Paul Wellstone

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, while we have begun to make important progress toward seriously addressing the devastating physical and emotional effects of domestic violence, little attention has been paid to the severe economic consequences of domestic abuse. The Battered Women's Employment Protection Act, which I am introducing today, will ensure eligibility for unemployment compensation to women who are separated from their jobs as a direct result of domestic violence. Several new studies illustrate the need for the legislation I am introducing today. The evidence is irrefutable, domestic violence dramatically affects women's ability to work and support themselves and their children. According to New York City's Victims Service, one-quarter of battered women recently surveyed who have survived abuse had lost their jobs due to the effects of domestic violence. Abusive husbands and partners harass 74 percent of employed battered women at work, either by showing up at the workplace or calling them at work. It is not unusual for women in abusive relationships to be late for work at least 5 times a month, to leave early at least 5 times a month, and to miss at least 3 full days of work a month--National Work- place Resource Center on Domestic Violence. There have been cases brought to my attention in my home State of Minnesota where the women trying to escape abusive relationships could have benefited from this legislation, and we know that, sadly, there are many more such stories throughout the country. On February 12, 1997, a woman came into the Women's Rural Advocacy Program in Marshall, MN, after her partner had emotionally, verbally, and physically assaulted her. After many years of fighting, her abuser finally let her get a drivers license and a car. His motivation for allowing her to do this was that she could get a job, resulting in more money for himself. Three months into her job, her partner assaulted her and she was in need of safe housing and constant protection. Because of the fear of her abuser finding her and her child, it was not safe for her to take their child to daycare, so she was unable to get to work. Seeing that this was a new job, she did not have any vacation days she could use. Her abuser soon found out where she was located. She panicked and took her child and left the shelter, presumably the city, her friends, and her job. The shelter advocate we spoke to had no idea where she went, but was sure she had no money, very little clothes, and no car. A woman, known as Sarah, is a 34-year-old college educated mother of 5 children, all under the age of 12. Sarah and her husband of 15 years had a successful market research company. Their combined salaries totaled over $225,000. The husband was the president of the company, Sarah the vice president. They were equal share holders in the company until Sarah came in contact with law enforcement and the Lewis House Shelter due to her hospitalization for extensive injuries suffered at the hands of her abusive husband. Sarah admits that the abuse has gone on for years. She filed for an order of protection, filed assault charges, and filed for divorce. Her husband then fired Sarah from the company they started. Her lawyer tells Sarah that she can sue for her position to be reinstated in the company. Sarah knows she is not safe and that nothing can protect her or her children from the repeated pattern of abuse. She is faced with the loss of her position, her income, legal fees, medical bills, as well as the foundation of her children's lives. It took Sarah 6 months to find a full-time position. She has supported herself by using credit cards she maintained in her own name. She begins her new life with $30,000 of new debt. Her batterer maintains his company today, with no loss of position and an increase in income. For women attempting to escape a violent environment, this legislation can be a lifeline. There has been great progress in the last few years in societal and legislative response to violence within the home. One area that has not been sufficiently addressed, in my opinion, is the economic cost of domestic abuse. The Bureau of National Affairs recently estimated that domestic violence costs employers between 3 and 5 billion dollars per year. Domestic violence results in lower productivity, greater absenteeism, and increased health costs. The National Institute for Justice estimates that from 1987 to 1990, domestic violence cost Americans $67 billion a year. According to annual estimates for reported domestic violence injuries, family violence exacts a significant economic toll on the well-being of the family, and the United States. Forty-four million, three hundred ninety-three thousand, seven hundred dollars total annual medical costs, 21,000 hospitalizations, 28,700 emergency room visits, and 175,000 days lost from work. In addition--50 to 80 percent of women on AFDC are victims or past victims of domestic violence (Taylor Institute Study, 1996). One year after divorce, women's incomes average only 67 percent of their pre- divorce incomes compared to 90 percent for men (Report of the American Psychological Association Presidential Task Force on Violence and the Family, 1996). The Battered Women's Employment Protection Act will help women retain employment and financial independence by ensuring that employed victims of domestic violence can have time off from work to make necessary court appearances, seek legal assistance, and get help with safety planning, without penalty from the employer. This bill enables employees to use their family, medical, sick, and other leave in order to deal with circumstances arising from domestic abuse. Circumstances that would allow an employee to take leave include going to the doctor for injuries caused by domestic violence, seeking legal remedies such as going to court, seeking orders of protection, or meeting with a lawyer. Current Federal and State laws fail to address the negative economic consequences domestic violence can cause. Today, battered women are not expressly allowed to take leave from work to address the consequences of family violence--both the physical and legal effects. This bill will help women to escape abusive situations by helping them retain employment and financial independence. And, by requiring employers to provide leave to employees for the purpose of dealing with domestic violence and its aftermath--it does not increase costs to employers, it permits employees to use their existing leave to deal with domestic violence. Furthermore, to ensure that battered women can retain the independence necessary to leave their abusers without having to rely on welfare, the bill requires that States provide unemployment benefits to women who are forced to leave work as a result of domestic abuse. The bill ensures eligibility for unemployment compensation to women who are separated from their jobs as a direct result of domestic violence. For example, victims of abuse could not be denied unemployment if they were forced to leave their jobs because they had to relocate for safety reasons. Similarly, a woman would be eligible for unemployment compensation if she was fired from her job because she repeatedly showed up late for work with physical signs of abuse or was excessively absent from work as a result of abuse. In addition, the bill provides for specialized training of personnel in assessing unemployment compensation claims based on domestic violence. All of us here today are committed to doing what we can to help battered women and their children escape domestic violence. I urge my colleagues to join in this effort by cosponsoring the Battered Women's Employment Protection Act. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, I introduce the Patient Protection Act of 1997. This bill addresses the issue of fairness in health care today. Mr. President, the last few years have seen an enormous growth in managed care health plans. Now, more than 50 percent of Americans are enrolled in some kind of managed care arrangement. We have learned a lot in the past several years about what works and what doesn't in managed care, in all kinds of health insurance for that matter. And, let me be clear that I recognize that there are things that are working well in managed care and other types of plans. We have seen a decrease in the rate of increase in healthcare costs. Health plans are emphasizing prevention and early intervention. Health plans are largely moving from managing costs to managing care to managing health. All of this is good, but enough time has gone by that we have found the problems, the glitches, the occasions and circumstances where patient and providers are not equal stakeholders in the systems and where they are treated unfairly, where their voices are either silent or disregarded. I am deeply concerned about the lack of availability of protections for patients and providers participating in all forms of health plans. This includes not only managed care plans in their various forms, but also point-of-service and traditional--fee-for- service--plans as well. The inclusion of self-insured plans, MEWA's multiple employer welfare agreements--and association plans is an important component of this act because it extends provisions to some of those consumers who most need the protections. Many States are currently developing and moving similar bills through their legislatures and assemblies. There is a clear cry for these corrections and protections. However, even if all 50 States were to pass patient protection acts, not all Americans would benefit from these protections. I believe that now more than ever, Federal standards are needed to ensure that consumers are protected in our rapidly changing health care delivery environment. Almost 50 percent of Americans, those who belong to health plans regulated by the Federal Government, are excluded from State based protections. According to a report released by the GAO in July 1995, 44 million Americans are covered under exempt plans. There are an additional 70 million who are covered by other employer plans that may also be outside of the realm of State authority. In addition, self-funded plans are becoming more common, especially in smaller businesses. The standards that I am proposing should assure fairness for consumers and providers, while still encouraging health plans to pursue innovative approaches to providing high quality, cost-effective care. I am sure, Mr. President, that each of us is committed to fairness and understands the need for the Federal Government to work cooperatively with the States on this issue. My Patient Protection Act of 1997 will do several things that will ease the confusion so often present for consumers and providers in the health care system. It will assist them with their rights as participants in health plans. The act will award a grant to each State to establish an office of consumer education counseling, and assistance with health care. This will help consumers choose among the many plans available to them, understand their rights for appeals if care that their provider advises is denied, and receive support if they undertake a grievance procedure. These offices will be modeled after the successful ones in the Medicare Program, staffed largely by volunteers, that have helped seniors find their way through what might be for many an overwhelming situation. The act will require that health plans disclose certain information so that consumers and providers are better informed. Information that must be disclosed ranges from the financial health of the plan to its internal review process and criteria used in making decisions about treatment. No longer will there be a black hole in health plans into which very personal information about a patient goes, something unknown happens and out comes a decision to treat or not treat the problem. That simply is not the way to provide health care in a democracy. The act will require that plans ensure timely access to services and specialized treatment expertise, when clinically indicated. The act will require the development of health plan standards, including utilization review activities and handling of grievances of consumers or providers. Providers and consumers will be involved in the development of these processes. The act will protect providers by requiring mechanisms for due process and disallowing dismissal of providers from the panel of a health plan without cause. It adds antigag clause and whistle-blower protection in order to ensure that consumers receive information that they need about health care options and quality of health care. In a country where many are either uninsured or underinsured, it is especially important that attempts to control costs be accompanied by clear legal rights for consumers and providers. With a competitive insurance market lacking adequate consumer protections and a health care system that says it's OK to leave some people out, what's to prevent plans from discriminating against patients who are likely to need expensive clinical services? Mr. President, these are not anti-managed care provisions. As a matter of fact, they are not anti anything. They are positive steps that will restore a better balance between health plans, consumers, and providers. Responsible health plans already comply with the standards that the Patient Protection Act would establish. But the Patient Protection Act would ensure that all patients and providers are guaranteed at least a baseline of protection. We are currently seeing attempts to regulate health care on a disease-by-disease basis. This is not the best way to protect consumers and providers. We need to focus on maintaining the unique relationship between health care providers and their patients, so that optimal care is available. Congress should not be in the business of deciding how long a patient needs to stay in the hospital for treatment of a specific condition, or whether a specific technology should be offered to a specific patient. We should instead make certain that health care providers can take into account the uniqueness of each of their patients in developing a rational and appropriate plan of care that can be followed. We can do this by ensuring that consumers and providers are included in the utilization review and decisionmaking process. The framework provided by the Patient Protection Act of 1997 will allow this to occur. These issues will become increasingly important as managed care arrangements proliferate, competition increases, more and more Americans and children lose their health insurance coverage, and costs continue to escalate. Until we are willing to make the hard choices and deal with the underlying problems in our current system, the very least we should do is enact some sensible protections that safeguard patients' and providers' rights. Mr. President, many people are fond of saying that health care reform is happening now--employers are managing their costs by enrolling increasing numbers of employees in managed care plans and new provider networks are emerging daily. But with so much attention being paid to the cost and business of health care, the providers and patients are losing substantial control over decisions affecting patients' health. It is therefore all the more important that we provide patient and provider protections. The Patient Protection Act of 1997 will go a long way toward doing that. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, I introduce the Patient Protection Act of 1997. This bill addresses the issue of fairness in health care today. Mr. President, the last few years have seen an enormous growth in managed care health plans. Now, more than 50 percent of Americans are enrolled in some kind of managed care arrangement. We have learned a lot in the past several years about what works and what doesn't in managed care, in all kinds of health insurance for that matter. And, let me be clear that I recognize that there are things that are working well in managed care and other types of plans. We have seen a decrease in the rate of increase in healthcare costs. Health plans are emphasizing prevention and early intervention. Health plans are largely moving from managing costs to managing care to managing health. All of this is good, but enough time has gone by that we have found the problems, the glitches, the occasions and circumstances where patient and providers are not equal stakeholders in the systems and where they are treated unfairly, where their voices are either silent or disregarded. I am deeply concerned about the lack of availability of protections for patients and providers participating in all forms of health plans. This includes not only managed care plans in their various forms, but also point-of-service and traditional--fee-for- service--plans as well. The inclusion of self-insured plans, MEWA's multiple employer welfare agreements--and association plans is an important component of this act because it extends provisions to some of those consumers who most need the protections. Many States are currently developing and moving similar bills through their legislatures and assemblies. There is a clear cry for these corrections and protections. However, even if all 50 States were to pass patient protection acts, not all Americans would benefit from these protections. I believe that now more than ever, Federal standards are needed to ensure that consumers are protected in our rapidly changing health care delivery environment. Almost 50 percent of Americans, those who belong to health plans regulated by the Federal Government, are excluded from State based protections. According to a report released by the GAO in July 1995, 44 million Americans are covered under exempt plans. There are an additional 70 million who are covered by other employer plans that may also be outside of the realm of State authority. In addition, self-funded plans are becoming more common, especially in smaller businesses. The standards that I am proposing should assure fairness for consumers and providers, while still encouraging health plans to pursue innovative approaches to providing high quality, cost-effective care. I am sure, Mr. President, that each of us is committed to fairness and understands the need for the Federal Government to work cooperatively with the States on this issue. My Patient Protection Act of 1997 will do several things that will ease the confusion so often present for consumers and providers in the health care system. It will assist them with their rights as participants in health plans. The act will award a grant to each State to establish an office of consumer education counseling, and assistance with health care. This will help consumers choose among the many plans available to them, understand their rights for appeals if care that their provider advises is denied, and receive support if they undertake a grievance procedure. These offices will be modeled after the successful ones in the Medicare Program, staffed largely by volunteers, that have helped seniors find their way through what might be for many an overwhelming situation. The act will require that health plans disclose certain information so that consumers and providers are better informed. Information that must be disclosed ranges from the financial health of the plan to its internal review process and criteria used in making decisions about treatment. No longer will there be a black hole in health plans into which very personal information about a patient goes, something unknown happens and out comes a decision to treat or not treat the problem. That simply is not the way to provide health care in a democracy. The act will require that plans ensure timely access to services and specialized treatment expertise, when clinically indicated. The act will require the development of health plan standards, including utilization review activities and handling of grievances of consumers or providers. Providers and consumers will be involved in the development of these processes. The act will protect providers by requiring mechanisms for due process and disallowing dismissal of providers from the panel of a health plan without cause. It adds antigag clause and whistle-blower protection in order to ensure that consumers receive information that they need about health care options and quality of health care. In a country where many are either uninsured or underinsured, it is especially important that attempts to control costs be accompanied by clear legal rights for consumers and providers. With a competitive insurance market lacking adequate consumer protections and a health care system that says it's OK to leave some people out, what's to prevent plans from discriminating against patients who are likely to need expensive clinical services? Mr. President, these are not anti-managed care provisions. As a matter of fact, they are not anti anything. They are positive steps that will restore a better balance between health plans, consumers, and providers. Responsible health plans already comply with the standards that the Patient Protection Act would establish. But the Patient Protection Act would ensure that all patients and providers are guaranteed at least a baseline of protection. We are currently seeing attempts to regulate health care on a disease-by-disease basis. This is not the best way to protect consumers and providers. We need to focus on maintaining the unique relationship between health care providers and their patients, so that optimal care is available. Congress should not be in the business of deciding how long a patient needs to stay in the hospital for treatment of a specific condition, or whether a specific technology should be offered to a specific patient. We should instead make certain that health care providers can take into account the uniqueness of each of their patients in developing a rational and appropriate plan of care that can be followed. We can do this by ensuring that consumers and providers are included in the utilization review and decisionmaking process. The framework provided by the Patient Protection Act of 1997 will allow this to occur. These issues will become increasingly important as managed care arrangements proliferate, competition increases, more and more Americans and children lose their health insurance coverage, and costs continue to escalate. Until we are willing to make the hard choices and deal with the underlying problems in our current system, the very least we should do is enact some sensible protections that safeguard patients' and providers' rights. Mr. President, many people are fond of saying that health care reform is happening now--employers are managing their costs by enrolling increasing numbers of employees in managed care plans and new provider networks are emerging daily. But with so much attention being paid to the cost and business of health care, the providers and patients are losing substantial control over decisions affecting patients' health. It is therefore all the more important that we provide patient and provider protections. The Patient Protection Act of 1997 will go a long way toward doing that. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. WELLSTONE

