Jay Rockefeller

Mr. ROCKEFELLER

Mr. ROCKEFELLER. I simply conclude this argument by saying the Finance Committee has been meeting all day. They are meeting as we talk. The Senator from Wyoming and I are on that. They are going to pass out--without my vote, but it will happen--the Committee will pass out $450 billion of cuts in Medicare and Medicaid. I repeat that one can say that there are fewer veterans, but it is also statistically true that the demands by veterans for health care, as the demand for other American citizens for health care, is increasing. It is larger than it was in the previous year. As a result of what we are doing in the Finance Committee and the cutbacks in Medicare and Medicaid, I envision a substantially increased number of veterans who will not be able to avail themselves, for example, of that assistance to the extent that they could before, and who will, therefore, need to turn to the Department of Veterans Affairs. To further cut veterans' health care is wrong. Is that emotional? Yes, partly. But mostly it is a promise. It is a commitment. It is a commitment that was made by this Nation and it is a commitment made to no other group in this Nation. Interestingly, veterans groups are not, as a rule, as caught up in amendments like this as I think they ought to be. I cannot help that. I know what the commitment is. I know what my responsibility is. I know what my 202,200 veterans in West Virginia require. I do not want to let them down. I hope that the amendment will be looked upon carefully by my colleagues. I yield the floor.

Mr. ROCKEFELLER. I ask unanimous consent to yield myself such time as I need.

Mr. ROCKEFELLER. Mr. President, how much time is remaining to the proponents?

Mr. ROCKEFELLER. The Senator asks permission to continue.

Mr. ROCKEFELLER. Mr. President, I ask unanimous consent that the reading of the amendment be dispensed with.

Mr. ROCKEFELLER. Mr. President, the second amendment I propose is also very simple. It would provide funding for VA medical care at the level requested by the President--that is, $16.96 billion--and would offset the cost of this increase, approximately $511 million, by a reduction in the amount set aside in the budget resolution to cover the revenue loss from any tax cut. The choice represented by the amendment is simple: Should VA health care be funded at a level which allows it to continue to meet health care needs and demands of those veterans who seek care from the Department of Veterans Affairs, or should medical care be cut so as to fund a tax cut? The Senator from Wyoming indicated this comparison would be made on a number of occasions, and he is entirely correct. The values implicit in this argument, and how one comes down on this argument, are profound. Obviously, to me the answer is self-evident. Mr. President, I want my colleagues to understand some of the ways that the level of funding included in the appropriations bill will affect the people who use the VA health care system.

