Pete Stark

Mr. STARK

Mr. STARK. Mr. Speaker, one of the many problems with the Republicans' most recent budget proposal is the drastic effect it will have on environmental research and technology. According to the White House, ``it would cut environmental research and technology funding by nearly $1 billion or 20 percent from the President's request for fiscal year 1996.'' Additionally, the Republican cuts include a 92-percent reduction from the President's request for the Environmental Technology Initiative [ETI], which would thwart efforts to encourage the development of new technologies that reduce pollution and clean up the environment while creating new jobs and economic growth--a market that is expected to boom to $400 billion by 2000--if American industry does not make sufficient investments in this area today. The need for environmental technology and services is rapidly growing on a global scale. The Organization for Economic Cooperation and Development estimates the market will be worth $300 billion and that the demand for waste-management products and air-pollution control equipment will grow by over 50 percent in the next 5 years, with water- and effluent-treatment growing by a third by the end of the decade. The U.S. Export-Import Bank already estimates the environmental technology and services market's worldwide value at $400 billion. However, developers of environmental technology face a series of hurdles before they can truly tap into this market. First, the market is ill-defined and driven almost entirely by regulation and the level of enforcement in different national and regional markets. According to Financial Times (6/21/95), in the UK the greatest demands by companies in this expanding market are for ever more accurate data and analysis. Of the 116 companies questioned in the first survey of purchases of environmental technology earlier this year, 90 percent said the main driving-force behind the market was legislation. The second problem facing developers, which is mainly due to weak environmental legislation, is convincing financiers that the technology can generate sufficient returns for investors. According to the Financial Times (December 1, 1995), international competition is fierce, primarily between the three biggest exporters, the United States, Japan, and Germany. The U.S. Ex-Im Bank started a special program to help its industry find markets abroad. Julie Belaga, a director of the bank, says the main aim is to create United States jobs by financing exports where the private sector is unwilling to do so. Helmut Kohl, the German chancellor, commented in a recent edition of Environment Strategy Europe, a yearbook for legislators and business leaders, that Germany's very tough environmental legislation had enabled the country to take a leading position in the world market for environmental protection goods. Now is not the time for the United States to cut back on funds for environmental research and technology, nor is it the time to backtrack on advances made in environmental legislation made over the past decade. Now is when the 104th Congress needs to seize this opportunity to create jobs, build new industries, and protect the environment by passing additional legislation, particularly in the area of tax reform, that will ensure that the United States will be a leader in the environmental technology and services industry into the next century. According to the Organization for Economic Cooperation and Development in an environmental assessment report of the United States scheduled to be released in January 1996, the United States has been a leader in environmental programs, but needs to eliminate ``environmentally unsound Federal subsidies'', including those to coal- fired power plants, and examine national consumption patterns. Back in September, I introduced a bill that would repeal 11 incentives in the corporate Tax Code to produce various polluting energy supplies and consume various nonrenewable minerals. Currently, these polluting tax subsidies cost taxpayers close to $2.2 billion per year. This figure is expected to total a $14.5 billion Treasury loss over the next 5 years. The cost is even greater when we consider that not only do these subsidies encourage waste and environment degradation, but they also discourage investment in new alternatives to existing technology. Some European countries, that is, Germany, Austria, and the Netherlands, are considering a fiscally-neutral Ecological Tax Reform (ETR) which would introduce a CO2/energy tax and at the same time reduce their income tax. The European Union Commission is considering a similar proposal. I am currently working on a bill along these same lines that would gradually reduce corporate and individual income taxes and gradually increase taxes on pollution, excessive depletion of valuable natural resources, and inefficient production and consumption of energy. The time is right from both an environmental and an economical view point to press forward with tough environmental legislation which will protect our environment, create jobs, and position the United States as a leader in the environmental technology and services industry, an industry that will be constantly expanding through the next century. Reprinted below is an article by Jessica Mathews which depicts the ease with which businesses developed substitutes for ozone-depleting chlorofluorocarbons [CFCs] once there was a modest incentive to do so. Clean Sweeps: Two Success Stories for the Environment Two extraordinary environmental successes are passing almost unnoticed. They illustrate the cost of ignoring good news--in particular good news about government--in favor of bad. When the success stories are missed so is the opportunity to reframe policy on the basis of what works instead of always focusing on what doesn't. In less than two weeks the United States will produce its last ozone-destroying chlorofluorocarbons (CFCs), completing a historic international phaseout of a class of chemicals that just a few years ago seemed irreplaceable. Since the original aim of cutting production by half by 2000 was set in 1987, the goal has been tightened to a phase out, the schedule repeatedly accelerated and the class of banned chemicals broadened. The developing countries are now full partners and will cease production in 2015. Each new goal has been reached more quickly and at lower cost--frequently at a profit--than anyone dreamed possible even five years ago. The ease with which businesses have developed CFC substitutes makes it easy to forget how hard the task looked at the outset. Industries predicted doomsday scenarios. The cuts would cripple the electronics industry, which would be unable to clean its chips, it was said, and would force offices, hospitals and shopping malls deprived of air conditioning to close. With hindsight it's obvious why the experts were so wrong. CFCs seemed irreplaceable only because there had never been a reason to look for substitutes. CFCs were cheap, easy to handle, environmentally benign outside the stratosphere and useful in an enormous number of applications. Once there was a need to replace them, a modest economic incentive (in this case a tax) and enough time to develop alternatives, innovation bloomed. The Clean Air Act amendments of 1990, which set the U.S. CFC rules, also established a plan to curb acid rain. In the 10 years it took to pass this law, no provisions were more bitterly fought. The need for controls at all, their appropriate level and their cost sparked trench warfare between environmentalists and industry and among pollution- emitting and pollution-receiving states. Utilities predicted a cost of $1,000 to $1,500 for every ton of sulfur dioxide removed. Some said it could not be done even at that exorbitant price. The debates of the 1980s have been replaced by a benefit/ cost ratio almost too lopsided to be believed. The newest estimate of the benefits of controlling acid rain, released by EPA this week, pegs the health benefits at an astonishing $12 billion to $40 billion annually. (The high estimate, based on more controversial science, is $78 billion.) The estimate does not include the considerable benefits to acidified lakes and streams, high-altitude forests, to buildings or to visibility--only health. On the other side, the costs to industry and government when the controls are fully implemented will be $2 billion to $3 billion per year. Acid rain emission allowances are trading for one-tenth what industry predicted--at $130 per ton. Power plants and industries that do not have to begin cutting back until 2000 have begun to do so by choice. Those required to begin cutbacks this year are, in the new lingo ``overcontrolling,'' cutting a staggering 40 percent more pollution than the law demands. To put it another way: Polluters are today emitting only 60 percent of what was allowed by a standard that, only a few years ago, many considered to be overly stringent and dangerously expensive. What happened? First, of course, it is a law of human nature that the technical difficulty and economic cost of change--no matter how cloaked in seemingly objective science--will be exaggerated by those most deeply affected. In the case of environmental controls that generally means by the affected industries. Something more important is at work. Both the CFC and the acid rain program set a goal, a performance standard, and left business free to figure out how best to meet it. Both avoided the traditional route of writing regulations specifying precisely what must be done. Both programs let the marketplace work. The acid rain emissions trading scheme lets pollution sources buy and sell rights to emit sulfur dioxide or to bank them for later use. Instead of being forced to move by an arbitrary schedule, a company sets whatever schedule works best for it. Rather than requiring a cut of 10 percent or 50 percent from one year to the next, banked allowances allow a smooth transition. An incentive is created to control more pollution than the law requires. Instead of being told what to do by a bureaucrat, businessmen are given the flexibility to do what they're trained to do. Innovation is unleashed. The sulfur emissions market is only a primitive first step toward an effective environmental marketplace. Newer schemes rely less heavily on government regulators. But EPA's best friends testify that while the agency's leadership has gotten the message, the command and control mentality still grips its troops--as well as too many environmentalists. It's important these days to know that major societal goals can be achieved and even exceeded, as well as missed. The ozone and acid rain successes mean, too, that we know how to achieve more environmental cleanup at less cost and with more exportable innovation that we are currently using. That's news.

