very countries. The only countries that and medicine. Yet what was done in it. we have sanctions against are those the House of Representatives 2 days I just talked to a farm group that countries. The very countries we say ago, in my judgment, comes up far supports this. When I asked them a we have sanctions against are these short. In fact, in some areas, it loses question about it, they admitted they countries. If you are on the list on ground. had not read the language. They read June 1, 2000, none of this law applies. I want to point out an article in the the paper, I guess. The implication was Second, it says on financial assist- Washington Post. I will come later that I was impeding the efforts to re- ance that you can’t have any Govern- with the legislation itself. But the move sanctions. ment support for Libya, Iran, North June 29, 2000 CONGRESSIONAL RECORD — SENATE S6053 Korea, and Sudan. And then, on private Missouri, Mr. ASHCROFT, is recognized (1) IN GENERAL.—Chapter 11 of subtitle II of financing, it says no financing on the to offer an amendment. title 31, United States Code, is amended by adding before section 1101 the following: part of the U.S. Government, any State AMENDMENT NO. 3689 or local government, private person, or (Purpose: To protect Social Security and ‘‘§ 1100. Protection of social security and entity—including, I suspect, even for- Medicare surpluses through strengthened medicare surpluses eign financing. budgetary enforcement mechanisms) ‘‘The budget of the United States Govern- This says if sanctions are coming off, Mr. ASHCROFT. Mr. President, I ment submitted by the President under this then we eliminate all means of financ- send an amendment to the desk. chapter shall not recommend an on-budget The PRESIDING OFFICER. The deficit for any fiscal year covered by that ing it—both public and private—and we budget.’’. continue with the same list that was in clerk will report. The legislative clerk read as follows: (2) CHAPTER ANALYSIS.—The chapter anal- effect June 1, 2000, which lists only ysis for chapter 11 of title 31, United States countries on whom we have unilateral The Senator from Missouri (Mr. Code, is amended by inserting before the sanctions. ASHCROFT), for himself and Mr. VOINOVICH, item for section 1101 the following: Mr. ALLARD, Mr. GRAMS, and Mr. ABRAHAM, This is a bill that needs more work. proposes an amendment numbered 3689. ‘‘1100. Protection of social security and medi- care surpluses.’’. The Senate Agriculture Appropriations Mr. ASHCROFT. Mr. President, I ask Subcommittee bill is vastly superior to unanimous consent that reading of the (d) EFFECTIVE DATE.—This section shall this. It is a bipartisan bill that col- amendment be dispensed with. take effect upon the date of its enactment and the amendments made by this section leagues cosponsored, and it deserves The PRESIDING OFFICER. Without the consideration of this body. shall apply to fiscal year 2001 and subsequent objection, it is so ordered. fiscal years. For those reasons, I will strenuously The amendment is as follows: AMENDMENT NO. 3690 object to the sanctions being included At the end, insert the following: as part of a supplemental. On page ll, after line ll, insert the fol- (Purpose: To establish an off-budget lockbox Mrs. MURRAY. Mr. President, I rise lowing: to strengthen Social Security and Medicare) in strong support of the Daschle SEC. ll. SOCIAL SECURITY AND MEDICARE Mr. REID. Mr. President, I send an amendment to prohibit genetic dis- SAFE DEPOSIT BOX ACT OF 2000. amendment to the desk. crimination in employment. I com- (a) SHORT TITLE.—This section may be The PRESIDING OFFICER. The cited as the ‘‘Social Security and Medicare clerk will report. mend the Senator for his leadership in Safe Deposit Box Act of 2000’’. this area, and I thank him for bringing (b) PROTECTION OF SOCIAL SECURITY AND The legislative clerk read as follows: this amendment to the floor. MEDICARE SURPLUSES.— The Senator from Nevada (Mr. REID), for The issue of genetic discrimination is (1) MEDICARE SURPLUSES OFF-BUDGET.—Not- Mr. CONRAD and Mr. LAUTENBERG, proposes a timely debate in light of the recent withstanding any other provision of law, the an amendment numbered 3690. announcement that science has con- net surplus of any trust fund for part A of Mr. REID. Mr. President, I ask unan- quered the genetic code. This is a Medicare shall not be counted as a net sur- imous consent that reading of the major milestone that brings us closer plus for purposes of— amendment be dispensed with. (A) the budget of the United States Gov- to finding cure for cancer, heart dis- ernment as submitted by the President; The PRESIDING OFFICER. Without ease, diabetes, Parkinsons, M.S., and a (B) the congressional budget; or objection, it is so ordered. whole host of other tragic diseases. (C) the Balanced Budget and Emergency The amendment is as follows: The science is moving ahead rapidly, Deficit Control Act of 1985. Strike all after the first word and insert and our standards for the use of that (2) POINTS OF ORDER TO PROTECT SOCIAL SE- the following: science must not lag behind. We must CURITY AND MEDICARE SURPLUSES.—Section TITLE ll—SOCIAL SECURITY AND MEDI- ensure that genetic information is not 312 of the Congressional Budget Act of 1974 is CARE OFF-BUDGET LOCKBOX ACT OF used in discriminatory ways. If we do amended by adding at the end the following 2000 new subsection: ll not take a stand prohibiting discrimi- ‘‘(g) POINTS OF ORDER TO PROTECT SOCIAL SEC. 1. SHORT TITLE. nation based on one’s genetic make up, SECURITY AND MEDICARE SURPLUSES.— This title may be cited as the ‘‘Social Se- we could jeopardize the benefits offered ‘‘(1) CONCURRENT RESOLUTIONS ON THE BUDG- curity and Medicare Off-Budget Lockbox Act by science. We must ensure that our ET.—It shall not be in order in the House of of 2000’’. genetic finger print is used only for Representatives or the Senate to consider SEC. ll2. STRENGTHENING SOCIAL SECURITY good, and not as a tool to discriminate. any concurrent resolution on the budget, or POINTS OF ORDER. I’ve talked to many women in my conference report thereon or amendment (a) IN GENERAL.—Section 312 of the Con- gressional Budget Act of 1974 (2 U.S.C. 643) is state who are concerned about breast thereto, that would set forth an on-budget deficit for any fiscal year. amended by inserting at the end the fol- cancer. They know they should under- ‘‘(2) SUBSEQUENT LEGISLATION.—It shall not lowing: go genetic testing to find out if they be in order in the House of Representatives ‘‘(g) STRENGTHENING SOCIAL SECURITY are predisposed to breast cancer, but or the Senate to consider any bill, joint reso- POINT OF ORDER.—It shall not be in order in they don’t. They avoid getting tested lution, amendment, motion, or conference the House of Representatives or the Senate because they are afraid that the results report if— to consider a concurrent resolution on the could be used against them and could ‘‘(A) the enactment of that bill or resolu- budget (or any amendment thereto or con- adversely affect their employment or tion as reported; ference report thereon) or any bill, joint res- olution, amendment, motion, or conference insurance coverage. ‘‘(B) the adoption and enactment of that amendment; or report that would violate or amend section They are concerned that if they use ‘‘(C) the enactment of that bill or resolu- 13301 of the Budget Enforcement Act of the science, it will be used against tion in the form recommended in that con- 1990.’’. them. Enacting a tough federal ban on ference report, (b) SUPER MAJORITY REQUIREMENT.— genetic discrimination will give these would cause or increase an on-budget deficit (1) POINT OF ORDER.—Section 904(c)(1) of women, along with thousands of other for any fiscal year. the Congressional Budget Act of 1974 is people across the country, the peace of ‘‘(3) DEFINITION.—For purposes of this sec- amended by inserting ‘‘312(g),’’ after mind that they can take advantage of tion, the term ‘on-budget deficit’, when ap- ‘‘310(d)(2),’’. (2) WAIVER.—Section 904(d)(2) of the Con- the latest tools of medicine without plied to a fiscal year, means the deficit in the budget as set forth in the most recently gressional Budget Act of 1974 is amended by being taken advantage of in the proc- agreed to concurrent resolution on the budg- inserting ‘‘312(g),’’ after ‘‘310(d)(2),’’. ess. et pursuant to section 301(a)(3) for that fiscal (c) ENFORCEMENT IN EACH FISCAL YEAR.— I urge my colleagues to support this year.’’. The Congressional Budget Act of 1974 is amendment now. We have made a sig- (3) SUPER MAJORITY REQUIREMENT.— amended in— nificant investment in genetic re- (A) POINT OF ORDER.—Section 904(c)(1) of (1) section 301(a)(7) (2 U.S.C. 632(a)(7)), by search. Let’s make sure that we all the Congressional Budget Act of 1974 is striking ‘‘for the fiscal year’’ through the pe- benefit from this investment. If we act amended by inserting ‘‘312(g),’’ after riod and inserting ‘‘for each fiscal year cov- ered by the resolution’’; and now, we will ensure this information is ‘‘310(d)(2),’’. (B) WAIVER.—Section 904(d)(2) of the Con- (2) section 311(a)(3) (2 U.S.C. 642(a)(3)), by used to treat patients and not to penal- gressional Budget Act of 1974 is amended by striking beginning with ‘‘for the first fiscal ize them. inserting ‘‘312(g),’’ after ‘‘310(d)(2),’’. year’’ through the period and insert the fol- The PRESIDING OFFICER. Under (c) PROTECTION OF SOCIAL SECURITY AND lowing: ‘‘for any of the fiscal years covered the previous order, the Senator from MEDICARE SURPLUSES.— by the concurrent resolution.’’. S6054 CONGRESSIONAL RECORD — SENATE June 29, 2000 SEC. ll3. MEDICARE TRUST FUND OFF-BUDGET. joint resolution, amendment, motion, or con- trust fund, I think it is important for (a) IN GENERAL.— ference report that would cause a decrease in us to look to the protection of other (1) GENERAL EXCLUSION FROM ALL BUDG- surpluses or an increase in deficits of the trust funds that are important to the ETS.—Title III of the Congressional Budget Federal Hospital Insurance Trust Fund in well-being of the people of this country Act of 1974 is amended by adding at the end any year relative to the levels set forth in and to protect them as well. the following: the applicable resolution. This paragraph shall not apply to amounts to be expended One of the other trust funds which re- ‘‘EXCLUSION OF MEDICARE TRUST FUND FROM markably has been invaded over and ALL BUDGETS from the Hospital Insurance Trust Fund for purposes relating to programs within part A over and over again as a source for ‘‘SEC. 316. (a) EXCLUSION OF MEDICARE of Medicare as provided in law on the date of spending money for a variety of Gov- TRUST FUND FROM ALL BUDGETS.—Notwith- standing any other provision of law, the re- enactment of this paragraph.’’. ernment programs has been the Medi- (f) BASELINE TO EXCLUDE HOSPITAL INSUR- ceipts and disbursements of the Federal Hos- care trust fund. For over 30 years, ANCE TRUST FUND.—Section 257(b)(3) of the pital Insurance Trust Fund shall not be working people have been contributing Balanced Budget and Emergency Deficit counted as new budget authority, outlays, to the country’s welfare by paying the Control Act of 1985 is amended by striking receipts, or deficit or surplus for purposes taxes they owe, paying their debts, sav- ‘‘shall be included in all’’ and inserting of— ‘‘shall not be included in any’’. ing for the future. Those values were ‘‘(1) the budget of the United States Gov- (g) MEDICARE TRUST FUND EXEMPT FROM rejected inside the beltway when we ernment as submitted by the President; SEQUESTERS.—Section 255(g)(1)(B) of the Bal- went into the trust funds in order to ‘‘(2) the congressional budget; or anced Budget and Emergency Deficit Control meet our spending desires. ‘‘(3) the Balanced Budget and Emergency Act of 1985 is amended by adding at the end Washington tried to impose its own Deficit Control Act of 1985. the following: rules and values on the rest of the ‘‘(b) STRENGTHENING MEDICARE POINT OF ‘‘Medicare as funded through the Federal ORDER.—It shall not be in order in the House country. These misdirected rules— Hospital Insurance Trust Fund.’’. spending beyond our means, making of Representatives or the Senate to consider (h) BUDGETARY TREATMENT OF HOSPITAL IN- a concurrent resolution on the budget (or SURANCE TRUST FUND.—Section 710(a) of the promises we did not keep, misleading any amendment thereto or conference report Social Security Act (42 U.S.C. 911(a)) is the American people about how their thereon) or any bill, joint resolution, amend- amended— money is being spent—for too long ment, motion, or conference report that (1) by striking ‘‘and’’ the second place it these rules were allowed to continue. would violate or amend this section.’’. appears and inserting a comma; and We have taken some very strong steps (2) SUPER MAJORITY REQUIREMENT.— (2) by inserting after ‘‘Federal Disability in the right direction. (A) POINT OF ORDER.—Section 904(c)(1) of Insurance Trust Fund’’ the following: ‘‘, Fed- Last year, this Congress took the the Congressional Budget Act of 1974 is eral Hospital Insurance Trust Fund’’. first step toward stopping this raid on amended by inserting ‘‘316,’’ after ‘‘313,’’. SEC. ll4. PREVENTING ON-BUDGET DEFICITS. (B) WAIVER.—Section 904(d)(2) of the Con- the Social Security trust fund by en- (a) POINTS OF ORDER TO PREVENT ON-BUDG- acting the Social Security lockbox rule gressional Budget Act of 1974 is amended by ET DEFICITS.—Section 312 of the Congres- inserting ‘‘316,’’ after ‘‘313,’’. sional Budget Act of 1974 (2 U.S.C. 643) is on the budget resolution. That creates (b) EXCLUSION OF MEDICARE TRUST FUND amended by adding at the end the following: a point of order against any budget for FROM CONGRESSIONAL BUDGET.—Section ‘‘(h) POINTS OF ORDER TO PREVENT ON- spending money out of what would be 301(a) of the Congressional Budget Act of 1974 BUDGET DEFICITS.— called the Social Security surplus. The (2 U.S.C. 632(a)) is amended by adding at the ‘‘(1) CONCURRENT RESOLUTIONS ON THE BUDG- Social Security surplus is pretty easy end the following: ‘‘The concurrent resolu- ET.—It shall not be in order in the House of to understand. It is defined in our ac- tion shall not include the outlays and rev- Representatives or the Senate to consider enue totals of the Federal Hospital Insurance counting as the amount of money that any concurrent resolution on the budget, or comes into Social Security because of Trust Fund in the surplus or deficit totals conference report thereon or amendment required by this subsection or in any other thereto, that would cause or increase an on- Social Security taxes that aren’t re- surplus or deficit totals required by this budget deficit for any fiscal year. quired in that year to meet the obliga- title.’’ ‘‘(2) SUBSEQUENT LEGISLATION.—Except as tions in that year of Social Security. (c) BUDGET TOTALS.—Section 301(a) of the provided by paragraph (3), it shall not be in Obviously, because we have a lot of Congressional Budget Act of 1974 (2 U.S.C. order in the House of Representatives or the young people working now, we have far 632(a)) is amended by inserting after para- Senate to consider any bill, joint resolution, more money coming in than we have graph (7) the following: amendment, motion, or conference report going out with the relatively small ‘‘(8) For purposes of Senate enforcement if— under this title, revenues and outlays of the group of older Americans consuming. ‘‘(A) the enactment of that bill or resolu- In the years ahead, though, when this Federal Hospital Insurance Trust Fund for tion as reported; each fiscal year covered by the budget reso- ‘‘(B) the adoption and enactment of that bulge of young people now contributing lution.’’. amendment; or to the fund become consumers of the (d) BUDGET RESOLUTIONS.—Section 301(i) of ‘‘(C) the enactment of that bill or resolu- fund, we will need a lot of the money the Congressional Budget Act of 1974 (2 tion in the form recommended in that con- they are sending in. That money they U.S.C. 632(i)) is amended by— ference report, are sending in is called the Social Se- (1) striking ‘‘SOCIAL SECURITY POINT OF would cause or increase an on-budget deficit curity surplus. For years we spent ORDER.—It shall’’ and inserting ‘‘SOCIAL SE- for any fiscal year.’’. that. I worked very hard to stop that CURITY AND MEDICARE POINTS OF ORDER.— (b) SUPER MAJORITY REQUIREMENT.— spending. I worked to get included in ‘‘(1) SOCIAL SECURITY.—It shall’’; and (1) POINT OF ORDER.—Section 904(c)(1) of (2) inserting at the end the following: the Congressional Budget Act of 1974 is the budget resolution a measure that ‘‘(2) MEDICARE.—It shall not be in order in amended by inserting ‘‘312(h),’’ after would make it out of order for the Con- the House of Representatives or the Senate ‘‘312(g),’’. gress to spend money on other things to consider any concurrent resolution on the (2) WAIVER.—Section 904(d)(2) of the Con- that was sent in by taxpayers for So- budget (or amendment, motion, or con- gressional Budget Act of 1974 is amended by cial Security purposes. That is the pro- ference report on the resolution) that would inserting ‘‘312(h),’’ after ‘‘312(g),’’. tection of the Social Security surplus. decrease the excess of the Federal Hospital AMENDMENTS NOS. 3689 AND 3690 In addition, last year Senator Insurance Trust Fund revenues over Federal The PRESIDING OFFICER. The Sen- DOMENICI, Senator ABRAHAM, and I Hospital Insurance Trust Fund outlays in tried several times to enact a law, not any of the fiscal years covered by the con- ator from Missouri. current resolution. This paragraph shall not Mr. ASHCROFT. Mr. President, I just a budget rule which we did get put apply to amounts to be expended from the want to address the amendment which in place, but a law which would protect Hospital Insurance Trust Fund for purposes I sent to the desk because for decades, Social Security proceeds as a statutory relating to programs within part A of Medi- in a business-as-usual context, Wash- measure. Obviously, the President care as provided in law on the date of enact- ington has constantly invaded various would have to sign it for it to become ment of this paragraph.’’. trust funds to spend for a variety of a law. The President said he wanted a (e) MEDICARE FIREWALL.—Section 311(a) of purposes and programs. One of those Social Security lockbox, but, unfortu- the Congressional Budget Act of 1974 (2 trust funds was the Social Security nately, despite all the words of support U.S.C. 642(a)) is amended by adding after paragraph (3), the following: trust fund. We spent a lot of time and for saving the Social Security surplus ‘‘(4) ENFORCEMENT OF MEDICARE LEVELS IN energy finding a way to protect the So- and locking away the surplus, the Sen- THE SENATE.—After a concurrent resolution cial Security trust fund. ate was unable to end the filibuster by on the budget is agreed to, it shall not be in Having developed at least a budget Members of the Senate who opposed us order in the Senate to consider any bill, rule to protect the Social Security and their President on the issue. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6055 Despite that opposition, Congress resentative Wally Herger and opposed President has described the Medicare was able to change how business in by only two House Members. lockbox proposal in my amendment, Washington was done on the Social Se- Now, there are a lot of Members of which I proposed last November, in a curity surplus. We are far better off as this body who will want to protect, I very simple, understandable manner: a result. believe, the Medicare trust fund sus- What taking Medicare off budget Last year, for the first time since taining the capacity of our Govern- means, the administration, speaking of 1957, not one penny of the Social Secu- ment to provide the hospitalization we itself says, is: rity surplus was spent. Again this year, have promised to individuals who are The Administration projects that if cur- we passed a budget resolution that will eligible for Medicare. I am pleased rent policies are continued, Medicare Part A, not touch the off-budget or Social Se- there are Members of this body who which covers hospital expenses, will run a join me in cosponsoring this amend- surplus of $403 billion from [the year] 2001 curity surplus, the Social Security through [the year] 2010. This surplus is the ment, one of whom is Senator ABRA- trust fund. It will also provide tax re- excess of Medicare income, principally from lief for married couples and dedicate HAM from Michigan. He has been active the 2.9 percent payroll tax, combined em- over $40 billion over the next 5 years to in the lockbox movement to protect ployer and employee, over benefit payments provide prescription drug coverage for Social Security, to make sure that So- and administrative costs. The Medicare sur- needy, older Americans who receive cial Security is not invaded for other plus has grown from $4 billion in 1993 to $24 Medicare. spending, and much of the success we billion in the year 2000. When I saw what we accomplished have had in protecting every dime of I am still quoting the President and last year, I knew we could, as well, pro- Social Security in the trust fund this the statement of the White House here: tect Part A of the Medicare surplus. year should flow to Senator ABRAHAM Under previous budget accounting conven- Part A of Medicare is the only Medi- of Michigan. I am pleased he has en- tions, this Medicare surplus was treated as dorsed this and is a cosponsor of this part of the total on-budget surplus and was care provision of which there is a trust thus available for new spending on other pro- fund. It is not funded out of the general measure with me in the Senate. It is just not several Senators who grams or tax cuts. revenue. It is something people pay endorse this. Both the Vice President By taking Medicare Part A off budget, the specifically their taxes for, with an an- President proposes to make it unavailable and the President of the United States ticipation that those resources will be for other spending or tax cuts. have endorsed enactment of a Medicare available. That is exactly what I proposed last lockbox such as the one I introduced On November 18 of last year, I intro- November. I quote again from the last November. Earlier this month Vice duced S. 1962, the Social Security and White House: President GORE announced his support Medicare Safe Deposit Box Act. I did Instead, the projected baseline Medicare for this kind of proposal. On June 13, this because Social Security is not the surplus would be used to pay down the debt. GORE announced he would ‘‘place Medi- only trust fund that has been raised care in a lockbox so its surpluses could Mr. SPECTER. Mr. President, if I might interrupt the distinguished Sen- over the recent years, over decades. only be used to pay down the national ator from Missouri for a moment? Over the next 5 years, taxpayers will debt and to strengthen Medicare, not pay in an estimated $179 billion more Mr. ASHCROFT. I will be happy to for pork barrel spending or tax cuts.’’ yield with the understanding that at into the Medicare Part A trust fund I am pleased that the Vice President the conclusion of this interruption I than will be required to sustain the has endorsed this Medicare lockbox. I continue to have the floor for my re- purpose of that trust fund, which is pa- welcome that support. Obviously, when marks. tient hospital care in Medicare. he says ‘‘so its surpluses,’’ he is refer- The amendment I offer today will add The PRESIDING OFFICER. The Sen- ring to the kind of thing we are talking ator from Pennsylvania, without objec- the Social Security and Medicare Safe about—dedicated tax resources de- Deposit Box Act to this pending bill. tion. signed to support the program that are Mr. SPECTER. Mr. President, I The Social Security and Medicare Safe in excess of the needs of the program in Deposit Box Act takes the Medicare thank the Senator from Missouri. We any current year. were conferring about the last amend- Part A trust fund off budget and cre- As we have already recounted this ates a permanent 60-vote point of order ment so I was unable to be on the floor morning, there are 175 billion of antici- when this debate started. We are inter- in the Senate and a majority point of pated such surplus that would be di- order in the House against any budget ested in a time agreement. I have just rected toward the Medicare trust fund discussed the matter with the Senator resolution or subsequent bill that uses for Medicare Part A, which is the only Medicare Part A or Social Security from North Dakota, who has the sec- Medicare trust fund we have. I am ond-degree amendment. It would be in surpluses to finance on-budget deficits. pleased he would endorse this concept. This amendment protects the Medicare the managers’ interest to see if we I think it is a concept that is bipar- could limit debate to 1 hour equally di- Part A surplus in the same way we pro- tisan that deserves our support. vided on the first-degree and second-de- tect the Social Security surplus. It Two days ago, the President of the gree amendment, and then have votes says that Congress and the President United States called for protecting on both amendments. cannot consider the Medicare surplus Medicare Part A surpluses through a The PRESIDING OFFICER. Is there as part of the on-budget surplus. They lockbox. Allow me to quote from the objection? can’t look to this fund for ordinary President’s announcement. This is Mr. ASHCROFT. Reserving the right spending. Therefore, Congress and the from a text provided by the adminis- to object, I do not want to object, but President should be unable to spend tration: I want to clarify. How much time have the Medicare surplus for additional President Clinton is proposing to take I consumed already with my expla- spending or for additional tax cuts. Medicare off budget. This would mean that, nation? Maybe I should ask, is the hour This lockbox protects the Medicare like the Social Security surplus, the pro- jected $403 billion Medicare surplus would in addition to what I have already trust fund from the raids of the past. used? This is a historic time. I hope this will not count toward on-budget surplus and therefore could no longer be diverted for Mr. SPECTER. If it is acceptable to be a historic day. In this, an election other purposes. Taking the Medicare surplus the Senator from North Dakota. I year, we have an unusual bipartisan off-budget would ensure that Medicare is hadn’t discussed that with him earlier. opportunity to support this measure. It protected for paying down the debt to help Mr. ASHCROFT. What I want to do is is not surprising that this is the right strengthen the life of the Medicare Program. protect the right of my colleague, Sen- policy. It is the right thing to do. The So the President has recognized there ator ABRAHAM from Michigan, to make House of Representatives has already are funds specifically paid in, and that remarks. I don’t want to have con- taken this step to protect the Medicare they are in surplus of what is needed sumed all the time. That is what I am trust fund from invasion of spending immediately to be paid out. He has in- interested in doing. So if we can work for other Government programs. Last dicated that for those surpluses, we something out with that in mind, I am week, the House passed their version, a should be safeguarding them with a willing. little different version, of the Medicare Medicare lockbox. Mr. SPECTER. I ask the Senator lockbox legislation, by a vote of 420–2. Let me quote further from the White from Missouri, would 15 additional The House bill was offered by Rep- House release, because I believe the minutes satisfy you on your side? S6056 CONGRESSIONAL RECORD — SENATE June 29, 2000 Mr. ASHCROFT. Let’s say we would Mr. LOTT. Mr. President, just so no- I also say to the leader that it would take 20 additional minutes? body will get nervous, I want to talk be a big help to those of us on the floor Mr. SPECTER. I suppose we then about the schedule. I am working with if we could shorten the time of the have 30 minutes. I discussed 1 hour Senator REID on a couple unanimous votes. We wasted tremendous time yes- equally divided with the Senator from consent requests that we may offer terday. We wasted at least 21⁄2 hours on North Dakota, so you would have 30 later. But I wanted to talk about the votes when people weren’t here. We minutes and 20 minutes on the other progress being made and what our waited 20, 30 minutes for Senators on side? hopes are. both sides. I believe that if a vote is Mr. CONRAD. That will be accept- I realize this is a very big, very im- completed within 15 or 18 minutes, we able if the understanding is this is ‘‘on portant bill—the Department of Labor, should go on to something else. If peo- or in relation to,’’ any votes ordered Health and Human Services, and Edu- ple miss a vote or two, everybody’s for that period? cation Appropriations bill. It is impor- record will be down a little bit, and it Mr. SPECTER. We would have two tant we get it done, and it is important will be the same for everybody. votes then on the two competing we have a few minutes to think Mr. LOTT. Obviously, the Senator amendments: One on the Ashcroft through critical amendments that are from Nevada is correct. We do allow amendment, and one on the Conrad offered. We are in that process. I thank these votes to drag on too long, and we amendment. the managers for what they have been should be prepared to cut them off Mr. CONRAD. That would be on or in doing. I urge them to keep pushing for- after the 15 minutes and the 5-minute relation? ward. The number of amendments has overtime. On both sides we try to be Mr. SPECTER. On or in relation. been substantially reduced. The ones understanding, but the more we are un- Mr. ASHCROFT. Mr. President, I ob- still pending are not easy amendments. derstanding, the more it is abused by ject and suggest the absence of a But I think if we can keep focused, we our colleagues. So, for today, I will quorum. can complete this very important ap- work with Democrats and Republicans The PRESIDING OFFICER. The propriations bill at a reasonable hour and be prepared to cut these votes off. clerk will call the roll. today. It could save us a lot of time. The legislative clerk proceeded to I urge my colleagues, when they have Let me say to the Senator from Ne- call the roll. an amendment, when there is an vada, we would not be making the Mr. SPECTER. Mr. President, I ask amendment on both sides, that we find progress we have made on this and unanimous consent that the order for a way to accept them both or get a other bills without his diligence, his the quorum call be rescinded. vote on both of them and let the Sen- presence on the floor, and the hard The PRESIDING OFFICER. Without ate speak its will and then move on. I work he does. I appreciate that. Last objection, it is so ordered. think that would be the best way to do night, even though I was disturbed Mr. SPECTER. Mr. President, I ask it. unanimous consent that the Conrad What I really want to comment on about the timing because of commit- amendment and the Ashcroft amend- today about this bill, and others, is ments that have been made, we worked ment each be considered amendments that there are Senators thinking we that out and we got a lot of good work in the first degree; that there be 30 are going to finish tonight and there done last night. I thank those who were minutes for Senator CONRAD, 20 min- won’t be votes tomorrow. Senator involved. utes for Senator ASHCROFT, and that DASCHLE and I have been indicating for f there be votes on both of their amend- quite some time now that that is not UNANIMOUS CONSENT REQUEST— ments with no point of order being per- going to happen. We have to complete S. 2340 mitted, and that the time of the votes this bill. I still would like to go to the Mr. LOTT. I have a unanimous con- be determined later in the day by Interior appropriations bill. But we sent request I would like to propound agreement of the leaders. also have a very important military The PRESIDING OFFICER. Is there construction appropriations bill with a now. I believe the Senators involved in objection? title II that involves emergencies. That this are on the floor. I ask unanimous Mr. REID. Reserving the right to ob- has to be completed and considered by consent that the Senate turn to the ject. the House Rules Committee, the House consideration of the NCAA gambling Mr. SPECTER. The Conrad amend- has to vote, and then it comes over bill, S. 2340, and following the report- ment will be voted on first. here. That could be late this afternoon ing of the bill by the clerk, the com- Mr. REID. I was talking to Senator or tonight or tomorrow or later. If mittee amendments be immediately CONRAD. I apologize. there are complications, it could take agreed to. Mr. SPECTER. The unanimous con- more time than that. I further ask consent that there be 4 sent agreement provides that each I assure everybody that we are going hours of debate on the bill, to be equal- amendment, the Conrad amendment to be in session and voting tomorrow. I ly divided in the usual form, and only and the Ashcroft amendment, be con- think that hoping we can wave a magic relevant amendments be in order dur- sidered as amendments in the first de- wand and miraculously complete this ing the pendency of the bill. gree; that the Conrad amendment be bill and the other measures by a rea- Finally, I ask consent that following voted on first, that there be no points sonable time tonight is just not likely. the conclusion of the time and the dis- of order raised, that Senator CONRAD I wanted to say that now. Those who position of any amendments, the bill be will have 30 minutes, and Senator have planes booked for 10 o’clock to- advanced to third reading and passage ASHCROFT 20 minutes, and the time of night or 10 o’clock in the morning, you occur, all without any intervening ac- the votes will be determined later in better start making other arrange- tion or debate. the day by agreement of the leaders. ments, unless you are willing to miss I know Senator REID will want to Mr. REID. Mr. President, if the Sen- votes. Quite often, some Senators make some comments. This is an issue ator will allow us to go into a quorum think that if enough of us leave, there that has been pending for some time. call for a minute, Senator CONRAD and won’t be votes. That is not going to be We have tried to find a way to have it I have a couple of things about which the case this time. This work is too im- as an amendment on other bills. I know we want to talk. I suggest the absence portant. I urge my colleagues to help Senator BROWNBACK has been diligent of a quorum. us get this very important work done and also very much interested in this The PRESIDING OFFICER (Mr. FITZ- in this critical week. matter, as are other Senators, includ- GERALD). The clerk will call the roll. Mr. REID. If the Senator will yield, I ing Senator MCCAIN. The legislative clerk proceeded to say to my colleagues that I was here Senator REID has indicated he would call the roll. last night about 7 o’clock when the ma- like to work with us on it. But I will Mr. LOTT. Mr. President, I ask unan- jority leader came to the floor. To say let him speak for himself. imous consent that the order for the that he was upset is an understate- Part of what I am doing here is this: quorum call be rescinded. ment. I heard him clearly that there I made a commitment to the sponsors The PRESIDING OFFICER. Without will be no more windows for the end of to try to find a way to consider this on objection, it is so ordered. this session. some bill, or freestanding at some June 29, 2000 CONGRESSIONAL RECORD — SENATE S6057 point. In order to complete work on the germane, so we can deal with that im- points of order raised. Senator Department of Defense authorization portant issue. I will be glad to work ASHCROFT will have 20 minutes because bill, now that we have worked through with Senator KENNEDY or anybody else he already had time to speak. Senator the disclosure issue, this issue is one to try to get that agreement. CONRAD will have 30 minutes to speak. we also need to find a way to address. Mr. BROWNBACK. Mr. President, if I ask unanimous consent. That is why I am asking for this con- the majority leader will be willing to Mr. REID. Mr. President, reserving sent. yield for a moment, I appreciate his of- the right to object, the only addition I Mr. President, I submit that unani- fering this unanimous consent request. would like is that the two votes occur mous consent request. I note that we have considered a num- at 2 o’clock. We would be happy to The PRESIDING OFFICER. Is there ber of items on various bills—whether have other amendments. Can we finish objection? it has been items on prescription drugs the debate on this? I know Senator Mr. REID. Mr. President, reserving or different items that have come for- LAUTENBERG, our ranking member of the right to object, I know the deep- ward. the Budget Committee, wishes to ness of feeling of the Senator from This is one that has cleared through speak. Senator CONRAD wishes to speak Kansas, Mr. BROWNBACK. I have spoken the committee by a strong vote of 13– on this matter. There are other Mem- to him personally. I understand how he 2 with wide bipartisan support. The bill bers who want to speak. I think it feels about this issue. I also feel very itself has broad bipartisan support would be appropriate to lock in the strongly about this issue. across the country. It is an important time on this. I am willing to work with the Repub- issue. We are having a lot of difficulty Mr. SPECTER. Mr. President, if I lican leadership and my leader to try with regard to our student athletes might respond, we want to come back to work out some kind of freestanding being involved in gambling themselves to the Daschle amendment with the bill so this matter can be fully debated. and referees in sporting events being second-degree amendment. We want to This is not an appropriate time to do involved in gambling. The NCAA and come back to the Dorgan amendment. it. I say respectfully to the Senator many of the sporting groups are saying We have a Helms amendment. I urge from Kansas and the majority leader this is a problem. that we defer these votes until later that we simply can’t do this now. Bigger than all of that, the lead gate- when we can have 10-minute votes. Per- I have been here since Thursday on way for college students getting into haps we can get the majority leader to the Labor-HHS bill that is before us. I addictive gambling is through sports crack the whip, and, as the Senator arrived home late last night, as every- wagering. What we are trying to deal from Nevada suggested, stay on the one else did. We are trying to carve out with is the one place in the country floor and limit them to 10 minutes, if amendments. This is just not an appro- where this remains a problem and we are going to finish this bill by mid- priate time to do it. where it remains legal. afternoon. I say to my friend from Kansas that I think we need to have a bill up and Mr. REID. There is no problem with I respect how he feels about this. There a vote. that. I hope we do not vote before 2 are strong feelings on this issue. This I ask my colleague from Nevada—he o’clock on these matters. is an issue which should be debated. At has been so persistent on a number of Mr. SPECTER. We will not vote be- an appropriate time, we will do that. different issues to bring up to the fore 2 o’clock. Therefore, I object. floor—when can we get this one up so May we proceed, Mr. President? Mr. KENNEDY. Mr. President, will we can have a set timeframe for de- The PRESIDING OFFICER. Is there the Senator from Nevada yield? bate? If the Senator from Nevada objection? Mr. REID. I would be happy to yield. would like to have a long period of Mr. ABRAHAM. Mr. President, re- The PRESIDING OFFICER. Objec- time, that is fine. I am willing to go as serving the right to object, I want to tion is heard. short as an hour equally divided. But clarify: How much time will be avail- The majority leader has the floor. can we get some idea of when we could able on the Ashcroft amendment? Mr. SPECTER. Twenty minutes is re- Mr. LOTT. Mr. President, will the do this? quested. Senator withhold his objection? The PRESIDING OFFICER. The Sen- Mr. ABRAHAM. I would only indi- Mr. REID. I would be happy to with- ator from Nevada. cate that I know Senator DOMENICI hold. I withdraw my objection. Mr. REID. Mr. President, under the wishes to speak on this issue as well. I also say this: Seeing the Senator reservation, I will not reply to the sub- Mr. SPECTER. Would the Senator from Massachusetts here floods my stance of the statement made by my mind with the work that needs to be like 30 minutes? friend from Kansas, but there are mer- Mr. ABRAHAM. I think at least that done in this Chamber. We need to in- its on both sides of this legislation. I troduce the minimum wage bill. We much time. would be happy to work with leader- Mr. SPECTER. We will take 30 min- have the Patients’ Bill of Rights and ship to find a time to bring this bill to utes. It will save time in the long run. prescription drugs. We have things to the floor. Mr. REID. Now we have others who do on education. In addition to my per- In the meantime, I object. wish to speak. How long does Senator sonal situation, I know the Senator The PRESIDING OFFICER. Objec- CONRAD wish to speak? from Massachusetts is concerned about tion is heard. Mr. CONRAD. As long as it takes to those bills. The Senator from Pennsylvania. persuade my colleagues to vote for it. Mr. KENNEDY. Mr. President, if the f Mr. REID. As articulate as the Sen- Senator will yield for just a brief obser- THE DEPARTMENTS OF LABOR, ator is, that should only take 10 min- vation, as I understand the request of utes. the majority leader, this does not in- HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED Mr. CONRAD. I need about 20 min- clude any request to bring back the re- utes. authorization of the Elementary and AGENCIES APPROPRIATIONS, 2001—Continued Mr. REID. We should reserve 10 min- Secondary Education Act. Did the Sen- utes for Senator LAUTENBERG. ator from Nevada hear that clearly? I Mr. SPECTER. Mr. President, I think Mr. BAUCUS. Mr. President, I would did not hear that clearly. we are now prepared to go ahead with like to be able to speak about 5 min- Mr. REID. That is true. the Ashcroft amendment and the utes, if possible. Mr. KENNEDY. That is not to be in- Conrad amendment. Mr. SPECTER. Now we are up to 35 cluded. We propounded a unanimous consent minutes. Mr. LOTT. Mr. President, I did not before, but I will repeat it. Mr. President, the unanimous con- include that. But I would be happy to There will be two votes on amend- sent request is modified to 35 minutes. work up an agreement where we could ments, each treated as a first-degree Mr. REID. Now we are up to 55. bring that back and have germane amendment. The first vote will be on Mr. NICKLES. We want equal time. I amendments on the Elementary and the Conrad amendment in regular insist on equal time. Secondary Education Act, have an order. The second vote will be on the Mr. SPECTER. We have already had agreed-to list of amendments that are Ashcroft amendment. There will be no a considerable amount of time. S6058 CONGRESSIONAL RECORD — SENATE June 29, 2000 Mr. NICKLES. I would be happy to ment also requires the President to risk Medicare because of a failure to yield it back if we don’t need it. I want protect Medicare and Social Security protect Medicare from raids for other equal time. by submitting a budget that does not purposes. We have been through this on Mr. SPECTER. Mr. President, I sug- spend either surplus. We make these Social Security. gest the absence of a quorum. changes. They are beneficial changes The amendment I am offering says The PRESIDING OFFICER. The for the people. I call upon the Members we are going to treat Medicare the clerk will call the roll. of this body to enact a Medicare same as we are treating Social Secu- The assistant legislative clerk pro- lockbox that is durable and strong and rity. Unfortunately, the amendment of ceeded to call the roll. real—not one with loopholes but one the Senator from Missouri fails to do Mr. SPECTER. Mr. President, I ask that will protect Part A Medicare sur- that. It suggests it is a Medicare unanimous consent that the order for pluses for expenditure for their in- lockbox, but it really isn’t. When we the quorum call be rescinded. tended purpose. examine the amendment of the Senator The PRESIDING OFFICER. Without It is with that in mind I ask my col- from Missouri, we find there is a fatal objection, it is so ordered. leagues to vote in favor of the amend- flaw. The fatal flaw is that the Senator Mr. SPECTER. Mr. President, I ask ment I proposed. from Missouri has no enforcement unanimous consent we proceed with 45 I ask unanimous consent the Senator mechanism for its provision taking minutes on each side to get this mov- from Michigan, Mr. ABRAHAM, and the Medicare surpluses off budget. In fact, ing. Senator from Wisconsin, Mr. FEINGOLD, it does not move Medicare off budget. The PRESIDING OFFICER. Without be included as a cosponsors. It only removes Medicare surpluses off objection, it is so ordered. The PRESIDING OFFICER. Without budget. The Senator from Missouri. objection, it is so ordered. The result is, under the Ashcroft Mr. ASHCROFT. I yield myself 5 Mr. ASHCROFT. I yield the floor and amendment, no point of order would minutes. I reserve the remainder of my time. apply against legislation that uses Mr. President, I previously spent AMENDMENT NO. 3690 Medicare surpluses for other reasons. some substantial time in talking about The PRESIDING OFFICER. The Sen- Under the Ashcroft amendment, the the need for a Medicare lockbox. I ator from North Dakota. Medicare trust fund could be depleted spent time indicating that as Social Mr. CONRAD. Mr. President, I rise for any purpose, as long as the overall Security is off budget, I think it would today to offer a lockbox amendment budget remained in balance. Unfortu- be good to protect Medicare with a with Senator LAUTENBERG and Senator nately, because of the way the amend- lockbox. In addition to talking about REID designed to protect Social Secu- ment of the Senator from Missouri has the common sense of not taking trust rity and Medicare. been drafted, it is opening Medicare to funds and spending them for things This amendment is simple but impor- raids for other purposes. That is a fatal other than that for which they were tant. flaw. That is what my amendment cor- paid into the trust fund, I indicated First, it says we must protect Social rects. My amendment takes Medicare there were a broad group of people who Security surpluses each and every trust fund surpluses off budget, pro- supported this concept, including the year. The budget has finally been bal- tecting them with points of order so Vice President, who has endorsed the anced without counting Social Secu- there could not be a raid on Medicare. concept of a Medicare lockbox, and the rity, and we must make sure it stays Let me make my point as clearly as President of the United States, who balanced without counting Social Se- I can. If we look at the fiscal year 2000, very recently has endorsed the concept curity and Medicare. we have a unified surplus projection of of a Medicare lockbox. Second, my amendment takes the $224 billion. Social Security is in sur- I was in the midst of reading an ex- Medicare hospital insurance trust fund plus by $150 billion. We will not permit tensive set of points that had been surpluses off budget to prevent those that to be raided. made available by the White House surpluses from being raided for any- Medicare is in surplus by $24 billion. supporting the concept. I believe the thing but Medicare. We will not permit that to be raided concept is worthy of our support. According to the Office of Manage- under my amendment. But under the I think it is important that we do it ment and Budget, the Medicare trust amendment of the Senator from Mis- with integrity, that we don’t leave any fund will run a surplus of over $400 bil- souri, one could take every penny of gaping holes or opportunities for the lion from the year 2001 to 2010. Taking the $24 billion in surplus in Medicare lockbox to be invaded or otherwise dis- these surpluses off budget and locking because the overall budget would still persed. It is important we not have a them away will ensure that they are be in balance. That is the fatal flaw of lockbox that appears to be a lockbox used only for Medicare and to pay down the amendment of the Senator from that doesn’t satisfy the idea of a the debt. Taking the Medicare trust Missouri. The Senator does not protect lockbox. fund off budget, as in Social Security these Medicare funds if the overall I hope Senators will join with me and off budget, will ensure that these pay- budget is in balance. I don’t know if with an almost unanimous House of roll taxes that workers pay will be used that was realized by the other side, but Representatives and join the President to meet the future demographic chal- that is a fatal flaw. That is why the and the Vice President of the United lenges Medicare and Social Security amendment of the Senator from North States, who have all voiced support for face. Dakota, my amendment, the amend- this concept of a Medicare lockbox. We have reached a bipartisan agree- ment I am offering with Senator LAU- When I came to Washington 5 years ment that Social Security belongs off TENBERG and Senator REID, is critically ago, people said it would be impossible budget and that its surpluses should be important; we would prevent any raid to balance the budget, but we did it. preserved solely for Social Security. on Medicare funds. They said we could not and would not For seniors, Medicare is just as criti- Our lockbox is simply stronger. We balance the budget without using the cally important for financial independ- establish points of order that protect Social Security trust fund. We have ence in their golden years. It is now the integrity of the Medicare trust done it. And there are those who say time to give the same protection to fund in each and every year. Our plan we cannot and will not balance the Medicare that we already accord to So- was drafted to make the Medicare trust budget and protect Medicare Part A cial Security, by taking Medicare off fund status exactly the same as Social surpluses. But we can and we will. We budget, too. Security. For some reason, the amend- are more than halfway to this point. Medicare is absolutely critical to the ment of the Senator from Missouri has The House has voted. The President health and economic well-being of been drafted differently. It does not has expressed himself in support of a nearly 40 million senior citizens. Be- give the full protections to Medicare lockbox, as has the Vice President. fore Medicare, many of our senior citi- that we have given to Social Security. Now it is the Senate’s turn. zens were one major medical event Why not? I believe the Senate will sign a Medi- away from poverty. Today, our seniors If we look at the Congressional Budg- care lockbox measure. That would send enjoy the security of knowing Medicare et Act of 1974, and I direct my col- a powerful message. A lockbox amend- is there for them. We should not put at leagues to page 17, on the bottom of June 29, 2000 CONGRESSIONAL RECORD — SENATE S6059 that page are laid out the specific pro- struct a lockbox here to protect Medi- lot of the credit for that. He has taken tections we provide for Social Secu- care, not a figleaf that will make peo- the lead and put this issue at the fore- rity. We provide them for Medicare in ple believe we protected Medicare but front of the public agenda. With the the amendment that I am offering. The really open up a gigantic loophole that spotlight now clearly on the Congress, Senator from Missouri has failed to do would allow for raids on Medicare as I am optimistic that we will respond. so. He has left them out. For some rea- we used to see on Social Security. We should not respond with half- son he is giving lesser protection to This is a defining vote. Those who hearted measures, like the bill ap- Medicare than we give to Social Secu- care about protecting Social Security proved in the House of Representatives rity. My amendment solves that fatal and Medicare, and are serious about it, or the pending Ashcroft amendment. flaw that is in the amendment of the will support our amendment. Those We should do ti right, and that means Senator from Missouri. who want a figleaf and a press release taking Medicare completely off-budget, In our plan, we treat Medicare simi- will be in opposition. with all the procedural protections now lar to Social Security by excluding all I yield the floor. provided to Social Security. receipts and disbursements of the Fed- The PRESIDING OFFICER. The Sen- That is what this amendment does. eral Hospital Insurance trust fund from ator from New Jersey. Who yields It treats Medicare just as we are al- budget totals. We exclude the Medicare time? ready treating Social Security. It says: trust fund from sequestration proce- Mr. LAUTENBERG. Mr. President, I Medicare, like Social Security, will dures and create parallel Budget Act think the Senator from North Dakota now be taken completely off of the points of order to protect the surplus is going to yield the time. How much Government’s books. It will not be in the Medicare trust fund in each and time do the proponents of the second- counted in the President’s budget cal- every year. degree amendment have remaining? culations. It will not be counted in the Our plan also creates a new point of The PRESIDING OFFICER. The pro- budget resolution, and it will not be order against legislation that would ponents have 34 minutes remaining. used as a piggy bank for tax breaks, or cause or increase an on-budget deficit. Mr. LAUTENBERG. Mr. President, I for any other Government programs. rise in support of the second-degree So it protects the integrity of the The legislation also creates points of amendment, which I am pleased to be Medicare trust fund and the on-budget order against any legislation that cosponsoring with Senator CONRAD. surplus for debt reduction. Our plan would deplete the Medicare Hospital This amendment would establish a also strengthens existing protections Insurance Trust Fund for any other lockbox to protect both Social Secu- for Social Security by enforcing points purpose. Similar points of order al- rity and Medicare surpluses from being of order against reducing Social Secu- ready apply for Social Security. Medi- raided to pay for other programs or tax rity surpluses in each and every year. care deserves the same protections. The Ashcroft amendment is silent on breaks. The amendment would take Social Security. It has verbiage there, Medicare completely off-budget, and it In addition, the amendment would but there is no new protection for So- would add iron-clad guarantees to en- protect Medicare from across-the-board cial Security in the amendment of the sure that neither Social Security nor cuts that could be triggered if Congress Senator from Missouri. Our amend- Medicare surpluses can be used for any exceeds other budgetary limits. Under ment adds a point of order against vio- other purposes. current law—the so-called ‘‘pay-as-you- lating the off-budget status of Social This amendment is based on a pro- go’’ rules—if Congress raids surpluses Security and requires Social Security posal first put forward last week by either for tax breaks or mandatory spending, Medicare automatically gets revenues and outlays to be set forth for Vice President GORE. And I want to every fiscal year in a budget resolution commend the Vice President for his cut. That is not right, and that will end rather than for only the 5 years under leadership in this area. As he has ar- under this amendment. current law. gued so forcefully, it is wrong for Con- In addition to taking Medicare off- In addition, we strengthen existing gress to use Social Security or Medi- budget, the amendment also strength- points of order protecting Social Secu- care surpluses as a piggy bank either ens existing rules that protect Social rity by enforcing points of order for tax breaks or new spending. In- Security. For example, the amendment against reducing the Social Security stead, Social Security and Medicare would establish a supermajority point surplus in every year covered by the should be taken off the table, and out of order against any measure that budget resolution rather than only in of the Federal budget. would put Social Security back on the first year and the total of all years Social Security already is officially budget, or violate the prohibition covered by the budget resolution as off budget. That is the law. There is a against including Social Security in a current law provides. bipartisan consensus that we should budget resolution. The amendment I am offering with not use Social Security surpluses for Our amendment also strengthens ex- Senator LAUTENBERG and Senator REID any other purpose. We all agree on isting law by requiring every budget is very clear: We are protecting Social that. resolution to include Social Security Security and Medicare in a lockbox But what we have not all agreed on is totals for each year covered in the res- that has real protections, and we treat that Medicare surpluses should be pro- olution, and then establishing a point them in the same way. Unfortunately, tected, as well. of order to protect those funds in each the proposal of the Senator from Mis- Senate Democrats have long argued year. This is an improvement over cur- souri creates a difference between the that Medicare must be included in any rent law, which protects Social Secu- protection we provide Social Security Social Security lockbox. That is why rity surpluses in the first year of a and the protection we provide Medi- last year, when Republicans sought to budget resolution, and for the entire care. The Senator from Missouri pro- move a lockbox that dealt only with period of the resolution, but not in vides much less protection for Medi- Social Security, we held firm and in- each individual year. There is no simi- care than we provide Social Security. sisted on our right to offer at least one lar provision in the pending Ashcroft It has a fatal flaw: no enforcement amendment. The amendment we want- amendment. mechanism. The result is, under the ed to offer would have added Medicare Mr. President, I want to take a mo- Ashcroft amendment, the Medicare to the GOP proposal. ment to comment on the Ashcroft trust fund could be depleted for any But the Republicans were so opposed amendment. purpose as long as the overall budget to that, they pulled the bill from the The Ashcroft amendment is described remained in balance. That is a pro- floor. In fact, this happened several as taking Medicare offbudget, some- found mistake. times. Each time, we Democrats in- thing deserving consideration. But the The amendment of the Senator from sisted that Medicare be part of the proposed amendment does not really do Missouri would allow the Medicare equation. And, each time, Republicans it. It does not fully protect Medicare. trust fund surplus in the year 2000 to be said: No. And the public must know why it is an raided of every penny. We should not I am hopeful that Republican opposi- inferior proposal to the second-degree allow that. That is not a lockbox; that tion to protecting Medicare is soft- amendment proposed by Senator is a ‘‘leakbox.’’ We are trying to con- ening, and I give Vice President GORE a CONRAD and myself. S6060 CONGRESSIONAL RECORD — SENATE June 29, 2000 The Conrad-Lautenberg amendment budget and should not in any way be closes the lid, locks it, and throws the calls for more than a surface account- able to be tapped into by this Congress key away. That is the difference be- ing change. Yes, we take Medicare’s or any succeeding Congress to pay for tween the Conrad amendment and the Hospital Insurance Trust Fund off- any deficit, to pay for any tax cuts, to Ashcroft amendment. What the Conrad budget, and that’s important. But we pay for any other kind of spending in amendment says to a future Congress are also insisting that we include pro- which this Congress or any future Con- is, if you want a tax cut for the cedural protections against any budget gress wants to engage. wealthy, if you want to spend on some resolution or legislation that would use That is really what a lockbox is. You programs, go somewhere else to get the Medicare funds for other purposes, and take funds and you set them aside; you money. You can’t pry open the box in permit undermining its solvency. put them in a box and you lock it. That which we have Medicare and Social Se- We do that by establishing a process means you cannot tap into it. curity funds; that is to be used only for that will protect Medicare by requiring That is what the American people Medicare and only for Social Security. a 60-vote point of order against any want us to do with Medicare and with That is what the Conrad amendment legislation that would invade the trust Social Security. This is money that does. fund’s solvency to be used for other they have paid into out of payroll Don’t be misled that these two purposes. Under our amendment, if you taxes. This is money that has been set amendments are the same. They are want to use Medicare funds to pay for aside for them for Medicare—and for not the same. The American people tax breaks, or for anything else, you Social Security, if we are talking about should not be misled. If your goal is to will need those 60 votes to do it. Social Security. We are only talking set aside Medicare funds and put them That is not true of the prevailing about Medicare here. in a box but if a future Congress wants amendment, however. The Ashcroft The American people believe very it can go in and open the lid and scoop amendment isn’t really able to protect deeply about this; that no Congress some money out, vote for Ashcroft. Medicare. It does establish a point of ought to be able to say: We want to Maybe some people think that is legiti- order, a higher hurdle, that obstructs give a tax cut to the wealthy, and we mate. Maybe some people say: Well, we creation of a larger budget deficit. And are going to pay for it by taking it out should not tie the hands of future Con- that’s a good thing that will help pro- of the surplus. And if the only surplus gresses. If they want to take some of mote debt reduction. we have is Medicare, we will take it that Medicare surplus and use it for But preventing an on-budget deficit out of there, or, if the only surplus we something, let them open the lid on the is not the same thing as protecting the have is Social Security, we will take it box and take the money out. Medicare Trust Fund. out of there. Maybe some people here believe that. For example, if legislation was pro- What we are saying on the Demo- I don’t believe that. Senator Conrad posed that reduced revenues into Medi- cratic side is, no, no deal. We are going does not believe that because it is his care’s Trust Fund and increased the to take Social Security and Medicare amendment. What he says is, we will possibility of earlier Medicare insol- off budget, lock the money away, you put it in that box and lock it. The only vency, that legislation would not be cannot tap into it for tax cuts or thing you can use that money for is subject to a point of order under the spending or anything else. Medicare, just as we should only use present Ashcroft amendment. That is The Senator from Missouri may Social Security for Social Security. because, again, the Ashcroft amend- think that is what he is doing. I heard The PRESIDING OFFICER. The Sen- ment isn’t really designed to protect him describe his amendment as a ator’s 7 minutes have expired. the solvency of Medicare. It is only de- lockbox, taking it out, but that is not Mr. HARKIN. How much more time signed to prevent on-budget deficits. what his amendment does. His amend- remains on our side? And that just doesn’t go far enough. ment does not do that. It does not pro- The PRESIDING OFFICER. Ten min- The point of all this talk about Medi- tect the Medicare trust fund from pro- utes remain. care is to ensure that the program will cedures that might be used by a future Mr. HARKIN. Mr. President, I will still be solvent and strong in the fu- Congress to pay for spending or tax take 1 more minute. ture, when the baby boomers retire. cuts totally unrelated to Medicare. If you want to secure Medicare fund- Well, if you don’t protect Medicare’s I could get into the jargon used ing and you want to lock it away, you solvency, you are really not accom- around here by talking about points of have to vote for the Conrad amend- plishing that goal. order and sequestration and stuff such ment. If, however, you want to take That is why the Ashcroft amendment as that. Who understands what all that Medicare funding and put it in a box is grossly inadequate and why I urge means, unless it is just a few of us and say that future Congresses can go my colleagues will instead support the around here. And I am not certain all in there, open the lid and take the Conrad-Lautenberg second degree of us understand it either. money out for other things, then vote amendment. But just to put it in simple lay terms for Ashcroft. It is that simple. Mr. President, I yield the floor. that the American people can under- I yield back whatever time I have re- The PRESIDING OFFICER. The Sen- stand, the amendment offered by the maining. ator from Iowa. Senator from Missouri sort of puts the The PRESIDING OFFICER. The Sen- Mr. HARKIN. I yield myself, ini- Medicare surplus in a box. It closes the ator from Missouri. tially, 7 minutes. lid. That looks pretty good, but the Mr. ASHCROFT. Mr. President, I The PRESIDING OFFICER. The Sen- next Congress or two Congresses from yield such time to the Senator from ator from Iowa. now may decide: Hey, we have had a Michigan as he may consume. Mr. HARKIN. Mr. President, what we downturn in the economy. We might The PRESIDING OFFICER. The Sen- have before us is a genuine lockbox want to give a tax cut to a group. We ator from Michigan. amendment by the Senator from North might want to do some spending. We Mr. ABRAHAM. Mr. President, I will Dakota, and we have a ‘‘box’’ amend- don’t have enough of a surplus in our be brief because in many ways I am ment offered by the Senator from Mis- budget, but we do have a big surplus in very pleased with the direction of to- souri. Now, notice I said ‘‘lockbox.’’ A that box. In that box there is a big sur- day’s debate, particularly with the fact lockbox is what has been offered by the plus. We will just go open the lid and that it actually will result in some Senator from North Dakota; no scoop a little bit out. That is what the votes. We have been on the floor talk- lockbox by the Senator from Missouri. Ashcroft amendment allows. It allows ing about trying to lock up Social Se- That really is the difference. a future Congress to open the lid on the curity on many occasions. I was seek- What do I mean by ‘‘lockbox’’? What box, put the scoop in there, and dig ing to get a final vote on a lockbox I mean is that we are trying to treat some money out for whatever that that I think really does do the job of Medicare as we treat Social Security; Congress wants. protecting Social Security. I think we that we are going to say that in the fu- What the Conrad amendment does is did it four times and couldn’t get to a ture, the Medicare trust fund should be take the Medicare money our people final vote. off budget, should not be counted in have paid out of their payroll taxes and Today, we are moving in the direc- budget totals, that it should be off puts it in a box, just as Ashcroft does, tion of getting final votes on both a June 29, 2000 CONGRESSIONAL RECORD — SENATE S6061 form of Social Security lockbox and on people all over America, there is little Mr. CONRAD. On this side, we have 4 the issue of locking up Medicare. I doubt that one of the most frustrating minutes remaining. Obviously, we think that is an important step. things to people, whether they are al- would like to reserve some of that time While I am happy to support almost ready Social Security recipients or will for the purpose of making a statement any effort that makes it more difficult be in the future, is the fact that they at the end. to spend the Social Security surplus, I have watched as too many Social Secu- Mr. COVERDELL. How much time do not believe that the forms offered rity surplus dollars have been spent on remains on our side? today go as far as we should to ensure other things in order to make the def- The PRESIDING OFFICER. There a permanent off-limits nature of the icit appear smaller. I think they are are 30 minutes remaining. Social Security surplus. I hope the going to be very pleased this year when Mr. COVERDELL. Thirty minutes. spirit which we have seen today, of we end the fiscal year not only with a Mr. President, I yield 10 minutes of our working towards giving people options balanced budget but also without time to the distinguished Senator from to vote, is one that we can build on, spending one penny of Social Security West Virginia and do not object to the and that I will soon have an oppor- on anything but Social Security or the additional 5 minutes that would bring tunity to have a vote on the Social Se- reduction of debt. That is a sea change. him to his 15 minutes. curity lockbox proposal on which Sen- I don’t think we should lose sight of the circumstances in which it has come The PRESIDING OFFICER. The Sen- ator DOMENICI, Senator ASHCROFT, and ator from West Virginia. about. Senator ASHCROFT, myself, Sen- I have been working. Mr. BYRD. Mr. President, I thank I think it is a very productive debate ator DOMENICI, and others in the budg- et process have worked to make sure the distinguished Senator. I apologize to talk about treating the Medicare for imposing myself at this moment. surplus, the Part A of the Medicare there were in place the kinds of budget rules that precluded Social Security But I had noticed several quorums of trust fund, in the same fashion. The considerable length, and I thought this disagreements over details are ones surpluses from being spent on other things. This year taxpayers who have might be a good time to have a state- that ought to be something we can ment made. I thank all Senators. work out. been so disappointed in the past that I do not think implications of intent such moneys were used for other pur- ‘‘THE SEARCH FOR JESUS’’ with respect to the future spending of poses are going to receive the good Mr. BYRD. Mr. President, I found these dollars that are being made are news that they were not and that they disappointing Peter Jennings’ ‘‘The are not going to be in the future. In- on point with the intent of the draft Search for Jesus,’’ which aired on ABC deed, this year’s budget resolution, as Senator ASHCROFT has offered. I think Monday night. The promotions for the last year’s, incorporates the kinds of his goal is very clearly to try to pro- show promised a pilgrimage to the rules that will protect it. I am proud to tect the surplus in Social Security roots of Christianity, but I think what have been involved in the drafting of from being spent, period. I think that we were actually given was more of a those rules. slide show. is his motive. I will leave it to him to I am glad we are back on this topic. comment. All too often we are told by members It may not resolve it fully, in the con- of the media that they are constrained I think implications that there were text of the Labor-HHS appropriations any ulterior goals in his proposal are by time. Broadcasters divvy up air bill, but hopefully, after today, we have time into 30 seconds, 60 seconds, an off the mark. In fact, I hope people will at least set the precedent that we will hour, 2 hours, and they are constrained examine more closely his longstanding create these lockboxes, that we are not by these blocks, which are further con- position on this issue. While it may be going to prevent votes from being strained by their ability to sell adver- now, in the middle of a Presidential taken on final passage of the various tisements to support their use of time. campaign, that people are talking options that are out there, at least to about a Medicare lockbox, I remember get final votes on those options in In case after case, including that of Senator ASHCROFT talking about a some context. ‘‘The Search for Jesus,’’ too little time Medicare lockbox more than a year be- I look forward to bringing back an is devoted to providing a serious look fore the Presidential election and cer- even stronger Social Security lockbox at important issues. Whatever one’s tainly months before it was an issue in and for a chance to get a vote on the view of Jesus may be, it is hard to deny terms of the national Presidential de- version we have drafted. I would like to that few, if any, other lives have so af- bate. As a colleague, I appreciate the have that opportunity. fected our world and humanity as that fact that he was ahead of everybody I yield the floor. of Jesus Christ. Here is someone who else in trying to raise that issue on the The PRESIDING OFFICER. Who literally split the centuries in two. Senate side. We have worked together yields time? If neither side yields time, The questions and controversies sur- to try to move both of these issues time will be charged equally against rounding His life on Earth certainly de- today and in the past. both sides. serve more than the 2 hours devoted to I want to go on record in favor of The Senator from West Virginia is it by ABC. Two hours—in fact, much having mechanisms in place that pro- recognized. less than that when one subtracts the tect these trust funds from seeing Mr. BYRD. Mr. President, I ask unan- commercial time, which was substan- these dollars used for anything other imous consent that I may speak for 15 tial—hardly scratches the surface. than their purpose. One hopes that minutes out of order, without the time The program presented many provoc- would be the outcome. If not in the being charged to anyone. ative ideas. A very limited number of The PRESIDING OFFICER. Is there context of this legislation, then let us theologians, historians, and ordinary objection? folk had much to offer in the way of re- be honest about it: The likelihood that Mr. COVERDELL. Mr. President, re- this type of amendment is going to be serving the right to object, I know the searched information, speculation, the- able to survive the entire conference Senator from West Virginia has some ory, heartfelt notions, and simple process may be questionable. I hope by remarks he wants to make. We are faith. But they were given only seconds going on record—as I suspect by the about to get this tangle resolved. Does here and there to provide us with what end of this afternoon every Member of that side have any more speakers? may well have been valuable insight the Senate will—in favor of locking up Mr. REID. Mr. President, with all due and inspirational ideas. If there is a both of these surpluses, we will take a respect to my friend from Georgia, if topic that deserves plenty of time, this step in the direction of ultimately the senior Member of the Republican is it. And, I daresay, as much as it may achieving it. I certainly intend to come side wanted to come out and speak, we also cause what to many, including back to the Senate and, in the context would drop everything no matter what myself, is a distasteful commercializa- of legislation that can get to final pas- we were doing. I think we should give tion of religion, this is a topic for sage inclusive of such lockboxes, give the Senator from West Virginia the which I assume the network easily sold the Senate opportunities to support same opportunity. loads of advertising time—as appar- such an effort. Mr. COVERDELL. Mr. President, the ently it did for the broadcast Monday As I talk to constituents in my question is, Is there time on your side night. In this case, what actually aired State, and from comments made by that we might use? was light on substance, but heavy on S6062 CONGRESSIONAL RECORD — SENATE June 29, 2000 advertising, giving the effort the ap- And it’s not much more illuminating to ‘‘a rather minor character’’ in the political pearance, at the very least, of a high- watch. turmoil of the era. toned money grab. ‘‘Peter Jennings Reporting: The Search for To the credit of producer Jeanmarie Jesus’’—yes, Jennings gets top billing over I cannot be sure what motivated the Condon, ‘‘The Search for Jesus’’ does contain even the Messiah—supposedly aims to dis- many visually arresting images, and the pro- show, ‘‘The Search for Jesus.’’ Evi- cover what can be learned about ‘‘Jesus, the gram was for the most part beautifully shot dently, Peter Jennings and staff spent man,’’ in historical rather than religious by Ben McCoy. There are such piquant iro- months preparing for it, conducting terms. But can those two aspects of Jesus’s nies as a sign warning ‘‘Danger! Mines!’’ near interviews, researching, and traveling life really be separated? The danger is that a spot where it is believed John the Baptist to Biblical sites. But viewers were cer- what you’ll end up with is an exercise in and Jesus himself once preached. The first tainly done a disservice by the encap- myth-debunking potentially offensive to de- image on the screen is striking: a silhouette sulated version that the network pro- vout members of the Christian faith. And of the Bethlehem skyline today, a cross atop that is precisely what happens. vided. As much as any journalist may one building and a satellite dish atop an- The program, at 9 tonight on Channel 7, is other. try to let others do the talking, to give peppered with disingenuous disclaimers. ‘‘We Thus the program is handsomely produced the experts the floor, and to present a are very aware of our limitations,’’ Jennings yet stubbornly wrongheaded and bogus, often rounded, unbiased view, when it comes says at one point, though much about the seeming a gratuitous effort to cast doubt on right down to it, the finished piece—ex- program suggests journalistic arrogance and deeply and widely held beliefs. This isn’t cept on very rare occasions—reflects hauteur. He concedes that it is difficult for a really proper terrain for journalists to tra- the decisions, good or bad, of producers reporter ‘‘to get the story right’’ in this case, verse. It was a bad idea to do the show and and editors who must slice and trim to but isn’t it rather presumptuous even to try? it came out as flawed and muddled as anyone A little later, when Jennings says the ques- make their program fit into the time might have dreaded. tion of Jesus’s divinity is ‘‘a matter of Some of the padding in the two-hour time frame relegated to it by the network. taste,’’ he sounds ridiculously nonchalant slot is filled with modern, hip and usually The show’s conclusion—that Jesus about a topic of the deepest spiritual profun- dreadful recordings of hymns and religious was a man, that he existed—comes as dity. songs. A lot of territory, physically as well no revelation to anyone who has lost Devout Christians may not be the only as thematically, is covered, but for little someone dear and found solace only in ones taking umbrage. Whenever Jennings pa- purpose. At several of the shrines in the Holy the Trinity. As the program noted, rades into the Middle East, warning flags are Land, we see tourists with video cameras raised by American Jewish groups that have making their own personal documentaries there were others before and during His objected several times to what they see as a time who professed to be the messiah. about a visit to the Middle East. Some view- pro-Palestinian, anti-Israeli bias evident in ers would be quite justified in wishing they They came and went, sometimes by some of the anchor’s past work. could look at those tapes rather than at execution, and their followers were ei- Thus one can only groan and shudder when ABC’s misbegotten and misguided ‘‘Search.’’ ther executed alongside their leaders or Jennings, later in the broadcast, opens the It is a search that leads nowhere. Slowly. old can of worms about whether ‘‘the Jews’’ they found new ‘‘messiahs’’ in whom to Mr. BYRD. Mr. President, I yield the place their faith. But, as the ABC show or the Romans are more responsible for the crucifixion of Christ. Oh how we don’t need floor. noted, Jesus was an exception. There to get into that again. As it turns out, the f was something extraordinary—one issue is rather diplomatically skirted by one might say miraculous—in the way that of several guest theologians who says, tip- THE DEPARTMENTS OF LABOR, His death promoted the proliferation of toeing carefully, that ‘‘a very narrow circle HEALTH AND HUMAN SERVICES, His teachings, and in the fact that, of the ruling Jewish elite’’ probably did col- AND EDUCATION AND RELATED nearly 2,000 years after His crucifixion, laborate with the ruling Roman elite in nail- AGENCIES APPROPRIATIONS, 2001 ing Jesus to the cross. He continues to inspire followers —Resumed around the world. As for the resurrection of Christ, upon which the entirety of Christian faith rests, Mr. BROWNBACK. Mr. President, I There is, indeed, no need to go to the Jennings notes in his cavalier style that Middle East to find Jesus. He can be yield up to 15 minutes to the Senator there is ‘‘a wide range of opinions’’ about from New Mexico, the chairman of the found in any West Virginia hamlet or whether it occurred. Come, now. You believe Budget Committee. hollow. He can be found in the arid it or you don’t. That’s the range of ‘‘opin- West, among towering urban buildings, ions.’’ Anyone looking for scientific or his- The PRESIDING OFFICER. The Sen- and along peaceful ocean shores. torical ‘‘proof’’ is flamboyantly Missing the ator from New Mexico. In the words of Job, that ancient man Point. Mr. DOMENICI. Thank you very ‘‘All but the most skeptical historians be- of Uz, ‘‘Oh that my words were now much. I hope I don’t use all of the time lieve Jesus was a real person,’’ Jennings is and that I can yield Senator written! Oh that they were printed in a willing to concede. But one by one he sets book! That they were graven with an BROWNBACK time because he started about discrediting what Matthew, Mark, this great discussion with his amend- iron pen and lead in the rock for ever! Luke and John say about the miracles and For I know that my Redeemer liveth, divinity of Jesus, making a big fuss, for one ment, on which I support and commend and that He shall stand at the latter thing, over the fact that the four New Testa- him—the Ashcroft Medicare lockbox. day upon the earth.’’ ment books contain inconsistencies in their I have a pretty good suspicion that I do not judge the intentions or the recountings of the story. sometime soon it is going to be adopted Did a star in the east guide the Three Wise by the Senate. The Senator can take views of those who helped to put to- Men to the manger where Jesus was born? ‘‘I gether ‘‘The Search for Jesus’’ pro- great credit, being one who from the don’t think there were Three Wise Men,’’ a very beginning wanted to have a gram, but I know exactly where to biblical scholar huffs, and that’s supposed to place my faith. dispel that detail. Jesus may not even have lockbox on Social Security—and even Mr. President, I ask unanimous con- been born in Jerusalem but rather in Naza- joined in the real lockbox bill, which, sent that an article entitled ‘‘He’s ev- reth, Jennings says; does it make a particle incidentally, was not the lockbox we erywhere but here,’’ be printed in the of difference to the spiritual essence of the are considering for Social Security matter? today. He has been on the cutting edge RECORD. Sometimes Jennings is content with ‘‘anal- There being no objection, the article of new ways to save both the Social Se- ysis’’ of the most innocuous sort. Jesus curity trust fund and today on the was ordered to be printed in the ‘‘must have been a controversial figure’’ in RECORD, as follows: his own time, Jennings says. No kidding. But Medicare HI part of the trust fund. I rise to talk a little bit about the [From the Washington Post, June 25, 2000] mostly we get specious debunkery. Stories of Jesus performing miracles were most likely Social Security lockbox. HE’S EVERYWHERE BUT HERE ‘‘invented’’ by ‘‘the gospel writers,’’ Jen- First of all, everybody should think (By Tom Shales) nings tells us. Even as relatively mundane a for a minute. What kind of lockbox An essentially thankless task that proves detail as Jesus getting a hero’s welcome must the Democrats have when they also to be a pointless one, ‘‘The Search for when he entered Jerusalem on Palm Sunday have resisted a lockbox five times? Jesus’’ is likely to anger many of those who is dismissed: The crowd ‘‘may have been That was a lockbox we came up with see it—and merely bore others. A two-hour singing and shouting, but not necessarily for ABC News special, the documentary proceeds Jesus,’’ one of the ‘‘experts’’ opines. that the distinguished Senator from from a foolhardy premise and, in the end, It’s also suggested, despite the daring Jen- Michigan, Mr. ABRAHAM, introduced doesn’t accomplish much more than a dog nings pronouncement that Jesus was ‘‘con- with me and others. And five times the chasing its tail. troversial,’’ that Jesus may in fact have been Democrats have resisted it and have June 29, 2000 CONGRESSIONAL RECORD — SENATE S6063 not let us pass it. That ought to put up would acknowledge I came up with it. I last reference is to a provision that a little bit of a question: what is the am very proud of him. For a long time, says you can spend Medicare money for difference between the two, since all of he has been trying to get that voted on. Medicare programs. That is so we can a sudden today on an appropriations He has told people what he was for, as have a BBA add-back, a balanced budg- bill—which probably means amend- Senator ASHCROFT has. We have not et add-back, for Medicare, as we did ments are going to go nowhere other had a vote. last year. There is nothing mysterious than to make a little racket here—we We tried six times to get a lockbox about that. have two distinguished and good col- vote, and we were denied it by this in- The Senator from New Mexico asked leagues of mine adopting a Democrat stitution, by our fellow Senators on why we weren’t supporting the lockbox lockbox for Social Security. the other side. Then all of a sudden, on proposal he made previously. There are First, let me change that to six occa- an appropriations bill, with a pretty two reasons: No. 1, we got a letter from sions when we have offered a lockbox positive chance that the amendments the Secretary of the Treasury saying we put together. Most people who aren’t going anywhere because we can- that could threaten default on the debt check for a real lockbox, in the sense of not pass this kind of an amendment on of the United States; No. 2, our ana- what that word means, say ours will do an appropriations bill when it gets to lysts indicated that could threaten So- it and that others are questionable. the House—you can take it out the cial Security payments to those who Others are, in one degree or another, door and send it to the House, but you are eligible for Social Security. Those more easy to use in terms of violating are pretty sure if it is not dropped be- are the reasons we have not accepted the lockbox and spending the money fore getting to the House, it is prob- that lockbox proposal. elsewhere. ably dropped when you open the doors I didn’t just come here today pro- The reason they are different is that to the conference because it does not posing a lockbox. For 2 years, I have ours is real. In the very sense of a belong on this bill. I am not suggesting proposed a Social Security and Medi- lockbox written into law, ours is real. that either amendment is being offered care lockbox as a senior member of the Let me essentially tell you what we knowing full well it is not going any- Senate Budget Committee. Frankly, did. We calculated where the debt of where, but I am asking why doesn’t the our friends on the other side of the the United States would be if all of the Senate vote on the real lockbox for So- aisle have resisted. Social Security money were left in, if cial Security. If the choice is between the lockbox we knew the numbers, and if we put in We are going to have our vote today. proposal I have made today and the law and statute the level of debt each I am wondering whether the Senator lockbox proposal of the Senator from year for the foreseeable future. Then might give consideration to offering Missouri on the question of which is we said that statute locks that money the real lockbox and see where we stronger, there is no question which is in, except in the case of war or the case stand. I ask Senator ABRAHAM what he stronger. The amendment I have of- of economic emergency—we defined thinks of that idea in terms of being a fered is stronger. That is because there that as most economists do—and great chief proponent. is a fatal flaw in the amendment of the Mr. ABRAHAM. I spoke on the floor national disaster. Senator from Missouri. He provides no a few minutes ago and raised many of That is a lockbox. In order to spend enforcement mechanism for the provi- the same inquiries the Senator has it, we have to have a statute, a law sion taking Medicare surpluses off raised. I am disappointed, after so that will change that level of debt that budget. is related to Social Security. many efforts on our part to get a vote, Under the amendment of the Senator My friend on the Budget Committee, that we couldn’t. from Missouri, no point of order would On the other hand, I indicated I was Senator CONRAD, has for a long time apply against legislation that could use heartened that today at least there been a proponent of making sure we Medicare surpluses for other purposes. seems to be a willingness to begin to have the debt down, and I commend the Under the Ashcroft amendment, the give people votes on issues relating to Senator. He has been concerned about Medicare trust fund could be depleted the lockbox. I want to have the votes. Social Security, as have many of us. There is a clear distinction between for any purpose as long as the overall Essentially their lockbox is an invi- the lockbox we have authored together budget remained in balance. That is tation to waive the lockbox or, by a 60- and we want to have an opportunity for the fact. That is the reality. vote majority, get rid of it. Thus, that stronger lockbox to be considered. I notice the chairman of the Budget whatever you want you spend. I want it done soon. It ought to be done Committee never referenced the I urge, instead of the lockbox they on a vehicle that becomes a law. amendment the Senator from Missouri have before the Senate, serious consid- Mr. DOMENICI. One last point in ref- has before the Senate today. Never ref- eration of accepting the lockbox that erence to the Medicare lockbox off- erenced it. He talked about a lockbox Senator ABRAHAM, Senator DOMENICI, budget proposal that my friends on the proposal they have had previously—not and Senator ASHCROFT have tendered other side of the aisle have offered. about the lockbox proposal before us on six occasions. It is truly what the There is a giant loophole that we today. senior citizens deserve when speaking have never considered in the Social Se- I yield the floor. about lockbox. We should not be telling curity trust fund lockbox, nor is it con- Mr. ASHCROFT. Mr. President, I them it is a lockbox, but it can be sidered in their lockbox on Social Se- yield to the Senator from New Mexico waived simply on the floor of the Sen- curity. Current HI law permits all 4 minutes. ate. kinds of additions on the expenditure Mr. DOMENICI. For 10 years, we have How simple is it? We have just side of Medicare. had a written proposal with reference waived, for the two bills before the If we leave that language in, we are to the lockbox for Social Security and Senate, the Budget Act, which pre- opening that trust fund instead of clos- never have we put in language that cluded doing what they were doing. We ing it. When we take it off budget we said what their Medicare lockbox got up and said: Let’s waive it. We open it to spend it, which, to me, seems amendment says, that the surpluses could reach the point where we want to almost inconsistent with why we are can be used for spending related to the spend Social Security and Members doing it. programs currently in HI. As a matter could come to the floor with a vital I am not going to vote for either of of fact, we have used the money for So- program and say, just as we waived the the Democratic lockboxes because I cial Security with a lockbox, a Budget Act in order to take this off think the Medicare does not work and ‘‘verbal’’ like theirs, that never in- budget, let’s waive it to spend it. the Social Security is not a real cluded such language, and we have If you do the Abraham-Domenici- lockbox. spent the money on Social Security. Ashcroft lockbox for Social Security, I yield the floor. What I am saying is this is an invita- you have to introduce a bill, say we The PRESIDING OFFICER (Mr. tion to expansion and spending, rather want to change the debt limit as Social SMITH of New Hampshire). The Senator than an invitation to protecting it. We Security impacts it. Frankly, I am from North Dakota. could be making HI less solvent under very proud to have come up with that Mr. CONRAD. I say to my colleague this language rather than more sol- idea. I think my friend from Michigan and my friend from New Mexico, his vent. S6064 CONGRESSIONAL RECORD — SENATE June 29, 2000 The PRESIDING OFFICER. The Sen- The Senator from Michigan and the parted Secretary of the Treasury, were ator from Missouri. Senator from New Mexico have again in fact responded to by us in the modi- Mr. ASHCROFT. Mr. President, I raised the question of the lockbox they fications that we brought in the most yield to the Senator from Michigan so offered previously; not the lockbox on recent version of this lockbox. much time as he may consume up to 5 which we are about to vote, but what Certainly I am not going to get into minutes. they offered previously. The reason our the merits of that at this point, but the The PRESIDING OFFICER. The Sen- side resisted that lockbox approach is notion that because the Secretary of ator from Michigan. because we received a letter from the the Treasury argues that something Mr. ABRAHAM. Mr. President, I Secretary of the Treasury from which I could cause problems should prevent us want to comment, in response to the quote: from having a chance to vote on an comments of the Senator from North Our analysis indicates that the provisions issue—there are plenty of issues we Dakota, the following: The Senator Senators Domenici and Abraham and vote here where Cabinet members have from North Dakota has characterized Ashcroft were previously offering could pre- raised the specter of problems if such the stance of those of us who have not clude the United States from meeting its fi- votes or legislation were passed. supported his proposal for a Medicare nancial obligations to repay maturing debt It is pretty clear to me that notwith- and Social Security lockbox as resist- and to make Social Security benefit pay- standing the seemingly positive steps ing his efforts for 2 years. Resisting his ments, and could also worsen a future eco- taken today to give the Senator from nomic downturn. efforts is not, in my judgment, a proper North Dakota an opportunity to have characterization. We have not sup- That is the reason we resisted those his Social Security lockbox voted on, ported those efforts. But what we have plans, because they were flawed. That we are still going to meet impediments done today is provided the Senator is the same reason I believe the amend- in the effort to get ours voted on. I from North Dakota a chance to have a ment I have offered today, to have a would put the Presiding Officer and the vote on a proposal he has worked on Social Security and Medicare Senate on notice, we are going to keep and for which he has sought support. I lockbox—something I have proposed trying. We, unfortunately, may have to would like to distinguish that from for 2 years—is superior to the option go into the sorts of tactical approaches what I consider to be the accurate defi- we are actually voting on today. The that cause a lot of time to be taken nition of resistance, which is to not reason our proposal is superior, I be- when it seems to me we could accom- even give a vote to people who have a lieve, is because it protects Medicare. modate both sides on this fairly easily. legitimate proposal to bring to the It protects it in the same way we pro- In any event, we will keep pressing for- floor of the Senate, and I consider the tect Social Security: by points of order ward on it. amendment Senators DOMENICI and to make certain that it is not raided. I close by complimenting the Senator ASHCROFT and I drafted with respect to Unfortunately, the amendment of the from Missouri whose steadfast efforts a Social Security lockbox to be a le- Senator from Missouri does not have on both the Social Security lockbox as gitimate piece of legislation that de- that level of protection. He has less well as the Medicare lockbox front pre- serves the same consideration that we protection for Medicare than for Social dated the efforts of anyone else of will soon give the Senator from North Security. He does not have a point of whom I am aware, certainly on the Dakota. order that can apply against legisla- I say to the Senator from North Da- Medicaid issue. He has certainly dem- tion that would use Medicare surpluses onstrated his commitment to that. kota and his colleagues, I hope, in the for other purposes. The problem with spirit with which a vote is being of- Certainly his efforts to bring these that is under the Ashcroft amendment issues to the floor deserve all our fered on the proposal that he has the Medicare trust fund could be raid- today, we will get a straight up-or- praise and thanks. ed, could be depleted for any purpose as The PRESIDING OFFICER. The Sen- down vote on the proposal we have long as the overall budget remained in been offering because now that you ator from Missouri. balance. Mr. ASHCROFT. Mr. President, I have had this chance we will see what I thank the Chair. thank the Senator from Michigan for happens, obviously, both here and in The PRESIDING OFFICER. All time his kind remarks and for his commit- the conference that will follow the pas- under the control of the Senator from ment to maintaining the integrity of sage of this legislation. I would like to North Dakota has expired. Who yields have the opportunity to get a straight our Social Security and Medicare trust time? The Senator from Missouri. fund. Frankly, I thank the Senator up-or-down vote on the legislation that Mr. ASHCROFT. Mr. President, how on five or six or whatever number it is from North Dakota for coming to the much time remains? floor to engage in the debate about a separate occasions has been prevented The PRESIDING OFFICER. There re- from happening. That to me would be very important issue, as well as the main 17 minutes. the difference between resistance and other Senators who have come forward Mr. ASHCROFT. I yield to the Sen- lack of support. to indicate their support for dis- I do not ask the Senator from North ator from Michigan as much time as he continuing—or stopping—what has be- Dakota to vote for my proposal. I hope may consume up to 5 minutes. come a rather traditional exercise of he and his colleagues would at least Mr. ABRAHAM. Mr. President, I this Congress: spending money out of give us an opportunity to let all of us thank the Senator from Missouri. I the Medicare trust fund for other pur- cast our votes up or down on it. I hope cannot resist responding to the closing poses. we get that chance. I yield the floor. remarks by the Senator from North It is time for us to cease that kind of The PRESIDING OFFICER. The Sen- Dakota. I have to say, I interpret his expenditure. It is time for us to say the ator from North Dakota is recognized. comments as saying he and his col- trust fund, which is made up of taxes Mr. CONRAD. Mr. President, I am leagues, because they oppose or would specifically paid by working people— running out of time. The Senator from vote against the lockbox proposal we you have to work to pay the Medicare Missouri informs me he has 20 minutes have offered so many times, would not tax; it is a specific tax paid by working left. I have 2 minutes left. Under the even let us have an up-or-down vote on people—should be off limits to other rules, if neither of us uses time right it. I think that is unfortunate. expenditures. now, the remaining time of each of us I think the way the Senate works, I thank the Senator from North Da- is used equally, which means I would they certainly have an ability to pre- kota. I thank the Senator from Michi- run out of time. He has indicated that vent votes. But so do we. I hope we will gan. I thank the Senator from New is what he would do. If I do not take not have to get to the point where we Mexico. I am grateful for the others— this time for my final argument, we have to engage both sides in those the Senator from New Jersey and oth- just lose the time. Those are the rules kinds of tactics. We have certainly ers—who have talked about this issue. of the Senate. That is fair. demonstrated today a willingness to It is a major step forward. I say this. I am saying this for the have a vote on his Social Security There are a lot of folks who have benefit of colleagues on my side who lockbox proposal. The concerns he come to the floor talking about how are wondering if there is additional raised in the letter that was written by they wanted this for a long time. time available. Clearly, there is not. Secretary Rubin, the long-since de- Frankly, we have not had this kind of June 29, 2000 CONGRESSIONAL RECORD — SENATE S6065 debate on protecting the Medicare The Senator from Missouri is recog- because of Medicare; another time they trust fund in my memory. When I filed nized. waved an opinion that came from the this legislation last November, I was Mr. ASHCROFT. Mr. President, I ask Secretary of the Treasury. One of the not aware of any, and I still do not unanimous consent that I be allowed to reasons the Secretary of the Treasury know that there is, any other legisla- finish my remarks on this measure indicated he would not want to support tion similar to this that had been filed without further interruption. what we were offering was they might at that time. I am delighted we are The PRESIDING OFFICER. Without need to do additional spending in cer- making this progress. I commend peo- objection, it is so ordered. tain times in our economy. I under- ple on both sides of the aisle for this Mr. ASHCROFT. Mr. President, I stand there are those who believe progress. begin—— wanting to spend more is a reason not My amendment protects the Social Mr. REID. I am sorry, I was talking to do this, but the real reason for want- Security surplus as well. Social Secu- with someone else. What was the re- ing to do this is to spend less, espe- rity is off budget already. My amend- quest? cially to spend less of the money that ment prohibits on-budget deficits. Mr. ASHCROFT. Mr. President, I be- is in the lockbox. The Senator from North Dakota is lieve I have the floor. The Senator from North Dakota has talking about how durably he protects Mr. REID. I am sorry, I could not raised issues regarding the security of the Medicare trust fund with a point of hear the Senator’s request. the lockbox which I have proposed. A order that takes 60 votes in the Senate. The PRESIDING OFFICER. The Sen- good debate on these issues is impor- I am pleased for him to embrace that ator from Missouri has the floor, but tant and appropriate. As a matter of and to talk about it and say how good the Chair will repeat the unanimous- fact, we want to have the strongest it is, in part because that is the budget consent request, which was, he be al- lockbox we can. I would not come to rule which I proposed. lowed to finish the remainder of his this Chamber and offer lockbox legisla- Mr. DASCHLE. Will the Senator from time uninterrupted. tion that is not durable and not strong. Missouri yield for 30 seconds? If he will Mr. REID. I apologize. I do not think the Senator from North Mr. ASHCROFT. Mr. President, I yield for a couple of seconds, I want to Dakota would either. There are prob- tried to accommodate the Senators on yield 5 minutes of my leader time to lems with the proposal of the Senator the other side. When the leader from the senior Senator from North Dakota. from North Dakota. This particular the other side asked for 5 additional Mr. ASHCROFT. I yield the floor for phrase on the fifth page of his amend- minutes, I interrupted my own re- 5 minutes of leader time for the Sen- ment beginning with the words: ator from North Dakota. marks, and I thought it would be fair The PRESIDING OFFICER. The Sen- for me to have an opportunity to spend This paragraph shall not apply to amounts ator from North Dakota is recognized my time without being interrupted. I to be expended from the hospital insurance trust fund— for 5 minutes. will start over. Mr. CONRAD. Mr. President, I will I commend the Senator from North That is, Medicare trust fund—— not take 5 minutes at this point. I want Dakota for his concern and for coming for purposes relating to programs within to make the point that I appreciate the to the floor to debate this issue. I am part A of the Medicare as provided in law on Senator from Missouri. He is serious delighted we have now come to a place date of enactment of this paragraph. and sincere about an effort to provide a where we are debating ‘‘hows’’ instead Frankly, they may have a durable Social Security and Medicare lockbox, of if we are going to do it—how we are lock on that box; they may have rein- but when you look at the specifics of going to do it. Both of these measures forced corners on the box; they may what he has proposed, it falls short. provide a 60-vote point of order, which have a stout handle on the box; but if There is a fatal flaw. is a pretty high hurdle to climb over, there is a hole in the side of the box, Let’s look at fiscal year 2000. There is as a way of protecting Medicare. As a we have problems. projected a $150 billion Social Security matter of fact, that is the mechanism I appreciate the Senator from New surplus. That is protected. There is a that is used in the protection for Social Mexico raising this issue about poten- $24 billion projected Medicare surplus. Security. tial leakage from the box. What we Under the proposal of the Senator from The Senator from North Dakota has should be about, though, is not trying Missouri, every penny of the Medicare commended that as durable, strong, to find ways in which our proposals are surplus could be taken for other pur- vigorous, robust protection. It happens inadequate or whether there is a hole poses because the protection he pro- to be the protection which I placed in in his box or whether my super- vides is aimed at the overall budget the law as a result of an amendment I majority point of order is as durable as being in surplus, not at the Medicare offered in the budget process in pre- his supermajority point of order. We component being in surplus. So he has vious budget years so that we would should be about the business of pro- a lockbox that leaks. That is the prob- find ourselves incapable of infringing tecting the Social Security surplus and lem. the Social Security surplus. When we the Medicare surplus and doing it in a The reason the amendment I have of- adopted that amendment and embraced durable way and a way which means fered, along with Senator LAUTENBERG, it, we had tremendously good results. this Congress will not relapse into hab- the ranking member of the Budget This year, it looks as if there may be its that Congress engaged in for decade Committee, is superior is that it solves as many as $175 billion we will save, after decade. It is time for us to respect that problem. We do not have a leak. not spend; that we will respect instead the need for a lockbox. We have a budget point of order that of invade in terms of the Social Secu- prevails. rity surplus. That is a big positive. I filed the measure last November. In addition, the Senator from Mis- Really, what both sides of the aisle are Last month, Vice President GORE en- souri does not have Social Security talking about is getting the kind of ro- dorsed the concept of a lockbox. This protection. We do. We have additional bust, strong protection for Medicare week, 2 days ago, the President of the points of order that apply to make sure that we have for Social Security. United States said we ought to have a nobody raids Social Security. I have to say how much I appreciate lockbox to secure the Medicare box so Our colleagues are going to have a the remarks of the Senator from New that it would not be available for defining vote in just a few minutes: Do Mexico, the chairman of the Budget spending. I do not know what the you want to have the strongest protec- Committee, who talked about the fact Treasury said last year, but I know tion for Social Security and Medicare, we need protection in the statute, not what the President said last week. And or do you want a weak tea version? just in the budget rules. It is lamen- I agree with that. That is going to be the choice, and all table that each time we have sought to So it is possible to quibble here or of us are going to be held accountable upgrade that protection from the budg- there about one aspect of this or the for our votes. That is the point. et rules to a statute, there has been a other. It is instructive for me to know I yield the floor. filibuster on the other side. that these amendments were not pro- The PRESIDING OFFICER. Who They now say the reason they were posed until I came to the floor to pro- yields time? filibustering—one time they said it is pose this. S6066 CONGRESSIONAL RECORD — SENATE June 29, 2000 I am delighted that for the first time I want to work with folks on the other same way that we protect Social Secu- in my memory we are debating a Medi- side of the aisle who agree with me on rity? I would hope so. Because if we do care lockbox, in conjunction with a So- this issue. I am not opposed to the idea not, the hard reality is the amendment cial Security lockbox, that is durable. of our working together to get it done. of the Senator from Missouri would May I inquire as to the time remain- So I announce to my colleagues in permit us to go and raid every penny of ing? the Senate, I do not think it is a dif- the Social Security surplus or every The PRESIDING OFFICER. The Sen- ficult thing to vote for my amendment. penny of the Medicare surplus this year ator has 4 minutes 15 seconds remain- I think it is a very good amendment. I and use it for another purpose. That is ing. do not think it is a difficult thing to a mistake. Mr. ASHCROFT. So with that in vote for the amendment on the other In addition, the Ashcroft amendment mind, I commend to the Members of side of the aisle. is silent on Social Security, while the the Senate, generally, the concept of a I hope if we vote for these amend- amendment that I have offered adds a lockbox: a durable, secure, mechanism ments, and they are enacted, that we point of order against violating the off- that keeps this Congress from re- will be able to work together toward a budget status of Social Security. engaging in activities it has engaged in solution that really helps the Amer- I hope my colleagues will vote for the over time. ican people, that protects senior citi- Conrad-Lautenberg-Reid amendment As this measure moves forward, let’s zens from having the Medicare trust so we really protect Medicare in the do what we can to improve it in every fund violated, and from having the same way we protect Social Security. way possible. Let’s talk about a trust fund for Social Security violated That is what we ought to do here lockbox for Social Security that is as well. today. That is the opportunity we have statutory. I would like to see that done in stat- here today. We ought to take it. We I was delighted to be able to put it in ute as well as in the rules of the Sen- ought to protect Medicare and Social the budget rules of the Senate so that ate. It is with that in mind that I Security. We ought to adopt this it is out of order for someone to pro- thank the Members of the opposition lockbox proposal. pose spending Social Security income and those who have spoken on behalf of Mr. President, I ask unanimous con- trust funds for non-Social Security this amendment. I think we can work sent that Senator FEINGOLD be added purposes. But I would like to see it en- together for a really important pur- as a cosponsor of my amendment. The PRESIDING OFFICER. Without shrined into law. pose. We have talked about waiving budget objection, it is so ordered. I yield the floor. Mr. CONRAD. I thank the Chair and points of order. Obviously, I would like The PRESIDING OFFICER. The Sen- yield the floor. to have this be beyond a point of order. ator’s time has expired. The PRESIDING OFFICER. The Sen- I would be very pleased to have a law All time on the Conrad amendment ator’s time has expired. enshrined for the way in which we and the Ashcroft amendment has ex- All time on the Conrad amendment would enforce these rules. pired. and the Ashcroft amendment has ex- It is with that in mind that I express Mr. CONRAD. Mr. President, I had 3 pired. my appreciation to the Members of the minutes of leader time remaining. Mr. REID. Mr. President, I ask unan- Senate and say that our objective here The PRESIDING OFFICER. The Sen- imous consent that the yeas and nays is relatively uniform. From what I can ator is recognized for 3 minutes. be ordered on both amendments. tell from arguments made on the other Mr. CONRAD. Mr. President, first, I The PRESIDING OFFICER. Without side, to arguments made on this side, assure my colleague that my amend- objection, it will be in order to order we both want a lockbox. We both want ment was not in response to his. I had the yeas and nays on both amend- a lockbox that is durable. We want one filed for an amendment yesterday. I of- ments. that does not leak. We want one that is fered this amendment in the Finance Is there a sufficient second? enforceable. Committee yesterday. I have offered a There is a sufficient second. The lockbox—I think we are agreeing lockbox for Social Security and Medi- The yeas and nays were ordered. today—should be one that protects not care for 21⁄2 years—a different Medi- The PRESIDING OFFICER. The Sen- only Social Security but Medicare. care-Social Security lockbox than is ator from Pennsylvania. When we get this close to this kind of advocated here today by the Senator Mr. SPECTER. Mr. President, I ask agreement on an issue that is this im- from Missouri because I believe there unanimous consent that the second portant, I think it is time for us to is a fatal flaw in the amendment of the vote be limited to 10 minutes. work together. Senator from Missouri. The PRESIDING OFFICER. Is there I do not want to fight with my col- That fatal flaw is that his protection objection? The Chair hears none, and it is so or- leagues on the other side of the aisle. I does not work. It does not work be- dered. want to work with them. If we are cause, under the Ashcroft amendment, Mr. SPECTER. On the time of the close to having a durable Social Secu- no point of order would apply against votes that are about to occur, I remind rity lockbox and if we are close to hav- legislation that would use Medicare my colleagues of what Senator LOTT ing one that protects Medicare, I want surpluses for other purposes. The result said earlier today in response to what to do it. of that is, under the Ashcroft amend- the Senator from Nevada said, that I have been working on this for over ment, the Medicare trust fund could be Senators need to be prepared to have 2 years. Early in 1999, S. 502, the Social depleted for any purpose as long as the the time limits enforced. Security Safe Deposit Act, was incor- overall budget remained in balance. VOTE ON AMENDMENT NO. 3690 porated in the fiscal year 2000 budget That is the problem with the amend- The PRESIDING OFFICER. The resolution, and again in the fiscal year ment of the Senator from Missouri. question is on agreeing to Conrad 2001 budget resolution, with those That is the reason the amendment amendment No. 3690. The clerk will kinds of rules. That is why we have the that I have offered is superior. It is call the roll. durability of at least the rules. stronger. It provides real protection for The assistant legislative clerk called Finally, the Conrad amendment does Medicare, by way of special points of the roll. not offer stronger protection for Social order against a budget resolution that Mr. NICKLES. I announce that the Security than the Ashcroft budget would violate the off-budget status of Senator from New Hampshire (Mr. rule. It is the same thing. It is codified. Medicare Part A. GREGG and the Senator from Kentucky I think we can even do better than The fact is, the amendment of the Mr. MCCONNELL) are necessarily ab- that. I would like to do better than Senator from Missouri does not provide sent. that with a statute. the same protection to Medicare that Mr. REID. I announce that the Sen- While both offer the same point of we provide to Social Security. ator from Hawaii (Mr. INOUYE) is nec- order protection for Medicare, my Now, why would we do that? If we are essarily absent. amendment does not have the hole in serious about protecting Medicare, The PRESIDING OFFICER. Are there the side of the box and, as a result, I wouldn’t we have the same points of any other Senators in the Chamber de- think it is stronger. But, very frankly, order apply to protect Medicare in the siring to vote?–– June 29, 2000 CONGRESSIONAL RECORD — SENATE S6067 The result was announced—yeas 60, Smith (NH) Specter Thurmond lowing the debate on the two amend- Smith (OR) Thomas Voinovich nays 37, as follows: Snowe Thompson Warner ments. [Rollcall Vote No. 162 Leg.] Mr. SPECTER. Mr. President, it ap- NAYS—43 pears it will be faster to accept Senator YEAS—60 Akaka Edwards Mikulski DASCHLE’s recommendation, so I do so. Abraham Dorgan Levin Baucus Feinstein Moynihan Mr. DOMENICI. Reserving the right Akaka Durbin Lieberman Bayh Graham Murray Ashcroft Edwards Lincoln Biden Harkin Reed to object—I will not object—I ask if Baucus Feingold Mikulski Bingaman Hollings Reid you could add 5 minutes for the Sen- Bayh Feinstein Moynihan Boxer Johnson Robb ator from New Mexico on this general Biden Fitzgerald Murray Breaux Kennedy Rockefeller subject, your amendment. I ask 5 min- Bingaman Gorton Reed Bryan Kerrey Sarbanes Boxer Graham Reid Byrd Kerry Schumer utes be set aside for me. Breaux Harkin Robb Cleland Kohl Stevens Mr. DASCHLE. Mr. President, I ask Bryan Hollings Rockefeller Conrad Landrieu Torricelli that Senator JEFFORDS and I be given Burns Hutchison Roth Daschle Lautenberg Wellstone 30 minutes each. Byrd Jeffords Sarbanes Dodd Levin Wyden Campbell Johnson Schumer Dorgan Lieberman The PRESIDING OFFICER. Without Chafee, L. Kennedy Smith (OR) Durbin Lincoln objection, it is so ordered. Cleland Kerrey Snowe Who yields time? NOT VOTING—3 Collins Kerry Specter AMENDMENT NO. 3691 Conrad Kohl Torricelli Gregg Inouye Leahy Daschle Landrieu Voinovich (Purpose: To prohibit health discrimination DeWine Lautenberg Wellstone The amendment (No. 3689) was agreed on the basis of genetic information or ge- Dodd Leahy Wyden to. netic services) Mr. SPECTER. Mr. President, I move NAYS—37 Mr. JEFFORDS. Mr. President, I call to reconsider the vote. I move to lay up my amendment, amendment No. Allard Grams Nickles Bennett Grassley Roberts that motion on the table. 3691, and ask unanimous consent Sen- Bond Hagel Santorum The motion to lay on the table was ators FRIST and SNOWE be added as co- Brownback Hatch Sessions agreed to. sponsors. I ask unanimous consent also Bunning Helms Shelby The PRESIDING OFFICER (Mr. Senator ASHCROFT be added as a co- Cochran Hutchinson Smith (NH) Coverdell Inhofe Stevens SANTORUM). The Senator from Pennsyl- sponsor. Craig Kyl Thomas vania. The PRESIDING OFFICER. Without Crapo Lott Thompson Mr. SPECTER. Mr. President, I ask objection, it is so ordered. The clerk Domenici Lugar Thurmond unanimous consent that a Jeffords will report. Enzi Mack Warner Frist McCain amendment be modified to be for- The legislative clerk read as follows: Gramm Murkowski matted as a first-degree amendment. I The Senator from Vermont [Mr. JEF- further ask unanimous consent that at FORDS], for himself, Mr. FRIST, Ms. SNOWE, NOT VOTING—3 a time determined by the majority and Mr. ASHCROFT, proposes an amendment Gregg Inouye McConnell leader, after consultation with the mi- numbered 3691. The amendment (No. 3690) was agreed nority leader, a vote occur in relation (The text of the amendment is print- to. to the Daschle amendment No. 3688, to ed in today’s RECORD under ‘‘Amend- Mr. LOTT. Mr. President, I move to be followed by a vote in relation to the ments Submitted.’’) reconsider the vote. Jeffords amendment, with no other Mr. JEFFORDS. Mr. President, may Mr. SPECTER. I move to lay that amendments in order to either amend- I inquire of the Chair as to the amount motion on the table. ment prior to the votes. of time I have? The PRESIDING OFFICER. The Sen- The motion to lay on the table was I further ask consent that the time for debate prior to votes in relation to ator from Vermont has 30 minutes. agreed to. The Senator from South Dakota has the amendments be the following: Sen- The PRESIDING OFFICER. The Sen- 30 minutes. ate will now proceed to vote on the ator JEFFORDS, 25 minutes; Senator Mr. JEFFORDS. Mr. President, this Ashcroft amendment No. 3689. The yeas DASCHLE, 25 minutes. week’s announcement of the comple- Mr. DASCHLE. Mr. President, reserv- and nays have been ordered. tion of the rough draft of the human ing the right to object. The Chair reminds the Senate that genetic map is cause for both celebra- The PRESIDING OFFICER. The this is a 10-minute vote by previous tion and concern. order. The clerk will call the roll. Democratic leader. One of the challenges that comes to Mr. DASCHLE. I ask if the distin- The legislative clerk called the roll. mind immediately is that we must pro- guished manager of the bill would mod- Mr. REID. I announce that the Sen- tect Americans against genetic self-in- ify the request to allow for votes to ator from Hawaii (Mr. INOUYE and the crimination. What we are, should not take place immediately following the Senator from Vermont (Mr. LEAHY) are be used against us. disposition of the debate on the two necessarily absent. This vast new storehouse of knowl- amendments. The unanimous consent Mr. NICKLES. I announce that the edge must be used to advance, not re- did call for that. I assume that is the Senator from New Hampshire (Mr. tard, individuals’ health and welfare. understanding of the proponent of the GREGG) is necessarily absent. In 1998, the Senate Labor and Human unanimous consent request. Resources Committee held a hearing on The PRESIDING OFFICER. Are there Mr. SPECTER. Mr. President, it any other Senators in the Chamber genetic information and health care would be my preference to stack these which proved to be one of the most im- who desire to vote? votes at the end. We always run into The result was announced—yeas 54, portant of the 105th Congress. delays. We have a number of amend- Following the hearing, I and Senator nays 43, as follows: ments. If we vote in between, it is FRIST, with the other members of the [Rollcall Vote No. 163 Leg.] going to add considerable time to the HELP Committee, together with Sen- YEAS—54 bill. We will have three or four votes. It ator MACK and Senator SNOWE, began Abraham DeWine Inhofe will be my hope—it requires the Sen- drafting legislation that builds on Sen- Allard Domenici Jeffords ator’s consent, of course—that we ator SNOWE’s bill, S. 89, to ensure that Ashcroft Enzi Kyl stack the votes. Bennett Feingold Lott individuals would be able to control Bond Fitzgerald Lugar Mr. DASCHLE. Mr. President, I was the use of their predictive genetic in- Brownback Frist Mack asked to delay the consideration of this formation. Bunning Gorton McCain amendment this morning. I said I After a lot of hard work, we agreed to Burns Gramm McConnell Campbell Grams Murkowski would. I have been attempting to ac- a set of strong protections against the Chafee, L. Grassley Nickles commodate Senators all the way use of genetic information to discrimi- Cochran Hagel Roberts through. We have lost a couple of Sen- nate in health care. The results of Collins Hatch Roth ators already. I would be compelled to these efforts are reflected in the ge- Coverdell Helms Santorum Craig Hutchinson Sessions object to this unless we were able to netic information provisions of The Pa- Crapo Hutchison Shelby get the two votes immediately fol- tients’ Bill of Rights Plus. S6068 CONGRESSIONAL RECORD — SENATE June 29, 2000 As Dr. Francis Collins, director of A second challenge that we face is The PRESIDING OFFICER. The the public genomic effort, pointed out the possibility that employers might Democratic leader. this week: use genetic information to screen em- Mr. DASCHLE. Mr. President, we Most of the sequencing of the human ge- ployees for various purposes, discrimi- now know what this is all about. Some nome by this international consortium has nating against one group or another of our Republican colleagues are going been done in just the last fifteen months. based on genetic information. This, to try to convince a majority in this The pace of change is rapid, and this too, I think we should prevent. body that employment ought not be in- issue has increased in importance since I am not sure, and I do not think cluded when we consider discrimina- our hearing two years ago. anyone in this Chamber can be sure, tion based upon genetic character. I do Everyone in this Chamber and out- that we do not already do so. It was my not think employment discrimination side of it agrees we need to guard ge- understanding that the Americans should be treated differently from in- netic privacy and guard against genetic With Disabilities Act already outlawed surance discrimination. I do not think discrimination. genetic discrimination in employment. people who have experienced discrimi- Citing a study that found that 46 per- That was certainly Congress’ intent nation, as we have already seen in so cent of Americans thought that the when we enacted the ADA. many illustrations, ought to be told consequences of the Human Genome I am not alone in my belief. The they have to be concerned about their Project would be negative, Dr. Craig Equal Employment Opportunity Com- job simply because of some genetic de- Venter said: mission has interpreted the ADA as in- fect. That has already happened. We have New laws to protect us from genetic dis- cluding genetic information relating to crimination are critical in order to maximize illness, disease or other disorders and already seen that happen in case after the medical benefits from genome discov- the Supreme Court issued a decision case. I described a case this morning eries. that provided further support for this where Terri Seargent, who had moved That’s why it’s included in the Bill of position. up the corporate ladder and was given Patients’ Rights passed by the Senate As recently as March of this year, promotion after promotion, was asked as our body of scientific knowledge EEOC Commissioner Paul Miller stated to resign when it was learned that she about genetics increases, so, too, do that the ADA does indeed cover genetic had the genetic marker for ‘‘Alpha 1’’. the concerns about how this informa- discrimination. However, if I am mis- No woman, no man, no person, no em- tion may be used. taken, then this just highlights the ployee, should be subjected to discrimi- There is no question that our under- need for further examination of the nation based upon genetic characteris- standing of genetics has brought us to issue. tics, and that is happening today. ADA passed a long time ago. That a new future. Our challenge as a Con- I am also concerned that Senator law did not envision the challenges gress is to enact legislation to help en- DASCHLE’s amendment contains new science presents us today. We are sim- sure that our society reaps the full statutory language that is different ply proposing that we clarify that it health benefits of genetic testing, and from the ADA, which would result in should be unlawful to discriminate on also to put to rest any concerns that treating genetics differently than other the basis of genetic information. the information will be used as a new health care information. The bottom line question is, when it tool to discriminate against specific More and more, I think this will be comes down to these two proposals, ethnic groups or individual Americans. an increasingly difficult line to draw. whether we should prohibit both health Our amendment which is already in If that is not confusing enough, there insurers and employers from using pre- the Patients’ Bill of Rights, addresses is yet another definition of genetic in- dictive genetic information in a dis- the concerns that were raised at our formation that is part of the rule being criminatory fashion? There is agree- hearing two years ago: promulgated by the Department of ment, at least with regard to one issue: First, it prohibits group health plans Health and Human Services to protect we should prohibit health insurers and health insurance companies in all individually identifiable health infor- from doing it, but our Republican col- markets from adjusting premiums on mation. leagues—at least the senior Senator the basis of predictive genetic informa- I want to guard against employment from Vermont—are saying we just tion; discrimination, but I want to do it should not cover employers. We should Second, it prohibits group health right. not do it because he would like to have plans and health insurance companies The Health, Education, Labor, and us believe it is already being done. Tell from requesting predictive genetic in- Pensions Committee will hold a hear- that to Terri Seargent. Tell that to formation as a condition of enrollment. ing in the next month or two on ge- myriad other people who already have Finally, it bars health plans from re- netic discrimination in the workplace. had difficulty explaining their situa- quiring that an individual disclose or In the hearing, the committee will tion, in large measure because they authorize the collection of predictive explore whether the ADA adequately have found some genetic defect. genetic information for diagnosis, covers genetic discrimination in the We agree that insurance companies treatment, or payment purposes. A workplace. If we find that the ADA should not discriminate. We agree plan or insurer may request such infor- does not provide adequate coverage for there should not be any tests for condi- mation, but if it does, it must provide genetic discrimination in the work- tions of coverage. We simply disagree individuals with a description of the place then we will work to enact legis- at this moment about whether or not procedures in place to safeguard the lation that will provide adequate pro- we ought to take what we have already confidentiality of the information. tection. done for virtually every other form of Our amendment is identical to the However, I think it is important that discrimination in this country and ex- provision adopted by the Senate last any law we enact is in parity with the tend it to genetic information. July. We should adopt it again today. ADA and our other employment dis- The senior Senator from Vermont Technology and scientific develop- crimination laws. says no, he does not want to do that. ments, stimulated by the Human Ge- Senator DASCHLE’s amendment has But I cannot imagine that in this day, nome Project, have led to remarkable good intentions, but putting provisions in this age, given what we are doing progress in genetics and better under- regarding genetic discrimination in with the genome project and our rec- standing of alterations in genes that employment into an appropriations ognition of what it will mean, both are associated with diseases in humans. bill, without studying the issue fur- good and bad, for this country and for We should witness extraordinary op- ther, is inappropriate. This issue de- our people that now is not the time to portunities to diagnose, treat, and pre- serves and requires a thorough discus- ensure that, regardless of cir- vent disease. sion in its own forum. cumstance, we will not allow this to be With the enactment of this amend- Again, I urge adoption of my amend- used as a means of discrimination in ment, we will be able to ensure that ment. It has already been agreed to by the workplace. these breakthroughs will be used to the Senate, and it is the product of two Listen to what Francis Collins, one provide better health for all members years of thought and hard work. of the key people who headed the inter- of our society. Mr. President, I yield the floor. national research team that makes up June 29, 2000 CONGRESSIONAL RECORD — SENATE S6069 the human genome project, said about dict that a person has a 75-percent now. But I do not know enough about this very issue: chance of getting prostate cancer 10 it until we can talk to people broadly. Genetic discrimination in insurance and years from now or a 90-percent chance This whole expansion of penalties in the workplace is wrong and it ought to be a person will have breast cancer. the fourth section of the bill, I do not prevented by effective Federal legislation. The potential good is the change in know exactly what we are penalizing, if This is from the head of the research behavior, the change in lifestyle, the it is just that one statement of penal- unit. He does not have any question change in the intervention that can izing people who use genetic informa- about whether or not ADA covers ge- come about to preempt, preclude, stop tion. First of all, it depends on what netic discrimination. He has already the progress of cancer. that definition is—which I do not agree decided. He is the head of the research Unfortunately, as has been laid out with—but if it goes beyond that—and I team. He said this ought to be a wake- and debated today, there are potential don’t know whether it does—I need to up call; let’s ban it today. He did not dangers, potential harm, if that infor- know that. say let’s wait for more hearings. He did mation is misused. Should policy- I say all that because this amend- not say let’s get out there and try to makers address this potential abuse of ment Senator DASCHLE has offered sim- figure out a way to do it through regu- genetic information in the workplace? ply has not been vetted. It has not been lation. He said this ought to be a wake- There is no question; yes, we have a re- discussed. I have been involved in the up call. That is not TOM DASCHLE; that sponsibility. genetic debates with my colleagues on is not Terri Seargent who has been dis- Technology has given us new tools both sides of the aisle—some initial criminated against; that is Francis which give us new ways to think about discussions—but I can tell you, we have Collins, the head of the international gene therapy, organ replacement, ge- not gone into any sort of detail on this research project calling upon the Sen- netic testing, and the treatment of whole issue of expanding penalties in ate today to ban discrimination based cancers and heart disease. We are obli- this expanded, complicated field of ge- upon employment. It cannot be any gated to make sure the barriers are netic privacy and employment. The one area that has been men- clearer than that, Mr. President. lowered to take the good in the devel- tioned is that of health care quality I reserve the remainder of my time opment of science but also minimize and the use of genetic information in and yield the floor. whatever harm there might potentially The PRESIDING OFFICER. Who be. health care, in the health insurance yields time? But to do that, what is our responsi- arena. It is very clear that patients need to The Senator from Vermont. bility? Not to have a knee-jerk reac- Mr. JEFFORDS. I yield the Senator tion and accept a proposal which very be free to undergo genetic testing be- from Tennessee 7 minutes. few people in this body have even read, cause that can influence, in a positive The PRESIDING OFFICER. The Sen- much less studied, discussed, and de- way, the outcome of their health care. If they receive information that there ator from Tennessee is recognized for 7 bated. But first, we should focus on the is an 80-percent chance they will de- minutes. issues that we have studied, that we velop breast cancer, that is likely to Mr. FRIST. Mr. President, earlier have addressed in committee, that we change how many times they do self- this week we received tremendously have debated, including the input we exams a week, how often they go to the exciting news in that we essentially have solicited from doctors, physicians, doctor, how often they get a mammo- had completion of the mapping of the scientists, and consumer groups, with gram. That information should be used. human genome. It is tremendously ex- both sides of the aisle coming to cer- There should be no chance that infor- citing to me, both as a policymaker tain agreements. mation will be used by an insurance but also as a physician, as someone Let us start there and systematically company to discriminate against them who has spent his life taking care of address these ethical-type issues which thousands of patients because it intro- in denying them insurance. have been introduced by this new It can change lifestyle. If there is a duces a whole new way of thinking science just 3 days ago. Let’s not have test with an 80-percent chance that you that in the history of mankind we just a knee-jerk reaction until every Sen- will develop lung cancer, you will want simply have not had. Now there will be ator can ask the important questions. to know that. Why? Because it can whole new ways of thinking. I agree 100 percent that we should not change lifestyle. I think we should salute both Craig discriminate in any way using pre- We have a bill we have debated ex- Venter from Celera and Francis Collins dictive genetic information in the tensively since 1996 which does just for pioneering, for leading this great workplace. That needs to be put first. I that. Our bill, the Jeffords-Frist bill, effort, which will totally change the think it is unfair for the other side to prohibits health insurers from requir- way we do such things as engineer say we are for discrimination in the ing patients to undergo genetic testing drugs, the so-called gene drugs. Now workplace by genetic testing. It is just and prohibits health insurers from and into the future, we can begin to unfair. It is just unfair because we are using genetic information to deny cov- think how we use our own genes, our against that. erage or set rates for currently healthy own proteins, our own metabolites in But to address the policies, in look- individuals who may be at risk for a fu- such a way that they become the phar- ing at this amendment that has been ture disease. maceutical agent instead of a manufac- offered today by Senator DASCHLE and Again, this issue has been vetted tured drug. his colleagues, there is a health insur- through the process, has been vetted It changes the way we will think ance section. I have read most of that through Chairman JEFFORDS’ com- about organ replacement. Before I because I have had several hours to do mittee. Discussion has gone on. In 1995, came to the Senate, I would make an that. I read a little of the employment the debate in the markup of the Kasse- incision, remove a diseased heart, and section. The genetic privacy is very baum-Kennedy bill was extensive in have to put in a new heart. Hopefully, complicated. I can tell you, we need to numerous areas. 10 years from now, or 15 years from discuss that a lot more. Mr. President, I urge our colleagues now, when we transplant kidneys or a As to the various definitions of what to adopt the amendment Chairman pancreas, or other organs, we will be a predictive genetic test is, I would JEFFORDS has offered. able to engineer them based on what have to say, the genetic tests they are The PRESIDING OFFICER. The time we have uncovered. talking about, where they are actually has expired. A third area which this human ge- talking about metabolites, I don’t The Democratic leader. nome project opens up, as we look to know, I will have to go out and talk to Mr. DASCHLE. Mr. President, let me the future, is that of genetic testing. the real experts, but they may go too just respond to a few of the arguments We have been talking about and debat- far. posed by the Senator from Tennessee. ing the issue of genetic testing over the So I do not want to pass a major re- First of all, with regard to the tech- last couple hours. That is where you form bill that will potentially totally nicalities to which he made reference, I can take a swab, and by rubbing that underwrite or change the way we treat do not know what technicalities and swap over an array, a pattern of DNA people in the workplace based on defi- what information could be murky that is lined up, you will be able to pre- nitions that I do not fully agree with about what it is we are trying to do. S6070 CONGRESSIONAL RECORD — SENATE June 29, 2000 We simply say there should not be tant clinical studies that require genetic yses of the individual including cholesterol any employment discrimination based testing, slowing medical and scientific tests; and information about physical exams on genetic information. That is it. He progress. of the individual.’’ This language should be The undersigned organizations, rep- talked about these discrimination ac- clarified so that it is clear that genetic infor- resenting patients, people with disabilities, mation derived from either physical tests or tions being subjected to a mysterious consumers, women’s and civil rights organi- physical exams is considered protected infor- penalty. All we have said in section 4 of zations and many others, urge the conferees mation. This can be accomplished by adding the bill is that if you think you were to retain and improve Title III of the Senate language such as ‘‘unless the physical test discriminated against, you can go to Bill in the final conference bill, by incor- [or physical exam] reveals genetic informa- court and have a court make some de- porating the following changes. tion.’’ cision with regard to whether there is 1. Add meaningful penalties and sanctions. We would like to discuss these issues with As currently drafted, the provision for pun- you further at your convenience. Please feel discrimination or not. That is the pen- ishing violators is tremendously weak. With- alty. We do not prescribe any penalties. free to contact Susannah Baruch at the Na- out meaningful mechanisms for holding vio- tional Partnership for Women & Families We prescribe some degree of account- lators accountable, even the strongest ge- (202) 986–2600 if you have any questions about ability. We simply say, if you think netic discrimination protections become this letter. We commend you on your will- you were discriminated against, you meaningless. Victims of discrimination must ingness to take on these critical and complex get to sue, period. That is all. have the ability to enforce their rights in issues, and we wish you well as the con- On another point, let me say that the state or federal court and to receive appro- ference continues its work. priate legal and equitable relief. legislation proposed by our Republican 2. Add protections from discrimination in American Association of Occupational colleagues has already been analyzed in employment. As currently drafted, the Sen- Health Nurses, Inc. some detail as part of their Patients’ ate bill bans discrimination by group health American Association of People with Dis- Bill of Rights, as the Senator from plans and issuers, but provides no protection abilities Vermont has said. against job-based discrimination. Thus, even American Association on Mental Retarda- tion On April 12, Senator HARKIN received if group health plans and issuers are pre- vented from misusing genetic information, American Cancer Society a letter from 59 health organizations American College of Nurse-Midwives that wrote with concern about the lan- the very same information could be used against individuals in employment. Genetic American Civil Liberties Union guage propounded in this amendment information must not be misused to deny American Health Information Management by the Senator from Vermont. Fifty- people employment opportunities. Association nine health organizations have already 3. Prevent unauthorized disclosure of ge- American Heart Association said: This is not the way we ought to netic information. One of the best ways to American Hemochromatosis Society do it. protect people against discrimination is to American Jewish Congress prevent the disclosure of information to American Nurses Association They don’t need more hearings. They Association of Women’s Health, Obstetric don’t need more information. They those in a position to misuse it. There is no federal law that prohibits group health plans and Neonatal Nurses have looked at the bill. They have or issuers from disclosing people’s genetic Beckwith-Wiedemann Support Network come to the conclusion that if we are information. We urge the committee to add Canavan Foundation going to write public policy regarding strong protections against disclosure of ge- CARE Foundation (Cardiac Arythmia Re- genetic discrimination, this isn’t it. netic information. search and Education Foundation) I ask unanimous consent that the 4. Clarify plans’ limited ability to request Center for Patient Advocacy letter and names of all 59 organizations predictive genetic information. S. 1344 pro- Coalition for Heritable Disorders of Connec- vides that a plan can request (but not re- tive Tissue be printed in the RECORD. quire) that an individual disclose predictive Crohn’s and Colitis Foundation of America There being no objection, the letter genetic information for purposes of ‘‘diag- Digestive Disease National Coalition was ordered to be printed in the nosis, treatment, or payment.’’ We are con- DNA Dynamics RECORD, as follows: cerned that this formulation makes it pos- Dystonia Medical Foundation APRIL 12, 2000. sible for plans to obtain an individual’s ge- The Ehlers-Danlos National Foundation Hon. TOM HARKIN, netic information in an overly broad set of Genetic Alliance U.S. Senate, circumstances. This language should be re- Great Lakes Regional Genetics Group Washington, DC. written to clarify that when plans are seek- Hadassah DEAR SENATOR HARKIN: In the very near fu- ing information related to payment for ge- Hemochromatosis Foundation ture, scientists will have deciphered the en- netic services received, they may only re- Intestinal Multiple Polyposis and Colorectal tire human genetic code, providing human quest such evidence as is minimally nec- Cancer (IMPACC) beings with more information about our essary to verify that an individual received Little People of America, Inc. health than ever before. Tests are already the services. In such circumstances, only in- National Medical Journeys Network available that can detect genetic traits asso- dividuals within the plan or insurance com- National Association for Pseudoxanthoma ciated with particular diseases, and the use pany who need access to the information for Elasticum (NAPE, Inc.) of such tests is expected to increase dramati- purposes of that claim should have access to National Association of People with AIDS cally in coming years. it. National Coalition for Cancer Survivorship Genetic testing will improve our lives by 5. Clarify definition of ‘‘Predictive Genetic National Hemophilia Foundation providing information on how we can pre- Information.’’ As currently drafted, S. 1344’s National Incontinential Pigmenti Founda- vent future health problems, and cope more definition of predictive genetic information tion effectively with unavoidable conditions. But is potentially confusing. The legislation National Marfan Foundation the ability to predict diseases through ge- states that ‘‘predictive genetic information’’ National Multiple Sclerosis Society netic testing and family history opens trou- means information ‘‘in the absence of symp- National Organization for Rare Disorders bling questions about discrimination, par- toms, clinical signs, or a diagnosis of the (NORD) ticularly in employment and health care. condition related to such information.’’ This National Osteoporosis Foundation As you begin to consider the House and phrasing is potentially troubling, because National Ovarian Cancer Alliance Senate versions of managed care reform, we ‘‘diagnosis’’ is a fairly broad and imprecise National Partnership for Women & Families write to draw your attention to Title III of term. In fact, as doctors and scientists learn National Pemphigus Foundation S. 1344, the Senate bill. We commend the more about genetics, it is possible that National Society of Genetic Counselors Senate for including provisions intended to someday they will consider the presence or National Tay-Sachs & Allied Diseases Asso- protect individuals from discrimination in absence of a particular genetic trait a ‘‘diag- ciation health insurance based on genetic informa- nosis.’’ Thus, we suggest that this phrase be National Tuberous Sclerosis Association tion. However, we believe that the provisions rewritten to read ‘‘in the absence of symp- National Women’s Health Network in the Senate bill as currently crafted are in- toms or clinical signs, and a diagnosis’’, in National Workrights Institute adequate to meet the challenges raised by order to clarify that the presence or absence Nationl Women’s Law Center the extraordinary scientific advances of our of a genetic trait should not be considered a Oncology Nursing Society time. ‘‘diagnosis’’ if the individual has no symp- Polycystic Kidney Foundation Without comprehensive protections cov- toms or clinical signs, and genetic informa- Religious Action Center of Reform Judaism ering both employment and health care, pa- tion would not be excluded from protection Ruth G. Gold tients have reason to fear that their genetic under those circumstances. Spondylitis Association of America information could be used as a basis for dis- The definition of predictive genetic infor- Susan G. Komen Breast Cancer Foundation crimination. Many health care professionals mation in S. 1344 also specifically excludes The Sturge-Weber Foundation report that because of these fears many pa- information derived from ‘‘physical tests, The Title II Community AIDS National Net- tients are reluctant to participate in impor- such as the chemical, blood, or urine anal- work June 29, 2000 CONGRESSIONAL RECORD — SENATE S6071 Tourette Syndrome Association raise this issue on the Senate floor, we NATIONAL BREAST CANCER COALITION, Union of American Hebrew Congregations are somehow acting out of order. Our Washington, DC, June 29, 2000. University of North Dakota School of Medi- committee, the committee of jurisdic- Senator EDWARD KENNEDY, cine and Health Science, Division of tion, has tried to focus attention on Senate Committee on Health, Education, Labor Med. Genetics, Dept. of Pediatrics and Pensions (Minority), Washington, DC. Xavier University Health Education Pro- the dangers of the utilization of ge- DEAR SENATOR KENNEDY: On behalf of the gram netic information toward possible dis- National Breast Cancer Coalition (NBCC), I crimination for health insurance and Mr. DASCHLE. We have the director am writing to urge you to support Senators employment, and we have been unable Daschle, Kennedy, Dodd and Harkin’s Ge- of the National Human Genome Re- to do so. Thankfully, with the Daschle netic Nondiscrimination in Health Insurance search Institute who has said we have amendment, we will have the oppor- and Employment Act, S. 1322, being offered to pass a bill immediately to bar dis- tunity to do so this afternoon. today as an amendment to the Fiscal Year crimination in the workplace. We have The Jeffords amendment pretends to 2001 Labor, Health and Human Services, and a bill pending that will allow us to do Education Departments appropriations bill. be a half a loaf because it addresses in- NBCC is a grassroots advocacy organiza- just that. We have another bill pending surance, but does not address employ- that does not provide that protection tion made up of over 500 organizations and ment. But it is not a half a loaf. It is tens of thousands of individuals, their fami- in terms of discrimination. Fifty-nine no more than a thin crust or a thin lies and friends. We are dedicated to the health organizations, including the slice. It will not deal with the central eradication of the breast cancer epidemic American Association of Occupational problem of people failing to get needed through action and advocacy. Addressing the Health Nurses, the Genetic Alliance, genetic tests because of unfair dis- complex privacy, insurance and employment the CARE Foundation, the Oncology crimination. That is the issue. As long discrimination questions raised by evolving Nursing Society have said: Please, do genetic discoveries is one of our top prior- as they can lose their job and as long ities. more than the legislation offered by as their children can be denied jobs, the Senator from Vermont. In light of the recent announcement by the this protection is no protection at all. White House about the completion of initial So it isn’t just Dr. Collins, it isn’t This program is as full of holes as sequencing of the human genome, the Na- just Terri Seargent, it is a list of Swiss cheese. They can still require ge- tional Breast Cancer Coalition is cautiously health organizations, the likes of netic information. They can still dis- optimistic about this important step in which you rarely see, who have come close it, and there is still no meaning- learning more about disease, prevention, together to say: We ought to do better treatment and cure. However, while the map- ful enforcement. An insurance com- than this. ping of the ‘‘genetic blueprint’’ has potential pany can still get the information to I yield 5 minutes to the distinguished for great advancements in healthcare, there the employer. There is no prohibition senior Senator from the State of Mas- is also the potential for great harm. NBCC is on that in the amendment of the Sen- committed to working to ensure that em- sachusetts. ator from Vermont. They can still do ployers and health insurers do not use ge- The PRESIDING OFFICER. The Sen- netic information to discriminate. Informa- ator from Massachusetts is recognized that. The fact is, they are doing that. In a tion learned from one’s genetic blueprint for 5 minutes. 1990 survey by the American Manage- should only be used to cure and prevent var- Mr. SPECTER. Mr. President, par- ious genetic diseases and cancer. liamentary inquiry. ment Association, 20 percent of em- Discrimination in health insurance and The PRESIDING OFFICER. The Sen- ployers collected family medical his- employment is a serious problem. In addi- ator from Massachusetts will withhold. tory information on applicants, includ- tion to the risks of losing one’s insurance or Mr. SPECTER. Isn’t it the rule of the ing genetic information. Five percent job, the fear of potential discrimination Senate that the first person seeking of the employers acknowledged using threatens both a woman’s decision to use that information in hiring decisions. new genetic technologies and seek the best recognition gets recognition and the medical care from her physician. It also lim- Senator does not have the authority to We already know that employers are using genetic information to make em- its the ability to conduct the research nec- yield to another Senator without unan- essary to understand the cause and find a imous consent? ployment decisions. We must ensure cure for breast cancer. The PRESIDING OFFICER. The time that employees and applicants are not The Kassebaum-Kennedy Health Insurance is under the control of the Senator discouraged against getting those Reform Act (1996) took some significant from South Dakota. He had the floor kinds of tests. That is what this is all steps toward extending protection in the and is in control of the time, and he about. area of genetic discrimination in health in- I ask for 1 more minute. surance. But it did not go far enough. More- may yield time since he is on the floor over, since the enactment of Kassebaum- and has recognition. Mr. DASCHLE. I yield the Senator 1 more minute. Kennedy, there have been incredible discov- Mr. SPECTER. Mr. President, does eries at a very rapid rate that offer fas- Mr. KENNEDY. As Senator DASCHLE that ruling supersede the rule that the cinating insights in the biology of breast pointed out, there is a group of more first Senator seeking recognition gets cancer, but that may also expose individuals it? than 60 organizations that support the to an increased risk of discrimination based The PRESIDING OFFICER. The Sen- Daschle amendment. The National on their genetic information. For instance, ator was recognized and had the floor Breast Cancer Coalition is, once again, because of the discovery of BRCA1 and at the time that he yielded. supporting the Daschle amendment: BRCA2, breast cancer susceptibility genes, The Senator from Massachusetts is Passage of this amendment, and the pro- we now face the reality of a test that can de- tections it offers, are essential not only for tect the risk of breast cancer. Genetic test- recognized. ing may well lead to the promise of improved Mr. KENNEDY. Mr. President, I want women with a genetic predisposition to breast cancer, but also for women living with health as we better learn how genes work. the record to show that I was on my breast cancer, their families, and the mil- But if women are too fearful to get tested, feet seeking recognition at the time lions of women who will be diagnosed with they won’t be able to benefit from the the Senator from South Dakota yielded breast cancer. We strongly urge you to sup- knowledge genetic testing might offer. the time. port this legislation. We commend the efforts of Senators Daschle, Kennedy, Dodd and Harkin to go be- I want to take a moment of the Sen- Let us stand with the patients. Let ate’s time to review what has happened yond Kassebaum-Kennedy toward ensuring us stand with the victims. Let us not that all individuals—not just those in group in terms of this policy issue in the stand only with the insurance compa- health plans—are guaranteed protection Human Resource Committee so there is nies. against discrimination in the health insur- no confusion about it. We had a hear- That is what this issue is about. I ance and employment arenas based on their ing on genetic discrimination in health hope the Jeffords amendment will be genetic information. S. 1322 would also guar- insurance on 21 May 1998. That was a defeated. antee individuals important protections good hearing. That was in 1998. Mr. President, I ask unanimous con- against rate hikes based on genetic informa- Then, in May of 1998, a number of us sent to print in the RECORD a letter tion, would prohibit insurers from demand- asked the chairman of the committee from the National Breast Cancer Coali- ing access to genetic information contained to have a further hearing about dis- in medical records or family histories, and tion. would restrict insurers’ release of genetic in- crimination in the workplace. We have There being no objection, the letter formation. not received it. So I don’t take kindly was ordered to be printed in the Passage of this amendment, and the pro- to those who suggest that when we RECORD, as follows: tections it offers, are essential not only for S6072 CONGRESSIONAL RECORD — SENATE June 29, 2000 women with a genetic predisposition to no hearings, no markups, and no anal- Daschle legislation, but I recognize the breast cancer, but also for women living with ysis. I have discussed with the Senator job ahead of trying to work it through breast cancer, their families, and the mil- from Vermont the possibility of his for the reasons I have said. I think the lions of women who will be diagnosed with committee having hearings in July. He objectives are admirable. I am not breast cancer. We strongly urge you to sup- port this legislation. may have a problem with that. My sub- committed yet. I want to hear the bal- Thank your for your support. Please do not committee will have hearings on this ance of his argument. I have not stated hesitate to call me or NBCC’s Government subject so that if the Daschle amend- an intention to oppose it. Relations Manager, Jennifer Katz at (202) ment passes and we have in conference Mr. DASCHLE. Mr. President, I ap- 973–0595 if you have any questions. its consideration, we will try to work preciate the clarification. I am de- Sincerely, through the complexities of this legis- lighted to hear that there is still some FRAN VISCO, lation. hope I can persuade him with the mer- President. Again, I think the objectives of what its of our legislation. Mr. JEFFORDS. I yield 5 minutes to Senator DASCHLE looks to are exactly To ensure that everybody under- the Senator from Pennsylvania. right. I do think those people who vote stands—I think it is pretty basic— Mr. SPECTER. Mr. President, I had against the Daschle amendment are three-fourths of the people in this sought a parliamentary inquiry a few going to be questioned for not having country obtain their health insurance minutes ago. I am glad to wait 5 min- concerns about privacy on a very im- through their employer. Whether or utes until Senator KENNEDY has fin- portant matter. not employers may discriminate ished his comments. I have asked the Last week we had a motion to recom- against employees and potential em- Parliamentarian to review his rules. mit this bill for prescription drugs. If ployees on the basis of genetic infor- There was a very heated exchange for that motion had passed, I, frankly, mation, in large measure, will be deter- more than an hour back in 1987, shortly don’t know what my subcommittee mined by whether or not we write into after Senator BYRD had Senator Pack- would have done on prescription drugs. law a pretty simple concept. It doesn’t wood arrested, as to the practice of Our subcommittee is a very competent take any complex legalism to say, having one Senator, the leader, yield subcommittee, but I don’t know that look, you should not discriminate time to other Senators. I believe the our competence extends to legislating based upon genetic information, period. correct application of the rule is that on prescription drugs, taking that into If you think you are discriminated the first Senator who seeks recognition account and working that through, against, you ought to have recourse in is recognized and then the question which is really a matter for the Fi- a court of law. That is all we are say- arises as to whether time will be yield- nance Committee. I have been ques- ing. ed to him when there is a time agree- tioned about why I was unwilling to ment. That is the point I was making. have the recommitment. I have said, Now, the Jeffords amendment pro- I have no concern about waiting 5 min- because I have the responsibility for vides no protection against employ- utes or longer for another Senator. I do dealing with it as the manager of the ment discrimination. That is clear. It have a concern about the propriety of a bill. does not prohibit insurers from dis- Senator being recognized who first So there is a lot to recommend the closing the results of genetic tests seeks recognition. Daschle amendment in terms of objec- without consent. That is clear. It does I have sought recognition to com- tives and moving along, but I caution not prohibit the use of predictive ge- ment briefly about this legislation. I my colleagues about where we end up netic information for hiring, advance- believe the Jeffords amendment is a in terms of this bill without the hear- ment, salary, or other workplace rights solid amendment. His committee has ings, without the refinement, without and privileges. That is clear. It doesn’t looked into this issue very extensively the analysis. I am not making any cri- provide persons who have suffered ge- with respect to eliminating discrimina- tique or criticism of the author of the netic discrimination in either arena tion based upon genes and medical in- bill. Any bill which is constructed with the right to seek redress through formation and research with respect to without hearings and without markup a legal action. That is clear. health care. and without that kind of rigorous anal- It is no wonder that 59 health organi- I do think the objectives of the ysis has natural problems. Even with zations have said: We have looked at Daschle amendment are sound, in seek- hearings and with markup, there are what Senator JEFFORDS is proposing ing to avoid discrimination in employ- still problems that have to be worked and we think you can do better. That is ment as well as in health care. I have out. no accident. They are asking us not to had an opportunity to review the I express my agreement with the support this legislation because there Daschle amendment very briefly. From Senator from Vermont on his legisla- is no meaningful protection in the Jef- the review which I have made and tion, express my agreement with the fords amendment. objectives of the legislation of the Sen- which staff has made, I have some I am all for more hearings, but it is ator from South Dakota, and say that grave concerns about some of the pro- ironic—how many times has the major- if we have it in conference, we will do visions which are very complicated and ity bypassed a committee to go our best to try to work through the which have not been subjected to hear- straight to the floor without hearings kinds of problems and deal with this ings. on bills of great import? We are going very important issue. Again, I think its objectives are laud- to do that as soon as we come back The PRESIDING OFFICER. The Sen- from the Fourth of July recess. We are able. I think the American people do ator’s time has expired. Who yields expect protection and confidentiality going to vote on an estate tax provi- time? sion that will cost, in the full 10-year on these issues on employment as well Mr. DASCHLE. Mr. President, I have period, three quarters of $1 trillion; we as on health care. immense respect for the Senator from are going to vote on it without one I express my concern about our abil- Pennsylvania and consider him a very hearing, without one committee mark- ity to handle this matter in conference able legislator. I am disappointed that up. I will bet you we are not going to on this state of the record. I think it is he will be opposing my amendment hear the argument by the other side more than a matter of people’s rights when we have our vote. and obligations and objectives and Mr. SPECTER. If the Senator will that we ought to have hearings on what we ought to have. We need to yield, I ask him what makes him think that. This is pretty simple. This is have a bill which sticks together, I am going to oppose his legislation? basic math. If you don’t want discrimi- which makes sense, and which will Mr. DASCHLE. I thought he an- nation in the workplace, vote for the stand the kind of scrutiny and exam- nounced he intended to oppose it be- Daschle amendment. ination and analysis to which it will be cause we didn’t have hearings. If there Mr. President, I yield 5 minutes to subjected. is still an opportunity to gain his sup- the distinguished Senator from Iowa, One of the grave problems our legis- port, I will give him all the time he Mr. HARKIN. lation has, when subjected to judicial needs to further discuss the issue. The PRESIDING OFFICER (Mr. GOR- review, is that it is hard to figure out Mr. SPECTER. Mr. President, I am TON). The Senator from Iowa is recog- sometimes, especially when there are very much inclined to support the nized. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6073 Mr. HARKIN. Mr. President, I am Secondly, we need to have better en- just been completed. This just became supporting the amendment of the Sen- forcement. The penalties that are in a sexy issue. While there are months, if ator from South Dakota because I have the amendment offered by the Senator not years, of research still required to been involved in this issue for a long from Vermont are toothless—$100 a realize the potential of this informa- time. In 1989, when I was chairman of day. Well, a large business concern can tion, we must be responsive to the the subcommittee that my good friend, factor that into their cost of doing range of pros and cons regarding its Senator SPECTER, chairs now, we start- business. That is not really a stiff use. ed funding for the Human Genome Cen- enough penalty. The committee has spent a lot of ter at NIH. So I have been involved in It seems to me that if I am discrimi- time developing a bill to address where this effort for a long time and am very nated against, under the law, I ought there do appear to be gaps in pre- supportive of it. to have a private right of action; I venting discrimination. Those gaps are I could not have been happier with ought to be able to go to court and say, most apparent in health insurance, the announcement that came out this wait a minute, my rights are being where a person’s health information, as week that we have now completed the abused, my civil rights are being well as his family’s health history, are map, and they will be completing the abused. And if we have this law that a determinant in their access to cov- sequencing of the human genome. With says you can’t discriminate against erage. This is an immediate concern that, we are going to have a very pow- someone because of their genetic pre- that requires our immediate response. erful diagnostic tool that will allow disposition, that person ought to have That is why I strongly support the medical practitioners to more accu- a right of action. That person ought to amendment being offered by Senator rately assess the health of an indi- FRIST, which would prohibit insurance be able to go to court and seek redress. vidual and their proclivity to come companies from discriminating based So that is why I say the Daschle down with an illness or a disease, or to on a person’s genetic makeup. amendment is the only one that really be more predictive of what kind of ill- The amendment Senator DASCHLE protects people both in the workplace nesses to which a person might be sub- has offered also attempts to address ge- and in insurance. ject. netic discrimination in employment. Well, that is a very powerful diag- The PRESIDING OFFICER. The Sen- Unfortunately, this issue is not nearly nostic tool, and it is going to do a lot ator from South Dakota is recognized. as clear cut. Until very recently, the Mr. DASCHLE. Mr. President, I re- to help millions of people all over this prevailing opinion among employment world. There may be other spinoffs in tain the remainder of my time. discrimination experts was that ge- The PRESIDING OFFICER. The Sen- terms of gene therapy, and things such netic discrimination was already cap- ator from Vermont is recognized. as that, but I wish to focus on the diag- tured under the Americans with Dis- Mr. JEFFORDS. Mr. President, I nostic tool that will help people get abilities Act (or ‘‘ADA’’). In fact, it is yield myself such time as I may con- better control over their health care. still not clear that the ADA does not sume. That is the upside. cover genetic discrimination. Even as The downside is that in the hands of Although many of us came into to- recently as March 24 of this year, the the wrong person this information day’s debate believing that the ADA Commissioner of the Equal Employ- could then be used to discriminate did in fact cover genetic discrimination ment Opportunity Commission, Paul against a person who may have a ge- in the workplace, we certainly under- Miller, told the American Bar Associa- netic predisposition toward a certain stand the importance of this issue and tion genetic discrimination was cov- illness. As I understand it, both of the of the need to hold a hearing on this ered under title I of the ADA. Specifi- amendments we have before us—the issue. However, I would like to empha- cally, Commissioner Miller said pro- one by the Senator from Vermont and size that as recently as a few months tect against genetic discrimination was the one by the Senator from South Da- ago experts in employment law and, in provided by the prong of the act which kota—prohibit discrimination when it particular, EEOC Commissioner Paul prevents discrimination against people comes to insurance. Well, that is all Miller is quoted as stating that who are regarded as disabled. well and good, but that is only a part of * * * discrimination against an employee However, because no court has ever it. on the basis of diagnosted genetic predisposi- ruled definitively on this issue and be- Why the amendment of the Senator tions toward an asymptomatic condition or cause of some related—but not control- from South Dakota is the one we need illness is covered under the ADA’s ‘‘regarded ling—recent Supreme Court cases, I un- as disabled’’ prong. to adopt is that it also prohibits dis- derstand that there may now be some crimination in the workplace. Why is So it is not as if we approached this insecurity about whether genetic dis- that important? I understand that ear- debate believing that employees should crimination is covered by the ADA. lier my friend from Vermont said we not be protected against genetic dis- And understandably, this insecurity is didn’t have to be too concerned about crimination in the workplace. We sim- being increased by the recent an- this because the Americans With Dis- ply thought that they already were nouncement of the Human Genome abilities Act covered the workplace. covered. Project. Well, as the chief sponsor of the Ameri- I want to reassure my colleagues We are sympathetic to this insecu- cans With Disabilities Act, and one that the HELP Committee will hold a rity, and I think we can all agree that who has lived with it since its incep- hearing in the near future on this issue employers should not be permitted to tion back in the 1980s, I say to my and that if we find that the ADA is not discriminate against employees based friend from Vermont that some lower providing protection to workers we will on genetic information in the same courts have ruled, for example, that develop and pass legislation to ensure manner that employers may not dis- breast cancer is not a disability, so the that genetic information is properly criminate based on disability, gender, ADA really does not cover the work- protected. I yield 4 minutes to the Sen- race, age, and other characteristics. I place when you come to genetic dis- ator from Wyoming. believe our committee needs to evalu- crimination. Some lower courts have The PRESIDING OFFICER. The Sen- ate the conflicting evidence as to held that breast cancer is not a dis- ator from Wyoming. whether or not genetic discrimination ability and not covered by the ADA. If Mr. ENZI. I thank the Senator from is already covered under current law, they rule that, are they then going to Vermont. particularly in light of the recent sci- rule that the gene for breast cancer is Mr. President, I rise today with the entific developments. I support holding covered? Hardly. Senator from Vermont, chairman of a hearing on this issue as soon as pos- So that is why I wanted to take this the Health, Education, Labor, and Pen- sible and I understand my colleague time to make it clear that genetic pre- sions Committee. The matter of ge- Senator JEFFORDS has scheduled a dispositions and disorders should be netic discrimination in employment hearing on this issue for July 11. We covered in employment, because of has taken on new relevance given a should examine not only the question some of these lower court rulings re- number of recent events. Most notably, of whether the ADA captures genetic garding the Americans With Disabil- the Human Genome Project announced discrimination, but also what the im- ities Act. So that is why it is so impor- this week that the ‘‘rough draft’’ of the plications are for the numerous work- tant that we have it in the workplace. map of some 3 billion human genes has place and work force issues that will S6074 CONGRESSIONAL RECORD — SENATE June 29, 2000 arise based on the availability of ge- genetic basis, or any other basis, in the little bit of a fuss, as they have on netics. Safety concerns and privacy workplace or in health care. We are other occasions, and as we do on occa- concerns being the most important. being lead to believe that this is a very sion. Also, I believe we should consider ge- simple bill, and that we ought to ac- I don’t believe there should be legis- netic discrimination in employment in cept it. ‘‘Simple’’ is not 50 pages. Sim- lation on appropriations bills. the broader context of the cultural im- ple is the statement that the Senator I yield the floor. plications and evaluate the historical from South Dakota made. But 50 pages The PRESIDING OFFICER. The experience with genetic information. to explain that means it is a lot more Democratic leader. Researching this issue has been a 10- complicated than the explanation we Mr. DASCHLE. Mr. President, I have year priority of the Human Genome are being given. We don’t want dis- great admiration for the Senator from Project’s Ethical, Legal and Social Im- crimination. Quite frankly, I think one Wyoming. I have worked with him on plications (ELSI) program. I welcome of the reasons we are being presented many issues. I never find it easy to dis- my colleagues to join the hearing proc- with this is a good example of why you agree with a colleague, but let me say ess in a bipartisan effort to address don’t legislate on appropriations bills with regard to his argument that this this matter. and avoid the entire process. It is a is going to be a turnstile to more law- Given the complexity of this issue, I handy way to do it. If I had a bill, that suits; that is the same argument used believe it is critical that we not rush to is how I might try to do it too. But it on so many occasions and that was accept Senator DASCHLE’s amendment isn’t the right way to do it. used against the ADA. without resolving all of these impor- I hope we will step back a minute and I was on the floor. I remember those tant issues. We may determine that go through the procedure for doing a debates so well. I participated in them. new legislation is necessary to protect 50-page bill that covers something as They said this was going to cause a against genetic discrimination—and if important to people as discrimination flurry of lawsuits. it is necessary, we will work hard to in the workplace, or discrimination in Who today would vote to repeal the pass it. But Senator DASCHLE’s amend- any other place. ADA? I daresay not one Senator—Re- ment simply goes too far. We must be If this bill passes, a person who can publican or Democrat. He made reference to the EEOC’s po- certain that any new legislation is find and accidentally disclose a genetic sition on whether the ADA covers ge- comparable to existing discrimination marker will have greater protection in netic discrimination. I hope they are legislation. Senator DASCHLE’s amend- the workplace than a paraplegic would. right. But what is wrong with making ment is not comparable, it is much Not only that—this allows people to absolutely sure they are right? That is broader. bypass the legal system. You can go what this bill does. This bill isn’t com- For example, Senator DASCHLE’s immediately to court. amendment would permit unlimited This will become a turnstile for trial plicated. I know some of our colleagues damages for genetic discrimination. It attorneys. This becomes a jackpot would like to point to the volume of would also permit parties to com- proposition. This will clog the courts, this amendment and say that bulk is pletely bypass the Equal Employment if it passes. It will be a heyday. Every clear evidence of complication. We are simply saying, as simply as Opportunity Commission—the federal single trial attorney will have their we can, that you shouldn’t discrimi- body set up to deal with employment own slot machine. That is not what we nate in the workplace; and, if you do, discrimination disputes—and go are trying to do. straight to federal court. This is sig- This isn’t an area that just comes you ought to have some opportunity to nificantly more extensive than the under the workplace safety and train- redress that problem. I have a real concern as well about ADA, the ADEA and title VII discrimi- ing subcommittee that I chair. It also what inaction means for research. Dr. nation protections. This just makes no comes under the health committee Craig Venter was on the Hill on several sense at all. Under Senator DASCHLE’s that Senator FRIST chairs. occasions and has made several public amendment, an individual with a ge- It is a topic that our entire com- statements. His concern about dis- netic marker showing he may at some mittee needs to address and will ad- crimination is one that we ought to be future point develop a genetic disease dress. But it has to be done through a truly appreciative of as well. Dr. or condition would have more protec- hearing process so we don’t wind up Venter, president of Celera Genomics, tion than a paraplegic. Again I say this with some of the unintended con- said: makes no sense at all. And it will over- sequences that I have just mentioned. tax federal courts and juries with high- As far as the Americans With Dis- The biggest concern I have is genetic dis- abilities Act, on March 24 of this year, crimination. This would be the biggest bar- ly complex genetic issues and give op- rier against having a real medical revolution portunistic trial lawyers a jackpot. the commissioner of the Equal Em- based on this tremendous new scientific in- If Senator DASCHLE has a valid rea- ployment Opportunity Commission, formation. son why genetics should have such sub- Paul Miller, told the American Bar As- Dr. Venter is worried, if we see dis- stantial additional protections, I wel- sociation that genetic discrimination crimination, that automatically and come him to come to our committee was covered under title I of the ADA. I almost immediately it is going to bot- hearing and explain them, but we guess that is why this 50-page ‘‘simple’’ tle up his opportunity to continue the should be very careful not to rush into bill bypasses the Equal Employment research. such significant legislation and treat Opportunity Commission. We shouldn’t I go to the next chart, and look at genetic information differently than bypass that group. That is a bill for what others have said. Dr. Collins, existing diseases, disorders, and ill- protection and for having a hearing somebody I have quoted on several oc- nesses. If we accept Senator DASCHLE’s process for individuals. The commis- casions, says: amendment, we are simply not doing sioner of the Equal Employment Op- Genetic information and genetic tech- our job. Again, I think we can all agree portunity Commission says it is cov- nology can be used in ways that are fun- that genetic discrimination should not ered under title I of the ADA. Maybe damentally unjust . . . Already, people have be permitted, but I think we should there have been some decisions that lost their jobs, lost their health insurance, also be able to agree not to pass legis- have come out since. and lost their economic well-being because lation on such a significant and impor- We can’t just be doing knee-jerk leg- of the misuse of genetic information. tant issue without having all the prop- islation on an appropriations bill. This It doesn’t get any clearer than that. er information before us. I urge my col- is an issue that deserves time and con- First, you have the top researcher say- leagues to vote against Senator sideration, and a hearing that will ing they are concerned about the rami- DASCHLE’s amendment so that we can produce the kind of bill of which we fications of a lack of congressional ac- examine this issue through the proper can be proud—the kind of bill that has tion, not only for job discrimination, procedural channels and pass respon- some opportunity for amendment. but for research. Then you have Dr. sible, reasonable legislation if such leg- I know if we were trying to pass a Collins who says we have already seen islation is necessary. bill of that magnitude and precluded cases where people have lost their jobs There isn’t anybody here who wants the minority from having any say-so, and lost their health insurance as a re- to have any discrimination done on a or any amendment, they would raise a sult of this. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6075 The Secretary’s Advisory Committee I’m a third generation [breast cancer] sur- protect the privacy of genetic informa- on Genetic Testing was equally as con- vivor and as of last October I have nine im- tion. Now it’s up to us to act by pass- cerned in their public statement. Keep mediate women in my family that have been ing this amendment, and I urge my col- in mind that this isn’t some Demo- diagnosed with breast cancer . . . I want my leagues to join me in doing just that. daughter to be able to live a normal life and Mr. JEFFORDS. Mr. President, I cratic advocate; this is the Advisory not worry about breast cancer. I want to Committee on Genetic Testing. This is have the BRCA test [for breast cancer] done yield to the Senator from New Mexico. a quote: but because of the insurance risk for my I believe he has 5 minutes. Federal legislation should be enacted to daughters future I don’t dare. The PRESIDING OFFICER. The Sen- prohibit discrimination in employment and Another of my constituents, Dr. ator from New Mexico. health insurance based on genetic informa- Mr. JEFFORDS. I point out that is tion. . ..Without these protections, individ- Tracy Weisberg, Medical Director of the Breast Cancer at the Maine Med- all of my time. So the Senator from uals will be reluctant to participate in re- Alabama will have to ask for addi- ical Center Research Institute, told me search on, or the application of, genetic test- tional time. ing. that while she has offered screening for Mr. DOMENICI. He and I are going to How much more information do we the breast cancer gene to approxi- share a little time. need? How many more hearings do we mately 35 women in 1997, only two Before I do that, I say to Senator have to have when you have the most opted for the test. She said that many DASCHLE, believe it or not, I was the credible experts anywhere to be found, of these women did not undergo testing first Senator involved in genome. here or anywhere else, who are plead- because of their fear of discrimination Whether people know it or not, it was ing with the Congress to do something in health insurance. not the National Institutes of Health before it gets even worse, before more Dr. Weisberg emphasized the need for that started this program. It was the people lose their jobs and their health legislation to protect patients from Department of Energy. In fact, the Na- insurance, and before we see some real this type of discrimination, so that tional Institutes of Health did not ramifications with regard to medical they could make genetic testing deci- want the program, and a very distin- testing? sions based on what they believe is best guished doctor left them and went to That is what we are doing. That is for their health, and not based on fear. DOE. They came to me. The first bill what this amendment does. That is As a legislator who has worked for was introduced and Senator Lawton why it needs to be passed this after- many years on the issue of breast can- Chiles funded it. That is the origin, noon. cer, and as a woman with a history of which I am going to talk with my I retain the remainder of my time breast cancer in her family, I am de- friend, Senator SESSIONS, about in a and yield the floor. lighted with the possibilities for fur- Mr. JEFFORDS. Mr. President, I ask minute. ther treatment advances based on the Let me suggest that I don’t know unanimous consent that Senator MACK discoveries of two genes related to what is in the Senator’s amendment. be added as a cosponsor of this bill. breast cancer—BRCA 1 and BRCA2. The PRESIDING OFFICER. Without But I do know from the very beginning Women who inherit mutated forms of that there has been concern about the objection, it is so ordered. either gene have an 85 percent risk of Mrs. SNOWE. Mr. President, I rise to effect of discrimination. I don’t believe developing breast cancer in their life- speak in support of the amendment we should go from being concerned time, and a 50 percent risk of devel- being offered by Senators JEFFORDS about the effects of discrimination to a oping ovarian cancer. and FRIST on genetic nondiscrimina- 30- or 40-page bill that we—how big is Although there is no known treat- tion in health insurance. This amend- it? Ten. Frankly, we need to make sure ment to ensure that women who carry ment, based on language I authored that what we are not doing is putting the mutated gene do not develop breast with Senator JEFFORDS and Senator genome research into a vulnerable po- cancer, genetic testing makes it pos- FRIST, provides strong protection to all sition where it is not stable and people sible for carriers of these mutated Americans against the unfair and im- do not know precisely what they can proper use of genetic information for genes to take extra precautions—such do on it. insurance purposes. as mammograms and self-examina- That is all I have to say about the tions—in order to detect cancer at its This amendment will: amendment. Prohibit insurers from collecting genetic earliest states. This discovery is truly I yield to Senator SESSIONS for a information a momentous breakthrough. question. Prohibit insurers from using predictive ge- But the tremendous promise of ge- Mr. SESSIONS. I know the Senator netic information, such as family back- netic testing is being significantly has been involved in this. I am excited ground or the results of a genetic test, to threatened by insurance companies so many others are involved with the deny coverage or to set premiums and rates, that use the results of genetic testing possibility that we can have a detailed and Require insurers to inform patients of to deny or limit coverage to con- map of the human genome through the their health plan’s confidentiality practices sumers. Unfortunately, this practice is identification of the 3 billion nucleo- and safeguards. not uncommon. In fact, one survey of tide basis that make up the human ge- The need for this legislation is clear. individuals with a known genetic con- nome, helping to cure diseases. As Senators DASCHLE and DODD pointed dition in their family revealed that 22 It is an exciting time. This Congress out this morning the announcement percent had been denied health insur- has played an important role. I know this week that scientists have com- ance coverage because of genetic infor- Dr. Charles DeLisi has played a key pleted their mapping of the human mation. role. I know Senator DOMENICI, perhaps gene is a remarkable and historic And consider that people may be un- more than any other official in govern- event. It opens the door to new sci- willing to participate in potentially ment, saw the possibilities of this sev- entific breakthroughs that may well ground-breaking research trials be- eral years ago, and used the power and help lead us one day to the cause and cause they do not want to reveal infor- leverage he had to make it a govern- the cure for cancer, for Parkinson’s mation about their genetic status. At mental project of the highest priority. and for Alzheimer’s disease. NIH, 32 percent of women eligible for I know he cares about it. This remarkable new tool has the po- genetic testing for the breast cancer Would the Senator share with the tential, unfortunately, to become a gene declined to undergo testing—the Senate his insight as to where we are dangerous tool. Because knowledge is majority of those who declined cited in the human genome at this time. power—Mr. President—and an insur- privacy issues and a fear of discrimina- Mr. DOMENICI. But whether it is ance company could use genetic infor- tion as their reason. Congress or the President, someone mation to deny insurance to an indi- Mr. President, this is simply unac- should recognize formally a Ph.D. vidual because they know that the per- ceptable. The Jeffords, Frist, Snowe named Dr. Charles DeLisi, the dean of son is predisposed to a particular dis- amendment before us today will go a engineering at Boston University. In ease or health problem. long way toward putting a halt to the the year 1986, he left the National In- Consider a letter that I received from unfair practice of discriminating on stitutes of Health in protest over their a constituent, Bonnie Lee Tucker, of the basis of genetic information, and to unwillingness to proceed with a ge- Hampden, Maine, who wrote: ensure that safeguards are in place to nome project of national significance. S6076 CONGRESSIONAL RECORD — SENATE June 29, 2000 He went to the Department of Energy. criminating on the basis of genetic in- A Utah biotechnology company, Myriad He said there were a lot of big brains in formation in the workplace. The Jef- Genetics Laboratories, sent 100,000 cancer the Department of Energy, and maybe fords amendment does not prohibit the specialists a glossy ‘‘resource kit,’’ boasting of its new ‘‘gold standard’’ testing for the they would listen and come to the disclosure of test results without con- gene mutations. The company warns doctors same conclusion. sent. It does not prohibit the use of about the risks of insurance and job dis- They were researching genetic predictive genetic information for hir- crimination. projects because they were charged ing. It does not ensure that those who But the promotional kit also tells doctors with deciding the extent of radiation suffer from genetic discrimination that the Equal Employment Opportunity incapacity generationally as a result of have the right to seek redress through Commission ‘‘has in included language in the the two bombs that were dropped in legal action. It fails on a basic level Americans with Disabilities Act making it unlawful to discriminate’’ base on the re- Japan. The Department has all the sci- with regards to what we ought to do sults of genetic tests. entists. He went there. They put to- with respect to genetic discrimination. Peggy Mastroianni, the associate legal gether a team in DOE. I am very fortu- It is on that basis I remind my col- counsel for the commission, dismissed this nate because they came to see me. leagues that 59 organizations have claim, saying that it merely issued an opin- They said: Why don’t we do this since come forward to urge Members to say ion, which has yet to be tested in the courts. the National Institutes of Health no to legislation that fails to regulate Some scientists and medical ethicists say that Myriad and other companies are over- doesn’t want to? Why don’t you start the workplace. Don’t listen to me. Lis- selling these tests. Should a woman test it? ten to those organizations. Listen to positive for a gene mutation, there is still no I got a little tiny bit of a bill Craig Venter of the Clera Genomics. way of knowing whether she will develop through, saying the DOE will run the Listen to Francis Collins, the director cancer. Even if that information was avail- program. That was the beginning for of the National Human Genome Re- able, there is no sure-fire preventive treat- the National Institutes of Health. As search Institute. Listen to the editorial ment. soon as they saw the bill introduced writers from papers across this country The Food and Drug Administration could regulate genetic tests, as it regulates new saying DOE would do it, they came who have said, again and again, we drugs. But so far the agency has declined to running to me saying: We told Lawton must pass legislation quickly before it become involved. And where discrimination Chiles we would like to get in on it. Of is too late. is concerned, many women would have little course, then we passed legislation that This is a no-brainer. This is our op- recourse if their health insurance sky- said both DOE and the National Insti- portunity today to say yes to Craig rocketed in cost or they lost their jobs on tutes of Health would run this pro- Venter, to say yes to Dr. Collins, to say the basis of a genetic test. yes to the organizations, and to say yes More than a dozen states have enacted lim- gram. its on insurance or employment discrimina- Since then, it has been a scientific to Terri Seargent, who has already tion related to genetic testing. But even in marvel. The entire chromosome system been victimized as a result of this. This New Jersey, where Gov. Christine Todd of human beings is mapped. Pretty is our opportunity to say no to dis- Whitman signed the country’s most com- soon it will be available for scientists crimination in the workplace, to say prehensive law last month, almost half of investigating grave diseases. They will the Senate will go on record for the the insured aren’t protected, because they have them at their fingertips in terms first time that we will not allow any belong to self-financed plans, which aren’t subject to stringent state regulations. of transmutation. genetic discrimination regardless of At the federal level, the new Kennedy- Perhaps we have just laid before the circumstances. Kassebaum law, among other things, pro- public and the people of the world the I hope on a bipartisan basis our col- tects people moving between jobs from being greatest wellness potential in the his- leagues will join in support of this leg- dropped by health insurers because of their tory of mankind. We may find locked islation. The time has come. It was in- genetic information. But the law doesn’t pro- up genetically the secret to most dis- troduced in the last Congress. It is now tect those with individual health insurance eases. The scientists may pick it up being offered in this Congress with from seeing their premiums raised if they and find solutions in the next 25 or 30 every expectation and hope that we can happen to carry an unlucky genetic finger- print. It also does not protect against job years that nobody thought possible. send the clearest message possible that bias. Sooner or later I will have somebody we will not tolerate discrimination. We Women are not the only ones affected by recognize Dr. Charles DeLisi. I have will allow the research to go forward this problem. Genetic tests for other diseases spoken to him. He is a marvelous edu- without any question that the informa- have been developed. Others are on the way. cator at a great university. President tion can be protected. That is what we Last month, scientists announced that they Clinton is now aware of this and very want. That is what the health organi- were zeroing in on the mutant gene in hered- itary prostate cancer. interested. I am very hopeful he will be zations want. That is what Terri In the last Congress, a dozen bills would recognized. It is important people un- Seargent wants. That is what we all have guarded against genetic discrimination derstand. should want in the Senate. and protected medical privacy. But even Mr. DASCHLE. How much time do I I ask unanimous consent to have those with some bipartisan support fell vic- have remaining? printed in the RECORD editorials from tim to a crammed legislative calendar and The PRESIDING OFFICER. Five around the country. insurance industry resistance. minutes. There being no objection, the mate- The 105th Congress has a chance to pass Mr. DASCHLE. I compliment the rial was ordered to be printed in the comprehensive laws protecting medical pri- vacy and barring insurers and employers Senator from New Mexico. He truly has RECORD, as follows: from discriminating on the basis of genetic been one of those leaders in the field. [From the Phoenix Gazette, Dec. 17, 1996] information. For its part, the FDA should In fact, I have before me S. 422 which DNA DILEMMA: GENE TESTS CAN COST YOU regulator genetic tests. Those charged with he introduced in the 105th Congress. Imagine the scene: A middle-age patient, protecting the public welfare have to move Title IV of his bill, discrimination by visiting her doctor for her yearly physical, quickly. employers or potential employers, is reminds him that her mother and aunt had [From the Washington Post, Feb. 12, 2000] almost exactly what is in the Daschle breast cancer. With the patient’s consent, GENETIC PRIVACY amendment this afternoon. her well-meaning physician decides to con- He was one of the first to be out duct a new test that will reveal whether she President Clinton has issued an executive carries genetic mutations that could radi- order limiting the use of genetic test results there. I give him great credit for what cally increase her chances of developing in deciding whether to hire, promote or ex- he has already done with his leadership breast cancer. tend particular benefits to federal employ- on this issue. He has given some his- The doctor submits a claim for the test to ees. For now, the order will have limited sig- tory this afternoon about how this the woman’s insurer. Before the results are nificance, since genetic testing is not yet as started. He was here in the last Con- back, the insurer, seeing what the test is for, common as it is likely to become. But it sets gress advocating that this body oppose triples the price of her coverage. the right example; in a not-yet-settled area An impossible chain of events? Think discrimination in the workplace. of medical ethics and privacy, it’s a pio- again. Several companies have begun mar- neering step. The order includes a plug for a So that everyone knows prior to the keting tests that will tell women whether bill by Senate Minority Leader Tom Daschle time they vote what it is we are talk- they have the recently discovered gene and Rep. Louise Slaughter that would im- ing about, the Jeffords amendment mutations that markedly increase their pose the same restraints on employers na- does not prohibit insurers from dis- risks for breast and ovarian cancer. tionwide as well. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6077 The problem is that people fear—and, it lation that would ban genetic discrimination [From the Chicago Tribune, Apr. 27, 1996] has been shown, avoid—being tested for a in the private sector. Congress should attend GROUND RULES FOR DNA SAMPLING predisposition to a genetic disease because to this matter as soon as possible and also to Two Marine corporals were court- they think employers or other authorities the problem of protecting individual gene martialed in Hawaii recently and convicted might penalize them for the results even if maps. of disobeying orders to give tissue samples they never develop the disease. This specific Discrimination in the workplace is wrong, for a Defense Department DNA registry. concern is symptomatic of a larger one: the whether it is based on a person’s personal ge- The idea behind the registry is that should danger that people may become less open netic code or the color of his skin. they become casualties in a future conflict, with their own doctors—or avoid treatment Genetic discrimination is un-American. there would be a foolproof way of identifying altogether—for lack of confidence that infor- [From the St. Louis Post-Dispatch, Feb. 14, their bodies. This is no frivolous concern, as mation about their health is any longer 2000] the recent exhumation of an allegedly veiled in the traditional confidentiality. misidentified Vietnam War casualty in Ft. Federal rules to protect patients’ privacy DISCRIMINATION GOES HIGH-TECH Wayne, Ind., demonstrated. when they give sensitive information to CIVIL RIGHTS Despite their convictions, the two Marines their doctors are finally nearing completion; The frightened middle-aged woman was re- got light penalties: seven days of restriction the public comment period ends this month. lieved she would not have to give her name. each, letters of reprimand and no dishonor- These, too, are only a start, though an ener- She handed over several $100 bills, counting able discharges. getic one. They give patients a right to see them out with trembling hands. She had This leniency may have stemmed from the and correct their medical records, oblige all never done anyuthing like this before. She fact that their concerns also were not frivo- health care providers and insurers to follow rolled up her sleeve and looked away, await- lous: They feared that, somewhere down the confidentiality safeguards and set civil and ing the needle. line, the DNA samples could be used to their criminal penalties for violations. There are It was not a street corner drug deal, al- detriment. And the Defense Department, like holes that Congress ought to fill: The rules though it felt like it. She was in a major the rest of American society, is only gradu- cover only electronic transactions, and allow teaching hospital undergoing genetic testing ally evolving answers to such concerns. a formidable array of exceptions where infor- to see if she had an increased risk of con- Almost daily, it seems, scientists announce mation may be shared without a patient’s tracting a life-threatening disease. Along that they’ve found a new gene that causes or consent. with her fears that this glass tube identified predisposes a person to some disease or trait. Lawmakers have been slow to recognize by number might render a deadly warning in Almost as rapidly, biotechnology companies the broad political appeal of strengthening every unseen strand of her DNA, she also was are developing tests to screen for those medical privacy, partly because of the many afraid of other threats unseen: that the test alone might prevent her, or a family mem- genes. conflicting interests that are represented in ber, from getting health or life insurance, a What those two Marines feared is what the fight over medical records. But polls job, a promotion, custody of her children, an many Americans in many other walks of life show privacy concerns rank high, and a bi- organ transplant; or perhaps even something fear: that samples given for one ostensibly partisan Congressional Privacy Caucus and a as simple as a home loan. benign purpose, or the data gleaned from Democratic privacy task force both declared As technology soars forward in the Human such samples, may be put to other uses, not their existence Wednesday. There’s plenty Genome Project and computer science, we all necessarily benign. for these privacy advocates to do. will know more about ourselves than ever Earlier this month, for example, research- before, and be less capable of keeping it to ers at Harvard and Stanford universities re- [From the Houston Chronicle, Feb. 15, 2000] ourselves. Medical science already has hun- leased a study citing more than 200 cases of GENE SECRETS; CLINTON RIGHT TO OPPOSE dreds of genetic tests that detect mutations ‘‘genetic discrimination.’’ Prominent among GENETIC DISCRIMINATION putting a person at increased risk for such these were cases in which insurance coverage From the moment of conception, the lives ailments as ovarian, breast, colon and pros- was denied because a member of a family had and medical futures of human beings are tate cancers, Alzheimer’s and other, rarer a gene-based disorder. Employment discrimi- greatly determined by the genes received diseases. The potential for good abounds in nation is another common fear, along with from their mothers and fathers. areas of prevention, early detection, treat- social ostracism. For the genes not only determine physical ment and, most spectacularly, cures. What happens when DNA screenings be- traits such as the color of a person’s eyes and But there is also tremendous potential for come readily and routinely available for a hair, but also a person’s predisposition to- abuse. In California, a government labora- whole range of diseases or conditions? Will ward certain medical ailments, ranging from tory had for years genetically tested govern- insurers be able to demand that would-be heart trouble and diabetes to cancer and Alz- ment employees for diseases, including sick- customers submit to such screenings? Will le cell anemia, without their knowledge fol- heimer’s disease. they be free to grant or deny coverage on the lowing pre-employment physicals. Even As the result of a national research effort, basis of the results? (The essence of insur- though genetic testing does not render a di- doctors are within a few years of completing ance is, after all, assessing and balancing agnosis, only indicators of increased risk, it a map of all the genes that make up human risks.) What about employers—what will has been used to deny medical insurance and beings, carefully identifying which gene does they be able to demand? charge higher rates. Such cases led Congress what. The overall aim, of course, is that one By comparison with civilian society, the to pass legislation in 1996 outlawing genetic day doctors will be able to use genetic infor- military has it easy. The Pentagon can sim- discrimination in group health insurance mation to treat people and make them ply promulgate rules for its DNA repository, healthier. plans serving 50 or more employees. But according to a Senior White House of- and it recently did. Among other things, That’s all well and good, as they say. Suf- ficial, many people who could benefit from those rules allow a service member to re- fering from diabetes? Well, the doctors will genetic testing still are deciding not to have quest that his or her DNA sample be de- just give you an injection of anti-diabetes it, solely because they are afraid the results stroyed immediately upon final separation genes, and you will soon become as healthy will be used against them by employers and from the military and require that the re- as a horse. insurers. quest be fulfilled within 180 days. But this fascinating research, with all of Last week President Bill Clinton took an Civilian society must work the issue its fine promise, has a terrible negative side important step, issuing an executive order through the process of public discussion, leg- if misused. Such genetic information on that forbids federal agencies genetic testing islative debate and legal enforcement. Laws John and Jane Q. Citizen—information that in any decision to hire, promote or dismiss will have to provide tough anti-discrimina- they are likely to suffer from heart disease workers. The order protects 2.8 milllion fed- tion strictures and confidentiality require- in their 40s or colon cancer in their 50s— eral employees. ments, with severe penalties for anyone who could be used by employers, insurance com- There is much left to be done. Genetic in- violates either. Congress should get to work panies or others to discriminate against formation that can be gleaned from testing on such laws quickly, because science is not them. will only increase, through innovations like standing still. Employers might not hire or promote Jane the biochip, which one day may be able to or John Q. Citizen because of the potential I yield the floor and I ask for the map from one strand of hair a person’s entire yeas and nays on the amendment. displayed by their genes that some future identity, from hair color to inquisitiveness. medical condition might cost them lost time Mr. Clinton challenged private sector em- The PRESIDING OFFICER. Is there a and higher insurance expenditures, as an ex- ployers to adopt similar non-discriminatory sufficient second? ample. Insurance companies, with a person’s policies. Even better is his endorsement of There is a sufficient second. gene map in their hands, might refuse to sell Congressional legislation sponsored by Sen. The question is on agreeing to that person insurance because of health Tom Daschle, D-S.D., and Rep. Louise M. amendment No. 3688. The clerk will risks. Slaughter, D-N.Y., that would make it ille- call the roll. President Clinton is acting correctly in gal for employers to discriminate on the The assistant legislative clerk called signing an executive order barring federal basis of genetic testing. agencies from discriminating against em- All of us are predisposed to some illness. the roll. ployees based on genetic testing. And he is No one should be penalized for discovering Mr. REID. I announce that the Sen- also correct in urging Congress to pass legis- what that illness might be. ator from Hawaii (Mr. INOUYE) and the S6078 CONGRESSIONAL RECORD — SENATE June 29, 2000 Senator from Vermont (Mr. LEAHY) are Hagel Mack Smith (OR) AMENDMENT NO. 3693 Hatch McCain Snowe necessarily absent. Helms McConnell Specter (Purpose: To require a federal floor with re- Mr. BYRD. Mr. President, may we Hutchinson Murkowski Stevens spect to protections for individuals en- have order, please. Hutchison Nickles Thomas rolled in health plans) Can we have the well cleared. Unless Inhofe Roberts Thompson Mr. DORGAN. Mr. President, I send Jeffords Roth Thurmond Senators are voting, Senators should Kyl Santorum Voinovich an amendment to the desk and ask for not be in the well. Lieberman Sessions Warner its immediate consideration. The PRESIDING OFFICER. The Sen- Lott Shelby The PRESIDING OFFICER. The ate will be in order. Lugar Smith (NH) clerk will report. Will those in the well vacate the NAYS—40 The legislative clerk read as follows: well. Akaka Edwards Mikulski The Senator from North Dakota [Mr. DOR- The result was announced—yeas 44, Baucus Feingold Moynihan GAN], for himself, Mr. KENNEDY, Mr. nays 54, as follows: Bayh Graham Murray DASCHLE, Mr. GRAHAM, Ms. MIKULSKI, Mr. Biden Harkin Reed LAUTENBERG, Mr. KERRY, Mr. EDWARDS, Mr. [Rollcall Vote No. 164 Leg.] Bingaman Hollings Reid REID, and Mr. HARKIN, proposes an amend- YEAS—44 Boxer Johnson Robb ment numbered 3693. Breaux Kennedy Rockefeller Akaka Edwards Lincoln Bryan Kerrey Sarbanes The amendment is as follows: Baucus Feingold Mikulski Cleland Kerry Schumer On page 92, between lines 4 and 5, insert Bayh Feinstein Moynihan Conrad Kohl Torricelli Biden Graham Murray Daschle Landrieu Wellstone the following: Bingaman Harkin Reed Dodd Lautenberg Wyden SEC. ll. Any Act that is designed to pro- Boxer Hollings Reid Dorgan Levin tect patients against the abuses of managed Breaux Johnson Robb Durbin Lincoln care that is enacted after June 27, 2000, shall, Bryan Kennedy Rockefeller at a minimum— Byrd Kerrey Sarbanes NOT VOTING—2 (1) provide a floor of Federal protection Cleland Kerry Schumer Inouye Leahy Conrad Kohl Specter that is applicable to all individuals enrolled Daschle Landrieu Torricelli The amendment (No. 3691) was agreed in private health plans or private health in- Dodd Lautenberg Wellstone surance coverage, including— Dorgan Levin Wyden to. (A) individuals enrolled in self-insured and Durbin Lieberman Mr. JEFFORDS. Mr. President, I insured health plans that are regulated NAYS—54 move to reconsider the vote, and I under the Employee Retirement Income Se- move to lay that motion on the table. curity Act of 1974; Abraham Fitzgerald McCain (B) individuals enrolled in health insur- Allard Frist McConnell The motion to lay on the table was Ashcroft Gorton Murkowski agreed to. ance coverage purchased in the individual Bennett Gramm Nickles market; and Bond Grams Roberts The PRESIDING OFFICER (Mr. (C) individuals enrolled in health plans of- Brownback Grassley Roth SMITH of Oregon). The Senator from fered to State and local government employ- Bunning Gregg Santorum North Dakota is recognized. ees; Burns Hagel Sessions Mr. SPECTER. Mr. President—— (2) provide that States may provide patient Campbell Hatch Shelby protections that are equal to or greater than Chafee, L. Helms Smith (NH) Mr. KENNEDY. Parliamentary in- the protections provided under such Act; and Cochran Hutchinson Smith (OR) quiry, Mr. President. Wasn’t the Sen- Collins Hutchison Snowe (3) provide the Federal Government with Coverdell Inhofe Stevens ator from North Dakota recognized? the authority to ensure that the Federal Craig Jeffords Thomas The PRESIDING OFFICER. The Sen- floor referred to in paragraph (1) is being Crapo Kyl Thompson ator from North Dakota was recog- guaranteed and enforced with respect to all DeWine Lott Thurmond nized. If the managers wish to pose an individuals described in such paragraph, in- Domenici Lugar Voinovich cluding determining whether protections Enzi Mack Warner inquiry—— provided under State law meet the standards NOT VOTING—2 Mr. SPECTER. Mr. President, I ask of such Act. the Senator from North Dakota to Inouye Leahy Mr. NICKLES. Mr. President, I sug- yield for a moment. gest the absence of a quorum. The amendment was rejected. Mr. DORGAN. I am happy to yield for VOTE ON AMENDMENT NO. 3691 The PRESIDING OFFICER. The the purpose of a question. clerk will call the roll. The PRESIDING OFFICER. The Mr. SPECTER. What I would like to The legislative clerk proceeded to question now is on agreeing to amend- say for the record is that we hope to call the roll. ment No. 3691. have a unanimous consent agreement Mr. SPECTER. Mr. President, I ask Mr. JEFFORDS. Mr. President, have here—we are not ready to propound unanimous consent that the order for the yeas and nays been ordered? it—where the Dorgan amendment and the quorum call be rescinded. The PRESIDING OFFICER. They the Nickles amendment, which would The PRESIDING OFFICER. Without have not been ordered. be ordinarily a second-degree amend- objection, it is so ordered. Mr. JEFFORDS. Mr. President, I ask ment, would be treated as first-degree Mr. SPECTER. Mr. President, I ask for the yeas and nays. amendments and try to seek a time unanimous consent that the Nickles The PRESIDING OFFICER. Is there a limit of 45 minutes on each. But we un- amendment be modified to be for- sufficient second? derstand that we are not in a position matted as a first-degree amendment There is a sufficient second. to do that because there has not been and that a vote occur on the Nickles The clerk will call the roll. an adequate opportunity to review the amendment, to be followed by a vote The legislative clerk called the roll. Nickles amendment. I wanted to make on the Dorgan amendment, with no Mr. REID. I announce that the Sen- that statement. amendments in order to the amend- ator from Hawaii (Mr. INOUYE) and the If the Senator from North Dakota ments prior to the votes. I further ask Senator from Vermont (Mr. LEAHY) are wants to lay his amendment down, unanimous consent that the debate necessarily absent. that is entirely appropriate. We just prior to the vote be 45 minutes for Sen- The result was announced—yeas 58, hope that when we have another ator NICKLES nays 40, as follows: and 45 minutes for Sen- amendment ready to go, either the ator DORGAN. [Rollcall Vote No. 165 Leg.] Helms amendment or Wellstone The PRESIDING OFFICER. Is there YEAS—58 amendment, we could set aside the objection? Abraham Campbell Enzi Dorgan amendment and proceed with Mr. KENNEDY. Mr. President, re- Allard Chafee, L. Feinstein argument on something we can close Ashcroft Cochran Fitzgerald serving the right to object, we are all Bennett Collins Frist debate on, and then come back at the operating in good faith and wanting to Bond Coverdell Gorton earliest moment to the Dorgan amend- move ahead. I ask if our floor staff has Brownback Craig Gramm ment, just as a management matter. seen this. I would like to, with all due Bunning Crapo Grams Burns DeWine Grassley The PRESIDING OFFICER. The Sen- respect, reserve a minute until our Byrd Domenici Gregg ator from North Dakota is recognized. floor staff has an opportunity to see it. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6079 Mr. SPECTER. Mr. President, I Patients should have the right to Senator REID and I held a hearing in amend the request to 55 minutes on know all of their medical options—not his home state of Nevada on the issue each side. just the cheapest medical options. That of the Patients’ Bill of Rights. At the Mr. KENNEDY. Parliamentary in- ought to be a fundamental right. hearing we had a mother come, the quiry: Is that on or in relation? Do I Patients ought to have the right to mother of Christopher Thomas Roe. understand that it is their intention to choose the doctor they want for the She stood up and told us about her son. have an up-or-down vote on both of care they need, including specialty He died October 12 of last year. It was these? care when they need it. That ought to his 16th birthday. The official cause of Mr. SPECTER. Up or down on both. be a right of patients who believe they Christopher’s death was leukemia, but Mr. KENNEDY. No points of order. are covered with a health care policy. the real reason he died is because he Mr. NICKLES. If I may respond to Patients ought to have the right to was denied the kind of opportunity for my colleague, I have no objection per- emergency room treatment and emer- patient care that he needed to give him sonally. I understand the chairman of gency room care wherever and when- a chance to live. He was diagnosed with the Budget Committee doesn’t want ever they need it. leukemia, but he had to fight cancer that waived. But it is not my intention Patients ought to have a right to a and his HMO at the same time. It is to raise a point of order on the Sen- fair and speedy process to resolve dis- one thing to tell a kid you have to ator’s amendment, nor on our amend- putes with their health care plan. And fight a dreaded disease, you have to ment. I think the Senator from New they ought to be able to hold their battle cancer. It is quite another thing Mexico has a standing objection. health care plan accountable if its de- Mr. KENNEDY. If it is the under- to tell that young child and his family: cision results in injury or death. Take on cancer and, by the way, take standing that we treat both of them The Senate passed a piece of legisla- on your insurance company as well. the same way, is it agreeable with the tion last year that was called the Pa- That is not a fair fight. That is never a floor manager that the point of order tients’ Bill of Rights. Some of us called be on both so they are both treated the it a patients’ bill of goods because it fair fight. The Roe family was told that the same way? was a relatively empty shell. Mr. SPECTER. It is. The House passed a Patients’ Bill of kind of treatment he needed to send his Mr. NICKLES. I have no objection to Rights that is a good bill. It is a bipar- cancer into remission was experi- that. tisan bill sponsored by Republican Con- mental. The family immediately ap- Mr. DASCHLE. Mr. President, I sug- gressman Norwood and Democratic pealed the health plan’s decision. The gest the absence of a quorum. Congressman Dingell. It passed by a review, which was supposed to take 48 The PRESIDING OFFICER. The 275–151 vote. hours during a very critical period of clerk will call the roll. Since that time, the Senate ap- this young boy’s life, took 10 days. As The legislative clerk proceeded to pointed a set of conferees on October the appeal dragged on, Christopher’s call the roll. 15, and the House appointed its con- condition worsened. And as Chris’s doc- Mr. SPECTER. Mr. President, I ask ferees on November 3. It wasn’t until tor had known, the traditional chemo- unanimous consent that the order for the end of February that there was a therapy did not work. the quorum call be rescinded. meeting of the conference committee. At the hearing, Chris’s mother, The PRESIDING OFFICER. Without As I said previously, the conference Susan, held up a very large picture of objection, it is so ordered. committee isn’t making much Christopher, about the size of this Mr. SPECTER. Mr. President, I chart. It was a picture of a strapping, renew the request, and, as previously progress. In this amendment, we deal with bright-eyed, 16-year-old boy. Susan stated, I ask unanimous consent that only one aspect of the Patients’ Bill of told Senator REID and I, with tears in there be 55 minutes on each side. her eyes, how Chris turned to her one The PRESIDING OFFICER. Without Rights and that is the question of the number of Americans that a bill of day not long before he died and said: objection, it is so ordered. Mom, I just don’t understand how they The Senator from North Dakota. rights should cover. If a Patients’ Bill Mr. DORGAN. Mr. President, let me of Rights is enacted by this Congress, could do this to a kid. This is a 16-year-old boy who died begin by describing this amendment we propose with this amendment that who wanted that extra chance to be and why I have offered it to this bill. Congress will cover all of the American Let me also say that the amendment people with private health insurance, cured but whose insurance company is not subject to a point of order. This rather than just the 48 million Ameri- said no, no, no. And he died. amendment deals with the Patients’ cans proposed to be covered in the Re- We all know the stories. There is the Bill of Rights. Quite simply, it says publican Patients’ Bill of Rights. We woman who fell off a 40-foot cliff in the that when this Congress enacts patient believe the Patients’ Bill of Rights Shenandoah Mountains. She was protection legislation, we should pro- should cover all 161 million Americans hauled into an emergency room uncon- tect all 161 million Americans enrolled in private health insurance plans, in- scious with broken bones and all kinds in private health insurance plans. cluding the 75 million people whose of physical problems. She survived and Many of us have been attempting to employers provide coverage through an was later told by her insurance plan: get this Congress to pass a meaningful HMO or private insurance. Unfortu- We will not cover your treatment be- Patients’ Bill of Rights, and so far, we nately, these folks are not covered in cause you didn’t have prior approval to have not been successful in doing so. the Republican plan. The 15 million get emergency room care. As most Americans know at this people with individual policies are not Or how about this young child, born point, more and more of the American covered in the majority party’s plan. with a horrible cleft lip? It is hard to people are being herded into HMOs and The 23 million State and local govern- look at. Dr. GREG GANSKE, a Member of managed care organizations which has ment employees are not covered in the the House of Representatives in the Re- jeopardized the quality of health care majority party’s plan. publican Party who supports this legis- they receive. Too often these days, de- We propose that when and if Congress lation, says in his practice that it is cisions about their health care are passes a Patients’ Bill of Rights, that often not considered a ‘‘medical neces- being made not by doctors but by some all 161 million Americans are covered sity’’ to fix this kind of problem. Let accountant in an HMO or in a managed by those provisions. Very simple. me show you how a child with this con- care organization 1,000 miles away. We understand from the previous dition looks when he receives proper We have all heard stories on the floor vote held a couple of weeks ago that medical intervention by a skilled sur- of this Senate about the problems pa- the majority in the Senate do not want geon. Is there a difference? How can tients experience when their health to pass our Patients’ Bill of Rights. We anyone look at these two pictures and care is viewed as a function of some- understand that. They voted against it. say fixing this condition is not a ‘‘med- one’s profit and loss, not of his or her But how about at least passing a part ical necessity’’? health care needs. of our Patients’ Bill of Rights, the part The point we are making with this We proposed a Patients’ Bill of that says everybody ought to be cov- amendment is very simple. Managed Rights to address these problems. It is ered? That is what I offer today as an care organizations hold the future of rather simple legislation. It says that: amendment. too many patients in the palm of their S6080 CONGRESSIONAL RECORD — SENATE June 29, 2000 hands. Decisions are not being made by passed. We have nothing that has come cans, or are we going to cover only a doctors in doctor’s offices. Too often, out of that conference. third of those, as was covered in the they are made in accountants’ offices We are going to have something now Senate Republican bill before and I 500 or 1,000 miles away. We are saying before the Senate, offered as an alter- daresay will be in the Republican bill that it is wrong to make medical deci- native to the Dorgan proposal, that tonight—although they have not sions a function of profit and loss. This evidently has been drafted solely by shared that with us, only with the staff country can do better than that. This Republicans. Whether it includes Re- for a few minutes. I daresay that will ought to be a slam dunk. The legisla- publicans in the House of Representa- be the fact. tion that provides real protection, a tives or not is something we will have Here it is. They cover 48 million— meaningful Patients’ Bill of Rights, to wait and see. I doubt it very much. self-funded proposals. They do not ought to get 100 votes in the Senate. Why? Because just this afternoon cover those fully insured; those who But we can’t get any movement on this Congressman NORWOOD, who was the are represented by Blue Cross or by at all from the conference committee principal sponsor of the Norwood-Din- Kaiser. They don’t cover those 75 mil- charged with working out the dif- gell bill, said in a press conference: lion. ferences between the House and Senate What is significant about today is that They don’t cover the individual mar- bills. all 21 Republican sponsors of the Nor- kets, the self-employed, the farmers, I know a few of the conferees and the wood-Dingell bill are standing behind child care providers, the truckers. chairman of the conference committee me and each of us has declared that we They don’t cover the teachers and were saying we have made great will not support any bill that does not the firefighters and the police officers. progress. I describe that progress in allow patients to choose their own doc- We cover all 161 million. They cover glacial terms. At least glaciers move tor, that does not protect all Ameri- 48 million. Here is a picture of Frank an inch or two a year. It is hard to see cans, and that does not hold the insur- Raffa, Vietnam veteran, decorated war that this conference moves at all. ance industry accountable for its deci- hero, 21 years in the fire department of We are only asking today to say with sions. It doesn’t matter what the Sen- Worchester, MA. He has two children. this amendment that if we are going to ate does today. The 25 us will vote Do you think he is covered? No, not pass a Patients’ Bill of Rights, let’s not against any bill that does not guar- covered under the Republican plan. create a hollow vessel. Let’s create a antee patients the protections they de- Why should Frank Raffa not be cov- Patients’ Bill of Rights that provides serve. If the Senate passes anything ered? Why should his family not be real protection for 161 million Ameri- less, they are killing the bill. covered, his wife and his children? He cans, not inadequate protection for 48 That isn’t a statement made by has dedicated his life to the people of million Americans. If we are going to Democrats; that was made by Repub- Worchester, MA, as a firefighter and to do this, let’s do it right. licans. this country in Vietnam. But, oh, no, That is the amendment. We will have So let’s understand it. Here are the the Republicans say we are not going a chance to vote on it. We understand leaders in the House of Representa- to cover State and county officials. that the majority of the Senate decided tives, in a bipartisan effort that got a No. 2, here we have Dave Morgan, they didn’t want a real Patients’ Bill of third of the Republican Party to pass with two of his 63 employees. He is a Rights. They wouldn’t vote for the en- an effective bill that we should pass, pharmacist in Boston. Tonya Harris tire package, the one that provides pro- and it failed by one vote only 2 weeks right here, she is a pharmacy techni- tection for young kids such as Chris- ago. We are being denied, week after cian, a single mother of two, and topher, who are fighting leukemia, or week after week, from being able to Rhonda Hines, another of Dave’s em- for young people born with this severe protect American families from being ployees. She is married and has three cleft lip deformity. So all we ask is harmed. children. Do you think working for a that whatever we are going to do with That statement is made by the Re- business they are going to be covered? respect to patients’ rights that we publican Congressman. The legislation Absolutely not. He is a community apply it to all Americans. Everyone we on this side of the aisle support is pharmacist. He worked hard building a ought to have the right and the oppor- supported by 300 organizations, includ- business employing 63 members of the tunity to expect decent health care ing every medical organization, every community. Some are in training, coverage if they have an insurance pol- doctor organization, every patient or- some are getting advanced degrees— icy. What about a Patients’ Bill of ganization, every organization that are they covered? Absolutely not. Why Rights for all Americans? represents women, every organization not? Why do you exclude those? Nor- I yield to the Senator from Massa- that represents children, every organi- wood-Dingell did not exclude them, chusetts. zation that cares about cancer—you why should we? The PRESIDING OFFICER. The Sen- name it, they support our proposal. Finally, Leslie Sullivan, a family ator from Massachusetts. Do you know who supports the other nurse practitioner in the Quincy Men- Mr. KENNEDY. Mr. President, the side? The insurance industry. They tal Health Center, a Massachusetts em- issue of providing protection for Amer- supported them before and they are ployee. She is not covered under the ican families has been before the Sen- supporting them tonight. So you will Republican plan. She has worked hard ate for the past 3 years, but we have have a chance to show, on the floor of all her life. been unable to pass legislation that the Senate, whether you are going to I want to hear a justification from will guarantee to the families of this cast your vote with those who have Senator NICKLES tonight why these country that medical decisions that been dedicated to protecting the lives people are being excluded. They can’t are going to affect them and the treat- and well-being of the families in this get it. We have insisted, in that con- ment of the family are going to be country, or protecting the profits of ference, on three basic things: One, you made on the basis of sound medical the HMOs. That is the issue as plain are going to have coverage and cover reasons rather than for the interests of and simple as can be stated. all Americans; No. 2, you are going to the HMOs. That is what this issue is all That is why Congressman NORWOOD, I have accountability; No. 3, you are about. think, has been so courageous, because going to have a definition of medical This chart indicates very clearly he understands it. He was there when necessity that is going to protect what has been happening. The Senate, the Senate considered 2 weeks ago the American consumers. in July 1999, about a year ago, passed Norwood-Dingell bill that failed by one At the end of 3 months of hearings, 3 legislation, the Republican bill, 53–47. vote. He was supporting our efforts, as months of meetings in the Nickles of- This 47 was basically the Norwood-Din- was the American Medical Association. fice—as much as I like and respect DON gell bill, virtually identical to the Nor- The particular amendment that Sen- NICKLES and consider him a friend, the wood-Dingell bill, which is a party-line ator DORGAN has proposed is a very fact is, of the 22 differences, only 2 had vote. The House passed the Norwood- basic and fundamental amendment been agreed to. Dingell bill 275–151 in October, 1999. that affects the Patients’ Bill of I will just take 3 more minutes. Here Then the House and the Senate con- Rights. It is the question of scope. Are are the guarantees under the legisla- ferees appointed. Now 8 months have we going to cover 161 million Ameri- tion that the Democrats support: 22 June 29, 2000 CONGRESSIONAL RECORD — SENATE S6081 different protections here. I would like better than States, and he always meal. Maybe we will do one on scope to hear from the other side: Which ones wanted the Federal Government to do and one on patient protections. don’t you want to guarantee to the it instead of States. I disagree with I tell my colleagues, this is not the American consumers? You don’t want that. We have a disagreement. That is way to legislate. We are on the Labor- to protect all of them? You don’t want one of the items we were wrestling HHS appropriations bill. Everyone to guarantee the specialists? You don’t with in conference. knows this bill is not going to come want to guarantee that women that are Now we have an amendment. back—maybe it will; maybe we will going to be able to go to an OB–GYN We tried to do this in a big fashion pass patient protections and put it on without first going to a general practi- last year. They had their amendments. Labor-HHS. My colleagues put min- tioner? You don’t want to guarantee We had a lot of votes on amendments imum wage on bankruptcy. Frankly, it prescription drugs? You don’t want to last year. Senator KENNEDY lost. We is a complicated effort for both bills. guarantee the emergency room? These had an amendment on scope. We de- Minimum wage did not belong on bank- are our guarantees. This is what we bated that last year. The Senator from ruptcy and patient protections does stand for. If the Republican bill em- Massachusetts lost. The majority of not belong on Labor-HHS. braces those without the loopholes, we the Senate said: No, we don’t want the Are they seriously legislating? No. will support it. But if it does not, it Federal Government to take over State Did they come up with a serious legis- ought to get defeated. That vote ought regulation of insurance. We don’t think lative proposal? They have a two-page to be no, and we ought to continue to HCFA is very good at administering proposal on scope. What is the amend- fight in this Congress to make sure we the insurance. They have a hard ment offered by my friend from North get a good Patients’ Bill of Rights. enough time in Medicare. Do we really Dakota? He has an amendment which I reserve the remainder of our time. want them to regulate State insur- deals with scope. The PRESIDING OFFICER. The Sen- ance? The Senate said no. The House My colleague talked about all these ator from Oklahoma is recognized. said yes. We were negotiating that. patient protections. Guess what. They Mr. NICKLES. Mr. President, I regret Incidentally, that is one of the things are not in his amendment. His amend- our colleagues on the Democrat side of we are negotiating as we speak. But ment basically says: We want the Fed- the aisle have decided to once again try my colleagues on the Democrat side eral Government to set standards, and, to turn an issue, an important issue, didn’t wait for the conference. Two oh, States, you have to meet these Patients’ Bill of Rights, into a political weeks ago they said: Let’s ignore the standards. If not, the Federal Govern- theater and not legislate, not come up conference. Let’s just adopt the House ment is going to take over. with reasonable compromise. Instead, position. In spite of the fact we have This little amendment, which looks they want votes. They want to try to reached a bicameral agreement on a lot innocuous and is like a thematic state- score points. I find that to be unfortu- of patient protections, including the ment, says we are going to have the nate because we are working very hard appeals process which, for my col- Federal Government design, mandate, to try to come up with a responsible leagues’ information, is the backbone and dictate benefits, and, States, if you product. of the bill. It is the most important do not meet these dictates, we are A compromise in the conference com- thing in the bill because if you do a going to have the Federal Government mittee is not easy on this issue because good job in the appeals process, you take over; HCFA will take over; you the differences between the House bill don’t have to go to the courthouse. will have to follow the HCFA standard. and the Senate bill are significant. The patients who need care, whether This is the GAO report: Implementa- They are significantly different in cost it is the cleft palate that my colleague tion of HCFA. The headline says: and scope and liability. We are trying continues to show in the picture—they ‘‘Progress slow in enforcing Federal to bridge those differences. It takes are going to have an appeal under the standards in nonconforming States.’’ time, it takes compromise, it takes bill that we have. They are going to get We have a lot of States not conforming both sides working together. care. It is going to be decided by a med- with existing laws where HCFA is sup- We made a lot of progress with our ical expert totally independent of the posed to have control—ask any of your colleagues on the Democrat side, in plan. That is going to be a binding de- doctors. Some people profess they want spite of what my good friend from Mas- cision. The person who is denied health to be helpful to doctors. Ask the doc- sachusetts says, a lot more progress care is going to have an appeal and is tors. If we adopt the Dorgan amend- than 2 out of 20 items. We agreed on an going to get the health care they need ment, we are asking HCFA to take over appeals process. Maybe not on every when they need it; not just go to court. State regulation of health care. That single last letter, but by and large we Mr. KENNEDY. Will the Senator would be a disaster. That would not agreed on the appeals process. We in- yield? improve quality health care. That vited the press in; we came to an agree- Mr. NICKLES. No, I will not yield. I would duplicate State regulation, con- ment. It took about 2 months. I have a lot of comments to make. fuse State regulation, and have Federal thought it should have taken a week. Maybe I will yield at a later time. regulators who do not have the where- The reason why it took 2 months is be- Instead of waiting for the conference withal or the talent—they say so them- cause our friends on the Democrat side to work, my colleague from Massachu- selves. They say in this report they do always kept wanting a little bit more. setts put the Patients’ Bill of Rights not have the talent; they cannot do it. That is tough negotiating. I am not on either the Department of Defense They are not doing it in existing law. faulting them for that. But they are authorization bill or the Defense appro- They have three areas in existing law the reason why it took 2 months to priations bill. they are supposed to enforce, and they come up with an appeals process. We There is no way in the world that bill are not doing it. This is the GAO report basically agreed with it. is ever going to come out of conference. saying this, not DON NICKLES. It is fact. I just have to make a mention on It was nothing but political theater. It And we are going to give them regula- scope. When they say: Wait a minute, disrupted the conference. I told him tion over State health care? That is ab- their bill only applies to 50 million and and my colleagues and I planned on surd. I know some people want na- our applies to 161 million; it should having a conference that day with my tional health care. They want the Fed- apply to everybody—our plan applies to Democratic colleagues. No, they en- eral Government to regulate health everybody covered by ERISA. That is gaged in political theater because care in the States. I do not. I think it the plan we are amending, every em- maybe some people wanted to have a would be a serious mistake. ployer-sponsored plan. headline that said: ‘‘Senate defeated What about scope? I know the Senator wants to overrule Patients’ Bill of Rights.’’ We moved to Mr. KENNEDY. Will the Senator the State of Massachusetts State em- table the amendment. The vote was 51– yield? ployee plan, he wants to regulate State 48. It accomplished nothing but head- Mr. NICKLES. I want to continue be- individual plans—he wants national lines for my colleagues. fore I lose my train of thought. health care. I compliment him. He is Two weeks after the vote, we have What about scope? The scope pro- being consistent. He always thought another Patients’ Bill of Rights. Maybe posal in our bill applies to every single the Federal Government could do it we will have several and do them piece- ERISA-covered plan. Every employer- S6082 CONGRESSIONAL RECORD — SENATE June 29, 2000 sponsored plan would have an external tember. I am happy to do that. No, cians; provider nondiscrimination; di- appeal because that is ERISA. It has they want to score points. They want rect access to specialists; continued Federal remedies. press conferences. They are not inter- care from a physician; timely binding We also included in this proposal a ested in patient protections. They are appeals to an independent physician; cause of action, a cause of action li- interested in press conferences and po- agreement on direct access to OB/ ability. In case the external appeal litical theater. GYNs; agreement to improve plan in- overturns the HMO and they do not They are not interested in helping formation; agreement on access to out- pay, we say you can sue the HMO. We patients. If they were interested in of-network physicians; agreement on did not have that in the bill before. We helping patients, they would be work- open discussion on treatment options did not have liability. We com- ing with us to resolve and compromise with physicians; agreement on access promised. in conference. Unfortunately, that is to prescription drugs; and agreement Some say the conference has not not the case. Maybe they will have the- on access to cancer clinical trials. done anything. We made a concession. ater, but we are going to give people We have made a lot of progress. My We have liability in our proposal so pa- substance on which to vote. colleagues say we have not done that. tients can sue HMOs. It turns out that Last time, when my colleague from Are we going to say the language we a lot of our colleagues want to sue Massachusetts offered basically the drafted is so much better than any- more, on every case. They want to turn House-passed bill—let’s adopt the thing the States can do and so we have this into an invitation for litigation. House position—we said no, and we ta- to supersede their language? Some peo- We do not. bled it. We saw the headlines: ‘‘Repub- ple think we are the font of all wisdom. We do have cause of action. We have licans Defeat Patients’ Bill of Rights.’’ I do not agree with that. It is absurd remedies allowing patients to go after Guess what. Today we are going to pass for us to say that. the HMO, and, frankly, the employer, if a Patients’ Bill of Rights. We are going States have been issuing patient pro- acting as the HMO, if they are the final to pass a Patients’ Bill of Rights and tections. Forty-three States have al- decisionmaker, if they are the ones de- give every single patient in America ready passed patient protection bills nying health care, if they are the ones who happens to be in an employer- way ahead of the Federal Government. causing injury, harm, damage, or sponsored plan an appeal. If they are I think it would be presumptuous of death, because of their decision to deny denied health care by an HMO, they us to say: We are going to draft some- health care, they can be held liable. My will have an appeal, done by a medical thing. We know it is better. And point being: We have moved forward in professional, an expert, using the best States, you must comply. If you don’t the conference. We have made com- medical evidence available. It is a bind- comply, the Federal Government is promises. We have been working. ing decision. going to come in to regulate. This is not the way to legislate: We If for some reason that appeal is not That is a serious mistake. I do not will put, at 5 o’clock on a Thursday adhered to nor complied with, they will want to do it. afternoon, on the Labor-HHS bill and have a right to sue. They can sue their I urge my colleagues to vote yes on say we are going to do part of patient HMO, they can sue the final decision- the proposal that I have submitted on protections, we are going to pick out a maker, if it is a self-funded, self-in- behalf of myself and several others who piece of it, a very significant piece. sured employer, if they make a deci- have worked for over a year and a half Maybe we will do another piece tomor- sion to deny health care. They can sue to put together. I urge my colleagues row. them in those circumstances. We are to vote in favor of that. And I urge my That is not the way we are going to offering real patient protections. colleagues to vote no on the Dorgan- do it. We offered a significant com- Time and again I have heard: We Kennedy amendment. prehensive proposal, one that deals have to have patient protections where I yield the floor. with scope, liability, patient protec- there is remedy against HMOs denying Mr. KENNEDY. Will the Senator tions, one that has an appeals process health care. We do that in this bill. We yield for one question? that will apply to every single em- do not want people going to court; we Mr. NICKLES. I am happy to yield on ployer-sponsored plan in America. We want them to settle it in the appeals your time. are going to give everybody a chance. process so they get health care when Mr. KENNEDY. I yield myself 2 min- You will not be voting on a real pa- they need it, not through the court sys- utes for that purpose. tient protections bill, not the one Sen- tem when it is too late. We want to re- What is the scope of and coverage in ator DORGAN offered as a two-page solve those cases. We want people to the Senator’s proposal, not what will amendment. We have an amendment get health care. apply in terms of internal-external ap- pending that is 250 pages that has real On the patient protections—about peals, but what is the total coverage? patient protections and one we have which my colleague says the Senate Mr. NICKLES. The total coverage is, been working on for over a year. does not do anything for the firefighter on scope, every single employer-spon- Frankly, over half that language— in Massachusetts, we want patient pro- sored plan in America would have the maybe over 70 percent of that lan- tections—we just do not think we are right to internal-external appeals. guage—has been negotiated with our protecting patients by coming up with Mr. KENNEDY. In terms of numbers, colleagues on the Democratic side of some facade that the Federal Govern- what are we talking about in the NICK- the aisle. It had tentatively been ment is going to take care of them LES proposal? The initial proposal, the signed off by Democrats and Repub- when we know it cannot, and have the first proposal, was 48 million. We are licans, House and Senate. It has pa- Federal Government basically preempt talking about 161 million in the Dorgan tient protections. It has an appeals State law with national health insur- proposal. Does the Nickles proposal in- process. We have a significant proposal. ance. clude 161 million American families? We do not have two pages. We have a Look at the countries with national Mr. NICKLES. To answer my col- Patients’ Bill of Rights. We have rem- health care. Do they have the quality league’s question, on the appeals proc- edies and cause of action where some- of health care that we do in this coun- ess, it applies to 131 million Americans. one can sue an HMO or sue a final deci- try? The answer is no; absolutely not. We do not say we should design plans sionmaker if they are denied health People think we can draft these patient written by the States for State em- care. We have a good proposal, and I protections in Washington, DC, and do ployees or for city employees or indi- hope my colleagues will vote for it and a better job than the States. I happen viduals. Those have always been regu- against the Dorgan proposal. to disagree. I will give some examples. lated by the Federal Government. They We will have up-and-down votes on The States have done a lot with pa- have never been regulated by ERISA, both proposals, on a bill on which nei- tient protections. We should not ignore and they aren’t regulated by them in ther one belongs. That is not my that. We should encourage it and com- our bill, either. choice. I told my colleagues on the pliment it. We should encourage them Mr. DORGAN. Mr. President, let me Democratic side that I will agree to a to do more. It would be presumptive. answer the question of the Senator time certain and a vote on both of We negotiated access to emergency from Massachusetts. The Senator from these proposals sometime—July, Sep- room care; direct access to pediatri- Oklahoma took a long while to say no. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6083 Their proposal does not cover the 161 incumbent upon myself to answer the stance, that he would be judged by the million Americans. It is essentially the question: Aren’t you being inconsistent standard of ‘‘the reasonable layperson’’ same proposal we have seen previously. by now supporting a national standard in terms of access, that he would not It falls far short of covering the major- of patients’ rights? Why not leave it up be judged, as happens to be the case in ity of the American people who our to the 50 States to decide for the 113 my own State of Florida, not by the proposal would cover. million Americans who have private reasonable layperson standard, which Mr. President, I yield 10 minutes to insurance rather than self-funded em- is the rule in Medicare and Medicaid the Senator from Florida, Mr. GRAHAM. ployer plans? Why shouldn’t those 113 and most States but, rather, as he is in The PRESIDING OFFICER. The Sen- million Americans be covered by a Florida, by the standard of an appro- ator from Florida. State’s Patients’ Bill of Rights? priate health care provider making a Mr. GRAHAM. Mr. President, the I would like to answer that question determination after the fact as to issue before us today is whether we are in the context of one of the provisions whether the patient should or should going to give the American people within this bill, and that is how you not have considered his or her condi- what I believe they expect and what will be treated if you go to an emer- tion requiring emergency room treat- they have a right to receive which is gency room. I think it is an appro- ment. uniform, consistent coverage of their priate provision to use as an example It also avoids confusion by the pro- fundamental rights as beneficiaries of of the larger question of whether this vider because the provider will know an HMO contract and as patients in a should be determined 50 times by the 50 that they can render services to all the health care facility as it relates to the States or should there be a national people who come into the emergency responsibilities of that health mainte- consistent standard. room based on a single set of standards nance organization. The emergency room happens to be in terms of what is in that individual’s The Senator from Oklahoma has in- the site of the largest number of com- best interest. dicated he is going to submit to us a plaints by patients against their HMO’s Talking about emergency rooms spe- counterproposal to the provision that treatment. There are more complaints cifically, as I understand it, in the pro- has been offered by the Senator from as to access, as to standard of care, and vision of the Senator from Oklahoma, North Dakota, which focuses on one of as to care after the initial critical serv- rather than using the norm, which is a the most fundamental issues and that ices are provided, there are more com- 1-hour period in which the HMO can de- is, who is going to be covered. plaints by patients in that setting than cide whether they will assume respon- It is a little difficult for us to re- any other aspect of patient-HMO rela- sibility for the patient in the emer- spond to the Senator from Oklahoma tionships. gency room or allow the hospital of the since at least none of us on this side of The emergency room is also a setting emergency room to render the aisle has had an opportunity to see which is heavy with urgency and emo- poststabilization care, the Senator the version of the amendment that will tion. That is not just watching ‘‘ER’’ from Oklahoma is going to propose be offered. It is similar to seeing a bi- on television; it is the emergency room that that 1-hour standard, which is the plane fly by with a long sign dragging in reality. standard for Medicare, for Medicaid, behind its tail. That is what we see—a I have a practice of taking a different for most plans, is now going to be long, fluttering sign that says Pa- job every month. In February of this ballooned up to 3 hours. So for a person tients’ Bill of Rights. But we can’t see year, my job was working at the emer- who has been in a serious automobile any of the detail that supports that gency room in one of the largest hos- wreck, who has had bleeding, hem- title of a Patients’ Bill of Rights. pitals in Florida, St. Joseph’s Hospital orrhaging, who is in very serious cir- The question raised by the amend- in Tampa. In that setting, I had an op- cumstances and has been stabilized but ment of the Senator from North Da- portunity, firsthand, to see some of the not yet cured or not yet cared for, we kota is whether we should have a na- issues that an emergency room poses are going to have a 3-hour period for tionwide standard or whether we for an HMO patient, such as the ques- that individual to wait for the HMO to should have 50 standards. tion of the patient arriving and asking decide whether it is OK for the hospital We have already answered that ques- the question: Am I going to be covered where the injured patient is located to tion as it relates to the 39 million for the services that I will secure from provide the care there, or is the patient Americans who are covered by Medi- this emergency room? going to have to be put in an ambu- care. We have a national standard for Am I entitled to access to the emer- lance and carried to one of their net- all of those 39 million Americans. gency room? work hospitals. I don’t think that con- We have answered that question for It is the question of: Have I come to fusion as to standard is good medical the 20 to 25 million Americans who get the right emergency room? Should I policy for the providers. It is even not their health care through the Medicaid have gone to the emergency room that good policy for the insurance compa- program. All of those people are cov- is part of the plan of my HMO or can I nies that have to deal with 50 different ered by a national standard. go to this emergency room because it State standards as to authorization, The question is whether we are going is a half hour closer? length of poststabilization care, the to provide for those people who get It is the question of: What is going to other issues that arise in an emergency their insurance through private HMO happen after they stop the hem- room. companies rather than through one of orrhaging and have moved into the Mr. President, as a self-declared Jef- these governmental programs to also poststabilization period? What kind of fersonian Federalist, this is a case in be granted the right to have a national services can I receive, and what types which we need to have a national standard. of authorization do I have to get from standard because it is for the benefit of The amendment Senator DORGAN has my HMO to be certain that those serv- the good health of the American peo- proposed would cover all 161 million ices are going to be paid for? ple. I urge adoption of the amendment Americans with private insurance. Those are very fundamental, tangible offered by the Senator from North Da- They will receive the same full array of questions that a family who is taking a kota. protections. The proposal that I antici- loved one to an emergency room will Mr. NICKLES. Mr. President, I am pate from the Senator from Oklahoma want to have answered. assuming we have an informal agree- will only fund one type of insurance: I suggest it would be preferable to all ment to go back and forth and to try to self-funded employer plans, which of the parties involved in this urgent keep the time fairly equally divided. I cover only 48 million Americans. The transaction in an emergency room if might ask of the Parliamentarian what others will be left out. there were a standard set of answers, the division of time is remaining. I take second place to no Member of whether you were in Tampa or Topeka The PRESIDING OFFICER (Mr. BEN- this body in terms of my support for or Tacoma, WA; that you would get the NETT). The Senator from Oklahoma has federalism. I basically believe in the same answer. It would be beneficial to 40 minutes remaining, and the Senator principle that, where possible, deci- the beneficiary, to the patient, to know from North Dakota has 24 minutes. sions should be made at the commu- that there would be a consistent set of Mr. NICKLES. I yield 7 minutes to nity and State level. So I consider it standards, that he would know, for in- my colleague from Tennessee. S6084 CONGRESSIONAL RECORD — SENATE June 29, 2000 The PRESIDING OFFICER. The Sen- rights, now 3 years ago. For ER serv- No. 8, gag rules: Under the Nickles ator from Tennessee. ices, emergency room services, 4 years bill, plans are prohibited from includ- Mr. FRIST. Mr. President, I rise in ago they passed a Patients’ Bill of ing gag rules in providers’ contracts or support of the Nickles bill a little bit Rights. They passed consumer griev- restricting providers from commu- hesitantly—not my support—because ance procedures; breast reconstruction nicating with patients about treatment of a conference which is underway in 1997; direct access to OB/GYNs options. which pulls together bills passed by the passed in 1998 in Florida; direct access No. 9, access to approved cancer clin- House of Representatives and by the to dermatologists, 1997; external ap- ical trials: Again, this is very impor- Senate wherein progress is being made peals, 1997. tant. We have heard a lot about the so that we can assure the American It comes down to the basic premise human genome project today and the people of a real Patients’ Bill of that we believe we should write a bill great advances. That is good because it Rights. in terms of scope, in terms of the ten gives you the ‘‘phone book.’’ We have This process seems to be interrupted patient protections that apply to those to figure out what it means. In the time and time again, if not with bills people under Federal jurisdiction, and same way, if you have new pharma- brought to the floor, with press con- not come in and say we know better ceutical agents, or treatments for can- ferences day after day. You haven’t than the Governor of the Assembly of cer, you have to figure out whether or seen that from this side. You have seen Florida or Tennessee or Arkansas. not they work; therefore, access to ap- us working on a very aggressive, daily Very briefly, I will talk about the pa- proved cancer clinical trials. The Nick- basis, in a bipartisan, bicameral way to tient protections. les bill provides coverage of routine pa- put together a Patients’ Bill of No. 1, emergency care: Under the tient costs associated with participa- Rights—a real challenge because of the Nickles bill, plans must allow access to tion in approved cancer clinical trials number of interests, the number of pa- emergency service. This provision sponsored by the NIH, the Department tient protection issues such as scope guarantees that an individual can go to of Veterans Affairs, the Food and Drug and liability. We are making progress. the nearest emergency room regardless Administration, and the Department of Because of the political theater that of whether the emergency room is in Defense. seems to be the name of the play put the network, in the plan or outside of No. 10, provider nondiscrimination: forth on the other side, we have our re- the plan. It is the nearest emergency Under the Nickles bill, plans may not sponse tonight. I am very excited about room. So these press conferences where exclude providers based solely on their it. I am very excited because we are you see pictures of people skipping to license or certification from providing putting on the table a real Patients’ different emergency rooms, it is not in services. Bill of Rights which has the objectives the bill. In this bill you go to the near- No. 11, after breast surgery, mastec- of returning decisionmaking back to est emergency room. tomy length of stay, and coverage of No. 2, point of service: In this bill all that doctor-patient relationship, of second opinions: Plans are required, beneficiaries covered by a self-insured getting HMOs out of the business of under the Nickles bill, to ensure inpa- employer of 50 or more employees must practicing medicine but not having the tient coverage for the surgical treat- have a point of service option regard- unnecessary mandates which need- ment of breast cancer for a time deter- less of how many different closed panel mined by the physician, in consulta- lessly drive the cost of health insur- options an employer offers. ance so high that people lose their tion with the patient. No. 3, access: Specialists such as an The PRESIDING OFFICER. The time health insurance. obstetrician/gynecologist, under the The alternative bill on the other side of the Senator has expired. Nickles bill, patients receive a new Mr. FRIST. Mr. President, I yield the of the aisle—one that was defeated last right for direct access to a physician floor. year, a very similar bill defeated 2 who specializes in obstetrics and gyne- Mr. LOTT. Mr. President, I have a weeks ago—we know would drive about cological care for all obstetrical and unanimous consent request that has 1.8 million people to the ranks of the gynecological care. been cleared now on both sides of the uninsured. No. 4, access to pediatricians: Under aisle, if I may interrupt momentarily. I can tell the Senate, as a physician, our plan, a pediatrician may be des- I ask unanimous consent that the as a policymaker, somebody who has ignated as the child’s primary care pro- motion to waive the Budget Act for now spent more than 2 years on this vider; that is, if a plan requires the des- consideration of the Gramm point of bill, we are obligated to the American ignation of a primary care provider for order be withdrawn. people to present a bill which is a Pa- a child. I further ask consent that the tients’ Bill of Rights that does not un- No. 5, continuity of care: Under the Gramm point of order be temporarily necessarily drive people to the ranks of Nickles bill, when a provider is termi- laid aside, to be recalled by the Sen- the uninsured by driving up cost. That nated from the plan network, patients ator from Texas, after consultation process is underway. It is interrupted currently receiving institutional care, with the majority leader and the mi- once again tonight. if they are terminally ill, may continue nority leader, and the Chair rule on the Tonight, for the first time, we are that treatment with the provider for a point of order immediately, without going to be able to put a new bill that period of up to 90 days. any intervening action, motion, or de- reflects this bicameral, bipartisan No. 6, access to medication, a real bate. work of the conference on the table. I issue for physicians and for patients, The PRESIDING OFFICER. Without would like to concentrate a few min- this whole idea of a formulary: under objection, it is so ordered. utes on the actual ten or so patient the Nickles bill, health plans that pro- Mr. LOTT. I yield the floor. protections that are in the bill that vide prescription drugs through a for- Mr. DORGAN. Mr. President, I yield 5 Senator NICKLES has put forward. mulary are required to ensure the par- minutes to the Senator from Rhode Is- We heard a little bit from the Sen- ticipation of physicians and phar- land. ator from Florida on a Florida Pa- macists in designing the initial for- Mr. REED. Mr. President, I rise in tients’ Bill of Rights and patient pro- mulary and in reviewing that for- support of Senator DORGAN’s proposal. tections. We will come back and talk mulary. It is very straightforward, simple, and about the scope of the bills a little bit If there are exceptions from that for- it states categorically that all Ameri- more, but in Florida there are a total mulary and a nonformulary alternative cans covered by health insurance of 44 mandates that have already been is available, then the patient has ac- should have the protections of the Pa- passed by the legislature and are law in cess to that nonformulary alternative. tients’ Bill of Rights. Nothing could be Florida today. The simple question is, No. 7, access to specialists: As a clearer or more effective and efficient Why do we in this body think we can do heart and lung transplant surgeon, this in providing protections to the Amer- a better job when the State has juris- is something I believe is absolutely ican people, to which we all, by and diction already in putting forth man- critical and very important to have in large, agree. dates? the Patients’ Bill of Rights. With the We have seen this proposal in the For example, in 1997, the State of Nickles bill, patients will receive time- Democratic legislation that was sub- Florida passed a comprehensive bill of ly access to specialists when needed. mitted to this Chamber. It is included June 29, 2000 CONGRESSIONAL RECORD — SENATE S6085 within the Norwood-Dingell legislation Now, also, they talk about the fact This Center will take the lead on pa- in the other body. It is consistent, it is that the cost of these patient protec- tient safety research and knowledge appropriate and, frankly, it seems so tions will go up dramatically. Yet the dissemination so that what is learned common sensical. Why should an Senator from Tennessee just an- about reducing medical errors can be American citizen be denied protections nounced a long list of protections that communicated across the country as and practices and benefits because he apply to ERISA plans. Why, if these quickly as possible. or she is in an ERISA plan rather than are so onerous and costly, would we The Institute of Medicine’s report a non-ERISA plan? ERISA is a time allow them to be applied to ERISA also calls on Congress to provide con- and security income program created plans and not to other plans? The an- fidentiality protections for informa- to protect the solvency of retirement swer, I think, also should be obvious. It tion that is collected for the purposes funds and the financial aspects of these is that, in fact, these proposals are not of quality improvement and patient plans. It was never intended to be a only necessary but appropriate, and study. This is the only way to get doc- health care plan or to define the cov- that the costs will not unnecessarily tors and nurses to begin to voluntarily erage for health care plans in the drive people away from insurance pro- report their errors. These protections United States. So on that point alone, tection. apply only to medical error reporting it seems to be an inappropriate way to So what we have in the Republican systems and do not diminish the cur- discriminate against those Americans proposal is based upon illogical prem- rent rights of injured patients. They who have access to the protections of ises, distinctions that should not be in will still have access to their medical the Patients’ Bill of Rights. place with respect to ERISA or non- records and they will still have the I have been listening to the proposals ERISA, and also would create a com- same right to sue as they do now. by the Senator from Oklahoma and the plexity that is one of the banes of our We heard loud and clear at our four description of the Senator from Ten- health care system today. On this side, hearings that we need to encourage the nessee and trying to understand their and also on the bipartisan measure reporting of close calls. A close call is proposals. My understanding is this: adopted by the House of Representa- a situation in which a mistake is made, They have—and Senator FRIST has an- tives, you have a very simple, direct but it does not result in injury to the nounced a long list of protections and rights, and they only apply to ERISA proposal that will cover every Amer- patient. No harm is done, but the po- plans—48 million Americans. The ap- ican—not just in the appeals process tential for harm is there. peals process, however, would be ex- but in the basic rights they have. I Many times these ‘‘close calls’’ or panded to apply to 131 million Ameri- think, in comparison, it is clear that ‘‘near misses’’ are the result of prob- cans. we should support the amendment of lems with the system. The nurse cal- Now, it appears to be inconsistent, the Senator from North Dakota. culates the dose incorrectly because but I think the rationale and the logic Mr. NICKLES. Mr. President, I yield the medication name ordered was fo- is pretty clear. If you don’t have 5 minutes to the Senator from linic acid and she is accustomed to giv- rights, it doesn’t matter whether or Vermont. ing folic acid. The doctor orders an in- not you have an appeals process. If you The PRESIDING OFFICER. The Sen- appropriate medication because he has don’t have the rights outlined by the ator from Vermont is recognized. no way to know that another doctor Senator from Tennessee, then you Mr. JEFFORDS. Mr. President, if we has given his patient a medicine that could have the appeals process, but are going to talk about improving pa- will interact. what are you appealing? You are ap- tient care, we should talk about im- Studies show that mandatory sys- pealing nothing. It comes back to the proving quality of care. We believe tems may actually suppress rather point that Senator DORGAN has made that every patient is entitled to the than encourage reporting. Punishment so well. This issue is about scope, so best medicine available. Reducing med- of individuals who make mistakes is that not only do you have the right to ical errors is an important part of im- not only ineffective, it is not the goal. appeal—all Americans—but you actu- proving quality. In fact, it is a critical The goal is patient safety. ally have valid rights that you can in- issue. It is time that we include our health sist upon in an appeals process. That is The Institute of Medicine released a care industry in the list of industries included within the Democratic pro- report late last year, which I re- that have adopted continuously quality posal, the Norwood-Dingell bill, and it quested. It focused our attention on improvement and have taken signifi- is significantly absent from the Repub- the need to reduce medical errors to cant steps to reduce human errors. lican proposal we are hearing today. improve patient safety. The IOM report Good people make mistakes. We need Now, the justification, of course, for said that more people in this country to do everything we can to put the sys- this approach—the Republican ap- die of medical errors than die of breast tems in place to ensure that health proach—is we can’t disrupt State regu- cancer, AIDS, or motor vehicle acci- care mistakes are very hard to make. lations, or the sanctity of State regula- dents—the one statistic we cannot ig- Neither the Institute of Medicine nor tions. However, step back and look nore. In response to this report, the Congress discovered this medical error again. Under the pressure of Norwood- HELP Committee held four hearings. problem. Health care professionals Dingell, the pressure of Senator DOR- On June 15, Senator FRIST, Senator have been at work for some time in GAN’s proposal, and the pressure build- ENZI, and I introduced S. 2738, the Pa- trying to address medical errors. I hope ing up month after month of trying to tient Safety and Errors Reduction Act. that by becoming a partner in this bring this Patients’ Bill of Rights to This amendment, which is based on process, the federal government can ac- the floor for final passage—something our legislation, will attack the prob- celerate the pace of reform and provide solid and substantive—the appeals lem of medical errors in several ways. the most effective structure possible. process has been expanded. When it First, it will provide a framework of I am pleased that this confidential, comes to appeals, we are saying we support for the numerous efforts that voluntary, non-punitive approach to don’t care about State regulations any- are underway in the public and private addressing medical errors has the sup- more. That argument falls out. If we sectors. Second, it will establish a cen- port of both the provider community don’t care about the appeals process ter for quality improvement and pa- and their oversight agencies. with respect to the sanctity of State tient safety within the agency for We cannot afford to wait on this regulations, why do we care when it health care research and quality. Fi- issue. The Nickles amendment will comes down to fundamental rights? Or nally, it will provide needed confiden- raise the quality of health care deliv- why do you care about it in this, I tiality protections for voluntary med- ered by decreasing medical errors and think, inappropriate, illogical, and ir- ical error reporting systems. These increasing patient safety. relevant distinction between ERISA provisions are consistent with the In- Mr. DORGAN. Mr. President, how plans and non-ERISA plans? The an- stitute of Medicine’s recommendations. much time remains on each side? swer is, this ERISA distinction is a The IOM report calls on Congress to The PRESIDING OFFICER. The Sen- convenient dodge to avoid providing establish a center for quality improve- ator from North Dakota has 19 min- rights for all Americans in this health ment and patient safety at the agency utes, and the Senator from Oklahoma care bill. of health care research and quality. has 27 minutes. S6086 CONGRESSIONAL RECORD — SENATE June 29, 2000 Mr. NICKLES. Mr. President, I yield fectionately known as HIPAA. I quote state does. For example, despite our to the Senator from Wyoming 5 min- from the report: elevation, we don’t need the mandate utes. Nearly only four years after HIPAA’s en- regarding skin cancer that Florida has The PRESIDING OFFICER. The Sen- actment, HCFA continues to be in the early on the books. My favorite illustration ator from Wyoming. stages of fully identifying where enforce- of just how crazy a nationalized system Mr. ENZI. Mr. President, I thank the ment will be required. of health care mandates would be Senator from Oklahoma. There are all kinds of stories about comes from my own time in the Wyo- I, too, am distressed that we are de- the Washington bureaucracy. Under ming legislature. It’s about a mandate bating the scope at this point. We had their scope, they want us to give up the that I voted for and still support today. the opportunity to discuss this in a bi- State plans in favor of this group that You see, unlike in Massachusetts or partisan way and to come up with good is still trying to figure out where they California, for example, in Wyoming we solutions. We were making good are going. Is that responsible? No. have few health care providers; and progress. We have been making good There are other things that need to their numbers virtually dry up as you progress. Unfortunately, the opposition be negotiated out in this bill. But that head out of town. So, we passed an any has decided that a national health care is not an option we are being given willing provider law that requires plan is the only way to go. A national when they start piecemeal. Every piece health plans to contract with any pro- health care plan has been defeated of a Patients’ Bill of Rights interacts vider in Wyoming who’s willing to do around here a lot of times. I can tell with the other part. When you jerk out so. While that idea may sound strange you that there are a lot of people who one part of the scope and try to do that to my ears in any other context, it was without talking about all of the other do not want a national health care the right thing to do for Wyoming. But parts of it that interacts with the plan. They do not understand a na- I know it’s not the right thing to do for scope you wind up with nothing but a tional health care plan. If I even con- Massachusetts or California, so I mess. To try to do that in a little two- sidered one, folks wouldn’t send me wouldn’t dream of asking them to page bill makes it look easy. We have back again—not the ones from Wyo- shoulder that kind of mandate for our gone from hard on an earlier one to a ming. We have a little different atmos- sake when we can simply, responsibly, really easy one now. And neither of phere in Wyoming than they do maybe apply it within our borders. What’s them will do it and protect the people in Massachusetts or New York or Flor- even more alarming to me is that Wyo- in my State. I suggest that it will also ida. But the people there want health ming has opted not to enact health care as bad as anywhere else. They not protect people in other States. I am becoming less surprised that care laws that specifically relate to don’t want to be driven out of the mar- after walking away from the con- HMOs, because there are, ostensibly, ket by rising costs for regulations that ference for the Patients’ Bill of Rights, no HMOs in the state! There is one, do not really even affect them. We the Democrats are hurling accusations which is very small and is operated by don’t have HMOs in Wyoming, except about others not wanting to get a bill a group of doctors who live in town, one small one owned by doctors. done and enacted. That’s an incredibly not a nameless, faceless insurance The regulations that will work for counter-productive reaction to giant company. Yet, under the proposal the other States in this country will not steps on our part toward compromise. Democrats insist is ‘‘what’s best for ev- work for Wyoming. We have an insur- This conference has been long and erybody,’’ the state of Wyoming would ance commissioner. His name is John time-consuming, but it has been work- have to enact and actively enforce at McBride. The nice thing about Wyo- ing. There is not a single reason why least fifteen new laws to regulate a ming is if you have an insurance prob- we should abandon a process that is style of health insurance that doesn’t lem you call the insurance commis- working. Yet, politics has been invited even exist in the state! sioner. You can talk to him or to one in, and I think the majority of us here As consumers, we should be down- of the people who work for him. You to highlight why that’s such a terrible right angry at how some of our elected can call them by their first names. I mistake. Choosing this path is a vote officials are responding to our concerns don’t have to call them ‘‘Mr. Commis- to abandon patients in favor of a polit- about the quality of our health care sioner.’’ And they will help you get ical issue. and the alarming problem of the unin- your problems straightened out. They Among the handful of principles that sured in this country. will help out a lot faster than using a are fundamental to any true protection It is being suggested that all of our national health care plan that results for health care consumers, probably local needs will be magically met by in a chart such as this. the most important is allowing states stomping on the good work of the Can you picture me telling the folks to continue in their role as the primary states through the imposition of an ex- in Wyoming that the insurance com- regulator of health insurance. panded, unenforceable federal bureauc- missioner can’t help them anymore, This is a principle which has been racy. It is being suggested that the and to just pick the phone up and call recognized—and respected—for more American consumer would prefer to HIPAA? I don’t know the thousands than 50 years. In 1945, Congress passed dial a 1–800–number to nowhere versus and thousands of employees who work the McCarran-Ferguson Act, a clear ac- calling their State Insurance Commis- there. I especially don’t know any of knowledgment by the federal govern- sioner, a real person whom they’re the thousands and thousands who they ment that states are indeed the most likely to see in the grocery store after will have to hire to do the kind of job appropriate regulators of health insur- church on Sundays. that the scope is calling for by our op- ance. It was acknowledged that states As for the uninsured population in ponent. are better able to understand their con- this country, carelessly slapping down A reasonable scope that handles the sumers’ needs and concerns. It was de- a massive new bureaucracy that rest of the people who are not covered termined that states are more respon- supercedes our states does nothing by States where they can call the peo- sive, more effective enforcers of con- more than squelch their efforts to cre- ple and get the same person every time sumer protections. ate innovative and flexible ways to get so they don’t have to explain again As recently as last year, this fact was more people insured. We should be their problem every single day is the re-affirmed by the General Accounting doing everything we can to encourage kind of service people expect. It is the Office. GAO testified before the Health, and support these efforts by states. We kind of service they can get, but not if Education Labor, and Pensions Com- certainly shouldn’t be throwing up we take away States rights. mittee, saying, ‘‘In brief, we found that roadblocks. Guess what. It looks even worse for many states have responded to man- And how about enforcement of the consumers under the HCFA’s ‘‘protec- aged care consumers’ concerns about minority’s proposal? tion,’’ according to a release by the access to health care and information Well, almost one year ago this body GAO on March 31 of this year. disclosure. However, they often differ adopted an amendment that stated, ‘‘It The model the Democrats are sup- in their specific approaches, in scope would be inappropriate to set federal porting for implementing the Patients’ and in form.’’ health insurance standards that not Bill of Rights is the Health Insurance Wyoming has its own unique set of only duplicate the responsibility of the Portability and Accountability Act, af- health care needs and concerns. Every 50 State insurance departments but June 29, 2000 CONGRESSIONAL RECORD — SENATE S6087 that also would have to be enforced by cause of action under a Patients’ Bill Mr. FRIST. Mr. President, emer- the Health Care Financing Administra- of Rights. Employers voluntarily pro- gency room provisions are a good case tion (HCFA) if a State fails to enact vide coverage for 133 million people in in point. It comes up all the time. It is the standard.’’ this country. That will no longer be important that people have the right Yet here we are one year later where, the case if we authorize lawsuits to go to emergency rooms. Emergency not only is it being suggested that we against them for providing such cov- room provisions are important. The trample the traditional, overwhelm- erage. This is basic math. If you add Senator is exactly right. For the 51 ingly appropriate authority of the 133 million more people to the 46 mil- million people who the Federal Govern- states with a three-fold expansion of lion people already uninsured, I’d say ment regulates, we have a responsi- the federal reach into our nation’s we have a crisis on our hands. In my bility to put emergency room provi- health care, they still insist on having mind, a simpler decision doesn’t exist. sions in there. That is what the Nickles HCFA be in charge. HCFA, the agency We should not be suing employers. bill does for the States. that leaves patients screaming, has Let me close by saying that the con- The other people the Senator is talk- doctors quitting Medicare, and, lest we ference has worked in incredible good ing about—does he know how many not forget, the agency in charge as the faith. We have come to conceptual people already have specific emergency Medicare program plunges towards agreement on a bipartisan, bicameral room provisions legislated for managed bankruptcy. basis on more than half of the common care? We do. It is not 10 States or 20 And guess what, it looks even worse patient protections. We have come to States or 30 States or 40 States. I don’t for consumers under HCFA’s ‘‘protec- bipartisan, bicameral conceptual have the exact number. I know more tion,’’ according to a new report re- agreement on the crown jewel of both than 43 States have taken care of the leased by GAO on March 31 of this year. bills—the independent, external med- emergency room provisions. The model the Democrats are sup- ical review process. Most dramatically, Mr. DORGAN. I understand the Sen- porting for implementing the Patient’s the bicameral Republicans offered a ator’s answer, which is that the sub- Bill of Rights is the Health Insurance compromise on liability and scope, to stitute offered by Senator NICKLES pro- Portability and Accountability Act, af- which the Democrats responded with vides coverage for only about 48 mil- fectionately known as HIPAA. I quote only rhetoric and political jabs in the lion Americans. It is the same ap- from the report: ‘‘Nearly four years press. It is absolutely bad faith to have proach they have used previously. One can suggest that all of these pro- after HIPAA’s enactment, HCFA con- done so. I think it would be regrettable tections I am proposing are covered tinues to be in the early stages of fully if these continued public relations elsewhere. If that is the case, why does identifying where federal enforcement moves torpedo what, so far, has pro- will be required.’’ Regarding HCFA’s the Senator object? duced almost everything we need for a The Senator from Oklahoma seems role in also enforcing additional federal far-reaching, substantive conference irritated we have raised this issue benefits mandates that Congress has product. again. Let me tell you what Congress- amended to HIPAA, the GAO states, I encourage all of my colleagues to man NORWOOD, a Republican serving in ‘‘HCFA is responsible for directly en- take the high road and support the leg- the House who is a sponsor of the forcing HIPAA and related standards islative process our forefathers had in House legislation, said on May 25, and for carriers in states that do not. In mind, versus a public relations circus. I quote: I am here to say the time’s up this role, HCFA must assume many of The PRESIDING OFFICER. The Sen- on the conference committee. We have the responsibilities undertaken by ator from North Dakota. waited 8 months for this conference Mr. DORGAN. Mr. President, I yield state insurance regulators, such as re- committee to approve a compromise myself such time as I may consume. sponding to consumers’ inquiries and bill. Senate Republicans have yet to I have listened to this discussion, and complaints, reviewing carriers’ policy even offer a compromise liability pro- it is pretty interesting. It seems to me forms and practices, and imposing civil posal. They have only demanded that that if you don’t want to pass a Pa- penalties on noncomplying carriers.’’ the House conferees abandon their po- tients’ Bill of Rights—perhaps for the And then, the GAO report reveals that sition. HCFA has finally managed to take a reason the Senator from Wyoming sug- This is a Republican saying the time baby step: ‘‘HCFA has assumed direct gested, which is that the Federal Gov- is up on the conference committee. regulatory functions, such as policy re- ernment ought not to have any in- Let me also point out that the Sen- views, in only the three states that vol- volvement in this issue—then just say ate passed, in my judgment, a poor untarily notified HCFA of their failure so. Don’t come out here and describe piece of legislation. It has the right to pass HIPAA-conforming legislation an alternative as if it is doing some- title but it doesn’t include the right more than 2 years ago.’’ thing that it is not really doing. provisions. The House passed a good Is this supposed to give consumers According to my colleague, we have a piece of legislation, but the House lead- comfort? First we should usurp their 258-page amendment. It kind of re- ership appointed conferees to the con- local electoral rights or their ability to minds me of the ‘‘Honey, I shrunk the ference that voted against the House influence the appointment of their plan’’ approach, this suggestion that bill. Their conferees voted against the state insurance commissioner and then what we should go back to covering 48 House bill. So the conference isn’t even offer up this agency as an alternative? million people rather than 161 million on the level. I’m sure I could find a single Wyoming- people. If month after month after month ite to clap me on the back for this kind The Senator from Tennessee talked goes by and you don’t want to have a of public service. earlier about emergency room care and Patients’ Bill of Rights because you I could go on at length about the a number of the patient protections we don’t believe the Federal Government very real dangers of empowering HCFA have proposed. I hope he will respond ought to be involved in this, just tell to swoop into the private market, with to my inquiry. Is it not the case that the patients that. Say to the patients: its embarrassing record of patient pro- the emergency room care provisions in We don’t believe Congress ought to do tection and enforcement of quality the Senator from Oklahoma’s amend- this. You should go ahead and fight standards. Such as how it took ten ment applies only to about 48 million cancer and fight your HMO at the same years for HCFA to implement a 1987 people. Isn’t it so that two out of three time. Go ahead and do that. law establishing new nursing home people will not be covered with the The fact is, we can do better. The standards intended to improve the kind of protection the Senator sug- proposal we are offering today is very quality of care for some of our most gested was covered in their proposal? It simple. We believe that a Patients’ Bill vulnerable patients. But I think the seems to me it would be a much better of Rights establishing basic rights that case has already been crystallized in approach to simply say we don’t sup- patients ought to be able to expect in the minds of many constituents: ‘‘en- port a Patients’ Bill of Rights. dealing with their insurance company able us to access quality health care, Mr. FRIST. Mr. President, will the is a proposal that ought to get 100 but don’t cripple us in the process.’’ Senator yield? votes in this Congress. The next, equally important issue is Mr. DORGAN. I will yield for about There are some who say, when asked that of exposing employers to a new 15 seconds. the question, Whose side are you on? S6088 CONGRESSIONAL RECORD — SENATE June 29, 2000 Let us stand with the insurance compa- resents, watch this on television at the solution is a government takeover nies. home. They wonder, what is this all of health care. We believe Members ought to stand about? You did, you didn’t; you did, This job is easier for them than it is with the patients. There is a genuine you didn’t. This has to be confusing. for us because they don’t care if the and serious problem in this country In the limited time I have, I want to baby dies, because they want to replace with patients not getting the treat- set this debate in historical perspective it. It reminds me of that story in the ment they expect, need, or deserve. Pa- so everybody knows what this is about. Bible. Some of you may remember it. tients find themselves having to fight When Bill Clinton was elected Presi- Two ladies had gone to bed, and during cancer and their insurance company. dent, he had a goal of having the Gov- the night one of them’s baby had died That is not fair. ernment take over and run the health and the other one had taken the baby. The question is whether this Con- care system. In fact, I have before me They come before Solomon. Solomon, gress will do something about it. The the Clinton health care bill. This would in his wisdom, after listening to their question is not whether this Congress have mandated one giant, national arguments, says let’s just cut the baby will pass a national health care plan. HMO run by the Government; HMOs in half. That is what they are saying— That is nonsense. That is not what is would set up health care collectives, cut the baby in half. Then one lady being debated. I see more shuffle and and of course the right people would be said: OK, cut the baby in half; and the tap dances going on around here on chosen to decide what health care we other said: No, let her have the baby. this debate. The fact is, if you want to all needed. Then Solomon knew whose baby it was. pass a good Patients’ Bill of Rights, do If you went to your doctor, he would This is our baby. We love freedom. what the House did. Understand that have dictated, under the Clinton plan, We love the right of people to choose. Dr. NORWOOD, a Republican Congress- the kind of treatment he could give. If We love the greatest health care sys- man, knows what he is talking about. he violated their guidelines because he tem the world has ever known. We are This conference hasn’t moved. This thought you needed it, he would be not going to let the Government take conference isn’t accomplishing any- fined $50,000. over and run the health care system. thing. That is why we have offered this If, under the Clinton health care bill, That is what this debate is about. That amendment. you went to a doctor and said, I don’t is what our Democrat colleagues want. I yield the floor, and I reserve the re- think all these experts are right and They are willing to destroy the great- mainder of my time. my baby is sick, my baby could be est health care system the world has The PRESIDING OFFICER. The Sen- dying, I will pay you to treat my baby, ever known because they want the ator from Oklahoma. if the doctor did it, he could go to pris- health care system where the Govern- Mr. NICKLES. To respond to a couple on for 5 years. ment runs it. They think it would work of comments, my colleague read from a That is the health care system my better. We don’t. Neither did America Norwood letter that said the Repub- Democrat colleagues are for. The Mem- in 1993 and 1994, which is why we have lican conferees are not addressing li- bers who were here voted for it and a Republican majority today. ability. We have liability on the floor supported it. They know what they The second issue is scope. What does of the Senate. Mr. NORWOOD is not a want. They want the Government to that mean? For those watching this on conferee. Maybe he didn’t know what take over and run the health care sys- television, what does ‘‘scope’’ mean? he was talking about. We have liability tem. They want to herd Americans into What it means is, what should this on the proposal. Granted, there was not health care purchasing cooperatives, or Federal law do as it relates to the liability in the Senate bill we passed. collectives, as they call them, and you State in which you live? There is on the bill we have before the have to be a member or else you don’t Our Democrat colleagues believe Senate. get health care in America. That is with all their heart—they are as sin- When we talk about scope, we have what they want. That is where this de- cere as they can be—that there is only scope that applies to 131 million Ameri- bate started. one place in the world where people cans in the appeals process and liabil- Now, we are trying to give patients have really any sense: Washington, DC. ity that they can sue their HMO. rights in dealing with HMOs. We want They think people in city governments To read a letter by a Congressman internal and external review. We want and county governments and State that says the conference is not doing the external review to be independent. governments are ignorant and anything, they don’t have liability, and We want to guarantee them rights. But uncaring. They believe Washington is we have liability is a little misleading. there is one fundamental difference be- brilliant, all-knowing, and all-caring. When my colleague from North Da- tween the Democrats and us. We think So what they want to do is write one kota says our proposal doesn’t have a this is a delicate balance, because we bill in Washington and impose it on Federal takeover of insurance, you don’t want to drive up health care in- every living person in America. might read the amendment. The surance costs so much that millions of We do not agree. We do not believe amendment on page 2 says: people lose their health care. that just coming to Washington all of a (3) provide the Federal Government with Senator KENNEDY’s bill was scored as sudden makes you brilliant. In fact, it the authority to ensure the Federal floor re- driving up the cost of every person’s is a long way from Washington to Wyo- ferred to in paragraph (1) is being guaranteed health care in America by over 4 per- ming. It is a long way from Washington and enforced with respect to all individuals cent and costing 1.2 million American to Texas. We joined the Union in Texas described in such paragraph, including deter- families their health insurance. What because we wanted freedom. We didn’t mining whether protections under State law patient right is more basic than having join the Union to give it up. meet the standards of such Act. health insurance? They give you lots of What is the difference between the In other words, the Federal Govern- rights, but if you lose your health in- two bills? Their bill says we are going ment will run State insurance, period. surance, how do you pay for your to write things the way we want them, The Federal Government is going to health care? There is the difference be- and you are going to do it that way or take over. It is in his amendment. tween them and us. We have to be con- we are going to come to your State, we I think that needed to be pointed out. cerned about 1.2 million people losing are going to cut off your money, we are I yield 10 minutes to my colleague their health care; they don’t. going to cut off your health care, and and conferee on this bill, the Senator When Clinton said, let us take over in some cases we are going to put you from Texas. and run the health care system and put in jail. That is their way of doing it. The PRESIDING OFFICER. The Sen- everybody into these health care col- You remember, in their bill if you went ator from Texas. lectives, what did he say the problem to this doctor, got down on your knees Mr. GRAMM. I thank Senator NICK- was? The problem was that we had too and begged that he take your money LES, whose leadership on this issue I many people without health insurance. and treat your child, he went to prison think is without equal on any issue on So if their bill passed and millions of for it; That was in their bill, the Clin- which I have worked since I have been people lost their health insurance, ton health care bill. in the Senate. I know the people of what do you think they would say? What we say is: Look, we will write a Oklahoma, who Senator NICKLES rep- They would say: We have a solution; basic standard for patient protections. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6089 But what if the people in Wyoming de- opposed to the protections which are only one of the House Republican con- cide, since they don’t have any HMOs— included in our Patients’ Bill of Rights. ferees was a supporter of the Norwood- and this bill is about dealing with There was a lovely, wonderful state- Dingell bill. HMOs—that they should not have to ment about his reservations and about There is no agreement on covering come under the Federal Government to the importance of freedom to HMOs: If all Americans. There is no agreement deal with a problem they don’t have? we give total freedom to HMOs, the on external appeals. There is no agree- They don’t think they should. I don’t public be damned. That is what has ment on holding health plans account- they should either. happened too often. What we are talk- able. There is no agreement on access People in Tennessee and Texas were ing about is the protections that are to specialists, to clinical trials, or a protecting patients before we got into guaranteed in a Patients’ Bill of host of other patient protections. this business. They passed comprehen- Rights, which is, interestingly, all the There was no agreement. sive bills. All we are saying is our bill kinds of protections he has in his This vote today is a chance for the applies to those not already covered. health insurance under the Federal em- Senate to make a statement. A vote for But if people in Texas, through their ployees program. the Dorgan amendment is a vote for government, through their elected Rep- There is not a Member of the Senate the proposition that every patient in resentatives, decide they appreciate who has not accepted the Federal em- America is entitled to protection. Es- our help, they appreciate our caring, ployees program, and it guarantees vir- tablishment of that principle is a giant they know we love them, they kind of tually every one of these protections step towards the day the Senate will figure we know everything—but just in we are talking about tonight with the pass a true patients protection pro- case we are wrong, they would rather exception of the right to sue. gram. A vote for the Nickles amend- implement their own program for their The question before the Senate to- ment is a vote against patients and for own jurisdiction, our Democrat col- night is this: Are we going to insist insurance companies. It is a vote for leagues say: No, they don’t care that whatever protections we are going covering less than a third of all Ameri- enough, they don’t know enough, they to pass in a Patients’ Bill of Rights are cans. It is a vote for the same limited are ignorant. going to be available and accessible to coverage originally passed by the Sen- We do not agree. We want people in all Americans? That is the Norwood- ate. It is a vote for a review process Wyoming to be able to say: Look we Dingell bill, the bill we on our side of that is not truly independent. It is a really appreciate the bill, we know you the aisle favor. Whatever protections vote against meaningful account- guys want to help us, but we don’t have we are going to put in ought to include ability. It is a vote against access to any HMOs; we say they ought to have the 161 million Americans with private specialists outside a plan, even if the the right to opt out. health insurance. That is our principle, specialist is the only one able to treat If Tennessee says: Look, we set up that is what we stand for. that condition. It is a vote against ac- TennCare because we adopted the Clin- All you have to do is read the Nickles cess to clinical trials for heart pa- ton health care bill in Tennessee—they bill and you will find out that it covers tients. It is a vote for a bill that is so wish they hadn’t done it, but they did— exactly what was in the Senate Repub- inadequate it will never pass the if they say we would rather do it our lican bill—only the 48 million Ameri- House, and it will never be signed by way than your way, our Democrat col- cans who are self-insured. Whatever the President. It will not protect the leagues say: What do you know? What protections they are talking about thousands of patients who are injured do you know in Tennessee? You people cover only those 48 million. every day. in Tennessee don’t know and don’t care Look at the Nickles access to pedi- It is up to the Senate. We should vote about people. We want to do it for you. atric provision: ‘‘If a group health for the principle that everyone be cov- We are going to tell you how to do it. plan’’—that would be 123 million peo- ered. We should vote against a plan re- What we say is: Look, we have writ- ple;—‘‘other than a fully insured group jected by every group of patients and ten a good bill. We want everybody to plan.’’ Other than; that knocks out the doctors, and by House Republicans. look at it very closely. In those areas fully insured. It knocks all of them And we should come back after the re- where only Federal law applies, the bill out. So the guarantees on pediatric cess and pass a real patients’ rights applies. You can’t get out from under care apply to only 48 million out of 161 bill, of which we can all be proud, it because there are no other protec- million. whether we are Republicans or Demo- tions. But if Tennessee decides in areas Go through the rest of the Nickles crats. Let’s protect patients, not where they have already passed a Pa- bill. Go through coverage of emergency HMOs. I withhold the remainder of my tients’ Bill of Rights that they would services. It says, again, ‘‘If a group time. rather do it their way than our way, we health plan’’—they are covering 123 Let’s protect patients, not HMOs. I say if their elected Representatives, million. The next sentence, ‘‘other reserve the remainder of my time. their Governor, decides to do it that than a fully insured group health The PRESIDING OFFICER. The Sen- way, they have the right to do it. plan.’’ Other than fully insured—75 ator from Oklahoma. Is that an extreme view? Is that million. How many are left out? Forty- Mr. NICKLES. Mr. President, how somehow denying people protection? Is eight million. They cover the same much time remains on both sides? freedom a denial of protection? Is keep- number of people they covered 7 The PRESIDING OFFICER. The Sen- ing the right to choose denying people months ago. That is the reality. Here it ator from Oklahoma has 10 minutes, a basic health right? I don’t think so. I is in their bill. Every one of these guar- and the Senator from North Dakota think it enhances rights. And that is antees: If a group plan, other than a has 7 minutes. what this debate is about. fully insured group plan. You go for the Mr. NICKLES. Mr. President, for the Our Democrat colleagues with all 48 million in the legislation that is re- information of all of our colleagues, it their hearts believe that the Govern- jected by Dr. NORWOOD, who is the prin- is my expectation we will have a vote ment ought to take over the health cipal health spokesman for Repub- about 7:20 p.m. I say to the majority care system and they think everything licans on health matters over in the leader, all time will expire by about should be done in Washington. House of Representatives. 7:20 p.m. We are happy to vote on both I reserve the remainder of our time. There it is. Their own language. They proposals. So colleagues should be on Mr. DORGAN. Mr. President, I yield 7 cover 48 million. The Dorgan proposal notice to expect two rollcall votes be- minutes to the Senator from Massa- said: Whatever we are going to do, in ginning at 7:20 p.m. chusetts. terms of protecting consumers, let’s I yield 5 minutes to my colleague, a The PRESIDING OFFICER (Mr. SES- protect them all—161 million. conferee on the bill, the Senator from SIONS). The Senator from Massachu- We are one vote away in the Senate Arkansas, Mr. HUTCHINSON. setts. from passing an effective Patients’ Bill The PRESIDING OFFICER. The Sen- Mr. KENNEDY. Mr. President, it is of Rights. The conference is a failure. ator from Arkansas. always interesting to listen to my The amendment offered by the Senator Mr. HUTCHINSON. Mr. President, I friend and colleague from Texas. But I from Oklahoma does not even have the compliment and commend the Senator still am trying to find out why he is support of the House Republicans. And from Oklahoma, Mr. NICKLES, for the S6090 CONGRESSIONAL RECORD — SENATE June 29, 2000 hard work he has done and the months been regulated at the State level. It is workplace; I did not give it to you so of labor he has put into this con- wrong for us to do that. lawyers could use it as a game area to ference. Anybody who has followed the To my colleagues I say we have a bring suits against me. reports of what has come out of this conference in progress. It is progress. It Employers across this Nation are conference cannot honestly say it has is working hard. It is making progress. going to simply drop their health care been glacial movement. Enormous That is the way we should provide pa- insurance. They will give their employ- progress has been made. Concessions tient protections, not through an ees a certificate to buy their own have been made on the part of the amendment on an appropriations bill. health insurance or some other type of House conferees as well as the Senate I thank my colleague, Senator NICK- vehicle to allow them to compete in conferees. LES, for the hard work he has done and the marketplace. Because employers This is no way to legislate and no all the conferees and look forward to are able to get a better price and are way to provide patient protections the when we will have a meaningful pa- able to tailor their insurance policies way Senator KENNEDY and Senator tients’ rights bill passed into law. more effectively to the needs of their DORGAN have done in parceling out a I reserve the remainder of our time. employees in different regions of this little piece here and there. Tonight we The PRESIDING OFFICER. The Sen- country, the practical effect will be are going to do scope. That is not the ator from North Dakota. employees get significantly much less way to legislate. This is truly the tri- Mr. DORGAN. Mr. President, has the health care under the proposal coming umph of politics over policy. Senator from Oklahoma completed his from the other side because employer I was writing as various Senators on debate? It is my intention to close de- after employer will simply drop their the Democratic side made speeches. bate on my amendment. employees’ health insurance programs They spoke of a national standard, of Mr. NICKLES. I will be happy to let and will allow the marketplace to com- universal coverage, and of a national my colleague close. How much time pete for their employees. Unfortu- health system. To this Senator’s mind, remains? nately, the result will be the employees they could be synonymous with a na- The PRESIDING OFFICER. The Sen- will be left with the short stick. tional health care system. We had that ator from Oklahoma has 5 minutes, and I think that is the actual goal of the debate. We had it in 1993. It was called the Senator from North Dakota has 7 other side. I think their real goal is to ‘‘Clinton care.’’ Senator GRAMM piled it minutes. drive up the number of uninsured up over here, and it was about 2 feet Mr. NICKLES. I yield 3 minutes to across this country. If one looks at the tall. my colleague from New Hampshire. pattern of activity on the other side of The American people made a judg- Mr. GREGG. Mr. President, I thank the aisle, it has been to annually in- ment on ‘‘Clinton care.’’ We do not the Senator for bringing forward this crease the number of uninsured by rais- want a national health care system, extremely positive proposal in the area ing the price of insurance in this nor is that in the best interest of of patient protections. This bill has a country. Americans. lot of initiatives, many of which have Since this administration has been in The real debate tonight centers been outlined very well by my col- office, the number of uninsured has around not whether we want protec- leagues. One that has not been high- gone up by 8 million people because the tions for all Americans or whether we lighted as completely as I would like price of insurance has gone up and up believe we are the only ones who can because of time—and I want to touch as the other side has tried to drive up provide that protection or whether the on it quickly—is the issue of liability. the price of that insurance. States have a legitimate role in pro- When our bill initially passed the What is the ultimate goal? ‘‘Hillary viding protections for their citizens. Senate, we did not include an oppor- care.’’ If they put enough people on the How many States have patient protec- tunity to sue, but we have changed street, if they create enough uninsured, tion laws? Forty-three States have al- that policy. Under the bill as it is pro- inevitably they will have to claim: I ready enacted patient protection laws. posed today, first there is a tremen- am sorry, everybody is uninsured so we Do we not believe they have the best dously positive appeals process. If a pa- have to nationalize the system. interests of their citizens in mind? tient believes they have been aggrieved The PRESIDING OFFICER. The Sen- What we are doing in our legislation is by their HMO, they have the right to ator’s time has expired. providing protection where States can- an internal appeal and an external ap- Mr. GREGG. I think that is a good not do it where Federal jurisdiction is peal which is set up with an inde- place to stop. I reserve the remainder legitimate. Under ERISA and self-fund- pendent group of physicians who will of the time on our side. ed plans, we do that, as we should. review the case and who are knowl- Mr. DORGAN. Mr. President, I yield 2 I listened to my colleague from Mas- edgeable on that subject. More impor- minutes to Senator EDWARDS. sachusetts, Senator KENNEDY. In his tantly, if a patient thinks they have The PRESIDING OFFICER. The Sen- State, in 1996, they had a ban on gag been aggrieved, under certain cir- ator from North Carolina. clauses. They passed a grievance proce- cumstances, they will be able to sue Mr. EDWARDS. Mr. President, I will dure. They, in fact, have 26 State man- that HMO. What they will not be able respond to the Senator from New dates. Does the Senator not believe to do is have an open season on the Hampshire. He argues there is a new they care about their citizens? employer. provision in the Republican plan that I heard my colleague and good friend If one looks at the proposal that has provides for liability. That provision is from Florida speak of the need for a been put forward by the other side, a sham. There are three points I want national system. The State of Florida they are suggesting we have an open to make in response. passed a comprehensive bill of rights in season on employers. The whole exer- First is the argument that we are 1997, emergency room services in 1996. cise in the Patients’ Bill of Rights is creating an open season on employers. They have 44 State mandates. Do they not to have open season on employers. It is simply false. Not true. A letter not care? They care as much as we It is to address inequities occurring to from the American Medical Associa- care, and they know their State better people as they deal with their insurers, tion of June 23 states clearly: than we do. specifically with health maintenance The insurance industry— I heard my colleague from the State organizations. And the Republican plan in this of Rhode Island speak about the need If we allow this open season on em- case— for a national health care system. ployers, we will simply drive people out is flat wrong, and to imply otherwise is Rhode Island passed a comprehensive of insurance. Instead of improving in- frankly deceptive. The fact is, the bipartisan consumer rights bill in 1996. They have surance for individuals across the House-passed bill would actually protect em- passed 27 mandates in Rhode Island. I country, individuals across this coun- ployers. can go on and on. Forty-three States try will walk into work one morning Under our bill, an employer cannot already have a bill of rights. It is not and their employers will say: I did not be held responsible under specific lan- our place to usurp their authority. It is give you this health care policy which guage unless they actively intervene in not our place to take over insurance happens to be a very expensive event in the decision of the insurance carrier, that has traditionally and historically my day in trying to make an effective which never occurs. There is to reason June 29, 2000 CONGRESSIONAL RECORD — SENATE S6091 for it to occur. It in fact never occurs. ment offered by Senator DASCHLE to Mr. DORGAN. Mr. President, we are It is a false argument that employers the FY 2001 Labor HHS Appropriations debating my amendment, I guess. I can be held liable under our proposal. bill which will protect people from hav- have the right to close debate on my They cannot. ing their personal, genetic information amendment; is that correct? Second, the argument that they are used against them by their employers The PRESIDING OFFICER. There is providing for liability is simply not or their health insurance companies. no right to do such. true. Under their plan, an insurance The provision is identical to the legis- Mr. DORGAN. All right, Mr. Presi- company can never be held responsible lation that Senator DASCHLE intro- dent. Let me take the 5 minutes at this for their initial decision to deny cov- duced earlier this year and which I point and close debate. erage. So if somebody goes to their have also cosponsored. Mr. President, this has been an inter- doctor with an emergency situation— If adopted, the Daschle amendment esting discussion, but it has not been they need care—and the insurance will bar insurance companies from about what is on the floor today. We company says no, and, as a result, they raising premiums or denying patients have had now a debate about the 1993 suffer a lifelong injury, a debilitating health care coverage based on genetic Clinton health plan. We have also had injury, or death, the insurance com- information. Employers will also be a discussion about ‘‘Hillary care.’’ If pany cannot be held accountable. They prohibited from using genetic informa- you have the interest in debating that, can only be held accountable, can only tion in hiring practices. Because a hire a hall, get your own audience, be held responsible, if they have ex- right without a remedy is not right at speak until you are exhausted, and hausted the internal review process all, these measures also provide an in- have a good time. But those are not the and the insurance company acted in dividual who has suffered genetic dis- subjects on the floor today. We are de- bad faith or if they failed to follow the crimination with the right to take bating the Patients’ Bill of Rights. decision from the external review legal action. This is an essential pro- Some people do not want to debate board. tection to ensure that discrimination that. They certainly do not want to The bottom line is, it creates an in- does not occur. talk about the facts, but this is what centive for the insurance company to With the latest breakthrough earlier we are talking about: The Patients’ deny coverage in the first instance be- this week of the Human Genome Bill of Rights. cause under no circumstances can they Project in mapping human genetic Dr. GREG GANSKE, a Republican Con- be held responsible, and under no cir- make-up, protecting Americans from gressman from Iowa, was just on the cumstances can they be held account- genetic discrimination—an issue that floor of the Senate and he indicated able. For those reasons, this provision was already important—has become that the 258-page missive that is now for HMO insurance carrier liability is critical. We must support the advance- offered as a substitute will in fact not real; it is a sham. ment of science and discovery through weaken HMO laws in the following Our proposal provides real and mean- research. But while we are embracing States: California, Texas, Georgia, ingful accountability. these new discoveries, we must also Washington, Louisiana, Oklahoma, Ar- The PRESIDING OFFICER. The Sen- provide safeguards to ensure the pro- izona, and Missouri. That is not from ator’s time has expired. tection of this new and potentially me; it is from Dr. GANSKE, a Repub- The Senator from Oklahoma. very sensitive and personal informa- lican Congressman. Mr. NICKLES. Mr. President, I yield tion. In order to help Americans em- By the way, let me read something the Senator from Tennessee—how brace scientific discoveries we must en- Dr. GANSKE said some time ago in a much time do I have? The PRESIDING OFFICER. The Sen- sure these discoveries will not cause discussion about all of these issues. He ator has 2 minutes. personal harm. said: Mr. NICKLES. I yield the Senator 1 This February, in recognition of the Let me give my colleagues one example minute. need to prevent abuse and misuse of ge- out of many of a health plan’s definition of Mr. FRIST. Mr. President, very netic information, President Clinton medically necessary services. This is from signed an Executive Order that pre- the contractual language of one of the HMOs quickly, a vote for the Nickles amend- that some of you probably belong to: ‘‘Med- ment is a vote for patient protection, vents federal agencies from discrimi- nating against workers if they discover ical necessity means the shortest, least ex- emergency room access to obstetri- pensive or least intense level of treatment, cians, pediatricians, specialists, and through genetic testing that they have care or service rendered or supply provided, clinical trials. a predisposition to a disease or some as determined by us.’’ A vote for the Nickles amendment is other conditions. President Clinton ex- Contracts like this demonstrate that some a vote for a strong internal appeals pressed his support for legislation to health plans are manipulating the definition process. If the HMO rejects the appeal prevent genetic discrimination which of medical necessity to deny appropriate pa- of the doctor, you can go internally. If will extend beyond the reach of the Ex- tient care by arbitrarily linking it to saving money, not to the patients’ medical needs. it is rejected again, you go to an exter- ecutive Order. The Genetic Non- nal appeal process. The decision made discrimination in Health Insurance and Some of my colleagues say we are by the external appeals process is made Employment Act and today’s amend- playing politics with this issue? Why by an independent physician not bound ment will allow Vermonters—and all don’t you tell that to some of these by how the plan may define ‘‘medical Americans—to undergo genetic testing kids. necessity.’’ If the external appeal over- without being afraid that their em- Dr. GANSKE described this child I rules the plan, and the plan does not ployer or their insurance company will show you a picture of, a child born comply, you go to court. This new abil- use this information to discriminate with a severe cleft lip. Fifty percent of ity to go to court, which is what many against them. the medical professionals in Dr. people believe is so important, is a new No one wants to find out they may be GANSKE’s field report that they have right to sue in Federal court. predisposed to a certain disease and been told that correcting this kind of Lastly, the access provisions have then have to worry about losing their condition is not a medical necessity. not been mentioned. job. These important measures would So tell that to the kids. Tell it to In closing, all of these mandates are give them the assurance and protection this young child, that it is not a med- going to drive up the cost of health that their personal information will be ical necessity to correct this condition. care. protected and will not be used against Dr. GANSKE also shared with us what Access provisions in the bill include them. a young child looks like who was born an above-the-line deduction for health Mr. DORGAN. Are we finished? Will I with this deformity—but who has it insurance expenses, a 100-percent self- close at this point? I have 5 minutes. corrected by the right kind of surgery. employed health insurance deduction, Mr. NICKLES. I have 1 minute. Let me show you another picture of expansion of medical savings accounts, Mr. DORGAN. I would like to close this child with the condition corrected. and deductions for long-term care. debate on my amendment, if the Sen- Does anybody want to tell this child it I reserve the remainder of our time. ator would like to proceed. was not worth it? Mr. LEAHY. Mr. President, I am Mr. NICKLES. I would like to close Or maybe you want to talk to Ethan please to be a cosponsor of the amend- on ours. You have 5 minutes. Bedrick. Tell Ethan that this is just S6092 CONGRESSIONAL RECORD — SENATE June 29, 2000 politics. Ethan was born during a com- Pass the bill. If you want those kinds and passage occur, all without any in- plicated delivery that resulted in se- of examples to be covered, pass the bill. tervening action and debate. vere cerebral palsy and impaired motor We are going to give you a chance to Finally, I ask unanimous consent the function in his limbs. When he was 14 vote on it tonight. I might mention, Senate insist on its amendments and months old, Ethan’s insurance com- my colleague from Tennessee says: We request a conference with the House pany abruptly curtailed his physical have a bill that is a Patients’ Bill of and the Chair appoint the entire sub- therapy, citing the fact that he had Rights-plus because we provide a lot of committee, including the chairman only a 50-percent chance of being able things for people who cannot afford it. and the ranking member, as conferees. to walk by age 5. We provide an above-the-line deduction I hope all of our colleagues will agree So talk to Ethan about this. You to buy health care, so more people can to this consent. If not, the Senate will think this is politics? Talk to Ethan. A buy health care. The Democrats’ pro- be in session late into the day tomor- 50-percent chance of being able to walk posal is going to uninsure millions of row concluding this bill and beginning by age 5 was deemed, quote, ‘‘insignifi- Americans. the appropriations bill on Interior. cant,’’ and therefore you don’t get the We should not do anything that is With that, I now propound the unani- medical help you need. And some peo- going to dramatically increase the mous consent just outlined. ple say: Well, it doesn’t matter. Appar- price of health care and uninsure mil- Mr. REID. Mr. President, if I could ently, you don’t deserve it. lions of Americans, as their proposal ask my friend to add one phrase, ‘‘any That is not the way health care would do. We also don’t think HCFA, amendments that may not be cleared ought to be delivered in this country. that glorious Federal agency they are as part of the managers’ package.’’ People ought to have basic rights. That trying to empower, should be regu- Mr. SPECTER. I make that addition. is why we call this a Patients’ Bill of lating all health care in the States. Mr. GRAMM. Reserving the right to Rights. I ask unanimous consent for an addi- object, parliamentary inquiry, Mr. The question, at the end of the day, tional 30 seconds. President. is: With whom do you stand? The PRESIDING OFFICER. Without The PRESIDING OFFICER. The Sen- Do you stand with the managed care objection, it is so ordered. companies that have developed con- ator from Texas will state his inquiry. Mr. NICKLES. Mr. President, my col- Mr. GRAMM. Mr. President, as I read tracts such as this, that say, ‘‘Medical leagues have said we are one vote necessity means the shortest, least ex- this unanimous consent request, the short. We are not one vote short. Un- pensive, or least intensive level of phrase ‘‘without intervening business’’ less somebody changes the rules of the treatment, care, or service as deter- suggests to me that possibly the point Senate, the Norwood-Dingell bill is mined by us,’’ which means that this of order that has been set aside against going to need a lot more votes. It will young child is told: Tough luck? the bill could not be raised. I would Or do you stand with the patients never pass this session of Congress. like to ask if that is the case. and decide that maybe we ought to do I yield the floor and ask for the yeas The PRESIDING OFFICER. The Sen- something, as a country, that responds and nays on my amendment. ator’s interpretation is correct. to real problems and pass a real Pa- The PRESIDING OFFICER. Is there a Mr. GRAMM. Mr. President, I ask tients’ Bill of Rights? sufficient second? unanimous consent that the request be A fellow once told me, in my little There appears to be a sufficient sec- revised to allow me to raise the point hometown: You never ought to buy ond. of order. I think that was always the something from somebody who is out The yeas and nays were ordered. intention, but I would like to be sure of breath. There is a breathless quality Mr. REID. Mr. President, I suggest that is the case. to some of the discussion I have heard the absence of a quorum. The PRESIDING OFFICER. Is there tonight. We raise the issue of a Pa- The PRESIDING OFFICER. The yeas objection? tients’ Bill of Rights, and instead we and nays have been ordered. The unanimous consent request is as hear a discussion about the 1993 health Mr. REID. Mr. President, I suggest amended by the Senator from Texas. care plan. Then we have a substitute the absence of a quorum. Mr. REID. Mr. President, we just got that is 258 pages that kills a lot of The PRESIDING OFFICER. The a call in the Cloakroom. Somebody has trees for nothing. You don’t need to clerk will call the roll. a problem with this. We will try to take up 258 pages to offer an empty The legislative clerk proceeded to take care of it as soon as we can. plan. Offer one page, and say: We don’t call the roll. Should we go ahead with the vote? support a Patients’ Bill of Rights. Just Mr. SPECTER. Mr. President, I ask Mr. SPECTER. Let us proceed with be honest about it. But do not try to unanimous consent that the order for the vote, Mr. President. fool the American people any longer. the quorum call be rescinded. The PRESIDING OFFICER. The Sen- It is true we have had a few votes on The PRESIDING OFFICER. Without ator from Pennsylvania withdraws his this. It is also true that there is a con- objection, it is so ordered. unanimous consent request. ference committee that is supposed to Mr. SPECTER. Mr. President, on be- The question is on agreeing to be working. But it is also true, as Dr. half of the leader, I am announcing amendment No. 3694. The yeas and nays Norwood and other Republican Con- that there will be no further votes this have been ordered. The clerk will call gressmen said, that the time is up and evening after these two votes. I will the roll. the conference committee has not done shortly ask unanimous consent that The legislative clerk called the roll. a thing. the debate and votes in relation to the Mr. REID. I announce that the Sen- following remaining amendments be No one ever accuses the Congress of ator from Hawaii (Mr. INOUOYE and the postponed to occur in a stacked se- speeding. I understand that. Senator from Vermont (Mr. LEAHY) are The PRESIDING OFFICER. All the quence beginning at 9:15 a.m. on tomor- necessarily absent. time of the Senator has expired. row, Friday, with 2 minutes prior to The PRESIDING OFFICER. Are there The Senator from Oklahoma has 1 each vote for explanation. Also in the any other Senators in the Chamber de- minute. request is a consent that no second-de- siring to vote? Mr. NICKLES. I will give my col- gree amendments be in order to the The result was announced—yeas 51, league an additional minute. amendments prior to the votes just nays 47, as follows: Let me say, I know he holds up a lot outlined. of photographs. I think that is a crum- The amendments are as follows: [Rollcall Vote No. 166 Leg.] my way to legislate. But I will say that Wellstone No. 3674, Helms amendment YEAS—51 every single example he mentioned regarding school facilities, and we have Abraham Cochran Gorton Allard Collins Gramm would be covered by external appeal. just added the Harkin amendment re- Ashcroft Coverdell Grams Those decisions would be made by med- garding IDEA. Bennett Craig Grassley ical experts. We even put in language I will also ask unanimous consent Bond Crapo Gregg that they would not be bound by the that following those votes and the dis- Brownback DeWine Hagel Bunning Domenici Hatch plan’s definition of ‘‘medical neces- position of the managers’ amendment, Burns Enzi Helms sity.’’ They would be covered. the bill be advanced to third reading Campbell Frist Hutchinson June 29, 2000 CONGRESSIONAL RECORD — SENATE S6093 Hutchison Murkowski Smith (OR) tients with the right to sue including a Mack Santorum Stevens Inhofe Nickles Snowe McConnell Sessions Thomas Jeffords Roberts Stevens cap on non-economic damages and no Murkowski Shelby Thompson Kyl Roth Thomas punitive damages. Both of these are Nickles Smith (NH) Thurmond Lott Santorum Thompson items that I have consistently fought Roberts Smith (OR) Voinovich Lugar Sessions Thurmond for inclusion in a HMO reform bill. Roth Snowe Warner Mack Shelby Voinovich McConnell Smith (NH) Warner People must be provided the right to NOT VOTING—2 sue for damages once all means have Inouye Leahy NAYS—47 been exhausted but it must be done in The amendment (No. 3693) was re- Akaka Edwards Lincoln a manner that does not cause excessive Baucus Feingold McCain jected. Bayh Feinstein Mikulski lawsuits and cause health care costs to Mr. COVERDELL. Mr. President, I Biden Fitzgerald Moynihan exorbitantly rise. move to reconsider the vote. Bingaman Graham Murray I am disappointed that this proposal Mr. REID. I move to lay that motion Boxer Harkin Reed Breaux Hollings Reid did not go far enough but I am hopeful on the table. Bryan Johnson Robb that a strong patient protection bill The motion to lay on the table was Byrd Kennedy Rockefeller can still be passed prior to Congress ad- agreed to. Chafee, L. Kerrey Sarbanes journing in the fall. It is the least we The PRESIDING OFFICER. Under Cleland Kerry Schumer the previous order, the Senator from Conrad Kohl Specter can do for America’s patients. Daschle Landrieu Torricelli Congress still has an excellent oppor- North Carolina wishes to be recognized Dodd Lautenberg Wellstone tunity to show the American people to offer an amendment. Dorgan Levin Wyden Mr. LOTT. Will the Senator from Durbin Lieberman that it can and will rise above partisan politics and find the consensus that North Carolina yield so we can get an NOT VOTING—2 serves the national interest and puts agreement on how to proceed for the Inouye Leahy the health care needs of patients first. remainder of the night? The PRESIDING OFFICER. Does the The amendment (No. 3694) was agreed This is too important an issue to allow Senator from North Carolina yield? to. the influence of special interests to Mr. HELMS. I yield. Mr. COVERDELL. I move to recon- prevent us from doing what is right for Mr. LOTT. Mr. President I want to sider the vote. all Americans and I am confident that take a few moments to go over the Mr. SANTORUM. I move to lay that the leaders in both the House and Sen- schedule for the remainder of the night motion on the table. ate will continue working with the and the morning and get a final agree- The motion to lay on the table was conferees to ensure that an agreement ment on a unanimous consent request. agreed to. is reached. These were the last two votes of the Mr. MCCAIN. Mr. President, today AMENDMENT NO. 3693 night. We want to complete the offer- the Senate voted on yet another pro- The PRESIDING OFFICER (Mr. ing and debating of the remaining posal for providing patient protections GRAMS). The question is on agreeing to amendments that have been requested to Americans enrolled in HMOs. Unfor- the DORGAN amendment. tonight, and then we will have those tunately, this proposal did not provide Mr. BREAUX. I ask for the yeas and votes stacked beginning at 9:30 a.m., the strong safeguards and protections nays. which is a little different from the that I believe each and every American The PRESIDING OFFICER. Is there a time earlier mentioned. We had dis- deserves to have. cussed 9:15 a.m. and there was a request This amendment failed on the three sufficient second? There is a sufficient second. we do that at 9:30 a.m. key areas for meaningful patient pro- I renew the unanimous consent re- The clerk will call the roll. tections—fair legal accountability for quest regarding the Labor-HHS bill The assistant legislative clerk called denied care, the right of every Amer- which now includes possible votes to- the roll. ican to choose their doctor, and basic morrow, Friday morning, beginning at patient rights for every American not Mr. REID. I announce that the Sen- the amended time, 9:30 a.m., relative to just a limited few. ator from Hawaii (Mr. INOUYE) and the the following issues: a Wellstone Under this amendment only a limited Senator from Vermont (Mr. LEAHY) are amendment regarding drug pricing; a number of Americans would be pro- necessarily absent. Helms amendment regarding school fa- vided with basic patient protections in- The PRESIDING OFFICER (Mr. L. cilities; a Harkin amendment regard- cluding the right for a woman to go di- CHAFEE). Are there any other Senators ing IDEA; a Baucus amendment regard- rectly to an OB/GYN and a parent to in the Chamber desiring to vote? ing impact aid; any amendment that is take their child directly to receive care The result was announced—yeas 47, not cleared within the managers’ pack- from a pediatrician. Every American nays 51, as follows: age; disposition of the point of order; should be protected from having their [Rollcall Vote No. 167 Leg.] and final passage of the Labor-HHS ap- doctors being ‘‘gagged’’ by HMO and YEAS—47 propriations bill. prevented from sharing all health care Akaka Edwards Lincoln The PRESIDING OFFICER. Without information with them. Baucus Feingold McCain objection, it is so ordered. Another disturbing provision con- Bayh Feinstein Mikulski Mr. LOTT. I thank my colleagues on Biden Fitzgerald Moynihan both sides of the aisle for their co- tained in this proposal was the lack of Bingaman Graham Murray legal redress available to an individual Boxer Harkin Reed operation. if they did not complete the internal Breaux Hollings Reid Mr. WARNER. Mr. President, may I review process. Under this proposal if a Bryan Johnson Robb address my leader? Byrd Kennedy Rockefeller Mr. LOTT. I yield to Senator WAR- patient died during the internal review Chafee, L. Kerrey Sarbanes NER. Cleland Kerry Schumer process—which could take up to 14 Mr. WARNER. Two things, Mr. Presi- days—then their surviving family Conrad Kohl Specter Daschle Landrieu Torricelli dent. The distinguished ranking mem- would have no legal recourse against Dodd Lautenberg Wellstone ber of the Armed Services Committee the HMO that denied or caused harm to Dorgan Levin Wyden and I have a package of about a dozen Durbin Lieberman the deceased individual. This is simply amendments which we can clear to- wrong and indefensible. NAYS—51 night. They are agreed upon. We need While I was disappointed in this pro- Abraham Coverdell Gregg to call up the bill. posal there were a few provisions that Allard Craig Hagel Second, we want to discuss with our were applaudable and made an impor- Ashcroft Crapo Hatch Bennett DeWine Helms leadership the possibility of a UC tant step towards providing stronger Bond Domenici Hutchinson which might help move our bill along. protections to patients. I appreciated Brownback Enzi Hutchison Can we give the general outline? the efforts that were made to make the Bunning Frist Inhofe Mr. LOTT. That will be fine. external review process more fair, un- Burns Gorton Jeffords Mr. WARNER. It will take but a Campbell Gramm Kyl biased and accessible. In addition I ap- Cochran Grams Lott minute. I ask my distinguished col- plaud the attempts made to provide pa- Collins Grassley Lugar league to generally outline what we S6094 CONGRESSIONAL RECORD — SENATE June 29, 2000 had in mind. I ask him to articulate it we will have an opportunity to con- AMENDMENT NO. 3697 if he can. sider other vehicles immediately fol- (Purpose: To prohibit the expenditure of cer- Mr. LEVIN. The idea would be, after lowing the completion of the Defense tain appropriated funds for the distribu- this package of cleared amendments is authorization bill so we will be able to tion or provision of, or the provision of a adopted, we would offer a unanimous continue this procedure of a dual track prescription for, postcoital emergency con- traception) consent agreement to limit the bill to to allow the consideration of other Mr. HELMS. Mr. President, I send an relevant amendments on the list, issues. amendment to the desk. which would include Senator BYRD’s With that understanding, we want to The PRESIDING OFFICER. The amendment on bilateral trade because work with the managers to rid our- clerk will report. that probably is relevant under any selves of nonrelevant amendments, The legislative clerk read as follows: circumstances. stick to those amendments which are The Senator from North Carolina [Mr. Mr. WARNER. We think that is rel- relevant in an effort to, as the leader HELMS] proposes an amendment numbered evant, Mr. President. suggested, finish the bill in a matter of 3697. Mr. LEVIN. The amendments will a night or two. I commend the man- Mr. HELMS. Mr. President, I ask have to be on file no later than ad- agers for the effort they have made unanimous consent that the reading of journment tomorrow for the recess. thus far. We will work with them to see the amendment be dispensed with. Second-degree amendments that are we finish it. The PRESIDING OFFICER. Without relevant would be in order even if they Mr. WARNER. I thank our respected objection, it is so ordered. are not filed. This is just preliminary. leaders very much. I told my leader The amendment is as follows: Since the Senator from Virginia asked, and Senator LEVIN, we will work At the appropriate place, insert the fol- I offer this at least as a suggestion pre- nights, we will go right straight lowing: ll liminarily. This is what we are talking through the evenings and stack such SEC. . (a) None of the funds appro- about. priated under this Act to carry out section votes that we feel are necessary. We 330 or title X of the Public Health Service Mr. WARNER. May I add, Senator will achieve that. DODD has an amendment in there Act (42 U.S.C. 254b, 300 et seq.), title V or Mr. LOTT. I yield to the Senator which has been cleared. XIX of the Social Security Act (42 U.S.C. 701 Mr. LOTT. Mr. President, if I can re- from Kansas. et seq., 1396 et seq.), or any other provision of law, shall be used for the distribution or pro- spond to the comments, first, I want to The PRESIDING OFFICER. The Sen- ator from North Carolina has the floor. vision of postcoital emergency contracep- make very clear I feel strongly we tion, or the provision of a prescription for should try to find a way to pass this Mr. HELMS. I yield to the majority postcoital emergency contraception, to an very important Department of Defense leader. unemancipated minor, on the premises or in authorization bill. It has a lot of provi- Mr. LOTT. I thank the Senator from the facilities of any elementary school or sions in it, changes in the law we have North Carolina for yielding further. I secondary school. to get done. We need to do this for our ask his indulgence for a moment so the (b) This section takes effect 1 day after the Senator from Kansas can respond. date of enactment of this Act. national security and for our men and (c) In this section: women who serve in our military. Mr. BROWNBACK. Mr. President, I (1) The terms ‘‘elementary school’’ and Senator DASCHLE and I have talked appreciate the majority leader men- ‘‘secondary school’’ have the meanings given about the fact we want to work to- tioning trying to work out the issue on the terms in section 14101 of the Elementary gether to move it forward. That is one NCAA gaming. I hope we can get that and Secondary Education Act of 1965 (20 of the many reasons we tried to find a worked out and come to a resolution U.S.C. 8801). way to conclude the disclosure require- and move the issue forward. I want to (2) The term ‘‘unemancipated minor’’ ments of the section 527 issue. We have make sure we get that one taken care means an unmarried individual who is 17 years of age or younger and is a dependent, achieved that. That is why I have been of as well. as defined in section 152(a) of the Internal working with Senator BROWNBACK to Mr. LOTT. I thank my colleagues and Revenue Code of 1986. find a way to deal with an issue that is yield the floor. Mr. HELMS. Mr. President, I further very important to him, NCAA gaming. Mr. DASCHLE. Mr. President, if I ask unanimous consent that it be in We want to get it done. can add one other thought. order for me to deliver my remarks at What I had in mind was for the man- The PRESIDING OFFICER. The Sen- my seat. agers to continue to work and clear as ator from North Carolina has the floor. The PRESIDING OFFICER. Without many amendments as they can, and the Mr. DASCHLE. Will the Senator objection, it is so ordered. week we come back—again, I have not yield for 30 seconds? Mr. HELMS. I thank the Chair. discussed the details of this with Sen- Mr. HELMS. I yield to the Senator. Mr. President, Americans who follow ator DASCHLE, so I will not agree to international news, will recall that the anything without us both having a Mr. DASCHLE. Mr. President, I would be remiss if I did not bring up French Government recently created chance to check on both sides and clear an uproar when it authorized its public it. But I was thinking in terms of ask- also the understanding the leader and I have about further confirmation of schools to distribute the post-concep- ing the managers, who have done yeo- tion ‘‘morning-after-pill’’ to girl stu- man’s work, to be prepared to work on judges. Obviously, when we come back, that is going to continue to be an im- dents as young as 12 years old. Monday night, Tuesday night, or I wish parents in our country could portant matter. The leader has cer- Wednesday night while we do other be assured that such an initiative will tainly indicated a willingness to work issues during the day. I am hoping one never see the light of day in the United with us on that. night will do the job but work a couple States, but no such assurance can be or three nights and complete this bill It is also with that understanding made under existing circumstances. the week we come back. We are glad to that Senator LEVIN has some very im- In fact, when the French Government work with them toward that goal. We portant matters, Senator REID, and announced that it would be distrib- want to get this bill in conference. I others. I appreciate very much the ma- uting the ‘‘morning-after pill’’ in think Senator DASCHLE wants to help jority leader’s commitment to work French schools, the Alan Guttmacher with that effort. with us on that as well. Institute—the research arm of Planned Mr. DASCHLE. Mr. President, if I Mr. LOTT. Mr. President, if Senator Parenthood—recommended almost im- can add my thoughts, I share the view HELMS will yield one second more, we mediately that the United States du- expressed just now by the majority are going to confirm some nominations plicate the Western European’s ap- leader. We really want to help the man- tonight. I do note it is our intent after proach in handing out contraceptions agers finish their work on this bill. we complete Labor-HHS and the to teenage girls. They have been working on it now for MILCON conference report to proceed So, isn’t it clear that attempts to weeks. We have come a long way. to the Interior appropriations bill. distribute the ‘‘morning-after pill’’ in The majority leader has also indi- I yield the floor. U.S. public schools are indeed under- cated to colleagues who have concerns The PRESIDING OFFICER. The Sen- way in planning boards of Planned Par- about nonrelevant amendments that ator from North Carolina. enthood? June 29, 2000 CONGRESSIONAL RECORD — SENATE S6095 Moreover, Americans will be alarmed from using Federal funds from the We contacted three different groups for to learn that Federal law currently Labor, HHS, Education appropriations this information: gives schools the authorization to dis- bill to distribute the lawfully given (1) The National Assembly on School-Based tribute these ‘‘morning-after pills’’ to ‘‘morning-after pill’’ in school. Health Care informed us that their group has But before the guardian angels of recently conducted a national survey of their schoolchildren. members and that data reflected that out of In fact, the Congressional Research Planned Parenthood get themselves in 1200 schools, 77% do not offer contraceptives, Service confirmed to me that Federal a tizzy, let me make clear precisely 15% offer contraceptives, including emer- law does, indeed, permit the distribu- what this amendment will and will not gency contraceptives, and the remaining 8% tion of the ‘‘morning-after pill’’ at do. offer contraceptives, but not emergency con- school-based health clinics receiving Under the proposed measure, elemen- traceptives. The schools offering contracep- Federal funds designated for family tary and secondary schools will be for- tives are middle schools and high schools. planning services. bidden to use funds from the Labor, The information is not yet available for pub- Simply put, this means that any HHS and Education appropriations bill lication. school receiving Federal family plan- to distribute to school children the (2) The National Conference of State Legis- latures informed us that they currently have ning money is prohibited by Federal ‘‘morning-after pill’’—which is widely no knowledge of any schools distributing law to place any sort of restriction on considered to be an abortifacient. In emergency contraceptives through school- contraception. Even parental consent fact, many pharmacists nationwide based health clinics. requirements. have refused to fill prescriptions for (3) The Healthy Schools/Healthy Commu- In a handful of cases, the Federal the ‘‘morning-after pill’’ because they, nities (HSHC) Program, Health Resources courts have struck down parental con- too, see it as an abortifacient. and Services Administration, Department of sent laws, ruling that any Federal fam- This amendment will apply only to Health and Human Services informed us that ily planning program trumps a State or school clinics on school property. HSHC does not provide direct dollars for spe- county parental consent statute be- Clearly, Congress simply must not ig- cialized services, such as emergency contra- cause Federal law prohibits parental nore the fact that our schoolchildren ceptives, but does support school-based pro- grams that provide full and comprehensive consent requirements—even though deserve to be protected. Mr. President, I ask unanimous con- health services. HSHC is administered as a Federal law says recipients of Federal discretionary program under the Health Cen- family planning money should ‘‘en- sent that two memoranda prepared by ters program, Section 330 of the Public courage family participation.’’ I make the Congressional Research Service be Health Service Act. Section 330 allows the this point because so many who oppose printed in the CONGRESSIONAL RECORD. provision of voluntary family planning serv- placing restrictions on contraception— There being no objection, the mate- ices at health centers. like parental consent requirements— rial was ordered to be printed in the Mr. HELMS. Mr. President, I ask for run for cover under this language ‘‘en- RECORD, as follows: the yeas and nays. courage family participation’’ when CONGRESSIONAL RESEARCH SERVICE, The PRESIDING OFFICER. Is there a they know good and well that it means LIBRARY OF CONGRESS, sufficient second? absolutely nothing in a court of law. Washington, DC, April 26, 2000. There appears to be. To: Senator Jesse Helms Let me reiterate a warning: There is The yeas and nays were ordered. nothing in Federal law to prevent the From: Kenneth R. Thomas, Legislative At- torney, American Law Division Mr. HELMS. Mr. President, I yield post-conception ‘‘morning-after pill’’ Subject: Application of Parental Consent Re- the floor. from being distributed on school quirements to Distribution of Emergency The PRESIDING OFFICER. The Sen- grounds by clinics receiving Federal Contraceptives in School-Based Clinics ator from Minnesota. funding—regardless of whether a paren- Receiving Federal Funds Mr. WELLSTONE. I say to my col- tal consent State statute exists. This revised memorandum is in response to league from North Carolina, is he fin- That is why I asked the Congres- your rush request to determine whether ished with his prepared remarks on his sional Research Service to look into state parental notification statutes would amendment? whether or not school clinics are dis- apply to the distribution of emergency con- Mr. HELMS. Yes, I am. tributing the ‘‘morning-after pill.’’ traceptives at a school-based clinic which re- ceives federal funds. Specifically, you re- Has the Chair ruled on the yeas and What CRS found is that there is some nays? discrepancy to the response to this quested an evaluation of whether state pa- rental notification statutes, regulations or The PRESIDING OFFICER. The yeas question. policies which applied to federally funded and nays have been ordered. For example, according to CRS, the clinics distributing contraceptives would be Mr. HELMS. They have been ordered. National Conference of State Legisla- preempted. Mr. President, I am advised I should tures spokesman said there was no In a series of cases in the mid-1980’s, var- ask unanimous consent that this ious federal courts reviewed the application knowledge that any school had distrib- amendment of mine be laid aside and uted the ‘‘morning-after-pill.’’ Yet, the of parental notification requirements to fed- the vote be put in regular order tomor- National Assembly on School-Based erally funded programs which distributed row morning. I ask unanimous consent Health Care—an organization which contraception. In general, the courts found that the application of parental notification that that be the case. works closely with HHS—told Congres- statutes to federally funded programs to pro- The PRESIDING OFFICER. Without sional Research Service that their vide contraception resulted in the frustra- objection, it is so ordered. group has recently conducted a na- tion of the federal purpose of the statutes, Mr. HELMS. I thank the Chair and tional survey of their members, and and consequently the courts invalidated such yield the floor. that the resulting data reflected that restrictions. out of 1,200 schools, 15 percent offer There is currently no federal prohibition AMENDMENT NO. 3698 contraceptives, including the ‘‘morn- on the distribution of emergency contracep- (Purpose: To provide for a limitation on the ing-after pill.’’ tives at school-based clinics. use of funds for certain agreements involv- If I can be of further assistance, please con- ing the conveyance or licensing of a drug) So, you see, it is not clear as to ex- tact me at 7–5863. actly what is being provided to school- Mr. WELLSTONE. Mr. President, I send an amendment to the desk. children these days. But it is clear that CONGRESSIONAL RESEARCH SERVICE, we are not just talking about condoms. LIBRARY OF CONGRESS, The PRESIDING OFFICER. The Simply put, Planned Parenthood and Washington, DC, April 12, 2000. clerk will report. its cronies have been given free reign To: Honorable Jesse Helms. The assistant legislative clerk read to distribute to American school- From: Technical Information Specialist, Do- as follows: children whatever they so please—to mestic Social Policy Division. The Senator from Minnesota [Mr. the point where schoolchildren are now Subject: School-Based Clinics. WELLSTONE], for himself and Mr. JOHNSON, being provided extremely controversial Your office requested a memorandum de- proposes an amendment numbered 3698. scribing policies of school-based clinics for Mr. WELLSTONE. Mr. President, I forms of contraception. And, in my distributing emergency contraceptives (more judgment, this has gone on far too commonly known as the ‘‘morning-after ask unanimous consent reading of the long. pill’’), including the number of schools esti- amendment be dispensed with. That is why I am offering an amend- mated to be offering emergency contracep- The PRESIDING OFFICER. Without ment today that would forbid schools tion, and any existing federal prohibitions. objection, it is so ordered. S6096 CONGRESSIONAL RECORD — SENATE June 29, 2000 The amendment is as follows: Again, this amendment says that drug research, done at their expense, is On page 92, between lines 4 and 5, insert pharmaceutical companies that nego- frequently used then by the pharma- the following: tiate an agreement with NIH—NIH is ceutical industry with no assurance SEC. ll. (a) LIMITATION ON USE OF FUNDS doing the research, helping out, the that American consumers will not be FOR CERTAIN AGREEMENTS.—Except as pro- drug is then developed, the pharma- charged outrageously high prescription vided in subsection (b), none of the funds made available under this Act may be used ceutical company now has the patent— drug prices. by the Secretary of Health and Human Serv- must sign an agreement to sell the Take the drug Taxol, for instance. ices to enter into— drug at a reasonable price. The NIH spent 15 years and $32 million (1) an agreement on the conveyance or li- I do not think it is unreasonable of our money, taxpayer money, to de- censing of a patent for a drug, or on another from the point of view of your con- velop Taxol, which is a popular cancer exclusive right to a drug; stituents and my constituents, people drug used for breast, lung, and ovarian (2) an agreement on the use of information in this country who pay the taxes and cancers. Following the development of derived from animal tests or human clinical support our Government, who feel just Taxol, the drug manufacturer was trials that are conducted by the Department a little bit ripped off by the prices awarded exclusive marketing rights on of Health and Human Services with respect today, that if we are going to put our to a drug, including an agreement under the drug, and Taxol is now priced at which such information is provided by the taxpayer dollars into the research and roughly 20 times what Taxol costs the Department to another Federal agency on an into the support and then the pharma- manufacturer to produce. So a cancer exclusive basis; or ceutical companies are going to get a patient on Taxol will pay $10,000 a year (3) a cooperative research and development patent, at the very minimum they while it only costs the drug company agreement under section 12 of the Stevenson- ought to be willing to sell the drug to $500. Wydler Technology Innovation Act of 1980 (15 people in our country at a reasonable As reported by Fortune 500 magazine U.S.C. 3710a) pertaining to a drug, excluding price defined by the Secretary of earlier this year, the pharmaceutical cooperative research and development agree- Health and Human Services. companies once again represent the ments between the Department of Health This amendment is all about cor- and Human Services and a college or univer- most profitable sector of the American sity. porate welfare at its worst. It is about economy. On top of that, we are seeing (b) EXCEPTIONS.—Subsection (a) shall not being there for consumers. It is about drug prices soaring at unimaginable apply to an agreement where— assuring people that their taxpayer rates year after year. In the United (1) the sale of the drug involved is subject dollars are contributing toward some States, drug spending is growing at to a price agreement that is reasonable (as research that will in turn contribute more than twice the rate of all other defined by the Secretary of Health and toward affordable drugs for themselves Human Services); or health care expenditures. Furthermore, and their children. Americans are paying far more for pre- (2) a reasonable price agreement with re- I yield the floor to my colleague, spect to the sale of the drug involved is not scription drugs than do the people in Senator JOHNSON of South Dakota. any other Western industrialized Na- required by the public interest (as defined by The PRESIDING OFFICER. The Sen- such Secretary). tion—many of these drugs manufac- (c) RULE OF CONSTRUCTION.—Nothing in ator from South Dakota. Mr. JOHNSON. Mr. President, I am tured in the United States and the re- this section shall be construed to apply to search having been conducted through any agreement entered into by a college or pleased to join my colleague from Min- university and any entity other than the nesota, extending strong support for American taxpayer dollars. Secretary of Health and Human Services or his amendment. As an example, tamoxifen, a widely an entity within the Department of Health Very simply, this amendment would prescribed drug for breast cancer, re- and Human Services. require that when companies receive cently received federally funded re- Mr. WELLSTONE. Mr. President, I federally funded drug research or a fed- search and numerous NIH-sponsored offer this amendment on behalf of my- erally owned drug, the benefits of that clinical trials. Yet today the pharma- self and Senator JOHNSON from South research or drug be made available to ceutical industry charges women in Dakota. the public on reasonable terms through this Nation 10 times more than they I am just going to take 1 minute to what is called a ‘‘reasonable pricing charge women in Canada for a drug summarize this amendment, I say to clause.’’ widely developed with U.S. taxpayer my colleagues, and then Senator JOHN- This issue first surfaced during the support. SON will proceed, and then I will come Bush administration, in fact, when the The evidence has shown that the back to the amendment. NIH insisted that cooperative research pharmaceutical companies are charg- Mr. President, if you just look right agreements contain a reasonable pric- ing enormously high rates for drugs de- here at this chart, it is very inter- ing clause that would protect con- veloped with the help of taxpayer esting. Tamoxifen and Prozac are two sumers from exorbitant prices of prod- money. Americans then are forced to widely used drugs. Look at the dif- ucts developed from federally funded pay twice for lifesaving drugs: first as ference between what the United research. taxpayers to develop the drug, and States citizens pay for a vial versus Two weeks ago, during floor debate then as a consumer to bolster pharma- what people in Canada pay. in the other body on the Labor, Health ceutical profits. Once again, who is In our country, a United States cit- and Human Services, and Education hurt most by this? As one would ex- izen pays $241 for tamoxifen; $34 in appropriations bill, a very similar pect, these costs fall hardest on those Canada. For Prozac, in this country it amendment to this one was offered and most vulnerable and least able to bear is $105; in Canada, it is $43. overwhelmingly accepted by nearly the burden, such as cancer patients, What this amendment says—and I three-quarters of the House of Rep- AIDS patients, and the elderly. want to go back to Bernadette Healy’s resentatives in a bipartisan vote. We have to put an end to the give- leadership at NIH. What this amend- The circumstances we face today are away of billions of taxpayer dollars to ment says is that what Ms. Healy did is extraordinary. As an example, between finance drug research that goes on the right thing to do, which is to say to 1955 and 1992, 92 percent of drugs ap- without any assurance whatsoever that the pharmaceutical companies, when proved by the FDA to treat cancer the American taxpayers will not see a the NIH does the research, and then the were researched and developed by the reasonable return on their investment patent is handed over to a pharma- taxpayers through the NIH. Today in terms of affordable prescription drug ceutical company, that pharmaceutical many of the most widely used drugs in prices. company—since we put the taxpayer this country dealing with a variety of I appreciate that this amendment dollars into the research—should at critical illnesses such as AIDS, breast may not be the silver bullet that solves least agree to provide citizens in this cancer, and depression were developed all of the problems of assuring the country with a decent, affordable through the use of taxpayer-funded American public they are receiving the charge; that the pharmaceutical com- NIH research. The Federal Government return on their investment that they pany should agree to an affordable funds about 36 percent of all medical deserve. But it does serve as an impor- price or a reasonable price which is de- research. tant message that this Congress is here fined specifically by the Secretary of The unfortunate scenario for Amer- to protect the millions of American Health and Human Services. ican taxpayers is that oftentimes this consumers who have invested their June 29, 2000 CONGRESSIONAL RECORD — SENATE S6097 money in research to develop drugs FAMILIES USA, We appreciate your leadership on this im- that they now cannot afford to buy. Washington, DC. portant issue. Furthermore, it shows we are here to Senator PAUL WELLSTONE, Sincerely, fight for affordable prescription drugs Washington, DC. MARTHA A. MCSTEEN, DEAR SENATOR WELLSTONE: We applaud President. for every American in this Nation. your amendment that would require that a Mr. WELLSTONE. I will quote from This is one part of an overall strat- price agreement be part of agreements be- Ron Pollack, executive director of egy that this Congress needs to enact tween NIH and companies who do research on new drugs. Families U.S.A.: to assure that we have equity, to as- Currently, once NIH has successfully devel- Currently, once NIH has successfully devel- sure that we have tax fairness, and to oped a new drug it signs over the commercial oped a new drug it signs over the commercial assure that we maximize the number of rights to pharmaceutical companies that rights to pharmaceutical companies that people in America who can afford their charge American consumers as much as they charge American consumers as much as they prescriptions. want. Americans are forced to pay twice for want. Americans are forced to pay twice for lifesaving drugs, first as taxpayers to de- lifesaving drugs, first as taxpayers to de- I urge my colleagues to vote for pas- velop the drug and then as consumers to the velop the drug and then as consumers to the sage of this critically important drug companies for the product. These costs drug companies for the product. These costs amendment tomorrow when the vote is fall hardest on those least able to bear the fall hardest on those least able to bear the taken on this amendment. I commend burden such as seniors and the uninsured, al- burden such as senior citizens and the unin- and applaud my colleague from Min- though all consumers wind up paying more sured, although all consumers wind up pay- ing more than they should have to. nesota for his work in crafting this than they should have to. Your amendment would help correct this I want to simply quote from a piece amendment and bringing it before the burdensome situation. Please let us know body. in the New York Times from April 23, how we can help make this amendment in which challenged the drug industry’s law. Mr. WELLSTONE. Mr. President, I contention that R&D cost justify the thank the Senator from South Dakota. Sincerely, RONALD F. POLLACK, prices they charge the American con- Again, the amendment says that when Executive Director. sumer. That is what we keep hearing, the pharmaceutical companies nego- that it is the R&D cost. That is why tiate an agreement with the NIH to de- NATIONAL COUNCIL they have to charge so much. I quote velop and market a drug based on tax- OF SENIOR CITIZENS, from the New York Times piece of payer-financed research, there must be Silver Spring, Maryland, June 29, 2000. April 23: an agreement signed by the pharma- Senator PAUL WELLSTONE, The industry’s reliance on taxpayer-sup- ceutical companies that they will sell Washington, DC. ported research—characterized as a ‘‘sub- DEAR SENATOR WELLSTONE: The National sidy’’ by the very same economists whose the drug at a reasonable price. Council of Senior Citizens fully supports work the industry relies on—is common- your amendment to the FY 2001 Labor HHS This is an eminently reasonable place, the examination also found. So com- appropriations bill to require that the Fed- amendment. This amendment does not monplace, in fact, that one industry expert eral government negotiate a reasonable and cover extramural NIH research grants, is now raising questions about the compa- fairer price for all drugs developed with pub- such as grants to universities. It does nies’ arguments. lic funds. The Federal government has for not cover grants to universities. It does The expert, Dr. Nelson Levy, a former head too long sold its most precious research find- of research and development at Abbott Lab- not establish a health care price con- ings for a mess of pottage to the pharma- trol scheme. oratories, who now works as a consultant for ceutical cartels. The drug companies, in industry and the Federal Government on This amendment will reinstate the turn, sell these findings back to the Amer- drug development, bluntly challenged the in- Bush administration’s reasonable pric- ican people at unconscionably high retail dustry’s oft-repeated cost of developing the prices. Pharmaceutical retail price reform drug. ‘‘That it costs $500 million to develop a ing clause which was in effect from 1989 must start at the source—where public drug to 1995. This amendment directs the drug,’’ Dr. Levy said in a recent interview, research and development investment has ‘‘is a lot of bull.’’ Secretary of Health and Human Serv- borne fruit. ices to determine what is a reasonable Your bill defines the public interest as re- Finally, the examination found that price. This amendment gives the Sec- quiring hard bargaining by the N.I.H. in be- Federal officials have abandoned or ig- retary flexibility to waive the pricing half of the public when selling patents to nored policies that could have led to drug companies. We also note that your lower prices for medicines developed clause if it is in the public interest to amendment only covers intramural N.I.H. re- do so. with taxpayer dollars. That is partly search. We call on your colleagues to support because the Government has lost track As my colleague from South Dakota this needed amendment. of what drugs have been invented with Sincerely, pointed out, a similar amendment, its money, and partly, officials say, be- which was introduced by Congressmen DAN SCHULDER, Director, Legislation & Public Affairs. cause the industry has resisted any SANDERS, ROHRABACHER, DEFAZIO, and Government effort to insist that they others passed the House of Representa- NATIONAL COMMITTEE TO PRESERVE charge people—our constituents—a rea- tives by a 3-to-1 margin, 313 to 109. It is SOCIAL SECURITY AND MEDICARE, sonable price. As Dr. Bernadine Healy, because people in the country feel Washington, DC, June 29, 2000. a former Director of the NIH, said in a ripped off by this industry. People in Hon. PAUL WELLSTONE, recent interview, ‘‘We sold away Gov- the country believe that the prices U.S. Senate, Washington, DC. ernment research so cheap.’’ should be more reasonable. Certainly DEAR SENATOR WELLSTONE: It has come to our attention that the Senate is likely to Again, it is not a new issue. During our constituents believe that if we are consider H.R. 4577, an amendment to the the Bush administration, the NIH, going to be funding some of the re- Labor, Health and Human Services, and Edu- from 1989 to 1995, insisted there be search and these companies are going cation appropriations bill. The amendment some reasonable pricing clause. There to benefit from our taxpayer dollars, would require drug companies to sell drugs was heavy pressure from the pharma- then there ought to be an agreement at a reasonable price if the drugs were devel- ceutical industry. They abandoned this that these companies are going to be oped based on intramural research done by practice. We are saying that we ought willing to charge us a reasonable price. the National Institute of Health. On behalf to be going back to it. of the members and supporters of the Na- There are multiple factors contrib- That is not too much to ask. tional Committee to Preserve Social Secu- This amendment is supported by rity and Medicare, I strongly support your uting to the prescription drug cost cri- Families U.S.A., the National Council proposed amendment. sis in our country today. I realize that of Senior Citizens, and the Committee When pharmaceutical companies build on this reasonable pricing clause is not a to Preserve Social Security and Medi- NIH research they are using taxpayer panacea for these egregiously high money. A Congressional Joint Economic care. drug costs for America’s seniors—and, Committee report revealed that seven out of for that matter, for families in our I ask unanimous consent that their the top 21 most important drugs introduced country—but this amendment makes it letters be printed in the RECORD. between 1965 and 1992 were developed with federally funded research. Taxpayers deserve clear the Congress will not allow tax- There being no objection, the letters some return on their investment in terms of payers to spend all of the money for were ordered to be printed in the lower prices. This amendment will help to this kind of research and then not get RECORD, as follows: ensure that. any kind of break in return. S6098 CONGRESSIONAL RECORD — SENATE June 29, 2000 For the most part, most of the drugs ceutical industry. This industry has They make these arguments that I that are developed with taxpayer basically become a cartel. I wish there cannot believe—that if NIH is going to money are then given over to the phar- were a lot of free enterprise. I wish force us to sign an agreement, since we maceutical industry with no assurance there were a lot of competition. But benefit from your research and the tax- whatsoever that Americans will not be that is not so. They basically have ad- payer money, we will charge people a charged outrageously high prices—in ministered prices; they basically have reasonable price, then we may not even fact, no assurance that they won’t be price gouged; and they have made an be willing to do this research. That is charged the highest prices in the world. immense amount of profit—an exorbi- blackmail, or white mail, or whatever Tamoxifen is a very important drug to tant amount of profit—based upon the you want to call it. It is outrageous. women struggling with breast cancer. sickness and misery and illness of peo- These companies dare to say to the This is what a prescription costs that ple. That, in and of itself, is an obscene NIH—or dare to say to the Govern- is getting filled. In Canada, it is $34. In proposition. ment, or to our constituents—if the the United States, it is $241. Prozac is This amendment goes after the worst Government says to the pharma- $43 in Canada, and in the U.S. it is $105. of corporate welfare. This amendment ceutical companies that get the re- Here is the next chart. This amend- is eminently reasonable, and I hope search dollars, do the work and re- ment will ensure that we get some fair that my colleagues will support it. search and get the patent, that they return on our investment and that we Again, I point out the support of should charge a reasonable price, we don’t get the highest prices for medica- Families U.S.A. I think I will read might not do the research at all, tions in the world. Let me restate that. from the letter of the National Council enough is enough. I don’t think it ensures that, but it can of Senior Citizens: My final point: I think this is a re- only help. I have given some examples The National Council of Senior Citizens form issue as well. I think Senators up here. Let me simply point out to fully supports your amendment to the vote their own way. But, honest to colleagues that the cost of prescription FY2001 Labor HHS appropriations bill to re- God, I think, at least speaking as a drugs has skyrocketed. Our people in quire that the Federal government negotiate Senator from Minnesota, I am just this country this past year paid 17 per- a reasonable and fairer price for all drugs de- tired of the way in which—if Fanny veloped with public funds. cent more. Lou Hammer were on the floor she Let me also point out that we are Ask the people back home. Do any of would say ‘‘sick and tired’’—this indus- paying the highest costs for pharma- our constituents think it is unreason- try pours the dollars in, makes these ceutical drugs of any people anywhere able for us to ask these companies that huge contributions, has all of these in the world— exorbitant prices. I have benefit from our taxpayer dollars and lobbyists, has all of this political this chart—The Fleecing of America— benefit from Government research to power, and is so well represented to the just to look at some of the profits of charge our citizens, our constituents, a point where they believe they run the companies. Let me give some exam- reasonable price? Congress. They do not. ples: entertainment companies, $4.2 bil- They go on to say: This amendment with very similar lion; airline companies, $4.7 billion; oil The Federal Government has for too long language passed the House of Rep- companies are doing pretty well right sold its most precious research findings for a resentatives by a huge margin. Very mess of pottage to the pharmaceutical car- similar language, the same proposition, now at $13.6 billion; auto companies, tels. The drug companies, in turn, sell the $15.4 billion; the drug companies, $20 and the same subject matter passed the findings back to the American people at un- House of Representatives by a huge billion. conscionably high retail prices. Pharma- As the Fortune 500 magazine said, margin. ceutical retail price reform must start at the I hope tomorrow on the floor of the this past year has been a ‘‘Viagra’’ source—where public drug research and de- Senate there will be a strong vote for kind of year for these drug companies. velopment investment has borne fruit. this amendment that I bring to the But do you know what. It is the con- Finally, from the National Com- floor with Senator JOHNSON of South sumers who paid the price. We are mittee to Preserve Social Security and Dakota. charged the highest prices of any coun- Medicare: Mr. President, I yield the floor. try in the world, and I think it is time On behalf of the members and supporters of The PRESIDING OFFICER. The Sen- to say to the pharmaceutical compa- the National Committee to Preserve Social ator from Michigan. nies that enough is enough. Security and Medicare, I strongly support Mr. LEVIN. Mr. President, it is just This industry has opposed every your proposed amendment. simply wrong that Americans are When pharmaceutical companies build on measure that has been introduced in forced to pay extraordinarily high this Congress to try to lower prices and NIH research they are using taxpayer money. A Congressional Joint Economic prices for prescription drugs and then to provide a decent prescription drug Committee report revealed that seven out of have to cross the border to Canada and benefit to senior citizens. Frankly, I the top 21 most important drugs introduced Mexico to buy those drugs manufac- hate talking about it in terms of senior between 1965 and 1992 were developed with tured in the United States at far lower citizens because there are a lot of federally funded research. Taxpayers deserve prices. It is simply wrong. But it is working families being hurt by this. some return on their investment in terms of doubly wrong when the U.S. taxpayers I think the amendment we have in- lower prices. This amendment would help to have paid for part of the research that troduced tonight is a small step, but I ensure that. produced those very same prescription think it is a step in the right direction. This amendment would help to en- drugs. It is not unreasonable to say to these sure that, and I don’t know why the Many of us have constituents who go companies that if we are going to fi- Senate tomorrow morning cannot go to Canada just for this purpose; they nance the research, if NIH is going to on record saying that when we, a Gov- are unable to afford prescription drugs do the research, if you are going to get ernment agency supported by taxpayer here in the United States. Sometimes valuable data and information from dollars, by our constituents, do the re- they go great distances to cross the NIH to use to develop your drugs, and search, provide the data, provide the border to Canada or to Mexico in order you are going to get the patent, at the information to these companies, which to buy prescription drugs at prices very least you have to agree to charge in turn get a patent for the drug, those they can afford. a reasonable price. companies will sign an agreement that We did a survey of a number of pre- That is all this amendment says. they will charge the citizens in this scription drugs. These are seven of the This is what we did under Dr. Healy’s country a reasonable price. most popular prescription drugs. We leadership. The pharmaceutical compa- They make all the arguments about took a look at those seven drugs and nies hated it. They were able to knock how they need all of these exorbitant then did a survey of the cost of those it out sometime around 1995. But do profits for their research. But there is prescription drugs in Michigan and in you know what. A lot has changed, I not a shred of evidence to support that. Ontario across the border. Premarin, say to Democrats and Republicans Their profits are so exorbitant that it $23.24 in Michigan, $10.04 in Ontario; alike, since 1995. People in our States goes way beyond any cost of research. Synthroid, $13 compared to $8; Prozac, are absolutely furious about the prices We all know that. That is what is be- $82 compared to $43; Prilosec, $111 com- they are being charged by the pharma- hind the record profits they make. pared to $48; Zithromax, $48 compared June 29, 2000 CONGRESSIONAL RECORD — SENATE S6099 to $28; Lipitor, $63 compared to $42; particularly wrong where we have IDEA is not a mandate of the Federal Norvasc, $76 compared to $41. originally done some of the subsidy of Government on the States. The fact When particularly seniors—some- the very research and development that the Federal courts have said if a times by the busload—gather together, which produced the drug which is now State provides a free and appropriate drive to a border point, and cross the sold for so much less in those other public education to its children—and border to get a 30- or 60-day supply of countries. States don’t have to do that—but if a prescriptions, and then come back into I commend the Senator from Min- State provides a free and appropriate Michigan or other States with prescrip- nesota. I support his amendment. I public education for all of its kids, it tion drugs that they cannot afford to hope we will adopt it. cannot discriminate on the basis of buy in their own hometown, something I yield the floor. race, it cannot discriminate on the is fundamentally wrong with that sys- The PRESIDING OFFICER. The Sen- basis of sex, or national origin, and in tem. ator from Minnesota. two court cases the court said it can- These are the percentages of those Mr. WELLSTONE. Mr. President, I not discriminate on the basis of dis- top seven drugs. The U.S. prices are thank the Senator from Michigan for ability. above the Canadian prices based on his remarks. I am very proud to have Simply because a child has a dis- that survey. That was a survey of his support. ability doesn’t relieve the State of its prices in Detroit compared to Ontario AMENDMENT NO. 3699 obligation under the equal protection across the border. (Purpose: To fully fund IDEA) clause to provide that child a free and For the first one, Premarin, the U.S. Mr. HARKIN. Mr. President, I send appropriate public education. price is 131 percent higher than the Ca- my amendment to the desk on the Indi- In 1975, the Congress said because nadian price; Synthroid is 63 percent viduals With Disabilities Education this would be such a burden on the higher than for Ontario purchasers; Act. States, we will pass national legisla- Prozac is 878 percent higher for Ameri- The PRESIDING OFFICER. The tion to help the States meet their con- cans than for Canadians; Prilosec is 132 pending amendment is laid aside. The stitutional obligation to educate kids percent higher; for Zithromax, Ameri- clerk will report the amendment. with disabilities. That is what IDEA is. cans are paying 674 percent more than The assistant legislative clerk read The Federal Government said, OK, if Canadians; Lipitor is 51 percent more as follows: you meet these certain requirements, than for Canadians; and Norvasc is 783 The Senator from Iowa [Mr. HARKIN], for you will be eligible for IDEA for this percent more than for Canadians. himself, and Mr. WELLSTONE, proposes an money. If we had no legislation at all, amendment numbered 3699. That is unconscionable. It is wrong. if there were no Individuals With Dis- It is infuriating. It is costly. We have Mr. HARKIN. I ask unanimous con- abilities Education Act, the States to do something to change the system sent reading of the amendment be dis- would still have to fund the education that allows this to happen. But it is pensed with. of kids with disabilities—not because The PRESIDING OFFICER. Without doubly wrong when U.S. taxpayers the Federal Government says so, but have paid for part of the research that objection, it is so ordered. The amendment is as follows: because the Constitution of the United produced those very same prescription States says so. As long as a State is On page 60, line 16, strike ‘‘$7,357,341,000’’ drugs. and insert ‘‘$15,800,000,000’’. providing a free public education to I don’t know which of these par- On page 60, line 19, strike ‘‘$4,624,000,000’’ other kids, they have to provide it to ticular prescription drugs were pro- and insert ‘‘$13,071,659,000’’. kids with disabilities. It is not a Fed- duced with U.S. taxpayer dollars or Mr. HARKIN. Mr. President, this is a eral mandate. It is a constitutional partly with U.S. taxpayer dollars. I very simple amendment. It is very mandate. don’t have that data. But that is not straightforward. It does not include a We have said in the Federal Govern- the point of the amendment of the Sen- lot of pages of text. All it does is fully ment, when we passed IDEA, we will ator from Minnesota. For the drugs fund the Individuals With Disabilities help. Furthermore, we said in the au- produced with U.S. taxpayer dollars, Education Act. By passing this amend- thorizing legislation, that it would be a there should be an agreement that the ment, we meet our goal of paying 40 goal of the Federal Government to pro- manufacturer will charge a fair price percent of the average per pupil ex- vide for 40 percent of the cost of the av- as determined by the Department of penditure. erage per pupil expenditure for all Health and Human Services. For years, many on both sides of the other kids. We have never reached that That is a very reasonable approach, aisle have agreed that the Federal Gov- 40 percent. It was a goal then. It is still it seems to me. There are other ap- ernment should increase our support a goal. Senators on both sides of the proaches which have been suggested to for States’ efforts to provide children aisle talked about meeting this goal. address this issue. I think there are with disabilities a free and appropriate Now we have the opportunity to do so. other approaches also worthy of con- public education. With this amendment My amendment is a win-win situa- sideration. But the approach before us we can do just that. tion for everyone. We are able to fully today is an approach which I believe is Congress enacted the Education for fund both the IDEA and our general eminently fair, which simply says if All Handicapped Children Act, which is education priorities so that all kids, you want to use taxpayer dollars in now known as IDEA, for two reasons. with and without disabilities, get the your research, that you make sure To establish a consistent policy of education they deserve and they are your pricing system is fair to Ameri- what constitutes compliance with the guaranteed by the Constitution of the cans who helped to fund that very re- equal protection clause of the 14th United States. search. amendment with respect to the edu- Over the past 5 years, I have worked I hope we will adopt the amendment cation of kids with disabilities, and to hard with my colleagues on the Appro- of the Senator from Minnesota. I think help States meet their constitutional priations Committee to more than dou- it is a fair approach. It is based on the obligations. ble the appropriation for Part B of contribution Americans have made to Mr. President, I ask unanimous con- IDEA. This year we have included an the creation of the very prescription sent to add Senator WELLSTONE as a co- additional $1.3 billion. Senator SPEC- drugs which too many Americans find sponsor. TER and I, in a bipartisan fashion, they cannot afford. The PRESIDING OFFICER. Without worked very hard to get this increase. We want pharmaceutical companies objection, it is so ordered. Because of the amendment offered by to be profitable. We want pharma- Mr. HARKIN. Mr. President, there Senator JEFFORDS yesterday and the ceutical companies to engage in robust has been a lot of misperception about statements made on the floor, it be- research and development. But we do IDEA. That misperception is amplified came clear to me that there is a strong not and should not, as Americans, pay in statement after statement until it will on both sides of the aisle to fully the share of research and development almost becomes a state of fact that fund IDEA to meet that 40-percent ob- that consumers in other countries IDEA is a Federal mandate on the ligation. should be shouldering. We can’t afford States. I hear it all the time: a Federal Now we can step up to the plate and to subsidize other countries, and it is mandate that is not fully funded. do it. This week the OMB informed us S6100 CONGRESSIONAL RECORD — SENATE June 29, 2000 that the non-Social Security surplus ciation top priorities. The Education gift to the States this year, if you real- will reach up to $1.9 trillion over the Task Force of the Consortium for Citi- ly want to help our local school dis- next 10 years. I believe we ought to use zens With Disabilities advocates full tricts, this is the amendment with these good economic times to prepare funding. The National School Boards which to do it, to fully fund IDEA once for the future. Association just sent me a letter last and for all. So, Mr. President, as I said, OMB has week requesting an increase in funding I yield for any comments or sugges- informed us we are going to have $1.9 for IDEA. tions my colleague from Minnesota trillion over the next 10 years in non- In January of 1997 the majority lead- might have. Social Security surplus. That means er, Senator LOTT, announced that fully Mr. WELLSTONE. Mr. President, I we can use some of this for a lot of dif- funding IDEA was a major component am going to be very brief. Staff is here, ferent things: Pay down the national of the Republican agenda. Later, Sen- and it is late. It has been a long week. debt, shore up Social Security, Medi- ator GORTON said that failure to fully I can do this in a couple of minutes. I care, and make appropriate invest- fund IDEA is fundamentally wrong— wanted to stay with Senator HARKIN ments in education. One of the most CONGRESSIONAL RECORD, May 13, 1997. because I think this amendment goes appropriate investments we can make In January of 1998 the majority lead- right to the heart of what we are is to fully fund the Individuals with er and other Republican Senators held about. It is a win-win-win-win amend- Disabilities Education Act. But there a major press conference to announce ment. I do not know how many times I are a lot of other ways we can help pay they were going to introduce a bill, S. said ‘‘win.’’ It is a win for us because for this. For example, we could save 1590, that would, among other things, we should match our budgets and our dollars by cracking down on Medicare fully fund IDEA. votes with the words we speak. Just waste fraud and abuse. The HHS In- Senator COVERDELL said the resolu- about everybody on the floor of the spector General said last year, Medi- tion of the issues in that bill were: Senate said they are for the Federal care made $13.5 billion in inappropriate As important a battle as the country has Government meeting this commitment payments. Eliminating that waste ever dealt with. of 40 percent funding of IDEA. It is also alone would more than pay for the en- On his Web site, Senator GREGG from a win for children with special needs. It tire IDEA expenditure. Yet the House- New Hampshire, who has always been a is about children. We ought to do well passed Labor-HHS bill actually cuts proponent of fully funding IDEA said for all of our children. the funding for detecting waste, fraud that: Maybe it is because I am getting a and abuse. I hope we can take care of He will continue to lead the fight to have little older and have six grandchildren, that in conference. My point is we have the Federal Government meet its commit- but I think all children are beautiful a lot of waste, fraud, and abuse in ment to fund 40 percent of the special edu- and all children have potential and all Medicare we can cut out to help pay for cation costs. children can make contributions. We this. On his Web site, Senator SANTORUM should do everything we can to nurture We have a lot of other things we can of Pennsylvania supports full funding and support them. That is what this do also: Cutting out Radio Marti, and for IDEA. program has been about. TV Marti; spending by Government Last night, Senator VOINOVICH of The Senator from Iowa has been, if agencies on travel, printing and sup- Ohio said it is about time we paid for 40 not the leader, one of the great few plies and other items could be frozen. percent of IDEA. That was last night. leaders from early time on for kids This could save $2.8 billion this year, And last night Senator JEFFORDS, with special needs. It is also a win be- about $12 billion over 5 years. Pentagon with whom I have worked many years cause I do think our States and school spending could be tied to the rate of in- on this issue, said: districts, if we can do better by way of flation. This would force the Pentagon This body has gone on record in vote after our investments, I say to Senator HAR- to reduce duplication and other ineffi- vote that we should fully fund IDEA. KIN, will not only be able to live up to ciencies. This change would save tax- Senator JEFFORDS also said: this commitment but will have more payers $9.2 billion this year alone; $69 If we can’t fully fund IDEA now with budg- resources to invest in other priority billion over 5 years. Enhancing the et surpluses and the economy we have, when areas. One of the things that has trou- Government’s ability to collect student will we do it? I do not believe that anyone bled me is, the Senator talked about loan defaults would be $1 billion over 5 can rationally argue that this is not the the surplus. What is it over 10 years, years. time to fulfill that promise. $1.9 trillion? The reason I cite these examples is to The reason I opposed the JEFFORDS Mr. HARKIN. Mr. President, $1.5 tril- show there is a lot of waste and a lot of amendment last night, and I said so lion, non-Social Security. spending we can tighten down on to openly last night in debate, is because Mr. WELLSTONE. It is $1.5 trillion help pay for IDEA. We have the sur- his amendment would have taken non-Social Security over the next 10 plus, however. All this money that we money out of class-size reduction and years. Some of what has been discussed found out there—as we go through this out of funding for school modernization is a zero-sum gain, whether we are year, you wait and see, transportation and construction to fund IDEA. I said faced with the choice of do you support will take a little bit of that money; we should not be robbing Peter to pay low-income kids with title I or do you housing will take a little bit of that Paul. We need to reduce class sizes. We support IDEA or do you support a money; defense will take a big chunk of need school construction money. lower class size or do you support try- that; the Finance Committee will have In fact, some of the biggest bene- ing to get more teachers into our tax provisions—they want to do away ficiaries of school construction and schools, or do you support rebuilding with all the estate taxes now. That will modernization are kids with disabil- crumbling schools. I believe we have a take away a big chunk. I hope we don’t ities. chance right now with the surplus, pass it but I assume something will Now we have an opportunity to fully with these additional resources, to come through. fund IDEA because we have these big make these decisive investments. I There is a big surplus out there and surpluses, as I said, $1.5 trillion on- cannot think of anything more impor- bit by bit special interests are going to budget surpluses over the next 10 tant than making this investment in come and take some of it away. Now is years, not counting Social Security. To children and education. our time to get in there and say we are fully fund IDEA would amount to less My last point is, all of us—and I will going to take enough to fully fund the than 6 percent of that over the next 10 even make this bipartisan, seeing Sen- Individuals with Disabilities Education years. And, like I said before, we ator CHAFEE presiding, whom I think Act. We can do it. We have the money wouldn’t have to touch the surplus if cares deeply about children and edu- to do it. And, if I listened correctly to we just implemented one of my pro- cation, just like his dad did, and I my friends on both sides of the aisle, posals to close up special interest tax mean that sincerely—we are all going we seem to have the will to do it. loopholes, eliminate wasteful govern- to have to make some decisions about I just point out a range of organiza- ment spending, including Pentagon consistency. tions fully support full funding. It is waste, or deal with Medicare waste, It is like the old Yiddish proverb: one of the National Governors’ Asso- fraud and abuse. If you want to give a You can’t dance at two weddings at the June 29, 2000 CONGRESSIONAL RECORD — SENATE S6101 same time. We cannot do everything. needs children who may not have all of ing States more flexibility in the use of Some people want to put yet more into the economic wherewithal to give their those funds. The booming economy tax cuts, including Democrats, more kids the best education. combined with successful State efforts here and more there. Ultimately, we As I understand it, this is the first to move more people from welfare to have to decide what is most important. vote up or down vote on fully funding work have allowed States to reduce the We have this surplus and we have the IDEA ever. Let’s make it our last. costs of welfare. Congress urged States opportunity. We have had all the de- I thank the Senator from Minnesota to save a portion of their TANF grants bate and discussion, and now we have for his support. I yield the floor. for the inevitable ‘‘rainy day’’ when ad- an opportunity, with this amendment— Mr. JEFFORDS. Mr. President, I rise ditional funds would be needed. Many of which I am proud to be a cosponsor— to commend Chairman STEVENS, Chair- States did save part of their TANF al- to match our votes with our rhetoric. man ROTH, and Chairman SPECTER for location, and Congress has threatened We should do that. I hope there is a their commitment to working in con- to reduce the TANF allocations prom- strong vote for this from Democrats ference to restore funding to the Social ised to the States, because the funds and Republicans. I am proud to be a co- Services Block Grant (Title XX), the have not been fully expended. I thank sponsor. I yield the floor. Temporary Assistance for Needy Fami- Senators STEVENS, ROTH, and SPECTER Mr. HARKIN. Mr. President, I thank lies (TANF) program and for the State for their commitment to uphold the my colleague for his words of support, Children’s Health Insurance Program promises we made in 1996 during con- not only tonight but for all the time I (S–CHIP). These programs provide a ference negotiations on the Labor-HHS have known him and all the years he vital safety net for our most vulnerable appropriations bill. has been in the Senate for making kids citizens. My home State of Vermont has an and education, especially special needs The Social Services Block Grant pro- unparalleled track record in extending kids, one of his top priorities. gram provides critical services for health insurance coverage to children I could not help but think when I was abused children, low-income seniors, and families, and the S–CHIP has listening to the Senator speak, this and other families in need of assist- played a key part in contributing to vote on this amendment—I do not ance. For example, my own State of this success. While Vermont has mean to puff it up bigger than it is. We Vermont uses 80 percent of its Title XX achieved its enrollment goals for this are going to be faced the remainder of funds to help abused and neglected program to date, it continues to reach this year with vote after vote on what children. Much of this money goes to out to enroll eligible children. Restora- to do with that surplus. We may dis- assist the roughly 300 children in foster tion of the S–CHIP funding is essential agree on whether it is the estate tax care in our State. This block grant was for Vermont and other States in order cut or marriage penalty—whatever it created under the Reagan Administra- for them to continue enrolling children might be. There might be other things tion to provide States with a source of in this program. It is essential for Con- coming down the pike, and we will flexible funding to meet a variety of gress to keep its commitment to the S– have our debates and disagreement, but human service needs. It was the suc- CHIP program, otherwise States are it seems to me that before we get into cess of the Social Services Block Grant not likely to continue their aggressive all that, we ought to do something for that paved the way for welfare reform. outreach and enrollment efforts and our kids with disabilities and we ought When welfare reform was passed, children may be left without health to do something that is right and is Congress made several agreements care. supported broadly, in a bipartisan way, with the states. One such agreement I believe strongly that it is impor- and supported by our States. was that funds for the Social Services tant for Congress to keep its agree- I can honestly say to my friend from Block Grant would be reduced to $2.38 ments with the States—-particularly Minnesota, if every Senator voted for billion with States permitted to trans- regarding the Social Services Block this amendment, they would not get fer up to 10 percent of allocated TANF Grant, TANF, and S–CHIP. The success one letter, one phone call taking them funds into the block grant to ‘‘make up of States in implementing these pro- to task for their vote in support of this the difference.’’ grams and the extent to which Con- amendment. I believe I can say that Since making that agreement in 1996, gress and the administration maintain without any fear that I would ever be Congress and the Administration have promised funding levels for these crit- wrong; that no Senator, whoever votes repeatedly cut the funds appropriated ical programs will help determine the for this amendment, would ever get one for the Block Grant to its current year future of State block grants. letter or one phone call from anyone funding level of $1.775 billion. I am How can we expect States and advo- saying they voted wrong. I believe that grateful that there is a strong commit- cates to agree to flexible block grant because it is so widely supported. ment to maintain this year’s funding initiatives, if Congress cannot fulfill Then we can go on with our other de- level in conference. However, the re- its promise to maintain adequate fund- bates on tax cuts and other issues with duction of the amount of TANF funds ing? the surplus and how we will deal with that States can transfer also must be Mr. ALLARD. Mr. President, I would it. addressed. Vermont is one of several like to make a statement concerning At this point in time, let us say we States which transfer the entire 10 per- the Federally funded research that is are going to take this little bit and in- cent that is allowable under TANF. Un- conducted at the various Centers for vest it in the Individuals With Disabil- fortunately, even with full use of the Disease Control (CDC) around the ities Education Act and, once and for transferability, many states are no country. all, meet that 40-percent goal, and we longer able to make up for the repeated February of this year I met with the will not have to be talking about it reductions in Social Service Block Director of the CDC, Jeffrey Koplan. anymore. Grant funds. CDC was highlighted in newspaper arti- As I said, this is a very simple and I believe that the amount of TANF cles concerning the misuse of research very straightforward amendment, but I funds that States are permitted to funds targeted for hantavirus disease. will admit, for the record, it is going to transfer should not be cut in half, as Because of the presence of this disease take 60 votes. I understand that. It will current law requires, but should be in- in our state, as with other neighboring take 60 votes, but I believe if Senators creased to help mitigate the loss of states, I am very concerned at the lack will just think about what they have Title XX funds that States have experi- of accountability from the CDC. said about IDEA and fully funding it enced since the 1996 agreement. The I expressed my concern for the cor- and think about that big surplus we commitment to restore Social Services rect utilization of funding for the dis- have and all of the demands that will Block Grant funds to the current level ease research programs that are man- be made on that surplus in the future, is a good first step, but we should keep dated by Congress. I stressed the im- they just might think: Yes, we ought in mind that it is just a first step. portance of CDC’s accountability and to carve out a little bit right now and In creating the TANF program, the obligation to carry out the letter of put it into IDEA. It would help our Federal Government limited the our laws. Mr. Koplan assured me that States and our schools and, most of all, amount of welfare funds that would be they have taken measures to complete help our families who have special provided to States in exchange for giv- a full audit of the misdirected funds S6102 CONGRESSIONAL RECORD — SENATE June 29, 2000 and that they will follow the intent of school sponsored web sites. I simply for the loans that have been canceled. Congress in the future. feel that these decisions are best made This amendment would simply fulfill Being a member of Congress, I for locally. its IOUs to the Perkins program. Mr. one can fully understand that the proc- Second, I am concerned that the President, we have a $1.9 trillion sur- ess of appropriating funds for research McCain amendment imposes an addi- plus, it is ironic and probably an over- is complicated at best. Although Con- tional cost to obtain filtering software sight that we are still in debt to Amer- gress designates specific funds for cer- upon schools and libraries without ade- ica’s colleges and universities that pro- tain diseases, there are several levels quate input from those institutions. vide loans to low income students, but of bureaucracy through which the dol- The McCain amendment relies upon it is a debt that I think we can and lars must pass before they are received the technical fix of filtering and im- should repay. That is why I am thank- by the appropriate agency. This still poses filtering software on all com- ful for the Managers’ efforts, and that does not account for an agency’s lack puters in a facility. The Santorum is why I will continue to push for the of dedication in meeting congressional amendment allows a school or library full $90 million in the future. direction that is law. Part of my re- to determine which computers are Both the cancellation program and sponsibility as a U.S. Senator is the available for student access and then the Perkins Loan Program are seri- oversight of various agencies and their install blocking software upon those ously undermined if the government accountability to Congress to carry out computers. Software licensing costs does not fulfill its debt obligations to the language of our laws. are not inexpensive, and requiring that the universities and colleges that Hantavirus outbreaks have rapidly software be installed on every machine choose to administer it. affected the U.S., reaching as far as may be financially difficult for small The Perkins Loan Program (formerly Vermont. Most recently, a 12-year-old communities. called the National Defense Student girl who lives in Loveland—my home- Finally, though I am concerned Loan Program) provides long-term, town—was diagnosed with the disease. about protecting children on the Inter- low-interest (5% per year) loans to the Doctor’s believe she may have con- net, I am also concerned about the con- poorest undergraduate and graduate tracted the disease while visiting a stitutionality of blocking material on students. 25 percent of the loans go to ranch in Arizona last April. Once the Internet for adult computer users. students with family incomes of $18,000 hantavirus is contracted it can be any- The Santorum amendment allows com- or less, and 83% of the loans go to stu- where from one week to as little as one munities to develop common sense so- dents with family incomes of $30,000 or day before symptoms appear. Once lutions to protect the rights of adults less. Since its inception, 11 million stu- symptoms are prevalent, it rapidly pro- to access information over the Internet dents received $15 billion in loans gresses to respiratory distress as the in a place like a public library. A Wis- through the Federal Perkins Loan Pro- lungs fill with fluid. consin community could decide, under gram. In the academic year 1997/98, Colorado has had 23 cases of the Santorum amendment, for exam- 698,000 students received Perkins loans. hantavirus since 1998—with three cases ple, that it wanted to have a locked Perkins is exceptional because it is a already this year. It is time to act with room in its public library with com- public/private partnership that no further delay by the CDC labora- puters in it that only adults could use leverages taxpayers’ dollars with pri- tory. to access the Internet and not install vate sector funding. The yearly Federal I hope that the CDC has worked out blocking software on those machines. contribution to Perkins Loans revolv- it’s problems and will carry out what There are ways to block children’s ac- ing funds leverages more than $1 bil- Congress expects of an agency. cess to computers that are structural, lion in student loans. This is because Mr. FEINGOLD. Mr. President, I rise Mr. President, like a locked door, that Perkins Loans are made from revolving today to describe why I opposed the would still protect the First Amend- funds, so the largest source of funding amendment offered by the senior Sen- ment right of adults. These options are for Perkins Loans is from the repay- ator from Arizona, Mr. MCCAIN, to this not available under the McCain amend- ment of prior-year loans. legislation on the issue of schools and ment. The Perkins Loan Cancellation Pro- libraries blocking children’s access to I appreciate the Senate’s interest in gram entitles any student who has re- certain materials on the Internet, and protecting children from inappropriate ceived a Perkins loan who enters supported the alternative amendment material on the Internet, but I feel teaching, nursing and other medical on this topic offered by Senator that the McCain amendment does not services, law enforcement or volun- SANTORUM. go far enough to ensure that local gov- teering to cancel their loans. This past The McCain amendment prohibits ernments, libraries, schools, and indi- year, more than 45,000 low income stu- schools and libraries from receiving viduals rights are protected. dents who chose to enter these impor- federal funds under the E-Rate pro- Mr. WELLSTONE. Mr. President, I tant professions were able to have their gram if they do not install software to thank Chairman SPECTER and ranking loans canceled. Last year, 26,000 teach- block children’s access to two specific member, Senator HARKIN, for working ers, 10,500 nurses and medical techni- kinds of information: materials that with me to see that funding is in- cians, 4,000 people who work with high- are obscene and materials that con- creased for the Perkins Loan Cancella- risk children and families, 4,000 law en- stitute child pornography. The tion Program. I filed an amendment forcement and 700 volunteers had their Santorum amendment contains a simi- that would have increased the level of loans canceled under this program. lar prohibition on funding, but gives the Perkins Loan Cancellation Pro- This year, thanks to the efforts of the local community the flexibility to gram by $30 million to $90 million. I am Senator DURBIN and others, it looks decide what materials are inappro- very appreciative that the committee like we may be able to expand the pro- priate for children’s viewing and to im- increased funds for this valuable pro- fessions eligible for cancellation to in- plement a comprehensive policy on mi- gram by $30 million—especially given clude public defenders. nors’ Internet use if they want to con- the terrible budget constraints on this The value of Perkins loans is enor- tinue to receive the E-Rate. I feel that bill. I am especially thankful that the mous. Since 1980 to 1998, the cost of local communities, not the federal gov- Managers of this bill have agreed to higher education has almost tripled, ernment, should decide what materials raise the appropriation by another $15 leading to a decline in the purchasing are suitable for children’s viewing. million. This will get the government power of federal grant programs. The Wisconsin communities may want to half way to where it needs to be to re- maximum Pell grant this year is worth address or restrict whether children imburse Perkins Revolving Funds for only 86% of what it was worth in 1980, have access to adult chat rooms even what they have lost to the Loan Can- making the Perkins program, and all though the chat may not be about cellation Program. It is an important loan programs, a more important part child pornography or may not contain step. of low income students’ financial aid technically obscene topics of conversa- The reason I asked for more is sim- packages. tion. They also may want to restrict ple. If we give the extra $30 million, the The value of the cancellation pro- whether they post identifying informa- federal government can pay back what gram is also enormous. It provides the tion or photographs of students on it owes to the universities and colleges lowest income people who want to June 29, 2000 CONGRESSIONAL RECORD — SENATE S6103 enter public service a small break from The numbers indicate that this is MORNING BUSINESS the crushing debts they incur attend- true. In 1998, men who had earned a Mr. STEVENS. Mr. President, I ask ing higher education. Offering loan bachelors degree earned 150% more unanimous consent that the Senate cancellation also highlights the need than men who had received only a high now proceed to a period of morning for well-trained people to enter public school diploma. Women earned twice as business and return to the pending much. (NCES, ‘‘Condition of Education, service and honors those who choose to business when I complete these re- 2000,’’ 2000). College graduates earn on enter public service. This is the kind of marks. average $600,000 more in their lifetime incentive and reward we should be The PRESIDING OFFICER. Without than people with only a high school di- doing more of and I thank the Senate objection, it is so ordered. ploma. (US Department of Commerce, for accepting my amendment earlier The PRESIDING OFFICER. The Sen- that would provide Stafford loan for- Bureau of the Census, 1994. Despite the obvious benefits of in- ator from Massachusetts. giveness for child care workers. Mr. KENNEDY. I ask unanimous con- Mr. President, I am here today be- vestments in higher education, funding is declining. Since 1980 to 1998, the cost sent to speak in morning business for cause the future of both of these pro- 10 minutes. grams is in great jeopardy because we of higher education has almost tripled, leading to a decline in the purchasing The PRESIDING OFFICER. Without are unable to repay the universities’ objection, it is so ordered. revolving funds what they are owed for power of federal grant programs. The the cancellation program. There are maximum Pell grant this year is worth f only 86% of what it was worth in 1980, colleges that receive only 47% of what APPROPRIATIONS they are owed by the government. making the Perkins program a more They are given the rest on an IOU. important part of low income students’ Mr. KENNEDY. Mr. President, before Because Perkins loans are funded financial aid package. Yet, the num- the Senate are the appropriations bills through revolving loans, the people bers of institutes of higher education which provide the funding for edu- who end up paying the price for this offering the Perkins Loan Program has cation, health, and training programs. IOU are low income students who are declined by 80% over the past 20 years. As I have mentioned over the past few During the last decade, student aid eligible for Perkins loans in the future. days, I respect the work by Senator funding has lagged behind inflation, As loans are canceled, and the govern- SPECTER and Senator HARKIN in trying yet in the next ten years, more than 14 ment is unable to reimburse the revolv- to shape that proposal. We have some million undergraduate students will be ing funds, there is less and less money differences, even within the limited enrolled in the nation’s colleges and available in the funds to generate new budget figures that were allocated, in universities, an increase of 11 percent. loans. It is estimated that 40,000 fewer areas we feel were shortchanged. We One-fifth of these students are from students will be eligible for Perkins tried to bring some of those matters to families below the poverty line. Many loans because of the declining money the floor yesterday. of them are the first in their families On the issues of making sure we will available in the revolving fund. to go to college. When you combine the pressure from reach out in the areas of recruiting The effect of the decline in funding teachers, providing professional devel- the unfulfilled government obligations has a disproportionate impact on low with recent cuts to the Perkins pro- opment for teachers, and mentoring for income students—the very students teachers, we received a majority of the gram in general, I believe that both that Perkins is designed to help. Stud- these key programs are at risk. Con- Members of the Senate. I believe it was ies show that an increase in tuition of 51 votes. A majority of the Members gress has cut the yearly Federal con- $100 lowers the enrollment of low in- tributions to the Perkins Loans revolv- felt that should be a higher priority come students by 1%. (McPherson and than designated. Even in the majority ing funds by $58 million since fiscal Shapiro, 1998). In Minnesota, students party, there is a clear indication, par- year 1997. Since 1980, the Federal Gov- from families that make $50,000 per ticularly against the backdrop of the ernment’s contributions have declined year or more are three times as likely announcements made in the past 2 days by almost 80%. 900 colleges and univer- to attend a four year college as stu- with these enormous surpluses, that sities around the country have cut dents from families who make $30,000 one of the priorities of the American their Perkins programs at least in part per year or less (and I remind my col- people is investing the surpluses in the because they were not economically leagues that 83% of Perkins loans children of this country. viable. In MN, colleges such as Metro would go directly to these students I think that is something that needs State University have ended this valu- with incomes less than $30,000.) Fur- to be done. We are going to proceed able program in large part because ther, more than 1/3 of students who they cannot afford to keep it going. enter college drop out. Often this is be- during the course of this day on This means one thing and one thing cause they cannot afford to continue. amendments which I think are very only. There are less and less loans The Perkins Loan Program is vital to important. The next one, which will be available for the lowest income stu- helping these low income students offered by Senator DASCHLE to deal dents. The $15 million the manager’s enter and stay in college. It would be a with issues of genetic discrimination package will provide will go far to re- shame if the program failed because and employment discrimination, is verse this situation. the government failed to pay univer- very important. We will go on, as has Reducing the number of loans avail- sities back the money it owes this val- been agreed to by the leaders. able is not the direction we want to be uable program. By increasing the ap- But as we are going through this de- going given what we know about the propriation for the cancellation pro- bate, I cannot remain silent on the al- rising importance of college education gram, the managers have taken a locating of resources. We are hopeful, and the increasing need for financial strong step toward getting the govern- as a result of the action of the Presi- aid. ment out of debt. I am also committed dent of the United States, there will be A study from Minnesota indicates to seeing that this program is fully a different form and shape of this ap- that for every $1 that is invested in funded in the future. We have on-budg- propriations bill by the time it comes higher education, $5.75 is returned to et surpluses of $1.9 trillion. We should back from the conference, or by the Minnesota’s economy. A 1999 Depart- use this appropriation to ensure that time it is actually enacted in the fall. ment of Education study indicates that we are not in debt to the 40,000 fewer We are not giving the priorities in the the real rate of return on investment students who will not receive the Per- areas of education, and I must say even in higher education is 12% based on kins loans they once could have be- in the health area, that I think the earnings alone. This does not include cause the federal government did not American people want and deserve. The savings on health care and other fac- meet its obligation to pay for its own principal reason for that is there is an tors. Further, a recent poll found that cancellation program. assumption within the Republican 91% of the American Public agree that These are America’s poorest students leadership that there will be a tax financial aid is an investment in Amer- who are simply trying to afford a col- break of some $792 billion. So if you are ica’s future (Student Aid Alliance, lege education. With a $1.9 trillion sur- going to write that into the budget, or 1999). plus, we owe it to them to pay it back. parts of that into the budget, you are S6104 CONGRESSIONAL RECORD — SENATE June 29, 2000 going to squeeze other programs. That the Republicans either in the House or local governments in enhancing aca- is really what has happened. the Senate in recent years. demic achievement. We have learned I daresay that at a time when we are I remember very clearly the 1995 re- important lessons: Smaller class sizes gaining increased awareness and under- scission because I remember the debate work and better trained teachers work. standing about what actually helps in 1994, when we had a rather signifi- Take the two States that have invested children expand their academic cant enhancement in our investment in in teachers: North Carolina and Con- achievement and their accomplish- children. The ink was hardly dry, the necticut. They are seeing dramatic re- ments, as a result of some dramatic re- results were in, and the results of 1994 sults in academic achievement. ports, which I find compelling—and ac- and 1995 were that we had a very vig- We have been fighting to provide the tually self-evident—we find we are orous debate on rescinding money that resources to do that. That is what the really not taking the benefits of those had already been appropriated and debate is about. We have, I think, dem- reports and using them in ways that signed by the President. After the ex- onstrated to this body and, hopefully, can benefit the greatest number of traordinary efforts made by the Repub- the American people the seriousness of children in this country. lican leadership to actually rescind our purpose in allocating resources to I think again of the excellent presen- those funds, we had those rescissions in what the American families want, and tations of the Senator from Wash- 1995. they want to invest in children and ington, Mrs. MURRAY, when she spoke Then the House bill in 1996 was $3.9 education. We believe that is quite time and time again about the impor- billion below what was actually en- preferable to the large tax breaks tance of smaller class sizes. She re- acted in 1995. Then in 1997, the Senate which have been included in the overall ferred again and again to the excellent bill was $3.1 billion below the Presi- budget. We will continue this battle. studies done in Tennessee with thou- dent’s request; the House and Senate I yield the floor. sands of children, going back to 1985, bill in 1998 was also below the Presi- f that resulted in smaller class sizes, and dent’s request. This was a time when we find that children have made very the Republicans were trying to abolish THE RURAL RECOVERY ACT OF significant progress. the Department of Education. 2000 I remember Senator MURRAY men- I think most parents feel it is impor- Mr. DASCHLE. Mr. President, yester- tioning the SAGE Program in Wis- tant to have a Cabinet Member sitting day I introduced the Rural Recovery consin, which has been enacted in re- in the Cabinet room so that every time Act of 2000 to help address the eco- cent years. I myself met these past the President of the United States nomic malaise that has gripped certain weeks with members of the school meets with the Cabinet to make deci- rural areas of our country. The legisla- board, parents and teachers out in War- sions on priorities, there will be some- tion will authorize the Department of saw, WI, who participated in that pro- one in there to say, ‘‘What are we Agriculture to provide grants to rural gram and commented about the impor- going to do on education, and particu- communities suffering from out-migra- tance of investing in children with larly education that is going to affect tion and low per-capita income. smaller class sizes. So we know this is the elementary and secondary school- Rural areas of our nation continue to something that works. If we are going children of this country, particularly experience an erosion in their eco- to have scarce resources, we ought to at a time when we have exploding num- nomic well-being. Statistics bear out give focus and attention to something bers of children who are going into our the decline in rural economic activity, that works, as Senator MURRAY has classrooms?’’ but they fail to fully capture the pointed out. I think she brings credi- Nonetheless, what we continue to human suffering that lies just beyond bility to this issue because she is a see, in 1999, is the House was $2 billion the numbers. Economic downturns lead former school board member and a below the President’s request; in 2000, to the migration away from farm-de- former first grade teacher herself. She $2.8 billion below the President’s re- pendent, rural communities, further has been in the classroom and knows quest; and in 2001, $2.9 billion below the stifling economic opportunities for what works. We have been very fortu- President’s request. This is what has those left behind. The 1990 Census high- nate to have her presentation on this happened. lighted these migratory trends, and I issue and her enthusiasm for it. Members ask: ‘‘Why do the Demo- anticipate that similar trends will be We also know, looking over the re- crats try to force these issues? Why captured by the 2000 Census, as well. cent history, that we have actually had don’t we just go ahead and accept what In short, the prosperity from which bipartisan support for smaller class these appropriations committees have many Americans have benefited from sizes. We saw yesterday her amend- done?’’ They try to defend their posi- during the past decade has left many ment was not successful, but it was tions with all these facts about what is rural areas standing by the wayside. If very closely fought in a divided Senate, really happening out there in edu- this trend continues, more and more and I am hopeful, with the strong sup- cation, but when you add them all up, young people will be forced to leave the port of the Senate, we can finally per- this is what you are finding: The Fed- towns they grew up in for opportunities suade Congress, as we have in the past, eral share of education funding has de- in urban areas. In towns like Webster, to move ahead in that direction. clined. If you look at higher education, Eureka, and Martin, South Dakota, we We have to understand this legisla- from 1980 to 1999, the federal share de- are seeing farm families broken up, tion is going to go to the House of Rep- clined from 15.4 percent to 10.7 percent. populations decline, and main street resentatives, which has seen a very siz- If you look at elementary-secondary businesses close their doors. While able reduction in its commitment to education, from 1980 to 1999, we see a there is no doubt that economic growth the funding of these various programs. decline from 11.9 percent to 7.7 percent. in our urban areas has benefited our Whatever we do here is going to be Only 7.7 percent of every dollar spent nation, the disparity of economic de- knocked back significantly. That is locally is Federal money, and this is velopment between our rural and urban why many of us were very hopeful we perhaps the lowest figure we have had areas cannot be ignored. If nothing is could go ahead and add some additional in elementary-secondary education. In done to address the economic chal- resources so at least coming out of the terms of the amount of our budget, lenges facing these areas, we will jeop- conference we would have something which is $1.8 trillion, this is less than ardize the future of rural America. worthy of the children of this country. one percent. It is less than one penny That is why I have introduced legis- But we have been unable to do that. We per dollar. If you combine the elemen- lation to provide the nation’s rural have to look back over the years and tary and higher education, you may be areas with the resources necessary to see what has happened, ultimately, in getting close to two pennies. That, I make critical investments in their fu- allocating funding resources in the think, is what concerns many of us, ture and, by doing so, to create eco- area of education when have had Re- particularly at a time when we are nomic opportunities that will help publican leadership. We hear a great finding out the total number of chil- them sustain a valuable and important deal about the importance of investing dren is increasing. way of life. It also will help rural areas in children, but the tragic fact is that We recognize there should be a part- provide basic services at times when it is not reflected in the requests by nership among the Federal, State, and they are losing a significant part of June 29, 2000 CONGRESSIONAL RECORD — SENATE S6105 their tax base. While federal agencies, still continues today. When he was HHS–Education Appropriations Act for such as the United States Department chairman of the Senate Committee on fiscal year 2001. of Agriculture’s Office of Rural Devel- Indian Affairs, Senator INOUYE was I also was unavoidably detained due opment and the Economic Develop- highly regarded among tribal leaders to a family commitment on the ment Administration, provide assist- for his efforts to re-establish their sov- evening of June 27, and I missed one ance for rural development purposes, ereignty over their own people and vote during that time. I would have there are no federal programs that pro- their own affairs. Tribal leaders con- voted ‘‘yes’’ on rollcall vote number vide a steady source of funding for sider Senator INOUYE to be a true lead- 149, Senate amendment number 3610, a rural areas most affected by severe er and friend to the Indian people to McCain amendment as amended to HR out-migration and low per-capita in- this day. I thank Senator INOUYE for 4577, the Labor–HHS–Education Appro- come. For these areas, the process of his leadership and dedication to service priations Act for fiscal year 2001. economic development is often most to our country, and I thank him for his f arduous. This legislation will provide friendship and example. SEPARATING THE FACTS FROM the basic, long-term assistance nec- Mr. President, inscribed on the medal THE PARTISAN RHETORIC essary to aid the coordination efforts is the word ‘‘Valor.’’ Senator INOUYE is of local community leaders as they one of the most valiant men I know. I Mr. LEAHY. Mr. President, this begin economic recovery efforts and praise the Members of Congress for statement is part of my continuing ef- struggle to provide basic public serv- honoring him and hope that our young fort to bring clarity to the facts under- ices. people may see that it takes courage, lying the oversight investigations on County and tribal governments will bravery, and valor to enjoy the free- campaign finance being pursued by be able to use this federal funding to dom which so many men like Senator Senator SPECTER within the Sub- improve their industrial parks, pur- INOUYE fought to protect. Thank you, committee on Administrative Over- chase land for development, build af- once again, to Senator INOUYE for your sight and the Courts. Staying focused fordable housing and create economic example, and thank you to all of the on the facts becomes even more impor- recovery strategies according to their veterans who have served to protect tant as the volume of the political needs. All of these important steps will liberty and justice. rhetoric continues to increase. help rural communities address their f Although oversight is an important economic problems and plan for long- function, there are obvious dangers of term growth and development. VICTIMS OF GUN VIOLENCE conducting oversight of pending mat- Mr. President, I believe this legisla- Mr. MOYNIHAN. Mr. President, it ters. Applying, or seeming to apply, po- tion holds great potential for revital- has been more than a year since the litical pressure to pending matters has izing many of our nation’s most ne- Columbine tragedy, but still this Re- real consequences, which we are now glected and vulnerable areas. I urge my publican Congress refuses to act on seeing first-hand. Recently, the Judici- colleagues to support its enactment. sensible gun legislation. ary Committee received requests for f Since Columbine, thousands of Amer- information from the defense attorney icans have been killed by gunfire. Until for Wen Ho Lee, a criminal defendant COMMEMORATING SENATOR DAN- we act, Democrats in the Senate will facing charges of improperly IEL INOUYE: RECIPIENT OF THE read some of the names of those who downloading classified information CONGRESSIONAL MEDAL OF lost their lives to gun violence in the from computers at Los Alamos Nuclear HONOR past year, and we will continue to do so Laboratory. Mr. Lee’s defense attorney Mr. DOMENICI. Mr. President, I rise every day that the Senate is in session. wants the Republican report on this today to join my fellow Senators in In the name of those who died, we matter, as well as other documents honoring Senator DANIEL INOUYE with will continue this fight. Following are gathered during oversight, presumably the Congressional Medal of Honor. This the names of some of the people who to aid his defense or at least to get po- man is a representative of our nation were killed by gunfire one year ago tential impeachment materials for pro- who has persevered through war, de- today. spective government witnesses. bate, and many had fought campaigns. June 29, 1999: Rokisha Denard, 18, Just today we learned that the Com- I have had the pleasure of working Trenton, NJ; Herman Eastorly, 79, St. mittee has now also been dragged into with Senator INOUYE and applaud my Louis, MO; Scott M. Echoles, 27, Chi- the pending case of Maria Hsia, a colleagues for bestowing this great cago, IL; William Hunter, 33, Nashville, criminal defendant who was recently honor upon him. TN; Elton James, 28, New Orleans, LA; convicted of campaign finance viola- Senator DANIEL INOUYE is a Veteran Craig Jones, 28, New Orleans, LA; Ber- tions and is awaiting sentencing. Ms. of World War II and was a captain in nard Lathan, San Francisco, CA; Jack- Hsia’s attorney apparently found the the Army with a Distinguished Service ie Lee Nabor, 39, Detroit, MI; Billy J. questioning of the Justice Department Cross (the second highest award for Phillips, 43, Chicago, IL; Richard Rog- prosecutor in charge of her case at last military valor), a Bronze Star, a Purple ers, 16, Fort Wayne, IN; Sidney Wilson, week’s hearing so offensive that it is Heart with cluster, and several other 14, Fort Wayne, IN; Tonya Tyler, 24, now the basis for a claim that Ms. medals and citations. Serving in the Nashville, TN; Unidentified male, 16, Hsia’s sentencing should be delayed be- Senate almost 40 years, Senator INOUYE Chicago, IL. cause to set a sentencing date now is also the first Congressman from the f would only serve political purposes. state of Hawaii. His courage in combat Indeed, at a hearing of the Specter is a testament to the Senator’s true POSITION ON VOTES investigation on June 21, 2000, a Repub- commitment to his country and to Mr. JOHNSON. Mr. President, I was lican member of the Judiciary Com- freedom. Serving on the Defense Appro- absent from the Senate last Thursday mittee queried Robert Conrad, the cur- priations Committee, I know how much afternoon to attend the high school rent head of the Justice Department Senator INOUYE cares about the protec- graduation of my daughter. Kelsey. I Campaign Financing Task Force about tion of our country and his profes- missed two different votes, and I would the Hsia sentencing, despite Conrad’s sionalism and dedication to finding a like to state for the RECORD, how I statements that he could not properly balance for defensive spending. His dili- would have voted in each instance. discuss pending matters. The Repub- gence and dedication speak for them- I would have voted ‘‘yes’’ on rollcall lican member stated that he expected selves and I am proud to serve our vote number 141, the third reading of Conrad to pursue Hsia’s sentencing vig- Armed Forces with a man of this cal- the Foreign Operations, Export Financ- orously, and asked whether the govern- iber near the helm. ing, and Related Programs Appropria- ment had filed a sentencing memo- I have also had the pleasure of work- tions Act for the fiscal year 2001. randum. After Conrad explained that ing with Senator INOUYE on the Indian I would have voted ‘‘yes’’ on rollcall the sentencing submissions had not yet Affairs Committee for over 20 years vote number 142, the motion to in- been made, the Republican member and know first hand that his bravery struct the Sergeant at Arms during the stated: ‘‘I would expect that you would did not cease on the battlefield, but consideration of HR 4577, the Labor– pursue vigorously the sentencing phase S6106 CONGRESSIONAL RECORD — SENATE June 29, 2000 of that case and that you personally recent hearing with the Attorney Gen- traffickers to divert legal guns to the would oversee it . . . I have seen some eral this week. In summary, the Vice illegal marketplace. The cases previously involving these very President indicated in response to gen- vulnerabilities in our law, identified by matters in which I believe the Depart- eral questions during an interview with the ATF, are a result of corrupt federal ment of Justice was not sufficiently Justice Department prosecutors on firearms licensees, who were associated aggressive toward sentencing.’’ He then April 18, 2000, that he had no concrete with only 10 percent of the investiga- expounded his view that the ‘‘only recollection of attending the coffees tions in the report but accounted for way’’ a person convicted at trial could though may have attended one briefly. nearly half of the firearms involved, a get a downward departure at sen- He fully acknowledged the fact that staggering 40,000 guns; gun shows, tencing is to cooperate fully and stated coffees took place and explained his which supplied channels for 26,000 guns, ‘‘I would expect that you would treat understanding of their purpose. the second highest number of illegally this like any other case, that unless Two days after the interview, on trafficked firearms in the investiga- the defendant was prepared to testify April 20th, the Vice President’s attor- tion; straw purchasers, who bought and fully and completely and provide infor- ney, James Neal, sent a letter to transferred firearms to unlicensed sell- mation that you can verify, that you Conrad clarifying the Vice President’s ers or prohibited users; unlicensed sell- would not accept a recommendation of recollection since he had not been ad- ers, who were not required to conduct any downward departure.’’ These com- vised before the interview that this Brady background checks or maintain ments clearly conveyed the Republican subject matter would come up. Neal ex- records of their sales; and firearms member’s view that Maria Hsia should plained that the Vice President ‘‘un- theft. be treated harshly at sentencing, derstood your questions about Coffees Mr. President, we can no longer af- The Specter investigation has broken to concern the Coffees hosted by the ford to ignore the deficiencies in our long-standing precedent and routinely President in the White House.’’ Based federal firearm laws. Gun trafficking demanded documents and testimony upon a record review, the Vice Presi- gives criminal users and young people involving ongoing criminal matters. I dent ‘‘was designated to attend four access to tens of thousands of illegal have warned repeatedly that such in- White House Coffees. The Vice Presi- guns. If Congress wants to reduce fire- terference risks that prosecutions may dent hosted approximately twenty-one arm trafficking, then first and fore- be compromised, more work will be Coffees in the Old Executive Office most, we must close the gun show loop- generated for prosecutors, and political Building. He did not understand your hole. Secretary Lawrence Summers, agendas will appear to take precedence questions to include the OEOB Cof- who oversees the ATF explained ‘‘This over effective and fair law enforce- fees.’’ Indeed, Conrad refers repeatedly report . . . shows that we must do more ment. Nevertheless, at Senator SPEC- in his questions on this subject to to close every trafficking channel, TER’s request, the majority on the Ju- ‘‘White House coffees’’ or ‘‘White House starting with closing the gun show diciary Committee has approved sub- hosted . . . coffees’’. loophole . . .’’ Furthermore, we must poenas in a number of ongoing criminal There is absolutely nothing unusual increase criminal penalties for traf- cases, including Wen Ho Lee, Peter about witnesses in depositions or even fickers and crack down on corrupt fed- Lee, who remains on probation and in testimony at Congressional hearings eral firearms licensees, straw pur- under court supervision, multiple cam- supplementing or clarifying the record chasers, and unlicensed sellers. I urge paign finance cases and investigations, after the completion of their testi- Congress to pay attention to this re- and the Loral/Hughes matter. mony. In fact, this common practice is port and pass sensible gun measures With respect to the Loral/Hughes embodied in Rule 30 of the Federal that will end the deadly flow of fire- matter, the Judiciary Committee ap- Rules of Civil Procedure, which grants arms to the illegal marketplace. I request an article be printed in the proved issuance of a subpoena on May deponent thirty days after the tran- RECORD entitled ‘‘The Biography of a 11, 2000, to the Justice Department for script is available to review the tran- Gun,’’ which explains how a single gun ‘‘any and all’’ Loral and Hughes docu- script and recite any changes in the makes the transition from legal to ille- ments, over the objection of Wilma testimony given. The same rules apply Lewis, the United States Attorney in gal commerce. to depositions taken in criminal mat- There being no objection, the mate- D.C., which is conducting the inves- ters, under Rule 15(d) of the Federal tigation. Ms. Lewis explained that the rial was ordered to be printed in the Rules of Criminal Procedure. RECORD, as follows: United States Attorney’s Office has At the June 27th Judiciary Com- [From the New York Times, Apr. 9, 2000] ‘‘an open active investigation’’ into al- mittee hearing, one Republican mem- THE NATION—THE BIOGRAPHY OF A GUN legations of the unlicensed export of ber asserted that ‘‘there is a question (By Jayson Blair and Sarah Weissman) defense services and that thousands of of the coffees,’’ without identifying the documents in the possession of her of- question. To the extent this implies In America, more than 200,000 guns are fice could be responsive to the pending traced by law enforcement each year. This is that there is something wrong with the story of one of those weapons—named requests from this Committee. Ms. clarifying a record with a letter short- after its serial number—No. 997126, a 12-shot, Lewis explained that her office is at an ly after providing testimony, this can 9 millimeter Jennings semi-automatic. ‘‘important point’’ in the investigation be summed up as just more partisan The gun, made mostly of plastic, was man- and will be making ‘‘critical prosecu- haze. ufactured in 1995, at a factory near John Wayne International Airport in Costa Mesa, torial decisions and recommendations’’ f in the near future. She noted that if Calif. It is now wrapped in plastic, locked in GUN TRAFFICKING REPORT a police property clerk’s office near the New this Committee were to subpoena re- York State Supreme Court building in down- sponsive documents from her office, Mr. LEVIN. Mr. President, last week town Brooklyn. In between, the gun is be- not only would we adversely affect the the Bureau of Alcohol, Tobacco and lieved to have been used in at least 13 investigation from a litigation stand- Firearms (ATF) released a new report crimes—including the murder of 2 people and point, we also would be diverting the about the illegal firearms market. The the wounding of at least 3 others in the attention of the key prosecutors in ATF’s report documents 1,530 criminal Brownsville section of Brooklyn. that case. Instead of working diligently investigations involving firearms traf- The dead were a 16-year-old boy who was sitting on top of a mailbox and a 48-year-old to conclude their investigation, these fickers for the time period between shopkeeper who was the father of 4 children. prosecutors would now be required to July 1996 and December 1998. These The injured were a man who got in the way sift through thousands of documents trafficking investigations led to the re- during a robbery, a Jehovah’s Witness from and to redact those documents to pro- covery of more than 84,000 illegal fire- Chicago who had moved to Brooklyn to do tect grand jury material. The majority arms and the prosecution of more than volunteer work, and a rookie New York City on the Senate Judiciary Committee re- 1,700 defendants. police officer. fused to honor the U.S. Attorney’s re- The ATF report provides significant In New York, about 6 in 10 murder victims are killed with firearms. quest and approved the subpoena. insight in to the gun trafficking trade. No. 997126 is 6 inches long and weighs 16 The subject of the Vice President’s The investigation reveals that too ounces. It was made at the Bryco Arms attendance at coffees was the focus of many loopholes in our national frame- plant, where more than 200,000 inexpensive inquiry at the Judiciary Committee’s work for firearms distribution permits handguns are manufactured each year. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6107 Byrco is owned by Janice Jennings, the from the Social Security trust funds, was officially nicknamed America’s former daughter-in-law of George Jennings, and they ensure that the programs ad- Dairyland. It was soon after the first who founded the first in what became a clus- ministered by the Social Security Ad- dairy cow came to Wisconsin in the ter of Southern California gun manufactur- ministration are delivered to the 1800’s that we began to take the dairy ers known collectively as the Ring of Fire. From Byrco, the gun was shipped to B.L. American public in an efficient, time- industry by storm. Jennings, Inc., a Carson City, Nev., dis- ly, and professional manner. In addi- In fact, before Wisconsin was even a tributor owned by George Jennings’s son and tion, SSA maintains records of the state, Ms. Anne Pickett established Janice’s ex-husband, Bruce. No. 997126 was yearly earnings of over 140 million U.S. Wisconsin’s first cheese factory when bought by Acua Sport Corporation, a feder- workers and provides them with annual she combined milk from her cows with ally licensed wholesaler in Bellefontaine, estimates of their future benefits. The milk from her neighbor’s cows and Ohio. Acua sold it, for about $90, to Classic agency will also administer the Ticket made it into cheese. Pawn and Jewelry, Inc. in Chickamauga, Ga. to Work Program, and the administra- Over the past month, Wisconsinites In August 1998, Classic resold the gun to a have recognized this proud tradition by Georgia woman for about $150. Investigators tive workload associated with the Re- believe that the woman was buying the 9 tirement Earnings Test. holding over 100 dairy celebrations millimeter gun as a straw purchaser on be- I am concerned that the level of fund- across our state, including dairy break- half of Charles Chapman. He was prohibited ing contained in the Labor/HHS Appro- fasts, ice cream socials, cooking dem- by federal law, because of a previous felony priations bill is not sufficient, and does onstrations, festivals and other events. conviction, from purchasing firearms. Inves- not recognize the administrative chal- These functions help to reinforce the tigators say they believe Mr. Chapman drove lenges Social Security will be facing in consumer’s awareness of the quality the firearm to New York, where it was sold the near future. Last year the Social variety and great taste of Wisconsin’s to a member of the Bloods gang. And that is Security Administration provided serv- dairy products and to honor the pro- how, investigators say, the gun got to Demeris Tolbert. ice to 48 million people. In 2010 SSA ducers who make it possible. The police say No. 997126 was recovered will be providing services to 62 million Unfortunately, the picture for pro- when Mr. Tolbert was arrested on the roof of people, due to the retirement of many ducers has not been that bright. Dairy the Howard Houses after the shooting of a baby boomers. During this same period, prices for this year’s National Dairy New York police officer, Tanagiot Benekos, the SSA will lose nearly half of its Month, along with most of the first who was looking for suspects in the killing staff to retirement, including many in- half of this year, have reached all of a pawnbroker earlier that afternoon. dividuals who staff the offices located times lows. Mr. Tolbert had been paroled the previous in our states and who work directly Low milk prices—the lowest since January after serving three years of a nine 1978—are wreaking havoc on Wiscon- year sentence for drug possession. Prosecu- with the public. tors say that after the New York City Police In North Dakota, there have been sin’s rural communities. In addition to Department’s ballistics laboratory linked large staff reductions in some of my these low prices, dairy farmers are also the gun to slugs recovered from the earlier state’s main SSA offices. These short- facing month to month price fluctua- shootings, Mr. Tolbert, 32, of Brownville con- ages have affected timely completion tions of up to 40 percent. fessed. of continuing disability reviews, and What is so troublesome is that farm- Investigators say he also took responsi- service delivery has been difficult to ers are experiencing these low prices bility for a 1990 shooting of a clerk at an maintain for those who live in rural while the retail price continues to in- East New York bodega, the 1991 killing of a crease. In fact, thanks to a 20 percent Crown Heights security guard, four other areas. shootings and an attempted murder. The Social Security Advisory jump last year in the retail price, the The Brooklyn District Attorney’s office Board—a bipartisan Congressionally farm retail price spread for dairy prod- has charged him with murder, attempted mandated Board—recently issued a re- ucts has more than doubled since the murder and attempted murder of a police of- port on ‘‘How the Social Security Ad- early 1980s. ficer. ministration Can Improve Its Service Because of this concern, earlier this The ballistic information and serial num- to the Public,’’ which stated that year, Senator LEAHY and I asked the ber were matched against a Bureau of Alco- ‘‘there is a serious administrative def- General Accounting Office to conduct a hol, Tobacco and Firearms database, which icit now in that there is a significant thorough investigation into the in- prompted a federal gun-smuggling investiga- creasing disparity between the prices tion. Special Agent Edgar A. Domenech, who gap between the level of services the oversees the bureau’s New York and New public needs and that which the agency dairy farmers receive for their milk, Jersey division, said the A.T.F. traced the is providing. Moreover, this gap could and the price retail stores charge for weapon and 30 others to Charles Chapman. grow to far larger proportions in the milk. He is being held, along with alleged accom- long term if it is not adequately ad- In the study, GAO will focus its at- plices, on charges of gun trafficking and con- dressed.’’ tention on the impact of market con- spiracy to illegally purchase firearms and The Senate Labor/HHS bill includes a centration in the retail, milk proc- transport them for sale to criminals in New funding level that is $123 million below essing, procurement and handling in- York, where more stringent laws bar the sort the President’s request. I hope that as dustries and describe the potential of wholesale purchases permitted in Georgia. Howard Safir, the New York City police the appropriations process moves for- risks of any such concentration for commissioner, has proposed tighter, uniform ward, the Congress will work to ensure dairy farmers and federal nutrition national licensing regulations, and the an- an adequate level of funding for SSA programs. nual registration of firearms to hold owners administrative expenses. Specifically, we asked the GAO to accountable for the illegal sales of weapons Mr. FEINGOLD. Mr. President, I rise identify the factors that are depressing they purchase. today to celebrate National Dairy the price farmers receive for their f Month, and the wonderful history of milk, and why this trend has persisted our nation’s dairy industry. During while retail prices continue to rise. SOCIAL SECURITY June Dairy Month we in Wisconsin After all, this trend defies economic ADMINISTRATIVE EXPENSES take a special opportunity to celebrate expectations, and frustrates the aspira- Mr. CONRAD. Mr. President, I want- Wisconsin dairy’s proud tradition and tions of hardworking farmers, with no ed to draw the attention of the Senate heritage of quality. This month pro- apparent benefit to consumers. to an important funding issue that is vides an opportunity for all Wisconsin- During June Dairy Month, the dairy pending in the Senate version of the ites—both those on and off the farm—a industry also called for mandatory Labor/HHS Appropriations bill. The special time to reflect on the historical price reporting for manufactured prod- funding level for Social Security ad- importance, and future of America’s ucts. In early June, the sudden dis- ministrative expenses doesn’t receive dairy industry. covery of 24 million pounds of butter much attention, but it is critical to the This month is especially important shined the spotlight on the need for an effective delivery of Social Security to my home state of Wisconsin, Amer- effective reporting system for storable benefits to those who are entitled to ica’s Dairyland. What many of my col- dairy products . them. leagues may not know is that Wis- The Chicago Mercantile Exchange Social Security administrative ex- consin became a leader in the dairy in- (CME), which tracks domestic butter penses are actually partially funded dustry well before the 1930’s when it stocks, discovered a new warehouse S6108 CONGRESSIONAL RECORD — SENATE June 29, 2000 that hadn’t been reporting its butter TESTIMONY BY THE SECRETARY Gallery and the National Museum of inventory. When this huge quantity of OF THE SMITHSONIAN INSTITU- American Art. Construction of this butter was finally reported, prices went TION Washington landmark was begun in down sharply, and so did the dairy in- Mr. DODD. Mr. President, this week 1836 and was the third great public dustry’s faith in the reporting system the Committee on Rules and Adminis- building constructed in Washington, for storable dairy products. tration held an oversight hearing on following the Capitol and The White Wall Street would never put up with the Smithsonian Institution and re- House. this kind of reporting errors in its mar- ceived testimony from the new Sec- The National Museum of Natural His- kets, and neither should the agri- retary, Lawrence M. Small. Although tory, home to the Hope Diamond and culture industry. he has only served in this capacity for the Smithsonian elephant, opened its doors in 1910. This year, nearly 1.3 mil- Regardless of where the dairy indus- a short 6 months, it is already clear lion visitors toured this museum in the try chooses to get its information, that Secretary Small’s vision for the month of April alone. The popularity of through the National Agricultural Sta- Smithsonian will have a lasting impact these grand and historic buildings is tistics Service or the Chicago Mer- on this uniquely American institution. Secretary Small envisions the taking its toll, and they are quite sim- cantile Exchange, that information Smithsonian as ‘‘. . . the most exten- ply in need of significant renovation must be accurate. These costly mis- sive provider, anywhere in the world, of and repair. takes happen because the current re- authoritative experiences that connect Secretary Small is committed to pre- porting system is voluntary, leaving the American people to their history serving not only the aging buildings of room for serious errors. and to their cultural and scientific her- the Smithsonian, but to upgrading the To address this growing concern, itage.’’ In other words, the Smithso- exhibits as well to ensure that they Senator CRAIG and I introduced the nian documents who and what we are provide a continuing educational expe- Dairy Market Enhancement Act of as Americans. And not surprisingly, rience. He is in the process of devel- 2000, which takes the next step toward over 90 percent of all visitors to the oping a 10-year plan to facilitate the fair and accurate reporting. It would Smithsonian come from the United necessary restorations and renovation. mandate reporting by dairy product States. These buildings are part of the his- manufacturing plants, would subject Who are these visitors and what toric fabric of this capital city, and it that reporting to independent makes the Smithsonian such a draw? would be very short-sighted of Con- verification, and would require the They are families who come to see the gress not to provide for their adequate USDA to ensure compliance with the relics of our history, such as the maintenance and repair. I commend mandatory reporting and verification Wright brothers’ flyer or the Star Secretary Small for his vision in this requirements. Spangled Banner which moved Francis regard and believe that Congress Our bill also would direct the Com- Scott Key to pen our national anthem. should act on his recommendations modities Futures Trading Commission They are school children who are learn- when they are received. An op-ed piece to conduct a study on the reporting ing about the ancient inhabitants of by Secretary Small appeared in Mon- practices at the CME and report its this land, whether dinosaurs or insects. day’s Washington Post in which he de- findings to Congress. They are young parents retracing the scribed his vision of the Smithsonian We must also ensure that America’s pilgrimage to our nation’s Capitol that and the need to preserve these historic dairy farmers are put on a level play- they made as children. They are new landmarks. ing field in the world economy. As I immigrants and Americans of all ages I urge my colleagues to acquaint travel to each county in Wisconsin, I who come to see the treasures that are themselves with the needs of this great hear a growing concern over efforts to housed in America’s attic. American institution as it faces the op- There are nearly 141 million objects change the natural cheese standard to portunities and challenges of the 21st in the Smithsonian’s collections, fewer allow dry ultra-filtered milk in natural century. than 2 million of which can be dis- cheese. I ask unanimous consent that the ar- played at any given time in the 16 mu- ticle by Secretary Small be included in Our dairy farmers have invested seums that make up the Smithsonian. the RECORD following my remarks. heavily in processes that make the best On average, there are nearly 39 million There being no objection, the article quality cheese ingredients, and I am visitors a year to the Smithsonian’s was ordered to be printed in the concerned about recent efforts to museums and the national zoo. The RECORD, as follows: change the law that would penalize fact is, 3 of the most visited museums [From the Washington Post, June 26, 2000] them for those efforts by allowing in the world are right here on the mall. AMERICA’S ICONS DESERVE A GOOD HOME lower quality ingredients to flood the They are the Smithsonian’s Air and U.S. market. Space Museum, the Natural History (By Lawrence M. Small) Senator JEFFORDS and I introduced Museum and the Museum of American A recent report from the General Account- the Quality Cheese Act of 2000 to re- History. And yet even with those amaz- ing Office identified 903 federal buildings around the country that are in need of some spond to the call of our nation’s dairy ing numbers, Secretary Small advised $4 billion in repairs and renovations. The farmers. the Rules Committee this week that he buildings are feeling the effects of age. It’s a Our legislation would disallow the believes the Smithsonian can do even feeling we know all too well at the Smithso- use of so called ‘‘dry’’ ultra-filtered better in making the Smithsonian ac- nian. milk—milk protein concentrate and cessible to the public, both in terms of Construction on the Patent Office Build- ing, the Smithsonian’s oldest, began in 1836. casein—in natural cheese products, and the quality and quantity of the exhib- its and the condition of the physical The cornerstone of the original Smithsonian require USDA to consider the impact Castle on the National Mall was laid in 1847; on the producer before any other space. But all of this popularity comes at a the National Museum building adjacent to it changes may be made to the natural was completed in 1881, and the National Mu- cheese standard. price, and that price is the physical seum of Natural History opened in 1910. wear and tear on the Smithsonian’s I recognize that these efforts are only The age of these four buildings would be buildings and exhibits. The buildings of reason enough for concern, but there’s a sig- a step in the right direction. the Smithsonian are in and of them- nificant additional stress on them. The In addition to addressing the in- selves historic monuments and land- Smithsonian’s museum buildings are open to creased market concentration, enact- marks within our nation’s capital. The the world. They exist to be visited and to be ing mandatary price reporting, and Smithsonian Castle, a fixture on the used—and they’ve been spectacularly suc- protecting the natural cheese standard, mall since the cornerstone was laid in cessful at attracting the public. Congress must also provide America’s Attendance in recent months at the Nat- 1847, receives nearly 2 million visitors a ural History Museum has made it the most- dairy farmers with a fair and truly na- year, even though it houses no mu- visited museum in the world, a title held pre- tional dairy policy and one that puts seum. viously by our National Air and Space Mu- them all on a level playing field, from The oldest building, the Patent Office seum. In the years ahead, the Smithsonian coast to coast. Building, houses the National Portrait will be working to open its doors wider still June 29, 2000 CONGRESSIONAL RECORD — SENATE S6109 and to attract even more visitors. So, what 4444. That bill authorizes PNTR for na’s compliance with its WTO obliga- time doesn’t do to our buildings, popularity China once the multilateral protocol tions and with other trade agreements will—and thank goodness for that. negotiations are completed and the made with the United States. It will More than 90 percent of Smithsonian visi- WTO General Council approves China’s make the administration in the future tors are Americans, many traveling great distances on a pilgrimage to the nation’s sec- accession. The bill includes a solid act promptly in the case of damaging ular shrines—the Capitol, the White House, package of provisions that establishes import surges. It provides for a vig- the Library of Congress, the many memo- a framework for monitoring progress orous monitoring of human rights, rials to brave Americans. The history of the and developments in China in the worker rights, and the import of goods nation is built into such structures. They’re human rights area. It also provides for produced by forced or prison labor. the physical manifestation of our shared enhanced monitoring of China’s com- H.R. 4444 also provides for technical as- sense of national identity. pliance with its trade commitments. sistance to help develop the rule of law Smithsonian Institution buildings belong Now, it is our turn in the Senate to in China. It enhances the ability of in the company of those other monuments, because the Smithsonian is the center of our act. We have two challenges. First, we U.S. government radios to broadcast cultural heritage—the repository of the cre- need to debate the bill now, not later. into China. And it states the sense of ativity, the courage, the aspirations and the And, second, we need to pass the bill Congress regarding Taiwan’s prompt ingenuity of the American people. Its collec- without amendment. I call on the Ma- admission to the WTO. tions hold a vast portion of the material jority Leader to set a date certain in To repeat, extending PNTR to China record of democratic America. July to start this process. is vitally important to America’s eco- The most sophisticated virtual representa- Extending permanent normal trade nomic and strategic interests. Our top tion on a screen cannot match the experi- relations status to China. Regularizing priority should be a bill approved by ence of standing just a few feet from the our economic and trade relationship star-spangled banner, or the lap-top desk on the Senate identical to H.R. 4444 so which Thomas Jefferson wrote the Declara- with China. Bringing China into the that it can immediately be sent to the tion of Independence, or the hat Lincoln global trade community. Helping the President for signature. I hope we com- wore the night he was shot, or the Wright development of a middle class in China. plete action rapidly in July. brothers’ Flyer and the Spirit of St. Louis. Developing an environment between f All those icons of America’s history, and our two countries where we can pro- countless others of comparable significance, ductively engage China in significant THE VERY BAD DEBT BOXSCORE are at the Smithsonian. security, regional, and global discus- Mr. HELMS. Mr. President, at the And yet the experience of viewing them is sions. These are not Democratic issues. close of business yesterday, Wednes- compromised by the physical deterioration of the Smithsonian’s buildings, which are be- These are not Republican issues. These day, June 28, 2000, the Federal debt coming unworthy of the treasures they con- are national issues. Passage of PNTR is stood at $5,649,147,080,050.00 (Five tril- tain. The family on a once-in-a-lifetime trip a first step, and it is critical to Amer- lion, six hundred forty-nine billion, one to Washington and the Smithsonian should ica’s national economic and security hundred forty-seven million, eighty not have to make allowances—to overlook interests. thousand, fifty dollars and no cents). peeling paint, leak-stained ceilings and ill-lit Support in the Senate is strong. I be- One year ago, June 28, 1999, the Fed- exhibition spaces. lieve there will be an overwhelming eral debt stood at $5,640,294,000,000 We can try to hide the problems behind vote in favor of final passage. Repub- (Five trillion, six hundred forty billion, curtains and plastic sheeting. But the reality licans and Democrats. Small states and cannot be concealed: The buildings are too two hundred ninety-four million). shabby. In the nation’s museum—to which large. East and West. North and South. Five years ago, June 28, 1995, the Fed- Americans have contributed more than 12 Conservative and liberal. Most of us eral debt stood at $4,948,205,000,000 billion of their tax dollars over the years— recognize how important this is to our (Four trillion, nine hundred forty-eight this embarrassment is not acceptable. It’s no country, to the region, and to the billion, two hundred five million). way to represent America. world. Twenty-five years ago, June 28, 1975, The Smithsonian has hesitated in the past That is why I will continue to urge the Federal debt stood at to put before Congress the full scale of its re- the Majority Leader to set a firm date $535,337,000,000 (Five hundred thirty- pair and renovation needs. It has tried in- to bring the PNTR bill to the floor so stead to make do. But it will be undone by five billion, three hundred thirty-seven making do, and the American people will be we can move this legislation. I ask my million) which reflects a debt increase the losers. colleagues, Republican, as well as Dem- of more than $5 trillion— So we intend to face the problem and to ocrat, to join me in delivering that $5,113,810,080,050.00 (Five trillion, one transform the physical environment of the message to the Majority Leader. hundred thirteen billion, eight hundred Smithsonian during the coming decade. The Once it comes to the floor, there will ten million, eighty thousand, fifty dol- United States is in a period of immense pub- likely be a plethora of amendments, lars and no cents) during the past 25 lic and private prosperity, and we should some germane and others non-germane. years. take every opportunity to turn that wealth The Senate has its own rights and pre- f to the long-term well-being and enhance- rogatives. I will always defend the ment of the nation. Restoring the museums ADDITIONAL STATEMENTS of the Smithsonian to a condition that befits right of Senators to offer amendments the high place of our nation in the world will to a bill. But, I am concerned that amendments in the Senate, which be a splendid legacy from this generation to HOW NOT TO SQUANDER OUR future generations of Americans. would force the bill into a conference In January the nation will swear in the with the House, would lead to delaying, SUPERPOWER STATUS new century’s first Congress and inaugurate and perhaps jeopardizing, final passage ∑ Mr. BIDEN. I rise today to comment its first president. They must be committed of this landmark legislation. We can- briefly on an extremely thought-pro- to preserving the nation’s heritage. At the not afford such a development. voking opinion piece by Josef Joffe in same time, we as private citizens must do the June 20th edition of the New York our part to meet this critical need. H.R. 4444 is a very balanced bill. It Americans should not have to wonder why deals with the major concerns relative Times. The article was entitled ‘‘A their treasures are housed in buildings that to China’s entry into the global trading Warning from Putin and Schroeder.’’ It seem to be falling apart. Instead they should system. Therefore, along with many of describes how the current global pre- marvel at the grandeur of the spaces and at my colleagues, I have made a commit- dominance of the United States is the objects that are the icons of our history. ment to oppose any amendment to H.R. being countered by constellations of f 4444, no matter how meritorious the countries, which include allies and amendment might be on its own terms. less-friendly powers alike, and how CHINA PERMANENT NORMAL Prompt passage and enactment of this American behavior is aiding and abet- TRADE RELATIONS LEGISLATION bill should be a top bipartisan priority. ting this development. Mr. BAUCUS. Mr. President, I would I urge all my colleagues to join me in Mr. Joffe is the co-editor of the pres- like to spend a few moments talking making the commitment to oppose any tigious German weekly Die Zeit. He re- about the issue of PNTR, Permanent attempt to amend this legislation. ceived his university education in the Normal Trade Relations, with China. H.R. 4444 ensures that future U.S. ad- United States and is well known and Last month, the House passed H.R. ministrations will closely monitor Chi- respected in American foreign policy S6110 CONGRESSIONAL RECORD — SENATE June 29, 2000 circles. In short, his thoughts are ad- Nevertheless, I note with dismay an From its earliest days to the period vice from a friend, not hostile criticism increasing tendency in this chamber—I of the Civil War, Manchester was very from an embittered or jealous antago- will leave judgments of the House of much frontier country with numerous nist. Representatives to others—for Mem- inns and taverns at its crossroads. In The take-off point of the article, bers to advocate aspects of foreign pol- 1781, according to the town history de- from which its headline is derived, was icy with a conscious disregard, occa- tailed in the 1998 Village Plan, ‘‘there the recent summit meeting in Berlin sionally even disdain, for the opinions were no churches, but there were four between German Chancellor Gerhard of our allies and the impact our poli- taverns, a jail, a pillory and a whipping Schroeder and Russian President cies have on them. post.’’ But by 1840, Vermont was the Vladimir Putin during which Putin em- This kind of unilateralism was exhib- slowest growing state in the Union, as ployed the classic Muscovite tactic of ited in the floor debate last fall on rati- much of the natural resources of the wooing Europe’s key country in an ef- fication of the Comprehensive Test Ban state had been depleted, and wool im- fort to have it join Russia as a counter- Treaty by one of my colleagues who, in ports from Australia had brought an weight to us. responding to an article jointly au- end to a brief boom of sheep raising in Fair enough, Joffe says. Whenever thored by British Prime Minister Tony Manchester and other parts of the the international system has been Blair, French President Jacques state. dominated by one power, a natural Chirac, and German Chancellor Schroe- Beginning just prior to the Civil War, movement to restore the balance has der, declared: ‘‘I don’t care about our however, tourists began to discover arisen. With regard to the United allies. I care about our enemies.’’ Manchester. In 1853, the Equinox Hotel States, this is nothing new—the Chi- No one, Mr. President, is advocating was opened by Franklin Orvis, who nese, as well as the Russians, have been abandoning or compromising the na- converted an inn that had begun in decrying a ‘‘unipolar world’’ and tional interest of the United States 1770. In 1863, when Mrs. Abraham Lin- ‘‘hegemonism’’ for years. simply because our allies oppose this or coln and her son, Robert Todd, stepped But Germany—the country the that aspect of our foreign and security off the ten o’clock train, Manchester’s United States practically reinvented policy. reputation was made. Later, Presidents from the ashes of World War II, ushered But power—in the current context, Ulysses S. Grant, William Howard Taft, back into the civilized family of na- our unparalleled power—must be ac- Benjamin Harrison, Theodore Roo- tions, and then stood out as the only companied by a sense of responsibility. sevelt, and Vice-President James S. champion of re-unification only a dec- Mr. Joffe alludes to this power-and- Sherman would follow as visitors to ade ago? No matter how gushy a host responsibility duality in recalling the Manchester Village. he wished to be, how could the Chan- golden age of bipartisan American for- Today, the Equinox remains as one of cellor of this Germany suddenly be eign policy in the years immediately Vermont’s grandest establishments. calling for a ‘‘strategic partnership’’ following the Second World War, when The Village is also home to Hildene, the summer home of Robert Todd Lin- with Russia? Republican Senator Arthur Vanden- coln and now operated as a house mu- One answer, according to Joffe, is the berg and Democratic President Harry seum. The Southern Vermont Art Cen- obvious and passionate hostility to the S. Truman collaborated on halting the ter, the Mark Skinner Library, Burr U.S. national missile defense project, spread of communism and on helping and Burton Academy, and two world known popularly as NMD, which the create the international institutions class golf courses can be found in Man- Russians and our German allies—for that remain the cornerstones of our chester Village, along with numerous that matter, all of our European al- world more than half a century later. delightful inns and hotels, charming lies—share. As he puts it ‘‘responsibility must defy churches, exquisite restaurants, engag- A second reason can be traced to the short-term self-interest or the domes- ing museums, enchanting galleries and obvious shock at the overwhelming tic fixation of the day.’’ unique shops. American military superiority shown Mr. President, one does not have to Manchester Village thrives today in in last year’s Yugoslav air campaign. agree with all of Joffe’s arguments to large part due to careful planning and The manifest European military impo- admit that his assertions at least merit the guardianship of an impressive tence impelled the European Union to our serious consideration. For if we do streetscape characterized by marble launch its own security and defense not begin to realize that even the sidewalks, deep front lawns, large, his- policy, which NATO is now struggling United States of America needs to fac- toric buildings, and an absence of to integrate into the alliance. tor in the opinions of its friends when fences. Village residents have faced the To some extent, then, the very fact formulating foreign policy, it may not challenge of responsible and active of our current power—military, eco- have many friends to worry about in stewardship since the tourist boom of nomic, and cultural—makes attempts the future. the second half of the 19th century, and at creating a countervailing force near- And if that development occurs, we the Village Charter is an important ly inevitable. will almost certainly no longer retain part of that history. But there is more. It is not only the the sole superpower status that we now For some details of the genesis of the policy that spawned NMD that irri- enjoy.∑ incorporation of Manchester Village tates our European allies. What also f 100 years ago, I turn to ‘‘The Man- irks them is the cavalier way in which TRIBUTE ON THE 100TH ANNIVER- chester Village Charter,’’ written by we neglected to consult with them in Mary Hard Bort and reprinted here by our rush to formulate that policy. As SARY OF MANCHESTER, VERMONT permission of the Manchester Journal. Joffe trenchantly puts it, ‘‘America is Congratulations to the Village of Man- ∑ so far ahead of the crowd that it has Mr. JEFFORDS. Mr. President, I rise chester on the event of its 100th birth- forgotten to look back.’’ today to note the 100th anniversary of day. I ask that that be printed in the In this, the second half of his expla- the Charter of Manchester Village. RECORD. nation, I fear that Joffe is on to some- Manchester Village lies in the valley The material follows. thing: a new kind of American hubris. of the Battenkill River nestled between THE MANCHESTER VILLAGE CHARTER Again, his use of English is enviable. the Green Mountains to the east and (By Mary Hard Bart) He describes the behavior of Congress the Taconic Mountains to the west. By 1900 a building boom was flourishing in these days as ‘‘obliviousness with a Due to its geography and topography, Manchester Village,. It was nearly impos- dollop of yahooism’’ (I assume he isn’t Manchester Village has been at the sible to hire a carpenter and the ‘‘summer talking about the search engine). crossroads of the earliest trails and people’’ who intended to build ‘‘cottages’’ Mr. President, no one loves and re- roads in Vermont. The slopes of Mount that year often found it necessary to hire spects this body more than I do. I be- Equinox, which rise 3,800 feet above the labor from out of town. Some twenty years earlier in 1880 Village lieve that the American people is ex- village, provide numerous fresh water boundaries had been laid out by the town’s ceedingly well served by the one hun- streams and natural springs for the en- selectmen and approved by the Vermont Leg- dred Senators, all of whom are intel- joyment of the resident and visiting islature for the purpose of providing fire pro- ligent and hard-working. populations. tection in Fire District #2 (the Village). June 29, 2000 CONGRESSIONAL RECORD — SENATE S6111 In 1894 John Marsden came to Manchester move ice, snow and garbage from their prop- news in this story: Although Jim Dun- from Utica, NY and contracted to purchase erty. Also allowed are street lights provided bar will still contribute radio essays the springs on Equinox Mountain from the by the Village and the purchase or construc- and special reports for KGO, July 14 Fire District and rights of way for a water tion of sewers as well as the regulation of will be his last morning show. Like system. Prior to this time water for fighting the width and grade of streets and sidewalks. fires was stored in huge barrels strategically Elected to serve this new Village of Man- thousands of others, I will miss Jim placed throughout the Village and individual chester were: Edward C. Orvis, as president, Dunbar in the morning, and I wish him households were supplied by wells, or D.K. Simonds, clerk, George Towsley, treas- all the best in his future endeavors.∑ springs, or cisterns. urer and Trustee; C.F. Orvis, Hiram Eggle- f Pipes were laid, a reservoir built and The ston, M.J. Covey and Charles H. Hawley. Manchester Water Company was formed in Promptly on January 10, 1901, according to FAIRFAX COUNTY URBAN SEARCH October 1894. The company had purchased all provisions in the Charter, the Village of AND RESCUE TEAM the water contracts, springs, rights of way Manchester purchased from private inves- ∑ Mr. WARNER. Mr. President, I rise and conduits from the Marsden family. Offi- tors, the sewer that served it. today to honor a fine group of Ameri- cers of the corporation included Mr. Quickly following on the heels of incorpo- Marsden, Mason Colburn of Manchester Cen- ration, the Manchester Development Asso- cans who have performed a remarkable ter, J.W. Fowler of Manchester Depot and ciation was formed in 1901 to promote tour- service to this country and to our glob- E.C. Orvis of the Village. The Marsden fam- ism in the area. This group, made up of full- al community. The Fairfax County ily continued to manage the water company time and summer residents, underwrote the Urban Search and Rescue Team were until it was purchased by the Town of Man- printing of 15,000 promotional booklets extol- honored on June 27, 2000 in a ceremony chester in 1980. ling the virtues of Manchester-in-the-Moun- held at The Pentagon for their extraor- With a water system in place, the need for tains as a summer resort. Its newly opened dinary efforts over the past 14 years. a sewage system was pressing. The inad- golf course (the Ekwanok), its pure spring The following remarks were delivered equacy of the open trench installed by water, its ‘‘salubious’’ climate were sure to on this occasion by Secretary of De- Franklin Orvis in 1882 was apparent and, in bring people here. the spring of 1900, public spirited Village In 1912 the Village hired a special police of- fense William Cohen: residents borrowed enough capital to build ficer for the summer to control the traffic. Senators Warner and Robb, Congressmen proper sewer lines through District #2. Many The mix of automobiles and horses had cre- Moran and Davis, thank you all for joining householders put in bathrooms at this time ated some dangerous situations and some us here today and for your tireless efforts on and eschewed the outhouses that had served automobile drivers were accused of driving behalf of our men and women in uniform. their modest needs up til then. These sewer too fast for conditions. Deputy Secretary DeLeon; Assistant Chief of lines emptied directly into the Bauerkill and In 1921, the year after women secured the Fairfax County Urban Fire and Rescue it was not until 1935 that a modern sewage vote, Mrs. George Orvis, who had taken over Team, Mark Wheatly; members of the Fair- treatment plant was built with federal funds, the Equinox Hotel after her husband’s death, fax County Urban Search and Rescue Team appropriated Village funds and private con- was elected president of the Village. and your families and friends; distinguished tributions. Assaults on the integrity of the Village as guests—including our canine friends; ladies Back in 1858 citizens of the Village had pe- a separate entity have been vigorously re- and gentlemen. It is a pleasure to welcome titioned the Legislature for authority to cre- pelled. In 1956 a measure to consolidate the all of our guests, whether they arrived on ate a charter and had received permission to Village with the Town was soundly defeated two legs or on four. do so but no action had ever been taken. and, though fire protection and police pro- Two years ago, I received a call in the mid- Now, at the end of the century, an entity tection are provided by the Town of Man- dle of the night. It was the tragic news of the with the authority to purchase and construct chester, the Village retains its own planning embassy bombings in Kenya and Tanzania. a sewer, to provide street lights, to regulate and zoning boards and its own road depart- And I think all Americans—indeed, people the width and grade of roads and sidewalks, ment and the privilege of hiring additional the world over—were simply stunned by the to prohibit certain activities, regulate others police officers if it deems that necessary. unspeakable cruelty and inhumanity of that and to protect property was clearly in order. Numerous amendments had been made to act, the lives of 267 innocent men and women The desire on the part of Village leaders to the charter over time. As estates bloomed snuffed out in a single instant of indiscrimi- develop Manchester as a fine summer resort land was added to the Village, other amend- nate violence. with all the amenities city people expected ments brought the charter up to date as time Such moments force us to pause and re- proved to be a strong incentive for action. went on. A new document was written to flect on the thinness of the membrane that These men whose vision of a thriving sum- bring the charter up to date in language and separates this life from the next, on how mer resort led to the building of elegant in provision and it was approved by the Town quickly our hearts can be stopped and our summer cottages, a golf course and the open- of Manchester and by Village voters and by voices can be silenced. And there is the futile ing of new streets were not satisfied with the the Legislature in 1943. wish that we all experience in grief: the wish progress being made by the town in pro- For one hundred years Manchester Village to turn back the hand of time, to reverse viding services they deemed essential. has existed as a recognized legal entity with what fate has just dictated. Of course, we Village voters were called to a series of the rights, privileges and obligations that cannot. But what we can do is renew our ap- meetings at the Courthouse where the need follow. Its officers today guard its integrity preciation of the precarious and precious na- for a charter was explained and by October a with as much vigor as did their predecessors. ture of our lives, resolve to use our time and bill was presented by Edward C. Orvis. He July 2000.∑ energy to preserve and protect the sanctity was the son of Franklin Orvis and the cur- f of life and freedom, and rededicate ourselves rent operator of the Equinox House, a select- to those principles of humaneness and gen- man for eight years and a representative TRIBUTE TO JIM DUNBAR erosity. and, later, senator in the Vermont Legisla- ∑ Mrs. BOXER. Mr. President, on July Today, we are here to honor and express ture. Also on the committee were William B. 14, Jim Dunbar will rise well before our thanks to a group of men and women Edgerton, well-known realtor and creator of who have taken that ideal to its highest ex- several spacious summer estates, and dawn, drive to San Francisco, and pression, who have made that ideal both a Charles F. Orvis, now elderly but with a wis- broadcast his morning show on KGO career and a calling. Time after time over dom greatly valued and respected in the vil- radio. As he has done each weekday for the past 14 years, those of you in the Fairfax lage. He was the proprietor of the Orvis Inn the past quarter century, Jim will read County Urban Search and Rescue Team have as well as the manufacturer of fishing equip- and comment on the news, tell a few responded to some of the worst disasters of ment. stories, and take listeners’ calls. He our time: Mexico City, Armenia, Oklahoma On November 11, 1900 the Bill of Incorpora- will help his audience start their day in City, Turkey, the Philippines, and Taiwan. tion for the Village of Manchester, Vermont a good mood, armed with good informa- You have gone into cities whose devastation passed in the House of Representatives and could vie with Dante’s vision of hell. And was signed by the governor. tion about the world. upon your arrival, there has been no food, no On December 3, 1900 the voters of Fire Dis- For 37 years, Jim Dunbar has served water, no electricity. On every block, hor- trict #2 met at the Courthouse and following KGO and the people of the Bay Area rific scenes of carnage. On every face, confu- an explanation of the provisions of the char- with dignity, intelligence, and good sion, fatigue, and grief. But in every case, ter, adopted the Village Charter, unani- humor. He blends solid reporting with you have used your energy, innovation, and mously. The Charter compels the Village to amiable companionship without com- skill to make a tangible difference in the assume the obligations and duties of Fire promising either his journalist’s integ- lives of disaster victims. District #2, which ceased to exist with the Sometimes it has been risky and adoption of the charter. Also incumbent rity or his personal charm. He gives his harrowing, such as in the Philippines, where upon it is care of its highways, bridges and listeners a good morning and his pro- your team worked more than 9 hours in a sidewalks. Permitted are improvements to fession a good name. collapsed hotel to free a trapped man while public grounds, sidewalks and parks and or- Speaking as one of his many lis- ground tremors from the earthquake contin- dinances compelling property owners to re- teners, I must add the one piece of sad ued. S6112 CONGRESSIONAL RECORD — SENATE June 29, 2000 Sometimes it has been a combination of I have known Lucy Calautti for twen- years as a high school and college-level thoughtful planning and sheer luck, such as ty years, since she was the Chief of teacher. To this day, Lucy continues when a special camera was able to locate an Staff for then Congressman DORGAN, her commitment to our nation’s chil- 8-year-old boy, who had practically been bur- even before becoming his chief of staff dren, reading to DC-area children every ied alive when his bunk bed collapsed under the weight of a crushed building in Turkey. in the U.S. Senate. Throughout the week. Truly, an inspiration. Sometimes it has been grim and bitter- years I have been inspired by her intel- Lucy has, literally, shifted the polit- sweet, such as when you were able to save an ligence and political skills in the serv- ical landscape in North Dakota and the elderly woman in Armenia who was the sole ice of the United States Congress. U.S. Senate. As campaign manager survivor from her building. Many people on the Hill know about Lucy Calautti engineered a come-from- The rest of us can only imagine the phys- Lucy’s professional accomplishments, behind victory for KENT CONRAD in the ical and psychological toll that these types but few of them know about the incred- 1986 U.S. Senate race against a seated of missions take on each of you: day upon day of work without sleep, the chaos of the ible service she has rendered our nation Republican, marking the first time circumstances, the calls for help and relief before she can to Washington. Lucy since 1944 that an incumbent North Da- that far outnumber your resources and man- Calautti’s extensive and varied career kota Senator lost a reelection bid. Her power. in the interest of the public, includes knowledge of the people of North Da- So we wanted, on behalf of the Department service in the United States Navy as an kota coupled with her superior grass- of Defense, to pay tribute to your efforts and aerial photographer during the Viet- roots organizing skills and her media say thank you; in particular, for the aid that savvy resulted in a campaign that is so you provided during our response to the nam War. After that her inspiration to tragedy in Kenya and Tanzania; but more serve the American people never respected, it was the subject of a book broadly, for your sacrifices and those of your faded—in fact it was enhanced—as she entitled ‘‘When Incumbency Fails.’’ families and friends, who have provided so photographed protesters outside the Contemporaries know Lucy most for much support during your deployments. 1968 Democratic convention. Her expe- her leadership in the office of Senator We want to commend you for the message rience in Chicago at the convention of DORGAN, as she has served as Chief of of friendship that you have sent to the peo- the social turmoil in our country at Staff to Senator DORGAN for more than ple of other nations on behalf of the United that them were some of the experiences twenty years. During this time, Lucy States. When you go to a foreign country performed a key role in shepherding and raise your tents, with those American that has made Lucy the dynamic and flags sewn on top, and use your skill, pa- sensitive person she is. key legislation through the United tience, courage, and compassion to help Lucy headed west to North Dakota States Senate. It wasn’t too long ago other people, that sends a powerful message from her birthplace in Queens, New that Lucy played an instrumental role of goodwill to other nations. York. She fell in love with the people with the Democratic party, staving off That is precisely the type of positive exam- and land of North Dakota as much as the Republican push for a Balanced ple that we in the Department of Defense en- Budget Amendment, and worked to courage in our soldiers, sailors, airmen, Ma- the people and land of North Dakota fell in love with her. She admired push an amendment that would not rines, and Coast Guardsmen when they are harm Social Security. In those tense abroad. Because it is a very eloquent and en- North Dakotans’ independence, their during statement about what America hard work, and their idealism. It days, Lucy was the calm inside the stands for. wasn’t long after Lucy arrived in North storm, as she quickly worked for a I cannot tell you how many times my Dakota that she began working with common-sense approach to the issue at counterparts abroad have expressed to me the same time she helped bring the now Senator DORGAN when he became their gratitude—to the United States and state of North Dakota into the lime- the elected State Tax Commissioner. the American people—for some type of as- light. For her skills in politics and leg- Theirs was a unique working partner- sistance or aid. That type of relationship— islation, Lucy has been praised univer- ship—one that has lasted more than a including the trust, respect, and apprecia- sally by her peers. A former aide to the tion that you earn—is indispensable to diplo- quarter of a century. late Senator Quentin Burdick lauded macy, stability, and peace. And so we thank In her lifetime, Lucy has also been a Lucy Calautti as ‘‘incredibly astute you. champion for the rights of women, chil- about politics and human nature, and Finally, I want to congratulate you for the dren, and working families. Some may absolutely brilliant at running a cam- example that you have set for cooperation not know how tirelessly Lucy Calautti between the military community and the ci- paign.’’ Former coworkers reserve the vilian community. Several of you have al- has fought for women’s rights through- highest accolades for Lucy, including ready participated in our Domestic Pre- out her career. Lucy began her dedica- one, who praised Lucy as ‘‘smart, ana- paredness Program, and your efforts are tion to the rights of women when she lytical, meticulous, loyal, and a hard going to be even more important in the fu- participated in landmark anti-dis- worker.’’ The Hill newspaper even ture as terrorism and weapons of mass de- crimination litigation. As a female GI, crowned Lucy Calautti with the title of struction become greater threats here in the she was a courageous pioneer who real- United States. Every time we work with you ‘‘most powerful woman in the nation’s ized first-hand that the benefits ex- capital.’’ to get your gear and trucks onto an air tended to women paled in comparison transport or fly you to a distant location, Now, we are losing Lucy to one of her our partnership becomes more valuable for to the benefits extended to her male lifetime loves—baseball. I suppose it is you and for us. Ultimately, when the sirens colleagues. Lucy took up the cause, only natural that Lucy return to one of sound the next time, that experience will and made sure that, for the first time, her first and most ardent interests. allow even more lives to be saved. full GI benefits were provided to Growing up in Queens, Lucy lived not Just across the hall from my office here in women serving in the military. Lucy too far from Shea Stadium where she the Pentagon there is a painting of a soldier continued her career in grassroots or- began her love of our nation’s favorite in prayer. It is graced with an inscription ganizing on behalf of the Women’s taken from the Book of Isaiah. In the pas- pastime. Last week, her father passed sage, God asks: ‘‘Whom shall I send? And Democratic Caucus in North Dakota. away. He instilled in her a love of the who will go for us?’’ And Isaiah answers: In fact, The Hill newspaper would later game of baseball, among so many other ‘‘Here I am. Send me.’’ anoint Lucy the ‘‘best political orga- attributes. She walks in her father’s Today it is my pleasure to honor an ex- nizer the state of North Dakota has footsteps, and I’m sure he’s the proud- traordinary group of Americans who, in the ever seen.’’ And while so many people est Dad in the world. It is with a great dark and decisive hours after tragedies, have would have stopped with just these ac- deal of respect that I pay tribute to always been willing to say, ‘‘Here I am. Send complishments, Lucy continued to es- me.’’ You proudly represent not only Fairfax Lucy Calautti today. Soon, Lucy will County and the state of Virginia, you rep- tablish the first public child care cen- join the Major League Baseball Organi- resent the best of America and the better an- ter in North Dakota, extending the zation as Director of Government Rela- gels of our nature. most necessary service to women who tions. She’ll still be playing ball with f juggle work, family, and far too often, us, and it’s be fun. poverty. Thank you, Lucy, for the time we TRIBUTE TO LUCY CALAUTTI Lucy’s career in public service has have been able to enjoy your magnifi- ∑ Mr. REID. Mr. President, I rise also included one of the most impor- cent intellect and skills in the United today to pay tribute to a woman who tant positions in American society States Senate. I thank you for your has dedicated her career to public serv- today—teaching. Lucy shaped the hard work, your dedication, your ideal- ice and is a good friend, Lucy Calautti. minds of our future leaders through her ism, and your service to our country June 29, 2000 CONGRESSIONAL RECORD — SENATE S6113 and most of all for you and KENT being continuing commitment to helping dedicated much of his life to improving the good friends you have been to others and a hearty congratulations to the State of Michigan. Landra and to me.∑ the 31 hardworking high school grad- Born in New York City in 1920, Mr. f uates.∑ Saltzman came to Michigan to work f for Ford Motor Company, where he was TRIBUTE TO R. GENE SMITH in charge of training/management pro- ∑ Mr. MCCONNELL. Mr. President, I MARIA’S CHILDREN AND RUSSIAN grams for salaried employees. rise today to pay tribute to my good ORPHANS After Mr. Saltzman retired from friend and philanthropist, R. Gene ∑ Mr. DODD. Mr. President, I want to Ford, he worked for the Greater De- Smith. advise our colleagues and their staff, troit Chamber of Commerce, was a con- I have had the privilege of knowing and their constituents visiting Wash- sultant with the U.S. Department of Gene for many years, and have always ington, of an educational exhibit in the Energy in Washington, DC, and was Di- been able to witness his compassion for Russell Rotunda next week. The ex- rector of the Michigan State Univer- others on numerous occasions. Gene hibit will include examples of colorful sity Advanced Management Program in has a kind heart and a giving spirit, murals used by the volunteer group, Troy, Michigan. He also was Director and constantly thinks of ways to help Maria’s Children, a Moscow-based arts of the Michigan Economic Opportunity those less fortunate than himself. rehabilitation center, as arts therapy Office and a member of the Oakland Eight years ago, he offered another of and training for Russian orphans with University Charter Board of Trustees. his generous gifts to a fourth grade learning difficulties. This therapy has Mr. Saltzman earned his Bachelor’s, class in Louisville. In a spectacular produced encouraging results. Master’s and Doctoral degrees from show of kindness, Gene promised an Maria’s Children is a Moscow-based New York University. During World all-expense paid college education to 58 foundation, with U.S.-based Board War II, he was with the Army Special- students at Jefferson County’s poorest members and volunteers, established to ized Training Program, serving in both school, Engelhard Elementary. The help children in Russian orphanages the Philippines and Tokyo. students’ part of the deal entailed com- recognize their creative potential, Surviving Mr. Saltzman are his wife, pleting high school and gaining accept- thereby developing their talents and Florence, with whom he celebrated his ance to a post-secondary college or uni- self-esteem so as to improve their 50th Anniversary on January 30, 1999; versity. As fourth graders, these chil- chances of successful integration into daughters Amie R. Saltzman and Sarah dren probably couldn’t grasp the in- Russian society. Created in 1993 by Saltzman; his sister, Doris Chartow of credible opportunity they were offered Maria Yeliseyeva, a local Moscow art- Syracuse, New York; grandchildren, then, but they certainly understand it ist, and her friends, the project quickly Joshua and Joanna; five nephews and now. found that through art, these orphans four nieces. As Gene often does, he went the extra could come to express themselves in Mr. President, Arthur Saltzman was mile on his promise and committed to ways they had not known before, im- a leader in the Michigan Republican helping each of the 58 students grad- proving both their social and psycho- Party at both the State and County uate from high school. He created the logical development. Through a com- level. I had the privilege to work with R. Gene Smith Foundation to meet the bination of arts therapy and exposure him on many occasions, and I found it academic, social, and emotional needs to normal family life, Maria’s Children to be a wonderful experience each and of each child. Over the students’ eight- have literally given these children a every time. Arthur was a man who year journey to graduation, the Foun- second chance. The program has ex- truly enjoyed life, and his love for liv- dation served as a haven for the chil- panded over time and has started a ing was infectious. I am sure that he dren and facilitated learning and per- summer art camp for orphans and is as- will be deeply missed by everyone who sonal growth opportunities. In spite of sociated with Dr. Patch Adams annual knew him.∑ numerous obstacles, Gene and his stu- clown tours of Moscow. The art work of f dents exceeded expectations and re- the children has been featured in sev- CHILD HANDGUN INJURY cently celebrated the graduation of 31 eral Moscow exhibits and is helping to PREVENTION ACT of the original 58 students. change Russian attitudes and views of Gene gave an amazing gift. Not only what orphans are capable of achieving. ∑ Mr. KERRY. Mr. President, yester- did Gene provided a free college edu- The exhibit will show in the Russell day I introduced legislation, along with cation, but he provided each of the stu- Rotunda from July 3–7. From there, it my good friend from Ohio Senator dents and their parents with compas- will move to the Russian Cultural Cen- DEWINE, that will set minimum stand- sion, motivation, and peace of mind tre, here in Washington, and will be on ards for gun safety locks. There has over the last eight years. He prevented display from July 8–21. The exhibit will been a lot of discussion swirling around 31 sets of parents from having to worry also show across the United States the U.S. Congress and in State legisla- about whether they would have the throughout the summer, appearing in tures throughout the country about money to pay for their child’s edu- New York City at the National Art the use of handgun safety locks to pre- cation. He provided 31 students with Club from July 28–August 6; at the vent children from gaining access to hope for a bright and successful future. Edina Southdale Court in Minneapolis dangerous weapons. In fact, just last Although this latest act of compas- from August 11–19; and at the week New York became the latest sion is extraordinary, it is only one ex- Bumbershoot Festival in Seattle from State to require that safety locks be ample of Gene’s generosity. Gene September 1–4. sold with firearms. Seventeen states chaired fund-raising efforts for Neigh- I invite our colleagues and their staff have Child Access Protection, or CAP borhood House, a community center in to visit this exhibit and learn about laws in place, which permit prosecu- a poverty-stricken area of Portland, the important work that is being done tion of adults if their firearm is left un- Kentucky. He supports a preschool pro- by Maria and her colleagues to improve secured and a child uses that firearm gram for underprivileged children in the opportunities for orphans in to harm themselves or others. Kentucky, called Jump Start. Addi- Russia.∑ An important element that is largely tionally, he donated $1 million towards f missing from the debate over the vol- redevelopment of the Louisville water- untary or required use of gun safety front. Gene also lends his support to IN MEMORY OF MR. ARTHUR locks is the quality and performance of such civic groups as the Speed Art Mu- SALTZMAN these locks. Mr. President, a gun lock seum, the Cathedral Heritage Founda- ∑ Mr. ABRAHAM. Mr. President, I rise will only keep a gun out of a child’s tion, the University of Louisville Hos- today in honor and in memory of a hands if the lock works. There are pital Foundation, and Greater Louis- dear friend of mine, Mr. Arthur many cheap, flimsy locks on the mar- ville, Inc. Saltzman, of Franklin, Michigan, who ket that are easily overcome by a On behalf of myself and my col- passed away on June 18, 2000, at the age child. In fact just last week in Dale leagues in the United States Senate, I of 79. Mr. Saltzman was not only a City, VA there was an absolutely offer heartfelt thanks to Gene for his friend, but an inspiration—a man who heart-wrenching accidental shooting of S6114 CONGRESSIONAL RECORD — SENATE June 29, 2000 a 10-year-old boy by his 13-year-old require the use of gun safety locks. It find a base of operation being restored brother. The parents of these young only requires that gun safety locks to its original state. They understand boys purchased both a lock box and a meet minimum standards. The legisla- the importance of preserving history trigger lock and I’m sure they assumed tion does not regulate handguns. It ap- and their role in this dwindling aspect that they were safely storing their plies only to after-market, external of the great American west. weapon. gun locks. I would like to extend my congratu- But, as was reported in Saturday’s The Senate has been gridlocked since lations and sincere best wishes to the Washington Post, the boys easily got last July over the issue of gun control. Carey family for high grass, plentiful past the flimsy lock box and then got And you can be sure that young lives water, and most importantly a fair around the lock. This incident ended in have been needlessly lost due to our in- market price for the fruits of their unspeakable, but all too common trag- action. This legislation—which I truly labor.∑ edy with the death of a 10-year-old boy believe every Senator can support— f at the hands of his brother. would make storing a gun in the home Mr. President, the legislation Sen- safer by ensuring safety devices are ef- RECOGNITION OF LOYAL CLARK AS NATIONAL FOREST SERVICE ator DEWINE and I introduced yester- fective. It would empower consumers. day might have prevented the acci- And most importantly it would protect EMPLOYEE OF THE DECADE dental shooting of that young boy last children and decrease the numbers of ∑ Mr. BENNETT. Mr. President, I rise week. Our legislation gives authority accidental shooting in this country. today to recognize the accomplish- to the Consumer Product Safety Com- We simply cannot stand by any ments of Ms. Loyal Clark, Public Af- mission to set minimum regulations longer and watch our young children fairs Specialist and administrator of for safety locks and to remove unsafe fall victim to accidental shootings. We the Senior, Youth, and Volunteer Pro- locks from the market. Our legislation cannot hear about tragedies like the gram in the Uinta National Forest lo- empowers consumers by ensuring that one last week in Dale City, VA without cated in my home state of Utah. they will only purchase high-quality responding. This legislation is a step in Ms. Clark has been instrumental in lock boxes and trigger locks. the right direction, one I believe every developing a model volunteer program Storing firearms safely is an effec- Senator should support.∑ that is clearly the largest in the na- tive and inexpensive way to prevent f tion, averaging 10,000 volunteers a year the needless tragedies associated with CAREY FAMILY REUNION for the past decade. Ms. Clark has unintentional firearm-related death worked to ensure that the Uinta Na- ∑ Mr. BURNS. Mr. President, I rise and injury. And I am pleased that sev- tional Forest can accommodate and today to acknowledge the achievement eral states, including my home state of provide quality experiences for the nu- of the Carey Cattle Operation in Boul- Massachusetts, have required the use merous volunteer groups and individ- der, Montana. uals. When there have been more vol- of gun safety locks. Last July here in In the late 1800’s Bart Carey settled unteers than available work, she has the U.S. Senate we passed an amend- in the Boulder Valley. Two of his sons not turned them away, but has been ment that would require the use of gun worked the mines and mills in Mon- able to direct their enthusiasm to adja- safety locks. tana and Idaho hoping to stake their So, while I am encouraged by this own ranches in the Valley. cent forests and other state, county, trend of increasing the use of gun safe- Frank, the patriarch of the oper- and community projects. She is a key ty locks, I am genuinely concerned ation, followed the gold rush north to contact with the community, ensuring that with the hundreds of different Alaska, enduring shipwreck and a win- that volunteers know about opportuni- types of gun locks on the market today ter living with an Eskimo family. After ties and that they are matched with it is difficult—probably impossible—for returning to the Valley he established jobs they want to do. consumers to be assured that the lock a ranching legacy that endures to this Ms. Clark developed and presented a they are purchasing will be effective. day. Frank and his wife Mary Ellen proposal to the forest supervisor to es- The latest data released by the Cen- have 12 children and 45 grandchildren. tablish volunteer coordinators on each ters for Disease Control in 1999 re- Their legacy of cussed independence, of the ranger districts in the forest. vealed that accidental shootings ac- integrity, and determination instilled These coordinator positions have counted for 7 percent of child deaths in their children the qualities of hard helped to provide the necessary staff and that more than 300 children died in work, responsibility and most impor- for the Uinta to manage its huge vol- gun accidents, almost one child every tantly a deep abiding faith in God. unteer program and to complete mil- day. A study in the Archives of Pedi- This attitude of responsibility fos- lions of dollars worth of vital project atric and Adolescent Medicine found tered a deep sense of patriotism and re- work, increasing the effectiveness of that 25 percent of 3- to 4-year-olds and sulted in their son, Martin B., answer- the Forest’s budget by as much as 70 percent of 5- to 6-year-olds had suffi- ing his nation’s call during World War twenty to thirty percent. cient finger strength to fire 59 (or 92 II. He was joined by four sisters—Lil- Ms. Clark has taken an active role to percent) of the 64 commonly available lian, Agnes, Eleanor, and Josephine— ensure various volunteers are recog- handguns examined in the study. Acci- who served as Navy nurses. nized and rewarded. She has organized dental shootings can be prevented by Service to our country, in spite of volunteer award ceremonies in the for- simple safety measures, one of which is the demands of managing a thriving est and actively ensures the nomina- the use of an effective gun safety lock. cattle operation, and the concessions tions of volunteers for forest, regional, As I have already mentioned, Mr. that were available under such condi- and national recognition. She is cur- President, the use of gun safety locks tions saw their youngest son Tom, the rently the team leader for the Uinta is increasing in the United States. De- current patriarch, answering the call National Forest partnership team, spite the growing use of gun safety during the Korean conflict. which is active in pursing new partner- locks, such products are not subject to As the only remaining son, Tom and ships with the forest while also main- any minimal safety standards. Many his extraordinary wife Helen, carry on taining its current relationships. currently available trigger locks, safe- the tradition. Operating out of the She has not only made a difference in ty locks, lock boxes, and other similar main ranch they have endeavored to the Uinta National Forest, but has also devices are inadequate to prevent the instill these same values in their chil- visited many of the forest management accidental discharge of the firearms to dren and grandchildren. In spite of the teams throughout the Intermountain which they are attached or to prevent current condition of American agri- Region and shared her wealth of knowl- access and accidental use by young culture they are making every effort to edge and experience in the manage- children. Consumers do not have any ensure that their children and the chil- ment of effective volunteer programs. objective criteria with which to judge dren of Tom’s siblings have every op- Because of Ms. Clark’s career-long the quality of gun safety locks. portunity to continue their ranching commitment to working with volun- My colleagues on both sides of the legacy. teers, the United States Forest Service aisle should be able to support this As the Carey family gathers for a re- recently presented her with an award amendment. The legislation does not union this Fourth of July they will for being the National Forest Service June 29, 2000 CONGRESSIONAL RECORD — SENATE S6115 Employee of the Nineties. I congratu- nyside Elementary for putting in extra at the age of 59. Mrs. Stewart was not late Ms. Clark on her well-deserved time and for bringing so much of their only a friend, but a truly special award from the Forest Service. energy into the classroom. woman. She believed deeply in the In closing, I am pleased to recognize Garfield Elementary is noted for its ideals of the Republican Party, and and thank Ms. Loyal Clark today for tremendous community involvement. worked extremely hard to fight for her sustained efforts to enlist and en- Student volunteers from Boise State these ideals. courage citizens to take ownership in University, most of them studying to Mrs. Stewart was born in Detroit, their national forests and communities be teachers, regularly tutor students Michigan. After attending Henry Ford through volunteering.∑ after school. Garfield hosts an annual Community College in Dearborn, f Career Day in which professionals from Michigan, she attended the Oakland the community describe their careers County Police Academy. She spent 15 TRIBUTE TO GARFIELD AND SUN- and how they pursued them. The school years as an investigator with the Oak- NYSIDE ELEMENTARY SCHOOLS also has a fifteen-member mentor pro- land County Prosecutor’s Office. ∑ Mr. CRAPO. Mr. President, I rise gram. Although none of the tutors On May 8, 1989, Mrs. Stewart was ap- today to commend two Idaho schools, have children of their own who attend pointed to the Michigan Liquor Control Garfield Elementary School in Boise Garfield, they come to the school fre- Commission as an Administrative and Sunnyside Elementary School in quently during lunchtime to read with Commissioner. In 1997, Governor John Kellogg for their high standards and children. This extensive community in- Engler elevated her to position of excellent teaching records. volvement is one of the reasons why Chairwoman of the Commission. For Last month, these two schools were the Iowa Test of Basic Skills for stu- her work in that position, Mrs. Stewart recognized by the U.S. Department of dents at Garfield Elementary have is credited with restoring credibility to Education and the National Associa- risen as much as thirty points on a 100- an agency that had fallen under con- tion of Title I Directors as Distin- point scale for some grades. troversy. guished Title I Schools. These two ele- In addition to volunteering, parents Mrs. Stewart also served the Oakland mentary schools were among the nine- at Garfield Elementary are encouraged County Republican Party in many ty schools nationwide to be recognized by Principal Elaine Eichelberg to join ways, most prominently as one of the for their efforts toward student one of the school’s many committees. top aides to former prosecutor and cur- achievement in schools that teach stu- At the beginning of the year, each rent County Executive, L. Brooks Pat- dents from low-income households. household receives a questionnaire terson. In the mid-1980’s, she led a peti- Garfield Elementary and Sunnyside El- that lists specific ways to help and tion drive that fell just short of placing ementary exemplify Idaho’s high edu- asks parents to indicate their interest a proposed restoration of the death cation standards and I am honored to and availability. Principal Eichelberg penalty on the Michigan ballot. congratulate these two schools for re- says, ‘‘One of the best things parents Mrs. Stewart is survived by her hus- ceiving this national award. can do to improve their child’s edu- band, Mr. James Stewart, former long- This national honor is especially im- cation is to keep close tabs on their time Huntington Woods Police Chief, pressive when one recognizes that more child’s progress themselves and work as well as her sons, Chris and Timothy than fifty thousand schools across the with teachers when problems at school Boelter; daughter Elizabeth Rose; step- country use Title I funds to boost the arise.’’ son James Stewart, and two brothers. achievement levels of students from The national recognition that Sunny- Mr. President, I consider it a privi- low-income households. The distinc- side Elementary and Garfield Elemen- lege to have been able to know and tion of 2000 Distinguished Title I tary have received reaffirms my belief work with Jackie Stewart. She was a School is awarded to schools whose that Idaho has some of the best teach- woman of complete integrity, who programs offer children from educa- ers and administrators in the nation. fought for what she believed regardless tionally disadvantaged communities Backed by strong involvement from of the odds against her. Her energy and access to effective academic lessons. parents and encouragement from the boundless efforts were an inspiration to Education is crucial to the well-being community, these elementary schools men and women throughout the State of these future adults because it is have demonstrated success in teacher of Michigan, and I am sure she will be often their means of upward mobility. training, utilized community re- dearly missed by everyone who knew Improved education opportunities al- sources, and established partnerships her.∑ lows these children to become better with parents. f citizens and achieve their education There has been much debate about THE CHALLENGER LEARNING and career goals, including higher pay- the success of the Title I program in CENTER OF ALASKA ing jobs, and a better quality of life. the Elementary and Secondary Edu- Much of Sunnyside Elementary’s suc- cation Act. Schools like Garfield and ∑ Mr. MURKOWSKI. Mr. President, I cess can be attributed to an active par- Sunnyside show us that the programs rise to offer my congratulations to the ent volunteer program. For example, implemented with the use of Title I Challenger Learning Center of Alaska, while the school has only 300 students, funds do work. When we invest in qual- its Board of Directors, and staffers, on approximately 124 parents volunteer ity education programs that focus on their Official Launch Ceremony on their time at least once a year and basic skills, such as reading and math- July 7, 2000. forty-nine parents volunteer at the ematics, our low-performing students The Challenger Learning Center of school on a regular basis. A web page, will improve. The methods employed in Alaska will be part of the national net- maintained by Principal Steve Idaho serve as a reminder that commu- work of 50 Learning Centers operating Shepperd and monthly school news- nity and parental support often make in the United States, Canada, and Eng- letters inform parents of school activi- the biggest difference in elementary land established in memory of the 1986 ties and highlight ways parents can get education. Challenger Space Shuttle crew. Lo- involved. The suggested tasks are often I am very proud of the accomplish- cated in Kenai, Alaska, the Challenger as simple as helping children with ments of these two schools. Their Learning Center of Alaska simulates homework assignments. steady focus on hard work has put space missions to give students the op- Principal Shepperd says, ‘‘Just be- their students on a path of continued portunity to explore the endless possi- cause sixty percent of the students we academic success.∑ bilities available in science and tech- teach come from households that are f nology fields. at or near the poverty level, it doesn’t Mr. President, currently 40 percent of mean that they cannot learn. We con- IN MEMORY OF MRS. JACQUELYN America’s 4th graders read below the centrate on setting high standards and STEWART basic level on national reading tests. we help the kids meet them by offering ∑ Mr. ABRAHAM. Mr. President, I rise On international tests, the nation’s encouragement and extra assistance today in honor and in memory of a twelfth graders rank last in Advanced with their lessons.’’ Principal Shepperd dear friend of mine, Mrs. Jacquelyn Physics compared with students in 18 credits the dedicated teachers of Sun- Stewart, who passed away on June 19 other countries. And one-third of all S6116 CONGRESSIONAL RECORD — SENATE June 29, 2000 incoming college freshmen must enroll the report of the committee of con- (RIN2120–AA66 (2000–0112)) received on May in a remedial reading, writing, or ference on the disagreeing votes of the 22, 2000; to the Committee on Commerce, mathematics class before taking reg- two Houses on the amendment of the Science, and Transportation. EC–9486. A communication from the Pro- ular courses. If we are going to turn Senate to the bill (H.R. 4425) making gram Analyst, Federal Aviation Administra- these dismal statistics around this appropriations for military construc- tion, Department of Transportation, trans- country needs an innovative approach tion, family housing, and base realign- mitting, pursuant to law, the report of a rule to teaching. The Challenger Learning ment and closure for the Department entitled ‘‘Establishing of Class E Airspace; Center of Alaska is working towards of Defense for the fiscal year ending Salem, MO; docket No. 00–ACE–6 [5–5/5–22]’’ ensuring that our elementary and sec- September 30, 2001, and for other pur- (RIN2120–AA66 (2000–0113)) received on May 22, 2000; to the Committee on Commerce, ondary students of today are the best- poses. Science, and Transportation. educated and motivated college grad- f EC–9487. A communication from the Pro- uates of tomorrow. gram Analyst, Federal Aviation Administra- The Challenger Learning Center pro- MEASURES REFERRED tion, Department of Transportation, trans- grams will not only create an environ- The following bill was read the first mitting, pursuant to law, the report of a rule ment conductive to pursuing the entitled ‘‘Amendment to Class E Airspace; and second times by unanimous con- Cuba, MO; direct final rule, confirmation of sciences, they will also assist students sent and referred as indicated: effective date; docket no. 00–ACE–3 [5–2/5– in developing skills vital to every field. H.R. 3240. An act to amend the Federal 22]’’ (RIN2120–AA66 (2000–0114)) received on In the Alaska workplace of the 21st Food, Drug, and Cosmetic Act to clarify cer- May 22, 2000; to the Committee on Com- century, survival will depend on team- tain responsibilities of the Food and Drug merce, Science, and Transportation. work, problem solving, communication Administration with respect to the importa- EC–9488. A communication from the Pro- and decision-making. Like no other tion of drugs into the United States; to the gram Analyst, Federal Aviation Administra- educational program, the Challenger Committee on Health, Education, Labor, and tion, Department of Transportation, trans- Pensions. mitting, pursuant to law, the report of a rule Learning Center of Alaska will help all entitled ‘‘Modification of Class E Airspace; of Alaska’s students develop these crit- f Marquette, MI; revocation of Class E Air- ical skills while providing the solid ENROLLED BILLS PRESENTED space; Sayer, MI and K.I. Sawyer, MI; new ef- educational content that promotes fective date; docket No. 99–AGL–42 [5–2/5–22]’’ science literacy. The Secretary of the Senate reported (RIN2120–AA66 (2000–0116)) received on May Mr. President, educators continue to that on June 28, 2000, he had presented 22, 2000; to the Committee on Commerce, to the President of the United States Science, and Transportation. site education as the number one deter- EC–9489. A communication from the Pro- minate in an individual’s success. I be- the following enrolled bill: gram Analyst, Federal Aviation Administra- lieve that the Challenger Learning S. 1309. An act to amend title I of the Em- tion, Department of Transportation, trans- Center of Alaska will profoundly affect ployee Retirement Income Security Act of mitting, pursuant to law, the report of a rule the future of Alaska. I commend the 1974 to provide for the preemption of State entitled ‘‘Special Visual Flight Rules; direct Challenger Learning Center staff, law in certain cases relating to certain final rule; confirmation of effective date [5– church plans. 19/5–22]’’ (RIN2120–AG94 (2000–0002)) received Board of Directors, NASA and state- f on May 22, 2000; to the Committee on Com- wide communities for their tireless ef- merce, Science, and Transportation. forts and dedication to our young Alas- EXECUTIVE AND OTHER EC–9490. A communication from the Pro- kans.∑ COMMUNICATIONS gram Analyst, Federal Aviation Administra- f tion, Department of Transportation, trans- The following communications were mitting, pursuant to law, the report of a rule MESSAGES FROM THE HOUSE laid before the Senate, together with entitled ‘‘Airworthiness Directives: At 12:24 p.m., a message from the accompanying papers, reports, and doc- Mitsubishi Heavy Industries, Ltd. MU–2B Se- uments, which were referred as indi- ries Airplanes; docket No. 97–CE–21 [5–15/5– House of Representatives, delivered by 18]’’ (RIN2120–AA64 (2000–0244)) received on Ms. Niland, one of its reading clerks, cated: May 18, 2000; to the Committee on Com- announced that the House has agreed EC–9482. A communication from the Pro- merce, Science, and Transportation. to the following bills, in which it re- gram Analyst, Federal Aviation Administra- EC–9491. A communication from the Pro- quests the concurrence of the Senate: tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- H.R. 4680. An act to amend title XVIII of entitled ‘‘Airworthiness Directives: Fokker mitting, pursuant to law, the report of a rule the Social Security Act to provide for a vol- Model F.28 Mark 0070 Series Airplanes; re- entitled ‘‘Airworthiness Directives: Rolls untary program for prescription drug cov- quest for comments; docket No. 99–NM–253 Royce plc RB211–535 Series; docket No. 2000– erage under the Medicare Program, to mod- [5–12/5–22]’’ (RIN2120–AA64 (2000–0268)) re- NE–04 [5–12/5–18]’’ (RIN2120–AA64 (2000–0245)) ernize the Medicare Program, and for other ceived on May 22, 2000; to the Committee on received on May 18, 2000; to the Committee purposes. Commerce, Science, and Transportation. on Commerce, Science, and Transportation. H.R. 3240. An act to amend the Federal EC–9483. A communication from the Pro- EC–9492. A communication from the Pro- Food, Drug, and Cosmetic Act to clarify cer- gram Analyst, Federal Aviation Administra- gram Analyst, Federal Aviation Administra- tain responsibilities of the Food and Drug tion, Department of Transportation, trans- tion, Department of Transportation, trans- Administration with respect to the importa- mitting, pursuant to law, the report of a rule mitting, pursuant to law, the report of a rule tion of drugs into the United States. entitled ‘‘Airworthiness Directives: Maule entitled ‘‘Airworthiness Directives: Boeing ENROLLED BILLS SIGNED Aerospace Technology, Inc. M4, M5, M6, M7, Model 747–200 Series Airplanes equipped with GE CF6–80C2 Series Engines; request for At 8:15 p.m., a message from the MX7 and MXT7 Series Airplanes & Models comments; docket No. 2000–NM–93 [5–4/5–18]’’ MT7235 and M8235 Airplanes; request for House of Representatives, delivered by (RIN2120–AA64 (2000–0246)) received on May comments; docket No. 2000–CE–04 [5–9/5–22]’’ Ms. Niland, one of its reading clerks, 18, 2000; to the Committee on Commerce, (RIN2120–AA64 (2000–0269)) received on May announced that the Speaker has signed Science, and Transportation. the following enrolled bills: 22, 2000; to the Committee on Commerce, EC–9493. A communication from the Pro- Science, and Transportation. S. 1515. An act to amend the Radiation Ex- gram Analyst, Federal Aviation Administra- EC–9484. A communication from the Pro- tion, Department of Transportation, trans- posure Compensation Act, and for other pur- gram Analyst, Federal Aviation Administra- poses. mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- entitled ‘‘Airworthiness Directives: Boeing H.R. 3051. An act to direct the Secretary of mitting, pursuant to law, the report of a rule the Interior, the Bureau of Reclamation, to Model 767 Series Airplanes equipped with GE entitled ‘‘Revision of Class E Airspace; Un- CF6–80C2 Series Engines; request for com- conduct a feasibility study on the Jicarilla alaska, AK; docket No. 99–AAL–18 [4–24/5–22]’’ Apache Reservation in the State of New ments; docket No. 2000–NM–94 [5–4/5–18]’’ (RIN2120–AA66 (2000–0111)) received on May (RIN2120–AA64 (2000–0247)) received on May Mexico, and for other purposes. 22, 2000; to the Committee on Commerce, H.R. 4762. An act to amend the Internal 18, 2000; to the Committee on Commerce, Science, and Transportation. Science, and Transportation. Revenue Code of 1986 to require 527 organiza- EC–9485. A communication from the Pro- EC–9494. A communication from the Pro- tions to disclose their political activities. gram Analyst, Federal Aviation Administra- gram Analyst, Federal Aviation Administra- tion, Department of Transportation, trans- tion, Department of Transportation, trans- At 9:08 p.m., a message from the mitting, pursuant to law, the report of a rule mitting, pursuant to law, the report of a rule House of Representatives, delivered by entitled ‘‘Amendment to Class E Airspace; entitled ‘‘Airworthiness Directives: GE Com- Mr. Hays, one of its reading clerks, an- Albion, NE, direct final rule, request for pany CF6–6, CF6–45, and CF6–50 Series Tur- nounced that the House has agreed to comments; docket No. 99–ACE–30 [5–5/5–22]’’ bofan Engines; docket No. 98–ANE–41 [4–24/5– June 29, 2000 CONGRESSIONAL RECORD — SENATE S6117 18]’’ (RIN2120–AA64 (2000–0256)) received on Piper Aircraft, Inc., Models PA46310P and mitting, pursuant to law, the report of a rule May 18, 2000; to the Committee on Com- PA46350P Airplanes; docket No. 99–CE–112 [5– entitled ‘‘Revision of Class D Airspace; Alex- merce, Science, and Transportation. 25/6–1]’’ (RIN2120–AA64 (2000–0292)) received andria England AFB, LA; Revocation of EC–9495. A communication from the Pro- on June 1, 2000; to the Committee on Com- Class D Airspace; Alexandria Esler Reg Air- gram Analyst, Federal Aviation Administra- merce, Science, and Transportation. port, LA; and Revision of Class E Airspace, tion, Department of Transportation, trans- EC–9504. A communication from the Pro- Alexandria, LA; docket No. 2000–ASW–10 [5– mitting, pursuant to law, the report of a rule gram Analyst, Federal Aviation Administra- 26/6–1]’’ (RIN2120–AA66 (2000–0126)) received entitled ‘‘Airworthiness Directives: GE CF6– tion, Department of Transportation, trans- on June 1, 2000 ; to the Committee on Com- 80A, CF6–80C2, and CF6–80E1 Series Turbofan mitting, pursuant to law, the report of a rule merce, Science, and Transportation. Engines; docket No. 98–ANE–49 [4–24/5–18]’’ entitled ‘‘Airworthiness Directives: Boeing EC–9513. A communication from the Pro- (RIN2120–AA64 (2000–0257)) received on May Model 737 Series Airplanes; docket No. 2000– gram Analyst, Federal Aviation Administra- 18, 2000; to the Committee on Commerce, NM–111 [5–26/6–1]’’ (RIN2120–AA64 (2000–0293)) tion, Department of Transportation, trans- Science, and Transportation. received on June 1, 2000; to the Committee mitting, pursuant to law, the report of a rule EC–9496. A communication from the Pro- on Commerce, Science, and Transportation. entitled ‘‘Revision of Class E; Waco, TX; gram Analyst, Federal Aviation Administra- EC–9505. A communication from the Pro- docket No. 2000–ASW–08 [5–25/6–1]’’ (RIN2120– tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- AA66 (2000–0127)) received on June 8, 2000 ; to mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- the Committee on Commerce, Science, and entitled ‘‘Airworthiness Directives: GE GE90 mitting, pursuant to law, the report of a rule Transportation. Series Turbofan Engines; docket No. 98– entitled ‘‘Airworthiness Directives: Boeing EC–9514. A communication from the Pro- ANE–39 [4–24/5–18]’’ (RIN2120–AA64 (2000– Model 747 Series Airplanes Equipped with P gram Analyst, Federal Aviation Administra- 0258)) received on May 18, 2000; to the Com- & W JT9D–70 Series Engines docket No. 99– tion, Department of Transportation, trans- mittee on Commerce, Science, and Transpor- NM–65 [5–26/6–1]’’ (RIN2120–AA64 (2000–0294)) mitting, pursuant to law, the report of a rule tation. received on June 1, 2000; to the Committee entitled ‘‘Revision of Class E Airspace; Fort EC–9497. A communication from the Pro- on Commerce, Science, and Transportation. Stockton, TX; docket No. 2000–ASW–09 [5–25/ gram Analyst, Federal Aviation Administra- EC–9506. A communication from the Pro- 6–1]’’ (RIN2120–AA66 (2000–0128)) received on tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- June 8, 2000; to the Committee on Commerce, mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- Science, and Transportation. entitled ‘‘Airworthiness Directives: Boeing mitting, pursuant to law, the report of a rule EC–9515. A communication from the Pro- Model 747 Series Airplanes; docket No. 99– entitled ‘‘Airworthiness Directives: Israel gram Analyst, Federal Aviation Administra- NM–231 [5–1/5–18]’’ (RIN2120–AA64 (2000–0259)) Aircraft Industries, LTD, model 1125 tion, Department of Transportation, trans- received on May 18, 2000; to the Committee Westwind Astra and Astra SPX Series Air- mitting, pursuant to law, the report of a rule on Commerce, Science, and Transportation. planes; docket No. 99–NM–360 [5–26/6–1]’’ entitled ‘‘Revision of Class E Airspace; En- EC–9498. A communication from the Pro- (RIN2120–AA64 (2000–0295)) received on June glewood, CO; docket No. 00–ANM–01 [5–25/6– gram Analyst, Federal Aviation Administra- 1, 2000; to the Committee on Commerce, 1]’’ (RIN2120–AA66 (2000–0129)) received on tion, Department of Transportation, trans- Science, and Transportation. June 8, 2000; to the Committee on Commerce, mitting, pursuant to law, the report of a rule EC–9507. A communication from the Pro- Science, and Transportation. entitled ‘‘Airworthiness Directives: Boeing gram Analyst, Federal Aviation Administra- EC–9516. A communication from the Pro- Model 727 and 727C Series Airplanes; docket tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- No. 98–NM–293 [5–1/5–18]’’ (RIN2120–AA64 mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- (2000–0260)) received on May 18, 2000; to the entitled ‘‘Airworthiness Directives: Airbus mitting, pursuant to law, the report of a rule Committee on Commerce, Science, and Model A319, A320, and A321 Series Airplanes; entitled ‘‘Changes to the International Transportation. docket No. 99–NM–28 [5–26/6–1]’’ (RIN2120– Aviational Safety Assessment (IASA); Policy EC–9499. A communication from the Pro- AA64 (2000–0296)) received on June 1, 2000; to Statement; 14 CFR Part 129 [5–25/6–1]’’ gram Analyst, Federal Aviation Administra- the Committee on Commerce, Science, and (RIN2120–ZZ26) received on June 8, 2000; to tion, Department of Transportation, trans- Transportation. the Committee on Commerce, Science, and mitting, pursuant to law, the report of a rule EC–9508. A communication from the Pro- Transportation. entitled ‘‘Airworthiness Directives: MD Heli- gram Analyst, Federal Aviation Administra- EC–9517. A communication from the Pro- copters, INC, Model 369D, 369E, 500N, and tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- 600N Helicopters; request for comments; mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- docket No. 2000–SW–02 [5–5/5–18]’’ (RIN2120– entitled ‘‘Airworthiness Directives: Airbus mitting, pursuant to law, the report of a rule AA64 (2000–0263)) received on May 18, 2000; to Model A320 Series Airplanes; docket No. 98– entitled ‘‘National Parks Air Tour Manage- the Committee on Commerce, Science, and NM–99 [5–26/6–1]’’ (RIN2120–AA64 (2000–0297)) ment; Notice of Statutory Requirement 14 Transportation. received on June 1, 2000; to the Committee CFR Part 91 [5–26/6–1]’’ (RIN2120–ZZ27) re- EC–9500. A communication from the Pro- on Commerce, Science, and Transportation. ceived on June 8, 2000; to the Committee on gram Analyst, Federal Aviation Administra- EC–9509. A communication from the Pro- Commerce, Science, and Transportation. tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- EC–9518. A communication from the Pro- mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- entitled ‘‘Airworthiness Directives: Allison mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- Engine Company AE3007 Series Turbofan En- entitled ‘‘Airworthiness Directives: Airbus mitting, pursuant to law, the report of a rule gines; docket No. 99–NE–46 [5–5/5–18]’’ Industrie Model A300, A300–600, and A310 Se- entitled ‘‘Airworthiness Directives: Com- (RIN2120–AA64 (2000–0264)) received on May ries Airplanes; docket No. 99–NM–251 [5–26/6– mander Aircraft Company Model 114TC Air- 18, 2000; to the Committee on Commerce, 1]’’ (RIN2120–AA64 (2000–0298)) received on planes; docket no. 99–CE–81 [6–1/6–8]’’ Science, and Transportation. June 1, 2000; to the Committee on Commerce, (RIN2120–AA64 (2000–0301)) received on June EC–9501. A communication from the Pro- Science, and Transportation. 8, 2000; to the Committee on Commerce, gram Analyst, Federal Aviation Administra- EC–9510. A communication from the Pro- Science, and Transportation. tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- EC–9519. A communication from the Pro- mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- entitled ‘‘Establishment of Class E Airspace; mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- Andres-Murphy, NC; correction; docket No. entitled ‘‘Airworthiness Directives: mitting, pursuant to law, the report of a rule 00–ASO–4 [5–12/5–18]’’ (RIN2120–AA66 (2000– Eurocopter France Model SE3160, SA316B, entitled ‘‘Standard Instrument Approach 0110)) received on May 18, 2000; to the Com- SA316C, SA319B, SA330F, SA330G, SA330J, Procedures; Miscellaneous Amendments (60); mittee on Commerce, Science, and Transpor- SA341G, and SA342J Helicopters; docket No. No. 1991; [5–19/6–8]’’ (RIN2120–AA65 (2000– tation. 99–SW–04 [5–25/6–1]’’ (RIN2120–AA64 (2000– 0029)) received on June 8, 2000; to the Com- EC–9502. A communication from the Pro- 0299)) received on June 1, 2000; to the Com- mittee on Commerce, Science, and Transpor- gram Analyst, Federal Aviation Administra- mittee on Commerce, Science, and Transpor- tation. tion, Department of Transportation, trans- tation. EC–9520. A communication from the Pro- mitting, pursuant to law, the report of a rule EC–9511. A communication from the Pro- gram Analyst, Federal Aviation Administra- entitled ‘‘Airworthiness Directives: Boeing gram Analyst, Federal Aviation Administra- tion, Department of Transportation, trans- Model 747–100, –200, –300, 747SR, and 747 SP tion, Department of Transportation, trans- mitting, pursuant to law, the report of a rule Series Airplanes; docket No. 97–NM–88 [5–26/ mitting, pursuant to law, the report of a rule entitled ‘‘Modification of Class E Airspace; 6–1]’’ (RIN2120–AA64 (2000–0291)) received on entitled ‘‘Establishment of Class D Airspace; Willits, CA; docket no. 00–AWP–1 [5–26/8–10]’’ June 1, 2000; to the Committee on Commerce, Salisbury, MD; docket No. 99–AEA–07 [5–25/6– (RIN2120–AA66 (2000–0131)) received on June Science, and Transportation. 1]’’ (RIN2120–AA66 (2000–0125)) received on 8, 2000; to the Committee on Commerce, EC–9503. A communication from the Pro- June 1, 2000; to the Committee on Commerce, Science, and Transportation. gram Analyst, Federal Aviation Administra- Science, and Transportation. EC–9521. A communication from the Pro- tion, Department of Transportation, trans- EC–9512. A communication from the Pro- gram Analyst, Federal Aviation Administra- mitting, pursuant to law, the report of a rule gram Analyst, Federal Aviation Administra- tion, Department of Transportation, trans- entitled ‘‘Airworthiness Directives: New tion, Department of Transportation, trans- mitting, pursuant to law, the report of a rule S6118 CONGRESSIONAL RECORD — SENATE June 29, 2000 entitled ‘‘Type of Certification Procedures tion, Department of Transportation, trans- tion, Department of Transportation, trans- for Changed Products; request for comments; mitting, pursuant to law, the report of a rule mitting, pursuant to law, the report of a rule docket no. 28903 [6/7–6/8]’’ (RIN2120–AF68) re- entitled ‘‘Airworthiness Directives: Boeing entitled ‘‘Standard Instrument Approach ceived on June 8, 2000; to the Committee on Model 767–200 and 300 Series Airplanes; dock- Procedures; Miscellaneous Amendments (30); Commerce, Science, and Transportation. et no. 98–NM–313 [6–13/6–15]’’ (RIN2120–AA64 Amdt. No. 1995 [6–14/6–15]’’ (RIN2120–AA65 EC–9522. A communication from the Pro- (2000–0326)) received on June 15, 2000; to the (2000–0034)) received on June 15, 2000; to the gram Analyst, Federal Aviation Administra- Committee on Commerce, Science, and Committee on Commerce, Science, and tion, Department of Transportation, trans- Transportation. Transportation. mitting, pursuant to law, the report of a rule EC–9531. A communication from the Pro- EC–9540. A communication from the Pro- entitled ‘‘Fees for FAA Services for Certain gram Analyst, Federal Aviation Administra- gram Analyst, Federal Aviation Administra- Flights; interim final rule with request for tion, Department of Transportation, trans- tion, Department of Transportation, trans- comments; notice of public meeting; docket mitting, pursuant to law, the report of a rule mitting, pursuant to law, the report of a rule no. FAA–00–7018;’’ (RIN2120–AG17 (2000–0001)) entitled ‘‘Airworthiness Directives: Boeing entitled ‘‘Establishment of Class D Airspace; received on June 8, 2000; to the Committee Model 767 Series Airplanes; docket no. 2000– Jackson, WY, Establishment of effective on Commerce, Science, and Transportation. NM–138 [6–13/6–15]’’ (RIN2120–AA64 (2000–0327)) date; docket no. 99–ANM–11 [5–22/6/15]]’’ EC–9523. A communication from the Pro- received on June 15, 2000; to the Committee (RIN2120–AA66 (2000–0123)) received on June gram Analyst, Federal Aviation Administra- on Commerce, Science, and Transportation. 15, 2000; to the Committee on Commerce, tion, Department of Transportation, trans- EC–9532. A communication from the Pro- Science, and Transportation. mitting, pursuant to law, the report of a rule gram Analyst, Federal Aviation Administra- EC–9541. A communication from the Pro- entitled ‘‘Prohibition of Smoking on Sched- tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- uled Passenger Flights; Docket No. FAA– mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- 2000–7467 [6/9–6/8]’’ (RIN2120–AH04) received entitled ‘‘Airworthiness Directives: Airbus mitting, pursuant to law, the report of a rule on June 8, 2000; to the Committee on Com- Model A320–232 and 233 Series Airplanes; entitled ‘‘Modification and Revocation of merce, Science, and Transportation. docket no. 2000–NM–22 [6–13/6–15]’’ (RIN2120– VOR and Colored Federal Airways and Jet EC–9524. A communication from the Pro- AA64 (2000–0328)) received on June 15, 2000; to Routes; AK; docket No. 98–AAL–26 [6–6/6–15]’’ gram Analyst, Federal Aviation Administra- the Committee on Commerce, Science, and (RIN2120–AA66 (2000–0135)) received on June tion, Department of Transportation, trans- Transportation. 15, 2000; to the Committee on Commerce, mitting, pursuant to law, the report of a rule EC–9533. A communication from the Pro- Science, and Transportation. entitled ‘‘Airworthiness Directives: gram Analyst, Federal Aviation Administra- EC–9542. A communication from the Pro- Eurocopter France Model AS332L2 Heli- tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- copters; docket no. 99–SW82 [6–14/6–15]’’ mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- (RIN2120–AA64 (2000–0320)) received on June entitled ‘‘Airworthiness Directives: Airbus mitting, pursuant to law, the report of a rule 15, 2000; to the Committee on Commerce, Model A300, A310 and A300–600 Series Air- entitled ‘‘Amendment to Class E Airspace; Science, and Transportation. planes; docket no. 99–NM–128 [6–13/6–15]’’ Orange City, IA; Correction; docket No. 00– EC–9525. A communication from the Pro- (RIN2120–AA64 (2000–0329)) received on June ACE–9 [6–9/6–15]’’ (RIN2120–AA66 (2000–0136)) gram Analyst, Federal Aviation Administra- 15, 2000; to the Committee on Commerce, received on June 15, 2000; to the Committee tion, Department of Transportation, trans- Science, and Transportation. on Commerce, Science, and Transportation. EC–9534. A communication from the Pro- EC–9543. A communication from the Pro- mitting, pursuant to law, the report of a rule gram Analyst, Federal Aviation Administra- gram Analyst, Federal Aviation Administra- entitled ‘‘Airworthiness Directives: GE CF6– tion, Department of Transportation, trans- tion, Department of Transportation, trans- 45/50 Series Turbofan Engines; docket no. 98– mitting, pursuant to law, the report of a rule mitting, pursuant to law, the report of a rule ANE–32 [6–13/6–15]’’ (RIN2120–AA64 (2000– entitled ‘‘Airworthiness Directives: Airbus entitled ‘‘Establishment of Class E Airspace; 0321)) received on June 15, 2000; to the Com- Model A319, A320 and A321 Series Airplanes; Yukon-Kuskokwim Delta, Alaska; docket mittee on Commerce, Science, and Transpor- docket no. 2000–NM–139’’ (RIN2120–AA64 No. 99–AAL–24 [6–13/6–15]’’ (RIN2120–AA66 tation. (2000–0330)) received on June 15, 2000; to the (2000–0137)) received on June 15, 2000; to the EC–9526. A communication from the Pro- Committee on Commerce, Science, and Committee on Commerce, Science, and gram Analyst, Federal Aviation Administra- Transportation. Transportation. tion, Department of Transportation, trans- EC–9535. A communication from the Pro- EC–9544. A communication from the Pro- mitting, pursuant to law, the report of a rule gram Analyst, Federal Aviation Administra- gram Analyst, Federal Aviation Administra- entitled ‘‘Airworthiness Directives: CFM tion, Department of Transportation, trans- tion, Department of Transportation, trans- International CFM56–2, 2A, 2B, 3, 3B, 3, 3C, 5, mitting, pursuant to law, the report of a rule mitting, pursuant to law, the report of a rule 5B, 5C, and 7B Series Turbofan Engines; entitled ‘‘Airworthiness Directives: Airbus entitled ‘‘Amendment to Time of Designa- docket no. 98–ANE–38 [6–13/6–15]’’ (RIN2120– Model A330 and A340 Series Airplanes; docket tion for Restricted Area R–7104, Vieques Is- AA64 (2000–0322)) received on June 15, 2000; to no. 2000–NM–53 [6–13/6–15]’’ (RIN2120–AA64 land, PR; docket No. 00–ASO–8 [6–13/6–15]’’ the Committee on Commerce, Science, and (2000–0331)) received on June 15, 2000; to the (RIN2120–AA66 (2000–0138)) received on June Transportation. Committee on Commerce, Science, and 15, 2000; to the Committee on Commerce, EC–9527. A communication from the Pro- Transportation. Science, and Transportation. gram Analyst, Federal Aviation Administra- EC–9536. A communication from the Pro- EC–9545. A communication from the Pro- tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- gram Analyst, Federal Aviation Administra- mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- tion, Department of Transportation, trans- entitled ‘‘Airworthiness Directives: British mitting, pursuant to law, the report of a rule mitting, pursuant to law, the report of a rule Aerospace Bae Model ATP Airplanes; docket entitled ‘‘Airworthiness Directives: Airbus entitled ‘‘Correction to Class E Airspace; Un- no. 99–NM–230 [6–13/6–15]’’ (RIN2120–AA64 Model A319, A320, and A321 Series Airplanes; alaska, AK; docket No. 99–AAL–18 [6–14/6–15]’’ (2000–0323)) received on June 15, 2000; to the docket No. 99–NM–331 [6–13/6–15]’’ (RIN2120– (RIN2120–AA66 (2000–0139)) received on June Committee on Commerce, Science, and AA64 (2000–0332)) received on June 15, 2000; to 15, 2000; to the Committee on Commerce, Transportation. the Committee on Commerce, Science, and Science, and Transportation. EC–9528. A communication from the Pro- Transportation. EC–9546. A communication from the Pro- gram Analyst, Federal Aviation Administra- EC–9537. A communication from the Pro- gram Analyst, Federal Aviation Administra- tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- tion, Department of Transportation, trans- mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- mitting, pursuant to law, the report of a rule entitled ‘‘Airworthiness Directives: bom- mitting, pursuant to law, the report of a rule entitled ‘‘Realignment of Jet Route; TX; bardier Model DHC–8–100 and 300 Series Air- entitled ‘‘Airworthiness Directives: Inter- docket No. 99–ASW–33 [6–14/6–15]’’ (RIN2120– planes; docket no. 98–NM–380 [6–13/6–15]’’ national Aero Engines AG V2500–A1/–A5/–D5 AA66 (2000–0140)) received on June 15, 2000; to (RIN2120–AA64 (2000–0324)) received on June series Turbofan Engines; docket No. 99–ANE– the Committee on Commerce, Science, and 15, 2000; to the Committee on Commerce, 45 [6–12/6–15]’’ (RIN2120–AA64 (2000–0333)) re- Transportation. Science, and Transportation. ceived on June 15, 2000 ; to the Committee on EC–9547. A communication from the Pro- EC–9529. A communication from the Pro- Commerce, Science, and Transportation. gram Analyst, Federal Aviation Administra- gram Analyst, Federal Aviation Administra- EC–9538. A communication from the Pro- tion, Department of Transportation, trans- tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- mitting, pursuant to law, the report of a rule mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- entitled ‘‘Airworthiness Directives: Pilatus entitled ‘‘Airworthiness Directives: Boeing mitting, pursuant to law, the report of a rule Aircraft Ltd. Models PC–12 and PC12/45; Model 747–400 and 747–200 and 300 Series Air- entitled ‘‘Standard Instrument Approach docket No. 99–CE–36 [6–2/6–12]’’ (RIN2120– planes powered by P & W Model PW4000 Se- Procedures; Miscellaneous Amendments (43); AA64 (2000–0302)) received on June 12, 2000; to ries Engines; docket no. 99–NM–208 [6–13/6– Amdt. No. 1996 [6–14/6–15]’’ (RIN2120–AA65 the Committee on Commerce, Science, and 15]’’ (RIN2120–AA64 (2000–0325)) received on (2000–0033)) received on June 15, 2000; to the Transportation. June 15, 2000; to the Committee on Com- Committee on Commerce, Science, and EC–9548. A communication from the Pro- merce, Science, and Transportation. Transportation. gram Analyst, Federal Aviation Administra- EC–9530. A communication from the Pro- EC–9539. A communication from the Pro- tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- gram Analyst, Federal Aviation Administra- mitting, pursuant to law, the report of a rule June 29, 2000 CONGRESSIONAL RECORD — SENATE S6119 entitled ‘‘Airworthiness Directives: Air Trac- EC–9557. A communication from the Pro- docket no. 99–ANM–06 [6–2/6–12]’’ (RIN2120– tor Incorporated Model AT–301, AT–401, and gram Analyst, Federal Aviation Administra- AA65 (2000–0132)) received on June 12, 2000; to AT–501 Airplanes; docket No. 2000–CE–21 [6–2/ tion, Department of Transportation, trans- the Committee on Commerce, Science, and 6–12]’’ (RIN2120–AA64 (2000–0303)) received on mitting, pursuant to law, the report of a rule Transportation. June 12, 2000; to the Committee on Com- entitled ‘‘Airworthiness Directives: Boeing EC–9566. A communication from the Pro- merce, Science, and Transportation. Model 747 200, 300, and 400 Series Airplanes; gram Analyst, Federal Aviation Administra- EC–9549. A communication from the Pro- docket no. 99–NM–30 [6–1/6–12]’’ (RIN2120– tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- AA64 (2000–0313)) received on June 12, 2000; to mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- the Committee on Commerce, Science, and entitled ‘‘Realignment and Establishment of mitting, pursuant to law, the report of a rule Transportation. VOR Federal Airways, KY and TN; Docket entitled ‘‘Airworthiness Directives: Honey- EC–9558. A communication from the Pro- no. 97–ASO–18 [6–2/6–12]’’ (RIN2120–AA65 well International Inc. ALF502R and LF507; gram Analyst, Federal Aviation Administra- (2000–0133)) received on June 12, 2000; to the docket No. 99–NE–36 [6–5/6–12]’’ (RIN2120– tion, Department of Transportation, trans- Committee on Commerce, Science, and AA64 (2000–0304)) received on June 12, 2000; to mitting, pursuant to law, the report of a rule Transportation. the Committee on Commerce, Science, and entitled ‘‘Airworthiness Directives: Boeing EC–9567. A communication from the Pro- Transportation. Model 767 Series Airplanes; docket no. 98– gram Analyst, Federal Aviation Administra- EC–9550. A communication from the Pro- NM–316 [6–1/6–12]’’ (RIN2120–AA64 (2000–0314)) tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- received on June 12, 2000; to the Committee mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- on Commerce, Science, and Transportation. entitled ‘‘Modification of the San Francisco mitting, pursuant to law, the report of a rule EC–9559. A communication from the Pro- Class B Airspace Area; CA; docket no. 97– entitled ‘‘Airworthiness Directives: Boeing gram Analyst, Federal Aviation Administra- AWA–1 [6–7/6–12]’’ (RIN2120–AA66 (2000–0134)) Model 777–200 Series Airplanes; docket No. tion, Department of Transportation, trans- received on June 12, 2000; to the Committee 99–NM–307 [6–5/6–12]’’ (RIN2120–AA64 (2000– mitting, pursuant to law, the report of a rule on Commerce, Science, and Transportation. 0305)) received on June 12, 2000; to the Com- entitled ‘‘Airworthiness Directives: Dassault EC–9568. A communication from the Pro- mittee on Commerce, Science, and Transpor- Model Falson 2000, Mystere–Falcon 900, Fal- gram Analyst, Federal Aviation Administra- tation. con 900EX, Fan Jet Falcon, Mystere–Falcon tion, Department of Transportation, trans- EC–9551. A communication from the Pro- 50, Mystere–Falcon 20, and Mystere–Falcon mitting, pursuant to law, the report of a rule gram Analyst, Federal Aviation Administra- 200 Series Airplanes–docket no. 2000–NM–109 entitled ‘‘IFR Altitudes; Miscellaneous tion, Department of Transportation, trans- [6–1/6–12]’’ (RIN2120–AA64 (2000–0315)) received Amendments (34); Amdt. no. 422 [5–9/5–25]’’ mitting, pursuant to law, the report of a rule on June 12, 2000; to the Committee on Com- (RIN2120–AA63 (2000–0003)) received on May entitled ‘‘Airworthiness Directives: merce, Science, and Transportation. 25, 2000; to the Committee on Commerce, Eurocopter France Model SA 365N1, AS EC–9560. A communication from the Pro- Science, and Transportation. EC–9569. A communication from the Pro- 365N2, and SA 366G1 Helicopters; docket No. gram Analyst, Federal Aviation Administra- gram Analyst, Federal Aviation Administra- 99–SW–45 [6–7/6–12]’’ (RIN2120–AA64 (2000– tion, Department of Transportation, trans- tion, Department of Transportation, trans- 0306)) received on June 12, 2000; to the Com- mitting, pursuant to law, the report of a rule mitting, pursuant to law, the report of a rule mittee on Commerce, Science, and Transpor- entitled ‘‘Airworthiness Directives: entitled ‘‘Airworthiness Directives: Boeing tation. Eurocopter France Model SA–365C, C1, C2, N, Model 747–400 Series Airplanes; docket no. EC–9552. A communication from the Pro- and N1; AS 365N2 and N3; and SA366G1 Heli- 2000–NM–75 [5–24/5–25]]’’ (RIN2120–AA64 (2000– gram Analyst, Federal Aviation Administra- copters; Docket no. 99–SW–62 [6–1/6–12]’’ 0270)) received on May 25, 2000; to the Com- tion, Department of Transportation, trans- (RIN2120–AA64 (2000–0316)) received on June mittee on Commerce, Science, and Transpor- mitting, pursuant to law, the report of a rule 12, 2000; to the Committee on Commerce, tation. entitled ‘‘Airworthiness Directives: Ayres Science, and Transportation. EC–9570. A communication from the Pro- Corp S2R Series and Model 600 S2D Air- EC–9561. A communication from the Pro- gram Analyst, Federal Aviation Administra- planes; docket No. 98–CE–56 [6–7/6–12]’’ gram Analyst, Federal Aviation Administra- tion, Department of Transportation, trans- (RIN2120–AA64 (2000–0308)) received on June tion, Department of Transportation, trans- mitting, pursuant to law, the report of a rule 12, 2000; to the Committee on Commerce, mitting, pursuant to law, the report of a rule entitled ‘‘Airworthiness Directives: Airbus Science, and Transportation. entitled ‘‘Airworthiness Directives: Fokker Model A300, B2, A300B2K, A300 B4–2C, A300 EC–9553. A communication from the Pro- Model F28, Mark 1000, 2000, 3000, and 4000 Se- Br–100, and A300 B4–200 Series Airplanes; gram Analyst, Federal Aviation Administra- ries Airplanes docket no. 99–NM–358 [6–6/6– docket no. 98–NM–56 [5–24/5–25]]’’ (RIN2120– tion, Department of Transportation, trans- 12]’’ (RIN2120–AA64 (2000–0317)) received on AA64 (2000–0271)) received on May 25, 2000; to mitting, pursuant to law, the report of a rule June 12, 2000; to the Committee on Com- the Committee on Commerce, Science, and entitled ‘‘Airworthiness Directives: Lock- merce, Science, and Transportation. Transportation. heed Model L 1011 385 Series Airplanes; dock- EC–9562. A communication from the Pro- EC–9571. A communication from the Pro- et no. 98–NM–311 [6–7/6–12]’’ (RIN2120–AA64 gram Analyst, Federal Aviation Administra- gram Analyst, Federal Aviation Administra- (2000–0309)) received on June 12, 2000; to the tion, Department of Transportation, trans- tion, Department of Transportation, trans- Committee on Commerce, Science, and mitting, pursuant to law, the report of a rule mitting, pursuant to law, the report of a rule Transportation. entitled ‘‘Airworthiness Directives: Rolls entitled ‘‘Airworthiness Directives: EC–9554. A communication from the Pro- Royce plc Rb211 Series Turbofan Engines; Eurocopter France Model As350B, BA, B1, B2, gram Analyst, Federal Aviation Administra- docket n. 94–ANE–16 [6–6/6–12]’’ (RIN2120– and D and Model AS355E, F, F1, F2, and N tion, Department of Transportation, trans- AA64 (2000–0318)) received on June 12, 2000; to Helicopters; Docket no. 99–SW–39 [5–22/5–25]]’’ mitting, pursuant to law, the report of a rule the Committee on Commerce, Science, and (RIN2120–AA64 (2000–0273)) received on May entitled ‘‘Airworthiness Directives: Allison Transportation. 25, 2000; to the Committee on Commerce, Engine Company AE3007A and AE 3007C Se- EC–9563. A communication from the Pro- Science, and Transportation. ries Turbofan Engines; docket no. 99–NE–07 gram Analyst, Federal Aviation Administra- EC–9572. A communication from the Pro- [6–8/6–12]’’ (RIN2120–AA64 (2000–0310)) received tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- on June 12, 2000; to the Committee on Com- mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- merce, Science, and Transportation. entitled ‘‘Standard Instrument Approach mitting, pursuant to law, the report of a rule EC–9555. A communication from the Pro- Procedures; Miscellaneous Amendments (49); entitled ‘‘Airworthiness Directives: gram Analyst, Federal Aviation Administra- Amdt. 1994 [6–2/6–12]’’ (RIN2120–AA65 (2000– Eurocopter France Model AS350B, BA, B1, tion, Department of Transportation, trans- 0030)) received on June 12, 2000; to the Com- B2, B3, and AS355E, F, F1, F2, and N Heli- mitting, pursuant to law, the report of a rule mittee on Commerce, Science, and Transpor- copters; docket no. 99–SW–36 [5–22/5–25]]’’ entitled ‘‘Airworthiness Directives: Airbus tation. (RIN2120–AA64 (2000–0274)) received on May Model A319, A320, and A321 Series Airplanes; EC–9564. A communication from the Pro- 25, 2000; to the Committee on Commerce, docket no. 99–NM–343 [6–1/6–12]’’ (RIN2120– gram Analyst, Federal Aviation Administra- Science, and Transportation. AA64 (2000–0311)) received on June 12, 2000; to tion, Department of Transportation, trans- EC–9573. A communication from the Pro- the Committee on Commerce, Science, and mitting, pursuant to law, the report of a rule gram Analyst, Federal Aviation Administra- Transportation. entitled ‘‘Standard Instrument Approach tion, Department of Transportation, trans- EC–9556. A communication from the Pro- Procedures; Miscellaneous Amendments (72); mitting, pursuant to law, the report of a rule gram Analyst, Federal Aviation Administra- Amdt. 1993 [6–2/6–12]’’ (RIN2120–AA65 (2000– entitled ‘‘Airworthiness Directives: Bell Hel- tion, Department of Transportation, trans- 0031)) received on June 12, 2000; to the Com- icopter Textron Canda Model 222, 222B, 222U, mitting, pursuant to law, the report of a rule mittee on Commerce, Science, and Transpor- and 230 Helicopters; docket no. 99–SW–43 [5– entitled ‘‘Airworthiness Directives: Boeing tation. 22/5–25]]’’ (RIN2120–AA64 (2000–0275)) received Model 747 and 767 Series Airplanes Powered EC–9565. A communication from the Pro- on May 25, 2000; to the Committee on Com- by GE Model CF6 80C2 Series Engines; docket gram Analyst, Federal Aviation Administra- merce, Science, and Transportation. no. 99–NM–228 [6–1/6–12]’’ (RIN2120–AA64 tion, Department of Transportation, trans- EC–9574. A communication from the Pro- (2000–0312)) received on June 12, 2000; to the mitting, pursuant to law, the report of a rule gram Analyst, Federal Aviation Administra- Committee on Commerce, Science, and entitled ‘‘Changing Using Agency for Re- tion, Department of Transportation, trans- Transportation. stricted Area R2602 Colorado Springs, CO; mitting, pursuant to law, the report of a rule S6120 CONGRESSIONAL RECORD — SENATE June 29, 2000 entitled ‘‘Airworthiness Directives: Israel EC–9583. A communication from the Pro- Committee on Commerce, Science, and Aircraft Industries Ltd Model 1124 and 1124A gram Analyst, Federal Aviation Administra- Transportation. Westwind Airplanes; docket no. 2000–NM–42 tion, Department of Transportation, trans- EC–9592. A communication from the Pro- [5–22/5–25]]’’ (RIN2120–AA64 (2000–0276)) re- mitting, pursuant to law, the report of a rule gram Analyst, Federal Aviation Administra- ceived on May 25, 2000; to the Committee on entitled ‘‘Airworthiness Directives: tion, Department of Transportation, trans- Commerce, Science, and Transportation. EMBRAER Model EMB–145 Series Airplanes; mitting, pursuant to law, the report of a rule EC–9575. A communication from the Pro- docket no. 99–NM–305 [5–12/5–25]]’’ (RIN2120– entitled ‘‘Amendment to Class E Airspace; gram Analyst, Federal Aviation Administra- AA64 (2000–0285)) received on May 25, 2000; to Hampton, IA, direct final rule, request for tion, Department of Transportation, trans- the Committee on Commerce, Science, and comments; docket No. 00–ACE–7 [5–23/5–15]’’ mitting, pursuant to law, the report of a rule Transportation. (RIN2120–AA66 (2000–0122)) received on May entitled ‘‘Airworthiness Directives: Gulf- EC–9584. A communication from the Pro- 25, 2000; to the Committee on Commerce, stream Model G–159 Series Airplanes; docket gram Analyst, Federal Aviation Administra- Science, and Transportation. no. 99–NM–138 [5–22/5–25]]’’ (RIN2120–AA64 tion, Department of Transportation, trans- EC–9593. A communication from the Pro- (2000–0277)) received on May 25, 2000; to the mitting, pursuant to law, the report of a rule gram Analyst, Federal Aviation Administra- Committee on Commerce, Science, and entitled ‘‘Airworthiness Directives: McDon- tion, Department of Transportation, trans- Transportation. nell Douglas Model DC–10–10, –15, –30, –30F, mitting, pursuant to law, the report of a rule EC–9576. A communication from the Pro- and –40 Series Airplanes and KC–10A Air- entitled ‘‘Establishment of Class D Airspace; gram Analyst, Federal Aviation Administra- planes; docket no. 99–NM–212 [5–12/5–25]]’’ Jackson WY, delay of effective date; docket tion, Department of Transportation, trans- (RIN2120–AA64 (2000–0286)) received on May No. 99–ANM–11 [5–22/5–25]’’ (RIN2120–AA66 mitting, pursuant to law, the report of a rule 25, 2000; to the Committee on Commerce, (2000–0123)) received on May 25, 2000; to the entitled ‘‘Airworthiness Directives: MD Heli- Science, and Transportation. Committee on Commerce, Science, and copters Inc Model MD900 Helicopters; docket EC–9585. A communication from the Pro- Transportation. no. 2000–SW–04 [5–17/5–25]]’’ (RIN2120–AA64 gram Analyst, Federal Aviation Administra- EC–9594. A communication from the Pro- (2000–0278)) received on May 25, 2000; to the tion, Department of Transportation, trans- gram Analyst, Federal Aviation Administra- Committee on Commerce, Science, and mitting, pursuant to law, the report of a rule tion, Department of Transportation, trans- Transportation. entitled ‘‘Airworthiness Directives: mitting, pursuant to law, the report of a rule EC–9577. A communication from the Pro- Raytheon (Beech) Model 400A and 400T Series entitled ‘‘Passenger Facility Charges; Dock- gram Analyst, Federal Aviation Administra- Airplanes; docket no. 99–NM–372 [5–12/5–25]]’’ et No. FAA–2000–7402 [5–30/5–25]’’ (RIN2120– tion, Department of Transportation, trans- (RIN2120–AA64 (2000–0287)) received on May AH05)) received on May 25, 2000; to the Com- mitting, pursuant to law, the report of a rule 25, 2000; to the Committee on Commerce, mittee on Commerce, Science, and Transpor- entitled ‘‘Airworthiness Directives: McDon- Science, and Transportation. tation. nell Douglas Model DC–10 Series Airplanes; EC–9586. A communication from the Pro- EC–9595. A communication from the Pro- docket no. 99–NM–213 [5–17/5–25]]’’ (RIN2120– gram Analyst, Federal Aviation Administra- gram Analyst, Federal Aviation Administra- AA64 (2000–0279)) received on May 25, 2000; to tion, Department of Transportation, trans- tion, Department of Transportation, trans- the Committee on Commerce, Science, and mitting, pursuant to law, the report of a rule mitting, pursuant to law, the report of a rule Transportation. entitled ‘‘Airworthiness Directives: Airbus entitled ‘‘Airworthiness Directives: EC–9578. A communication from the Pro- Model A319, A320, A321, A330, and A340 Series Eurocopter France Model SA–365N, AS– gram Analyst, Federal Aviation Administra- Airplanes; docket no. 99–NM–103 [5–15/5–25]]’’ 365N1, AS–365N2 and AS–365N3 Helicopters; tion, Department of Transportation, trans- (RIN2120–AA64 (2000–0288)) received on May docket No. 99–SW–86 [5–22/5–25]’’ (RIN2120– mitting, pursuant to law, the report of a rule 25, 2000; to the Committee on Commerce, AA64 (2000–0272)) received on May 25, 2000; to entitled ‘‘Airworthiness Directives: Science, and Transportation. the Committee on Commerce, Science, and Eurocopter France Model SA365N1, AS365N2, EC–9587. A communication from the Pro- Transportation. and SA366G1 Helicopters; docket no. 99–SW– gram Analyst, Federal Aviation Administra- f 34 [5–17/5–25]]’’ (RIN2120–AA64 (2000–0280)) re- tion, Department of Transportation, trans- ceived on May 25, 2000; to the Committee on mitting, pursuant to law, the report of a rule REPORTS OF COMMITTEES Commerce, Science, and Transportation. entitled ‘‘Airworthiness Directives: British The following reports of committees EC–9579. A communication from the Pro- Aerospace Jetstream Model 3201 Airplanes; gram Analyst, Federal Aviation Administra- docket no. 99–CE–72 [5–15/5–25]]’’ (RIN2120– were submitted: tion, Department of Transportation, trans- AA64 (2000–0289)) received on May 25, 2000; to By Mr. WARNER, from the Committee on mitting, pursuant to law, the report of a rule the Committee on Commerce, Science, and Armed Services, with amendments: entitled ‘‘Airworthiness Directives: Transportation. S. 2507: An original bill to authorize appro- Eurocopter Deutschland CmbH Model EC 135 EC–9588. A communication from the Pro- priations for fiscal year 2001 for intelligence Helicopters; docket no. 99–SW–05 [5–17/5–25]]’’ gram Analyst, Federal Aviation Administra- and intelligence-related activities of the (RIN2120–AA64 (2000–0281)) received on May tion, Department of Transportation, trans- United States Government, the Community 25, 2000; to the Committee on Commerce, mitting, pursuant to law, the report of a rule Management Account, and the Central Intel- Science, and Transportation. entitled ‘‘Modification of Class D Airspace ligence Agency Retirement and Disability EC–9580. A communication from the Pro- for Rapid City, SD; Rapid City Ellsworth System, and for other purposes (Rept. No. gram Analyst, Federal Aviation Administra- AFB, SD; and Modification of Class E Air- 106–325). tion, Department of Transportation, trans- space; Rapid City, SD; docket no. 00–AGL–03 By Mr. HATCH, from the Committee on mitting, pursuant to law, the report of a rule [5–15/5–25]’’ (RIN2120–AA66 (2000–0118)) re- the Judiciary, without amendment: entitled ‘‘Airworthiness Directives: Lock- ceived on May 25, 2000; to the Committee on S. 869: A bill for the relief of Mina Vahedi heed Model L–1011 385 Airplanes; docket no. Commerce, Science, and Transportation. Notash. 99–NM–221 [5–12/5–25]]’’ (RIN2120–AA64 (2000– EC–9589. A communication from the Pro- S. 2413: A bill to amend the Omnibus Crime 0282)) received on May 25, 2000; to the Com- gram Analyst, Federal Aviation Administra- Control and Safe Streets Act of 1968 to clar- mittee on Commerce, Science, and Transpor- tion, Department of Transportation, trans- ify the procedures and conditions for the tation. mitting, pursuant to law, the report of a rule award of matching grants for the purchase of EC–9581. A communication from the Pro- entitled ‘‘Modification of Class E Airspace; armor vests. gram Analyst, Federal Aviation Administra- Yankton, SD; docket No. 98–AGL–78 [5–15/5– f tion, Department of Transportation, trans- 25]’’ (RIN2120–AA66 (2000–0119)) received on mitting, pursuant to law, the report of a rule May 25, 2000; to the Committee on Com- INTRODUCTION OF BILLS AND entitled ‘‘Airworthiness Directives: Airbus merce, Science, and Transportation. JOINT RESOLUTIONS Model A300–600 Series Airplanes; docket no. EC–9590. A communication from the Pro- The following bills and joint resolu- 99–NM–362 [5–12/5–25]]’’ (RIN2120–AA64 (2000– gram Analyst, Federal Aviation Administra- tions were introduced, read the first 0283)) received on May 25, 2000; to the Com- tion, Department of Transportation, trans- mittee on Commerce, Science, and Transpor- mitting, pursuant to law, the report of a rule and second times by unanimous con- tation. entitled ‘‘Modification of Class E Airspace; sent, and referred as indicated: EC–9582. A communication from the Pro- Ely, MN; docket No. 00–AGL–04 [5–25/5–15]’’ By Mr. HATCH (for himself, Mr. DODD, gram Analyst, Federal Aviation Administra- (RIN2120–AA66 (2000–0120)) received on May Mrs. FEINSTEIN, Mr. DEWINE, Mr. tion, Department of Transportation, trans- 25, 2000; to the Committee on Commerce, KOHL, Mr. FEINGOLD, and Mr. KEN- mitting, pursuant to law, the report of a rule Science, and Transportation. NEDY): entitled ‘‘Airworthiness Directives: Boeing EC–9591. A communication from the Pro- S. 2812. A bill to amend the Immigration Model 747–100, –200, 747Sp, & 747SR Series gram Analyst, Federal Aviation Administra- and Nationality Act to provide a waiver of Airplanes Equipped with Pratt & Whitney tion, Department of Transportation, trans- the oath of renunciation and allegiance for JT9D–7, –7A, –7F, and –7J Series Engines; mitting, pursuant to law, the report of a rule naturalization of aliens having certain dis- docket no. 99–NM–242 [5–12/5–25]]’’ (RIN2120– entitled ‘‘Modification and Establishment of abilities; to the Committee on the Judiciary. AA64 (2000–0284)) received on May 25, 2000; to Class D & E Airspace; Belleville, IL; docket By Mr. MCCAIN: the Committee on Commerce, Science, and No. 00–AGL–01 [5–15/5–25]’’ (RIN2120–AA66 S. 2813. A bill to provide for a land ex- Transportation. (2000–0121) received on May 25, 2000; to the change to fulfill the Federal obligation to June 29, 2000 CONGRESSIONAL RECORD — SENATE S6121 the State of Arizona under the State’s ena- S. 2823. A bill to amend the Andean Trade tional policy toward the practice of shark- bling act, and to use certain Federal land in Preference Act to grant certain benefits with finning; to the Committee on Commerce, Arizona to acquire by eminent domain State respect to textile and apparel, and for other Science, and Transportation. trust land located adjacent to Federal land purposes; to the Committee on Finance. By Ms. SNOWE: for the purpose of improving public land By Mr. CLELAND (for himself, Mr. S. 2832. A bill to reauthorize the Magnu- management, enhancing the conservation of JOHNSON, Mr. WARNER, Mr. KERREY, son-Stevens Fishery Conservation and Man- unique natural areas, and fulfilling the pur- Mr. HAGEL, Mrs. MURRAY, Mr. agement Act, and for other purposes; to the poses for which State trust land is set aside, MCCAIN, Mr. ROBB, Ms. SNOWE, Mr. Committee on Commerce, Science, and and for other purposes; to the Committee on BIDEN, Mr. BURNS, Mr. GRAHAM, Mr. Transportation. Energy and Natural Resources. HELMS, Mr. EDWARDS, Mr. THURMOND, By Mr. DODD: By Mr. MCCONNELL: Mr. KOHL, Mr. DOMENICI, Mr. DURBIN, S. 2833. A bill to amend the Federal Elec- S. 2814. A bill to amend title XI of the So- Mr. MACK, Mr. TORRICELLI, Mr. SMITH tion Campaign Act of 1971 to improve the en- cial Security Act to direct the Commissioner of Oregon, Ms. LANDRIEU, Mr . SHEL- forcement capabilities of the Federal Elec- of Social Security to conduct outreach ef- BY, Mrs. LINCOLN, Mr. GRASSLEY, Mr. tion Commission, and for other purposes; to forts to increase awareness of the avail- REED, Mr. ALLARD, Mr. KERRY, Mr. the Committee on Rules and Administration. ability of medicare cost-sharing assistance INHOFE, Mr. LAUTENBERG, Mr. HATCH, f to eligible low-income medicare bene- Mrs. BOXER, Mr. BENNETT, Mr. LEVIN, ficiaries; to the Committee on Finance. Mr. JEFFORDS, Mr. BAUCUS, Mr. L. SUBMISSION OF CONCURRENT AND By Mr. CLELAND (for himself and Ms. CHAFEE, Mr. REID, Mr. SMITH of New SNOWE): SENATE RESOLUTIONS Hampshire, Mr. DASCHLE, Mr. COVER- S. 2815. A bill to provide for the nationwide DELL, Mr. BYRD, Mr. CRAIG, Mr. The following concurrent resolutions designation of 2-1-1 as a toll-free telephone WELLSTONE, Mr. ABRAHAM, Mr. FEIN- and Senate resolutions were read, and number for access to information and refer- GOLD, Mrs. HUTCHISON, Mr. SCHUMER, referred (or acted upon), as indicated: rals on human services, to encourage the de- Mr. CAMPBELL, Mr. DORGAN, Mr. ployment of the toll-free telephone number, By Mr. INHOFE: COCHRAN, Mr. CONRAD, Ms. COLLINS, and for other purposes; to the Committee on S. Res. 330. A resolution designating the Mr. HOLLINGS, Mr. KYL, Mr. ROCKE- Commerce, Science, and Transportation. week beginning September 24, 2000, as ‘‘Na- FELLER, Mr. FRIST, Ms. MIKULSKI, Mr. By Mr. GRAHAM (for himself, Mr. tional Amputee Awareness Week’’; to the SANTORUM, Mrs. FEINSTEIN, Mr. AKAKA, Mr. L. CHAFEE, and Mr. Committee on the Judiciary. AKAKA, Mr. BAYH, Mr. LIEBERMAN, MCCAIN): By Mr. LOTT (for himself and Mr. S. 2816. A bill to provide the financial Mr. BRYAN, Mr. LEAHY, Mr. BINGA- DASCHLE): mechanisms, resource protections, and pro- MAN, and Mr. WYDEN): S. Res. 331. A resolution to authorize testi- fessional skills necessary for high quality S. 2824. A bill to authorize the President to mony, document production, and legal rep- stewardship of the National Park System, to award a gold medal on behalf of Congress to resentation in United States v. Ellen Rose commemorate the heritage of people of the General Wesley K. Clark, United States Hart; considered and agreed to. Army, in recognition of his outstanding lead- United States to invest in the legacy of the f National Park System, and to recognize the ership and service during the military oper- importance of high quality outdoor rec- ations against the Federal Republic of Yugo- STATEMENTS ON INTRODUCED slavia (Serbia and Montenegro); to the Com- reational opportunities on federally man- BILLS AND JOINT RESOLUTIONS aged land; to the Committee on Energy and mittee on Banking, Housing, and Urban Af- Natural Resources. fairs. By Mr. HATCH (for himself, Mr. By Mr. GRAHAM (for himself and Mr. By Mr. ROCKEFELLER (for himself, DODD, Mrs. FEINSTEIN, Mr. GORTON): Mr. JEFFORDS, and Mr. BREAUX): DEWINE, Mr. KOHL, Mr. FEIN- S. 2825. A bill to strengthen the effective- S. 2817. A bill to authorize the Secretary of GOLD, and Mr. KENNEDY): the Interior and the Secretary of Agriculture ness of the earned income tax credit in re- ducing child poverty and promoting work; to S. 2812. A bill to amend the Immigra- to establish permanent recreation fee au- tion and Nationality Act to provide a thority; to the Committee on Energy and the Committee on Finance. Natural Resources. By Mr. SANTORUM (for himself and waiver of the oath of renunciation and By Mr. JOHNSON: Mr. ROCKEFELLER): allegiance for naturalization of aliens S. 2818. A bill to amend the Agricultural S. 2826. A bill to amend title XVIII of the having certain disabilities; to the Com- Market Transition Act to establish a flexible Social Security Act to provide for coverage mittee on the Judiciary. fallow program under which a producer may of substitute adult day care services under WAIVER OF OATH OF RENUNCIATION AND ALLE- idle a portion of the total planted acreage of the medicare program; to the Committee on GIANCE FOR NATURALIZATION OF ALIENS HAV- the loan commodities of the producer in ex- Finance. ING CERTAIN DISABILITIES change for higher loan rates for marketing By Mr. ALLARD: assistance loans on the remaining acreage of S. 2827. A bill to provide for the convey- ∑ Mr. HATCH. Mr. President, I rise the producer; to the Committee on Agri- ance of the Department of Veterans Affairs today with my colleagues, Senator culture, Nutrition, and Forestry. Medical Center at Ft. Lyon, Colorado, to the CHRISTOPHER DODD and others, to in- By Mr. REED (for himself and Mr. JEF- State of Colorado, and for other purposes; to troduce a simple but highly significant FORDS): the Committee on Veterans’ Affairs. bill which will confer the treasured sta- By Mr. GRASSLEY (for himself, Mr. S. 2819. To provide for the establishment of tus of American citizenship on individ- an assistance program for health insurance CONRAD, Mr. SHELBY, Mr. BAUCUS, consumers; to the Committee on Health, Mr. THOMAS, and Mr. COCHRAN): uals with disabilities. Education, Labor, and Pensions. S. 2828. A bill to amend title XVIII of the Under current law, the Attorney Gen- By Mr. HOLLINGS (by request): Social Security Act to require that the Sec- eral possesses the authority to waive S. 2820. A bill to provide for a public inter- retary of Health and Human Services wage certain requirements of naturalization, est determination by the Consumer Product adjust the actual, rather than the estimated, such as the English and civics test re- Safety Commission with respect to repair, proportion of a hospital’s costs that are at- quirements, for disabled applicants. tributable to wages and wage-related costs; replacement, or refund actions, and to revise The law, however, has been construed the civil and criminal penalties, under both to the Committee on Finance. the Consumer Product Safety Act and the By Mr. HUTCHINSON (for himself, Mr. to stop short of granting the Attorney Federal Hazardous Substances Act; to the LOTT, Mr. NICKLES, Mr. GREGG, Mr. General authority to waive the require- Committee on Commerce, Science, and GORTON, Mr. COVERDELL, and Mr. ment for the oath of renunciation and Transportation. INHOFE): allegiance for disabled adult appli- By Mr. DODD: S. 2829. A bill to provide of an investiga- cants. S. 2821. A bill to amend chapter 84 of title tion and audit at the Department of Edu- Consequently, even though such per- 5, United States Code, to make certain tem- cation; to the Committee on Health, Edu- porary Federal service performed for the cation, Labor, and Pensions. sons are able to fulfill all other re- Federal Deposit Insurance Corporation cred- By Mr. LEAHY (for himself and Mr. quirements of naturalization, or it is itable for retirement purposes; to the Com- FEINGOLD): clear that the Attorney General can mittee on Governmental Affairs. S. 2830. A bill to preclude the admissibility waive them, certain individuals with By Mrs. FEINSTEIN: of certain confessions in criminal cases; to disabilities may never become citizens. S. 2822. A bill for the relief of Denes and the Committee on the Judiciary. This is the sad situation that a young Gyorgyi Fulop; to the Committee on the Ju- By Mr. KERRY (for himself and Mr. man from my home state of Utah is diciary. HOLLINGS): By Mr. GRAHAM (for himself, Mr. S. 2831. A bill to amend the Magnuson-Ste- facing. Gustavo Galvez Letona, a 27 DEWINE, Mr. MOYNIHAN, Mr. GRASS- vens Fishery Conservation and Management year-old immigrant from Guatemala, LEY, Mr. DODD, Mr. COVERDELL, and Act to improve conservation and manage- suffers from Down’s syndrome. Mr. Mr. BIDEN): ment of sharks and establish a consistent na- Letona’s entire family are already S6122 CONGRESSIONAL RECORD — SENATE June 29, 2000 American citizens. But, while Mr. viduals who applied for naturalization be- are unable to learn from taking the Letona is otherwise able to become a fore, on, or after the date of enactment of English and civics tests. Unfortu- citizen, despite his developmental dis- this Act.∑ nately, these efforts have not effec- ability, the fact that the Attorney Mr. DODD. Mr. President, I rise with tively addressed the problem of indi- General’s authority to waive the oath Senator HATCH, Senator FEINGOLD, viduals who are unable to take the is unclear will prevent Mr. Letona from Senator KENNEDY, Senator DEWINE, oath because of mental incapacity, enjoying the same status as a natural- Senator FEINSTEIN, and Senator KOHL leaving the oath as the only barrier to ized American citizen. to introduce a bill to resolve a rare but citizenship for such individuals. Imagine a family in which mother, serious problem for some American The legislation we introduce today father, brothers and sisters could be- families. would amend the Immigration and Na- come U.S. citizens, but one sibling I want to tell you a story about a tionality Act to give the INS the dis- could not only because of a disability. young man named Mathieu, a resident cretion to waive the oath of allegiance I believe all my colleagues would agree of Connecticut. Mathieu’s family—his for certain individuals who lack the that this would be a sad and tragic sit- mother, his father, and his sister—have mental capacity to comprehend the uation. It is discriminatory to boot. all become naturalized U.S. citizens. oath. This bill would not affect a large But Mathieu has not been allowed to Waiving the oath is really a technical number of people. A recent estimate become a citizen because he’s a 23- amendment. There is no indication was that only about 1100 individuals year-old low-functioning autistic man that Congress ever intended to split up with disabilities would possibly be eli- who cannot meet a very technical re- families or cast doubt on the futures of gible for such a waiver. Moreover, I quirement of the naturalization proc- family members not able to utter the used the word ‘‘possibly’’ because the ess, namely that he be able to swear an oath by virtue of a mental disability. oath of loyalty to the United States. waiver would not be automatic. The Waiving the oath does not defeat the His naturalization request has been in waiver would be granted at the discre- purpose of Naturalization or the oath limbo since November of 1996 because tion of the Attorney General and is not requirement. Individuals with disabil- Mathieu could not understand some of intended to confer citizenship on indi- ities who receive oath waivers would the questions he was asked by the INS viduals—regardless of a disability—who still have to fulfill the other require- agent processing his application for would not otherwise qualify for citizen- ments of naturalization, including good citizenship. All of the other members ship. It would not apply to every indi- moral character and residency. Re- of Mathieu’s family have become U.S. vidual with a disability, most of whom member the main purpose of the oath citizens. Now Mathieu’s mother lives would not need such a waiver. requirement is to prevent the natu- Today’s legislation remedies this un- with the fear that when she dies her ralization of people who are hostile to fortunate scenario facing Gustavo most vulnerable child could be re- the government of the United States, Letona by extending the Attorney Gen- moved from the country and sent to a or the principles of the Constitution. eral’s authority to waive the taking of nation that he hardly knows, and People with severe disabilities who the oath if the applicant is unable to where he has no family and no friends. lack the capacity to understand the understand or communicate an under- Mathieu’s mother—again, an American oath cannot form the intent to act standing of the oath because of dis- citizen—wants what every American against the government. Waiving the ability. This simple solution allows Mr. wants—she wants to know that her oath poses no danger and manifests Letona and others the privilege of be- child will be treated fairly by her gov- America’s best, most compassionate coming American citizens. ernment even when she’s no longer ca- characteristics. I would like to express my gratitude pable of taking care of him herself. to Senator DODD for his willingness to Mathieu’s life is here. His friends and Let me conclude by saying that this make this a bipartisan effort. I would caregivers are here. His family is here. is not a problem that faces millions of also like to thank my Utah Advisory Mathieu’s place is here and but for his people—or even many thousands of Committee on Disability Policy, and disability, he would be allowed to stay people, but it is an important issue for particularly Ron Gardner, who brought here where he belongs. He would be al- the few families that are affected. Mr. this problem to my attention and who lowed to become a citizen and his President the United States should not works tirelessly to protect the rights mother’s fears would be relieved. Mr. force the break up of families. This bill of the disabled. President, this is a problem that a will right an injustice and I urge its I ask unanimous consent that the compassionate nation can fix. This is a passage. text of the bill be placed in the RECORD problem that we have the power to By Mr. MCCAIN: following my remarks. solve. There being no objection, the bill was Under current law, a very small sub- S. 2813. A bill to provide for a land ordered to be printed in the RECORD, as group of people with severe mental dis- exchange to fulfill the Federal obliga- follows: abilities cannot become citizens be- tion to the State of Arizona under the S. 2812 cause they lack the capacity to take State’s enabling act, and to use certain Be it enacted by the Senate and House of Rep- the oath of renunciation and alle- Federal land in Arizona to acquire by resentatives of the United States of America in giance. Since the Immigration and Na- eminent domain State trust land lo- Congress assembled, tionality Act (INA) does not contain cated adjacent to Federal land for the SECTION 1. WAIVER OF OATH OF RENUNCIATION explicit statutory authority for the Im- purpose of improving public land man- AND ALLEGIANCE FOR NATURALIZA- agement, enhancing the conservation TION OF ALIENS HAVING CERTAIN migration and Naturalization Service DISABILITIES. (INS) to waive the oath, people with of unique natural areas, and fulfilling (a) IN GENERAL.—The last sentence of sec- brain injuries and other mental disabil- the purposes for which State trust land tion 337(a) of the Immigration and Nation- ities are routinely denied citizenship— is set aside, and for other purposes; to ality Act (8 U.S.C. 1448(a)) is amended to even when the rest of their families are the Committee on Energy and Natural read as follows: ‘‘The Attorney General may already U.S. citizens. Resources. waive the taking of the oath if in the opinion Congress has previously recognized THE ARIZONA LAND EXCHANGE FACILITATION of the Attorney General the applicant for ACT OF 2000 naturalization is an individual with a dis- the injustice of denying citizenship to ability, or a child, who is unable to under- individuals based on their disabilities Mr. MCCAIN. Mr. President, I rise to stand or communicate an understanding of and has attempted to resolve the prob- introduce legislation that authorizes the meaning of the oath. If the Attorney lem. In fact, in 1991 Congress created a the Secretary of the U.S. Department General waives the oath for such an indi- procedure for expedited administration of Interior and the Governor of Arizona vidual, the individual shall be considered to of the oath for applicants who have to carry out a federal-state land ex- have met the requirements of section special circumstances, including dis- change in order to protect environ- 316(a)(3) as to attachment to the Constitu- abilities, that prevent them from per- mentally significant lands in the state tion and well disposition to the United States.’’. sonally appearing at a scheduled cere- and enhance the state education trust (b) EFFECTIVE DATE.—The amendment mony. And in 1994, Congress exempted fund to benefit Arizona’s school- made by subsection (a) shall apply to indi- certain applicants with disabilities who children. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6123 I must first make mention that Inte- to reduce the number of state (3) while the State has recognized that cer- rior Secretary Bruce Babbitt and Gov- inholdings on federal property and tain State trust land is of unique and signifi- ernor Jane Hull of Arizona are cur- vice-versa—a situation that com- cant value and ought to be conserved as open rently involved in negotiating a com- plicates resource management and does space to benefit future generations, while en- suring that there is a higher benefit to pub- prehensive state-federal land exchange not serve the public interest. This leg- lic schools and other trust beneficiaries, agreement. The Secretary and the Gov- islation could be an important step for- there is no mechanism currently available to ernor have been engaged in land ex- ward in reducing state inholdings in the State to conserve such unique State change negotiations since January of federal land management areas which trust land; and this year, which so far have been very makes good environmental, economic (4) an exchange of certain Federal and productive and positive. If their nego- and administrative sense. State land in Arizona will provide for im- tiations are successful and a land trade Mr. President, let me make very proved land management by the Federal and is agreed upon, legislation will be nec- clear once again, this legislation is a State governments by exchanging certain State trust land that is of significant eco- essary to authorize that exchange. starting point only. It does not rep- resent by any means an endorsement of logical value for permanent protection for To express my strong support for a certain Federal land that is suitable for the potential exchange, I am introducing any particular lands for exchange that revenue generation mission of the State and this bill as a place holder for the nec- are currently under negotiation. Nor is other purposes identified by the State on be- essary authorization to implement any it my intention to fast-track any pro- half of its beneficiaries. agreement for a land exchange. This posal that does not abide by a fair and (b) PURPOSES.—The purposes of this Act legislation is in no way intended to strict appraisal process. It is intended are to improve manageability of Federal override or influence ongoing negotia- to encourage the Secretary and the public land and State trust land in the State, Governor to forward a serious proposal to promote the conservation of unique nat- tions, nor do I intend to force either ural areas, and to fulfill obligations to the party to accept a proposal that is not to the Congress for consideration. Once a proposal is forwarded, I have every beneficiaries of State trust land by providing in their best interests. for a land conveyance and a land exchange The purpose of this legislation is intention to consult with affected enti- between the Federal and State governments two-fold. One, it is simply a framework ties and engage in a thorough process under which— for a future agreement. It is intended of public input from local citizenry, (1) the Secretary of the Interior shall iden- to facilitate discussion to define the governments and other interested par- tify a pool of parcels of land that are vacant, necessary legislative authority to im- ties. unappropriated, unreserved, and suitable for plement a state-federal land exchange I also recognize that such land ex- disposal, so that the State may select Fed- changes do take time and it is very eral land that the Secretary shall convey to in Arizona. If the details of a land ex- the State to fulfill the State’s entitlement change are agreed upon between the possible that a land exchange proposal may not be finalized this year. My col- under the State’s enabling act; and Secretary and the Governor, those spe- (2) the Secretary shall acquire certain cifics can be incorporated into this leg- leagues from Arizona recall as well as I State trust land in the State by eminent do- islation. do that it took three years to negotiate main, with the consent of the State, in ex- The second purpose is to define the and enact the Arizona Desert Wilder- change for certain Federal land. necessary legislative language that ness Act of 1990 to preserve over two SEC. 3. DEFINITIONS. will accommodate existing Arizona million acres as designated wilderness. In this Act: Constitutional and Arizona Enabling We never would have accomplished (1) IN LIEU BASE LAND.—The term ‘‘in lieu Act restrictions that require state that feat without the front-line leader- base land’’ means land granted to the State trust lands to be managed for the ben- ship and vision of Mo Udall who initi- under section 25 of the Act of June 20, 1910 ated the process by offering a legisla- (36 Stat. 573). efit of education and other public pur- (2) SECRETARY.—The term ‘‘Secretary’’ poses. In addition, the bill recognizes tive framework. I believe that this op- portunity is one that Mo would have means the Secretary of the Interior. the important goal of resolving the fed- (3) STATE.—The term ‘‘State’’ means the eral government’s land ‘‘debt’’ to Ari- supported. I hope that my colleagues State of Arizona. zona as a result of not receiving the and friends in Arizona will agree and (4) STATE TRUST LAND.—The term ‘‘State state’s full allotment at statehood. that we can all work together on a trust land’’ means all right, title, and inter- This legislation proposes to use federal comprehensive land exchange proposal est of the State on the date of enactment of friendly-condemnation authority to ef- that will accomplish educational and this Act in and to— (A) land (including the mineral estate) fect other aspects of a comprehensive environmental objectives. Mr. President, I ask unanimous con- granted by the United States under sections exchange to address the current Ari- sent to include the full text of the bill 24 and 25 of the Act of June 20, 1910 (36 Stat. zona constitutional restriction on land 572, 573, chapter 310); and in the RECORD. trades. There being no objection, the bill was (B) land (including the mineral estate) In recent years, the people of Arizona owned by the State on the date of enactment ordered to be printed in the RECORD, as have embraced the idea of promoting of this Act that, under State law, is required follows: conservation as part of the state’s land to be managed for the benefit of the public S. 2813 management objectives. Through pub- school system or the institutions of the Be it enacted by the Senate and House of Rep- State designated under that Act. lic referenda and other proposals, the resentatives of the United States of America in SEC. 4. FULFILLMENT OF ENTITLEMENT UNDER people of Arizona have strongly sup- Congress assembled, THE ENABLING ACT. ported the concept of a state-wide ef- SECTION 1. SHORT TITLE. (a) IN GENERAL.—Not later than 60 days fort to conserve unique natural areas. This Act may be cited as the ‘‘Arizona after the date of enactment of this Act, the The federal-state land exchange cur- Land Exchange Facilitation Act of 2000’’. Secretary shall identify land under the juris- rently under discussion could ensure SEC. 2. FINDINGS AND PURPOSES. diction of the Secretary that— that ecologically important state lands (a) FINDINGS.—Congress finds that— (1) is vacant, unappropriated, and unre- are placed under permanent conserva- (1) when the State of Arizona entered the served; and tion protection as part of an existing Union, the State was granted more than (2) is suitable for disposal under land man- 9,000,000 acres of State trust land to be held agement plans in effect on the date of enact- federal land management unit. In re- in permanent trust to be managed on behalf ment of this Act. turn, the state would receive parcels of the beneficiaries of the trust, primarily (b) SELECTION.—Not later than 120 days currently owned by the federal govern- Arizona’s schoolchildren; after the date of enactment of this Act, the ment that may be more suitable for (2) the State is entitled to select additional State shall select land, identified by the Sec- revenue-generating activity in keeping land of a value that is approximately equal retary under subsection (a), of approxi- with the requirements of state law. to the value of 15,234 acres of in lieu base mately equal value (determined in accord- Such an exchange could accomplish land from vacant, unappropriated, and unre- ance with section 6) to the 15,234 acres of in both state conservation and education served Federal land to fulfill the entitlement lieu base land identified as base land de- arising from the Act of June 20, 1910 (36 Stat. picted on the map entitled ‘‘Arizona State goals. The opportunity to explore and 557, chapter 310), and the consent judgment Trust Base Lands Not Compensated by the effect a means of serving these two im- known as the ‘‘San Carlos Consent Judg- Federal Government’’ and dated llll. portant purposes should not be missed. ment’’ entered in State of Arizona v. Rogers (c) CONVEYANCE.—On final agreement be- In the past, some of my colleagues C.B. Morton, Court Document 74–696–PHX– tween the Secretary and the State under sec- and I have evaluated different options WPC (D. Ariz. (1978)); tion 7(a), the Secretary shall convey to the S6124 CONGRESSIONAL RECORD — SENATE June 29, 2000 State the land selected by the State under issue that arises in the appraisal process, the SEC. 9. LAS CIENEGAS STUDY. subsection (b). appraisal or appraisal issue shall be resolved (a) IN GENERAL.—Not later than 1 year SEC. 5. LAND EXCHANGE. in accordance with section 206(d)(2) of the after the date of enactment of this Act, the (a) CONVEYANCE BY THE SECRETARY OF FED- Federal Land Policy and Management Act of Secretary, in consultation with the State, ERAL LAND.— 1976 (43 U.S.C. 1716(d)(2)). shall— (1) IN GENERAL.—In exchange for the State (d) ADJUSTMENT TO ACHIEVE EQUAL (1) conduct a study of land values of all trust land acquired by the Secretary under VALUE.—After the values of the parcels of State trust land within the exterior bound- subsection (b), the Secretary shall convey to land are determined, the Secretary and the aries of the proposed conservation area the State Federal land described in para- State may— under the Las Cienegas National Conserva- graph (2) that is of a value that is approxi- (1) add or remove parcels to achieve a tion Area Establishment Act of 1999, H.R. mately equal to the value of the acquired package of equally valued Federal land and 2941, 106th Congress, in Pima County and State trust land, as determined under sec- State trust land; and Santa Cruz County, Arizona; and tion 6. (2) make public a list of the parcels in- (2) submit to Congress a recommendation (2) FEDERAL LAND.—The Federal land re- cluded in the package. on whether any such land should be acquired ferred to in paragraph (1) is land under the (e) EFFECT OF DETERMINATION.—A deter- by the Federal Government. jurisdiction of the Secretary and in the mination of the value of a parcel of land (b) CONTENTS.—The study shall include an State that the Secretary determines is avail- under this section shall serve to establish examination of possible forms of compensa- able for exchange under this Act. the value of the parcel or interest in land in tion for the State trust land within the pro- (b) ACQUISITION BY THE SECRETARY OF any eminent domain proceeding. posed Las Cienegas National Conservation (f) COSTS.—The costs of carrying out this STATE TRUST LAND.— Area, including— section shall be shared equally by the Sec- (1) IN GENERAL.—The Secretary shall— (1) cash payments; retary and the State. (A) on final agreement between the Sec- (2) Federal administrative sites under the retary and the State under section 7(a), ac- SEC. 7. CONVEYANCES OF TITLE. management of the Administrator of General quire by eminent domain the State des- (a) AGREEMENT.—The Secretary and the Services; ignated trust land described in paragraph (2); State shall enter into an agreement that (3) water rights; and and specifies the terms under which land and in- (4) relief from debt payment for the Cen- (B) manage the land in accordance with terests in land shall be conveyed under sec- tral Arizona Water Conservation District. paragraph (3). tions 4 and 5, consistent with this section. SEC. 10. AUTHORIZATION OF APPROPRIATIONS. (b) CONVEYANCES BY THE UNITED STATES.— (2) STATE TRUST LAND.—The State trust There are authorized to be appropriated All conveyances by the United States to the land referred to in paragraph (1) is land such sums as are necessary to carry out this State under this Act shall be subject to valid under the jurisdiction of the State that the Act. existing rights and other interests held by State determines is available for exchange SEC. 11. EXPIRATION OF AUTHORITY. third parties. under this Act. The authority of the Secretary to make (c) CONVEYANCES BY THE STATE.—All con- (3) MANAGEMENT OF LAND ACQUIRED BY THE veyances by the State to the United States the land conveyance under section 4 and the SECRETARY.— under this Act shall be subject only to such land exchange under section 5 expires on the (A) IN GENERAL.—On acceptance of title by valid existing surface and mineral leases, date that is 2 years after the date of enact- the United States, any land or interest in grazing permits and leases, easements, ment of this Act. land acquired by the United States under rights-of-way, and other interests held by this section that is located within the bound- third parties as are determined to be accept- By Mr. MCCONNELL: aries of a unit of the National Park System, able under the title regulations of the Attor- S. 2814. A bill to amend title XI of the the National Wildlife Refuge System, or any ney General of the United States. social Security Act to direct the Com- other system established by Act of (d) TIMING.—The conveyance of all land missioner of Social Security to con- Congress— and interests in land to be conveyed under duct outreach efforts to increase (i) shall become a part of the unit; and this Act shall be made not later than 60 days (ii) shall be subject to all laws (including awareness of the availability of Medi- after final agreement is reached between the care cost-sharing assistance to eligible regulations) applicable to the unit. Secretary and the State under subsection (B) ALL OTHER LAND.—Any land or interest (a). low-income Medicare beneficiaries, to in land acquired by the United States under (e) FORM OF CONVEYANCE.—A conveyance of the Committee on Finance. this section (other than land or an interest land or an interest in land by the State to f in land described in subparagraph (A))— the United States under this section shall be (i) shall be administered by the Bureau of in such form as is determined to be accept- THE LOW-INCOME WIDOWS Land Management in accordance with laws able under the title regulations of the Attor- ASSISTANCE ACT OF 2000 (including regulations) applicable to the ney General of the United States. ∑ Mr. MCCONNELL. Mr. President, I management of public land under the admin- SEC. 8. GENERAL PROVISIONS. come to the floor today to introduce istration of the Bureau of Land Manage- (a) HAZARDOUS WASTE.— ment; or the Low-Income Widows Assistance (1) IN GENERAL.—Notwithstanding the con- Act of 2000. Since 1988, Congress has es- (ii) where appropriate to protect land of veyance to the United States of land or an unique ecological value, may be made sub- interest in land, the State shall continue to tablished several programs to help pay ject to special management considerations, be responsible for all environmental remedi- the out of pocket medical costs for low- including a conservation easement, to— ation, waste management, and environ- income Medicare beneficiaries. These (I) protect the land or interest in land from mental compliance activities arising from programs, commonly referred to as development; and ownership and control of the land or interest Medicare Buy-in or QMB, SLMB, and (II) preserve open space. in land under applicable Federal and State QI–1, operate as federal-state partner- (4) WITHDRAWAL.—Subject to valid existing laws with respect to conditions existing on rights, all land acquired by the Secretary ships and are funded through state the land on the date of conveyance. Medicaid programs. Depending on an under this subsection is withdrawn from all (2) CONTINUING RESPONSIBILITY.—Notwith- forms of entry, appropriation, or disposal standing the conveyance to the State of land eligible senior’s income level, the pro- under the public land laws, from location, or an interest in land, the United States grams could cover the cost of Medicare entry, and patent under the mining laws, and shall continue to be responsible for all envi- Part B premiums, doctor visits, from operation of the mineral leasing and ronmental remediation, waste management, deductibles, and co-payments. geothermal leasing laws. and environmental compliance activities Despite the availability of these pro- SEC. 6. DETERMINATION OF VALUE. arising from ownership and control of the grams, many seniors are not aware (a) IN GENERAL.—All exchanges authorized land or interest in land under applicable that they may be eligible to receive under this Act shall be for approximately Federal and State laws with respect to con- these additional benefits. According to equal value. ditions existing on the land on the date of (b) APPRAISAL PROCESS.—The Secretary conveyance. a 1998 Families USA study, there are and the State shall jointly determine an (b) COSTS.—The United States and the somewhere between 3.3 and 3.8 million independent appraisal process, which shall State shall each bear its own respective seniors in America who are eligible to reflect nationally recognized appraisal costs incurred in the implementation of this receive these benefits, but not cur- standards, including, to the extent appro- Act, except for the costs incurred under sec- rently receiving them. In my home priate, the Uniform Appraisal Standards for tion 6. state, the same study estimates that Federal Land Acquisitions, to estimate val- (c) MAPS AND LEGAL DESCRIPTIONS.—The there are somewhere between 49,000 and ues for the categories and groupings of land State and the Secretary shall each provide to be conveyed under section 4 and ex- to the other the legal descriptions and maps 58,000 Kentucky seniors who may be el- changed under section 5. of the parcels of land and interests in land igible for one of these assistance pro- (c) DISPUTE RESOLUTION.—In the case of a under their respective jurisdictions that are grams but are not enrolled. While the dispute concerning an appraisal or appraisal to be exchanged under this Act. actual task of enrolling eligible seniors June 29, 2000 CONGRESSIONAL RECORD — SENATE S6125 is left to the states, there are several SLMB eligibility, the agency would be groups are attempting to replicate this important steps the federal govern- required to notify Sally that she may service in almost every state in the na- ment, through the Social Security Ad- be eligible for SLMB benefits. SSA also tion. Petitions to designate 2–1–1 as a ministration (SSA), can and should would be required to notify Sally’s referral to health and human services take. state government that she may be eli- have been approved or are pending in A key component in improving par- gible for these additional benefits. It is several other states. However, 2–1–1 of- ticipation in cost-sharing programs is my hope that the states would then use fers such an important service to com- the capacity of federal and state agen- this information to conduct their own munities, that I believe it is time to re- cies to identify those individuals who outreach efforts to enroll Sally and serve this number nationwide. Several experience a reduction in income after others like her. states have indicated reservations they have already enrolled in Social I look forward to working with my about pending petitions without direc- Security and Medicare. One group at colleagues in the Senate, as well as tion from the appropriate federal agen- particular risk of reduced income in Congressmen LEWIS and FLETCHER who cies that 2–1–1 will not be used for an- their later years is widowed spouses. are introducing similar legislation in other purpose. Senator SNOWE and I be- For anyone who has lost a loved one, the House, to help low-income widows lieve it is time to indicate to state and the experience is often overwhelming by enacting the Low-Income Widows federal regulators Congress’s clear sup- both mentally and emotionally. The Assistance Act of 2000.∑ port for 2–1–1. loss of a spouse leaves many elderly One of the unique aspects of 2–1–1 in with the difficult task of restructuring By Mr. CLELAND (for himself Metropolitan Atlanta, which I believe their lives in order to regain personal and Ms. SNOWE): can be replicated in the other states, is and financial stability. When SSA is S. 2815. A bill to provide for the na- the generous support it has received informed that a married individual has tionwide designation of 2–1–1 as a toll- from the community through private died, the agency recalculates the ben- free telephone number for access to in- donations. This funding model is one of efit to determine the new benefit level. formation and referrals on human serv- the unique aspects of this legislation. Frequently, the widowed spouse’s ben- ices, to encourage the deployment of Specifically, the bill stipulates that efit is lower than the amount the mar- the toll-free telephone number, and for none of the costs of 2–1–1 service shall ried couple received from Social Secu- other purposes; to the Committee on be passed on to telephone customers rity. This sets up a circumstance in Commerce, Science, and Transpor- but will be supported by the organiza- which a widow who was not previously tation. tions operating the 2–1–1 service. eligible to receive QMB/SLMB benefits ∑ Mr. CLELAND. Mr. President, I rise Mr. President, I would like to submit when she was married, would now be today to introduce with my colleague, a letter endorsing this legislation eligible to receive these benefits be- Senator SNOWE, a bill to designate 2–1– signed by the United Way of America, cause her income has fallen. 1 as the nationwide, toll-free number to the American Red Cross, the Alliance In an effort to address this serious access health and human services. for Children and Families, Girls Scouts problem, I am today introducing the Such designation is needed to simplify of the United States of America, Low-Income Widows Assistance Act. access to the maze of numbers and United Jewish Communities, Lutheran This legislation directs Social Security service organizations that currently Services of America, and Volunteers of to undertake outreach efforts designed exist. These organizations, which exist America to name only a few. I realize to identify and notify individuals who to help people, are useless if those in that N–1–1 numbers are finite in avail- may be eligible for these expanded ben- need do not know how to access the ability, but 2–1–1 is a service in the efits. It also addresses the unique chal- services provided. public interest that needs a national lenges facing widowed spouses by re- Imagine a single mother who needs designation. I urge my colleagues to quiring that when SSA recalculates the shelter and dinner one night for herself support this legislation that will en- benefits for a recently widowed spouse and her children. Although she may able Americans, no matter where they and finds that he or she might be eligi- know of a shelter providing these serv- are, to obtain the assistance they need ble for these assistance programs, the ices, there may be one closer that bet- through the use of a three digit num- agency must: ter fits her needs by catering to chil- ber. One, notify the beneficiary that he or dren and women in need. 2–1–1 could I ask consent that a copy of the she may now be eligible for this addi- provide her with a targeted referral to United Way letter and a copy the bill tional assistance. a shelter specializing in child care and be printed in the RECORD. Two, notify the beneficiary’s state empowering mothers to get back on There being no objection, the mate- that she may be eligible so that they their feet. Or, visualize an older Amer- rial was ordered to be printed in the can begin their own outreach efforts. ican on a fixed income, who may need RECORD, as follows: In order to help better understand assistance paying her electricity bill S. 2815 how the Low-Income Widows Assist- during a particularly cold month, can Be it enacted by the Senate and House of Rep- ance Act would work in practical call 2–1–1 for a referral to an agency to resentatives of the United States of America in terms, I would like my colleagues to assist her with her need. Also, if some- Congress assembled, imagine the following scenario. Sally one has goods or services she would SECTION 1. NATIONWIDE DESIGNATION OF TOLL- and Bob enjoyed 60 years of marriage, like to donate to her community, she FREE TELEPHONE NUMBER FOR AC- CESS TO HUMAN SERVICES INFOR- but just last fall, Bob suddenly passed can call 2–1–1 for a referral to an agen- MATION AND REFERRAL. away. Since Bob’s death, Sally has cy with a specific need for her items or (a) FINDINGS.—Congress makes the fol- been having a hard time making ends time. All 2–1–1 calls are confidential lowing findings: meet. She now has a lot of expenses to and unaffiliated with government (1) N–1–1 codes, or 3-digit abbreviated dial- take care of on her own: making the agencies. ing telephone numbers, provide Americans house payment, buying food and The United Way of Metropolitan At- with easy, efficient, nationwide access to lanta has implemented 2–1–1 service emergency and nonemergency information clothes, and paying for doctors’ visits that serves the public interest. and prescriptions—and not to mention with much success. Not only has this (2) Individuals and families often find it the ‘‘extras’’ like birthday and Christ- consolidation of human services refer- difficult to navigate the complex and ever mas presents for her many grand- rals provided direction and aid to those growing maze of human services agencies children. While her expenses remain es- in need, it also has helped pool the re- and programs and often spend inordinate sentially the same, Sally’s Social Secu- sources of area charitable organiza- amounts of time in trying to identify the rity survivors benefit is lower than tions. This pooling of resources has agency or program that provides a service what she and Bob were receiving. eliminated duplication and highlighted that may be immediately or urgently re- Under the Low-Income Widows As- gaps in current service, which in turn quired. (3) Americans desire to volunteer and be- sistance Act, when SSA recalculates has improved the delivery of services come involved in their communities, and Sally’s benefit and finds that her to the citizens of Metro Atlanta. Be- this desire, together with a desire to donate monthly Social Security check has cause of the great success in Atlanta, to organizations which provide human serv- fallen below the $855 threshold for the United Way and other non-profit ices, are among the reasons to call a center S6126 CONGRESSIONAL RECORD — SENATE June 29, 2000

