William Roth

Mr. ROTH

Mr. ROTH. I thank the Senator from Illinois. asbestos victims

Mr. ROTH. We should note for the record that during the drafting of this legislation, a few words were inadvertently left out, with the unintended consequence of the language being not as clear as we would like for Customs' interpretation. It was our intent with this legislation that re-liquidation should occur within 90 days of enactment. This was the intent of the Congress when it reviewed and passed this section.

Mr. ROTH. The senior Senator from Illinois is correct and I thank him for his kind words. He is correct with regard to the purpose and intended effect of this section. My understanding is that the antidumping duty order covering these entries has recently been revoked. I also understand that the domestic industry association that was the complainant in the dumping proceedings is aware of this legislation and does not object.

Mr. ROTH

Mr. ROTH. I investigated this issue with the Health Care Financing Administration, HCFA, to ensure that they are not proceeding in a way that disadvantages these facilities and protects access to important cancer services. It is my understanding that the Medicare fiscal intermediaries are keeping the interim payments to these facilities artificially low in order to avoid the risk of overpayments. While I think it is appropriate to make interim payments to facilities as accurately as possible, paying these facilities as low as 80-85 percent of what HCFA estimates final costs to be seems too low. If in fact these reductions are lower than previous rates of reduction when a system transition has been implemented, then I strongly urge HCFA to immediately review their proposal to make upward adjustments in the payment rates. Also, I urge the Administration to give special attention to the expeditious handling of the initial cost reports from cancer hospitals as they are submitted over the next few months in order to determine what appropriate payment levels need to be.

Mr. ROTH. Senator, I share the Senator's concern. Last year, the Congress was concerned about how cancer hospitals would fare under the new Medicare outpatient prospective payment system. Cancer hospitals face many unique costs and the advent of exciting new treatments caused many to question the wisdom of applying the new outpatient prospective payment system to these facilities. To this end, the Finance Committee proposed and the Congress enacted provisions to protect these important facilities. In brief, this provision created a permanent ``hold harmless'' for cancer hospitals. We instructed the Medicare program to pay cancer centers the same proportion of the facility's cost covered in 1996. In addition, we instructed the Secretary of the Department of Health and Human Services to make interim payments to these facilities consistent with this hold harmless.

Mr. ROTH. I, too, support restating within the Congressional Record our intent with regard to last year's Medicare bill.