Mr. WELLSTONE. I shall be brief, Mr. President. The majority leader, I appreciate his graciousness. I actually like his passion. It does not trouble me at all. Mr. President, I actually made it very clear that I am not trying to--he has his own ideas about what should be in a bill. I did not insist on a particular piece of legislation. We have the McCain- Feingold bill that has been much talked about and could be a vehicle that people could work with. My point is I learned through the gift ban we only finally took action when we just started putting that piece of legislation on other bills. The majority leader is, after all, the majority leader, and, yes, we are now on the constitutional amendment to balance the budget, but the majority leader, I think, can be a real leader on this if we can get a commitment that says, look, we will not have delay and delay and delay. We will have a bill on the floor and resolve this by July 4 or whatever date the majority leader picks out, and that makes it clear to people in the country that we are not going to just stall and stall. The majority leader is talking about today's piece in the Washington Post, but the point is we do not really need to find out that there are problems in the way campaigns are financed. This has been going on for a long time. There is plenty to be fixed. People in the country are experts at what they do not like. There is no reason whatever that we cannot move forward with a bill. I just would like to get a commitment. I take it from what the majority leader has said today and the way he said it that he is not ready to make such a commitment. That is fine, but I want to be clear that if that is the case come March, I think the majority leader can expect to see at least on my part as a Senator from Minnesota, some different parts of campaign finance reform as amendments on other bills. I want colleagues to know that this time I am not objecting to the UC for recess. But, come next spring--and this is plenty of warning--that may very well happen.

Mr. WELLSTONE. I am pleased to respond to the majority leader. I did not know we would have quite this debate but I understand----

Mr. WELLSTONE. Mr. President, reserving the right to object, I shall not object, I just wanted to bring up two quick questions with the majority leader. Last time after the swearing-in ceremony, the majority leader will remember that I said I might object and I asked the majority leader whether I could get some kind of a commitment for a clear timeframe for taking up comprehensive campaign finance reform. I do not know whether the majority leader is prepared to make that commitment tonight, but I do want to be clear that if by March when we come back there has been no commitment made as to when we will have a bill on the floor and how we will move forward on it--because otherwise I fear delay and delay and delay, much like we did with gift ban--I will start to take amendments, campaign finance reform amendments, and attach those amendments to other bills because I believe we have to move this discussion forward. I think people want action. I am interested in the response of the majority leader. I want to make clear to colleagues, because I think you need to give people a warning, that when we come to our next recess it may be the case that I will not agree to a unanimous consent. So I am using the model the majority leader and I worked out together at the end on gift ban and we came up with reform. I am using that model, and I think it is important for Senators to be out here on the floor really pushing very hard for this. I wonder whether the majority leader could tell me whether he has any plan now, whether we could get a specific time when we could have a bill--again, I am not trying to predetermine what the piece of legislation would be--on this floor.

Mr. WELLSTONE

Mr. WELLSTONE. I reserve the remainder of my time. Mr. President, I yield the rest of my time.

