Nancy Johnson

Mrs. JOHNSON of Connecticut

Mrs. JOHNSON of Connecticut. Madam Speaker, I rise today to address the increasingly acute, immediate problems in our Medicare program, one of the pillars of retirement security for America's seniors. It is significant that I rise at a time when Republicans, Democrats, the Congress and the President recognize that Medicare must include a new prescription drug benefit. While I strongly agree that we need to add prescription drugs to the Medicare system, we must provide coverage prudently and fairly and not by endangering funding for other Medicare services. Medicare simply cannot tolerate the scheduled deep cuts ahead, much less the billions of dollars in cuts proposed by the President in his budget and in the outline of his prescription drug proposal. I fervently believe that we must address the current problems immediately or hundreds of providers nationwide will close their doors, creating a crisis in access to care for our seniors of unprecedented proportions. My purpose in this speech today is not to address long-term reform of Medicare nor the crying need to provide access to prescription drugs through Medicare, as important as those issues are to strengthening this crucial seniors' security program. My purpose is more mundane and more urgent. It is critical to assuring seniors' access to quality care now and to assuring the survival of critical community health care institutions like our local hospitals, home health agencies and nursing homes. In 1997, Congress adopted many reforms to Medicare because it was galloping toward bankruptcy. Already in 1997, it was paying out more for services than it was collecting in payroll taxes and premiums. Medicare spending was exploding, especially in the areas of home health and skilled nursing facility costs. And as it reached the unsustainable level of 11 percent growth per year, the Balanced Budget Act reforms were adopted to cut this growth rate in half, from 11 percent to 5.5 percent, a modest and responsible goal. Why, then, are home health agencies, nursing homes and hospitals begging us to hear their problems and pleading for relief? Alas, it is simple. The projected savings from the Balanced Budget Act were $106 billion over 5 years. The real savings that will be achieved are about $100 billion above that. While the goal was to slow the rate of growth to 5.5 percent, growth has dropped to 1.5 percent, though the number of seniors and frail elderly continues to grow. I believe we face a crisis and must act now. While the data from the real world has not reached the shores of Washington, in the real world in my estimation the crisis is immediate and beginning to endanger the quality of care available under Medicare. Seniors' access is at stake and the very institutions we depend on for care are at risk. There are five causes for the very serious problems we face in Medicare: First, though a relatively minor factor, important mistakes were made in writing the Balanced Budget Act reforms. Second, bureaucratic problems have developed and are delaying payments to providers for many, many months. Third, the reform bill included expanded funding and authority to eliminate fraud and abuse. As a result, the Inspector General has not only identified and eliminated a lot of fraud and abuse but has changed many rules, delaying payments unmercifully and unfairly in my mind. Further, the fear of the Inspector General is causing some providers to cancel negotiated discounts and pushing costs up as reimbursements are going down, all because the Inspector General is ignoring old rules and refusing to clarify new ones. Fourth, the fact that rates are based on data that is 4 years old is exacerbating our problems dramatically. And, fifth and possibly the most significant cause of the looming crisis is the unintended and unanticipated consequences of the interaction of the many changes in payment levels and payment systems made by both public and private payers over a short period of time. In fairness, we have placed enormous burdens on the good people of the Health Care Financing Administration which administers Medicare and their claims processors and on the providers with the level of changes that we have enacted. It would be sheer hubris to believe that so many changes could be implemented without unintended consequences, especially as they are interacting with private sector changes of a pace and a breadth unprecedented. Not surprisingly, there are slowdowns in the payments, real mistakes to be corrected and unanticipated problems to be solved. There is no shame in the problems. The shame would be if we did not address them this Congress. We must simply have the political courage to examine the concerns of the providers and deal with those that are legitimate, and we must have the courage to fund the changes from the surplus we have set aside for retirement security since many of what we call surplus dollars are dollars we appropriated to spend on care for Medicare patients and that are needed by those very patients. Some people are discouraging action and criticizing providers for whining. Not so. Go visit hospitals, nursing homes, home health agencies and physicians. Changes made and the additional cuts of $11 billion proposed by the President in his budget will, I think, put providers in severe constraints, put many small providers out of business, and will go directly to affect access and quality of care for our seniors. We cannot expect facilities to simply absorb millions of dollars of loss without compromising their role in our communities. We cannot expect small providers that are not getting paid for many months to be able to meet payroll, provide medications and meet the standard of care we expect. Over the August District Work Period, I encourage my colleagues to meet with providers in their district and listen to what they are going through, see what precisely they are facing and the impact the current law cuts in the HCFA administration, the administrators of Medicare, their actions are having on service availability and quality. Then make your judgment. I think you will come to the same conclusion that I have. Through many visits to hands-on caregivers, I am convinced that providers cannot survive if we do not act and the administration does not provide relief from policies that are harsh and unfair and begin spending the full appropriation provided for Medicare services. Congress must listen up and act. The administration, HCFA, the agency that governs the Medicare program, must also listen up and act, for it will take all of us working hard and now to prevent a catastrophic loss of providers, research capability and sophisticated treatment options. We do not need to fundamentally undo the reforms adopted in 1997. In fact, we cannot undo those reforms because we must succeed in slowing the rate of growth in Medicare. But we must act now to respond to the doubly deep cuts that resulted unintentionally from the law to preserve access to needed health care services and ensure community providers will survive. I will now look at each sector, nursing homes, hospitals and home health agencies, to suggest administrative fixes in the way the balanced budget is being implemented and legislative changes to the policies enacted, in other words, actions that the executive branch can take immediately and laws, legal changes, that the Congress must adopt. In the area of payments to skilled nursing facilities, we expected to save $9.5 billion through the Balanced Budget Act, but the savings are now estimated at $16.6 billion, more than half again as much. There are two administrative policies that together have delayed payments to nursing homes so severely that literally payrolls will not be met if relief does not come soon, spelling closure for good facilities providing compassionate care. First, HCFA needs to repeal sequential billing for nursing homes. The balanced budget reforms required nursing homes to coordinate and pay for all ancillary services given to Medicare patients in nursing homes, but the law does not require sequential billing. If one ancillary service provider is late in submitting their bill, the nursing home is late in submitting its bill to Medicare. This creates a domino effect of payment delays when we require all of May's bills to be settled before June's bills can be looked at. HCFA, the Medicare administrator, has announced that they are ending sequential billing for home health agencies and they should repeal this destructive and unfair policy for nursing homes. Payments for room, board and regular services need to flow predictably as they have in the past while the problems with the ancillary services billing system are ironed out. This will prevent the serious cash flow problems that threaten small providers, particularly small providers in our rural areas and small cities. Secondly, the administration must speed up Medicare payment denials. In my region, nursing homes are having difficulty getting payment denials from Medicare. The real world problem for providers is that they cannot bill other payers, such as Medicare or the private sector, until they get a payment denial from Medicare. Yet they are providing care month after month, often borrowing money, accruing interest charges and endangering their solvency and licensure. We also need to ensure that these denials are written in clear language. Even when providers do get letters of denial, the language is so convoluted and legalistic that it is difficult to determine whether a payment has been denied or not. In addition to these two administrative actions, which I urge the Health Care Financing Administration to take promptly to relieve the terrible strain on nursing homes that threatens the institutional survival