Daniel Moynihan

Mr. MOYNIHAN

Mr. MOYNIHAN. Mr. President, I rise today to express concern and dismay over the unwarranted delay of a critical analysis of S. 172, the Acid Deposition and Ozone Control Act. This analysis thoroughly documents the substantial benefits to be achieved, at comparatively insignificant costs, by passing S. 172. Unfortunately, we have received this information only after it is too late to coordinate the bill's passage this year. I first asked the Environmental Protection Agency (EPA) to analyze the impacts of S. 172 in 1998. Specifically, EPA was asked to calculate the costs and benefits of the legislation with regard to effects on human health, environment and the business community. EPA completed the report in March, 2000 and submitted it to the Office of Management and Budget (OMB) for their review. Unfortunately, OMB withheld the analysis for six months despite the fact that co-sponsors in both the House and Senate requested the report's release in letters to Director Jacob Lew. We have EPA's report today because Representative Dan Burton, Chairman of the House Committee on Government Reform, was willing to subpoena the report. I am disappointed that this course of events had to occur. Nonetheless, I am quite pleased with the results of EPA's analysis. Not only would S. 172 significantly improve visibility and the state of ecosystems sensitive to acid rain and nitrogen loading, but it would produce approximately $60 billion in public health benefits annually and save 10,000 lives each year. All this for an additional cost to utilities of $3.3 billion. What a tremendous service we could do to society by simply passing this legislation. If we don't, an epidemic could ensue. For example, according to EPA an DGAO, 43% of the lakes in New York's Adirondack Park will become acidified by 2040 even with the reductions mandated by the 1990 Clean Air Amendments. As far back as the 1960s, fisherman in the Adirondacks began to complain about more than ``the big one that got away.'' Fish, once abundant in the pristine, remote Adirondack lakes, were not just getting harder to catch--they were gone. When I entered the Senate in 1977, there was much we needed to learn about acid rain. So I introduced the first Federal legislation to address our ``knowledge deficit'' about acid rain--the Acid Precipitation Act of 1979. My bill was enacted into law as Title VII of the energy Security Act, which Congress passed in June 1980. Title VII established the National Acid Precipitation Assessment Program (NAPAP), an interagency program charged with assessing the causes and damages of acid deposition, and reporting its findings to Congress. NAPAP spawned tremendous academic interest in the subject of acid deposition, and our understanding of the subject has since developed substantially. In 1990, I helped write Title IV of Clean Air Act Amendments, which established a ``Sulfur Dioxide Allowance Program.'' Its creation represented a radical departure from the traditional ``command and control'' approach to environmental regulation, common at the time. This program was the first national, statutorily-mandated, market-based approach to pollution control. It has been immensely successful. We can be proud of these accomplishments, but we have a long way to go yet. Since 1990 we have learned, for instance, that the sulfur dioxide (SO2) emissions reductions required under the Clean Air Act Amendments of 1990 are insufficient to prevent continued damage to human health and sensitive ecosystems. NAPAP has reported that forests, streams, and rivers in the Front Range of Colorado, the Great Smoky Mountains of Tennessee, the San Gabriel and San Bernardino Mountains of California are also now showing the effects of acidification and nitrogen saturation. We have learned that nitrogen oxides (NOX), which we largely ignored nine years ago, are significant contributors to our nation's air quality deficiencies. And finally, we have demonstrated that legislation containing regulatory flexibility and market incentives is highly effective. S. 172, which I first introduced with Senator D'Amato in 1997, seeks to build upon this new body of knowledge, combining the best and most current scientific evaluation of our environmental needs with the most effective and efficient regulatory framework. Today, S. 172 is cosponsored by Senators Schumer, Jeffords, Lieberman, Reed, Dodd, Kerry, Feinstein, Lautenberg, Kennedy, Boxer, and Wyden. In the House, the bill is sponsored by Representatives Boehlert and Sweeney, and co- sponsored by 48 House Members. These are my final days in this great legislative body, and I will surely cherish the accomplishments we have made through the years. Today, I ask my friends and colleagues to continue the push to protect our nation's public health and environment from critical pollutants such as nitrogen oxides, sulfur dioxide, mercury and carbon dioxide. It is my understanding that the able Chairman of the Environment and Public Works Committee, Senator Bob Smith, has indeed made this commitment and I commend him for it. As I mentioned before, I am disappointed that the release of important information regarding the effects of S. 172 was withheld for so long. However, now that we have this information, we must act upon it and pass legislation that goes beyond our clean air achievements so far. The SO2 Allowance Program established by the Clean Air Act Amendments of 1990 has achieved extraordinary benefits at costs less than half of initial projections. The efficacy of the approach is proven. The science indicates that we did not go far enough. The Acid Deposition and Ozone Control Act endeavors to build upon our accomplishments, and to begin the work which remains to be done. Mr. President, I ask unanimous consent that my remarks and two recent articles on this issue be printed in the Record.

