Benjamin Cardin

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, will the gentleman yield?

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, let me thank my friend for yielding me this time. People listening to this debate have to be wondering what we are debating about and why we are debating this. It is certainly not advancing a bipartisan solution of our budget crisis in this country, and it is certainly not about deficit reduction, because the budget resolution before us is not being seriously considered. Those who brought it forward indicate they will vote against it. Democrats would welcome a new budget resolution. We know that the Republican budget resolution is not going to become law. We welcome bringing a new budget resolution to the floor. Many of us have suggested the coalition budget, a budget that has much more deficit reduction, realistic spending targets, and protects Medicare, Medicaid, education, and the environment. It does that by putting tax breaks after we balance the budget. If we want to reduce the deficit, we can do that today. Let us pass a clean CR and stop wasting $40 million a day of the taxpayers' money by closing Government when it should be open and we should be negotiating a new budget. These are childish games to be debating this type of an issue while Government is closed. We need serious negotiations without preconditions. That is what the Democrats are asking for. Yes, the Majority asked about a 7-year balanced budget and CBO numbers. We are prepared for that. But what my constituents are saying is, where is the change in the budget that protects Medicare, Medicaid, education, and the environment? The continuing resolution that we passed last month contained those promises as well, but the Republicans have not, in good faith, brought forth changes in their budget in order to protect Medicare, Medicaid, education, and the environment. Mr. Speaker, let us stop these games, let us sit down and negotiate a budget that we can all agree with so that we can pass a new budget resolution on the floor of this House that, yes, brings us to a balanced budget but also protects the priorities that are important to the American people. That is what we should be doing here today and not playing the games on this resolution.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, today I rise to introduce the Medicare Preventive Benefits Improvement Act. This bill seeks to amend Medicare by adding new preventive benefits to the program--benefits that not only save lives, but improve quality of life, and will save Medicare expenditures in the long run. My bill would improve Medicare by adding the following new benefits: Mammography: The benefit would be expanded so that all women over age 50 would be eligible for yearly mammographies and the deductible is waived. Screening pap smears and pelvic exams: Expands the benefit from the 3-year limitation so that women of childbearing age or at high risk of developing cervical cancer are eligible for yearly pap smears and cervical exams. The deductible is also waived. Colorectal cancer screening: Adds procedures for the purpose of early detection of colorectal cancer. These tests would include: screening fecal occult blood test, screening flexible sigmoidoscopy, and colonoscopy for high risk individuals. The Secretary also would make a decision within two years about covering screening barium enemas as an alternative to flexible sigmoidoscopy or colonoscopy. In addition, changes in technology would be taken into account to update the benefit in future years. Prostate cancer screening: Adds procedures for the purpose of early detection of prostate cancer in men. The tests would include a digital rectal examination and a prostate-specific antigen blood test. In addition, changes in technology would be taken into account to update the benefit in future years. Diabetes screening benefits: Adds two new diabetes benefits. First, coverage of diabetes outpatient self-management training services which teach people with diabetes how to properly care for their disease and avoid unnecessary medical complications. Second, Medicare would cover the costs of blood- testing strips as durable medical equipment. Many of you should recognize this package of preventive benefits. It is the same as the benefits we included in the Democratic alternative Medicare proposal that was considered on the House floor earlier this year. In addition, the coalition budget proposal includes a similar package of benefits. President Clinton has also included a preventive benefits package in his new Medicare proposal. Congress is currently facing the daunting task of making the most dramatic changes to Medicare ever contemplated. We keep hearing the words ``Medicare reform'' in relation to the variety of plans being put forth at this time. My contention is that if we are to accomplish real Medicare reform, we must make needed improvements to the program Medicare is 30 years old and its benefit package shows its age. What I am proposing with these new benefits is not a major cost item for the program. Of course there will be an upfront investment in these new screening procedures--and we expect that cost to be around $2 billion over the next 7 years based upon CBO analysis of earlier versions of the bill. However, this is a small price to pay at the beginning compared to the benefits Medicare will reap in the long run by covering such procedures. As we all know, preventive medicine saves money as well as lives. Early identification of a disease allows less costly, more effective treatment techniques to be used. For example, in the area of colorectal cancer, the second deadliest cancer in this country, 138,000 new cases will be diagnosed and 53,300 people will die from this disease this year. Most of these people will be Medicare beneficiaries. These patients often suffer through years of chemotherapy, surgery and hospitalization. In fact, the most recent data has shown that colorectal cancer has led to over 125,000 Medicare hospital admissions in one year. Each of these admissions led to costly diagnostic, surgical and medical therapeutic interventions. Surely, it is both more cost effective and more medically appropriate to prevent than to treat this disease. To continue using colorectal cancer as the example, this disease is one of the most preventable and curable types of cancer when detected early. Most colorectal cancers develop from benign polyps. Finding and removing these polyps reduces the risk of developing cancer by 90 percent. Screening for colorectal cancer and other preventive services included in this bill must be covered by Medicare if we hope to stem rising health care costs. We must not continue to be ``penny wise and pound foolish'' by covering the expensive treatments and ignoring preventive services. These efforts are supported by broad-range of organizations representing consumers and health professionals. The following organizations have endorsed our bill: the American Cancer Society, the American College of Gastroenterology, the American Gastroenterological Association, the American Nurses Association, the Digestive Disease National Coalition, the American Diabetes Association, the American Association of Clinical Urologists, the American Foundation for Urologic Disease, the American Urological Association, the American Society for Gastrointestinal Endoscopy, the