which provides information and referrals on ‘‘(D) CALL LOCATION INFORMATION.—Nothing uals and families in need and the appropriate human services. in this paragraph shall be construed to re- community-based organizations and govern- (4) The number ‘‘2–1–1’’ is easy-to-remem- quire any telecommunications carrier to ment agencies. Since United Way of Metro- ber and universally recognizable and would provide call location information to a pro- politan Atlanta and United Way of Con- serve well as the designation of a telephone vider of information or referrals on human necticut switched from 10-digit I&R numbers service for linking individuals and families services through the telephone number des- to 211, the volume of calls received at both to information and referral centers which ignated under this paragraph. has increased by 40 percent, with each han- could, in turn, make critical connections be- ‘‘(E) DEFINITIONS.—In this paragraph: dling over 200,000 calls in 1999. tween individuals and families in need and ‘‘(i) HUMAN SERVICES.—The term ‘human A petition to nationally designate 211 for appropriate human services agencies, includ- services’ means services as follows: health and human services I&R submitted by ing both community-based organizations and ‘‘(I) Services that assist individuals in be- the 211 Collaborative, of which United Way government agencies. coming more self-sufficient, in preventing and the Alliance of Information and Referral (5) United Ways and other non-profit and dependency, and in strengthening family re- Systems are members, has awaited action by governmental centers that provide informa- lationships. the Federal Communications Commission tion about and referrals to human services ‘‘(II) Services that support personal and so- (FCC) for well over a year. FCC inaction have secured funding for the establishment, cial development. leaves current and ongoing 211 implementa- implementation, and current operation in ‘‘(III) Services that help ensure the well- tion in state and local jurisdictions in jeop- the United States of three centers that pro- being of individuals, families, and commu- ardy. Additionally, some state public utility vide such information and referrals and are nities. commissions have indicated they will not accessed through the telephone number 2–1– ‘‘(ii) INFORMATION AND REFERRAL CENTER.— take action on 211 petitions before the FCC 1. The term ‘information and referral center’ makes its decision. Further, with 211 being (6) United Way of Metropolitan Atlanta, means a center that— considered or implemented in 45 states, if the Contact Helpline of Columbus, Georgia, and ‘‘(I) maintains a database of providers of FCC designates the number for a different United Way of Connecticut currently utilize human services in a State or locality; and purpose, all current and future 211 call cen- the telephone number 2–1–1 for the purpose ‘‘(II) assists individuals, families, and com- ters would need to make significant expendi- of access to information about and referral munities in identifying, understanding, and tures and do considerable outreach to con- to human services. accessing such providers and the human vert to a new, 10-digit number. (7) Since United Way of Metropolitan At- services offered by such providers.’’. lanta and United Way of Connecticut (2) TRANSITION.—The Federal Communica- Legislation designating 211 for human switched from 10-digit telephone numbers for tions Commission shall provide for the im- services I&R would alleviate these concerns access to their centers of information and re- plementation within a reasonable period of and would bypass a potentially lengthy and ferral on human services to the telephone time of the designation required by para- uncertain FCC approval process. We urge you number 2–1–1 for access to such centers, the graph (3) of section 251(e) of the Communica- to support the Cleland—Snowe bill. Thank volume of calls received at such centers has tions Act of 1934, as added by paragraph (1) of you. increased by approximately 40 percent. The this subsection, throughout the areas of the Sincerely, centers of United Way of Metropolitan At- United States where the designation is not Alliance for Children and Families lanta and United Way of Connecticut each in effect as of the date of the enactment of Alliance of Information and Referral Sys- handled approximately 200,000 calls in 1999. this Act. tems (8) Rapid deployment nationwide of the (c) SUPPORT FOR STATE EFFORTS.— American Association of Homes and Services telephone number 2–1–1 as a means of access (1) IN GENERAL.—The Commission shall en- for the Aging to information about and referral to human courage and support efforts by States to de- American Red Cross services requires coordination among State velop and implement the use of the toll-free America’s Blood Centers governments and the information and refer- telephone number 2–1–1 for access to pro- Association of Jewish Family & Children’s ral centers of many localities. viders of information and referrals on human Agencies (9) Alabama, Massachusetts, North Caro- services. Camp Fire Boys and Girls lina, and Utah have approved petitions for (2) ACTIVITIES.—In providing encourage- Citizen’s Scholarship Foundation of America the implementation of the telephone number ment and support under paragraph (1), the Coalition of Human Needs 2–1–1 statewide for that purpose, and imple- Commission shall— Coalition of Labor Union Women mentation of the use of that number for that (A) consult with appropriate State offi- Council for Health and Human Service Min- purpose is underway. Jurisdictions in Lou- cials, including State human services agen- istries isiana and Tennessee have also designated cies, and appropriate representatives of the Girl Scouts of the USA the use of 2–1–1 for that purpose. telecommunications industry, United Ways, Girls Incorporated (10) Ohio, South Dakota, Texas, and Wis- Alliance of Information and Referral Sys- Lutheran Services of America consin are considering petitions to designate tems (AIRS), AIRS affiliates, law enforce- National Association of Child Care Resource the telephone number 2–1–1 for that purpose. ment and emergency service providers, and and Referral Agencies (11) Florida and Virginia have developed local non-profit and governmental informa- National Association of State Units on statewide models for telephone access for tion and referral centers; and Aging that purpose. (B) encourage States to coordinate state- National Association of WIC Directors (12) The use of 2–1–1 for that purpose is wide implementation of the use of the tele- Service Employees International Union being consider by nearly every other State. phone number in consultation with such rep- The Salvation Army (b) DESIGNATION OF TOLL-FREE HUMAN resentatives. SERVICES ACCESS TELEPHONE NUMBER.— United Jewish Communities (3) PROHIBITION ON IMPOSITION OF OBLIGA- (1) IN GENERAL.—Section 251(e) of the Com- United Neighborhood Houses TIONS OR COSTS.—Nothing in this subsection munications Act of 1934 (47 U.S.C. 251(e)) is United Way of America shall be construed to authorize or require amended by adding at the end the following Volunteers of America the Commission to impose an obligation or ∑ new paragraph: Women in Community Service cost on any person. ‘‘(3) HUMAN SERVICES ACCESS TELEPHONE (d) PROVISION OF CALL INFORMATION.—Sec- NUMBER.— tion 222(d) of the Communications Act of 1934 By Mr. GRAHAM (for himself, ‘‘(A) DESIGNATION.—The Commission, and (47 U.S.C. 222(d)) is amended— Mr. AKAKA, Mr. L. CHAFEE, and each commission or other entity to which (1) by striking ‘‘or’’ at the end of paragraph Mr. MCCAIN): the Commission has delegated authority (2); under this subsection, shall designate 2–1–1 S. 2816. A bill to provide the financial (2) by striking the period at the end of mechanisms, resource protections, and as a toll-free telephone number within the paragraph (3) and inserting ‘‘; or’’; and United States for access to information and (3) by adding at the end the following: professional skills necessary for high referral centers for information about and ‘‘(4) to provide call information when re- quality stewardship of the National referral to providers of human services, in- quired by applicable law.’’. Park System, to commemorate the cluding information and referrals for pur- heritage of people of the United States poses of volunteering and making donations. UNITED WAY OF AMERICA, to invest in the legacy of the National ‘‘(B) APPLICABILITY.—The designation Alexandria, VA June 29, 2000. under subparagraph (A) shall apply to wire Park System, and to recognize the im- DEAR SENATOR: The undersigned organiza- portance of high quality outdoor rec- and wireless telephone service. tions support the bill cosponsored by Sen- ‘‘(C) PAYMENT OF COSTS.—The costs of a ators Max Cleland (D–GA) and Olympia reational opportunities on federally telecommunications carrier in providing ac- Snowe (R–ME) to nationally designate the managed land; to the Committee on cess to a provider of information and refer- 211 abbreviated dialing code for access to Energy and Natural Resources. rals through the telephone number des- health and human services information and ignated under this paragraph shall be borne referral (I&R). 211 is an easy-to-remember THE NATIONAL PARKS STEWARDSHIP ACT by the provider of such information and re- and universally recognizable number that By Mr. GRAHAM (for himself and ferrals. makes a critical connection between individ- Mr. GORTON): June 29, 2000 CONGRESSIONAL RECORD — SENATE S6127 S. 2817. A bill to authorize the Sec- rine systems and the northernmost ship. It is an honor to have LINCOLN retary of the Interior and the Sec- coral reef in the United States. This CHAFEE, a fine statesman in his own retary of Agriculture to establish per- was my 4th workday in a National right, as a co-sponsor. manent recreation fee authority; to the Park. The federal government must be uni- Committee on Energy and Natural Re- At Biscayne National Park, we fied in its stewardship of the National sources. Americans are in danger of losing a Parks. THE RECREATIONAL FEE AUTHORITY ACT OF 2000 piece of our history. The HMS Fowey, My legislation requires that federal Mr. GRAHAM. Mr. President, I come an 18th century British warship, lies agencies taking action on lands bor- before you to today to discuss one of submerged in a highly unstable loca- dering National Park units consult our nation’s most valued assets—our tion. This very significant, national with the Department of the Interior to National Parks. register site has been weakened by ensure such actions do not degrade or Throughout the history of our coun- looting, prop-wash deflection, storms destroy National Park resources. try, visionary statesmen have arisen to and other forces. The best choice avail- It also requires the Secretary of the remind us of the natural resource her- able is to excavate the wreckage and Interior to prohibit actions on Interior lands that will adversely impact Park itage on which our country rests. As recover whatever of the historical resources. early as 1903, President Theodore Roo- record we can. This kind of operation is The second action I propose to pro- well beyond the means of Biscayne Na- sevelt, spoke of the challenge at hand: tect park resources relates to park We must handle the woods, the water, the tional Park’s annual operating budget. My feelings about the National Park uses. grasses so that we will hand them to our The National Park Stewardship Act children and our children’s children in better System are truly of wonder. The won- requires that activities allowed in Na- and not worse shape than we got them. der that I feel at the treasures in our tional Parks pass the test of compat- park system is only matched by my It is a challenge we still face today, ibility with natural, cultural and his- and will into the future, in our role as wonder at how we can take such treas- torical resource protection. As our stewards of the world in which we live. ures for granted. The importance of our parks are used and enjoyed by visitors, Our system of National Parks and National Parks should be reflected in we must ensure that park resources are other public lands is the envy of the our stewardship of the National Park not inadvertently damaged. For exam- world. It serves as a model for other System. We have failed to provide the ple, the Park Service recently issued countries, as they also seek to preserve National Park Service with the tools it regulations limiting or prohibiting the their natural and cultural heritage. No needs to be good stewards of our Na- use of personal water craft in some other country has set aside as full a tional Parks. areas. This action was only taken after spectrum of public lands—from wilder- Today, with my colleagues Senator the use of these water craft in some ness to urban parks—for people to use AKAKA, Senator L. CHAFEE and Senator areas was allowed at intensities seri- and enjoy. But to just set them aside MCCAIN, I am introducing the ‘‘Na- ously degrading water and air quality, is, of course, not enough. The feature tional Parks Stewardship Act’’. and threatening both park wildlife and that makes these lands remarkable— I would also like to include for the other park visitors. that they are open and accessible to all record a letter from the National Parks My bill requires the National Park Americans to enjoy—also threatens Conservation Association expressing Service to take action to protect these their existence in the future. that organization’s support for this resources before damage occurs. Ac- Mr. President, we face an ironic ques- legislation. tivities must be analyzed and the im- tion: are we loving our national parks This legislation seeks to give the Na- pacts understood before they are au- to death? The simple answer to that tional Park Service the tools it needs thorized. It also asks the National question is yes. to prepare for the next century. It also Parks to seriously plan for the future, Earlier this year, the National Parks includes many of the proposals of oth- projecting visitation and use trends Conservation Association released its ers who feel strongly about the impor- and identify needed personnel and fa- list of the Ten Most Endangered Na- tance of our National Parks. cilities. tional Parks. We should all feel This bill gives park managers the Another resource protection portion ashamed that they have so many en- protective tools needed to support the of the bill focuses on ensuring that our dangered Parks from which to chose. stewardship challenges of Theodore National Park System fully represents This year’s list includes National Roosevelt. We provide three types of the history of our nation. Each year, a Parks across the country, from Alaska tools: resource protection, financial smaller percentage of the American to Arizona, from Tennessee to Hawaii. tools and human resources. population can trace its ancestry to It also includes Everglades National The first element in the resource pro- those who landed at Plymouth rock, Park in my state of Florida, where dec- tection section of my bill deals with settled Jamestown, or fought in the ades of human manipulation have led activities occurring outside park American revolution. Many Americans to ecosystem destruction. boundaries. are descended from people who crossed This list of the 2000 Ten Most Endan- My inspiration for this was legisla- international boarders from the North gered National Parks is unfortunately tion introduced by the late Senator or South, or landed at locations from not comprehensive, but is representa- John Chafee who proposed the forma- the Florida Keys to the Aleutian Is- tive. During the past year I have vis- tion of ‘‘park protection areas’’ in 1986. lands, from Ellis Island to the island of ited several national parks to get a John Chafee proposed that these areas Oahu. All those who came to settle first hand view of the problem. From be formed outside park boundaries to write their history alongside, and often personal experience, I can enlarge the create the ‘‘buffer zone’’ needed for re- atop the history of our country’s na- list of endangered national parks. source protection. tive peoples. At Ellis Island National Monument, a I identified strongly with this con- The bill calls for a comprehensive facade of immaculate buildings hides cept, having worked since the 1970’s on look at the ethnic and cultural content an inventory of dilapidated historical a state-federal partnership for Ever- of our National Park System. It asks structures. glades restoration that focuses heavily the National Park Service to report At Bandelier National Monument in on providing a buffer zone for Ever- this review to Congress, and to make New Mexico, lack of maintenance and glades National Park. Today, the origi- recommendations on sites that might vandalism is leading to the deteriora- nal boundaries of Everglades National round out the American story. It en- tion of historical artifacts. Park are surrounded by Big Cypress courages cultural/ethnic groups to I recently witnessed a similar dete- Preserve, an expanded park boundary, nominate sites important to their her- rioration of marine-related artifacts at and undeveloped land on the eastern itage for inclusion in the System, and a park in my own state of Florida. side of the park. to recommend changes in the interpre- In April I participated in my 359th It is as a memorial to John Chafee tation of present sites to improve his- work day at Biscayne National Park, a that I echo his provision in my bill, toric accuracy. chain of subtropical islands protecting which I hope will become a permanent America is etched with a rich histor- mangrove shoreline, interrelated ma- component of National Park steward- ical record. I commend those who have S6128 CONGRESSIONAL RECORD — SENATE June 29, 2000 succeeded in adding important heritage Even at Yellowstone National Park, sonable fee. Over 95 percent of respond- sites to the National park System. certainly a crown jewel of the system, ents to this year’s National Survey on Units like the National Underground a dilapidated sewer system leaking un- Recreation and the Environment felt Railroad Network to Freedom, author- treated waste befouls what should be reasonable fees were acceptable as a ized by Congress in 1998, and the Juan pristine streams and lakes. At Yellow- means for funding recreation services Bautista de Anza National Historic stone, a park visited by over 3 million on public lands. Trail in California, tracing the path of people a year, certainly we should pro- The recreation fee demonstration au- a party of Spanish colonists in 1776, en- vide the means for financing a new thority is temporary. If it is not ex- sure that these events do not pass from sewer system. tended or made permanent, Biscayne our historical landscape. There are cer- My colleague Senator MCCAIN ad- and other National Parks will lose this tainly many as equally important sites dressed this need through his bill, S. very necessary means to get the job to consider. 831, which would authorize a portion of done. Let’s instead make this a perma- Mr. President, I would like to include park entrance fees to be used to secure nent tool for National Park Steward- in the RECORD letters from the Ambas- bonds for these very necessary capital ship. sador of Spain and the Spanish Insti- improvements. Bonding would seem to In addition to revenue bonding and tute for Military History and Culture. be a workable approach, if we could the recreation fee program, I propose These letters exemplify the willingness find an appropriate way for a federal the expanded use of Challenge Cost of those who contributed to the history agency to issue revenue bonds. Share agreements, which allow the of the United States to help in this ef- The National Parks Stewardship Act ‘‘leveraging’’ of Park Service appro- fort. The Ambassador points out how introduced today calls for the Sec- priations with funds from the private the Institute’s letter, ‘‘opens the way retary of the Treasury and the Sec- sector and other federal agencies. for a cooperation between the two in- retary of the Interior to study and re- The final tool I propose in this legis- stitutions that could result in a much port to Congress how National Parks lation focuses on the professional skills better use of the many historical sites, could issue revenue bonds to meet such of those we employ as the stewards for of Spanish origin, on American soil. large infrastructure needs. National Parks. Professionals typically They could ‘‘make the stones speak’’ to The authority to issue revenue bonds attracted to the Service come from many people in this country who are places into the hands of National Park many fields, including education, still unaware of a very rich and com- superintendents a tool to generate the recreation management, and the bio- mon heritage.’’ I am sure other coun- funds to make these repairs. logical sciences. Today park managers tries will be willing to help illustrate The second revenue provision I pro- must also demonstrate fiscal and pro- how the history of our country is pose is to make the recreation fee pro- gram accountability and management linked to their own history. gram in operation as a demonstration planning, skills that are not found Our National Park System, the treas- since its authorization in 1996 into a throughout National Park Service ured sites of American history, must permanent park program. The program ranks. I am proposing a pilot program, contain the history of all Americans. If has demonstrated that park visitors ‘‘Professionals for Parks’’, to attract not, our National Park System is like can get a good return on the fees they needed skilled professionals to Na- a partially woven tapestry, depicting pay; a return paid out in better main- only part of the picture. Instead let our tional Park Service careers. It will tained facilities, improved visitor serv- focus on recruiting at business schools National Park System be woven, whole ices, and all-in-all, a more enjoyable and beautiful, from the multi-colored across the country, offering talented park visit. graduates an entry level professional threads of history of the people of To underscore the importance of job within the National Park Service these United States. recreation fee permanence, I, along I hope this proposal will move us one and a student loan buy-back program. with Senator GORTON, am introducing step closer to a National Park System Professionals for Parks will add to today the ‘‘Recreation Fee Authority where all Americans should be entitled National Park Service ranks the busi- Act of 2000,’’ a stand along piece of leg- to see the role of their people in the ex- ness management skills needed for bet- ploration, settlement and development islation containing these provisions. ter management, leading to long term In fiscal year 1999, the recreation fee of this country. And I see it as comple- stewardship. And we know this can demonstration program generated menting Senator AKAKA’s bill, S. 2478, make a difference. $176.4 million in fee revenue at Na- calling for a study on the ‘‘Peopling of We’re looking for people like Nick America,’’ which I am honored to co- tional Parks, National Forests, Na- Hardigg, a recent graduate of the Yale sponsor. tional Wildlife Refuges and Bureau of School of Management, who is now The second major section of the Na- Land Management sites. Even more working as Chief of Concessions at tional Parks Stewardship act deals important than the amount collected is Denali National Park. His financial with financial resources. the fact that the large majority of the analysis of the visitor transportation Last year, I introduced legislation fees were retained at the site where system in Denali led to a newly nego- with Senators REID and MACK, S. 819, collected for use in Park operations, tiated contract with the bus company. the National Park Preservation Act, maintenance, resource protection and This contract allows for a healthy prof- that would provide dedicated funding visitor services. it for the operator and for the first to the National Park Service to restore Biscayne National Park, where I time in several years does not increase and conserve the natural, cultural and worked for a day in April, is one of the fees to park visitors. It also protects historic resources in our park system. units benefitting from the recreation park resources by providing a quality We continue to work toward final pas- fee demonstration program. Last year, transportation system. sage of S. 819. However, this bill alone that park collected over $20,000 in It’s a long way from the Ivy League does not meet all of the needs in our recreation fees. At Biscayne, these to the Alaskan wilderness. Mr. Hardigg National Parks. funds were used to: has made that journey, and has put his The need for construction and main- replace the broken tables and grills business skills to good use for National tenance in National Parks is great. in the picnic area; Park stewardship. Backlog estimates range from 2 to 8 restore a historic breeze way trail Mr. President, the National Park billion dollars, depending on the meth- across Elliott Key; and Stewardship Act is not calling for a od of calculation. renovate the public showers and revolution in the National Park Sys- In order to accommodate many visi- bathrooms on Elliott Key, improving tem. It recognizes the value of what we tors each year, some National Parks their accessibility for people with dis- have in the National Park System, rec- have facilities and services that rival abilities. ognizes what we stand to lose without those of towns or small cities. Along When park visitors see their ‘‘fees at immediate attention, and supplies the with these facilities come the problems work’’ in the form of improved facili- tools to the right people to tackle the of infrastructure maintenance and re- ties and services, research has shown job. pair that are beyond the reach of annu- that they understand and support the In closing I would like to recall the ally appropriated budgets. collection of an appropriate and rea- words of John Chafee, a visionary June 29, 2000 CONGRESSIONAL RECORD — SENATE S6129 statesman who helped craft much of all peoples that contributed to the shaping of operate in some way in the efforts to height- the foundation on which our system of the United States. We commend you for this en the historical value of the old Spanish environmental protection rests. farsighted proposal. military monuments in the U.S. as well as In 1994, he reminded us of the impor- Thank you for undertaking this effort to that of any other collection of documents, assure the vitality of the National Park Sys- books or movables that can be considered tance of our Parks stewardship role: tem through the 21st century and beyond. We part of this important historical legacy. I can think of no instance where the Gov- look forward to promoting this legislation This institute has a considerable collection ernment has designated an area as a park with you. of documents and artifacts in its archives re- and years later people have looked back, re- Sincerely, lating to the ancient viceroyalty and over- gretted the decision, and tried to reverse it. THOMAS C. KIERNAN. seas provinces. Most of the items have al- As we continue to develop and extract re- ready been catalogued (some have even been ˜ sources from the remaining open spaces in EL EMBAJADOR DE ESPANA, studied by U.S. specialists). Now we are in our Nation, it is important that we ensure Washington, DC, April 27, 2000. the advanced stages of negotiation with that there will always be places where people Hon. BOB GRAHAM, Puerto Rico whose Legislative Assembly has can get away and renew their spirits, breathe U.S. Senate, already allocated a budget for cataloguing, fresh air, and appreciate nature’s gifts. Washington, DC. microfilming and digitizing all the material DEAR SENATOR, I have read with the ut- in our historical military archives about Mr. President, I ask unanimous con- matters related to that island. sent that additional material be print- most interest your proposed legislation on the role of the National Park Service of the In any case, Antonio, you know that you ed in the RECORD. can count on the Institute for Military His- United States in conservation and promotion tory and Culture to initiate a collaborative There being no objection, the mate- of historic sites in this country. rial was ordered to be printed in the With respect to the numerous monuments effort with the National Park Service. It would be advisable to establish direct con- RECORD, as follows: left by Spain in the southern States, we tact between the National Park Service and would certainly welcome all possible co- NATIONAL PARKS this Institute so as to define the matters of operation with the Park Service to give CONSERVATION ASSOCIATION, most interest to them. While we could begin these venerable ruins a real cultural and Washington, DC, May 23, 2000. in writing, a trip to Spain by a director or Hon. BOB GRAHAM, educational purpose. We believe that solid historian of the Park Service so that they U.S. Senate, support from historians and other experts might gain an understanding in situ of our Washington, DC. from Spanish official institutions such as capabilities with regard to their projects DEAR SENATOR GRAHAM: The National our Ministry of Defense or the Institute for would be very fruitful. They will be most Parks and Conservation Association (NPCA) the Protection of Historic Legacy, could warmly received. would like to commend you and your cospon- make these sites incite the interest of new I am at your service! sors for the introduction of the National generations on pages of their past that they With my best regards,˜ Parks Stewardship Act. This bill includes might have insufficient knowledge of. JUAN MADEPENARANDA Y ALGAR. many provisions that will promote better I have written to the two aforementioned Spanish cultural institutions to ensure their Mr. GORTON. Mr. President, I am protection and management of national park pleased to join my colleague from Flor- resources. willingness to collaborate with the National As you know, the beginning of the 21st cen- Park Service on the goals set forth in the ida, Senator GRAHAM, in introducing tury is a watershed moment for Americans draft Resolution. legislation today that seeks to perma- and our National Park System. One hundred In the meantime, let me assure you of our nently authorize the recreation fee pro- and twenty-eight years after the establish- enthusiastic support for your initiative that gram for the federal land management ment of Yellowstone, we have a magnificent I certainly hope will muster the necessary agencies. Congress authorized the park system that stretches from the coast of backing from the rest of the Senate. Recreation Fee Demonstration Pro- Maine to the tropical reefs of American Thanking you most warmly for your en- lightened defense of the cultural integrity of gram in the FY 1996 Omnibus Consoli- Samoa. Millions people visit and enjoy these dated Recissions and Appropriations parks every year. this great country. However, the National Park System also is I remain, Act, and has extended the program severely troubled. Threats to the health of Yours very sincerely, ´ through the Interior Appropriations the National Park System fall into several ANTONIO DE OYARZABAL. bill several times since 1996. broad categories: lack of funding; activities ˜ In the Pacific Northwest, the fees that damage park resources from inside and EL EMBAJADOR DE ESPANA, collected by the National Park Service outside park boundaries; and poor manage- Washington, DC, June 9, 2000. and Forest Service have been a tremen- ment. As a result, basic information about Hon. BOB GRAHAM, dous additional resource to provide im- park resources is lacking, much of the infra- U.S. Senate, Washington, DC. proved campgrounds, trails, and other structure and visitor services are in poor visitor facilities. As chairman of the condition, and parks are increasingly jeop- DEAR SENATOR, I am pleased to enclose the Senate Interior Appropriations Com- ardized by activities around them. attached˜ letter from my friend General Your National Stewardship Act addresses Penaranda, the Director of the Institute for mittee, I have consistently provided in- many of these concerns by: Military History and Culture in Madrid, in creases for operations, maintenance, Facilitating the issuance of national park response to my request for support to your and repair of park, forest, and refuge revenue bonds that would help finance need- initiative in Congress, on behalf of the ‘‘Na- facilities. Regardless, this country’s ed improvements at national parks; tional Park Service.’’˜ love affair with recreation and the I think General Penaranda’s very enthusi- Requiring that all activities in national great outdoors has begun to take its parks be consistent with resource protection astic answer opens the way for a cooperation and preservation; between the two institutions that could re- toll on the public lands we enjoy so Ensuring that other federal government sult in a much better use of the many histor- much. agencies respect the integrity of national ical sites, of Spanish origin, on American Since I took over the chairmanship park lands; soil. They could ‘‘make the stones speak’’ to of the Interior Appropriations Sub- Promoting the protection of the historical many young people in this country who are committee, I also have been faced with documents in National Park Service collec- still unaware of a very rich and common her- an unending list of federal land acqui- tions; itage. ´ sition proposals. The demand to in- Expanding the opportunities for national EMBAJADA DE ESPANA, crease the federal government’s land park managers to develop public administra- Madrid, May 29, 2000. base cannot be considered in a vacuum, tion and business management skills. His Excellency´ Ambassador Antonio de The National Parks Stewardship Act also Oyarzabal Marchesi, especially when we’re faced with at ensures that the National Park System will Ambassador of Spain to the U.S., least a $12 billion maintenance backlog better represent the diverse heritage of all Washington, DC. on the lands we already own. In fact, people of the United States. Support for the DEAR AMBASSADOR AND FRIEND: It gives me the Congressional Budget Office rec- National Park System runs deep in the great pleasure to be able to oblige you with ommended last year that the federal hearts of millions of Americans. That sup- regard to the wishes of the National Park government place a ten-year morato- port, however, will wane if significant num- Service which you refer to in your letter of rium on land acquisitions in an effort bers of people feel disconnected from the April 26. I have consulted this Institute’s to address the backlog in maintenance message and meaning of the parks. To ensure Standing Committee on Historical Studies ´ projects. continued public support, and historical rel- (Comisio´ n Permanente de Estudios evance, the National Parks Stewardship Act Historicos) regarding the possibility of satis- I don’t support taking such an ex- requires that the National Park Service re- fying the possible American request, and it treme step. Rather, I believe we can view existing sites to determine if there are could not be more favorably disposed to the have a reasonable level of land acquisi- deficiencies in the accurate representation of idea. It is very satisfying to be able to co- tions, but we also need to commit to S6130 CONGRESSIONAL RECORD — SENATE June 29, 2000 finding the additional resources to ested parties can air their concerns and Natural Resources Committee, to au- maintain what we already have. I am suggestions. My staff and I have spent thorize a permanent program that pro- committed to providing access to our a considerable amount of time meeting vides necessary resources to maintain public lands, but this can only happen and talking with recreation groups and improve these national treasures if we have enough funding to maintain based in Washington state. I am cer- for generations to come. the land and facilities treasured by tain there will be many ways we can Americans and visitors from all over improve the legislation introduced By Mr. JOHNSON: the world. today to address their concerns S. 2818. A bill to amend the Agricul- Over the past five years of the fee through the committee process, and I tural Market Transition Act to estab- demonstration project, the federal am excited to continue that dialogue. lish a flexible fallow program under agencies have tested various types of It goes without saying that no one which a producer may idle a portion of fees and collection methods in prepara- really wants to pay a fee to recreate on the total planted acreage of the loan tion for the possibility of some day es- public lands. The key to making a per- commodities of the producer in ex- tablishing a long-term, consistent, and manent program a success in the fu- change for higher loan rates for mar- fair fee program. In general terms, the ture will depend on keeping the fees keting assistance loans on the remain- project has been a great success, pro- reasonable and the results tangible. ing acreage of the producer; to the viding the federal land management The most important component of the Committee on Agriculture, Nutrition, agencies nearly $200 million last year Recreation Fee Demonstration Project and Forestry. in additional revenue for maintenance is the requirement that 80 percent of THE FOOD SECURITY AND LAND STEWARDSHIP and repair projects, and resources for the fees remain at the site the fees are ACT OF 2000 improved visitor services. collected. The legislation introduced Mr. JOHNSON. Mr. President, I rise In 1999, at the Mt. Baker-Snoqualmie today maintains that requirement. In to introduce legislation to amend the Forest in my state, the program al- addition, Congress and the Administra- 1996 farm bill. This legislation is really lowed this Forest to clear 739.6 miles of tion must make a firm commitment to the culmination of at least two years trail, hire 22 trail maintenance work- uphold its responsibility to continue to of work on the part of two agricultural ers, develop leveraged partnerships increase appropriations in the future to producers from my home State of with non-profit groups to accomplish reduce the maintenance backlog. It’s a South Dakota. These two individuals, maintenance work with volunteers, two-way street, and we must all do our Craig Blindert of Salem and Phil Cyre and maintain 67 trailhead toilets and part. of Watertown, have devoted an enor- 136 trailheads. All of this vital work Further, I fully expect to address mous amount of time and energy refin- was accomplished by charging $3 for other issues raised by my friends in the ing the proposal I am introducing day passes or $25 for an annual pass. recreation community. Although the today and I want to express my thanks Last week, the Senate Appropria- situation has improved recently, the and gratitude. tions Committee reported the Interior multiple fee structures tested by the While some policy makers purport to Appropriations bill, which extends the Forest Service created a confusing and have all the answers to agricultural Recreation Demonstration Fee Pro- frustrating situation for hikers and policy and our current economic dis- gram through the end of fiscal year rock climbers. In particular, rock aster in farm country, I am proud that 2002. Despite my resistance to using climbers have been hit with multiple two South Dakota farmers approached the Interior bill to continue this pro- fees for just one visit to the forest. me with their plan. Mr. Blindert and gram, I felt it was vital to provide the Many recreationists are calling for Mr. Cyre exhibit a quality inherent to agencies certainty for another year. In multi-agency passes. I find this idea in- a farmer that most policy makers will fact, recent improvements to the For- triguing and would urge further discus- never exhibit, something I call ‘‘trac- est Service fee program in the North- sion through the committee process. I tor seat common sense.’’ Former Presi- west, including the new Northwest For- must note, however, that multi-agency dent Eisenhower once said, farming est Pass, would have been jeopardized fees may distract from the expectation looks mighty easy when your plow is a without the extension. that fees remain at the facilities and pencil and you’re a thousand miles With that said, I believe the Senate, sites where they are collected. Further, away from a farm. Instead of pre- through the Energy and Natural Re- some outdoor enthusiasts are con- tending I have all of the answers, I sources Committee, deserves the oppor- cerned the fee program could inspire think it just makes good practical tunity to fully consider legislation to over-building on our public lands to sense to listen to farmers who know permanently authorize the recreation justify collection of the fees. I, too, am their business better than anyone in fee program. The success stories are concerned with preserving the integ- the world, and that is what I have tried abundant, but by no means am I blind rity of our public lands and avoiding to do with this proposal. to the problems we’ve seen over the the impulse to provide unnecessary fa- Unfortunately, all of that expertise past five years. Most importantly, the cilities. This legislation directs the our farmers demonstrate about the public deserves the opportunity to par- agencies to place a priority on deferred production of crops and livestock, mar- ticipate, both through hearings and maintenance projects. But again, these keting, and risk management means contact with their elected representa- are topics that deserve thoughtful dis- little when our farm policy and agri- tives, to provide us the input we need cussion, and I look forward to address- businesses minimizes them into mere to authorize a permanent program. ing them in the near future. price takers. The legislation I am in- That’s why I have chosen to join Sen- Finally, many active recreationists troducing today attempts to allow ator GRAHAM today in introducing a have made a strong case for developing farmers to become price setters in re- bill to begin the debate over how and a recognition program that rewards sponse to the free market, and it at- whether Congress should permanently volunteers for dedicating their time to tempts to ensure responsibility from authorize the recreation fee program. improving our public lands. Many for- agribusiness to finally offer a decent The bill we’ve crafted provides the ests and parks have well-developed vol- price for commodities. framework for a permanent program unteer programs, while others do not. I The current economic setting and that will build upon the successes and am dedicated to working with recre- commodity price forecast for farmers correct the problems we’ve seen so far. ation groups to provide the agencies and ranchers remains disastrous. Crop I want to stress that this bill will appropriate guidelines in the bill to de- prices have absolutely collapsed with serve as the starting point for what I velop a consistent program that pro- corn prices at a 12 year low, soybeans hope to be a full and deliberative dis- vides volunteers reduced or free access prices at a 27 year low, and wheat course on recreation fees. I intend to to our public lands. prices that have not been so low since work with the Energy and Natural Re- Again, I want to thank my colleague 1977. Meatpacker concentration and un- sources Committee to hold a series of from Florida for being a leader in the fair livestock dumping are still crip- hearings, including field hearings, so protection of the nation’s public lands. pling livestock producers. Prices paid representatives of recreation groups, I look forward to working with him, for livestock have remained low in the gateway communities, and other inter- and the members of the Energy and pork and lamb sectors while they have June 29, 2000 CONGRESSIONAL RECORD — SENATE S6131 recovered, at a very limited and still proposal. In a letter to me he describes Flex Fallow targets disaster assistance unprofitable rate, for cattle producers. Flex Fallow as ‘‘the missing link to the to producers who suffer from weather- As a result, net farm income has plum- 1996 farm bill.’’ He believes this pro- related crop loss and price collapse. Fi- meted to around $40 billion this past posal will function in a market ori- nally, Flex Fallow will result in a mod- year, plunging $9 billion from last year, ented fashion and ensure that ‘‘farmers est cost to taxpayers. The FAPRI anal- without government assistance. Agri- continue to make production decisions ysis finds net Commodity Credit Cor- cultural exports are down over $11 bil- based upon their own operations in a poration expenditures under Flex Fal- lion from 1996, and constricted global manner that makes economic sense.’’ low to compare with that of the 1996 demand for our agricultural products Mr. President, farmers electing to de- farm bill without billion-dollar emer- restricts exports from boosting prices. vote a portion of their total crop acre- gency spending additions. It is clear that once again this disas- age to conservation-use under my bill In the coming months I anticipate a trous marketplace clouds the landscape receive a higher loan rate on their re- full airing of my Flex Fallow amend- of rural America as a woefully inad- maining crop production. On an annual ment to the farm bill, alongside other equate farm bill continues to rip the and crop-by-crop basis, farmers can pieces of farm bill reform legislation safety net from beneath farmers and choose to conserve up to thirty percent that others in Congress may introduce. ranchers. If not for government market of their total crop acreage. I expect to refine this proposal after loss assistance the last three years—a An adjustable loan rate schedule is a discussing it further with farmers and record level of $23 billion in 1999—many key feature of this proposal. With the farm organizations across South Da- hard-working farmers and ranchers exception of wheat and soybeans, the kota and the entire country. As a re- might be out of business. proposed base loan rates for 0 percent sult, it is likely I will introduce an- The course of the last few years participation in Flex Fallow (otherwise other piece of legislation similar to under the current farm bill has given known as full production) are set at Flex Fallow in the next session of Con- all of us the opportunity to measure 2000 levels. Participation in Flex Fal- gress, wherein two other significant the theories of Freedom to Farm low is directly proportional to in- issues will be addressed. First, of critical importance to me is against the practical reality of experi- creased loan rates. For corn, wheat, the need to design a farm bill in the fu- ence. The measurable results of that and soybeans, loan rates increase by ture that targets the benefits to fam- one percent for each one percent in- practical experience should convince ily-sized farmers and ranchers. Too Congress we cannot delay to reform the crease in conservation-use. often, Congress and the Administration In 1999, the Food and Agricultural current farm bill. Some tend to ignore devise tactics to ignore and plow under Policy Research Institute (FAPRI) this reality, choosing instead to over- the existing farm program payment completed an analysis of the Flex Fal- look the flawed farm policy, in hopes limitations. If we have a limited that over time our nation’s family low proposal. I believe the results were amount of taxpayer funds in which to farmers and ranchers will find them- very promising. In years and regions devote to price support for farmers, it selves enjoying the prosperity of our (areas of the country with a wide basis) simply makes sense to target those booming economy. However, most of low commodity prices, Flex Fallow benefits to small and mid-sized family farmers merely read about this pros- encourages farmers to voluntarily set- producers. While the amendment I in- perity as they face escalating produc- aside land in turn for a higher loan troduce today does not alter current tion expenses, eroding equity, and col- rate. Yet in years of better commodity payments limits under the farm bill, I lapsing crop prices. prices, farmers are inclined to produce am a strong supporter of targeting. As Delay in reforming farm policy is for the market, planting most or all of such, I will work to place sensible, re- dangerous to the entire fabric of rural their land to crop production. The re- sponsible, payment limitations that America. The other day a farmer re- duced plantings in years of poor crop provide benefits to all but ensure tar- marked to me, ‘‘the best time for Con- prices, like the last three years, would geted benefits to the small and mid- gress to write a better farm bill would lead to higher crop prices. More specifi- sized family farmers and ranchers who have been in 1996, but, the next best cally, reduced plantings in the first need and deserve greater attention time is today.’’ I couldn’t agree more. two years of the program would trans- from Congress. Congress cannot continue to over- late into the following higher crop Second, I believe Congress will be un- look the link between the current fi- prices. Corn prices rise 27 cents per able to develop a future farm bill with- nancial stress our family producers bushel over current levels, soybean out the support of those in the con- face and the 1996 farm bill provisions prices climb 44 cents per bushel, wheat servation and wildlife community. I which eliminated the financial safety prices recover 29 cents per bushel, and am a strong supporter of conservation net for farmers. Consequently, there cotton prices rise 9 cents per pound. programs that protect sensitive soil should be no higher priority for this The FAPRI analysis predicts a com- and water resources, promote wildlife Congress to accomplish in farm policy modity price recovery in the long- habitat, and provide farmers and land- than to restore a fair price from a truly term, and the analysis found participa- owners with benefits and incentives to free marketplace. tion in Flex Fallow to decline after conserve land. Flex Fallow can work The legislation I am introducing 2002. very well with both short-term and today is not a radical departure from While I work on this amendment to longer-term conservation practices. It the current farm bill. We try to rein- the current farm bill, I am absolutely is my goal to bring conservation force the advantages of Freedom to open to other ideas and alternatives groups together with farm interests in Farm while improving upon other that revise our farm policy. Unlike the order to develop a well-balanced ap- areas of our farm policy. Coined authors of the 1996 farm bill, I do not proach to future farm policy that pro- ‘‘Flexible Fallow’’ by the farmers who cling to a pride in authorship in a farm tects our resources while promoting developed it, my proposal adds a vol- program. So, I want the opportunity to family-farm agriculture. untary, annual, conservation-use fea- support as many viable alternatives as Mr. President, I ask unanimous con- ture to the loan rate provisions of the possible. sent that the letter from Dr. Harl be 1996 Farm Bill. Should a farmer desire In summary, here are a few high- printed in the RECORD at the end of my to operate under current farm bill con- lights of the Flex Fallow farm bill statement. ditions, my legislation ensures that op- amendment I am introducing today. There being no objection, the letter portunity. However, should a farmer Flex Fallow is flexible and adjustable was ordered to be printed in the need greater leverage over crop produc- enough to meet the needs of individual RECORD, as follows: tion and marketing, Flex Fallow guar- farm operations. Flex Fallow is vol- IOWA STATE UNIVERSITY antees that planting and marketing untary. Flex Fallow is market-oriented OF SCIENCE AND TECHNOLOGY, flexibility. because it permits farmers the freedom Ames, IA, April 17, 2000. Neil Harl of Iowa State University, to plant for marketplace conditions. Senator TIM JOHNSON, U.S. Senate, arguably the most respected agricul- Flex Fallow emphasizes conservation Washington, DC. tural economist in the country, has en- practices. Flex Fallow updates yield DEAR SENATOR JOHNSON: It is my under- thusiastically endorsed my Flex Fallow data and eliminates current base acres. standing that legislation based on the S6132 CONGRESSIONAL RECORD — SENATE June 29, 2000 ‘‘Flexible-Fallow’’ concept developed and ad- viders. Earlier this month, the Henry have a place where they can go for in- vanced by Craig Blindert and Phil Cyre of J. Kaiser Family Foundation and Con- formation, counseling and assistance. South Dakota is being prepared for introduc- sumer Reports magazine released the As health plan options become more tion. I would like to write in strong support results of a survey they conducted on complicated and the web of policies of the legislation and do so most enthusiasti- and principles governing those plans cally. consumer satisfaction with their Mr. Blindert called me in late 1998 with a health plans. Their survey is part of a becomes more enmeshed, people need a request for a half day to discuss a farm bill larger project looking at ways to im- reliable, accessible source of informa- proposal. I was extremely busy at the time prove how consumers resolve problems tion, and state health care consumer but reluctantly agreed to set aside an after- with their health insurance plans. The assistance programs have proven their noon in late December. As the proposal was survey found that while most people ability to meet this challenge. I look explained, I could see that what Blindert and who experienced a problem with their forward to working with my colleague, Cyre had developed was the missing link for plan were often able to resolve them, Senator JEFFORDS, in advancing this the 1996 farm bill. I wrote in strong support the majority of those surveyed were important and timely legislation. of the proposal following that meeting—en- confused about where to go for infor- Mr. President, I ask unanimous con- couraging an analysis by the Food and Agri- sent to have the text of my bill printed culture Policy Research Institute (FAPRI)— mation and help if they have a problem and am even more supportive today. with their health plan. Eventhough a in the RECORD. The weak element of the 1996 farm bill was growing number of states have taken There being no objection, the bill was the downside protection in the event of pres- steps to give patients new rights in ordered to be printed in the RECORD, as sure on the supply side for commodities. A dealing with their health insurance follows: series of normal to good weather years, a plans, most consumers are either un- S. 2819 drop of nearly 20 percent in exports and the aware or do not know how to exercise Be it enacted by the Senate and House of Rep- relentless effects of technology have com- resentatives of the United States of America in bined to produce very low prices for most those rights. The legislation I am introducing Congress assembled, crops. SECTION 1. SHORT TITLE. What I find so appealing about the today with Senator JEFFORDS seeks to This Act may be cited as the ‘‘Health Care Blindert-Dyre proposal is that—(1) the pro- remedy this information gap by pro- Consumer Assistance Act’’. posal would function in a market-oriented viding grants to states that wish to es- SEC. 2. FINDINGS. manner; (2) it would be most appealing in the tablish health care consumer assist- Congress makes the following findings: so-called ‘‘swing’’ areas which are expected ance programs. These programs are de- (1) People with health care insurance or to shift land use patterns when prices for in- signed to help consumers understand coverage have many more options with re- tensively-produced crops are low and to re- spect to coverage of, payment or payments turn to such production when prices recover; and act on their health care choices, rights, and responsibilities. Under this for, items, services or treatments. Also, their (3) the proposal would self-correct when health plans, coverages, rights, and providers prices rise; (4) it would entail only a modest bill, the Secretary of Health and are frequently being reorganized, expanded, amount of administrative involvement on a Human Services will offer states funds or limited. discretionary basis; (5) it would enable pro- to create or contract with an inde- (2) All consumers need information and as- ducers to continue to make decisions based pendent, nonprofit agency to provide a sistance to understand their health insur- on their own situation, in a manner that variety of information and support ance choices and to maximize their access to makes economic sense to them; and (6) the services for health care consumers, in- needed health services. Many do not under- cost would be modest to taxpayers and to stand their health care rights or how to exer- consumers. cluding the following: educational ma- terials for health care consumers about cise them, despite the current efforts of both I would be pleased to respond further in the public and private sectors. support of the proposal. Mr. Blindert and Mr. strategies to resolve problems and (3) Few people with health care coverage Cyre are to be commended for developing grievances; operate a 1–800 telephone have independent credible sources of infor- what I believe would be an enormously help- hotline to respond to consumer inquir- mation or assistance to guide their decision- ful adjunct to the 1996 farm bill. ies; coordinate and make referral to making or to help resolve problems. Sincerely, other private and public health care (4) It is important to maintain and NEIL E. HARL, entities when appropriate; conduct strengthen a productive working relation- Charles F. Curtiss Dis- ship between all consumers and their health tinguished Professor education and outreach in the commu- nity; and collect and disseminate data care professionals and health insurance pro- in Agriculture, Pro- viders. fessor of Economics about nature of inquiries, problems and (5) Federally initiated health care con- and Director, Center grievances handled by the program. sumer assistance and information programs for International The concept of a health care con- targeted to consumers of long-term care and Agricultural Fi- sumer assistance program has already to medicare beneficiaries under title XVIII nance. received considerable support and sev- of the Social Security Act (42 U.S.C. 1395 et eral states have taken the initiative to seq.) are effective, as are a number of State By Mr. REED (for himself and create these programs. Governors and and local consumer assistance initiatives. Mr. JEFFORDS): state legislatures in many states in- (6) The principles, policies, and practices of S. 2819. To provide for the establish- cluding, Florida, Georgia, Massachu- health care providers for delivering safe, ef- fective, and accessible health care can be en- ment of an assistance program for setts, Maryland, Nebraska, Nevada, health insurance consumers; to the riched by State-based collaborative, inde- Rhode Island, Texas, Vermont, Vir- pendent education, problem resolution, and Committee on Health, Education, ginia and Wisconsin have introduced or Labor, and Pensions. feedback programs. Health care consumer enacted health care ombudsman legis- assistance programs have proven their abil- THE HEALTH CARE CONSUMER ASSISTANCE ACT lation. While some states have success- ity to meet this challenge. Mr. REED. Mr. President, I am fully launched their programs, other (7) Health care consumers want and need pleased to join my colleague Senator state initiatives have faltered due to a reliable information about their health care JEFFORDS today to introduce the lack of sufficient funding. options that integrates data and effective Health Care Consumer Assistance Act. While important strides are being resolution strategies from the full range of This important legislation seeks to ad- available resources. Health care consumer made to enhance health care consumer assistance programs can provide that reli- dress a significant problem that cur- information and resources, clearly able, problem-solving information to help in rently exists in the health insurance more needs to be done to expand access navigating the health care system. market, the lack of a reliable source of to these simple and cost-effective serv- (8) Health care delivered to individuals and information and assistance for health ices to all Americans. within communities can be improved by col- care consumers. Mr. President, I believe that Ameri- lecting and examining consumers’ experi- In 1997, President Clinton’s Health cans deserve access to the information ences, questions, and problems and the ways Quality Commission identified the and assistance they need to be empow- in which their questions and problems are re- need for consumer assistance programs ered and informed health care con- solved. Health care consumer assistance pro- grams can educate and inform consumers to that allow consumers access to accu- sumers. As the health insurance sys- be more effective, self-directed health care rate, easily understood information tem becomes more confusing and com- consumers. and get assistance in making informed plex, it is critically important that as (9) Many states have created health care decisions about health plans and pro- consumers navigate this system, they consumer assistance programs. The Federal June 29, 2000 CONGRESSIONAL RECORD — SENATE S6133