Mr. MOYNIHAN

Mr. MOYNIHAN. Mr. President, I am pleased to join with Senator Roth, distinguished chairman of the Finance Committee, in sponsoring the Medicare, Medicaid, and SCHIP Improvement Act of 2000. As part of the effort to balance the Federal Budget, the Balanced Budget Act of 1997 (BBA) provided for reduction in Medicare payments for medical services. At the time of enactment, the Congressional Budget Office (CBO) estimated that these provisions would reduce Medicare outlays by $112 billion over 5 years. We now know that these BBA cuts have been much larger than originally anticipated--some argue twice as large, although it's difficult to determine this with any precision. Hospital industry representatives and other providers of health care services have asserted that the magnitude of the reductions are having unintended consequences which are seriously impacting the quantity and quality of health care services available to our citizens. Last year, the Congress addressed some of those unintended consequences, by enacting the Balanced Budget Refinement Act (BBRA), which added back $16 billion over 5 years in payments to various Medicare providers, including: Teaching Hospitals; Hospital Outpatient Departments; Medicare HMOs (Health Maintenance Organizations); Skilled Nursing Facilities; Rural Health Providers; and Home Health Agencies. However, Members of Congress are continuing to hear from providers who argue that the 1997 reductions are still having serious unanticipated consequences. To respond to these continuing problems, the President last June proposed additional BBA relief in the amount of $21 billion over the next 5 years. On September 20, Senator Daschle and I, along with 32 of our Democratic colleagues, introduced a similar, but more substantial, BBA relief package that would provide about $40 billion over 5 years in relief to health care providers and beneficiaries. Today, along with Senator Roth, I am pleased to be cosponsoring a bipartisan BBA relief bill to provider about $28 billion in relief over 5 years. I want, in particular, to highlight that this legislation would--for fiscal years 2001 and 2002--prevent further reductions in the special Medicare payments to our Nation's teaching hospitals. A little background is in order. Medicare provides support to our Nation's teaching hospitals by adjusting its payments upward to reflect Medicare's share of costs associated with care provided by medical residents. This is accomplished under two mechanisms: direct graduate medical education (direct GME) payments; and indirect medical education (IME) adjustments. Direct GME costs include items such as salaries of residents, interns, and faculty and overhead costs for classroom training. The separate IME adjustment was established in 1983 and pertains to residency training costs that are not directly attributable to medical education expenses, but are nevertheless associated with teaching activities and the teaching hospital's research mission--for example, extra demands placed on hospital staff, additional tests ordered by residents, and increased use of diagnostic testing and advanced technology. Prior to the BBA, the IME adjustment increased Medicare's hospital payments by approximately 7.7 percent for each 10 percent increase in a hospital's ratio of interns and residents to hospital beds. The BBA included a reduction in the IME adjustment from the previous 7.7 percent to 7.0 percent in FY 1998; to 6.5 percent in FY 1999; to 6.0 percent in FY 2000; and to 5.5 percent in FY 2001 and subsequent years. In my judgment, these cuts would have seriously impaired the cutting edge research conducted by teaching hospitals, as well as impaired their ability to train doctors and to serve so many of our nation's indigent. Last year, in the BBRA, we mitigated the scheduled reduction in FY 2000--freezing the IME adjustment at 6.5 percent; and the IME adjustment was set at 6.25 percent for FY 2001, and 5.5 percent thereafter. The package we are introducing today, would restore $600 million in funds for FY 2001 and FY 2002 by setting the IME adjustment at 6.5 percent in both years. The IME adjustment would then fall to 5.5 percent thereafter--a reduction which I had hoped to cancel this year, and sincerely hope the congress will cancel in future legislation. I have stood before my colleagues on countless occasions to bring attention to the financial plight of medical schools and teaching hospitals. Yet, I regret that the fate of the 144 accredited medical schools and 1416 graduate medical education teaching institutions still remains uncertain. The proposals in this bill will provide critically needed financing--at least in the short-run. In the long-run, however, we need to restructure the financing of graduate medical education along the lines I have proposed in the Graduate Medical Education Trust fund Act (S. 210). What is needed is explicit and dedicated funding for these institutions, which will ensure that the United States continues to lead the world in this era of medical discovery. The Graduate Medical Education Trust Fund Act would require that the public sector, through the Medicare and Medicaid programs, and the private sector through an assessment on health insurance premiums, provide broad-based financial support for graduate medical education. S. 210 would roughly double current funding levels for Graduate Medical Education and would establish a Medical Education Advisory Commission to make recommendations on the operation of the Medical Education Trust Fund, on alternative payment sources for funding graduate medical education and teaching hospitals, and on policies designed to maintain superior research and educational capacities. In addition to restoring much needed funding to our Nation's teaching hospitals for the next two years, this bill would add back funding in many vital areas of health care. Key provisions of the bill we are introducing today would: provide full market basket (inflation) adjustments to hospitals for 2001 and 2002; target additional relief to rural hospitals; reduce cuts in payments to hospitals for handling large numbers of low-income patients (referred to as ``disproportionate share (DSH) hospital payments''); delay the scheduled 15 percent cut in payments to home health agencies; improve funding for skilled nursing facilities; and assist beneficiaries through preventive benefits and smaller coinsurance payments. Let me close by again complimenting Senator Roth on developing this bill on a bipartisan basis and expressing my hope that the forthcoming information negotiations with committees of the House will be similarly conducted on a bipartisan basis.

