William Roth

Mr. ROTH

Mr. ROTH. Mr. President, I, like Mr. Shelby, strongly support the use of tax incentives to promote adoption, and that is why the Finance Committee unanimously reported out of committee an adoption tax credit bill. The distinguished majority leader has assured me that he will schedule action on the Finance Committee bill before the end of this year. Unlike the Finance Committee-passed adoption tax credit bill, Mr. Shelby's adoption tax credit is refundable, provides no extra credit for special needs adoption, and is not paid for. I remind my colleagues that we have had tremendous problems with fraud with refundable credits. Take, for example, the earned income credit. Furthermore, if Mr. Shelby's amendment is adopted, we will be required to find an additional $1.5 billion over 6 years in savings from the welfare legislation. In addition to these issues, Mr. Shelby's amendment is not germane to the welfare bill. I believe we need incentives to promote adoption, however, now is not the time to consider such legislation. I urge my colleagues to vote against Mr. Shelby's motion to waive the Budget Act. I yield the remainder of my time.

Mr. ROTH

Mr. ROTH. Mr. President, I strongly oppose the Specter-Biden substitute. While it does include some of the provisions of S. 1956 such as ending the individual entitlement, it stops far short of the goals of welfare reform. The Specter-Biden substitute is $10 billion short on savings and short on time limits. It has an open-ended contingency fund. It does include, however, a liberalization on Medicaid benefits in which Medicaid could be extended to illegal aliens. I would like to clarify that our legislation does include transitional Medicaid benefits for 1 year for those families leaving welfare. It also includes emergency Medicaid coverage for illegal aliens which is current law. Mr. President, I urge defeat of the Specter-Biden amendment. I yield back the remainder of my time.

Mr. ROTH. Madam President, I strongly oppose the Breaux amendment which would seriously undermine the real 5-year time limit on welfare assistance. One of the most important features of welfare reform is that recipients must understand that public assistance is temporary, not a way of life. Opponents of the 5-year time limit would have the American people believe this bill would abandon children. This is simply not true. Families and children would still be eligible for food stamps, Medicaid, housing assistance, WIC, and dozens of other means-tested programs. Let me reiterate that S. 1956, the bill before us, is identical to H.R. 4 on this issue when it passed the Senate on a vote of 87 to 12 last September. The Senate rejected amendments to weaken the 5-year time limit then, and it should do so again. If States want to use vouchers to provide services beyond the time limit, they could do so with State funds or with title XX funds of social services block grants. The State can also exempt 20 percent of the caseload from the limit for those truly hardship cases. I urge the defeat of the amendment. Mr. DOMENICI addressed the Chair.

Mr. ROTH. Mr. President, I oppose the Wellstone amendment. It is wholly unnecessary and unprecedented. In regard to studying welfare reform, this amendment is wholly unnecessary. The legislation is filled with studies, evaluations and rankings of successful and unsuccessful States. We absolutely want to know what works in welfare reform. But what is unacceptable and unprecedented is the rules given to the Secretary of HHS in sending recommendations to the Congress which must then be considered under expedited procedures in Congress. Let me point out that there were about 11.7 million AFDC recipients in 1990. In 1993 the caseload exceeded 14 million for the first time. The caseload was over 14 million again in 1994. Last year HHS told the Congress that, if we do nothing, there will still be more children in poverty. That is under the current welfare system. Again, we welcome the study. The legislation includes a study. But no Congress should yield its authority to a Cabinet Secretary for this or any other reason. I urge defeat of the amendment.

Mr. ROTH

Mr. ROTH. I will soon offer a second-degree amendment to the Chafee- Breaux amendment.

