Kent Conrad

Mr. CONRAD

Mr. CONRAD. I wonder if the distinguished Chairman and Ranking Member share our interest in the idea of an EW mission for the B-52 and belief that it should be carefully studied?

Mr. CONRAD. I greatly appreciate the comments of the Armed Services Committee's distinguished leadership. I am willing to withdraw my amendment in light of assurances that the study is underway and will continue to accord the B-52 full, fair, and thorough consideration as a potential dedicated EW platform.

Mr. CONRAD. Mr. President, as my colleagues may be aware, in recent years there has been discussion within the military about modifying or equipping B-52 aircraft with advanced electronic jamming equipment that would allow them to perform a dedicated electronic warfare, or EW, mission. I joined Senator Dorgan in filing amendments calling for a thorough study of an ``EB-52'' option.

Mr. CONRAD

Mr. CONRAD. On this side, we have 4 minutes remaining. Obviously, we would like to reserve some of that time for the purpose of making a statement at the end.

Mr. CONRAD. As long as it takes to persuade my colleagues to vote for it.

Mr. CONRAD. Mr. President, I rise today to offer a lockbox amendment with Senator Lautenberg and Senator Reid designed to protect Social Security and Medicare. This amendment is simple but important. First, it says we must protect Social Security surpluses each and every year. The budget has finally been balanced without counting Social Security, and we must make sure it stays balanced without counting Social Security and Medicare. Second, my amendment takes the Medicare hospital insurance trust fund surpluses off budget to prevent those surpluses from being raided for anything but Medicare. According to the Office of Management and Budget, the Medicare trust fund will run a surplus of over $400 billion from the year 2001 to 2010. Taking these surpluses off budget and locking them away will ensure that they are used only for Medicare and to pay down the debt. Taking the Medicare trust fund off budget, as in Social Security off budget, will ensure that these payroll taxes that workers pay will be used to meet the future demographic challenges Medicare and Social Security face. We have reached a bipartisan agreement that Social Security belongs off budget and that its surpluses should be preserved solely for Social Security. For seniors, Medicare is just as critically important for financial independence in their golden years. It is now time to give the same protection to Medicare that we already accord to Social Security, by taking Medicare off budget, too. Medicare is absolutely critical to the health and economic well-being of nearly 40 million senior citizens. Before Medicare, many of our senior citizens were one major medical event away from poverty. Today, our seniors enjoy the security of knowing Medicare is there for them. We should not put at risk Medicare because of a failure to protect Medicare from raids for other purposes. We have been through this on Social Security. The amendment I am offering says we are going to treat Medicare the same as we are treating Social Security. Unfortunately, the amendment of the Senator from Missouri fails to do that. It suggests it is a Medicare lockbox, but it really isn't. When we examine the amendment of the Senator from Missouri, we find there is a fatal flaw. The fatal flaw is that the Senator from Missouri has no enforcement mechanism for its provision taking Medicare surpluses off budget. In fact, it does not move Medicare off budget. It only removes Medicare surpluses off budget. The result is, under the Ashcroft amendment, no point of order would apply against legislation that uses Medicare surpluses for other reasons. Under the Ashcroft amendment, the Medicare trust fund could be depleted for any purpose, as long as the overall budget remained in balance. Unfortunately, because of the way the amendment of the Senator from Missouri has been drafted, it is opening Medicare to raids for other purposes. That is a fatal flaw. That is what my amendment corrects. My amendment takes Medicare trust fund surpluses off budget, protecting them with points of order so there could not be a raid on Medicare. Let me make my point as clearly as I can. If we look at the fiscal year 2000, we have a unified surplus projection of $224 billion. Social Security is in surplus by $150 billion. We will not permit that to be raided. Medicare is in surplus by $24 billion. We will not permit that to be raided under my amendment. But under the amendment of the Senator from Missouri, one could take every penny of the $24 billion in surplus in Medicare because the overall budget would still be in balance. That is the fatal flaw of the amendment of the Senator from Missouri. The Senator does not protect these Medicare funds if the overall budget is in balance. I don't know if that was realized by the other side, but that is a fatal flaw. That is why the amendment of the Senator from North Dakota, my amendment, the amendment I am offering with Senator Lautenberg and Senator Reid, is critically important; we would prevent any raid on Medicare funds. Our lockbox is simply stronger. We establish points of order that protect the integrity of the Medicare trust fund in each and every year. Our plan was drafted to make the Medicare trust fund status exactly the same as Social Security. For some reason, the amendment of the Senator from Missouri has been drafted differently. It does not give the full protections to Medicare that we have given to Social Security. Why not? If we look at the Congressional Budget Act of 1974, and I direct my colleagues to page 17, on the bottom of that page are laid out the specific protections we provide for Social Security. We provide them for Medicare in the amendment that I am offering. The Senator from Missouri has failed to do so. He has left them out. For some reason he is giving lesser protection to Medicare than we give to Social Security. My amendment solves that fatal flaw that is in the amendment of the Senator from Missouri. In our plan, we treat Medicare similar to Social Security by excluding all receipts and disbursements of the Federal Hospital Insurance trust fund from budget totals. We exclude the Medicare trust fund from sequestration procedures and create parallel Budget Act points of order to protect the surplus in the Medicare trust fund in each and every year. Our plan also creates a new point of order against legislation that would cause or increase an on-budget deficit. So it protects the integrity of the Medicare trust fund and the on-budget surplus for debt reduction. Our plan also strengthens existing protections for Social Security by enforcing points of order against reducing Social Security surpluses in each and every year. The Ashcroft amendment is silent on Social Security. It has verbiage there, but there is no new protection for Social Security in the amendment of the Senator from Missouri. Our amendment adds a point of order against violating the off-budget status of Social Security and requires Social Security revenues and outlays to be set forth for every fiscal year in a budget resolution rather than for only the 5 years under current law. In addition, we strengthen existing points of order protecting Social Security by enforcing points of order against reducing the Social Security surplus in every year covered by the budget resolution rather than only in the first year and the total of all years covered by the budget resolution as current law provides. The amendment I am offering with Senator Lautenberg and Senator Reid is very clear: We are protecting Social Security and Medicare in a lockbox that has real protections, and we treat them in the same way. Unfortunately, the proposal of the Senator from Missouri creates a difference between the protection we provide Social Security and the protection we provide Medicare. The Senator from Missouri provides much less protection for Medicare than we provide Social Security. It has a fatal flaw: no enforcement mechanism. The result is, under the Ashcroft amendment, the Medicare trust fund could be depleted for any purpose as long as the overall budget remained in balance. That is a profound mistake. The amendment of the Senator from Missouri would allow the Medicare trust fund surplus in the year 2000 to be raided of every penny. We should not allow that. That is not a lockbox; that is a ``leakbox.'' We are trying to construct a lockbox here to protect Medicare, not a figleaf that will make people believe we protected Medicare but really open up a gigantic loophole that would allow for raids on Medicare as we used to see on Social Security. This is a defining vote. Those who care about protecting Social Security and Medicare, and are serious about it, will support our amendment. Those who want a figleaf and a press release will be in opposition. I yield the floor.