Mr. STARK

Mr. STARK. Mr. Speaker, Christmas is the season when charity and compassion go public. The time period between Thanksgiving and Christmas is when the true spirit of giving comes into the open. Outside the grocery store you see the bell ringers. Each way you turn there is an open mind and an open heart. Why do people care? For one reason, the Bible says we should care for the poor. The Bible says: If there is a poor man among your brothers in any of the towns of the land that the Lord your God is giving you, do not be hard hearted or tightfisted toward your poor brother. Rather be openhanded and freely lend him whatever he needs . . . Give generously to him and do so without a grudging heart. There will always be poor people in the land. Therefore I command you to be openhanded toward your brothers and toward the poor and needy in you land. (Deuteronomy, 15:7-11). I believe that as a society, we should care for certain groups of people who can't care for themselves--the poor, the elderly, the disabled. It is simply the right thing to do. What has happened since the Republican Party took control of this House? We have suddenly decided that these people can miraculously care for themselves. Even in Biblical times it was recognized that there will always be poor among us and that we should care from them generously. Why now have the Republicans decided to prioritize corporate and wealthy tax breaks above the poor? The Republican welfare bill is frightening. The bill denies guaranteed Medicaid coverage for children and parents receiving AFDC and for children receiving Federal foster care or adoption assistance under title IV-E of the Social Security Act. The welfare conference agreement could eliminate Medicaid eligibility for 1 to 2 million low-income children leaving millions more uninsured if Medicaid eligibility ends. Combined with other massive social service cuts, this is a tragedy waiting to happen. The Republican budget cuts aid to severely disabled children by 25 percent, slashing $12 billion from disabled children's SSI benefits. Over 160,000 children currently in the program would lose eligibility 1 year after enactment. The Republicans claim they want to move people from welfare to work but fail to provide much needed child care. The Republican bill denies SSI benefits and food stamps to legal immigrants, and permits States to deny legal immigrants cash welfare, Medicaid, and title X social services. This punitive bill prohibits States from paying additional welfare benefits to families that have an additional child while on welfare. Don't they realize that the child is an innocent victim in this arrangement? The child did not ask to be born into such a family. This bill pays a bounty to States that reduce their illegitimacy ratio or the number of children born out of wedlock. This provision will serve only to increase the number of abortions or to further restrict a woman's legal right to make her own reproductive health choices. The bill does not reform welfare. It destroys the only safety net some people have on which to depend. At this time of holiday giving, we should remember those most in need; we should count our own blessings; and we should vote against this hard-hearted bill that will send millions further into poverty.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise today to congratulate Marie Elizabeth Zeman Engberg, who will celebrate her 100th birthday this Saturday, December 16, 1995. Ms. Engberg is a long-time resident of San Leandro in California's 13th Congressional District. I want to take this opportunity to congratulate Ms. Engberg on reaching this milestone, but also to recognize her for achieving something that may be even more distinguished. At this time, she has accumulated over 23,360 hours of volunteer work in the disabled American veteran medical system in California's bay area. Ms. Engberg was born on December 16, 1895, in Pittsburgh, PA, to immigrant parents. She spent her early years in Kensington, Canada, and later moved to Crosby, ND, where she married a World War I soldier. She moved on to Lawrence, KS, and then to Tarkio, MO. Ms. Engberg made her living by working in the corn fields. While living in a tent, she volunteered to cook for the other field hands. She believes that this was the beginning of her volunteer spirit. She also worked the carnivals before she traveled to Alameda, CA, where she finally settled. She took a job at Bethlehem Shipyards in a machine shop and made her home in the projects, which, at that time, were at the west end of the island of Alameda. After the war ended, she worked in the insurance industry until she retired at age 65. After her retirement, Ms. Engberg continued to volunteer at VA hospitals in Oakland and later at the Martinez facility. As late as 1990, at the age of 95, she attended a VAVS meeting in Martinez. She joined the DAV Auxiliary, chapter 7, in Oakland, in 1949, and has been an active member ever since. In 1954, she served as the chapter's commander. She has represented the chapter at national conventions all over the United States. Ms. Engberg is also a member of Rebekah Lodge No. 19 and has two children. Her daughter is also an active volunteer and her son has served as California State Commander of the DAV and the AMVETS. Mr. Speaker, I ask you and my colleagues to join me in saluting Ms. Engberg for her great spirit and to wish her a very happy 100th birthday.

Mr. STARK

Mr. STARK. Mr. Speaker, Representative Robert Matsui and I are today introducing a bill to help those who, through no fault of their own, were not able to participate in the Medicare Program during their working years and now face over $3,000 a year in Medicare part A buy-in costs. Our bill lowers the cost of the monthly part A buy-in for about 216,000 people over age 80 who, for no fault of their own, could not participate in Medicare during their working years, because their employers were not in Social Security. The people in this group are mostly retired teachers, policemen, and firemen over age 80 who worked for State and local governments which elected not to join the Medicare payroll tax system. These retirees have been stuck in increasingly expensive small public or private insurance policies, and many of them have had to drop insurance coverage because they could no longer afford it on their shrinking pensions. Since most of them could not afford to maintain private insurance, even if it were available, they have been buying into Medicare part A, some for as long as 15 years. The Medicare buy-in monthly premium is set to equal the full actuarial cost of part A, and today premiums are more than $250 a month and now many of these retirees cannot afford to buy into this basic level of Medicare hospital protection. Many are becoming uninsured--and uninsurable--at the most vulnerable period in their lives. In the last Congress, Representative Bill Thomas and I developed an amendment to help this population by lowering the part A buy-in for those who achieved 30 quarters of coverage but not the necessary 40 required for Medicare eligibility. This has been a help to a few of these retirees, but many of the poorest of these seniors, of course, do not have even 30 quarters of coverage and desperately need help. Therefore, the amendment Representative Matsui and I are introducing today would lower the cost of the monthly buy-in by about $150 a month. Individuals would still have to contribute $100 per month--and the full actuarial rate for years before their 80th birthday. Our bill does not include a way to pay for this change, but we expect to be able to offer a funding proposal at such time as the legislation is considered for markup. I hope other Members will join us in supporting this much needed relief to a group of our older retirees who--to repeat--through no fault of their own, were unable to participate in the regular Medicare Program during their working years.

