Nancy Kassebaum

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Madam President, the Senate has returned once again to the question of whether the United States should act unilaterally in lifting the arms embargo on Bosnia. We debated this course before and rejected it for what I believed then, and I still believe, were compelling reasons. I listened with great interest to the amendment that was put forward by the Senator from Georgia, [Mr. Nunn], about some language that would, indeed, begin to make it a collective action on the part of the Security Council and with our allies. This approach may be something that will improve, although I hope not unduly confuse further, the language in the bill. It seems to me that does open possibilities, but I would like to explain why I still share deep concerns about unilaterally lifting the embargo. I well understand--in fact, I share--the sense of frustration and anger that underlies this legislation. Time after time, we and our allies have failed to find a consensus for acting on the pressing and horrific situation in Bosnia. Time after time, we have been cowed and buffaloed by the Bosnian Serbs and by Serbia. We have appeared, and have been, indecisive, ineffective, and divided. It is, therefore, no surprise that unilateral American action has great appeal to many Senators and will, I do not doubt, be approved by a large number of Members of the Senate at the end of this debate. That may make us feel better. But I am not at all sure that it means it is the right solution. I have enormous respect for the bill's authors. The majority leader and my colleague from Kansas, [Mr. Dole], has been a firm, consistent, and powerful advocate for clear and concerted action in Bosnia, as has his coauthor, the Senator from Connecticut, [Mr. Lieberman]. This is a bipartisan effort. It is not a partisan effort. Given the President's failure to produce a consensus with our allies for such action, it may well be that Congress must step into the breach by dictating a go-it-alone American strategy. If so, I think we should not fool ourselves about the realities that may follow. All the old arguments against this course are still valid, I believe. In acting unilaterally, we are breaking the kind of international agreement that we have needed before and we may need again. We are creating a precedent for others to thumb their noses at the international community. In acting alone, we are directly undercutting our allies, primarily the British and the French, who have troops on the ground in Bosnia. Those troops will be the first targets of what could be a steadily escalating conflict, as the Serbs seek a decisive victory before Bosnia can obtain the heavy weapons to prolong the war. In acting alone, we may force the total abandonment of humanitarian relief. But despite the profound flaws of the current effort, and they have been significant, its elimination would create enormous hardship and disaster in the short run. Finally, in acting alone, we will give force to our failure of leadership. Madam President, this may be, in some ways, the most significant and subtle aspect of this. Far from demonstrating America's willingness and ability to lead the west, unilateral action is the final concession that we can find no one willing to follow us. The full impact of that admission may not stop in Bosnia. It could be felt for a long time to come in NATO and other multilateral organizations that are vital to our national interests. Against these very real dangers, supporters of this legislation raise the argument that since we, our allies and United Nations cannot defend Bosnia--which we clearly have not--then Bosnia should be allowed to defend itself by lifting the arms embargo. It is a compelling argument, made more effective each day as the allies and the U.N. forces appear more and more ineffective. We have all felt this as we have watched food convoys be turned back because there was a Bosnian Serb tank blocking the convoy, and rather than stand up and say, ``This food delivery is going to get through,'' it turns around and retreats. Certainly, Bosnia has the right to defend itself. What it lacks is the ability to defend itself. This legislation, by itself, cannot create that ability. That can only happen as Bosnia obtains armaments and supplies and then trains its forces in their use. That will take a great deal of effort and money--which we here may or may not be willing to provide--but most of all it will take time. and not that that is not also important. But we have to recognize that it will take time. There is going to be a certain period of time in there in which the armament--the large armament and the capability to do so--they will still be trying to put it in place. And the population that we most want to help can be at risk. The reality is that the only time left to Bosnia may be that purchased by the international community. Clearly, the U.N. protection force [UNPROFOR] [[Page S 10636]] has not and cannot serve that purpose in any effective way and its mission should be ended. Whether the current shift of policy will produce an effective replacement for the U.N. force remains to be seen. There is considerable confusion and many conflicting signals about the role of NATO air power and the new rapid reaction force being put in place by Britain and France. It is possible that this new policy will never evolve into an effective force but I believe we must not cut off that possibility prematurely. If in passing this legislation we undermine that international effort, we may prove that it is still possible to make the situation in Bosnia even worse. Madam President, this legislation is well intended. The anger and dismay of its authors is well founded. It may be the right thing to do, but I do not believe so and I will oppose it as it presently is presented. I yield the floor. Mr. BIDEN addressed the Chair.