Mr. WELLSTONE. Mr. President, when Senators vote on this they should not confuse two different issues. There is not anybody on the floor of the Senate that I know of who is opposed to balancing the budget. There are Senators who oppose this amendment. My colleague keeps talking about balancing the budget or passing the constitutional amendment to balance the budget is the best thing that we can do for our children. My amendment speaks to the concerns and circumstances of the lives of poor children. Close to one out of every four children in America is poor. One out of every two children of color is poor. Every 30 seconds a child is born into poverty in our country. Every 2 minutes a child is born to a mother who has had no prenatal care. Every 12 or 13 seconds a child drops out of school, many of them children from poor families. And there is a higher correlation between high school dropout and winding up in prison than there is between cigarette smoking and lung cancer. Mr. President, all too many of our children are rushing into the arms of the police and not into parents' arms, or teachers' arms. My colleague used the word ``gimmick.'' This is no gimmick. This is a very serious amendment because for these children they don't have any future. How can you argue that a child who is born severely underweight and damaged and who can't do well in school is going to benefit by deficit reduction and balancing the budget 7 years from now? What about that child right now? How can you argue that the 50 percent of children or the 60 percent of children who could be given a head start but come to school without a head start not ready to learn are going to do well, if we do not make a commitment that we are going to invest in them? Balancing the budget 7 years from now does not help those children right now. There are 10 million children who have no health care coverage, most of them from working poor families, many of them with ear infections who have lost hearing; too many. Many can't read well because they should have had an eye examination. They can't afford it. Many of them should have dental care, and they come to school with an infected tooth and abscess. They can't learn well. It is difficult for children who are in pain and discomfort to learn well. If we do not make a commitment that in balancing this budget we will not balance this budget on the backs of those children and we proceed to do what we did in the last Congress, which is disproportionately cut programs that affect poor people and poor children in America, they don't have any future. What good does it do those children if we are going to balance the budget 6 years from now if we are going to savage them right now? This is all about values. And if my colleague means or is sincere-- and he always is. I guess it is just an honest difference that we have--that surely we are not going to make these cuts, that is what we have done in the past because these children don't hire the lobbyists. They don't march on Washington every day, and one more time they are not the big givers. Maybe there is a connection with all that we are reading about money and politics. Mr. President, I ask all of my colleagues whether you are against this constitutional amendment to balance the budget or whether you are for it to vote for this amendment. It is all about fairness. We ought to go on record. We ought to make it clear that in our effort to balance the budget with a constitutional amendment--or the way I prefer to do it, not a constitutional amendment--that we go on record that we will not do what we have all too often done in the past--unfortunately, the evidence is clear--that we will not disproportionately cut the programs that benefit and affect the health and the nutrition and education of children. What is the definition? Just pick out the percentage of low-income programs that are part of the entitlement programs. Pick out the low- income programs for children that are part of the discretionary spending. Pick out the percentage, and in our overall cuts, don't cut them any higher. It is simple. It does not take a rocket scientist to figure it out. Let us not weave and dodge on this question. I hope that I can get a strong vote. It is a difficult debate because the Senator from Utah is one of the Senators whom I like the most and whom I respect the most. It is an honest disagreement. But I hope Senators will vote for this. It is the right thing to do. This does not say we are not going to balance the budget. This does not say we should not do what the Senator from Utah believes we should do. It just says that if we are going to lock ourselves into a constitutional amendment, or, if we do not do that, we are still going to make the commitment to balance the budget, that we will not balance the budget on the backs of poor children; that we will invest in the skills, health, and character of children in America, including poor children. These are all God's children. I am telling you something, and I could argue this for 24 straight hours, the history of the way we have done deficit reduction is that they come out on the short end of the stick. This amendment I think is the right thing to do. It puts us on record and it makes it clear that we are going to balance this budget based upon the Minnesota standard of fairness. Mr. President, how much time do I have left?

Mr. WELLSTONE. Mr. President, I reserve the balance of my time.

Mr. WELLSTONE. I thank the Chair and, again, I thank my colleague. I appreciate his kind words. I know he is very sincere in the offer. Again, what happened last time was we went ahead and adopted an amendment saying we would not take any action to create more malnutrition, hunger, or poverty among children, and then we went ahead and did budget cuts that, in fact, disproportionately affected poor people in America, many of them children. Mr. President, I really do view this amendment as a litmus test. I think I do want to draw a line in the sand here. If Senators put children first, and Senators believe we ought to invest in the health and skills and intellect and character of our children, and Senators understand--and they do--that what happens before kindergarten is so important, then I do not know why in the world we cannot make a commitment that when it comes to programs like Head Start and WIC and health care programs that affect poor children in America, that we at least make a commitment that we not disproportionately cut those programs. As to which programs, listen, with a lot of what is in this amendment, we are going to be writing implementing language, that is all going to be made specific. So I just do not think that critique really does any damage to this amendment. I would like to speak, again, about what is at stake. Yesterday, I read from some examples, just some stories of some families as we kind of reach out and talk to people around the country, not just Minnesota. Marlene is a lot like many women. She went from her parent's home to her husband's. With the exception of a waitressing job in high school, she never had worked outside the home, and had no job skills. After 9 years of marriage, Marlene's husband left her with two children and pregnant with a third. At 27, she found herself alone with no job skills or means of support. With the help of a neighbor, she enrolled in her local WIC Program. ``I knew about nutrition, child care and how to take care of myself. I just didn't have the money to. I knew that I needed to have a healthy baby. I just did not know how to get it.'' WIC provided Marlene with vouchers to purchase the basics for a healthy baby--milk, cheese, eggs, et cetera. To this day, I believe that the food from WIC saved me and my baby. Emotionally, I was so distraught and inept, I didn't know if I was coming or going. Thankfully for WIC, for that part of my life, I could just go on auto pilot. I knew that I was taking care of my baby. I could go on with taking care of the rest of the issues I was facing. It has been 10 years since Marlene received help from WIC. Now she works full time and supports her children. She says, WIC was crucial for me. WIC was like a bridge to help me go from being dependent on someone to learning how to take care of myself and my kids. It's like they took care of me so I could take care of the rest of my life. I cringe to think of how things would have been without it. Mr. President, Danielle is 8 years old. She looks closer to 6. Though a spirited and cheerful little girl, Danielle struggles in life. She was born at a low birth weight and has endured its effects. She will for a long time. As with many children born at a low birth weight, she has a limited immunity system and she catches a lot of colds and flus. She misses a lot of school. Like many children born at low birth weight, it takes Danielle a bit longer to figure things out in school. Says her teacher, ``I see her little brain trying to figure things out. She works hard and struggles. She's always a few steps behind us.'' While pregnant with Danielle, her mother had no prenatal care or guidance. Every 2 minutes a baby is born to a woman, a mother who had no prenatal care in our country. Her diet of chips, fast food, soda, and candy did not change during the 8\1/2\ months of pregnancy. Danielle's mother did not participate in the Women, Infants, and Children Program. At 5, Danielle's sister Alfrieda is healthy and active. While pregnant with Alfrieda, her mother participated in WIC. She had a healthy diet, checkups, and guidance. When she gave birth, she then gave birth to a fit and strong baby. She named her after the WIC nurse who mentored her. Says their mother: I see how Danielle is not all there * * * how she's slow and kind of sick. They tell me it is 'cause of how it was when I was pregnant. I think they are right 'cause I really see a difference with my baby, Alfrieda. You would not know that Danielle is older. In one family, in the case of two sisters, we see the impact and influence that WIC has. Danielle will always be a little behind, a little slow, and a little weak. Alfrieda will always be a bit smarter than her older sister, a bit ahead of her older sister, and a bit stronger than her older sister. One small family and one big difference. Mr. President, I said this yesterday, the medical evidence is irrefutable and irreducible that the most important educational program for our country is to make sure that every woman expecting a child has a diet rich in vitamins, minerals, and protein; otherwise, that child at birth may not have the same chance as all of our children and grandchildren have. And that is wrong. The goodness of our country is for every child to have that chance. Mr. President, we do not even fully fund the Women, Infants, and Children Program right now, a program for women during pregnancy, a program for infants, and a program for small children who, by definition, do not have enough income to be able to purchase the food to have an adequate diet. We know the WIC Program has made an enormous difference. It saves us dollars. It enables children to have a head start. It enables children to go on and do well in school. We know all of that. The only thing this amendment says is, let us make a commitment if we are going to balance this budget that in this constitutional amendment to balance the budget we make a commitment we will not, as we move forward, disproportionately cut programs that affect the nutritional status of children. That is what this amendment is all about. It is not a sense-of-the-Senate amendment. I do want to draw a line on this. I believe I should be able to get a strong vote for this. I do not think it should be tabled. This is all about, as we go forward with deficit reduction, who is going to decide and who is going to benefit, and who is going to be asked to sacrifice. Are we going to decide, as we did last Congress, that we are going to disproportionately cut programs that affect the quality of life for children, poor children in America? Who will decide to cut the nutrition programs and whose children will be hurt? They will not be our children, but they are all of God's children. I think we all agree on that. So I am really hopeful that I will get support for this amendment. This is about values. We talk about values. This is about values. This is about Minnesota values. If you asked people, are they in favor of a constitutional amendment to balance the budget, they say yes. I have been in disagreement. I wish we would separate the capital investment part of the budget from on operating budget. I worry about it on political economic grounds. But forgetting that, most people say yes. But if you ask people, are you in favor of balancing the budget by making cuts in educational programs or nutritional programs or health care programs that affect children, they say no. So I am hoping that this will not be tabled and that Senators will vote for it. Arel is only 14 years old but has the responsibility of someone much older. He has two sisters. Even though they are at the right age and eligible for Head Start, they do not participate because the program near their home is full. I forget--I do not have the numbers right before me--but something like only 17 percent of the eligible 3-year-olds are participating and only 40 percent of the eligible 4-year-olds are participating. Really, we should work Head Start back, Mr. President, to age 1 and 2 as well. By the way, it should be decentralized. This is a parent- participation program. It should happen at the local level. It should happen at the neighborhood level. It can be done through nonprofits and it can be done through nongovernmental organizations. But when we know something works, when we know these kinds of programs give children a head start, why can't we make a commitment that we will not disproportionately cut these programs? Because if we do not make that commitment, I really fear that is what is going to happen. While we know how no Head Start will affect Arel's sisters, do we know how it is going to affect Arel? Their mother leaves for work as a bus driver at 4 a.m. She is working. This means Arel is responsible for the morning ritual with his sisters. After he gets them fed and dressed, Arel puts one sister on the handlebars of his bike and rides 5 miles to drop her off at affordable day care. He returns home and gets his second sister to drop her off. Since he cannot drop them off early, he is late for school every day. Because of tardiness, he failed his first-period class twice. Though a talented athlete and a popular kid, Arel does not stay after school for any activities. He would probably make the football team. He is interested in track. He would love to be in a dance troupe. Instead, Arel gets on his bike, rain or shine, to pick up his sisters one at a time. I will not reveal to you what no Head Start means for his sisters. We know that. Unfortunately, so does their brother, a boy who has no childhood. Finally, Mr. President, Marcus is a shy and quiet first-grader who finds himself in the principal's office for the third time in a week. I gave this example yesterday. According to his teacher, Marcus is either overagitated, annoying other students in class, or listless and disinterested in the class at hand. Marcus does not usually know what is happening in class and he does not know yet his colors, numbers, or alphabet. Though many of his class attends a Head Start program and learns the initial steps toward understanding school and learning, Marcus does not. He represents 1 of the 1.2 million children that, though eligible, could not participate in Head Start when he was younger. The program near his home was full. Not only were they full, but there was a year waiting list when Marcus's grandmother tried to sign him up. Though there was room at another program, it was too far for his grandmother to take him. Marcus stayed alone sometimes at home while his grandmother worked. Marcus is conspicuously behind his classmates. While his classmates scurry around the teacher to be read to, he had not yet held a book or ever been read to. While his classmates--I am going to repeat this-- while his classmates scurry around the teacher to be read to, he has not yet held a book or ever been read to. Marcus does not know how to write his name, nor can he recite the alphabet. In a phrase, Marcus is not part of the culture of the school. Marcus' teacher is concerned and anxious about him. He is far behind his classmates, and she has little, if any, time to help him catch up. As each week progresses, he falls further behind and more frustrated. Already Marcus hates school and learning, counting the days until summer vacation. He knows he is different. He knows he does not understand. But he also knows there is not much he can do about it. Said his teacher: ``I just don't know what can be done for him. I know that he needs a lot of one-on-one attention and love, but I just don't have the time or the resources. Every day, I feel him slipping and, frankly, it breaks my heart. He is a good boy and a smart boy. I feel as if he is being punished for what we did not do for him. I am worried that he will always hate school and suffer until he can leave. He tries so hard, sometimes,'' says his teacher, ``I want to cry.'' Mr. President, I do not want Senators to make this amendment out to be what it is not. There is an amendment on the floor. It is a constitutional amendment to balance the budget. This amendment says, as a part of that constitutional amendment to balance the budget--if that is what we are going to do--we make a commitment that we are not going to disproportionately cut programs that affect the educational and nutrition and health care status of children. It is that simple. This is about values. This is about fairness. I think we should make that commitment. I think we should make that commitment. Mr. President, we can no longer give speeches about children and no longer have photo opportunities with children unless we are willing-- unless we are willing--to invest in the health and skills and intellect and character of our children. Mr. President, that includes poor children, and that means we are part of local communities, but we are part of a national community. The U.S. Senate ought to go on record that these are our priorities. These poor children are a part of our priorities. That is appropriate, and it is the right thing to do. Mr. President, how much time do I have left?