Mr. CONRAD. I need about 20 minutes.

Mr. CONRAD

Mr. CONRAD. That would be on or in relation?

Mr. CONRAD. That will be acceptable if the understanding is this is ``on or in relation to,'' any votes ordered for that period?

Mr. CONRAD

Mr. CONRAD. Mr. President, I am running out of time. The Senator from Missouri informs me he has 20 minutes left. I have 2 minutes left. Under the rules, if neither of us uses time right now, the remaining time of each of us is used equally, which means I would run out of time. He has indicated that is what he would do. If I do not take this time for my final argument, we just lose the time. Those are the rules of the Senate. That is fair. I say this. I am saying this for the benefit of colleagues on my side who are wondering if there is additional time available. Clearly, there is not. The Senator from Michigan and the Senator from New Mexico have again raised the question of the lockbox they offered previously; not the lockbox on which we are about to vote, but what they offered previously. The reason our side resisted that lockbox approach is because we received a letter from the Secretary of the Treasury from which I quote: Our analysis indicates that the provisions Senators Domenici and Abraham and Ashcroft were previously offering could preclude the United States from meeting its financial obligations to repay maturing debt and to make Social Security benefit payments, and could also worsen a future economic downturn. That is the reason we resisted those plans, because they were flawed. That is the same reason I believe the amendment I have offered today, to have a Social Security and Medicare lockbox--something I have proposed for 2 years--is superior to the option we are actually voting on today. The reason our proposal is superior, I believe, is because it protects Medicare. It protects it in the same way we protect Social Security: by points of order to make certain that it is not raided. Unfortunately, the amendment of the Senator from Missouri does not have that level of protection. He has less protection for Medicare than for Social Security. He does not have a point of order that can apply against legislation that would use Medicare surpluses for other purposes. The problem with that is under the Ashcroft amendment the Medicare trust fund could be raided, could be depleted for any purpose as long as the overall budget remained in balance. I thank the Chair.

Mr. CONRAD. Mr. President, I had 3 minutes of leader time remaining.

Mr. CONRAD. Mr. President, I will not take 5 minutes at this point. I want to make the point that I appreciate the Senator from Missouri. He is serious and sincere about an effort to provide a Social Security and Medicare lockbox, but when you look at the specifics of what he has proposed, it falls short. There is a fatal flaw. Let's look at fiscal year 2000. There is projected a $150 billion Social Security surplus. That is protected. There is a $24 billion projected Medicare surplus. Under the proposal of the Senator from Missouri, every penny of the Medicare surplus could be taken for other purposes because the protection he provides is aimed at the overall budget being in surplus, not at the Medicare component being in surplus. So he has a lockbox that leaks. That is the problem. The reason the amendment I have offered, along with Senator Lautenberg, the ranking member of the Budget Committee, is superior is that it solves that problem. We do not have a leak. We have a budget point of order that prevails. In addition, the Senator from Missouri does not have Social Security protection. We do. We have additional points of order that apply to make sure nobody raids Social Security. Our colleagues are going to have a defining vote in just a few minutes: Do you want to have the strongest protection for Social Security and Medicare, or do you want a weak tea version? That is going to be the choice, and all of us are going to be held accountable for our votes. That is the point. I yield the floor.