Cancer Research Foundation of America, the Association of American Cancer Institutes, the Association of Pediatric Oncology Nurses, and the United Ostomy Association. I have also attached a letter to the congressional leadership signed by 15 organizations supporting the identical provisions included in my bill. It is my hope that this legislation will be used as a model for the preventive benefit package that should be added to Medicare as we seek to reform the system. I encourage my colleagues to join me in support of this bill and look forward to continuing to work on this important issue as Congress grapples with the difficult task of reforming Medicare. November 16, 1995. Hon. Robert Dole, Majority Leader U.S. Senate, Washington, DC. Hon. Newt Gingrich, Speaker, U.S. House of Representatives, Washington, DC. Dear Senator Dole and Speaker Gingrich: In crafting the future Medicare system, the 104th Congress would be remiss to overlook the most significant key to the future health status of our nation's citizens--preventive health services. The undersigned organizations urge you to include preventive services coverage for Medicare recipients during the Reconciliation Conference. When details of the draft Republican health plan first became known this summer, we applauded the foresight of Congressional policymakers for including Medicare payments for a small number of proven preventive health services. While we recognize the fiscal constraints dominating this first round of Budget Reconciliation decisionmaking, we urge your reconsideration of the critical omission of colorectal cancer screening, mammography expansions, pap smears and pelvic examinations, prostate cancer screening and reimbursement for diabetes care and education. We believe strong bipartisan support exists for including these limited preventive benefits under Medicare. In revamping Medicare, now is the time to provide reimbursement for: Annual mammography screening services for all women over the age of 49, without a twenty percent copayment. Pap smear and pelvic exam screenings as well as clinical breast examinations for female Medicare beneficiaries, without copayments. Colorectal screening services for Medicare beneficiaries, including screening of fecal-occult blood testing, flexible sigmoidoscopies and colonoscopies. Prostate cancer screening for men. Diabetes care and education, specifically the coverage of outpatient self-management training services and blood testing strips for diabetics. We strongly urge that you include the above screening services as part of the revamped Medicare program. In the long run, providing preventive services to Medicare beneficiaries will save not only money, but more importantly lives. The Senate and House are uniquely poised to better the lives of millions of Medicare beneficiaries who stand so much to lose or gain from this historic legislative opportunity. We respectfully request the opportunity to meet with you at your earliest convenience to discuss including these preventive benefits in the final package. Sincerely, American Cancer Society, American College of Gastroenterology, American Diabetes Association, American Foundation for Urologic Disease, American Public Health Association, Cancer Research Foundation of America, Digestive Disease National Coalition, Families Against Cancer Terror (FACT). National Breast Cancer Coalition, National Coalition for Cancer Survivorship, The Oncology Nursing Society, The Association of Pediatric Oncology Nurses, The Susan G. Komen Breast Cancer Foundation, United Ostomy Association, The V Foundation.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, let me thank my friend from Florida, Mr. Gibbons, for yielding me this time. Mr. Speaker, I am sure that the viewers who are listening and the people in the gallery that are listening are somewhat confused about what this is all about. You would believe it is about protecting Social Security trust funds if you listen to what the Republicans are saying. Mr. Speaker, that is not what this is about. This is about putting additional leverage on the President in budget negotiations; it is about causing the default on our national debt. They claim it is not about causing default on our national debt, even though that is what this bill in fact does. If you are concerned about protecting the Social Security trust fund, in the motion to recommit we will have something to speak about that. But I daresay that my Republican friends will vote against the motion to recommit because this is not about protecting the Social Security trust fund. You do not protect the Social Security trust fund or any other trust fund by putting the national debt default at risk. That is not how you protect the payments to our Social Security beneficiaries. During fiscal chaos, those who rely on the trust funds are at more risk, not less at risk. That is when we tend to do things that we later regret. So this is about trying to put additional leverage on the President and on the Congress on dealing with the deficit, and this should not be the vehicle to do it. You do not put the debt of the Nation at risk and default, particularly when this debt limit has already been approved by the Republican leadership and the Members by previous votes of this House. You have already agreed on this debt limit. You have already spent this money. Now you have the audacity to come forward to say that we should not pay the bills that we have already incurred under the bills you have already brought forward and the debt limit you have already approved. Let us act responsibly, let us defeat this bill. That is the best way we can protect the trust funds of this Nation.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, I thank the gentleman for yielding me the time. I just took this time because I think it is important to correct the record. Mr. Speaker, this bill does not protect the trust funds. We do not protect the trust funds by causing fiscal chaos for this Nation. If we want to ensure that our Social Security recipients receive their Social Security checks, we do not jeopardize the payment on our debt of this Nation. If this bill were to pass, it would cause an immediate default on the national debt. I do not think anybody wants to see that happen. Why are we not passing a clean debt extension? It has already been passed a couple of times by this House. This is not anything new. This debt limit has already been approved and voted on by just about every Republican in this House. But they are playing games with the ability of people to receive their Social Security checks. I urge my colleagues to defeat the previous question so that we can get a clean debt extension that will really protect our Social Security recipients.