Mr. ROCKEFELLER. Under the bill as reported, VA would be forced to operate at a level below current services. In human terms, 113,000 eligible veterans would be denied inpatient and outpatient care in 1996. In terms of VA's capacity to provide a full range of health care services nationwide, the equivalent of four VA hospitals would have to be shut down; 6,500 VA health care professionals would lose their jobs. I spent most of the day in the Finance Committee, and people there say that a reduction in the increase in the amount of money put aside for health care is not a cut. They are, of course, entirely wrong. Health care is not like a loaf of bread. A loaf of bread is subject to normal inflation; it goes up a couple pennies a year, whatever. Health care is subject to entirely different influences. It is subject to technology. It is subject to the fact that veterans are aging. The Senator from Wyoming made the point that there are fewer veterans, but he did not make the point that, in fact, demand for veterans' health care, even with fewer veterans, is increasing. Are we to deny them that? My amendment would seek to try to deny them less. Mr. President, I ask my colleagues to focus on these repercussions in human terms. I fear too often we hear numbers and we become numb. We lose sight of the human element in what we are doing. If we do not appropriate funds for VA medical care at the level sought by the President, which is a modest level, in my estimation, and which only covers the cost of inflation--not medical inflation but inflation--real people, veterans who answered our country's call, will not receive the health care that they need, the health care that they deserve, the health care that they have been promised. One can ridicule all one wants the commitment to our Nation's veterans, but it was made, and it is justified. This is not pulling on heart strings. This has to do with whether veterans get treatment for different kinds of conditions which might range all the way from prostate problems to Alzheimer's to other long-term care problems or immediate problems. They are real problems and real people. I do not say that any person in this body cares for people less than any other person, but what they do about what is available to those people may differ substantially, and in what they do is the judgment about what they feel, in terms of their priorities. Every VA medical center furnishes vital care to veterans in the geographic regions served. We know that. We stopped all new construction in the Veterans' Committee. We have stopped any major renovation of our current veterans hospitals, many of which were built 75 years ago. The Senator from Maryland mentioned a psychiatric hospital which is literally crumbling on its foundations, but are we doing anything to build that up, to restore it, to improve it? No. So we are not doing that. We are talking here about veterans health care as it exists, to be made available to veterans who need it. We will deny service to my constituents who are veterans and to the constituents of others who are veterans. Some have disabilities from their service; others were able to complete their service without injuries but are now unable to afford the cost of health care. What do they do if they are unable to afford the cost of health care? We have 40 million, 50 million Americans who do not have health insurance. To deny veterans health care is wrongheaded. We must avoid it, and my amendment will help us to do so. Mr. President, I find it very ironic that we are being asked to cut VA health care funding below current services, thereby turning veterans away from their health care, just as we conclude a great national celebration of the 50th anniversary of the end of the Second World War, an enormous emotional outpouring. I remember staying up late one night a couple of weeks ago to watch President Clinton out in Hawaii. C-SPAN did something at 2 or 3 in the morning for an hour, or hour and a half. We have had people talk about it on the floor of the Senate, Senators discussing their service with each other. Powerful, powerful testimony. We have all agreed that these people saved the world. One thing came through very loud and clear to me during those recent celebrations, and that is how the victory belonged to the GI's--not to me, I was 5 years old, but to the GI's--who fought the battles from Normandy to Iwo Jima. Oh, how we love to talk about that, and ought to and are inspired by it, made better by it. Mr. President, these are the same GI's who are now veterans in their seventies seeking care from the VA. Not everybody is rich. They say a third of the Members of the Senate are millionaires. Well, we may be out of touch. A lot of those folks out there are not, and they are broke and they need VA, and that is what the VA is there for, to serve them. These same GI's could be turned away from the care they need if the cutback envisioned by the Appropriations Committee is enacted. That hardly seems like a fitting or worthy tribute after all the speeches that we have heard. I also find it ironic that there are proposals to cut VA below current services at the very time that cutbacks [[Page S 14291]] are being proposed in Medicare and Medicaid. Now, why do I say that? There is every reason to suspect that as individuals are pushed out of those programs because of the changes that are being contemplated, the veterans who have relied on either Medicare, which is being diminished by $270 billion, or Medicaid, which is being diminished by $182 billion, will have to turn to VA for needed health care. I find that ironic. Mr. President, VA health care is at a crossroads, and many innovative and dynamic changes are happening within the system. We have a lot of improvements that we can make, and they are being done--not all, but some. Some, as I have indicated, suggest that the number of veterans is declining, and that that, therefore, justifies cutbacks in VA health care. People even laugh at that. Well, it is true that the overall veteran population is coming down. It is now just over 26 million. A few years ago, it was close to 27 million. It is also true the demand for VA health care continues to increase. The question is whether we will meet it under the obligations that we have. This is a phenomenon--this demand for more health care--that is easy to understand once one realizes that as the population continues to age, the demand for health care services actually is on the rise. As our veterans age, we must make sure that the promises a grateful nation has made will not be undone as we rush to balance the budget. I urge my colleagues to adopt this amendment.

Mr. ROCKEFELLER. Objection is not heard.

Mr. ROCKEFELLER. Mr. President, I move to waive the application of the Budget Act to the pending amendment.

Mr. ROCKEFELLER. I urge adoption of my amendment.

