Don Nickles

Mr. NICKLES

Mr. NICKLES. Reserving the right to object, parliamentary inquiry. I think it requires unanimous consent to set the pending amendment aside, is that correct?

Mr. NICKLES. I move to lay that motion on the table. The motion to lay on the table was agreed to.

Mr. NICKLES. I will be happy to answer the Senator's question. The regulations I was waving around a moment ago--this thing--came out on December 16, 3 months ago. I doubt that all the States have had time to review these regulations. Maybe some of them have, and maybe some of them haven't. So how would anyone know whether all the States are in compliance with that? On the newborns law my colleague alluded to, which is not enforced by HCFA, the regs aren't out yet. So how could anyone know whether or not there is compliance? Now, the 65 people that HCFA was requesting in the supplemental were not to enforce either the mental parity or the 48 hours for newborns. It was not in the request, not in their letter, not in the GAO study. I think my colleague makes an interesting diversion in trying to say that they should be doing this, too. But frankly, that is not their responsibility. It is the responsibility of the Department of Labor. It is not in this bill and it would not be helped by passing this supplemental, even as originally requested. Mr. GRAMM addressed the Chair.

Mr. NICKLES. I am happy to yield for a question.

Mr. NICKLES. Not just yet. I will make a final comment, because this is of interest. Yesterday and today, we have spent several hours debating $16 million. I am trying to save for taxpayers, and basically save it for Medicare, that $16 million that should stay in Medicare. We should not be raiding the Medicare trust funds to pay for an expansion to hire more Federal employees. We are spending several hours on that. I tell my colleague from Texas and my other colleagues, I spent an hour opposing an expansion of $1.9 billion, and I lost. So this Senate expanded the cost of this bill from $3.3 billion to $5.1 billion, and we did it in an hour. Maybe some people are kind of proud of that. I am not proud of it. Yet, to try to cut $16 million, we have spent several hours. Some people fight very, very hard to expand Government. I think that is a mistake. I think it is a mistake in this bill. It should not be in this bill. When my colleague read the letters, he didn't read all of the letters. It says that HCFA doesn't have enforcement authority over these two bills, and it doesn't have anything to do with the legislation that is before us. I happen to have enough confidence in the State of Massachusetts, the State of California, the State of Michigan, the State of Missouri, and Rhode Island. They care about their people just as much as we do in Washington, DC. Hiring another army of bureaucrats to go in and tell them what to do will not, in my opinion, improve the quality of health care in those States.

Mr. NICKLES. Mr. President, let me make a couple of quick comments. The initial request that came from HCFA for the $16 million supplemental did not include anything dealing with mental parity; not a word, not a letter, nothing. It didn't include it. The GAO report didn't include it. A couple of reasons. Here are the mental parity regulations. If I may have the attention of my colleague from Minnesota for a second. This is a copy of the regs that came in on mental health. Guess when they were announced. December 16, 1997, which was about 3 months ago. How in the world can somebody know 30 States aren't complying? The regs just came out. I heard comments that some States aren't complying with the newborns regulations, the 48 hours. Guess what. Those regs aren't out. The law became effective January 1, and there are no regulations. Yet they want to hire an army of new federal employees. HCFA didn't ask for an army of people to go out and comply with these regulations. My colleague alluded to a letter that Senator Kennedy worked hard on, which he probably got late last night, from Nancy Ann Min DeParle, the Administrator of HCFA. I want to read what she says, if I can get my colleague's attention for just a second. I want to read the part of the letter he forgot to read. He left out just a little bit. In the second paragraph of the letter she sent to Senator Kennedy--not to the managers of the bill; she didn't send it to the authorizers of the committee--it might have been written by Senator Kennedy; I'm not sure. But this part certainly wasn't written by Senator Kennedy: Moreover, we understand that as many as 30 States may not have standards that comply with Mental Health Parity Act and as many of 10 States may not have standards that comply with the Newborns' and Mothers' Health Protection Act. This is what I want you to pay attention to: We don't have precise numbers because States are not required to notify HCFA about their intention to implement these two laws. HCFA doesn't have control over these two laws. These States aren't told to tell HCFA about compliance with these two laws. Those laws are going to be managed by the Department of Labor. That is not in HCFA's jurisdiction. These 65 people will not spend 1 minute of time on mental parity or the 24 hours or 48 hours for newborns. Some people are trying to create an issue that is not real. The issue is, very frankly, are we going to spend $16 million to expand the bureaucracy of HCFA? They already have over 4,000 employees and 58,500 at HHS. I have said time and time again, if they need to borrow some of those employees, they can do so. People say, no, we want to expand the base, hire more people, have more intrusion. I have a final comment----

