John Chafee

Mr. CHAFEE

Mr. CHAFEE. Mr. President, I wonder if the Senator could keep it to a couple of minutes.

Mr. CHAFEE. You go ahead.

Mr. CHAFEE. Mr. President, I thank the distinguished Senator from Wyoming for yielding me 3 minutes. Mr. President, the challenge facing the Senate over the next few days is whether we will be able to muster the courage--there has been a lot of talk about courage out here tonight--but the question is whether we will have the courage to pass a budget resolution that, for the first time in three decades, 30 years, will bring the Federal budget into balance. It is a monumental debate involving the single most important step we can take this year to markedly improve this Nation's future. We cannot continue on the path we are currently on, which is spending more money than we take in and sending the bill to our children. Think of it. Of every dollar the Federal Government spends, 13 cents is borrowed. That is what is going on right now in this Nation of ours. Our current deficit, what we are budgeted for this year, is $200 billion more--$200 billion more--spending than we are going to take in. And this debt, this deficit, unless we take dramatic steps, will not stay at $200 billion a year. It will grow to $400 billion a year 10 years from now. Because of the horrendous $5 trillion debt our Nation has, 15 percent of our budget is solely devoted to paying the interest on the debt. Fifteen percent of all the expenditures, taxes, that are raised in this Nation go to pay the interest on the debt. Not a penny of that for principal, all of this for interest. Interest currently constitutes the third largest expenditure in our budget. First is Social Security, second is defense, and third is interest on the debt. And that last item, interest on the debt, is going up steeply. The resolution before us represents a fundamental shift in the manner in which the Federal Government is going to run its finances. Seven years from now, as a result of this budget, if it is adopted, we will end the practice of pushing the cost of today's Federal spending onto the backs of our children and our grandchildren. They are the ones that are going to have to pick up the tab. I commend the chairman of the Budget Committee, Senator Domenici, for what he has done and for his excellent work. This budget does what he said he was going to do. It balances the budget by the year 2002, in 7 years. There is nothing dramatic about steep declines. We have 7 years in order to bring this thing into balance. Senator Domenici has done this without resorting to any tricks or gimmicks. The Senate and the whole country owe Senator Domenici a deep debt of gratitude. And I want to congratulate him for standing firm against any tax cuts. There has been a lot of talk, the Senator from Arkansas was talking about the cuts, tax cuts that we are providing. In this resolution, there are no tax cuts. This budget provides a mechanism which allows us to consider tax cuts only after we have enacted a viable and enforceable balanced budget. I personally believe we are in too deep a hole to even think about embarking on any sizable tax cuts. If we do realize an economic benefit that comes from balancing this budget--in other words, there is going to be lower interest rates in the future; if, and most economists agree, this budget is adopted, that will occur--then we ought to use that to pay back our debt. Why use it for a tax cut, in my judgment, of any sizable nature? Instead, use it to reduce the debt. Mr. President, I support the resolution that is on the floor that the Budget Committee has brought to us. Do I agree with every aspect of it? No, I do not. No one does, but it is very, very good in its totality. I obviously have grave concerns about the level of the Medicaid cuts that might have to occur if we adopt the rules, the duties that are imposed upon the Finance Committee. I am concerned about the cuts in Amtrak, for example. But for those on the other side of the aisle who criticize what we are doing, come up with a better proposal. Do not just criticize what we are suggesting. Do something better. When we debated and voted on the constitutional amendment on the balanced budget, they all said: ``We do not need it; the true test of deficit reduction is our resolve. All we need to do is balance the budget if we have the courage.'' Well, this side is showing the courage to do it, Mr. President. Here we are. We are taking these steps that are long overdue, and I am just happy to be part of this effort. I hope when all is said and done that this budget, or something very close to it, will be adopted by this Senate. I want to thank the distinguished Senator from Wyoming for letting me proceed. Mr. SIMPSON addressed the Chair.

Mr. CHAFEE

Mr. CHAFEE. I know the distinguished Senator from Texas wants to speak briefly on this, and if she needs a few minutes of extra time, I presume the Senator from West Virginia will be agreeable to that. Amendment No. 1108 (Purpose: To extend the period for offering Medicare Select policies for 2 years)

Mr. CHAFEE. I yield. The Senator may take as much of my time as he wants.

Mr. CHAFEE. I am.

Mr. CHAFEE. Mr. President, I thank Senator Rockefeller, the Senator from West Virginia, for all of his help. I am glad we were able to work this out. It looked a little sticky at first, but we have done it. I look forward to working with him on the Finance Committee as we have the hearings next fall or whenever the report comes in from HHS.