Mrs. KASSEBAUM. Madam President, I think it is good to follow an order. I know the Senator from Michigan was here before I was on the floor and I am happy to yield at this time to the Senator from Michigan.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I ask unanimous consent that the Committee on Foreign Relations be authorized to meet during the session of the Senate on Friday, July 21, 1995, at 11 a.m.

Mrs. KASSEBAUM. Mr. President, I ask unanimous consent that the Committee on Finance be permitted to meet on Friday, July 21, 1995, beginning at 9:30 a.m. in room SD-215, to conduct a hearing on foreign tax issues.

Mrs. KASSEBAUM. Mr. President, I ask unanimous consent that the Committee on the Judiciary be authorized to meet during the session of the Senate on Friday, July 21, 1995, at 10 a.m. to hold a hearing on Federal Law Enforcement and the Good Ol' Boys Roundup.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I thank the Senator from Hawaii and prior to the Senator from Hawaii speaking, the Senator from Illinois, Senator Moseley-Braun, for their cosponsorship and assistance with this legislation as we have been putting it together and as it is now ready to be considered by the full Senate. I just wish to thank the Senator from Hawaii for his support. Mr. President, I suggest the absence of a quorum.

Mrs. KASSEBAUM. I suggest the absence of a quorum.

Mrs. KASSEBAUM. Mr. President, I rise today to offer to the Senate for its consideration S. 641, the Ryan White CARE Reauthorization Act. This bipartisan legislation, which cleared the Labor and Human Resources Committee on a voice vote, is cosponsored by the ranking member of the Labor and Human and Resources Committee, Senator Kennedy, and 63 other colleagues. The act reauthorizes critical health care programs which provide services for individuals living with HIV and AIDS. Accordingly, I urge the Senate to move expeditiously to pass this reauthorization legislation. Mr. President, if I will just describe what this legislation is all about. The Ryan White CARE Act plays a critical role in improving the quality and availability of medical and support services for individuals living with HIV disease and AIDS. As the HIV epidemic continues, the need for this important legislation remains. Title I provides emergency relief grants to eligible metropolitan areas [EMA's] disproportionately affected by the HIV epidemic. Just over one-half of the title I funds are distributed by formula; the remaining amount is distributed competitively. Title II provides grants to States and territories to improve the quality, availability, and organization of health care and support services for individuals with HIV disease and their families. Sometimes I think we do not think, when we are doing legislation such as this, about the stress that the families are under with such a tragic disease. This is why this initially came about, Mr. President, and this is why I think it does fill an enormously important niche. The funds are used: to provide medical support services; to continue insurance payments; to provide home care services; and to purchase medications necessary for the care of these individuals. Funding for title II is distributed by formula. Title III(b) supports early intervention services on an out-patient basis--including counseling, testing, referrals, and clinical, diagnostic, and other therapeutic services. This funding is distributed by competitive grants. Finally, title IV provides grants for health care services and the coordination of access to research for children and families. This legislation also includes many important changes to take into account the changing face of the HIV epidemic. When the CARE Act was first authorized in 1990, the epidemic was primarily a coastal urban area problem. Now it reaches the smallest and most rural areas of this country. In addition, minorities, women, and children are increasingly affected. Chief among these improvements are changes in the funding formulas which are based on General Accounting Office [GAO] recommendations. The purpose of these changes is to assure a more equitable allocation of funding. These formula changes would better allocate funding based on where people currently live with this illness, rather than where people with AIDS lived in highest proportion in the past. In addition, the funds are better targeted based on differences in health care delivery costs in different areas of our country. Based on a request from Senator Brown and myself, the GAO has identified large disparities and inequities in the current distribution of CARE Act funding. This is due to: a caseload measure which is cumulative, the absence of any measure of differences in services costs, and the counting of EMA cases by both the titles I and II formulas. To correct these problems, the new equity formulas will include an estimate of living cases of AIDS and a cost-of-service component. The AIDS case estimate is calculated by applying a different weight to each year of cases reported to the Centers for Disease Control and Prevention over the most recent 10 year period. The cost index uses the average Medicare hospital wage index for the 3 year period immediately preceding the grant award. In addition, the new title II formula includes an adjustment to offset the double-counting of individuals by states, when such States also include title I cities. Mr. President, with any formula change, there is always the concern about the potential for disruption of services to individuals now receiving them. There is also a concern that someone will be getting more or someone will be getting less than they had before. To address this concern, the bill maintains hold-harmless floors designed to assure that no entity receives less than 92.5 percent of its 1995 allocation over the next 5 years. This reauthorization legislation also establishes a single appropriation for title I and title II. The appropriation is divided between the two titles based on the ratio of fiscal year 1995 appropriations for each title. Sixty-four percent is designated for title I in fiscal year 1996. This is a significant change which should help unify the interests of grantees in assuring funding for all individuals living with AIDS--regardless of whether these persons live in title I cities or in States. Because the face of the AIDS epidemic is changing so rapidly, the Secretary is authorized to develop and implement a method to adjust the ratio of funding for title I and title II. This method should account for new title I cities and other relevant factors. If the Secretary does not implement such a method, separate appropriations for titles I and II are authorized, beginning in fiscal