of some, there are legislative corrections to the Balanced Budget Act that we must make if quality care is to be maintained. First, we must fairly address the issue of medically complex patients. There is clear evidence that the payments under the nursing home prospective payment system are not sufficient to pay for the medical needs of the acutely ill patient. The General Accounting Office testified before the Senate Finance Committee that, and I quote, certain other modifications to the prospective payment system must be, may be appropriate because there is evidence that payments are not being appropriately targeted to patients who require costly care. The potential access problems that may result from underpaying for high-cost cases will likely result in beneficiaries staying in acute care hospitals longer rather than foregoing care, end quote. Indeed, I have already heard about this problem from the hospitals in my district, yet we cannot expect hospitals to continue to treat patients without compensation simply because there is not a nursing home that can afford to care for them, nor can we expect nursing homes to accept patients for whose care they will not be paid sufficiently. The Health Care Financing Administration has also testified about its concern that the prospective payment system, and I quote, does not fully reflect the costs of non-therapy ancillaries such as drugs for high acuity patients, unquote. HCFA announced that they were conducting research that will serve as the basis for refinements to the resource utilization groups that we expect to implement next year. It is good that HCFA has recognized that we do not have the data to account for the cost of medications for acutely ill patients, but gathering the data for next year is not an acceptable solution. We cannot ignore patients and care providers who are facing serious problems now. We must take immediate action to direct increased payments to the sicker patients or to allow nursing homes to bill directly for drugs until we have better data to refine the payment system. Secondly, we must exclude ambulance, the cost of ambulance rides and prosthetic devices from the current payment system. When Congress passed the prospective payment system, we did not expect to require that nursing homes cover the cost of ambulance transport. Fortunately, the Health Care Financing Administration has exempted several types of ambulance transportation from the payments, but they are still requiring that nursing homes pay for the cost of ambulance transport when it is necessary as part of a patient's treatment plan. This requirement is terribly burdensome for rural nursing homes that face significant charges for long ambulance trips. A rural nursing home in my district gets $200 a day in Medicare payments. An ambulance ride to the nearest hospital costs $800. How could such a home accept a dialysis patient who needs regular transportation to a dialysis facility for treatment? We do not require the nursing home to pay for the cost of dialysis treatment, but we are requiring to pay for the transportation associated with that treatment. The same is true for radiation treatments. We should exclude these types of transport charges from the prospective payment system and fold them into the negotiated rulemaking process that is currently under way to set an ambulance fee schedule. It is also difficult for a nursing home to serve an amputee because of the high cost of prosthetic devices. The cost of these devices can often run from 2 to $7,000. It is impossible for a facility to accommodate this cost in their 2 to $400 a day reimbursement and still provide all the services necessary for a patient to recover from an amputation. The patient cannot get the device while they are in the hospital because their wound must recover, and they cannot wait until they have been discharged from the nursing home because they must begin to use it for therapy. So the nursing home must find a way to pay for it, and that is impossible without losing thousands of dollars on a case. That is unfair to both patient and nursing home. In sum, if the Health Care Financing Administration moves swiftly to address administrative problems that it has the power to address and Congress acts on legislative issues, we can both meet the savings goal of the Balanced Budget Act for nursing homes and not lose the small homes that are truly at risk of closure though they provide wonderful care for our seniors. And now to turn to hospital payment problems which are too numerous to detail here. Instead, I will mention only some of the most troublesome. First, the balanced budget amendment projected savings of 48.9 billion from hospital reimbursements. Currently the Congressional Budget Office projects savings of 52.6 billion. So the savings are being made in spite of major payment cuts in the law that have not yet gone into effect and now, I believe, are inappropriate. In fact, without relief, current law will dramatically escalate cuts in hospital reimbursements and severely damage our community hospitals as well as the medical centers on which we rely for sophisticated expertise, research into new treatments, training of new physicians and a great deal of uncompensated care for uninsured and low-income patients. First, we must repeal the transfer policy. Hospitals are currently paid based on the average cost for caring for a patient with a specific disease. Naturally the facility will have some patients whose treatment requires them to stay longer than the average and some that will be able to be discharged earlier than the average. The difference in the cost to the hospital of the longer- and shorter-stay patients works well over all. The incentive is to reduce the length of stay by getting patients to the most appropriate care setting, and this payment structure has indeed reduced the length of hospital stays dramatically. Starting in the Balanced Budget Amendment, however, through enactment of the transfer policy, we began to send hospitals a completely different message about how they treat patients by reducing payment for patients referred to nursing homes, long-term care hospitals or home health agencies. We know that the bulk of the cost of hospital care is eaten up in the first few days of admission in which a procedure is done and tests are performed. Yet the transfer policy revokes the full prospective payment for the hospital and instead pays them at a lower per diem rate if a patient is transferred to another facility to recover or even to home care. This policy must be repealed because it works against the positive incentives of the prospective payment system which has successfully over time reduced the length of hospital stays by providing less costly alternatives for recovery. Ironically, if a patient tells the hospital discharge planner that they have a relative who can care for them at home but that care-giver becomes overwhelmed or their circumstances change and they cannot provide home care, the transfer policy penalizes the hospital by reducing its payments simply because the patient now legitimately needs home care services. That is unfair to the patient and to the hospital. In addition to repealing the transfer policy, which we must do legislatively, the Health Care Financing Administration must not go forward with a 5.7 percent cut in reimbursements for outpatient services, which was clearly not intended by Congress. The Health Care Financing Administration's interpretation of the law would effectively implement a 5.7 percent across-the-board cut in payments to outpatient departments. That would be a heavy cut. It is clearly inconsistent with Congress' intent and threatens to undercut support for what had been a delicately balanced policy compromise. The House and Senate language in the 1997 bills was identical regarding our outpatient policy clearly precluding this payment reduction, and the conference report reiterated that no change was intended. Further, the 1997 bill included a 7.2 billion outpatient payment reduction, but no additional payment reductions were discussed nor contemplated by Congress nor were analyzed or scored by the Congressional Budget Office. Congress' intent throughout a very long process was very clear that total payment to hospitals for outpatient services was to be budget neutral to a clearly identified new baseline in the law that did save money. No additional hospital outpatient payment reduction of the type outlined in the notice of proposed rulemaking was contemplated. The department should carry out Congress' clear intent and withdraw the proposed rule. It would be inappropriate and destructive to impose 850 million per year of additional payment cuts on hospital outpatient departments. Seventy-seven Senators have signed a letter to the Health Care Financing Agency saying just this, and I am seeking your signatures on a similar letter to get this problem addressed now. Thirdly, the Health Care Financing Administration must recognize the true cost of cancer drugs in the outpatient prospective payment system. The Medicare Payment Advisory Commission has reported to Congress a concern that the method of developing payments under the outpatient PPS system is likely to overpay for some services, and I quote, ``and underpay for others,'' unquote. HCFA has developed payments on aggregate failing to recognize the high costs associated with individual patients. This has a particularly dramatic impact on cancer treatments. HCFA's current proposed rule fails to recognize the complexities of chemotherapy, individual drug costs, and most importantly, differing medical needs of cancer patients. As a result, the new system will create financial incentives that may lower the quality of care available to cancer patients and