Mr. STARK

Mr. STARK. Mr. Speaker, I would like to take this opportunity to congratulate Senior Chief Aviation Machinist Mate Stephen Lee Adams upon his retirement from the U.S. Naval Reserve and to honor his mother, Mrs. Ottie Adams, for her dedication and great service to this country. Both Mrs. Adams and her son Stephen are longtime residents of Fremont, CA, in California's 13th Congressional District. Mrs. Adams is a widow and the mother of 10 children. Her eldest son, Larry, enlisted in the Marines and served in Vietnam in 1962. Her son Stephen, enlisted in the Navy, served 3 tours in Vietnam and, more recently, served in the Gulf war. Her son Phillip, enlisted in the Marines and served in Vietnam in 1968 and 1969. Her son Ricky enlisted in the Navy and received a medical discharge. Her son Kim enlisted in the Army and is a first sergeant (E8) with the 1st Armored Division in Germany, who is preparing to go to Bosnia within the next 3 weeks. Mrs. Adams has devoted her life to this country and its veterans. In early 1966, her nephew Mike Bledsoe was wounded in combat in Vietnam and was sent to Oak Knoll Naval Hospital to recuperate. When she and her husband, Charles, a World War II Marine Corps veteran, visited Mike, they saw how depressing it was in the hospital wards--the patients had a few board games, playing cards and not much else. The Adamses were determined to fix things. They began by calling on the local business community and asking them to donate items. They also began to devote all of their weekends to the wounded veterans. They visited the wards each weekend to pass out the items such as candy and games that local businesses had donated, and stayed to talk with the patients. Mr. Adams also had a connection to the entertainment industry through a friend at work. Through this, he was able to bring a variety of entertainers to the hospital. He brought in country and western groups, folk singers, rock groups, and variety acts to boost morale on the wards. The Adams family became close to many of the veterans and opened their home to those who could leave the hospital for short periods of time in order to provide them with a family atmosphere. Although they still had eight children at home, they made room for any veteran who needed time away. They continued their dedication to the wounded veterans from 1966 to 1970. Unfortunately in 1970, Charles was diagnosed with cancer and had to keep his hospital visits to a minimum. Mrs. Adams continued to care for veterans and to this day receives an occasional Christmas card from one of the patients she cared for. Mr. Speaker, I would like to ask you and my colleagues to join me in saluting Mrs. Ottie Adams for her constant devotion to this country on the occasion of her son's retirement from the U.S. Naval Reserve. She deserves our admiration and our thanks.

Mr. STARK

Mr. STARK. Mr. Speaker, if enacted, this bill would cause the immediate default of the United States. Instead of protecting Social Security payments, it would delay January's benefit checks. January's Social Security checks could not be paid until enough tax revenues came in to pay all pervious unpaid Government checks which we defaulted on in December upon enactment of this bill. For the Nation's lower income seniors and disabled, January would be a cold and frightening month. If we have immediate default, people who seek to cash their savings bonds will be told to wait. Families that have bought savings bonds--as we have begged them to do--to save for January college tuitions would be in limbo. Why? Because the Republicans are insisting on a budget bill that includes massive tax breaks for the very upper income. Retroactive capital gains breaks will provide billions to the very wealthiest in our society, while we create delays and uncertainty for those dependent on retirement checks. The wealthiest 1 percent will get an average $90,000 in estate tax relief--while millions will be told that we can't cash their savings bonds on Social Security checks. The top 1 percent of families, whose income averages $651,274, will receive $8,231 in tax breaks in the year 2002 under their tax bill--but the Republican majority will default on this winter's earned income tax credits. Default would be a stain on this Nation's 220 year financial history. The Republican budget priorities--making the rich richer and the poor poorer--are a stain on our Nation's moral history. Please defeat this terribly disruptive bill. Mr. Speaker, I yield back the balance of my time.

Mr. STARK

Mr. STARK. Mr. Speaker, I would like to compliment the chairman and the ranking member of the Commerce Committee's Health and Environment Subcommittee, Mr. Bilirakis and Mr. Waxman, for bringing H.R. 325 to the floor today. This legislation gives greater reign to local authorities in determining how best to meet pollution standards. H.R. 325, a balance has been struck between providing greater flexibility while maintaining the commitment to achieving the federal goals. If the author of H.R. 325, Mr. Manzullo of Illinois, had come to the floor with a bill that provided flexibility to States but eliminated the Federal standards of performance, there would not be the bipartisan support you see today. There is a consensus across America that the days of polluted skies should be no more. There is a recognition by citizens across America that what occurs in one State impacts the quality of life in another State. I am puzzled that in other areas of Federal policy where a national consensus is as strong, the new Majority has taken a different approach. I believe we can learn something from the approach taken in H.R. 325 and carry it to other areas of vital importance to Americans. I'd like to take just a couple of minutes to do just that--highlight how the example of H.R. 325 can be instructive for legislating in other areas of vital importance to Americans. The Republican plan for Medicaid provides the greatest contrast in approach to H.R. 325. Flexibility for States abounds. Standards are absent. Rather than maintain the Federal guarantee for Americans of very modest means to a set of health care benefits, under the guise of State flexibility Republicans remove any semblance of accountability. Republicans intend to send checks to the States totaling $790 billion over the next 7 years with little-to-no requirements on how States must perform. This is in contrast to the structure of H.R. 325 which provides flexibility but maintains standards of performance. For $790 billion in taxpayer money, it would seem reasonable to require States to guarantee health insurance coverage to low-income Americans. Does the Republican Medicaid plan guarantee that all kids that live in poverty have comprehensive health insurance coverage? No. Does the Republican Medicaid plan guarantee that the Medicare Part B premiums of low-income senior citizens are paid? No. Does the Republican Medicaid plan guarantee a nursing home bed to those who are entitled today? No. Does the Republican Medicaid plan continue the guarantee of coverage for Medicare-related copayments and deductibles for poor seniors? No. Does the Republican Medicaid plan require States to provide even just one person a comprehensive package of health insurance benefits, something equivalent to what they as Members of Congress receive? No. Why not apply the model of H.R. 325? Why not hold States accountable? Why shouldn't we guarantee American taxpayers that their taxes will be spent as promised? H.R. 325 requires that an equivalent level of emission reductions be achieved. The Republican Medicaid plan does not require an equivalency of performance. This difference in standards is not trivial. The Urban Institute predicts that 4 to 9 million Americans will lose health insurance coverage because of the Republican Medicaid plan. Consumers Union, the publishers of Consumers Reports, has estimated that 395,000 nursing home residents are likely to lose Medicaid payment for their care next year if the Republican Medicaid plan is approved. The Council on the Economic Impact of Health Care Reform--a panel of respected health economists--found that that the uninsured rolls will soar to over 66 million Americans, or one-in-four Americans, under the Republican plans. This is a 70-percent increase in the number of uninsured Americans over today's level. H.R. 325 extends flexibility in meeting national goals; it does not eliminate them. Likewise, flexibility for States in meeting the health care needs of low-income Americans should not be used as a cover to shred the national commitment to a health care safety net. While the guarantee to coverage is explicitly eliminated under the Republican Medicaid bill, I'd argue that the spending for Medicaid isn't enough to meet the national commitment either. I believe that a per person growth rate of under 2 percent isn't wise. It's rationing. Members of Congress would never inflict that type of constraints on their own health care spending. In fact they don't. Under the Republican budget, taxpayer spending for their health insurance will increase right along with health care inflation. But whatever the amount of health care spending, we should hold States accountable for how they spend the money we give them. As with H.R. 325, there must be accountability. The balance struck in H.R. 325 between providing broader flexibility to States at the same time requiring that national goals be met should apply to other initiatives as well, like Medicaid. If Republicans tried this approach, they might find themselves with the support of Congressional Democrats. And instead of having their Medicaid bill vetoed, they'd have the support of President Clinton.

