Jay Rockefeller

Mr. ROCKEFELLER

Mr. ROCKEFELLER. To the Senator I say, you have to get your money somehow. If you are going to cut to get all this tax-break money, you have to go to where the money is. The money is in Medicare. The money is in Medicaid. There is some money in the earned income tax credit, which they call a welfare program, which is very interesting to me, because how come those same people then pay a personal income tax and Social Security tax? I did not think people on welfare paid those taxes. It is just a very depressing aspect of how far they will go.

Mr. ROCKEFELLER. I thank the Senator from Iowa. I just simply say that it is a shocking thing. It is a hidden thing. It is malicious to seniors, and it is particularly embarrassing, I think, in the context of fair debate, when people all afternoon have been talking about the fact that seniors on Medicare in the regular fee-for-service Medicare system, which is 90 percent of the system now, will continue to have this wonderful existence, when they know perfectly well that what they are doing is they are capping expenditures. They are capping expenditures several percentage points below what they know the cost of expenditures will rise in health care and then guaranteeing, therefore, the sequestering followed by the reduction in services on all fronts of health care for Medicare patients. Then the only way you can get out of it is through a supermajority, which I would assume is two-thirds of the Congress, both the House and the Senate, which I think would be very hard to do. It is also interesting that--well, Medicare recipients on top of this will pay more out-of-pocket expenses. In other words, there is going to be $700 less per beneficiary in the year 2002. It is going to double deductibles, raise premiums, raise the Medicare eligibility age to 67. These are all very important, very troublesome problems. Private health premiums will be increased, as the minority leader indicated, by cost- shifting. Hospital closings will take place in States like West Virginia and, I assume, Iowa. I think most rural States. Frankly, it is my judgment that doctors will be driven out of the program and will be turning away Medicare recipients.

Mr. ROCKEFELLER. If the Senator will yield, after a period of 7 years, I believe it is, they are saying that you can no longer get Medicare when you are 65; you can only get it when you are 67.

Mr. ROCKEFELLER. Mr. President, I move to commit Senate bill 1357 to the Committee on Finance with instructions to report the bill back to the Senate within 3 days, not to include any day the Senate is not in session, making changes in legislation within that committee's jurisdiction to eliminate any reductions in Medicare beyond the $89 billion necessary to maintain trust fund solvency through the year 2006, and to reduce revenue reductions for upper-income taxpayers by the amount necessary to ensure deficit neutrality.

Mr. ROCKEFELLER. No. The Senator was laying down a motion, and the Senator wishes to speak on that motion.