Mr. CONRAD. Mr. President, first, I assure my colleague that my amendment was not in response to his. I had filed for an amendment yesterday. I offered this amendment in the Finance Committee yesterday. I have offered a lockbox for Social Security and Medicare for 2\1/2\ years--a different Medicare-Social Security lockbox than is advocated here today by the Senator from Missouri because I believe there is a fatal flaw in the amendment of the Senator from Missouri. That fatal flaw is that his protection does not work. It does not work because, under the Ashcroft amendment, no point of order would apply against legislation that would use Medicare surpluses for other purposes. The result of that is, under the Ashcroft amendment, the Medicare trust fund could be depleted for any purpose as long as the overall budget remained in balance. That is the problem with the amendment of the Senator from Missouri. That is the reason the amendment that I have offered is superior. It is stronger. It provides real protection for Medicare, by way of special points of order against a budget resolution that would violate the off-budget status of Medicare Part A. The fact is, the amendment of the Senator from Missouri does not provide the same protection to Medicare that we provide to Social Security. Now, why would we do that? If we are serious about protecting Medicare, wouldn't we have the same points of order apply to protect Medicare in the same way that we protect Social Security? I would hope so. Because if we do not, the hard reality is the amendment of the Senator from Missouri would permit us to go and raid every penny of the Social Security surplus or every penny of the Medicare surplus this year and use it for another purpose. That is a mistake. In addition, the Ashcroft amendment is silent on Social Security, while the amendment that I have offered adds a point of order against violating the off-budget status of Social Security. I hope my colleagues will vote for the Conrad-Lautenberg-Reid amendment so we really protect Medicare in the same way we protect Social Security. That is what we ought to do here today. That is the opportunity we have here today. We ought to take it. We ought to protect Medicare and Social Security. We ought to adopt this lockbox proposal. Mr. President, I ask unanimous consent that Senator Feingold be added as a cosponsor of my amendment.

Mr. CONRAD. I thank the Chair and yield the floor.

Mr. CONRAD. I say to my colleague and my friend from New Mexico, his last reference is to a provision that says you can spend Medicare money for Medicare programs. That is so we can have a BBA add-back, a balanced budget add-back, for Medicare, as we did last year. There is nothing mysterious about that. The Senator from New Mexico asked why we weren't supporting the lockbox proposal he made previously. There are two reasons: No. 1, we got a letter from the Secretary of the Treasury saying that could threaten default on the debt of the United States; No. 2, our analysts indicated that could threaten Social Security payments to those who are eligible for Social Security. Those are the reasons we have not accepted that lockbox proposal. I didn't just come here today proposing a lockbox. For 2 years, I have proposed a Social Security and Medicare lockbox as a senior member of the Senate Budget Committee. Frankly, our friends on the other side of the aisle have resisted. If the choice is between the lockbox proposal I have made today and the lockbox proposal of the Senator from Missouri on the question of which is stronger, there is no question which is stronger. The amendment I have offered is stronger. That is because there is a fatal flaw in the amendment of the Senator from Missouri. He provides no enforcement mechanism for the provision taking Medicare surpluses off budget. Under the amendment of the Senator from Missouri, no point of order would apply against legislation that could use Medicare surpluses for other purposes. Under the Ashcroft amendment, the Medicare trust fund could be depleted for any purpose as long as the overall budget remained in balance. That is the fact. That is the reality. I notice the chairman of the Budget Committee never referenced the amendment the Senator from Missouri has before the Senate today. Never referenced it. He talked about a lockbox proposal they have had previously--not about the lockbox proposal before us today. I yield the floor.

Mr. CONRAD

Mr. CONRAD. Mr. President, I wanted to draw the attention of the Senate to an important funding issue that is pending in the Senate version of the Labor/HHS Appropriations bill. The funding level for Social Security administrative expenses doesn't receive much attention, but it is critical to the effective delivery of Social Security benefits to those who are entitled to them. Social Security administrative expenses are actually partially funded from the Social Security trust funds, and they ensure that the programs administered by the Social Security Administration are delivered to the American public in an efficient, timely, and professional manner. In addition, SSA maintains records of the yearly earnings of over 140 million U.S. workers and provides them with annual estimates of their future benefits. The agency will also administer the Ticket to Work Program, and the administrative workload associated with the Retirement Earnings Test. I am concerned that the level of funding contained in the Labor/HHS Appropriations bill is not sufficient, and does not recognize the administrative challenges Social Security will be facing in the near future. Last year the Social Security Administration provided service to 48 million people. In 2010 SSA will be providing services to 62 million people, due to the retirement of many baby boomers. During this same period, the SSA will lose nearly half of its staff to retirement, including many individuals who staff the offices located in our states and who work directly with the public. In North Dakota, there have been large staff reductions in some of my state's main SSA offices. These shortages have affected timely completion of continuing disability reviews, and service delivery has been difficult to maintain for those who live in rural areas. The Social Security Advisory Board--a bipartisan Congressionally mandated Board--recently issued a report on ``How the Social Security Administration Can Improve Its Service to the Public,'' which stated that ``there is a serious administrative deficit now in that there is a significant gap between the level of services the public needs and that which the agency is providing. Moreover, this gap could grow to far larger proportions in the long term if it is not adequately addressed.'' The Senate Labor/HHS bill includes a funding level that is $123 million below the President's request. I hope that as the appropriations process moves forward, the Congress will work to ensure an adequate level of funding for SSA administrative expenses.