Government can assist the States in devel- (c) AMOUNT OF GRANT.— scribed listed in paragraphs (3) and (4) of sec- oping and maintaining effective health care (1) IN GENERAL.—From amounts appro- tion 3(b) so as to maximize the ability of consumer assistance programs. priated under section 4 for a fiscal year, the consumers to resolve health care questions SEC. 3. GRANTS. Secretary shall award a grant to a State in and problems and achieve the best health (a) IN GENERAL.—The Secretary of Health an amount that bears the same ratio to such care outcomes; and Human Services (referred to in this Act amounts as the number of individuals within (6) conduct education and outreach within as the ‘‘Secretary’’) shall award grants to the State covered under a health insurance the State in partnership with consumers, States to enable such States to establish and plan (as determined by the Secretary) bears health plans, health care providers, health administer (including the administration of to the total number of individuals covered care payers and governmental agencies with programs established by States prior to the under a health insurance plan in all States health oversight responsibilities; enactment of this Act) consumer assistance (as determined by the Secretary). Any (7) provide information to consumers about programs designed to provide information, amounts provided to a State under this sec- an internal, external, or administrative assistance, and referrals to consumers of tion that are not used by the State shall be grievance or appeals procedure (in health insurance products. remitted to the Secretary and reallocated in nonlitigative settings) to appeal the denial, (b) STATE ELIGIBILITY.—To be eligible to accordance with this paragraph. termination, or reduction of health care receive a grant under this section a State (2) MINIMUM AMOUNT.—In no case shall the services, or the refusal to pay for such serv- shall prepare and submit to the Secretary an amount provided to a State under a grant ices, under a health insurance plan; and application at such time, in such manner, under this section for a fiscal year be less (8) provide information to State agencies, and containing such information as the Sec- than an amount equal to .5 percent of the employers, health plans, insurers, and the retary may require, including a State plan amount appropriated for such fiscal year general public concerning the kinds of in- that describes— under section 5. quiries, problems, and grievances handled by (1) the manner in which the State will es- (d) PROVISION OF FUNDS FOR ESTABLISH- the office. tablish, or solicit proposals for, and enter ONFIDENTIALITY AND CCESS TO NFOR MENT OF OFFICE.— (d) C A I - into a contract with, an entity eligible under MATION.—The health insurance consumer as- (1) IN GENERAL.—From amounts provided subsection (d) to serve as the health care under a grant under this section, a State sistance office of a State shall establish and consumer assistance office for the State; implement procedures and protocols to en- shall, directly or through a contract with an (2) the manner in which the State will en- sure the confidentiality of all information independent, nonprofit entity with dem- sure that the health care consumer assist- shared by consumers and their health care onstrated experience in serving the needs of ance office will assist health care consumers providers, health plans, or insurers with the health care consumers, provide for the estab- in accessing needed care by educating and office and to ensure that no such informa- assisting health insurance enrollees to be re- lishment and operation of a State health tion is used, released or referred to State sponsible and informed consumers; care consumer assistance office. agencies or outside entities without the ex- (3) the manner in which the State will co- (2) ELIGIBILITY OF ENTITY.—To be eligible pressed permission of the consumer, except ordinate and distinguish the services pro- to enter into a contract under paragraph (1), to the extent that the office collects or uses vided by the health care consumer assistance an entity shall demonstrate that the entity aggregate information described in sub- office with the services provided by the long- has the technical, organizational, and profes- section (c)(8). term care ombudsman authorized by the sional capacity to deliver the services de- (e) AVAILABILITY OF SERVICES.—The health Older Americans Act of 1965 (42 U.S.C. 3001 et scribed in section 4 throughout the State to insurance consumer assistance office of a seq.), the State health insurance information all public and private health insurance con- State shall not discriminate in the provision program authorized under section 4360 of the sumers. of information and referrals regardless of the Omnibus Budget Reconciliation Act of 1990 SEC. 4. USE OF FUNDS. source of the individual’s health insurance (42 U.S.C. 1395b–4), the protection and advo- (a) BY STATE.— coverage or prospective coverage, including cacy program authorized under the Protec- (1) IN GENERAL.—A State shall use amounts individuals covered under employer-provided tion and Advocacy for Mentally Ill Individ- received under a grant under this Act to es- insurance, self-funded plans, the medicare or uals Act of 1986 (42 U.S.C. 10801 et seq.), and tablish and operate of a health insurance medicaid programs under title XVII or XIX any other programs that provide information consumer assistance office as provided for in of the Social Security Act (42 U.S.C. 1395 and and assistance to health care consumers; this section and section 3(d). 1396 et seq.), or under any other Federal or (4) the manner in which the State will co- (2) NONCOMPLIANCE.—If the State fails to State health care program. ordinate and distinguish the health care con- enter into or renew a contract for the oper- (f) DESIGNATION OF RESPONSIBILITIES.— sumer assistance office and its services from ation of a State health insurance consumer (1) WITHIN EXISTING STATE ENTITY.—If the health insurance consumer assistance office enrollment services provided under the med- assistance office, the Secretary shall reallo- of a State is located within an existing State icaid and State children’s health insurance cate amounts to be provided to the State regulatory agency or office of an elected programs under titles XIX and XXI of the under this Act. State official, the State shall ensure that— Social Security Act (42 U.S.C. 1396 et seq. (b) BY ENTITY.—An entity that enters into (A) there is a separate delineation of the and 1397aa et seq.), and medicare and med- a contract with a State under section 3(d) funding, activities, and responsibilities of icaid health care fraud and abuse activities shall use amounts received under the con- the office as compared to the other funding, including those authorized by Federal law tract to establish and operate a health insur- activities, and responsibilities of the agency; under title 11 of the Social Security Act (42 ance consumer assistance office. and U.S.C. 1301 et seq.); (c) ACTIVITIES OF OFFICE.—A health insur- (B) the office establishes and implements ance consumer assistance office established (5) the manner in which the State will pro- procedures and protocols to ensure the con- vide services to underserved and minority under this Act shall— fidentiality of all information shared by con- populations and populations residing in rural (1) operate a toll-free telephone hotline to sumers and their health care providers, areas; respond to requests for information and as- health plans, or insurers with the office and (6) the manner in which the State will es- sistance with health care problems and as- to ensure that no information is transferred tablish and implement procedures and proto- sist all health insurance consumers to navi- or released to the State agency or office cols to ensure the confidentiality of all in- gate the health care system; without the expressed permission of the con- formation shared by consumers and their (2) acquire or produce and disseminate cul- sumer. health care providers, health plans, or insur- turally and language appropriate edu- (2) CONTRACT ENTITY.—In the case of an en- ers with the office established under sub- cational materials concerning health insur- tity that enters into a contract with a State section (d)(1) and to ensure that no such in- ance products available within the State, under section 3(d), the entity shall provide formation is used, released or referred with- how best to access health care, and the assurances that the entity has no real or per- out the express permission of the consumer, rights and responsibilities of the health care ceived conflict of interest in providing ad- except to the extent that the office collects consumer; vice and assistance to consumers regarding or uses aggregate information as described in (3) educate health care consumers about health insurance and that the entity is inde- section 4(c)(8); strategies that such consumers can imple- pendent of health insurance plans, compa- (7) the manner in which the State will pro- ment to promptly and efficiently resolve in- nies, providers, payers, and regulators of vide for the collection of non-Federal con- quiries, problems, and grievances related to care. tributions for the operations of the office in health insurance and access to health care; (g) SUBCONTRACTS.—The health insurance an amount that is not less than 30 percent of (4) refer health care consumers to appro- consumer assistance office of a State may the amount of Federal funds provided under priate private and public entities so that in- carry out activities and provide services this Act; and quiries, problems, and grievances with re- through contracts entered into with 1 or (8) the manner in which the State will en- spect to health insurance and access to more nonprofit entities so long as the office sure that funds made available under this health care can be handled promptly and ef- can demonstrate that all of the requirements Act will be used to supplement, and not sup- ficiently; of this Act are complied with by the office. plant, any other Federal, State, or local (5) coordinate with health organizations in (i) TRAINING.— funds expended to provide services for pro- the State, State health-insurance related (1) IN GENERAL.—The health insurance con- grams described under this Act and those de- agencies, and State organizations respon- sumer assistance office of a State shall en- scribed in paragraphs (3) and (4). sible for administering the programs de- sure that personnel employed by the office S6134 CONGRESSIONAL RECORD — SENATE June 29, 2000 possess the skills, expertise, and information pendent program to help them navigate the maximum civil penalty that can be necessary to provide the services described the complex health care delivery sys- assessed to companies that violate con- in subsection (c). tem. The state offices of the Division of sumer product safety laws is $1,650,000, (2) CONTRACTS.—To meet the requirement Banking and Insurance and the Office a figure that is less than the amount of paragraph (1), an office may enter into contracts with 1 or more nonprofit entities of Vermont Health Access (our Med- that generally could be assessed by the for the training (both through technical and icaid agency) jointly administer the CPSC. According to the agency, in educational assistance) of personnel and vol- Vermont Ombudsman. It has helped many instances, it seeks penalties unteers. To be eligible to receive a contract Vermonters find care providers and use against very large companies, which under this paragraph, an entity shall be appeal procedures. likely are not deterred by the $1,650,000 independent of health insurance plans, com- It is time for the federal government cap. Second, the legislation proposes to panies, providers, payers, and regulators of to play a constructive role in aiding increase the CPSC’s authority over re- care. states like Vermont that will answer calls by authorizing the Commission to (3) LIMITATION.—An amount not to exceed 7 percent of the amount awarded to an entity the needs of their citizens for a con- determine the manner in which a de- under a contract under section 3(d) for a fis- sumer-focused, consumer-directed fective product is to be corrected. Cur- cal year may be used for the provision of health care assistance program. This rently, a company that has marketed a training under this section. bill builds on the existing state-based defective product has the right to de- (j) ADMINISTRATIVE COSTS.—An amount not programs to provide an office that pro- termine the remedy that is offered to to exceed 1 percent of the amount of a grant vides consumers with the basic and the public, regardless of whether the awarded to the State under this Act for a fis- credible information they want and selected remedy is the most effective cal year may be used by the State for admin- need to make all kinds of important istrative expenses. solution. The proposed legislation al- (k) TERM.—A contract entered into under health care decisions. ters this situation by permitting the this section shall be for a term of 3 years. The bill gives each State the oppor- CPSC to choose the remedy that is best SEC. 5. FUNDING. tunity to design a consumer assistance suited to protect the public as opposed There are authorized to be appropriated program that meets local needs. At the to the company. $100,000,000 to carry out this Act. same time, the grant program calls For these reasons, Mr. President, I SEC. 6. REPORT OF THE SECRETARY. upon the state to coordinate this over- am pleased to introduce this act on be- Not later than 1 year after the date of en- all health care consumer assistance of- half of the Administration and the actment of this Act, and annually thereafter, fice’s activities with its existing con- CPSC. the Secretary shall prepare and submit to sumer assistance offices such as the the appropriate committees of Congress a re- By Mr. GRAHAM (for himself, port that contains— long-term care Ombudsman program Mr. DEWINE, Mr. MOYNIHAN, Mr. (1) a determination by the Secretary of for long term care consumers and its whether amounts appropriated to carry out work in registering children and fami- GRASSLEY, Mr. DODD, Mr. this Act for the fiscal year for which the re- lies for S–CHIP. COVERDELL, and Mr. BIDEN): port is being prepared are sufficient to fully Access to quality health care services S. 2823. A bill to amend the Andean fund this Act in such fiscal year; is a priority for every American fam- Trade Preference Act to grant certain (2) with respect to a fiscal year for which ily, every state, and this nation. It is benefits with respect to textile and ap- the Secretary determines under paragraph clearly time for a federal commitment parel, and for other purposes; to the (1) that sufficient amounts are not appro- Committee on Finance. priated, the recommendations of the Sec- to help families get the health care in- formation and assistance they want THE PLAN COLOMBIA TRADE ACT retary for fully funding this Act through the ∑ use of additional funding sources; and and need. Mr. GRAHAM. Mr. President, I rise (3) information on States that have been Once again, I want to thank Senator today, joined by Senators DEWINE, awarded a grant under this Act and a sum- REED for this bipartisan effort on such MOYNIHAN, GRASSLEY, DODD, COVER- mary of the activities of such States and the important health legislation. Health DELL, and BIDEN, to introduce the Plan data that is produced. care consumers, plans, providers, and Colombia Trade Act, a bill that would Mr. JEFFORDS. Mr. President, I am states will be well served by enacting provide additional trade benefits to the here today to join in introducing the our legislation as soon as possible. nations of the Andean Trade Pact, Health Care Consumer Assistance Act. which includes Bolivia, Colombia, Ec- This important bill has been crafted to By Mr. HOLLINGS (by request): uador and Peru. help Americans navigate our increas- S. 2820. A bill to provide for a public This bill is an important component ingly complex and ever changing interest determination by the Con- of Plan Colombia, which seeks to ad- health care system. I want to recognize sumer Product Safety Commission dress not only the nation’s crisis with the leadership of Senator JACK REED in with respect to repair, replacement, or respect to massive narcotrafficking bringing this issue forward for consid- refund actions, and to revise the civil and insurgent and paramilitary forces, eration. and criminal penalties, under both the but also focuses on Colombia’s deep Americans need and want help with Consumer Product Safety Act and the economic recession. The bill is con- their health care. In a recent national Federal Hazardous Substances Act; to sistent with U.S. policy of promoting survey, Consumers Report and the Kai- the Committee on Commerce, Science, trade and combating drugs on a re- ser Family Foundation learned that and Transportation. gional basis, thereby ensuring that half of all managed care plan members THE CONSUMER PRODUCT SAFETY COMMISSION U.S. benefits and assistance provided have had a problem with their plan in ENHANCED ENFORCEMENT ACT to one nation do not adversely affect the last year. The vast majority of Mr. HOLLINGS. Mr. President, I rise other nations in the immediate region. those ‘‘problems’’ were minor and suc- to introduce at the request of the Ad- Such a strategy is the only way to cessfully resolved in a very short pe- ministration and the Consumer Prod- avoid what is often described as the riod of time. However, a large number uct Safety Commission (CPSC), the ‘‘balloon effect,’’ which has meant that of Americans report significant finan- Consumer Product Safety Commission the drug problem, at best, is displaced cial consequences, lost time at work, Enhanced Enforcement Act of 2000. from one location to another. Finally, or actual health declines as a result of This legislation is designed to enhance the bill would re-assert our commit- these disputes. the authority of the CSPC to prevent ment to promote economic growth and The same survey reports that 84% of the manufacture and sale of defective regional stability throughout the An- Americans want ‘‘an independent place products. dean region, and to provide alter- to turn for help’’ with their health care The legislation seeks to accomplish natives to the cultivation and expor- rights. In fact, Americans prefer, by a this goal in two significant ways. First, tation of illegal narcotics. wide margin, an independent source of it proposes to remove the cap that ex- Passage of this legislation by the help, as provided for in the Health Care ists under current law on the max- Senate will signal the United States’ Consumer Assistance Act, rather than imum civil penalty that can be as- support of the Andean Trade Pact’s a right to sue. sessed to companies that market prod- economic reform efforts, and will boost Three years ago, my own state recog- ucts in violation of federal consumer the confidence of both domestic and nized that Vermonters needed an inde- product safety regulations. Currently, international investors in pursuing June 29, 2000 CONGRESSIONAL RECORD — SENATE S6135 business opportunities that create jobs nies have utilized Colombia as a manu- other region of the world—in fact, and enhance international trade in the facturing base for over ten (10) years, since 1995, U.S. exports to the CBI re- Andean region, particularly in Colom- providing desperately needed legiti- gion have increased by almost 32 per- bia. In addition, this bill would ensure mate employment in the Colombian cent. that U.S. trade with these important economy. In 1991, after 8 years of resounding nations is not adversely affected by the In summary, the immediate reaction success in the CBI region, Congress recent passage of the ‘‘Trade and De- of these companies to enhanced Carib- passed the ATPA, providing CBI-like velopment Act of 2000,’’ which provided bean trade benefits clearly dem- trade benefits to the countries of Bo- significant trade benefits to the Carib- onstrates the negative effects of the livia, Colombia, Ecuador and Peru. In bean Basin. CBI legislation on Colombia. It would the nine years following enactment of To briefly summarize, the ‘‘Plan Co- be foolish for the Congress to approve a ATPA, U.S. exports to the Andean re- lombia Trade Act,’’ would extend, for comprehensive aid package for Colom- gion have more than doubled—from $3.8 approximately one year, additional bia, while simultaneously imple- billion in 1991 to over $8.6 billion in trade benefits to Bolivia, Colombia, Ec- menting legislation that puts tens of 1998. U.S. exports to Colombia account uador, and Peru–nations that currently thousands of Colombians out of work. for over half of this increase, growing benefit from the Andean Trade Pref- This bill will address that critical, un- from $2 billion in 1991 to $4.8 billion in erences Act of 1991 (commonly known intended contradiction. 1998. During the same time period, An- as the ATPA). New trade benefits On a more comprehensive scale, pas- dean exports to the U.S. increased by would include some—but not all—trade sage of this legislation is critical to en- almost 80 percent. In addition, in 1998, benefits extended to the nations of the sure that all nations in the Western the U.S. achieved a $309 million trade Caribbean Basin under the ‘‘Trade and Hemisphere can maintain their long- surplus with the ATPA nations. Under Development Act of 2000,’’ which was term competitiveness with Asian na- ATPA, Bolivia, Colombia, Ecuador, and signed by the President on May 18, 2000. tions, particularly in the textile indus- Peru enjoyed the same trade benefits Specifically, the bill would extend try. At present, the textile products of that we had extended to the CBI re- duty-free, quota-free treatment to ap- most Asian nations are subject to gion. However, on May 18, 2000, the parel articles assembled or cut in quotas imposed by the Multi-Fiber President signed the ‘‘Trade and Devel- ATPA beneficiary nations using yarns Agreement, now known as the Agree- opment Act of 2000,’’ which extended and fabric wholly formed in the United ment on Textiles and Clothing. This re- additional trade benefits—particularly States, thereby achieving a measure of striction on Asian textiles has enabled with respect to textiles and apparel—to parity with the CBI nations, as well as the nations of the Western Hemisphere the nations of the CBI region. There- expanding an important source of eco- to remain competitive, and further, the fore, our Andean trading partners are nomic and employment growth for the Andean region—specifically Colom- now likely to lose significant trade and U.S. textile and apparel industry. bia—has become a significant market investment opportunities that will In its March 2000 interim report, for fabric woven in U.S. mills from shift to the CBI, given the additional ‘‘First Steps Toward a Constructive yarn spun in the U.S., originating from trade benefits included in the ‘‘Trade U.S. Policy in Colombia,’’ a Council on U.S. cotton growers. and Development Act of 2000.’’ Foreign Relations/Inter-American Dia- However, in 2005, these Asian import NEED FOR THE ‘‘PLAN COLOMBIA TRADE ACT’’ logue Independent Task Force—which I quotas will be phased out. At that The United States is at now a critical co-chair with Brent Scowcroft—rec- time, textile production in both the juncture with its neighbors in the An- ommended the extension of the ATPA, Andean region and the Caribbean basin dean region. As was demonstrated by to include the same benefits as those will be placed at a distinct and growing the recent passage of the ‘‘Trade and contained under the Caribbean Basin disadvantage. Disinvestment in the re- Development Act of 2000.’’ it is clear Initiative. Specifically, we rec- gion will occur, reducing the incentive that we must continue enhance our ommended the following: to use any material from U.S. textile trading relationship with our partners Indeed, Colombia’s economic well-being is mills or cotton grown in the United in the Caribbean and the Andean re- absolutely critical, and in this area the States. gion. United States can be more helpful. Perhaps BACKGROUND In particular, these additional trade even more important than providing in- Seventeen years ago, the U.S. Con- benefits should be extended to Colom- creased assistance to the Colombian govern- gress passed the first legislation to pro- ment to support employment programs is as- bia, which is currently fighting a war suring Colombia greater access to U.S. mar- vide trade preferences to the twenty- for the survival of its democratic insti- kets for its products. Extending trade-re- seven countries of the Caribbean Basin. tutions, its free market economy and lated benefits to Colombia would have a In 1983, the Caribbean Basin was a re- for the future of its people. Those chal- positive impact on the country’s prospects gion inflamed with violent conflict and lenging Colombia’s future include drug for higher growth and employment levels. rampant drug trafficking that threat- traffickers, guerilla groups (the FARC Although the bill provides benefits to ened the political and economic sta- and the ELN) and other elements of so- all ATPA beneficiaries, it is particu- bility of our closest neighbors, as well ciety who seek to foster instability and larly critical to Colombia, which in as our own national security. The pri- fear. A comprehensive strategy in re- 1998 exported 59 percent of all textiles mary goal of the Caribbean Basin Ini- sponse to the crisis in essential for Co- and apparel from the Andean region to tiative (CBI) was to stabilize the region lombia. the U.S., two-thirds of which were as- by building stronger and more diverse The government of Colombia, there- sembled and/or cut from U.S. yarns and economies, encouraging growth in fore, has formulated Plan Colombia. fabric. international trade, developing a The United States government, in This legislation addresses an impor- strong economic relationship between turn, has responded generously to Co- tant, albeit unintentional, contradic- the U.S. and the region, and creating lumbia’s needs by considering a supple- tion in U.S. policy towards Colombia. employment opportunities in the le- mental appropriations package of more With the recent passage of enhanced gitimate economy as an alternative to than $1.6 billion to help the country in trade benefits to the countries of Car- drug trafficking. this time of crisis. This will supple- ibbean Basin Initiative, Colombia Following enactment of CBI, the U.S. ment over $4.0 billion being spent by stands to lose up to 150,000 jobs in the trade position with the region im- Colombia itself. apparel industry. At least ten (10) U.S.- proved from a deficit of $3 billion in Fundamental to Plan Colombia (and based companies that purchase apparel 1983, to a surplus of nearly $3.5 billion to the government’s ability to succeed from Colombian garment manufactur- in 1998. Between 1983 and 1998, U.S. ex- in its efforts to safeguard the country) ers have already indicated their near- ports to the region increased fourfold, will be efforts to encourage economic term intentions to shift production to while total imports from the region growth and provide jobs to the Colom- CBI countries due to the significant grew by less than 20 percent. On a per bian people. Today in Colombia more cost savings associated with the new capita basis, the U.S. trade surplus than one million people are displaced, trade benefits afforded to the Carib- with the region has consistently out- the unemployment rate is nearly 20 bean basin. Some of these U.S. compa- paced the U.S. trade surplus with any percent and Colombia is experiencing S6136 CONGRESSIONAL RECORD — SENATE June 29, 2000 the worst recession in 70 years. With- the purpose of the generalized system of ‘‘(bb) Interlinings eligible for the treat- out new economic opportunities, more preferences under title V of the Trade Act of ment described in division (aa) include only and more Colombians will turn to il- 1974; a chest type plate, ‘hymo’ piece, or ‘sleeve licit activities to support their families ‘‘(C) tuna, prepared or preserved in any header’, of woven or weft-inserted warp knit or seek to join the growing numbers of manner, in airtight containers; construction and of coarse animal hair or ‘‘(D) petroleum, or any product derived man-made filaments. people who are leaving the country to from petroleum, provided for in headings 2709 ‘‘(cc) The treatment described in this sub- find a better, safer future for their fam- and 2710 of the HTS; clause shall terminate if the President ilies. ‘‘(E) watches and watch parts (including makes a determination that United States Measuring both imports and exports, cases, bracelets and straps), of whatever type manufacturers are producing such inter- Colombia is by far the most important including, but not limited to, mechanical, linings in the United States in commercial U.S. trade partner in the ATPA region. quartz digital or quartz analog, if such quantities. In 1998, over 53 percent of U.S. exports watches or watch parts contain any material ‘‘(III) DE MINIMIS RULE.—An article that to the Andean region went to Colom- which is the product of any country with re- would otherwise be ineligible for preferential bia, and over 53 percent of U.S. imports spect to which HTS column 2 rates of duty treatment under this paragraph because the from the Andean region originated apply; article contains fibers or yarns not wholly from Colombia. ‘‘(F) articles to which reduced rates of formed in the United States or in one or Mr. President, to promote economic duty apply under subsection (c); more beneficiary countries shall not be ineli- ‘‘(G) sugars, syrups, and molasses classified gible for such treatment if the total weight growth and regional stability, the Con- in subheadings 1701.11.03, 1701.12.02, 1701.99.02, of all such fibers or yarns is not more than gress must consider additional trade 1702.90.32, 1806.10.42, and 2106.90.12 of the HTS; 7 percent of the total weight of the good. measures that benefit the entire Ande- or Notwithstanding the preceding sentence, an an region. Therefore, Congress should ‘‘(H) rum and tafia classified in subheading apparel article containing elastomeric yarns grant CBI parity to the ATPA bene- 2208.40.00 of the HTS. shall be eligible for preferential treatment ficiaries, specifically with respect to ‘‘(2) TRANSITION PERIOD TREATMENT OF CER- under this paragraph only if such yarns are textiles and apparel. During 1999, Co- TAIN TEXTILE AND APPAREL ARTICLES.— wholly formed in the United States. lombia and its Andean neighbors ex- ‘‘(A) ARTICLES COVERED.—During the tran- ‘‘(IV) SPECIAL ORIGIN RULE.—An article ported approximately $562 million in sition period, the preferential treatment de- otherwise eligible for preferential treatment scribed in subparagraph (B) shall apply to textiles and apparel to the United under clause (i) or (ii) of this subparagraph the following articles: shall not be ineligible for such treatment be- States. While insignificant in compari- ‘‘(i) APPAREL ARTICLES ASSEMBLED IN ONE cause the article contains nylon filament son to the $8.4 billion in textile and ap- OR MORE BENEFICIARY COUNTRIES.—Apparel yarn (other than elastomeric yarn) that is parel exports originating in the CBI re- articles assembled in one or more bene- classifiable under subheading 5402.10.30, gion, Andean textile and apparel pro- ficiary countries from fabrics wholly formed 5402.10.60, 5402.31.30, 5402.31.60, 5402.32.30, duction sustains more than 200,000 jobs and cut in the United States, from yarns 5402.32.60, 5402.41.10, 5402.41.90, 5402.51.00, or in Colombia alone—valuable jobs in the wholly formed in the United States, that 5402.61.00 of the HTS duty-free from a coun- legitimate economy. Absent CBI par- are— try that is a party to an agreement with the ity, the Andean region will find itself ‘‘(I) entered under subheading 9802.00.80 of United States establishing a free trade area, the HTS; or which entered into force before January 1, at a significant competitive disadvan- ‘‘(II) entered under chapter 61 or 62 of the tage with the 27 countries of the CBI 1995. HTS, if, after such assembly, the articles ‘‘(iv) SPECIAL RULE FOR FABRICS NOT region. would have qualified for entry under sub- FORMED FROM YARNS.— Mr. President, upon final passage of heading 9802.00.80 of the HTS but for the fact ‘‘(I) APPLICATION TO CLAUSE (i).—An article CBI enhancement legislation, I stated that the articles were embroidered or sub- otherwise eligible for preferential treatment that we had initiated the process of es- jected to stone-washing, enzyme-washing, under clause (i) of this subparagraph shall tablishing true ‘‘partnership for suc- acid washing, perma-pressing, oven-baking, not be ineligible for such treatment because cess’’ with some of our most important bleaching, garment-dyeing, screen printing, the article is assembled in one or more bene- neighbors. Although that legislation or other similar processes. ficiary countries from fabrics not formed ‘‘(ii) APPAREL ARTICLES CUT AND ASSEMBLED was a good start, it was only the begin- from yarns, if such fabrics are classifiable IN ONE OR MORE BENEFICIARY COUNTRIES.—Ap- ning. I urge my colleagues to look to- under heading 5602 or 5603 of the HTS and are parel articles cut in one or more beneficiary wholly formed and cut in the United States. wards the future by supporting the countries from fabric wholly formed in the ‘‘Plan Colombia Trade Act,’’ and by ‘‘(II) APPLICATION TO CLAUSE (ii).—An arti- United States from yarns wholly formed in cle otherwise eligible for preferential treat- taking advantage of the real economic the United States, if such articles are assem- ment under clause (ii) of this subparagraph benefits that can be achieved by fur- bled in one or more such countries with shall not be ineligible for such treatment be- ther enhancing our relationship with thread formed in the United States. cause the article is assembled in one or more ‘‘(iii) SPECIAL RULES.— all of the nations of the Western Hemi- beneficiary countries from fabrics not ‘‘(I) EXCEPTION FOR FINDINGS AND TRIM- sphere. formed from yarns, if such fabrics are classi- MINGS.—(aa) An article otherwise eligible for Mr. President, I ask unanimous con- fiable under heading 5602 or 5603 of the HTS preferential treatment under this paragraph and are wholly formed in the United States. sent that the text of the bill be printed shall not be ineligible for such treatment be- ‘‘(B) PREFERENTIAL TREATMENT.—During in the RECORD. cause the article contains findings or trim- the transition period, the articles to which There being no objection, the bill was mings of foreign origin, if such findings and this paragraph applies shall enter the United ordered to be printed in the RECORD, as trimmings do not exceed 25 percent of the States free of duty and free of any quan- follows: cost of the components of the assembled titative restrictions, limitations, or con- S. 2823 product. Examples of findings and trimmings sultation levels. Be it enacted by the Senate and House of Rep- are sewing thread, hooks and eyes, snaps, buttons, ‘bow buds’, decorative lace, trim, ‘‘(C) TRANSITION PERIOD.—In this para- resentatives of the United States of America in graph, the term ‘transition period’ means, Congress assembled, elastic strips, zippers, including zipper tapes and labels, and other similar products. Elas- with respect to a beneficiary country, the pe- SECTION 1. SHORT TITLE. riod that begins on the date of enactment of This Act may be cited as the ‘‘Plan Colom- tic strips are considered findings or trim- mings only if they are each less than 1 inch the Plan Colombia Trade Act or October 1, bia Trade Act’’. 2000, whichever is later, and ends on the date SEC. 2. TEMPORARY EXTENSION OF ADDITIONAL in width and are used in the production of brassieres. that duty-free treatment ends under this TRADE BENEFITS TO CERTAIN AN- title.’’. DEAN COUNTRIES. ‘‘(bb) In the case of an article described in (a) IN GENERAL.—Section 204(b) of the An- clause (ii) of this subparagraph, sewing (b) FACTORS AFFECTING DESIGNATION.— dean Trade Preference Act (19 U.S.C. 3203(b)) thread shall not be treated as findings or (1) IN GENERAL.—Section 203(d) of the Ande- is amended to read as follows: trimmings under this subclause. an Trade Preference Act (19 U.S.C. 3202(d)) is ‘‘(b) EXCEPTIONS TO DUTY-FREE TREAT- ‘‘(II) CERTAIN INTERLINING.—(aa) An article amended— MENT.— otherwise eligible for preferential treatment (A) by striking ‘‘and’’ at the end of para- ‘‘(1) IN GENERAL.—Subject to paragraphs under this paragraph shall not be ineligible graph (11); (2), the duty-free treatment provided under for such treatment because the article con- (B) by striking the period at the end of this title shall not apply to— tains certain interlinings of foreign origin, if paragraph (12) and inserting ‘‘; and’’; and ‘‘(A) textile and apparel articles which are the value of such interlinings (and any find- (C) by adding at the end the following: subject to textile agreements; ings and trimmings) does not exceed 25 per- ‘‘(13) the extent to which such country ad- ‘‘(B) footwear not designated at the time of cent of the cost of the components of the as- heres to democratic principles and the rule the effective date of this Act as eligible for sembled article. of law.’’. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6137 (2) EFFECTIVE DATE.—The amendments our neighbors in the south to maintain to seven. Her 16-year-old son has Downs made by this subsection take effect on the political and economic stability, we Syndrome. Last year she earned $13,800 earlier of— will in effect be securing the National and she used her EITC to purchase a (A) October 1, 2000; or Security of the United States. This leg- used van so she would have reliable (B) the date of enactment of the Plan Co- lombia Trade Act.∑ islation will provide these countries transportation for her 50-mile com- with the opportunity build their indus- mute to work. Another year, the EITC Mr. GRASSLEY. Mr. President, I rise try and their struggling economies and helped pay for new mattresses for her today to co-sponsor the Plan Colombia will improve the quality of their every- children’s beds. With an increase, she’d Trade Act along with my colleague, day lives. like to save a little money in case of an Senator BOB GRAHAM. This important I urge my colleagues to support this emergency or for better housing. bill will supplement Plan Colombia by important bill which will have a posi- These are real stories of real families expanding trade benefits to the coun- tive effect on the prosperity of our who are working hard to make ends tries of Colombia, Bolivia, Ecuador and neighbors in Colombia, Ecuador, Bo- meet but need and deserve more help. Peru. livia, and Peru. This is a bipartisan bill. We have Plan Colombia is an important pack- closely consulted with leading groups age that provides about a billion dol- By Mr. ROCKEFELLER (for him- like the Center on Budget and Policy lars to the government of Colombia, self, Mr. JEFFORDS, and Mr. Priorities, Catholic Charities U.S.A., and other countries in that region. BREAUX): the United Way of America, and the These funds will go to fight drugs, S. 2825. A bill to strengthen the effec- Progressive Policy Institute. eradicate the crops which create them, tiveness of the earned income tax cred- In addition to increasing the EITC and provide for alternative develop- it in reducing child poverty and pro- available to large families, our bill in- ment. Unfortunately, Plan Colombia moting work; to the Committee on Fi- cludes several bipartisan provisions to does not provide for an important nance. simplify the credit by conforming the measure that we can do to help these THE TAX RELIEF FOR WORKING FAMILIES ACT OF definition of earned income and simpli- countries, that is to stimulate their 2000 fying the definition of a dependent economy. We can achieve this by pass- Mr. ROCKEFELLER. Mr. President, I child. ing the Plan Colombia Trade Act, am proud to be joined by Senators JEF- Some may question the cost of ex- which will provide assistance to de- FORDS and BREAUX in introducing the panding the EITC, but I believe, com- velop their textile and apparel indus- Tax Relief for Working Families Act of pared to other tax proposals such as tries. 2000. This bipartisan bill is designed to providing additional marriage tax re- Developing the apparel industry of strengthen the effectiveness of the lief, investing an additional $8 billion these countries will encourage global Earned Income Tax Credit (EITC) in re- over the next five years is a reasonable trade, and offer the good people of that ducing child poverty and promoting investment to help low-wage working region a future filled with prosperity. work. families. Most of these families are Additionally, the trade benefits out- Our bill will increase the EITC for married. All are struggling, but work- lined in this bill will enhance peace, families with three or more children. ing hard to do the right thing for their stability, and prosperity in that region, Families could qualify for almost an children. In its letter supporting our which will ultimately yield a better additional $500. Obviously, raising a efforts, Catholic Charities U.S.A. de- quality of life for all involved. This bill large family costs more, and these fam- scribes our legislation is ‘‘pro-family, will not only benefit the struggling ilies have a higher poverty rate of 29 pro-marriage, and pro-work.’’ economies of Colombia, Bolivia, Ecua- percent, more than double the poverty During the 1998 tax year, over 19 mil- dor, and Peru, but will advance the rate of children in smaller families. lion working Americans got $30.5 bil- economy of the United States as well. Nearly three out of every five poor lion in tax relief, thanks to the EITC. As important as the assistance pack- children live in families with three or In my state, about 141,000 West Vir- age to Colombia is, most of the money more children. ginians claimed $210.7 million. About we provide will not reach ordinary Co- A report by the Committee for Eco- nineteen percent of West Virginia tax- lombians. They also are engaged in the nomic Development found that the payers benefit from the EITC. In my effort to combat illegal drugs. We need ‘‘EITC has become a powerful force in state, 84 percent of taxpayers earn less to ensure that they are not penalized dramatically raising the employment than $50,000. I believe that this legisla- for doing so. The current bill helps us of low-income women in recent years.’’ tion to expand the EITC for families help Colombians not with cash but The report also recommended further with three or more children will help with opportunity. It preserves legiti- expansions of the EITC. Since research more West Virginians than many of the mate jobs in a country sorely beset shows that larger families have greater other, more expensive provisions under with problems. problems leaving welfare for work, this consideration as part of the marriage Most garments that are produced in legislation should build upon our wel- penalty relief debate. Colombia are subject to a 20–30% duty fare reform efforts. We know that the EITC works. It en- rate upon importation into the U.S. As But even more compelling than na- courages work, and it helps lift fami- an example, swimsuits are subject to a tional statistics are the real stories lies out of poverty. I urge my col- duty rate of 33%. By granting duty-free from West Virginia families. One leagues to join with Senators JEFFORDS and quota-free benefits to apparel as- woman in Huntington, West Virginia is and BREAUX to help hard working fami- sembled in these countries from U.S. struggling to raise five daughters and lies raise their children. made yarn, and U.S. made fabric, these care for her husband who was disabled Mr. JEFFORDS. Mr. President, I am countries will now be able to compete in a roofing accident. That family is pleased today to join with Senators with other developing countries that managing on approximately $13,000 a ROCKEFELLER and BREAUX to introduce currently enjoy duty-free and quota- year. She works the night shift, but a bill that will provide a third-tier free benefits. It will also afford them must currently rely on the public bus. earned income tax credit (EITC) for the opportunity to participate in the Her shift begins at midnight, but the families with three or more children. I global economy. This will encourage last bus is at 9:00 p.m. so she takes the believe that the additional tax credit additional export of U.S. made cotton earlier bus, and spends several hours provided by this bill could be of signifi- and yarn, stimulate U.S. investment in waiting for her shift instead of having cant help to working low-income fami- the region and create needed jobs as time with her family. Last year, she lies. well. used the EITC to pay her bills, includ- The EITC is a refundable tax credit This bill is an opportunity to help re- ing a winter coat for one of her daugh- to low-income families. It is only avail- build a region which has been plagued ters. With an increase, she hopes to able to taxpayers who work and earn by the drug trade. We can assist these save for a used car. wages. Indeed, the EITC was enacted to countries, not by giving them more Another West Virginia mother is re- encourage taxpayers to work—even at money, but by providing these en- cently divorced and struggling to raise low-paying jobs—rather than relying hanced trade opportunities. By helping four sons, ranging in age from sixteen on government programs. The EITC S6138 CONGRESSIONAL RECORD — SENATE June 29, 2000 has played a key role in reducing the It does not have to be the case with Mr. President, I ask unanimous con- poverty rate for families. By some esti- the choices afforded by legislation I am sent that the text of the bill be printed mates, it has been the single most im- pleased to be introducing today along in the RECORD. portant factor in removing children with Senator ROCKEFELLER of West There being no objection, the bill was from poverty. Virginia aimed at reforming Medicare’s ordered to be printed in the RECORD, as As currently structured, the EITC home health benefit. The Medicare follows: provides a credit to families with one Adult Day Services Alternative Act of S. 2826 child, and a higher credit to families 2000 would provide Medicare bene- Be it enacted by the Senate and House of Rep- that have two or more children. Fami- ficiaries who qualify for home health resentatives of the United States of America in lies with three or four children receive benefits the choice to receive those Congress assembled, the same EITC as families with two services in qualified adult day care SECTION 1. SHORT TITLE. children. centers, and simultaneously assist fam- This Act may be cited as the ‘‘Medicare For low-income families of four, we ily caregivers with the very real dif- Adult Day Services Alternative Act of 2000’’. have seen significant progress in reduc- ficulties in caring for a homebound SEC. 2. FINDINGS. ing the incidence of poverty. The com- family member. Congress finds that— bination of the minimum wage, the It is with America’s Medicare bene- (1) adult day care offers services, including EITC, and food stamps can raise a fam- ficiaries and family caregivers in mind medical care, rehabilitation therapies, dig- ily of four with a full-time year-round which makes the Medicare Adult Day nified assistance with activities of daily liv- minimum wage worker close to the Services Alternative Act a winner for ing, social interaction, and stimulating ac- poverty line. But poverty persists in Medicare, for patients and for their tivities, to seniors who are frail, physically large families where there are more caregivers. First, it would allow pa- challenged, or cognitively impaired; tients to receive home health services (2) access to adult day care services pro- than two children. In families with vides seniors and their familial caregivers three or more children, the official in a setting that promotes rehabilita- support that is critical to keeping the senior poverty rate is 29 percent—twice the tion by providing social interaction, in the family home; rate for families with two children. meals and therapeutic activities above (3) more than 22,000,000 families in the While children in families with three and beyond the provision of the pre- United States serve as caregivers for aging or more children were 37 percent of all scribed home health benefit. Second, or ailing seniors, nearly 1 in 4 American fam- children in the United States in 1998, caregivers for homebound patients ilies, providing close to 80 percent of the care they comprised 57 percent of the chil- would be able to maintain employment to individuals requiring long-term care; (4) nearly 75 percent of those actively pro- dren living in poverty. outside of the home because they would know that their family member viding such care are women who also main- It is not surprising that reducing tain other responsibilities, such as working poverty is more problematic in large is in a healthy, protected environment outside of the home and raising young chil- families. As family size rises, so do during the day. dren; family expenses. Welfare benefits in- With this legislation, patients could (5) the average loss of income to these crease with family size; wages, how- elect to receive some, or all, of their caregivers has been shown to be $659,130 in ever, do not. For a large family, mov- home health benefit in a home or an wages, pension, and Social Security benefits; ing from welfare to work may actually adult day care congregate setting. I (6) the loss in productivity in United mean less money. In addition, with think my colleagues would agree with States businesses ranges from $11,000,000,000 more children, child care is not only me that the opportunity to interact to $29,000,000,000 annually; with others with similar needs can im- (7) the services offered in adult day care fa- more expensive, it is also more com- cilities provide continuity of care and an im- plicated. prove patients’ mental and physical portant sense of community for both the sen- With surplus projections now reach- wellbeing. While not expanding the ex- ior and the caregiver; ing $1.7 trillion, there are a whole host isting eligibility criteria for home (8) there are adult day care centers in of tax reform proposals—many meri- health, this legislation offers Medicare every State in the United States and the Dis- torious—circulating on Capitol Hill. In beneficiaries a greater sense of auton- trict of Columbia; the debate about tax cuts, we must not omy afforded by receiving necessary (9) these centers generally offer transpor- lose sight of our most vulnerable work- care outside of their homes. tation, meals, personal care, and counseling ers. We should build on the proven suc- The adult day care center would be in addition to the medical services and so- cess of the EITC to help these workers. paid 95% of the rate paid to a home cialization benefits offered; and health agency for providing the Medi- (10) with the need for quality options in I believe a larger earned income tax how to best care for our senior population credit for families with three or more care-covered service. But within that about to dramatically increase with the children will help put more low-income lump-sum payment, the adult day care aging of the baby boomer generation, the families on the path to self-sufficiency, center would also be required to cover time to address these issues is now. while at the same time helping welfare transportation, medication manage- SEC. 3. COVERAGE OF SUBSTITUTE ADULT DAY reform succeed. ment, therapeutic activities, and CARE SERVICES UNDER MEDICARE. meals. (a) SUBSTITUTE ADULT DAY CARE SERVICES By Mr. SANTORUM (for himself The Medicare Adult Day Services Al- BENEFIT.— and Mr. ROCKEFELLER): ternative Act recognizes the benefit (1) IN GENERAL.—Section 1861(m) of the So- S. 2826. A bill to amend title XVIII of that will come to family members of cial Security Act (42 U.S.C. 1395x(m)) is the Social Security Act to provide for Medicare recipients of this service. amended— (A) in the matter preceding paragraph (1), coverage of substitute adult day care These caregivers will be able to attend services under the Medicare Program; by inserting ‘‘or (8)’’ after ‘‘paragraph (7)’’; to other things in today’s fast-paced (B) in paragraph (6), by striking ‘‘and’’ at to the Committee on Finance. family life, knowing their loved ones the end; THE MEDICARE ADULT DAY SERVICES are well cared for. This creative solu- (C) in paragraph (7), by adding ‘‘and’’ at ALTERNATIVE ACT tion to health care delivery also ade- the end; and Mr. SANTORUM. Mr. President, as quately reimburses providers and is de- (D) by inserting after paragraph (7), the this Congress continues to deliberate signed to be budget neutral. following new paragraph: options of how best to care for our sen- I hope that members on both sides of ‘‘(8) substitute adult day care services (as ior population, it is critical to con- the aisle will join me in advancing this defined in subsection (uu));’’. sider, as well, the role that caregivers important issue for Medicare bene- (2) SUBSTITUTE ADULT DAY CARE SERVICES play in accommodating the delivery of DEFINED.—Section 1861 of the Social Security ficiaries and their families. As this Act (42 U.S.C. 1395x) is amended by adding at such care to loved ones. Family care- Congress considers various proposals to the end the following new subsection: givers are often forced to make dif- improve Medicare’s home health ben- ‘‘Substitute Adult Day Care Services; Adult ficult sacrifices. By just one measure, efit, this proposal deserves the serious Day Care Facility it is estimated that the average loss of attention and consideration of my col- ‘‘(uu)(1)(A) The term ‘substitute adult day income to these caregivers is more leagues. I look forward to working with care services’ means the items and services than $600,000 in wages, pensions and So- them to enact this pro-beneficiary, po- described in subparagraph (B) that are fur- cial Security benefits. This does not tentially cost-saving reform legisla- nished to an individual by an adult day care have to be the case, though. tion. facility as a part of a plan under subsection June 29, 2000 CONGRESSIONAL RECORD — SENATE S6139 (m) that substitutes such services for a por- tion 1861(uu)(1)(B)(i)) furnished to an indi- the closure of Fort Lyon to provide tion of the items and services described in vidual under the plan of care established better service to Colorado’s veterans subparagraph (B)(i) furnished by a home under section 1861(m) with respect to such through new outpatient clinics in La health agency under the plan, as determined services. Junta, Lamar and Alamosa and a by the physician establishing the plan. ‘‘(2) The Secretary shall estimate the ‘‘(B) The items and services described in amount that would otherwise be payable smaller, more efficient nursing home this subparagraph are the following items under this section for all home health serv- in Pueblo, CO. and services: ices under that plan of care other than sub- Ft. Lyon is a historical building, but ‘‘(i) Items and services described in para- stitute adult day care services for a week or it is simply not more important than graphs (1) through (7) of subsection (m). other period specified by the Secretary. the needs of those who served us. I ‘‘(ii) Transportation of the individual to ‘‘(3) The total amount payable for home would prefer that the money currently and from the adult day care facility in con- health services consisting of substitute adult used to maintain the facility was in- nection with any such item or service. day care services under such plan may not ‘‘(iii) Meals. exceed 95 percent of the amount estimated to stead used to provide medical care for ‘‘(iv) A program of supervised activities de- be payable under paragraph (2) furnished those veterans who need it. signed to promote physical and mental under the plan by a home health agency. This bill will lead to an improvement health and furnished to the individual by the ‘‘(4) No payment may be made under this in medical services for veterans in sev- adult day care facility in a group setting for title for home health services consisting of eral ways. With the estimated $8.6 mil- a period of not fewer than 4 and not greater substitute adult day care services described lion in savings to be realized after the than 12 hours per day. in clauses (ii) through (v) of section Ft. Lyon closure, clinics will be set up ‘‘(v) A medication management program 1861(uu)(1)(B).’’. in local communities which will be (as defined in subparagraph (C)). (c) ADJUSTMENT IN CASE OF OVERUTILIZA- ‘‘(C) For purposes of subparagraph (B)(v), TION OF SUBSTITUTE ADULT DAY CARE SERV- closer and more responsive to their the term ‘medication management program’ ICES.— local veteran communities. This bill means a program of services, including medi- (1) MONITORING EXPENDITURES.—Beginning mandates that the VA must open the cine screening and patient and health care with fiscal year 2002, the Secretary of Health replacement clinics before they convey provider education programs, that provides and Human Services shall monitor the ex- Ft. Lyon to the State of Colorado, to services to minimize— penditures made under the medicare pro- ensure there is no gap in service. This ‘‘(i) unnecessary or inappropriate use of gram under title XVIII of the Social Secu- bill will help to ensure that no service- prescription drugs; and rity Act (42 U.S.C. 1395 et seq.) for home ‘‘(ii) adverse events due to unintended pre- health services (as defined in section 1861(m) connected veteran’s needs are unmet. scription drug-to-drug interactions. of such Act (42 U.S.C. 1395x(m))) for the fiscal No veteran will go homeless. Every ‘‘(2)(A) Except as provided in subpara- year, including substitute adult day care veteran who needs a nursing home bed graphs (B) and (C), the term ‘adult day care services under paragraph (8) of such section due to service connected illness will facility’ means a public agency or private or- (as added by subsection (a)), and shall com- still be granted one. Those veterans ganization, or a subdivision of such an agen- pare such expenditures to expenditures that currently in Ft. Lyon will continue to cy or organization, that— the Secretary estimates would have been ‘‘(i) is engaged in providing skilled nursing receive nursing home care, at no addi- made for home health services for that fiscal tional charges to them. The cemetery services and other therapeutic services di- year if subsection (a) had not been enacted. and historic Kit Carson chapel will re- rectly or under arrangement with a home (2) REQUIRED REDUCTION IN PAYMENT health agency; RATE.—If the Secretary determines, after main fully accessible to the public. ‘‘(ii) meets such standards established by making the comparison under paragraph (1) And the people of the region will also the Secretary to ensure quality of care and and making such adjustments for changes in be assisted by the opening of a state fa- such other requirements as the Secretary demographics and age of the medicare bene- cility to replace Ft. Lyon in the local finds necessary in the interest of the health ficiary population as the Secretary deter- economy. Without this legislation, and safety of individuals who are furnished mines appropriate, that expenditures for services in the facility; there are no guarantees any of this home health services under the medicare would occur. ‘‘(iii) provides the items and services de- program, including such substitute adult day scribed in paragraph (1)(B); and care services, exceed expenditures that I hope that this bill will be consid- ‘‘(iv) meets the requirements of paragraphs would have been made under such program ered and pass quickly, so that the sav- (2) through (8) of subsection (o). for home health services for a year if sub- ings and the improvements in veteran’s ‘‘(B) Notwithstanding subparagraph (A), section (a) had not been enacted, then the healthcare can begin as soon as pos- the term ‘adult day care facility’ shall in- Secretary shall adjust the rate of payment sible. clude a home health agency in which the to adult day care facilities so that total ex- items and services described in clauses (ii) penditures for home health services under By Mr. HUTCHINSON (for him- through (v) of paragraph (1)(B) are provided such program in a fiscal year does not exceed self, Mr. LOTT, Mr. NICKLES, Mr. by others under arrangements with them the Secretary’s estimate of such expendi- GREGG, Mr. GORTON, Mr. COVER- made by such agency. tures if subsection (a) had not been enacted. ‘‘(C) The Secretary may waive the require- (d) EFFECTIVE DATE.—The amendments DELL, and Mr. INHOFE): ment of a surety bond under paragraph (7) of made by this section shall apply to items S. 2829. A bill to provide for an inves- subsection (o) in the case of an agency or or- and services furnished on or after the date on tigation and audit at the Department ganization that provides a comparable sur- which the prospective payment system for ety bond under State law. of Education; to the Committee on home health services furnished under the ‘‘(D) For purposes of payment for home Health, Education, Labor, and Pen- medicare program under section 1895 of the health services consisting of substitute adult sions. Social Security Act (42 U.S.C. 1395fff) is es- day care services furnished under this title, tablished and implemented. DEPARTMENT OF EDUCATION INVESTIGATION any reference to a home health agency is AND AUDIT LEGISLATION deemed to be a reference to an adult day care facility.’’. By Mr. ALLARD. Mr. HUTCHINSON. Mr. President, I (3) CONFORMING AMENDMENTS.—Sections S. 2827. A bill to provide for the con- rise today to introduce legislation re- 1814(a)(2)(C) and 1835(a)(2)(A)(i) of the Social veyance of the Department of Veterans quiring an audit of accounts at the Security Act (42 U.S.C. 1395f(a)(2)(C); Affairs Medical Center at Ft. Lyon, U.S. Department of Education that are 1395n(a)(2)(A)(i)) are each amended by strik- Colorado, to the State of Colorado, and susceptible to waste, fraud, and abuse. ing ‘‘section 1861(m)(7)’’ and inserting ‘‘para- for other purposes; to the Committee It is unfortunate that Congress has to graph (7) or (8) of section 1861(m)’’. on Veterans’ Affairs. be dealing with this issue, but unfortu- (b) PAYMENT FOR SUBSTITUTE ADULT DAY nately, it is all too necessary. CARE SERVICES.—Section 1895 of the Social LEGISLATION TO IMPROVE HEALTHCARE OPTIONS Security Act (42 U.S.C. 1395fff) is amended by FOR VETERANS As Members of the Senate have been adding at the end the following new sub- Mr. ALLARD. Mr. President, today I debating education this year, we have section: am introducing a bill to improve the stressed the need for accountability of ‘‘(e) PAYMENT RATE FOR SUBSTITUTE ADULT healthcare options for veterans in federal funds. Before we stress account- DAY CARE SERVICES.—In the case of home southern Colorado. To do this, I am ex- ability at the local level, though, we health services consisting of substitute adult pediting the transfer of the Ft. Lyon must ensure that accountability is also day care services (as defined in section 1861(uu)), the following rules apply: facility to the State of Colorado, which occurring at the federal level. It we are ‘‘(1) The Secretary shall determine each will allow the Veterans Administration going to increase the budget for the component (as defined by the Secretary) of (VA) to implement their plan to use Department of Education, as the Fiscal substitute adult day care services (under sec- the annual $8.6 million in savings from Year 2001 Labor, Health and Human S6140 CONGRESSIONAL RECORD — SENATE June 29, 2000 Services, and Education Appropria- ber clearly the immediate impact that are constitutionally required and can- tions bill does, we have the responsi- this momentous decision had upon law not be overruled by an act of Congress. bility to determine whether the De- enforcement, prosecutors, criminal de- Section 3501’s attempt to authorize the partment is properly accounting for fendants and the criminal justice sys- admission at trial of statements that the funding that they already have. tem as a whole. The Supreme Court’s would be excluded under Miranda is The U.S. Department of Education is pronouncement that all suspects in therefore unconstitutional, as I have already having problems overseeing custody needed to be advised of certain long believed. the programs that it currently admin- constitutional rights, including the This week’s resounding reaffirmation isters. For the second year in a row, privilege against self-incrimination, of the Miranda rule should put to rest the Department of Education has been before being questioned was as new the issue of Miranda’s continuing vital- unable to address its financial manage- then as it is familiar today. ity. Most law enforcement officers ment problems. In its last two audits, The Miranda decision put into place made their peace with Miranda long the Department was unable to account a fair and bright-line rule that both ago: It is time for the rest to do the for parts of its $32 billion program protects the rights of the accused and same. That is why I am disturbed by budget and the $175 billion owed in stu- has proven workable for law enforce- Justice Scalia’s parting shot in dent loans. Every year, the Depart- ment. Statements stemming from cus- Dickerson. In a dissenting opinion ment is required to undergo an inde- todial interrogation of a suspect are in- joined by Justice Thomas, Justice pendent audit. Unfortunately, for Fis- admissible at trial unless the police Scalia vowed to continue to apply sec- cal years 1998 and 1999, auditors have first provide the suspect with a set of tion 3501 until such time as it is re- declared the Department of Education four specific warnings: (1) you have the pealed. inauditable. right to remain silent; (2) anything you Mr. President, that time has come. I The House Education and the Work- say may be used as evidence against am introducing a bill today, together force Committee has been holding you; (3) you have the right to an attor- with my good friend, Senator FEIN- hearing on financial problems at the ney; and (4) if you cannot afford an at- GOLD, to repeal section 3501. I can think Department of Education, and has torney, one will be appointed for you. of no good reason to allow this pat- found serious instances of duplicate These warnings are necessary to dis- ently unconstitutional statute to re- payments to grant winners and an $800 pel the compulsion inherent in custo- main on the books. On the contrary, million college loan to a single stu- dial surroundings and so ensure that leaving section 3501 on the books is dent. In its 1998 audit, the Department any statement obtained from the sus- sure to invite more unwarranted at- blamed its problems on a faulty new pect is truly the product of his free tacks on Miranda by the same conserv- accounting system that cost $5.1 mil- choice. As author and former Federal ative activists who brought us the lion, in addition to the cost of man- prosecutor Scott Thurow wrote in an Dickerson case. Enough is enough. power to try to fix the system. A new opinion article in Wednesday’s New Whatever you think of Miranda’s rea- accounting system will be the third in York Times: ‘‘The requirement to re- soning and its resulting rule, seven Su- five years. cite Miranda is an important reminder preme Court Justices have reaffirmed The most recent 1999 audit showed to the police that the war on lawless- its constitutional pedigree. I urge my that the Department’s financial stew- ness is always subject to the guidance colleagues on both sides of the aisle to ardship remains in the bottom quartile of the law.’’ uphold their oaths to defend the Con- of all major federal agencies. It also Over the last 34 years, the Miranda stitution by repudiating an unconstitu- sent duplicate payments to 52 schools rule has developed into a bedrock prin- tional statute. in 1999 at a cost of more than $6.5 mil- ciple of American criminal law. The re- I ask unanimous consent that the lion. In addition, none of the material quired issuance of Miranda warnings text of the bill be printed in the weaknesses cited in the 1998 audit were has been incorporated in local, State RECORD. corrected. and Federal police practice across this There being no objection, the bill was These instances show that the De- nation. Indeed, it is no exaggeration to ordered to be printed in the RECORD, as partment is currently vulnerable to say, as the Court said this week, that follows: fraud, waste, and abuse. The House of Miranda warnings ‘‘have become part S. 2830 Representatives has already indicated of our national culture.’’ Two years after Miranda was decided, Be it enacted by the Senate and House of its support for a fraud audit at the De- Representatives of the United States of America partment of Education by passing its Congress enacted 18 U.S.C. 3501, which in Congress assembled, laid down a rule that purported to own version of this bill on June 13, 2000, SECTION 1. SHORT TITLE. by an overwhelming vote of 380–19. Be- overrule Miranda and to restore the This Act may be cited as the ‘‘Miranda Re- fore Congress entrusts the U.S. Depart- case-by-case, totality-of-the-cir- affirmation Act of 2000’’. ment of Education with funding that is cumstances test of a confession’s ‘‘vol- SEC. 2. AMENDMENTS TO TITLE 18. so important to our nation’s schools untariness’’ that the Miranda decision Section 3501 of title 18, United States Code, and students, we must demand that the found constitutionally inadequate. The is amended— funds they already have are well-man- validity of section 3501 did not come (1) by striking subsections (a) and (b); and aged. before the Court until now because no (2) by redesignating subsections (c), (d), Administration of either party sought and (e) as subsections (a), (b), and (c) respec- By Mr. LEAHY (for himself and to use it, out of concern for its dubious tively. Mr. FEINGOLD): constitutionality. The issue was finally Mr. FEINGOLD. Mr. President, I am S. 2830. A bill to preclude the admis- presented only because an organization pleased to join with my friend from sibility of certain confessions in crimi- of conservative activists maneuvered a Vermont to introduce the Miranda Re- nal cases; to the Committee on the Ju- case before the most conservative Fed- affirmation Act, a bill that repeals two diciary. eral appeals court in the country. To sections of the United States Criminal THE MIRANDA REAFFIRMATION ACT OF 2000 her credit, Attorney General Reno de- Code because they directly conflict Mr. LEAHY. Mr. President, this clined to argue that Miranda had been with the constitutional rule set forth week, the Supreme Court reaffirmed invalidated by section 3501. She also by the United States Supreme court in its landmark decision in Miranda v. Ar- declined to ask the Supreme Court to the 1966 landmark decision of Miranda izona. I applaud that decision. Miranda overrule Miranda, on the ground that v. Arizona. struck a balance between the needs of it has proved to be workable in prac- This week, nearing the conclusion of law enforcement and the rights of a tice and in many respects beneficial to a busy term, the United States Su- suspect that has worked well for 34 law enforcement. preme Court handed down several very years. There is no reason to upset that The Court’s decision this week in important decisions. In one of the more balance now. Dickerson v. United States—announced highly anticipated rulings, Dickerson Shortly after Miranda was decided in by the Chief Justice and joined by six v. United States, the Court held by a 7– 1966, I became State’s Attorney for other Justices—erased any doubt that 2 majority that the rule announced in Chittenden County, Vermont. I remem- the protections announced in Miranda Miranda is still the supreme law of this June 29, 2000 CONGRESSIONAL RECORD — SENATE S6141 land. As we are all aware, the Miranda Dickerson, we now have a law on the shark populations. I am pleased to be rule instructs all law enforcement offi- books that the Court has ruled is in- joined in this effort by the Ranking cers that prior to an in-custody inter- consistent with what the Constitution Member of the Commerce Committee, rogation they must inform suspects of requires with respect to constitutional Senator HOLLINGS. several important constitutional in-custody interrogations. That may Mr. President, sharks are among the rights: the right to remain silent, the seem to be a matter of little con- most biologically vulnerable species in right to counsel, and the right to have sequence, but the statement of Justice the ocean. Their slow growth, late ma- counsel appointed if they cannot afford Scalia that he will continue to apply it turity and small number of offspring one. in future cases shows that it is not. leave them exceptionally vulnerable to As the Court noted, ‘‘Miranda has be- The bill that we are introducing today overfishing and slow to recover from come embedded in routine police prac- eliminates this potential problem by depletion. At the same time, sharks, as tice to the point where the warning removing the unconstitutional provi- top predators, are essential to main- have become part of our national cul- sion from the criminal code. taining the balance of life in the sea. ture.’’ Millions of American children This repeal will accomplish two While many of our other highly migra- have first learned about their constitu- things. It will bring our criminal code tory species such as tunas and sword- tional rights by watching police dram- into line with what the Supreme Court fish are subject to rigorous manage- as on television and hearing the fa- has now firmly established as the law ment regimes, sharks have largely been mous Miranda warnings given to crimi- of the land, and it will remove from the overlooked until recently. nal suspects. books an ineffective law that Justice The bill first amends the Magnuson- Mr. President, the Supreme Court’s Rehnquist considered ‘‘more difficult Stevens Fishery Conservation and reaffirmation of the Miranda rule was than Miranda for law enforcement offi- Management Act to prohibit shark fin- extremely important. In the Dickerson cers to conform to, and for courts to ning, which is the practice of removing case, a private legal foundation and a apply in a consistent manner.’’ The a shark’s fins and returning the re- law professor intervened in a criminal prophylactic rule established by Mi- mainder of the shark to sea, and pro- case and questioned whether Miranda randa has worked well and stood the vides a rebuttable presumption that warnings are constitutionally required. test of time. Law enforcement officers, shark fins found on board a U.S. vessel Relying on 18 U.S.C. § 3501, they argued prosecutors, and defense attorneys were taken by finning, thus closing the that law enforcement officers should have found that it is a far better way transshipment loophole. National Ma- not have to inform suspects of their to protect the constitutional rights of rine Fisheries Service (NMFS) regula- basic constitutional rights before pro- tions in the Atlantic Ocean prohibit ceeding with in-custody interrogations those accused of crimes than the ‘‘vol- untariness’’ standard that was in place the practice of shark finning, but a na- as long as any confessions obtained tionwide prohibition does not currently were determined to be voluntary. While before Miranda and that § 3501 at- tempted to keep in place. exist. Shark fins comprise only a small every administration since the law was percentage of the weight of the shark, passed in 1968 has refused to make this Mr. President, it is simply not appro- priate for the existing criminal code to and yet this is often the only portion of argument, a lower court in the the shark retained. The Magnuson-Ste- Dickerson case agreed with it. Section conflict with what the Supreme Court has ruled that the Constitution re- vens Act and international commit- 3501 was enacted in 1968, just two years ments discourage unnecessary waste of after the original Miranda decision. It quires. It is our duty to act to repeal a provision that the Department of Jus- fish, and thus I believe this bill ensure was a clear attempt by Congress to our domestic regulations are con- overturn the constitutional rule laid tice has refused to apply and that the sistent on this point. Another goal of down in that case. Supreme Court has held, in any event, the Magnuson-Stevens Act—the mini- It is a strange quirk of history that cannot be enforced. As the ranking the validity of § 3501 and Congress’s at- member of the Constitution Sub- mization of bycatch and bycatch mor- tempt to overrule Miranda was ad- committee of the Senate Judiciary tality—is an issue that I have been par- dressed for the first time by the Su- Committee, I am proud to join the ticularly committed to over the years. preme Court in the Dickerson case. The ranking member of the full Committee, Because most of the sharks caught and reason is that a series of Departments Senator LEAHY, in offering this finned are incidentally captured in of Justice, under both Republican and straightforward and commonsense fisheries targeting other species, I be- Democratic Presidents assumed that measure. lieve establishing a domestic ban will the statute was unconstitutional and help us further reduce this type of refused to proceed under it. In By Mr. KERRY (for himself and shark mortality. Dickerson, the Supreme Court agreed Mr. HOLLINGS): Mr. President, this legislation would with that view. S. 2831. A bill to amend the Magnu- also direct the Secretary of Commerce Writing for a seven justice majority, son-Stevens Fishery Conservation and to initiate negotiations with foreign Chief Justice Rehnquist pointed out Management Act to improve conserva- countries in order to encourage those that ‘‘because of the obvious conflict tion and management of sharks and es- countries to adopt shark finning prohi- between our decision in Miranda and tablish a consistent national policy to- bitions similar to ours. The establish- § 3501 we must address whether Con- ward the practice of shark-finning; to ment of a prohibition of shark finning gress has the constitutional authority the Committee on Commerce, Science, by United States fishermen, or in wa- to thus supercede Miranda.’’ Second, and Transportation. ters subject to our jurisdiction, will the Chief Justice reiterated the estab- f not reduce finning by international lished principle that ‘‘Congress may fishing fleets or transshipment or land- THE SHARK CONSERVATION ACT ing of fins taken by these fleets. At not legislatively supercede our OF 2000 decision[s] interpreting and applying present, foreign fleets transship or land the constitution,’’ and he concluded by Mr. KERRY. Mr. President, I rise approximately 180 metric tons of shark ruling that ‘‘Miranda announced a con- today to introduce the Shark Con- fins annually through ports in the Pa- stitutional rule that Congress may not servation Act of 2000, legislation that cific alone. The global shark fin trade supercede legislatively.’’ will significantly improve conservation involves at least 125 countries, and the Justice Scalia, in dissent, disagreed and management of sharks worldwide, demand for shark fins and other shark vehemently with the majority’s anal- and establish a consistent national pol- products has driven dramatic increases ysis. In a somewhat curious declara- icy toward the practice of shark-fin- in shark fishing and shark mortality tion of defiance he wrote: ‘‘[U]ntil § 3501 ning. The bill would prohibit the prac- around the world. is repealed, [I] will continue to apply it tice of shark finning and trans- International measures are an abso- in all cases where there has been a sus- shipment of shark fins by U.S. vessels, lutely critical component of achieving tainable finding that the defendant’s set forth a process to encourage foreign effective shark conservation. Under my confession was voluntary.’’ governments to end this practice by legislation, the Secretary would be Mr. President, as a result of the their own fishing fleets, and authorize mandated to report to Congress on Court’s unequivocal ruling in badly needed fisheries research on progress being made domestically and S6142 CONGRESSIONAL RECORD — SENATE June 29, 2000 internationally to reduce shark fin- Therefore, today, Mr. President, I in- limits and determining rules for for- ning. Further, this legislation will es- troduce the Magnuson-Stevens Reau- eign ownership. tablish a procedure for determining thorization Act of 2000 with several Mr. President, the NAS report con- whether governments have adopted very specific goals in mind. First and tains important recommendations that shark conservation measures which are foremost, this bill provides for a major should be thoroughly examined by Con- comparable to ours through import increase in funding. While the demands gress and the public. I understand that certification procedures for sharks or on fisheries managers at the local and in some regions of the country, both shark parts. Imports of sharks or shark federal levels have increased exponen- commercial and recreational fishermen parts from countries that do not meet tially, funding has essentially re- want to immediately move to the de- these certification procedures are pro- mained level. One of the most serious sign and implementation of new IFQ hibited. I have also included provisions problems in fisheries management is a programs. However, it is clear that which would provide technical assist- lack of basic information on the re- many of the important questions asso- ance to foreign nations in an attempt source. This bill, through increased ciated with any new IFQ program have to promote compliance. funding and the establishment of two not been fully considered and imme- Finally, my bill would authorize a programs, will go a long way toward diate implementation of such programs Western Pacific longline fisheries coop- filling existing critical gaps in our in- could have deleterious affects on fish- erative research program to provide in- formation databases. For the past sev- eries and fishing communities. For formation for shark stock assessments, eral years, Senators KERRY, GREGG, that reason, the bill I introduce today identify fishing gear and practices that and I have worked to establish a coop- contains a three year extension of the prevent or minimize incidental catch erative research program in New Eng- existing moratorium. of sharks and ensure maximum survi- land fisheries. This program, which re- This provision simply recognizes that vorship of released sharks, and provide quires federal and local scientists to fisheries conservation and manage- data on the international shark fin partner with commercial fishermen in ment must be approached from a long- trade. the gathering and development of fish- term perspective. Widespread imple- Mr. President, the United States is a eries data, has proven quite successful. mentation of IFQ programs will dras- global leader in fisheries conservation Therefore, this bill would establish a tically alter the face of fishing commu- and management. I believe this legisla- National Cooperative Research and nities and the way we pursue fisheries tion provides us the opportunity to fur- Management program to be adminis- conservation measures. If IFQs are in- ther this role, and take the first step in tered by the agency in conjunction deed the answer that many of their ad- addressing an international fisheries with the regional councils and local vocates claim, then surely IFQs will management issue. In addition, I be- fishermen. In addition, the bill also es- still be a viable option in three years. lieve the U.S. should continue to lead tablishes a National Cooperative En- But, a short-term extension of the mor- efforts at the United Nations and inter- forcement program. This too is based atorium, as this bill proposes, will national conventions to achieve coordi- on existing programs in several states, force the Congress and fishing commu- nated international management of where state marine law enforcement nities to consider the many other nec- sharks, including an international ban officers are deputized by their federal essary questions related to IFQs. The on shark-finning. I look forward to counterparts to help enforce conserva- NAS report recommended Congress working with Committee members on tion and management provisions of the provide guidance on these issues be- this important legislation. Magnuson-Stevens Act and other ma- cause they are clearly questions of na- Thank you Mr. President. rine related laws. Lack of enforcement tional concern, and I suggest that we By Ms. SNOWE: of fisheries laws has been a constant follow that course. S. 2832. A bill to reauthorize the Mag- problem for fishermen and fisheries Mr. President, this bill provides a nuson-Stevens Fishery Conservation managers. number of other improvements, includ- and Management Act, and for other This bill also addresses one of the ing increased flexibility to the agency purposes; to the Committee on Com- most serious and emotional questions to reaffirm the original intent of Con- merce, Science, and Transportation. in fisheries management—individual gress that there is no ‘‘one-size-fits- THE MAGNUSON-STEVENS REAUTHORIZATION ACT fishing quotas (IFQs). The SFA in- all’’ solution to fisheries management. OF 2000 cluded a five year moratorium on new Moreover, the bill would provide for an Ms. SNOWE. I rise today to introduce IFQ programs and required the Na- expanded national observer program to a bill that will reauthorize the most tional Academy of Sciences (NAS) to help collect critical information. It is important Federal fisheries manage- study the issue. The NAS report issued widely recognized that we need to in- ment law, the Magnuson-Stevens Fish- a series of recommendations on IFQs. crease our use of observers to gain data ery Conservation and Management Act. The first recommendation was for Con- on species composition, age structure, In 1996, Congress last reauthorized this gress to lift the existing moratorium and bycatch. The bill also establishes a law through enactment of the Sustain- on new IFQ programs and authorize the pilot program to help fisheries man- able Fisheries Act (SFA). The SFA con- councils to design and implement new agers begin the move toward eco- tained the most substantial improve- IFQs. The moratorium is set to expire system-based management. While it is ments to fisheries conservation since on October 1, 2000. clear that we do not currently have the original passage of the Magnuson This recommendation has received a sufficient information of resources to Act in 1976. lot of publicity. However, the NAS re- make a full shift to ecosystem-based The SFA made wholesale changes in port contained a number of other rec- management, it is equally clear that fisheries management. For the first ommendations to Congress that were we need to move in this direction and time, it required the regional fishery to be considered in conjunction with a pilot program can illustrate for us management councils and the Sec- the authorization of any new IFQ pro- how to do this. retary of Commerce to prevent and end grams. These recommendations con- Finally, I would like to say that this overfishing, reduce bycatch, protect es- cern substantive issues, yet they have bill represents a significant amount of sential fish habitat, and consider fish- not received the level of attention that work by the Subcommittee on Oceans ing communities in the regulatory de- they fully deserve. For instance, the and Fisheries. Over the past year, the cision-making process. These provi- NAS recommended that Congress Subcommittee held six hearings in var- sions of the SFA have presented a should encourage cost recovery and ex- ious parts of the country on the Mag- great challenge to the National Marine traction of profits from new IFQ pro- nuson Stevens Act. We begin the proc- Fisheries Service the regional councils, grams through fees, annual taxes, and ess in Washington, DC, and then visited and the fishermen who are regulated zero-revenue auctions. The NAS also fishing communities in New England, under this law. While the goals and in- recommended that the Act be amended The Gulf of Mexico, the North Pacific tent of the SFA were certainly laud- to allow the public to capture windfall and the Pacific. In this bill, I have able, four years later, we still have a gains generated from the initial alloca- tried to incorporate many of the sug- significant amount of work to do in tion of IFQs. Additional recommenda- gestions we heard from those men and that regard. tions include requiring accumulation women who fish for a living and who June 29, 2000 CONGRESSIONAL RECORD — SENATE S6143 are most affected by the law and its The legislation I am proposing today GRASSLEY) was added as a cosponsor of regulations. I view this bill as a basis would give the Federal Election Com- S. 1142, a bill to protect the right of a from which I intend to work with other mission the tools it needs to ensure member of a health maintenance orga- members of the Subcommittee so that compliance with the law. Specifically, nization to receive continuing care at a the Commerce Committee can consider this legislation would give the Com- facility selected by that member, and it in executive session in July. I look mission the authority to conduct ran- for other purposes. forward to providing our fishing com- dom audits and investigations to en- S. 1150 munities with a bill that will improve sure voluntary compliance with the At the request of Mr. HATCH, the lives in a meaningful way. act. The potential of a random audit is name of the Senator from Oklahoma a well-recognized deterrent to poten- (Mr. NICKLES) was added as a cosponsor By Mr. DODD: tial violators and an authority given to of S. 1150, a bill to amend the Internal S. 2833. A bill to amend the Federal many federal enforcement agencies. Revenue Code of 1986 to more accu- Election Campaign Act of 1971 to im- Secondly, this legislation would rately codify the depreciable life of prove the enforcement capabilities of grant the Commission the authority to semiconductor manufacturing equip- the Federal Election Commission, and seek injunctive relief in the event that ment. for other purposes; to the Committee certain statutory conditions are met, S. 1155 on Rules and Administration. including: At the request of Mr. ROBERTS, the FEDERAL ELECTION CAMPAIGN ACT OF 1971 that there is a substantial likelihood names of the Senator from South Da- AMENDMENTS LEGISLATION that a violation of the act is occurring kota (Mr. DASCHLE) and the Senator Mr. DODD. Mr. President, Today the or about to occur; from North Dakota (Mr. CONRAD) were Senate passed, and sent to the Presi- that the failure to act expeditiously added as cosponsors of S. 1155, a bill to dent for signature, the most significant will result in irreparable harm; amend the Federal Food, Drug, and campaign finance reform in the last 2 that expeditious action will not Cosmetic Act to provide for uniform decades—the so-called section 527 re- cause undue harm or prejudice; and food safety warning notification re- form. Clearly, our campaign finance that the best interest of the public quirements, and for other purposes. system is in need of further com- would be served by the issuance of an S. 1322 prehensive reform. The McCain-Fein- injunction. At the request of Mr. LEAHY, his gold legislation, I believe, is still the Finally, this legislation would in- name was added as a cosponsor of S. most comprehensive and necessary re- crease the penalties for knowing and 1322, a bill to prohibit health insurance form that we could pass in the 106th willful violations of the act from and employment discrimination Congress. $10,000 to $15,000 or an amount equal to against individuals and their family In the meantime, however, we must 300 percent. In order to ensure that the members on the basis of predictive ge- also strengthen the abilities of the Commission has sufficient resources to netic information or genetic services. agency charged with enforcing the laws carry out its statutory responsibilities, S. 1459 on the books today—and that is the my legislation provides for an author- At the request of Mr. MACK, the name Federal Election Commission. For that ization of appropriations for FY 2001 at of the Senator from Iowa (Mr. GRASS- reason, I am today introducing legisla- the full amount requested by the Com- LEY) was added as a cosponsor of S. tion to improve the enforcement capa- mission, or nearly $41 million. 1459, a bill to amend title XVIII of the bilities of the Federal Election Com- Enhanced enforcement authority is Social Security Act to protect the mission. not a substitute for comprehensive re- right of a medicare beneficiary en- Created in the wake of the Watergate form. But passage of this legislation rolled in a Medicare+Choice plan to re- scandal, the primary purpose of the should be something every member of ceive services at a skilled nursing facil- Federal Election Commission is to en- this body can support. Not to do so ity selected by that individual. sure the integrity of federal elections only confirms the critics’ views that S. 1759 by overseeing federal election disclo- this agency is a toothless tiger. At the request of Mr. BREAUX, the sure requirements and enforcing the I urge my colleagues to give serious name of the Senator from Montana federal campaign finance laws. consideration to this legislation. (Mr. BAUCUS) was added as a cosponsor Regardless of the views of my col- of S. 1759, a bill to amend the Internal f leagues with regard to the need for Revenue Code of 1986 to allow a refund- campaign finance reform, it cannot be ADDITIONAL COSPONSORS able credit for taxpayers owning cer- argued that Congress intended that S. 573 tain commercial power takeoff vehi- this enforcement agency be nothing cles. At the request of Mr. LEAHY, the more than a paper tiger. And yet, that name of the Senator from Massachu- S. 1805 is precisely what many view it to be. At the request of Mr. KENNEDY, the setts (Mr. KERRY) was added as a co- The legislation I am introducing today sponsor of S. 573, a bill to provide indi- name of the Senator from New York is intended to put some teeth into this (Mr. SCHUMER) was added as a cospon- viduals with access to health informa- enforcement body. sor of S. 1805, a bill to restore food tion of which they are a subject, ensure As a long time supporter of com- stamp benefits for aliens, to provide personal privacy with respect to prehensive campaign finance reform, I States with flexibility in administering health-care-related information, im- am not suggesting that my proposal is the food stamp vehicle allowance, to pose criminal and civil penalties for in any way a substitute for the index the excess shelter expense deduc- unauthorized use of protected health McCain-Feingold bill or any other com- tion to inflation, to authorize addi- information, to provide for the strong prehensive reform. But sadly, it is tional appropriations to purchase and enforcement of these rights, and to clear that a minority in this body will make available additional commodities protect States’ rights. once again prevent a majority of both under the emergency food assistance houses of Congress from enacting S. 1066 program, and for other purposes. meaningful reform this year. At the request of Mr. ROBERTS, the S. 2018 As has been the case for the last sev- name of the Senator from Montana At the request of Mrs. HUTCHISON, the eral congresses, the 106th Congress will (Mr. BAUCUS) was added as a cosponsor name of the Senator from New York likely come to a close without enact- of S. 1066, a bill to amend the National (Mr. MOYNIHAN) was added as a cospon- ing comprehensive campaign finance Agricultural Research, Extension, and sor of S. 2018, a bill to amend title reform. In light of that reality, it is all Teaching Policy Act of 1977 to encour- XVIII of the Social Security Act to re- the more important that we ensure age the use of and research into agri- vise the update factor used in making that the campaign finance laws that cultural best practices to improve the payments to PPS hospitals under the are currently on the books are vigor- environment, and for other purposes. medicare program. ously enforced. And that requires an S. 1142 S. 2061 agency that is fully armed with all the At the request of Ms. MIKULSKI, the At the request of Mr. BIDEN, the enforcement tools we can give it. name of the Senator from Iowa (Mr. name of the Senator from Washington S6144 CONGRESSIONAL RECORD — SENATE June 29, 2000 (Mrs. MURRAY) was added as a cospon- (Mr. WELLSTONE) was added as a co- itation on holding and transfer of sor of S. 2061, a bill to establish a crime sponsor of S. 2698, a bill to amend the broadcast licenses to foreign persons, prevention and computer education ini- Internal Revenue Code of 1986 to pro- and to apply a similar limitation to tiative. vide an incentive to ensure that all holding and transfer of other tele- S. 2062 Americans gain timely and equitable communications media by or to foreign At the request of Mr. DEWINE, the access to the Internet over current and governments. name of the Senator from Ohio (Mr. future generations of broadband capa- S. 2799 VOINOVICH) was added as a cosponsor of bility. At the request of Mr. MURKOWSKI, the S. 2062, a bill to amend chapter 4 of S. 2700 names of the Senator from Indiana title 39, United States Code, to allow At the request of Mr. L. CHAFEE, the (Mr. LUGAR) and the Senator from postal patrons to contribute to funding names of the Senator from South Da- Maine (Ms. SNOWE) were added as co- for organ and tissue donation aware- kota (Mr. DASCHLE) and the Senator sponsors of S. 2799, a bill to allow a de- ness through the voluntary purchase of from Massachusetts (Mr. KERRY) were duction for Federal, State, and local certain specially issued United States added as cosponsors of S. 2700, a bill to taxes on gasoline, diesel fuel, or other postage stamps. amend the Comprehensive Environ- motor fuel purchased by consumers be- S. 2274 mental Response, Compensation, and tween July 1, 2000, and December 31, At the request of Mr. GRASSLEY, the Liability Act of 1980 to promote the 2000. name of the Senator from Delaware cleanup and reuse of brownfields, to S. 2811 (Mr. BIDEN) was added as a cosponsor of provide financial assistance for At the request of Mr. DASCHLE, the S. 2274, a bill to amend title XIX of the brownfields revitalization, to enhance names of the Senator from Mississippi Social Security Act to provide families State response programs, and for other (Mr. COCHRAN), the Senator from Kan- and disabled children with the oppor- purposes. sas (Mr. ROBERTS), the Senator from tunity to purchase coverage under the South Dakota (Mr. JOHNSON), and the medicaid program for such children. S. 2707 At the request of Mr. CRAPO, the Senator from Arkansas (Mrs. LINCOLN) S. 2379 name of the Senator from Oklahoma were added as cosponsors of S. 2811, a At the request of Mr. HARKIN, the (Mr. INHOFE) was added as a cosponsor bill to amend the Consolidated Farm name of the Senator from South Da- and Rural Development Act to make kota (Mr. JOHNSON) was added as a co- of S. 2707, a bill to help ensure general aviation aircraft access to Federal land communities with high levels of out- sponsor of S. 2379, a bill to provide for migration or population loss eligible the protection of children from to- and the airspace over that land. for community facilities grants. bacco. S. 2709 S. RES. 268 S. 2434 At the request of Mr. BAUCUS, the At the request of Mr. EDWARDS, the At the request of Mr. L. CHAFEE, the name of the Senator from Idaho (Mr. name of the Senator from Massachu- name of the Senator from Rhode Island CRAIG) was added as a cosponsor of S. setts (Mr. KERRY) was added as a co- (Mr. REED) was added as a cosponsor of 2709, to establish a Beef Industry Com- sponsor of S. Res. 268, a resolution des- S. 2434, a bill to provide that amounts pensation Trust Fund with the duties ignating July 17 through July 23 as allotted to a State under section 2401 of imposed on products of countries that ‘‘National Fragile X Awareness Week.’’ the Social Security Act for each of fis- fail to comply with certain WTO dis- cal years 1998 and 1999 shall remain pute resolution decisions. S. RES. 294 At the request of Mr. ABRAHAM, the available through fiscal year 2002. S. 2735 names of the Senator from New Hamp- S. 2463 At the request of Mr. CONRAD, the shire (Mr. GREGG) and the Senator At the request of Mr. FEINGOLD, the name of the Senator from North Da- from Ohio (Mr. DEWINE) were added as name of the Senator from Illinois (Mr. kota (Mr. DORGAN) was added as a co- cosponsors of S. Res. 294, a resolution DURBIN) was added as a cosponsor of S. sponsor of S. 2735, a bill to promote ac- designating the month of October 2000 2463, a bill to institute a moratorium cess to health care services in rural as ‘‘Children’s Internet Safety Month.’’ on the imposition of the death penalty areas. S. RES. 301 at the Federal and State level until a S. 2739 National Commission on the Death At the request of Mr. THURMOND, the At the request of Mr. LAUTENBERG, names of the Senator from Utah (Mr. Penalty studies its use and policies en- the names of the Senator from HATCH), the Senator from Maine (Ms. suring justice, fairness, and due process Vermont (Mr. JEFFORDS) and the Sen- SNOWE), the Senator from New Hamp- are implemented. ator from Alaska (Mr. MURKOWSKI) shire (Mr. GREGG), the Senator from S. 2527 were added as cosponsors of S. 2739, a Florida (Mr. GRAHAM), the Senator At the request of Mr. GRASSLEY, the bill to amend title 39, United States from Georgia (Mr. CLELAND), and the name of the Senator from Mississippi Code, to provide for the issuance of a (Mr. COCHRAN) was added as a cospon- Senator from Missouri (Mr. BOND) were semipostal stamp in order to afford the added as cosponsors of S. Res. 301, a sor of S. 2527, a bill to amend the Pub- public a convenient way to contribute lic Health Service Act to provide grant resolution designating August 16, 2000, to funding for the establishment of the as ‘‘National Airborne Day.’’ programs to reduce substance abuse, World War II Memorial. and for other purposes. S. RES. 304 S. 2787 S. 2583 At the request of Mr. BIDEN, the At the request of Mr. BIDEN, the At the request of Mr. LIEBERMAN, the names of the Senator from Illinois (Mr. name of the Senator from Wisconsin name of the Senator from Maine (Ms. DURBIN) and the Senator from Pennsyl- (Mr. FEINGOLD) was added as a cospon- COLLINS) was added as a cosponsor of S. vania (Mr. SPECTER) were added as co- 2583, a bill to amend the Internal Rev- sor of S. 2787, a bill to reauthorize the sponsors of S. Res. 304, a resolution ex- enue Code of 1986 to increase disclosure Federal programs to prevent violence pressing the sense of the Senate re- for certain political organizations ex- against women, and for other purposes. garding the development of edu- empt from tax under section 527. S. 2791 cational programs on veterans’ con- S. 2684 At the request of Mrs. HUTCHISON, the tributions to the country and the des- At the request of Ms. SNOWE, the name of the Senator from Maine (Ms. ignation of the week that includes Vet- name of the Senator from Maine (Ms. SNOWE) was added as a cosponsor of S. erans Day as ‘‘National Veterans COLLINS) was added as a cosponsor of S. 2791, a bill instituting a Federal fuels Awareness Week’’ for the presentation 2684, a bill to redesignate and reauthor- tax suspension. of such educational programs. ize as anchorage certain portions of the S. 2793 AMENDMENT NO. 3648 project for navigation, Narraguagus At the request of Mr. HOLLINGS, the At the request of Mr. COVERDELL, the River, Milbridge, Maine. name of the Senator from Nevada (Mr. name of the Senator from New Hamp- S. 2698 BRYAN) was added as a cosponsor of S. shire (Mr. SMITH) was added as a co- At the request of Mr. MOYNIHAN, the 2793, a bill to amend the Communica- sponsor of amendment No. 3648 in- name of the Senator from Minnesota tions Act of 1934 to strengthen the lim- tended to be proposed to H.R. 4577, a June 29, 2000 CONGRESSIONAL RECORD — SENATE S6145 bill making appropriations for the De- Whereas the general public is unaware of also look for alternate occupations partments of Labor, Health and Human the plight of the amputee community; once limb loss has made their current Services, and Education, and related Whereas an increased awareness to the occupation infeasible. As a result, am- issues faced by the amputee community will agencies for the fiscal year ending Sep- also bring about increased awareness for fur- putees must often undergo counseling tember 30, 2001, and for other purposes. ther research; and to help them come to terms emotion- AMENDMENT NO. 3654 Whereas establishing ‘‘National Amputee ally with their altered lifestyle. At the request of Mr. KERREY, his Awareness Week’’ will bring the cause of am- According to the Amputee Coalition name was added as a cosponsor of putee awareness to the national front: Now, of America, amputees hope to one day amendment No. 3654 proposed to H.R. therefore, be it see the elimination of barriers to their 4577, a bill making appropriations for Resolved, That the Senate— full participation in all aspects of life. (1) proclaims the week of September 24, In addition, they hope to see improve- the Departments of Labor, Health and through September 30, 2000, as ‘‘National Human Services, and Education, and Amputee Awareness Week’’; and ments in artificial limbs and prosthetic related agencies for the fiscal year end- (2) requests that the President issue a research. Finally they hope to see im- ing September 30, 2001, and for other proclamation calling upon the people of the proved outcomes for amputees in the purposes. United States, interested groups, and af- areas of chronic post-amputation pain fected persons to promote the awareness of AMENDMENT NO. 3657 and depression. the amputee community, and to observe the At the request of Ms. SNOWE, her There are countless locally-based or- week with appropriate ceremonies and ac- ganizations in the United States who name was added as a cosponsor of tivities. amendment No. 3657 intended to be pro- provide services to amputees with very Mr. INHOFE. Mr. President, I am posed to H.R. 4577, a bill making appro- little recognition. One of those such or- pleased to come to the Senate floor priations for the Departments of ganizations is located in Oklahoma. today to introduce a resolution to de- Labor, Health and Human Services, The Limbs of Life Foundation is a na- clare the week of September 24–30 ‘‘Na- and Education, and related agencies for tionwide non-profit organization estab- tional Amputee Awareness Week.’’ the fiscal year ending September 30, lished in 1995 in Oklahoma City to When passed, this resolution will des- 2001, and for other purposes. meet the needs of the amputee commu- ignate a specific time around which the nity. They do this in part by providing AMENDMENT NO. 3681 Nation’s amputee community can limbs at a free or discounted rate to in- At the request of Mr. TORRICELLI, the rally. Too often, we lose sight of many name of the Senator from Rhode Island dividuals who would not normally be of those who are right in front of our able to afford such devices. To date (Mr. REED) was added as a cosponsor of very eyes. By dedicating this week to they have provided over 4,700 amputees amendment No. 3681 intended to be pro- their cause, we will make certain that posed to H.R. 4577, a bill making appro- with a prosthetic limb. we no longer forget both the accom- However, Limb for Life’s efforts are priations for the Departments of plishments and problems of the large not limited to limb provision. They Labor, Health and Human Services, and diverse amputee community. also seek to raise awareness of the am- and Education, and related agencies for The loss of limb can strike anyone, putee cause. Each year this foundation the fiscal year ending September 30, at any time. Each year 156,000 people holds a bike ride from Oklahoma City 2001, and for other purposes. lose a limb. This equates to 13,000 am- to Austin, Texas to raise funds for AMENDMENT NO. 3682 putations per month, 2,996 amputations their efforts. This year’s ‘‘Project 50– At the request of Mr. TORRICELLI, the per week, 428 amputations per day and 2000’’ will provide funds to purchase name of the Senator from Rhode Island 18 amputations per hour in the United limbs for those in need and will bring (Mr. REED) was added as a cosponsor of States alone. People from all back- national attention to the amputee amendment No. 3682 intended to be pro- grounds have had to deal with the community. This is the type of effort posed to H.R. 4577, a bill making appro- hardships associated with amputation. that National Amputee Awareness priations for the Departments of Over half of amputations in the United Week is designed to spotlight. Labor, Health and Human Services, States occur among elderly citizens as Mr. President, declaring the week of and Education, and related agencies for a result of vascular deficiencies. From September 24–30 ‘‘National Amputee the fiscal year ending September 30, childhood to middle adulthood, the Awareness Week’’ would serve many 2001, and for other purposes. most common cause of limb loss is purposes. At this point in time ampu- f from traumatic injuries. Other major tees have only a fragmented network SENATE RESOLUTION 330—DESIG- causes can include primary bone malig- through which to address their con- NATING THE WEEK BEGINNING nancies and congenital limb defects. cerns. This week would provide them SEPTEMBER 24, 2000, AS ‘‘NA- Although there have been great with a point of cohesion during which TIONAL AMPUTEE AWARENESS strides in prosthetic research, many all amputees can come together in re- WEEK’’ people are still limited by the financial sponse to and in recognition of their burdens associated with acquiring an Mr. INHOFE submitted the following common cause. Not only will amputees artificial limb. A new prosthetic device benefit from this week, the general resolution; which was referred to the can cost between $8,000 and $70,000. Committee on the Judiciary: population would also have the oppor- These limbs must often be replaced tunity to be informed of the unique S. RES. 330 every few years, adding to the burden needs and problems faced by the ampu- Whereas current research indicates that placed on an amputee. Even when in- tee community. The amputee commu- more than 1.5 million Americans, of all ages surance does cover the cost of these and of both genders, have had amputations; nity and the general population would Whereas every year 156,000 individuals in new prosthetic devices, it is often a both gain from increased interaction the United States lose a limb; one-time reimbursement. This leaves that this week would bring. Whereas each month 13,000 individuals lose the amputee to deal with any further In closing, I hope all of my colleagues a limb; care or replacement devices that are will join me in creating this important Whereas each week 2,996 individuals lose a necessary. awareness and outreach opportunity limb; The prosthetic device is not the only for the amputee community. Whereas each day 428 individuals lose a cost incurred by the amputee. There limb; f are many secondary factors that must Whereas becoming an amputee is a lifetime SENATE RESOLUTION 331—TO AU- condition, not just a temporary cir- be considered. Over 25,000 people are re- cumstance; admitted to the hospital each year due THORIZE TESTIMONY, DOCU- Whereas prosthetic care can range in cost to complications resulting from their MENT PRODUCTION, AND LEGAL from $8,000 to more than $70,000 depending on amputation. Amputees must deal with REPRESENTATION IN UNITED the level of care and function of the patient; both the physical and emotional con- STATES V. ELLEN ROSE HART Whereas most insurance policies cover prosthetics with the stipulation of one pros- sequences of limb loss. Physical ther- Mr. LOTT (for himself and Mr. thesis per patient for life; apy must be undertaken to learn how DASCHLE) submitted the following reso- Whereas the average prosthesis lasts be- to perform the most basic tasks with a lution; which was considered and tween three and five years; new, foreign limb. They must often agreed to: S6146 CONGRESSIONAL RECORD — SENATE June 29, 2000

