Trent Lott

Mr. LOTT

Mr. LOTT. The following Senators are necessarily absent: the Senator from Kansas (Mr. Brownback) and the Senator from Arizona (Mr. McCain).

Mr. LOTT

Mr. LOTT. I thank the Senator for his explanation and for his amendment because it is clear that through these waivers or through moves by various States, without questioning their motives, they have been able to develop a system which is very unequal among the States. I found, for instance, the reimbursement rate to the States--by the States--as required by the States for Medicaid, for instance, varies greatly from as low as 50 percent to as high as 80 percent. That is not fair, and we need to do something about it. I thank the Senator for yielding.

Mr. LOTT. I ask unanimous consent that the order for the quorum call be rescinded.

Mr. LOTT. Madam President, we were alternating back and forth on both sides, but the Senator from Illinois had a need to go forward. I agreed that he would go first and then I would follow. Let me say on the bill we have here, again, it is very easy to get up and talk about children and the need to help children. That affects us all. I am a parent. I am a grandparent. There is nothing that excites me more in the world than going to see my four little grandchildren. I can't stand the thought of children anywhere, regardless of income level, not getting the kind of health care they need. That is why I voted for SCHIP in 1997. I remember Senator Kennedy was in the debate. Senator Phil Gramm of Texas had a little different point of view. Senator Hatch was involved. We came to a conclusion. We got a good program to help children who did not have health care. I thought we had done a good thing. The problem here is, we are exploding the program in terms of costs, tax increases, or cuts in the House. They are not doing the tobacco tax increase. They are cutting Medicare Advantage which affects people at the other end of the age schedule, people who need Medicare Advantage to get health care in rural areas in States such as mine. There is a balance here. Why can't we agree on a reasonable increase to make sure we continue to cover children who would not be covered otherwise. Also what is happening here is a steady march toward higher and higher and higher income level children. You heard Senator Allard talk about the fact, now we are up in the range of $73,000 income for a family of four. The ultimate goal is for all children to be covered by ``Mother Washington,'' Washington bureaucracy health care. Why should any family have to worry, regardless of income, or any State have to worry about children being covered of all ages, forever, for everything, including dental care? I agree, dental needs can be as damaging healthwise as any other illness. I am connected to a family of dentists, dental hygienists, and dental technicians. But the question is, how much can the Government pay for? Why can't we keep some limits? Why do we want to force people off of private insurance? We are going to have children now covered by private insurance going into SCHIP or Medicaid. Why are we trying to force everybody on to SCHIP? This chart shows what is happening. When we started this program in 1997, the next year, 1998, the children enrollment in Medicaid and SCHIP, the children's health program, was 27 percent covered by Medicaid, 1 percent was covered by the Children's Health Insurance Program, and 72 percent by other programs including private insurance. By 2005, it had grown to 37 percent covered by Medicaid, 8 percent by the CHIP program, and 55 percent other. With this bill, the underlying bill going into effect the way it is now, it will jump to 71 percent of all children will be covered by Medicaid and SCHIP, and only 29 percent other. You see the steady march toward every child being covered by this particular program. The problem with this bill can be described with A, B, C. Not only have you had the steady march of higher and higher income level children being covered, adults are being covered. Where is the ``A'' in SCHIP? Again, it is a creeping thing. First, gee whiz, yes, it is supposed to be for children, but pregnant mothers should be covered and what about parents of children. There are some other adults that maybe need some extra consideration, too. So it is not only higher and higher income children, it is adults and more adults and even more adults. So the first appropriate problem is adults, A. B, we are talking billions here. The underlying program is $25 billion. The Finance Committee adds 35 at a minimum on top of that. And in the outyears it expands tremendously, up to, I think in the year 2012, the number is maybe 37 billion in that single year. Remember, if we pass the Finance Committee bill, that 60 billion--25 plus 35, it will be 60 billion--the House is going to pass a bill at what, 80, 90, 100 billion, paid for by taking money away from Medicare beneficiaries and we go to conference, if we go to conference. What will happen? What always happens, you split the difference. We are at 60; they are at 90. How about 75, $75 billion? How is that going to be paid for? It is going to be paid for by cutting benefits for the elderly and/or raising taxes for all kinds of people. We can fix this, though. It gets back to the A, B, C. Keep to the core mission, children who are low-income families. We need to get back to that. We have some good amendments pending. We should pass the Bunning amendment which would eliminate the high income eligibility above 300 percent, the Allard amendment which would stop the income disregards which drives the income level up steadily, and I understand that Senator Gregg will have one that will strike the adult coverage. We can fix this. We could get together on a bill that would be bipartisan and would help the children who do need it, the ones we started out to help before we got the bright idea we will cover everybody by the Children's Health Insurance Program. I yield the floor.

