Paul Wellstone

Mr. WELLSTONE

Mr. WELLSTONE. Parliamentary inquiry. Is the second-degree amendment in order now?

Mr. WELLSTONE. Mr. President, the second-degree amendment does not say anything about whether or not the funding is going to be there next year for the COPS Program. That is the commitment we made. We made the commitment it would come out of this violent crime reduction trust fund, and we should honor that commitment. What the Senator is representing is that it can come from the Low- Income Home Energy Assistance Program, it can come from aid for kids with spinal bifida, MS, cerebral palsy. This is a very different amendment. We made a commitment for full funding in this trust fund. That is why we should support the amendment I offered.

Mr. WELLSTONE. May I have 30 seconds for a response?

Mr. WELLSTONE. I thank the Chair. Mr. President, this is to make sure we have the funds for the hiring of new police under the COPS Program in fiscal year 1997. This comes directly out of the violent crime reduction trust fund which we passed as a part of the crime bill in 1994. We were all very clear in our commitment that the money would come out of this fund and the commitment would be lived up to and it would be money that would be spent on the COPS Program. As a Senate, we made that commitment, and this amendment just makes sure that we confirm that commitment.

Mr. WELLSTONE. Mr. President, since I have just 30 seconds, this is an amendment that I proposed. It is a leadership amendment on our side which addresses the sense of the Senate that any tax revenue raised by the Finance Committee that does not go toward a child tax credit will be used to finance a tax deduction of up to $10,000 a year for higher education tuition or to help pay off student loan interest or for strict budget deficit reduction. I cannot think of an issue that is more important to a broad section of the population than to be able to finance higher education for families.