Mr. MOYNIHAN

Mr. MOYNIHAN. Mr. President, I am pleased to join with Senator Roth, distinguished chairman of the Finance Committee, in sponsoring the Medicare, Medicaid, and SCHIP Improvement Act of 2000. As part of the effort to balance the Federal Budget, the Balanced Budget Act of 1997 (BBA) provided for reduction in Medicare payments for medical services. At the time of enactment, the Congressional Budget Office (CBO) estimated that these provisions would reduce Medicare outlays by $112 billion over 5 years. We now know that these BBA cuts have been much larger than originally anticipated--some argue twice as large, although it's difficult to determine this with any precision. Hospital industry representatives and other providers of health care services have asserted that the magnitude of the reductions are having unintended consequences which are seriously impacting the quantity and quality of health care services available to our citizens. Last year, the Congress addressed some of those unintended consequences, by enacting the Balanced Budget Refinement Act (BBRA), which added back $16 billion over 5 years in payments to various Medicare providers, including: Teaching Hospitals; Hospital Outpatient Departments; Medicare HMOs (Health Maintenance Organizations); Skilled Nursing Facilities; Rural Health Providers; and Home Health Agencies. However, Members of Congress are continuing to hear from providers who argue that the 1997 reductions are still having serious unanticipated consequences. To respond to these continuing problems, the President last June proposed additional BBA relief in the amount of $21 billion over the next 5 years. On September 20, Senator Daschle and I, along with 32 of our Democratic colleagues, introduced a similar, but more substantial, BBA relief package that would provide about $40 billion over 5 years in relief to health care providers and beneficiaries. Today, along with Senator Roth, I am pleased to be cosponsoring a bipartisan BBA relief bill to provider about $28 billion in relief over 5 years. I want, in particular, to highlight that this legislation would--for fiscal years 2001 and 2002--prevent further reductions in the special Medicare payments to our Nation's teaching hospitals. A little background is in order. Medicare provides support to our Nation's teaching hospitals by adjusting its payments upward to reflect Medicare's share of costs associated with care provided by medical residents. This is accomplished under two mechanisms: direct graduate medical education (direct GME) payments; and indirect medical education (IME) adjustments. Direct GME costs include items such as salaries of residents, interns, and faculty and overhead costs for classroom training. The separate IME adjustment was established in 1983 and pertains to residency training costs that are not directly attributable to medical education expenses, but are nevertheless associated with teaching activities and the teaching hospital's research mission--for example, extra demands placed on hospital staff, additional tests ordered by residents, and increased use of diagnostic testing and advanced technology. Prior to the BBA, the IME adjustment increased Medicare's hospital payments by approximately 7.7 percent for each 10 percent increase in a hospital's ratio of interns and residents to hospital beds. The BBA included a reduction in the IME adjustment from the previous 7.7 percent to 7.0 percent in FY 1998; to 6.5 percent in FY 1999; to 6.0 percent in FY 2000; and to 5.5 percent in FY 2001 and subsequent years. In my judgment, these cuts would have seriously impaired the cutting edge research conducted by teaching hospitals, as well as impaired their ability to train doctors and to serve so many of our nation's indigent. Last year, in the BBRA, we mitigated the scheduled reduction in FY 2000--freezing the IME adjustment at 6.5 percent; and the IME adjustment was set at 6.25 percent for FY 2001, and 5.5 percent thereafter. The package we are introducing today, would restore $600 million in funds for FY 2001 and FY 2002 by setting the IME adjustment at 6.5 percent in both years. The IME adjustment would then fall to 5.5 percent thereafter--a reduction which I had hoped to cancel this year, and sincerely hope the congress will cancel in future legislation. I have stood before my colleagues on countless occasions to bring attention to the financial plight of medical schools and teaching hospitals. Yet, I regret that the fate of the 144 accredited medical schools and 1416 graduate medical education teaching institutions still remains uncertain. The proposals in this bill will provide critically needed financing--at least in the short-run. In the long-run, however, we need to restructure the financing of graduate medical education along the lines I have proposed in the Graduate Medical Education Trust fund Act (S. 210). What is needed is explicit and dedicated funding for these institutions, which will ensure that the United States continues to lead the world in this era of medical discovery. The Graduate Medical Education Trust Fund Act would require that the public sector, through the Medicare and Medicaid programs, and the private sector through an assessment on health insurance premiums, provide broad-based financial support for graduate medical education. S. 210 would roughly double current funding levels for Graduate Medical Education and would establish a Medical Education Advisory Commission to make recommendations on the operation of the Medical Education Trust Fund, on alternative payment sources for funding graduate medical education and teaching hospitals, and on policies designed to maintain superior research and educational capacities. In addition to restoring much needed funding to our Nation's teaching hospitals for the next two years, this bill would add back funding in many vital areas of health care. Key provisions of the bill we are introducing today would: provide full market basket (inflation) adjustments to hospitals for 2001 and 2002; target additional relief to rural hospitals; reduce cuts in payments to hospitals for handling large numbers of low-income patients (referred to as ``disproportionate share (DSH) hospital payments''); delay the scheduled 15 percent cut in payments to home health agencies; improve funding for skilled nursing facilities; and assist beneficiaries through preventive benefits and smaller coinsurance payments. Let me close by again complimenting Senator Roth on developing this bill on a bipartisan basis and expressing my hope that the forthcoming information negotiations with committees of the House will be similarly conducted on a bipartisan basis.

Mr. MOYNIHAN

Mr. MOYNIHAN. Mr. President, may I have one moment?

Mr. MOYNIHAN. Mr. President, we all thank the majority leader for this action. I know it will be particularly pleasing to the chairman of our committee, Senator Roth, who took up this measure, introduced in the first instance by Senator Chafee. It came out of our committee unanimously. It is good legislation. It should be pursued. We thank the leader for his effort. I yield the floor.

Mr. MOYNIHAN

Mr. MOYNIHAN. Would the majority leader yield for a question?

Mr. MOYNIHAN. You say ``reservations.'' Sir, if there are any reservations about the legislation as such, I would hope they would bring them to the attention of Senator Roth, myself, and others, and the administration. This is absolutely must do legislation. If we do not do it, we put ourselves at risk of a probable certain outcome--a trade war with Europe. In fact, it would astonish us and injure us, and we will wonder what happened. And nothing need have happened. It was found that our tax arrangements for foreign sales corporations were in violation of WTO rules. Fine. We said we will produce a different measure that is compliant. The American industry is very happy. We have the bill. All we need to do is pass it. The deadline was October 1. It has been extended to November 1. If we do not do this, we will be remembered as a Congress that did not, and not favorably, sir. I thank you for bringing it up. I regret there are reservations, but they have nothing to do, that I know of, with the essence of this measure.

Mr. MOYNIHAN. I will stay here all afternoon and evening.