Mr. ROTH

Mr. ROTH. Mr. President, I would like to address the comprehensive tax and Medicare conference report that is pending before the Senate. We have worked long and hard on this package, but the result is certainly worth the effort. If our objective is to provide legislation that promotes an environment conducive to jobs, opportunity and growth--security for our families and retirees--and greater access to quality health care, then this is a package worthy of praise. The numerous provisions in this legislation are too many to address in a single floor statement, and they certainly cover a lot of important initiatives. But they have a central theme: strengthening individuals and famiies--increasing prosperity, building security in retirement, promoting access to health care, improving quality of life, and assisting small businesses and farmers. This legislation offers over 50 provisions to strengthen IRAs and pension plans. With broad bipartisan support, it increases IRA contributions from $2,000 to $5,000, and allows a $1,500 IRA catch-up contribution for those age 50 and above. The increase in the amount an individual is allowed to put away will enable IRA participants to earn a full $1 million more for retirement, if they save the maximum amount each year and begin their program at age 25. This is tremendous empowerment, Mr. President, but it is only the beginning of what this legislation will do. It also allows individuals to increase contribution limits in 401(k), 403(b), and 457 plans from $10,500 to $15,000 a year. And it allows employees over the age of 50 to make additional $5,000 contributions to these plans. This is especially important for women, many of whom take time off from work to raise children. Now, when they return, they can make critical catch-up payments to strengthen their retirement savings. And for those individuals who change jobs, this legislation provides easier transfers to be made between IRAs and employer plans, and it reduces the complexity of plan administration. One of the most innovative new tools provided in this legislation is the creation of the Roth 401(k). Like the Roth IRA, the Roth 401(k) will allow employees to make after-tax contributions to accounts where distributions will be tax free at retirement. This allows investment income to grow faster, as it is taxed only once--when it is earned. Interest build-up and withdrawal--like the Roth IRA--remain free from taxation. To increase access to quality health care, this legislation includes major refinements to the Balanced Budget Act of 1997. These are in addition to $27 billion worth of refinements enacted last year, as part of the Balanced Budget Refinement Act of 1999. This legislation offers improved benefits for Medicare seniors, expanding preventative benefits, lowering out-of-pocket outpatient costs, and covering several new exams, screening and therapies. Going even further, this legislation provides improved access to Medigap coverage and protects access to important drugs. It lowers out- of-pocket hospital costs, strengthens rural, teaching, and critical access hospitals, and protects funding for home health services. It also increases access to care for nursing home patients. In the area of health care, alone, this legislation provides more than $30 billion in additional funding over the next five years. Retired Americans will also be happy to note that this legislation fixes a math mistake made in computing the Social Security cost-of- living adjustment for last year. The increase should have been 2.5% instead of the 2.4% that was actually awarded. The correction we've included in this bill means seniors will be receiving more than $5 billion in additional payments over the next ten years. For children, we take an important step to strengthen the State Children's Health Insurance Program by establishing policies for the retention and redistribution of unspent SCHIP funds. We also include measures to begin to protect the financial integrity of the Medicaid program. For individuals and families, we provide an above-the-line deduction for payment of medical insurance premiums for those who do not participate in an employer-sponsored medical plan. We also provide an above-the-line deduction for long-term care insurance, and we allow individuals who incur long-term care expenses providing for relatives an extra tax deduction. To help our family farmers and small businesses, this legislation offers a 100% deduction for payment of medical insurance for self- employed individuals. It creates FFARM accounts--tax-deferred savings accounts for farmers and fishermen, allowing a deduction of up to 20% of the income deposited into a custodial account. Going even further to provide tax relief for small businesses, this legislation extends the Work Opportunity Tax Credit. It allows small businesses to use cash accounting methods without limitation, and clarifies and extends a number of expansion provisions and business deductions, including the business meal deduction. And these are only a few of many other provisions to support America's small businesses, the engine behind the historic economic expansion our nation enjoys. Again, increasing opportunity and improving the quality of life is what this legislation is all about. For this reason, we have also included an important provision to help AMTRAK build important infrastructure, to improve services, and help answer critical transportation needs throughout the country. There are some areas, Mr. President, where congestion from auto and air traffic are running at maximum levels. The answer is a modernized and efficient rail service--one that includes high-speed trains, not only to move passengers along the Eastern corridor, but all across America. As a New York Times editorial correctly observed: ``Eighteen of the 20 most congested airports nationwide are in cities on designated high- speed rail corridors. The time has come for Congress and transportation officials to promote high-speed rail service as a means alleviating air traffic congestion.'' Strengthening AMTRAK will not only help ease car and air congestion, but it will also help revitalize inner cities, encouraging downtown redevelopment. It will also promote jobs in construction, engineering, manufacturing, and service industries. Finally, Mr. President, to strengthen our urban areas and promote greater opportunity for individuals and families in our cities, this legislation creates 40 new ``renewal communities'' and gives those poor areas a number of tax incentives to assist them in building up their economic base. Among other things, these communities--located in urban and rural areas--would get a zero percent capital gains rate to attract much needed investments. This bill also provides incentives to invest in low income areas around the country and to clean up brownfields anywhere in the U.S. This community renewal package also contains long awaited increases in the low income housing tax credit and the private activity bond volume cap. Both of these caps have not been adjusted since 1986 and have lost over 40 percent of their original value. This package also contains a number of measures to help school renovation and construction. Each of the provisions in this legislation will go far toward promoting an environment of opportunity and growth--security for our families and retirees--greater access to quality health care, and an improved quality of life. Mr. President, as we consider this conference report on legislation to provide tax relief and to protect and strengthen Medicare and Medicaid, there is a lot of talk about the irregular process by which the legislation was created. No one is more unhappy than I that regular order was not adhered to. I have long labored in trying to reach a bipartisan consensus on the many important matters that comes before the Finance Committee. However, I do not believe it useful for me to dwell on the causes of irregular order. Suffice it to say that cooperation must come from both sides. When it doesn't, when Senators instead invoke their rights at every turn, bipartisanship suffers. As to the President's veto threat, it should be remembered that our early Presidents believed that the veto was available only to check the Congress from going beyond its constitutional authority. Later Presidents judged legislation on the whole of its merits: does the bill do more harm than good? I find it hard to find in his letter any mention of the harm he sees in this legislation. Rather, he says that this legislation is different from what he proposed, and therefore, he has ``no choice but to veto it.'' I find this assertion somewhat remarkable. The Congress and the Presidency are comprised of 536 individuals. In fashioning legislation as far-reaching as this, no one can expect perfection from his own point of view. When I read the President's list of disappointments, I did not find it any longer than mine. And my reaction is generally shared by my colleagues. We are all pleased by some items. We are all disappointed by some other items, or by their omission. That is because, Mr. President, this legislation is bipartisan in its content. Republican Members may be displeased that we included school construction bonds or dropped the FUTA tax reduction. Democrats may be displeased that we included a tax break for employees to buy their own health insurance or that we dropped the low-income savers tax credit. But where there are over a hundred provisions, it is not possible to write a bill the way each of us might wish. It was clearly our intention to put together a package that would be signed into law. It was my desire that Senator Moynihan be present during House-Senate negotiations, but the House majority objected. So, instead, I kept Senator Moynihan informed, sought his counsel, and advocated his cause. I think he did fairly well. He was successful in garnering increased funding for graduate medical education, increased funding for hospitals, increased DSH payments in both Medicare and Medicaid, and-- this is very important--a special transition rule for New York with respect to the Medicaid upper payment level issue. On the tax side, he successfully obtained the AMTRAK provision to build a train station in New York City. And, as I recall, he was also an advocate of section 809 and 815 insurance provisions that have been included in the conference report. Senator Moynihan also asked, as did others, for the inclusion of long-term health care provisions and inclusion of a school-construction bond proposal. These were incorporated in a modified form. Perhaps not a total victory, but a substantial one nevertheless. This progress was not accomplished easily. The chairman of the Ways and Means Committee has been steadfastly opposed to the creation and expansion of tax credits. Thus he fought the inclusion of several tax credit proposals, including those for AMTRAK and for school construction. He was able to block several of them but not these two supported by the Senator from New York. And because these provisions were included, the chairman of the Ways and Means opposes this conference report. Some Members have taken to the floor to try to create a picture that a few of us got in a room and wrote a bill entirely our way. But the fact is that some in the room lost and some outside the room won. And that is because, as a group, we had a paramount objective of constructing a balanced bill that would be signed into law. I recall my own effort to remove the application of the nondiscrimination clause from the catch-up provision of the retirement security title. Everyone in the room agreed with my position. But the bill is not written that way. My amendment was dropped out of deference to the wishes of a Democrat, Congressman Ben Cardin, who had worked on this legislation in the House. We tried to write a balanced bill that would be signed into law. In each of the past four weeks, there was some reason to believe that Congress was about to finish its work for the year. So in drafting this bill, we had to act quickly. I have given a great deal of thought to the process employed. I do not believe that if we had had bipartisan meetings with votes on the particular items, the text of the bill would be any different. What was lost in the process followed was any bipartisan appreciation of why the text is what it is. That is unfortunate. At this stage, all I can ask is that you look at the text and decide if this is a good bill. You owe it to your constituents to do that. Do you want to provide Social Security recipients with the increased COLA they deserve? Do you want to protect American businesses from European Union retaliation against our exports? Do you want to update our tax laws to provide for greater retirement security? Do you want to provide tax incentives for impoverished communities? Do you want to provide more money for hospitals, hospices, home health, and nursing homes? Do you want to increase the minimum wage? Or do you want to deny all the benefits of this legislation to your constituents because of the procedure by which the text was born? This bill does not contain everything I'd like to see. It's not perfect. But it's a good bill, one that will help a great many Americans. It will help individuals and families prepare for greater security in retirement. It will help seniors receive improved Medicare coverage and a higher cost-of-living adjustment in their Social Security checks. It will help small businesses and family farmers. It will improve education and ease traffic congestion. It will improve inner cities and help our hospitals. These are good objectives. They are objectives shared on both sides of the aisle. And I encourage my colleagues to join me in voting for this legislation.