Mr. ROTH. Mr. President, let me discuss the purpose of my amendment. The purpose of my amendment to the Chafee-Breaux amendment is to ensure Medicaid coverage to all individuals currently receiving Medicaid benefits because of their eligibility through the current AFDC Program. By this approach we would ensure that no child or adult currently receiving Medicaid benefits would lose coverage because of welfare reform. Let me first explain that under our bill as currently written we believe that no child would lose Medicaid coverage because of welfare reform. The Congressional Budget Office has not scored any Medicaid babies because of the change in AFDC. But how can that be? The overwhelming reason for this is because Medicaid eligibility is no longer tied exclusively to AFDC eligibility. Medicaid eligibility was expanded in the late 1980's and is now tied to the national poverty level as well as to AFDC eligibility. This is an important point. Medicaid eligibility is higher than State AFDC eligibility. We believe that children currently receiving Medicaid would not be affected by the change to the AFDC Program. The minimum Federal standard is that pregnant women, infants, and children, and children under the age of 6, under 133 percent of the Federal poverty level, must be covered by Medicaid. Children age 6 to 13 must be covered if under 100 percent of the poverty level. Moreover, the General Accounting Office recently reported that 40 States have already expanded Medicaid coverage to pregnant women, infants, or children beyond these Federal mandates. One State has chosen to go as high as 300 percent of the Federal poverty level. Thirty-two States extend coverage to pregnant women and children up to 150 percent of the poverty level. Some States have extended coverage to children up to 19 years of age. So the overwhelming evidence points to the conclusion that States are expanding Medicaid eligibility, not reducing it. For 3 years President Clinton has been saying that the key to getting people off welfare is giving child care and Medicaid coverage. Governors already know this, and that is what they are doing. But to be on the cautious side, the bill, as amended, in committee provides for a 1-year transition period for anyone who may lose Medicaid eligibility as States change AFDC into the block grants, if there is still some concern that this is not enough. That is the reason that at the appropriate moment I will offer my amendment to grandfather in those individuals currently receiving Medicaid benefits so long as they are still under the poverty level. Let me point out, Mr. President, that there is no difference between the Chafee-Breaux amendment and my amendment in the second degree in regard to individuals currently receiving Medicaid. As I have already indicated, those individuals will continue to receive Medicaid, an approach which I think is, indeed, fair and equitable. The difference is that the Chafee-Breaux amendment applies to categories rather than people. That means that someone 5 or 10 years from now may not qualify for Medicaid under a State's new welfare program. Nevertheless, they could claim eligibility under the old program. It seems to me that this creates serious issues of inequity. I think it also is very burdensome to the State as it would require them to maintain these eligibility standards without end. I know that the Governors are deeply concerned about the Chafee-Breaux approach. They think it is unduly administratively burdensome to have to maintain two sets of systems. It is in contrast with the purpose of this legislation which is to create flexibility as we move forward with welfare reform, Medicaid, and other reforms. What we hope to do is to develop the kind of flexibility that will enable the States to develop approaches to these problems that brings some positive result. But it is hard to see how requiring a State to continue indefinitely an old program as the Chafee-Breaux amendment does. It is, indeed, hard to grasp. So I hope that my good friends and colleagues, Senator Chafee and Senator Breaux, would look at the amendment which I intend to offer as soon as all time has expired. As I said, it seems to me that this is, indeed, a fair and equitable approach. We are protecting those who are currently receiving Medicaid under AFDC. They will continue indefinitely to be eligible so long as they meet the requirements of AFDC. But I find it hard to see the equity, the fairness, the reason for, or the principle behind that we should continue in effect old programs that are going to be modified. The basic purpose of welfare reform is to provide flexibility to the States. We think that the Chafee-Breaux amendment is a step in the opposite direction. Mr. President, I yield the floor.

Mr. ROTH. I make the additional comment that under our legislation, the tax credit can be carried over for 5 years. I believe, therefore, we have addressed the problem about which Senator Shelby is concerned. I yield back the balance of my time. It is my understanding the Senator has yielded back his time.

Mr. ROTH. Mr. President, I make a point of order against the Shelby amendment under sections 305 and 310 of the Budget Act on the grounds that the amendment is not germane. Since the amendment, if adopted, would reduce revenue by $1.515 billion over the next 6 years, I also make a point of order against the amendment under section 310(d)(2) of the Budget Act.

Mr. ROTH. Inherent in what the Senator from Rhode Island is saying is that the Governors, in developing new programs, are inherently going to shortchange those on welfare. The fact is, and as you know, in the Finance Committee, it was clearly shown that much of the spending in welfare, Medicaid and other programs is beyond what is required by the Federal Government. In fact, I think in the case of Medicaid, they were spending more than 50 percent on a voluntary basis. So I think it is wrong to assume necessarily that the programs that are going to be developed under TANF are going to be less desirable. Let me say, a family could increase earnings and drop off AFDC but still be eligible for Medicaid if less than 100 percent of poverty. So there are alternatives. I yield the floor.

Mr. ROTH. Mr. President, how much time do I have?

Mr. ROTH. I say to my distinguished friend from Michigan that, as he knows, the yeas and nays have been ordered. There are people on this side who want a recorded vote.

Mr. ROTH. Mr. President, I yield the remainder of my time.

Mr. ROTH. Mr. President, I now call up my amendment in the second degree.