Mr. NICKLES. Mr. President, I appreciate my colleague's comments. I appreciate his coming to the floor. I think it is important that we have the discussion. We had a significant discussion on this amendment yesterday. I will make a few comments. I understand one other Senator wishes to speak on it, or if the Senator has any additional Senators. I mentioned yesterday that HCFA, the Health Care Finance Administration, has over 4,000 employees. That is a lot. Now, the Health and Human Services Department has 58,500 employees. Now, if they need to move a few employees around, they can do it if there is an emergency. There is not really an emergency. Frankly, compliance with HCFA, the so-called Kassebaum-Kennedy bill, which deals with portability, also deals with moving from group to individual plans. Most States have complied. The State of Massachusetts has not complied. But I don't think that we should presume the State of Massachusetts doesn't care about their employees or about their people in their State. The State of California hasn't, the State of Missouri hasn't, the State of Michigan hasn't, but every one of those States has pretty advanced policies dealing with health care. Now, some would presume because they haven't enacted legislation exactly as we told them to do, that we now need to have Federal regulators go in and run their insurance departments. I do not think that is the case. The Senator from Massachusetts says California has over 1,000 regulators. You cannot do this with 65. You could not do this with 650. You would have to hire thousands if we were going to have the Federal Government come in and regulate State insurance. So that is really something we should not be doing, it would be a serious mistake to do. Some people have a real tendency to say if we have any problem, let's go in and have Federal regulators come in and take over. I think that would be a mistake. As I mentioned before, there are over 4,000. Surely they can borrow a few if this is such a critical need. A couple people said, ``This is needed to enforce the mental parity issue that was passed also as part of the Kassebaum-Kennedy.'' It is not. I tell my colleagues, this GAO report that was alluded to by my friend from Massachusetts does not mention mental parity once--not once. I might mention, the request for the supplement from the director of HCFA did not mention mental parity. It was not in their request. What their request was: ``Hey, we want to help these five States.'' I am saying they can help those five States. They already have 26 employees. They can use additional employees already in the system. We don't need to give them an additional $16 million or $6 million for these 65 employees that cost $93,000 each. That is a lot to pay for somebody in the State of Mississippi or Oklahoma. Our States are in compliance, I might mention; the State of Massachusetts is not in compliance. I might also mention two things. The way the Senator pays for this is robbing Medicare. All of us that have been dealing with the appropriations and so on, we know we have discretionary accounts and we have mandatory accounts. Medicare is one of the mandatory accounts. It is paid for. The HI Trust Fund--Hospital Insurance Trust Fund--is paid for by payroll tax; 2.9 percent of all payroll goes into the Hospital Insurance Trust Fund. That ought to be plenty of money. President Clinton had a big increase in 1993, and it is on all income now. It used to be just on the Social Security base up to $68,000. Now it is on all income. Guess what. It is still going broke. It is paying out more this year than is coming in. The fund is going broke. Does it make real sense for us to be taking money out of that fund that is dedicated for senior citizens--take money out of the fund to hire more bureaucrats at HCFA? They already have over 4,000, and this says let's hire another 65. The President's budget for next year says he wants another 215. Well, we will wrestle with that in next year's annual appropriations process and let the committees review and discuss it. This is an emergency supplemental. This is supposed to be helping communities that are devastated by floods and bad weather and to pay for our forces that had to be on call in Iraq and in Bosnia. What is urgent about this? This is a law that passed. This is a law that became effective--frankly, we passed the law 20 months ago; it only became effective January 1. The reason California has not passed a law--California passed a law, but Governor Wilson vetoed it because there are other things in the law he did not think were very good. In Missouri, the Missouri legislature passed a law to be in compliance, but the Governor vetoed it because he had a disagreement. In almost all cases, the five States are not saying, ``Federal Government, we want you to regulate us and take over our insurance.'' It is because they had a disagreement between the legislative bodies. It is not, they don't want to cover it. It is not, they don't want to give the benefits that we have provided. I think these States do. My guess is, the State of Massachusetts wants to. But for some reason legislatively it has not happened. It may be, again, because there is a different party as Governor, as in the legislative body. Sometimes you get some impasses. The solution is not to send an army of HCFA bureaucrats to go in and try to take over regulation of insurance within those five States. That would be a serious mistake. So I mention, Mr. President, let's pass this amendment, let's save $16 million, let's not raid the hospital insurance fund. That is the wrong thing to do, a serious mistake. So I urge my colleagues to support the amendment. I ask for the regular order. Mr. WELLSTONE addressed the Chair.