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, for the past 4 years, we have witnessed systematic ethnic cleansing in the former Yugoslavia. The United States and its allies have done precious little. It is an outrage to humanity that Europe and the United States stood on the sidelines, watching the aggressors willfully violate international standards of human rights. It can be argued that it is too late to help the people of Bosnia. That Sarajevo lies in rubble. That Europe is primarily to blame for the failure to act. That the United States should have exercised its leadership earlier. In my opinion, all of these concerns are true. However, it is never too late to act to stop human atrocities. President Clinton deserves the international community's appreciation for bringing the warring parties together. Although all of us hope these recent peace efforts will succeed, I have serious questions about this NATO mission. The territorial boundaries that have been agreed upon lack historical confidence. The will of the leadership in the former Yugoslavia for peace is uncertain. Yet, this agreement presents the only hope for peace and an end to the massive human rights abuses. There are those who believe that we have no national interest in Bosnia. I disagree. Stability in the Balkans is important to a stable Europe and a stable Europe is important to the economic and security interests of the United States. It is also in the national interest to speak loudly against the continuation of ethnic cleansing. Others say correctly that the United States cannot act in all parts of the world when human rights are violated. However, that should not be a justification for failing to act when we can. Mr. Speaker, I have serious reservations about the military strategy of this mission. I am concerned as to whether the time table is reasonable and as to whether we can achieve peace. I am disappointed that the President has chosen not to precede under the war powers act, to seek congressional approval to send our troops to a foreign hostile area. In addition, the house leadership has regrettably failed to allow us to consider a resolution, similar to what is being considered by the other body, which speaks to an appropriate exit policy. An appropriate exit policy clearly would ensure the arming and training of the Bosnian Moslems, the primary victims of aggression, It is imperative for NATO forces to exit the region with the Bosnian Moslems adequately prepared and knowing that a long-term NATO presence is not necessary because there is an equal military balance among the formerly warring factions. However, the three resolutions that are before us today do not speak to these military concerns. Therefore, I voted against the rule in which these resolutions where made in order. It is clear from court decisions that the President has the constitutional authority to commit U.S. troops to this mission. All of us, regardless of our views as to whether the President should commit the United States to the NATO implementation force, stand behind our troops, therefore, the only resolution that I can support is the Hamilton resolution which speaks to the support of our troops and points out concerns raised by Members.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, I rise to pay tribute to Stewart Greenebaum. On December 10, 1995, Stewart Greenebaum will receive the Humanitarian Award from the Baltimore Zionist District. Stewart Greenebaum deserves this award because of his strong commitment to his community and to the State of Israel. Stewart has donated his time, effort, and energy to worthy causes. [[Page E 2317]] Stewart Greenebaum has made tremendous contributions to the Baltimore Zionist District. He is currently serving as chairman for Israel Bonds of Maryland, as well as chairman of the Board of the University of Maryland Medical System. In addition, Stewart Greenebaum is the founder and chairman of a scholarship fund for financially disadvantaged medical students and he is the founder and chairman of the Children's House at Johns Hopkins which provides shelter and comfort to families of sick children. Mr. Speaker, it is a pleasure to call Stewart Greenebaum's achievements to the attention of my colleagues. By having individuals like Stewart Greenebaum in our communities, our work as public servants in Congress is made that much easier and that much more pleasurable.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, I rise today to honor the accomplishments of my hometown Baltimore Stallions, 1995's Grey Cup CFL Champions. This class organization, in just its second year of existence, has become the first American team to win the Grey Cup, Canadian football's version of the Super Bowl. Led by C.F.L. most valuable player Mike Pringle, along with the quarterback Tracy Ham and an excellent supporting cast, the Stallions victory in their second consecutive Grey Cup appearance is proof that football has, indeed, been alive and well in Baltimore for quite some time now. In winning the Grey Cup, the Stallions have capped off a remarkable season this year by finishing 18-3, a new C.F.L. record. This victory also completes a football trifecta for Baltimore as we become the first city to have won an N.F.L. title, a U.S.F.L. title, and now our latest, a C.F.L. crown for our Stallions. I am proud to be a Baltimorean today Mr. Speaker, as I congratulate the 1995 C.F.L. Champion Baltimore Stallions.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, quite frankly my constituents do not quite understand why we are behaving the way we are today, when it is my constituents, when it is the Federal worker, when it is the taxpayer, when it is the person who needs Federal services that has the right to be outraged and to lose their patience from what we are not doing in this Chamber. Let me bring us back to the rule that is before us that will permit us to have a continuing resolution so that our veterans, Social Security benefits, and Medicare can be processed. That is a reasonable request, a continuing resolution for those purposes. My constituents are asking why can we not have a continuing resolution for the other agencies of Government? If it is simple enough under suspension of the rules to pass authority to spend money for veterans, Social Security, and Medicare, why can we not do it for all of the appropriations where this House has not sent to the President an appropriation bill? My constituents are being inconvenienced not just on Social Security and veterans' checks but on their inability to get a passport processed, on their inability to have other Government services performed. They are outraged because our agencies are closed, we are telling Federal workers to stay home and be paid for the services that are not being performed, we are in fiscal crisis, and we are doing that? If we can pass a continuing resolution without holding the President hostage on these areas, then why can we not come together and pass a continuing resolution on all of the agencies of Federal Government? Do not bring up the balanced budget or other issues. Many of us support balancing the budget in 7 years. We can debate that on the budget. Not on a continuing resolution. You are showing willingness for veterans, Social Security, and Medicare, then show a way to do it for all of our agencies. Yes, let us support this, but let us bring up a continuing resolution for all Government services.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, let me thank my friend for yielding me this time. I oppose this budget. It is based upon the wrong premises. It is based upon a large tax cut for the wealthy while we are wallowing in debt, asking our seniors to pay more for their health care and get less, and extreme cuts in education and the environment. There is a better way. The Coalition budget would balance the budget in 7 years with less borrowing and debt, with reasonable appropriations for Medicare and for education programs. I ask my colleagues to reject this Republican budget. Let us truly work together in a bipartisan way and support a budget that will balance the budget in 7 years with less extreme cuts. We can do it if we were only willing to work together in a bipartisan way. Vote against this Republican budget.