Mr. STARK

Mr. STARK. Mr. Speaker, I would like to compliment my colleagues on identifying a redundancy in Federal law and working together to eliminate it. As has been stated, current law requires grocery stores to post a notice on the potential dangers of saccharin in addition to the labeling of the food product itself. Clearly, one notice is enough. I am concerned, though, that down the line the remaining notice requirement will be repealed even though it is a necessary consumer protection. Let me tell you why. Today, in Federal law, there is a requirement that private insurance companies provide notice to Medicare beneficiaries if a health insurance policy they are selling duplicates Medicare benefits. In the Republican Medicare plan, this notification requirement is eliminated. Again, under the Republican Medicare plan a notification requirement is to be eliminated that alerts Medicare beneficiaries that a policy they are considering purchasing may duplicate insurance coverage they already have under Medicare. The notification requirement isn't a second notice that is eliminated. There is only one requirement of notification, and it is to be repealed. Let me walk-through why I am raising a word of caution today regarding H.R. 1787. Current Medicare law states that: It is unlawful for a person to sell or issue [to a Medicare beneficiary] a health insurance policy with the knowledge that the policy duplicates health benefits to which the person is entitled under Medicare . . . unless there is disclosed in a prominent manner the extent to which benefits under the policy duplicate Medicare benefits. This simple notice saves senior citizens from wasting millions of dollars each year on what one consumer organization has described as ``illusory policies which pay out little or nothing to Medicare beneficiaries.'' In contrast to the action taken today with H.R. 325 in full public view, buried in the Republican Medicare bill that passed the Congress last month was a provision that deletes this important notification requirement. Why? There are a few well-heeled insurance companies that sell these disease specific, or dread-disease policies, and they have an interest in having ignorant consumers. And they have an interest--a stockholder share you might say--in the new Republican majority. These insurance companies expect a return on their investments. To give them that return, the interests of elderly Americans were brushed aside and the notification requirement was erased. To protect Americans from similar anti-consumer actions in the future by the Republican majority, maybe we need to maintain two of everything in Federal law. When at some point down the line Republicans need to provide a sweetener for a particular special interest, they can delete one provision but leave the second one intact so consumers can maintain needed consumer protections. I am not opposed to the bill we are considering today. By passing H.R. 1787, we will eliminate a redundancy but maintain a notice that is a necessary consumer protection. The notice to Medicare beneficiaries warning them that they are being sold a worthless or near-worthless insurance policy also is worthy of maintaining. In fact, in opposing the Republican Medicare effort the National Association of Insurance Commissioners stated that the Republican Medicare bill ``would strip seniors of the protections afforded by the disclosure statement.'' Again, I'd like to compliment the work of Mr. Waxman and Mr. Bliley on bringing H.R. 1787 to the floor but reiterate my word of caution that we not go to the extreme as was done in case of Medicare. Despite what well-heeled lobbyists may say, ignorance is not bliss. Ignorance can be dangerous to consumers. Luckily for Medicare beneficiaries, we have a Democratic President in the White House who has made a commitment to protect the physical and financial health of the seniors of America. He has vetoed the Republican Medicare bill. Now, their damaging special-interest provisions can be eliminated and consumer protections maintained.

Mr. STARK

Mr. STARK. Mr. Speaker, the Republican budget cuts Federal support for Medicaid by an unprecedented $163 billion--over 10 times anything ever enacted by any Republican or Democratic President. The Republican plan achieves these savings by capping overall spending. This means that spending growth per beneficiary would fall from the current 7 to 1.6 percent annually--far below the rate of inflation. States cannot sustain coverage when Federal funds are increasing at only 1.6 percent per beneficiary. States will be forced to reduce benefits and/or provider payments and eliminate coverage for millions of people on Medicaid. A recent column in the November 28 edition of the Sacramento Bee leaves me fearful for the poor in our California. The author, Mr. Dan Walters, was commenting on California's plans for Medi-Cal if the Republican welfare bill becomes law. Currently, more than 5 million Californians receive their medical care through Medi-Cal. If the Republican welfare bill becomes law, California and other States will have to decide whether to maintain current eligibility and make up the shortfall with their own money or begin cutting caseloads. California may well slash Medi-Cal recipient rolls by hundreds of thousands. The column reports that Eloise Anderson, California's social services director, is urging the Wilson administration to adopt a policy that would focus Medi-Cal benefits on some subgroups and deny benefits to others. She advocates a program of varying benefits that depends on one's suitability to obtain employment. Anderson is quoted as saying: By denying or limiting Medi-Cal availability, families could be further encouraged to exercise personal responsibility and to obtain self-sufficiency through full or part-time work. This philosophy is frightening. What will happen when a poor, non- Medicaid person gets sick? Won't those eliminated simply turn up in hospital emergency rooms? Are they supposed to go to work sick? Ms. Anderson recommends cutting Medicaid for people on welfare or trying to leave welfare as a way to prod them into work. What if they have a minimum wage job--how much would it cost to buy a health insurance policy for a mother and a child? Is it realistic to expect that to happen? What about the extensive medical literature which shows that people who don't have health insurance tend to be sicker and less dependable workers? Are the types of jobs a welfare mom is likely to get the ones that offer employer-paid health insurance? Of course not. The reduction in Federal support under the Republican plan could force States to deny coverage for nearly 8 million Americans in 2002 alone. California is considering a dramatic reduction in eligibility. How will other States respond? Will they also cut their program, to be competitive with California's reduced tax expenditures? Who knows--the Republicans have stripped away the Medicaid guarantee for the sick, elderly, poor, blind, or disabled. The States will have the choice whether to cover these vulnerable citizens. Statements like Ms. Anderson's point to a ``race to the bottom''--a race which will leave the most vulnerable in our society sick or dead.