year 1997. In an effort to target resources to the areas in greatest need of assistance, the bill also limits the addition of new title I cities to the program. The current designation criteria for title I cities was developed to target emergency areas. Five years after the initial enactment of the Ryan White CARE Act, the epidemic persists. However, the needs of potential title I cities are not the same as the original cities. This is so because title II funding has been used to develop infrastructure in many of these metropolitan areas. This decreases the relative need for new cities to receive emergency title I funding. The growth of new title I cities would be slowed beginning in fiscal year 1998. At that time, current provisions which establish eligibility for areas with a cumulative AIDS caseload in excess of 2,000 will be replaced with provisions offering eligibility only when over 2,000 cases emerge within a five-year period. I believe this change will truly allow us to target these limited resources to areas where the real emergencies exist. As I talked with public health experts about this proposal, they indicated a rapid growth of AIDS cases over a five year period would truly stretch the limits of their existing public health infrastructure. Mr. President, the legislation makes a number of other important modifications: First, it moves the Special Projects of National Significance program to a new title V, funded by a 3 percent set-aside from each of the other four titles. In addition, it adds Native American communities to the current list of entities eligible for projects of national significance. Second, it creates a statewide coordination and planning process to improve coordination of services, including services in title I cities and title II states. Third, it extends the administrative expense caps for title I and II to subcontractors. Fourth, it authorizes guidelines for a minimum state drug formulary. Fifth, it modifies representation on the title I planning councils to reflect more accurately the demographics of the HIV epidemic in the eligible area. Sixth, for the title I supplemental grants, a priority is established for eligible areas with the greatest prevalence of co-morbid conditions, such as tuberculosis, which indicate a more severe need. I believe that the changes proposed by this legislation will assure the continued effectiveness of the Ryan White CARE Act by maintaining its successful components and by strengthening its ability to meet emerging challenges. Putting together this legislation has involved the time and commitment of a wide variety of individuals and organizations. I want to acknowledge all of their efforts. Mr. President, I would also like to say that this is a controversial bill. It has been ever since it was approved and became law in 1990. I think this is so largely because of the fear of AIDS, the concern about HIV, where it may strike next, and as I mentioned earlier, the changing face of this tragic disease, particularly when it strikes children. I think we wonder how can this be. We have in the past had infected blood transmitted by blood transfusions. We are beginning to try to gain control over that so that the frequency of that does not occur. But it becomes a ripple effect that goes down through families. It is a tragic disease, and it is one for which I think we all want to be able to help provide some support for a population that is viewed with great uncertainty and great concern, and as I said, great fear. That is why we always have a hard time with this legislation, Mr. President. We have a hard time making the case, even though there are 63 cosponsors, that this is an important piece of legislation; it will help a large number of people. I am particularly appreciative of the constructive and cooperative approach which the ranking member of the Labor and Human Resources Committee, Senator Kennedy, has lent to the development of this legislation. I also wish to thank the other 63 cosponsors of this bill for assisting me in bringing this important legislation to the floor. I am not without an understanding of those who oppose this legislation and their concerns. These are about our limited resource dollars, our limited support of those in need in the health care area, and the question of why we are targeting this money to this particular arena. I hope that the Senate can act promptly and approve this measure. I yield the floor, Mr. President.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, in response to the Senator from Minnesota, I say I am sure there will be a thorough debate once the facts of the legislation are down and before the Senate. I think we all share some similar goals.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I am pleased to introduce with Senators Kennedy, Jeffords, Pell, and Simon, the Health Centers Consolidation Act of 1995. This legislation consolidates and reauthorizes the community and migrant health center programs, the health care for the homeless program and the health services for residents of public housing program as one streamlined, flexible program authority. These programs play a vital role in ensuring access to health care services for millions of medically-underserved Americans. Consolidating the current, often duplicative authorities will simplify grant application and recordkeeping requirements, freeing up time and money better spent on expanding [[Page S 10150]] access to care. The legislation provides the enhanced program flexibility necessary to respond to the unique challenges of providing health care services to medically underserved populations. This legislation also substantially strengthens the ability of health centers to respond to our nation's changing health care environment through the development of provider networks and health plans to improve access to better-coordinated, more cost-effective services. The ability to form networks and health plans, including managed care plans, is particularly important as states are increasingly moving their Medicaid beneficiaries into managed care plans. Finally, the Health Centers Consolidation Act responds to the unique challenges of delivering health care services in rural areas. The legislation authorizes and focuses the current rural health outreach grant program on the formation of provider networks, including telemedicine networks, to strengthen the rural health care delivery system, encourage the consolidation and coordination of services on a local and regional basis, and bring access to specialized services to remote rural areas.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. If I may yield myself another minute or two, I would ask the Senator from Delaware.