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, today I am introducing legislation that would convert the budget resolution from a concurrent resolution of the Congress into a joint resolution that would require the President's signature and have the force of law. For the past several months, news reports have been full of discussion about the possibility of a fiscal train wreck. Tomorrow, due to the failure of Congress to pass appropriations bills and a reconciliation bill, 800,000 Federal employees will be sent home and Federal agencies will shut down. Millions of Americans will be without the services of those agencies and will again have to contemplate the absurd process that brought us to this situation. At the root of the crisis is disagreement between the Congress and the President over big-ticket items in the budget. The congressional leadership is attempting to gain leverage over the President in the budget debate by attaching extraneous, irrelevant, and controversial provisions to such must-pass legislation as the continuing resolution and the debt-ceiling bill. The resulting disruption of Federal services would be a major inconvenience for millions of Americans, and a financial catastrophe for thousands of American families which depend on Federal paychecks. The legislation I am introducing today is designed to prevent future threats of train wrecks by bringing the President into the congressional budget process at an earlier point. Currently, the President is required to submit a budget at the start of the calendar year. Congress then spends the next few months working on its own budget resolution. The congressional budget resolution is a concurrent resolution of the Congress, which does not have the force of law. This year, Congress spent the first 100 days of this session working on the Contract With America legislation. As a result, the work on the budget resolution was delayed. Instead of complying with the April 15 deadline established in the Budget Act, the House did not complete its work on the budget until May 18, and the final budget was not approved until June 29, 2\1/2\ months late. The delay in passing a budget put Congress way behind schedule on the appropriations bills. In addition to putting Congress behind schedule, the budget resolution, passed without Presidential involvement or approval, also put Congress and the President on a collision course on policy. By calling for $270 billion in Medicare cuts, and $245 billion in tax breaks, mostly directed to the wealthiest Americans, the budget also created the likelihood of the crisis we face now. Now, 6 weeks after the start of the new fiscal year, we have still not passed reconciliation legislation, only 3 of the 13 regular appropriations bills have been sent to the President, and the President and the congressional leadership remain sharply at odds over these major issues. The shame is that this situation could have been prevented. Had the Congress been required to pass a budget resolution that must be signed into law by the President, these issues would have been resolved months ago. Instead of having a legislative showdown that threatens the delivery of Federal services to millions of Americans and the paychecks of thousands of American families, we should have resolved the issues during the spring and summer. The budget resolution can never be more than a blueprint for Federal spending. The thousands of individual programmatic decisions on spending must be handled in the appropriations process. By making the budget resolution a joint resolution, and giving the President the power to sign it or veto it, we would force the tough decisions between the two branches of Government to be resolved before we reach crisis stage. The result would produce a Government that functioned more efficiently. In addition to requiring the President to sign the budget resolution, the bill I introduce today would also address the issue of increasing the debt ceiling. In addition to the crisis of shutting down Federal agencies, we also face a potentially far more serious crisis regarding the creditworthiness of the Federal Government. It is an outrage that the congressional Republican leadership is willing to risk the full faith and credit of the Federal Government in order to achieve its political objectives. Yet that is the situation we face today. Never in the history of our country has the Federal Government defaulted on its financial obligations. This legislation would automatically increase the debt ceiling with adoption of the budget resolution. Once a budget has been approved, and signed by the President, the amount of debt that will be incurred has been established. It makes no sense to require a separate vote to raise the debt ceiling. Passage of the budget sets the deficit or surplus, and the [[Page E 2166]] amount, if any, by which the debt ceiling will need to be increased. It is utterly irresponsible, once Congress has authorized a deficit, to refuse to raise the debt ceiling. The irony of our current circumstances is that the Republican majority in both Houses of Congress has already voted to raise the debt ceiling to $5.5 trillion, to cover the deficits over the next 2 years. My legislation would give the force of law to Congress' budget policy decisions. Nobody benefits when the Congress and the President are at loggerheads and the Nation's fiscal credibility hangs in the balance. The American people are sick and tired of the gridlock in Washington. Some in Washington, anticipating the shutdown of Government, have adopted the slogan, ``Don't Blink.'' What they mean is they have their eyes closed right to the damage this train wreck will inflict. The American people are not interested in a Government in which elected officials close their eyes to their responsibilities. This crisis is of our own making. We can take steps to prevent it from recurring in the future. The legislation I have introduced today will require the President and the Congress to work together much earlier in the budget process, and will help us keep the trains on track.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, let me make it clear. To the extent that there is any risk to our trust funds, to the extent that there is a risk as to whether we will honor our debt, to the extent that whether there is a risk as to whether we are able to continue essential services, that falls to the Republicans' failure to bring to this floor a clean extension of our debt ceiling, and let me explain the hypocrisy of the Republicans here. Their budget calls for an increase, an increase in our national debt authority of $600 billion. They have already approved it on the House floor. They have already approved it on the Senate floor. But we have not brought to the President an agreed budget that includes that $600 billion, so we do not have that authority here today. Now why do we not have that $600 billion additional authority? Because the Republicans have missed the deadline. The deadline was October 1 to get their budget passed and to the President. They missed that deadline, they missed it badly, and now we run up against the debt ceiling, and we are being asked to extend it by about one-tenth of the permanent amount that is in their budget, a little over $60 billion, and the Republicans say, ``Wait a minute. We want to put all types of conditions on that extension that aren't acceptable to the President.'' Mr. Speaker, the President is not at fault that we have not met our deadlines. It is the Republican leadership's fault, and yet they are trying to use process here on attaching legislation that is wrong, that when they took the leadership of this House they said they would not do, and they are doing it here today, and it is wrong, and the Republicans are putting at risk the credit of this country. The Republicans are putting at risk our trust funds and our ability to pay the obligations of this country, and that is wrong. Mr. Speaker, we have said from our side of the aisle bring a clean debt extension and we will support it, but this bill is wrong. It should be defeated.