Mr. ROTH. Mr. President, this bill passed by the Senate satisfies the United States' WTO obligations and ensures that U.S. companies will compete on a level playing field in the global marketplace. By enacting this legislation, we will avoid a needless trade dispute, protect the American economy, and satisfy our international obligations to our trading partners. This bill also represents a continuation of this Senate's outstanding record of accomplishment in promoting free trade. This legislation is the third significant piece of trade legislation passed by the Senate this year. I believe you would have to search long and hard to find a better record of trade legislation. I don't believe it is necessary to go through the extended history of the dispute between the United States and the European Union that gave rise to the need for the bill before us. The bill represents a good faith attempt to comply with the WTO's ruling that the current FSC provisions constitute an illegal export subsidy. This bill withdraws the current FSC provisions and, in their place, makes fundamental adjustments to the Internal Revenue Code that incorporate territorial features akin to those of several European tax systems. The bill not only addresses the specific concerns raised by the WTO, it also takes into account the comments received from the EU in the course of consultations over the last eight months. I want to stress the need to pass this bill. Failure to do so could result in the imposition of retaliatory duties against American exports to the European Union. Under the WTO rules, the EU will have the right to retaliate against U.S. exports as of today unless this legislation is passed. A failure to enact this legislation would prove costly for the American worker, the American farmer, and for American business. So it is with a great sense of satisfaction that we pass this bill today. I compliment the Senate on its farsighted vote for passage of this legislation.

Mr. ROTH

Mr. ROTH. You are correct. Station projects such as those you described on the Charlotte-Greensboro-Raleigh line are important examples of critical investments envisioned in this legislation.

Mr. ROTH. I thank the Senator from North Carolina (Mr. Helms) for his support for these provisions. Intercity passenger rail service is a key element of our Nation's multi-model transportation system.

Mr. ROTH

Mr. ROTH. Mr. President, I applaud the passage of H.R. 4868. This bill includes a critically important provision that I first introduced on June 9, 1999, that bans the importation of products made with dog or cat fur. An estimated 2,000,000 dogs and cats are slaughtered and sold annually as part of the international fur trade. We want this trade in dog and cats pelts to stop at our borders, and hopefully save millions of animals from this cruel practice. I have worked very hard to see this bill come to fruition, and I urge the President to sign it into law. We are also helping companies across the United States to reduce their costs on vital inputs used in manufacturing a wide variety of products. Among these are provisions that help reduce the costs of potentially life-saving medicines used to treat HIV and AIDS. I am particularly proud that this bill will have an immediate and positive impact on my home state of Delaware. There are provisions in this bill that reduce duties on imports used by Delaware companies to manufacture final products. There are also restrictions on cigarette imports included in this legislation that will help ensure that cigarettes entering our market will fully comply with all health and labeling requirements. It will also ensure that Delaware receives its full share of payments under the tobacco settlement agreement, which will likely mean millions of additional dollars to my State and others.