Mrs. KASSEBAUM. Mr. President, I yield back all time remaining on our side and move to table the amendment of the Senator from Massachusetts. I ask for the yeas and nays.

Mrs. KASSEBAUM. Let me just give you an example. For instance, OSHA is currently working on its indoor air quality regulation that it estimates may cost the business community about $8 billion to implement. This indoor air standard, according to OSHA, will prevent some respiratory diseases such as sick building syndrome, which can cause asthma, lung irritation, and other congestion. Yes, that surely is a problem in some workplaces, but we are not talking about putting a price tag on human life necessarily in this instance. We are talking about congestion and irritation, and we are talking about a process that may become so regulatory and burdensome that we might lose the opportunity to have an effectively functioning work force. And we threaten our workers' job security when the burden becomes so onerous to both the business side and the work force side. To its credit, OSHA is now carefully examining that proposed regulation. There has to be a balance. It has to be a positive one. There has to be worker protection through health and safety standards that operate to the benefit of both employer and employee. I would just suggest that this is not the time or the place to undermine the efforts that are in this legislation. I urge my colleagues to defeat the amendment of the Senator from Massachusetts. I yield the floor, Mr. President. Mr. KENNEDY addressed the Chair.

Mrs. KASSEBAUM. Mr. President, I would like to yield myself 3 minutes.

Mrs. KASSEBAUM. I would just like to say as chairman of the Labor and Human Resources Committee, that there is no way that either the committee or this body would ever put at risk the lives of American workers. That is not what is in question here. And I find it very troubling that that is the message being conveyed on the floor of the Senate. We would all agree that health and safety standards are enormously important. That is why there has been support over the years for OSHA. OSHA addresses workplace hazards by issuing safety and health standards. That has not been the question. But OSHA has also become one of the most intrusive of all Federal agencies, and that is one of the primary reasons why we need regulatory reform. I do not understand, as the Senator from Illinois mentioned, why coal mining fatalities would increase simply because we would do a stronger cost-benefit analysis of regulations promulgated since April. There has been much made about Senator Gregg's legislation which was, of course, drafted and introduced without knowing whether there would be a significant regulatory reform effort. Since we are now dealing with regulatory reform in this Chamber, Mr. President, OSHA must be considered as part of that process. And I think Senator Gregg's legislation, as he would acknowledge himself at this point, has been overtaken by events. It is really very sad to me that somehow, some in this Chamber would say that workers' lives were being placed at risk when all we are trying to do is to make the regulatory process work in a positive and constructive way. The Senator from Illinois acknowledged that OSHA itself is working to eliminate about one-third of their regulations. They are recognizing that changes need to be made. We have held two hearings in the Labor and Human Resources Committee, and we heard from many witnesses that changes must be made. But I think in no way does this regulatory reform legislation undermine that positive effort. I do not know how much time I have remaining, Mr. President.