Mr. ROCKEFELLER. Mr. President, people talk about people with remote heirs and people who may care for mentally disabled veterans as if they did not really care. They say, why would one care for a mentally incompetent veteran? Well, I am sorry, but there are people who do care. And there is nothing in the law which says that you have to care to 20 percent or 70 percent or 90 percent for this to be fair. There is no justification for singling out mentally disabled people for discriminatory treatment. None. We have not said they are entitled to compensation only if they are poor. The law does not say that. We have not said they are entitled to compensation only if they have savings less than $25,000. And we have not said they are entitled to compensation only if they have no money from anywhere else, like so many Members of this body do who do not have to worry about things like this. These are people who have people who care about them. To assume they do not is not in line with thinking about family values. We have said that they are entitled to compensation for their disability based on their disability. And that is what my amendment asks for. Are we prepared to say now that for some reason the mentally disabled are somehow less entitled solely because they are mentally disabled? Is that what those who oppose this amendment would do? The Senator from West Virginia will not join such an effort. I hope very much that my amendment will be accepted. I think it is right, fair, reasonable, just, and nondiscriminatory. I yield back the remainder of my time.

Mr. ROCKEFELLER. How much time do I have remaining?

Mr. ROCKEFELLER. Mr. President, my amendment is very simple. It would strike a provision of the appropriations bill which seeks to limit compensation benefits to certain veterans who are disabled by mental illness, and offset the savings that would result from the enactment by limiting any tax cut under the budget resolution to families earning less than $100,000. Mr. President, the choice posed by my amendment is, again, simple and, I think, straightforward. Do we favor tax cuts for the wealthy or benefits for mentally disabled veterans? I trust the answer will be obvious. The Appropriations Committee would reenact a 1990 provision which cut off VA compensation benefits to mentally incompetent veterans who have no spouse, children, nor dependent parents, when the veteran's savings reached $25,000. Payments were resumed when the savings fell to $10,000. [[Page S 14287]] This provision expired at the end of 1992. Attempts to reenact this provision were rejected by the House and Senate Veterans Affairs' Committees in both 1993 and again this year, 1995, in our reconciliation efforts. It is bad policy, and, in any event, it does not belong in an appropriations measure. Mr. President, some may argue that suspending compensation to mentally disabled veterans when their savings reach $25,000 prevents uncaring heirs from acquiring funds amassed through the receipt of VA compensation benefits. Indeed, that is usually the argument which is used against this. While it is undoubtedly true that this will happen in a few cases--that is, that individuals truly remote from the mentally incompetent veteran will receive moneys on the death of that veteran--it is equally true that it does not happen in the great majority of cases in which a mentally incompetent veteran dies without a spouse, child, or dependent parent. In fact, to the contrary, in many cases there are other family members--nondependent parents, brothers, sisters, uncles, aunts, or cousins--who have been involved with the veteran and the care of the veteran. Also--this is important to note--there is absolutely no reason to suppose that the situation of funds going to so-called remote heirs occurs any more frequently with mentally incompetent veterans than with other seriously disabled veterans who have acquired significant savings based upon their receipt of compensation. If there is indeed some interest in ensuring that savings derived from VA compensation not go to remote heirs, then the law should be changed to provide that the cutoff in compensation apply across the board to everyone. I do not believe that this is something the Government should do only for those who are mentally incompetent, disabled veterans. If we are to undertake this policy--and I would not favor that--it must be done in a fair, across-the-board fashion. Otherwise, we single out mentally disabled veterans and in that classic sense discriminate against them when, of course, they are unable to do anything about this themselves. Mr. President, on its face this provision discriminates against one small group of veterans: those who are mentally disabled. There is no sound policy reason for allowing a competent disabled veteran to save money that could possibly go to remote heirs upon the veteran's death, while limiting savings of a mentally incompetent, disabled veteran. There is a rather important matter of fairness involved here. This provision would do terrible harm to families who sacrificed to provide care for their mentally incompetent son or daughter. In many cases, parents who act in fiduciary roles build savings so that when the parents are deceased, there will be enough money to care for the disabled veteran. Under the proposal, families could not accomplish this goal. Another outcome of the 1990 provision was that many veterans and their guardians did very creative things to circumvent the law. For example, mentally incompetent veterans arranged marriages in order to avoid losing their compensation. Others made large purchases of unneeded property or cars to lower their savings or otherwise disburse their savings. Guardians in these cases often consented because it was better to expend those savings than to lose VA compensation altogether. We can expect more of the same if this proposal becomes law. By cutting off payments, the provision punishes the veteran whose guardian conscientiously administers the veteran's funds, while it rewards the guardian who allows the veteran to spend frivolously everything that he gets. Mr. President, I note that all of the major veterans service organizations oppose this provision, some of them very strongly. They generally believe, as I do, that there is no justifiable reason for singling out these veterans for discrimination solely because they are mentally disabled. Also, as I noted briefly earlier in my remarks, this provision is a clear example of authorizing legislation on an appropriations bill. That is not considered lightly around here. The Veterans Affairs' Committee considered this provision as part of meeting our reconciliation mandate under the leadership of Chairman Simpson, and we rejected it. That is the business of an authorizing committee. It should not be resurrected in the guise of an appropriations issue. Mr. President, for all of these reasons, I urge my colleagues to join me in supporting this amendment to remove this onerous provision from the appropriations bill. I yield the floor and thank the Chair.