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

Mr. ROTH. Mr. President, I have, of course, already discussed the purpose of my amendment. As I said, the purpose of my amendment is to ensure Medicaid coverage to all individuals currently receiving Medicaid benefits because of their eligibility through the current AFDC program. As I said, this would ensure no child or adult currently receiving Medicaid benefits would lose coverage because of welfare reform. I believe this is fair. I think it is equitable. I think it just makes common sense. Yes, there are going to be changes in the future. That is the reason we are providing for welfare reform. Hopefully, at a later stage we will have Medicaid reform. I personally thought it was a mistake to separate the two reforms because they are interrelated. But it makes no sense to me, when we are trying to provide greater flexibility to the Governors, to require that two sets or systems of eligibility be maintained if a State changes the welfare program under TANF. As far as the administrative burdens are concerned, I would say to my good friend from Rhode Island, that his plan, too, will require the maintenance of two books. The difference is that in time ours will become less important. But I hope the sponsors of the basic amendment will review and look at my proposal, as I believe it is an approach that does provide for equity in that it guarantees all those who are currently receiving Medicaid benefits under AFDC would continue to do so. I yield the floor.

Mr. ROTH. Mr. President, I say to the Senator from Rhode Island, that is correct. What we have provided here is a transition rule, trying to ease the change by providing that all women and children who are currently receiving Medicaid benefits because of AFDC programs will continue to do so. But, to answer him directly, yes, that is true for a year from now and it will be true 5 years from now. It would be true 10 years from now.

Mr. ROTH. Mr. President, I agree with my good friend, Senator Shelby, that we need tax incentives to promote adoptions. Adoption is good for the child, is good for the family, and it is good for society. It was for this reason that the Finance Committee unanimously passed out of committee an adoption tax credit bill. The Shelby amendment, unlike the Finance Committee adoption tax credit bill, provides a refundable tax credit. The Finance Committee decided against a refundable credit in its legislation because of the very, very serious history of problems we have had with fraud in refundable credits. I also point out that unlike the Shelby amendment, the Finance Committee bill, which, as I said, passed out of the committee unanimously, provides not only a $5,000 credit for non-special-needs adoptions, but also a $6,000 credit for special-needs adoptions. I think this is a very important provision of this legislation that addresses a very, very special need. Going back to the Shelby amendment, I must point out also that it is not paid for. If the Shelby amendment were to pass, we would be required to find additional savings in the welfare bill of $1.515 billion over the next 6 years. The Finance Committee bill, on the other hand, is fully offset. Let me also say that I have been assured by the majority leader that he will schedule the adoption tax credit legislation which passed out of the Finance Committee for floor consideration before the end of the year. Although I strongly support giving tax incentives for the promotion of adoptions, Senator Shelby's amendment is not germane to the welfare legislation. Therefore, it is my intent when the time on this amendment has expired to make a point of order.

Mr. ROTH. Once people go off the rolls, their eligibility in the future would depend upon the new program. So they would not go back on the basis of AFDC.

Mr. ROTH

Mr. ROTH. I understand that, although they have been cleared, a question has been raised. So I withdraw my request until clarified. Mr. DeWINE addressed the Chair.

Mr. ROTH. Mr. President, I have a unanimous consent agreement to propound to dispose of four amendments which have been agreed to on both sides of the aisle. These amendments are Senator Jeffords' amendment to protect recipients of Federal energy assistance; the second is Senator Gregg's amendment to require administrative summons to request child support information from public utilities; the third is Senator McCain's amendment to allow child support agencies to enter into cooperative agreements with Indian tribes; and the fourth, Senator Coats' amendment relating to placing children separated from their parents with a relative. Senator Wyden is a cosponsor of this amendment. Mr. President, I ask unanimous consent that it be in order for me to offer these four amendments, which I now send to the desk en bloc, that they be considered and agreed to en bloc, and that the motions to table and the motions to reconsider be agreed upon en bloc, and that they appear on the Record as if considered individually.

Mr. ROTH. Mr. President, I withhold my request until such time as we hear from the senior Senator from Hawaii.

Mr. ROTH. I yield back the floor.

Mr. ROTH

Mr. ROTH. Will the distinguished Senator yield?