Mrs. KASSEBAUM. I ask for the yeas and nays.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. I thank the Chair. (The remarks of Mrs. Kassebaum and Mr. Kennedy pertaining to the introduction of S. 1028 are located in today's Record under ``Statements on Introduced Bills and Joint Resolutions.'') Mr. DORGAN addressed the Chair.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I rise today to introduce on behalf of myself, Senators Kennedy, Frist, Gregg, Jeffords, Gorton, Hatch, Chafee, Pell, Dodd, Simon, Mikulski, Wellstone, and Lieberman, the Health Insurance Reform Act of 1995. This legislation will make it easier for individuals and employers to buy and keep health insurance--even when a family member or employee becomes ill. And it will allow people to change jobs without fear of losing their health coverage. Despite past State and Federal reform efforts, the lack of poor portability of health insurance remains a serious concern for many Americans, particularly those with preexisting health conditions. The General Accounting Office estimates that as many as 25 million Americans could benefit from this legislation. The Health Insurance Reform Act builds upon and strengthens the current private insurance market by, one, guaranteeing that private health insurance coverage will be available, renewable and portable; two, limiting preexisting condition exclusions; and, three, increasing the purchasing clout of individuals and small employers by creating incentives to form private, voluntary coalitions to negotiate with the providers and health plans. Mr. President, I believe that the American people want us to work together to fix what is broken in the current system without relying on big Government solutions. The legislation we are introducing today does not impose new, expensive regulatory requirements on individuals, employers or States. It does not create new Federal bureaucracies. It does not create any new taxes, spending or price controls nor does it require employers to pay for health insurance coverage. While this insurance reform legislation alone will not cure all the ills of the Nation's health care system, it will in some small and important ways, I believe, promote greater access and security for health coverage for all Americans by requiring private insurance carriers to compete based on quality, price, and service instead of by refusing to provide coverage to those who are in poor health and who need it the most. Mr. President, I want to thank all of my cosponsors. Senators Gregg, Frist, Jeffords, Hatch and Gorton have all contributed a great deal to this effort. Senator Jeffords has worked particularly hard on the group purchasing provisions of the legislation. But I want to especially recognize the contributions of the ranking member of the Labor and Human Resources Committee, Senator Kennedy. He has worked, along with his staff, for many hours, in many ways, to help make this legislation a bipartisan effort. Senator Kennedy has spent many years on the health care agenda working tirelessly to improve the health care delivery system. And I am particularly pleased that this is such a strong bipartisan bill that we are introducing today. It is not a major piece of legislation. As I said, it is not going to be the answer to all the ills in our health care system. But I think it is a very important step forward. I am confident that with the support of the other original cosponsors and others, the Labor Committee we will be able to report this legislation favorably in the near future and we can begin to move forward, on a bipartisan basis, to make private health insurance more readily available, more secure and more affordable for all Americans. Mr. President, I intend to work with all of my colleagues to ensure that these reforms are enacted during the 104th Congress.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I rise this evening to express my deep concern about the deteriorating situation in Nigeria. And I thought it was important to express my concern about what was happening there that has been illustrated by the arrest and detention of General Obasanjo of Nigeria and 23 other political prisoners. Recent reports indicate the military dictatorship in Lagos may be trying General Obasanjo in a secret tribunal on unspecified charges possibly leading to capital sentencing. I join with President Clinton, Foreign Secretary Hurd of Great Britain, and much of the international community in strongly condemning the arrest and continuing detention of General Obasanjo. I have known General Obasanjo for a number of years and have long respected his intellect and leadership abilities. He is one of the few leaders in African history to peacefully step down from power in favor of a civilian democratic regime. Despite the unbanning of political parties, I remain deeply skeptical about the commitment of the Nigerian military government to a democratic transition. The continuing imprisonment of General Obasanjo and disregard for basic human rights and due process only reinforces the mistrust of the current regime. To date, I have supported the administration's policy of limited sanctions and diplomatic engagement in Nigeria. I believe the time is coming, however, where the United States, together with our European allies, should consider tougher and more aggressive steps to pressuring the Nigerian Government into political reform. I will chair a hearing of the Subcommittee on African Affairs of the Senate Foreign Relations Committee on July 20 to explore further options of U.S. policy. Mr. President, I have long believed that Nigeria held the key to development of a large portion of Africa. It has been a large and rich and bountiful nation. It is a country with tremendous economic and human potential. It is also a country with a history of deep-seated ethnic and religious division. For these reasons, the continuing intransigence of the current military leadership is particularly troubling. It could lead, I fear, to further political and economic instability and great tragedy in Nigeria. I firmly hope, together with all friends of Nigeria, that the Nigerian Government will move quickly toward [[Page S 9415]] reestablishing democratic, civilian rule. Only then can Nigeria fulfill its true promise and stand in its rightful place as one of the great countries in Africa and the world. Mr. President, I would like to thank again the Senator from Ohio [Mr. Glenn] for yielding to me because certainly the debate on regulatory reform is a very important debate that needs the most thoughtful consideration. I appreciate him for yielding to me. I yield the floor. Mr. GLENN addressed the Chair.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I very much appreciate the Senator from Ohio letting me speak for a few minutes as if in morning business.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Let me just add this, Mr. President, and I realize everybody has time they want to use. Throughout the debate on this budget, much has been made of the idea of shared sacrifice. And this is always tough. But let me just tell you when a student who is worried about a student loan reduction will say to me, ``So what is going to happen to you?'' I think in order to accomplish the goal of balancing the budget and restoring sound fiscal policy, all of us have to be willing to do our part. That is why I consider it essential that those of us in Congress take action to freeze our own salaries until our budget is in order. Already this year we have made significant cuts in legislative branch spending, and the budget calls for more cuts next year. The conference report does not explicitly say that we will freeze our salaries but that we can. We should enact legislation soon to implement that freeze. I believe, Mr. President, while saving $72 million is not large in the context of our entire budget, it is a step we must take. I strongly support this budget because I believe that it outlines and points to fiscal responsibility, and I congratulate again the chairman and those who have worked hard to make this possible. I yield back my time. I thank the Chair. Mr. MURKOWSKI addressed the Chair.