restrict their access to care. HCFA needs to follow MEDPAC'S recommendations and adjust the outpatient payment system to reflect the complexity of care within hospital outpatient departments. Fourthly, HCFA must recognize the higher cost of treating patients in cancer institutes. There are 10 cancer centers throughout the country that are distinguished from other acute-care hospitals because they are devoted exclusively to the treatment of cancer patients. These facilities provide the most up-to-date cancer treatments available, are on the cutting edge of research, develop many of their new treatments for patients, and are now treating 50 percent of their cancer patients in the outpatient setting, reducing the cost of providing care. We have recognized them as distinct hospitals by making them exempt from the acute-care perspective payment system, and in the Balanced Budget Act we directed HCFA to consider establishing a separate payment methodology for cancer centers. HCFA has failed to do this in their proposed regulation, and their initial analysis of the new payment system is that payments to cancer centers will fall by one-third compared to a 5 percent decline across all hospitals. MEDPAC has recognized this problem and recommended that HCFA modify its payment rationale to better reflect the needs of cancer center outpatient departments. Such administrative remedies are extremely important to preserving access to high-quality care in outpatient and cancer centers; but as important as they are to stemming overly severe cuts and hospital reimbursements legislative action is also required. First, we must pass a stop-loss bill to prevent sudden and deep cuts in outpatient payments. According to MEDPAC, Medicare paid hospitals only 90 cents for each dollar of outpatient care provided prior to the 1997 Balanced Budget Act. The balanced budget has further reduced this to 82 cents for every dollar. Once the proposed outpatient PPS system is in place, hospitals will lose an additional 5.7 percent on average if the administration does not act in accordance with Congress' intention. And some hospitals will be impacted even further. More than half the Nation's major teaching hospitals would lose more than 10 percent, and nearly half of our rural hospitals would lose more than 10 percent. Catastrophic losses would be experienced in some individual hospitals. For example, large hospitals in Iowa and New Hampshire, will immediately lose 14 to 15 percent of Medicare outpatient revenue. Other large, urban hospitals in Missouri, Massachusetts, Wisconsin, Florida, and California will lose 20 to 40 percent. Some small rural hospitals in Arkansas, Kansas, Mississippi, Washington, and Texas will lose more than 50 percent of their Medicare revenue. We must enact legislation to limit the amount of losses that any hospital sustains. As more treatments are moving into the outpatient setting, we simply cannot expect hospitals to absorb losses of 15 percent and more. Legislation to limit losses will ensure that hospitals will still be able to treat patients, and Medicare will secure the savings it needs to remain solvent in the short term. Secondly, we must legislatively prevent any further cuts in the disproportionate share of hospital payments. Many hospitals' emergency departments are the only option for people without health insurance, because they cannot refuse to see patients. With the increasing number of uninsured Americans, hospitals are bearing an increasing burden. Congress must reassess our cuts in disproportionate share of payments in light of the increasing number of uninsured, by freezing payments at their present levels. Thirdly, we must increase the hospital update to reflect the costs of preparing for Y2K. MEDPAC has recommended that hospitals receive one- half to a 1 percent increase in their operating payments to account for the need to update information systems and medical devices to become Y2K compliant, year 2000 compliant. Perhaps more than any other industry, hospitals have had to spend significant amounts of money to update their systems because of the wide variety of devices and systems that they deal with. I have talked with hospitals in my district that have had to replace entire systems and devices ahead of schedule to ensure that they will continue to operate after the clock strikes midnight at the close of this year. The replacements range from simple devices such as IV pumps to costly systems such as a monitoring system in the intensive care unit. It is important to note that the ICU monitoring system was only 8 years old and was not due to be replaced, but the Y2K computer glitch possibility made replacement necessary. The Y2K problem is not something that hospitals could have planned in their operating and capital budgets a few years ago, but it is something they cannot afford to ignore. The American Hospital Association survey of their membership shows that member hospitals will spend $8.2 billion to become Y2K compliant. We should follow MEDPAC's recommendation to increase reimbursements to hospitals to reflect these additional costs. Finally, immediate attention must be paid to the needs of our great teaching hospitals. These institutions have been particularly hard hit because they are affected by essentially all of the Balanced Budget Act changes, while most institutions are only affected by a few provisions. They deal with a large number of uninsured, have more acutely ill patients, because they serve as regional referral centers. They must train the specialists of the future and maintain cutting-edge technology. And they must use National Institutes of Health grants which require a 25 percent match from the institution to do the clinical research that we so deeply depend upon. Madam Speaker, we must look at the way that all the payment changes adopted are affecting these hospitals and provide relief in this Congress. Lastly, let us turn to home health agencies. In this sector, we projected that the Balanced Budget Act would save $16 billion. We have now realized savings of $48.8 billion, more than any other area. The Balanced Budget Act imposed significant changes on the home health industry, and we achieved the greatest savings in this area. I believe the high savings reflects the useful work of the Fraud and Abuse Unit, but through talking to my providers, I know a lot of nonpayment lurks behind that $48.8 billion figure, and good agencies are on the brink of closure from both administrative actions by the government and the balanced Budget Act's effects. First, having saved more than double the intended goal in home health services, we need to eliminate the threat of the 15 percent further additional reduction that will take place on October 1 in the year 2000. While we put the 15 percent reduction in the system to ensure that there would be sufficient savings, we should remove the 15 percent, because the necessary savings have been achieved, completely eliminating the 15 percent reduction. If we are to assure our sickest seniors that home health services will continue to be available, will be expensive, about $7 billion over 5 years. But we should be able to accomplish this out of the savings that we have already generated, which are now making the surplus larger than expected. We must also increase slightly the per-patient reimbursement limit, and the administration must stop the waste of revenues, the scandalous squandering of our resources that is taking place as a result of the high review rate in these agencies. It is a technical problem. It is administrative, but it is taking nurses away from care. It is raising administrative costs at an unprecedented rate, and HCFA must address this terrible problem of the high rate of post-payment reviews. Lastly, we must raise the $1,500 cap on rehabilitative therapy services for both home health care providers and nursing homes. The Balanced Budget Amendment implemented two caps on outpatient rehabilitative therapy services, a $1,500 cap for occupational and physical therapy, and a $1,500 cap for speech therapy. This is an arbitrary dollar limit that does not take into account the severity of a patient's illness. While this cap may be sufficient to provide services to many seniors, there are those who have multiple conditions or who have more than one illness in a career that quickly exceeds the $15,000 allowed and must pay themselves or go to hospital outpatient departments. The Health Care Financing Administration has identified this problem in testimony before the Senate Finance Committee, and I quote: ``We continue to be concerned about these limits, and are troubled by anecdotal reports about the adverse impact of these limits. Limits on these services of $1,500 may not be sufficient to cover necessary care for all beneficiaries.'' HCFA has directed the Inspector General to study the cap to assess whether any adjustments to the cap should be made. MEDPAC has also expressed concern in this area. We need to get relief to the patients most in need, and not let them slip through the cracks. This has been a long and sometimes technical Special Order; however, its message is simple. There are real, serious problems in today's Medicare program that are affecting care for seniors and threatening the future of some of our most beloved community hospitals, nursing homes, doctors' practices, and visiting nurses associations. We need to address these problems now, not next year, through targeted, immediate relief and through strong action. Congress must act now. The administration must act now. At stake, I believe, is quality care for our seniors and indirectly for all of us who rely on our community hospital and community providers. Mr. Speaker, I ask my colleagues to please join me in this crusade for action.