Mr. STARK

Mr. STARK. Mr. Speaker, the movement to managed care is sweeping the country, and it is vital that patients know whether the HMO's and other organizations they are being asked to join provide quality care or are financially sound. A bad sign for consumers is the lawsuit of giant Health Net HMO against the tiny rating firm of Weiss Ratings, Inc. Health Net claims that Weiss' analysis of Health Net's very shakey financial status--a ``D-'' rating--was harmful to the HMO. Mr. Speaker, the law suit smacks of intimidation. The financial data was very clear. At the time of the rating, Health Net was in bad shape. Weiss has an excellent reputation for spotting companies in trouble. Customers and investors have a right to know. If lawsuits like this succeed in silencing the analysts and critics, there will be no competitive marketplace because the consumer will have no hope of making an informed decision. Ignorant customers don't make good customers--and Health Net's lawsuit is an effort to keep the public ignorant. The problem is, ignorance in picking a health plan can cause customer bankruptcy or even death. Enclosed is a portion of the New York Times article of November 24, 1995, that describes the kind of anticonsumer lawsuit that Health Net is pursuing. [From the New York Times, Nov. 24, 1995] Rating Agencies Facing Lawsuits For Low Grades (By Michael Quint) Rating agencies that grade the financial strength of companies and local governments are accustomed to lawsuits by investors who say that the ratings failed to alert them to serious problems. But the agencies are not used to being sued by the entities they rate. Now that is changing, as agencies ranging from the giant Moody's Investors Service in New York, a unit of the Dun & Bradstreet Corporation, to tiny Weiss Group, of Palm Beach Gardens, Fla., are learning that they are vulnerable to suits from companies or governments who say that their ratings were so low as to be libelous. Rating agencies defend their right to publish opinions as a matter of freedom of the press, regardless of whether they were hired to issue the rating. But in two current disputes, one by the second-largest health maintenance organization in California and the other by the largest school district in Colorado, rating agencies that issued unsolicited ratings were accused of using their reports to drum up business. Unsolicited ratings can become an issue when companies and local governments that paid to be rated wanted to choose the agencies that they thought would give them the best ratings, testifying to their strength. If an unsolicited rating was much different from what the company thought it deserved, sparks could fly. Malik Hasan, a doctor and chairman of Health Net, a California health maintenance organization, said a D- rating by Weiss ``made us into their poster boy.'' Mr. Hasan said that Weiss used the rating to attract attention and sell more of the agency's reports. Late last year, after Weiss gave Health Net the lowest rating of any of the country's 13 largest H.M.O.'s, Health Net filed suit in Federal court in Los Angeles accusing Weiss of interfering with its business, and of defamation, slander and libel. Martin Weiss, chairman of the rating agency, said he had spent more than $350,000 of his own money defending the agency against the lawsuit and was in no mood to back down. ``I am fighting to the bitter end, because if I cave in now, the word would get around that the way to get a better rating or to shut up Weiss is to sue him,'' he said. Although Mr. Weiss has sold only 21 reports about Health Net, he hopes that H.M.O. ratings will raise his company's revenues above the $764,000 total for 1994. The financial ratings of H.M.O.'s were important, he said, because the groups were growing and ``a group that is under financial pressure could be more likely to cut corners on medical care.'' Concern about his reputation led Mr. Weiss to reject a compromise settlement proposal a week ago, because it would not have made clear that Mr. Weiss did not pay any damages to Health Net, nor would he have been able to talk publicly about the case. Dr. Hasan of Health Net said he was pushing the suit because the criteria for Weiss ratings remained secret and put too much emphasis on measures of financial strength that did not accurately reflect the ability of his company to pay the medical costs of its 1.4 million customers in California. Mr. Weiss defended his rating formula, saying it was similar to one being developed by state insurance commissioners for H.M.O.'s. He said that his standards did not condemn the entire industry. Nearly half the 385 H.M.O.'s he now rates are in the A or B categories, with another 32 percent in the C rating group.

Mr. STARK

Mr. STARK. Mr. Speaker, I want to thank the distinguished gentleman from Alaska for joining in bringing this bill to the floor. It honors one of the most wonderful persons ever to serve in the House of Representatives. Don Edwards is a great and caring environmentalist, and it is fit and proper that he be honored by naming the San Francisco Bay National Wildlife Refuge after him. His consistent strong work on behalf of the refuge preserves for the present and future generations one of the great wonders of our Nation. As a matter of fact, in the field of preservation, it ought to be noted here among his friends that Don Edwards has not done a bad job of preserving himself. I saw him not so long ago, and he looks fine and fit and I am sure he may be watching us today. It may be a very proud time in his life. As the previous speaker mentioned, Don's main work in Congress was of course in defense of the Bill of Rights. He indeed truly gave the Constitution and the Bill of Rights its own refuge, a safe haven from the whims and angry passions of the moment. Our rights protecting us against Government intrusion and abuse were given a shelter from the storm in Don Edwards' subcommittee. The rights of women, the right to pray without direction from the local majority, the right of speech, were all given protection and refuge by the courage and wisdom of this gentle Congressman from San Jose, CA. So anyone who has seen the vast sweep of the San Francisco Bay will immediately understand the importance and enduring beauty of the work that Don did in creating the bay refuge. It is a monument to a monumental Congressman. I thank the committee for bringing this bill forward, and join in asking my colleagues to adopt it unanimously.