Mr. MOYNIHAN

Mr. MOYNIHAN. Mr. President, last week the Finance Committee was scheduled to mark up the ``Community Renewal and New Markets Act of 2000,'' but the legislation became burdened by extraneous matters, and the Committee was unable to complete the mark-up. I rise today to join my good friend and Chairman of the Finance Committee, Senator Roth, in introducing the ``Community Renewal and New Markets Act of 2000'' as an original bill with 15 cosponsors from the Finance Committee. Sir, we all should be grateful for Senator Roth's leadership in this matter. Community renewal is an effort to rebuild American communities, which is based on an agreement reached between the President and the Speaker of the House that this is legislation we ought to have. The signals are clear: the legislation will be enacted this year with or without us. Today, Senator Roth and I give a voice in this process to the Finance Committee and the Senate. Mr. President, this bill represents the will of the Finance Committee. It incorporates the worthwhile ideas of its members, including the work of my good friend, Senator Robb, who, along with Senator Rockefeller, has worked tirelessly to provide meaningful incentives for investment in distressed communities. I also take a moment of the Senate's time to echo Senator Roth's tribute to Senator John Chafee. It is fitting that we should enact, in a bipartisan bill, the tax credit for renovating historic homes in honor of a great Senator. Substantively, the Community Renewal legislation is significant in several respects. First, it provides a notable measure of tax simplification, even as it accomplishes a worthwhile goal--tax benefits for investment in poor communities. While the bill designates 30 new ``Renewal Zones,'' it also conforms the tax incentives available to individuals and businesses investing in any of the zone designations, current or future. Our legislation smartly unifies these Empowerment and Renewal Zones and creates a common set of incentives. This is the right kind of legislation. I also note, Mr. President, with some appreciation, two provisions that will make transportation and data transmission very quick indeed. The bill includes provisions to accelerate and expand access to high- technology infrastructure for all communities. First, it authorizes $10 billion of tax credit bonds for Amtrak to develop high-speed railways. High-speed railways have the potential to connect the very communities targeted by this legislation and provide them with greater access to information. Second, the bill includes a proposal that I first introduced on June 8, 2000. That proposal, which now has 52 Senate supporters, provides graduated tax credits for deployment of high-speed communications-- called ``broadband''--to residential and rural communities. Current market forces are driving deployment of broadband technology almost exclusively to urban businesses and wealthy households. The proposal in the bill will encourage broadband providers to act quickly to deploy broadband to Americans in all communities. Mr. President, if you will allow me one further observation, as I am compelled to compliment the bill in one other respect. Consistent with the purpose of this legislation, it includes a tax incentive for investment in labor in Puerto Rico. The provision does not accomplish all that I had hoped it would, but I believe it represents a positive step forward. It extends to Puerto Rico tax incentives for job creation similar to the ones in other areas of the bill, and it does so, quite simply, through an existing tax-code provision, the Puerto Rico economic activity credit. Mr. President, I again applaud the leadership of our revered Chairman and proudly join him in introducing the Community Renewal and New Markets Act of 2000.

Mr. MOYNIHAN. Mr. President, in April, 1808, Secretary of the Treasury Albert Gallatin proposed to the Senate a national system of roads and canals, an idea feasible because payment of the National debt was within reach. It was a time for thinking big. A canal between the Hudson River and Lake Erie was one of his recommendations. As assemblyman from Onondaga County, Joshua Forman, traveled to Washington to tell President Jefferson that New York was ready to proceed with a canal 350 miles through the wilderness. Jefferson said ``. . . it is little short of madness to think of it at this day,'' and later wrote that New York had anticipated by a full century the means to build such a waterway. New York proceeded on its own. Seventeen years and $7,143,789 later we had our canal, the Erie Canal. Towns sprang up along the way, often at the locks, and prospered. Lockport, Spencerport, Fairport, Macedon, Utica, Canajoharie, Scotia. Then the railroads came, and some could not maintain that prosperity. The canal was rebuilt and enlarged between 1835 and 1862 to accommodate larger vessels. At the turn of the 20th century much of the original channel was abandoned and a new one was created by greatly altering natural waterways. This canal system continued to support considerable freight traffic until the opening of the St. Lawrence Seaway in 1959. Today many segments and fragments of the original canal still exist across the state, as do examples of the first expansion in the 1830s. Together they show us one of the first great public works projects in this country, the means by which many thousands of settlers moved west and many tons of food and raw materials moved east. The Erie Canal created the first effective means of interstate commerce in the nation and realigned the relationship among regions. In conjunction with the Hudson River it fueled the growth of New York City. Put simple, New York would not have become the Empire State without it. The canal today is primarily a recreational resource. Thanks to the Great Lakes Water Quality Agreement of 1972, the water flowing out of Lake Erie is much cleaner than it once was, making boating and recreation along the canal much more enjoyable. Today my colleague Senator Schumer and I are introducing a bill that would establish the Erie Canalway National Heritage Corridor. The National Park Service conducted a special resource study and found that the canal system ``contains resources and represents themes that are of national significance.'' Moreover, ``no single unit (of the Park Service) now exists that can offer as complete a portrait of the development of the United States from the last part of the 18th through the early 20th centuries.'' This designation would provide Park Service resources and some funding that would help improve education, historic preservation, open space protection, and trail development along the canal corridor. I believe it would be a great benefit for those cities, towns, and residents along the canal system. I also believe no other corridor deserves this designation as much. I ask my colleagues for their support, and I ask that the text of the bill be printed in the Record.