Mrs. JOHNSON of Connecticut

Mrs. JOHNSON of Connecticut. Mr. Speaker, I rise to speak in support of a program very important to Connecticut. With Congress presently debating its annual spending bills, people may wonder how the budget affects them and their well being. I would like to take this opportunity to tell you about one particular program of which I am a strong supporter--the Connecticut State Technology Extension program (CONN/STEP). CONN/STEP helps Connecticut manufacturers become more competitive through the use of advanced manufacturing and management technologies. Through their team of field engineers CONN/STEP provides onsite technical assistance, detailed assessments, outlines potential solutions, and identifies external service providers. CONN/STEP is funded jointly by the State Department of Economic and Community Development and the National Institute of Standards and Technology (NIST) under the Department of Commerce. Here's how CONN/STEP helped one local company in Bristol, Connecticut. Ultimate Wireforms manufactures arch wires and other orthodontic appliances from superelastic/memory alloys and stainless steel for orthodontry applications. The arch wires apply pressure to teeth, slowly causing them to move a predetermined amount to correctively position teeth. The company has provided support to the orthodontic industry since 1989 and currently employs 65 people. Ultimate Wireforms was searching for opportunities to expand their product offerings and decided to focus on the Titanium arch wire business which was undergoing rapid growth. Titanium arch wires apply higher forces to the teeth, which accelerate the corrective orthodontic process. Ultimate, however had no titanium technology experts in house and was being restricted from entering this market by an existing patent, held by a competitor. Ultimate initially attempted to find a Titanium alloy to leap-frog the patent but all of the candidate alloys had one or more drawbacks and, consequently, were not pursued beyond the laboratory phase. With the eventual expiration of the patent, Ultimate was poised to pursue entry into this market, but lacked the in-house expertise to develop Titanium technology. This led them to CONN/STEP for help. A CONN/STEP specialist, knowledgeable in the Titanium industry, identified melting, ingot conversion and wire making suppliers to make small and medium- sized experimental quantities. CONN/STEP soon became the technical interface with the titanium suppliers, resolving problems as they arose until multiple batches with the correct composition and mechanical properties were produced. Ultimate has since entered the Titanium arch market and is now enjoying a 60% increase in sales. Satisfied with the technical service, Ultimate Wireforms had subsequently entered into several additional projects with CONN/STEP, including a comprehensive assessment of their accounting and financial system to help Ultimate better understand their internal functions as well as their place in the market.

Mrs. JOHNSON of Connecticut

Mrs. JOHNSON of Connecticut. Mr. Speaker, I rise in strong opposition to this resolution. Denying NTR to China will undermine United States economic interests. It is our twelfth largest market and China increased imports from the United States 11 percent last year, all products made by highly skilled workers earning high wages. Connecticut exports to China in 1998 totaled more than 301 million ranking it tenth in the Nation. Connecticut businesses and its workers have a direct interest in maintaining normal trading relations with China and with further opening China's markets. With a quarter of the world's population and the third largest economy, China's buying power will grow tremendously in the years ahead. If we do not engage this emerging major market, other nations will replace U.S. companies and through the significant resulting profits gain a competitive advantage over us. That has already happened in the helicopter market through shortsighted American policy. Mr. Speaker, it is just a fact that China is making quiet but significant progress in many areas. Unlike Russia, China has recognized the need to recapitalize their state-owned businesses and has gradually sold many to foreign companies. They are modernizing their economy without the level of unemployment, crime, and turmoil that has plagued other communist nations faced with this challenge. Furthermore, western companies have brought management practices to China that develop individual initiative and respect workers' ideas. They have brought more stringent health safety and environmental standards accomplishing goals like reducing industrial waste 35 percent and harmful air emissions 36 percent, as did Carrier since 1995. And western companies have brought more opportunity to workers through benefits like Otis Elevator's home ownership program. In addition, China has had direct elections in half its villages, gaining experience with secret ballots and multicandidate elections. In some provinces, 40 percent of the candidates are young entrepreneurs and not Communist Party members. In 1997, as part of the rule of law initiative the training of legal aid lawyers began. In sum, China is modernizing its economy and governance through a process that is harmonious with her long history and cultural traditions, but that should not obscure the growth of values in common with people in the west. It should certainly not obscure our common interest in the growth of trade between our nations based on the principles that undergird the WTO relationships. By renewing NTR and working with China to enter WTO we can help China adopt free and fair trade policies. Lower tariffs make our goods more affordable. Distribution rights under WTO will provide access to customers. Good for China, good for us. I urge renewal of the normal trade relations with China and opposition to this resolution of disapproval.