S. RES. 331 Public Health Service Act (42 U.S.C. 300gg– ‘‘(1) any entity that is a member of the Whereas, in the case of United States v. 1(a)(1)(F)) is amended by inserting before the same controlled group as such issuer or plan Ellen Rose Hart, CR–F 99–5275 AWI, pending period the following: ‘‘(or information about sponsor of such group health plan; in the United States District Court for the a request for or the receipt of genetic serv- ‘‘(2) any other group health plan or health Eastern District of California, testimony has ices by an individual or a family member of insurance issuer or any insurance agent, been requested from Eric Vizcaino, an em- such individual)’’. third party administrator, or other person ployee in the office of Senator Boxer, and (B) NO DISCRIMINATION IN GROUP RATE BASED subject to regulation under State insurance Monica Borvice, an employee in the office of ON PREDICTIVE GENETIC INFORMATION.— laws; Senator Feinstein; (i) IN GENERAL.—Subpart 2 of part A of title ‘‘(3) the Medical Information Bureau or Whereas, pursuant to sections 703(a) and XXVII of the Public Health Service (42 any other person that collects, compiles, 704(a)(2) of the Ethics in Government Act of U.S.C. 300gg-4 et seq.) is amended by adding publishes, or otherwise disseminates insur- 1978, 2 U.S.C. §§ 288b(a) and 288c(a)(2), the at the end the following: ance information; Senate may direct its counsel to represent ‘‘SEC. 2707. PROHIBITING DISCRIMINATION ‘‘(4) the individual’s employer or any plan employees of the Senate with respect to any AGAINST GROUPS ON THE BASIS OF sponsor; or subpoena, order, or request for testimony re- PREDICTIVE GENETIC INFORMA- ‘‘(5) any other person the Secretary may TION. specify in regulations. lating to their official responsibilities; ‘‘A group health plan, and a health insur- Whereas, by the privileges of the Senate of ‘‘(f) INFORMATION FOR PAYMENT FOR GE- ance issuer offering group health insurance NETIC SERVICES.— the United States and Rule XI of the Stand- coverage in connection with a group health ing Rules of the Senate, no evidence under ‘‘(1) IN GENERAL.—With respect to payment plan, shall not deny eligibility to a group or for genetic services conducted concerning an the control or in the possession of the Senate adjust premium or contribution rates for a may, by the judicial or administrative proc- individual or the coordination of benefits, a group on the basis of predictive genetic in- group health plan, or a health insurance ess, be taken from such control or possession formation concerning an individual in the but by permission of the Senate; issuer offering group health insurance cov- group (or information about a request for or erage in connection with a group health Whereas, when it appears that evidence the receipt of genetic services by such indi- plan, may request that the individual pro- under the control or in the possession of the vidual or family member of such indi- vide the plan or issuer with evidence that Senate may promote the administration of vidual).’’. such services were performed. justice, the Senate will take such action as (ii) CONFORMING AMENDMENTS.— ‘‘(2) RULE OF CONSTRUCTION.—Nothing in will promote the ends of justice consistently (I) Section 2702(b)(2)(A) of the Public paragraph (1) shall be construed to— with the privileges of the Senate: Now, Health Service Act (42 U.S.C. 300gg– ‘‘(A) permit a group health plan or health therefore, be it 1(b)(2)(A)) is amended to read as follows: Resolved, That Eric Vizcaino, Monica ‘‘(A) to restrict the amount that an em- insurance issuer to request (or require) the Borvice, and any other employee of the Sen- ployer may be charged for coverage under a results of the services referred to in such ate from whom testimony or document pro- group health plan, except as provided in sec- paragraph; or duction may be required are authorized to tion 2707; or’’. ‘‘(B) require that a group health plan or testify and produce documents in the case of (II) Section 2721(a) of the Public Health health insurance issuer make payment for United States v. Ellen Rose Hart, except con- Service Act (42 U.S.C. 300gg–21(a)) is amend- services described in such paragraph where cerning matters for which a privilege should ed by inserting ‘‘(other than subsections the individual involved has refused to pro- be asserted. (a)(1)(F), (b) (with respect to cases relating vide evidence of the performance of such SEC. 2. The Senate Legal Counsel is author- to genetic information or information about services pursuant to a request by the plan or ized to represent Eric Vizcaino, Monica a request or receipt of genetic services by an issuer in accordance with such paragraph. Borvice, and any Member or employee of the individual or family member of such indi- ‘‘(g) INFORMATION FOR PAYMENT OF OTHER Senate in connection with the testimony and vidual), (c), (d), (e), (f), or (g) of section 2702 CLAIMS.—With respect to the payment of claims for benefits other than genetic serv- document production authorized in section and section 2707)’’ after ‘‘subparts 1 and 3’’. ices, a group health plan, or a health insur- one of this resolution. (2) LIMITATIONS ON GENETIC TESTING AND ON ance issuer offering group health insurance f COLLECTION AND DISCLOSURE OF PREDICTIVE coverage in connection with a group health GENETIC INFORMATION.—Section 2702 of the plan, may request that an individual provide AMENDMENTS SUBMITTED Public Health Service Act (42 U.S.C. 300gg–1) predictive genetic information so long as is amended by adding at the end the fol- such information— lowing: ‘‘(1) is used solely for the payment of a DEPARTMENT OF LABOR ‘‘(c) GENETIC TESTING.— claim; APPROPRIATIONS ACT, 2001 ‘‘(1) LIMITATION ON REQUESTING OR REQUIR- ‘‘(2) is limited to information that is di- ING GENETIC TESTING.—A group health plan, rectly related to and necessary for the pay- or a health insurance issuer offering health ment of such claim and the claim would oth- DASCHLE (AND OTHERS) insurance coverage in connection with a erwise be denied but for the predictive ge- AMENDMENT NO. 3688 group health plan, shall not request or re- netic information; and quire an individual or a family member of Mr. HARKIN (for Mr. DASCHLE (for ‘‘(3) is used only by an individual (or indi- such individual to undergo a genetic test. himself, Mr. KENNEDY, Mr. HARKIN, Mr. viduals) within such plan or issuer who needs ‘‘(2) RULE OF CONSTRUCTION.—Nothing in access to such information for purposes of DODD, and Mr. ROBB)) proposed an this title shall be construed to limit the au- payment of a claim. amendment to the bill (H.R. 4577) mak- thority of a health care professional, who is ‘‘(h) RULES OF CONSTRUCTION.— ing appropriations for the Departments providing treatment with respect to an indi- ‘‘(1) COLLECTION OR DISCLOSURE AUTHORIZED vidual and who is employed by a group of Labor, Health and Human Services, BY INDIVIDUAL.—The provisions of sub- health plan or a health insurance issuer, to and Education, and related agencies for sections (d) (regarding collection) and (e) request that such individual or family mem- the fiscal year ending September 30, shall not apply to an individual if the indi- ber of such individual undergo a genetic test. 2001, and for other purposes; as follows: vidual (or legal representative of the indi- Such a health care professional shall not re- vidual) provides prior, knowing, voluntary, On page 92, between lines 4 and 5, insert quire that such individual or family member and written authorization for the collection the following: undergo a genetic test. or disclosure of predictive genetic informa- TITLE ll GENETIC NONDISCRIMINATION ‘‘(d) COLLECTION OF PREDICTIVE GENETIC IN- tion. IN HEALTH INSURANCE AND EMPLOY- FORMATION.—Except as provided in sub- MENT sections (f) and (g), a group health plan, or a ‘‘(2) DISCLOSURE FOR HEALTH CARE TREAT- MENT.—Nothing in this section shall be con- ll health insurance issuer offering health insur- SEC. 01. SHORT TITLE. strued to limit or restrict the disclosure of This title may be cited as the ‘‘Genetic ance coverage in connection with a group health plan, shall not request, require, col- predictive genetic information from a health Nondiscrimination in Health Insurance and care provider to another health care provider Employment Act of 2000’’. lect, or purchase predictive genetic informa- tion concerning an individual (or informa- for the purpose of providing health care Subtitle A—Prohibition of Health Insurance tion about a request for or the receipt of ge- treatment to the individual involved. Discrimination on the Basis of Predictive netic services by such individual or family ‘‘(i) DEFINITIONS.—In this section: Genetic Information member of such individual). ‘‘(1) CONTROLLED GROUP.—The term ‘con- SEC. ll11. AMENDMENTS TO THE PUBLIC ‘‘(e) DISCLOSURE OF PREDICTIVE GENETIC IN- trolled group’ means any group treated as a HEALTH SERVICE ACT. FORMATION.—A group health plan, or a health single employer under subsections (b), (c), (a) AMENDMENTS RELATING TO THE GROUP insurance issuer offering health insurance (m), or (o) of section 414 of the Internal Rev- MARKET.— coverage in connection with a group health enue Code of 1986. (1) PROHIBITION OF HEALTH INSURANCE DIS- plan, shall not disclose predictive genetic in- ‘‘(2) GROUP HEALTH PLAN, HEALTH INSUR- CRIMINATION ON THE BASIS OF PREDICTIVE GE- formation about an individual (or informa- ANCE ISSUER.—The terms ‘group health plan’ NETIC INFORMATION OR GENETIC SERVICES.— tion about a request for or the receipt of ge- and ‘health insurance issuer’ include a third (A) NO ENROLLMENT RESTRICTION FOR GE- netic services by such individual or family party administrator or other person acting NETIC SERVICES.—Section 2702(a)(1)(F) of the member of such individual) to— for or on behalf of such plan or issuer.’’. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6147