Mr. ROCKEFELLER. Mr. President, I yield 3 minutes to the distinguished Senator from Maryland, Senator Mikulski. [[Page S 14292]]

Mr. ROCKEFELLER. This Senator thanks the distinguished colleague from Maryland. Mr. President, I will use my remaining time to say the following. In 1992, Senators Hatfield and Domenici and Kasten wrote to the President of the United States, President Bush, about precisely this subject. And they said in a letter, which I ask unanimous consent be printed in the Record, the following: . . . based on ``irrational discrimination against the mentally disabled . . . the virtually exclusive, if unintended result is impermissible discrimination against mentally incompetent disabled veterans.''

Mr. ROCKEFELLER. Mr. President, I ask unanimous consent that reading of the amendment be dispensed with.

Mr. ROCKEFELLER. I am indeed.

Mr. ROCKEFELLER. Would have to do with veterans' health care.

Mr. ROCKEFELLER. I wanted to lead off with the amendment relating to the mentally disabled veterans.

Mr. ROCKEFELLER. The Senator is entirely correct.

Mr. ROCKEFELLER. Mr. President, I send an amendment to the desk and ask for its immediate consideration. Mr. BOND addressed the Chair.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am proud to be a cosponsor of the amendment to ensure the survival of AmeriCorps, today's commitment to national service throughout the country and in my State of West Virginia. I was proud to be an original cosponsor of the legislation that created AmeriCorps. I know something about the importance of public service because of the VISTA program back in 1964. After President Kennedy issued his famous call for serving our country, I went to West Virginia through the VISTA program and to a place called Emmon that changed the course of my life. AmeriCorps is a wise and meaningful investment in our country's future. Whenever I am home talking to West Virginians of every age, I see heads nod when the idea of national service comes up. West Virginians and our fellow Americans believe in the values of service and responsibility, and AmeriCorps is a very exciting, important way for these values to have meaning. It is incredible to see this appropriations bill include a retreat from one of the most exciting initiatives taken in the recent years. We should be working together to renew and reinvigorate service, especially by our young people, and not retreat from it. There is a great deal of talk about solving problems at the local level and working in communities. I agree and I believe that AmeriCorps is one Federal program that successfully delivers on this promise. For every Federal dollar invested in AmeriCorps, we reap as much as $2.60 in return. While it is important to note that AmeriCorps is a cost-effective program, I know it is more compelling to talk about what AmeriCorps has done for communities. In West Virginia, the AmeriCorps program places workers at seven domestic violence shelters to help battered women and children with a range of issues. I have visited a shelter in West Virginia and was deeply touched by the need to help women and their children caught in violent homes. This is important community work, and AmeriCorps is helping make a difference. My State also sponsors Project HEALTH--Health Education Associates Learning to Teach Health--which places 20 AmeriCorps members in 15 sites that focus on promoting health care in rural areas. This is a unique partnership program with the Kellogg Foundation, my State, and AmeriCorps. AmeriCorps workers will be promoting child immunizations, working to reduce the prevalence of low birth weight, and promoting healthy behaviors. AmeriCorps members are also involved in a West Virginia project called Energy Express. This is an innovative summer program for disadvantaged children that combines remedial education and child nutrition. Energy Express also works to promote parental involvement with a child's education which is a goal we all share. I could go on and on about the extraordinary work by AmeriCorps and the other service programs sponsored in my State. We have more than 20,000 West Virginians participating in public service initiatives thanks to the leadership and encouragement of the Corporation for National and Community Service. There are 189 West Virginians in AmeriCorps, and others are involved in VISTA, RSVP, the Retired and Senior Volunteer Program, and ``Learn and Service'' in the schools. The Corporation for National and Community Service weaves all of these important incentives together. As we talk about the need to strengthen our communities and to solve problems at the grassroots, we should continue our support for AmeriCorps, which reflects this basic goals. Mr. President, I ask unanimous consent that two West Virginia articles be printed in the Record. These pieces tell the story of AmeriCorps in West Virginia more eloquently than I can. There being on objection, the articles were ordered to be printed in