Mr. STARK

Mr. STARK. Mr. Speaker, according to Tom DeLay, House majority whip, ``What has happened over the last 10 to 20 years is the environmental extremists have had their way with regulators and with Congress and they've gone way beyond reasonableness and common sense''--October 8 Houston Chronicle. In support of this argument, Mr. DeLay has introduced a bill to lift the ban on the chemicals covered by the ozone-layer ban and other substances. In the October 27 Washington Post, DeLay, a former exterminator, was quoted as saying ``the science underlying the CFC ban is debatable'' and the agreement to terminate the use of CFC's ``is the result of a media scare.'' A couple of weeks later, the Royal Swedish Academy of Science announced this year's Nobel Prize in chemistry was awarded for work that led to the international ban on chemicals believed to be depleting the Earth's protective ozone layer. These scientists discovered that when chlorofluorocarbons [CFC's], standard coolants in refrigerators and air-conditioners, leak, they rise heavenward and destroy ozone molecules that shield the Earth from the Sun. As you know, in 1985, scientists confirmed the existence of a hole in the ozone layer over Antarctica. This ecological crisis spurred more than 120 countries to negotiate and approve the Montreal Protocol on Substances That Deplete the Ozone Layer, which President Reagan signed in 1987. In 1989, Congress enacted a tax on ozone-depleting chemicals-- CFC's or chlorofluorocarbons--to provide an economic incentive to reduce production and use of these destructive substances. This tax has very successfully accelerated the phase-out of harmful chemicals while at the same time it has spurred development of ozone-safe alternatives. However, Tom DeLay, the House majority whip, remains unconvinced. In the November 4 Houston Chronicle, DeLay said the Nobel Prize has not changed his opinion that the ban on the chemicals to protect the ozone layer was the result of media scare. In a separate interview, one of the three Nobel winners for ozone-depletion research, Mario Molina of the Massachusetts Institute of Technology, said such charges evidently result from DeLay's lack of knowledge * * * and that all I can say is it's ignorance, real ignorance. DeLay was also quoted as saying that Sweden--where the Nobel program is based--is an extremist country, and the award to Molina and the two other scientists was nothing more than the Nobel appeasement prize linked to a Swedish agenda. DeLay said the Nobel Prize notwithstanding, he and a number of scientists are not persuaded by the Chicken Little theory that ozone depletion is being caused by CFC's or other manmade materials, or that there would be substantial negative effects even if that happened. DeLay said his University of Houston biology degree and his many years of dealing with chemicals as owner of a pest-control company enable him to interpret scientific findings, including emerging research that calls the CFC ban into question. To support a ban on chemicals to protect the ozone layer, he said he would want to see ``a direct correlation'' between CFC's and ozone depletion, and also ``make sure the so-called UV [ultraviolet] radiation that's supposed to make people drop like flies is actually making people drop like flies. Common sense dictates that waiting for this degree of evidence is waiting too long. A person doesn't need to wait for a brick to drop on his head before he believes it would hurt. The proof that Mr. DeLay requires is exactly the type of catastrophe that current legislation regarding ozone-depleting chemicals was enacted to prevent. Normally, I would not take this type of know-nothingness seriously. However, with the new Republicans and their antienvironment. Contract With America it appears they are not [[Page E 2285]] going to let real ignorance stand in the way of attacking environmental policy, policy which was supported by Republican Presidents Ronald Reagan and George Bush. Therefore, it is very important that we continue to rally support from the scientific community, environmental groups, and our constituents in opposition to this type of real ignorance so that we may preserve our Nation's and the world's most precious commodity, the environment.

Mr. STARK

Mr. STARK. Mr. Speaker, I commend to my colleagues an opinion piece in today's Washington Post. Professors Jerry Mashaw and Theodore Marmor provide a straight to the point analysis of what maintaining the best health insurance program in the world, Medicare, requires. Real Talk About Medicare Although Medicare reform has been at the very center of the budget negotiations between Congress and the administration, much of the political discussion on this issue has been about as thoughtful as a food fight. Republicans have made the claim that Medicare faces bankruptcy and offered their ``Medicare Preservation Act,'' cutting $270 billion in projected spending on the program in order to ``preserve, protect and strengthen'' the program. Democrats respond that this would mean Medicare's destruction and that big cuts are unnecessary--except to facilitate tax cuts for the rich while keeping the Republican promise to eliminate the deficit. Behind this unilluminating, alarmist debate there are some hard facts that need to be considered: Medicare does need fiscal adjustment. A 10 percent annual growth rate in program costs is simply not sustainable in the long run. Changes in longevity, medical technology, cultural conceptions of adequate medical care, national fiscal capacity and a host of other factors demand that any long- term program of medical insurance accept periodic adjustments. Rigid defense of the status quo is silly. But so is the demand for ``preservation'' by complete overhaul. Reformers should attend to the many small adjustments that really will preserve a highly valued program. They should not search for some untried one big thing that will ``fix'' the system for all time. Talk of the projected ``bankruptcy'' of the ``trust fund'' is an unhelpful way to think about the urgency of Medicare's financial problems. The trust fund is an accounting convention signaling that Medicare's hospital insurance (Part A) is financed by earmarked taxes. If time is needed to make sensible, gradual adjustments in Medicare, the ``fund'' for Part A can be increased by extremely modest new taxes or by temporary transfers from the surpluses in the Social Security retirement accounts. In any event, no one is going to wake up some Saturday morning to find that his hospital coverage has suddenly ceased because Medicare is ``broke.'' Costs are not the only problem. For example, major elements in the treatment of chronic disease are not covered by Medicare, nor are pharmaceutical therapies and long-term care. These gaps not only ensure that the program fails to meet important needs of the elderly and the disabled, they also promote costly gaming of the system. To get Medicare payments for nursing home care, patients must be cycled through hospital stays, whether needed or not. Personal assistance must be provided by highly paid nurses, even if the ``medical'' content of the care is minimal. Reform should concentrate on helping Medicare meet the genuine needs of beneficiaries and avoid artificial boundaries that cannot, in any case, be policed effectively. Broadened coverage need not necessarily be the enemy of cost control and in some instances may be its ally. Lest this proposal for expanded coverage suggest we have lost touch with fiscal reality, we must emphasize that the costs of care may be reduced in many ways. Less expensive forms of care can substitute for more heroic interventions. Unnecessary and marginally necessary care can be lessened. The amounts paid for particular interventions can be restrained. But reformers should remember that Medicare administrators have been quite successful at constraining costs when given the tools and political support to do so. They can be even more effective in the current context, in which private insurers are doing similar things. Providers now have nowhere to hide from system-wide demands for cost control. Taxes can be raised. So can premiums. Anyone who thinks that an earmarked tax for a popular program can't be increased marginally in the current political climate simply has not been paying attention to what we have been doing over the past decade--or to what opinion polls say Americans will support. On the other hand, there is no reason that a program originally designed to prevent financial catastrophe for the elderly and disabled should use general revenues to subsidize 80 percent of all their expenditures for physician services (Part B). Some of these costs can and should be distributed differently. In other words, reform should (and almost surely will) require some adjustments in current payment arrangements: who pays, how much and through what types of levies, charges or deductibles. Finally, those who are old or disabled--and also sick-- deserve a more patient-friendly system of health insurance. Offering them a smorgasbord of private insurance alternatives may appeal to those for whom ``privatization'' is the presumptive answer to all questions of public policy. The political and economic realities, however, are very different. This type of ``freedom of choice,'' not of doctors but of ``plans,'' would increase the administrative costs and complexity of Medicare while driving most of the old and the sick to distraction. How it would save federal dollars remains a mystery. Moreover, responsible privatization would actually require massive federal regulation of the insurance industry to try to prevent ``cherry picking'' of the better risks and cost shifting between the Medicare and non-Medicare patients by insurers covering both. The earlier proposal for mandatory HMOs for all generated effective political resistance--and for good reason. Most HMOs have catered to a quite different and much healthier slice of the population. Whether HMOs can serve the elderly and disabled well, and at reduced costs, is unknown. Reforming Medicare will be neither simple nor painless, and wise solutions are unlikely to emerge from political processes that distort the real issues and the real alternatives. President Clinton should veto virtually any Medicare ``reform'' that emerges from the current, overheated, political context. The president should then remind Sen. Bob Dole and his congressional colleagues of the senator's earlier suggestion for a presidential commission on Medicare that would not report until after the 1996 elections. Handing off to a commission really is the right thing to do now just as it was in achieving sensible tension reforms in the early 1980s. [[Page E 2292]]