Mr. WELLSTONE. I will be pleased to yield on the Senator's time.

Mr. WELLSTONE. If I could just finish. I think this time around, given the track record of the last Congress and given the fact that the citizens that I am trying to represent today--poor children--do not seem to have much of a presence here, quite frankly, I do not think a sense-of-the-Senate amendment does the job.

Mr. WELLSTONE. Mr. President, I appreciate the comments of the Senator from Utah. Actually, the language of this amendment is constitutional. It is designed that way. If there is going to be a constitutional amendment to balance the budget, I say to my good friend from Utah--and he has taken the leadership on this, he absolutely believes in it--if that is the direction we go in, then it is quite appropriate for me to have an amendment to this amendment to make sure that we do not lock ourselves into some very harsh and distorted priorities. I tried the route of a sense of the Senate last Congress, and actually I lost a couple of times on a sense of the Senate that we would not take any action to create more hunger, malnutrition, and poverty among children. Finally, it was adopted on a voice vote. I wish there had been a recorded vote. Then I think we went ahead and, in fact, passed some legislation or provisions of some legislation that is going to create that.

Mr. WELLSTONE. I will be pleased to yield on the time of the Senator from Utah.

Mr. WELLSTONE. Mr. President, yesterday I had a chance to speak for some time about this amendment and then Senator Hatch and I had a very honest exchange of views. Let me one more time just make clear to colleagues what this amendment says. This amendment says that if we are going to make a commitment by way of a constitutional amendment to balance the budget, then we go on record that the Federal outlays, as we do this, should not be reduced in a manner that disproportionately affects outlays for education, nutrition, and health programs for poor children. Yesterday my colleague, Senator Hatch, said I was asking for an exemption. There is no request for an exemption. This is just simply a request for fairness, and it just simply says let us not lock ourselves into a very harsh set of priorities. I also pointed out yesterday that in the last Congress, 93 percent of the cuts in entitlement programs were entitlement programs that affected poor people in America, too many of them poor children. I also cited the Committee on Economic Development, representing really some of the largest corporations in America, saying that what we did last time, last Congress, was really disproportionate and really not based on a standard of fairness, because we cut a lot of programs that were important to the nutrition and health care and educational status of children. I also quoted from the Concord Coalition, which has been a driving force for our balancing the budget, taking the same position. I also quoted from an editorial yesterday in the Washington Post. I think the most important thing that I did yesterday, though, Mr. President--and I would like to start this way today, and then develop these points, and then listen very respectfully to my colleague from Utah, and then respond to some of what he has to say--was to try to translate this debate into human terms. Yesterday, my colleague from Utah said, and I appreciated it, ``You know, I don't agree with Senator Wellstone but he is very sincere in his conviction.'' And I appreciated that. That's a tribute from another Senator. But this is really not about me. This is an amendment that I think is substantive, I think it is important, and I wish there would be 100 votes for it. Because the fact of the matter is, all too often--and that was the record last Congress and I think it has been the record of too many Congresses--when we come down to the nitty-gritty, to the point where the rubber meets the road, we do deficit reduction based on the path of least political resistance. And usually, all too often, it is not the special interests or heavy hitters or well connected or big givers who are the ones that we target. And poor children have been, with the exception of some Senators, the Chair is one of them--you have shown a tremendous commitment to what we can do at a neighborhood level, at a community level, as has the Senator from Missouri, by way of commitment to children. But all too often, poor children in America are faceless and voiceless in the U.S. Senate, and I just think that it is not at all inconsistent for Senators--even if they are for this amendment, to vote for the constitutional amendment to balance the budget--to at least vote for this proposition. As a matter of fact, we are going to make it clear we are going to do it on a standard of fairness, and we are not going to disproportionately make cuts in programs that so vitally affect the nutritional and the educational and the health care status of children.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, I am pleased to introduce the Ambulance Services Act of 1997 today to ensure that Medicare beneficiaries are covered for necessary transport for emergency treatment. I am deeply concerned that Medicare beneficiaries in rural areas have a difficult time gaining access to emergency care, and there are relatively few hospitals in these areas, and patients must often travel a great distance to reach them. The Medicare ambulance transport reimbursement regulations have not kept pace with changes in the health care system that have occurred as a result of efforts to improve care while decreasing the cost of care. In many locales, clinics and ambulatory surgery centers staffed by physicians have developed the ability to provide routine emergency care. The local physicians are often available at the clinic, which has facilities and capability for emergency treatment. In fact, patients who are transported to the hospital emergency department during the day wait longer to see a physician than those at the clinic, as the physician must travel from the clinic to the hospital in order to see the patient. It is often necessary for seniors who are experiencing a medical emergency to be transported via an ambulance. Under current regulation, seniors who require ambulance transport to an emergency care facility must be taken to a hospital. Therefore, the senior is left with a difficult choice: be transported to the hospital facility, which may take longer and is likely to involve a longer waiting time for emergency care, or be transported to a local facility that provides emergency care to other citizens, and pay for the ambulance transport out of pocket. Neither of these is an optimal choice. As the reimbursement policy stands now, patients are required to use a more expensive facility when it may not be necessary. It would seem that allowing reimbursement for transport to nonhospital facilities that provide emergency care could result in fiscal savings in that the cost of ambulance transport combined with a clinic visit bill would be less than that of ambulance transport and a hospital emergency department bill. In addition, it would allow our senior citizens to have a health care benefit that is available to other members of the community. Concerns that might arise about the medical necessity of transporting certain patients to a hospital emergency department can and should continue to be addressed by local and regional emergency medical service systems, based on levels of care that are available in the area. These systems set standards and protocols for emergency medical service providers and work with the health care community in developing protocols for transport and patient care. Mr. President, I remain concerned about providing all of our citizens with an adequate level of health care. Our seniors need to be able to avail themselves of expeditious emergency care, without having to worry about how transport for this care will be paid for. The Ambulance Services Act of 1997 will go a long way toward this goal. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. WELLSTONE