Mrs. JOHNSON of Connecticut

Mrs. JOHNSON of Connecticut. Mr. Chairman, it is not the same old debate. First of all, remember, the Smith language has never ever become law. The Greenwood language this time includes a new requirement that the Smith language does not include. The Greenwood language requires that an organization certify that the funds will be used to reduce abortion. I think every prolife Member of this body ought to be voting for Greenwood. It requires certification that the money will be used to reduce the incidence of abortion. How can he do that? Well, in Central Asia, where abortion was the only method of family planning under Soviet rule, once women were given access to family planning, abortion rates plummeted, plummeted. So under this bill, if they receive this money, they will have to be willing to certify that they are going to go after those populations that have essentially no choice in family planning but abortion. Support the Greenwood amendment.

Mrs. JOHNSON of Connecticut

Mrs. JOHNSON of Connecticut. Mr. Chairman, I thank the gentlewoman from California for yielding me the time. This is a sad moment. We are one of the most educated nations in the world. We spent decades teaching American women that spacing your children creates healthier babies and healthier mothers, enables you to nurture your children and support them economically. And now we are going to deny money to other countries where women and families are poorer so that they will be denied the opportunity to learn how to manage their fertility and space their children. It is an outrage, an outrage. We all know the figures. Children who are born 10 months after the preceding sibling die far more often than children born 2 years apart. Why do we not want women in these other nations to have the knowledge to control their fertility and space their children? It has made stronger, healthier families in America, and it has made better, healthier children with greater opportunity. I urge opposition to this amendment.

Mrs. JOHNSON of Connecticut. I yield to the gentleman from Michigan.

Mrs. JOHNSON of Connecticut

Mrs. JOHNSON of Connecticut. Mr. Speaker, I rise in strong opposition to this resolution. Denying NTR to China will undermine our interests, United States economic interests. It is our twelfth largest market and increased imports from the United States 11 percent last year all on products made by highly skilled workers earning high wages. Connecticut exports to China in 1998 totaled more than 301 million ranking it tenth in the Nation. Connecticut businesses and its workers have a direct interest in maintaining normal trading relations with China and with further opening China's markets. With a quarter of the world's population and the third largest economy, China's buying power will grow tremendously in the years ahead. If we do not engage this emerging major market, other nations will replace U.S. companies and these significant profits gained as a competitive advantage over us. That has already happened in the helicopter and other markets through shortsighted American policy. Mr. Speaker, it is just a fact that China is making quiet but significant progress in many areas. Unlike Russia, China has recognized the need to recapitalize their state-owned businesses and has gradually sold many to foreign companies. They are modernizing their economy without the level of unemployment, crime, and turmoil that has plagued other nations faced with this challenge. Furthermore, western companies have brought management practices to China that develop individual initiative and respect workers' ideas. They have brought more stringent health safety and environmental standards accomplishing goals like reducing industrial waste 35 percent and harmful air emissions 36 percent, as did Carrier since 1995. And western companies have brought more opportunity to workers like Otis Elevator's home ownership program. In addition, China has had direct elections in half its villages, gaining experience with secret ballots and multicandidate elections. In some provinces, 40 percent of the candidates are young entrepreneurs and not Communist Party members. In 1997, as part of the rule of law initiative the training of legal aid lawyers began. In sum, China is modernizing its economy and governance through a process that is harmonious with her long history and cultural traditions, but that should not obscure the growth of values in common with people in the west. It should certainly not obscure our common interest in the growth of trade between our nations based on the principles that undergird the WTO relationships. By renewing NTR and working with China to enter WTO we can help China adopt free and fair trade policies. Lower tariffs make our goods more affordable. Distribution rights under WTO will provide access to customers. Good for China, good for us. I urge renewal of the normal trade relations with China and opposition to this resolution of disapproval. I rise in strong opposition to this resolution. Denying NTR to China will undermine our entire U.S. economic interests. It is our 12th largest market and increased imports from the U.S. 11% last year. With a population of 1.2 billion, China imported approximately $18 billion worth of U.S. goods and services in 1998, supporting thousands of high- wage, high-skill, export-related American jobs. This represents an increase of more than 11% from the previous year, making China the 12th largest U.S. export market. Connecticut exports to China in 1998 totaled more than $301 million, ranking it 10th in the nation. Connecticut businesses and its workers have a direct interest in maintaining normal trade relations with China and in further opening its markets. With a quarter of the world's population and third largest economy, China's buying power will grow tremendously in the years ahead. If we do not engage this emerging major market, other nations will replace U.S. companies and use the significant profits gained as a competitive advantage over us. That has already happened in the helicopter market with U.S. producers guilty of short-sighted policy. It is just fact that China is making quiet but significant progress in many areas. Unlike Russia, China recognized the need to recapitalize their state-owned businesses and has gradually sold many to foreign companies. They are modernizing their economy without the level of unemployment, crime and turmoil that has plagued other nations faced with this challenge. Furthermore, western countries have brought stringent management practices to China that develop individual initiative and respect workers' ideas, have brought management health, safety and environmental standards, accomplishing goals like reducing industrial waste 35% and harmful air emissions by 36% as did Carrier since 1995 and western companies have brought new opportunities to workers like Otis Elevator home ownership programs. In addition China has held direct election in half its villages, gaining experience with secret ballots and multi-candidate elections. In some provinces, 40% of the candidates are young entrepreneurs and not communist party members. (They seek better schools and roads, and are cracking down on corruption.) In 1997, as part of a rule of law initiative, the training of legal aid lawyers began. In sum, China is modernizing its economy and governance through a process that is harmonious with her cultural traditions, but that should not obscure the growth of values shared by people in the West. China is now on the verge of gaining membership in the World Trade Organization. WTO membership requires a country to adopt free and fair trade practices. We must encourage this progress toward a more open market economy because with it will come the opportunity for American companies to distribute their goods in China far more broadly and the lower Chinese tariffs will make our goods competitive in that growing market. It should certainly not obscure our common interest in the growth of trade between us based on the principles that undergird WTO relationships (transparency of law and regulation, equal treatment of foreign and domestic producers, lower tariffs and reduced non-tariff barriers, intellectual property protection and dispute settlement through a fair process.) By allowing NTR and working with China to enter the WTO, we can help China ``adopt free and fair'' trade practices and assure the growth of our economy. The lower tariffs required by WTO will make our goods more affordable and the distribution rights under WTO will provide us access to customers good for us and good for China. Denying normal trade relations with China will only limit our ability to influence and work with China in other areas of mutual concern. Only a policy of principled and persistent engagement will promote American interests on all issues from economic security to non-proliferation, the rule of law, and human rights. I urge the renewal of normal trade relations with China and opposition to this resolution of disapproval.