Mr. CONRAD

Mr. CONRAD. Mr. President, I rise today to alert my colleagues that another series of national disasters have hit my home State of North Dakota. This newspaper headline from the largest paper in our State says it best with the headline on the front page, ``Swamped.'' The newspaper goes on to say NDSU, the State university, suffered millions in damage. In fact, I talked to the president of the university hours ago. He believes the damage is in excess of $20 million just at North Dakota State University. This newspaper indicated that the flood filled the Fargo dome where NDSU plays the football games. The dome was filled with over 8 feet of water. This monsoon that hit Fargo, ND, on the night of June 19, absolutely flooded the entire town. It was an incredible series of circumstances. This is a picture that shows cars under water. We saw this all over the city of Fargo. Basements are flooded. Every kind of structure is flooded with 2 to 3 feet of water in the streets of the city of Fargo, the biggest city in my State. We also saw massive flooding on the outskirts of town. This is the interstate. This is I-94 that connects Fargo to the rest of North Dakota. It is a major east-west highway in North Dakota. It was under water. Every part of town saw massive flooding. Homes and trailers are under water all across the city of Fargo. North Dakota State University is one of the two major universities in our State. They suffered millions in damage, with very little flood insurance. The president of the university told me their insurance carrier tells them for this kind of event they only had $10,000 of insurance coverage--with losses of over $20 million. Even the president's house was wet. The newspaper says the president of the university was among many people dealing with the soggy conditions after fighting battles throughout the night, with 2 inches of sewage that entered the basement of the president's house through the failure of the sewer system. This disaster was not confined to the city of Fargo, unfortunately. It spread throughout the area. Probably one of the great ironies is that until June 11 we were in a drought in much of eastern North Dakota. On June 12, 13, and 14, we had heavy rains in the northeastern part of the State. I was there last week with FEMA officials assessing the damage. In that part of the State, they received 20 inches of rain in 2 days-- absolutely Biblical. I have never seen anything like it--20 inches of rain in 2 days. The entire annual precipitation we receive in the State of North Dakota came in 2 days. Over 150,000 acres of prime farmland flooded in that series of incidents. Of course, that was followed a week later, last Monday night, by this devastation hitting Fargo, ND, the largest city in the State. The mayor of Fargo said it perhaps best: ``It's the worst rain flood we've ever had.'' This is an event unparalleled in North Dakota history. There is something very odd going on with the weather pattern. I can only say in my State we have had eight Presidential disaster declarations in the last 7 years. We fully anticipate we will have number nine as a result of this series of incidents in northeastern North Dakota and then in southeastern North Dakota. Hundreds of thousands of acres of farmland were flooded. The major city of my State was very badly hurt by this massive flooding. I have come before with requests for disaster assistance. I was very hopeful we weren't going to have a disaster this year. Until these devastating events, the worst thing happening was that we appeared to have a drought in part of the State. It is truly stunning to get 20 inches of rain in 2 days. The damage is incalculable. In North Dakota State University, there wasn't a building on the campus that was not flooded. The president informed me today that the basement of the library was badly flooded where some of the archives were kept. They were in the basement because that is the safest place in a tornado. Fargo is a town that has previously been hit by tornadoes--not frequently, but on occasion. So the most valuable materials were stored in the basement. Then we get hit by these massive monsoon rains that flooded every building on that campus, including devastating and destroying some of the archives of the State. This is, again, a disaster of stunning proportion. Tomorrow, top officials of FEMA and I will be going to North Dakota, accompanied by top officials of the USDA, to further assess the damage. I talked to the Governor today. He tells me he is readying a request for disaster assistance. Without question, we will be coming to this body once again to ask for assistance for a remarkable set of what can only be described as almost unimaginable occurrences. It does make me wonder if there is something going on with global climate change that we don't fully understand, to have these extraordinary sets of circumstances 8 years in a row. That is the fact. That is the circumstance that we face. I wanted to draw my colleagues' attention to it. We in North Dakota have expressed our thanks to our colleagues on repeated occasions for the assistance provided North Dakota in the face of these remarkable natural disasters. I regret very much standing here today again drawing my colleagues' attention to what has occurred in my home State. I think it is important for colleagues to know this has occurred, and that, once again, we will be asking for assistance. I yield the floor.