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, for a very long time, I have argued for welfare reform. My fundamental goal for reform is to see parents work and accept personal responsibility. Welfare should be a temporary program to help people become independent, not a trap of long-term dependency. But at the same time, innocent children should be protected and not punished for circumstances beyond their control. I rise to explain how I came to the conclusion to vote for the final version of welfare reform legislation before the Senate this afternoon. My vote is for the basic idea that the current welfare system can't be continued. It must be changed. This bill is now our opportunity for changing the rules and encouraging major reform. While I strongly opposed the original bill offered by the Majority Leader, Bob Dole, I am relieved that the persistent, dedicated work of a team that I was proud to join has resulted in many changes--including some major improvements that were essential for West Virginia--to the legislation. In my view, there are still flaws and disappointments in this bill. But as someone who serves to achieve the most good possible through consensus and cooperation, I am voting for this bill to do just that. West Virginians have told me for a long time why they are anxious for welfare reform. It is unfair to hard-working families when it is too easy for others to receive public assistance that does not end. And for parents who want to work or can work, the system has to emphasize the means to that end instead of the criteria for staying on welfare. None of this will be easy, but it is time for these changes. This is not a new mission for me. I have worked on ways to reform our welfare system for years. In 1982 as Governor of West Virginia, I was proud to start a program called Community Work Experience Program in our State that required many parents on welfare to work in their community when they could not find private sector jobs, mostly because of high unemployment. This idea is more commonly known as workfare, and West Virginia was one of the first two States in the country to start this program and we are still using it today. I believe in workfare and community service as important alternatives when a private sector job is not available. In the Senate, I continued to work on changing the welfare system, and I am proud of the efforts begun in 1988 under the Family Support Act that passed with strong bipartisan involvement and support. This legislation was an important first step. While we all know that the Family Support Act was not perfect, it began to change the system to move families from welfare to work. The Family Support Act also gave States the latitude to try various approaches to welfare reform which have now encouraged bolder efforts, today. Based on my goals for West Virginia and my work as Chairman of the National Commission on Children, I participated in the welfare reform debate as a cosponsor and strong proponent of the Democratic Leader's bill, ``Work First.'' In my view, it was a mistake for the Senate to reject our amendment containing this bill. ``Work First'' would end welfare as we know it by eliminating the existing Aid to Families With Dependent Children (AFDC). The Democratic alternative would require work and promote parental responsibility, and yet at the same time provide the best safeguards for both children and State budgets during times of economic downturns. Unfortunately, this strong package was not taken seriously by the Republican side and was defeated. So in good faith, Democrats did not disappear from the process to enact welfare reform, nor did we surrender on the goals we think the American people share, too. We have spent the last week on the floor to push for consensus and compromise on very important issues. It was discouraging to deal with the original Republicans' bill that made promises without the means to keep those promises. The early refusal to work in a bipartisan spirit was unnecessary, and made it very difficult to work through decisions that will have consequences for taxpayers and poor families in our States. But we persisted in order to make our best attempt at achieving welfare reform and protecting principles represented in the ``Work First'' alternative. As a result, major changes have been made to the Republican bill on the Senate floor, including adding a maintenance of effort requirement to ensure that States continue to invest their fair share to help needy children and their families. This was a victory for the principle of responsible government and a major step in reserving adequate resources for poor children. Child care funding is another fundamental change to the original Dole bill that is absolutely crucial if we are serious about moving parents from welfare to work. We should insist that parents go to work, but we also must be realistic and acknowledge that a lack of safe, affordable child care remains a barrier. Democrats worked very hard to secure additional funding for child care. I still worry that this final compromise might be short on funding, but I am relieved that we secured the additional funds for something that families literally can not go without. Let us remember that parents are put in jail for leaving children