Mr. ROCKEFELLER. In about 2 hours, I guess, every U.S. Senator will be asked to vote on the future of a program that makes the difference between security and insecurity, peace of mind and terror, health and illness, and sometimes, obviously, life or death for 30 million older Americans--including 330,000 seniors from my own State of West Virginia. We offer this amendment, Democrats, to give Senators one more chance to preserve Medicare, and stop the destruction of one of America's proudest, most enduring achievements. We make a very straightforward proposition with our amendment to save Medicare. This amendment calls for sending the Medicare part of this package back to the Senate Finance Committee, and says Medicare should not be cut beyond the $89 billion needed to keep the trust fund solvent for another 10 years. That means we want to restore the $181 billion of unnecessary, dangerous Medicare cuts back to the trust fund, back to the health care system that seniors depend on every single day of their lives. This amendment is a final opportunity, quite frankly, for our colleagues on the other side of the aisle to defend the Medicare trust fund from a mind boggling raid that will cut health care benefits, increase seniors' costs, and threaten the very existence of hospitals-- a raid that is designed purely and simply to pay for tax breaks tilted in favor of the most affluent, comfortable households in this land. The reconciliation bill on the floor cuts Medicare by $270 billion over 7 years. We all know that now. We have all been told that this will save Medicare, keep it solvent, and, indeed, make the program stronger. Wrong, wrong, and wrong. The professional experts in charge of keeping the books for Medicare say exactly $89 billion is needed to keep Medicare solvent for the same number of years. Hospitals, doctors, nurses, and other health care providers in every one of our States believe with absolute certainty that cuts of this size will disintegrate the kind of health care coverage that 30 million American senior citizens have counted on for over three decades. When the average income of senior citizens is, in fact, $17,750 on a national basis, and closer to $10,700 in my own State, and when they pay 21 percent of their income for health expenses as it is now--that is, unless they are over 84, in which case the figure rises to 34 percent--no wonder they are incredulous, no wonder they are petrified to hear their Medicare is being used to pay for tax breaks, tax giveaways to far, far wealthier Americans and every imaginable kind of corporation. I have no way that I can think of to explain to the 330,000 Medicare beneficiaries in my State why their Medicare deductibles will double, their premiums will skyrocket, and West Virginia hospitals are threatened with the possibility of losing $25 million in 1996 and more than $681 million over the next 7 years. I keep saying I wish this were some kind of a dream. I keep expecting to wake up and find something different. I wish this were some kind of a dream. But the threat is real. It is written into the pages of the bill before the Senate unless we send it back. I can only report what I read in the budget package. Mr. President, $270 billion will be cut out of Medicare. That is fact. Mr. President, $225 billion will be given away in tax breaks and giveaways. That is fact. Then there is the $187 billion sliced out of Medicaid, subject to another amendment leaving it in tatters as it is chopped into a block grants which States are not ready, in fact, to handle, with virtually none of the guarantees left for Americans hurting the most. The response on the other side will be that we are exaggerating, that we are trying to scare seniors, that we do not understand. Mr. President, this budget is a scary budget. It is a very scary budget. I am the very first to admit that I fear for my State. I fear for 330,000 older West Virginians. I fear for the health care system in America. I do not say that as a Democrat or as a Republican. I say that as a citizen of the State of West Virginia. I am afraid of the consequences of what it is likely we are going to do here, and hence this amendment. When the very people who are trustees of Medicare say only $89 billion is needed to keep the trust fund solvent for 10 years, it is frightening to see a budget that sucks $270 billion out of the lifeline for older Americans. That is what older Americans are now coming to truly believe on their own, not because of what we say but because of what they are beginning to find out on their own. Their fear is genuine and justified. Today, we offer one last chance to Senators to protect Medicare and older Americans. Vote for this amendment to ensure the solvency of Medicare for another 10 years. There is plenty of time for a bipartisan, thoughtful effort to plan Medicare's future for the 50 years beyond that period of time. Vote for this amendment to protect Medicare from highway robbery, from being used to pay for tax breaks, to take money from seniors with an average income of $17,500 and hand it over to Americans with incomes from $75,000 all the way up to millions. Vote for the right way to balance the budget and for a balance in the Nation's priorities. We offer this amendment to remind every Senator that he and she can respond to the seniors, the families, and the health care providers of America who are scared by rejecting the part of this budget that casts a dangerous, deep, and dark shadow over Medicare--that is, unless this amendment is passed. Mr. President, I yield 5 minutes to the Senator from Massachusetts.

Mr. ROCKEFELLER. Mr. President, I yield 5 minutes to the Senator from North Dakota.

Mr. ROCKEFELLER. Mr. President, I ask the Senator from New Hampshire or the Senator from Michigan--a number of questions have been raised on this side. We have been listening for months now to the attack on an $89 billion cut as opposed to a $270 billion cut. I raised the question, what has happened to the $181 billion? Is this really going to a tax cut? What about the doubling of the deductible in the premiums? Things of this sort. I ask if any on the other side care to explain why they would vote against my amendment, if, in fact, they are going to? I would just be interested if they have anything they choose to say? Mr. GREGG addressed the Chair.

Mr. ROCKEFELLER. I will not yield. Because I would like to hear the response from the majority party as to some of the reasons for their certainty as to the need for the $270 billion cut which is causing so much consternation throughout the land.

Mr. ROCKEFELLER. The Senator does not have to answer.

Mr. ROCKEFELLER. No; the Senator is not going to engage in this kind of game. It is clear the majority does not want to answer some of these basic questions. So at this point I will call on the Senator from Iowa.

Mr. ROCKEFELLER. There are Democratic Members on their way down here to speak. They have not gotten down here to speak, and I hope they recognize they will have to get here very quickly. But I will yield myself 5 minutes.