Mr. STARK

Mr. STARK. Mr. Speaker, the Nation's seniors and low-income citizens are starting to be hit with a tidal wave of sales pitches for managed care health plans. Some of the information is helpful. A lot of it is just old-fashioned boiler room high-pressure sales pitch. I've just received the following letter from Dr. Harley Schultz of San Leandro, CA, which explains some of the dangers of this marketing. Mr. Speaker, before a lot of seniors and disabled and low-income people are hurt by gross sales practices, we need to establish some standards so that people can make rationale, careful choices on their health plans--after all, it could be a matter of life and death. The letter follows: Dear Congressman: Recently I had the experience where a Medicare/MediCal patient of ours was marketed and sold an HMO plan. Neither the patient or family understood that the plan resulted in a limitation of their choice of hospital, home health service, would result in a co-payment for office visits, and possibly limitations in service available. The salesman told them that since MediCal patients would soon be enrolled in managed-care plans, that they should sign up early instead of later. Several other patients have commented to me that they signed up for various plans because they eventually succumbed to persistent telemarketing, and didn't know any other way to stop the phone calls from coming. Many of our elderly citizens are clearly no match for sophisticated insurance salesmen who work on commission. Inasmuch as you have a long record of interest in fraud and abuse, I would suggest to you that you may wish to direct some of your attention to marketing practices in the health care industry. Specifically, the Federal Government may wish to set certain guidelines for the plans with which they contract with regard to the information that is presented, the way it is presented, and the amount of aggression that can be used in pursuing a potential client.

Mr. STARK

Mr. STARK. Mr. Speaker, I thank the gentleman for his kindness. I want to support H.R. 2525, granting antitrust relief to charitable gift annuities, because we are going to need some more charitable gifts. Now, to my modern-day pharisees on the other side of the aisle, I would point out it is, indeed, a Christian thing to do to encourage giving. The Bible uses the word ``give'' 862 times, and the phrase ``stop giving'' does not appear at all. But the Republicans are stopping giving. H.R. 2525 may help that. But I wonder, and I am not a lawyer so I would have to rely on the Committee on the Judiciary, low-income energy assistance is being cut. Should we, therefore, give an exemption to the oil companies? Food stamps are being capped and cut 20 percent. point of order

Mr. STARK. I thank the Speaker, and I shall continue to talk about granting of antitrust relief to encourage gift annuities, which I believe is the bill, the nexus of the relationship. For instance, Medicare, which is being cut where it pays for debt for low-income seniors, the hospitals very much want an antitrust exemption, which is really the nexus of this bill. Would it not be wise to correct the Republican mistake of cutting Medicare and to give hospitals an antitrust exemption? Or, in the same vein, H.R. 2525 allows antitrust relief. Would if not be good to give antitrust relief to the landlords of Macy's and Wal- Mart because of the $33 billion in earned income tax credits being cut out of low-income people while rich people will not need it? I suggest that is within the nexus of H.R. 2525 and antitrust relief. Finally, college aid is being cut $5 billion. Last weekend Muskingum College in Ohio was dropping tuition from $13,000 a year to $9,000 a year. I remember when MIT and the Ivy leagues were clamped for antitrust for getting together on student aid. Why not give the college antitrust relief? Then we will not need the college loan program that the Republican are gutting. So I say support H.R. 2525. Start a movement. Replace the $254 billion in charitable cuts the Republicans are making with a Thousand Points of Light. I urge support of the bill.

Mr. STARK

Mr. STARK. Mr. Speaker, I thank the distinguished gentleman from Massachusetts [Mr. Markey]. Mr. Speaker, I rise in strong support of H.R. 2519 and again to repeat from the previous week my urge that there is nothing we need more around here than corrections. I would like to explain that the most correcting that is needed is not entirely addressed by H.R. 2519 by charities alone but also is to do away with the approach that the congressional Republicans have taken in their budget. Referring to H.R. 2519, we clearly need to encourage more charitable giving. A summer study of 100 charities showed that, based on the Republican budget, they alone would cause the Nation's charities a $250 billion shortfall between 1996 and 2002. Now, it may just be coincidental that that is almost the amount of the tax cut that the Republicans intend to give to their rich friends. However, the head of the independent sector, Dr. Sara Melendez, says that the Nation's nonprofits will not only be unable to provide services at their current levels but their capacity will be so reduced that they will be incapable of meeting the increasing services that are projected for the new needs created by the Federal reductions in entitlement programs by 2002. Now, H.R. 2519 takes a small step in correcting that. However, when we look at the huge problem that has been created by the Republican budget, and I quote here; for example, the study shows that the Lutheran Social Services of Michigan will have a shortfall of almost 280,000 days in nursing homes for the elderly. The Crittendon Family Services in Columbus, OH, will serve 13 percent fewer people in their Family Preservation Services program. The Arkansas Easter Seal Society will serve 20 percent fewer children in its early intervention program for children with disabilities. In Houston, TX, the Family Resources Society will have to turn away 20,000 children from its Child Abuse Prevention and Treatment program, all because of the Republican budget cuts. The Jewish Family Service of Los Angeles, CA, will be unable to meet the needs of some 80,000 meals for its Meals to the Elderly program. If the participating organizations are to make up their program revenue with private giving, which H.R. 2519 will help them do, the contributions would have to increase by 125 percent from the previous year over and above expected increases. Now, when we are going to cut services to the elderly from 17 to 9 percent, nursing homes for the elderly from 42 to 30 percent, community development programs from 50 to 31 percent, home health care from 39 to 27 percent, legal services from 40 to 4 percent, food services from 46 to 40 percent, we need H.R. 2519. Because the Republican draconian cuts that impact the poor and the disadvantaged, which these charities under H.R. 2519 are designed to serve, and where that money is being given, the $245 billion that is being cut and given to the very rich in tax cuts, we can only hope that H.R. 2519 will encourage those same rich Republicans who get the $245 billion in tax cuts to give a little bit of it back. The harm they are causing the poor, the elderly, the disadvantaged, the disabled in this country and the young children is so huge that one wonders if this little correction is going to be enough to overcome that awful, heartless cutting and gutting of the social programs that protect the needy and the disadvantaged in this country. While I urge my colleagues to vote for H.R. 2519, I urge them to remember that we cannot let this budget that the Republicans have suggested go through, giving all of this $245 billion in tax cuts to rich, taking it out of the hides of the poor. H.R. 2519, while it is a good bill, will do a little bit but not nearly enough to correct the egregious error and hurt that the Republicans are inflicting on American society.