unattended. Government can not require parents to be at work if they do not have a way for their children to be cared for. When we talk about family values, child care belongs in how to turn our rhetoric into reality. If we make the huge leap from an entitlement to a block grant program, one of my early goals has been to secure a contingency fund to provide additional help to States when poverty rises. Under the Democratic ``Work First'' alternative, we maintained the historic Federal-State shared responsibility for this population so there was no need for a contingency fund. But under a block grant approach, there is a need for some type of safeguard in times of high unemployment, natural disasters, or other unforeseen reasons that increase the number of very poor families in a State. As a former Governor who led my State of West Virginia through a severe recession with double-digit unemployment rates, I am keenly aware of this problem. Families who always worked and never wanted welfare were temporarily forced to seek assistance because of harsh economic conditions in my State in the 1980s. Then, Federal assistance was there to help needy families through hard times even though our State revenues declined, and it would have been impossible for West Virginia to serve needy families without additional Federal help. Even with a contingency grant fund, I worry how a block grant approach will work when a State or several States face problems of high unemployment or a natural disaster. But after a hard battle, we managed to get a provision into this final legislation that will make the contingency fund a grant program, instead of loans, and which will offer real help when families and States hit difficult times. As we think about the problems of unemployment, it brings to mind the worries of what happens to families who hit the time-limit in the midst of a deep recession? I know numerous personal stories, because I know families on welfare in West Virginia who would eagerly work, but the jobs just are not there. I submitted two specific amendments to this bill designed to give States the option of waiving the time limits for good reasons--such as high unemployment or if adults simply could not work because they were ill, incapacitated, or caring for a disabled child. In my view, it would be best to spell out limited reasons for exceptions. While my criteria were not adopted, our success in winning an increase in the States' hardship waiver from 15 percent to 20 percent will achieve the same goal. I appreciate the strong support for my amendments that was voiced by the National Governors' Association, State Legislatures, and other officials who know the practicalities involved in real welfare reform. I also want to note why it is so essential to maintain the Senate approach on child welfare, foster care and adoption assistance. In the Finance Committee, we specifically stated our intention to retain current law so that the Nation's basic commitment to abused and neglected child would continue. Child welfare is very different than general cash assistance for poor children. Child welfare serves children at risk of abuse and neglect in their own homes. We should not reduce or cap Federal aid to such vulnerable children. That means we must maintain the entitlement nature of foster care and adoption assistance. There is support from both sides of the aisle for this in the Senate, and I specifically want to commend Senator Chafee for his leadership on the important issue. The Senate approach on child welfare and foster care system must be preserved in the conference, and I am personally determined that we not retreat from the country's important guidelines and reliable support that abused and neglected children rely on. Bold changes in child support enforcement are a real victory in this legislative package. Because this was one section developed in a bipartisan manner from an early point, it has not attracted much debate or public attention. But West Virginians and our fellow Americans certainly know the significance of child support and insisting on parental responsibility. There are billions of dollars owed to children by absent parents. I cosponsored the bipartisan legislation offered by Senator Bradley which provided a good framework for the tough provisions in this legislation that will help collect those dollars. Getting tough on child support is a priority. In addition to changing the rules, we also need to change attitudes. It is pathetic that adults are more responsible about paying their car loan payments than their child support. This is unacceptable and must be turned around. As Chairman of the bipartisan National Commission on Children, I have been working on the issue of welfare and families closely for years. I want to find creative, bipartisan ways to strengthen and stabilize families. Our Commission issued a unanimous report that called for a whole new approach on children and family policy at all levels-- Federal, State, and in our communities. The legislation passed today reflect some of the direction recommended by the Children's Commission. I strongly support the idea that States and local communities must take a leadership role in helping all families, including those needy families on welfare. And again, I