Mr. ROCKEFELLER. Mr. President, one of the things that most concerns me about all of this is the concept of senior citizens being able to keep their own physician. And one of the things that most scares me, that puts genuine fear in the heart not just of this Senator but of the seniors that I represent, is the fear they are going to lose their right to choose their own doctor. I say this with a special feeling because, over the last couple of years, when we were debating health care, that was one of the things that was absolutely going to be able to happen. People are going to be able to have their own doctor. But there is this enormous movement in the private sector to move people into health maintenance organizations to cut costs down. I read this, this morning, in the newspaper, that Washington General Hospital, now DC General, which is kind of the last resort for the people of Washington DC, is thinking, now, of closing down, merging with Howard University. That is happening now in the private sector. I hesitate to even imagine what happens if you take tens of millions of dollars away from them, or institutions like them, over the next number of years. How many essential services in our city--I know in the city of Chicago, I know either seven or eight emergency rooms of hospitals have closed down under the current free-market system. And the exacerbation of all that, under these drastic Medicare cuts, is something which I think is truly terrifying.

Mr. ROCKEFELLER. Well, of course, Social Security will be cut, too, will it not, under the Republican plan?

Mr. ROCKEFELLER. If the Senator will yield, I think there is a very interesting point that goes along with all of this. The majority party--the Republican Party--has accused us of ``fear mongering,'' and scaring seniors. Yet, for a long period of time--and in telling the truth, everybody is entitled to their own opinion but not their own facts. We have been talking about some of the facts which the Senator and I have discussed this afternoon, a relatively new fact in that 2,000 pages. But, hopefully, more people will know about that. What is interesting is that the American Hospital Association really did not get very much--even though they are getting terrible cuts, they did not get involved too much in taking all of this on.

Mr. ROCKEFELLER. I will be glad to yield.

Mr. ROCKEFELLER. Mr. President, I yield 4 minutes to the Senator from Louisiana.

Mr. ROCKEFELLER. I yield 5 minutes to the Senator from Nebraska.

Mr. ROCKEFELLER. I will answer the Senator from Massachusetts that for the average senior in West Virginia, their income would be about $10,700 a year, and 21 percent of that they already spend on health care. There is little left on the margin just to survive. If this happens, the deductible will double, and the premiums will go up. All kinds of costs will increase, and services I believe, particularly in the rural areas, will decrease. I think that, No. 1, they are going to feel like they have been abandoned. Whether or not they will be is yet to be fully determined. But they are going to believe they are going to be abandoned. Hospitals in rural areas are going to close down. They already are closing. That will pick up. So in a State which is 97 percent mountain and 3 percent flat, as the Senator knows, they are going to feel cut off from health care, and in many cases they will be cut off from health care because they will have no acute care beds that will be available to them because of hospitals that are closing down. So expenses will go up. Their fear will skyrocket. Their hospitals will begin to close down. Doctors are going to become much more reluctant to go into the rural areas of West Virginia because of the cuts in the graduate medical education. You are going to find the kinds of doctors who have traditionally gone into rural areas to service seniors are not going to be trained because they are no longer going to be funded by the Republican cuts under Medicare because of the cuts in graduate medical education. So I do not know any way that they win. I can think of no way that they win, and I can think of 10 ways they lose.

Mr. ROCKEFELLER. It is not necessary to anticipate it. It is a fact. They will go up. They will double.

Mr. ROCKEFELLER. That is just more money out of pocket. Of course, the ironic thing there is that 40 percent of what it is that the majority party is cutting out of Medicare--$100 billion--cannot even be used to help the trust fund, cannot even be used because it is from part B. I yield to the Senator from Iowa.

Mr. ROCKEFELLER. Mr. President, what is the time remaining?