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, I thank my colleague for yielding time to me. Mr. Speaker, I have a question as to why are we considering a temporary debt extension? Why are we not considering a permanent extension for the 2-year period? After all, we have already approved in this House an increase in the debt by $600 billion to $5.5 trillion. Why should we not separate that? Let us pass a permanent extension for this term of Congress so that we do not hold hostage the credit of this Nation, which could affect the interest rates that our constituents pay on their mortgage payments or on their car loans or on their credit cards. Why do we not just do that, separate it, get it done. Mr. Speaker, we could have bipartisan support for that type of a debt extension. But no, we have a temporary bill before us. Why is it temporary? Why? Because we have not gotten our work done. Republicans have not brought forward the appropriation bills or the changes in the entitlement programs to conform to their budget. It should have been done by October 1, but we are now debating this in November when it should have been done in October. So we need to do a temporary extension. Well, we could have bipartisan support for a temporary extension, if we would just remove the issues that are not relevant to the debt extension. It is your fault that we have a delay. We are willing to have bipartisan support for a temporary extension if we just do a temporary extension. But no, you have to have all of these other issues to this temporary debt extension bill. Mr. Speaker, they promised that we were going to have regular legislative process, that we would use the procedures properly in this House. That was one of their promises. This bill that is before us and the rule that is before us violates that promise. Another Republican promise broken. [[Page H 12001]] I urge my colleagues to defeat the rule.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, I thank the gentleman from Virginia for yielding. Mr. Speaker, the gentleman's motion is an effort for us to work in a bipartisan manner on dealing with this budget. Let me explain this. It is the preference of the President, it is my preference, that we have a long-term extension of the debt ceiling. That is not to be the case. The Republicans want to have leverage on the debt ceiling in dealing with the budget. I think that is wrong. I do not think we should jeopardize the credit of this Nation. I do not think we should jeopardize interest rates that consumers have to pay. But if we are going to [[Page H 12063]] have a short-term extension, it should be one that both Democrats and Republicans can support. It is not the President's fault that we are here tonight asking for an extension of the debt ceiling. It is the failure of the leadership to pass the appropriation bills, to pass the budget by the October 1 deadline. We are well past that. Democrats are willing to work with Republicans on a debt extension so we do not jeopardize the credit of the Nation, but let us make it a clean extension. Let us not put these extra issues in there to make it impossible for Democrats to support and guarantee a Presidential veto. It is our fault, the Republican leadership's fault, for not meeting the deadlines. Give us a debt extension that Democrats and Republicans can support so we do not run the risk of the credit of this Nation. That is the choice we have. The gentleman's motion will extend the debt ceiling until we pass the budget bills and have sent them to the President. It is a clean extension. I urge my colleagues in a bipartisan manner to support the motion.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, as a Member of the congressional delegation that attended Mr. Rabin's funeral, let me share with you some of my observations from returning from Jerusalem. Mr. Rabin was truly a unique individual who pursued peace, and his loss will be deeply felt in the peace process, make no mistake about that. We have lost a unique individual who was committed to bringing about peace. As President Clinton remarked and as King Hussein of Jordan remarked, the legacy of Mr. Rabin must be to move forward in the peace process. The best way to honor Mr. Rabin's memory is for all of us to rededicate ourselves to peace in the Middle East. My observations of what is happening in Israel today is that the Israelis are more united, more committed to peace than ever before, and I think that is a fitting tribute to Mr. Rabin's work.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, I am very pleased to be an original cosponsor of this bill and part of a true bipartisan effort to reform the way campaigns are financed. Such a complex issue can only be responsibly addressed in a bipartisan fashion. We, the Members of the 104th Congress, have an opportunity to stop the erosion of public confidence in our democratic system. The skyrocketing cost of congressional campaigns, the influence of special interests through large contributions and political action committees [PAC's], and the advantage of incumbency in raising campaign funds in elections must be addressed. This bill addresses all three issues. This bill is strong reform. It places firm but reasonable limits on the amount of money candidates can spend on campaigns. In addition, it bans soft money and leadership PAC's and deals responsibly with independent expenditures. Furthermore, it encourages small, individual contributions. I am, however, opposed to one part of this proposed legislation. There should be parity in the restrictions imposed on large contributions and PAC contributions. Instead, this legislation bans PAC contributions but allows large contributions to finance up to 25 percent of a candidate's campaign. In the spirit of bipartisanship, PAC contributions should be treated similarly to large contributions. Perhaps the most important message we could take to the American people is that we have a bipartisan bill. By treating large individual contributions differently from PAC contributions, we lose that message. I hope that as this legislation proceeds throughout the Congress, we will address this disparity. I am convinced that once this inequity is resolved, the bill will receive even stronger support. Mr. Speaker, I urge my colleagues to carefully review this legislation. I know that once they do, they will agree that this type of bipartisan effort is the only way to achieve real campaign finance reform.