Mr. ROTH

Mr. ROTH. Mr. President, I rise today to express my grave concerns regarding a provision relating to our trade remedy laws that is a part of the agriculture appropriations conference report that is before us today. My concerns regarding this measure relate both to the way this provision found its way into this conference report, as well as to its substance. With regard to procedure, I am troubled, to say the least, that a significant modification of our trade laws is being made with no consideration or deliberation by the committees of jurisdiction. I would have hoped that the Agriculture Subcommittee of the Appropriations Committee would have considered the importance of allowing the committee of jurisdiction--the Committee on Finance--to review this provision before deciding to adopt this measure in conference. After all, this amendment represents a dramatic change in the function and purpose of our trade laws. Currently, our trade laws are designed to address any dumping or subsidized sales into our market by imposing an offsetting duty on imports. With the enactment of this procedure, however, not only will the domestic producer enjoy the benefit of having a surcharge applied to the sales of its foreign competitor, but they will also get a significant cash payment courtesy of the U.S. treasury. This is not an insignificant amount. According to the U.S. Customs Service, over $200 million of dumping and countervailing duties were assessed on imports last year. What this will likely do is to encourage the filing of cases in circumstances that would not otherwise merit it. After all, the cash payment will not be made to the whole domestic industry. Instead, only those who supported the filing of the antidumping petition will be paid. Differentiating between different parts of a domestic industry in this way is unprecedented in our trade policy and completely unwarranted. Now I understand that the money under this proposal is supposed to be funneled to research and development, and other legitimate purposes. But money is fungible, and I fear that we will only be encouraging litigiousness. Who will benefit from this proposal? It is certainly not our consumers, who will pay significantly higher prices as a result, and who will likely have to suffer from an even greater number of cases being filed. Our farmers and our other export industries will not benefit. After all, what will now happen with the enactment of this measure is that we will likely be obliged to pay in some future negotiation, such as market access on agriculture, to preserve what will undoubtedly be described as a private right of action to garner industry-specific government subsidies. Ironically, the industries that traditionally rely on the dumping and countervailing duty laws will also likely get little benefit from this proposal. While I understand the frustration of some of those who have suffered from foreign dumping and subsidization, this measure, ironically, will do nothing to eliminate unfair trade practices or to ameliorate the conditions that allow these unfair trade practices to persist. We will only have undercut our own efforts to impose greater disciplines on European agricultural subsidies, Japanese support for its steel industry, or Korean support for their automobile industry. This is manifestly bad trade policy wholly apart from the serious technical deficiencies of the proposal. And what will we say once our trading partners decide to follow our lead and adopt this same scheme in their trade remedy laws? Will we complain? Or will we sit quietly as our farmers and manufacturers begin to face yet another hurdle in their efforts to sell in foreign markets. Mr. President, this is an ill-considered proposal that not only damages our broader trade policy interests, but it also up-ends the committee structure. I am a strong supporter of our trade remedy laws, but this proposal distorts our laws in a way that serves no constructive purpose. This is unfortunate and unnecessary, and I regret that the Agriculture Subcommittee chose to take this action.

Mr. ROTH

Mr. ROTH. Mr. President, over the past several months, the Finance Committee has been focusing its oversight attention on an urgent problem in the Medicaid program related to the use of upper payment limits to exploit federal Medicaid spending. The Health Care Financing Administration, HCFA, had assured me that it would solve the problem. It has not. Instead, last week HCFA released a notice of proposed rulemaking that sanctions the de facto abuse of this vitally important program--a program that provides health care coverage to 40 million low-income pregnant women, children, individuals with disabilities, and senior citizens. This Administration has failed to live up to its responsibility to protect the financial integrity of the Medicaid program. Accordingly, I am introducing legislation today to do the right thing and stop the draining of potentially tens of billions of dollars from this program for our most vulnerable citizens. The problem confronting the program is a complicated one. Through the inappropriate use of aggregated upper payment limits, some states have been using the Medicaid program inappropriately, including for purposes such as filling in holes in state budgets. This has turned a program intended to provide health insurance coverage to vulnerable populations into a bank account for state projects having nothing to do with health care. In fact, as I examine the current situation I am vividly reminded of the Medicaid spending scandals we confronted 10 years ago when disproportionate share hospital program dollars were used to build roads, bridges and highways. Let me be very clear--this cannot be permitted to continue without endangering the program. The use of this complicated accounting mechanism may seem dry and technical--but let me assure you that the consequences are enormous. If unchecked, both the General Accounting Office and the Office of Inspector General at the Department of Health and Human Services agree that we face a situation that fundamentally undermines the fiscal integrity of the Medicaid program and circumvents the traditional partnership of financial responsibility shared between the federal and state governments. I have been advised that what states are doing through upper payment limits is technically not illegal. The states are taking advantage of a loophole in HCFA regulations. It is time to close that loophole fully. We must act because nearly 40 million of the neediest Americans rely on Medicaid for needed health care services. It is nothing short of a safety net. The program must not be undermined and weakened by clever consultants and state budgeters. What looks like loopholes to some are holes in Medicaid safety net for 40 million Americans. Several months ago, I began working with the Administration to respond to this scandal. We must stop it in its tracks--while of course at the same time working thoughtfully and carefully with those states that have become dependent on the revenues generated through the use of upper payment limits to help them transition to a more sustainable payment relationship between the state and federal government. Finally, last week, after repeated delays, this Administration released its notice of proposed rulemaking--in a form much weaker than it originally intended when I first started working with HCFA on this problem last spring. The proposed regulation is inadequate. Instead of stopping a burgeoning Medicaid spending scandal, the proposed regulation looks the other way and tolerates the abuse of the program. The proposed regulation permits facilities to be reimbursed for providing services at a rate one and a half times that Medicare would have paid for a given service. Then states are free to pocket the difference between the payment level and the often much lower Medicaid payment rates through intergovernmental transfers. Not only does the regulation allow those who are exploiting the program to continue to do so, it also invites all others to come in and help themselves. The regulation permits the scam to continue while only modestly attempting to contain its magnitude. Simply containing wasteful spending is not sufficient. The American taxpayer who pays the bills should not stand for it, nor should the beneficiaries who depend on the program. In fact, the Center on Budget and Policy Priorities, whose advocacy on social policy issues is well- known, agrees that the scam must be shut down or the long-term health of the program will be jeopardized. Not only does the proposed regulation fail to protect the financial integrity of the Medicaid program, it also has a very low probability of ever being implemented. There is virtually no chance this Administration will be able to finalize the proposed regulation before it leaves office in January. Until the regulation is finalized, nothing changes. No abuser state has to modify its behavior one bit, and more and more states will be under pressure to take advantage of the windfall their neighbor states are enjoying. If anything, the White House action may spur greater abuse in the Medicaid program. The Congressional Budget Office estimates that truly solving the problem will save taxpayers $127 billion over the next decade. the stakes are high and we owe it to the 40 million Medicaid beneficiaries to protect the program so it remains strong and viable for the years to come. Accordingly, today I am introducing legislation that does what HCFA should have done but failed to do. My bill does not sanction abuse--it stops it. It closes the loophole, and treats non-state governmental facilities the same way state facilities are already treated. For those states with upper payment limits approved by HCFA already in place, it gives them two years to fully transition into compliance with the law. But no longer will schemes to exploit federal funding be tolerated. Even if HCFA is willing to look the other way, I am not. We must think about the long-term interests of the program and act now to stop the abuse. We should save the safety net for those that depend on it and save $127 billion over the next decade for he American taxpayer at the same time.