Mr. WELLSTONE

Mr. WELLSTONE. Madam President, I am pleased and honored to introduce legislation which I believe will demonstrate the cost effectiveness and feasibility of Medicare subvention funding to the Department of Veterans Affairs [VA] for treatment of some Medicare-eligible veterans at VA medical facilities. This legislation would authorize a demonstration project of Medicare subvention whereby Medicare would reimburse VA for delivering health care to some veterans age 65 and over. My legislation would authorize the Secretaries of Veterans Affairs and of Health and Human Services to enter into an agreement to carry out the demonstration project. This bill would bar reimbursement to the VA until the expenditure for health care services for participating veterans by a veterans integrated service network exceeds the amount that the VA would expend for such services in the absence of the project. In effect, this ensures that VA will receive Medicare reimbursement only for additional health care costs that are directly attributable to the demonstration project. My bill would ensure that costs to the Medicare program of providing services under the project do not exceed the usual costs Medicare would incur in providing such services. To prevent red tape from delaying the start of this test, the legislation specifies that VA health care facilities chosen to participate in the demonstration project will automatically be deemed to meet Medicare standards. Reimbursement to the VA will be on a capitated basis and veterans age 65 and over who are not eligible for VA health care for a service-connected disability may be selected to participate in the project. Madam President, I now want to address the two key reasons I am introducing this legislation and will press for its passage. First, reforming veterans' health care is one of my highest priorities and I am quite frankly disappointed that the Senate has not yet emulated the House in taking significant bipartisan legislative action to reform unwieldy, arcane, and obsolete eligibility rules that Minnesota and other veterans face when they visit VA hospitals and clinics. While Secretary of Veterans Affairs Jesse Brown and his Under Secretary for Health Ken Kizer have taken bold and innovative steps to modernize, restructure and decentralize VA health care, their efforts to overhaul the VA health care system--so that it will remain viable and serve the needs of veterans into the 21st century--are being hamstrung by outmoded eligibility criteria that stress inpatient care even when outpatient care would be more appropriate, user-friendly and cost effective. I believe that Medicare reimbursement is an important and, with an aging veterans population, even an essential component of eligibility reform. My view is shared by major veterans service organizations [VSO's] which have submitted two different eligibility reform proposals that would authorize the VA to receive Medicare reimbursement for treating Medicare-eligible veterans. Medicare reimbursement will allow the VA to offset the costs of delivering care to older veterans who may gain access to outpatient and preventive care when eligibility reform legislation is enacted. The GAO, however, has questioned both the feasibility and cost of providing Medicare reimbursement to the VA. While I lean toward the VSO's view that Medicare reimbursement would be both feasible and cost- effective, the only way to prove it is by means of a demonstration project. This is precisely what my legislation authorizes. Second, because the VA is facing and will likely continue to face severe funding constraints that probably will reduce its capabilities to provide access to quality health care, the VA will be under strong pressure to deny some vital health care services to Medicare-eligible veterans. In recent years the VA health care budget has lagged behind medical cost inflation and under the budget resolution adopted by Congress last year the VA medical care budget would be frozen for 7 years, thus lagging behind overall inflation and probably even further behind medical cost inflation. As a consequence, the VA may be compelled to further ration care, with veterans 65 and over one of the groups likely to be affected. Even before the VA was faced with a flat health care budget, many of its facilities were compelled to resort to rationing. In this connection it is important to note that recent GAO testimony before the Senate Subcommittee on VA, HUD, and Independent Agencies Appropriations underscored the fact that in 1993 ``118 VA medical centers reported rationing some types of care to eligible veterans when the centers ran short of resources.'' There is no doubt whatever that a flat VA health care budget for 7 years can only lead to more extensive rationing of health care for veterans. This will further fray our solemn contract with the men and women who selflessly defended our country. Madam President, this bill is intended to ensure that our aging veterans population is not denied access to VA health care precisely when they need it most. I believe that this demonstration project will show that Medicare subvention will at least be budget neutral, and may even save Medicare dollars by using less costly VA care. But I would hope that even those who do not share my views would agree that the demonstration project that I am proposing is the best way of determining the impact on Medicare, the VA, and most important, our aging veterans. These brave men and women deserve the best health care that can be provided, not rationed care whose quality is determined by an eroding VA health care budget and not by the health care needs of veterans who risked their lives for this country at times when it was in dire peril. Madam President, improving and protecting health care for the increasing numbers of older veterans should be a priority issue for my colleagues on both sides of the aisle. I hope all of my colleagues will carefully scrutinize this bill, strongly support it, and join me in the fight to ensure its passage. Madam President, I am introducing a bill today that focuses on health care eligibility in the VA health care system. It is, interestingly enough, analogous to a bill that the majority leader, Senator Dole, has introduced that essentially says for those Department of Defense retirees, that there can be a Medicare third-party payment for them to continue to receive health care within the military health care system. That is put on a demonstration project basis. I think it is an important piece of legislation. What the bill I have introduced says, again, on the demonstration model basis--demonstration project basis--is that for some of the veterans within a certain narrow framework, they also will be able to receive health care within the VA health care coverage--within the VA health care system--with a Medicare third-party payment. I now sit on the Veterans' Committee. It has taken me several years to get on that committee. These issues are near and dear to my heart. It is clear to me, and I think it is clear to all Senators on both sides of the aisle, that health care eligibility is at the very top of, if you will, an agenda that is responsive to the concerns and circumstances of the veterans community. This will be a demonstration model. That is what this bill calls for. I think it is extremely important. There is a debate as to whether or not, for example, Medicare third- party payment for the VA health care system will work well or not. The only way we can find out, without having to debate ad nauseam, is to put this on a pilot project basis. I think this is only a step, but this piece of legislation, if passed, either as a piece of legislation or an amendment on the appropriate vehicle, I think it is an extremely important step in the right direction of enabling us to do some things within our VA health care system that will enable us to provide very efficient and very effective and very compassionate health care for veterans. Also, Madam President, I want to mention that Dr. Ken Kizer, with the VA health care system, I think is really making a heroic effort to think deeply about VA health care and where it is going into the next century. I think he is joined by Secretary Jesse Brown. Secretary Brown, in my view as a Senator from Minnesota--and I think I have been a fierce advocate for veterans--has been a very powerful and very articulate advocate for veterans in this country. I know that he has put health care eligibility reform at the very top of his list of priorities. I know that he cares deeply about veterans. I know as someone who was very active within the DAV, Disabled Veterans of America, he knows these issues. They are not abstract or intellectual to him. He came to this Cabinet position as someone who has been down in the trenches struggling not only for disabled veterans but for all vets. So with the time I have on the floor, again I am devoted to this piece of legislation which I have introduced. I think there is going to be strong bipartisan support for this. I also want to say a few words about the Secretary of Veterans Affairs because I think he has been a great Secretary for the veterans of Minnesota and across the country.