Mr. STARK

Mr. STARK. Mr. Speaker, I would like to talk just for a moment about the Medicare issue. It has been suggested we do not need to fix Medicare. Actually, that would not be such a bad idea, because if we did not fix Medicare, 26 million more uninsured would not lose their insurance as they will under the Republican bill. Twenty-six million Americans will become uninsured as a result of this $270 billion. Marie Antoinette would have called it a decapitation; you want to call it a cut. It is a reduction. Twenty-six million people are going to lose their insurance. Nine million people get 80 percent of the tax cuts you are giving them. So you are giving 9 million of the richest people $250 billion, and you are taking insurance away from 26 million. Thirty-seven million people will pay more in part B, and the doctors will be able to balance their bill, which means you take the lid off. Doctors can charge the Medicare beneficiaries whatever the traffic will bear. The referral fees that the doctors can get are no longer limited, so the doctors can own labs, x-ray labs and physical therapy labs, and they can sell their patients like pork belly options to get referral fees and kickbacks. The most unethical practice that was denied some years ago is being reinstated by the Republican bill. The Republicans are destroying the fee-for-service medical system and the choice, and they are destroying the nursing homes for so many, and the ability through the Medicaid cuts for so many of the lower-income seniors who need nursing home care in their dwindling years. This is what they are doing with their fix. If the Republicans think that the Democrats want to fix the system that works well, they are wrong. They are wrong to cut $270 billion for the tax cuts for the rich.

Mr. STARK

Mr. STARK. Madam Speaker, will the gentleman yield?

Mr. STARK. If the gentleman would yield further, now under the current Medicare system as designed by the Democrats 30 years ago, we have compensated those hospitals, those distinguished teaching hospitals, the centers of excellence. We have compensated, and I am going to get to S. 790 here in a minute, because it is to this report on Medicare treatment of uncompensated care that is the nexus of my remarks. If the gentleman from Texas will yield further as I make my nexus, the reports on the Medicare treatment of uncompensated care are how we know how to reimburse those hospitals, because under the Gingrich plan to demolish Medicare to help pay for tax cuts for the rich, these hospitals will not get paid. If we do not know, when we come to our next corrections day and they have closed the hospitals in Houston, and when they have closed the hospitals in Los Angeles, because they are treating people who cannot pay and the local taxpayers will not have any money to pay for it, Medicare has been reduced, we will not have that information anymore. Can the gentleman assure me that aside from the hordes of disadvantaged children and crippled seniors and poor seniors who will be marching on Washington asking why Speaker Gingrich led the fight to destroy Medicare, if there is no other way, will we know, will we still have reports that will call to our attention the obscene, criminal way in which the Republican bill will treat these seniors, if we do in fact support S. 790 as the gentleman suggests?

Mr. STARK. Madam Speaker, if the gentleman will yield further, the gentleman's compassion for the seniors and his fight to preserve Medicare, in spite of the fight to destroy it led by Speaker Gingrich and the chairman of the House Committee on Ways and Means, who is also a neighbor of the gentleman's, and it is evidenced by his supporting of this wonderful bill, S. 790, which, on the basis of the gentleman's recommendation, I certainly intend to vote for, but further, the gentleman's assurance that eliminating this report on uncompensated care will not further impact the hospitals in Houston beyond which the Committee on Ways and Means bill reported out by the chairman, who is also from Houston, which will probably cause the closing of many hospitals in Houston, I know that is not this gentleman's intent. I respect the gentleman for his battle to preserve Texas hospitals for the seniors and the poor in the face of the Republican onslaught, where they are attempting to cut Medicare to pay for capital gains for the rich people in Houston, who will get these great capital gains tax reductions as the hospitals close and the homeless, by the way, in Houston, will go up. [[Page H 12230]] If the gentleman will yield further, in this same section under S. 790 we are eliminating a report on programs to assist homeless individuals. Now, with the increased costs in Medicare that the Gingrich-Archer Medicare bill will cause, huge increases in costs to low-income seniors under Medicare, many of them write to me and tell me they will not be able to pay their rent, because not only will their copayments go up, the doctors will be charging them more. If we do not have the report under S. 790 on page 33 in the report, we do not know of the huge increase in those homeless people, how will the city of Houston be able to come back here through its Representatives who are concerned about the matter and those Representatives who care anything about the poor, how will you be able to know how the problem is growing as a result of the inhumane treatment under the Gingrich-Archer Medicare-Medicaid destruction bill, and how will you be able to, without the reports, if S. 790 passes, how will you know how this problem is being exacerbated?

Mr. STARK. Madam Speaker, if the gentleman will yield further, the gentleman is sure this Texas Medical Center and the people that run the housing programs will understand that there is a difference, we talk about a farm problem, the difference between hamburger and the other part of the cow, between the Members representing Houston, that this Member from Houston is an adamant supporter of programs for the poor and the hospitals, while other Members from Texas may be supporting the Gingrich plan, which will destroy the hospitals. The gentleman is sure the hospitals will recognize him as a supporter of the Medicare plan, and not a destroyer?

Mr. STARK. Madam Speaker, I certainly hope so. I hope the hospitals in Houston know in spite of the gentleman's distinguished leadership on the part of S. 790, the gentleman has not taken leave of his senses and the gentleman is and continues to be an adamant fighter for the cause of the poor and for Medicare, in spite of the onslaught made by the Republicans and Speaker Gingrich to destroy it.

Mr. STARK

Mr. STARK. Yes.

Mr. STARK. Madam Speaker, in H.R. 2366 line 3, section 1, it says, repeal section 1862 of the Social Security Act, and it is amended by striking subsection (h). It is my understanding that in amending a section of the Social Security Act, the Member can strike the last word and discuss anything under that Social Security Act, which would be 42 U.S.C. 1395, and if section 1862 of the Social Security Act covers all of these topics, I would like the Speaker to suggest whether or not we may therefore discuss anything in section 1862, which this bill seeks to repeal, or a subsection thereof.