Mr. ROTH

Mr. ROTH. Mr. President, I am very pleased today to join Senator Moynihan and my other colleagues on the Senate Finance Committee in introducing the Medicare, Medicaid and SCHIP Improvements Act of 2000. This is important, bipartisan legislation intended to address needed health care funding and other improvements in these programs that are so important to millions of Americans. Every year on the Finance Committee we maintain watchful oversight of these critical programs to make sure that beneficiary access to services is maintained, and that payments and benefits are adjusted to meet beneficiaries' needs. This bill would add about $28 billion in funds to these programs over the next five years. Following are some of the highlights of this legislation. (1) Medicare beneficiary assistance provisions would reduce coinsurance liability for hospital outpatient services; improve access to Medigap coverage; permit Medicare+Choice plans to give beneficiaries cash rebates of Part B premiums; protect access to immunosuppressive, cancer, hemophilia and other drugs, and extend Part B premium assistance for lower-income beneficiaries. (2) Preventive health benefits would expand existing or add new coverage for pap smears, colorectal cancer screening, and nutrition therapy, and request further work on effective preventive benefits for later consideration in Medicare. (3) Rural health care improvements address service capacity and access to services through increased payments for critical access, sole-community and Medicare-dependent hospitals. The package also includes provisions for rural health clinics, ambulance services, and telemedicine. Rural hospitals, skilled nursing facilities and home health agencies also benefit from general financing improvements detailed in other sections. (4) Medicare+Choice provisions stabilize and improve funding for beneficiaries electing to enroll in privately-offered Medicare+Choice plans, with special attention to rural communities; restore funding for beneficiary education campaigns; and provide additional assistance for frail, disabled and rural beneficiaries. (5) Hospital funding improvements increase annual payment updates; improve disproportionate share hospital (DSH) payments under Medicare and Medicaid for providing uncompensated care to uninsured patients; reform Medicare's DSH program to reduce disparities in the treatment of rural and urban hospitals; add funding for rehabilition hospitals; and protect payments for teaching hospitals. (6) Skilled nursing facility (SNF) provisions improve funding, maintain access to therapy services, and reduce regulatory burdens by delaying implementation of consolidated billing. (7) Home health and hospice provisions protect funding for home health services by delaying a scheduled 15% cut in payments; increasing funding for high-cost outlier cases, and making special temporary payments to rural agencies. Hospice provisions improve funding, require research on issues related to eligibility for the benefit and establish a hospice demonstration program. (8) Dialysis and durable medical equipment (DME) provisions improve payments for DME for all Medicare beneficiaries, and for services received by individuals with end-stage renal disease, as well as enhancing their opportunities to participate in the Medicare+Choice program. (9) Additional provisions address physician, laboratory, ambulatory surgery center and other medical services. The package also creates a Joint Committee on Health Care Financing to provide professional support to the Congress in addressing the burgeoning cost and legislative complexity of the Medicare, Medicaid and State Children's Health Insurance programs and monitoring the viability of safety net providers. (10) Medicaid and SCHIP provisions improve the financing of and access to services provided by federally qualified health centers and rural health clinics; establish policies for the retention and redistribution of unspent SCHIP funds; increase authorization for the Maternal and Child Health Block Grant; and add funding for special diabetes programs for children and Native Americans. I would like to accomplish even more this year, especially in the Medicare program. For instance, I remain committed to securing comprehensive drug benefits for the aged and disabled beneficiaries in Medicare. I will continue to work towards that goal. However, I am pleased that we were able to achieve bipartisan support for these improvements and I will continue my efforts to build the bipartisan consensus needed to proceed on larger Medicare reforms in the near future.