Mr. CONRAD

Mr. CONRAD. Mr. President, last Friday I was necessarily absent from the Senate to survey recent flood damage in North Dakota. For a period of three days, rain, hail and tornadoes inundated northeast North Dakota and, sadly, four people lost their lives. My duty was to my constituents who were in the middle of another devastating natural disaster. As a result, I missed one vote Friday morning. For the record, had I been present, I would have voted yes on adoption of the conference report to S. 761, the Electronic Signatures Act. The legislation will have an important impact on the electronic marketplace and how business is conducted via the Internet. My vote would not have changed the outcome of this vote.

Mr. CONRAD

Mr. CONRAD. Mr. President, this is clearly a Federal responsibility. A Federal project created Lake Sakakawea and flooded a significant portion of the reservation, thus creating the need for this bridge. In 1992, Congress accepted the recommendations of the Joint Tribal Advisory Commission, which studied the impact of the Garrison Reservoir, created by the Pick-Sloan Missouri River Project, on the Three Affiliated Tribes. The Commission found that the Three Affiliated Tribes are entitled to replacement of infrastructure lost by the creation of the Garrison Dam and Lake Sakakawea. The Federal Government has a responsibility to the Three Affiliated Tribes to play a major role in providing for the infrastructure necessitated by the permanent flood created by this project. Mr. President, will the Chairman of the Subcommittee also support funding this bridge as recommended by President Clinton?

Mr. CONRAD

Mr. CONRAD. Mr. President, today, I rise to introduce the Health Care Access and Rural Equality Act of 2000 (H-CARE). This proposal is the result of a bipartisan and bicameral effort. I am proud to be joined by several cosponsors, including Senators Grassley, Daschle, Thomas, Harkin, Baucus, Kerrey, Jeffords, Rockefeller, Roberts, Johnson, Lincoln, and Cochran. I would also like to thank our House companions for joining me as supporters of this proposal. In particular, would like to recognize Representatives Foley, Pomeroy, Tanner, Nussle, McIntyre, Stenholm, Berry, and Lucas for their efforts. Working together, I believe we are taking important steps toward improving health care access in our rural communities. Also, I would like to thank the National Rural Health Association, the Federation of American Health Systems, and the College of American Pathologists for their support of this effort. Last year, we received information that 12 of my State's 35 rural hospitals were in jeopardy of closing. In North Dakota, many areas do not have hospitals within their county borders. This means that in some areas of my State, many communities depend on having access to one specific rural health care facility. If this facility were to close, this would leave residents in these areas without access to vital health care services. We know that in many rural communities, Medicare patients make up the majority of the typical rural hospitals' caseloads--in N.D., more than 70 percent of most rural hospitals' patients are covered by Medicare. This means that Medicare funding and changes to the program greatly impact our small, rural providers. Unfortunately, while our rural facilities may serve a disproportionate number of Medicare patients, they are often forced to operate with merely half the reimbursement of their urban counterparts. For example, Mercy Hospital in Devils Lake receives on average about $4,200 for treating a patient with pneumonia. In New York City, we know that some hospitals receive more than $8,500 for treating the same illness. This disparity places our providers at a clear disadvantage. Against the backdrop of this funding disparity, we know that rural providers were particularly hard hit by reductions in the Balanced Budget Act of 1997. Last year, N.D. hospitals were losing at minimum 7 percent on every Medicare patient they serve. In some of our smaller communities, hospital margins fell as low as negative 21 percent. How can our hospitals be expected to survive at a 20 percent loss? Recognizing the challenges that our communities were facing, I fought hard last year to offer relief to our rural providers. I am happy to say that the Balanced Budget Refinement Act of 1999 (BBRA) brought more than $100 million to our ND providers--but we must do more. Even though the BBRA improved the outlook for our hospitals, N.D. facilities are still in financial trouble--they are still projected to have negative 4.9 percent margins by 2002. Continued funding shortfalls have made it, and will continue to make it, impossible for our smallest rural hospitals to make needed building improvements; impossible for them to provide patients access to updated technologies; and difficult for them to competitively recruit and retain health care providers, particularly to the most isolated, frontier areas. For this reason, I rise to introduce H-CARE. This legislation offers targeted relief to our most vulnerable rural providers, including: our sole community, critical access, and Medicare dependent hospitals. In particular, H-CARE would offer a full inflation update to all rural hospitals. The BBA limited hospitals' inflation updates through 2002. This has meant that our providers have not been allowed to receive payments that are in line with the costs they incur for serving Medicare patients. H-CARE would close the gap on this funding shortfall. Also, H-CARE permanently extends the important Medicare dependent hospital program, which is due to expire in 2006, and would offer these providers more up-to-date funding. Currently, they are reimbursed based on 1988 costs. As providers that serve at least a 60 percent Medicare caseload, it is important that they receive appropriate Medicare payments. In addition, H-CARE addresses several flaws in last year's Medicare add-back bill that have adversely impacted our rural providers. For example, many rural hospitals entered the Critical Access Hospital (CAH) program under the promise that they would receive adequate resources to keep their doors open. The BBRA inadvertently limited these hospitals' ability to receive funding for providing lab services to their patients. H-CARE fixes this problem by ensuring CAHs once again receive the funding they need to provide lab services. For our sole community hospitals, H-CARE corrects an error in the BBRA which excluded some of these hospitals from receiving higher reimbursement rates based on more recent costs. H-CARE fixes this mistake by letting all sole community hospitals receive more up-to-date payments based on 1996 costs. This is particularly important for N.D. since 29 of my state's 36 rural facilities are sole community hospitals. Lastly, H-CARE would establish a loan fund that rural facilities could access to repair crumbling buildings or update their equipment-- eligible facilities could receive up to $5m to make repairs and an extra $50,000 to help develop a capital improvement plan. H-CARE also includes grants, in the amount of $50,000 per facility, that hospitals could use to purchase new technology and train staff on using this technology. In summary, this year, I will fight to enact these and other measures that are vital to improving our rural health care system. I urge my colleagues to support this important effort.