Mr. CHAFEE. Mr. President, the Committee on Finance is hereby giving a commitment to the distinguished Senator from West Virginia, Senator Rockefeller, that there will be a hearing on Medicare Select once the Department of Health and Human Services submits its report on this program. What we are doing is extending Medicare Select to all 50 States for 18 months. This will continue unless the Secretary of Health and Human Services determines one of the following: That beneficiaries do not save dollars compared to other MediGap policies or that there are additional expenditures under Medicare or that access to quality care is diminished. Mr. President, there will be a GAO study on whether or not beneficiaries have a problem getting coverage under another MediGap policy if they wish to change policies and recommendations if there are problems. Mr. President, that is the arrangement here. Mr. ROCKEFELLER addressed the Chair.

Mr. CHAFEE. Mr. President, I ask unanimous consent that the Senate now turn to the consideration of Calendar Order No. 92, H.R. 483, regarding Medicare Select, and it be considered under the following time agreement: 10 minutes on the bill, to be equally divided between the chairman and ranking minority member of the Finance Committee; that one amendment be in order to be offered by Senators Packwood, Chafee, Rockefeller, and Kennedy, on which there will be 10 minutes for debate equally divided in the usual form; and that following the conclusion of time, that the amendment--namely, the Packwood-Chafee-Rockefeller- Kennedy amendment--be agreed to; and that the bill be read a third time and passed and that the motions to reconsider be laid upon the table all without any intervening action or debate.

Mr. CHAFEE. Mr. President, since this has been agreed to, I am authorized to say there will be no further rollcall votes today.

Mr. CHAFEE. Mr. President, I ask unanimous consent that Senator Dole be added as a cosponsor of the amendment.

Mr. CHAFEE

Mr. CHAFEE. I will make one other point, if I might, and that is, as you recall, when I said my staff spoke to the Health Care Financing Administration, what I said was they asked for suggested changes and none came back. In the letter the Senator quoted from Secretary Shalala, he mentioned somewhere in there concerns about expansion into the part B plan. We do not do that. There is no expansion into that in this Medicare Select. So I will be glad to talk with the Senator. If he would like, we can suggest the absence of a quorum and have a little chat here.

Mr. CHAFEE. Mr. President, our staff asked the Health Care Financing Administration [HCFA] for suggested changes. Any problems? What do you think we ought to do? They did not have any. They had no suggestions for us. Maybe the Senator from West Virginia can find, what we cannot find, any documented quality problem with this program. Now, some beneficiary somewhere may object, I am sure they have, just like they have objected to a host of other medigap policies. But, as I say, this has received a favorable report by the Consumers Union and by Consumers Report magazine and by the State insurance commissioners. So, I do not have anything particular to offer. I would be glad to talk with the Senator from West Virginia. Whatever ideas we have, we would have to transmit them. Obviously, I would have to speak to the chairman of the Finance Committee, whom I do not see on the floor here. Mr. ROCKEFELLER addressed the Chair.

Mr. CHAFEE. Mr. President, I do not concede that there are all these problems or that there are these problems. It seems to me what the Senator from West Virginia is doing is applying a higher standard to the Medicare Select, these managed care MediGap policies, than he is to the regular MediGap policies. I do not think that is fair. I do not think it is fair to say, ``No, in Medicare Select, you cannot have attained age,'' whereas it is permitted in the other MediGap policies. The suggestion here is that we ought to have hearings on this. Well, I cannot speak for what the majority leader said, but all I do know is that the Senate has passed a permanent extension of this proposal twice in the past 4 years. It was included in every major health reform proposal last year, including Senator Mitchell's, Senator mainstream coalition bill. All of them had Medicare Select in them. So it is not that we are coming up against some unknown item here that we better be terribly cautious of. As I say, it has been out in these States. In 15 States, it is authorized. I cannot challenge the Senator's information when he says it is actually in practice, I believe he said, in 14 States. All I know is that I think it is a good option that is less expensive and that we ought to give all the citizens a chance at it. And the citizens from my State would like a chance at this. If they do not want to use it, that is their business. But if they have a right to choose a MediGap policy that is less expensive than the current ones, I think they ought to have it and not be prevented from doing so because this Congress refuses to extend Medicare Select to all the States. Again, no one is more thoughtful and compassionate in this Senate than the Senator from West Virginia, so I am not sure why he takes this particular position. Because, as we mentioned before, this passed in the House 408 to 14. You could hardly get a motherhood resolution passed by that amount.

Mr. CHAFEE. Let me just finish. The Senator is objecting to that. What I find puzzling is the Senator, a distinguished member of the Finance Committee, has twice voted in the Senate Finance Committee and twice on the floor to pass a permanent 50-State extension of legislation that is before us. What has changed?