(3) DEFINITIONS.—Section 2791(d) of the issuer offering health insurance coverage in access to such information for purposes of Public Health Service Act (42 U.S.C. 300gg– the individual market shall not request or payment of a claim. 91(d)) is amended by adding at the end the require an individual or a family member of ‘‘(f) RULES OF CONSTRUCTION.— following new paragraphs: such individual to undergo a genetic test. ‘‘(1) COLLECTION OR DISCLOSURE AUTHORIZED ‘‘(15) FAMILY MEMBER.—The term ‘family ‘‘(2) RULE OF CONSTRUCTION.—Nothing in BY INDIVIDUAL.—The provisions of sub- member’ means with respect to an this title shall be construed to limit the au- sections (c) (regarding collection) and (d) individual— thority of a health care professional, who is shall not apply to an individual if the indi- ‘‘(A) the spouse of the individual; providing treatment with respect to an indi- vidual (or legal representative of the indi- ‘‘(B) a dependent child of the individual, vidual and who is employed by a group vidual) provides prior, knowing, voluntary, including a child who is born to or placed for health plan or a health insurance issuer, to and written authorization for the collection adoption with the individual; and request that such individual or family mem- or disclosure of predictive genetic informa- ‘‘(C) all other individuals related by blood ber of such individual undergo a genetic test. tion. to the individual or the spouse or child de- Such a health care professional shall not re- ‘‘(2) DISCLOSURE FOR HEALTH CARE TREAT- scribed in subparagraph (A) or (B). quire that such individual or family member MENT.—Nothing in this section shall be con- ‘‘(16) GENETIC INFORMATION.—The term ‘ge- undergo a genetic test. strued to limit or restrict the disclosure of netic information’ means information about ‘‘(b) COLLECTION OF PREDICTIVE GENETIC IN- predictive genetic information from a health genes, gene products, or inherited character- FORMATION.—Except as provided in sub- care provider to another health care provider istics that may derive from an individual or sections (d) and (e), a health insurance issuer for the purpose of providing health care a family member of such individual (includ- offering health insurance coverage in the in- treatment to the individual involved. ing information about a request for or the dividual market shall not request, require, ‘‘(g) DEFINITIONS.—In this section: receipt of genetic services by such individual collect, or purchase predictive genetic infor- ‘‘(1) CONTROLLED GROUP.—The term ‘con- or family member of such individual). mation concerning an individual (or infor- trolled group’ means any group treated as a ‘‘(17) GENETIC SERVICES.—The term ‘genetic mation about a request for or the receipt of single employer under subsections (b), (c), services’ means health services, including genetic services by such individual or family (m), or (o) of section 414 of the Internal Rev- genetic tests, provided to obtain, assess, or member of such individual). enue Code of 1986. interpret genetic information for diagnostic ‘‘(c) DISCLOSURE OF PREDICTIVE GENETIC IN- ‘‘(2) GROUP HEALTH PLAN, HEALTH INSUR- and therapeutic purposes, and for genetic FORMATION.—A health insurance issuer offer- ANCE ISSUER.—The terms ‘group health plan’ education and counselling. ing health insurance coverage in the indi- and ‘health insurance issuer’ include a third ‘‘(18) GENETIC TEST.—The term ‘genetic vidual market shall not disclose predictive party administrator or other person acting test’ means the analysis of human DNA, genetic information about an individual (or for or on behalf of such plan or issuer.’’. RNA, chromosomes, proteins, and certain information about a request for or the re- (c) ENFORCEMENT.— metabolites in order to detect genotypes, ceipt of genetic services by such individual (1) GROUP PLANS.—Section 2722 of the Pub- mutations, or chromosomal changes. or family member of such individual) to— lic Health Service Act (42 U.S.C. 300gg–22) is ‘‘(19) PREDICTIVE GENETIC INFORMATION.— ‘‘(1) any entity that is a member of the amended by adding at the end the following: ‘‘(A) IN GENERAL.—The term ‘predictive ge- same controlled group as such issuer or plan ‘‘(c) VIOLATION OF GENETIC DISCRIMINATION netic information’ means— sponsor of such group health plan; OR GENETIC DISCLOSURE PROVISIONS.—In any ‘‘(i) information about an individual’s ge- ‘‘(2) any other group health plan or health action under this section against any admin- netic tests; insurance issuer or any insurance agent, istrator of a group health plan, or health in- ‘‘(ii) information about genetic tests of third party administrator, or other person surance issuer offering group health insur- family members of the individual; or subject to regulation under State insurance ance coverage in connection with a group ‘‘(iii) information about the occurrence of laws; health plan (including any third party ad- a disease or disorder in family members. ‘‘(3) the Medical Information Bureau or ministrator or other person acting for or on ‘‘(B) LIMITATIONS.—The term ‘predictive any other person that collects, compiles, behalf of such plan or issuer) alleging a vio- genetic information’ shall not include— publishes, or otherwise disseminates insur- lation of subsections (a)(1)(F), (b) (with re- ‘‘(i) information about the sex or age of the ance information; spect to cases relating to genetic informa- individual; ‘‘(4) the individual’s employer or any plan tion or information about a request or re- ‘‘(ii) information about chemical, blood, or sponsor; or ceipt of genetic services by an individual or urine analyses of the individual, unless these ‘‘(5) any other person the Secretary may family member of such individual), (c), (d), analyses are genetic tests; or specify in regulations. (e), (f), or (g) of section 2702 and section 2707 ‘‘(iii) information about physical exams of ‘‘(d) INFORMATION FOR PAYMENT FOR GE- the court may award any appropriate legal the individual, and other information rel- NETIC SERVICES.— or equitable relief. Such relief may include a evant to determining the current health sta- ‘‘(1) IN GENERAL.—With respect to payment requirement for the payment of attorney’s tus of the individual.’’. for genetic services conducted concerning an fees and costs, including the costs of expert (b) AMENDMENT RELATING TO THE INDI- individual or the coordination of benefits, a witnesses. ‘‘(d) CIVIL PENALTY.—The monetary provi- VIDUAL MARKET.—The first subpart 3 of part health insurance issuer offering health insur- sions of section 308(b)(2)(C) of Public Law B of title XXVII of the Public Health Service ance coverage in the individual market may 101–336 (42 U.S.C. 12188(b)) shall apply for pur- Act (42 U.S.C. 300gg–51 et seq.) is amended— request that the individual provide the plan poses of the Secretary enforcing the provi- (1) by redesignating such subpart as sub- or issuer with evidence that such services sions referred to in subsection (c), except part 2; and were performed. that any such relief awarded shall be paid (2) by adding at the end the following: ULE OF CONSTRUCTION.—Nothing in ‘‘(2) R only into the general fund of the Treasury.’’. ‘‘SEC. 2753. PROHIBITION OF HEALTH INSURANCE paragraph (1) shall be construed to— (2) INDIVIDUAL PLANS.—Section 2761 of the DISCRIMINATION AGAINST INDIVID- ‘‘(A) permit a health insurance issuer to Public Health Service Act (42 U.S.C. 300gg– UALS ON THE BASIS OF PREDICTIVE request (or require) the results of the serv- GENETIC INFORMATION. 45) is amended by adding at the end the fol- ices referred to in such paragraph; or lowing: ‘‘(a) IN ELIGIBILITY TO ENROLL.—A health ‘‘(B) require that a health insurance issuer insurance issuer offering health insurance ‘‘(c) VIOLATION OF GENETIC DISCRIMINATION make payment for services described in such OR GENETIC DISCLOSURE PROVISIONS.—In any coverage in the individual market shall not paragraph where the individual involved has establish rules for eligibility to enroll in in- action under this section against any health refused to provide evidence of the perform- dividual health insurance coverage that are insurance issuer offering health insurance ance of such services pursuant to a request based on predictive genetic information con- coverage in the individual market (including by the plan or issuer in accordance with such cerning the individual (or information about any other person acting for or on behalf of paragraph. a request for or the receipt of genetic serv- such issuer) alleging a violation of section ‘‘(e) INFORMATION FOR PAYMENT OF OTHER ices by such individual or family member of 2753 and 2754 the court in which the action is CLAIMS.—With respect to the payment of such individual). commenced may award any appropriate legal claims for benefits other than genetic serv- ‘‘(b) IN PREMIUM RATES.—A health insur- or equitable relief. Such relief may include a ance issuer offering health insurance cov- ices, a health insurance issuer offering requirement for the payment of attorney’s erage in the individual market shall not ad- health insurance coverage in the individual fees and costs, including the costs of expert just premium rates on the basis of predictive market may request that an individual pro- witnesses. genetic information concerning an indi- vide predictive genetic information so long ‘‘(d) CIVIL PENALTY.—The monetary provi- vidual (or information about a request for or as such information— sions of section 308(b)(2)(C) of Public Law the receipt of genetic services by such indi- ‘‘(1) is used solely for the payment of a 101–336 (42 U.S.C. 12188(b)) shall apply for pur- vidual or family member of such individual). claim; poses of the Secretary enforcing the provi- ‘‘SEC. 2754. LIMITATIONS ON GENETIC TESTING ‘‘(2) is limited to information that is di- sions referred to in subsection (c), except AND ON COLLECTION AND DISCLO- rectly related to and necessary for the pay- that any such relief awarded shall be paid SURE OF PREDICTIVE GENETIC IN- ment of such claim and the claim would oth- only into the general fund of the Treasury.’’. FORMATION. erwise be denied but for the predictive ge- (d) PREEMPTION.— ‘‘(a) GENETIC TESTING.— netic information; and (1) GROUP MARKET.—Section 2723 of the ‘‘(1) LIMITATION ON REQUESTING OR REQUIR- ‘‘(3) is used only by an individual (or indi- Public Health Service Act (42 U.S.C. 300gg– ING GENETIC TESTING.—A health insurance viduals) within such plan or issuer who needs 23) is amended— S6148 CONGRESSIONAL RECORD — SENATE June 29, 2000