Mr. MOYNIHAN

Mr. MOYNIHAN. Mr. President, last week the Finance Committee was scheduled to mark up the ``Community Renewal and New Markets Act of 2000,'' but the legislation became burdened by extraneous matters, and the Committee was unable to complete the mark-up. I rise today to join my good friend and Chairman of the Finance Committee, Senator Roth, in introducing the ``Community Renewal and New Markets Act of 2000'' as an original bill with 15 cosponsors from the Finance Committee. Sir, we all should be grateful for Senator Roth's leadership in this matter. Community renewal is an effort to rebuild American communities, which is based on an agreement reached between the President and the Speaker of the House that this is legislation we ought to have. The signals are clear: the legislation will be enacted this year with or without us. Today, Senator Roth and I give a voice in this process to the Finance Committee and the Senate. Mr. President, this bill represents the will of the Finance Committee. It incorporates the worthwhile ideas of its members, including the work of my good friend, Senator Robb, who, along with Senator Rockefeller, has worked tirelessly to provide meaningful incentives for investment in distressed communities. I also take a moment of the Senate's time to echo Senator Roth's tribute to Senator John Chafee. It is fitting that we should enact, in a bipartisan bill, the tax credit for renovating historic homes in honor of a great Senator. Substantively, the Community Renewal legislation is significant in several respects. First, it provides a notable measure of tax simplification, even as it accomplishes a worthwhile goal--tax benefits for investment in poor communities. While the bill designates 30 new ``Renewal Zones,'' it also conforms the tax incentives available to individuals and businesses investing in any of the zone designations, current or future. Our legislation smartly unifies these Empowerment and Renewal Zones and creates a common set of incentives. This is the right kind of legislation. I also note, Mr. President, with some appreciation, two provisions that will make transportation and data transmission very quick indeed. The bill includes provisions to accelerate and expand access to high- technology infrastructure for all communities. First, it authorizes $10 billion of tax credit bonds for Amtrak to develop high-speed railways. High-speed railways have the potential to connect the very communities targeted by this legislation and provide them with greater access to information. Second, the bill includes a proposal that I first introduced on June 8, 2000. That proposal, which now has 52 Senate supporters, provides graduated tax credits for deployment of high-speed communications-- called ``broadband''--to residential and rural communities. Current market forces are driving deployment of broadband technology almost exclusively to urban businesses and wealthy households. The proposal in the bill will encourage broadband providers to act quickly to deploy broadband to Americans in all communities. Mr. President, if you will allow me one further observation, as I am compelled to compliment the bill in one other respect. Consistent with the purpose of this legislation, it includes a tax incentive for investment in labor in Puerto Rico. The provision does not accomplish all that I had hoped it would, but I believe it represents a positive step forward. It extends to Puerto Rico tax incentives for job creation similar to the ones in other areas of the bill, and it does so, quite simply, through an existing tax-code provision, the Puerto Rico economic activity credit. Mr. President, I again applaud the leadership of our revered Chairman and proudly join him in introducing the Community Renewal and New Markets Act of 2000.

Mr. MOYNIHAN

Mr. MOYNIHAN. When I arrived at the Senate near 25 years ago, it was very clear to me that I would look to Robert C. Byrd as my mentor; and he has been. I have sat at the foot of this Gamaliel for a quarter century. As I leave, sir, he is my mentor still. I am profoundly grateful. If I have met with your approval, sir, it is all I have hoped for. I thank you beyond words. And I thank you for your kind remarks about Elizabeth. And my great respect and regard to Erma. Thank you, Mr. President.

Mr. MOYNIHAN

Mr. MOYNIHAN. Mr. President, will the revered Senator, who I like to think of as the President pro tempore, yield 5 minutes to this Senator?

Mr. MOYNIHAN. Sir, I would like to speak to the matter that the Senator from West Virginia has addressed from the perspective of the Finance Committee. I think the Senator will agree that most of the budget of the Federal Government goes through the Finance Committee in terms of tax provisions, Social Security, Medicare, Medicaid, the interest on the public debt, which is a very large sum, which we do not debate much because we have to pay it. The two committees--Finance and Appropriations--were formed at about the same time in our history and have had the preeminent quality that comes with the power of the purse, that primal understanding of the founders that this is where the responsibilities of government lie--to lay and collect taxes; to do so through tariffs, to do so through direct taxation. We had an income tax briefly in the Civil War, but there was the judgment that we ought to amend the Constitution to provide for it directly. Sir, I came to this body 24 years ago. I have learned that, as I shall retire in January--and, God willing, I will live until then-- there will only have been 120 Senators in our history who served more terms. So they claim a certain experience. I obtained a seat on the Finance Committee with that wondrous Senator from Rhode Island. We were in the same class, Senator Chafee and Senator Danforth and I. I obtained a seat as a first-time Senator, through the instrumentality of the new majority leader. I avow that. I acknowledge it. I am proud of it. I will take that with me from the Senate as few others. I underwent an apprenticeship at the feet, if you will, of Russell Long, the then-chairman, who, for all his capacity for merriment, was a very strict observer of the procedures of this body and the prerogatives of the Finance Committee. We brought bills to the floor. They were debated. They were debated at times until 4 in the morning. I can remember then-Majority Leader Byrd waking me up on a couch out in the Cloakroom to say, ``Your amendment is up, Pat,'' and my coming in, finding a benumbed body. The vote was aye, nay. It wasn't clear. It was the first time and the last in my life I asked for a division. And we stood up, and you could count bodies, but you could not hear voices. Then we would go to conference with the House side. The conferees would be appointed. Each side would have conferees, each party. They each would have a say. We would sit at a table--sometimes very long times, but in time--and we would bring back a conference report and say: Here it is. And if anyone would like to know more about it, there are seven of us in this room who did the final negotiations with the House. It is all there. It is comprehensible. And it is following the procedures of the body. I stayed on the committee, sir. This went on under Senator Dole as chairman; Senator Bentsen as chairman. I would like to think it went on during the brief 2 years that I was chairman. In the 6 years since that time, I have seen that procedure collapse. In our committee, we have a very fine chairman. No one holds Senator Roth in higher regard than I do. I think my friend recognized this when he saw the two of us stand here for 3 weeks on the floor to pass the legislation which he did not approve. Senator Byrd did not approve of permanent normal trade relations, but when it was all over, he had the graciousness as ever to say he did approve of the way we went about it. Every amendment was offered. Cloture was never invoked. And in the end, we had a vote, and the Senate worked its will. Now, in the last several days in the Finance Committee, we have been working on major legislation, legislation for rebuilding American communities, which is based on an agreement reached between the President and the Speaker of the House that this is legislation we ought to have, which is fine. The President should have every opportunity to reach some agreement with the leadership over here and say: Let us have this legislation. You send it to me; I will sign it. But you send it to me; I won't write it. I might send you a draft. We were not even contemplating bringing the bill to the floor, passing it, going to conference. It is just assumed that can't happen. And indeed, in the end, we could not even get it out of committee. So the chairman and I will introduce a bill and a rule XIV will have it held here at the desk so it is around when those mysterious powers sit down to decide what our national budget will be. You spoke of something difficult to speak to but necessary in this body, which is our relations with the Executive, which increasingly have found themselves not just with a place at the table, as you have so gentlemanly put it, but a commanding, decisive role in the legislative process. Sir, I can report--and I don't have to face constituents any longer, so I might just as well--I can recall around 11 o'clock one evening on the House side in the Speaker's conference room--that particular Speaker had a glass case with the head of an enormous Tyrannosaurus rex in it, a great dinosaur--and tax matters were being taken up. There were representatives of the White House, representatives of the majority leadership in the House, the leadership in the Senate. I didn't really recognize any committee members, just leadership. And I arrived in the innocent judgment of something in which I wouldn't have a large part, but I would be expected to sign the papers, the conference papers the conferees sign, a ritual we all take great pleasure in because it means it is over. Sir, I was asked to leave the room. I was asked to leave the room. There as a Member of the Senate minority, the ranking member of the committee, that decision was not going to have anything to do with the Finance Committee or much less the Democrats. It would be a White House and a congressional leadership meeting. In 24 years, nothing like that had ever happened. I don't believe, sir, it ever happened. I can't imagine how we came to this. I do know how, from the point of view of our party--the calamitous elections of 1994, when we lost our majorities in both bodies. So I would say, I do not believe in the two centuries we have been here--and we are the oldest constitutional government in history, but we have seen our constitutional procedures degrade. We have seen practices not ever before having taken place, nor contemplated. They are not the way this Republic was intended. They are subversive of the principles of our Constitution, the separation of power. The separation of powers is the first principle of American constitutional government. We would not have a King or a King in Parliament. We would have an elected President, an elected Congress and an independent judiciary. When the White House is in the room drafting the bill that becomes the law, the separation of power has been violated in a way we should not accept.