Mr. CHAFEE. Mr. President, I see the distinguished Senator from West Virginia in the Chamber. I would be glad to pose him some questions if he is available to respond. As the chairman of our committee just pointed out, we are talking about Medicare Select. But what is Medicare Select, anyway? Medicare Select is the name of a type of MediGap policy. It is something that seniors can buy to cover their Medicare deductibles and copayments. Medicare Select is a type of MediGap policy that permits managed care; that is, a managed care MediGap policy. That is what it is. What was the problem in getting this plan started and why the restrictions? Why could not the insurance companies offer Medicare Select if they wanted to? Because when MediGap legislation was originally passed in the House of Representatives, there were some objections to Medicare Select. A Representative from California did not believe in managed care. Consequently seniors were not able to have these plans. Well, finally, after patiently working at this several years ago in late evening sessions, we arranged that there would be 15 States that could try this and see how it worked out. And so 15 States have done it, and as the chairman of our committee pointed out, it has worked very well. The trouble is that the option of these 15 States to offer this policy ends June 30; which is what--a month and a half from now. As the chairman pointed out, there is now a danger that we cannot extend Medicare Select because of having to deal with the budget, and so forth, and then all these people who have these MediGap policies-- and, indeed, it is a MediGap policy--will not be able to buy it or renew it. Indeed, there is question about enrollments right now: Should a senior enroll in a MediGap policy that has this managed care plan or should I not? What happens if the plan is going to disappear? Our point is not only should we extend Medicare Select but should we also make it permanent. But what about the rest of the States? Why should not seniors in other States have this option? In my State, for example, why should not my citizens have the option of buying a MediGap policy that is $25 to $27 less per month, depending on the situation, than they are paying for other MediGap policies?

Mr. CHAFEE. Thank you. Mr. HELMS addressed the Chair.

Mr. CHAFEE. Mr. President, I know the distinguished Senator from North Carolina is waiting to give a brief statement, and then I would like to speak. Let me discuss it with the Senator from Oregon. But meanwhile, I ask unanimous consent that privileges of the floor be granted to a member of my staff, Douglas Guerdat during today.

Mr. CHAFEE. Mr. President, the Senator says we have to wrestle with these problems. Who says there is a problem? Let me just touch on one matter that the Senator raised, and that is the so-called attained-age rating, with a suggestion that Medicare Select, this type of managed care policy, MediGap policy, has this attained-age rating. Well, the fact is that the attained-age rating is permitted under current MediGap law. It is not restricted. The attained age is not something peculiar to Medicare Select. That is permitted under the current MediGap law. And so while it is true that most medigap policies and most Medicare Select policies do not use the attained-age method, I do not see why you focus in and say that is something peculiar to MediGap or Medicare Select, because it is not.

Mr. CHAFEE. Mr. President, the problem here is--I know the Senator is concerned about this--but the points he raises affect not Medicare Select but affect the whole MediGap range. In other words, when he says he is interested in open enrollment, there is no open enrollment now in the MediGap policies. He is saying he wants it for Medicare Select. But that means you want it presumably for all of MediGap. Now, that is a very big separate issue that can come up any time. You do not have to tag it on to a Medicare Select policy which, as I say, is just one of a whole series of medigap policies. If the Senator wants to do that, that is changing the rules for the whole series of policies that are issued under medigap.

Mr. CHAFEE. Well, the Senator from West Virginia may wish to be assured, but I do not know how far we have to go. The National Association of Insurance Commissioners supports the extension of this program. We just had the list of those who were supporting Medicare Select read by the chairman of our committee. You can go on and on and find reasons not to do something. But we are really in a very, very difficult situation here. This program expires in 30 days from now or 45 days from now. It seems to me we ought to get on and extend it, and not only extend it but let the other States in on it. Some mention was made about the Consumers Union's concerns about Medicare Select. But the fact of the matter is the Consumers Union's problems that were raised apply to all medigap policies, not focused in on Medicare Select.

Mr. CHAFEE. Yes.

Mr. CHAFEE

Mr. CHAFEE. Mr. President, I ask that we now have a period for morning business.

Mr. CHAFEE

Mr. CHAFEE. The majority leader is exactly right. We are working now with staffs trying to see if we cannot come to an agreement on the problems raised by the Senator from West Virginia, Senator Rockefeller. Everything seems to take longer than anybody thinks around here. So I would say in the next half-hour, I hope, we can have some information on whether indeed there would be the necessity for a vote.

Mr. CHAFEE

Mr. CHAFEE. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.