Mr. WELLSTONE

Mr. WELLSTONE. Madam President, I am pleased and honored to introduce legislation which I believe will demonstrate the cost effectiveness and feasibility of Medicare subvention funding to the Department of Veterans Affairs [VA] for treatment of some Medicare-eligible veterans at VA medical facilities. This legislation would authorize a demonstration project of Medicare subvention whereby Medicare would reimburse VA for delivering health care to some veterans age 65 and over. My legislation would authorize the Secretaries of Veterans Affairs and of Health and Human Services to enter into an agreement to carry out the demonstration project. This bill would bar reimbursement to the VA until the expenditure for health care services for participating veterans by a veterans integrated service network exceeds the amount that the VA would expend for such services in the absence of the project. In effect, this ensures that VA will receive Medicare reimbursement only for additional health care costs that are directly attributable to the demonstration project. My bill would ensure that costs to the Medicare program of providing services under the project do not exceed the usual costs Medicare would incur in providing such services. To prevent red tape from delaying the start of this test, the legislation specifies that VA health care facilities chosen to participate in the demonstration project will automatically be deemed to meet Medicare standards. Reimbursement to the VA will be on a capitated basis and veterans age 65 and over who are not eligible for VA health care for a service-connected disability may be selected to participate in the project. Madam President, I now want to address the two key reasons I am introducing this legislation and will press for its passage. First, reforming veterans' health care is one of my highest priorities and I am quite frankly disappointed that the Senate has not yet emulated the House in taking significant bipartisan legislative action to reform unwieldy, arcane, and obsolete eligibility rules that Minnesota and other veterans face when they visit VA hospitals and clinics. While Secretary of Veterans Affairs Jesse Brown and his Under Secretary for Health Ken Kizer have taken bold and innovative steps to modernize, restructure and decentralize VA health care, their efforts to overhaul the VA health care system--so that it will remain viable and serve the needs of veterans into the 21st century--are being hamstrung by outmoded eligibility criteria that stress inpatient care even when outpatient care would be more appropriate, user-friendly and cost effective. I believe that Medicare reimbursement is an important and, with an aging veterans population, even an essential component of eligibility reform. My view is shared by major veterans service organizations [VSO's] which have submitted two different eligibility reform proposals that would authorize the VA to receive Medicare reimbursement for treating Medicare-eligible veterans. Medicare reimbursement will allow the VA to offset the costs of delivering care to older veterans who may gain access to outpatient and preventive care when eligibility reform legislation is enacted. The GAO, however, has questioned both the feasibility and cost of providing Medicare reimbursement to the VA. While I lean toward the VSO's view that Medicare reimbursement would be both feasible and cost- effective, the only way to prove it is by means of a demonstration project. This is precisely what my legislation authorizes. Second, because the VA is facing and will likely continue to face severe funding constraints that probably will reduce its capabilities to provide access to quality health care, the VA will be under strong pressure to deny some vital health care services to Medicare-eligible veterans. In recent years the VA health care budget has lagged behind medical cost inflation and under the budget resolution adopted by Congress last year the VA medical care budget would be frozen for 7 years, thus lagging behind overall inflation and probably even further behind medical cost inflation. As a consequence, the VA may be compelled to further ration care, with veterans 65 and over one of the groups likely to be affected. Even before the VA was faced with a flat health care budget, many of its facilities were compelled to resort to rationing. In this connection it is important to note that recent GAO testimony before the Senate Subcommittee on VA, HUD, and Independent Agencies Appropriations underscored the fact that in 1993 ``118 VA medical centers reported rationing some types of care to eligible veterans when the centers ran short of resources.'' There is no doubt whatever that a flat VA health care budget for 7 years can only lead to more extensive rationing of health care for veterans. This will further fray our solemn contract with the men and women who selflessly defended our country. Madam President, this bill is intended to ensure that our aging veterans population is not denied access to VA health care precisely when they need it most. I believe that this demonstration project will show that Medicare subvention will at least be budget neutral, and may even save Medicare dollars by using less costly VA care. But I would hope that even those who do not share my views would agree that the demonstration