Mr. ROTH

Mr. ROTH. I yield myself such time as I might take. Mr. President, I rise in support of the leader's motion to separate Medicaid from this welfare reform legislation. Leo Tolstoy once said that ``Life and the ideal are hard to reconcile. To try to make them follow the same path is a life's work.'' I have to say that this observation has taken on new meaning for me as we have worked diligently to craft welfare reform in a way that is workable and meaningful. In the case of welfare reform, the ideal, of course, is a proposal that breaks the back of dependency, a proposal that reverses the perverse incentives in the current program, and empowers men, women and families to find security through work. The ideal program returns authority to state and local governments--allowing them to unleash their creativity, to be innovative, effective and, of course, compassionate. This is where the people live; it is where their needs are best met; it is where they are seen as individuals rather than as statistics. Likewise, Mr. President, the ideal welfare reform program contains real and necessary reforms to Medicaid. In the past, President Clinton has expressed why Medicaid reform is necessary for real welfare reform. The Nation's Governors, liberal and conservative, have been eloquent and persuasive as to why: Medicaid is quickly overtaking education to be the number one expense in State budgets. Medicaid as it is currently administered leads families to impoverishment, as they find it necessary to qualify in an ``all-or-nothing'' way. Federal Medicaid spending will be over $827 billion in the next 5 years, Mr. President, challenging our Treasury, our taxpayer resources, as well as America's economic well-being. The ideal would be to have Medicaid reform attached to welfare reform. I have made no secret of this. In trying to keep Medicaid a part of this proposal, we have compromised time and again to give the President a bill he could sign. In fact, the President himself proposed to cut Medicaid by $59 billion. In our proposal to reform Medicaid, we came within 2 percent of this number--2 percent--the difference of about two dimes a day per beneficiary. And in our compromise we continued to increase spending in the Medicaid Program--increase it faster than Social Security. But, unfortunately, despite all this, President Clinton maintains that Medicaid reform is a ``poison pill.'' Many of the President's allies in Congress support him. In their arguments, they suggested that they could support welfare reform, and the President would sign welfare reform, if the two were decoupled. We have separated, or are in the process of separating Medicaid reform from this legislation. Welfare reform is so important to the American people that they are willing to accept compromise. Like Tolstoy, they understand that ``life and the ideal are hard to reconcile.'' While it may take a life's work to achieve the ideal, it will certainly take the best efforts of this Senate to eventually return to Medicaid reform when the time comes. We cannot leave undone something so important and declare complete victory. Medicaid, in my opinion, must be addressed, if not now, later. Anyone who looks at the spending trends, anyone who looks at how this one program is threatening the States, anyone who sees how it leads families to choices, behaviors that are counterproductive to their well-being and long-term success can understand that Medicaid must be changed. It must be improved. It must be administered in a way that allows States to be more flexible, more creative, and more effective in helping families. For the time, we must move forward. This is what the American people want. We must pass this welfare reform legislation, a bill that takes a very important first step toward meeting the needs of those most vulnerable among us, a bill that returns common sense to the welfare system, a bill that gives greater flexibility to the Federal and State governments to help people help themselves. The time is right for this legislation. At another time, we will revisit Medicaid, but for the moment we must move on. Mr. President, it is no secret that I firmly believe that it is vitally important that both welfare and Medicaid reform should go together. I believe there are compelling reasons for Medicaid reform. The Governors, Democratic and Republican alike, have been strong advocates of including Medicaid with welfare reform. President Clinton himself for more than 3 years has talking about Medicaid's role in removing the incentives to families to stay in poverty. More than 3 years ago, President Clinton told the Nation's Governors that, ``* * * many people stay on welfare not because of the checks * * * they do it solely because they do not want to put their children at risk of losing health care or because they do not have the money to pay for child care * * *. This is precisely the purpose of the legislation we introduced in May, S. 1795. That is why we have worked for months with the Nation's Governors to keep welfare and Medicaid reform together. Let me spell out some of the reasons why they belong together. It is important for the American people to understand that the difference between our proposal and the President's plan for Medicaid is not about spending money. There is now little difference between this plan and the President's own plan in terms of Federal spending levels on Medicaid. Secretary Shalala appeared before the Finance Committee last month and knowledged the President proposed to cut Medicaid by $59 billion. Under our plan, the Federal commitment to Medicaid remains intact. Even while slowing the rate of growth Medicaid spending would still rise faster than Social Security under our plan. The Federal Government will spend an estimated $827.1 billion between 1996 and 2002 on Medicaid, an average annual increase of approximately 6 percent. We have met the President half-way in terms of Medicaid savings. The difference between us is less than 2 percent of the total Federal cost of Medicaid. That is difference of about two dimes a day per beneficiary. The American people should fully understand that the critical difference between President Clinton and this legislation is not about the level of spending. The difference between us is who controls the spending. The fundamental issue is whether or not the Governors and State legislators and judges can do a better job in running the $2.4 trillion welfare system than the bureaucracy in Washington. The essence of the administration's opposition to Medicaid reform is that the States cannot be trusted. The Clinton plan is built