Mr. NICKLES. Mr. President, I understand that the so-called amendment that has my name on it, the Nickles amendment, to delete $16 million that is in the bill right now to add an additional 65 HCFA employees, is the pending business. We debated that significantly yesterday. I am happy to vote on it. I am ready to vote on it. I know Senator Kennedy had a different idea. I do not know what his intentions are, but this Senator is ready to vote, ready to have a time limit, ready to move forward. I think it is important we do so, and do so rather quickly and move on to other business. I know we have the Mexican certification process. So I just make mention of that. I see my colleague from Massachusetts is here, so hopefully we will be able to vote on my amendment. If he has an alternative, we are happy to vote on that as well. I yield the floor. Mr. KENNEDY addressed the Chair.

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

Mr. NICKLES

Mr. NICKLES. Mr. President, I suggest the absence of a quorum.

Mr. NICKLES. I thank the Chair. (The remarks of Mr. Nickles pertaining to the introduction of S. 1868 are located in today's Record under ``Statements on Introduced Bills and Joint Resolutions.'')

Mr. NICKLES. Mr. President, I ask unanimous consent to proceed in morning business for 5 minutes.

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

Mr. NICKLES

Mr. NICKLES. I announce that the Senator from Delaware (Mr. Roth) is necessarily absent.

Mr. NICKLES. No. The result would be the same.

Mr. NICKLES. I am getting too many fights going at the same time. I have a nice engagement with Senator Kennedy on a HCFA add-on that was put into the budget, which we will be voting on later. And $1.6 billion is on the floor now. That is enough. I am not trying to anger Members; I am trying to have a little bit of fiscal responsibility. Again, since FEMA did not make this request until yesterday, I cannot believe it is that urgent. But I remind my colleagues, my amendment does not strike the $1.6 billion; it just says that the emergency classification will not be in there. So for next year's budget it will have to live within the caps, and for the following year it will have to live within the caps. That is the essence of my amendment, so we can help protect the surplus and maybe give taxpayers some relief. So that is my hope, and that is my desire. If there is going to be a motion to table my amendment, I urge colleagues to vote no on tabling the amendment.

Mr. NICKLES. I will yield.

Mr. NICKLES. Do we have the request in writing? The staff informs me that we do. I have not seen that. I would appreciate a copy of that. It is a heck of a deal. Here we are on Wednesday, and this request came in on Tuesday to give us another $1.8 billion or $1.9 billion, and we are just going to do it. For the life of me, if this is that much of an emergency, you would think James Lee Witt would have been working on every Member of the Congress saying, ``We have to have this money.'' He has not. What I was hearing up until a week or so ago is that they had enough. Now, all of a sudden, they need $1.6 billion or $260 million on Community Development Block Grant money, and we do not even know how they spent $500 million last year. They cannot even account for that $500 million of the emergency money last year. Yet, we are getting ready to give another $260 million plus $1.6 billion for FEMA. I think that is a mistake. I am told that there are no community block development requests from the administration--none. There may be a verbal request, but no written request. I am assuming that is what my staff is telling me. They did not make the request, but we gave them the money anyway. I know some of my colleagues would like to have that money.