Mr. MOYNIHAN. I yield the floor.

Mr. MOYNIHAN. I yield the floor to my distinguished friend, the chairman of the Appropriations Committee.

Mr. MOYNIHAN. I thank the Senator from Alaska, my friend of all these years. Just to conclude my thought, which is that the separation of powers is what distinguishes American government. We brought it into being. It did not exist in any previous democratic regimes, the various Grecian cities, the Roman era had a legislature period. There was no executive authority. What Madison once referred to as the fugitive existence of the ancient republics was largely because they had no executive authority to carry out the decisions of the legislature. The legislature was left to be the executive as well. It didn't work. We have worked. There are two countries on Earth, sir, that both existed in 1800 and have not had their form of government changed by violence since 1800: the United States and the United Kingdom. There are seven, sir, that both existed in 1900 and have not had their form of government changed by violence since. Many of the British dominions were not technically independent nations. The separation of powers is the very essence of our system. We have seen it evanescing before us. I say evanescing because--the misty clouds over San Clemente, noise rising from the sea--because I was not in that room after I was asked to leave, nor was there any journalist, nor were there any of our fine stenographers. No one was there save a group of self-selected people. They weren't selected for that role. They should not have been playing it. This has gone on too long, and it ought to stop. With that, sir, I thank my friend from Alaska and I yield the floor.

Mr. MOYNIHAN. Said Benjamin Franklin, yes.

Mr. MOYNIHAN. I thank my friend.

Mr. MOYNIHAN

Mr. MOYNIHAN. Mr. President, early this Congress, I introduced S. 224, the Stop Tax-Exempt Arena Debt Issuance Act or STADIA for short. This bill would end a tax subsidy that inures largely to the benefit of wealthy sports franchise owners, by eliminating tax-subsidized financing of professional sports facilities. This legislation would close a loophole that provides an unintended Federal subsidy--in fact, contravenes Congressional intent--and that contributes to the enrichment of persons who need no Federal assistance whatsoever. This is the fourth time I have introduced this legislation, and I chose to keep the original effective date for a number of reasons. Most importantly, because Congress intended to eliminate the issuance of tax-exempt bonds to finance professional sports facilities as part of the Tax Reform Act of 1986. At the same time, I recognized that a few localities may have expended significant time and funds in planning and financing a professional sports facility, in reliance upon professional advice on their ability to issue tax-exempt bonds. Thus, in my original introductory statement, I specifically requested comment regarding the need for equitable relief for stadiums already in the planning stages. In response to my request, several localities that had been planning to finance professional sports facilities with tax-exempt bonds came forward and provided the details necessary to craft appropriate ``binding contract'' type transitional relief. Accordingly, I agreed to change the bill in subsequent Congresses to exempt projects which had progressed to a point where it would be unfair to stop them. Now I have been contacted by others who make the case that retaining the 1996 effective date creates a lack of certainty which is unhealthy for communities desiring new stadiums and for the bond market itself. Therefore, I am inserting into the record my intention to modify the effective date if and when S. 224 is adopted in committee or on the Senate floor. Mr. President, I ask that this language be printed in the Record.

Mr. MOYNIHAN

Mr. MOYNIHAN. Mr. President, I want to congratulate the Catholic Charities USA on this their 90th anniversary of commitment to social change. Their organization has done tremendous work in the community towards reducing poverty and working with lawmakers to improve so many lives. Catholic Charities USA began as a small group called the National Conference of Catholic Churches in 1910, with the goal in mind of providing legal representation for impoverished persons. They have grown under the current leadership of Father Kammer, SJ, to include after-school programs and parenting classes, all of which have made an impact on the people they have touched. In celebrating their 90th anniversary, I want to thank Catholic Charities USA for their devotion in developing stronger families and neighborhoods and wish them many more years of success.