on the premise that Washington must control the decisionmaking. It is unfortunate that the potential achievements which would have been brought from including Medicaid in welfare reform are not better known. Too many people listened to unfounded accusations that the Governors and State legislatures cannot wait to abandon the children in their State. That is pure nonsense. If a family stays on welfare, that family will get both a welfare check and Medicaid. Under this reform proposal, the States have greater incentives to expand Medicaid coverage and help prevent families from being forced onto the welfare rolls in the first place. Reform is a critical component of getting those now on welfare off of cash assistance. The Governors also understand that under current law, Medicaid is an all or nothing proposition. The current system contains built-in incentives for families to impoverish themselves in order to qualify for Medicaid. The Governors also understand that under today's all or nothing scheme, a lot of low-income working families get nothing. As if to add insult to injury, many low-income families are paying for the benefits a welfare family is getting while their own children go without coverage. Medicaid is an important program for our elderly citizens in terms of long-term care coverage. But the current system is far from perfect in serving our senior citizens. The current system forces elderly citizens into poverty even before any benefits can be provided. Our senior citizens often do not receive the most appropriate services because the current system, run under rules dictated by the Federal Government, is not flexible enough. What is good for the bureaucracy is not necessarily good for the individual. Our legislation would have given the States greater flexibility to redesign benefits so that our senior citizens could be better saved. But instead of reform, the Clinton administration chose to scare the elderly and hide behind children. The very idea that the current system must remain in place in order to protect our vulnerable citizens from their Governors and State legislators is not only insulting. It is wrong. More than half of the money being spent on Medicaid is there solely because the States have chosen to provide optional benefits and extend optional coverage to a greater number of people. The administration scared people with a convoluted argument that our legislation ``lacks a Federal guarantee'' as if only the Federal Government is entirely responsible for anything good in the Medicaid program. This argument is completely hollow. As Secretary Shalala acknowledged to the Finance Committee earlier this month, the States could take nearly $70 billion today, more than half the spending in the program, out of the current Medicaid system without needing her approval. We did not create the linkage between welfare and Medicaid. That was done more than 30 years ago when Medicaid was created. Our legislation guarantees coverage and benefits for poor children, children in foster care, pregnant women, senior citizens, persons with disabilities, and families on welfare. If anything, our legislation goes beyond the Governors' resolution in terms of setting guarantees. In committee, we extended those Medicaid guarantees even further to phase in coverage of children ages 13 to 18. We also extended coverage to families leaving welfare. The modification also requires States to provide health coverage under the Medicaid Program for 1 year to families leaving welfare to go into the work force. This goal of Medicaid reform also goes directly to issue of a balanced budget, another major issue of concern to the American people. Simply put, the Federal budget cannot be balanced without Medicaid reform. It is the third largest domestic program in the Federal budget. It costs more than AFDC, food stamps, and SSI combined. Medicaid reform is also critical to balancing State budgets and priorities. One out of every $5 spent by the States goes to Medicaid. The National Association of State Budget Officers reports that Medicaid surpassed higher education as the second largest program in 1990. If nothing changes, Medicaid spending may soon overtake elementary and secondary education spending as well. To those taxpayers who are wondering why there is not more money for schools, to repair roads, and build bridges, a large part of the answer is the uncontrolled spending of Medicaid. Our Medicaid legislation would have returned power and flexibility to the States, while retaining guarantee of a safety net for the most vulnerable populations. It would have helped replace a failed welfare system in which dependence is measured in generations and illegitimacy is the norm, with a system that encourages work and helps keep families together. But in the past few weeks, it has become clear that the President cannot stand the heat of a compromise on Medicaid. For the record, let me point out that President Clinton vetoed a welfare reform last January, H.R. 4, which did not include Medicaid. In doing so, he also vetoed a bill which provided more support, including child care, for welfare families than his own legislation does. H.R. 4 did not include Medicaid. But it did include the sweeping child support enforcement reform for which millions of American families are waiting. This legislation, again included in S. 1795, goes light years beyond anything the President could ever accomplish solely through administrative actions. In the meantime, thousands of children have remained in poverty or under the threat of poverty for at least another 6 months because they have not received the cash assistance and medical insurance of their absent parent as a result of President Clinton's vetoes. My Democratic colleagues on the Finance Committee vowed that unless we agreed to drop Medicaid, welfare reform would be lost. To his great credit, the Republican nominee for President, our former colleague and majority leader, Bob Dole, also encouraged us to not allow this dissent to keep us from achieving welfare reform. Senator Dole understands that the children and families in poverty should not be forced to wait any longer for welfare reform. In that spirit, we have again agreed to compromise. I support the leader's motion to strike Medicaid. Having now removed this stumbling block, it is my hope that the administration will not erect new barriers to welfare reform at the 11th hour. The children and families who need this legislation should not have to wait any longer.

Mr. ROTH. If the distinguished Senator will yield, I would just point out that that vote reflects the ideal.