repeat my hope that this country will maintain a nationwide, steadfast commitment to safeguarding children. Our country has a stake in every child, whether a child is born to a poor family in rural West Virginia or a family in an inner city. A child born to an unwed mother has the same basic needs and the same potential, as a child who is more fortunate and born into a stable, wealthy family. I honestly don't believe that the legitimate cry we hear for welfare reform is a demand to forget or abandon children. As I said at the outset, I believe in welfare reform, and it is obvious that the American public demands it. As someone who has fought for children and families for years, I hope that the States receiving so much new responsibility for the fate of their poor citizens will take it very, very seriously. Children are two out of three people who depend on welfare today, and they should not be punished. Because of this deep concern, I was one of the members who pushed very hard to incorporate an evaluation amendment into this legislation. We should acknowledge that this legislation is a huge experiment. We are eliminating the Federal safety net that has assured minimum support for needy children and families for over 60 years, and this legislation will replace it with a new approach. While AFDC has serious flaws and must be changed, this approach is new and untested. I feel a strong moral obligation to thoroughly study and evaluate how this new approach serves children and families. Optimists and staunch supporters of the Work Opportunity Act predict this bill will reduce dependency and move families from welfare to work. Critics warn that children will end up on the streets. I am willing to try, and I am willing to vote for this legislation. But I insist that we monitor it closely to evaluate carefully how children are affected. Because of our evaluation amendment, we now have this commitment and obligation. I truly hope that this bill fulfills its bold promise to help move families from welfare to work and to end the cycle of dependency. When a conference is established to negotiate the final welfare reform bill to send to the President, I hope that the debate and revisions that have taken place here in the Senate will be taken extremely seriously. And if and when a welfare reform bill is signed into law, and if the warnings of the critics are true and children are abandoned, we must swiftly revise the law and try again. My fundamental principle remains that children should be protected. From my work on the National Commission on Children, I believe in building consensus and trying creative approaches. For the sake of our children, and the future of our country, we need to chart a bipartisan course that emphasizes cooperation on behalf of children and families. Children should not become pawns in a partisan rhetoric and politics, and I hope that the conference on welfare reform will adopt such an approach so that common ground and reasonable compromises will be achieved. I congratulate the numerous Senators, staff members, and experts who devoted untold hours and energy into preventing the original Dole bill from succeeding and working out important, vital improvements. West Virginia was better served through the process of these revisions, and will be better equipped to prod and help poor families avoid dependency. I worked hard to achieve the changes most important to my State, and I hope they will remain in the final welfare reform legislation that must be negotiated with the House. Welfare reform must also work in the real world. We have seen in the recent months once again how attractive the words are to politicians and others who see advantage in dividing people, scoring cheap points, and pretending that the country's problems are easy to solve. That is an injustice to all Americans, to taxpayers frustrated with the welfare system and to the families who find themselves poor for whatever reason. We know that America feels best when we succeed in achieving ambitious goals by pulling together, living up to our Nation's principles, and making the effort required to get the job done. Welfare reform is a very ambitious goal, and the passage of this bill takes us one step further to accomplishing the real results and true change that Americans expect.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, on rollcall 440 I voted aye; my intention was to vote no. I did not know it was a tabling amendment. I ask unanimous consent that I be permitted to change my vote, which in no way will change the outcome of the vote.