Mr. WELLSTONE. Madam President, the answer is no, absolutely not, on the basis of what was attempted. Also on the basis of some of the cuts made in the last Congress, the evidence is quite to the contrary. The evidence is, in the absence of some assurance and some sort of commitment in spite of all the speeches made and words uttered, we will make disproportionate cuts in the programs that affect health, nutrition, and educational status of these children. If the Senator from Vermont would not mind if I go on briefly and respond to some of the comments made by my colleague, the Senator from Utah. First of all, sort of a clarification about how you define ``disproportionate.'' It is pretty simple. Again, the evidence, and I am interested if somebody wants to argue with it, in the last Congress 93 percent of the budget reductions in entitlements came from programs for low-income people. Madam President, 93 percent. All you need to do is figure out the percentage of the overall entitlement programs that are low income and you do not cut by more than that. We have the same thing with discretionary. You do not have to be a rocket scientist to understand what the amendment says. You cannot dance around it. Second, in all of the amendments we introduced and all the amendments that the majority party is introducing, in this whole constitutional amendment there will be implementing legislation to work out the final details. Third, Madam President, as to the Constitution and whether you can have policy in the Constitution, I am not a lawyer, but article III says: The judicial power of the United States, shall be invested in one supreme Court, in such inferior courts as the Congress may from time to time ordain and establish. The Judges, both of the supreme and inferior Courts, shall hold their offices during good Behaviour, and shall, at stated Times, receive for their Services a Compensation which will not be diminished during their Continuance in Office. It certainly seems as if we have such policies in the Constitution right now. Madam President, what troubles me the most about the comments of my colleague from the Senator from Utah, first of all, he talks about this amendment giving an exemption. There is no exemption. This amendment just says give them what we did last time. Make a commitment that we will not disproportionately cut programs that vitally affect the nutritional, educational, and health care status of poor children in America. I gave examples of those programs in the way they work and what they mean to children. That is all it says and no more. Senators should be clear on what they are voting on. Finally, Madam President, and I want to be clear if I could get the attention of my colleague from Utah, I do not want him to think I say this without giving him a chance to respond, but in all due respect to my good friend from Utah, when we talk about bringing the deficit down and real interest rates down, and that is the way to help children, a lot of the children that I have talked about, Senator, do not have that future. If we do not make a commitment that we will make sure that they have adequate diet, adequate nutrition, that they come to school prepared to learn, that they come to school in good health, they are not going to have this future. For gosh sake, we should not in the name of deficit reduction savage poor children in America today. You do not want an up-or-down vote? You will vote to table. Fine. But this amendment is substantive. It speaks to the very real problem of the deficit reduction based on the path of least political resistance, picking out the most vulnerable citizens. If we do not make a commitment that we are not going to cut these programs that are so vital to poor children's lives--as a matter of fact, we should be investing much more--then these children do not have a future. Deficit reduction, I am all for. Balancing the budget, we should do it. But instead of focusing on poor children in America, why do we not focus on the subsidies that go to oil companies, tobacco companies, pharmaceutical, big insurance companies, and a whole lot of other corporate welfare? Why do we not focus on the $17 billion over 2 years more than the Pentagon requested wanted for the Pentagon? There are other places to make the cuts, but I say to my colleague from Utah, and I am sorry to say with indignation, this is anything but an abstraction to the children I am talking about. Your argument about how the best thing for these children is to make sure we balance the budget because real interest rates will come down-- by the way, the Federal Reserve ought to bring the real interest rates down right now if everybody is right, I am not sure they are about the Consumer Price Index having overstated inflation, what in the world are we talking about even the possibility of real interest rates going up? They ought to be going down. Above and beyond that point, it does not do the children that I am talking about today one bit of good to talk about balancing the budget in the future when you balance the budget on their backs. That is what we did the last Congress. That is what we did the last Congress. I am just saying, Senators, we should do this on the basis of some standard of fairness. I still think I can get 100 votes for this. I hope the Senator from Utah tomorrow, after we have a little bit more time for final debate, will not move to table this. I hope he will support it. With all due respect, the evidence does not suggest that with the absence of this assurance we will not make these cuts in exactly these decisive areas of life that so crucially affect the quality, or if we do not make this commitment, the lack of quality of the lives of poor children in America. I yield the floor.

Mr. WELLSTONE. I know the Senator from Vermont wants to speak, and then I will, after the Senator from Vermont speaks, respond to some of my colleague's points. I don't understand, I will say to my friend from Utah, he talks about tabling the amendment because this is an orderly way to do it. I don't understand why an up-or-down, yes-or-no vote isn't just as orderly. What is the problem with an up-or-down vote as opposed to tabling? It is just as orderly. The second thing--I guess it is less a question, and I don't know if my colleague, who is a good friend, meant it in this way--I don't think this is a game. This is less a question than, I guess, a response. I don't think it's a game at all. I don't think it's a game to these children, and it is not a game to me. I just want to be clear about it. It is an amendment offered out of respect. It is an amendment that I believe is profoundly important for our country. It is an amendment I hope Senators will support. It is not a game. It is not a game.

Mr. WELLSTONE. Will the Senator yield for a moment?

Mr. WELLSTONE. Will the Senator yield?