Mr. LOTT. Madam President, I am glad to yield.

Mr. LOTT. Madam President, we do have a program that has input from the Treasury, yes.

Mr. LOTT. Well, if I can respond, I have a solution. Let's cut that. Maybe we are not entitled to that.

Mr. LOTT. Well, now, Madam President, I might say, the Senator has been here much longer than I have, and I presume he would know the origin of how these programs were created and voted for or against them. But I want to correct something he said right at the beginning. I have not advocated cutting children. I advocate covering the children who are now covered and making sure we cover the children we have committed to. What I am opposed to is the ever increasing income level and number of children and adults. What about adults who are being covered by this program? If it is going to be ``ACHIP,'' adults-children health insurance program, that is one thing. But I would like to keep the focus on covering the children who really need it and would not be able to get it perhaps through a private insurance program or in Medicaid. But if the Senator wants to propose we cut the Senator's benefits, I will be glad to join him in that.

Mr. LOTT. Everything we are doing to ourselves, we might as well do that too. That would be fine with me. If we could control the growth of this program, I would be more than glad to help pay for it.

Mr. LOTT. I am perfectly delighted to do that. Of course, my children are grown, and they are not covered at all by this, but I would be glad, to control that, to do anything the Senator wants to do to the Senate. I suspect it richly deserves it. And another thing, what I am saying is, one State is only covering children up to 200 percent, other States now have 350 percent, or even one of them is now wanting 400 percent of poverty for children and adults. All I am saying is, stick with the program we intended. Let's not turn this into just a Washington bureaucratic health-run program. That is what this is all about. This is about moving us toward a system we could not get any other way, where the Government will pay for and control everything in terms of health coverage in America. I do not believe the American people want it. I worry about my children and grandchildren in this respect. What kind of burden are we putting on their backs in terms of what they will have to pay for in the future? Does nobody ever think about that anymore? Every program is growing exponentially; every one of them. So I worry about my grandchildren having to pay for all the things we are coming up with here. I yield the floor.

Mr. LOTT. Madam President, if the distinguished Senator would withhold so I could just address a couple of questions to him on his amendment? The amendment would say that the States have to take into consideration the gross income of the family, not including certain so- called income disregards. That is the way we talk in Washington, but to the average man and woman, what are we talking about? Are we saying, even though we think they may have other sources of income--I don't know what that might be, and I was going to ask you, are you talking about rental income? Are you talking about some part-time income? I wonder, what types of things are used by these various States to reduce the gross level of income so they can get under this, whatever it is, 350 percent of poverty or--400 percent of poverty is the newest application, I understand, from New York. Do you have any information on that?

Mr. LOTT. The following Senators are necessarily absent: the Senator from Kansas (Mr. Brownback) and the Senator from Arizona (Mr. McCain).

Mr. LOTT

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

Mr. LOTT. Mr. President, I believe under the agreements that have been worked out I am going to speak at this time with regard to the SCHIP issue.