(A) in subsection (a)(1), by inserting ‘‘or (1) GROUP MARKET.—Section 2721(d)(3) of action under this section against any admin- (e)’’ after ‘‘subsection (b)’’; and the Public Health Service Act (42 U.S.C. istrator of a group health plan, or health in- (B) by adding at the end the following: 300gg–23(d)(3)) is amended by inserting ‘‘, surance issuer offering group health insur- ‘‘(e) SPECIAL RULE IN CASE OF GENETIC IN- other than the requirements of subsections ance coverage in connection with a group FORMATION.—With respect to group health in- (a)(1)(F), (b) (in cases relating to genetic in- health plan (including any third party ad- surance coverage offered by a health insur- formation or information about a request for ministrator or other person acting for or on ance issuer, the provisions of this part relat- or the receipt of genetic services by an indi- behalf of such plan or issuer) alleging a vio- ing to genetic information (including infor- vidual or a family member of such indi- lation of section 714, the court may award mation about a request for or the receipt of vidual)), (c), (d), (e), (f) and (g) of section 2702 any appropriate legal or equitable relief. genetic services by an individual or a family and section 2707,’’ after ‘‘The requirements of Such relief may include a requirement for member of such individual) shall not be con- this part’’. the payment of attorney’s fees and costs, in- strued to supersede any provision of State (2) INDIVIDUAL MARKET.—Section 2763(b) of cluding the costs of expert witnesses. law which establishes, implements, or con- the Public Health Service Act (42 U.S.C. ‘‘(o) CIVIL PENALTY.—The monetary provi- tinues in effect a standard, requirement, or 300gg–47(b)) is amended— sions of section 308(b)(2)(C) of Public Law remedy that more completely— (A) by striking ‘‘The requirements of this 101–336 (42 U.S.C. 12188(b)) shall apply for pur- ‘‘(1) protects the confidentiality of genetic part’’ and inserting the following: poses of the Secretary enforcing the provi- information (including information about a ‘‘(1) IN GENERAL.—Except as provided in sions referred to in subsection (n), except request for or the receipt of genetic services paragraph (2), the requirements of this that any such relief awarded shall be paid by an individual or a family member of such part’’; and only into the general fund of the Treasury.’’. individual) or the privacy of an individual or (B) by adding at the end the following: (c) PREEMPTION.—Section 731 of the Em- ployee Retirement Income Security Act of a family member of the individual with re- ‘‘(2) LIMITATION.—The requirements of sec- spect to genetic information (including in- tions 2753 and 2754 shall apply to excepted 1974 (29 U.S.C. 1191) is amended— formation about a request for or the receipt benefits described in section 2791(c)(4).’’. (1) in subsection (a)(1), by inserting ‘‘or (e)’’ after ‘‘subsection (b)’’; and of genetic services by an individual or a fam- (g) EFFECTIVE DATE.— (2) by adding at the end the following: ily member of such individual); or (1) IN GENERAL.—The amendments made by ‘‘(e) SPECIAL RULE IN CASE OF GENETIC IN- ‘‘(2) prohibits discrimination on the basis this section shall apply with respect to— FORMATION.—With respect to group health in- of genetic information than does this part.’’. (A) group health plans, and health insur- surance coverage offered by a health insur- (2) INDIVIDUAL MARKET.—Section 2762 of the ance coverage offered in connection with Public Health Service Act (42 U.S.C. 300gg– ance issuer, the provisions of this part relat- group health plans, for plan years beginning; ing to genetic information (including infor- 46) is amended— and (A) in subsection (a), by inserting ‘‘and ex- mation about a request for or the receipt of (B) health insurance coverage offered, sold, genetic services by an individual or a family cept as provided in subsection (c),’’ after issued, renewed, in effect, or operated in the ‘‘Subject to subsection (b),’’; and member of such individual) shall not be con- individual market, after July 1, 2000. strued to supersede any provision of State (B) by adding at the end the following: (2) SPECIAL RULE FOR COLLECTIVE BAR- ‘‘(c) SPECIAL RULE IN CASE OF GENETIC IN- law which establishes, implements, or con- GAINING AGREEMENTS.—In the case of a group tinues in effect a standard, requirement, or FORMATION.—With respect to individual health plan maintained pursuant to one or health insurance coverage offered by a remedy that more completely— more collective bargaining agreements be- ‘‘(1) protects the confidentiality of genetic health insurance issuer, the provisions of tween employee representatives and one or this part (or part C insofar as it applies to information (including information about a more employers ratified before the date of request for or the receipt of genetic services this part) relating to genetic information the enactment of this Act, the amendments (including information about a request for or by an individual or a family member of such made by this section shall not apply to plan individual) or the privacy of an individual or the receipt of genetic services by an indi- years beginning before the later of— vidual or a family member of such indi- a family member of the individual with re- (A) the date on which the last of the collec- spect to genetic information (including in- vidual) shall not be construed to supersede tive bargaining agreements relating to the any provision of State law (as defined in sec- formation about a request for or the receipt plan terminates (determined without regard of genetic services by an individual or a fam- tion 2723(d)) which establishes, implements, to any extension thereof agreed to after the or continues in effect a standard, require- ily member of such individual) than does this date of the enactment of this Act); or ment, or remedy that more completely— part; or ‘‘(1) protects the confidentiality of genetic (B) July 1, 2001. ‘‘(2) prohibits discrimination on the basis information (including information about a For purposes of subparagraph (A), any plan of genetic information than does this part.’’. request for or the receipt of genetic services amendment made pursuant to a collective (d) DEFINITIONS.—Section 733(d) of the Em- of an individual or a family member of such bargaining agreement relating to the plan ployee Retirement Income Security Act of individual) or the privacy of an individual or which amends the plan solely to conform to 1974 (29 U.S.C. 1191b(d)) is amended by adding a family member of the individual with re- any requirement of the amendments made by at the end the following: spect to genetic information (including in- this section shall not be treated as a termi- ‘‘(5) FAMILY MEMBER.—The term ‘family formation about a request for or the receipt nation of such collective bargaining agree- member’ means with respect to an of genetic services by an individual or a fam- ment. individual— ily member of such individual) than does this SEC. ll12. AMENDMENTS TO EMPLOYEE RE- ‘‘(A) the spouse of the individual; part (or part C insofar as it applies to this TIREMENT INCOME SECURITY ACT ‘‘(B) a dependent child of the individual, part); or OF 1974. including a child who is born to or placed for ‘‘(2) prohibits discrimination on the basis (a) PROHIBITION OF HEALTH INSURANCE DIS- adoption with the individual; and of genetic information than does this part CRIMINATION ON THE BASIS OF GENETIC SERV- ‘‘(C) all other individuals related by blood (or part C insofar as it applies to this part).’’. ICES OR PREDICTIVE GENETIC INFORMATION.— to the individual or the spouse or child de- (e) ELIMINATION OF OPTION OF NON-FEDERAL Subpart B of Part 7 of subtitle B of title I of scribed in subparagraph (A) or (B). GOVERNMENTAL PLANS TO BE EXCEPTED FROM the Employee Retirement Income Security ‘‘(6) GENETIC INFORMATION.—The term ‘ge- REQUIREMENTS CONCERNING GENETIC INFOR- Act of 1974 (29 U.S.C. 1185 et seq.) is amended netic information’ means information about MATION.—Section 2721(b)(2) of the Public by adding at the end the following: genes, gene products, or inherited character- Health Service Act (42 U.S. C. 300gg–21(b)(2)) ‘‘SEC. 714. PROHIBITING DISCRIMINATION istics that may derive from an individual or is amended— AGAINST GROUPS ON THE BASIS OF a family member of such individual (includ- (1) in subparagraph (A), by striking ‘‘If the PREDICTIVE GENETIC INFORMA- ing information about a request for or the plan sponsor’’ and inserting ‘‘Except as pro- TION. receipt of genetic services by such individual vided in subparagraph (D), if the plan spon- ‘‘Each group health plan, and health insur- or family member of such individual). sor’’; and ance issuer offering group health insurance ‘‘(7) GENETIC SERVICES.—The term ‘genetic (2) by adding at the end the following: coverage in connection with a group health services’ means health services, including ‘‘(D) ELECTION NOT APPLICABLE TO REQUIRE- plan, shall comply with the genetic non- genetic tests, provided to obtain, assess, or MENTS CONCERNING GENETIC INFORMATION.— discrimination provisions of subsections interpret genetic information for diagnostic The election described in subparagraph (A) (a)(1)(F) and (c) through (g) of section 2702, and therapeutic purposes, and for genetic shall not be available with respect to the and section 2707 of the Public Health Service education and counseling. provisions of subsections (a)(1)(F), (c), (d), Act, and each health insurance issuer shall ‘‘(8) GENETIC TEST.—The term ‘genetic test’ (e), (f), and (g) of section 2702 and section comply with such provisions with respect to means the analysis of human DNA, RNA, 2707, and the provisions of section 2702(b) to group health insurance coverage it offers, chromosomes, proteins, and certain metabo- the extent that they apply to genetic infor- and such provisions shall be deemed to be in- lites in order to detect genotypes, mation (or information about a request for corporated into this subsection.’’. mutations, or chromosomal changes. or the receipt of genetic services by an indi- (b) ENFORCEMENT.—Section 502 (29 U.S.C. ‘‘(9) PREDICTIVE GENETIC INFORMATION.— vidual or a family member of such indi- 1132) is amended by adding at the end the fol- ‘‘(A) IN GENERAL.—The term ‘predictive ge- vidual).’’. lowing: netic information’ means— (f) AMENDMENT CONCERNING SUPPLEMENTAL ‘‘(n) VIOLATION OF GENETIC DISCRIMINATION ‘‘(i) information about an individual’s ge- EXCEPTED BENEFITS.— OR GENETIC DISCLOSURE PROVISIONS.—In any netic tests; June 29, 2000 CONGRESSIONAL RECORD — SENATE S6149 ‘‘(ii) information about genetic tests of that any such relief awarded shall be paid (ii) information about genetic tests of fam- family members of the individual; or only into the general fund of the Treasury.’’. ily members of the individual; or ‘‘(iii) information about the occurrence of (b) EFFECTIVE DATE.— (iii) information about the occurrence of a a disease or disorder in family members. (1) IN GENERAL.—Except as provided in this disease or disorder in family members. ‘‘(B) LIMITATIONS.—The term ‘predictive section, this section and the amendments (B) LIMITATIONS.—The term ‘‘predictive ge- genetic information’ shall not include— made by this section shall apply with respect netic information’’ shall not include— ‘‘(i) information about the sex or age of the to group health plans for plan years begin- (i) information about the sex or age of the individual; ning after July 1, 2001. individual; ‘‘(ii) information about chemical, blood, or (2) SPECIAL RULE FOR COLLECTIVE BAR- (ii) information about chemical, blood, or urine analyses of the individual, unless these GAINING AGREEMENTS.—In the case of a group urine analyses of the individual, unless these analyses are genetic tests; or health plan maintained pursuant to one or analyses are genetic tests; or ‘‘(iii) information about physical exams of more collective bargaining agreements be- (iii) information about physical exams of the individual, and other information rel- tween employee representatives and one or the individual, and other information rel- evant to determining the current health sta- more employers ratified before the date of evant to determining the current health sta- tus of the individual.’’. the enactment of this Act, this section and tus of the individual. (e) AMENDMENT CONCERNING SUPPLEMENTAL the amendments made by this section shall SEC. ll22. EMPLOYER PRACTICES. EXCEPTED BENEFITS.—Section 732(c)(3) of the not apply to plan years beginning before the (a) IN GENERAL.—It shall be an unlawful Employee Retirement Income Security Act later of— employment practice for an employer— of 1974 (29 U.S.C. 1191a(c)(3)) is amended by (A) the date on which the last of the collec- (1) to fail or refuse to hire or to discharge inserting ‘‘, other than the requirements of tive bargaining agreements relating to the any individual, or otherwise to discriminate section 714,’’ after ‘‘The requirements of this plan terminates (determined without regard against any individual with respect to the part’’. to any extension thereof agreed to after the compensation, terms, conditions, or privi- (f) EFFECTIVE DATE.— date of the enactment of this Act), or leges of employment of the individual, be- (1) IN GENERAL.—Except as provided in this (B) July 1, 2001. cause of predictive genetic information with section, this section and the amendments For purposes of subparagraph (A), any plan respect to the individual (or information made by this section shall apply with respect amendment made pursuant to a collective about a request for or the receipt of genetic to group health plans for plan years begin- bargaining agreement relating to the plan services by such individual or family mem- ning after July 1, 2001. which amends the plan solely to conform to ber of such individual; any requirement of the amendments made by (2) SPECIAL RULE FOR COLLECTIVE BAR- (2) to limit, segregate, or classify the em- this section shall not be treated as a termi- GAINING AGREEMENTS.—In the case of a group ployees of the employer in any way that health plan maintained pursuant to one or nation of such collective bargaining agree- would deprive or tend to deprive any indi- more collective bargaining agreements be- ment. vidual of employment opportunities or oth- tween employee representatives and one or Subtitle B—Prohibition of Employment Dis- erwise adversely affect the status of the indi- more employers ratified before the date of crimination on the Basis of Predictive Ge- vidual as an employee, because of predictive the enactment of this Act, this section and netic Information genetic information with respect to the indi- the amendments made by this section shall SEC. ll21. DEFINITIONS. vidual, or information about a request for or not apply to plan years beginning before the In this subtitle: the receipt of genetic services by such indi- later of— (1) EMPLOYEE; EMPLOYER; EMPLOYMENT vidual or family member of such individual; (A) the date on which the last of the collec- AGENCY; LABOR ORGANIZATION; MEMBER.—The or tive bargaining agreements relating to the terms ‘‘employee’’, ‘‘employer’’, ‘‘employ- (3) to request, require, collect or purchase plan terminates (determined without regard ment agency’’, and ‘‘labor organization’’ predictive genetic information with respect to any extension thereof agreed to after the have the meanings given such terms in sec- to an individual or a family member of the date of the enactment of this Act), or tion 701 of the Civil Rights Act of 1964 (42 individual except— (B) July 1, 2001. U.S.C. 2000e), except that the terms ‘‘em- (A) where used for genetic monitoring of ployee’’ and ‘‘employer’’ shall also include biological effects of toxic substances in the For purposes of subparagraph (A), any plan the meanings given such terms in section 717 workplace, but only if— amendment made pursuant to a collective of the Civil Rights Act of 1964 (42 U.S.C. (i) the employee has provided prior, know- bargaining agreement relating to the plan 2000e–16). The terms ‘‘employee’’ and ‘‘mem- ing, voluntary, and written authorization; which amends the plan solely to conform to ber’’ include an applicant for employment (ii) the employee is informed of individual any requirement of the amendments made by and an applicant for membership in a labor monitoring results; this section shall not be treated as a termi- organization, respectively. (iii) the monitoring conforms to any ge- nation of such collective bargaining agree- (2) FAMILY MEMBER.—The term ‘‘family netic monitoring regulations that may be ment. member’’ means with respect to an promulgated by the Secretary of Labor pur- SEC. ll13. AMENDMENTS TO INTERNAL REV- individual— suant to the Occupational Safety and Health ENUE CODE OF 1986. (A) the spouse of the individual; Act of 1970 (29 U.S.C. 651 et seq.) or the Fed- (a) PROHIBITION OF HEALTH INSURANCE DIS- (B) a dependent child of the individual, in- eral Mine Safety and Health Act of 1977 (30 CRIMINATION ON THE BASIS OF GENETIC SERV- cluding a child who is born to or placed for U.S.C. 801 et seq.); and ICES OR PREDICTIVE GENETIC INFORMATION.— adoption with the individual; and (iv) the employer, excluding any licensed Subchapter B of chapter 100 of the Internal (C) all other individuals related by blood to health care professional that is involved in Revenue Code of 1986 is amended by adding the individual or the spouse or child de- the genetic monitoring program, receives at the end the following: scribed in subparagraph (A) or (B). the results of the monitoring only in aggre- ‘‘SEC. 9813. PROHIBITING DISCRIMINATION ON (3) GENETIC MONITORING.—The term ‘‘ge- gate terms that do not disclose the identity THE BASIS OF PREDICTIVE GENETIC netic monitoring’’ means the periodic exam- of specific employees; or INFORMATION. ination of employees to evaluate acquired (B) where genetic services are offered by ‘‘(a) IN GENERAL.—Each group health plan modifications to their genetic material, such the employer and the employee provides shall comply with the genetic non- as chromosomal damage or evidence of in- prior, knowing, voluntary, and written au- discrimination provisions of subsections creased occurrence of mutations, that may thorization, and only the employee or family (a)(1)(F) and (c) through (i) of section 2702, have developed in the course of employment member of such employee receives the re- and section 2707 of the Public Health Service due to exposure to toxic substances in the sults of such services. Act and such provisions shall be deemed to workplace, in order to identify, evaluate, and (b) LIMITATION.—In the case of predictive be incorporated into this subsection. respond to the effects of or control adverse genetic information to which subparagraph ‘‘(b) VIOLATION OF GENETIC DISCRIMINATION environmental exposures in the workplace. (A) or (B) of subsection (a)(3) applies, such OR GENETIC DISCLOSURE PROVISIONS.—In any (4) GENETIC SERVICES.—The term ‘‘genetic information may not be used in violation of action under this section against any admin- services’’ means health services, including paragraph (1) or (2) of subsection (a). istrator of a group health plan (including genetic tests, provided to obtain, assess, or SEC. ll23. EMPLOYMENT AGENCY PRACTICES. any third party administrator or other per- interpret genetic information for diagnostic It shall be an unlawful employment prac- son acting for or on behalf of such plan) al- and therapeutic purposes, and for genetic tice for an employment agency— leging a violation of subsection (a), the court education and counseling. (1) to fail or refuse to refer for employ- may award any appropriate legal or equi- (5) GENETIC TEST.—The term ‘‘genetic test’’ ment, or otherwise to discriminate against, table relief. Such relief may include a re- means the analysis of human DNA, RNA, any individual because of predictive genetic quirement for the payment of attorney’s fees chromosomes, proteins, and certain metabo- information with respect to the individual and costs, including the costs of expert wit- lites in order to detect genotypes, (or information about a request for or the re- nesses. mutations, or chromosomal changes. ceipt of genetic services by such individual ‘‘(c) CIVIL PENALTY.—The monetary provi- (6) PREDICTIVE GENETIC INFORMATION.— or family member of such individual); sions of section 308(b)(2)(C) of Public Law (A) IN GENERAL.—The term ‘‘predictive ge- (2) to limit, segregate, or classify individ- 101–336 (42 U.S.C. 12188(b)) shall apply for pur- netic information’’ means— uals or fail or refuse to refer for employment poses of the Secretary enforcing the provi- (i) information about an individual’s ge- any individual in any way that would de- sions referred to in subsection (b), except netic tests; prive or tend to deprive any individual of S6150 CONGRESSIONAL RECORD — SENATE June 29, 2000 employment opportunities or would limit SEC. ll26. MAINTENANCE AND DISCLOSURE OF (3) limit the rights or protections of an in- the employment opportunities or otherwise PREDICTIVE GENETIC INFORMA- dividual under any other Federal or State adversely affect the status of the individual TION. statute that provides equal or greater pro- as an employee, because of predictive genetic (a) MAINTENANCE OF PREDICTIVE GENETIC tection to an individual than the rights ac- information with respect to the individual INFORMATION.—If an employer possesses pre- corded under this subtitle; (or information about a request for or the re- dictive genetic information about an em- (4) apply to the Armed Forces Repository ployee (or information about a request for or ceipt of genetic services by such individual of Specimen Samples for the Identification receipt of genetic services by such employee or family member of such individual); of Remains; or or family member of such employee), such (3) to request, require, collect or purchase (5) limit the statutory or regulatory au- information shall be treated or maintained predictive genetic information with respect thority of the Occupational Safety and as part of the employee’s confidential med- to an individual (or information about a re- Health Administration or the Mine Safety ical records. quest for or the receipt of genetic services by and Health Administration to promulgate or (b) DISCLOSURE OF PREDICTIVE GENETIC IN- enforce workplace safety and health laws such individual or family member of such in- FORMATION.—An employer shall not disclose and regulations. dividual); or predictive genetic information (or informa- ll (4) to cause or attempt to cause an em- tion about a request for or receipt of genetic SEC. 29. AUTHORIZATION OF APPROPRIA- TIONS. ployer to discriminate against an individual services by such employee or family member There are authorized to be appropriated in violation of this subtitle. of such employee) except— such sums as may be necessary to carry out SEC. ll24. LABOR ORGANIZATION PRACTICES. (1) to the employee who is the subject of It shall be an unlawful employment prac- this subtitle. the information at the request of the em- ll tice for a labor organization— ployee; SEC. 30. EFFECTIVE DATE. This subtitle shall become effective on Oc- (1) to exclude or to expel from the member- (2) to an occupational or other health re- tober 1, 2000. ship of the organization, or otherwise to dis- searcher if the research is conducted in com- SEC. 31. NO IMPACT ON SOCIAL SECURITY criminate against, any individual because of pliance with the regulations and protections TRUST FUND.— predictive genetic information with respect provided for under part 46 of title 45, Code of (1) IN GENERAL.—Nothing in this title shall to the individual (or information about a re- Federal Regulations; be construed to alter or amend the Social Se- quest for or the receipt of genetic services by (3) under legal compulsion of a Federal curity Act (or any regulation promulgated such individual or family member of such in- court order, except that if the court order under that Act). dividual); was secured without the knowledge of the in- (2) TRANSFERS.— (2) to limit, segregate, or classify the mem- dividual to whom the information refers, the (A) ESTIMATE OF SECRETARY.—The Sec- bers of the organization, or fail or refuse to employer shall provide the individual with retary of the Treasury shall annually esti- refer for employment any individual, in any adequate notice to challenge the court order mate the impact that the enactment of this way that would deprive or tend to deprive unless the court order also imposes confiden- title has on the income and balances of the any individual of employment opportunities, tiality requirements; and trust funds established under section 201 of or would limit the employment opportuni- (4) to government officials who are inves- the Social Security Act (42 U.S.C. 401). tigating compliance with this subtitle if the ties or otherwise adversely affect the status (B) TRANSFER OF FUNDS.—If, under subpara- of the individual as an employee, because of information is relevant to the investigation. graph (A), the Secretary of the Treasury es- ll predictive genetic information with respect SEC. 27. CIVIL ACTION. timates that the enactment of this title has to the individual (or information about a re- (a) IN GENERAL.—One or more employees, a negative impact on the income and bal- quest for or the receipt of genetic services by members of a labor organization, or partici- ances of the trust funds established under such individual or family member of such in- pants in training programs may bring an ac- section 201 of the Social Security Act (42 dividual); tion in a Federal or State court of competent U.S.C. 401), the Secretary shall transfer, not (3) to request, require, collect or purchase jurisdiction against an employer, employ- less frequently than quarterly, from the gen- predictive genetic information with respect ment agency, labor organization, or joint eral revenues of the Federal Government an labor-management committee or training to an individual (or information about a re- amount sufficient so as to ensure that the program who commits a violation of this quest for or the receipt of genetic services by income and balances of such trust funds are subtitle. such individual or family member of such in- not reduced as a result of the enactment of (b) ENFORCEMENT BY THE EQUAL EMPLOY- dividual); or such title. MENT OPPORTUNITY COMMISSION.— (4) to cause or attempt to cause an em- SEC. 32. INFORMATION REQUIREMENTS.— (1) IN GENERAL.—The powers, remedies, and ployer to discriminate against an individual (1) INFORMATION FROM GROUP HEALTH procedures set forth in sections 705, 706, 707, in violation of this subtitle. PLANS.—Section 1862(b) of the Social Secu- 709, 710, and 717 of the Civil Rights Act of SEC. ll25. TRAINING PROGRAMS. rity Act (42 U.S.C. 1395y(b)) is amended by 1964 (42 U.S.C. 2000e–4, 2000e–5, 2000e–6, 2000e– It shall be an unlawful employment prac- 8, 2000e–9, and 2000e–16) shall be the powers, adding at the end the following: tice for any employer, labor organization, or remedies, and procedures provided to the ‘‘(7) INFORMATION FROM GROUP HEALTH joint labor-management committee control- Equal Employment Opportunity Commission PLANS.— ling apprenticeship or other training or re- to enforce this subtitle. The Commission ‘‘(A) PROVISION OF INFORMATION BY GROUP training, including on-the-job training may promulgate regulations to implement HEALTH PLANS.—The administrator of a programs— these powers, remedies, and procedures. group health plan subject to the require- (1) to discriminate against any individual (2) EXHAUSTION OF REMEDIES.—Nothing in ments of paragraph (1) shall provide to the because of predictive genetic information this subsection shall be construed to require Secretary such of the information elements with respect to the individual (or informa- that an individual exhaust the administra- described in subparagraph (C) as the Sec- tion about a request for or the receipt of ge- tive remedies available through the Equal retary specifies, and in such manner and at netic services by such individual), in admis- Employment Opportunity Commission prior such times as the Secretary may specify (but sion to, or employment in, any program es- to commencing a civil action under this sec- not more frequently than 4 times per year), tablished to provide apprenticeship or other tion, except that if an individual files a with respect to each individual covered training or retraining; charge of discrimination with the Commis- under the plan who is entitled to any bene- (2) to limit, segregate, or classify the mem- sion that alleges a violation of this subtitle, fits under this title. bers of the organization, or fail or refuse to the individual shall exhaust the administra- ‘‘(B) PROVISION OF INFORMATION BY EMPLOY- refer for employment any individual, in any tive remedies available through the Commis- ERS AND EMPLOYEE ORGANIZATIONS.—An em- way that would deprive or tend to deprive sion prior to commencing a civil action ployer (or employee organization) that main- any individual of employment opportunities, under this section. tains or participates in a group health plan or would limit the employment opportuni- (c) REMEDY.—A Federal or State court may subject to the requirements of paragraph (1) ties or otherwise adversely affect the status award any appropriate legal or equitable re- shall provide to the administrator of the of the individual as an employee, because of lief under this section. Such relief may in- plan such of the information elements re- predictive genetic information with respect clude a requirement for the payment of at- quired to be provided under subparagraph to the individual (or information about a re- torney’s fees and costs, including the costs of (A), and in such manner and at such times as quest for or receipt of genetic services by experts. the Secretary may specify, at a frequency such individual or family member of such in- SEC. ll28. CONSTRUCTION. consistent with that required under subpara- dividual); Nothing in this subtitle shall be construed graph (A) with respect to each individual de- (3) to request, require, collect or purchase to— scribed in subparagraph (A) who is covered predictive genetic information with respect (1) limit the rights or protections of an in- under the plan by reason of employment to an individual (or information about a re- dividual under the Americans with Disabil- with that employer or membership in the or- quest for or receipt of genetic services by ities Act of 1990 (42 U.S.C. 12101 et seq.), in- ganization. such individual or family member of such in- cluding coverage afforded to individuals ‘‘(C) INFORMATION ELEMENTS.—The infor- dividual); or under section 102 of such Act; mation elements described in this subpara- (4) to cause or attempt to cause an em- (2) limit the rights or protections of an in- graph are the following: ployer to discriminate against an individual dividual under the Rehabilitation Act of 1973 ‘‘(i) ELEMENTS CONCERNING THE INDI- in violation of this subtitle. (29 U.S.C. 701 et seq.); VIDUAL.— June 29, 2000 CONGRESSIONAL RECORD — SENATE S6151 ‘‘(I) The individual’s name. net surplus of any trust fund for part A of TITLE ll—SOCIAL SECURITY AND MEDI- ‘‘(II) The individual’s date of birth. Medicare shall not be counted as a net sur- CARE OFF-BUDGET LOCKBOX ACT OF ‘‘(III) The individual’s sex. plus for purposes of— 2000 ‘‘(IV) The individual’s social security in- (A) the budget of the United States Gov- SEC. ll1. SHORT TITLE. surance number. ernment as submitted by the President; This title may be cited as the ‘‘Social Se- ‘‘(V) The number assigned by the Secretary (B) the congressional budget; or curity and Medicare Off-Budget Lockbox Act to the individual for claims under this title. (C) the Balanced Budget and Emergency of 2000’’. ‘‘(VI) The family relationship of the indi- Deficit Control Act of 1985. SEC. ll2. STRENGTHENING SOCIAL SECURITY vidual to the person who has or had current (2) POINTS OF ORDER TO PROTECT SOCIAL SE- POINTS OF ORDER. or employment status with the employer. CURITY AND MEDICARE SURPLUSES.—Section (a) IN GENERAL.—Section 312 of the Con- ‘‘(ii) ELEMENTS CONCERNING THE FAMILY 312 of the Congressional Budget Act of 1974 is gressional Budget Act of 1974 (2 U.S.C. 643) is MEMBER WITH CURRENT OR FORMER EMPLOY- amended by adding at the end the following amended by inserting at the end the fol- MENT STATUS.— new subsection: lowing: ‘‘(I) The name of the person in the individ- ‘‘(g) POINTS OF ORDER TO PROTECT SOCIAL ‘‘(g) STRENGTHENING SOCIAL SECURITY ual’s family who has current or former em- SECURITY AND MEDICARE SURPLUSES.— POINT OF ORDER.—It shall not be in order in ployment status with the employer. ‘‘(1) CONCURRENT RESOLUTIONS ON THE BUDG- ‘‘(II) That person’s social security insur- the House of Representatives or the Senate ET.—It shall not be in order in the House of to consider a concurrent resolution on the ance number. Representatives or the Senate to consider ‘‘(III) The number or other identifier as- budget (or any amendment thereto or con- any concurrent resolution on the budget, or ference report thereon) or any bill, joint res- signed by the plan to that person. conference report thereon or amendment ‘‘(IV) The periods of coverage for that per- olution, amendment, motion, or conference thereto, that would set forth an on-budget report that would violate or amend section son under the plan. deficit for any fiscal year. ‘‘(V) The employment status of that person 13301 of the Budget Enforcement Act of ‘‘(2) SUBSEQUENT LEGISLATION.—It shall not 1990.’’. (current or former) during those periods of be in order in the House of Representatives (b) SUPER MAJORITY REQUIREMENT.— coverage. or the Senate to consider any bill, joint reso- ‘‘(VI) The classes (of that person’s family (1) POINT OF ORDER.—Section 904(c)(1) of lution, amendment, motion, or conference the Congressional Budget Act of 1974 is members) covered under the plan. report if— ‘‘(iii) PLAN ELEMENTS.— amended by inserting ‘‘312(g),’’ after ‘‘(A) the enactment of that bill or resolu- ‘‘310(d)(2),’’. ‘‘(I) The items and services covered under tion as reported; the plan. (2) WAIVER.—Section 904(d)(2) of the Con- ‘‘(B) the adoption and enactment of that ‘‘(II) The name and address to which gressional Budget Act of 1974 is amended by amendment; or claims under the plan are to be sent. inserting ‘‘312(g),’’ after ‘‘310(d)(2),’’. ‘‘(C) the enactment of that bill or resolu- ‘‘(iv) ELEMENTS CONCERNING THE EM- (c) ENFORCEMENT IN EACH FISCAL YEAR.— tion in the form recommended in that con- PLOYER.— The Congressional Budget Act of 1974 is ference report, ‘‘(I) The employer’s name. amended in— would cause or increase an on-budget deficit ‘‘(II) The employer’s address. (1) section 301(a)(7) (2 U.S.C. 632(a)(7)), by for any fiscal year. ‘‘(III) The employer identification number striking ‘‘for the fiscal year’’ through the pe- ‘‘(3) DEFINITION.—For purposes of this sec- of the employer. riod and inserting ‘‘for each fiscal year cov- tion, the term ‘on-budget deficit’, when ap- ‘‘(D) USE OF IDENTIFIERS.—The adminis- ered by the resolution’’; and trator of a group health plan shall utilize a plied to a fiscal year, means the deficit in (2) section 311(a)(3) (2 U.S.C. 642(a)(3)), by unique identifier for the plan in providing in- the budget as set forth in the most recently striking beginning with ‘‘for the first fiscal formation under subparagraph (A) and in agreed to concurrent resolution on the budg- year’’ through the period and insert the fol- other transactions, as may be specified by et pursuant to section 301(a)(3) for that fiscal lowing: ‘‘for any of the fiscal years covered the Secretary, related to the provisions of year.’’. by the concurrent resolution.’’. (3) SUPER MAJORITY REQUIREMENT.— this subsection. The Secretary may provide SEC. ll3. MEDICARE TRUST FUND OFF-BUDGET. (A) POINT OF ORDER.—Section 904(c)(1) of to the administrator the unique identifier (a) IN GENERAL.— described in the preceding sentence. the Congressional Budget Act of 1974 is amended by inserting ‘‘312(g),’’ after (1) GENERAL EXCLUSION FROM ALL BUDG- ‘‘(E) PENALTY FOR NONCOMPLIANCE.—Any ETS.—Title III of the Congressional Budget entity that knowingly and willfully fails to ‘‘310(d)(2),’’. (B) WAIVER.—Section 904(d)(2) of the Con- Act of 1974 is amended by adding at the end comply with a requirement imposed by the the following: previous subparagraphs shall be subject to a gressional Budget Act of 1974 is amended by civil money penalty not to exceed $1,000 for inserting ‘‘312(g),’’ after ‘‘310(d)(2),’’. ‘‘EXCLUSION OF MEDICARE TRUST FUND FROM each incident of such failure. The provisions (c) PROTECTION OF SOCIAL SECURITY AND ALL BUDGETS of section 1128A (other than subsections (a) MEDICARE SURPLUSES.— ‘‘SEC. 316. (a) EXCLUSION OF MEDICARE and (b)) shall apply to a civil money penalty (1) IN GENERAL.—Chapter 11 of subtitle II of TRUST FUND FROM ALL BUDGETS.—Notwith- under the previous sentence in the same title 31, United States Code, is amended by standing any other provision of law, the re- manner as those provisions apply to a pen- adding before section 1101 the following: ceipts and disbursements of the Federal Hos- alty or proceeding under section 1128A(a).’’. ‘‘§ 1100. Protection of social security and pital Insurance Trust Fund shall not be (2) EFFECTIVE DATE.—The amendment medicare surpluses counted as new budget authority, outlays, receipts, or deficit or surplus for purposes made by paragraph (1) shall take effect 180 ‘‘The budget of the United States Govern- of— days after the date of the enactment of this ment submitted by the President under this ‘‘(1) the budget of the United States Gov- Act. chapter shall not recommend an on-budget SEC. 33. OFFSET.—Amounts made avail- ernment as submitted by the President; deficit for any fiscal year covered by that able under this Act for the administrative ‘‘(2) the congressional budget; or budget.’’. and related expenses for departmental man- ‘‘(3) the Balanced Budget and Emergency (2) CHAPTER ANALYSIS.—The chapter anal- agement for the Department of Labor and Deficit Control Act of 1985. ysis for chapter 11 of title 31, United States the Department of Health and Human Serv- ‘‘(b) STRENGTHENING MEDICARE POINT OF Code, is amended by inserting before the ices shall be reduced on a pro rata basis by ORDER.—It shall not be in order in the House item for section 1101 the following: $25,000,000. of Representatives or the Senate to consider ‘‘1100. Protection of social security and medi- a concurrent resolution on the budget (or ASHCROFT (AND OTHERS) care surpluses.’’. any amendment thereto or conference report AMENDMENT NO. 3689 (d) EFFECTIVE DATE.—This section shall thereon) or any bill, joint resolution, amend- ment, motion, or conference report that Mr. ASHCROFT (for himself, Mr. take effect upon the date of its enactment and the amendments made by this section would violate or amend this section.’’. VOINOVICH, Mr. ALLARD, Mr. GRAMS, shall apply to fiscal year 2001 and subsequent (2) SUPER MAJORITY REQUIREMENT.— Mr. ABRAHAM, and Mr. FEINGOLD) pro- fiscal years. (A) POINT OF ORDER.—Section 904(c)(1) of posed an amendment to the bill, H.R. the Congressional Budget Act of 1974 is 4577, supra; as follows: amended by inserting ‘‘316,’’ after ‘‘313,’’. (B) WAIVER.—Section 904(d)(2) of the Con- At the end, insert the following: CONRAD (AND LAUTENBERG) ll gressional Budget Act of 1974 is amended by SEC. . SOCIAL SECURITY AND MEDICARE AMENDMENT NO. 3690 SAFE DEPOSIT BOX ACT OF 2000. inserting ‘‘316,’’ after ‘‘313,’’. (a) SHORT TITLE.—This section may be Mr. REID (for Mr. CONRAD (for him- (b) EXCLUSION OF MEDICARE TRUST FUND FROM CONGRESSIONAL BUDGET.—Section cited as the ‘‘Social Security and Medicare self, Mr. LAUTENBERG, and Mr. FEIN- Safe Deposit Box Act of 2000’’. 301(a) of the Congressional Budget Act of 1974 GOLD)) proposed an amendment to the (b) PROTECTION OF SOCIAL SECURITY AND (2 U.S.C. 632(a)) is amended by adding at the MEDICARE SURPLUSES.— bill, H.R. 4577, supra; as follows: end the following: ‘‘The concurrent resolu- (1) MEDICARE SURPLUSES OFF-BUDGET.—Not- Strike all after the first word and insert tion shall not include the outlays and rev- withstanding any other provision of law, the the following: enue totals of the Federal Hospital Insurance S6152 CONGRESSIONAL RECORD — SENATE June 29, 2000 Trust Fund in the surplus or deficit totals any concurrent resolution on the budget, or of predictive genetic information (including required by this subsection or in any other conference report thereon or amendment information about a request for or receipt of surplus or deficit totals required by this thereto, that would cause or increase an on- genetic services), see section 714.’’. title.’’ budget deficit for any fiscal year. (B) TABLE OF CONTENTS.—The table of con- (c) BUDGET TOTALS.—Section 301(a) of the ‘‘(2) SUBSEQUENT LEGISLATION.—Except as tents in section 1 of the Employee Retire- Congressional Budget Act of 1974 (2 U.S.C. provided by paragraph (3), it shall not be in ment Income Security Act of 1974 is amended 632(a)) is amended by inserting after para- order in the House of Representatives or the by inserting after the item relating to sec- graph (7) the following: Senate to consider any bill, joint resolution, tion 713 the following new item: ‘‘(8) For purposes of Senate enforcement amendment, motion, or conference report ‘‘Sec. 714. Prohibiting premium discrimina- under this title, revenues and outlays of the if— tion against groups on the basis Federal Hospital Insurance Trust Fund for ‘‘(A) the enactment of that bill or resolu- of predictive genetic informa- each fiscal year covered by the budget reso- tion as reported; tion.’’. lution.’’. ‘‘(B) the adoption and enactment of that (b) LIMITATION ON COLLECTION OF PRE- (d) BUDGET RESOLUTIONS.—Section 301(i) of amendment; or DICTIVE GENETIC INFORMATION.—Section 702 the Congressional Budget Act of 1974 (2 ‘‘(C) the enactment of that bill or resolu- of the Employee Retirement Income Secu- U.S.C. 632(i)) is amended by— tion in the form recommended in that con- rity Act of 1974 (29 U.S.C. 1182) is amended by (1) striking ‘‘SOCIAL SECURITY POINT OF ference report, adding at the end the following: ORDER.—It shall’’ and inserting ‘‘SOCIAL SE- would cause or increase an on-budget deficit ‘‘(c) COLLECTION OF PREDICTIVE GENETIC IN- CURITY AND MEDICARE POINTS OF ORDER.— for any fiscal year.’’. FORMATION.— (b) SUPER MAJORITY REQUIREMENT.— ‘‘(1) SOCIAL SECURITY.—It shall’’; and ‘‘(1) LIMITATION ON REQUESTING OR REQUIR- (1) POINT OF ORDER.—Section 904(c)(1) of (2) inserting at the end the following: ING PREDICTIVE GENETIC INFORMATION.—Ex- ‘‘(2) MEDICARE.—It shall not be in order in the Congressional Budget Act of 1974 is cept as provided in paragraph (2), a group the House of Representatives or the Senate amended by inserting ‘‘312(h),’’ after health plan, or a health insurance issuer of- to consider any concurrent resolution on the ‘‘312(g),’’. fering health insurance coverage in connec- budget (or amendment, motion, or con- (2) WAIVER.—Section 904(d)(2) of the Con- tion with a group health plan, shall not re- ference report on the resolution) that would gressional Budget Act of 1974 is amended by quest or require predictive genetic informa- decrease the excess of the Federal Hospital inserting ‘‘312(h),’’ after ‘‘312(g),’’. tion concerning any individual (including a Insurance Trust Fund revenues over Federal dependent) or family member of the indi- Hospital Insurance Trust Fund outlays in JEFFORDS (AND OTHERS) vidual (including information about a re- any of the fiscal years covered by the con- AMENDMENT NO. 3691 quest for or receipt of genetic services). current resolution. This paragraph shall not ‘‘(2) INFORMATION NEEDED FOR DIAGNOSIS, Mr. JEFFORDS (for himself, Mr. apply to amounts to be expended from the TREATMENT, OR PAYMENT.— Hospital Insurance Trust Fund for purposes FRIST, Ms. SNOWE, Mr. ASHCROFT, Mr. ‘‘(A) IN GENERAL.—Notwithstanding para- relating to programs within part A of Medi- ENZI, and Mr. MACK) proposed an graph (1), a group health plan, or a health in- care as provided in law on the date of enact- amendment to amendment No. 3688 surance issuer offering health insurance cov- ment of this paragraph.’’. proposed by Mr. DASCHLE to the bill, erage in connection with a group health (e) MEDICARE FIREWALL.—Section 311(a) of H.R. 4577, supra; as follows: plan, that provides health care items and the Congressional Budget Act of 1974 (2 At the end of the bill, add the following: services to an individual or dependent may U.S.C. 642(a)) is amended by adding after request (but may not require) that such indi- ll paragraph (3), the following: TITLE GENETIC INFORMATION AND vidual or dependent disclose, or authorize ‘‘(4) ENFORCEMENT OF MEDICARE LEVELS IN SERVICES the collection or disclosure of, predictive ge- THE SENATE.—After a concurrent resolution SEC. ll01. SHORT TITLE. netic information for purposes of diagnosis, on the budget is agreed to, it shall not be in This title may be cited as the ‘‘Genetic In- treatment, or payment relating to the provi- order in the Senate to consider any bill, formation Nondiscrimination in Health In- sion of health care items and services to joint resolution, amendment, motion, or con- surance Act of 1999’’. such individual or dependent. ference report that would cause a decrease in ll ‘‘(B) NOTICE OF CONFIDENTIALITY PRACTICES surpluses or an increase in deficits of the SEC. 02. AMENDMENTS TO EMPLOYEE RE- TIREMENT INCOME SECURITY ACT AND DESCRIPTION OF SAFEGUARDS.—As a part Federal Hospital Insurance Trust Fund in OF 1974. of a request under subparagraph (A), the any year relative to the levels set forth in (a) PROHIBITION OF HEALTH DISCRIMINATION group health plan, or a health insurance the applicable resolution. This paragraph ON THE BASIS OF GENETIC INFORMATION OR GE- issuer offering health insurance coverage in shall not apply to amounts to be expended NETIC SERVICES.— connection with a group health plan, shall from the Hospital Insurance Trust Fund for (1) NO ENROLLMENT RESTRICTION FOR GE- provide to the individual or dependent a de- purposes relating to programs within part A NETIC SERVICES.—Section 702(a)(1)(F) of the scription of the procedures in place to safe- of Medicare as provided in law on the date of Employee Retirement Income Security Act guard the confidentiality, as described in enactment of this paragraph.’’. of 1974 (29 U.S.C. 1182(a)(1)(F)) is amended by subsection (d), of such predictive genetic in- (f) BASELINE TO EXCLUDE HOSPITAL INSUR- inserting before the period the following: formation. ANCE TRUST FUND.—Section 257(b)(3) of the ‘‘(including information about a request for ‘‘(d) CONFIDENTIALITY WITH RESPECT TO Balanced Budget and Emergency Deficit or receipt of genetic services)’’. PREDICTIVE GENETIC INFORMATION.— Control Act of 1985 is amended by striking (2) NO DISCRIMINATION IN GROUP PREMIUMS ‘‘(1) NOTICE OF CONFIDENTIALITY PRAC- ‘‘shall be included in all’’ and inserting BASED ON PREDICTIVE GENETIC INFORMATION.— TICES.— ‘‘shall not be included in any’’. Subpart B of part 7 of subtitle B of title I of ‘‘(A) PREPARATION OF WRITTEN NOTICE.—A (g) MEDICARE TRUST FUND EXEMPT FROM the Employee Retirement Income Security group health plan, or a health insurance SEQUESTERS.—Section 255(g)(1)(B) of the Bal- Act of 1974 is amended by adding at the end issuer offering health insurance coverage in anced Budget and Emergency Deficit Control the following: connection with a group health plan, shall Act of 1985 is amended by adding at the end post or provide, in writing and in a clear and the following: ‘‘SEC. 714. PROHIBITING PREMIUM DISCRIMINA- TION AGAINST GROUPS ON THE conspicuous manner, notice of the plan or ‘‘Medicare as funded through the Federal BASIS OF PREDICTIVE GENETIC IN- issuer’s confidentiality practices, that shall Hospital Insurance Trust Fund.’’. FORMATION. include— (h) BUDGETARY TREATMENT OF HOSPITAL IN- ‘‘A group health plan, or a health insur- ‘‘(i) a description of an individual’s rights SURANCE TRUST FUND.—Section 710(a) of the ance issuer offering group health insurance with respect to predictive genetic informa- Social Security Act (42 U.S.C. 911(a)) is coverage in connection with a group health tion; amended— plan, shall not adjust premium or contribu- ‘‘(ii) the procedures established by the plan (1) by striking ‘‘and’’ the second place it tion amounts for a group on the basis of pre- or issuer for the exercise of the individual’s appears and inserting a comma; and dictive genetic information concerning any rights; and (2) by inserting after ‘‘Federal Disability individual (including a dependent) or family ‘‘(iii) the right to obtain a copy of the no- Insurance Trust Fund’’ the following: ‘‘, Fed- member of the individual (including informa- tice of the confidentiality practices required eral Hospital Insurance Trust Fund’’. tion about a request for or receipt of genetic under this subsection. SEC. ll4. PREVENTING ON-BUDGET DEFICITS. services).’’. ‘‘(B) MODEL NOTICE.—The Secretary, in (a) POINTS OF ORDER TO PREVENT ON-BUDG- (3) CONFORMING AMENDMENTS.— consultation with the National Committee ET DEFICITS.—Section 312 of the Congres- (A) IN GENERAL.—Section 702(b) of the Em- on Vital and Health Statistics and the Na- sional Budget Act of 1974 (2 U.S.C. 643) is ployee Retirement Income Security Act of tional Association of Insurance Commis- amended by adding at the end the following: 1974 (29 U.S.C. 1182(b)) is amended by adding sioners, and after notice and opportunity for ‘‘(h) POINTS OF ORDER TO PREVENT ON- at the end the following: public comment, shall develop and dissemi- BUDGET DEFICITS.— ‘‘(3) REFERENCE TO RELATED PROVISION.— nate model notices of confidentiality prac- ‘‘(1) CONCURRENT RESOLUTIONS ON THE BUDG- For a provision prohibiting the adjustment tices. Use of the model notice shall serve as ET.—It shall not be in order in the House of of premium or contribution amounts for a a defense against claims of receiving inap- Representatives or the Senate to consider group under a group health plan on the basis propriate notice. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6153

‘‘(2) ESTABLISHMENT OF SAFEGUARDS.—A period the following: ‘‘(including informa- conspicuous manner, notice of the plan or group health plan, or a health insurance tion about a request for or receipt of genetic issuer’s confidentiality practices, that shall issuer offering health insurance coverage in services)’’. include— connection with a group health plan, shall (B) NO DISCRIMINATION IN PREMIUMS BASED ‘‘(i) a description of an individual’s rights establish and maintain appropriate adminis- ON PREDICTIVE GENETIC INFORMATION.—Sub- with respect to predictive genetic informa- trative, technical, and physical safeguards to part 2 of part A of title XXVII of the Public tion; protect the confidentiality, security, accu- Health Service Act (42 U.S.C. 300gg-4 et seq.) ‘‘(ii) the procedures established by the plan racy, and integrity of predictive genetic in- is amended by adding at the end the fol- or issuer for the exercise of the individual’s formation created, received, obtained, main- lowing new section: rights; and tained, used, transmitted, or disposed of by ‘‘SEC. 2707. PROHIBITING PREMIUM DISCRIMINA- ‘‘(iii) the right to obtain a copy of the no- such plan or issuer.’’. TION AGAINST GROUPS ON THE tice of the confidentiality practices required (c) DEFINITIONS.—Section 733(d) of the Em- BASIS OF PREDICTIVE GENETIC IN- under this subsection. ployee Retirement Income Security Act of FORMATION IN THE GROUP MAR- ‘‘(B) MODEL NOTICE.—The Secretary, in 1974 (29 U.S.C. 1191b(d)) is amended by adding KET. consultation with the National Committee at the end the following: ‘‘A group health plan, or a health insur- on Vital and Health Statistics and the Na- ‘‘(5) FAMILY MEMBER.—The term ‘family ance issuer offering group health insurance tional Association of Insurance Commis- member’ means with respect to an coverage in connection with a group health sioners, and after notice and opportunity for individual— plan shall not adjust premium or contribu- public comment, shall develop and dissemi- ‘‘(A) the spouse of the individual; tion amounts for a group on the basis of pre- nate model notices of confidentiality prac- ‘‘(B) a dependent child of the individual, dictive genetic information concerning any tices. Use of the model notice shall serve as including a child who is born to or placed for individual (including a dependent) or family a defense against claims of receiving inap- adoption with the individual; and member of the individual (including informa- propriate notice. ‘‘(C) all other individuals related by blood tion about a request for or receipt of genetic ‘‘(2) ESTABLISHMENT OF SAFEGUARDS.—A to the individual or the spouse or child de- services).’’. group health plan, or a health insurance scribed in subparagraph (A) or (B). (C) CONFORMING AMENDMENT.—Section issuer offering health insurance coverage in ‘‘(6) GENETIC INFORMATION.—The term ‘ge- 2702(b) of the Public Health Service Act (42 connection with a group health plan, shall netic information’ means information about U.S.C. 300gg–1(b)) is amended by adding at establish and maintain appropriate adminis- genes, gene products, or inherited character- the end the following: trative, technical, and physical safeguards to istics that may derive from an individual or ‘‘(3) REFERENCE TO RELATED PROVISION.— protect the confidentiality, security, accu- a family member (including information For a provision prohibiting the adjustment racy, and integrity of predictive genetic in- about a request for or receipt of genetic serv- of premium or contribution amounts for a formation created, received, obtained, main- ices). group under a group health plan on the basis tained, used, transmitted, or disposed of by ‘‘(7) GENETIC SERVICES.—The term ‘genetic of predictive genetic information (including such plan or issuer.’’. services’ means health services provided to information about a request for or receipt of (2) DEFINITIONS.—Section 2791(d) of the obtain, assess, or interpret genetic informa- genetic services), see section 2707.’’. Public Health Service Act (42 U.S.C. 300gg– tion for diagnostic and therapeutic purposes, (D) LIMITATION ON COLLECTION AND DISCLO- 91(d)) is amended by adding at the end the and for genetic education and counseling. SURE OF PREDICTIVE GENETIC INFORMATION.— following: ‘‘(8) PREDICTIVE GENETIC INFORMATION.— Section 2702 of the Public Health Service Act ‘‘(15) FAMILY MEMBER.—The term ‘family ‘‘(A) IN GENERAL.—The term ‘predictive ge- (42 U.S.C. 300gg–1) is amended by adding at member’ means, with respect to an netic information’ means, in the absence of the end the following: individual— symptoms, clinical signs, or a diagnosis of ‘‘(c) COLLECTION OF PREDICTIVE GENETIC IN- ‘‘(A) the spouse of the individual; the condition related to such information— FORMATION.— ‘‘(B) a dependent child of the individual, ‘‘(i) information about an individual’s ge- ‘‘(1) LIMITATION ON REQUESTING OR REQUIR- including a child who is born to or placed for netic tests; ING PREDICTIVE GENETIC INFORMATION.—Ex- adoption with the individual; and ‘‘(ii) information about genetic tests of cept as provided in paragraph (2), a group ‘‘(C) all other individuals related by blood family members of the individual; or health plan, or a health insurance issuer of- to the individual or the spouse or child de- ‘‘(iii) information about the occurrence of fering health insurance coverage in connec- scribed in subparagraph (A) or (B). a disease or disorder in family members. tion with a group health plan, shall not re- ‘‘(16) GENETIC INFORMATION.—The term ‘ge- ‘‘(B) EXCEPTIONS.—The term ‘predictive ge- quest or require predictive genetic informa- netic information’ means information about netic information’ shall not include— tion concerning any individual (including a genes, gene products, or inherited character- ‘‘(i) information about the sex or age of the dependent) or a family member of the indi- istics that may derive from an individual or individual; vidual (including information about a re- a family member (including information ‘‘(ii) information derived from physical quest for or receipt of genetic services). about a request for or receipt of genetic serv- tests, such as the chemical, blood, or urine ‘‘(2) INFORMATION NEEDED FOR DIAGNOSIS, ices). analyses of the individual including choles- TREATMENT, OR PAYMENT.— ‘‘(17) GENETIC SERVICES.—The term ‘genetic terol tests; and ‘‘(A) IN GENERAL.—Notwithstanding para- services’ means health services provided to ‘‘(iii) information about physical exams of graph (1), a group health plan, or a health in- obtain, assess, or interpret genetic informa- the individual. surance issuer offering health insurance cov- tion for diagnostic and therapeutic purposes, ‘‘(9) GENETIC TEST.—The term ‘genetic test’ erage in connection with a group health and for genetic education and counseling. means the analysis of human DNA, RNA, plan, that provides health care items and ‘‘(18) PREDICTIVE GENETIC INFORMATION.— chromosomes, proteins, and certain metabo- services to an individual or dependent may ‘‘(A) IN GENERAL.—The term ‘predictive ge- lites, including analysis of genotypes, request (but may not require) that such indi- netic information’ means, in the absence of mutations, phenotypes, or karyotypes, for vidual or dependent disclose, or authorize symptoms, clinical signs, or a diagnosis of the purpose of predicting risk of disease in the collection or disclosure of, predictive ge- the condition related to such information— asymptomatic or undiagnosed individuals. netic information for purposes of diagnosis, ‘‘(i) information about an individual’s ge- Such term does not include physical tests, treatment, or payment relating to the provi- netic tests; such as the chemical, blood, or urine anal- sion of health care items and services to ‘‘(ii) information about genetic tests of yses of the individual including cholesterol such individual or dependent. family members of the individual; or tests, and physical exams of the individual, ‘‘(B) NOTICE OF CONFIDENTIALITY PRACTICES ‘‘(iii) information about the occurrence of in order to detect symptoms, clinical signs, AND DESCRIPTION OF SAFEGUARDS.—As a part a disease or disorder in family members. or a diagnosis of disease.’’. of a request under subparagraph (A), the ‘‘(B) EXCEPTIONS.—The term ‘predictive ge- (d) EFFECTIVE DATE.—Except as provided in group health plan, or a health insurance netic information’ shall not include— this section, this section and the amend- issuer offering health insurance coverage in ‘‘(i) information about the sex or age of the ments made by this section shall apply with connection with a group health plan, shall individual; respect to group health plans for plan years provide to the individual or dependent a de- ‘‘(ii) information derived from physical beginning 1 year after the date of the enact- scription of the procedures in place to safe- tests, such as the chemical, blood, or urine ment of this Act. guard the confidentiality, as described in analyses of the individual including choles- SEC. ll03. AMENDMENTS TO THE PUBLIC subsection (d), of such predictive genetic in- terol tests; and HEALTH SERVICE ACT. formation. ‘‘(iii) information about physical exams of (a) AMENDMENTS RELATING TO THE GROUP ‘‘(d) CONFIDENTIALITY WITH RESPECT TO the individual. MARKET.— PREDICTIVE GENETIC INFORMATION.— ‘‘(19) GENETIC TEST.—The term ‘genetic (1) PROHIBITION OF HEALTH DISCRIMINATION ‘‘(1) NOTICE OF CONFIDENTIALITY PRAC- test’ means the analysis of human DNA, ON THE BASIS OF GENETIC INFORMATION IN THE TICES.— RNA, chromosomes, proteins, and certain GROUP MARKET.— ‘‘(A) PREPARATION OF WRITTEN NOTICE.—A metabolites, including analysis of genotypes, (A) NO ENROLLMENT RESTRICTION FOR GE- group health plan, or a health insurance mutations, phenotypes, or karyotypes, for NETIC SERVICES.—Section 2702(a)(1)(F) of the issuer offering health insurance coverage in the purpose of predicting risk of disease in Public Health Service Act (42 U.S.C. 300gg– connection with a group health plan, shall asymptomatic or undiagnosed individuals. 1(a)(1)(F)) is amended by inserting before the post or provide, in writing and in a clear and Such term does not include physical tests, S6154 CONGRESSIONAL RECORD — SENATE June 29, 2000

such as the chemical, blood, or urine anal- ‘‘(iii) the right to obtain a copy of the no- ‘‘(d) COLLECTION OF PREDICTIVE GENETIC IN- yses of the individual including cholesterol tice of the confidentiality practices required FORMATION.— tests, and physical exams of the individual, under this subsection. ‘‘(1) LIMITATION ON REQUESTING OR REQUIR- in order to detect symptoms, clinical signs, ‘‘(B) MODEL NOTICE.—The Secretary, in ING PREDICTIVE GENETIC INFORMATION.—Ex- or a diagnosis of disease.’’. consultation with the National Committee cept as provided in paragraph (2), a group (e) AMENDMENTS TO PHSA RELATING TO THE on Vital and Health Statistics and the Na- health plan shall not request or require pre- INDIVIDUAL MARKET.—The first subpart 3 of tional Association of Insurance Commis- dictive genetic information concerning any part B of title XXVII of the Public Health sioners, and after notice and opportunity for individual (including a dependent) or a fam- Service Act (42 U.S.C. 300gg–51 et seq.) (relat- public comment, shall develop and dissemi- ily member of the individual (including in- ing to other requirements) (42 U.S.C. 300gg-51 nate model notices of confidentiality prac- formation about a request for or receipt of et seq.) is amended by adding at the end the tices. Use of the model notice shall serve as genetic services). following: a defense against claims of receiving inap- ‘‘(2) INFORMATION NEEDED FOR DIAGNOSIS, TREATMENT, OR PAYMENT.— ‘‘SEC. 2753. PROHIBITION OF HEALTH DISCRIMI- propriate notice. NATION ON THE BASIS OF PRE- ‘‘(2) ESTABLISHMENT OF SAFEGUARDS.—A ‘‘(A) IN GENERAL.—Notwithstanding para- DICTIVE GENETIC INFORMATION. health insurance issuer offering health insur- graph (1), a group health plan that provides ‘‘(a) PROHIBITION ON PREDICTIVE GENETIC ance coverage in the individual market shall health care items and services to an indi- INFORMATION AS A CONDITION OF ELIGI- establish and maintain appropriate adminis- vidual or dependent may request (but may BILITY.—A health insurance issuer offering trative, technical, and physical safeguards to not require) that such individual or depend- health insurance coverage in the individual protect the confidentiality, security, accu- ent disclose, or authorize the collection or market may not use predictive genetic infor- racy, and integrity of predictive genetic in- disclosure of, predictive genetic information mation as a condition of eligibility of an in- formation created, received, obtained, main- for purposes of diagnosis, treatment, or pay- dividual to enroll in individual health insur- tained, used, transmitted, or disposed of by ment relating to the provision of health care ance coverage (including information about such issuer.’’. items and services to such individual or de- a request for or receipt of genetic services). (c) EFFECTIVE DATE.—The amendments pendent. ‘‘(B) NOTICE OF CONFIDENTIALITY PRACTICES; ‘‘(b) PROHIBITION ON PREDICTIVE GENETIC made by this section shall apply with respect DESCRIPTION OF SAFEGUARDS.—As a part of a INFORMATION IN SETTING PREMIUM RATES.—A to— request under subparagraph (A), the group health insurance issuer offering health insur- (1) group health plans, and health insur- health plan shall provide to the individual or ance coverage in the individual market shall ance coverage offered in connection with dependent a description of the procedures in not adjust premium rates for individuals on group health plans, for plan years beginning after 1 year after the date of enactment of place to safeguard the confidentiality, as de- the basis of predictive genetic information scribed in subsection (e), of such predictive concerning such an individual (including a this Act; and (2) health insurance coverage offered, sold, genetic information. dependent) or a family member of the indi- ‘‘(e) CONFIDENTIALITY WITH RESPECT TO issued, renewed, in effect, or operated in the vidual (including information about a re- PREDICTIVE GENETIC INFORMATION.— individual market after 1 year after the date quest for or receipt of genetic services). ‘‘(1) NOTICE OF CONFIDENTIALITY PRAC- of enactment of this Act. ‘‘(c) COLLECTION OF PREDICTIVE GENETIC IN- TICES.— ll FORMATION.— SEC. 04. AMENDMENTS TO THE INTERNAL ‘‘(A) PREPARATION OF WRITTEN NOTICE.—A ‘‘(1) LIMITATION ON REQUESTING OR REQUIR- REVENUE CODE OF 1986. group health plan shall post or provide, in ING PREDICTIVE GENETIC INFORMATION.—Ex- (a) PROHIBITION OF HEALTH DISCRIMINATION writing and in a clear and conspicuous man- cept as provided in paragraph (2), a health ON THE BASIS OF GENETIC INFORMATION OR GE- ner, notice of the plan’s confidentiality prac- insurance issuer offering health insurance NETIC SERVICES.— tices, that shall include— coverage in the individual market shall not (1) NO ENROLLMENT RESTRICTION FOR GE- ‘‘(i) a description of an individual’s rights request or require predictive genetic infor- NETIC SERVICES.—Section 9802(a)(1)(F) of the with respect to predictive genetic informa- mation concerning any individual (including Internal Revenue Code of 1986 is amended by tion; a dependent) or a family member of the indi- inserting before the period the following: ‘‘(ii) the procedures established by the plan vidual (including information about a re- ‘‘(including information about a request for for the exercise of the individual’s rights; quest for or receipt of genetic services). or receipt of genetic services)’’. and ‘‘(2) INFORMATION NEEDED FOR DIAGNOSIS, (2) NO DISCRIMINATION IN GROUP PREMIUMS ‘‘(iii) the right to obtain a copy of the no- TREATMENT, OR PAYMENT.— BASED ON PREDICTIVE GENETIC INFORMATION.— tice of the confidentiality practices required ‘‘(A) IN GENERAL.—Notwithstanding para- (A) IN GENERAL.—Subchapter B of chapter under this subsection. 100 of the Internal Revenue Code of 1986 is graph (1), a health insurance issuer offering ‘‘(B) MODEL NOTICE.—The Secretary, in health insurance coverage in the individual further amended by adding at the end the consultation with the National Committee market that provides health care items and following: on Vital and Health Statistics and the Na- services to an individual or dependent may ‘‘SEC. 9813. PROHIBITING PREMIUM DISCRIMINA- tional Association of Insurance Commis- request (but may not require) that such indi- TION AGAINST GROUPS ON THE sioners, and after notice and opportunity for BASIS OF PREDICTIVE GENETIC IN- vidual or dependent disclose, or authorize public comment, shall develop and dissemi- the collection or disclosure of, predictive ge- FORMATION. ‘‘A group health plan shall not adjust pre- nate model notices of confidentiality prac- netic information for purposes of diagnosis, tices. Use of the model notice shall serve as treatment, or payment relating to the provi- mium or contribution amounts for a group on the basis of predictive genetic informa- a defense against claims of receiving inap- sion of health care items and services to propriate notice. such individual or dependent. tion concerning any individual (including a dependent) or a family member of the indi- ‘‘(2) ESTABLISHMENT OF SAFEGUARDS.—A ‘‘(B) NOTICE OF CONFIDENTIALITY PRACTICES vidual (including information about a re- group health plan shall establish and main- AND DESCRIPTION OF SAFEGUARDS.—As a part quest for or receipt of genetic services).’’. tain appropriate administrative, technical, of a request under subparagraph (A), the and physical safeguards to protect the con- health insurance issuer offering health insur- (B) CONFORMING AMENDMENT.—Section 9802(b) of the Internal Revenue Code of 1986 fidentiality, security, accuracy, and integ- ance coverage in the individual market shall rity of predictive genetic information cre- provide to the individual or dependent a de- is amended by adding at the end the fol- lowing: ated, received, obtained, maintained, used, scription of the procedures in place to safe- transmitted, or disposed of by such plan.’’. ‘‘(3) REFERENCE TO RELATED PROVISION.— guard the confidentiality, as described in (c) DEFINITIONS.—Section 9832(d) of the In- For a provision prohibiting the adjustment subsection (d), of such predictive genetic in- ternal Revenue Code of 1986 is amended by formation. of premium or contribution amounts for a adding at the end the following: group under a group health plan on the basis ‘‘(d) CONFIDENTIALITY WITH RESPECT TO ‘‘(6) FAMILY MEMBER.—The term ‘family of predictive genetic information (including PREDICTIVE GENETIC INFORMATION.— member’ means, with respect to an information about a request for or the re- ‘‘(1) NOTICE OF CONFIDENTIALITY PRAC- individual— ceipt of genetic services), see section 9813.’’. TICES.— ‘‘(A) the spouse of the individual; (C) AMENDMENT TO TABLE OF SECTIONS.— ‘‘(A) PREPARATION OF WRITTEN NOTICE.—A ‘‘(B) a dependent child of the individual, The table of sections for subchapter B of health insurance issuer offering health insur- including a child who is born to or placed for chapter 100 of the Internal Revenue Code of ance coverage in the individual market shall adoption with the individual; and 1986 is amended by adding at the end the fol- post or provide, in writing and in a clear and ‘‘(C) all other individuals related by blood lowing: conspicuous manner, notice of the issuer’s to the individual or the spouse or child de- confidentiality practices, that shall ‘‘Sec. 9813. Prohibiting premium discrimina- scribed in subparagraph (A) or (B). include— tion against groups on the basis ‘‘(7) GENETIC INFORMATION.—The term ‘ge- ‘‘(i) a description of an individual’s rights of predictive genetic informa- netic information’ means information about with respect to predictive genetic informa- tion.’’. genes, gene products, or inherited character- tion; (b) LIMITATION ON COLLECTION OF PRE- istics that may derive from an individual or ‘‘(ii) the procedures established by the DICTIVE GENETIC INFORMATION.—Section 9802 a family member (including information issuer for the exercise of the individual’s of the Internal Revenue Code of 1986 is about a request for or receipt of genetic serv- rights; and amended by adding at the end the following: ices). June 29, 2000 CONGRESSIONAL RECORD — SENATE S6155