Mr. ROTH

Mr. ROTH. Mr. President, I am very pleased today to join Senator Moynihan and my other colleagues on the Senate Finance Committee in introducing the Medicare, Medicaid and SCHIP Improvements Act of 2000. This is important, bipartisan legislation intended to address needed health care funding and other improvements in these programs that are so important to millions of Americans. Every year on the Finance Committee we maintain watchful oversight of these critical programs to make sure that beneficiary access to services is maintained, and that payments and benefits are adjusted to meet beneficiaries' needs. This bill would add about $28 billion in funds to these programs over the next five years. Following are some of the highlights of this legislation. (1) Medicare beneficiary assistance provisions would reduce coinsurance liability for hospital outpatient services; improve access to Medigap coverage; permit Medicare+Choice plans to give beneficiaries cash rebates of Part B premiums; protect access to immunosuppressive, cancer, hemophilia and other drugs, and extend Part B premium assistance for lower-income beneficiaries. (2) Preventive health benefits would expand existing or add new coverage for pap smears, colorectal cancer screening, and nutrition therapy, and request further work on effective preventive benefits for later consideration in Medicare. (3) Rural health care improvements address service capacity and access to services through increased payments for critical access, sole-community and Medicare-dependent hospitals. The package also includes provisions for rural health clinics, ambulance services, and telemedicine. Rural hospitals, skilled nursing facilities and home health agencies also benefit from general financing improvements detailed in other sections. (4) Medicare+Choice provisions stabilize and improve funding for beneficiaries electing to enroll in privately-offered Medicare+Choice plans, with special attention to rural communities; restore funding for beneficiary education campaigns; and provide additional assistance for frail, disabled and rural beneficiaries. (5) Hospital funding improvements increase annual payment updates; improve disproportionate share hospital (DSH) payments under Medicare and Medicaid for providing uncompensated care to uninsured patients; reform Medicare's DSH program to reduce disparities in the treatment of rural and urban hospitals; add funding for rehabilition hospitals; and protect payments for teaching hospitals. (6) Skilled nursing facility (SNF) provisions improve funding, maintain access to therapy services, and reduce regulatory burdens by delaying implementation of consolidated billing. (7) Home health and hospice provisions protect funding for home health services by delaying a scheduled 15% cut in payments; increasing funding for high-cost outlier cases, and making special temporary payments to rural agencies. Hospice provisions improve funding, require research on issues related to eligibility for the benefit and establish a hospice demonstration program. (8) Dialysis and durable medical equipment (DME) provisions improve payments for DME for all Medicare beneficiaries, and for services received by individuals with end-stage renal disease, as well as enhancing their opportunities to participate in the Medicare+Choice program. (9) Additional provisions address physician, laboratory, ambulatory surgery center and other medical services. The package also creates a Joint Committee on Health Care Financing to provide professional support to the Congress in addressing the burgeoning cost and legislative complexity of the Medicare, Medicaid and State Children's Health Insurance programs and monitoring the viability of safety net providers. (10) Medicaid and SCHIP provisions improve the financing of and access to services provided by federally qualified health centers and rural health clinics; establish policies for the retention and redistribution of unspent SCHIP funds; increase authorization for the Maternal and Child Health Block Grant; and add funding for special diabetes programs for children and Native Americans. I would like to accomplish even more this year, especially in the Medicare program. For instance, I remain committed to securing comprehensive drug benefits for the aged and disabled beneficiaries in Medicare. I will continue to work towards that goal. However, I am pleased that we were able to achieve bipartisan support for these improvements and I will continue my efforts to build the bipartisan consensus needed to proceed on larger Medicare reforms in the near future.

Mr. ROTH

Mr. ROTH. Mr. President, I am pleased that the Senate has passed legislation that will dramatically improve the lives of lower-income women faced with a terrifying diagnosis of breast or cervical cancer. Ten years ago, Congress created the National Breast and Cervical Cancer Early Detection Program, through the Centers for Disease Control, to help lower-income women receive the early detection services that are the best protection against breast and cervical cancer. This important program has served more than a million women in subsequent years. However, the screening program does not include a treatment component. Instead, women who receive a cancer diagnosis must rely on informal networks of donated care. Last year, Senator John Chafee introduced S. 662, the Breast and Cervical Cancer Treatment Act, to make it easier for women facing breast and cervical cancer to receive necessary treatment--and I think each and every one of us shares that important goal. S. 662 makes treatment available through the Medicaid program. Now, maybe some of us would have approached the problem differently. I think there are very valid concerns about creating disease-specific eligibility categories within the Medicaid program. However, despite those concerns, I am pleased that the Senate passed S. 662 because we are dealing with a thoroughly unique set of circumstances. The new Medicaid eligibility category created in S. 662 is specifically linked to a unique and existing federal screening program and must not, and will not, be viewed as a precedent for extending Medicaid eligibility body-part by body-part. Instead, today the Senate fulfills a promise made nearly 10 years ago. We are saying to lower-income, uninsured women that we will continue to help you access the preventive health care services you need. But now, through S. 662, our commitment to you will not stop with screening. If problems are found, the federal government stands ready to work with the states to make sure you receive the treatment you need to get well. I am grateful to my colleagues in the Senate for joining me in supporting this important legislation, and I look forward to working with my colleagues in the House to quickly reconcile the differences between our bills so we can see this necessary legislation signed into law this year.