Mr. NICKLES. I would be happy to.

Mr. NICKLES. Madam President, I appreciate the comments made by my good friends from Missouri and Maryland. I do look forward to working with them. We need to reform this program. A lot of evidence is in need of reforming this program because, in fact, we do not fund it but then every year we come up and start asking for more money. I want to tell my friend and colleague from Maryland something, because I gave you half an answer. I said that within the caps we would have to offset, although the caps have increased. There is one other option. If we breach the caps, the budget law calls for a sequester to offset. That is how that would happen--one of those two ways. I wanted to make sure of that. That is my purpose. I think we should stay within the caps, so we can keep more money to either pay down the debt, or if there is a surplus, we can save Social Security or give taxpayers relief, not spend more money. I hate to work so hard on the budget and come and say we are going to have a great big bill and spend billions of dollars. This started at $2 billion, and now it is going to be over a $5 billion bill. My colleague from Missouri mentioned that I read the committee report. It said that in last year's emergency bill we spent $500 million, I tell my friend from Alaska. We do not know how they spent it. I compliment my colleagues that are heading up the HUD subcommittee. They are trying to stay up with the housing people and say, ``Where did that money go?'' It is not accountable. Then I heard, ``Well, we spent $500 million on rebuilding one hospital.'' I appreciate the fact when Oklahoma City had the Murrah Building bombing in 1995, which killed 169 people, we put in $39 million. We also paid for it; we had an offset. That was good. I might have supported it without an offset. But I think we ought to be within the budget and try to fix this problem. We ought to find out what happened to that $500 million Community Development Block Grant money last year. I do not like that. I would have opposed the amendment. I was going to oppose the $260 million add-on for Community Development Block Grant money. I am bothered that the administration didn't request this money until yesterday, if this was such an urgent need and we had to have this for these emergencies. They came up yesterday. They had plenty of money a week ago. But all of a sudden, now we need the money. I cannot help but get the feeling that they see a gravy train coming along and we are going to call this thing an emergency and say, give us an extra almost $2 billion so we can fund a lot of things that will be off budget, so we don't have to live by the caps.

Mr. NICKLES. If I can respond, it would either come from within your subcommittee's budget or it could come from some other budget. Some budgets have been growing. I mention we had a $14 billion growth in domestic discretionary between 1997 and 1998. It could be in the growth funds. We are only talking about maybe $600 million or $500 million per year. It could come out of your subcommittee or out of another subcommittee, but the point is it would be accountable. We wouldn't have something totally extraneous to whatever budget agreement we come up with.

Mr. NICKLES. Madam President, you have to use offsets; $600 million in 1999, we have a total amount of spending on domestic discretionary side. I have the 1997 figure of $288--it is more than that in 1999. I might mention, between 1997 and 1998, it went from $274 to $288, an increase of $14 billion that went into domestic discretionary accounts. I don't have the figure in front of me, what it increases in the next year, but there was $14 billion in increases. You only have outlays of about $600 million. Somewhere in that $288 or almost $300 billion we have to find an offset. I think we should do that.

Mr. NICKLES. Let me respond. The $1.6 billion, in all likelihood you would have about, I will say, $600 million next year and probably $600 million----

Mr. NICKLES. Right.

Mr. NICKLES. To respond to my colleague, this year, 1997, we have domestic discretionary caps at $288 billion. What we will have to do is fund it within that amount. To answer you specifically, if you wanted to stay on your HUD baseline--you have a baseline, all the other subcommittees have a baseline--you would either have to fund it within your baseline, within your group, within your subcommittee, or if that wasn't possible, you would have to borrow from some other subcommittee, but the total would have to stay on the cap amount.