Mr. MOYNIHAN

Mr. MOYNIHAN. Mr. President, I rise to commend the Senate for again unanimously passing the Drug Addiction Treatment Act of 2000. Today it passed as an amended version of S. 324, of which I am an original cosponsor, in Title XXXV, sections 3501 and 3502, of the Senate substitute to the Children's Health Act of 2000, H.R. 4365. The Senate's action today marks a milestone in the treatment of opiate dependence. The Drug Addiction Treatment Act increases access to new medications, such as buprenorphine, to treat opiate addiction. I thank my colleagues Senator Levin (whose long-term vision inspired this legislation), Senator Hatch, and Senator Biden for their leadership and dedication in developing this Act, and I look forward to seeing the Drug Addiction Treatment Act of 2000 become law. Determining how to deal with the problem of addiction is not a new topic. Just over a decade ago when we passed the Anti-Drug Abuse Act of 1988, I was assigned by our then-Leader, Senator Robert Byrd, with Senator Sam Nunn, to co-chair a working group to develop a proposal for drug control legislation. We worked together with a similar Republican task force. We agreed, at least for a while, to divide funding under our bill between demand reduction activities (60 percent) and supply reduction activities (40 percent). And we created the Director of National Drug Control Policy (section 1002); next, ``There shall be in the Office of National Drug Control Policy a Deputy Director for Demand Reduction and a Deputy Director for Supply Reduction.'' We put demand first. To think that you can ever end the problem by interdicting the supply of drugs, well, it's an illusion. There's no possibility. I have been intimately involved with trying to eradicate the supply of drugs into this country. It fell upon me, as a member of the Nixon Cabinet, to negotiate shutting down the heroin traffic that went from central Turkey to Marseilles to New York --``the French Connection''-- but we knew the minute that happened, another route would spring up. That was a given. The success was short-lived. What we needed was demand reduction, a focus on the user. And we still do. Demand reduction requires science and it requires doctors. I see the science continues to develop, and The Drug Addiction Treatment Act of 2000 will allow doctors and patients to make use of it. Congress and the public continue to fixate on supply interdiction and harsher sentences (without treatment) as the ``solution'' to our drug problems, and adamantly refuse to acknowledge what various experts now know and are telling us: that addiction is a chronic, relapsing disease; that is, the brain undergoes molecular, cellular, and physiological changes which may not be reversible. What we are talking about is not simply a law enforcement problem, to cut the supply; it is a public health problem, and we need to treat it as such. We need to stop filling our jails under the misguided notion that such actions will stop the problem of drug addiction. The Drug Addiction Treatment Act of 2000 is a step in the right direction.

Mr. MOYNIHAN

Mr. MOYNIHAN. Mr. President, I am pleased to join with Senator Daschle and many of my Democratic colleagues in sponsoring the Balanced Budget Refinement Act of 2000 (BBRA-2000). First, a few words on the genesis of this bill. As part of the effort to balance the Federal Budget, the Balanced Budget Act of 1997 (BBA) provided for reduction in Medicare payments for medical services. At the time of enactment, the Congressional Budget Office (CBO) estimated that these provisions would reduce Medicare outlays by $112 billion over 5 years. We now know that these BBA cuts have been much larger than originally anticipated. Hospital industry representatives and other providers of health care services have asserted that the magnitude of the reductions are having unintended consequences which are seriously impacting the quantity and quality of health care services available to our citizens. Last year, the Congress address some of those unintended consequences, by enacting the Balanced Budget Refinement Act (BBRA), which added back $16 billion over 5 years in payments to various Medicare providers, including: Teaching Hospitals; Hospital Outpatient Departments; Medicare HMOs (Health Maintenance Organizations); Skilled Nursing Facilities; Rural Health Providers; and Home Health Agencies. However, Members of Congress are continuing to hear from providers who argue that the 1997 reductions are still having serious unanticipated consequences. To respond to these continuing problems, the President last June proposed additional BBA relief in the amount of $21 billion over the next 5 years. On July 27, Senator Daschle and I announced the outlines of a similar, but more substantial, Senate Democratic BBA relief package that would provide about $40 billion over 5 years in relief to health care providers and beneficiaries. Today, along with many of our colleagues, Senator Daschle and I are introducing this package as the Balanced Budget Refinement Act of 2000 (BBRA-2000). Before I submit for the record a summary of this legislation, I want, in particular, to highlight that our legislation would prevent further reductions in payments to our Nation's teaching hospitals. The BBA, unwisely in my view, enacted a multi-year schedule of cuts in payments by Medicare to academic medical centers. These cuts would seriously impair the cutting edge research conducted by teaching hospitals, as well as impair their ability to train doctors and to serve so many of our nation's indigent. Last year, in the BBRA, we mitigated the scheduled reductions in fiscal years 2000 and 2001. The package we are introducing today, would cancel any further reductions in what we call ``Indirect Medical Education payments,'' thereby restoring nearly $2.7 billion over 5 years ($6.9 billion over 10 years) to our Nation's teaching hospitals. I have stood before my colleagues on countless occasions to bring attention to the financial plight of medical schools and teaching hospitals. Yet, I regret that the fate of the 144 accredited medical schools and 1416 graduate medical education teaching institutions still remains uncertain. The proposals in our Democratic BBRA-2000 package will provide critically needed financing in the short-run. In the long-run, however, we need to restructure the financing of graduate medical education along the lines I have proposed in the Graduate Medical Education Trust Fund Act (S. 210). What is needed is explicit and dedicated funding for these institutions, which will ensure that the United States continues to lead the world in this era of medical discovery. The Graduate Medical Education Trust Fund Act would require that the public sector, through the Medicare and Medicaid programs, and the private sector through an assessment on health insurance premiums, provide broad-based financial support for graduate medical education. S. 210 would roughly double current funding levels for Graduate Medical Education and would establish a Medical Education Advisory Commission to make recommendations on the operation of the Medical Education Trust Fund, on alternative payment sources for funding graduate medical education and teaching hospitals, and on policies designed to maintain superior research and educational capacities. In addition to restoring much needed funding to our Nation's teaching hospitals, BBRA-2000 would add back funding in many vital areas of health care. Key provisions of the bill we are introducing today would: provide full market basket (inflation) adjustments to hospitals for 2001 and 2002; prevent further reductions in Indirect Medical Education (IME) payments to teaching hospitals; target additional relief to rural hospitals; eliminate cuts in payments to hospitals for handling large numbers of low-income patients (referred to as ``disproportionate share (DSH) hospital payments''); repeal the scheduled 15 percent cut in payments to home health agencies; provide a full market basket (inflation) adjustment to skilled nursing facilities; assist beneficiaries through preventive benefits and smaller coinsurance payments; provide increased payments to Medicare manager care plans (HMOs); and improve eligibility and enrollment processes in Medicaid and the State Children's Health Insurance Program (SCHIP). Mr. President, I ask unanimous consent that the bill language, a summary of the bill, and several letters of support which I send to the desk, be placed in the Record at the conclusion of my statement. I would like to thank Kyle Kinner and Kirsten Beronio of the minority health staff of the Finance Committee for their efforts in assembling this legislation.