Mr. LOTT. Mr. President, let me first emphasize that we will have a motion to proceed to the State Children's Health Insurance Program this afternoon, and Republicans and Democrats will vote for that procedural motion to go forward because all of us support reauthorization of the so-called SCHIP program, which is Washington speak for State Children's Health Insurance Program. This is a classic example of how no good deed goes unpunished because I remember when this program was developed legislatively on the Senate floor. The Senator from Utah was a key player. I remember some of the exchanges that were made at the time with Senator Hatch talking and Senator Kennedy and Senator Phil Gramm when we created this program. This was about, I guess, 10 years ago or so. We created it because we did believe there was a need in America for children to have health assistance--a health insurance program--particularly low-income children. There were a large number of children who were not then covered, so it was well intentioned, and everybody wanted to go forward with a program that would cover these children so their health needs could be addressed and so they could live healthier lives. I just heard Senator Hatch make the point that if we don't have this type of health insurance available for children in critical times, a longer term cost will greatly exceed what the cost might be for the program at this time. So we were in it together. We created it at a time when we had a Republican majority in the Congress and a Democratic President in the White House. It was generally a bipartisan effort, and we created a good program that was targeted. It was expensive, but we believed it was important that we get this done. Now, since that time, this program has continued to grow, and we have seen States start adding not only higher and higher levels of income for these children to be covered--up now to, I think, 350 percent of poverty in some States, and another State now is actually trying to get it up to 400 percent of poverty, which certainly is not low-income children. That is middle-income coverage. That would cover children in the range of a family of three making $60,000 to $70,000 a year. So that has really started causing problems, with the higher and higher level of income for children and adults being included. That was never the intent. The core mission of this program was for children to get this help, but more and more States have included adults, and not just the pregnant mother but the parents and even adults beyond that in some of these States that have gotten waivers. It is going to be argued by some Senators, Senator Grassley and probably Senator Baucus, that a lot of this problem has been caused by this administration--probably the previous administration but certainly this administration--by giving waivers to the States to begin to cover a higher and higher income level of children and adults. That is a legitimate criticism. They shouldn't have done it, and they shouldn't have done it the way they did. And certainly they shouldn't have done it repeatedly. I don't know how many States have gotten waivers now--14, 16 States, something of that nature, and more to come probably. Some people at the Department of HHS will say: Well, we don't have much discretion under the waiver. I don't believe that is true, and certainly they had more discretion than they exercised. So the program now, with these waivers, has got lots of problems, and that is why I oppose it in its current form. Let me first talk about the Baucus bill and give the reasons I am opposed to it. The baseline for this children's health program is $25 billion over 5 years--$25 billion. I believe the President, and these are general numbers, but I think the President asked for basically a $5 billion increase over those 5 years, which would have brought it up to the $30 billion range. I was thinking in committee that was not enough; that we were going to have to go higher so that we could try to cover those children now covered in the program, realizing some who would be eligible are not covered because, No. 1, they may not have applied, No. 2, they are covered by private insurance, and No. 3, they were covered by Medicaid. But it was clear to me it was going to take more money in order to cover the children we really intended to cover than the basic of $25 billion. Now, I thought we were going to be talking in the range of $7 billion or $8 billion, and I still believe that is the right number to continue to cover those children who are now covered by the program. The bill we have before us, though, has risen by $35 billion above the so-called baseline for a total of $60 billion over 5 years--$60 billion. A program that was originally intended for low-income children to get this health insurance, certainly never intended to be $25 billion, now in this bill would be $60 billion over 5 years, and explosive in the outyears. And this is before we go to conference with the House. The House is talking $70 billion to $100 billion. So even though one might say: Well, this bill has gone way too far, this is the new baseline, if we pass it at $60 billion, it will only go up. What will it be, $70 billion, $80 billion, $90 billion for this program--only for this program? And by the way, a program that will include adults and will include children probably certainly well above 200 percent of poverty. That is why we have an alternative that will make sure we cover those children we originally intended to cover and children now under the program, but we did not want this sort of doubling of the size of the program in the next 5 years. Ours would even provide for a 33-percent increase over the next 5 years. We have a real problem. It is a massive spending increase. It uses certain budget considerations to deal with what happens after the fifth year. Some people say: Well, there will be time to change that. But nobody really believes that once you build a program, like this chart shows, that goes up, up, and up, and then all of a sudden when it reaches a certain level, it drops back down. It won't do that. It will continue to go up. And therein is the second part of the problem. How do you pay for this? The bill before us has tax increases in the $61 billion to $70 billion range. I believe that is accurate, but a minimum of $61 billion, with that coming from a tax on cigarettes and other tobacco products. The fact is, when you tax something with that much of an increase, which takes it up to a full dollar from the current 39 cents, that is a huge increase. When you have that kind of increase, a dollar a pack on cigarettes, what you are going to get is less revenue. So at a time when the cost of the program is going up, the revenue that is actually going to be coming in is going down. That is a prescription for huge budget problems. Of course, the argument again is, well, that is down the road; we will have time to fix that later on. But one of my concerns about the program as it is now is that it also will actually be taking children now on private insurance--children who have coverage--and they will be going off private insurance coverage and going into the so-called SCHIP program. There are an estimated 600,000 children--and I don't know how you estimate those numbers, which I suspect are low--but a large number of kids, up to perhaps as many as 2.1 million, will be moved from private health insurance programs to the Government-run health care program. So here we have a massive spending increase, we have a program that will be taking children now covered off of private insurance and moving them on to a government program, and you have a massive tax increase. We will have an alternative that reauthorizes the program, keeps it focused on the core mission of low-income children, which does increase funding generously, by as much as 33 percent, and avoids the huge tax increase. And the revenue it brings in is real, not a revenue that will be on a declining basis. It will give, additionally, millions of Americans access to health insurance through the small business health plans and includes reforms in the health savings accounts. Mr. President, I know we have a number of Senators lined up to speak, but I just wanted to begin to point out some of the basic problems of how we got here, what is in this bill, and the fact that we will have an alternative that I believe is better than the one that was reported by the Finance Committee. Mr. President, I yield the floor.