Mr. WELLSTONE. Mr. President, there is another interesting statement from the Committee on Economic Development. By the way, I would like to congratulate the business community in our country. The Committee on Economic Development over and over and over again, over the last several years, have said, from the point of view of economic performance for our Nation, we must invest in the health, skills and intellectual character of our children. We must do that. I quote, as a part of a letter that was written November 26, 1996, by the senior vice president and director of research of the Committee on Economic Development: Second, in an unfortunate surrender to misplaced ideology and political opportunism, our leaders in both political parties have increased the magnitude of the financing problem by insisting that tax reductions be included in their balanced budget plans. That was their view. By the way, I think we are going to have to look very closely at some of those budget proposals. My understanding is the Joint Tax Committee, in projecting the majority party's tax cuts over the next 10 years, has identified close to $500 billion in the first 5 years more targeted toward middle-income people and the second 5 years more targeted toward wealthy, high-income people. What is going to be the offset? Cuts in the nutritional and educational and health care programs for poor children in America? If that was the case, that would be unconscionable. If there was some sort of budget deal that leaves these children out in the cold, that would be unconscionable. The senior vice president of the Committee on Economic Development goes on to say: Third, as a result of the fiscal pressures created by these two factors, the burden of budget austerity has fallen disproportionately on those parts of the budget, and those parts of society, that offer the least political resistance. Actually, I have been saying that over and over again. I guess we are in agreement. I am pleased to hear them actually state it that way. For the budget that means that the discretionary annually appropriated programs, including those public investment activities for a society--it quite simply means the poor. Now the quote: As David Stockman observed a decade ago, politics triumphs over policy in seeking out weak clients rather than weak claims. This amendment asks us not to let politics triumph over policy. This amendment asks us to seek out the weak claims, not the weak clients. This amendment says we go on record that when we balance the budget, we will not cut disproportionately those programs that affect the health care, nutritional and educational status of poor children. We ought to have 100 Senators voting for that. We can go forward to balance the budget. We can go forward with deficit reduction. But given the way we did it in the last Congress, and the evidence, I must say to my colleagues, it is irreducible and irrefutable that we ought to at least make this commitment. Mr. President, the Washington Post in an editorial written today had this to say: The balanced budget debate is only in part what it purports to be--an argument over the deficit, savings, growth, and the shifting of cost to the next generation. It is also a sharp debate over social policy, conducted in fiscal code. If you decide to balance the budget, the question immediately becomes, at whose expense? The budget is by its very nature a redistributive device. On balance, it tends to move money from people who are better off to those who are not. If you narrow the deficit, will it end up doing more of that, less or about the same? This editorial goes on to make the argument that if we are going to do it, we ought to do it on the basis of a standard of fairness. We did not do that in the 104th Congress. This amendment asks the U.S. Senate, in the 105th Congress, Democrats and Republicans, to go on record that if we are going to balance the budget, we are not going to do it on the basis of the path of least political resistance and not going to go after weak clients. We are going to go after weak claims. And we are not going to end up passing budgets that disproportionately cut programs that affect the health, nutritional and educational status of poor children in America. If I were to get 100 votes, I would feel like I have died and gone to Heaven. I really would. I am so hopeful that my colleagues will vote for this amendment. Mr. President, in an interesting poll result, the Committee for Education Funding points out that whereas there is support for the constitutional amendment to balance the budget--and there is. I have been opposed to it. You have to ultimately follow your conviction and vote for what you think is right or wrong. Senator Hatch clearly takes another position, and he votes his conviction. No one would ever say otherwise. But it is interesting that public opinion polls show--according to the Committee for Education Funding--that 90 percent of Americans support maintaining or increasing Federal support for education. When directly asked if they would support a balanced budget constitutional amendment that reduces funds for education, nearly 70 percent disagreed. So this amendment just asks us to be clear about how we intend to do this. Mr. President, just a little bit more context. I am going to get a chance to speak on this amendment today, and then I guess we will go back to the Durbin amendment and tomorrow get a chance to speak and then have a vote. We are, as I said the other day on the floor of the Senate, in many varied ways a model for much of the world. I mean, we should be so proud of our country, the diversity of our country, so proud of our economic performance, so proud of our leadership in the world, so proud, I think, of really helping to create a world where we no longer have to think so much about a nuclear war that could be the end for our children and grandchildren. But there is at least one way in which we are not a model, one area in which I think in recent years we have been moving in the wrong direction. And that is in fulfilling our national vow of equal opportunity. That kind of national commitment is in need of refurbishing and renewal. I bring this amendment to the floor because more than 35 million Americans are poor. That is one out of every seven citizens. In 1994, of poor children under the age of 6, nearly half lived in families below half the poverty line. That figure has doubled over 20 years. The number of people who work and are poor and work full time, 52 weeks a year, 40 hours a week, and still are poor has dramatically increased as well. Mr. President, minorities are poorer than the rest of Americans. African-Americans are close to 30 percent, Hispanics at a little over 30 percent, and female-headed households are even poorer, and 44.6 percent of the children who live in such families are poor. In 1994, almost half of all children who were poor in America lived in female- headed households. So what we have here is one out of every five children poor, but it is getting closer to one out of every four children. One out of every two children of color are poor. Unfortunately, we cannot turn our gaze away from this reality, a strong convergence between poverty and race and gender and children in America. I am asking us to go on record to be for fairness in how we do this deficit reduction. Mr. President, let me give a few examples of the kinds of programs that I am talking about when I say that we should go on record that we will not disproportionately cut these programs that affect the nutritional health and educational status of children. Let me start out with the Women, Infants, and Children Program. Let me make a point with my colleagues, because sometimes I am going to give a lot of examples. I am going to talk about women and children. I want to translate these statistics into personal terms. But, first, as a teacher, I think I have said it before on the floor of the Senate, but I want to say it again. I was a college teacher for over 20 years. I have been in a school in Minnesota probably about every 2 weeks ever since I was elected. It is just crystal clear to me that the most important educational program in the United States of America--you know we talk about higher education. I was a college teacher. It is a big issue. It cuts across affordable higher education, cuts across a broad section of the population that people are very focused on, and it should be. But as a matter of fact, I think the most important educational program is to make sure that every women who is expecting a child has an adequate diet, rich in vitamins, minerals, and protein. It is just a fact. It is just a fact. The evidence is irreducible and irrefutable and it is medical evidence. If we do not make sure that every woman carrying a child has an adequate diet, all too often her child will be born severely underweight, her child will be born with an impairment that may mean that no matter what we do in our public schools, that child will never have the same chance as probably all of our children, Senators' children, or grandchildren. It is the essence of the American dream. It is the goodness of our country, for us to say that every child, no matter what race or gender or income of family, will have the same opportunity to reach her full potential or his full potential. That is what my father, who was a Jewish immigrant from Russia, taught me about our country. That is the greatness of our country. It is not too much for me to ask my colleagues to go on record that in balancing the budget we will not make any cuts in the most important educational program, the Women, Infants, and Children Program. In 1996, Mr. President, WIC provided assistance for 7.2 million women, infants, and children. That was about 60 percent of the eligible population. There are about 11 million women and children that are eligible. So, some women and some infants and some children are left behind. Mr. President, let me talk a little bit about the WIC Program. It was established as a pilot program in 1972 and it was made permanent in 1974. It is administered by the U.S. Department of Agriculture. Who is eligible? Pregnant or postpartum women, infants, and children up to the age of 5 are eligible. Mr. President, how many people does it serve? More than 7 million people get WIC benefits every month, and participation has risen steadily. Children are the largest category of WIC recipients. Of the average 6.89 million people who received WIC benefits each month, 3.5 million were children, 1.8 million were infants, and 1.6 million were women. Mr. President, this is a program that is a huge priority or should be a huge priority for this Senate. It is a success story. Sometimes we harp on the complexity of it all like we do not know what to do. I am in agreement with every single Senator that says some of these Government programs ought to be reevaluated, some of them do not work well. But from the point of view of decency, of fairness, of justice, of saving money--what is the figure? For every $1 we invest in the Women, Infants, and Children Program, it is $3 less we spend in medical assistance later on. WIC is a huge success story. The Women, Infants, and Children Program reduces fetal deaths and infant mortality. WIC reduces low birth rates and increases the duration of pregnancy. WIC improves the growth of at- risk infants and children. WIC decreases the incidence of iron deficiency anemia in children, improves the dietary intake of pregnant and postpartum women, and improves weight gain in pregnant women. Pregnant women participating in the Women, Infants, and Children Program receive prenatal care earlier. I think, Mr. President, about every 2 minutes in America a child is born to a woman who had no prenatal care. Children enrolled in WIC are more likely to have a regular source of medical care and are better immunized. Children who receive WIC benefits demonstrate superior cognitive development. WIC significantly improves children's diet. WIC is cost effective. I am just asking my colleagues to make a commitment that we will not disproportionately cut this program as we move forward to balance the budget because in the last Congress we disproportionately made cuts in programs that affected those citizens who did not have the political clout here, who did not give the big dollars, who are not the heavy hitters, who are not the well connected. This is a distorted priority if we at least do not make a commitment on behalf of these children. Mr. President, I will give some examples from the Women, Infants, and Children Program, but I want to first of all call attention to my colleagues to a special report in Time magazine February 3, 1997, ``How a Child's Brain Develops and What It Means for Child Care Welfare Reform.'' Mr. President, I congratulate Time magazine for this issue. I really believe that we will see major change in how we think about our priorities here as a result of the kind of research that Time magazine reports on. Basically, if I had to summarize this whole issue, the conclusion is as follows: If you do not make sure that women expecting a child have an adequate diet, if you do not make a commitment to these children when they are young, if you do not make sure that they do not have not only adequate nutrition and adequate health care, but if you do not make sure that they do not have intellectual stimulation, a nurturing and caring environment--and by the way, Government cannot do all of that. The President knows that. Much of that is up to the family. If you do not make sure that that does not happen, then by age 3 for many of these children, it is almost close to all over; certainly by age 5. I think that what we are going to see and more of the concern that will come out, and it will be compelling, if we do not make the investment, if we do not do everything to make good things happen at the local and community level, and realizing people need resources to make sure that for these children we invest in the intellect and the character of these children, or many of them will therefore not make it. What a waste that would be for our Nation. Mr. President, I have said before on the floor of the Senate and today is my day to try and give this context because I think so much of politics is personal, I have learned so much as a grandfather. Because our children are all older and we had our children when we were very young, I forget what it was like. Now when we have the grandchildren over, I have said on the floor of the Senate before, you take a 2-year- old and you watch him or I watch our granddaughter, it is amazing. Being in the same room, in the same house, and every 15 seconds they find something interesting and new. The President is smiling. He may have seen the same thing. What is going on is that these small children are experiencing all the unnamed magic of the world that is before them. We ought to ignite that spark for all of our children. We do not want to pour cold water on that spark, and we have, for too many children. Actually, it does not make much of a difference whether it is my grandchildren or anyone else's grandchildren, they are all God's children. I think it is time for us to move beyond symbolic politics and it is time to stop giving the speech and having the photo opportunities next to the small children unless we are willing to make an investment. Mr. President, at 23 years old, Elaine became pregnant and soon after she was laid off of her $9 an hour office job. Since she was pregnant she had difficulty finding another job. She did find one at $6 an hour. With little resources, she immediately learned about the Women, Infants, and Children Program which she says is the reason her baby was born healthy and strong. Her initial guidance from the WIC office in Reno, NV, taught her the basic nutritional information. I am just reading from this example. We have collected stories from people around the country. All too often we just speak in statistics here, or strategy or tactics. I want to try and translate this amendment into personal terms as it affects people's lives. Every month Elaine attended nutritional classes and received vouchers for items like milk, cheese, peanut butter, and beans. She said, ``I had no idea what I was supposed to eat and what was right for my baby. The public nurses were all so nice and helpful, I never felt bad. They wanted me to have a healthy baby as much as I did. I knew nothing about babies, like breast feeding and stuff. They taught me all that.'' After Elaine gave birth to a healthy boy, she would take him to the WIC clinic where he was examined. The same nurses who guided her through the pregnancies guided her through the initial steps of child rearing. Not only did she learn the basics of taking care of her son, but she continued to receive financial assistance. Says Elaine, ``The formula cost $160 a month and I did not have it. WIC gave it to me, and I'm not sure what I would have done without that help.'' Eventually, Mr. President, Elaine returned to her office job at a rate of $9.60 an hour, and she was no longer eligible for WIC, and she should not have been. She now lives independently with her son. ``WIC saved me. I really don't know how I would have survived. It helped me survive on an emotional level and with finances. I was really surprised. I always thought these kinds of programs were for `low- lifes,' but they were a lot like me. I just had hard luck and needed help. I got it.'' And Elaine's son got it. That is the difference between Elaine's son having a really what we would call successful and full life versus what might have happened to her son if she had not received this assistance. Is it too much for me to ask colleagues to go on record that we will not disproportionately cut the Women, Infants, and Children Program? Really, we should not cut it at all. This amendment doesn't even ask us to do that. Actually, we ought to fully fund it now. I don't understand some of these proposals here in Washington--some from the White House. When we don't actually fully fund some of these programs, I don't know exactly how we figure out which children go without health care, which children go without the nutritional help they need, which children are not in the Head Start programs. Who makes that decision? We know how we can make a difference and be helpful. We have some proven, credible programs that have worked, that are key to children, key to what we are about as a country. I am just saying, let us at least make a commitment that these programs are not the programs that we disproportionately cut. Mr. President, let me now move on and talk about the Head Start Program. Mr. President, the Head Start Program is a program that began, as I remember, back in 1965, or thereabouts. It is a program which, in many ways, is not perfect, but it has lived up to its title, which is that we do, as a Nation, just what the program says; we give children from some really difficult and tough circumstances, from low-income families, a head start. That is the goodness of America, what we are about. Yet, Mr. President, in 1996, the Head Start Program reached only 17 percent of eligible 3-year-olds and only 41 percent of eligible 4- year-olds. In the United States, almost 4 million children are eligible for Head Start, because children 1 and 2 could be receiving or participating in this program. But it served just over 800,000 of those over 4 million children. Roughly, 3.2 million children are not being served. The President's budget proposal says we will, by 2000, 2001, fund Head Start for another 1 million children. I still don't understand how we can make the collective decision not to fully fund it. How do we explain to people in the country, or more important, how do we explain to children? Jonathan Kozol--and I recommend Jonathan's work--wrote a book called ``Amazing Grace: Poor Children and the Conscience of America.'' He wrote another book called ``Savage Inequalities: Public Education in America.'' His writing is so powerful. In an article he recently wrote for a journal called Tikun, a very interesting journal, he writes at the end: Millions of children in sequestered neighborhoods, like the South Bronx, do not know what they have the right to hope for. Their eyes ask questions that you and I and all of us have yet to answer. Their eyes ask questions that, as Senators, we have not answered. One of those questions is, how can a country, how can a Congress, that purports to love children do so precious little to help some of the children that are the most vulnerable citizens with the direst need? Mr. President, across the freeway from the comforts of Disneyland is a housing division, a stone's throw from the lavish and affluent hotels that serve tourists. In a corner apartment lives Rene, a lively, exuberant, and bright 8-year-old. She is in the second grade where she is doing well in school. In fact, every morning Rene runs to school excited to learn. Too many of our children are running into the arms of police, rather than into the arms of parents and teachers. We pay a price for not investing in our children. We pay a price for not investing in poor children in America. Rene attended two years of Head Start, which, according to her mother, was ``a Godsend.'' At Head Start, Rene learned the fundamentals of schools, such as her colors, the alphabet, and writing her name. More importantly, Rene and her family learned about school. For Rene, learning about school at Head Start meant more than academics. It meant her mother learned about nutrition and eating right. It meant her mother learned how to interact with and talk to teachers. Her mother learned how to prepare Rene for school, things like clean clothes and breakfast. It meant her mother learned about reading to Rene. It meant her mother learned that Rene needed a structure, a set time to eat dinner and to go to bed. Head Start taught this. Learning about school meant Rene learned to interact with her peers. She learned about sharing. She learned how to listen, how to take directions. Rene learned about curling up and being read to. She even learned to brush her teeth. Rene, Mr. President, represents one of the many children who have benefited from Head Start. Said her mother, ``Before Rene got in this program, I knew nothing about what she needed. I was kind of scared for her to go to school. I didn't do so good in school, and I was getting ready for the same with her. Her teachers cared about her and me. They wanted to work with us, too. I knew they cared.'' Remember, Mr. President, that the Head Start teachers who did so much for Rene and began her on the path to school success earn about $17,000 a year. Also, keep in mind that for every Rene that benefited in Head Start, two are turned away. For every Rene that benefited in Head Start, two are turned away. I am asking Senators to make a commitment with this amendment, in an up-or-down vote, that we will not, in balancing this budget, disproportionately cut programs that affect the educational, health care, or nutritional status of children. WIC is one example, and the Head Start Program is another. I don't think that is too much to ask. Marcus, a shy and quiet first-grader, finds himself in the principal's office for the third time in a week. According to his teacher, Marcus is either overagitated, annoying other students in class, or else listless and disinterested in the tasks at hand. Marcus usually doesn't understand what is happening in class. He does not yet know all of his colors, his numbers, or the alphabet. Though many of his classmates attended a Head Start Program and learned the initial steps toward understanding school and learning, Marcus did not. He represents one of the 1.2 million children who, though eligible, could not participate in the Head Start Program. Mr. President, in Minnesota, my State, only 40 percent of the children who are eligible for Head Start have access to it. In other States it is much lower. The program near his home was full. Not only was it full but there was a year waiting list when Marcus' grandmother tried to sign him up. Though there was room in another program, it was too far for his grandmother to take him. Instead, Marcus stayed home, sometimes alone, while his grandmother worked. Marcus is conspicuously behind his classmates. While his classmates scurry around the teacher to be read to, he had not yet held a book or had ever been read to. Marcus does not even know how to write his name. Let me pick up on that. He had not held a book, and he had never been read to. Why don't we go on record, in all of this haste to balance the budget, that we will not balance the budget on the backs of poor children, and we will not make cuts which would make it impossible for a child like Marcus to have a book read to him in a Head Start Program? There are a lot of homes that do not have any books at all. I read somewhere that one of the factors that most explains how well children do in school is the number of books that are in the home. Mr. President, there are many homes where the parent or parents can't afford any books. I would just suggest to my colleagues that one of the most important things we could ever do is to make sure that children have access to those books or that someone can read those books and nurture those children and stimulate those children. Peter Hutchinson, superintendent of schools in Minneapolis, made an excellent suggestion that I am going to try out speaking at the legislature next week speaking about children. Peter Hutchinson, Mr. President, said something that I think is appealing to you; a wonderful voluntary effort. He said, ``You know, Paul * * *'' and he has two teenagers--``we have all of these wonderful children's books in the home but the children are older now. Why don't we get those books in the other child's home? Let us get those books out of our homes. Let's get bookmobiles and get them into the homes of those children. And let us get them to those Head Start Programs and make sure that all of our children get that stimulation.'' That is what I am talking about today. Marcus did not know how to write his name nor did he know how to recite the alphabet. In a phrase, Marcus is not a part of the culture of the school. He did not come to school ready to learn. Marcus' teacher is concerned and anxious about him. He is far behind his classmates, and she has little, if any, time to help him catch up. As weeks progress, he falls further behind and is more frustrated. Already Marcus hates school and learning, counting the days until summer vacation. He knows he is different. He knows he does not understand but also knows there is not much he can do. Here is a child who is utterly defeated. I meet children. I travel the State. I travel the country and I meet with children who are age 10, age 8, who can't look me in the face, who look down. They have no confidence. They don't believe they are going to be teachers. They don't believe they are going to be doctors. They don't believe they are going to be successful business people. They don't believe they are going to be lawyers. They don't believe they are going to be architects. They don't believe they are ever going to be Senators or Representatives. None believe they will ever be President. They have none of that hope. It is gone. Can't we make a commitment as a Senate knowing full well the importance of family and community? But can't we at least get some resources for the communities and neighborhoods and families so that we can support our children? I will tell you something. I am absolutely convinced that when historians write about this time period of the decade of the 1980's moving into the decade of the 1990's, the ultimate indictment of our country will be the way in which we have abandoned our children and devalued the work of adults who work with those children. Think about it for a moment. I am not off the topic. I love to take my grandchildren to the zoo. But if you work at the zoo, you get paid twice the salary, twice the wage, that a woman or a man makes working in a child care center. We pay people who work for the zoo twice as much money as we pay men and women who work with children. What in the world does that say? When I was a teacher at Carleton College in Northfield, MN, I would meet students, and they would say, ``In all due respect, we do not want to be college teachers. We want to work with these children when they are young, 1, 2, 3, or 4 years of age, because we know that is such a critical time.'' But many of them would then go on and say, ``But we can't. We can't support the family. We would make $6 an hour with no health care benefits.'' What are we saying? Let us dig into our pockets. Let us not spend money on wasteful programs. Let us cut. Let us balance the budget. Let us be fiscally responsible. But, please, let us make a commitment with this amendment that we are not going to balance the budget on the backs of poor children. Please let us invest in certain areas of life in America, starting with our children. Marcus' teacher said: I just don't know what could be done for him. I know that he needs a lot of one-on-one attention and love, but I just do not have the time or the resources. Every day I feel him slipping, and, frankly, it breaks my heart. He is a good boy and a smart boy. I feel as if he is being punished for what we did not do for him. I am worried that he will always hate school and suffer until he can leave. He tries so hard. Sometimes I want to cry. That is what this debate is all about. It is about people. It is about children. I say to my colleague from Utah that I really believe there can be 100 Senators voting for this. I am not bringing this amendment to the floor because I want to point the finger at other colleagues. I am not bringing this amendment to the floor to force an embarrassing vote. I am bringing this amendment to the floor in good faith and in good conscience really hoping that my colleagues will support it because, otherwise, I will just tell you, given our track record of deficit reduction based on the path of least political resistance, we are, with this constitutional amendment to balance the budget, going to lock ourselves into very stoic priorities, and we will make these cuts, and I believe in the absence of some commitment, we will make cuts in these very programs that affect these very children. By August of 1996, in West Monroe, Louisiana, there was already a waiting list for Head Start for August 1997. Zora Cheney has been a Head Start teacher there since 1965. She was there at the very beginning. Not only does she see the need for it, but she lives the success. According to Zora, without Head Start the lives of many children would be in words ``a disaster.'' I visit Head Start programs all across Minnesota. Another outstanding feature is parental participation--high-participation parents--in meeting with the teachers and in talking about the children. This program is a really important investment in poor children. We get kids here, so many kids here, that need us and would not endure later school years without it. I have seen some kids who come in, and it is obvious they are not cared for enough and that the home family needs help. While Zora's program emphasizes the traditional things that we discuss with Head Start, like building on language, learning shapes and colors and developing social skills, it does so much more. Says Zora, ``We are concerned with everything about that child. We want the parents to learn how to feed them, how to dress them, how to parent them.'' She continued, ``I have had children come to school, and I know they have been sleeping on the floor. I know they need so much at home. We work with other groups. We refer the families to get things like furniture and doctor appointments.'' When asked the most significant contribution that Head Start in West Monroe, Louisiana has made to the community Zora replies, ``For many its the first place that they feel safe.'' I have other examples that I will go through tomorrow, but I just wanted to give some examples of some children, and I am going to be doing this over and over and over again, actually thanks to the people in Minnesota--I am just going to bring to the floor of the Senate the lives of children so that we can get some votes on their behalf because I will tell you something. For example, the Senator from Utah--and this is not meant to challenge him--on these children's issues he is effective and he is a powerful Senator for children. I know that. So I do not feel like I am spitting in the wind when I come out here to speak or I do not think I make a mistake with this amendment. I am just trying to get my colleagues to make this commitment because I know so many of them care so deeply about children. The amendment says we make a commitment that we will not put into effect disproportionate cuts in programs that affect education--I talked about that--nutritional and health care programs for children. According to the Childrens Defense Fund, 10 million children, one in seven children in America, are without any health care coverage at all, and I think that close to about a million children a year have been dropped from coverage because actually more and more people are getting dropped from employment-based coverage, or what has happened, employers will cover the adult but they do not cover the children. It used to be that people could get coverage for everyone in their family. Who are these 10 million uninsured children? Nine in ten, 88 percent, have parents who work. Nearly two in three, 64 percent have parents who work full time. These are children of working poor families. More than three in four, 77 percent, are white. Sometimes we do a little bit too much by way of stereotyping and always assume we are talking about African American people or Hispanics. Two-thirds live in families with income above the poverty level, and more than three in five, 61 percent, live in two-parent families. Each year since 1989-- this was the statistic I was struggling for--900,000 fewer children on the average have received private coverage. I think actually it is real important for me to make this point about what this amendment is talking about and also some of the legislative initiatives that will be taken in this Senate in the 105th Congress. We are talking about working poor families. We are talking about people who are not old enough for Medicare, and even if, by the way, you receive Medicare in my State of Minnesota people do not have prescription drug costs covered and elderly people still live in terror of catastrophic expenses if they are no longer to stay at home and the nursing home costs, or we are talking about families that are not poor enough to qualify for medical assistance. They fall between the cracks. They work, they work hard, they are barely above the poverty-level income and they are not fortunate enough to have an employer that provides them with health care coverage. So their children are at risk. These families live paycheck to paycheck. What does this translate into? More than half of uninsured children with asthma never see the doctor during the year. More than half of uninsured children with asthma never see the doctor during the year. Many of these asthmatic children are hospitalized with problems that could have been prevented. One-third of uninsured children with recurring ear infections never see the doctor. Many suffer permanent hearing loss. Children with untreated health problems are less likely to learn in school. If you have an ear infection, if you suffer permanent hearing loss, if you are not treated for asthma, if you do not have dental care, if you come to school with an infected tooth, with a tooth with an abscess and you cannot even get dental treatment, you are not likely to do as well in school. Mr. President, it will actually save money when we invest in children. Each dollar invested to immunize a child saves between $3.40 and, some say, $16 in direct medical costs, and it goes on and on. In every other advanced economy children get better health care coverage than in America. So, Mr. President, here we have children with undiagnosed vision problems who do not get glasses and do not even see the blackboard. We have children who suffer from asthma, we have children who have ear infections and can suffer hearing loss, we have children who are in pain and discomfort and have trouble concentrating, we have children who are not treated early for lead paint poisoning and these children can suffer permanent mental retardation, and we have 10 million children in America who are uninsured. Given this shameful statistic, is it too much to ask my colleagues to make the commitment that in our effort to balance the budget we are not going to make any disproportionate cuts that affect the health care status of poor children in America? We are not doing near enough right now. That is all this amendment does. I am fearful, on the basis of what we did in the last Congress, that when push comes to shove, we will not have a deficit reduction plan locked in by this constitutional amendment to balance the budget based upon a standard of fairness, that we will embark upon once again deficit reduction based upon the path of least political resistance, and those Americans who will disproportionately be asked to sacrifice are the very Americans who cannot tighten their belts any longer--poor children in America. This amendment goes to the very heart of who we are and what we are about. I do not know. My colleague from Utah may speak to this. Maybe there is a strategy on the other side--not the other side as if we are not friends, but we have majority party and minority party. I am in the minority party--to basically vote against all the amendments. I hope not. And one more time, I really hope that we will have an up-or-down vote on this amendment. I introduce this amendment with respect for colleagues. I think it speaks to a terribly important matter. I really hope that people will vote for it. I really believe most Senators agree that these are not the areas where we are going to make disproportionate cuts. I really think most Senators agree. Mr. President, I will speak more to this amendment, but for right now I yield the floor. Mr. HATCH addressed the Chair.