Mr. CONRAD

Mr. CONRAD. Mr. President, today, I rise to introduce the Health Care Access and Rural Equality Act of 2000 (H-CARE). This proposal is the result of a bipartisan and bicameral effort. I am proud to be joined by several cosponsors, including Senators Grassley, Daschle, Thomas, Harkin, Baucus, Kerrey, Jeffords, Rockefeller, Roberts, Johnson, Lincoln, and Cochran. I would also like to thank our House companions for joining me as supporters of this proposal. In particular, would like to recognize Representatives Foley, Pomeroy, Tanner, Nussle, McIntyre, Stenholm, Berry, and Lucas for their efforts. Working together, I believe we are taking important steps toward improving health care access in our rural communities. Also, I would like to thank the National Rural Health Association, the Federation of American Health Systems, and the College of American Pathologists for their support of this effort. Last year, we received information that 12 of my State's 35 rural hospitals were in jeopardy of closing. In North Dakota, many areas do not have hospitals within their county borders. This means that in some areas of my State, many communities depend on having access to one specific rural health care facility. If this facility were to close, this would leave residents in these areas without access to vital health care services. We know that in many rural communities, Medicare patients make up the majority of the typical rural hospitals' caseloads--in N.D., more than 70 percent of most rural hospitals' patients are covered by Medicare. This means that Medicare funding and changes to the program greatly impact our small, rural providers. Unfortunately, while our rural facilities may serve a disproportionate number of Medicare patients, they are often forced to operate with merely half the reimbursement of their urban counterparts. For example, Mercy Hospital in Devils Lake receives on average about $4,200 for treating a patient with pneumonia. In New York City, we know that some hospitals receive more than $8,500 for treating the same illness. This disparity places our providers at a clear disadvantage. Against the backdrop of this funding disparity, we know that rural providers were particularly hard hit by reductions in the Balanced Budget Act of 1997. Last year, N.D. hospitals were losing at minimum 7 percent on every Medicare patient they serve. In some of our smaller communities, hospital margins fell as low as negative 21 percent. How can our hospitals be expected to survive at a 20 percent loss? Recognizing the challenges that our communities were facing, I fought hard last year to offer relief to our rural providers. I am happy to say that the Balanced Budget Refinement Act of 1999 (BBRA) brought more than $100 million to our ND providers--but we must do more. Even though the BBRA improved the outlook for our hospitals, N.D. facilities are still in financial trouble--they are still projected to have negative 4.9 percent margins by 2002. Continued funding shortfalls have made it, and will continue to make it, impossible for our smallest rural hospitals to make needed building improvements; impossible for them to provide patients access to updated technologies; and difficult for them to competitively recruit and retain health care providers, particularly to the most isolated, frontier areas. For this reason, I rise to introduce H-CARE. This legislation offers targeted relief to our most vulnerable rural providers, including: our sole community, critical access, and Medicare dependent hospitals. In particular, H-CARE would offer a full inflation update to all rural hospitals. The BBA limited hospitals' inflation updates through 2002. This has meant that our providers have not been allowed to receive payments that are in line with the costs they incur for serving Medicare patients. H-CARE would close the gap on this funding shortfall. Also, H-CARE permanently extends the important Medicare dependent hospital program, which is due to expire in 2006, and would offer these providers more up-to-date funding. Currently, they are reimbursed based on 1988 costs. As providers that serve at least a 60 percent Medicare caseload, it is important that they receive appropriate Medicare payments. In addition, H-CARE addresses several flaws in last year's Medicare add-back bill that have adversely impacted our rural providers. For example, many rural hospitals entered the Critical Access Hospital (CAH) program under the promise that they would receive adequate resources to keep their doors open. The BBRA inadvertently limited these hospitals' ability to receive funding for providing lab services to their patients. H-CARE fixes this problem by ensuring CAHs once again receive the funding they need to provide lab services. For our sole community hospitals, H-CARE corrects an error in the BBRA which excluded some of these hospitals from receiving higher reimbursement rates based on more recent costs. H-CARE fixes this mistake by letting all sole community hospitals receive more up-to-date payments based on 1996 costs. This is particularly important for N.D. since 29 of my state's 36 rural facilities are sole community hospitals. Lastly, H-CARE would establish a loan fund that rural facilities could access to repair crumbling buildings or update their equipment-- eligible facilities could receive up to $5m to make repairs and an extra $50,000 to help develop a capital improvement plan. H-CARE also includes grants, in the amount of $50,000 per facility, that hospitals could use to purchase new technology and train staff on using this technology. In summary, this year, I will fight to enact these and other measures that are vital to improving our rural health care system. I urge my colleagues to support this important effort.