Mrs. JOHNSON of Connecticut

Mrs. JOHNSON of Connecticut. Mr. Chairman, I have the greatest respect for the gentleman from California (Mr. Lewis), subcommittee chairman, and the gentleman from Pennsylvania (Mr. Murtha), ranking member. However, I must rise to express my grave reservations and concerns about the decision to cut $1.8 billion in procurement funding the F-22. The Air Force and the Department of Defense developed the F-22 as a modern air superiority fighter to seize and hold air dominance in future conflicts. The F-22 is the cornerstone of our Nation's global air power in the 21st century and will ensure our technological lead for the next 30 years, just like the F-15 did 25 years ago. Pausing or delaying production puts our forces at higher risk and hurts thousands of workers whose skills are critical in fighter sophistication and safety and reliability. In addition, delaying the program just 2 years will add approximately $8 billion in completely unnecessary costs to the F-22 program. No matter how much money this bill throws at the F-15, the cost of sustaining the current F-15 fleet will increasingly compromise Air Force modernization. Mr. Chairman, I urge support of the amendment.

Mrs. JOHNSON of Connecticut

Mrs. JOHNSON of Connecticut. Mr. Speaker, I rise in strong support of this legislation. This is not a bill about numbers. The numbers will change as the budget process moves forward, both the budget and the tax bill processes. This is a bill about policy. For the first time in my many years here in Congress and my many years as a member of the Committee on Ways and Means, this is the very first tax bill that lays out a policy that looks to the future: How can America create the high-paying jobs her kids will need in the 21st century. This bill answers that question. It reforms the complicated rules governing foreign income of our global companies. It will stop Daimler- Chryslers and create Chrysler-Daimlers. We have many, many American companies merging with foreign companies, and when they become Daimler- Chryslers, then they create a power shift over those very high-paying jobs that we need. We heard testimony directly to that effect, and we know if we do not make these changes, we will not have the strong companies we need to create the high-paying jobs our kids will depend on. Secondly, we know every single one of those high-paying jobs now requires a greater investment in technology than ever in history, and that will be true in the 21st century. This Tax Code will enable us to create the capital to invest in those jobs. So if we care about high-paying jobs, we have to plan now to create those. We cannot look at just next year. We have to do a tax bill that lays out the policy we need to create a strong economy and high-paying jobs in the 21st century. But this bill also looks at personal security. For the first time, it creates pension opportunities for the 50 percent of American people who do not work for employers that offer pensions. Pension opportunities, personal savings opportunities, long-term care premium deductibility, so that people can be not only economically secure in their retirement but they can be personally secure against the catastrophic costs of long-term health care. Job creation, personal security, and, yes, tax relief and fairness. I am proud to support a bill that creates an across-the-board cut in personal income taxes; relieves the marriage penalty; provides deductions for those who have to pay their own health insurance, thereby reducing the number of uninsureds in our country; provides a small savers deduction; the deduction of student loans, making that permanent. It is the poorest students who have the biggest loans and the biggest interest payments. This is important if we want an educated work force for the 21st century. I urge support of a sound, thoughtful plan for the future of America.

Mrs. JOHNSON of Connecticut

Mrs. JOHNSON of Connecticut. Mr. Chairman, I rise in strong support of the amendment to the amendment. The example that my colleague just gave about a nurse having the right not to administer a contraceptive that they believed was abortifacient because they believed it was an abortion is a right that is protected under the underlying bill. The nurse, as a provider, has a right not to provide services to which she morally objects. Any provider and any entity has that right under this bill. No hospital has to provide abortions if they do not want to. No physician has to. That is a very important right that is protected in the law. It is also true that if an insurance company offers contraceptive coverage, every woman covered by that insurance policy has a right to use it or not. If they have moral objections to contraceptives, they do not have to use contraceptives. There is nothing in the insurance policy that mandates that they use any of the health care services that the health care plan provides. It is a menu of services that they have the option of choosing, depending on their personal conviction, their religious convictions, and their moral convictions. But to give to a plan the power to deny because the plan, which is a piece of paper, it is not a person, but because the plan decides that I, as a woman, do not have the right to take the common contraceptives that 90 percent of American women depend on so that they can have a healthy marriage and be a good mother, that is what family planning does. It spaces our children and limits the number so parents can support them and send them to college, so women can be a loving wife in a happy partnership. That is what family planning is about. It is about good healthy married sex. And I am proud to say that. And I think every woman in America has a right not only to limit the number of children, but to enjoy a healthy relationship with her husband. Mr. Chairman, one thing I wanted to add, the gentleman from Illinois (Mr. Hyde), my dear friend said that we do not suffer from too much morality. That is true. But there is no question that in America we suffer from too much government regulation. And the idea that government is going to regulate, give to a plan on a piece of paper the moral authority to dictate to me, a woman of religious integrity, whether or not I can choose to use a contraceptive is a level, frankly, of intrusiveness into personal freedom that I as a Republican object to and reject. I find it very hard to believe that Republicans who believe in less government and more freedom could endow a plan with the moral authority to limit my right not only to manage when I have children in accord with my good health and my family's ability to support them, but also regulate my right to have confidence, the confidence that frankly healthy sexual relationships among married couples demands, and that is just true.