Mrs. KASSEBAUM. Mr. President, first, I would like to recognize the superb leadership on the master plan of this budget, the chairman of the Budget Committee, Senator Domenici. I used to serve on the Budget Committee a long time ago. It is not easy putting together a truly substantive budget, but, indeed, this budget is that. It is putting us on a path that is going to be [[Page S 9380]] a sound and a sensible direction for the future. It may not be what we all would like. I am sure there are parts of it that we might not be truly comfortable with in the short term. But it envisions what we can do with the short term, but more importantly, what we will be able to do for the future. Mr. President, I am struck by some of the debate that we heard back and forth yesterday and today about the sense of finality that some are imposing on this debate. Depending on your perspective, it is as if this resolution, on its own, will either save our economy or wreck it. The fact of the matter is that the vote on this budget will not end the debate on how to restore fiscal responsibility and set priorities. In many ways, the debate--and the work--is just beginning. This budget resolution, like all budget resolutions, provides a framework for the tasks that will fill the rest of the year, and years ahead, as a matter of fact. It does not and cannot prescribe specific actions. It paints, in broad strokes, the outlines of Federal spending and revenues over the next 7 years. That picture is a good one, because it shows a Federal Government that has slowed the rate of its growth and trimmed away the excess spending that adds to our national debt. The details of the picture, however, will be painted by the authorizing and appropriating committees with jurisdiction over individual programs and policies. The budget requires only that we stay within the lines of the resolution that is before us. As difficult as it has been to produce this outline, producing the finished picture will be much more challenging. For example, I will mention one that was mentioned by the Senator from Maine, Senator Snowe. I am very concerned about the magnitude of cuts this budget would have us make in Federal student loan programs. During the recent debate on the Senate resolution, we rejected the idea of stripping away loan subsidies for college students. Senator Snowe's amendment gave 67 of us the opportunity to make ourselves very clear on that point. Yet, the budget resolution assumes we will cut $10 billion from the program in 7 years. This was worked out through the compromise with the House and the Senate, and it is now before us. I think it will be very difficult for the Committee on Labor and Human Resources--and the full Senate, for that matter--to agree to the cuts the budget resolution assumes we will make to meet its instruction. As chairman of that committee, I can only say that I will do the best I can. And, obviously, it is very important that indeed we achieve that goal. I also am not convinced that the mechanism this resolution sets up for certifying spending cuts and triggering a $245 billion tax cut will be effective. Nor am I convinced that a tax cut of that size is wise while we are still running deficits. That has been a concern of a number of us. Even if CBO certifies that our planned spending reductions are sufficient to cover the lost revenues, we still could balk when the time comes to follow through with the spending cuts. Seven years is a long time. Before I vote for any tax cut this fall, I will have to be convinced that we have locked in real spending cuts. And that is, indeed, the responsibility of the authorizing and appropriating committees. I also have to mention that I do not agree with some of the discretionary spending assumptions this budget makes. A good example, I think, is spending on public health and basic research. I remain concerned about the funding reductions for the National Institutes of Health and other programs in the U.S. Public Health Service. The budget resolution assumes a 1-percent reduction in NIH funding in 1996 and then a 3-percent reduction for each year thereafter. That does not seem like a lot. But I think it takes away from that budget some very important funding that is necessary for us in the future. And I am worried about the detrimental impact of any NIH budget reduction. I believe that biomedical research advancement and breakthroughs could slow dramatically, and I think this is a concern we all share. We want to make sure we can do it the right way. However, I am pleased that the conference agreement would allow for a 1-year transition period before the full impact of any reduction would occur. This is necessary because the National Institutes of Health will need time to plan for the discontinuation of some ongoing research projects to fund new initiatives. As chairman of the Committee on Labor and Human Resources, I am committed to working with NIH to find ways to achieve these budget reductions without harming basic biomedical research. In fact, we will explore these options when the committee takes up the NIH reauthorization next year.