‘‘(8) GENETIC SERVICES.—The term ‘genetic in private health plans or private health in- tion 4980B and without regard to payments services’ means health services provided to surance coverage, including— made with respect to any coverage described obtain, assess, or interpret genetic informa- (A) individuals enrolled in self-insured and in subsection (e)) is paid or incurred by the tion for diagnostic and therapeutic purposes, insured health plans that are regulated employer. and for genetic education and counseling. under the Employee Retirement Income Se- ‘‘(B) EMPLOYER CONTRIBUTIONS TO CAFE- ‘‘(9) PREDICTIVE GENETIC INFORMATION.— curity Act of 1974; TERIA PLANS, FLEXIBLE SPENDING ARRANGE- ‘‘(A) IN GENERAL.—The term ‘predictive ge- (B) individuals enrolled in health insur- MENTS, AND MEDICAL SAVINGS ACCOUNTS.—Em- netic information’ means, in the absence of ance coverage purchased in the individual ployer contributions to a cafeteria plan, a symptoms, clinical signs, or a diagnosis of market; and flexible spending or similar arrangement, or the condition related to such information— (C) individuals enrolled in health plans of- a medical savings account which are ex- ‘‘(i) information about an individual’s ge- fered to State and local government employ- cluded from gross income under section 106 netic tests; ees; shall be treated for purposes of subparagraph ‘‘(ii) information about genetic tests of (2) provide that States may provide patient (A) as paid by the employer. family members of the individual; or protections that are equal to or greater than ‘‘(C) AGGREGATION OF PLANS OF EM- ‘‘(iii) information about the occurrence of the protections provided under such Act; and PLOYER.—A health plan which is not other- a disease or disorder in family members. (3) provide the Federal Government with wise described in subparagraph (A) shall be ‘‘(B) EXCEPTIONS.—The term ‘predictive ge- the authority to ensure that the Federal treated as described in such subparagraph if netic information’ shall not include— floor referred to in paragraph (1) is being such plan would be so described if all health ‘‘(i) information about the sex or age of the guaranteed and enforced with respect to all plans of persons treated as a single employer individual; individuals described in such paragraph, in- under subsection (b), (c), (m), or (o) of sec- ‘‘(ii) information derived from physical cluding determining whether protections tion 414 were treated as one health plan. tests, such as the chemical, blood, or urine provided under State law meet the standards ‘‘(D) SEPARATE APPLICATION TO HEALTH IN- analyses of the individual including choles- of such Act. SURANCE AND LONG-TERM CARE INSURANCE.— terol tests; and Subparagraphs (A) and (C) shall be applied ‘‘(iii) information about physical exams of NICKLES AMENDMENT NO. 3694 separately with respect to— the individual. ‘‘(i) plans which include primarily cov- ‘‘(10) GENETIC TEST.—The term ‘genetic Mr. NICKLES proposed an amend- erage for qualified long-term care services or test’ means the analysis of human DNA, ment to the bill, H.R. 4577, supra; as are qualified long-term care insurance con- RNA, chromosomes, proteins, and certain follows: tracts, and metabolites, including analysis of genotypes, On page 92, strike line 5, and insert the fol- ‘‘(ii) plans which do not include such cov- mutations, phenotypes, or karyotypes, for lowing: erage and are not such contracts. the purpose of predicting risk of disease in ‘‘(2) COVERAGE UNDER CERTAIN FEDERAL DIVISION ll HEALTH CARE ACCESS AND asymptomatic or undiagnosed individuals. PROGRAMS.— PROTECTIONS FOR CONSUMERS Such term does not include physical tests, ‘‘(A) IN GENERAL.—Subsection (a) shall not such as the chemical, blood, or urine anal- SEC. 1. SHORT TITLE. apply to any amount paid for any coverage yses of the individual including cholesterol This division may be cited as the ‘‘Pa- for an individual for any calendar month if, tests, and physical exams of the individual, tients’ Bill of Rights Plus Act’’. as of the first day of such month, the indi- in order to detect symptoms, clinical signs, TITLE I—TAX-RELATED HEALTH CARE vidual is covered under any medical care or a diagnosis of disease.’’. PROVISIONS program described in— (d) EFFECTIVE DATE.—Except as provided in Subtitle A—Health Care and Long-Term Care ‘‘(i) title XVIII, XIX, or XXI of the Social this section, this section and the amend- Security Act, SEC. 101. DEDUCTION FOR HEALTH AND LONG- ‘‘(ii) chapter 55 of title 10, United States ments made by this section shall apply with TERM CARE INSURANCE COSTS OF respect to group health plans for plan years INDIVIDUALS NOT PARTICIPATING Code, beginning after 1 year after the date of the IN EMPLOYER-SUBSIDIZED HEALTH ‘‘(iii) chapter 17 of title 38, United States enactment of this Act. PLANS. Code, (a) IN GENERAL.—Part VII of subchapter B ‘‘(iv) chapter 89 of title 5, United States TORRICELLI (AND REED) of chapter 1 of the Internal Revenue Code of Code, or AMENDMENT NO. 3692 1986 is amended by redesignating section 222 ‘‘(v) the Indian Health Care Improvement as section 223 and by inserting after section Act. (Ordered to lie on the table.) 221 the following new section: ‘‘(B) EXCEPTIONS.— Mr. TORRICELLI (for himself and ‘‘SEC. 222. HEALTH AND LONG-TERM CARE INSUR- ‘‘(i) QUALIFIED LONG-TERM CARE.—Subpara- Mr. REED) submitted an amendment in- ANCE COSTS. graph (A) shall not apply to amounts paid for tended to be proposed by them to the ‘‘(a) IN GENERAL.—In the case of an indi- coverage under a qualified long-term care in- bill, H.R. 4577, supra; as follows: vidual, there shall be allowed as a deduction surance contract. an amount equal to the applicable percent- ‘‘(ii) CONTINUATION COVERAGE OF FEHBP.— On page 26, line 25, strike ‘‘$3,204,496,000, of age of the amount paid during the taxable Subparagraph (A)(iv) shall not apply to cov- which’’ and insert ‘‘$3,214,496,000, of which year for insurance which constitutes medical erage which is comparable to continuation $10,000,000 shall be made available to carry care for the taxpayer and the taxpayer’s coverage under section 4980B. out section 317A of the Public Health Service spouse and dependents. ‘‘(d) LONG-TERM CARE DEDUCTION LIMITED Act and of which’’. ‘‘(b) APPLICABLE PERCENTAGE.— TO QUALIFIED LONG-TERM CARE INSURANCE On page 92, between lines 4 and 5, insert ‘‘(1) IN GENERAL.—For purposes of sub- CONTRACTS.—In the case of a qualified long- the following: section (a), the applicable percentage shall term care insurance contract, only eligible SEC. ll. Amounts made available under long-term care premiums (as defined in sec- this Act for the salaries and expenses of the be determined in accordance with the fol- lowing table: tion 213(d)(10)) may be taken into account Department of Labor, the Department of under subsection (a). Health and Human Services, and the Depart- ‘‘For taxable years beginning The applicable ‘‘(e) DEDUCTION NOT AVAILABLE FOR PAY- ment of Education shall be reduced on a pro in calendar year— percentage is— MENT OF ANCILLARY COVERAGE PREMIUMS.— rata basis, by a total of $10,000,000. 2002 and 2003 ...... 25 Any amount paid as a premium for insurance 2004 ...... 35 which provides for— 2005 ...... 65 ‘‘(1) coverage for accidents, disability, den- DORGAN (AND OTHERS) 2006 and thereafter ...... 100. AMENDMENT NO. 3693 tal care, vision care, or a specified illness, or ‘‘(2) LONG-TERM CARE INSURANCE FOR INDI- ‘‘(2) making payments of a fixed amount Mr. DORGAN (for himself, Mr. KEN- VIDUALS 60 YEARS OR OLDER.—In the case of per day (or other period) by reason of being NEDY, Mr. DASCHLE, Mr. GRAHAM, Ms. amounts paid for a qualified long-term care hospitalized, MIKULSKI, Mr. LAUTENBERG, Mr. KERRY, insurance contract for an individual who has shall not be taken into account under sub- attained age 60 before the close of the tax- Mr. EDWARDS, Mr. HARKIN, Mr. REID, section (a). able year, the applicable percentage is 100. ‘‘(f) SPECIAL RULES.— Mr. ROCKEFELLER, and Mr. ROBB) pro- ‘‘(c) LIMITATION BASED ON OTHER COV- ‘‘(1) COORDINATION WITH DEDUCTION FOR posed an amendment to the bill, H.R. ERAGE.— HEALTH INSURANCE COSTS OF SELF-EMPLOYED 4577, supra; as follows: ‘‘(1) COVERAGE UNDER CERTAIN SUBSIDIZED INDIVIDUALS.—The amount taken into ac- On page 92, between lines 4 and 5, insert EMPLOYER PLANS.— count by the taxpayer in computing the de- the following: ‘‘(A) IN GENERAL.—Subsection (a) shall not duction under section 162(l) shall not be SEC. ll. Any Act that is designed to pro- apply to any taxpayer for any calendar taken into account under this section. tect patients against the abuses of managed month for which the taxpayer participates in ‘‘(2) COORDINATION WITH MEDICAL EXPENSE care that is enacted after June 27, 2000, shall, any health plan maintained by any employer DEDUCTION.—The amount taken into account at a minimum— of the taxpayer or of the spouse of the tax- by the taxpayer in computing the deduction (1) provide a floor of Federal protection payer if 50 percent or more of the cost of cov- under this section shall not be taken into ac- that is applicable to all individuals enrolled erage under such plan (determined under sec- count under section 213. S6156 CONGRESSIONAL RECORD — SENATE June 29, 2000

‘‘(g) REGULATIONS.—The Secretary shall ‘‘(e) ADDITIONAL EXEMPTION FOR CERTAIN (3) How to improve the quality of long- prescribe such regulations as may be appro- ELDERLY FAMILY MEMBERS RESIDING WITH term health care services. priate to carry out this section, including TAXPAYER.— (4) The integration of long-term health regulations requiring employers to report to ‘‘(1) IN GENERAL.—An exemption of the ex- care services for individuals between dif- their employees and the Secretary such in- emption amount for each qualified family ferent classes of health care providers (such formation as the Secretary determines to be member of the taxpayer. as hospitals, nursing facilities, and home appropriate.’’. ‘‘(2) QUALIFIED FAMILY MEMBER.—For pur- care agencies) and different Federal pro- (b) DEDUCTION ALLOWED WHETHER OR NOT poses of this subsection, the term ‘qualified grams (such as the medicare and medicaid TAXPAYER ITEMIZES OTHER DEDUCTIONS.— family member’ means, with respect to any programs). Subsection (a) of section 62 of such Code is taxable year, any individual— (5) The possibility of expanding private amended by inserting after paragraph (17) ‘‘(A) who is an ancestor of the taxpayer or sector initiatives, including long-term care the following new item: of the taxpayer’s spouse or who is the spouse insurance, to meet the need to finance such ‘‘(18) HEALTH AND LONG-TERM CARE INSUR- of any such ancestor, services. ANCE COSTS.—The deduction allowed by sec- ‘‘(B) who is a member for the entire tax- (6) An examination of the effect of enact- tion 222.’’. able year of a household maintained by the ment of the Health Insurance Portability (c) CLERICAL AMENDMENT.—The table of taxpayer, and and Accountability Act of 1996 on the provi- sections for part VII of subchapter B of chap- ‘‘(C) who has been certified, before the due sion and financing of long-term health care ter 1 of such Code is amended by striking the date for filing the return of tax for the tax- services, including on portability and afford- last item and inserting the following new able year (without extensions), by a physi- ability of private long-term care insurance, items: cian (as defined in section 1861(r)(1) of the the impact of insurance options on low-in- ‘‘Sec. 222. Health and long-term care insur- Social Security Act) as being an individual come older Americans, and the options for ance costs. with long-term care needs described in para- eligibility to improve access to such insur- ‘‘Sec. 223. Cross reference.’’. graph (3) for a period— ance. ‘‘(i) which is at least 180 consecutive days, (7) The financial impact of the provision of (d) EFFECTIVE DATE.—The amendments and long-term health care services on caregivers made by this section shall apply to taxable ‘‘(ii) a portion of which occurs within the and other family members. years beginning after December 31, 2001. taxable year. (c) REPORT AND RECOMMENDATIONS.— SEC. 102. DEDUCTION FOR 100 PERCENT OF Such term shall not include any individual (1) IN GENERAL.—October 1, 2002, the Sec- HEALTH INSURANCE COSTS OF SELF-EMPLOYED INDIVIDUALS. otherwise meeting the requirements of the retary shall provide for a report on the study 1 (a) IN GENERAL.—Paragraph (1) of section preceding sentence unless within the 39 ⁄2 under this section. 162(l) of the Internal Revenue Code of 1986 is month period ending on such due date (or (2) RECOMMENDATIONS.—The report under amended to read as follows: such other period as the Secretary pre- paragraph (1) shall include findings and rec- ‘‘(1) ALLOWANCE OF DEDUCTION.—In the case scribes) a physician (as so defined) has cer- ommendations regarding each of the fol- of an individual who is an employee within tified that such individual meets such re- lowing: the meaning of section 401(c)(1), there shall quirements. (A) The most effective and efficient man- be allowed as a deduction under this section ‘‘(3) INDIVIDUALS WITH LONG-TERM CARE ner that the Federal Government may use an amount equal to 100 percent of the NEEDS.—An individual is described in this its resources to educate the public on plan- amount paid during the taxable year for in- paragraph if the individual— ning for needs for long-term health care surance which constitutes medical care for ‘‘(A) is unable to perform (without sub- services. the taxpayer and the taxpayer’s spouse and stantial assistance from another individual) (B) The public, private, and joint public- dependents.’’. at least two activities of daily living (as de- private strategies for meeting identified (b) CLARIFICATION OF LIMITATIONS ON OTHER fined in section 7702B(c)(2)(B)) due to a loss needs for long-term health care services. COVERAGE.—The first sentence of section of functional capacity, or (C) The role of States and local commu- 162(l)(2)(B) of such Code is amended to read ‘‘(B) requires substantial supervision to nities in the financing of long-term health as follows: ‘‘Paragraph (1) shall not apply to protect such individual from threats to care services. any taxpayer for any calendar month for health and safety due to severe cognitive im- (3) INCLUSION OF COST ESTIMATES.—The re- which the taxpayer participates in any sub- pairment and is unable to perform, without port under paragraph (1) shall include cost sidized health plan maintained by any em- reminding or cuing assistance, at least one estimates of the various options for which ployer (other than an employer described in activity of daily living (as so defined) or to recommendations are made. section 401(c)(4)) of the taxpayer or the the extent provided in regulations prescribed (d) CONDUCT OF STUDY.— spouse of the taxpayer.’’. by the Secretary (in consultation with the (1) USE OF INSTITUTE OF MEDICINE.—The (c) EFFECTIVE DATE.—The amendments Secretary of Health and Human Services), is Secretary of Health and Human Services made by this section shall apply to taxable unable to engage in age appropriate activi- shall seek to enter into an appropriate ar- years beginning after December 31, 2001. ties. rangement with the Institute of Medicine of SEC. 103. LONG-TERM CARE INSURANCE PER- ‘‘(4) SPECIAL RULES.—Rules similar to the the National Academy of Sciences to con- MITTED TO BE OFFERED UNDER rules of paragraphs (1), (2), (3), (4), and (5) of duct the study under this section. If such an CAFETERIA PLANS AND FLEXIBLE section 21(e) shall apply for purposes of this arrangement cannot be made, the Secretary SPENDING ARRANGEMENTS. subsection.’’. may provide for the conduct of the study by (a) CAFETERIA PLANS.— (b) EFFECTIVE DATE.—The amendments any other qualified non-governmental enti- (1) IN GENERAL.—Subsection (f) of section made by this section shall apply to taxable ty. 125 of the Internal Revenue Code of 1986 (de- years beginning after December 31, 2001. (2) CONSULTATION.—The study should be fining qualified benefits) is amended by in- SEC. 105. STUDY OF LONG-TERM CARE NEEDS IN conducted under this section in consultation serting before the period at the end ‘‘; except THE 21ST CENTURY. with experts from a wide-range of groups that such term shall include the payment of (a) IN GENERAL.—The Secretary of Health from the public and private sectors. premiums for any qualified long-term care and Human Services (referred to in this sec- Subtitle B—Medical Savings Accounts insurance contract (as defined in section tion as the ‘‘Secretary’’) shall on or after Oc- 7702B) to the extent the amount of such pay- SEC. 111. EXPANSION OF AVAILABILITY OF MED- tober 1, 2001, provide, in accordance with this ICAL SAVINGS ACCOUNTS. ment does not exceed the eligible long-term section, for a study in order to determine— (a) REPEAL OF LIMITATIONS ON NUMBER OF care premiums (as defined in section (1) future demand for long-term health MEDICAL SAVINGS ACCOUNTS.— 213(d)(10)) for such contract’’. care services (including institutional and (1) IN GENERAL.—Subsections (i) and (j) of (b) FLEXIBLE SPENDING ARRANGEMENTS.— home and community-based services) in the Section 106 of such Code (relating to con- section 220 of the Internal Revenue Code of United States in order to meet the needs in tributions by employer to accident and 1986 are hereby repealed. the 21st century; and health plans) is amended by striking sub- (2) CONFORMING AMENDMENTS.— (2) long-term options to finance the provi- section (c). (A) Paragraph (1) of section 220(c) of such (c) EFFECTIVE DATE.—The amendments sion of such services. Code is amended by striking subparagraph made by this section shall apply to taxable (b) DETAILS.—The study conducted under (D). years beginning after December 31, 2001. subsection (a) shall include the following: (B) Section 138 of such Code is amended by SEC. 104. ADDITIONAL PERSONAL EXEMPTION (1) An identification of the relevant demo- striking subsection (f). FOR TAXPAYER CARING FOR ELDER- graphic characteristics affecting demand for (b) AVAILABILITY NOT LIMITED TO ACCOUNTS LY FAMILY MEMBER IN TAXPAYER’S long-term health care services, at least FOR EMPLOYEES OF SMALL EMPLOYERS AND HOME. through the year 2030. SELF-EMPLOYED INDIVIDUALS.— (a) IN GENERAL.—Section 151 of the Inter- (2) The viability and capacity of commu- (1) IN GENERAL.—Section 220(c)(1)(A) of nal Revenue Code of 1986 (relating to allow- nity-based and other long-term health care such Code (relating to eligible individual) is ance of deductions for personal exemptions) services under different federal programs, in- amended to read as follows: is amended by redesignating subsection (e) cluding through the medicare and medicaid ‘‘(A) IN GENERAL.—The term ‘eligible indi- as subsection (f) and by inserting after sub- programs, grants to States, housing services, vidual’ means, with respect to any month, section (d) the following new subsection: and changes in tax policy. any individual if— June 29, 2000 CONGRESSIONAL RECORD — SENATE S6157

‘‘(i) such individual is covered under a high ‘‘(3) ROUNDING.—If any increase under para- tract year involved (as defined by paragraph deductible health plan as of the 1st day of graph (1) or (2) is not a multiple of $50, such (2)), exceeds such month, and increase shall be rounded to the nearest mul- ‘‘(B) the amount of the biweekly Govern- ‘‘(ii) such individual is not, while covered tiple of $50.’’. ment contribution payable on such employ- under a high deductible health plan, covered (f) LIMITATION ON ADDITIONAL TAX ON DIS- ee’s or annuitant’s behalf under section under any health plan— TRIBUTIONS NOT USED FOR QUALIFIED MED- 8906(b) for the period involved. ‘‘(I) which is not a high deductible health ICAL EXPENSES.—Section 220(f)(4) of such ‘‘(2) For purposes of this section, the term plan, and Code (relating to additional tax on distribu- ‘maximum Government contribution’ means, ‘‘(II) which provides coverage for any ben- tions not used for qualified medical ex- with respect to a contract year, the max- efit which is covered under the high deduct- penses) is amended by adding at the end the imum Government contribution that could ible health plan.’’. following: be made for health benefits for an employee (2) CONFORMING AMENDMENTS.— ‘‘(D) EXCEPTION IN CASE OF SUFFICIENT AC- or annuitant for such contract year, as de- (A) Section 220(c)(1) of such Code is amend- COUNT BALANCE.—Subparagraph (A) shall not termined under section 8906(b) (disregarding ed by striking subparagraph (C). apply to any payment or distribution in any paragraph (2) thereof). (B) Section 220(c) of such Code is amended taxable year, but only to the extent such ‘‘(3) Notwithstanding any other provision by striking paragraph (4) (defining small em- payment or distribution does not reduce the of this section, no contribution under this ployer) and by redesignating paragraph (5) as fair market value of the assets of the med- section shall be payable to any medical sav- paragraph (4). ical savings account to an amount less than ings account of an employee or annuitant for (C) Section 220(b) of such Code is amended the annual deductible for the high deductible any period— by striking paragraph (4) (relating to deduc- health plan of the account holder (deter- ‘‘(A) if, as of the first day of the month be- tion limited by compensation) and by redes- mined as of the earlier of January 1 of the fore the month in which such period com- ignating paragraphs (5), (6), and (7) as para- calendar year in which the taxable year be- mences, such employee or annuitant (or the graphs (4), (5), and (6), respectively. gins or January 1 of the last calendar year in spouse of such employee or annuitant, if cov- (c) INCREASE IN AMOUNT OF DEDUCTION AL- which the account holder is covered under a erage is for self and family) is entitled to LOWED FOR CONTRIBUTIONS TO MEDICAL SAV- high deductible health plan).’’. benefits under part A of title XVIII of the INGS ACCOUNTS.— (g) TREATMENT OF NETWORK-BASED MAN- Social Security Act; (1) IN GENERAL.—Paragraph (2) of section AGED CARE PLANS.—Section 220(c)(2)(B) of ‘‘(B) to the extent that such contribution, 220(b) of such Code is amended to read as fol- such Code (relating to special rules for high when added to previous contributions made lows: deductible health plans) is amended by add- under this section for that same year with ‘‘(2) MONTHLY LIMITATION.—The monthly ing at the end the following: respect to such employee or annuitant, limitation for any month is the amount ‘‘(iii) TREATMENT OF NETWORK-BASED MAN- would cause the total to exceed— ‘‘(i) the limitation under paragraph (1) of equal to 1⁄12 of the annual deductible (as of AGED CARE PLANS.—A plan which provides the first day of such month) of the individ- health care services through a network of section 220(b) of the Internal Revenue Code ual’s coverage under the high deductible contracted or affiliated health care pro- of 1986 (determined without regard to para- health plan.’’. viders, if the benefits provided when services graph (3) thereof) which is applicable to such (2) CONFORMING AMENDMENT.—Clause (ii) of are obtained through network providers employee or annuitant for the calendar year section 220(d)(1)(A) of such Code is amended meet the requirements of subparagraph (A), in which such period commences; or by striking ‘‘75 percent of’’. shall not fail to be treated as a high deduct- ‘‘(ii) such lower amount as the employee or annuitant may specify in accordance with (d) BOTH EMPLOYERS AND EMPLOYEES MAY ible health plan by reason of providing bene- regulations of the Office, including an elec- CONTRIBUTE TO MEDICAL SAVINGS AC- fits for services rendered by providers who tion not to receive contributions under this COUNTS.—Paragraph (4) of section 220(b) of are not members of the network, so long as such Code (as redesignated by subsection the annual deductible and annual limit on section for a year or the remainder of a year; (b)(2)(C)) is amended to read as follows: out-of-pocket expenses applicable to services or ‘‘(C) for which any information (or docu- ‘‘(4) COORDINATION WITH EXCLUSION FOR EM- received from non-network providers are not mentation) under subsection (d) that is need- PLOYER CONTRIBUTIONS.—The limitation lower than those applicable to services re- which would (but for this paragraph) apply ceived from the network providers.’’. ed in order to make such contribution has under this subsection to the taxpayer for any (h) MEDICAL SAVINGS ACCOUNTS MAY BE OF- not been timely submitted. ‘‘(4) Notwithstanding any other provision taxable year shall be reduced (but not below FERED UNDER CAFETERIA PLANS.—Subsection of this section, no contribution under this zero) by the amount which would (but for (f) of section 125 of such Code is amended by section shall be payable to any medical sav- section 106(b)) be includible in the taxpayer’s striking ‘‘106(b),’’. ings account of an employee for any period gross income for such taxable year.’’. (i) EFFECTIVE DATE.— in a contract year unless that employee was (e) REDUCTION OF PERMITTED DEDUCTIBLES (1) IN GENERAL.—Except as provided by enrolled in a health benefits plan under this UNDER HIGH DEDUCTIBLE HEALTH PLANS.— paragraph (2), the amendments made by this chapter as an employee for not less than— (1) IN GENERAL.—Subparagraph (A) of sec- section shall apply to taxable years begin- ‘‘(A) the 1 year of service immediately be- tion 220(c)(2) of such Code (defining high de- ning after December 31, 2001. fore the start of such contract year, or ductible health plan) is amended— (2) LIMITATION ON ADDITIONAL TAX ON DIS- ‘‘(B) the full period or periods of service be- (A) by striking ‘‘$1,500’’ in clause (i) and in- TRIBUTIONS NOT USED FOR QUALIFIED MED- tween the last day of the first period, as pre- serting ‘‘$1,000’’; ICAL EXPENSES.—The amendment made by scribed by regulations of the Office of Per- (B) by striking ‘‘$3,000’’ in clause (ii) and subsection (f) shall apply to taxable years be- sonnel Management, in which he is eligible inserting ‘‘$2,000’’; and ginning after December 31, 2005. to enroll in the plan and the day before the (C) by striking the matter preceding sub- SEC. 112. AMENDMENTS TO TITLE 5, UNITED start of such contract year, clause (I) in clause (iii) and inserting ‘‘pursu- STATES CODE, RELATING TO MED- ICAL SAVINGS ACCOUNTS AND HIGH whichever is shorter. ant to which the annual out-of-pocket ex- ‘‘(5) The Office shall provide for the con- penses (including deductibles and co-pay- DEDUCTIBLE HEALTH PLANS UNDER FEHBP. version of biweekly rates of contributions ments) are required to be paid under the plan (a) MEDICAL SAVINGS ACCOUNTS.— specified by paragraph (1) to rates for em- (other than for premiums) for covered bene- (1) CONTRIBUTIONS.—Title 5, United States ployees and annuitants whose pay or annuity fits and may not exceed—’’. Code, is amended by redesignating section is provided on other than a biweekly basis, (2) CONFORMING AMENDMENT.—Subsection and for this purpose may provide for the ad- (g) of section 220 of such Code is amended to 8906a as section 8906c and by inserting after section 8906 the following: justment of the converted rate to the nearest read as follows: cent. ‘‘(g) COST-OF-LIVING ADJUSTMENT.— ‘‘§ 8906a. Government contributions to med- ‘‘(c) A Government contribution under this ‘‘(1) IN GENERAL.—In the case of any tax- ical savings accounts section— able year beginning in a calendar year after ‘‘(a) An employee or annuitant enrolled in ‘‘(1) shall be made at the same time that, 2002, each dollar amount in subsection (c)(2) a high deductible health plan is entitled, in and the same frequency with which, Govern- shall be increased by an amount equal to— addition to the Government contribution ment contributions under section 8906(b) are ‘‘(A) such dollar amount, multiplied by under section 8906(b) toward the subscription made for the benefit of the employee or an- ‘‘(B) the cost-of-living adjustment deter- charge for such plan, to have a Government nuitant involved; and mined under section 1(f)(3) for the calendar contribution made, in accordance with suc- ‘‘(2) shall be payable from the same appro- year in which such taxable year begins by ceeding provisions of this section, to a med- priation, fund, account, or other source as substituting ‘calendar year 2001’ for ‘cal- ical savings account of such employee or an- would any Government contributions under endar year 1992’ in subparagraph (B) thereof. nuitant. section 8906(b) with respect to the employee ‘‘(2) SPECIAL RULES.—In the case of the ‘‘(b)(1) The biweekly Government contribu- or annuitant involved. $1,000 amount in subsection (c)(2)(A)(i) and tion under this section shall, in the case of ‘‘(d) The Office shall by regulation pre- the $2,000 amount in subsection (c)(2)(A)(ii), any such employee or annuitant, be equal to scribe the time, form, and manner in which paragraph (1)(B) shall be applied by sub- the amount (if any) by which— an employee or annuitant shall submit any stituting ‘calendar year 2002’ for ‘calendar ‘‘(A) the biweekly equivalent of the max- information (and supporting documentation) year 2001’. imum Government contribution for the con- necessary to identify any medical savings S6158 CONGRESSIONAL RECORD — SENATE June 29, 2000 account to which contributions under this ‘‘(3) the conditions under which contribu- under this section, that satisfy the require- section are requested to be made. tions to a medical savings account may be ments of clauses (i) and (ii) of section ‘‘(e) Nothing in this section shall be con- made under section 8906b through 8903(5)(A).’’. sidered to entitle an employee or annuitant withholdings from pay or annuity; and (B) Section 8909(d) of title 5, United States to any Government contribution under this ‘‘(4) any other matter the Office considers Code, is amended by striking ‘‘8903a(d)’’ and section with respect to any period for which appropriate in connection with medical sav- inserting ‘‘8903a(e)’’. such employee or annuitant is ineligible for ings accounts.’’. (4) REFERENCES.—Section 8903 of title 5, a Government contribution under section (c) HIGH DEDUCTIBLE HEALTH PLAN AND United States Code, is amended by adding 8906(b). MEDICAL SAVINGS ACCOUNT DEFINED.—Sec- after paragraph (5) (as added by paragraph (1) ‘‘§ 8906b. Individual contributions to medical tion 8901 of title 5, United States Code, is of this subsection) as a flush left sentence, savings accounts amended— the following: ‘‘(a) Upon the written request of an em- (1) in paragraph (10) by striking ‘‘and’’ ‘‘The Office shall prescribe regulations in ac- ployee or annuitant enrolled in a high de- after the semicolon; cordance with which the requirements of sec- ductible health plan, there shall be withheld (2) in paragraph (11) by striking the period tion 8902(c), 8902(n), 8909(e), and any other from the pay or annuity of such employee or and inserting a semicolon; and provision of this chapter that applies with annuitant and contributed to the medical (3) by adding at the end the following: respect to a plan described by paragraph (1), savings account identified by such employee ‘‘(12) the term ‘high deductible health plan’ (2), (3), or (4) of this section shall apply with or annuitant in accordance with applicable means a plan described by section 8903(5) or respect to the corresponding plan under regulations under subsection (c) such section 8903a(d); and paragraph (5) of this section. Similar regula- amount as the employee or annuitant may ‘‘(13) the term ‘medical savings account’ tions shall be prescribed with respect to any specify. has the meaning given such term by section plan under section 8903a(d).’’. ‘‘(b) Notwithstanding subsection (a), no 220(d) of the Internal Revenue Code of 1986.’’. (f) EFFECTIVE DATE.—The amendments (d) AUTHORITY TO CONTRACT FOR HIGH DE- withholding under this section may be made made by this section shall apply with respect DUCTIBLE HEALTH PLANS, ETC.— from the pay or annuity of an employee or to contract years beginning on or after Octo- (1) CONTRACTS FOR HIGH DEDUCTIBLE HEALTH annuitant for any period— ber 1, 2001. The Office of Personnel Manage- PLANS.—Section 8902 of title 5, United States ‘‘(1) if, or to the extent that, a Government ment shall take appropriate measures to en- Code, is amended by adding at the end the contribution for such period under section sure that coverage under a high deductible following: 8906a would not be allowable by reason of health plan under chapter 89 of title 5, ‘‘(p)(1) The Office shall contract under this subparagraph (A) or (B)(i) of subsection (b)(3) United States Code (as amended by this sec- chapter for a high deductible health plan thereof; tion) shall be available as of the beginning of with any qualified carrier that offers such a ‘‘(2) for which any information (or docu- the first contract year described in the pre- plan and, as of the date of enactment of this mentation) that is needed in order to make ceding sentence. subsection, offers a health benefits plan such contribution has not been timely sub- SEC. 113. RULE WITH RESPECT TO CERTAIN under this chapter. PLANS. mitted; or ‘‘(2) The Office may contract under this ‘‘(3) if the employee or annuitant submits chapter for a high deductible health plan (a) IN GENERAL.—Notwithstanding any a request for termination of withholdings, with any qualified carrier that offers such a other provision of law, health insurance beginning on or after the effective date of plan, but does not, as of the date of enact- issuers may offer, and eligible individuals the request and before the end of the year. ment of this subsection, offer a health bene- may purchase, high deductible health plans ‘‘(c) The Office of Personnel Management fits plan under this chapter.’’. described in section 220(c)(2)(A) of the Inter- shall prescribe any regulations necessary to nal Revenue Code of 1986. Effective for the 5- (2) COMPUTATION OF GOVERNMENT CONTRIBU- carry out this section, including provisions year period beginning on October 1, 2001, TIONS TO PLANS UNDER CHAPTER 89 NOT AF- relating to the time, form, and manner in such health plans shall not be required to FECTED BY HIGH DEDUCTIBLE HEALTH PLANS.— which any request for withholdings under Paragraph (2) of section 8906(a) of title 5, provide payment for any health care items this section may be made, changed, or termi- United States Code, is amended by striking or services that are exempt from the plan’s nated.’’. ‘‘(2)’’ and inserting ‘‘(2)(A)’’, and adding at deductible. (2) RULES OF CONSTRUCTION.—Nothing in the end the following: (b) EXISTING STATE LAWS.—A State law re- this section or in any amendment made by ‘‘(B) Notwithstanding any other provision lating to payment for health care items and this section shall be considered— of this section, the subscription charges for, services in effect on the date of enactment of (A) to permit or require that any contribu- and the number of enrollees enrolled in, high this Act that is preempted under paragraph tions to a medical savings account (whether deductible health plans shall be disregarded (1), shall not apply to high deductible health by the Government or through withholdings for purposes of determining any weighted av- plans after the expiration of the 5-year pe- from pay or annuity) be paid into the Em- erage under paragraph (1).’’. riod described in such paragraph unless the ployees Health Benefits Fund; or (e) DESCRIPTION OF HIGH DEDUCTIBLE State reenacts such law after such period. (B) to affect any authority under section HEALTH PLANS AND BENEFITS TO BE PRO- Subtitle C—Other Health-Related Provisions 1005(f) of title 39, United States Code, to VIDED THEREUNDER.— vary, add to, or substitute for any provision SEC. 121. EXPANDED HUMAN CLINICAL TRIALS (1) IN GENERAL.—Section 8903 of title 5, QUALIFYING FOR ORPHAN DRUG of chapter 89 of title 5, United States Code, United States Code, is amended by adding at CREDIT. as amended by this section. the end the following: (a) IN GENERAL.—Subclause (I) of section (3) CONFORMING AMENDMENTS.— ‘‘(5) HIGH DEDUCTIBLE HEALTH PLANS.—(A) 45C(b)(2)(A)(ii) of the Internal Revenue Code (A) The table of sections at the beginning One or more plans described by paragraph of 1986 is amended to read as follows: of chapter 89 of title 5, United States Code, (1), (2), (3), or (4), which— ‘‘(I) after the date that the application is is amended by striking the item relating to ‘‘(i) are high deductible health plans (as de- filed for designation under such section 526, section 8906a and inserting the following: fined by section 220(c)(2) of the Internal Rev- and’’. ‘‘8906a. Government contributions to med- enue Code of 1986); and (b) CONFORMING AMENDMENT.—Clause (i) of ical savings accounts. ‘‘(ii) provide benefits of the types referred section 45C(b)(2)(A) of such Code is amended ‘‘8906b. Individual contributions to medical to by section 8904(a)(5). by inserting ‘‘which is’’ before ‘‘being’’ and savings accounts. ‘‘(B) Nothing in this section shall be by inserting before the comma at the end ‘‘8906c. Temporary employees.’’. considered— ‘‘and which is designated under section 526 of (B) Section 8913(b)(4) of title 5, United ‘‘(i) to prevent a carrier from simulta- such Act’’. States Code, is amended by striking neously offering a plan described by subpara- (c) EFFECTIVE DATE.—The amendments ‘‘8906a(a)’’ and inserting ‘‘8906c(a)’’. graph (A) and a plan described by paragraph made by this section shall apply to amounts (b) INFORMATIONAL REQUIREMENTS.—Sec- (1) or (2); or paid or incurred after December 31, 2001. tion 8907 of title 5, United States Code, is ‘‘(ii) to require that a high deductible SEC. 122. CARRYOVER OF UNUSED BENEFITS amended by adding at the end the following: health plan offer two levels of benefits.’’. FROM CAFETERIA PLANS, FLEXIBLE ‘‘(c) In addition to any information other- (2) TYPES OF BENEFITS.—Section 8904(a) of SPENDING ARRANGEMENTS, AND wise required under this section, the Office title 5, United States Code, is amended by in- HEALTH FLEXIBLE SPENDING AC- shall make available to all employees and serting after paragraph (4) the following: COUNTS. annuitants eligible to enroll in a high de- ‘‘(5) HIGH DEDUCTIBLE HEALTH PLANS.— (a) IN GENERAL.—Section 125 of the Inter- ductible health plan, information relating Benefits of the types named under paragraph nal Revenue Code of 1986 (relating to cafe- to— (1) or (2) of this subsection or both.’’. teria plans) is amended by redesignating sub- ‘‘(1) the conditions under which Govern- (3) CONFORMING AMENDMENTS.— sections (h) and (i) as subsections (i) and (j) ment contributions under section 8906a shall (A) Section 8903a of title 5, United States and by inserting after subsection (g) the fol- be made to a medical savings account; Code, is amended by redesignating sub- lowing new subsection: ‘‘(2) the amount of any Government con- section (d) as subsection (e) and by inserting ‘‘(h) ALLOWANCE OF CARRYOVERS OF UNUSED tributions under section 8906a to which an after subsection (c) the following: BENEFITS TO LATER TAXABLE YEARS.— employee or annuitant may be entitled (or ‘‘(d) The plans under this section may in- ‘‘(1) IN GENERAL.—For purposes of this how such amount may be ascertained); clude one or more plans, otherwise allowable title— June 29, 2000 CONGRESSIONAL RECORD — SENATE S6159 ‘‘(A) notwithstanding subsection (d)(2), a shall be construed to alter or amend the So- (B) is a claim that cannot be processed and plan or other arrangement shall not fail to cial Security Act (or any regulation promul- must, in accordance with the Secretary of be treated as a cafeteria plan or flexible gated under that Act). Health and Human Service’s instructions, be spending or similar arrangement, and (b) TRANSFERS.— returned by the fiscal intermediary or car- ‘‘(B) no amount shall be required to be in- (1) ESTIMATE OF SECRETARY.—The Sec- rier to the individual or entity for comple- cluded in gross income by reason of this sec- retary of the Treasury shall annually esti- tion. tion or any other provision of this chapter, mate the impact that the enactment of this (c) TREATMENT OF FEES FOR PURPOSES OF solely because under such plan or other ar- division has on the income and balances of COST REPORTS.—An entity may not include a rangement any nontaxable benefit which is the trust funds established under section 201 fee assessed pursuant to this section as an unused as of the close of a taxable year may of the Social Security Act (42 U.S.C. 401). allowable item on a cost report under title be carried forward to 1 or more succeeding (2) TRANSFER OF FUNDS.—If, under para- XVIII of the Social Security Act (42 U.S.C. taxable years. graph (1), the Secretary of the Treasury esti- 1395 et seq.) or title XIX of such Act (42 ‘‘(2) LIMITATION.—Paragraph (1) shall not mates that the enactment of this division U.S.C. 1396 et seq.). apply to amounts carried from a plan to the has a negative impact on the income and bal- (d) EFFECTIVE DATE.—The provisions of extent such amounts exceed $500 (applied on ances of the trust funds established under this section apply to claims submitted on or an annual basis). For purposes of this para- section 201 of the Social Security Act (42 after January 1, 2002. graph, all plans and arrangements main- U.S.C. 401), the Secretary shall transfer, not TITLE II—PATIENTS’ BILL OF RIGHTS tained by an employer or any related person less frequently than quarterly, from the gen- shall be treated as 1 plan. eral revenues of the Federal Government an Subtitle A—Right to Advice and Care ‘‘(3) ALLOWANCE OF ROLLOVER.— amount sufficient so as to ensure that the SEC. 201. PATIENT RIGHT TO MEDICAL ADVICE ‘‘(A) IN GENERAL.—In the case of any un- income and balances of such trust funds are AND CARE. used benefit described in paragraph (1) which not reduced as a result of the enactment of (a) IN GENERAL.—Part 7 of subtitle B of consists of amounts in a health flexible such division. title I of the Employee Retirement Income spending account or dependent care flexible SEC. 132. CUSTOMS USER FEES. Security Act of 1974 (29 U.S.C. 1181 et seq.) is spending account, the plan or arrangement Section 13031(j)(3) of the Consolidated Om- amended— shall provide that a participant may elect, in nibus Budget Reconciliation Act of 1985 (19 (1) by redesignating subpart C as subpart lieu of such carryover, to have such amounts U.S.C. 58c(j)(3)) is amended by striking D; and distributed to the participant. ‘‘2003’’ and inserting ‘‘2010’’. (2) by inserting after subpart B the fol- ‘‘(B) AMOUNTS NOT INCLUDED IN INCOME.— SEC. 133. ESTABLISHMENT OF MEDICARE ADMIN- lowing: Any distribution under subparagraph (A) ISTRATIVE FEE FOR SUBMISSION OF ‘‘Subpart C—Patient Right to Medical Advice shall not be included in gross income to the PAPER CLAIMS. and Care extent that such amount is transferred in a (a) IMPOSITION OF FEE.—Notwithstanding trustee-to-trustee transfer, or is contributed ‘‘SEC. 721. ACCESS TO EMERGENCY MEDICAL any other provision of law and subject to CARE. within 60 days of the date of the distribution, subsection (b), the Secretary of Health and to— ‘‘(a) COVERAGE OF EMERGENCY SERVICES.—If Human Services shall establish (in the form a group health plan (other than a fully in- ‘‘(i) a qualified cash or deferred arrange- of a separate fee or reduction of payment ment described in section 401(k), sured group health plan) provides coverage otherwise made under the medicare program for any benefits consisting of emergency ‘‘(ii) a plan under which amounts are con- under title XVIII of the Social Security Act tributed by an individual’s employer for an medical care, except for items or services (42 U.S.C. 1395 et seq.)) an administrative fee specifically excluded from coverage, the plan annuity contract described in section 403(b), of $1 for the submission of a claim in a paper ‘‘(iii) an eligible deferred compensation shall, without regard to prior authorization or non-electronic form for items or services or provider participation— plan described in section 457, or for which payment is sought under such ‘‘(iv) a medical savings account (within the ‘‘(1) provide coverage for emergency med- title. ical screening examinations to the extent meaning of section 220). (b) EXCEPTION AUTHORITY.—The Secretary that a prudent layperson, who possesses an Any amount rolled over under this subpara- of Health and Human Services shall waive average knowledge of health and medicine, graph shall be treated as a rollover contribu- the imposition of the fee under subsection would determine such examinations to be tion for the taxable year from which the un- (a)— necessary; and used amount would otherwise be carried. (1) in cases in which there is no method ‘‘(2) provide coverage for additional emer- ‘‘(C) TREATMENT OF ROLLOVER.—Any available for the submission of claims other gency medical care to stabilize an emer- amount rolled over under subparagraph (B) than in a paper or non-electronic form; and gency medical condition following an emer- shall be treated as an eligible rollover under (2) for rural providers and small providers gency medical screening examination (if de- section 220, 401(k), 403(b), or 457, whichever is that the Secretary determines, under proce- termined necessary), pursuant to the defini- applicable, and shall be taken into account dures established by the Secretary, are un- tion of stabilize under section 1867(e)(3) of in applying any limitation (or participation able to purchase the necessary hardware in the Social Security Act (42 U.S.C. requirement) on employer or employee con- order to submit claims electronically. 1395dd(e)(3)). tributions under such section or any other (c) TREATMENT OF FEES FOR PURPOSES OF ‘‘(b) COVERAGE OF EMERGENCY AMBULANCE provision of this chapter for the taxable year COST REPORTS.—An entity may not include a of the rollover. fee assessed pursuant to this section as an SERVICES.—If a group health plan (other than ‘‘(4) COST-OF-LIVING ADJUSTMENT.—In the allowable item on a cost report under title a fully insured group health plan) provides case of any taxable year beginning in a cal- XVIII of the Social Security Act (42 U.S.C. coverage for any benefits consisting of emer- endar year after 2002, the $500 amount under 1395 et seq.) or title XIX of such Act (42 gency ambulance services, except for items paragraph (2) shall be adjusted at the same U.S.C. 1396 et seq.). or services specifically excluded from cov- time and in the same manner as under sec- (d) EFFECTIVE DATE.—The provisions of erage, the plan shall, without regard to prior tion 415(d)(2), except that the base period this section apply to claims submitted on or authorization or provider participation, pro- taken into account shall be the calendar after January 1, 2002. vide coverage for emergency ambulance serv- ices to the extent that a prudent layperson, quarter beginning October 1, 2001, and any SEC. 134. ESTABLISHMENT OF MEDICARE ADMIN- increase which is not a multiple of $50 shall ISTRATIVE FEE FOR SUBMISSION OF who possesses an average knowledge of be rounded to the next lowest multiple of DUPLICATE AND UNPROCESSABLE health and medicine, would determine such $50. CLAIMS. emergency ambulance services to be nec- ‘‘(5) APPLICABILITY.—This subsection shall (a) IMPOSITION OF FEE.—Notwithstanding essary. apply to taxable years beginning after De- any other provision of law, the Secretary of ‘‘(c) CARE AFTER STABILIZATION.— cember 31, 2001.’’. Health and Human Services shall establish ‘‘(1) IN GENERAL.—In the case of medically (b) EFFECTIVE DATE.—The amendments (in the form of a separate fee or reduction of necessary and appropriate items or services made by this section shall apply to taxable payment otherwise made under the medicare related to the emergency medical condition years beginning after December 31, 2001. program under title XVIII of the Social Se- that may be provided to a participant or ben- SEC. 123. REDUCTION IN TAX ON VACCINES. curity Act (42 U.S.C. 1395 et seq.)) an admin- eficiary by a nonparticipating provider after (a) IN GENERAL.—Paragraph (1) of section istrative fee of $2 for the submission of a the participant or beneficiary is stabilized, 4131(b) of the Internal Revenue Code of 1986 claim described in subsection (b). the nonparticipating provider shall contact (relating to amount of tax) is amended by (b) CLAIMS SUBJECT TO FEE.—A claim de- the plan as soon as practicable, but not later striking ‘‘75 cents’’ and inserting ‘‘50 cents’’. scribed in this subsection is a claim that— than 2 hours after stabilization occurs, with (b) EFFECTIVE DATE.—The amendment (1) is submitted by an individual or entity respect to whether— made by subsection (a) shall take effect on for items or services for which payment is ‘‘(A) the provision of items or services is January 1, 2002. sought under title XVIII of the Social Secu- approved; Subtitle D—Miscellaneous Provisions rity Act; and ‘‘(B) the participant or beneficiary will be SEC. 131. NO IMPACT ON SOCIAL SECURITY (2) either— transferred; or TRUST FUND. (A) duplicates, in whole or in part, another ‘‘(C) other arrangements will be made con- (a) IN GENERAL.—Nothing in this division claim submitted by the same individual or cerning the care and treatment of the partic- (or an amendment made by this division) entity; or ipant or beneficiary. S6160 CONGRESSIONAL RECORD — SENATE June 29, 2000

‘‘(2) FAILURE TO RESPOND AND MAKE AR- 1395dd(e)(3)) an emergency medical condi- cological care provided by a participating RANGEMENTS.—If a group health plan fails to tion. physician who specializes in obstetrics or respond and make arrangements within 2 ‘‘(3) EMERGENCY MEDICAL CONDITION.—The gynecology. hours of being contacted in accordance with term ‘emergency medical condition’ means a ‘‘(2) OBSTETRICAL AND GYNECOLOGICAL paragraph (1), then the plan shall be respon- medical condition manifesting itself by CARE.—A group health plan described in sub- sible for the cost of any additional items or acute symptoms of sufficient severity (in- section (b) shall treat the provision of ob- services provided by the nonparticipating cluding severe pain) such that a prudent stetrical and gynecological care, and the or- provider if— layperson, who possesses an average knowl- dering of related obstetrical and gyneco- ‘‘(A) coverage for items or services of the edge of health and medicine, could reason- logical items and services, pursuant to the type furnished by the nonparticipating pro- ably expect the absence of immediate med- direct access described under paragraph (1), vider is available under the plan; ical attention to result in placing the health by a participating health care professional ‘‘(B) the items or services are medically of the participant or beneficiary (or, with re- who specializes in obstetrics or gynecology necessary and appropriate and related to the spect to a pregnant woman, the health of the as the authorization of the primary care pro- emergency medical condition involved; and woman or her unborn child) in serious jeop- vider. ‘‘(C) the timely provision of the items or ardy, serious impairment to bodily func- ‘‘(b) APPLICATION OF SECTION.—A group services is medically necessary and appro- tions, or serious dysfunction of any bodily health plan described in this subsection is a priate. organ or part. group health plan (other than a fully insured group health plan), that— ‘‘(3) RULE OF CONSTRUCTION.—Nothing in ‘‘SEC. 722. OFFERING OF CHOICE OF COVERAGE this subsection shall be construed to apply OPTIONS. ‘‘(1) provides coverage for obstetric or gynecologic care; and to a group health plan that does not require ‘‘(a) REQUIREMENT.—If a group health plan ‘‘(2) requires the designation by a partici- prior authorization for items or services pro- (other than a fully insured group health pant or beneficiary of a participating pri- vided to a participant or beneficiary after plan) provides coverage for benefits only mary care provider other than a physician the participant or beneficiary is stabilized. through a defined set of participating health who specializes in obstetrics or gynecology. ‘‘(d) REIMBURSEMENT TO A NON-PARTICI- care professionals, the plan shall offer the ‘‘(c) RULES OF CONSTRUCTION.—Nothing in PATING PROVIDER.—The responsibility of a participant the option to purchase point-of- this section shall be construed— group health plan to provide reimbursement service coverage (as defined in subsection ‘‘(1) to require that a group health plan ap- to a nonparticipating provider under this (b)) for all such benefits for which coverage prove or provide coverage for— section shall cease accruing upon the earlier is otherwise so limited. Such option shall be ‘‘(A) any items or services that are not of— made available to the participant at the covered under the terms and conditions of ‘‘(1) the transfer or discharge of the partic- time of enrollment under the plan and at the group health plan; ipant or beneficiary; or such other times as the plan offers the par- ‘‘(B) any items or services that are not ‘‘(2) the completion of other arrangements ticipant a choice of coverage options. medically necessary and appropriate; or made by the plan and the nonparticipating ‘‘(b) POINT-OF-SERVICE COVERAGE DE- ‘‘(C) any items or services that are pro- provider. FINED.—In this section, the term ‘point-of- vided, ordered, or otherwise authorized under ‘‘(e) RESPONSIBILITY OF PARTICIPANT.—With service coverage’ means, with respect to ben- subsection (a)(2) by a physician unless such respect to items or services provided by a efits covered under a group health plan items or services are related to obstetric or nonparticipating provider under this section, (other than a fully insured group health gynecologic care; the participant or beneficiary shall not be plan), coverage of such benefits when pro- ‘‘(2) to preclude a group health plan from responsible for amounts that exceed the vided by a nonparticipating health care pro- requiring that the physician described in amounts (including co-insurance, co-pay- fessional. subsection (a) notify the designated primary ments, deductibles or any other form of cost- ‘‘(c) SMALL EMPLOYER EXEMPTION.— care professional or case manager of treat- sharing) that would be incurred if the care ‘‘(1) IN GENERAL.—This section shall not ment decisions in accordance with a process was provided by a participating health care apply to any group health plan (other than a implemented by the plan, except that the provider with prior authorization. fully insured group health plan) of a small group health plan shall not impose such a ‘‘(f) RULE OF CONSTRUCTION.—Nothing in employer. notification requirement on the participant this section shall be construed to prohibit a ‘‘(2) SMALL EMPLOYER.—For purposes of or beneficiary involved in the treatment de- group health plan from negotiating reim- paragraph (1), the term ‘small employer’ cision; bursement rates with a nonparticipating pro- means, in connection with a group health ‘‘(3) to preclude a group health plan from vider for items or services provided under plan (other than a fully insured group health requiring authorization, including prior au- this section. plan) with respect to a calendar year and a thorization, for certain items and services ‘‘(g) DEFINITIONS.—In this section: plan year, an employer who employed an av- from the physician described in subsection ‘‘(1) EMERGENCY AMBULANCE SERVICES.—The erage of at least 2 but not more than 50 em- (a) who specializes in obstetrics and gyne- term ‘emergency ambulance services’ means, ployees on business days during the pre- cology if the designated primary care pro- with respect to a participant or beneficiary ceding calendar year and who employs at vider of the participant or beneficiary would under a group health plan (other than a fully least 2 employees on the first day of the plan otherwise be required to obtain authoriza- insured group health plan), ambulance serv- year. For purposes of this paragraph, the tion for such items or services; ices furnished to transport an individual who provisions of subparagraph (C) of section ‘‘(4) to require that the participant or ben- has an emergency medical condition to a 712(c)(1) shall apply in determining employer eficiary described in subsection (a)(1) obtain treating facility for receipt of emergency size. authorization or a referral from a primary medical care if— ‘‘(d) RULE OF CONSTRUCTION.—Nothing in care provider in order to obtain obstetrical ‘‘(A) the emergency services are covered this section shall be construed— or gynecological care from a health care pro- under the group health plan (other than a ‘‘(1) as requiring coverage for benefits for a fessional other than a physician if the provi- fully insured group health plan) involved; particular type of health care professional; sion of obstetrical or gynecological care by and ‘‘(2) as requiring an employer to pay any such professional is permitted by the group ‘‘(B) a prudent layperson who possesses an costs as a result of this section or to make health plan and consistent with State licen- average knowledge of health and medicine equal contributions with respect to different sure, credentialing, and scope of practice could reasonably expect the absence of such health coverage options; laws and regulations; or transport to result in placing the health of ‘‘(3) as preventing a group health plan ‘‘(5) to preclude the participant or bene- the participant or beneficiary (or, with re- (other than a fully insured group health ficiary described in subsection (a)(1) from spect to a pregnant woman, the health of the plan) from imposing higher premiums or designating a health care professional other woman or her unborn child) in serious jeop- cost-sharing on a participant for the exercise than a physician as a primary care provider ardy, serious impairment to bodily func- of a point-of-service coverage option; or if such designation is permitted by the group tions, or serious dysfunction of any bodily ‘‘(4) to require that a group health plan health plan and the treatment by such pro- organ or part. (other than a fully insured group health fessional is consistent with State licensure, ‘‘(2) EMERGENCY MEDICAL CARE.—The term plan) include coverage of health care profes- credentialing, and scope of practice laws and ‘emergency medical care’ means, with re- sionals that the plan excludes because of regulations. spect to a participant or beneficiary under a fraud, quality of care, or other similar rea- ‘‘SEC. 724. ACCESS TO PEDIATRIC CARE. group health plan (other than a fully insured sons with respect to such professionals. ‘‘(a) PEDIATRIC CARE.—If a group health group health plan), covered inpatient and ‘‘SEC. 723. PATIENT ACCESS TO OBSTETRIC AND plan (other than a fully insured group health outpatient items or services that— GYNECOLOGICAL CARE. plan) requires or provides for a participant ‘‘(A) are furnished by any provider, includ- ‘‘(a) GENERAL RIGHTS.— or beneficiary to designate a participating ing a nonparticipating provider, that is ‘‘(1) DIRECT ACCESS.—A group health plan primary care provider for a child of such par- qualified to furnish such items or services; described in subsection (b) may not require ticipant or beneficiary, the plan shall permit and authorization or referral by the primary care the participant or beneficiary to designate a ‘‘(B) are needed to evaluate or stabilize (as provider described in subsection (b)(2) in the physician who specializes in pediatrics as the such term is defined in section 1867(e)(3) of case of a female participant or beneficiary child’s primary care provider if such pro- the Social Security Act (42 U.S.C. who seeks coverage for obstetrical or gyne- vider participates in the network of the plan. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6161

‘‘(b) RULES OF CONSTRUCTION.—With re- (as defined in subparagraph (B)) to receive a tion shall extend for up to 90 days from the spect to the child of a participant or bene- referral to a specialist for the treatment of date of the notice described in subsection ficiary, nothing in subsection (a) shall be such condition and such specialist may au- (a)(1) of the provider’s termination. construed to— thorize such referrals, procedures, tests, and ‘‘(2) INSTITUTIONAL OR INPATIENT CARE.— ‘‘(1) require that the participant or bene- other medical services with respect to such ‘‘(A) IN GENERAL.—The transitional period ficiary obtain prior authorization or a refer- condition, or coordinate the care for such under this section for institutional or non- ral from a primary care provider in order to condition, subject to the terms of a treat- elective inpatient care from a provider shall obtain pediatric care from a health care pro- ment plan referred to in subsection (c) with extend until the earlier of— fessional other than a physician if the provi- respect to the condition. ‘‘(i) the expiration of the 90-day period be- sion of pediatric care by such professional is ‘‘(B) ONGOING SPECIAL CONDITION DEFINED.— ginning on the date on which the notice de- permitted by the plan and consistent with In this subsection, the term ‘ongoing special scribed in subsection (a)(1) of the provider’s State licensure, credentialing, and scope of condition’ means a condition or disease termination is provided; or practice laws and regulations; or that— ‘‘(ii) the date of discharge of the individual ‘‘(2) preclude the participant or beneficiary ‘‘(i) is life-threatening, degenerative, or from such care or the termination of the pe- from designating a health care professional disabling; and riod of institutionalization. other than a physician as a primary care ‘‘(ii) requires specialized medical care over ‘‘(B) SCHEDULED CARE.—The 90 day limita- provider for the child if such designation is a prolonged period of time. tion described in subparagraph (A)(i) shall permitted by the plan and the treatment by ‘‘(c) TREATMENT PLANS.— include post-surgical follow-up care relating such professional is consistent with State li- ‘‘(1) IN GENERAL.—Nothing in this section to non-elective surgery that has been sched- censure, credentialing, and scope of practice shall be construed to prohibit a group health uled before the date of the notice of the ter- laws. plan (other than a fully insured group health mination of the provider under subsection ‘‘SEC. 725. TIMELY ACCESS TO SPECIALISTS. plan) from requiring that specialty care be (a)(1). ‘‘(a) TIMELY ACCESS.— provided pursuant to a treatment plan so ‘‘(3) PREGNANCY.—If— ‘‘(1) IN GENERAL.—A group health plan long as the treatment plan is— ‘‘(A) a participant or beneficiary has en- (other than a fully insured group health ‘‘(A) developed by the specialist, in con- tered the second trimester of pregnancy at plan) shall ensure that participants and sultation with the case manager or primary the time of a provider’s termination of par- beneficiaries receive timely coverage for ac- care provider, and the participant or bene- ticipation; and cess to specialists who are appropriate to the ficiary; ‘‘(B) the provider was treating the preg- medical condition of the participant or bene- ‘‘(B) approved by the plan in a timely man- nancy before the date of the termination; ficiary, when such specialty care is a covered ner if the plan requires such approval; and the transitional period under this subsection benefit under the plan. ‘‘(C) in accordance with the applicable with respect to provider’s treatment of the ‘‘(2) RULE OF CONSTRUCTION.—Nothing in quality assurance and utilization review pregnancy shall extend through the provi- paragraph (1) shall be construed— standards of the plan. sion of post-partum care directly related to ‘‘(A) to require the coverage under a group ‘‘(2) NOTIFICATION.—Nothing in paragraph the delivery. health plan (other than a fully insured group (1) shall be construed as prohibiting a plan ‘‘(4) TERMINAL ILLNESS.—If— health plan) of benefits or services; from requiring the specialist to provide the ‘‘(A) a participant or beneficiary was deter- ‘‘(B) to prohibit a plan from including pro- plan with regular updates on the specialty mined to be terminally ill (as determined viders in the network only to the extent nec- care provided, as well as all other necessary under section 1861(dd)(3)(A) of the Social Se- essary to meet the needs of the plan’s par- medical information. curity Act) at the time of a provider’s termi- ticipants and beneficiaries; ‘‘(d) SPECIALIST DEFINED.—For purposes of nation of participation; and ‘‘(C) to prohibit a plan from establishing this section, the term ‘specialist’ means, ‘‘(B) the provider was treating the ter- measures designed to maintain quality and with respect to the medical condition of the minal illness before the date of termination; control costs consistent with the responsibil- participant or beneficiary, a health care pro- the transitional period under this subsection ities of the plan; or fessional, facility, or center (such as a center shall extend for the remainder of the individ- ‘‘(D) to override any State licensure or of excellence) that has adequate expertise ual’s life for care that is directly related to scope-of-practice law. (including age-appropriate expertise) the treatment of the terminal illness. ‘‘(3) ACCESS TO CERTAIN PROVIDERS.— through appropriate training and experience. ‘‘(c) PERMISSIBLE TERMS AND CONDITIONS.— ‘‘(A) PARTICIPATING PROVIDERS.—Nothing ‘‘(e) RIGHT TO EXTERNAL REVIEW.—Pursu- A group health plan (other than a fully in- in this section shall be construed to prohibit ant to the requirements of section 503B, a sured group health plan) may condition cov- a group health plan (other than a fully in- participant or beneficiary shall have the erage of continued treatment by a provider sured group health plan) from requiring that right to an independent external review if under this section upon the provider agree- a participant or beneficiary obtain specialty the denial of an item or service or condition ing to the following terms and conditions: care from a participating specialist. that is required to be covered under this sec- ‘‘(1) The treating health care provider ‘‘(B) NONPARTICIPATING PROVIDERS.— tion is eligible for such review. agrees to accept reimbursement from the ‘‘(i) IN GENERAL.—With respect to specialty ‘‘SEC. 726. CONTINUITY OF CARE. plan and individual involved (with respect to care under this section, if a group health ‘‘(a) TERMINATION OF PROVIDER.—If a con- cost-sharing) at the rates applicable prior to plan (other than a fully insured group health tract between a group health plan (other the start of the transitional period as pay- plan) determines that a participating spe- than a fully insured group health plan) and a ment in full (or at the rates applicable under cialist is not available to provide such care treating health care provider is terminated the replacement plan after the date of the to the participant or beneficiary, the plan (as defined in paragraph (e)(4)), or benefits or termination of the contract with the group shall provide for coverage of such care by a coverage provided by a health care provider health plan) and not to impose cost-sharing nonparticipating specialist. are terminated because of a change in the with respect to the individual in an amount ‘‘(ii) TREATMENT OF NONPARTICIPATING PRO- terms of provider participation in such plan, that would exceed the cost-sharing that VIDERS.—If a group health plan (other than a and an individual who is a participant or could have been imposed if the contract re- fully insured group health plan) refers a par- beneficiary in the plan is undergoing an ac- ferred to in this section had not been termi- ticipant or beneficiary to a nonparticipating tive course of treatment for a serious and nated. specialist pursuant to clause (i), such spe- complex condition, institutional care, preg- ‘‘(2) The treating health care provider cialty care shall be provided at no additional nancy, or terminal illness from the provider agrees to adhere to the quality assurance cost to the participant or beneficiary beyond at the time the plan receives or provides no- standards of the plan responsible for pay- what the participant or beneficiary would tice of such termination, the plan shall— ment under paragraph (1) and to provide to otherwise pay for such specialty care if pro- ‘‘(1) notify the individual, or arrange to such plan necessary medical information re- vided by a participating specialist. have the individual notified pursuant to sub- lated to the care provided. ‘‘(b) REFERRALS.— section (d)(2), on a timely basis of such ter- ‘‘(3) The treating health care provider ‘‘(1) AUTHORIZATION.—Nothing in this sec- mination; agrees otherwise to adhere to such plan’s tion shall be construed to prohibit a group ‘‘(2) provide the individual with an oppor- policies and procedures, including procedures health plan (other than a fully insured group tunity to notify the plan of the individual’s regarding referrals and obtaining prior au- health plan) from requiring an authorization need for transitional care; and thorization and providing services pursuant in order to obtain coverage for specialty ‘‘(3) subject to subsection (c), permit the to a treatment plan (if any) approved by the services so long as such authorization is for individual to elect to continue to be covered plan. an appropriate duration or number of refer- with respect to the active course of treat- ‘‘(d) RULES OF CONSTRUCTION.—Nothing in rals. ment with the provider’s consent during a this section shall be construed— ‘‘(2) REFERRALS FOR ONGOING SPECIAL CON- transitional period (as provided for under ‘‘(1) to require the coverage of benefits DITIONS.— subsection (b)). which would not have been covered if the ‘‘(A) IN GENERAL.—A group health plan ‘‘(b) TRANSITIONAL PERIOD.— provider involved remained a participating (other than a fully insured group health ‘‘(1) SERIOUS AND COMPLEX CONDITIONS.— provider; or plan) shall permit a participant or bene- The transitional period under this section ‘‘(2) with respect to the termination of a ficiary who has an ongoing special condition with respect to a serious and complex condi- contract under subsection (a) to prevent a S6162 CONGRESSIONAL RECORD — SENATE June 29, 2000 group health plan from requiring that the group health plan) provides coverage for ben- ‘‘(B) The individual is eligible to partici- health care provider— efits with respect to prescription drugs, and pate in an approved clinical trial according ‘‘(A) notify participants or beneficiaries of limits such coverage to drugs included in a to the trial protocol with respect to treat- their rights under this section; or formulary, the plan shall— ment of such illness. ‘‘(B) provide the plan with the name of ‘‘(1) ensure the participation of physicians ‘‘(C) The individual’s participation in the each participant or beneficiary who the pro- and pharmacists in developing and reviewing trial offers meaningful potential for signifi- vider believes is eligible for transitional care such formulary; and cant clinical benefit for the individual. under this section. ‘‘(2) in accordance with the applicable ‘‘(2) Either— ‘‘(e) DEFINITIONS.—In this section: quality assurance and utilization review ‘‘(A) the referring physician is a partici- ‘‘(1) CONTRACT.—The term ‘contract be- standards of the plan, provide for exceptions pating health care professional and has con- tween a plan and a treating health care pro- from the formulary limitation when a non- cluded that the individual’s participation in vider’ shall include a contract between such formulary alternative is medically necessary such trial would be appropriate based upon a plan and an organized network of pro- and appropriate. the individual meeting the conditions de- viders. ‘‘(b) RIGHT TO EXTERNAL REVIEW.—Pursu- scribed in paragraph (1); or ‘‘(2) HEALTH CARE PROVIDER.—The term ant to the requirements of section 503B, a ‘‘(B) the participant or beneficiary pro- ‘health care provider’ or ‘provider’ means— participant or beneficiary shall have the vides medical and scientific information es- ‘‘(A) any individual who is engaged in the right to an independent external review if tablishing that the individual’s participation delivery of health care services in a State the denial of an item or service or condition in such trial would be appropriate based and who is required by State law or regula- that is required to be covered under this sec- upon the individual meeting the conditions tion is eligible for such review. tion to be licensed or certified by the State described in paragraph (1). to engage in the delivery of such services in ‘‘SEC. 729. SELF-PAYMENT FOR BEHAVIORAL the State; and HEALTH CARE SERVICES. ‘‘(c) PAYMENT.— ‘‘(B) any entity that is engaged in the de- ‘‘(a) IN GENERAL.—A group health plan ‘‘(1) IN GENERAL.—Under this section a livery of health care services in a State and (other than a fully insured group health group health plan (other than a fully insured that, if it is required by State law or regula- plan) may not— group health plan) shall provide for payment tion to be licensed or certified by the State ‘‘(1) prohibit or otherwise discourage a par- for routine patient costs described in sub- to engage in the delivery of such services in ticipant or beneficiary from self-paying for section (a)(2) but is not required to pay for the State, is so licensed. behavioral health care services once the plan costs of items and services that are reason- ‘‘(3) SERIOUS AND COMPLEX CONDITION.—The has denied coverage for such services; or ably expected to be paid for by the sponsors term ‘serious and complex condition’ means, ‘‘(2) terminate a health care provider be- of an approved clinical trial. with respect to a participant or beneficiary cause such provider permits participants or ‘‘(2) STANDARDS FOR DETERMINING ROUTINE under the plan, a condition that is medically beneficiaries to self-pay for behavioral PATIENT COSTS ASSOCIATED WITH CLINICAL determinable and— health care services— TRIAL PARTICIPATION.— ‘‘(A) in the case of an acute illness, is a ‘‘(A) that are not otherwise covered under ‘‘(A) IN GENERAL.—The Secretary shall, in condition serious enough to require special- the plan; or accordance with this paragraph, establish ized medical treatment to avoid the reason- ‘‘(B) for which the group health plan pro- standards relating to the coverage of routine able possibility of death or permanent harm; vides limited coverage, to the extent that patient costs for individuals participating in or the group health plan denies coverage of the clinical trials that group health plans must ‘‘(B) in the case of a chronic illness or con- services. meet under this section. dition, is an illness or condition that— ‘‘(b) RULE OF CONSTRUCTION.—Nothing in ‘‘(B) FACTORS.—In establishing routine pa- ‘‘(i) is complex and difficult to manage; subsection (a)(2)(B) shall be construed as tient cost standards under subparagraph (A), ‘‘(ii) is disabling or life- threatening; and prohibiting a group health plan from termi- the Secretary shall consult with interested ‘‘(iii) requires— nating a contract with a health care provider parties and take into account — ‘‘(I) frequent monitoring over a prolonged for failure to meet applicable quality stand- ‘‘(i) quality of patient care; period of time and requires substantial on- ards or for fraud. ‘‘(ii) routine patient care costs versus costs going specialized medical care; or ‘‘SEC. 730. COVERAGE FOR INDIVIDUALS PARTICI- associated with the conduct of clinical ‘‘(II) frequent ongoing specialized medical PATING IN APPROVED CANCER trials, including unanticipated patient care CLINICAL TRIALS. care across a variety of domains of care. costs as a result of participation in clinical ‘‘(a) COVERAGE.— ‘‘(4) TERMINATED.—The term ‘terminated’ trials; and ‘‘(1) IN GENERAL.—If a group health plan includes, with respect to a contract (as de- (other than a fully insured group health ‘‘(iii) previous and on-going studies relat- fined in paragraph (1)), the expiration or plan) provides coverage to a qualified indi- ing to patient care costs associated with par- nonrenewal of the contract by the group vidual (as defined in subsection (b)), the ticipation in clinical trials. health plan, but does not include a termi- plan— ‘‘(C) APPOINTMENT AND MEETINGS OF NEGO- nation of the contract by the plan for failure ‘‘(A) may not deny the individual partici- TIATED RULEMAKING COMMITTEE.— to meet applicable quality standards or for pation in the clinical trial referred to in sub- ‘‘(i) PUBLICATION OF NOTICE.—Not later fraud. section (b)(2); than November 15, 2000, the Secretary shall ‘‘(f) RIGHT TO EXTERNAL REVIEW.—Pursu- ‘‘(B) subject to subsections (b), (c), and (d) publish notice of the establishment of a ne- ant to the requirements of section 503B, a gotiated rulemaking committee, as provided participant or beneficiary shall have the may not deny (or limit or impose additional conditions on) the coverage of routine pa- for under section 564(a) of title 5, United right to an independent external review if States Code, to develop the standards de- the denial of an item or service or condition tient costs for items and services furnished in connection with participation in the trial; scribed in subparagraph (A), which shall that is required to be covered under this sec- include— tion is eligible for such review. and ‘‘(C) may not discriminate against the in- ‘‘(I) the proposed scope of the committee; ‘‘SEC. 727. PROTECTION OF PATIENT-PROVIDER ‘‘(II) the interests that may be impacted by COMMUNICATIONS. dividual on the basis of the participant’s or the standards; ‘‘(a) IN GENERAL.—Subject to subsection beneficiaries participation in such trial. ‘‘(iii) a list of the proposed membership of (b), a group health plan (other than a fully ‘‘(2) EXCLUSION OF CERTAIN COSTS.—For pur- insured group health plan and in relation to poses of paragraph (1)(B), routine patient the committee; a participant or beneficiary) shall not pro- costs do not include the cost of the tests or ‘‘(iv) the proposed meeting schedule of the hibit or otherwise restrict a health care pro- measurements conducted primarily for the committee; fessional from advising such a participant or purpose of the clinical trial involved. ‘‘(v) a solicitation for public comment on beneficiary who is a patient of the profes- ‘‘(3) USE OF IN-NETWORK PROVIDERS.—If one the committee; and sional about the health status of the partici- or more participating providers is partici- ‘‘(vi) the procedures under which an indi- pant or beneficiary or medical care or treat- pating in a clinical trial, nothing in para- vidual may apply for membership on the ment for the condition or disease of the par- graph (1) shall be construed as preventing a committee. ticipant or beneficiary, regardless of whether plan from requiring that a qualified indi- ‘‘(ii) COMMENT PERIOD.—Notwithstanding coverage for such care or treatment are pro- vidual participate in the trial through such a section 564(c) of title 5, United States Code, vided under the contract, if the professional participating provider if the provider will ac- the Secretary shall provide for a period, be- is acting within the lawful scope of practice. cept the individual as a participant in the ginning on the date on which the notice is ‘‘(b) RULE OF CONSTRUCTION.—Nothing in trial. published under clause (i) and ending on No- this section shall be construed as requiring a ‘‘(b) QUALIFIED INDIVIDUAL DEFINED.—For vember 30, 2000, for the submission of public group health plan (other than a fully insured purposes of subsection (a), the term ‘quali- comments on the committee under this sub- group health plan) to provide specific bene- fied individual’ means an individual who is a paragraph. fits under the terms of such plan. participant or beneficiary in a group health ‘‘(iii) APPOINTMENT OF COMMITTEE.—Not ‘‘SEC. 728. PATIENT’S RIGHT TO PRESCRIPTION plan and who meets the following conditions: later than December 30, 2000, the Secretary DRUGS. ‘‘(1)(A) The individual has been diagnosed shall appoint the members of the negotiated ‘‘(a) IN GENERAL.—To the extent that a with cancer for which no standard treatment rulemaking committee under this subpara- group health plan (other than a fully insured is effective. graph. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6163

‘‘(iv) FACILITATOR.—Not later than Janu- ‘‘(A) to be comparable to the system of (b) RULE WITH RESPECT TO CERTAIN ary 10, 2001, the negotiated rulemaking com- peer review of studies and investigations PLANS.— mittee shall nominate a facilitator under used by the National Institutes of Health, (1) IN GENERAL.—Notwithstanding any section 566(c) of title 5, United States Code, and other provision of law, health insurance to carry out the activities described in sub- ‘‘(B) assures unbiased review of the highest issuers may offer, and eligible individuals section (d) of such section. scientific standards by qualified individuals may purchase, high deductible health plans ‘‘(v) MEETINGS.—During the period begin- who have no interest in the outcome of the described in section 220(c)(2)(A) of the Inter- ning on the date on which the facilitator is review. nal Revenue Code of 1986. Effective for the 5- nominated under clause (iv) and ending on ‘‘(e) CONSTRUCTION.—Nothing in this sec- year period beginning on the date of the en- March 30, 2001, the negotiated rulemaking tion shall be construed to limit a plan’s cov- actment of this Act, such health plans shall committee shall meet to develop the stand- erage with respect to clinical trials. not be required to provide payment for any ards described in subparagraph (A). ‘‘(f) PLAN SATISFACTION OF CERTAIN RE- health care items or services that are ex- ‘‘(D) PRELIMINARY COMMITTEE REPORT.— QUIREMENTS; RESPONSIBILITIES OF FIDU- empt from the plan’s deductible. ‘‘(i) IN GENERAL.—The negotiated rule- CIARIES.— (2) EXISTING STATE LAWS.—A State law re- making committee appointed under subpara- ‘‘(1) IN GENERAL.—For purposes of this sec- lating to payment for health care items and graph (C) shall report to the Secretary, by tion, insofar as a group health plan provides services in effect on the date of enactment of not later than March 30, 2001, regarding the benefits in the form of health insurance cov- this Act that is preempted under paragraph committee’s progress on achieving a con- erage through a health insurance issuer, the (1), shall not apply to high deductible health sensus with regard to the rulemaking pro- plan shall be treated as meeting the require- plans after the expiration of the 5-year pe- ceedings and whether such consensus is like- ments of this section with respect to such riod described in such paragraph unless the ly to occur before the target date described benefits and not be considered as failing to State reenacts such law after such period. in subsection (F). meet such requirements because of a failure (c) DEFINITION.—Section 733(a) of the Em- ‘‘(ii) TERMINATION OF PROCESS AND PUBLICA- of the issuer to meet such requirements so ployee Retirement Income Security Act of TION OF RULE BY SECRETARY.—If the com- long as the plan sponsor or its representa- 1974 (42 U.S.C. 1191(a)) is amended by adding mittee reports under clause (i) that the com- tives did not cause such failure by the issuer. at the end the following: mittee has failed to make significant ‘‘(2) CONSTRUCTION.—Nothing in this sec- ‘‘(3) FULLY INSURED GROUP HEALTH PLAN.— progress towards such consensus or is un- tion shall be construed to affect or modify The term ‘fully insured group health plan’ likely to reach such consensus by the target the responsibilities of the fiduciaries of a means a group health plan where benefits date described in subsection (F), the Sec- group health plan under part 4 of subtitle B. under the plan are provided pursuant to the retary shall terminate such process and pro- ‘‘(g) STUDY AND REPORT.— terms of an arrangement between a group vide for the publication in the Federal Reg- ‘‘(1) STUDY.—The Secretary shall study the health plan and a health insurance issuer ister, by not later than June 30, 2001, of a impact on group health plans for covering and are guaranteed by the health insurance rule under this paragraph through such other routine patient care costs for individuals issuer under a contract or policy of insur- methods as the Secretary may provide. who are entitled to benefits under this sec- ance.’’. ‘‘(E) FINAL COMMITTEE REPORT AND PUBLI- tion and who are enrolled in an approved (d) CONFORMING AMENDMENT.—The table of CATION OR RULE BY SECRETARY.— cancer clinical trial program. contents in section 1 of the Employee Retire- ‘‘(i) IN GENERAL.—If the rulemaking com- ‘‘(2) REPORT TO CONGRESS.—Not later than ment Income Security Act of 1974 is mittee is not terminated under subparagraph January 1, 2005, the Secretary shall submit a amended— (D)(ii), the committee shall submit to the report to Congress that contains an assess- (1) in the item relating to subpart C of part Secretary, by not later than May 30, 2001, a ment of— 7 of subtitle B of title I, by striking ‘‘Sub- report containing a proposed rule. ‘‘(A) any incremental cost to group health part C’’ and inserting ‘‘Subpart D’’; and ‘‘(ii) PUBLICATION OF RULE.—If the Sec- plans resulting from the provisions of this (2) by adding at the end of the items relat- retary receives a report under clause (i), the section; ing to subpart B of part 7 of subtitle B of Secretary shall provide for the publication ‘‘(B) a projection of expenditures to such title I, the following: plans resulting from this section; and in the Federal Register, by not later than ‘‘SUBPART C—PATIENT RIGHT TO MEDICAL ‘‘(C) any impact on premiums resulting June 30, 2001, of the proposed rule. ADVICE AND CARE ‘‘(F) TARGET DATE FOR PUBLICATION OF from this section. ‘‘(h) RIGHT TO EXTERNAL REVIEW.—Pursu- ‘‘Sec. 721. Access to emergency medical RULE.—As part of the notice under subpara- ant to the requirements of section 503B, a care. graph (C)(i), and for purposes of this para- participant or beneficiary shall have the ‘‘Sec. 722. Offering of choice of coverage op- graph, the ‘target date for publication’ (re- right to an independent external review if tions. ferred to in section 564(a)(5) of title 5, United the denial of an item or service or condition ‘‘Sec. 723. Patient access to obstetric and States Code) shall be June 30, 2001. that is required to be covered under this sec- gynecological care. ‘‘(G) EFFECTIVE DATE.—The provisions of ‘‘Sec. 724. Access to pediatric care. tion is eligible for such review. this paragraph shall apply to group health ‘‘Sec. 725. Timely access to specialists. plans (other than a fully insured group ‘‘SEC. 730A. PROHIBITION OF DISCRIMINATION ‘‘Sec. 726. Continuity of care. AGAINST PROVIDERS BASED ON LI- ‘‘Sec. 727. Protection of patient-provider health plan) for plan years beginning on or CENSURE. communications. after January 1, 2002. ‘‘(a) IN GENERAL.—A group health plan ‘‘Sec. 728. Patient’s right to prescription ‘‘(3) PAYMENT RATE.—In the case of covered (other than a fully insured group health drugs. items and services provided by— plan) shall not discriminate with respect to ‘‘Sec. 729. Self-payment for behavioral ‘‘(A) a participating provider, the payment participation or indemnification as to any health care services. rate shall be at the agreed upon rate, or provider who is acting within the scope of ‘‘(B) a nonparticipating provider, the pay- ‘‘Sec. 730. Coverage for individuals partici- the provider’s license or certification under pating in approved cancer clin- ment rate shall be at the rate the plan would applicable State law, solely on the basis of normally pay for comparable services under ical trials. such license or certification. ‘‘Sec. 730A. Prohibition of discrimination subparagraph (A). ‘‘(b) CONSTRUCTION.—Subsection (a) shall against providers based on li- not be construed— ‘‘(d) APPROVED CLINICAL TRIAL DEFINED.— censure. ‘‘(1) IN GENERAL.—In this section, the term ‘‘(1) as requiring the coverage under a ‘‘Sec. 730C. Generally applicable provision.’’. ‘approved clinical trial’ means a cancer clin- group health plan of a particular benefit or service or to prohibit a plan from including SEC. 202. CONFORMING AMENDMENT TO THE IN- ical research study or cancer clinical inves- TERNAL REVENUE CODE OF 1986. providers only to the extent necessary to tigation approved or funded (which may in- Subchapter B of chapter 100 of the Internal meet the needs of the plan’s participants or clude funding through in-kind contributions) Revenue Code of 1986 is amended— beneficiaries or from establishing any meas- by one or more of the following: (1) in the table of sections, by inserting ure designed to maintain quality and control ‘‘(A) The National Institutes of Health. after the item relating to section 9812 the costs consistent with the responsibilities of ‘‘(B) A cooperative group or center of the following new item: National Institutes of Health. the plan; ‘‘(C) The Food and Drug Administration. ‘‘(2) to override any State licensure or ‘‘Sec. 9813. Standard relating to patient’s ‘‘(D) Either of the following if the condi- scope-of-practice law; or bill of rights.’’; tions described in paragraph (2) are met: ‘‘(3) as requiring a plan that offers network and ‘‘(i) The Department of Veterans Affairs. coverage to include for participation every (2) by inserting after section 9812 the fol- ‘‘(ii) The Department of Defense. willing provider who meets the terms and lowing: ‘‘(2) CONDITIONS FOR DEPARTMENTS.—The conditions of the plan. ‘‘SEC. 9813. STANDARD RELATING TO PATIENTS’ conditions described in this paragraph, for a ‘‘SEC. 730B. GENERALLY APPLICABLE PROVISION. BILL OF RIGHTS. study or investigation conducted by a De- ‘‘In the case of a group health plan that ‘‘A group health plan (other than a fully partment, are that the study or investiga- provides benefits under 2 or more coverage insured group health plan) shall comply with tion has been reviewed and approved through options, the requirements of this subpart the requirements of subpart C of part 7 of a system of peer review that the Secretary shall apply separately with respect to each subtitle B of title I of the Employee Retire- determines— coverage option.’’. ment Income Security Act of 1974, as added S6164 CONGRESSIONAL RECORD — SENATE June 29, 2000 by section 201 of the Patients’ Bill of Rights beneficiaries, to the extent that such infor- under the terms and conditions of the plan Plus Act, and such requirements shall be mation is provided to participants or bene- or coverage, and the right to obtain coverage deemed to be incorporated into this sec- ficiaries via the United States Postal Service for approved cancer clinical trials under sec- tion.’’. or other private delivery service. tion 729 if such section applies. SEC. 203. EFFECTIVE DATE AND RELATED RULES. ‘‘(b) REQUIRED INFORMATION.—The informa- ‘‘(10) PRESCRIPTION DRUGS.—To the extent (a) IN GENERAL.—The amendments made by tional materials to be distributed under this the plan or issuer provides coverage for pre- this subtitle shall apply with respect to plan section shall include for each option avail- scription drugs, a statement of whether such years beginning on or after January 1 of the able under the group health plan or health coverage is limited to drugs included in a second calendar year following the date of insurance coverage the following: formulary, a description of any provisions the enactment of this Act. The Secretary ‘‘(1) BENEFITS.—A description of the cov- and cost-sharing required for obtaining on- shall issue all regulations necessary to carry ered benefits, including— and off-formulary medications, and a de- out the amendments made by this section ‘‘(A) any in- and out-of-network benefits; scription of the rights of participants and ‘‘(B) specific preventative services covered before the effective date thereof. beneficiaries in obtaining access to access to under the plan or coverage if such services (b) LIMITATION ON ENFORCEMENT ACTIONS.— prescription drugs under section 727 if such are covered; No enforcement action shall be taken, pursu- section applies. ‘‘(C) any benefit limitations, including any ant to the amendments made by this sub- ‘‘(11) EMERGENCY SERVICES.—A summary of annual or lifetime benefit limits and any title, against a group health plan with re- the rules and procedures for accessing emer- monetary limits or limits on the number of spect to a violation of a requirement im- gency services, including the right of a par- posed by such amendments before the date of visits, days, or services, and any specific cov- erage exclusions; and ticipant or beneficiary to obtain emergency issuance of regulations issued in connection services under the prudent layperson stand- with such requirement, if the plan has ‘‘(D) any definition of medical necessity used in making coverage determinations by ard under section 721, if such section applies, sought to comply in good faith with such re- and any educational information that the quirement. the plan, issuer, or claims administrator. ‘‘(2) COST SHARING.—A description of any plan or issuer may provide regarding the ap- Subtitle B—Right to Information About Plans cost-sharing requirements, including— propriate use of emergency services. and Providers ‘‘(A) any premiums, deductibles, coinsur- ‘‘(12) CLAIMS AND APPEALS.—A description SEC. 211. INFORMATION ABOUT PLANS. ance, copayment amounts, and liability for of the plan or issuer’s rules and procedures (a) EMPLOYEE RETIREMENT INCOME SECU- balance billing above any reasonable and pertaining to claims and appeals, a descrip- RITY ACT OF 1974.—Subpart B of part 7 of sub- customary charges, for which the participant tion of the rights of participants and bene- title B of title I of the Employee Retirement or beneficiary will be responsible under each ficiaries under sections 503, 503A and 503B in Income Security Act of 1974 (29 U.S.C. 1185 et option available under the plan; obtaining covered benefits, filing a claim for seq.) is amended by adding at the end the fol- ‘‘(B) any maximum out-of-pocket expense benefits, and appealing coverage decisions lowing: for which the participant or beneficiary may internally and externally (including tele- ‘‘SEC. 714. HEALTH PLAN INFORMATION. be liable; phone numbers and mailing addresses of the ‘‘(a) REQUIREMENT— ‘‘(C) any cost-sharing requirements for appropriate authority), and a description of ‘‘(1) DISCLOSURE.— out-of-network benefits or services received any additional legal rights and remedies ‘‘(A) IN GENERAL.—A group health plan, from nonparticipating providers; and available under section 502. and a health insurance issuer that provides ‘‘(D) any additional cost-sharing or charges ‘‘(13) ADVANCE DIRECTIVES AND ORGAN DONA- coverage in connection with group health in- for benefits and services that are furnished TION.—A description of procedures for ad- surance coverage, shall provide for the dis- without meeting applicable plan or coverage vance directives and organ donation deci- closure of the information described in sub- requirements, such as prior authorization or sions if the plan or issuer maintains such section (b) to participants and precertification. procedures. beneficiaries— ‘‘(3) SERVICE AREA.—A description of the ‘‘(14) INFORMATION ON PLANS AND ISSUERS.— ‘‘(i) at the time of the initial enrollment of plan or issuer’s service area, including the The name, mailing address, and telephone the participant or beneficiary under the plan provision of any out-of-area coverage. number or numbers of the plan adminis- or coverage; ‘‘(4) PARTICIPATING PROVIDERS.—A direc- trator and the issuer to be used by partici- ‘‘(ii) on an annual basis after enrollment— tory of participating providers (to the extent pants and beneficiaries seeking information ‘‘(I) in conjunction with the election period a plan or issuer provides coverage through a about plan or coverage benefits and services, of the plan or coverage if the plan or cov- network of providers) that includes, at a payment of a claim, or authorization for erage has such an election period; or minimum, the name, address, and telephone services and treatment. The name of the des- ‘‘(II) in the case of a plan or coverage that number of each participating provider, and ignated decision-maker (or decision-makers) does not have an election period, in conjunc- information about how to inquire whether a appointed under section 502(n)(2) for purposes tion with the beginning of the plan or cov- participating provider is currently accepting of making final determinations under sec- erage year; and new patients. tion 503A and approving coverage pursuant ‘‘(iii) in the case of any material reduction ‘‘(5) CHOICE OF PRIMARY CARE PROVIDER.—A to the written determination of an inde- to the benefits or information described in description of any requirements and proce- pendent medical reviewer under section 503B. paragraphs (1), (2) and (3) of subsection (b), in dures to be used by participants and bene- Notice of whether the benefits under the the form of a summary notice provided not ficiaries in selecting, accessing, or changing plan are provided under a contract or policy later than the date on which the reduction their primary care provider, including pro- of insurance issued by an issuer, or whether takes effect. viders both within and outside of the net- benefits are provided directly by the plan ‘‘(B) PARTICIPANTS AND BENEFICIARIES.— work (if the plan or issuer permits out-of- sponsor who bears the insurance risk. The disclosure required under subparagraph network services), and the right to select a ‘‘(15) TRANSLATION SERVICES.—A summary (A) shall be provided— pediatrician as a primary care provider description of any translation or interpreta- ‘‘(i) jointly to each participant and bene- under section 724 for a participant or bene- tion services (including the availability of ficiary who reside at the same address; or ficiary who is a child if such section applies. printed information in languages other than ‘‘(ii) in the case of a beneficiary who does ‘‘(6) PREAUTHORIZATION REQUIREMENTS.—A English, audio tapes, or information in not reside at the same address as the partici- description of the requirements and proce- Braille) that are available for non-English pant, separately to the participant and such dures to be used to obtain preauthorization speakers and participants and beneficiaries beneficiary. for health services, if such preauthorization with communication disabilities and a de- ‘‘(2) RULE OF CONSTRUCTION.—Nothing in is required. scription of how to access these items or this section shall be construed to prevent a ‘‘(7) EXPERIMENTAL AND INVESTIGATIONAL services. group health plan sponsor and health insur- TREATMENTS.—A description of the process ‘‘(16) ACCREDITATION INFORMATION.—Any in- ance issuer from entering into an agreement for determining whether a particular item, formation that is made public by accrediting under which either the plan sponsor or the service, or treatment is considered experi- organizations in the process of accreditation issuer agrees to assume responsibility for mental or investigational, and the cir- if the plan or issuer is accredited, or any ad- compliance with the requirements of this cumstances under which such treatments are ditional quality indicators (such as the re- section, in whole or in part, and the party covered by the plan or issuer. sults of enrollee satisfaction surveys) that delegating such responsibility is released ‘‘(8) SPECIALTY CARE.—A description of the the plan or issuer makes public or makes from liability for compliance with the re- requirements and procedures to be used by available to participants and beneficiaries. quirements that are assumed by the other participants and beneficiaries in accessing ‘‘(17) NOTICE OF REQUIREMENTS.—A descrip- party, to the extent the party delegating specialty care and obtaining referrals to par- tion of any rights of participants and bene- such responsibility did not cause such non- ticipating and nonparticipating specialists, ficiaries that are established by the Pa- compliance. including the right to timely coverage for tients’ Bill of Rights Plus Act (excluding ‘‘(3) PROVISION OF INFORMATION.—Informa- access to specialists care under section 725 if those described in paragraphs (1) through tion shall be provided to participants and such section applies. (16)) if such sections apply. The description beneficiaries under this section at the last ‘‘(9) CLINICAL TRIALS.—A description the required under this paragraph may be com- known address maintained by the plan or circumstances and conditions under which bined with the notices required under sec- issuer with respect to such participants or participation in clinical trials is covered tions 711(d), 713(b), or 606(a)(1), and with any June 29, 2000 CONGRESSIONAL RECORD — SENATE S6165 other notice provision that the Secretary de- pant and beneficiary with respect to which ‘‘SEC. 503A. CLAIMS AND INTERNAL APPEALS termines may be combined. the failure to comply with the requirements PROCEDURES FOR GROUP HEALTH PLANS. ‘‘(18) AVAILABILITY OF ADDITIONAL INFORMA- of this section occurs. ‘‘(a) INITIAL CLAIM FOR BENEFITS UNDER TION.—A statement that the information de- ‘‘(B) INCREASE IN AMOUNT.—The amount re- scribed in subsection (c), and instructions on ferred to in subparagraph (A) shall be in- GROUP HEALTH PLANS.— obtaining such information (including tele- creased or decreased, for each calendar year ‘‘(1) PROCEDURES.— phone numbers and, if available, Internet that ends after December 31, 2000, by the ‘‘(A) IN GENERAL.—A group health plan, or health insurance issuer offering health insur- websites), shall be made available upon re- same percentage as the percentage by which ance coverage in connection with a group quest. the medical care expenditure category of the health plan, shall ensure that procedures are ‘‘(c) ADDITIONAL INFORMATION.—The infor- Consumer Price Index for All Urban Con- in place for— mational materials to be provided upon the sumers (United States city average), pub- ‘‘(i) making a determination on an initial request of a participant or beneficiary shall lished by the Bureau of Labor Statistics, for claim for benefits by a participant or bene- include for each option available under a September of the preceding calendar year ficiary (or authorized representative) regard- group health plan or health insurance cov- has increased or decreased from the such ing payment or coverage for items or serv- erage the following: Index for September of 2000. ices under the terms and conditions of the ‘‘(1) STATUS OF PROVIDERS.—The State li- ‘‘(3) FAILURE DEFINED.—For purposes of plan or coverage involved, including any censure status of the plan or issuer’s partici- this subsection, a plan or issuer shall have cost-sharing amount that the participant or pating health care professionals and partici- failed to comply with the requirements of pating health care facilities, and, if avail- beneficiary is required to pay with respect to this section with respect to a participant or such claim for benefits; and able, the education, training, specialty beneficiary if the plan or issuer failed or re- qualifications or certifications of such pro- ‘‘(ii) notifying a participant or beneficiary fused to comply with the requirements of (or authorized representative) and the treat- fessionals. this section within 30 days— ing health care professional involved regard- ‘‘(2) COMPENSATION METHODS.—A summary ‘‘(A) of the date described in subsection ing a determination on an initial claim for description of the methods (such as capita- (a)(1)(A)(i); benefits made under the terms and condi- tion, fee-for-service, salary, bundled pay- ‘‘(B) of the date described in subsection tions of the plan or coverage, including any ments, per diem, or a combination thereof) (a)(1)(A)(ii); or cost-sharing amounts that the participant or used for compensating participating health ‘‘(C) of the date on which additional infor- beneficiary may be required to make with care professionals (including primary care mation was requested under subsection (c).’’. respect to such claim for benefits, and of the providers and specialists) and facilities in (b) CONFORMING AMENDMENTS.— right of the participant or beneficiary to an connection with the provision of health care (1) Section 732(a) of the Employee Retire- internal appeal under subsection (b). under the plan or coverage. The requirement ment Income Security Act of 1974 (29 U.S.C. ‘‘(B) ACCESS TO INFORMATION.—With respect of this paragraph shall not be construed as 1191a(a)) is amended by striking ‘‘section to an initial claim for benefits, the partici- requiring plans or issuers to provide infor- 711’’ and inserting ‘‘sections 711 and 714’’. pant or beneficiary (or authorized represent- mation concerning proprietary payment (2) The table of contents in section 1 of the ative) and the treating health care profes- methodology. Employee Retirement Income Security Act sional (if any) shall provide the plan or RESCRIPTION DRUGS.—Information ‘‘(3) P of 1974 (29 U.S.C. 1001) is amended by insert- issuer with access to information necessary about whether a specific prescription medi- ing after the item relating to section 713, the to make a determination relating to the cation is included in the formulary of the following: claim, not later than 5 business days after plan or issuer, if the plan or issuer uses a de- the date on which the claim is filed or to ‘‘Sec 714. Health plan comparative informa- fined formulary. meet the applicable timelines under clauses tion.’’. ‘‘(4) EXTERNAL APPEALS INFORMATION.—Ag- (ii) and (iii) of paragraph (2)(A). gregate information on the number and out- (3) Section 502(b)(3) of the Employee Re- ‘‘(C) ORAL REQUESTS.—In the case of a comes of external medical reviews, relative tirement Income Security Act of 1974 (29 claim for benefits involving an expedited or to the sample size (such as the number of U.S.C. 1132(b)(3)) is amended by striking concurrent determination, a participant or covered lives) determined for the plan or ‘‘733(a)(1))’’ and inserting ‘‘733(a)(1)), except beneficiary (or authorized representative) issuer’s book of business. with respect to the requirements of section may make an initial claim for benefits oral- ‘‘(d) MANNER OF DISCLOSURE.—The infor- 714’’. ly, but a group health plan, or health insur- mation described in this section shall be dis- ance issuer offering health insurance cov- closed in an accessible medium and format SEC. 212. INFORMATION ABOUT PROVIDERS. erage in connection with a group health that is calculated to be understood by the (a) STUDY.—The Secretary of Health and average participant. plan, may require that the participant or Human Services shall enter into a contract beneficiary (or authorized representative) ‘‘(e) RULES OF CONSTRUCTION.—Nothing in with the Institute of Medicine for the con- this section shall be construed to prohibit a provide written confirmation of such request duct of a study, and the submission to the in a timely manner. group health plan, or a health insurance Secretary of a report, that includes— ‘‘(2) TIMELINE FOR MAKING DETERMINA- issuer in connection with group health insur- (1) an analysis of information concerning TIONS.— ance coverage, from— health care professionals that is currently ‘‘(A) PRIOR AUTHORIZATION DETERMINA- ‘‘(1) distributing any other additional in- available to patients, consumers, States, and TION.— formation determined by the plan or issuer professional societies, nationally and on a to be important or necessary in assisting ‘‘(i) IN GENERAL.—A group health plan, or State-by-State basis, including patient pref- health insurance issuer offering health insur- participants and beneficiaries in the selec- erences with respect to information about tion of a health plan; and ance coverage in connection with a group such professionals and their competencies; health plan, shall maintain procedures to en- ‘‘(2) complying with the provisions of this (2) an evaluation of the legal and other section by providing information in bro- sure that a prior authorization determina- barriers to the sharing of information con- tion on a claim for benefits is made within 14 chures, through the Internet or other elec- cerning health care professionals; and tronic media, or through other similar business days from the date on which the (3) recommendations for the disclosure of plan or issuer receives information that is means, so long as participants and bene- information on health care professionals, in- ficiaries are provided with an opportunity to reasonably necessary to enable the plan or cluding the competencies and professional issuer to make a determination on the re- request that informational materials be pro- qualifications of such practitioners, to better vided in printed form. quest for prior authorization, but in no case facilitate patient choice, quality improve- shall such determination be made later than ‘‘(f) CONFORMING REGULATIONS.—The Sec- ment, and market competition. retary shall issue regulations to coordinate 28 business days after the receipt of the the requirements on group health plans and (b) REPORT.—Not later than 18 months claim for benefits. health insurance issuers under this section after the date of enactment of this Act, the ‘‘(ii) EXPEDITED DETERMINATION.—Notwith- with the requirements imposed under part 1, Secretary of Health and Human Services standing clause (i), a group health plan, or to reduce duplication with respect to any in- shall forward to the appropriate committees health insurance issuer offering health insur- formation that is required to be provided of Congress a copy of the report and study ance coverage in connection with a group under any such requirements. conducted under subsection (a). health plan, shall maintain procedures for ‘‘(g) SECRETARIAL ENFORCEMENT AUTHOR- Subtitle C—Right to Hold Health Plans expediting a prior authorization determina- ITY.— Accountable tion on a claim for benefits described in such ‘‘(1) IN GENERAL.—The Secretary may as- clause when a request for such an expedited sess a civil monetary penalty against the ad- SEC. 221. AMENDMENTS TO EMPLOYEE RETIRE- determination is made by a participant or ministrator of a plan or issuer in connection MENT INCOME SECURITY ACT OF beneficiary (or authorized representative) at with the failure of the plan or issuer to com- 1974. any time during the process for making a de- ply with the requirements of this section. (a) IN GENERAL.—Part 5 of subtitle B of termination and the treating health care ‘‘(2) AMOUNT OF PENALTY.— title I of the Employee Retirement Income professional substantiates, with the request, ‘‘(A) IN GENERAL.—The amount of the pen- Security Act of 1974 is amended by inserting that a determination under the procedures alty to be imposed under paragraph (1) shall after section 503 (29 U.S.C. 1133) the fol- described in clause (i) would seriously jeop- not exceed $100 for each day for each partici- lowing: ardize the life or health of the participant or S6166 CONGRESSIONAL RECORD — SENATE June 29, 2000 beneficiary. Such determination shall be ceed directly to external review under sec- 60 business days after the receipt of the re- made within 72 hours after a request is re- tion 503B. quest for the appeal. ceived by the plan or issuer under this ‘‘(2) TIMELINES FOR MAKING DETERMINA- ‘‘(3) CONDUCT OF REVIEW.— clause. TIONS.— ‘‘(A) IN GENERAL.—A review of a denial of a ‘‘(iii) CONCURRENT DETERMINATIONS.—A ‘‘(A) ORAL REQUESTS.—In the case of an ap- claim for benefits under this subsection shall group health plan, or health insurance issuer peal of a denial of a claim for benefits under be conducted by an individual with appro- offering health insurance coverage in con- this subsection that involves an expedited or priate expertise who was not directly in- nection with a group health plan, shall main- concurrent determination, a participant or volved in the initial determination. tain procedures to ensure that a concurrent beneficiary (or authorized representative) ‘‘(B) REVIEW OF MEDICAL DECISIONS BY PHY- determination on a claim for benefits that may request such appeal orally, but a group SICIANS.—A review of an appeal of a denial of results in a discontinuation of inpatient care health plan, or health insurance issuer offer- a claim for benefits that is based on a lack is made within 24 hours after the receipt of ing health insurance coverage in connection of medical necessity and appropriateness, or the claim for benefits. with a group health plan, may require that based on an experimental or investigational ‘‘(B) RETROSPECTIVE DETERMINATION.—A the participant or beneficiary (or authorized treatment, or requires an evaluation of med- group health plan, or health insurance issuer representative) provide written confirmation ical facts, shall be made by a physician with offering health insurance coverage in con- of such request in a timely manner. appropriate expertise, including age-appro- nection with a group health plan, shall main- ‘‘(B) ACCESS TO INFORMATION.—With respect priate expertise, who was not involved in the tain procedures to ensure that a retrospec- to an appeal of a denial of a claim for bene- initial determination. tive determination on a claim for benefits is fits, the participant or beneficiary (or au- ‘‘(4) NOTICE OF DETERMINATION.— made within 30 business days of the date on thorized representative) and the treating ‘‘(A) IN GENERAL.—Written notice of a de- which the plan or issuer receives information health care professional (if any) shall pro- termination made under an internal appeal that is reasonably necessary to enable the vide the plan or issuer with access to infor- of a denial of a claim for benefits shall be plan or issuer to make a determination on mation necessary to make a determination issued to the participant or beneficiary (or the claim, but in no case shall such deter- relating to the appeal, not later than 5 busi- authorized representative) and the treating mination be made later than 60 business days ness days after the date on which the request health care professional not later than 2 after the receipt of the claim for benefits. for the appeal is filed or to meet the applica- business days after the completion of the re- ‘‘(3) NOTICE OF A DENIAL OF A CLAIM FOR ble timelines under clauses (ii) and (iii) of view (or within the 72-hour or 24-hour period BENEFITS.—Written notice of a denial made subparagraph (C). referred to in paragraph (2) if applicable). under an initial claim for benefits shall be ‘‘(C) PRIOR AUTHORIZATION DETERMINA- ‘‘(B) FINAL DETERMINATION.—The decision issued to the participant or beneficiary (or TIONS.— by a plan or issuer under this subsection authorized representative) and the treating ‘‘(i) IN GENERAL.—A group health plan, or shall be treated as the final determination of health care professional not later than 2 health insurance issuer offering health insur- the plan or issuer on a denial of a claim for business days after the determination (or ance coverage in connection with a group benefits. The failure of a plan or issuer to within the 72-hour or 24-hour period referred health plan, shall maintain procedures to en- issue a determination on an appeal of a de- to in clauses (ii) and (iii) of paragraph (2)(A) sure that a determination on an appeal of a nial of a claim for benefits under this sub- if applicable). denial of a claim for benefits under this sub- section within the applicable timeline estab- ‘‘(4) REQUIREMENTS OF NOTICE OF DETER- section is made within 14 business days after lished for such a determination shall be MINATIONS.—The written notice of a denial of the date on which the plan or issuer receives treated as a final determination on an appeal a claim for benefits determination under information that is reasonably necessary to of a denial of a claim for benefits for pur- paragraph (3) shall include— enable the plan or issuer to make a deter- poses of proceeding to external review under ‘‘(A) the reasons for the determination (in- mination on the appeal, but in no case shall section 503B. cluding a summary of the clinical or sci- such determination be made later than 28 ‘‘(C) REQUIREMENTS OF NOTICE.—With re- entific-evidence based rationale used in mak- business days after the receipt of the request spect to a determination made under this ing the determination and instruction on ob- for the appeal. subsection, the notice described in subpara- taining a more complete description written ‘‘(ii) EXPEDITED DETERMINATION.—Notwith- graph (A) shall include— in a manner calculated to be understood by standing clause (i), a group health plan, or ‘‘(i) the reasons for the determination (in- the average participant); health insurance issuer offering health insur- cluding a summary of the clinical or sci- ‘‘(B) the procedures for obtaining addi- ance coverage in connection with a group entific-evidence based rationale used in mak- tional information concerning the deter- health plan, shall maintain procedures for ing the determination and instruction on ob- mination; and expediting a prior authorization determina- taining a more complete description written ‘‘(C) notification of the right to appeal the tion on an appeal of a denial of a claim for in a manner calculated to be understood by determination and instructions on how to benefits described in clause (i), when a re- the average participant); initiate an appeal in accordance with sub- quest for such an expedited determination is ‘‘(ii) the procedures for obtaining addi- section (b). made by a participant or beneficiary (or au- tional information concerning the deter- ‘‘(b) INTERNAL APPEAL OF A DENIAL OF A thorized representative) at any time during mination; and CLAIM FOR BENEFITS.— the process for making a determination and ‘‘(iii) notification of the right to an inde- ‘‘(1) RIGHT TO INTERNAL APPEAL.— the treating health care professional sub- pendent external review under section 503B ‘‘(A) IN GENERAL.—A participant or bene- stantiates, with the request, that a deter- and instructions on how to initiate such a re- ficiary (or authorized representative) may mination under the procedures described in view. appeal any denial of a claim for benefits clause (i) would seriously jeopardize the life ‘‘(c) DEFINITIONS.—The definitions con- under subsection (a) under the procedures de- or health of the participant or beneficiary. tained in section 503B(i) shall apply for pur- scribed in this subsection. Such determination shall be made not later poses of this section. ‘‘(B) TIME FOR APPEAL.—A group health than 72 hours after the request for such ap- ‘‘SEC. 503B. INDEPENDENT EXTERNAL APPEALS plan, or health insurance issuer offering peal is received by the plan or issuer under PROCEDURES FOR GROUP HEALTH health insurance coverage in connection this clause. PLANS. with a group health plan, shall ensure that a ‘‘(iii) CONCURRENT DETERMINATIONS.—A ‘‘(a) RIGHT TO EXTERNAL APPEAL.—A group participant or beneficiary (or authorized rep- group health plan, or health insurance issuer health plan, and a health insurance issuer of- resentative) has a period of not less than 60 offering health insurance coverage in con- fering health insurance coverage in connec- days beginning on the date of a denial of a nection with a group health plan, shall main- tion with a group health plan, shall provide claim for benefits under subsection (a) in tain procedures to ensure that a concurrent in accordance with this section participants which to appeal such denial under this sub- determination on an appeal of a denial of a and beneficiaries (or authorized representa- section. claim for benefits that results in a dis- tives) with access to an independent external ‘‘(C) FAILURE TO ACT.—The failure of a plan continuation of inpatient care is made with- review for any denial of a claim for benefits. or issuer to issue a determination on a claim in 24 hours after the receipt of the request ‘‘(b) INITIATION OF THE INDEPENDENT EXTER- for benefits under subsection (a) within the for appeal. NAL REVIEW PROCESS.— applicable timeline established for such a de- ‘‘(B) RETROSPECTIVE DETERMINATION.—A ‘‘(1) TIME TO FILE.—A request for an inde- termination under such subsection shall be group health plan, or health insurance issuer pendent external review under this section treated as a denial of a claim for benefits for offering health insurance coverage in con- shall be filed with the plan or issuer not purposes of proceeding to internal review nection with a group health plan, shall main- later than 60 business days after the date on under this subsection. tain procedures to ensure that a retrospec- which the participant or beneficiary receives ‘‘(D) PLAN WAIVER OF INTERNAL REVIEW.—A tive determination on an appeal of a claim notice of the denial under section 503A(b)(4) group health plan, or health insurance issuer for benefits is made within 30 business days or the date on which the internal review is offering health insurance coverage in con- of the date on which the plan or issuer re- waived by the plan or issuer under section nection with a group health plan, may waive ceives necessary information that is reason- 503A(b)(1)(D). the internal review process under this sub- ably required by the plan or issuer to make ‘‘(2) FILING OF REQUEST.— section and permit a participant or bene- a determination on the appeal, but in no case ‘‘(A) IN GENERAL.—Subject to the suc- ficiary (or authorized representative) to pro- shall such determination be made later than ceeding provisions of this subsection, a group June 29, 2000 CONGRESSIONAL RECORD — SENATE S6167 health plan, and a health insurance issuer of- plan or issuer, and the treating health care not make a referral to an independent med- fering health insurance coverage in connec- professional (if any) shall provide the exter- ical reviewer, the entity shall provide notice tion with a group health plan, may— nal review entity with access to information to the plan or issuer, the participant or bene- ‘‘(i) except as provided in subparagraph that is necessary to conduct a review under ficiary (or authorized representative) filing (B)(i), require that a request for review be in this section, as determined by the entity, the request, and the treating health care writing; not later than 5 business days after the date professional (if any) that the denial is not ‘‘(ii) limit the filing of such a request to on which a request is referred to the quali- subject to independent medical review. Such the participant or beneficiary involved (or fied external review entity under paragraph notice— an authorized representative); (1), or earlier as determined appropriate by ‘‘(I) shall be written (and, in addition, may ‘‘(iii) except if waived by the plan or issuer the entity to meet the applicable timelines be provided orally) in a manner calculated to under section 503A(b)(1)(D), condition access under clauses (ii) and (iii) of subsection be understood by an average participant; to an independent external review under this (e)(1)(A). ‘‘(II) shall include the reasons for the de- section upon a final determination of a de- ‘‘(3) SCREENING OF REQUESTS BY QUALIFIED termination; and nial of a claim for benefits under the inter- EXTERNAL REVIEW ENTITIES.— ‘‘(III) include any relevant terms and con- nal review procedure under section 503A; ‘‘(A) IN GENERAL.—With respect to a re- ditions of the plan or coverage. ‘‘(iv) except as provided in subparagraph quest referred to a qualified external review ‘‘(ii) GENERAL TIMELINE FOR DETERMINA- (B)(ii), require payment of a filing fee to the entity under paragraph (1) relating to a de- TIONS.—Upon receipt of information under plan or issuer of a sum that does not exceed nial of a claim for benefits, the entity shall paragraph (2), the qualified external review $50; and refer such request for the conduct of an inde- entity, and if required the independent med- ‘‘(v) require that a request for review in- pendent medical review unless the entity de- ical reviewer, shall make a determination clude the consent of the participant or bene- termines that— within the overall timeline that is applicable ficiary (or authorized representative) for the ‘‘(i) any of the conditions described in sub- to the case under review as described in sub- release of medical information or records of section (b)(2)(A) have not been met; section (e), except that if the entity deter- the participant or beneficiary to the quali- ‘‘(ii) the thresholds described in subpara- mines that a referral to an independent med- fied external review entity for purposes of graph (B) have not been met; ical reviewer is not required, the entity shall conducting external review activities. ‘‘(iii) the denial of the claim for benefits provide notice of such determination to the ‘‘(B) REQUIREMENTS AND EXCEPTION RELAT- does not involve a medically reviewable deci- participant or beneficiary (or authorized rep- ING TO GENERAL RULE.— sion under subsection (d)(2); resentative) within 2 business days of such ‘‘(i) ORAL REQUESTS PERMITTED IN EXPE- ‘‘(iv) the denial of the claim for benefits re- determination. DITED OR CONCURRENT CASES.—In the case of lates to a decision regarding whether an in- an expedited or concurrent external review dividual is a participant or beneficiary who ‘‘(d) INDEPENDENT MEDICAL REVIEW.— as provided for under subsection (e), the re- is enrolled under the terms of the plan or ‘‘(1) IN GENERAL.—If a qualified external re- quest may be made orally. In such case a coverage (including the applicability of any view entity determines under subsection (c) written confirmation of such request shall be waiting period under the plan or coverage); that a denial of a claim for benefits is eligi- made in a timely manner. Such written con- or ble for independent medical review, the enti- firmation shall be treated as a consent for ‘‘(v) the denial of the claim for benefits is ty shall refer the denial involved to an inde- purposes of subparagraph (A)(v). a decision as to the application of cost-shar- pendent medical reviewer for the conduct of ‘‘(ii) EXCEPTION TO FILING FEE REQUIRE- ing requirements or the application of a spe- an independent medical review under this MENT.— cific exclusion or express limitation on the subsection. ‘‘(I) INDIGENCY.—Payment of a filing fee amount, duration, or scope of coverage of ‘‘(2) MEDICALLY REVIEWABLE DECISIONS.—A shall not be required under subparagraph items or services under the terms and condi- denial described in this paragraph is one for (A)(iv) where there is a certification (in a tions of the plan or coverage unless the deci- which the item or service that is the subject form and manner specified in guidelines es- sion is a denial described in subsection of the denial would be a covered benefit tablished by the Secretary) that the partici- (d)(2)(C); under the terms and conditions of the plan pant or beneficiary is indigent (as defined in Upon making a determination that any of or coverage but for one (or more) of the fol- such guidelines). In establishing guidelines clauses (i) through (v) applies with respect to lowing determinations: under this subclause, the Secretary shall en- the request, the entity shall determine that ‘‘(A) DENIALS BASED ON MEDICAL NECESSITY sure that the guidelines relating to the denial of a claim for benefits involved is AND APPROPRIATENESS.—The basis of the de- indigency are consistent with the poverty not eligible for independent medical review termination is that the item or service is not guidelines used by the Secretary of Health under subsection (d), and shall provide notice medically necessary and appropriate. and Human Services under title XIX of the in accordance with subparagraph (D). ‘‘(B) DENIALS BASED ON EXPERIMENTAL OR Social Security Act. ‘‘(B) THRESHOLDS.— INVESTIGATIONAL TREATMENT.—The basis of ‘‘(II) FEE NOT REQUIRED.—Payment of a fil- ‘‘(i) IN GENERAL.—The thresholds described the determination is that the item or service ing fee shall not be required under subpara- in this subparagraph are that— is experimental or investigational. graph (A)(iv) if the plan or issuer waives the ‘‘(I) the total amount payable under the ‘‘(C) DENIALS OTHERWISE BASED ON AN EVAL- internal appeals process under section plan or coverage for the item or service that UATION OF MEDICAL FACTS.—A determination 503A(b)(1)(D). was the subject of such denial exceeds a sig- that the item or service or condition is not ‘‘(III) REFUNDING OF FEE.—The filing fee nificant financial threshold (as determined covered but an evaluation of the medical paid under subparagraph (A)(iv) shall be re- under guidelines established by the Sec- facts by a health care professional in the spe- funded if the determination under the inde- retary); or cific case involved is necessary to determine pendent external review is to reverse the de- ‘‘(II) a physician has asserted in writing whether the item or service or condition is nial which is the subject of the review. that there is a significant risk of placing the required to be provided under the terms and ‘‘(IV) INCREASE IN AMOUNT.—The amount life, health, or development of the partici- conditions of the plan or coverage. referred to in subclause (I) shall be increased pant or beneficiary in jeopardy if the denial ‘‘(3) INDEPENDENT MEDICAL REVIEW DETER- or decreased, for each calendar year that of the claim for benefits is sustained. MINATION.— ends after December 31, 2001, by the same ‘‘(ii) THRESHOLDS NOT APPLIED.—The ‘‘(A) IN GENERAL.—An independent medical percentage as the percentage by which the thresholds described in this subparagraph reviewer under this section shall make a new Consumer Price Index for All Urban Con- shall not apply if the plan or issuer involved independent determination with respect to— sumers (United States city average), pub- waives the internal appeals process with re- ‘‘(i) whether the item or service or condi- lished by the Bureau of Labor Statistics, for spect to the denial of a claim for benefits in- tion that is the subject of the denial is cov- September of the preceding calendar year volved under section 503A(b)(1)(D). ered under the terms and conditions of the has increased or decreased from the such ‘‘(C) PROCESS FOR MAKING DETERMINA- plan or coverage; and Index for September of 2001. TIONS.— ‘‘(ii) based upon an affirmative determina- ‘‘(c) REFERRAL TO QUALIFIED EXTERNAL RE- ‘‘(i) NO DEFERENCE TO PRIOR DETERMINA- tion under clause (i), whether or not the de- VIEW ENTITY UPON REQUEST.— TIONS.—In making determinations under sub- nial of a claim for a benefit that is the sub- ‘‘(1) IN GENERAL.—Upon the filing of a re- paragraph (A), there shall be no deference ject of the review should be upheld or re- quest for independent external review with given to determinations made by the plan or versed. the group health plan, or health insurance issuer under section 503A or the rec- ‘‘(B) STANDARD FOR DETERMINATION.—The issuer offering coverage in connection with a ommendation of a treating health care pro- independent medical reviewer’s determina- group health plan, the plan or issuer shall fessional (if any). tion relating to the medical necessity and refer such request to a qualified external re- ‘‘(ii) USE OF APPROPRIATE PERSONNEL.—A appropriateness, or the experimental or in- view entity selected in accordance with this qualified external review entity shall use ap- vestigation nature, or the evaluation of the section. propriately qualified personnel to make de- medical facts of the item, service, or condi- ‘‘(2) ACCESS TO PLAN OR ISSUER AND HEALTH terminations under this section. tion shall be based on the medical condition PROFESSIONAL INFORMATION.—With respect to ‘‘(D) NOTICES AND GENERAL TIMELINES FOR of the participant or beneficiary (including an independent external review conducted DETERMINATION.— the medical records of the participant or under this section, the participant or bene- ‘‘(i) NOTICE IN CASE OF DENIAL OF REFER- beneficiary) and the valid, relevant scientific ficiary (or authorized representative), the RAL.—If the entity under this paragraph does evidence and clinical evidence, including S6168 CONGRESSIONAL RECORD — SENATE June 29, 2000

peer-reviewed medical literature or findings ‘‘(A) PRIOR AUTHORIZATION DETERMINA- ‘‘(B) COMPLIANCE WITH DETERMINATION.—If and including expert consensus. TION.— the determination of an independent medical ‘‘(C) NO COVERAGE FOR EXCLUDED BENE- ‘‘(i) IN GENERAL.—The independent medical reviewer is to reverse the denial, the plan or FITS.—Nothing in this subsection shall be reviewer (or reviewers) shall make a deter- issuer, upon the receipt of such determina- construed to permit an independent medical mination on a denial of a claim for benefits tion, shall authorize coverage to comply reviewer to require that a group health plan, that is referred to the reviewer under sub- with the medical reviewer’s determination in or health insurance issuer offering health in- section (c)(3) not later than 14 business days accordance with the timeframe established surance coverage in connection with a group after the receipt of information under sub- by the medical reviewer. health plan, provide coverage for items or section (c)(2) if the review involves a prior ‘‘(2) FAILURE TO COMPLY.—If a plan or services that are specifically excluded or ex- authorization of items or services. issuer fails to comply with the timeframe es- pressly limited under the plan or coverage ‘‘(ii) EXPEDITED DETERMINATION.—Notwith- tablished under paragraph (1)(B)(i) with re- and that are not covered regardless of any standing clause (i), the independent medical spect to a participant or beneficiary, where determination relating to medical necessity reviewer (or reviewers) shall make an expe- such failure to comply is caused by the plan and appropriateness, experimental or inves- dited determination on a denial of a claim or issuer, the participant or beneficiary may tigational nature of the treatment, or an for benefits described in clause (i), when a re- obtain the items or services involved (in a evaluation of the medical facts in the case quest for such an expedited determination is manner consistent with the determination of involved. made by a participant or beneficiary (or au- the independent external reviewer) from any ‘‘(D) EVIDENCE AND INFORMATION TO BE USED thorized representative) at any time during provider regardless of whether such provider the process for making a determination, and IN MEDICAL REVIEWS.—In making a deter- is a participating provider under the plan or the treating health care professional sub- mination under this subsection, the inde- coverage. stantiates, with the request, that a deter- pendent medical reviewer shall also consider ‘‘(3) REIMBURSEMENT.— mination under the timeline described in appropriate and available evidence and infor- ‘‘(A) IN GENERAL.—Where a participant or clause (i) would seriously jeopardize the life mation, including the following: beneficiary obtains items or services in ac- ‘‘(i) The determination made by the plan or or health of the participant or beneficiary. Such determination shall be made not later cordance with paragraph (2), the plan or issuer with respect to the claim upon inter- issuer involved shall provide for reimburse- nal review and the evidence or guidelines than 72 hours after the receipt of informa- tion under subsection (c)(2). ment of the costs of such items of services. used by the plan or issuer in reaching such Such reimbursement shall be made to the determination. ‘‘(iii) CONCURRENT DETERMINATION.—Not- withstanding clause (i), a review described in treating health care professional or to the ‘‘(ii) The recommendation of the treating participant or beneficiary (in the case of a health care professional and the evidence, such subclause shall be completed not later than 24 hours after the receipt of informa- participant or beneficiary who pays for the guidelines, and rationale used by the treat- costs of such items or services). ing health care professional in reaching such tion under subsection (c)(2) if the review in- ‘‘(B) AMOUNT.—The plan or issuer shall recommendation. volves a discontinuation of inpatient care. ‘‘(B) RETROSPECTIVE DETERMINATION.—The fully reimburse a professional, participant or ‘‘(iii) Additional evidence or information beneficiary under subparagraph (A) for the obtained by the reviewer or submitted by the independent medical reviewer (or reviewers) shall complete a review in the case of a ret- total costs of the items or services provided plan, issuer, participant or beneficiary (or an rospective determination on an appeal of a (regardless of any plan limitations that may authorized representative), or treating denial of a claim for benefits that is referred apply to the coverage of such items of serv- health care professional. to the reviewer under subsection (c)(3) not ices) so long as— ‘‘(iv) The plan or coverage document. later than 30 business days after the receipt ‘‘(i) the items or services would have been ‘‘(E) INDEPENDENT DETERMINATION.—In of information under subsection (c)(2). covered under the terms of the plan or cov- making the determination, the independent ‘‘(2) NOTIFICATION OF DETERMINATION.—The erage if provided by the plan or issuer; and medical reviewer shall— external review entity shall ensure that the ‘‘(ii) the items or services were provided in ‘‘(i) consider the claim under review with- plan or issuer, the participant or beneficiary a manner consistent with the determination out deference to the determinations made by (or authorized representative) and the treat- of the independent medical reviewer. the plan or issuer under section 503A or the ing health care professional (if any) receives ‘‘(4) FAILURE TO REIMBURSE.—Where a plan recommendation of the treating health care a copy of the written determination of the or issuer fails to provide reimbursement to a professional (if any); independent medical reviewer prepared professional, participant or beneficiary in ‘‘(ii) consider, but not be bound by the defi- under subsection (d)(3)(F). Nothing in this nition used by the plan or issuer of ‘medi- accordance with this subsection, the profes- paragraph shall be construed as preventing sional, participant or beneficiary may com- cally necessary and appropriate’, or ‘experi- an entity or reviewer from providing an ini- mental or investigational’, or other equiva- mence a civil action (or utilize other rem- tial oral notice of the reviewer’s determina- edies available under law) to recover only lent terms that are used by the plan or issuer tion. to describe medical necessity and appro- the amount of any such reimbursement that ‘‘(3) FORM OF NOTICES.—Determinations is unpaid and any necessary legal costs or priateness or experimental or investiga- and notices under this subsection shall be tional nature of the treatment; and expenses (including attorneys’ fees) incurred written in a manner calculated to be under- in recovering such reimbursement. ‘‘(iii) notwithstanding clause (ii), adhere to stood by an average participant. the definition used by the plan or issuer of ‘‘(4) TERMINATION OF EXTERNAL REVIEW ‘‘(g) QUALIFICATIONS OF INDEPENDENT MED- ‘medically necessary and appropriate’, or PROCESS IF APPROVAL OF A CLAIM FOR BENE- ICAL REVIEWERS.— ‘experimental or investigational’ if such def- FITS DURING PROCESS.— ‘‘(1) IN GENERAL.—In referring a denial to 1 inition is the same as the definition of such ‘‘(A) IN GENERAL.—If a plan or issuer— or more individuals to conduct independent term— ‘‘(i) reverses a determination on a denial of medical review under subsection (c), the ‘‘(I) that has been adopted pursuant to a a claim for benefits that is the subject of an qualified external review entity shall ensure State statute or regulation; or external review under this section and au- that— ‘‘(II) that is used for purposes of the pro- thorizes coverage for the claim or provides ‘‘(A) each independent medical reviewer gram established under titles XVIII or XIX payment of the claim; and meets the qualifications described in para- of the Social Security Act or under chapter ‘‘(ii) provides notice of such reversal to the graphs (2) and (3); 89 of title 5, United States Code. participant or beneficiary (or authorized rep- ‘‘(B) with respect to each review at least 1 ‘‘(F) DETERMINATION OF INDEPENDENT MED- resentative) and the treating health care such reviewer meets the requirements de- ICAL REVIEWER.—An independent medical re- professional (if any), and the external review scribed in paragraphs (4) and (5); and viewer shall, in accordance with the dead- entity responsible for such review, ‘‘(C) compensation provided by the entity lines described in subsection (e), prepare a the external review process shall be termi- to the reviewer is consistent with paragraph written determination to uphold or reverse nated with respect to such denial and any fil- (6). the denial under review. Such written deter- ing fee paid under subsection (b)(2)(A)(iv) ‘‘(2) LICENSURE AND EXPERTISE.—Each inde- mination shall include the specific reasons of shall be refunded. pendent medical reviewer shall be a physi- the reviewer for such determination, includ- ‘‘(B) TREATMENT OF TERMINATION.—An au- cian or health care professional who— ing a summary of the clinical or scientific- thorization of coverage under subparagraph ‘‘(A) is appropriately credentialed or li- evidence based rationale used in making the (A) by the plan or issuer shall be treated as censed in 1 or more States to deliver health determination. The reviewer may provide a written determination to reverse a denial care services; and the plan or issuer and the treating health under section (d)(3)(F) for purposes of liabil- ‘‘(B) typically treats the diagnosis or con- care professional with additional rec- ity under section 502(n)(1)(B). dition or provides the type or treatment ommendations in connection with such a de- ‘‘(f) COMPLIANCE.— under review. termination, but any such recommendations ‘‘(1) APPLICATION OF DETERMINATIONS.— ‘‘(3) INDEPENDENCE.— shall not be treated as part of the determina- ‘‘(A) EXTERNAL REVIEW DETERMINATIONS ‘‘(A) IN GENERAL.—Subject to subparagraph tion. BINDING ON PLAN.—The determinations of an (B), each independent medical reviewer in a ‘‘(e) TIMELINES AND NOTIFICATIONS.— external review entity and an independent case shall— ‘‘(1) TIMELINES FOR INDEPENDENT MEDICAL medical reviewer under this section shall be ‘‘(i) not be a related party (as defined in REVIEW.— binding upon the plan or issuer involved. paragraph (7)); June 29, 2000 CONGRESSIONAL RECORD — SENATE S6169 ‘‘(ii) not have a material familial, finan- ‘‘(B) The participant or beneficiary (or au- a professional or trade association of plans cial, or professional relationship with such a thorized representative). or issuers or of health care providers. party; and ‘‘(C) The health care professional that pro- ‘‘(iii) The entity has provided assurances ‘‘(iii) not otherwise have a conflict of in- vides the items of services involved in the that it will conduct external review activi- terest with such a party (as determined denial. ties consistent with the applicable require- under regulations). ‘‘(D) The institution at which the items or ments of this section and standards specified ‘‘(B) EXCEPTION.—Nothing in this subpara- services (or treatment) involved in the de- in subparagraph (C), including that it will graph (A) shall be construed to— nial are provided. not conduct any external review activities in ‘‘(i) prohibit an individual, solely on the ‘‘(E) The manufacturer of any drug or a case unless the independence requirements basis of affiliation with the plan or issuer, other item that is included in the items or of subparagraph (B) are met with respect to from serving as an independent medical re- services involved in the denial. the case. viewer if— ‘‘(F) Any other party determined under ‘‘(iv) The entity has provided assurances ‘‘(I) a non-affiliated individual is not rea- any regulations to have a substantial inter- that it will provide information in a timely sonably available; est in the denial involved. manner under subparagraph (D). ‘‘(II) the affiliated individual is not in- ‘‘(h) QUALIFIED EXTERNAL REVIEW ENTI- ‘‘(v) The entity meets such other require- TIES.— volved in the provision of items or services ments as the Secretary provides by regula- ‘‘(1) SELECTION OF QUALIFIED EXTERNAL RE- in the case under review; and tion. VIEW ENTITIES.— ‘‘(III) the fact of such an affiliation is dis- ‘‘(B) INDEPENDENCE REQUIREMENTS.— ‘‘(A) LIMITATION ON PLAN OR ISSUER SELEC- ‘‘(i) IN GENERAL.—Subject to clause (ii), an closed to the plan or issuer and the partici- TION.—The Secretary shall implement proce- entity meets the independence requirements pant or beneficiary (or authorized represent- dures with respect to the selection of quali- of this subparagraph with respect to any ative) and neither party objects; fied external review entities by a plan or case if the entity— ‘‘(ii) prohibit an individual who has staff issuer to assure that the selection process ‘‘(I) is not a related party (as defined in privileges at the institution where the treat- among qualified external review entities will subsection (g)(7)); ment involved takes place from serving as an not create any incentives for external review ‘‘(II) does not have a material familial, fi- independent medical reviewer if the affili- entities to make a decision in a biased man- nancial, or professional relationship with ation is disclosed to the plan or issuer and ner. such a party; and the participant or beneficiary (or authorized ‘‘(B) STATE AUTHORITY WITH RESPECT TO ‘‘(III) does not otherwise have a conflict of representative), and neither party objects; QUALIFIED EXTERNAL REVIEW ENTITIES FOR interest with such a party (as determined ‘‘(iii) permit an employee of a plan or HEALTH INSURANCE ISSUERS.—With respect to under regulations). issuer, or an individual who provides services health insurance issuers offering health in- ‘‘(ii) EXCEPTION FOR REASONABLE COMPENSA- exclusively or primarily to or on behalf of a surance coverage in connection with a group TION.—Nothing in clause (i) shall be con- plan or issuer, from serving as an inde- health plan in a State, the State may, pursu- strued to prohibit receipt by a qualified ex- pendent medical reviewer; or ant to a State law that is enacted after the ternal review entity of compensation from a ‘‘(iv) prohibit receipt of compensation by date of enactment of the Patients’ Bill of plan or issuer for the conduct of external re- an independent medical reviewer from an en- Rights Plus Act, provide for the designation view activities under this section if the com- tity if the compensation is provided con- or selection of qualified external review enti- pensation is provided consistent with clause sistent with paragraph (6). ties in a manner determined by the State to (iii). ‘‘(4) PRACTICING HEALTH CARE PROFESSIONAL assure an unbiased determination in con- ‘‘(iii) LIMITATIONS ON ENTITY COMPENSA- IN SAME FIELD.— ducting external review activities. In con- TION.—Compensation provided by a plan or ‘‘(A) IN GENERAL.—The requirement of this ducting reviews under this section, an entity issuer to a qualified external review entity paragraph with respect to a reviewer in a designated or selected under this subpara- in connection with reviews under this sec- case involving treatment, or the provision of graph shall comply with the provision of this tion shall— items or services, by— section. ‘‘(I) not exceed a reasonable level; and ‘‘(i) a physician, is that the reviewer be a ‘‘(2) CONTRACT WITH QUALIFIED EXTERNAL ‘‘(II) not be contingent on the decision ren- practicing physician of the same or similar REVIEW ENTITY.—Except as provided in para- dered by the entity or by any independent specialty, when reasonably available, as a graph (1)(B), the external review process of a medical reviewer. physician who typically treats the diagnosis plan or issuer under this section shall be ‘‘(C) CERTIFICATION AND RECERTIFICATION or condition or provides such treatment in conducted under a contract between the plan PROCESS.— the case under review; or or issuer and 1 or more qualified external re- ‘‘(i) IN GENERAL.—The initial certification ‘‘(ii) a health care professional (other than view entities (as defined in paragraph (4)(A)). and recertification of a qualified external re- a physician), is that the reviewer be a prac- ‘‘(3) TERMS AND CONDITIONS OF CONTRACT.— view entity shall be made— ticing physician or, if determined appro- The terms and conditions of a contract under ‘‘(I) under a process that is recognized or priate by the qualified external review enti- paragraph (2) shall— approved by the Secretary; or ty, a health care professional (other than a ‘‘(A) be consistent with the standards the ‘‘(II) by a qualified private standard-set- physician), of the same or similar specialty Secretary shall establish to assure there is ting organization that is approved by the as the health care professional who typically no real or apparent conflict of interest in the Secretary under clause (iii). treats the diagnosis or condition or provides conduct of external review activities; and ‘‘(ii) PROCESS.—The Secretary shall not the treatment in the case under review. ‘‘(B) provide that the costs of the external recognize or approve a process under clause ‘‘(B) PRACTICING DEFINED.—For purposes of review process shall be borne by the plan or (i)(I) unless the process applies standards (as this paragraph, the term ‘practicing’ means, issuer. promulgated in regulations) that ensure that with respect to an individual who is a physi- Subparagraph (B) shall not be construed as a qualified external review entity— cian or other health care professional that applying to the imposition of a filing fee ‘‘(I) will carry out (and has carried out, in the individual provides health care services under subsection (b)(2)(A)(iv) or costs in- the case of recertification) the responsibil- to individual patients on average at least 1 curred by the participant or beneficiary (or ities of such an entity in accordance with day per week. authorized representative) or treating health this section, including meeting applicable ‘‘(5) AGE-APPROPRIATE EXPERTISE.—The care professional (if any) in support of the deadlines; independent medical reviewer shall have ex- review, including the provision of additional ‘‘(II) will meet (and has met, in the case of pertise under paragraph (2) that is age-appro- evidence or information. recertification) appropriate indicators of fis- priate to the participant or beneficiary in- ‘‘(4) QUALIFICATIONS.— cal integrity; volved. ‘‘(A) IN GENERAL.—In this section, the term ‘‘(III) will maintain (and has maintained, ‘‘(6) LIMITATIONS ON REVIEWER COMPENSA- ‘qualified external review entity’ means, in in the case of recertification) appropriate TION.—Compensation provided by a qualified relation to a plan or issuer, an entity that is confidentiality with respect to individually external review entity to an independent initially certified (and periodically recer- identifiable health information obtained in medical reviewer in connection with a re- tified) under subparagraph (C) as meeting the course of conducting external review ac- view under this section shall— the following requirements: tivities; and ‘‘(A) not exceed a reasonable level; and ‘‘(i) The entity has (directly or through ‘‘(IV) in the case recertification, shall re- ‘‘(B) not be contingent on the decision ren- contracts or other arrangements) sufficient view the matters described in clause (iv). dered by the reviewer. medical, legal, and other expertise and suffi- ‘‘(iii) APPROVAL OF QUALIFIED PRIVATE ‘‘(7) RELATED PARTY DEFINED.—For pur- cient staffing to carry out duties of a quali- STANDARD-SETTING ORGANIZATIONS.—For pur- poses of this section, the term ‘related party’ fied external review entity under this section poses of clause (i)(II), the Secretary may ap- means, with respect to a denial of a claim on a timely basis, including making deter- prove a qualified private standard-setting or- under a plan or coverage relating to a partic- minations under subsection (b)(2)(A) and pro- ganization if the Secretary finds that the or- ipant or beneficiary, any of the following: viding for independent medical reviews ganization only certifies (or recertifies) ex- ‘‘(A) The plan, plan sponsor, or issuer in- under subsection (d). ternal review entities that meet at least the volved, or any fiduciary, officer, director, or ‘‘(ii) The entity is not a plan or issuer or standards required for the certification (or employee of such plan, plan sponsor, or an affiliate or a subsidiary of a plan or recertification) of external review entities issuer. issuer, and is not an affiliate or subsidiary of under clause (ii). S6170 CONGRESSIONAL RECORD — SENATE June 29, 2000