Mr. WELLSTONE. Mr. President, let me read this amendment slowly and carefully, because I am hoping to get a very strong vote in favor of this amendment, and I hope it will be an up-or-down vote. This is a pretty important matter amending the Constitution, and if this is going to be done--it may or may not be done--we better do it well, we better do it carefully. This amendment says: It is the policy of the United States that, in achieving a balanced budget, Federal outlays must not be reduced in a manner that disproportionately affects outlays for education, nutrition, and health programs for poor children. What this amendment is saying, and I will give plenty of historical and economic context for it, is that we should go on record and make it very clear that if, in fact, this constitutional amendment to balance the budget is passed, which then locks us into this goal, will make the commitment that we are not going to, as we did in the last Congress, disproportionately cut programs that affect, quite often dramatically, the nutritional or health or educational status of poor children in America. The reason that I offer this amendment is that I think we need to have some focus on this question. There can be arguments made, and there have been, on whether or not we ought to amend the Constitution. There can be arguments made about whether or not this is a mistake vis- a-vis our fiscal and monetary policy to make sure recessions don't become depressions. There are arguments both ways. Senator Durbin has an amendment on the floor that says, look, if we need to move forward with an economic plan that puts the budget out of balance during a downturn in the economy, it should just be a requirement of a majority vote. I think that amendment is on the mark. I see the budgets over the years. There could be an argument of whom to blame. I wasn't here during the decade of the eighties or prior to that time. We can argue it both ways. I think historians are going to write about a piece of legislation which was euphemistically called the Economic Recovery Act which dramatically cut tax rates. I think it became rather regressive, because most benefits went to higher income citizens, at the same time of dramatically increased expenditures in the Pentagon. I think President Bush once called it voodoo economics. All of it was to lead to economic growth. People would have more money with a tax cut, productivity, jobs. It would lead to eliminating the debt. Actually, quite the opposite happened. That was actually borrowed money and borrowed time. It was politics of illusion. I really appreciate the focus of Senator Hatch on no longer having that illusion and the message from the people in the country that we should get our economic house in order and our political house in order. But what I am asking Senators to do, because I think we really owe it to the people we represent, is to make a commitment that one more time, as we go about achieving a balanced budget, Federal outlays must not be reduced in a manner which disproportionately affects outlays for education, nutrition and health care programs for poor children. I hope this amendment will not be tabled. I offer this amendment with passion and with commitment to a matter that I think is very important. I think there should be an up-or-down vote, and I hope it will be adopted. Mr. President, why the amendment? Well, because of recent history. The Center on Budget and Policy Priorities issued a report entitled ``Bearing Most of the Burden: How Deficit Reduction During the 104th Congress Concentrated on Programs for the Poor.'' I will just read a few of their conclusions: More than 93 percent of the budget reductions in entitlements have come from programs for low-income people. The Congressional Budget Office estimates that legislation enacted during the 104th Congress reduced entitlement programs by $65.6 billion from 1996 to 2002. Of that, almost $61 billion out of the $65.6 billion comes out of low- income entitlement programs, the largest reductions in the supplemental security income program and programs for the elderly and the poor. Please remember, I say to my colleagues, that one out of every five children in America today is poor. Mr. President, I read an article the other day with great interest of how you, as the Senator from Missouri, have teamed up with other Senators, like Senator Coats, and you have your own commitments to really not turning our gaze away from the concerns and circumstances of one out of every seven Americans, many of them children, but you are committed to doing something. We might have different ideas of what to do. I think that is commendable, and I know you well enough to know that you have that commitment. What I am worried about is deficit reduction based on the path of least political resistance, because I think that is exactly what we did in the last Congress. That is to say, we are afraid to take on powerful interests, so, instead, what we do is we go after the people who are not the heavy hitters, who are not the big givers, who are not well connected, and those people, all too often, in the Senate are voiceless and they are faceless and they are powerless and they are disproportionately poor children in America. I hope my colleagues will at least support this amendment. If this passes, it happens one time. Let's get it right. If we are going to lock ourselves into balancing the budget and deficit reduction, let's lock ourselves into humane and fair priorities that we are not going to disproportionately cut programs that affect the educational and nutritional and health care status of children. Mr. President, other than entitlements, 34 percent of the reduction in nondefense programs that are not entitlements came from nonentitlement programs for people with low incomes. Those low-income people programs accounted for only 21 percent of overall funding, but they were disproportionately cut as well. Just looking at the 104th Congress, I offer this amendment to make sure that we make a commitment that we are not going to cut such vital programs. Sometimes we are just too generous with the suffering of others. Let's not be too generous with the suffering of poor children in America. The Concord coalition had this to say. Martha Phillips the executive director, on November 26, 1996: Balancing the Federal budget-- And this has been a goal of the Concord coalition-- and keeping it in balance is critically important, but balance ought not to be achieved principally on the backs of the poor. Every program should be on the budget cutting table. No programs, groups or special interests should be exempt or get a free ride when the budget is being balanced. But neither should the needy be singled out to bear a disproportionate share of the load. They go on to say--this is the Concord coalition, I say to my colleagues, committed to deficit reduction. The Concord coalition goes on to say, under the able leadership of Senator Rudman and Senator Tsongas, who passed away--a real loss for our country--the Concord coalition goes on to say: Even though the 104th Congress, which passed the laws, and the President, who signed them, did not plan to target deficit reduction efforts on programs affecting low income people, that was nevertheless the result of both actions that were taken and those that were not. (Mr. ROBERTS assumed the chair.)