Mr. CONRAD

Mr. CONRAD. Mr. President, I rise to introduce, along with my colleague, Senator Gordon Smith of Oregon, legislation that we call the Combined Fund Stability and Fairness Act. The Coal Act of 1992 represents an unbreakable commitment to retired miners, their spouses, and their dependents. But it is clear today that if we do not address the shortcomings of the 1992 Act, we will fall short of keeping that promise. Simply put, the Combined Benefit Fund needs to be put on a firm financial footing so that the miners and their family members--who depend on the health benefits the Fund provides--can stop worrying about when their benefits might be cut. The Coal Act of 1992 cast a wide net in identifying companies that would be obligated to pay into the fund. Not only were companies then in the coal mining business included, but the Act also brought in companies that were no longer in the bituminous coal mining business as well as successor companies. Nearly eight years later, we know that Congress overreached. Two years ago, the Supreme Court in Eastern Enterprises versus Apfel, held that the so-called ``super reachback'' companies should not have been included among Combined Benefit Fund contributors in the first place. The logic of the Court's decision in Eastern appears just as applicable to the reachback companies. They should not have been included either. The bill the Senator from Oregon and I are introducing today is not a bailout for the reachback companies. In fact, the reachbacks will not receive one penny under this legislation. It provides relief to the reachbacks on a prospective basis only. There are a limited number of companies that will receive payments under this bill. One group--what we refer to as the ``final judgment'' companies--are companies in the same situation as Eastern Enterprises. However, they had been unsuccessful in litigation decided before the Eastern decision, and were barred from recovery by the doctrine of res judicata. The other group--the ``stranded interim'' companies--are companies that were assessed following the enactment of the 1992 Act but were never assigned any beneficiaries. The total of the refunds to be paid to these two groups of companies amounts to about $28 million. That is the only money under this bill that would not go retired miners and their dependents. I think this is a fundamental question of fairness and equity. Those companies ought to be treated the same way as those companies that were relieved of the obligation because of the Eastern decision. That is just basic fairness. To help ensure the solvency of the Combined Benefit Fund into the future, the legislation would extend the Abandoned Mine Reclamation Fee program beyond its current expiration date of 2004 through 2010. The interest earned on the Abandoned Mine Lands Fund would be made available to the Combined Benefit Fund. This is similar to the approach Congress took with respect to the AML fund in the 1992 Act. It is important to stress that the AML fees would be lowered substantially from current levels. The rate on surface-mined coal would drop from 35 cents per ton to 20 cents per ton; the rate on underground-mined coal would drop from 15 cents per ton to 5 cents per ton; and the rate on lignite coal would drop from 10 cents per ton to 5 cents per ton. The legislation also authorizes the transfer of $38 million in general fund revenues every year to cover any shortfall in the fund. The combination of the AML Fund interest money, the premium adjustment mechanism, and the annual general fund transfers will ensure that all Combined Benefit Fund obligations will be fully met. The fundamental purpose of the Combined Fund Stability and Fairness Act is to provide a secure, sound and fair financial foundation for the benefits miners have been promised. It is my hope that Congress will not delay in addressing this issue. Too many people are depending on us. I ask unanimous consent that the text of the bill be printed in the Record.