Mr. CARDIN

Mr. CARDIN. Mr. Chairman, I rise in strong support of the coalition budget. It is clearly the best plan before us. It balances the budget within 7 years, and it provides for less borrowing and less debt than the Republican plan. It is not perfect. I disagree with some of the provisions in there. I would like to see a little more time in understanding the COLA changes. I would have had less Medicare cuts. However, the key difference between the substitute and the Republican bill is the tax provisions. There are no tax cuts in this proposal, because this proposal is serious about deficit reduction. The Republican budget runs the risk of us repeating the same mistakes that we made in 1981. In 1981 we thought we could cut taxes. We promised to control future spending. We saw the deficit soar. We could very well end up with the Republican budget devastating programs for our seniors, for our children, and our environment, and still have large deficits. That is the risk we run with the Republican budget. The coalition budget puts the spending cuts towards deficit reduction, where it should. It does less cuts in order to preserve Medicare, in order to preserve our opportunities for higher education, in order to preserve our programs for the environment. The Members have a clear choice. In supporting the coalition budget, they are supporting cuts for deficit reduction. In the Republican plan, we are talking about cuts in order to provide for tax breaks for the wealthy. I think it is a clear choice, and I am proud to support the coalition budget. I rise in support of the coalition budget plan. It is the best plan that has yet been proposed for balancing the budget. Two years ago, we took a major first step toward eliminating Federal budget deficits. The 1993 budget plan has succeeded in bringing deficits down for 3 consecutive years, and the deficit in the year just ended was about half what it would have been. This year, we have to take the next step, and move toward a balanced budget. The coalition budget will balance the budget in 7 years, through spending cuts that are real, but not harsh. The plan balances the budget more quickly, with less borrowing than the Republican leadership budget. The coalition budget is not perfect. The cost of living adjustment in this plan raises many serious issues that have not been adequately considered. The level of Medicare cuts would not devastate the program, as the Republican plan does, but they exceed the amount I believe is necessary. I would have preferred alternative spending cuts. Nonetheless, the authors of the coalition plan have learned the lessons of recent budget history. In 1981, in the Reagan revolution, Congress enacted the Reagan plan of tax cuts and promised spending cuts. What resulted was an explosion of Federal deficit spending. Today, in 1995, the Gingrich revolution is hell-bent on repeating the fiscal mistakes of 1981. By cutting taxes by $245 billion, mostly to benefit the most well-off Americans, this plan again puts the cart before the horse. We should not be borrowing hundreds of billions of dollars for tax breaks, while we are still piling up hundreds of billions of debt. With the Republican budget, we could very easily end up slashing programs that are needed for our seniors, students, and the environment, and still have large budget deficits. The coalition budget is driven by the need to balance the budget, preserve Medicare, and maintain our commitment to higher education. The Republican leadership budget is about cutting taxes and taking the first step toward eliminating Medicare. Do not take my word for it. Speaker Gingrich, the architect of this plan, yesterday said that he would have gotten rid of Medicare but it would not be ``politically smart.'' The difference could not be clearer. The coalition budget cuts spending to balance the budget. The Republican budget cuts taxes to benefit the wealthy, and cuts Medicare as a first step toward eliminating this most successful American program. I urge my colleagues to support the coalition budget, and reject the committee budget.

Mr. CARDIN

Mr. CARDIN. Mr. Chairman, I rise in strong opposition to a budget reconciliation package that violates every concept of truth in labeling and truth in advertising. If you believe this reconciliation bill is about balancing the budget and keeping promises, you believe Joe Camel was created to teach children about dangers of smoking. The problems with this bill begin with the numerous horrendous provisions that betray the middle class, working Americans who pull the wagon. The attack on the middle class is broad and bold. This bill opens the door to those who would raid pension funds and put at risk the retirement benefits of working Americans. At the same time, it closes the door to higher education for millions of Americans by restricting access to student loans. Elderly Americans also face a double-barreled attack. Two hundred seventy billion dollars of Medicare cuts threaten the availability and affordability of basic medical care. Another $180 billion of cuts in Medicaid will tear at the family budgets of millions of elderly Americans, and their children, who are trying to cope with the costs of nursing care. The promises broken in this bill are far too many to mention in just a few minutes. But one deserves special attention. The promise of the Contract With America--in the Speaker's term, the crown jewel--was a $500-per-child tax credit. Under the bill before us today, the crown jewels have been devalued by 27 percent. This bill walks away from that promise and many more. But the bill does preserve the spirit of the contract in one important way--the elderly, the middle class, and the poor bear the burden of paying for tax cuts that overwhelmingly benefit wealthy taxpayers. There will be an opportunity tomorrow to vote for a plan that will balance the budget in 7 years. We can vote for a plan that will borrow less money than the Republican plan, that will balance the budget without tax increases, and that does not require the harsh and unwise cuts proposed by the Republican budget. I refer to the coalition budget. That substitute demonstrates you can balance the budget in 7 years without the extreme proposals of the Republicans, with less borrowing, if you only will give up the special- interest tax breaks that are included in the Republican bill.