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

Mr. WELLSTONE. Mr. President, I send an amendment to the desk.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, I am pleased to introduce the Ambulance Services Act of 1997 today to ensure that Medicare beneficiaries are covered for necessary transport for emergency treatment. I am deeply concerned that Medicare beneficiaries in rural areas have a difficult time gaining access to emergency care, and there are relatively few hospitals in these areas, and patients must often travel a great distance to reach them. The Medicare ambulance transport reimbursement regulations have not kept pace with changes in the health care system that have occurred as a result of efforts to improve care while decreasing the cost of care. In many locales, clinics and ambulatory surgery centers staffed by physicians have developed the ability to provide routine emergency care. The local physicians are often available at the clinic, which has facilities and capability for emergency treatment. In fact, patients who are transported to the hospital emergency department during the day wait longer to see a physician than those at the clinic, as the physician must travel from the clinic to the hospital in order to see the patient. It is often necessary for seniors who are experiencing a medical emergency to be transported via an ambulance. Under current regulation, seniors who require ambulance transport to an emergency care facility must be taken to a hospital. Therefore, the senior is left with a difficult choice: be transported to the hospital facility, which may take longer and is likely to involve a longer waiting time for emergency care, or be transported to a local facility that provides emergency care to other citizens, and pay for the ambulance transport out of pocket. Neither of these is an optimal choice. As the reimbursement policy stands now, patients are required to use a more expensive facility when it may not be necessary. It would seem that allowing reimbursement for transport to nonhospital facilities that provide emergency care could result in fiscal savings in that the cost of ambulance transport combined with a clinic visit bill would be less than that of ambulance transport and a hospital emergency department bill. In addition, it would allow our senior citizens to have a health care benefit that is available to other members of the community. Concerns that might arise about the medical necessity of transporting certain patients to a hospital emergency department can and should continue to be addressed by local and regional emergency medical service systems, based on levels of care that are available in the area. These systems set standards and protocols for emergency medical service providers and work with the health care community in developing protocols for transport and patient care. Mr. President, I remain concerned about providing all of our citizens with an adequate level of health care. Our seniors need to be able to avail themselves of expeditious emergency care, without having to worry about how transport for this care will be paid for. The Ambulance Services Act of 1997 will go a long way toward this goal. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.