Mr. ROCKEFELLER. Does the Senator from Michigan wish to allocate time to anyone? Mr. ABRAHAM addressed the Chair.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I have a motion here in my hand. It is a motion to recommit with instructions. And I would like to say to every one of my colleagues on both sides of the aisle that the first amendment that we deal with today in the U.S. Senate--that we are dealing with today, the day that we meant for dealing with amendments of absolutely enormous importance to the future of our country--is going to be the Medicare amendment. I do not care how many meetings are held in the majority leader's office, I do not care how many long speeches are given, I do not care how many morning businesses are taken, and I do not care even to the fact that no Democrat, other than the chairmen of the Budget Committee and the Finance Committee, has been able to say a word on this day, the day we meant to be devoting an hour to a series of extraordinarily important amendments on Medicare, EITC, Medicaid, and other matters, this amendment is going to be the first amendment laid down. It will recommit the Republican $270 billion cut in Medicare to the Finance Committee for further work. I just want my colleagues to be fully aware of that fact. That will be the first amendment, the Medicare amendment. And it will come regardless of what tactics are used or whatever dilatory procedures are adopted. I will say that the reason we on the Democratic side are laying this motion down is that the Republicans are cutting three times as much out of Medicare as they need to do in order to make the hospital insurance trust fund solvent to the year 2006. There is no need to do $270 billion of cuts. So between the $89 billion that the trustees of the trust fund say is needed to make the Medicare hospital insurance trust fund solvent, which is what all the rhetoric is around here, to make the thing solvent--they all say, the trustees, that is, $89 billion--and the majority party taking $270 billion out of Medicare to do the work for which only $89 billion is required, therefore, there is a gap of $181 billion, to which I would think an ordinary inquiring citizen would say: What is this $181 billion for if all we need is $89 billion to make the Medicare trust fund solvent? And the answer, of course, is oft proclaimed, oft denied on the other side but a matter of irrefutable fact, and that is that it is going to be used to give in part an enormous tax break to families and institutions of wealth, and that emanates from the fact that this was part of the contract. It had its genesis when Newt Gingrich on a sunny day went with a band of very committed, newly elected House Members and in front of all kinds of American flags pronounced the 10 commandments, of which the greatest was a tax cut, the crown jewel was a tax cut. That having been done, obviously no less could be done in this body and so the $245 billion, or $225 billion tax cut became the mantra. So that tax cut has to be achieved. We do not have that kind of money laying around, nor does the average American family, and therefore where do we get it? We go to Medicare and to Medicaid, and we cut them egregiously in order to do that. I have no idea of how I am going to explain the damage done to the people of West Virginia, to the seniors of West Virginia, to the health institutions of West Virginia, to the veterans of West Virginia by this Medicare cut. And I will be talking at length about that at the time we actually do lay the amendment down. But the amendment is simply to say on our side we will not accept a $270 billion cut when $89 billion will do the job, stamped and approved by those whose responsibility it is to do the job, the trustees of the hospital insurance trust fund, in order to not have to do the $270 billion cut which the majority party is doing for the purpose of raising enough money to give a tax cut to those who do not need it. I find this extraordinary. I find it certainly worth the meager 1 hour that we are going to be able to have on each side to discuss the Medicare amendment. But the Medicare amendment there will be, and it will be the first one and it will happen. I thank the Presiding Officer. Mr. KENNEDY addressed the Chair.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, on September 26, during the Senate debate on H.R. 2099, the VA-HUD appropriations bill, I offered an amendment to strike a provision in the bill which would discontinue disability compensation payments to certain mentally disabled veterans when their savings reach $25,000. Unfortunately, my amendment was not adopted. I continue to believe strongly that this provision should not be enacted and urge the conferees on H.R. 2099 to drop it. Mr. President, as I noted in that debate, this provision discriminates against a small group of veterans: those who are mentally disabled. It does terrible harm to these veterans. One proponent of the provision expressed the view that the provision does not affect the standard of living or the condition of any veteran. I disagree. Mr. President, let me describe the situation of a veteran who called my office to explain how this provision affects her. She is from New Mexico. She receives VA compensation for a mental disorder that resulted from her military service. At times over the years, her disability has been particularly bad and she has been rated incompetent by VA. Right now, she is doing better and is not rated incompetent. However, she never knows when things will turn bad again and she will again be at risk of being rated incompetent. Because of this risk, she told committee staff that, if this provision is enacted, she will not go to the VA hospital for treatment because she is afraid they will determine her condition is worse and they will recommend she be rated incompetent. If that happened, she would lose her compensation. Then she would lose her house because she could not make the mortgage payments. That is what she said. So, she will not seek treatment. Mr. President, I understood that this bill would take away disability compensation from incompetent veterans whose estates exceed $25,000, and I have opposed it as rank discrimination against a small group of veterans who are unable to protect themselves. Until this veteran called, however, I had not focused on how this provision would inhibit the very people we are trying to help from seeking medical treatment. I am convinced that this woman's condition will be affected by this provision. She is so afraid of this provision she will not seek the help she needs--help she has earned--help she is entitled to. That is what this provision does to mentally disabled veterans. That is why it should be dropped in the conference report.