Mr. LOTT. The following Senators are necessarily absent: the Senator from Kansas (Mr. Brownback), the Senator from Kentucky (Mr. Bunning), the Senator from Idaho (Mr. Craig), the Senator from Idaho (Mr. Crapo), the Senator from South Carolina (Mr. DeMint), the Senator from Nevada (Mr. Ensign), the Senator from South Carolina (Mr. Graham), the Senator from New Hampshire (Mr. Gregg), the Senator from Florida (Mr. Martinez) the Senator from Alaska (Ms. Murkowski), the Senator from Alabama (Mr. Sessions), and the Senator Alabama (Mr. Shelby). Further, if present and voting, the Senator from Kentucky (Mr. Bunning) would have voted ``yea.'' The PRESIDNG OFFICER. Are there are any other Senators in the Chamber desiring to vote?

Mr. LOTT

Mr. LOTT. Mr. President, will the distinguished majority leader yield for a question?

Mr. LOTT. The following Senators are necessarily absent: the Senator from Kansas (Mr. Brownback), the Senator from Minnesota (Mr. Coleman), and the Senator from Arizona (Mr. McCain). Further, if present and voting, the Senator from Minnesota (Mr. Coleman) would have voted ``no.''

Mr. LOTT. The following Senators are necessarily absent: the Senator from Kansas (Mr. Brownback), the Senator from Minnesota (Mr. Coleman), and the Senator from Arizona (Mr. McCain). Further, if present and voting, the Senator from Minnesota (Mr. Coleman) would have voted ``yea.''

Mr. LOTT. The following Senators are necessarily absent: the Senator from Kansas (Mr. Brownback), the Senator from Minnesota (Mr. Coleman), and the Senator from Arizona (Mr. McCain). Further, if present and voting, the Senator from Minnesota (Mr. Coleman) would have voted ``yea.''

Mr. LOTT. That is what I wish to comment on, Mr. President, if the distinguished Senator will yield briefly. Without getting into the substance or without questioning anybody's motives, it is important that we understand--and I can put this in the form of a question to the majority leader--if, in fact, this appeal of the ruling of the Chair should succeed, that would do away with rule XVI, as I understand it, and then we would all have a grand old time legislating on appropriations bills. Before the leader responds, let me say there are pent-up feelings on this side, probably on your side: Well, we can't get the authorizations and some of the language we want and the appropriations bills may be about the only thing moving through here, in some respects, and we want to have an opportunity to legislate on appropriations bills. But here is part of my concern, honestly. I don't think we can win that battle against the other side. I suspect you all would wind up legislating more than we would on appropriations bills. Mr. President, I think we need to calm down around here. There is a rule on the books for a reason. For good reason we took an action that knocked it out a few years ago. I learned painfully what a mistake that was. We should not be legislating on appropriations bills. You can make a good-faith effort around here if you want to do that. I think this action would cause some consequences we would not want, if we look at it in the future. Am I stating this correctly, I ask the majority leader?

Mr. LOTT. Mr. President, will the distinguished majority leader yield briefly?

Mr. LOTT. Mr. President, I feel a necessity at this point--and I will follow it with a question--to also say that I understand the right of the Senator from South Carolina to do this procedure. I am not questioning that at all. I think the result would be one that would not be good for the institution, and I think we would be abusing it on both sides. But also I want to emphasize the right of a Senator to modify his own amendment. I wasn't here when the discussions took place with regard to Senator Vitter's modifying of his own amendment, and I know that has caused some consternation. Mr. President, if I could say to the majority leader, wouldn't it be better for this institution if we would not get in the position of questioning each other's motives? I realize we have to be honest with each other, and I understand what everybody is doing. I understand the amendment on Osama bin Laden. Yes, we want to catch him, and I know there is a lot being done--and I won't get into the intelligence--and I understand what Senator DeMint is doing, but I would hope this would give us an opportunity, in a bipartisan way, for the sake of this institution, to step back, to calm down, and to stop trying to do these things to each other on both sides of the aisle. I am grandstanding, and I apologize, but my purpose is to try to say to the institution, to our people, I hope we will find a way to avoid this. I think it would be a mistake, and I assume the majority leader agrees with that.

Mr. LOTT. The following Senators are necessarily absent: the Senator from Kansas (Mr. Brownback), the Senator from Minnesota (Mr. Coleman), and the Senator from Arizona (Mr. McCain). Further, if present and voting, the Senator from Minnesota (Mr. Coleman) would have voted ``nay.''

Mr. LOTT

Mr. LOTT. The following Senators are necessarily absent: the Senator from Kansas (Mr. Brownback) and the Senator from Arizona (Mr. McCain).