Mrs. JOHNSON of Connecticut

Mrs. JOHNSON of Connecticut. Mr. Chairman, I rise in strong support of this amendment. I would call the attention of my colleagues to Mr. Ivey's new program called Challenge America, because he is committed to doing exactly what this body has wanted the National Endowment for the Arts to do all along. He is challenging America at the neighborhood level to develop the arts in our schools, in our neighborhoods; to make partnerships between neighborhoods and old established art museums and symphony orchestras on a level and with a variety of creative approaches that simply is unprecedented. Little tiny bits of money can leverage partnerships between businesses, schools, and outstanding art museums that are simply unprecedented. Some have had the idea that the NEA does not affect them. I got a letter citing my district as one of the ones that did not get one brown cent from the NEA, and I want to tell the Members, that was so far off base it was really tragic. I have walked into schools in my home town and seen fifth graders with their shiny faces looking up at me and saying, you know, we are a HOT school. So what is a HOT school? A HOT school is a higher order of thinking school. As we walk through these HOT schools, an NEA idea, NEA money, local money, school money, do Members know what they have to do to get a HOT school grant? The principal, the teachers, and the parents have to go to a summer education program that is at least a week and some years 2 weeks. When we get this approach in place, our kids have an opportunity to integrate the arts and every other aspect of learning that is unprecedented. The kindergartners were doing self-portraits in the style of Miro. He is a very abstract painter, but when we see how he paints a head, think of the discussion among kids of communication, of self-concept, of cultural issues, of history, of our times. So this little fifth grader was showing me how on the hallway these were the kindergartner's self-portraits in the style of Miro. And then she showed me in another hallway the fifth grader's renditions of Lascaux cave drawings as if they were in a Connecticut hillside in contemporary America. Mr. Chairman, these kids are learning history, they are learning the arts, they are drawing themselves. Every 2 weeks they have an assembly at which kids perform. They read their poetry and their stories; and throughout this curriculum they are integrating the arts, the performing arts, communications. When we came to the school, the kids were lined up. There were two people who followed me around all day drawing everything I did, two taking notes to write up everything that went on and so on and so forth. These kids are in a public school system in a city with the old kind of inner city where the jobs have flown, the difficulty of property taxes supporting our education system is just a struggle every single year. And yet these kids's scores are going up like we would not believe because they are a HOT school in every sense of the word. And the idea that this kid would look at me and say, ``We are a Higher Order of Thinking school'' really blew me away. The arts matter in our lives. The arts are not just about symphony orchestras and art museums, as important as they are. They do help our kids grow. They do help our kids learn, and the evidence, the research shows it. If a kid is exposed to the arts when they are young, they do better as an adult because their intuitive thinking has developed along with their logical thinking. HOT schools, if our kid came home from school all excited because now his trumpet playing, his trombone, whatever it was, he has had the chance to learn to play with those who are experts in the music of Duke Ellington and compete in a high school jazz band competition and festival, we would not ask him who paid for it. He would not tell you it was the NEA because he probably did not know, but that is exactly what happened in the high school in the town next to me. The New York City Ballet Hispanico was up at Plainville High School in my district. How else would they have an opportunity unless someone could help, that is, the Federal Government could help share that tremendous resource of New York City with the small towns around? I urge support for this bill. It is just $10 million more for the NEA, $10 million more for the NEH, and we owe it to our kids.

Mrs. JOHNSON of Connecticut

Mrs. JOHNSON of Connecticut. Mr. Chairman, I yield 2 minutes to the gentleman from New York (Mr. Gilman), who is chairman of the Committee on International Relations, but for today's purpose introduced the legislation that is bringing to our Filipino veterans really a very humane and wonderful option. I thank the gentleman from New York for his work. (Mr. GILMAN asked and was given permission to revise and extend his remarks.)

Mrs. JOHNSON of Connecticut. Mr. Chairman, will the gentleman yield?

Mrs. JOHNSON of Connecticut. Mr. Chairman, I thank the gentleman for yielding to me. I, too, look forward to the report. It is the kind of problem that for many years passed us by. We must take the opportunity with this family to find a way to help. We will give that report every consideration.

Mrs. JOHNSON of Connecticut. Mr. Chairman, I yield 2 minutes to the gentleman from Arizona (Mr. Hayworth).

Mrs. JOHNSON of Connecticut. Mr. Chairman, I yield myself such time as I may consume. Mr. Chairman, I submit for the Record some additional information in regard to this portion of the amendment that alters the hold-harmless provisions in the child support enforcement bill. House of Representatives, Committee on Ways and Means, Subcommittee on Human Resources, Washington, DC, June 10, 1999. Hon. Tommy G. Thompson, Hon. Frank O'Bannon, Co-Lead Governors on Welfare, National Governors Association, Washington, DC. Dear Governors Thompson & O'Bannon: Thanks for your letter expressing your opposition to our policy of ending the child support hold harmless provision. Bill Archer has asked me to respond to the letter because I negotiated the hold harmless provisions in 1995-96 and I now chair the Subcommittee with jurisdiction over child support enforcement. Here is my response to your arguments about why we should not end the hold harmless provision. First, I think it is somewhat of a stretch to argue that governors accepted the mandates on child support in exchange for fixed child support funding. As someone who was directly involved in the negotiations, I can tell you that to my knowledge this point was never made by either side during the negotiations. Rather, the hold harmless agreement was developed because a specific provision of the Republican bill required States to share collections on arrearages with families after they left welfare. Our thinking was that federal policy should give families more child support money after they leave welfare and less while they remain on welfare. After all, the point of welfare reform was to get people off welfare. Thus, providing them with more child support money after they left the rolls would help them stay off welfare. In addition, ending the $50 passthrough provided states with significant compensation for sharing more post- welfare collections with families. In fact, according to CBO states saved in excess of $1.2 billion over 6 years (and lots of administrative hassle) by our policy of ending the $50 passthrough. Despite this huge savings by states and the federal government, some states felt they were still financially at risk. So we agreed both to an arrangement in which the arrearages collections would be roughly split between states and families and to a provision requiring the federal government to make up the difference if the collections states could retain in any given year were less than retained collections in 1995. These provisions were negotiated between a small group of members of the Ways and Means and Financial Committees and one state IV-D director. The provisions were not part of the overall agreement between Congress and the governors on the TANF welfare reform law. A broader issue raised in your letter is that the repeal of the hold harmless provision comes at a time when state collections in former welfare cases are declining because there are fewer welfare cases. But your letter does not mention that as welfare cases decline, states save considerable funds in their TANF block grant. In fact, on average across states, the 45 percent reduction in TANF caseloads since 1994 means that states have a very substantial surplus of TANF funds over which they have nearly complete control. Recently, the Congressional Budget Office estimated that by the end of 2003, States will have excess funds of over $24 billion. To raise the problems caused in child support financing because of the TANF caseload decline without mentioning the substantial savings in the TANF block grant is a one-sided presentation of state benefits. Another important consideration in this discussion is that most states make a profit on their child support enforcement program. The enclosed table shows that in 1996, the last year for which we have complete data, 33 states made a profit on their child support program and that the total profit to states was a net of $407 million. While states were showing a positive net cash flow, the federal government had a negative cash flow of nearly $1.2 billion. The second enclosed table shows that the federal government has had a negative cash flow while states have enjoyed a positive cash flow every year since the program began. There is no doubt that the child support program is a good investment, but it is difficult to understand why the federal government should lose money on the program while states enjoy a profit. It may well be the case that the child support financing arrangements that have been adequate for a quarter of a century are now outdated, primarily because of the dramatic changes in the TANF program. We are certainly open to suggestions about new ways to efficiently and fairly fund this vital federal-state program. But in the meantime, we intend to more equitably share the financing burden between the federal government and the states. Thanks for your thoughtful letter. I'm sorry that I am not in closer agreement with your perspectives on these child support financing issues. Nonetheless, in accord with the recommendation in your letter, we have agreed to drop the provision that would have ended federal 90 percent funding for blood testing and other expenses of establishing paternity. Sincerely, Nancy L. Johnson, Chairman. Enclosures.