‘‘(iv) CONSIDERATIONS IN RECERTIFI- ‘‘(E) LIMITATION ON LIABILITY.—No quali- concurrent review, second opinions, case CATIONS.—In conducting recertifications of a fied external review entity having a contract management, discharge planning, or retro- qualified external review entity under this with a plan or issuer, and no person who is spective review.’’. paragraph, the Secretary or organization employed by any such entity or who fur- (b) CONFORMING AMENDMENT.—The table of conducting the recertification shall review nishes professional services to such entity contents in section 1 of the Employee Retire- compliance of the entity with the require- (including as an independent medical re- ment Income Security Act of 1974 is amended ments for conducting external review activi- viewer), shall be held by reason of the per- by inserting after the item relating to sec- ties under this section, including the fol- formance of any duty, function, or activity tion 503 the following: lowing: required or authorized pursuant to this sec- ‘‘Sec. 503A. Claims and internal appeals pro- ‘‘(I) Provision of information under sub- tion, to be civilly liable under any law of the cedures for group health plans. paragraph (D). United States or of any State (or political ‘‘Sec. 503B. Independent external appeals ‘‘(II) Adherence to applicable deadlines subdivision thereof) if there was no actual procedures for group health (both by the entity and by independent med- malice or gross misconduct in the perform- plans.’’. ical reviewers it refers cases to). ance of such duty, function, or activity. (c) EFFECTIVE DATE.—The amendments ‘‘(III) Compliance with limitations on com- ‘‘(i) DEFINITIONS.—In this section: made by this section shall apply with respect pensation (with respect to both the entity ‘‘(1) AUTHORIZED REPRESENTATIVE.—The to plan years beginning on or after 2 years and independent medical reviewers it refers term ‘authorized representative’ means, with after the date of enactment of this Act. The cases to). respect to a participant or beneficiary— Secretary shall issue all regulations nec- ‘‘(IV) Compliance with applicable inde- ‘‘(A) a person to whom a participant or essary to carry out the amendments made by pendence requirements. beneficiary has given express written con- this section before the effective date thereof. ERIOD OF CERTIFICATION OR RECERTIFI sent to represent the participant or bene- ‘‘(v) P - SEC. 222. ENFORCEMENT. ficiary in any proceeding under this section; CATION.—A certification or recertification Section 502(c) of the Employee Retirement ‘‘(B) a person authorized by law to provide provided under this paragraph shall extend Income Security Act of 1974 (29 U.S.C. substituted consent for the participant or for a period not to exceed 5 years. 1132(c)) is amended by adding at the end the beneficiary; or ‘‘(vi) REVOCATION.—A certification or re- following: certification under this paragraph may be re- ‘‘(C) a family member of the participant or ‘‘(8) The Secretary may assess a civil pen- voked by the Secretary or by the organiza- beneficiary (or the estate of the participant alty against any plan of up to $10,000 for the or beneficiary) or the participant’s or bene- tion providing such certification upon a plan’s failure or refusal to comply with any ficiary’s treating health care professional showing of cause. deadline applicable under section 503B or any when the participant or beneficiary is unable ‘‘(D) PROVISION OF INFORMATION.— determination under such section, except to provide consent. ‘‘(i) IN GENERAL.—A qualified external re- that in any case in which treatment was not ‘‘(2) CLAIM FOR BENEFITS.—The term ‘claim view entity shall provide to the Secretary, in commenced by the plan in accordance with for benefits’ means any request by a partici- such manner and at such times as the Sec- the determination of an independent exter- retary may require, such information (relat- pant or beneficiary (or authorized represent- nal reviewer, the Secretary shall assess a ing to the denials which have been referred ative) for benefits (including requests that civil penalty of $10,000 against the plan and to the entity for the conduct of external re- are subject to authorization of coverage or the plan shall pay such penalty to the partic- view under this section) as the Secretary de- utilization review), for eligibility, or for pay- ipant or beneficiary involved.’’. termines appropriate to assure compliance ment in whole or in part, for an item or serv- with the independence and other require- ice under a group health plan or health in- Subtitle D—Remedies ments of this section to monitor and assess surance coverage offered by a health insur- SEC. 231. AVAILABILITY OF COURT REMEDIES. the quality of its external review activities ance issuer in connection with a group (a) IN GENERAL.—Section 502 of the Em- and lack of bias in making determinations. health plan. ployee Retirement Income Security Act of Such information shall include information ‘‘(3) GROUP HEALTH PLAN.—The term ‘group 1974 (29 U.S.C. 1132) is amended by adding at described in clause (ii) but shall not include health plan’ shall have the meaning given the end the following: individually identifiable medical informa- such term in section 733(a). In applying this ‘‘(n) CAUSE OF ACTION RELATING TO DENIAL tion. paragraph, excepted benefits described in OF A CLAIM FOR HEALTH BENEFITS.— ‘‘(ii) INFORMATION TO BE INCLUDED.—The in- section 733(c) shall not be treated as benefits ‘‘(1) IN GENERAL.— formation described in this subclause with consisting of medical care. ‘‘(A) FAILURE TO COMPLY WITH EXTERNAL respect to an entity is as follows: ‘‘(4) HEALTH INSURANCE COVERAGE.—The MEDICAL REVIEW.—In any case in which— ‘‘(I) The number and types of denials for term ‘health insurance coverage’ has the ‘‘(i) a designated decision-maker described which a request for review has been received meaning given such term in section 733(b)(1). in paragraph (2) fails to exercise ordinary by the entity. In applying this paragraph, excepted benefits care in approving coverage pursuant to the ‘‘(II) The disposition by the entity of such described in section 733(c) shall not be treat- written determination of an independent denials, including the number referred to a ed as benefits consisting of medical care. medical reviewer under section 503B(d)(3)(F) independent medical reviewer and the rea- ‘‘(5) HEALTH INSURANCE ISSUER.—The term that reverses a denial of a claim for benefits; sons for such dispositions (including the ap- ‘health insurance issuer’ has the meaning and plication of exclusions), on a plan or issuer- given such term in section 733(b)(2). ‘‘(ii) the failure described in clause (i) is specific basis and on a health care specialty- ‘‘(6) PRIOR AUTHORIZATION DETERMINA- the proximate cause of substantial harm to, specific basis. TION.—The term ‘prior authorization deter- or the wrongful death of, the participant or ‘‘(III) The length of time in making deter- mination’ means a determination by the beneficiary; minations with respect to such denials. group health plan or health insurance issuer such designated decision-maker shall be lia- ‘‘(IV) Updated information on the informa- offering health insurance coverage in con- ble to the participant or beneficiary (or the tion required to be submitted as a condition nection with a group health plan prior to the estate of such participant or beneficiary) for of certification with respect to the entity’s provision of the items and services as a con- economic and noneconomic damages in con- performance of external review activities. dition of coverage of the items and services nection with such failure and such injury or ‘‘(iii) INFORMATION TO BE PROVIDED TO CER- under the terms and conditions of the plan death (subject to paragraph (4)). TIFYING ORGANIZATION.— or coverage. ‘‘(B) WRONGFUL DETERMINATION RESULTING ‘‘(I) IN GENERAL.—In the case of a qualified ‘‘(7) TREATING HEALTH CARE PROFES- IN DELAY IN PROVIDING BENEFITS.—In any case external review entity which is certified (or SIONAL.—The term ‘treating health care pro- in which— recertified) under this subsection by a quali- fessional’ with respect to a group health ‘‘(i) a designated decision-maker described fied private standard-setting organization, at plan, health insurance issuer or provider in paragraph (2) acts in bad faith in making the request of the organization, the entity sponsored organization means a physician a final determination denying a claim for shall provide the organization with the infor- (medical doctor or doctor of osteopathy) or benefits under section 503A(b); mation provided to the Secretary under other health care practitioner who is acting ‘‘(ii) the denial described in clause (i) is re- clause (i). within the scope of his or her State licensure versed by an independent medical reviewer ‘‘(II) ADDITIONAL INFORMATION.—Nothing in or certification for the delivery of health under section 503B(d); and this subparagraph shall be construed as pre- care services and who is primarily respon- ‘‘(iii) the delay attributable to the failure venting such an organization from requiring sible for delivering those services to the par- described in clause (i) is the proximate cause additional information as a condition of cer- ticipant or beneficiary. of substantial harm to, or the wrongful tification or recertification of an entity. ‘‘(8) UTILIZATION REVIEW.—The term ‘utili- death of, the participant or beneficiary; ‘‘(iv) USE OF INFORMATION.—Information zation review’ with respect to a group health such designated decision-maker shall be lia- provided under this subparagraph may be plan or health insurance coverage means ble to the participant or beneficiary (or the used by the Secretary and qualified private procedures used in the determination of cov- estate of such participant or beneficiary) for standard-setting organizations to conduct erage for a participant or beneficiary, such economic and noneconomic damages in con- oversight of qualified external review enti- as procedures to evaluate the medical neces- nection with such failure and such injury or ties, including recertification of such enti- sity, appropriateness, efficacy, quality, or ef- death (subject to paragraph (4)). ties, and shall be made available to the pub- ficiency of health care services, procedures ‘‘(2) DESIGNATED DECISION-MAKERS FOR PUR- lic in an appropriate manner. or settings, and includes prospective review, POSES OF LIABILITY.—An employer or plan June 29, 2000 CONGRESSIONAL RECORD — SENATE S6171

sponsor shall not be liable under any cause ‘‘(3) REQUIREMENT OF EXHAUSTION OF INDE- resentative) or the treating health care pro- of action described in paragraph (1) if the PENDENT MEDICAL REVIEW.—Paragraph (1) fessional (if any), sufficient information re- employer or plan sponsor complies with the shall apply only if a final determination de- garding the medical condition of the partici- following provisions: nying a claim for benefits under section pant or beneficiary that was necessary to ‘‘(A) APPOINTMENT.—A group health plan 503A(b) has been referred for independent make a final determination on a claim for may designate one or more persons to serve medical review under section 503B(d) and a benefits under section 503A(b); as the designated decision-maker for pur- written determination by an independent ‘‘(B) the participant or beneficiary (or au- poses of paragraph (1). Such designated deci- medical reviewer to reverse such final deter- thorized representative)— sion-makers shall have the exclusive author- mination has been issued with respect to ‘‘(i) was in possession of facts that were ity under the group health plan (or under the such review. sufficient to enable the participant or bene- health insurance coverage in the case of a ‘‘(4) LIMITATIONS ON RECOVERY OF DAM- ficiary (or authorized representative) to health insurance issuer offering coverage in AGES.— know that an expedited review under section connection with a group health plan) to ‘‘(A) MAXIMUM AWARD OF NONECONOMIC DAM- 503A or 503B would have prevented the harm make determinations described in section AGES.—The aggregate amount of liability for that is the subject of the action; and 503A with respect to claims for benefits and noneconomic loss in an action under para- ‘‘(ii) failed to notify the plan or issuer of determination to approve coverage pursuant graph (1) may not exceed $350,000. the need for such an expedited review; or to written determination of independent ‘‘(B) INCREASE IN AMOUNT.—The amount re- ‘‘(C) the cause of action is based solely on medical reviewers under section 503B, except ferred to in subparagraph (A) shall be in- the failure of a qualified external review en- creased or decreased, for each calendar year that the plan documents may expressly pro- tity or an independent medical reviewer to that ends after December 31, 2001, by the vide that the designated decision-maker is meet the timelines applicable under section same percentage as the percentage by which subject to the direction of a named fiduciary. 503B. the Consumer Price Index for All Urban Con- ‘‘(B) PROCEDURES.—A designated decision- Nothing in this paragraph shall be construed sumers (United States city average), pub- maker shall— to limit the application of any other affirma- lished by the Bureau of Labor Statistics, for ‘‘(i) be a person who is named in the plan tive defense that may be applicable to the September of the preceding calendar year or coverage documents, or who, pursuant to cause of action involved. has increased or decreased from the such procedures specified in the plan or coverage Index for September of 2001. ‘‘(6) WAIVER OF INTERNAL REVIEW.—In the documents, is identified as the designated case of any cause of action under paragraph ‘‘(C) JOINT AND SEVERAL LIABILITY.—In the decision-maker by— case of any action commenced pursuant to (1), the waiver or nonwaiver of internal re- ‘‘(I) a person who is an employer or em- paragraph (1), the defendant shall be liable view under section 503A(b)(1)(D) by the group ployee organization with respect to the plan only for the amount of noneconomic dam- health plan, or health insurance issuer offer- or issuer; ages attributable to such defendant in direct ing health insurance coverage in connection ‘‘(II) a person who is such an employer and proportion to such defendant’s share of fault with a group health plan, shall not be used in such an employee organization acting joint- or responsibility for the injury suffered by determining liability. ly; or the participant or beneficiary. In all such ‘‘(7) LIMITATIONS ON ACTIONS.—Paragraph ‘‘(III) a person who is a named fiduciary; cases, the liability of a defendant for non- (1) shall not apply in connection with any ac- ‘‘(ii) agree to accept appointment as a des- economic damages shall be several and not tion that is commenced more than 1 year ignated decision-maker; and joint. after— ‘‘(iii) be identified in the plan or coverage ‘‘(D) TREATMENT OF COLLATERAL SOURCE ‘‘(A) the date on which the last act oc- documents as required under section PAYMENTS.— curred which constituted a part of the fail- 714(b)(14). ‘‘(i) IN GENERAL.—In the case of any action ure referred to in such paragraph; or ‘‘(C) QUALIFICATIONS.—To be appointed as a commenced pursuant to paragraph (1), the ‘‘(B) in the case of an omission, the last designated decision-maker under this para- total amount of damages received by a par- date on which the decision-maker could have graph, a person shall be— ticipant or beneficiary under such action cured the failure. ‘‘(i) a plan sponsor; shall be reduced, in accordance with clause ‘‘(8) LIMITATION ON RELIEF WHERE DEFEND- ‘‘(ii) a group health plan; (ii), by any other payment that has been, or ANT’S POSITION PREVIOUSLY SUPPORTED UPON ‘‘(iii) a health insurance issuer; or will be, made to such participant or bene- EXTERNAL REVIEW.—In any case in which the ‘‘(iv) any other person who can provide ficiary to compensate such participant or court finds the defendant to be liable in an adequate evidence, in accordance with regu- beneficiary for the injury that was the sub- action under this subsection, to the extent lations promulgated by the Secretary, of the ject of such action. that such liability is based on a finding by ability of the person to— ‘‘(ii) AMOUNT OF REDUCTION.—The amount the court of a particular failure described in ‘‘(I) carry out the responsibilities set forth by which an award of damages to a partici- paragraph (1) and such finding is contrary to in the plan or coverage documents; pant or beneficiary for an injury shall be re- a previous determination by an independent ‘‘(II) carry out the applicable requirements duced under clause (i) shall be— medical reviewer under section 503B(d) with of this subsection; and ‘‘(I) the total amount of any payments respect to such defendant, no relief shall be ‘‘(III) meet other applicable requirements (other than such award) that have been made available under this subsection in addition under this Act, including any financial obli- or that will be made to such participant or to the relief otherwise available under sub- gation for liability under this subsection. beneficiary to pay costs of or compensate section (a)(1)(B). ‘‘(D) FLEXIBILITY IN ADMINISTRATION.—A such participant or beneficiary for the injury ‘‘(9) CONSTRUCTION.—Nothing in this sub- group health plan, or health insurance issuer that was the subject of the action; less section shall be construed as authorizing a offering coverage in connection with a group ‘‘(II) the amount paid by such participant cause of action under paragraph (1) for— health plan, may provide— or beneficiary (or by the spouse, parent, or ‘‘(A) the failure of a group health plan or ‘‘(i) that any person or group of persons legal guardian of such participant or bene- health insurance issuer to provide an item or may serve in more than one capacity with ficiary) to secure the payments described in service that is specifically excluded under respect to the plan or coverage (including subclause (I). the plan or coverage; or service as a designated decision-maker, ad- ‘‘(iii) DETERMINATION OF AMOUNTS FROM ‘‘(B) any denial of a claim for benefits that ministrator, and named fiduciary); or COLLATERAL SOURCES.—The reduction re- was not eligible for independent medical re- ‘‘(ii) that a designated decision-maker may quired under clause (ii) shall be determined view under section 503B(d). employ one or more persons to provide ad- by the court in a pretrial proceeding. At the ‘‘(10) FEDERAL JURISDICTION.—In the case of vice with respect to any responsibility of subsequent trial no evidence shall be admit- any action commenced pursuant to para- such decision-maker under the plan or cov- ted as to the amount of any charge, pay- graph (1) the district courts of the United erage. ments, or damage for which a participant or States shall have exclusive jurisdiction. ‘‘(E) FAILURE TO DESIGNATE.—In any case beneficiary— ‘‘(11) DEFINITIONS.—In this subsection: in which a designated decision-maker is not ‘‘(I) has received payment from a collateral ‘‘(A) AUTHORIZED REPRESENTATIVE.—The appointed under this paragraph, the group source or the obligation for which has been term ‘authorized representative’ has the health plan (or health insurance issuer offer- assured by a third party; or meaning given such term in section 503B(i). ing coverage in connection with the group ‘‘(II) is, or with reasonable certainty, will ‘‘(B) CLAIM FOR BENEFITS.—The term ‘claim health plan), the administrator, or the party be eligible to receive from a collateral source for benefits’ shall have the meaning given or parties that bears the sole responsibility which will, with reasonable certainty, be as- such term in section 503B(i), except that for making the final determination under sumed by a third party. such term shall only include claims for prior section 503A(b) (with respect to an internal ‘‘(5) AFFIRMATIVE DEFENSES.—In the case of authorization determinations (as such term review), or for approving coverage pursuant any cause of action under paragraph (1), it is defined in section 503B(i)). to the written determination of an inde- shall be an affirmative defense that— ‘‘(C) GROUP HEALTH PLAN.—The term ‘group pendent medical reviewer under section 503B, ‘‘(A) the group health plan, or health in- health plan’ shall have the meaning given with respect to a denial of a claim for bene- surance issuer offering health insurance cov- such term in section 733(a). fits shall be treated as the designated deci- erage in connection with a group health ‘‘(D) HEALTH INSURANCE COVERAGE.—The sion-maker for purposes of liability under plan, involved did not receive from the par- term ‘health insurance coverage’ has the this section. ticipant or beneficiary (or authorized rep- meaning given such term in section 733(b)(1). S6172 CONGRESSIONAL RECORD — SENATE June 29, 2000

‘‘(E) HEALTH INSURANCE ISSUER.—The term ‘‘(11) TREATMENT OF CERTAIN COVERAGE OP- ‘‘SEC. 715. REQUIRED COVERAGE FOR MINIMUM ‘health insurance issuer’ has the meaning TIONS.—If a self-insured medical reimburse- HOSPITAL STAY FOR given such term in section 733(b)(2) (includ- ment plan offers the coverage option de- MASTECTOMIES AND LYMPH NODE ing health maintenance organizations as de- scribed in section 502(o)(2) of the Employee DISSECTIONS FOR THE TREATMENT OF BREAST CANCER AND COVERAGE fined in section 733(b)(3)). Retirement Income Security Act of 1974, em- FOR SECONDARY CONSULTATIONS. ‘‘(F) ORDINARY CARE.—The term ‘ordinary ployees who elect such option shall be treat- ‘‘(a) INPATIENT CARE.— care’ means the care, skill, prudence, and ed as eligible to benefit under the plan and ‘‘(1) IN GENERAL.—A group health plan, and diligence under the circumstances prevailing the plan shall be treated as benefiting such a health insurance issuer providing health at the time the care is provided that a pru- employees.’’ insurance coverage in connection with a (c) CONFORMING AMENDMENT.—Section dent individual acting in a like capacity and group health plan, that provides medical and 502(a)(1)(A) of the Employee Retirement In- familiar with the care being provided would surgical benefits shall ensure that inpatient come Security Act of 1974 (29 U.S.C. use in providing care of a similar character. coverage with respect to the treatment of 1132(a)(1)(A)) is amended by inserting ‘‘or ‘‘(G) SUBSTANTIAL HARM.—The term ‘sub- breast cancer is provided for a period of time (n)’’ after ‘‘subsection (c)’’. stantial harm’ means the loss of life, loss or as is determined by the attending physician, significant impairment of limb or bodily SEC. 232. LIMITATION ON CERTAIN CLASS AC- in consultation with the patient, to be medi- TION LITIGATION. function, significant disfigurement, or severe cally necessary and appropriate following— and chronic physical pain. (a) ERISA.—Section 502 of the Employee Retirement Income Security Act of 1974 (29 ‘‘(A) a mastectomy; ‘‘(12) EFFECTIVE DATE.—The provisions of ‘‘(B) a lumpectomy; or this subsection shall apply to acts and omis- U.S.C. 1132), as amended by section 231, is further amended by adding at the end the ‘‘(C) a lymph node dissection for the treat- sions occurring on or after the date of enact- ment of breast cancer. ment of this subsection.’’. following: ‘‘(p) LIMITATION ON CLASS ACTION LITIGA- ‘‘(2) EXCEPTION.—Nothing in this section (b) IMMUNITY FROM LIABILITY FOR PROVI- TION.—A claim or cause of action under sec- shall be construed as requiring the provision SION OF INSURANCE OPTIONS.— tion 502(n) may not be maintained as a class of inpatient coverage if the attending physi- (1) IN GENERAL.—Section 502 of the Em- action.’’. cian and patient determine that a shorter pe- ployee Retirement Income Security Act of (b) RICO.—Section 1964(c) of title 18, riod of hospital stay is medically appro- 1974 (29 U.S.C. 1132), as amended by sub- United States Code, is amended— priate. section (a), is further amended by adding at (1) by inserting ‘‘(1)’’ after the subsection ‘‘(b) PROHIBITION ON CERTAIN MODIFICA- the end the following: designation; and TIONS.—In implementing the requirements of ‘‘(o) IMMUNITY FROM LIABILITY FOR PROVI- (2) by adding at the end the following: this section, a group health plan, and a SION OF INSURANCE OPTIONS.— ‘‘(2) No action may be brought under this health insurance issuer providing health in- ‘‘(1) IN GENERAL.—No liability shall arise subsection, or alleging any violation of sec- surance coverage in connection with a group under subsection (n) with respect to a partic- tion 1962, against any person where the ac- health plan, may not modify the terms and ipant or beneficiary against a group health tion seeks relief for which a remedy may be conditions of coverage based on the deter- plan (other than a fully insured group health provided under section 502 of the Employee mination by a participant or beneficiary to plan) if such plan offers the participant or Retirement Income Security Act of 1974.’’. request less than the minimum coverage re- beneficiary the coverage option described in (c) EFFECTIVE DATE.— quired under subsection (a). paragraph (2). (1) IN GENERAL.—The amendments made by ‘‘(c) NOTICE.—A group health plan, and a ‘‘(2) COVERAGE OPTION.—The coverage op- this section shall apply to all civil actions health insurance issuer providing health in- tion described in this paragraph is one under that are filed on or after the date of enact- surance coverage in connection with a group which the group health plan (other than a ment of this Act. health plan shall provide notice to each par- fully insured group health plan), at the time (2) PENDING CIVIL ACTIONS.—Notwith- ticipant and beneficiary under such plan re- of enrollment or as provided for in paragraph standing section 502(p) of the Employee Re- garding the coverage required by this section (3), provides the participant or beneficiary tirement Income Security Act of 1974 and in accordance with regulations promulgated with the option to— section 1964(c)(2) of title 18, United States by the Secretary. Such notice shall be in ‘‘(A) enroll for coverage under a fully in- Code, such sections 502(p) and 1964(c)(2) shall writing and prominently positioned in any sured health plan; or apply to civil actions that are pending and literature or correspondence made available ‘‘(B) receive an individual benefit payment, have not been finally determined by judg- or distributed by the plan or issuer and shall in an amount equal to the amount that ment or settlement prior to the date of en- be transmitted— would be contributed on behalf of the partic- actment of this Act if such actions are sub- ‘‘(1) in the next mailing made by the plan ipant or beneficiary by the plan sponsor for stantially similar in nature to the claims or or issuer to the participant or beneficiary; enrollment in the group health plan, for use causes of actions referred to in such sections ‘‘(2) as part of any yearly informational by the participant or beneficiary in obtain- 502(p) and 1964(c)(2). packet sent to the participant or beneficiary; ing health insurance coverage in the indi- SEC. 233. SEVERABILITY. or vidual market. If any provision of this subtitle, an amend- ‘‘(3) not later than January 1, 2001; ‘‘(3) TIME OF OFFERING OF OPTION.—The cov- ment made by this subtitle, or the applica- whichever is earlier. erage option described in paragraph (2) shall tion of such provision or amendment to any ‘‘(d) SECONDARY CONSULTATIONS.— be offered to a participant or beneficiary— person or circumstance is held to be uncon- ‘‘(1) IN GENERAL.—A group health plan, and ‘‘(A) during the first period in which the stitutional, the remainder of this subtitle, a health insurance issuer providing health individual is eligible to enroll under the the amendments made by this subtitle, and insurance coverage in connection with a group health plan; or the application of the provisions of such to group health plan, that provides coverage ‘‘(B) during any special enrollment period any person or circumstance shall not be af- with respect to medical and surgical services provided by the group health plan after the fected thereby. provided in relation to the diagnosis and date of enactment of the Patients’ Bill of TITLE III—WOMEN’S HEALTH AND treatment of cancer shall ensure that full Rights Plus Act for purposes of offering such CANCER RIGHTS coverage is provided for secondary consulta- coverage option.’’. SEC. 301. WOMEN’S HEALTH AND CANCER tions by specialists in the appropriate med- (2) AMENDMENTS TO INTERNAL REVENUE RIGHTS. ical fields (including pathology, radiology, CODE.— (a) SHORT TITLE.—This section may be and oncology) to confirm or refute such diag- (A) EXCLUSION FROM INCOME.—Section 106 cited as the ‘‘Women’s Health and Cancer nosis. Such plan or issuer shall ensure that of the Internal Revenue Code of 1986 (relat- Rights Act of 2000’’. full coverage is provided for such secondary ing to contributions by employer to accident (b) FINDINGS.—Congress finds that— consultation whether such consultation is and health plans) is amended by adding at (1) the offering and operation of health based on a positive or negative initial diag- the end the following: plans affect commerce among the States; nosis. In any case in which the attending ‘‘(d) TREATMENT OF CERTAIN COVERAGE OP- (2) health care providers located in a State physician certifies in writing that services TION UNDER SELF-INSURED PLANS.—No serve patients who reside in the State and necessary for such a secondary consultation amount shall be included in the gross income patients who reside in other States; and are not sufficiently available from special- of an individual by reason of— (3) in order to provide for uniform treat- ists operating under the plan with respect to ‘‘(1) the individual’s right to elect a cov- ment of health care providers and patients whose services coverage is otherwise pro- erage option described in section 502(o)(2) of among the States, it is necessary to cover vided under such plan or by such issuer, such the Employee Retirement Income Security health plans operating in 1 State as well as plan or issuer shall ensure that coverage is Act of 1974, or health plans operating among the several provided with respect to the services nec- ‘‘(2) the receipt by the individual of an in- States. essary for the secondary consultation with dividual benefit payment described in sec- (c) AMENDMENTS TO ERISA.— any other specialist selected by the attend- tion 502(o)(2)(A) of such Act.’’ (1) IN GENERAL.—Subpart B of part 7 of sub- ing physician for such purpose at no addi- (B) NONDISCRIMINATION RULES.—Section title B of title I of the Employee Retirement tional cost to the individual beyond that 105(h) of such Code (relating to self-insured Income Security Act of 1974, as amended by which the individual would have paid if the medical expense reimbursement plans) is section 211(a), is further amended by adding specialist was participating in the network amended by adding at the end the following: at the end the following: of the plan. June 29, 2000 CONGRESSIONAL RECORD — SENATE S6173

‘‘(2) EXCEPTION.—Nothing in paragraph (1) in accordance with regulations promulgated ‘‘SEC. 2753. REQUIRED COVERAGE FOR MINIMUM shall be construed as requiring the provision by the Secretary. Such notice shall be in HOSPITAL STAY FOR MASTECTOMIES AND LYMPH NODE of secondary consultations where the patient writing and prominently positioned in any determines not to seek such a consultation. DISSECTIONS FOR THE TREATMENT literature or correspondence made available OF BREAST CANCER AND SEC- ‘‘(e) PROHIBITION ON PENALTIES OR INCEN- or distributed by the plan or issuer and shall ONDARY CONSULTATIONS. TIVES.—A group health plan, and a health in- be transmitted— ‘‘The provisions of section 2707 shall apply surance issuer providing health insurance to health insurance coverage offered by a coverage in connection with a group health ‘‘(1) in the next mailing made by the plan or issuer to the participant or beneficiary; health insurance issuer in the individual plan, may not— market in the same manner as they apply to ‘‘(1) penalize or otherwise reduce or limit ‘‘(2) as part of any yearly informational packet sent to the participant or beneficiary; health insurance coverage offered by a the reimbursement of a provider or specialist health insurance issuer in connection with a because the provider or specialist provided or ‘‘(3) not later than January 1, 2001; group health plan in the small or large group care to a participant or beneficiary in ac- market.’’. cordance with this section; whichever is earlier. (f) AMENDMENTS TO THE IRC.— ‘‘(2) provide financial or other incentives (1) IN GENERAL.—Subchapter B of chapter to a physician or specialist to induce the ‘‘(d) SECONDARY CONSULTATIONS.— ‘‘(1) IN GENERAL.—A group health plan, and 100 of the Internal Revenue Code of 1986, as physician or specialist to keep the length of amended by section 202, is further amended inpatient stays of patients following a mas- a health insurance issuer providing health insurance coverage in connection with a by inserting after section 9813 the following: tectomy, lumpectomy, or a lymph node dis- ‘‘SEC. 9814. REQUIRED COVERAGE FOR MINIMUM section for the treatment of breast cancer group health plan that provides coverage with respect to medical and surgical services HOSPITAL STAY FOR below certain limits or to limit referrals for MASTECTOMIES AND LYMPH NODE secondary consultations; or provided in relation to the diagnosis and DISSECTIONS FOR THE TREATMENT ‘‘(3) provide financial or other incentives treatment of cancer shall ensure that full OF BREAST CANCER AND COVERAGE to a physician or specialist to induce the coverage is provided for secondary consulta- FOR SECONDARY CONSULTATIONS. physician or specialist to refrain from refer- tions by specialists in the appropriate med- ‘‘(a) INPATIENT CARE.— ring a participant or beneficiary for a sec- ical fields (including pathology, radiology, ‘‘(1) IN GENERAL.—A group health plan that ondary consultation that would otherwise be and oncology) to confirm or refute such diag- provides medical and surgical benefits shall covered by the plan or coverage involved nosis. Such plan or issuer shall ensure that ensure that inpatient coverage with respect under subsection (d).’’. full coverage is provided for such secondary to the treatment of breast cancer is provided (2) CLERICAL AMENDMENT.—The table of consultation whether such consultation is for a period of time as is determined by the contents in section 1 of the Employee Retire- based on a positive or negative initial diag- attending physician, in consultation with ment Income Security Act of 1974 is amended nosis. In any case in which the attending the patient, to be medically necessary and by inserting after the item relating to sec- physician certifies in writing that services appropriate following— tion 714 the following new item: necessary for such a secondary consultation ‘‘(A) a mastectomy; ‘‘Sec. 715. Required coverage for minimum are not sufficiently available from special- ‘‘(B) a lumpectomy; or hospital stay for mastectomies ists operating under the plan with respect to ‘‘(C) a lymph node dissection for the treat- and lymph node dissections for whose services coverage is otherwise pro- ment of breast cancer. the treatment of breast cancer vided under such plan or by such issuer, such ‘‘(2) EXCEPTION.—Nothing in this section and coverage for secondary con- plan or issuer shall ensure that coverage is shall be construed as requiring the provision of inpatient coverage if the attending physi- sultations.’’. provided with respect to the services nec- cian and patient determine that a shorter pe- (d) AMENDMENTS TO PHSA RELATING TO THE essary for the secondary consultation with riod of hospital stay is medically appro- GROUP MARKET.—Subpart 2 of part A of title any other specialist selected by the attend- priate. XXVII of the Public Health Service Act (42 ing physician for such purpose at no addi- ‘‘(b) PROHIBITION ON CERTAIN MODIFICA- U.S.C. 300gg-4 et seq.) is amended by adding tional cost to the individual beyond that TIONS.—In implementing the requirements of at the end the following new section: which the individual would have paid if the this section, a group health plan may not ‘‘SEC. 2707. REQUIRED COVERAGE FOR MINIMUM specialist was participating in the network modify the terms and conditions of coverage HOSPITAL STAY FOR of the plan. based on the determination by a participant MASTECTOMIES AND LYMPH NODE ‘‘(2) EXCEPTION.—Nothing in paragraph (1) or beneficiary to request less than the min- DISSECTIONS FOR THE TREATMENT shall be construed as requiring the provision OF BREAST CANCER AND COVERAGE imum coverage required under subsection FOR SECONDARY CONSULTATIONS. of secondary consultations where the patient (a). ‘‘(a) INPATIENT CARE.— determines not to seek such a consultation. ‘‘(c) NOTICE.—A group health plan shall ‘‘(1) IN GENERAL.—A group health plan, and ‘‘(e) PROHIBITION ON PENALTIES OR INCEN- provide notice to each participant and bene- a health insurance issuer providing health TIVES.—A group health plan, and a health in- ficiary under such plan regarding the cov- insurance coverage in connection with a surance issuer providing health insurance erage required by this section in accordance with regulations promulgated by the Sec- group health plan, that provides medical and coverage in connection with a group health surgical benefits shall ensure that inpatient retary. Such notice shall be in writing and plan, may not— coverage with respect to the treatment of prominently positioned in any literature or ‘‘(1) penalize or otherwise reduce or limit breast cancer is provided for a period of time correspondence made available or distrib- the reimbursement of a provider or specialist as is determined by the attending physician, uted by the plan and shall be transmitted— in consultation with the patient, to be medi- because the provider or specialist provided ‘‘(1) in the next mailing made by the plan cally necessary and appropriate following— care to a participant or beneficiary in ac- to the participant or beneficiary; ‘‘(A) a mastectomy; cordance with this section; ‘‘(2) as part of any yearly informational ‘‘(B) a lumpectomy; or ‘‘(2) provide financial or other incentives packet sent to the participant or beneficiary; ‘‘(C) a lymph node dissection for the treat- to a physician or specialist to induce the or ment of breast cancer. physician or specialist to keep the length of ‘‘(3) not later than January 1, 2000; ‘‘(2) EXCEPTION.—Nothing in this section inpatient stays of patients following a mas- whichever is earlier. shall be construed as requiring the provision tectomy, lumpectomy, or a lymph node dis- ‘‘(d) SECONDARY CONSULTATIONS.— of inpatient coverage if the attending physi- section for the treatment of breast cancer ‘‘(1) IN GENERAL.—A group health plan that cian and patient determine that a shorter pe- below certain limits or to limit referrals for provides coverage with respect to medical riod of hospital stay is medically appro- secondary consultations; or and surgical services provided in relation to priate. ‘‘(3) provide financial or other incentives the diagnosis and treatment of cancer shall ‘‘(b) PROHIBITION ON CERTAIN MODIFICA- to a physician or specialist to induce the ensure that full coverage is provided for sec- TIONS.—In implementing the requirements of physician or specialist to refrain from refer- ondary consultations by specialists in the this section, a group health plan, and a ring a participant or beneficiary for a sec- appropriate medical fields (including pathol- health insurance issuer providing health in- ondary consultation that would otherwise be ogy, radiology, and oncology) to confirm or surance coverage in connection with a group covered by the plan or coverage involved refute such diagnosis. Such plan or issuer health plan, may not modify the terms and under subsection (d).’’. shall ensure that full coverage is provided for such secondary consultation whether conditions of coverage based on the deter- (e) AMENDMENTS TO PHSA RELATING TO THE mination by a participant or beneficiary to such consultation is based on a positive or INDIVIDUAL MARKET.—The first subpart 3 of request less than the minimum coverage re- negative initial diagnosis. In any case in part B of title XXVII of the Public Health quired under subsection (a). which the attending physician certifies in ‘‘(c) NOTICE.—A group health plan, and a Service Act (42 U.S.C. 300gg–51 et seq.) (relat- writing that services necessary for such a health insurance issuer providing health in- ing to other requirements) (42 U.S.C. 300gg-51 secondary consultation are not sufficiently surance coverage in connection with a group et seq.) is amended— available from specialists operating under health plan shall provide notice to each par- (1) by redesignating such subpart as sub- the plan with respect to whose services cov- ticipant and beneficiary under such plan re- part 2; and erage is otherwise provided under such plan garding the coverage required by this section (2) by adding at the end the following: or by such issuer, such plan or issuer shall S6174 CONGRESSIONAL RECORD — SENATE June 29, 2000 ensure that coverage is provided with respect 1974 (29 U.S.C. 1182(b)) is amended by adding tional Association of Insurance Commis- to the services necessary for the secondary at the end the following: sioners, and after notice and opportunity for consultation with any other specialist se- ‘‘(3) REFERENCE TO RELATED PROVISION.— public comment, shall develop and dissemi- lected by the attending physician for such For a provision prohibiting the adjustment nate model notices of confidentiality prac- purpose at no additional cost to the indi- of premium or contribution amounts for a tices. Use of the model notice shall serve as vidual beyond that which the individual group under a group health plan on the basis a defense against claims of receiving inap- would have paid if the specialist was partici- of predictive genetic information (including propriate notice. pating in the network of the plan. information about a request for or receipt of ‘‘(2) ESTABLISHMENT OF SAFEGUARDS.—A ‘‘(2) EXCEPTION.—Nothing in paragraph (1) genetic services), see section 716.’’. group health plan, or a health insurance shall be construed as requiring the provision (B) TABLE OF CONTENTS.—The table of con- issuer offering health insurance coverage in of secondary consultations where the patient tents in section 1 of the Employee Retire- connection with a group health plan, shall determines not to seek such a consultation. ment Income Security Act of 1974, as amend- establish and maintain appropriate adminis- ‘‘(e) PROHIBITION ON PENALTIES.—A group ed by section 301, is further amended by in- trative, technical, and physical safeguards to health plan may not— serting after the item relating to section 715 protect the confidentiality, security, accu- ‘‘(1) penalize or otherwise reduce or limit the following new item: racy, and integrity of predictive genetic in- the reimbursement of a provider or specialist ‘‘Sec. 716. Prohibiting premium discrimina- formation created, received, obtained, main- because the provider or specialist provided tion against groups on the basis tained, used, transmitted, or disposed of by care to a participant or beneficiary in ac- of predictive genetic informa- such plan or issuer.’’. (c) DEFINITIONS.—Section 733(d) of the Em- cordance with this section; tion.’’. ‘‘(2) provide financial or other incentives ployee Retirement Income Security Act of (b) LIMITATION ON COLLECTION OF PRE- to a physician or specialist to induce the 1974 (29 U.S.C. 1191b(d)) is amended by adding DICTIVE GENETIC INFORMATION.—Section 702 at the end the following: physician or specialist to keep the length of of the Employee Retirement Income Secu- inpatient stays of patients following a mas- ‘‘(5) FAMILY MEMBER.—The term ‘family rity Act of 1974 (29 U.S.C. 1182) is amended by member’ means with respect to an tectomy, lumpectomy, or a lymph node dis- adding at the end the following: section for the treatment of breast cancer individual— ‘‘(c) COLLECTION OF PREDICTIVE GENETIC IN- below certain limits or to limit referrals for ‘‘(A) the spouse of the individual; FORMATION.— secondary consultations; or ‘‘(B) a dependent child of the individual, ‘‘(1) LIMITATION ON REQUESTING OR REQUIR- ‘‘(3) provide financial or other incentives including a child who is born to or placed for ING PREDICTIVE GENETIC INFORMATION.—Ex- adoption with the individual; and to a physician or specialist to induce the cept as provided in paragraph (2), a group physician or specialist to refrain from refer- ‘‘(C) all other individuals related by blood health plan, or a health insurance issuer of- to the individual or the spouse or child de- ring a participant or beneficiary for a sec- fering health insurance coverage in connec- ondary consultation that would otherwise be scribed in subparagraph (A) or (B). tion with a group health plan, shall not re- ‘‘(6) GENETIC INFORMATION.—The term ‘ge- covered by the plan involved under sub- quest or require predictive genetic informa- section (d).’’. netic information’ means information about tion concerning any individual (including a genes, gene products, or inherited character- (2) CLERICAL AMENDMENT.—The table of dependent) or family member of the indi- contents for chapter 100 of such Code is istics that may derive from an individual or vidual (including information about a re- a family member (including information amended by inserting after the item relating quest for or receipt of genetic services). to section 9813 the following new item: about a request for or receipt of genetic serv- ‘‘(2) INFORMATION NEEDED FOR DIAGNOSIS, ices). ‘‘Sec. 9814. Required coverage for minimum TREATMENT, OR PAYMENT.— ‘‘(7) GENETIC SERVICES.—The term ‘genetic hospital stay for mastectomies ‘‘(A) IN GENERAL.—Notwithstanding para- services’ means health services provided to and lymph node dissections for graph (1), a group health plan, or a health in- obtain, assess, or interpret genetic informa- the treatment of breast cancer surance issuer offering health insurance cov- tion for diagnostic and therapeutic purposes, and coverage for secondary con- erage in connection with a group health and for genetic education and counseling. sultations.’’. plan, that provides health care items and ‘‘(8) PREDICTIVE GENETIC INFORMATION.— TITLE IV—GENETIC INFORMATION AND services to an individual or dependent may ‘‘(A) IN GENERAL.—The term ‘predictive ge- SERVICES request (but may not require) that such indi- netic information’ means, in the absence of SEC. 401. SHORT TITLE. vidual or dependent disclose, or authorize symptoms, clinical signs, or a diagnosis of This title may be cited as the ‘‘Genetic In- the collection or disclosure of, predictive ge- the condition related to such information— formation Nondiscrimination in Health In- netic information for purposes of diagnosis, ‘‘(i) information about an individual’s ge- surance Act of 1999’’. treatment, or payment relating to the provi- netic tests; SEC. 402. AMENDMENTS TO EMPLOYEE RETIRE- sion of health care items and services to ‘‘(ii) information about genetic tests of MENT INCOME SECURITY ACT OF such individual or dependent. family members of the individual; or 1974. ‘‘(B) NOTICE OF CONFIDENTIALITY PRACTICES ‘‘(iii) information about the occurrence of (a) PROHIBITION OF HEALTH DISCRIMINATION AND DESCRIPTION OF SAFEGUARDS.—As a part a disease or disorder in family members. ON THE BASIS OF GENETIC INFORMATION OR GE- of a request under subparagraph (A), the ‘‘(B) EXCEPTIONS.—The term ‘predictive ge- NETIC SERVICES.— group health plan, or a health insurance netic information’ shall not include— (1) NO ENROLLMENT RESTRICTION FOR GE- issuer offering health insurance coverage in ‘‘(i) information about the sex or age of the NETIC SERVICES.—Section 702(a)(1)(F) of the connection with a group health plan, shall individual; Employee Retirement Income Security Act provide to the individual or dependent a de- ‘‘(ii) information derived from physical of 1974 (29 U.S.C. 1182(a)(1)(F)) is amended by scription of the procedures in place to safe- tests, such as the chemical, blood, or urine inserting before the period the following: guard the confidentiality, as described in analyses of the individual including choles- ‘‘(including information about a request for subsection (d), of such predictive genetic in- terol tests; and or receipt of genetic services)’’. formation. ‘‘(iii) information about physical exams of (2) NO DISCRIMINATION IN GROUP PREMIUMS ‘‘(d) CONFIDENTIALITY WITH RESPECT TO the individual. BASED ON PREDICTIVE GENETIC INFORMATION.— PREDICTIVE GENETIC INFORMATION.— ‘‘(9) GENETIC TEST.—The term ‘genetic test’ Subpart B of part 7 of subtitle B of title I of ‘‘(1) NOTICE OF CONFIDENTIALITY PRAC- means the analysis of human DNA, RNA, the Employee Retirement Income Security TICES.— chromosomes, proteins, and certain metabo- Act of 1974, as amended by section 301(c), is ‘‘(A) PREPARATION OF WRITTEN NOTICE.—A lites, including analysis of genotypes, further amended by adding at the end the group health plan, or a health insurance mutations, phenotypes, or karyotypes, for following: issuer offering health insurance coverage in the purpose of predicting risk of disease in ‘‘SEC. 716. PROHIBITING PREMIUM DISCRIMINA- connection with a group health plan, shall asymptomatic or undiagnosed individuals. TION AGAINST GROUPS ON THE post or provide, in writing and in a clear and Such term does not include physical tests, BASIS OF PREDICTIVE GENETIC IN- conspicuous manner, notice of the plan or such as the chemical, blood, or urine anal- FORMATION. issuer’s confidentiality practices, that shall yses of the individual including cholesterol ‘‘A group health plan, or a health insur- include— tests, and physical exams of the individual, ance issuer offering group health insurance ‘‘(i) a description of an individual’s rights in order to detect symptoms, clinical signs, coverage in connection with a group health with respect to predictive genetic informa- or a diagnosis of disease.’’. plan, shall not adjust premium or contribu- tion; (d) EFFECTIVE DATE.—Except as provided in tion amounts for a group on the basis of pre- ‘‘(ii) the procedures established by the plan this section, this section and the amend- dictive genetic information concerning any or issuer for the exercise of the individual’s ments made by this section shall apply with individual (including a dependent) or family rights; and respect to group health plans for plan years member of the individual (including informa- ‘‘(iii) the right to obtain a copy of the no- beginning 1 year after the date of the enact- tion about a request for or receipt of genetic tice of the confidentiality practices required ment of this Act. services).’’. under this subsection. SEC. 403. AMENDMENTS TO THE PUBLIC HEALTH (3) CONFORMING AMENDMENTS.— ‘‘(B) MODEL NOTICE.—The Secretary, in SERVICE ACT. (A) IN GENERAL.—Section 702(b) of the Em- consultation with the National Committee (a) AMENDMENTS RELATING TO THE GROUP ployee Retirement Income Security Act of on Vital and Health Statistics and the Na- MARKET.— June 29, 2000 CONGRESSIONAL RECORD — SENATE S6175

(1) PROHIBITION OF HEALTH DISCRIMINATION ‘‘(1) NOTICE OF CONFIDENTIALITY PRAC- ‘‘(19) GENETIC TEST.—The term ‘genetic ON THE BASIS OF GENETIC INFORMATION IN THE TICES.— test’ means the analysis of human DNA, GROUP MARKET.— ‘‘(A) PREPARATION OF WRITTEN NOTICE.—A RNA, chromosomes, proteins, and certain (A) NO ENROLLMENT RESTRICTION FOR GE- group health plan, or a health insurance metabolites, including analysis of genotypes, NETIC SERVICES.—Section 2702(a)(1)(F) of the issuer offering health insurance coverage in mutations, phenotypes, or karyotypes, for Public Health Service Act (42 U.S.C. 300gg– connection with a group health plan, shall the purpose of predicting risk of disease in 1(a)(1)(F)) is amended by inserting before the post or provide, in writing and in a clear and asymptomatic or undiagnosed individuals. period the following: ‘‘(including informa- conspicuous manner, notice of the plan or Such term does not include physical tests, tion about a request for or receipt of genetic issuer’s confidentiality practices, that shall such as the chemical, blood, or urine anal- services)’’. include— yses of the individual including cholesterol (B) NO DISCRIMINATION IN PREMIUMS BASED ‘‘(i) a description of an individual’s rights tests, and physical exams of the individual, ON PREDICTIVE GENETIC INFORMATION.—Sub- with respect to predictive genetic informa- in order to detect symptoms, clinical signs, part 2 of part A of title XXVII of the Public tion; or a diagnosis of disease.’’. Health Service Act (42 U.S.C. 300gg-4 et seq.), ‘‘(ii) the procedures established by the plan (e) AMENDMENTS TO PHSA RELATING TO THE as amended by section 301(d), is amended by or issuer for the exercise of the individual’s INDIVIDUAL MARKET.—The first subpart 3 of adding at the end the following new section: rights; and part B of title XXVII of the Public Health ‘‘SEC. 2708. PROHIBITING PREMIUM DISCRIMINA- ‘‘(iii) the right to obtain a copy of the no- Service Act (42 U.S.C. 300gg–51 et seq.) (relat- TION AGAINST GROUPS ON THE tice of the confidentiality practices required ing to other requirements) (42 U.S.C. 300gg-51 BASIS OF PREDICTIVE GENETIC IN- under this subsection. et seq.), as amended by section 301(e), is fur- FORMATION IN THE GROUP MAR- ther amended by adding at the end the fol- ‘‘(B) MODEL NOTICE.—The Secretary, in KET. lowing: ‘‘A group health plan, or a health insur- consultation with the National Committee on Vital and Health Statistics and the Na- ‘‘SEC. 2754. PROHIBITION OF HEALTH DISCRIMI- ance issuer offering group health insurance NATION ON THE BASIS OF PRE- coverage in connection with a group health tional Association of Insurance Commis- DICTIVE GENETIC INFORMATION. plan shall not adjust premium or contribu- sioners, and after notice and opportunity for ‘‘(a) PROHIBITION ON PREDICTIVE GENETIC tion amounts for a group on the basis of pre- public comment, shall develop and dissemi- INFORMATION AS A CONDITION OF ELIGI- dictive genetic information concerning any nate model notices of confidentiality prac- BILITY.—A health insurance issuer offering individual (including a dependent) or family tices. Use of the model notice shall serve as health insurance coverage in the individual member of the individual (including informa- a defense against claims of receiving inap- market may not use predictive genetic infor- tion about a request for or receipt of genetic propriate notice. mation as a condition of eligibility of an in- services).’’. ‘‘(2) ESTABLISHMENT OF SAFEGUARDS.—A dividual to enroll in individual health insur- (C) CONFORMING AMENDMENT.—Section group health plan, or a health insurance ance coverage (including information about 2702(b) of the Public Health Service Act (42 issuer offering health insurance coverage in a request for or receipt of genetic services). U.S.C. 300gg–1(b)) is amended by adding at connection with a group health plan, shall ‘‘(b) PROHIBITION ON PREDICTIVE GENETIC the end the following: establish and maintain appropriate adminis- INFORMATION IN SETTING PREMIUM RATES.—A ‘‘(3) REFERENCE TO RELATED PROVISION.— trative, technical, and physical safeguards to health insurance issuer offering health insur- For a provision prohibiting the adjustment protect the confidentiality, security, accu- ance coverage in the individual market shall of premium or contribution amounts for a racy, and integrity of predictive genetic in- not adjust premium rates for individuals on group under a group health plan on the basis formation created, received, obtained, main- the basis of predictive genetic information of predictive genetic information (including tained, used, transmitted, or disposed of by concerning such an individual (including a information about a request for or receipt of such plan or issuer.’’. dependent) or a family member of the indi- genetic services), see section 2708.’’. (2) DEFINITIONS.—Section 2791(d) of the vidual (including information about a re- (D) LIMITATION ON COLLECTION AND DISCLO- Public Health Service Act (42 U.S.C. 300gg– quest for or receipt of genetic services). SURE OF PREDICTIVE GENETIC INFORMATION.— 91(d)) is amended by adding at the end the ‘‘(c) COLLECTION OF PREDICTIVE GENETIC IN- Section 2702 of the Public Health Service Act following: FORMATION.— (42 U.S.C. 300gg–1) is amended by adding at ‘‘(15) FAMILY MEMBER.—The term ‘family ‘‘(1) LIMITATION ON REQUESTING OR REQUIR- the end the following: member’ means, with respect to an ING PREDICTIVE GENETIC INFORMATION.—Ex- ‘‘(c) COLLECTION OF PREDICTIVE GENETIC IN- individual— cept as provided in paragraph (2), a health FORMATION.— ‘‘(A) the spouse of the individual; insurance issuer offering health insurance ‘‘(1) LIMITATION ON REQUESTING OR REQUIR- ‘‘(B) a dependent child of the individual, coverage in the individual market shall not ING PREDICTIVE GENETIC INFORMATION.—Ex- including a child who is born to or placed for request or require predictive genetic infor- cept as provided in paragraph (2), a group adoption with the individual; and mation concerning any individual (including health plan, or a health insurance issuer of- ‘‘(C) all other individuals related by blood a dependent) or a family member of the indi- fering health insurance coverage in connec- to the individual or the spouse or child de- vidual (including information about a re- tion with a group health plan, shall not re- scribed in subparagraph (A) or (B). quest for or receipt of genetic services). quest or require predictive genetic informa- ‘‘(16) GENETIC INFORMATION.—The term ‘ge- ‘‘(2) INFORMATION NEEDED FOR DIAGNOSIS, tion concerning any individual (including a netic information’ means information about TREATMENT, OR PAYMENT.— dependent) or a family member of the indi- genes, gene products, or inherited character- ‘‘(A) IN GENERAL.—Notwithstanding para- vidual (including information about a re- istics that may derive from an individual or graph (1), a health insurance issuer offering quest for or receipt of genetic services). a family member (including information health insurance coverage in the individual ‘‘(2) INFORMATION NEEDED FOR DIAGNOSIS, about a request for or receipt of genetic serv- market that provides health care items and TREATMENT, OR PAYMENT.— ices). services to an individual or dependent may ‘‘(A) IN GENERAL.—Notwithstanding para- ‘‘(17) GENETIC SERVICES.—The term ‘genetic request (but may not require) that such indi- graph (1), a group health plan, or a health in- services’ means health services provided to vidual or dependent disclose, or authorize surance issuer offering health insurance cov- obtain, assess, or interpret genetic informa- the collection or disclosure of, predictive ge- erage in connection with a group health tion for diagnostic and therapeutic purposes, netic information for purposes of diagnosis, plan, that provides health care items and and for genetic education and counseling. treatment, or payment relating to the provi- services to an individual or dependent may ‘‘(18) PREDICTIVE GENETIC INFORMATION.— sion of health care items and services to request (but may not require) that such indi- ‘‘(A) IN GENERAL.—The term ‘predictive ge- such individual or dependent. vidual or dependent disclose, or authorize netic information’ means, in the absence of ‘‘(B) NOTICE OF CONFIDENTIALITY PRACTICES the collection or disclosure of, predictive ge- symptoms, clinical signs, or a diagnosis of AND DESCRIPTION OF SAFEGUARDS.—As a part netic information for purposes of diagnosis, the condition related to such information— of a request under subparagraph (A), the treatment, or payment relating to the provi- ‘‘(i) information about an individual’s ge- health insurance issuer offering health insur- sion of health care items and services to netic tests; ance coverage in the individual market shall such individual or dependent. ‘‘(ii) information about genetic tests of provide to the individual or dependent a de- ‘‘(B) NOTICE OF CONFIDENTIALITY PRACTICES family members of the individual; or scription of the procedures in place to safe- AND DESCRIPTION OF SAFEGUARDS.—As a part ‘‘(iii) information about the occurrence of guard the confidentiality, as described in of a request under subparagraph (A), the a disease or disorder in family members. subsection (d), of such predictive genetic in- group health plan, or a health insurance ‘‘(B) EXCEPTIONS.—The term ‘predictive ge- formation. issuer offering health insurance coverage in netic information’ shall not include— ‘‘(d) CONFIDENTIALITY WITH RESPECT TO connection with a group health plan, shall ‘‘(i) information about the sex or age of the PREDICTIVE GENETIC INFORMATION.— provide to the individual or dependent a de- individual; ‘‘(1) NOTICE OF CONFIDENTIALITY PRAC- scription of the procedures in place to safe- ‘‘(ii) information derived from physical TICES.— guard the confidentiality, as described in tests, such as the chemical, blood, or urine ‘‘(A) PREPARATION OF WRITTEN NOTICE.—A subsection (d), of such predictive genetic in- analyses of the individual including choles- health insurance issuer offering health insur- formation. terol tests; and ance coverage in the individual market shall ‘‘(d) CONFIDENTIALITY WITH RESPECT TO ‘‘(iii) information about physical exams of post or provide, in writing and in a clear and PREDICTIVE GENETIC INFORMATION.— the individual. conspicuous manner, notice of the issuer’s S6176 CONGRESSIONAL RECORD — SENATE June 29, 2000 confidentiality practices, that shall ‘‘Sec. 9815. Prohibiting premium discrimina- ‘‘(C) all other individuals related by blood include— tion against groups on the basis to the individual or the spouse or child de- ‘‘(i) a description of an individual’s rights of predictive genetic informa- scribed in subparagraph (A) or (B). with respect to predictive genetic informa- tion.’’. ‘‘(7) GENETIC INFORMATION.—The term ‘ge- tion; netic information’ means information about (b) LIMITATION ON COLLECTION OF PRE- ‘‘(ii) the procedures established by the genes, gene products, or inherited character- DICTIVE GENETIC INFORMATION.—Section 9802 issuer for the exercise of the individual’s istics that may derive from an individual or of the Internal Revenue Code of 1986 is rights; and a family member (including information amended by adding at the end the following: ‘‘(iii) the right to obtain a copy of the no- about a request for or receipt of genetic serv- tice of the confidentiality practices required ‘‘(d) COLLECTION OF PREDICTIVE GENETIC IN- ices). under this subsection. FORMATION.— ‘‘(8) GENETIC SERVICES.—The term ‘genetic ‘‘(B) MODEL NOTICE.—The Secretary, in ‘‘(1) LIMITATION ON REQUESTING OR REQUIR- services’ means health services provided to consultation with the National Committee ING PREDICTIVE GENETIC INFORMATION.—Ex- obtain, assess, or interpret genetic informa- on Vital and Health Statistics and the Na- cept as provided in paragraph (2), a group tion for diagnostic and therapeutic purposes, tional Association of Insurance Commis- health plan shall not request or require pre- and for genetic education and counseling. sioners, and after notice and opportunity for dictive genetic information concerning any ‘‘(9) PREDICTIVE GENETIC INFORMATION.— public comment, shall develop and dissemi- individual (including a dependent) or a fam- ‘‘(A) IN GENERAL.—The term ‘predictive ge- nate model notices of confidentiality prac- ily member of the individual (including in- netic information’ means, in the absence of tices. Use of the model notice shall serve as formation about a request for or receipt of symptoms, clinical signs, or a diagnosis of a defense against claims of receiving inap- genetic services). the condition related to such information— propriate notice. ‘‘(2) INFORMATION NEEDED FOR DIAGNOSIS, ‘‘(i) information about an individual’s ge- ‘‘(2) ESTABLISHMENT OF SAFEGUARDS.—A TREATMENT, OR PAYMENT.— netic tests; health insurance issuer offering health insur- ‘‘(A) IN GENERAL.—Notwithstanding para- ‘‘(ii) information about genetic tests of ance coverage in the individual market shall graph (1), a group health plan that provides family members of the individual; or establish and maintain appropriate adminis- health care items and services to an indi- ‘‘(iii) information about the occurrence of trative, technical, and physical safeguards to vidual or dependent may request (but may a disease or disorder in family members. protect the confidentiality, security, accu- not require) that such individual or depend- ‘‘(B) EXCEPTIONS.—The term ‘predictive ge- racy, and integrity of predictive genetic in- ent disclose, or authorize the collection or netic information’ shall not include— formation created, received, obtained, main- disclosure of, predictive genetic information ‘‘(i) information about the sex or age of the tained, used, transmitted, or disposed of by for purposes of diagnosis, treatment, or pay- individual; such issuer.’’. ment relating to the provision of health care ‘‘(ii) information derived from physical tests, such as the chemical, blood, or urine (c) EFFECTIVE DATE.—The amendments items and services to such individual or de- analyses of the individual including choles- made by this section shall apply with respect pendent. terol tests; and to— ‘‘(B) NOTICE OF CONFIDENTIALITY PRACTICES; ‘‘(iii) information about physical exams of (1) group health plans, and health insur- DESCRIPTION OF SAFEGUARDS.—As a part of a the individual. ance coverage offered in connection with request under subparagraph (A), the group ‘‘(10) GENETIC TEST.—The term ‘genetic group health plans, for plan years beginning health plan shall provide to the individual or test’ means the analysis of human DNA, after 1 year after the date of enactment of dependent a description of the procedures in RNA, chromosomes, proteins, and certain this Act; and place to safeguard the confidentiality, as de- metabolites, including analysis of genotypes, (2) health insurance coverage offered, sold, scribed in subsection (e), of such predictive genetic information. mutations, phenotypes, or karyotypes, for issued, renewed, in effect, or operated in the the purpose of predicting risk of disease in ‘‘(e) CONFIDENTIALITY WITH RESPECT TO individual market after 1 year after the date asymptomatic or undiagnosed individuals. PREDICTIVE GENETIC INFORMATION.— of enactment of this Act. Such term does not include physical tests, ‘‘(1) NOTICE OF CONFIDENTIALITY PRAC- SEC. 404. AMENDMENTS TO THE INTERNAL REV- such as the chemical, blood, or urine anal- TICES.— ENUE CODE OF 1986. yses of the individual including cholesterol (a) PROHIBITION OF HEALTH DISCRIMINATION ‘‘(A) PREPARATION OF WRITTEN NOTICE.—A tests, and physical exams of the individual, ON THE BASIS OF GENETIC INFORMATION OR GE- group health plan shall post or provide, in in order to detect symptoms, clinical signs, NETIC SERVICES.— writing and in a clear and conspicuous man- or a diagnosis of disease.’’. (1) NO ENROLLMENT RESTRICTION FOR GE- ner, notice of the plan’s confidentiality prac- (d) EFFECTIVE DATE.—Except as provided in NETIC SERVICES.—Section 9802(a)(1)(F) of the tices, that shall include— this section, this section and the amend- Internal Revenue Code of 1986 is amended by ‘‘(i) a description of an individual’s rights ments made by this section shall apply with inserting before the period the following: with respect to predictive genetic informa- respect to group health plans for plan years ‘‘(including information about a request for tion; beginning after 1 year after the date of the or receipt of genetic services)’’. ‘‘(ii) the procedures established by the plan enactment of this Act. (2) NO DISCRIMINATION IN GROUP PREMIUMS for the exercise of the individual’s rights; TITLE V—PATIENT SAFETY AND ERRORS BASED ON PREDICTIVE GENETIC INFORMATION.— and REDUCTION ‘‘(iii) the right to obtain a copy of the no- (A) IN GENERAL.—Subchapter B of chapter SEC. 501. SHORT TITLE. tice of the confidentiality practices required 100 of the Internal Revenue Code of 1986, as This title may be cited as the ‘‘Patient under this subsection. amended by section 301(f), is further amend- Safety and Errors Reduction Act’’. ed by adding at the end the following: ‘‘(B) MODEL NOTICE.—The Secretary, in consultation with the National Committee SEC. 502. PURPOSES. ‘‘SEC. 9815. PROHIBITING PREMIUM DISCRIMINA- It is the purpose of this title to— on Vital and Health Statistics and the Na- TION AGAINST GROUPS ON THE (1) promote the identification, evaluation, tional Association of Insurance Commis- BASIS OF PREDICTIVE GENETIC IN- and reporting of medical errors; sioners, and after notice and opportunity for FORMATION. (2) raise standards and expectations for im- public comment, shall develop and dissemi- ‘‘A group health plan shall not adjust pre- provements in patient safety; nate model notices of confidentiality prac- mium or contribution amounts for a group (3) reduce deaths, serious injuries, and on the basis of predictive genetic informa- tices. Use of the model notice shall serve as other medical errors through the implemen- tion concerning any individual (including a a defense against claims of receiving inap- tation of safe practices at the delivery level; dependent) or a family member of the indi- propriate notice. (4) develop error reduction systems with vidual (including information about a re- ‘‘(2) ESTABLISHMENT OF SAFEGUARDS.—A legal protections to support the collection of quest for or receipt of genetic services).’’. group health plan shall establish and main- information under such systems; (B) CONFORMING AMENDMENT.—Section tain appropriate administrative, technical, (5) extend existing confidentiality and peer 9802(b) of the Internal Revenue Code of 1986 and physical safeguards to protect the con- review protections to the reports relating to is amended by adding at the end the fol- fidentiality, security, accuracy, and integ- medical errors that are reported under such lowing: rity of predictive genetic information cre- systems that are developed for safety and ‘‘(3) REFERENCE TO RELATED PROVISION.— ated, received, obtained, maintained, used, quality improvement purposes; and For a provision prohibiting the adjustment transmitted, or disposed of by such plan.’’. (6) provide for the establishment of sys- of premium or contribution amounts for a (c) DEFINITIONS.—Section 9832(d) of the In- tems of information collection, analysis, and group under a group health plan on the basis ternal Revenue Code of 1986 is amended by dissemination to enhance the knowledge of predictive genetic information (including adding at the end the following: base concerning patient safety. information about a request for or the re- ‘‘(6) FAMILY MEMBER.—The term ‘family SEC. 503. AMENDMENT TO PUBLIC HEALTH SERV- ceipt of genetic services), see section 9815.’’. member’ means, with respect to an ICE ACT. (C) AMENDMENT TO TABLE OF SECTIONS.— individual— Title IX of the Public Health Service Act The table of sections for subchapter B of ‘‘(A) the spouse of the individual; (42 U.S.C. 299 et seq.) is amended— chapter 100 of the Internal Revenue Code of ‘‘(B) a dependent child of the individual, (1) by redesignating part C as part D; 1986, as amended by section 301(f), is further including a child who is born to or placed for (2) by redesignating sections 921 through amended by adding at the end the following: adoption with the individual; and 928, as sections 931 through 938, respectively; June 29, 2000 CONGRESSIONAL RECORD — SENATE S6177 (3) in section 938(1) (as so redesignated), by ‘‘(iv) includes the consideration of relevant activities that are designed to improve the striking ‘‘921’’ and inserting ‘‘931’’; and literature. quality of health care, the Director shall en- (4) by inserting after part B the following: ‘‘(B) CHARACTERISTICS.—The characteris- sure that the Center— tics described in this subparagraph include ‘‘(i) builds scientific knowledge and under- ‘‘PART C—REDUCING ERRORS IN HEALTH the following: standing of the causes of medical errors in CARE ‘‘(i) The analysis is interdisciplinary in na- all health care settings and identifies or de- ‘‘SEC. 921. DEFINITIONS. ture and involves those individuals who are velops and validates effective interventions ‘‘In this part: responsible for administering the reporting and strategies to reduce errors and improve ‘‘(1) ADVERSE EVENT.—The term ‘adverse systems. the safety and quality of patient care; event’ means, with respect to the patient of ‘‘(ii) The analysis focuses primarily on sys- ‘‘(ii) promotes public and private sector re- a provider of services, an untoward incident, tems and processes rather than individual search on patient safety by— therapeutic misadventure, or iatrogenic in- performance. ‘‘(I) developing a national patient safety jury directly associated with the provision of ‘‘(iii) The analysis involves a thorough re- research agenda; health care items and services by a health view of all aspects of the process and all con- ‘‘(II) identifying promising opportunities care provider or provider of services. tributing factors involved. for preventing or reducing medical errors; ‘‘(iv) The analysis identifies changes that ‘‘(2) CENTER.—The term ‘Center’ means the and could be made in systems and processes, Center for Quality Improvement and Patient ‘‘(III) tracking the progress made in ad- through either redesign or development of Safety established under section 922(b). dressing the highest priority research ques- new processes or systems, that would im- ‘‘(3) CLOSE CALL.—The term ‘close call’ tions with respect to patient safety; prove performance and reduce the risk of means, with respect to the patient of a pro- ‘‘(iii) facilitates the development of vol- medical events. vider of services, any event or situation untary national patient safety goals by con- ‘‘(12) SENTINEL EVENT.—The term ‘sentinel that— vening all segments of the health care indus- event’ means, with respect to the patient of ‘‘(A) but for chance or a timely interven- try and tracks the progress made in meeting a provider of services, an unexpected occur- tion, could have resulted in an accident, in- those goals; rence that— jury, or illness; and ‘‘(iv) analyzes national patient safety data ‘‘(A) involves death or serious physical or for inclusion in the annual report on the ‘‘(B) is directly associated with the provi- psychological injury (including loss of a sion of health care items and services by a quality of health care required under section limb); and 913(b)(2); provider of services. ‘‘(B) is directly associated with the provi- ‘‘(4) EXPERT ORGANIZATION.—The term ‘ex- ‘‘(v) strengthens the ability of the United sion of health care items and services by a States to learn from medical errors by— pert organization’ means a third party act- health care provider or provider of services. ing on behalf of, or in conjunction with, a ‘‘(I) developing the necessary tools and ad- ‘‘SEC. 922. RESEARCH TO IMPROVE THE QUALITY provider of services to collect information vancing the scientific techniques for anal- AND SAFETY OF PATIENT CARE. ysis of errors; about, or evaluate, a medical event. ‘‘(a) IN GENERAL.—To improve the quality ‘‘(II) providing technical assistance as ap- ‘‘(5) HEALTH CARE OVERSIGHT AGENCY.—The and safety of patient care, the Director propriate to reporting systems; and term ‘health care oversight agency’ means shall— ‘‘(III) entering into contracts to receive an agency, entity, or person, including the ‘‘(1) conduct and support research, evalua- and analyze aggregate data from public and employees and agents thereof, that performs tions and training, support demonstration private sector reporting systems; or oversees the performance of any activities projects, provide technical assistance, and necessary to ensure the safety of the health develop and support partnerships that will ‘‘(vi) supports dissemination and commu- care system. identify and determine the causes of medical nication activities to improve patient safety, ‘‘(6) HEALTH CARE PROVIDER.—The term errors and other threats to the quality and including the development of tools and ‘health care provider’ means— safety of patient care; methods for educating consumers about pa- ‘‘(A) any provider of services (as defined in ‘‘(2) identify and evaluate interventions tient safety; and section 1861(u) of the Social Security Act); and strategies for preventing or reducing ‘‘(vii) undertakes related activities that and medical errors and threats to the quality and the Director determines are necessary to en- ‘‘(B) any person furnishing any medical or safety of patient care; able the Center to fulfill its mission. other health care services as defined in sec- ‘‘(3) identify, in collaboration with experts ‘‘(C) LIMITATION.—Aggregate data gathered tion 1861(s)(1) and (2) of such Act through, or from the public and private sector, reporting for the purposes described in this section under the authority of, a provider of services parameters to provide consistency through- shall not include specific patient, health described in subparagraph (A). out the errors reporting system; care provider, or provider of service identi- ‘‘(7) PROVIDER OF SERVICES.—The term ‘pro- ‘‘(4) identify approaches for the clinical fiers. vider of services’ means a hospital, skilled management of complications from medical ‘‘(c) LEARNING FROM MEDICAL ERRORS.— nursing facility, comprehensive outpatient errors; and ‘‘(1) IN GENERAL.—To enhance the ability of rehabilitation facility, home health agency, ‘‘(5) establish mechanisms for the rapid the health care community in the United renal dialysis facility, ambulatory surgical dissemination of interventions and strate- States to learn from medical events, the Di- center, or hospice program, and any other gies identified under this section for which rector shall— entity specified in regulations promulgated there is scientific evidence of effectiveness. ‘‘(A) carry out activities to increase sci- by the Secretary after public notice and ‘‘(b) CENTER FOR QUALITY IMPROVEMENT entific knowledge and understanding regard- comment. AND PATIENT SAFETY.— ing medical error reporting systems; ‘‘(8) PUBLIC HEALTH AUTHORITY.—The term ‘‘(1) ESTABLISHMENT.—The Director shall ‘‘(B) carry out activities to advance the ‘public health authority’ means an agency or establish a center to be known as the Center scientific knowledge regarding the tools and authority of the United States, a State, a for Quality Improvement and Patient Safety techniques for analyzing medical events and territory, a political subdivision of a State to assist the Director in carrying out the re- determining their root causes; or territory, and an Indian tribe that is re- quirements of subsection (a). ‘‘(C) carry out activities in partnership sponsible for public health matters as part of ‘‘(2) MISSION.—The Center shall— with experts in the field to increase the ca- its official mandate. ‘‘(A) provide national leadership for re- pacity of the health care community in the ‘‘(9) MEDICAL EVENT.—The term ‘medical search and other initiatives to improve the United States to analyze patient safety data; event’ means, with respect to the patient of quality and safety of patient care; ‘‘(D) develop a confidential national safety a provider of services, any sentinel event, ad- ‘‘(B) build public-private sector partner- database of medical event reports; verse event, or close call. ships to improve the quality and safety of ‘‘(E) conduct and support research, using ‘‘(10) MEDICAL EVENT ANALYSIS ENTITY.— patient care; and the database developed under subparagraph The term ‘medical event analysis entity’ ‘‘(C) serve as a national resource for re- (D), into the causes and potential interven- means an entity certified under section search and learning from medical errors. tions to decrease the incidence of medical er- 923(a). ‘‘(3) DUTIES.— rors and close calls; and ‘‘(11) ROOT CAUSE ANALYSIS.— ‘‘(A) IN GENERAL.—In carrying out this sec- ‘‘(F) ensure that information contained in ‘‘(A) IN GENERAL.—The term ‘root cause tion, the Director, acting through the Cen- the national database developed under sub- analysis’ means a process for identifying the ter, shall consult and build partnerships, as paragraph (D) does not include specific pa- basic or contributing causal factors that un- appropriate, with all segments of the health tient, health care provider, or provider of derlie variation in performance associated care industry, including health care practi- service identifiers. with medical events that— tioners and patients, those who manage ‘‘(2) NATIONAL PATIENT SAFETY DATABASE.— ‘‘(i) has the characteristics described in health care facilities, systems and plans, The Director shall, in accordance with para- subparagraph (B); peer review organizations, health care pur- graph (1)(D), establish a confidential na- ‘‘(ii) includes participation by the leader- chasers and policymakers, and other users of tional safety database (to be known as the ship of the provider of services and individ- health care research. National Patient Safety Database) of reports uals most closely involved in the processes ‘‘(B) REQUIRED DUTIES.—In addition to the of medical events that can be used only for and systems under review; broad responsibilities that the Director may research to improve the quality and safety of ‘‘(iii) is internally consistent; and assign to the Center for research and related patient care. In developing and managing the S6178 CONGRESSIONAL RECORD — SENATE June 29, 2000 National Patient Safety Database, the Direc- lecting information about, or evaluating, ‘‘(1) establish a system for— tor shall— certain medical events. ‘‘(A) identifying, collecting information ‘‘(A) ensure that the database is only used ‘‘(b) COMPATIBILITY OF COLLECTED DATA.— about, and evaluating medical events that for its intended purpose; To ensure that data reported to the National occur with respect to a patient in the care of ‘‘(B) ensure that the database is only used Patient Safety Database under section the provider of services or a practitioner em- by the Agency, medical event analysis enti- 922(c)(2) concerning medical errors and close ployed by the provider of services, that may ties, and other qualified entities or individ- calls are comparable and useful on an ana- include— uals as determined appropriate by the Direc- lytic basis, the Director shall require that ‘‘(i) the provision of a medically coherent tor and in accordance with paragraph (3) or the entities described in subsection (c) follow description of each event so identified; other criteria applied by the Director; the recommendations regarding a common ‘‘(ii) the provision of a clear and thorough ‘‘(C) ensure that the database is as com- set of core measures for reporting that are accounting of the results of the investigation prehensive as possible by aggregating data developed by the National Forum for Health of such event under the system; and from Federal, State, and private sector pa- Care Quality Measurement and Reporting, or ‘‘(iii) a description of all corrective meas- tient safety reporting systems; other voluntary private standard-setting or- ures taken in response to the event; and ‘‘(D) conduct and support research on the ganization that is designated by the Director ‘‘(B) determining appropriate follow-up ac- taking into account existing measurement most common medical errors and close calls, tions to be taken with respect to such systems and in collaboration with experts their causes, and potential interventions to events; from the public and private sector. reduce medical errors and improve the qual- ‘‘(2) establish policies and procedures with ‘‘(c) DUTIES OF CERTIFIED ENTITIES.— ity and safety of patient care; respect to when and to whom such events are ‘‘(1) IN GENERAL.—An entity that is cer- to be reported; ‘‘(E) disseminate findings made by the Di- tified under subsection (a) shall collect and rector, based on the data in the database, to ‘‘(3) take appropriate follow-up action with analyze information, consistent with the re- respect to such events; and clinicians, individuals who manage health quirement of subsection (b), provided to the care facilities, systems, and plans, patients, ‘‘(4) submit to the appropriate medical entity under section 924(a)(4) to improve pa- event analysis entity information that con- and other individuals who can act appro- tient safety. priately to improve patient safety; and tains descriptions of the medical events ‘‘(2) INFORMATION TO BE REPORTED TO THE identified under paragraph (1)(A). ‘‘(F) develop a rapid response capacity to ENTITY.—A medical event analysis entity provide alerts when specific health care ‘‘(b) PROMOTING IDENTIFICATION, EVALUA- shall, on a periodic basis and in a format TION, AND REPORTING OF CERTAIN MEDICAL practices pose an imminent threat to pa- that is specified by the Director, submit to EVENTS.— tients or health care practitioners, or other the Director a report that contains— ‘‘(1) IN GENERAL.—Notwithstanding any providers of health care items or services. ‘‘(A) a description of the medical events other provision of law any information (in- ‘‘(3) CONFIDENTIALITY AND PEER REVIEW that were reported to the entity during the cluding any data, reports, records, memo- PROTECTIONS.—Notwithstanding any other period covered under the report; randa, analyses, statements, and other com- provision of law any information (including ‘‘(B) a description of any corrective action munications) developed by or on behalf of a any data, reports, records, memoranda, anal- taken by providers of services with respect provider of services with respect to a med- yses, statements, and other communica- to such medical events or any other meas- ical event pursuant to a system established tions) developed by or on behalf of a health ures that are necessary to prevent similar under subsection (a) shall be privileged in ac- care provider or provider of services with re- events from occurring in the future; and cordance with section 925. spect to a medical event, that is contained in ‘‘(C) a description of the systemic changes ‘‘(2) RULES OF CONSTRUCTION.—Nothing in the National Patient Safety Database shall that entities have identified, through an this subsection shall be construed as be confidential in accordance with section analysis of the medical events included in prohibiting— 925. the report, as being needed to improve pa- ‘‘(A) disclosure of a patient’s medical ‘‘(4) PATIENT SAFETY REPORTING SYSTEMS.— tient safety. record to the patient; The Director shall identify public and pri- ‘‘(3) COLLABORATION.—A medical event ‘‘(B) a provider of services from complying vate sector patient safety reporting systems analysis entity that is collaborating with a with the requirements of a health care over- and build scientific knowledge and under- health care provider or provider of services sight agency or public health authority; or standing regarding the most effective— to address close calls and adverse events ‘‘(C) such an agency or authority from dis- ‘‘(A) components of patient safety report- may, at the request of the health care pro- closing information transferred by a provider ing systems; vider or provider of services— of services to the public in a form that does ‘‘(B) incentives intended to increase the ‘‘(A) provide expertise in the development not identify or permit the identification of rate of error reporting; of root cause analyses and corrective action the health care provider or provider of serv- ‘‘(C) approaches for undertaking root cause plan relating to such close calls and adverse ices or patient. analyses; events; or ‘‘SEC. 925. CONFIDENTIALITY. ‘‘(D) ways to provide feedback to those fil- ‘‘(B) collaborate with such provider of serv- ‘‘(a) CONFIDENTIALITY AND PEER REVIEW ing error reports; ices to identify on-going risk reduction ac- PROTECTIONS.—Notwithstanding any other ‘‘(E) techniques and tools for collecting, tivities that may enhance patient safety. provision of law— integrating, and analyzing patient safety ‘‘(d) CONFIDENTIALITY AND PEER REVIEW ‘‘(1) any information (including any data, data; and PROTECTIONS.—Notwithstanding any other reports, records, memoranda, analyses, ‘‘(F) ways to provide meaningful informa- provision of law, any information (including statements, and other communications) de- tion to patients, consumers, and purchasers any data, reports, records, memoranda, anal- veloped by or on behalf of a health care pro- that will enhance their understanding of pa- yses, statements, and other communica- vider or provider of services with respect to tions) collected by a medical event analysis tient safety issues. a medical event, that is contained in the Na- entity or developed by or on behalf of such ‘‘(5) TRAINING.—The Director shall support tional Patient Safety Database, collected by an entity under this part shall be confiden- training initiatives to build the capacity of a medical event analysis entity, or developed tial in accordance with section 925. the health care community in the United by or on behalf of such an entity, or col- ‘‘(e) TERMINATION AND RENEWAL.— States to analyze patient safety data and to lected by a health care provider or provider act on that data to improve patient safety. ‘‘(1) IN GENERAL.—The certification of an entity under this section shall terminate on or services for use under systems that are de- ‘‘(d) EVALUATION.—The Director shall rec- veloped for safety and quality improvement ommend strategies for measuring and evalu- the date that is 3 years after the date on which such certification was provided. Such purposes under this part— ating the national progress made in imple- ‘‘(A) shall be privileged, strictly confiden- menting safe practices identified by the Cen- certification may be renewed at the discre- tion of the Director. tial, and may not be disclosed by any other ter through the research and analysis re- person to which such information is trans- quired under subsection (b) and through the ‘‘(2) NONCOMPLIANCE.—The Director may terminate the certification of a medical ferred without the authorization of the voluntary reporting system established health care provider or provider of services; under subsection (c). event analysis entity if the Director deter- mines that such entity has failed to comply and ‘‘(e) IMPLEMENTATION.—In implementing ‘‘(B) shall— strategies to carry out the functions de- with this section. ‘‘(f) IMPLEMENTATION.—In implementing ‘‘(i) be protected from disclosure by civil, scribed in subsections (b), (c), and (d), the Di- strategies to carry out the functions de- criminal, or administrative subpoena; rector may contract with public or private scribed in subsection (c), the Director may ‘‘(ii) not be subject to discovery or other- entities on a national or local level with ap- contract with public or private entities on a wise discoverable in connection with a civil, propriate expertise. national or local level with appropriate ex- criminal, or administrative proceeding; ‘‘SEC. 923. MEDICAL EVENT ANALYSIS ENTITIES. pertise. ‘‘(iii) not be subject to disclosure pursuant ‘‘(a) IN GENERAL.—The Director, based on ‘‘SEC. 924. PROVIDER OF SERVICES SYSTEMS FOR to section 552 of title 5, United States Code information collected under section 922(c), REPORTING MEDICAL EVENTS. (the Freedom of Information Act) and any shall provide for the certification of entities ‘‘(a) INTERNAL MEDICAL EVENT REPORTING other similar Federal or State statute or to collect and analyze information on med- SYSTEMS.—Each provider of services that regulation; and ical errors, and to collaborate with health elects to participate in a medical error re- ‘‘(iv) not be admissible as evidence in any care providers or providers of services in col- porting system under this part shall— civil, criminal, or administrative proceeding; June 29, 2000 CONGRESSIONAL RECORD — SENATE S6179 without regard to whether such information (2) the amount made available under this Secretary of Health and Human Services or is held by the provider or by another person title under the heading ‘‘OFFICE OF POSTSEC- an entity within the Department of Health to which such information was transferred; ONDARY EDUCATION’’ under the heading and Human Services. ‘‘(2) the transfer of any such information ‘‘HIGHER EDUCATION’’ to carry out part B of by a provider of services to a health care title VII of the Higher Education Act of 1965 HARKIN (AND WELLSTONE) oversight agency, an expert organization, a is decreased by $5,000,000. AMENDMENT NO. 3699 medical event analysis entity, or a public Mr. HARKIN (for himself and Mr. health authority, shall not be treated as a HELMS AMENDMENT NO. 3697 waiver of any privilege or protection estab- WELLSTONE) proposed an amendment to lished under paragraph (1) or established Mr. HELMS proposed an amendment the bill, H.R. 4577, as follows: under State law. to the bill, H.R. 4577, supra; as follows: On page 60, line 16, strike ‘‘$7,352,341,000’’ ‘‘(b) PENALTY.—It shall be unlawful for any At the appropriate place, insert the fol- and insert ‘‘$15,800,000,000.’’ person to disclose any information described lowing: On page 60, line 19, strike ‘‘$4,624,000,000’’ in subsection (a) other than for the purposes SEC. ll. (a) None of the funds appro- and insert ‘‘$13,071,659,000.’’ provided in such subsection. Any person vio- priated under this Act to carry out section f lating the provisions of this section shall, 330 or title X of the Public Health Service upon conviction, be fined in accordance with Act (42 U.S.C. 254b, 300 et seq.), title V or NOTICE OF HEARING title 18, United States Code, and imprisoned XIX of the Social Security Act (42 U.S.C. 701 SUBCOMMITTEE ON NATIONAL PARKS, HISTORIC for not more than 6 months, or both. et seq., 1396 et seq.), or any other provision of PRESERVATION, AND RECREATION OF THE ‘‘(c) APPLICATION OF PROVISIONS.—The pro- law, shall be used for the distribution or pro- COMMITTEE ON ENERGY AND NATURAL RE- tections provided under subsection (a) and vision of postcoital emergency contracep- the penalty provided for under subsection (b) SOURCES tion, or the provision of a prescription for Mr. THOMAS. Mr. President, I would shall apply to any information (including postcoital emergency contraception, to an any data, reports, memoranda, analyses, unemancipated minor, on the premises or in like to announce for the information of statements, and other communications) col- the facilities of any elementary school or the Senate and the public that a hear- lected or developed pursuant to research, in- secondary school. ing has been scheduled before the Sub- cluding demonstration projects, with respect (b) This section takes effect 1 day after the committee on National Parks, Historic to medical error reporting supported by the date of enactment of this Act. Preservation, and Recreation of the Director under this part. (c) In this section: Committee on Energy and Natural Re- ‘‘SEC. 926. AUTHORIZATION OF APPROPRIATIONS. (1) The terms ‘‘elementary school’’ and sources. The purpose of this hearing is ‘‘There is authorized to be appropriated to ‘‘secondary school’’ have the meanings given carry out this part, $50,000,000 for fiscal year the terms in section 14101 of the Elementary to receive testimony on S. 2294, a bill 2001, and such sums as may be necessary for and Secondary Education Act of 1965 (20 to establish the Rosie the Riveter- subsequent fiscal years.’’. U.S.C. 8801). World War II Home Front National His- SEC. 504. EFFECTIVE DATE. (2) The term ‘‘unemancipated minor’’ torical Park in the State of California, The amendments made by section 503 shall means an unmarried individual who is 17 and for other purposes; S. 2331, a bill to become effective on the date of the enact- years of age or younger and is a dependent, direct the Secretary of the Interior to ment of this Act. as defined in section 152(a) of the Internal recalculate the franchise fee owned by This Act may be cited as the ‘‘Depart- Revenue Code of 1986. Fort Sumter Tours, Inc., a conces- ments of Labor, Health and Human Services, sioner providing service to Fort Sum- and Education, and Related Agencies Appro- WELLSTONE (AND JOHNSON) priations Act, 2001.’’. ter National Monument, South Caro- AMENDMENT NO. 3698 lina; S. 2598, a bill to authorize appro- Mr. WELLSTONE (for himself and priations for the United States Holo- SCHUMER AMENDMENT NO. 3695 Mr. JOHNSON) proposed an amendment caust Memorial Museum, and for other (Ordered to lie on the table.) to the bill, H.R. 4577, supra; as follows: purposes; and S. Con. Res. 106, a resolu- Mr. SCHUMER submitted an amend- On page 92, between lines 4 and 5, insert tion recognizing the Hermann Monu- ment intended to be proposed by him the following: ment and Herman Heights Park in New to the bill, H.R. 4577, supra; as follows: SEC. ll. (a) LIMITATION ON USE OF FUNDS Ulm, Minnesota, as a national symbol On page 27, line 24, before the period insert FOR CERTAIN AGREEMENTS.—Except as pro- of the contributions of Americans of the following: ‘‘: Provided further, That in ad- vided in subsection (b), none of the funds German heritage. dition to amounts made available under this made available under this Act may be used by the Secretary of Health and Human Serv- The hearing will take place on Thurs- heading for the National Program of Cancer day, July 13, 2000, at 2:30 p.m., in room Registries, an additional $15,000,000 shall be ices to enter into— made available for such Program and special (1) an agreement on the conveyance or li- SD–366 of the Dirksen Senate Office emphasis in carrying out such Program shall censing of a patent for a drug, or on another Building in Washington, DC. be given to States with the highest number exclusive right to a drug; Because of the limited time available of the leading causes of cancer mortality: (2) an agreement on the use of information for the hearing, witnesses may testify Provided further, That amounts made avail- derived from animal tests or human clinical by invitation only. However, those able under this Act for the administrative trials that are conducted by the Department wishing to submit written testimony and related expenses of the Centers for Dis- of Health and Human Services with respect for the hearing record should send two to a drug, including an agreement under ease Control and Prevention shall be reduced copies of their testimony to the Com- by $15,000,000’’. which such information is provided by the Department to another Federal agency on an mittee on Energy and Natural Re- sources, United States Senate, SD–364, BINGAMAN AMENDMENT NO. 3696 exclusive basis; or (3) a cooperative research and development Dirksen Senate Office Building, Wash- (Ordered to lie on the table.) agreement under section 12 of the Stevenson- ington, DC 20510–6150. Mr. BINGAMAN (for himself, Mr. Wydler Technology Innovation Act of 1980 (15 For further information, please con- DASCHLE, Mr. JOHNSON, Mr. MCCAIN, U.S.C. 3710a) pertaining to a drug, excluding tact Jim O’Toole or Kevin Clark of the Mr. CONRAD, Mrs. MURRAY, Mr. LEAHY, cooperative research and development agree- Committee staff at (202) 224–6969. ments between the Department of Health and Mrs. BOXER) submitted an amend- f ment intended to be proposed by him and Human Services and a college or univer- sity. to the bill, H.R. 4577, supra; as follows: AUTHORITY FOR COMMITTEES TO (b) EXCEPTIONS.—Subsection (a) shall not MEET At the end of title III, insert the following: apply to an agreement where— SEC. ll. CONSTRUCTION AND RENOVATION (1) the sale of the drug involved is subject COMMITTEE ON AGRICULTURE, NUTRITION AND PROJECTS. to a price agreement that is reasonable (as FORESTRY Notwithstanding any other provision of defined by the Secretary of Health and Mr. FRIST. Mr. President, I ask this Act— Human Services); or unanimous consent that the Com- (1) the amount made available under this (2) a reasonable price agreement with re- mittee on Agriculture, Nutrition, and title under the heading ‘‘OFFICE OF POSTSEC- spect to the sale of the drug involved is not Forestry be allowed to meet during the ONDARY EDUCATION’’ under the heading required by the public interest (as defined by session of the Senate on Thursday, ‘‘HIGHER EDUCATION’’ to carry out section 316 such Secretary). of the Higher Education Act of 1965 is in- (c) RULE OF CONSTRUCTION.—Nothing in June 29, 2000. The purpose of this meet- creased by $6,000,000, which increase shall be this section shall be construed to apply to ing will be to mark up new legislation. used for construction and renovation any agreement entered into by a college or The PRESIDING OFFICER. Without projects under such section; and university and any entity other than the objection, it is so ordered. S6180 CONGRESSIONAL RECORD — SENATE June 29, 2000 COMMITTEE ON ARMED SERVICES nent Subcommittee on Investigations James L. Whigham, of Illinois, to be Mr. FRIST. Mr. President, I ask be authorized to meet during the ses- United States Marshal for the Northern Dis- unanimous consent that the Com- sion of the Senate on Thursday, June trict of Illinois for the term of four years. mittee on Armed Services be author- 29, 2000, 9:30 a.m., for a hearing entitled Russell John Qualliotine, of New York, to be United States marshal for the Southern ized to meet during the session of the ‘‘HUD’s Government Insured Mort- District of New York for the term of four Senate on Thursday, June 29, 2000, at gages: The Problem of Property ‘Flip- years. 9:15 a.m., in closed session to mark up ping.’ ’’ Julio F. Mercado, of Texas, to be Deputy the Fiscal Year 2001 Intelligence Au- The PRESIDING OFFICER. Without Administrator of Drug Enforcement. thorization Act. objection, it is so ordered. f The PRESIDING OFFICER. Without SUBCOMMITTEE ON NATIONAL PARKS HISTORIC LEGISLATIVE SESSION objection, it is so ordered. PRESERVATION AND RECREATION COMMITTEE ON ARMED SERVICES Mr. FRIST. Mr. President, I ask The PRESIDING OFFICER. Under Mr. FRIST. Mr. President, I ask unanimous consent that the Sub- the previous order, the Senate will re- unanimous consent that the Com- committee on National Parks, Historic sume legislative session. mittee on Armed Services be author- Preservation and Recreation be author- f ized to meet during the session of the ized to meet during the session of the Senate on Thursday, June 29, at 2:30 NEOTROPICAL MIGRATORY BIRD Senate on Thursday, June 29, 2000, at 10 p.m., to conduct a hearing. The sub- CONSERVATION ACT a.m., in open and closed session to re- committee will receive testimony on S. Mr. STEVENS. Mr. President, I ask ceive testimony on the report of the 134, a bill to direct the Secretary of the the Chair lay before the Senate a mes- National Missile Defense Independent Interior to study whether the Apostle sage from the House of Representatives Review Team. Islands National Lakeshore should be on the bill (S. 148), to require the Sec- The PRESIDING OFFICER. Without protected as a wilderness area; S. 2051, retary of the Interior to establish a objection, it is so ordered. a bill to revise the boundaries of the program to provide assistance in the COMMITTEE ON GOVERNMENTAL AFFAIRS Golden Gate National Recreation Area, conservation of neotropical migratory Mr. FRIST. Mr. President, I ask and for other purposes; S. 2279, a bill to birds. unanimous consent that the Com- authorize the addition of land to Se- The PRESIDING OFFICER laid be- mittee on Governmental Affairs be au- quoia National Park, and for other pur- fore the Senate the following message thorized to meet during the session of poses; S. 2512, a bill to convey certain from the House of Representatives: the Senate on Thursday, June 29, 2000, Federal properties on Governors Island, Resolved, That the bill from the Senate (S. at 1 p.m., for a hearing regarding Over- New York. 148) entitled ‘‘An Act to require the Sec- sight of Rising Oil Prices and the Effi- The PRESIDING OFFICER. Without retary of the Interior to establish a program ciency and Effectiveness of Executive objection, it is so ordered. to provide assistance in the conservation of Branch Response—Part II. SUBCOMMITTEE ON SUPERFUND, WASTE neotropical migratory birds’’, do pass with The PRESIDING OFFICER. Without CONTROL, AND RISK ASSESSMENT the following amendment: objection, it is so ordered. Mr. FRIST. Mr. President, I ask Strike out all after the enacting clause and insert: COMMITTEE ON THE JUDICIARY unanimous consent that the Sub- committee on Superfund, Waste Con- SECTION 1. SHORT TITLE. Mr. FRIST. Mr. President, I ask This Act may be cited as the ‘‘Neotropical Mi- unanimous consent that the Com- trol, and Risk Assessment be author- gratory Bird Conservation Act’’. mittee on the Judiciary be authorized ized to meet during the session of the SEC. 2. FINDINGS. to meet to conduct a markup on Thurs- Senate on Thursday, June 29, at 2 p.m., Congress finds that— day, June 29, 2000, at 10 a.m., in SD226. to conduct a hearing to receive testi- (1) of the nearly 800 bird species known to The PRESIDING OFFICER. Without mony on S. 2700, the Brownfields Revi- occur in the United States, approximately 500 objection, it is so ordered. talization and Environmental Restora- migrate among countries, and the large majority of those species, the neotropical migrants, win- SUBCOMMITTEE ON FISHERIES, WILDLIFE, AND tion Act of 2000. ter in Latin America and the Caribbean; WATER The PRESIDING OFFICER. Without objection, it is so ordered. (2) neotropical migratory bird species provide Mr. FRIST. Mr. President, I ask invaluable environmental, economic, rec- f unanimous consent that the Sub- reational, and aesthetic benefits to the United committee on Fisheries, Wildlife, and PRIVILEGES OF THE FLOOR States, as well as to the Western Hemisphere; Water be authorized to meet during the (3)(A) many neotropical migratory bird popu- Mr. JOHNSON. Mr. President, I ask lations, once considered common, are in decline, session of the Senate on Thursday, unanimous consent that Sharon June 29, at 9:30 a.m., to conduct a hear- and some have declined to the point that their Boysen of my office be granted floor long-term survival in the wild is in jeopardy; ing to receive testimony on pending privileges for the remainder of the day. and issues in the implementation of the f (B) the primary reason for the decline in the Safe Drinking Water Act. populations of those species is habitat loss and The PRESIDING OFFICER. Without EXECUTIVE SESSION degradation (including pollution and contami- objection, it is so ordered. nation) across the species’ range; and SUBCOMMITTEE ON FORESTS AND PUBLIC LANDS (4)(A) because neotropical migratory birds EXECUTIVE CALENDAR Mr. FRIST. Mr. President, I ask range across numerous international borders each year, their conservation requires the com- unanimous consent that the Sub- Mr. STEVENS. Mr. President, I ask unanimous consent that the Senate im- mitment and effort of all countries along their committee on Forests and Public migration routes; and Lands be authorized to meet during the mediately proceed to executive session (B) although numerous initiatives exist to session of the Senate on Thursday, to consider the following nominations conserve migratory birds and their habitat, June 29, at 10 a.m., to conduct an over- on today’s Executive Calendar, nomi- those initiatives can be significantly strength- sight hearing. The subcommittee will nations en bloc: 560 through 563. ened and enhanced by increased coordination. receive testimony on the United States I further ask unanimous consent the SEC. 3. PURPOSES. Forest Service’s Draft Environmental nominations be confirmed, the motion The purposes of this Act are— to consider be laid upon the table, the (1) to perpetuate healthy populations of Impact Statement for the Sierra Ne- President be immediately notified of neotropical migratory birds; vada Forest Plan Amendment, and the Senate’s action, and the Senate (2) to assist in the conservation of neotropical Draft Supplemental Environmental then return to legislative session. migratory birds by supporting conservation ini- Impact Statement for the Interior Co- The PRESIDING OFFICER. Without tiatives in the United States, Latin America, and the Caribbean; and lumbia Basin Ecosystem Management objection, it is so ordered. Plan. (3) to provide financial resources and to foster The nominations considered and con- international cooperation for those initiatives. The PRESIDING OFFICER. Without firmed en bloc are as follows: objection, it is so ordered. SEC. 4. DEFINITIONS. DEPARTMENT OF JUSTICE In this Act: SUBCOMMITTEE ON INVESTIGATIONS Daniel G. Webber, Jr., of Oklahoma, to be (1) ACCOUNT.—The term ‘‘Account’’ means the Mr. FRIST. Mr. President, I ask United States Attorney for the Western Dis- Neotropical Migratory Bird Conservation Ac- unanimous consent that the Perma- trict of Oklahoma. count established by section 9(a). June 29, 2000 CONGRESSIONAL RECORD — SENATE S6181

(2) CONSERVATION.—The term ‘‘conservation’’ (B) FORM OF PAYMENT.— (1) all amounts received by the Secretary in means the use of methods and procedures nec- (i) PROJECTS IN THE UNITED STATES.—The non- the form of donations under subsection (d); and essary to bring a species of neotropical migra- Federal share required to be paid for a project (2) other amounts appropriated to the Ac- tory bird to the point at which there are suffi- carried out in the United States shall be paid in count. cient populations in the wild to ensure the long- cash. (c) USE.— term viability of the species, including— (ii) PROJECTS IN FOREIGN COUNTRIES.—The (1) IN GENERAL.—Subject to paragraph (2), the (A) protection and management of neotropical non-Federal share required to be paid for a Secretary may use amounts in the Account, migratory bird populations; project carried out in a foreign country may be without further Act of appropriation, to carry (B) maintenance, management, protection, paid in cash or in kind. out this Act. and restoration of neotropical migratory bird SEC. 6. DUTIES OF THE SECRETARY. (2) ADMINISTRATIVE EXPENSES.—Of amounts habitat; In carrying out this Act, the Secretary shall— in the Account available for each fiscal year, (C) research and monitoring; (1) develop guidelines for the solicitation of the Secretary may expend not more than 3 per- (D) law enforcement; and proposals for projects eligible for financial as- cent or up to $80,000, whichever is greater, to (E) community outreach and education. sistance under section 5; pay the administrative expenses necessary to (3) SECRETARY.—The term ‘‘Secretary’’ means (2) encourage submission of proposals for carry out this Act. the Secretary of the Interior. projects eligible for financial assistance under (d) ACCEPTANCE AND USE OF DONATIONS.—The section 5, particularly proposals from relevant Secretary may accept and use donations to SEC. 5. FINANCIAL ASSISTANCE. wildlife management authorities; carry out this Act. Amounts received by the Sec- (a) IN GENERAL.—The Secretary shall estab- (3) select proposals for financial assistance retary in the form of donations shall be trans- lish a program to provide financial assistance that satisfy the requirements of section 5, giving ferred to the Secretary of the Treasury for de- for projects to promote the conservation of preference to proposals that address conserva- posit into the Account. neotropical migratory birds. tion needs not adequately addressed by existing SEC. 10. AUTHORIZATION OF APPROPRIATIONS. (b) PROJECT APPLICANTS.—A project proposal efforts and that are supported by relevant wild- There is authorized to be appropriated to the may be submitted by— life management authorities; and Account to carry out this Act $5,000,000 for each (1) an individual, corporation, partnership, (4) generally implement this Act in accordance of fiscal years 2001 through 2005, to remain trust, association, or other private entity; with its purposes. (2) an officer, employee, agent, department, or available until expended, of which not less than SEC. 7. COOPERATION. 75 percent of the amounts made available for instrumentality of the Federal Government, of (a) IN GENERAL.—In carrying out this Act, the any State, municipality, or political subdivision each fiscal year shall be expended for projects Secretary shall— carried out outside the United States. of a State, or of any foreign government; (1) support and coordinate existing efforts to (3) a State, municipality, or political subdivi- conserve neotropical migratory bird species, Mr. ABRAHAM. Mr. President, the sion of a State; through— Migratory Bird Conservation Act (4) any other entity subject to the jurisdiction (A) facilitating meetings among persons in- which I introduced with the Minority of the United States or of any foreign country; volved in such efforts; Leader, Senator DASCHLE, and our late and (B) promoting the exchange of information colleague Senator Chafee, is designed (5) an international organization (as defined among such persons; to protect the habitat of the over 90 en- in section 1 of the International Organizations (C) developing and entering into agreements Immunities Act (22 U.S.C. 288)). with other Federal agencies, foreign, State, and dangered species of migratory birds (c) PROJECT PROPOSALS.—To be considered for local governmental agencies, and nongovern- which spend the spring and summer financial assistance for a project under this Act, mental organizations; and months in the United States and the an applicant shall submit a project proposal (D) conducting such other activities as the winter months in other Western Hemi- that— Secretary considers to be appropriate; and sphere nations. (1) includes— (2) coordinate activities and projects under This will be the third time this bill (A) the name of the individual responsible for this Act with existing efforts in order to enhance has passed the Senate. It previously conservation of neotropical migratory bird spe- the project; cleared the Senate in 1998 and early (B) a succinct statement of the purposes of the cies. project; (b) ADVISORY GROUP.— 1999, but, until Monday’s 384–22 House (C) a description of the qualifications of indi- (1) IN GENERAL.—To assist in carrying out this vote, the legislation was stalled in the viduals conducting the project; and Act, the Secretary may convene an advisory other chamber. (D) an estimate of the funds and time nec- group consisting of individuals representing Despite taking almost three years, essary to complete the project, including sources public and private organizations actively in- this legislation remains very timely. and amounts of matching funds; volved in the conservation of neotropical migra- Many bird species of birds are threat- tory birds. (2) demonstrates that the project will enhance ened despite the growing popularity of the conservation of neotropical migratory bird (2) PUBLIC PARTICIPATION.— (A) MEETINGS.—The advisory group shall— birdwatching. species in the United States, Latin America, or (i) ensure that each meeting of the advisory Every year approximately 25 million the Caribbean; group is open to the public; and Americans travel to observe birds, and (3) includes mechanisms to ensure adequate (ii) provide, at each meeting, an opportunity local public participation in project development 60 million American adults watch and for interested persons to present oral or written feed birds at home. According to the and implementation; statements concerning items on the agenda. (4) contains assurances that the project will (B) NOTICE.—The Secretary shall provide to Fish and Wildlife Service, bird watch- be implemented in consultation with relevant the public timely notice of each meeting of the ing and feeding generates fully $20 bil- wildlife management authorities and other ap- advisory group. lion every year in revenue across propriate government officials with jurisdiction (C) MINUTES.—Minutes of each meeting of the America. over the resources addressed by the project; advisory group shall be kept by the Secretary Protecting the various species of (5) demonstrates sensitivity to local historic and shall be made available to the public. birds benefits the nation in a variety of and cultural resources and complies with appli- (3) EXEMPTION FROM FEDERAL ADVISORY COM- cable laws; MITTEE ACT.—The Federal Advisory Committee ways. The increased popularity of bird- (6) describes how the project will promote sus- Act (5 U.S.C. App.) shall not apply to the advi- watching is increasingly reflected in tainable, effective, long-term programs to con- sory group. the new tourist dollars being spent in serve neotropical migratory birds; and SEC. 8. REPORT TO CONGRESS. small, rural communities. Healthy bird (7) provides any other information that the Not later than October 1, 2002, the Secretary communities also prevent crop failures Secretary considers to be necessary for evalu- shall submit to Congress a report on the results and infestations by controlling insect ating the proposal. and effectiveness of the program carried out populations, thus saving hundreds of (d) PROJECT REPORTING.—Each recipient of under this Act, including recommendations con- assistance for a project under this Act shall sub- millions of dollars in economic losses cerning how the Act might be improved and each year to farming and timber inter- mit to the Secretary such periodic reports as the whether the program should be continued. ests. And yet, despite the enormous Secretary considers to be necessary. Each report SEC. 9. NEOTROPICAL MIGRATORY BIRD CON- shall include all information required by the SERVATION ACCOUNT. benefits we derive from our bird popu- Secretary for evaluating the progress and out- (a) ESTABLISHMENT.—There is established in lations, many of them are struggling to come of the project. the Multinational Species Conservation Fund of survive. (e) COST SHARING.— the Treasury a separate account to be known as In my own State we are working to (1) FEDERAL SHARE.—The Federal share of the the ‘‘Neotropical Migratory Bird Conservation bring the Kirtland’s Warbler back from cost of each project shall be not greater than 25 Account’’, which shall consist of amounts de- the brink of extinction. A few years percent. posited into the Account by the Secretary of the ago, the population of this distinctive (2) NON-FEDERAL SHARE.— Treasury under subsection (b). (A) SOURCE.—The non-Federal share required (b) DEPOSITS INTO THE ACCOUNT.—The Sec- bird has been estimated at approxi- to be paid for a project shall not be derived from retary of the Treasury shall deposit into the mately 200 nesting pairs. Since then, a any Federal grant program. Account— great deal of work has been done by S6182 CONGRESSIONAL RECORD — SENATE June 29, 2000 Michigan DNR employees to preserve ward. The continuing commitment of agreed to, the preamble be agreed to, the Kirtland’s Warbler habitat in the the Senate Environment Committee and the motion to reconsider be laid Bahamas, where they winter. Thanks was essential to bringing this bill to upon the table. in large part to this effort, the number the finish line. The PRESIDING OFFICER. Without of breeding pairs has recently increased And let me recognize the efforts of objection, it is so ordered. to an estimated 800. Kevin Kolevar of my staff, who began The resolution (S. Res. 331) was The problem we face in Michigan is the work on this bill back in February agreed to. simple. Since the entire species spends of 1998. The preamble was agreed to. half of the year in the Bahamas, the Finally, Mr. President, I want to rec- The resolution, with its preamble, significant efforts made by Michigan’s ognize the efforts of our former col- reads as follows: Department of Natural Resources and league and friend, Senator John S. RES. 331 concerned residents of Michigan will Chafee, who passed away earlier this Whereas, in the case of United States v. not be enough to save this bird if its year. As chairman of the Environ- Ellen Rose Hart, CR–F 99–5275 AWI, pending winter habitat is destroyed. The same mental Committee, Senator Chafee was in the United States District Court for the story is likely true for at least one bird a driving force behind this legislation. Eastern District of California, testimony has species in every other state. Senator Chafee and his committee been requested from Eric Vizcaino, an em- Because migratory birds range across staffer, Jason Patlis, shepherded this ployee in the office of Senator Boxer, and a number of international borders bill through the Senate twice. Monica Borvice, an employee in the office of every year, we must work to establish Senator Feinstein; This legislation is yet another addi- Whereas, pursuant to sections 703(a) and safeguards at both ends of their migra- tion to the long list of contributions 704(a)(2) of the Ethics in Government Act of tion routes, as well as at critical stop- made by Senator John Chafee to pro- 1978, 2 U.S.C. §§ 288b(a) and 288c(a)(2), the over areas along their way. Only in tect our natural resources for genera- Senate may direct its counsel to represent this case can conservation efforts prove tions. employees of the Senate with respect to any successful. I can think of no better tribute to subpoena, order, or request for testimony re- That is why Senator DASCHLE, Sen- Senator Chafee than to send this bill to lating to their official responsibilities; ator Chafee, and I introduced the the President with a resounding bipar- Whereas, by the privileges of the Senate of Neotropical Migratory Bird Conserva- tisan vote by the Senate. the United States and Rule XI of the Stand- ing Rules of the Senate, no evidence under tion Act. This legislation will protect Mr. STEVENS. I ask unanimous con- the control or in the possession of the Senate bird habitats across international sent the Senate agree to the amend- may, by the judicial or administrative proc- boundaries by teaming businesses with ment of the House. ess, be taken from such control or possession conservation groups, thus combining The PRESIDING OFFICER. Without but by permission of the Senate; capital with know-how. objection, it is so ordered. Whereas, when it appears that evidence These entities will then partner with f under the control or in the possession of the local organizations in countries where Senate may promote the administration of bird habitat is endangered to help AUTHORIZING TESTIMONY, DOCU- justice, the Senate will take such action as teach the local people how to preserve MENT PRODUCTION, AND LEGAL will promote the ends of justice consistently with the privileges of the Senate: Now, and maintain their critical natural REPRESENTATION IN UNITED STATES V. ELLEN ROSE HART therefore, be it habitat. Resolved, That Eric Vizcaino, Monica The 5 year demonstration project Mr. STEVENS. Mr. President, I now Borvice, and any other employee of the Sen- created by this Act will provide $5 mil- ask unanimous consent the Senate pro- ate from whom testimony or document pro- lion each year to help establish cost- ceed to the immediate consideration of duction may be required are authorized to sharing, habitat conservation programs S. Res. 331, submitted earlier by Sen- testify and produce documents in the case of in the United States, Latin America ator LOTT and Senator DASCHLE. United States v. Ellen Rose Hart, except con- and the Caribbean. The PRESIDING OFFICER. The cerning matters for which a privilege should This legislation is proactive, avoids clerk will report the resolution by be asserted. SEC. 2. The Senate Legal Counsel is author- complicated and expensive bureau- title. ized to represent Eric Vizcaino, Monica cratic structures and will bring needed The legislative clerk read as follows: Borvice, and any Member or employee of the focus and expertise to areas now re- A resolution (S. Res. 331), to authorize tes- Senate in connection with the testimony and ceiving relatively little attention in timony, document production, and legal rep- document production authorized in section the area of environmental degradation. resentation in United States v. Ellen Rose one of this resolution. And it has wide support in the environ- Hart. f mental and conservation communities. The Senate proceeded to consider the This legislation is endorsed by the concurrent resolution. MEASURE READ THE FIRST National Audubon Society, Ducks Un- Mr. LOTT. Mr. President, this resolu- TIME—H.R. 4680 limited, the Nature Conservancy, the tion concerns a request for testimony Mr. STEVENS. Mr. President, I un- American Bird Conservancy, Defenders in a criminal action in the United derstand H.R. 4680 is at the desk. I ask of Wildlife, the American Forest and States District Court for the Eastern for its first reading. Paper Association and the Conserva- District of California. In a federal in- The PRESIDING OFFICER. The tion Fund. These organizations agree dictment, the defendant has been clerk will report the bill by title. that establishing partnerships between charged with making a false statement The legislative clerk read as follows: business, government and nongovern- on a passport application and pos- A bill (H.R. 4680) to amend title XVIII of mental organizations both here and sessing a false identification document the Social Security Act to provide for a vol- abroad can greatly enhance the protec- in violation of federal law. untary program for prescription drug cov- tion of migratory bird habitat. In connection with the passport ap- erage under the Medicare Program, to mod- I want to thank the distinguished mi- plication that is the subject of the in- ernize the Medicare Program, and for other nority leader, my original partner for dictment, the defendant sought con- purposes. the past two and one half years, for his stituent casework assistance from the Mr. STEVENS. I now ask for its sec- hard work and efforts on behalf of this offices of Senator BARBARA BOXER and ond reading, and I object to my own re- legislation. His involvement and Senator DIANE FEINSTEIN. At the re- quest. perserverance—long with those of quest of the U.S. attorney who is pros- The PRESIDING OFFICER. The bill Peter Hanson and Eric Washburn of his ecuting this case, this resolution au- will receive its second reading on the staff—helped us overcome a variety of thorizes employees in both Senators’ following legislative day. obstacles and pave the way for this bill offices who worked on this constituent f to become law. casework matter to testify and produce I also want to thank Senator BOB documents at trial, with representa- ORDERS FOR FRIDAY, JUNE 30, 2000 SMITH, Chairman of the Environment tion by the Senate Legal Counsel. Mr. STEVENS. I now ask unanimous and Public Works Committee, for his Mr. STEVENS. Mr. President, I ask consent when the Senate completes its efforts to move this legislation for- unanimous consent the resolution be business today it stand in adjournment June 29, 2000 CONGRESSIONAL RECORD — SENATE S6183 until 9:30 a.m. on Friday, June 30, 2000. garding drug pricing, the Helms evening. I do encourage our colleagues I further ask that on Friday, imme- amendment regarding school facilities, to remain in the Chamber during the diately following the prayer, the Jour- the Harkin amendment regarding series of votes that will come about in nal of proceedings be approved to date, IDEA, the Baucus amendment regard- the morning hours tomorrow. the morning hour be deemed expired, ing the impact aid, any amendment f the time for the two leaders be re- that is not cleared within the man- served for their use later in the day, agers’ package, disposition of the point ADJOURNMENT UNTIL 9:30 A.M. and the Senate then resume consider- of order that is pending, final passage TOMORROW ation of H.R. 4577, the Labor, Health of the Labor, Health and Human Serv- Mr. STEVENS. If there is no further and Human Services, and Education ices, and Education appropriations bill, business to come before the Senate, I and possibly a vote on adoption of the appropriations bill under the previous ask unanimous consent the Senate conference report to accompany the order. stand in adjournment under the pre- The PRESIDING OFFICER. Without military construction appropriations vious order. objection, it is so ordered. bill. Mr. STEVENS. Mr. President, I fur- Mr. President, I hope that ‘‘possibly’’ There being no objection, the Senate, ther ask consent that following the is not possibly but it is a fact tomor- at 9:30 p.m., adjourned until Friday, June 30, 2000, at 9:30 a.m. votes, Senator DOMENICI be recognized row. as in morning business. I do want to say on my own behalf f The PRESIDING OFFICER. Without that the enactment of this bill that we objection, it is so ordered. have just brought out of conference is CONFIRMATIONS f absolutely essential to the well-being Executive nominations confirmed by of the men and women of the armed the Senate June 29, 2000: PROGRAM services of this country. If it is not DEPARTMENT OF JUSTICE Mr. STEVENS. For the information passed tomorrow and signed by the DANIEL G. WEBBER, JR., OF OKLAHOMA, TO BE UNITED of all Senators, on Friday the Senate President before the Fourth of July, STATES ATTORNEY FOR THE WESTERN DISTRICT OF will resume consideration of the Labor, OKLAHOMA. there will be severe repercussions in JAMES L. WHIGHAM, OF ILLINOIS, TO BE UNITED Health and Human Services, and Edu- the military services of this country. STATES MARSHAL FOR THE NORTHERN DISTRICT OF IL- cation bill at 9:30 a.m. Under the pre- LINOIS FOR THE TERM OF FOUR YEARS. We have worked day and night to get RUSSELL JOHN QUALLIOTINE, OF NEW YORK, TO BE vious order, there will be several votes this bill done, and I congratulate the UNITED STATES MARSHAL FOR THE SOUTHERN DIS- on the remaining amendments, which TRICT OF NEW YORK FOR THE TERM OF FOUR YEARS. Members of the House in accom- JULIO F. MERCADO, OF TEXAS, TO BE DEPUTY ADMIN- include the Wellstone amendment re- plishing passage of it earlier this ISTRATOR OF DRUG ENFORCEMENT.