Mr. CARDIN

Mr. CARDIN. Mr. Chairman, let me correct some of the misstatements that have been made by my colleagues on the other side of the aisle. First, it has been said that our beneficiaries will not have to pay anymore because we are just continuing the current law. That is not correct. According to the Congressional Budget Office, ``It would increase the portion of costs borne by beneficiaries through premiums relative to current law.'' Under the bill before us, the premium increase goes up to $87 a month for part B. Under the bill that we will be bringing forward as a substitute, it is $30 a month less. That is $360 a year. For seniors who on average have a modest income, that is a lot of money. Second, CBO has estimated seniors will have to pay an extra $1,000 a year in order to be able to maintain the same benefits. When it costs you more to maintain the same benefits, it is a cut. Let me quote finally from the Washington Post. You have quoted the Washington Post before the plan was unveiled. The Washington Post said, ``It is not clear that Government contributions would any longer even pay for basic insurance.''

Mr. CARDIN. Mr. Chairman, we seem to have a debate over what is a cut. My constituents define it this way. If they are asked to pay more to get the same benefits, it is a cut. If they are receiving moneys that will not buy the same amount of service 7 years from now, and they are expected to put more money in their pocket in order to pay for those services, it is a cut. The chart shown by the gentleman from Ohio [Mr. Portman] shows what the per cost is per person. Yes, it costs less to provide for people under 65 than over 65, because people over 65 use more health care. This bill is a cut.

Mr. CARDIN. Mr. Chairman, first and foremost the substitute that is before us will deal with the solvency of the Medicare trust fund. It provides for $90 billion of savings to go into the Medicare trust fund providing for solvency to the year 2006. We have followed the suggestions of the trustees. It is equivalent to the Republican bill in solvency. The Republican bill originally was advertised that it was going to go to the year 2014. They have later changed it to 2010. If we take away the magic wand of taking general funds into the trust fund, it is 2006. Mr. Chairman, our bill is equivalent to the Republican bill on solvency for 10 years. Why do we have in the Republican bill three times more cuts in Medicare? It is not needed for the solvency. They do not use it for the solvency. It is used for a tax cut, paid for by the Medicare beneficiaries. Mr. Chairman, they can use all the language they want about lock- boxes and that we have in the tax bill separate ways to pay for the tax bill, but I ask my colleagues to answer a simple question: If we do not pass this Medicare bill, the tax bill cannot go into effect, can it? Because we must have the savings from this bill in order to finance the tax cut. Pure and simple, our seniors are being asked to pay for the tax cut. The substitute envisions no such thing. As a consequence of these draconian cuts, seniors are forced into plans that take away their choice. They have to pay more, $1,000 a year, just to maintain the same benefits. We have gone through that. If seniors have to pay more for the same benefits, it is a cut. The Democratic substitute does not do that. The Democratic substitute provides for $90 billion of savings to go into the Medicare trust fund without jeopardizing our seniors' ability to have affordable health care. There is no increase, no increase in the premium costs to our beneficiaries. Unlike the Republican bill that changes current law and allows the Medicare Part B premium to go up to $87 a month, the substitute that we are submitting, the premiums would be $30 a month less, $360 a year less. For seniors who have limited income, who already have the highest out-of-pocket costs of any group of Americans, that is a large increase. Our substitute does not do that. Mr. Chairman, let me talk for a moment to my friends who are part of the coalition budget. This substitute is better on deficit reduction, because we do not believe in the tax cut. If you add the revenue lost to the Treasury by the tax cut of $245 billion to the $90 billion of savings that we have in this bill, we get $335 billion in deficit reduction compared to $270 on the Republican side. We are $65 billion better off, better off on deficit reduction, as a result of the substitute that is before you. I would encourage my coalition Members to take a look at that particular point. We also provide for reform in our substitute. We move forward rather than backward on fraud and abuse. We strengthen, not weaken, fraud and abuse. We do not weaken the standards for civil penalties that is in the Republican bill. We provide additional protection, so that we can go after fraud and abuse. Do not take the Democrats' word on it. Do not take the Republicans' word on it. The inspector general has said, an independent person, that the Republican bill threatens the ability to go after fraud and abuse. We move forward, not backward, in providing additional benefits to our seniors. We provide for colorectal screening and annual mammography testing. Why? Because medical technology tells us that these tests are needed today. If we do not provide these tests, we are moving backward in providing seniors the care that they need. Our bill moves forward, not backward. Seniors already have too high out-of-pocket costs. They need these types of screenings. Mr. Chairman, I say to Members that we have a choice before us. We do not have to vote for the extreme, mean-spirited Republican approach that would slash Medicare in order to pay for tax cuts. We have a substitute before us that provides for the solvency of the Medicare trust fund, provides for reform in the Medicare system, protects our seniors, protects the system, and deals with solvency. Mr. Chairman, I urge Members to support the Democrat substitute.