Mrs. JOHNSON of Connecticut. Mr. Chairman, I yield 2 minutes to the gentleman from Florida (Mr. Foley), a member of the subcommittee.

Mrs. JOHNSON of Connecticut. Mr. Chairman, I yield 3 minutes to the gentlewoman from New Jersey (Mrs. Roukema).

Mrs. JOHNSON of Connecticut. Mr. Chairman, I yield myself such time as I may consume. Mr. Chairman, I am grateful for this opportunity to present to the House H.R. 1802, the Foster Care Independence Act of 1999. H.R. 1802 provides important help to children who are leaving foster care so that they can establish themselves as self-reliant adults. The goal is to prepare these young people to be able to move into the work force or to continue with their education on the very day they leave foster care. These children face very difficult problems and we must create programs to help them learn to be self-reliant. I want to thank my colleagues and lead cosponsor, the gentleman from Maryland (Mr. Cardin) for his leadership in drafting this legislation. His great interest in these young people, and knowledge of their problems and of the current programs has made him an invaluable coauthor of this legislation. The gentleman from Maryland and I have also worked with numerous highly qualified and experienced people in the administration, State governments, and private and nonprofit sectors, and have gained from their experience. Consequently, this bill enjoys broad bipartisan support and is endorsed by the administration. Our bill contains five central innovations. First of all, we double the money available to the States for helping children leaving foster care establish themselves as adults. Second, we require States to in effect conduct two programs, one for adolescents before they leave foster care, and a second program for young adults who have left foster care and are in the process of establishing themselves as independent adults. Third, we require States to prepare every adolescent in foster care by age 18 to either get a job or attend an institution of higher education. On the very day they leave foster care, it is our expectation that State programs will have these children ready to follow one or both of these paths. Fourth, we have worked with the Committee on Commerce to modify Medicaid law so that many of the 18, 19, and 20 year olds who leave foster care may receive Medicaid coverage. And fifth, we raise the asset level so that these young people can save as they work in high school for a security deposit on an apartment, down payment on insurance on a car, and build a cushion for life's inevitable challenges. The services States must provide to these young people so they will succeed are broad: Assistance in obtaining high school diploma; postsecondary education; career exploration, vocational training, job placement and retention; training in daily life skills; budgeting; substance abuse prevention education; education in preventive health care, including smoking avoidance; nutrition education; pregnancy prevention; and for the first time, foster children must be involved in designing their program and accepting personal responsibility for carrying it out. Lastly, States must coordinate their independent living programs with their school-to-work programs, other work force training programs, community college and university programs, and other relevant programs like abstinence training. Finally, let me briefly outline the contents of the manager's amendment. Actually, I am going to skip through this in defense to many who want to speak on this bill and just mention that one of the things that we do in this bill is to authorize additional payments to States for increasing their rate of adoptions. The amount of bonus money we appropriated in previous legislation is inadequate because States have done such a remarkable job of increasing the number of adoptions of children in foster care. Mr. Chairman, many of these kids have suffered more hard knocks in their lives than any of us ever will, but they have skills and abilities. They have dreams and hopes. Many of them are an inspiration. They not only deserve our support, but they are a good investment. Today, two-thirds do not complete high school, 61 percent have no job experience, and 38 percent are diagnosed emotionally disturbed. Most end up jobless, addicted, pregnant, or in jail. That is a terrible thing, to waste a child's life when they are filled with the same abilities and dreams that our own children are. We can and must change that. With common sense and resources, with focus on work and education, with just good care, common sense and concern, these kids can fulfill their dreams like all American children should be able to. Mr. Chairman, I am pleased to present this legislation to the Members today. Mr. Chairman, I reserve the balance of my time.

Mrs. JOHNSON of Connecticut. Mr. Chairman, I yield 2 minutes to the gentleman from Kentucky (Mr. Lewis), a member of the subcommittee. I appreciate his work on this bill.

Mrs. JOHNSON of Connecticut. Mr. Chairman, I yield such time as he may consume to the gentleman from Texas (Mr. DeLay), the majority whip. Mr. Chairman, around here and in this process we rarely get a chance to see the dimensions of any Member, and I would have to say when he testified before our committee he was the first one to describe the agony of foster parents as they have to deal with the 18th birthday issue. So I commend the gentleman for both his work on this legislation and for his good work as a foster father.

Mrs. JOHNSON of Connecticut. Mr. Chairman, I yield 3 minutes to the gentleman from Louisiana (Mr. McCrery) not only a member of the subcommittee as we developed this bill but the member of the subcommittee that has put enormous time into understanding the SSI program and the needs of the disabled. I thank him for the provisions in this bill that address the problems of fraud and abuse in that system. (Mr. McCRERY asked and was given permission to revise and extend his remarks.)

Mrs. JOHNSON of Connecticut. Mr. Chairman, will the gentlewoman yield?

Mrs. JOHNSON of Connecticut. I thank the gentlewoman for her question. I do regret that that letter is fairly inaccurate. Many States get no money at all under the hold harmless provisions. And, in fact, the money that States get under the hold harmless provisions varies widely. In 1997, only seven States received hold harmless funds. In 1998, 21 States received hold harmless funds. There is a great variation in this provision in the law and its impact on the States. Overall, it is absolutely true that the States make a profit on child support and the Federal Government loses money. I do want to point out that in repealing the hold harmless, which I think is good policy, we do protect up to 50 percent of their loss, those States that actually pass those funds through to women coming off welfare and do not allow it to interfere with their eligibility for benefits or the level of those benefits. There is not time to go in on the floor here to the fact that at the time we made these changes, we gave the States the right to retain a 50 percent pass-through and save $1.2 billion for themselves. This is, in my estimation, good policy and we have moderated its impact on those States that had a just cause.

Ms. JOHNSON of Connecticut

Ms. JOHNSON of Connecticut. Mr. Speaker, I ask unanimous consent that in the engrossment of the bill, H.R. 1802, the Clerk be authorized to make technical corrections and conforming changes to the bill.