Mr. ROTH

Mr. ROTH. Mr. President, along with Senator Moynihan and the other members of the committee I ask unanimous consent that S. 3152, the Community Renewal and New Markets Act of 2000 be printed in the Record. I also ask unanimous consent that a technical explanation of S. 3152, which has been prepared by the Joint Committee on Taxation, be printed in the Record, at a cost of $4,290.00, immediately following the text of the bill.

Mr. ROTH. Mr. President, today I am, along with 14 cosponsors from the Finance Committee, introducing a Community Renewal tax reduction bill that will help all America benefit from today's economic boom. As you know, the House bill embodies an agreement between the House and the Administration. Personally, I think that it would be wrong for the Senate to be silent in this process. It is important for this body to at least have a voice in crafting this legislation. While I would have preferred that this legislation to have been reported from the Finance Committee, I believe my bill represents the Committee's will. It is largely composed of the Chairman's mark and amendments submitted by the Committee's members. Every Member of the Finance Committee had input into this bill. In the regular course of Finance Committee business, we would have reported this bill out of the Committee with an overwhelming vote in support. And the fact that 15 members on both sides of the aisle have joined me as original cosponsors, I believe, attests to the Finance Committee's approval of this legislation. It goes without saying that America's communities are important. I believe that there are many ways in which we can extend help to them. I also feel that any time we can work together with the Administration to cut taxes we must try and see it to fruition. While I listened to the concerns of every senator--both on and off the Finance committee--who approached me with a provision in which they were interested, I did not incorporate them all. I did not because I could not without the cost of the bill growing out of control. It is important that we not forget communities that may not have received as much as others from America's economic boom. However, it is also important that we consider the size of this bill in the context of other tax relief priorities that remain. These other priorities are marriage tax relief, retirement security, education, estate tax relief, small business tax relief, and other items. Community renewal tax relief must fit within the overall framework of the tax relief agenda. This Finance Committee bill is fair and it is in line with the revenue loss of the package, proposed by Senators Santorum, Abraham, and Lieberman, which was considered earlier this year in the Senate. In designing this bill, members of the Finance Committee decided not to turn this bill into a grab bag of special interest provisions. This Finance Committee bill includes a variety of proposals that will further the bill's goals of community renewal--rationalizing and simplifying what was and, was proposed to be, a hodge-podge of often conflicting provisions. It includes an immediate--let me emphasize immediate--increase in the volume caps for low-income housing tax credits and private activity bonds. It also addresses many, many important problems left out of the House and Administration proposal. Among other things, this package contains an energy and conservation component, a farm relief component, an Individual Development Account proposal, an extension of the adoption credit and the enhanced deduction for computer donations, a program to develop high speed rail around the country, and a broadband Internet incentive that will make sure that no one gets left on the wrong side of the digital divide. One provision that I particularly want to talk about is the tax credit for renovating historic homes. This was one of Senator John Chafee's signature items and I am pleased to include it in the Finance Committee bill, not only because I support it, but as a tribute to our good friend. We all know that if he were here, he would have fought hard for this tax incentive. In fact, Senator Lincoln Chafee came to see me earlier this year. Lincoln told that in his dad's last speech, John talked about the importance of the tax credit and said that it was something he wanted to get done before he left the Senate. Unfortunately, he is not with us today, but hopefully we can complete this unfinished business for him. This is a fair package and a generous package. I believe it is one that this Senate should feel comfortable embracing. I hope each of you who has not done so, will do so.

Mr. ROTH

Mr. ROTH. Mr. President, along with Senator Moynihan and the other members of the committee I ask unanimous consent that S. 3152, the Community Renewal and New Markets Act of 2000 be printed in the Record. I also ask unanimous consent that a technical explanation of S. 3152, which has been prepared by the Joint Committee on Taxation, be printed in the Record, at a cost of $4,290.00, immediately following the text of the bill.

Mr. ROTH. Mr. President, today I am, along with 14 cosponsors from the Finance Committee, introducing a Community Renewal tax reduction bill that will help all America benefit from today's economic boom. As you know, the House bill embodies an agreement between the House and the Administration. Personally, I think that it would be wrong for the Senate to be silent in this process. It is important for this body to at least have a voice in crafting this legislation. While I would have preferred that this legislation to have been reported from the Finance Committee, I believe my bill represents the Committee's will. It is largely composed of the Chairman's mark and amendments submitted by the Committee's members. Every Member of the Finance Committee had input into this bill. In the regular course of Finance Committee business, we would have reported this bill out of the Committee with an overwhelming vote in support. And the fact that 15 members on both sides of the aisle have joined me as original cosponsors, I believe, attests to the Finance Committee's approval of this legislation. It goes without saying that America's communities are important. I believe that there are many ways in which we can extend help to them. I also feel that any time we can work together with the Administration to cut taxes we must try and see it to fruition. While I listened to the concerns of every senator--both on and off the Finance committee--who approached me with a provision in which they were interested, I did not incorporate them all. I did not because I could not without the cost of the bill growing out of control. It is important that we not forget communities that may not have received as much as others from America's economic boom. However, it is also important that we consider the size of this bill in the context of other tax relief priorities that remain. These other priorities are marriage tax relief, retirement security, education, estate tax relief, small business tax relief, and other items. Community renewal tax relief must fit within the overall framework of the tax relief agenda. This Finance Committee bill is fair and it is in line with the revenue loss of the package, proposed by Senators Santorum, Abraham, and Lieberman, which was considered earlier this year in the Senate. In designing this bill, members of the Finance Committee decided not to turn this bill into a grab bag of special interest provisions. This Finance Committee bill includes a variety of proposals that will further the bill's goals of community renewal--rationalizing and simplifying what was and, was proposed to be, a hodge-podge of often conflicting provisions. It includes an immediate--let me emphasize immediate--increase in the volume caps for low-income housing tax credits and private activity bonds. It also addresses many, many important problems left out of the House and Administration proposal. Among other things, this package contains an energy and conservation component, a farm relief component, an Individual Development Account proposal, an extension of the adoption credit and the enhanced deduction for computer donations, a program to develop high speed rail around the country, and a broadband Internet incentive that will make sure that no one gets left on the wrong side of the digital divide. One provision that I particularly want to talk about is the tax credit for renovating historic homes. This was one of Senator John Chafee's signature items and I am pleased to include it in the Finance Committee bill, not only because I support it, but as a tribute to our good friend. We all know that if he were here, he would have fought hard for this tax incentive. In fact, Senator Lincoln Chafee came to see me earlier this year. Lincoln told that in his dad's last speech, John talked about the importance of the tax credit and said that it was something he wanted to get done before he left the Senate. Unfortunately, he is not with us today, but hopefully we can complete this unfinished business for him. This is a fair package and a generous package. I believe it is one that this Senate should feel comfortable embracing. I hope each of you who has not done so, will do so.