Mr. CARDIN

Mr. CARDIN. Let me just correct this, Mr. Chairman. The gentlewoman from Connecticut is not accurate when she says we are cutting premiums. We are not. We are sticking with current law. They are changing current law. By changing current law, they are increasing the burdens on our seniors by increasing the part B premium. The Democratic substitute or the substitute that we are offering stays with existing law. The dollar amount is currently in law and it goes back to 25 percent and then goes back to a COLA increase. They are increasing it, we are keeping current law.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, I rise today, on the day that Congress has chosen to commemorate and salute the veterans of World War II, to recognize the contributions of the workers whose productivity gave our military men and women the tools they needed to achieve victory. This Sunday, October 15, thanks to a grant from the National Endowment for the Humanities as well as State, local, and private moneys, the men and women of Glenn L. Martin Aircraft Co. will celebrate their role in the 50th anniversary of the end of World War II. And what a role they played. Glenn L. Martin in the Middle River area of Baltimore County attracted tens of thousands of workers from all over America and forged them into a team that contributed the first modern bombers to the U.S. Navy and Army Air Corps as well as our Allies. During the war, more than 100,000 workers built more than 7,000 bombers. In addition, these Maryland immigrants created new communities and stayed to raise families and share their talents and ideas. They won the production battle of World War II. I am delighted that this Sunday will offer them a time of reunion and recognition for their contributions to the victory effort.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, on behalf of all the Members of this House, and all baseball fans around the Nation, let me offer our collective congratulations to Cal Ripken, Jr., of the Baltimore Orioles. Last night at Camden Yards in the Third Congressional District of Maryland, Cal played his 2,131st consecutive game, one more than the immortal Lou Gehrig, and did it with the same grace and dignity that has marked his remarkable career. Mr. Speaker, there was not a dry eye in Camden Yards when Cal Ripken spoke after the game and gave credit to his family and the baseball fans for this remarkable accomplishment. Thank you, Cal, for being such a great role model for young and old alike.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, today, I want to share information on a new, innovative treatment and prevention system for lead poisoning, conceived in Baltimore, that is achieving far better results for greater numbers of children, at a dramatically lower cost than traditional treatments. Approximately 15 percent of the children in the United States, that is one in every six under 6 years of age, have high levels of lead in their blood. I urge my colleagues, whose constituents face this problem, to take note of this treatment model and consider endorsing the approach in their own districts. The sad truth is that, even though lead poisoning is entirely preventable, it is the No. 1 environmental disease that threatens children in our country. The long term effects of lead can cause learning disabilities, hyperactivity, impaired hearing and speech, even brain damage. Most children are treated for lead poisoning on an outpatient basis and receive chelation therapy. Children with dangerously high levels of lead in their bodies are treated on an inpatient basis. The good news is that traditional treatments are usually reimbursed by insurance companies and provide necessary relief to the children. The bad news is that traditional treatment has not focused on the root cause of lead poisoning: the child's environment. This often leads to multiple poisonings and very costly medical care for each child. This revolving door syndrome is traumatic for the child and family, frustrating for care provides and costly to the payors. An exciting new model, called the Community Lead Poisoning Prevention and Treatment Center, created by the Kennedy Kreiger Institute, a leading speciality pediatric facility located in Baltimore, MD, offers a leap forward in lead poisoning treatment and a significant reduction in costs to State and Federal Government. The key elements to the model are: Kennedy Kreiger Institute provides a community-based setting for chelation therapy, a renovated rowhouse conveniently located near the outpatient clinic. This is important because it allows children to be treated in a home-like setting, ensures that they live in a lead-free environment--thus avoiding repeated poisoning--and it costs much less than in-hospital treatment. Kennedy Krieger Institute uses a comprehensive case management approach, addressing not only treatment but also correction of the child's home environment. The institute will facilitate the family's relocation to a lead-free environment or abatement of lead in the family's current dwelling. This crucial, commonsense component in treating a wholly environmental disease has been absent from traditional treatment. Kennedy Kreiger Institute's comprehensive approach also includes community outreach and education regarding sources and negative effects of lead poisoning, abatement, nutrition, and proper household cleaning techniques. Kennedy Krieger created a partnership with the Maryland Department of Health and Mental Hygiene [DHMH] to secure a waiver from Medicaid. DHMH pays a years capitated rate to Kennedy Krieger, a fixed amount well below normal inpatient costs. DHMH does not limit its authorization of dollars to medical treatment only. Recognizing the institute's expertise in treating lead poisoning, the department allows these experts flexibility to prescribe a mix of services appropriate to the individual child and family. The department frees the experts to do what is right for the child, focusing on prevention and reducing the revolving door syndrome. Isn't it refreshing to see a government agency act sensibly, removing constraints for real, lasting results for these children? The results have been striking. Since the program's inception in the summer of 1994, 150 children from 133 families have been enrolled; 95 percent of the children have lower blood lead levels at the second visit than at the enrollment visit and continue to have lower blood lead levels; 84 percent of the families who brought their children to the Kennedy Krieger Institute for their second visit now live in lead safe environments; and 60 families have participated in educational programs, and a team of six individuals is being trained in the first Lead Patrol class to educate their communities about lead poisoning issues. Substantially improved results are only the beginning. When the historical costs of treating children with lead poisoning are applied to the current group of children enrolled in the program and compared with the current costs to payors, the program costs represent 37 percent of the historical costs. During its first year of operation, the total cost savings will reach $2 million, of which the State of Maryland will save between $500,000 and $1 million. Not only has Kennedy Krieger reduced the costs of treating lead poisoned children, it has also improved upon the quality of care given. I have simplified my explanation of the program in the interest of time. There is so much more to this exciting program, and I urge you to encourage your local pediatric hospitals and health departments to contact the Kennedy Krieger Institute. In the interest of children across the Nation, the institute will be happy to share information and work with local organizations to replicate the model in towns and cities where lead poisoning is such a tragic, yet preventable problem.