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am pleased to introduce a bill to reform the way Medicare administers its health benefits. Under current law, Medicare is not allowed sufficient flexibility to award contracts to administer Medicare benefits based on performance, skill and expertise, or competition. This bill is long overdue and follows up on an oversight hearing I held as chairman of the Medicare subcommittee a few years ago. When Medicare was enacted 30 years ago, private health insurance companies were awarded the task of administering the program. GAO recently testified before the Finance Committee that when Medicare was enacted ``legislation essentially delegated many day-to-day administrative decisions to private insurers, to further lessen the risk of undue Federal interference and to better ensure that Medicare would treat its beneficiaries no differently than the private insured.'' Under my legislation, important administrative functions would still be performed by private sector companies but the pool of eligible companies would be broadened. Medicare would also have the opportunity to take advantage of private sector initiatives to improve customer service, lower administrative costs, and improve operational efficiency. Mr. President, there is bipartisan recognition that funding for Medicare's administrative operations is currently inadequate. Funding for contractors has actually declined over the last several years. When adjusted for inflation, Medicare's contractor budget actually declined by 37 percent over the last 6 years. The Finance Committee, on which I serve, has heard testimony from the General Accounting Office, the HHS Office of Inspector General, and others in support of higher spending for Medicare administrative services. Increased spending on payment safeguard activities can actually save the Medicare Program money. According to the GAO, every dollar spent on Medicare safeguard activities returns at least $11 to the Medicare Program. But, Mr. President, before we spend additional money on program administration we need to make sure that the Health Care Financing Administration [HCFA] has the ability to spend its contractor funds wisely and to enter into contracts with the most efficient entities. The legislation I am introducing today replaces outdated Medicare law and gives HCFA the tools to take full advantage of innovations and efficiencies in the private sector when it comes to utilization review, detecting fraud and abuse, and processing claims. No longer would all Medicare contractors be required to perform all Medicare administrative activities. This legislation would permit the Secretary of HHS to selectively contract with any agency or organization that is capable of carrying out specific administrative functions, such as fraud and abuse detection, customer service, or utilization review. Under current law, Medicare is restricted to contracting with health insurance companies. In the private sector, many large employers selectively contract with companies that specialize in, and have expertise in, utilization review or in adjudicating claims. The Medicare Program should not be prohibited from making similar competitive decisions. This flexibility will not only increase competition but it will enhance contractor performance by allowing Medicare to contract with entities who excel in a specific function. Under current law, Medicare is forced to pay the costs of terminating a Medicare administrative contract even if the contract is terminated for cause, including poor performance, outright fraud, or even if the contract merely expires. Medicare is the only Federal program required to pay for these extraordinary termination costs. This is inconsistent with the Federal contracting authority and should be changed immediately. Mr. President, my legislation would change current law that automatically renews Medicare's administrative contracts every year. More important, the decision on the awarding administrative contracts for part A would be given to HCFA while preserving a provider's right to choose its own fiscal intermediary. Because most hospitals have nominated the national Blue Cross-Blue Shield Association as their fiscal intermediary, when a State Blue Cross-Blue Shield plan leaves the Medicare Program the national Blue Cross-Blue Shield Association chooses which State Blue Cross-Blue Shield plan becomes the fiscal intermediary for the hospitals in that State. Under my legislation, new contractors would be awarded contracts using the same competitive requirements that apply throughout the Federal Government. Hospital and nursing homes would still be able to choose their fiscal intermediary every 5 years from a list of at least 3 approved contractors. This freedom of choice keeps pressure on contractors to continuously improve customer service to beneficiaries and health care providers. HCFA would also be allowed to monitor and respond to instances when a health insurance company is processing claims or auditing costs reports of health care providers that it owns. As the distinction between providers and insurers becomes blurred, a serious conflict of interest could emerge in these types of situations and HCFA must have the ability to safeguard the Medicare Trust Fund from these types of conflicts of interest. Just as Medicare has reformed its payments to doctors and hospitals over the past decade, and is considering changes to the way it pays health maintenance organizations, it is time to consider alternative ways to pay contractors. Current Medicare law that requires cost-based reimbursement is inconsistent with payment performance incentives and competitive bidding. Mr. President, I believe my legislation updates current Medicare law and is long overdue. This bill would equip the Health Care Financing Administration with the tools to move the Medicare Program into the next century. I ask unanimous consent that a copy of the legislative proposal be printed in the Record.