Mrs. KASSEBAUM. If I may just have 2 more seconds to finish.

Mrs. KASSEBAUM. Just 1 minute will do it.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I join today with my colleague from New Jersey, Senator Bradley, in introducing the Newborns' and Mothers' Health Protection Act of 1995. This legislation seeks to ensure that adequate care is provided to mothers and newborns in the critical first few days following birth. Modeled after legislation recently considered in Maryland and passed unanimously by the New Jersey Legislature, it requires health insurers to allow new mothers and their infants to remain in the hospital for a minimum of 48 hours after a normal birth, and 96 hours after a cesarean delivery. If the mother and the doctor agree, shorter hospital stays are permitted, provided that there is a follow-up visit. ``Guidelines for Perinatal Care'' issued by the American Academy of Pediatrics [AAP] and the American College of Obstetricians and Gynecologists [ACOG] state that in uncomplicated deliveries the postpartum hospital stay should range from 48 hours for vaginal births to 96 hours for cesarean sections, exclusive of the day of delivery. However, as hospitalization costs continue to climb, it has become increasingly common for health insurers to require that new mothers and their babies be discharged from the hospital 24 hours after birth. In some parts of the country, hospital stays for a routine delivery can be as short as 12 hours. The American Medical Association [AMA], ACOG, and the Academy of Pediatrics all have stated that the trend toward shorter hospital stays is placing the health of newborns and their mothers at risk. Early hospital discharges have caused conditions such as jaundice-- that do not appear until after the first 24 hours of life and which may lead to brain damage--to go undetected. A 24-hour stay is often too short for new mothers to be taught basic infant care skills, such as breastfeeding. And many mothers are not physically capable of providing for a newborn's needs 24 hours after giving birth. This can lead to inadequate nourishment during a child's crucial first few days of life. Mr. President, I must say that I have agreed to cosponsor this legislation [[Page S 9177]] with some reservation. I generally view any effort to influence private contracting arrangements with great skepticism. However, I view this situation as limited and unique. What is at stake here is not merely an impediment to the traditional doctor-patient relationship, but instead the health and safety of millions of America's children. My primary concern is that the most recent trend toward shorter hospital stays appears to be motivated primarily by financial considerations--instead of sound medicine. In calling for a moratorium on shorter hospital stays last week, ACOG stated that: The routine imposition of a short and arbitrary time limit on hospital stays that does not take maternal and infant need into account could be equivalent to a large, uncontrolled, uninformed experiment that may potentially affect the health of American women and their babies. Like ACOG, I fear that insurers may be acting prematurely, without sufficient information about the long-term health implications of shorter hospital stays. As more conclusive data becomes available, I would be open to revisiting this issue. Until then, I believe we should proceed with caution. I strongly believe that decisions regarding early discharge must be individualized and should place primary emphasis on the health of a mother and her child. I believe that the legislation we are introducing today will help restore that perspective to this important decision.