Mr. MOYNIHAN

Mr. MOYNIHAN. Mr. President, I am pleased to join with Senator Daschle and many of my Democratic colleagues in sponsoring the Balanced Budget Refinement Act of 2000 (BBRA-2000). First, a few words on the genesis of this bill. As part of the effort to balance the Federal Budget, the Balanced Budget Act of 1997 (BBA) provided for reduction in Medicare payments for medical services. At the time of enactment, the Congressional Budget Office (CBO) estimated that these provisions would reduce Medicare outlays by $112 billion over 5 years. We now know that these BBA cuts have been much larger than originally anticipated. Hospital industry representatives and other providers of health care services have asserted that the magnitude of the reductions are having unintended consequences which are seriously impacting the quantity and quality of health care services available to our citizens. Last year, the Congress address some of those unintended consequences, by enacting the Balanced Budget Refinement Act (BBRA), which added back $16 billion over 5 years in payments to various Medicare providers, including: Teaching Hospitals; Hospital Outpatient Departments; Medicare HMOs (Health Maintenance Organizations); Skilled Nursing Facilities; Rural Health Providers; and Home Health Agencies. However, Members of Congress are continuing to hear from providers who argue that the 1997 reductions are still having serious unanticipated consequences. To respond to these continuing problems, the President last June proposed additional BBA relief in the amount of $21 billion over the next 5 years. On July 27, Senator Daschle and I announced the outlines of a similar, but more substantial, Senate Democratic BBA relief package that would provide about $40 billion over 5 years in relief to health care providers and beneficiaries. Today, along with many of our colleagues, Senator Daschle and I are introducing this package as the Balanced Budget Refinement Act of 2000 (BBRA-2000). Before I submit for the record a summary of this legislation, I want, in particular, to highlight that our legislation would prevent further reductions in payments to our Nation's teaching hospitals. The BBA, unwisely in my view, enacted a multi-year schedule of cuts in payments by Medicare to academic medical centers. These cuts would seriously impair the cutting edge research conducted by teaching hospitals, as well as impair their ability to train doctors and to serve so many of our nation's indigent. Last year, in the BBRA, we mitigated the scheduled reductions in fiscal years 2000 and 2001. The package we are introducing today, would cancel any further reductions in what we call ``Indirect Medical Education payments,'' thereby restoring nearly $2.7 billion over 5 years ($6.9 billion over 10 years) to our Nation's teaching hospitals. I have stood before my colleagues on countless occasions to bring attention to the financial plight of medical schools and teaching hospitals. Yet, I regret that the fate of the 144 accredited medical schools and 1416 graduate medical education teaching institutions still remains uncertain. The proposals in our Democratic BBRA-2000 package will provide critically needed financing in the short-run. In the long-run, however, we need to restructure the financing of graduate medical education along the lines I have proposed in the Graduate Medical Education Trust Fund Act (S. 210). What is needed is explicit and dedicated funding for these institutions, which will ensure that the United States continues to lead the world in this era of medical discovery. The Graduate Medical Education Trust Fund Act would require that the public sector, through the Medicare and Medicaid programs, and the private sector through an assessment on health insurance premiums, provide broad-based financial support for graduate medical education. S. 210 would roughly double current funding levels for Graduate Medical Education and would establish a Medical Education Advisory Commission to make recommendations on the operation of the Medical Education Trust Fund, on alternative payment sources for funding graduate medical education and teaching hospitals, and on policies designed to maintain superior research and educational capacities. In addition to restoring much needed funding to our Nation's teaching hospitals, BBRA-2000 would add back funding in many vital areas of health care. Key provisions of the bill we are introducing today would: provide full market basket (inflation) adjustments to hospitals for 2001 and 2002; prevent further reductions in Indirect Medical Education (IME) payments to teaching hospitals; target additional relief to rural hospitals; eliminate cuts in payments to hospitals for handling large numbers of low-income patients (referred to as ``disproportionate share (DSH) hospital payments''); repeal the scheduled 15 percent cut in payments to home health agencies; provide a full market basket (inflation) adjustment to skilled nursing facilities; assist beneficiaries through preventive benefits and smaller coinsurance payments; provide increased payments to Medicare manager care plans (HMOs); and improve eligibility and enrollment processes in Medicaid and the State Children's Health Insurance Program (SCHIP). Mr. President, I ask unanimous consent that the bill language, a summary of the bill, and several letters of support which I send to the desk, be placed in the Record at the conclusion of my statement. I would like to thank Kyle Kinner and Kirsten Beronio of the minority health staff of the Finance Committee for their efforts in assembling this legislation.

Mr. MOYNIHAN

Mr. MOYNIHAN. Mr. President, I yield such time as the Senator from Virginia may require.