Mr. CONRAD

Mr. CONRAD. Mr. President, I rise to introduce, along with my colleague, Senator Gordon Smith of Oregon, legislation that we call the Combined Fund Stability and Fairness Act. The Coal Act of 1992 represents an unbreakable commitment to retired miners, their spouses, and their dependents. But it is clear today that if we do not address the shortcomings of the 1992 Act, we will fall short of keeping that promise. Simply put, the Combined Benefit Fund needs to be put on a firm financial footing so that the miners and their family members--who depend on the health benefits the Fund provides--can stop worrying about when their benefits might be cut. The Coal Act of 1992 cast a wide net in identifying companies that would be obligated to pay into the fund. Not only were companies then in the coal mining business included, but the Act also brought in companies that were no longer in the bituminous coal mining business as well as successor companies. Nearly eight years later, we know that Congress overreached. Two years ago, the Supreme Court in Eastern Enterprises versus Apfel, held that the so-called ``super reachback'' companies should not have been included among Combined Benefit Fund contributors in the first place. The logic of the Court's decision in Eastern appears just as applicable to the reachback companies. They should not have been included either. The bill the Senator from Oregon and I are introducing today is not a bailout for the reachback companies. In fact, the reachbacks will not receive one penny under this legislation. It provides relief to the reachbacks on a prospective basis only. There are a limited number of companies that will receive payments under this bill. One group--what we refer to as the ``final judgment'' companies--are companies in the same situation as Eastern Enterprises. However, they had been unsuccessful in litigation decided before the Eastern decision, and were barred from recovery by the doctrine of res judicata. The other group--the ``stranded interim'' companies--are companies that were assessed following the enactment of the 1992 Act but were never assigned any beneficiaries. The total of the refunds to be paid to these two groups of companies amounts to about $28 million. That is the only money under this bill that would not go retired miners and their dependents. I think this is a fundamental question of fairness and equity. Those companies ought to be treated the same way as those companies that were relieved of the obligation because of the Eastern decision. That is just basic fairness. To help ensure the solvency of the Combined Benefit Fund into the future, the legislation would extend the Abandoned Mine Reclamation Fee program beyond its current expiration date of 2004 through 2010. The interest earned on the Abandoned Mine Lands Fund would be made available to the Combined Benefit Fund. This is similar to the approach Congress took with respect to the AML fund in the 1992 Act. It is important to stress that the AML fees would be lowered substantially from current levels. The rate on surface-mined coal would drop from 35 cents per ton to 20 cents per ton; the rate on underground-mined coal would drop from 15 cents per ton to 5 cents per ton; and the rate on lignite coal would drop from 10 cents per ton to 5 cents per ton. The legislation also authorizes the transfer of $38 million in general fund revenues every year to cover any shortfall in the fund. The combination of the AML Fund interest money, the premium adjustment mechanism, and the annual general fund transfers will ensure that all Combined Benefit Fund obligations will be fully met. The fundamental purpose of the Combined Fund Stability and Fairness Act is to provide a secure, sound and fair financial foundation for the benefits miners have been promised. It is my hope that Congress will not delay in addressing this issue. Too many people are depending on us. I ask unanimous consent that the text of the bill be printed in the Record.

Mr. CONRAD

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

Mr. CONRAD

Mr. CONRAD. Mr. President, I am pleased to rise today to offer with my colleague from Missouri, Senator Ashcroft, an amendment which increases the appropriation for a new, more advanced cruise missile for the B-52 from $20 million to $43 million. As my colleagues are aware, the B-52 is the sole carrier of the Conventional Air Launched Cruise Missile [CALCM], a conventional variant of the nuclear-capable Air Launched Cruise Missile [ALCM]. Our nation has relied on the CALCM in all recent conflicts and it has become the weapon of choice for theater commanders. The CALCM offers range, payload, and accuracy that are superior to any other conventional stand-off munition in service today, including the Navy's Tomahawk. A year ago, as Operation Allied Force was underway, we had a tremendous problem. The United States had expended more than 200 CALCMs against Iraq and Yugoslavia and we had less than 100 remaining. I asked the Pentagon what they were going to do about this situation and they recommended that we convert the remaining, ALCMs not needed by the United States Strategic Command for nuclear missions to CALCMs. I was pleased to work with the Air Force and the defense committees to secure funding to do just that. Today, the remaining unneeded 322 ALCMs are being converted to CALCMs. However, conversion will only give us around 400 CALCMs, and to meet future threats our nation will require around 1,000 of these missiles. In May 1999 I was informed that there was no plan to make up the shortfall. I went to Senators Warner and Levin, the chairman and ranking member of the Armed Services Committee, and asked them to adopt my amendment requiring the administration to come up with a plan to replace the CALCM. That amendment passed on May 27, 1999, and I was pleased to have my friend from Missouri, Senator Ashcroft, as an original cosponsor. The result of the Air Force's study was inclusion in General Ryan's unfunded priority list of $86.1 million in fiscal year 2001 and $689.7 million throughout the future years defense plan for research and development and production of more than 600 extended range cruise missiles (ERCMs), also referred to as extended range CALCMs (CALCM- ERs). The ERCM will offer all of the advantages of the CALCM and dramatically extend its range, to beyond 1,000 miles. I am pleased that both the Senate and House Defense authorization bills fully support General Ryan's request for $86.1 million in Fy01. However, the Senate Defense appropriations bill provides only $20 million and the House Defense appropriations bill includes no funding. Consequently, I am very pleased that the chairman of the Appropriations Committee, Senator Stevens, and the ranking member of the Defense Subcommittee, Senator Inouye, have agreed to support the amendment that Senator Ashcroft and I have brought to the floor today. This amendment will increase the ERCM appropriation to $43 million, enough for the Air Force to begin work on this important program during the coming fiscal year. A quick start to ERCM program will ensure that the B-52 remains relevant and our nation retains the capability to strike vital targets with tremendous accuracy at long range in the coming years. I appreciate the cosponsorship of Senators Bond and Breaux and look forward to continuing to work with Senator Ashcroft, the Senate's defense committees, and the Air Force to make the ERCM a reality. I thank the chairman and ranking member again for their support, and yield the floor. THE PRESIDING OFFICER. If there be no further debate, the question is on agreeing to the amendment.