Mr. ROTH

Mr. ROTH. Mr. President, I ask unanimous consent that the joint resolution be printed in the Record.

Mr. ROTH

Mr. ROTH. Mr. President, with passage of the legislative branch appropriations conference report, the Senate will successfully roll back one of the most regressive taxes in history and given Americans everywhere a much-deserved break. For some time, now, I have pushed to repeal the telephone excise tax, a tax that is placed on individuals and families, regardless of income or circumstances. Quite simply, if you owned a phone, you paid the tax, and along with its regressive nature, the tax was lamentable because it stood as one more example of how antiquated, unfair, counterproductive government policies not only outlive their original design, but become almost impossible to abolish. The telephone excise tax was first imposed in 1898, more than 102 years ago. Its purpose was to fund the Spanish-American War, to provide for those who, like Teddy Roosevelt and his Rough Riders, needed the wherewithal to defend U.S. interests. At the time it was imposed, it came as something of a luxury tax--a tax on the wealthy, as few Americans owned telephones. Roosevelt rode up San Juan Hill. The war came to an end. But Washington couldn't resist holding on to the revenue. From time to time, the tax was repealed, but it always seemed to get reinstated-- rising as high as 25 percent at one point--and placing an unfair burden on millions. Today, however, we shall successfully eliminate the telephone excise tax, and this--in my mind--is cause for celebration. Studies show that individuals and families with income less than $10,000 spend almost 10 percent of their income on telephone bills. Individuals and families earning $50,000 spend 2 percent of their income for telephone service. Because of what we have done here today, these families--and all families--will benefit. I'm proud of this action, grateful to those who supported repealing this excise tax. What we have done is not only in the interest of Americans everywhere, but it is a clear demonstration that we are willing and able to appropriately address the need to reduce the excessive tax burden that has been placed on the back of America's middle class. My sincere hope is that this is the beginning of a long and successful trend. On another issue, I am concerned that the legislative branch appropriations conference report--while it contains good news for taxpayers--while it contains good news for taxpayers--does not meet the full funding needs of the Internal Revenue Service. As you know, 2 years ago in a major bipartisan initiative, Congress successfully passed the largest IRS reform and restructuring effort in history. That law has been effective in protecting taxpayers and giving the IRS the direction necessary to re-engineer its business practices, upgrade its computer systems, and provide taxpayers with better service. But in order to most effectively carry out Congress' mandate, and to fulfill its mission to collect and protect the Federal revenue, the IRS needs adequate funding. This appropriations conference report, unfortunately, provides hundreds of millions of dollars less than what the agency needs. And the absence of proper funding will cut directly into the improved conditions that Congress desires. Unless additional funding is provided, the Service may be unable to effectively perform its audit and collection functions. Without adequate funding, service functions will diminish. There will be a loss of telephone and walk-in service for taxpayers, a decrease in the level of toll-free service, and it will become more difficult for taxpayers to receive assistance. We must provide additional funds to the IRS in other appropriate bills before this Congress adjourns. Only by doing this can we ensure that the IRS has the resources it needs to meet the standards of service and accountability that Congress has required. Along with eight members of the Senate Finance Committee, I have signed a letter to members of the Appropriations Committee asking that funding be restored. And I intend to work with my colleagues toward this end. Mr. President, I yield the floor, and I suggest the absence of a quorum.

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

Mr. ROTH

Mr. ROTH. I yield the floor.

Mr. ROTH. I yield to my distinguished Senator on that point. I stand corrected. But, again, I really want to thank my personal staff, and my trade staff, whether it is Frank Polk, who is always there when you need him, and Grant Aldonas, Faryar Shirzad, Tim Keeler, J.T. Young, and Carrie Clark from the Finance Committee. I also particularly want to thank John Duncan and Dan Bob from my personal office. Dan is really one of our great experts on Asia, and on international politics in general. I owe him so much for his help during these last 2 weeks. Thank you all for a job well done. Let me say it is an honor and pleasure to work with the ranking member.