project that I am proposing is the best way of determining the impact on Medicare, the VA, and most important, our aging veterans. These brave men and women deserve the best health care that can be provided, not rationed care whose quality is determined by an eroding VA health care budget and not by the health care needs of veterans who risked their lives for this country at times when it was in dire peril. Madam President, improving and protecting health care for the increasing numbers of older veterans should be a priority issue for my colleagues on both sides of the aisle. I hope all of my colleagues will carefully scrutinize this bill, strongly support it, and join me in the fight to ensure its passage. Madam President, I am introducing a bill today that focuses on health care eligibility in the VA health care system. It is, interestingly enough, analogous to a bill that the majority leader, Senator Dole, has introduced that essentially says for those Department of Defense retirees, that there can be a Medicare third-party payment for them to continue to receive health care within the military health care system. That is put on a demonstration project basis. I think it is an important piece of legislation. What the bill I have introduced says, again, on the demonstration model basis--demonstration project basis--is that for some of the veterans within a certain narrow framework, they also will be able to receive health care within the VA health care coverage--within the VA health care system--with a Medicare third-party payment. I now sit on the Veterans' Committee. It has taken me several years to get on that committee. These issues are near and dear to my heart. It is clear to me, and I think it is clear to all Senators on both sides of the aisle, that health care eligibility is at the very top of, if you will, an agenda that is responsive to the concerns and circumstances of the veterans community. This will be a demonstration model. That is what this bill calls for. I think it is extremely important. There is a debate as to whether or not, for example, Medicare third- party payment for the VA health care system will work well or not. The only way we can find out, without having to debate ad nauseam, is to put this on a pilot project basis. I think this is only a step, but this piece of legislation, if passed, either as a piece of legislation or an amendment on the appropriate vehicle, I think it is an extremely important step in the right direction of enabling us to do some things within our VA health care system that will enable us to provide very efficient and very effective and very compassionate health care for veterans. Also, Madam President, I want to mention that Dr. Ken Kizer, with the VA health care system, I think is really making a heroic effort to think deeply about VA health care and where it is going into the next century. I think he is joined by Secretary Jesse Brown. Secretary Brown, in my view as a Senator from Minnesota--and I think I have been a fierce advocate for veterans--has been a very powerful and very articulate advocate for veterans in this country. I know that he has put health care eligibility reform at the very top of his list of priorities. I know that he cares deeply about veterans. I know as someone who was very active within the DAV, Disabled Veterans of America, he knows these issues. They are not abstract or intellectual to him. He came to this Cabinet position as someone who has been down in the trenches struggling not only for disabled veterans but for all vets. So with the time I have on the floor, again I am devoted to this piece of legislation which I have introduced. I think there is going to be strong bipartisan support for this. I also want to say a few words about the Secretary of Veterans Affairs because I think he has been a great Secretary for the veterans of Minnesota and across the country.

Mr. WELLSTONE

Mr. WELLSTONE. Madam President, in just 10 seconds, I want to say I was really remiss in the beginning when I laid down the amendment in not saying that it was on behalf of myself and Senator Biden. I am really proud to have him out here on the floor speaking about this. I was just going to say to my colleague from Delaware that if you think about the economics of this, this becomes the sort of central middle-class issue, working-family issue, because really what happens is, those students who can get the grant assistance tend to be the lower income students, and then if you are in the very high-income end, you can pay your way. But it is those families in between that are really feeling the squeeze. He is so right on the mark. The only other point I will make, Madam President, which is why I hope this is adopted as a statement before the Senate, I spent a great deal of time on campus. It takes a student on the average of 6 years-- it is getting up near 7 years--and that is because they are working two and three minimum-wage jobs. Most students are working 30, 45 hours a week while they are going to school. The other thing to add to the equation, which is very different than when we went to school, because we are similar in age, is that the students now are no longer 18 and 19 and living in the dorm. I think the majority of students now, if not the majority just about close to the majority of students are 30, 40, 45, 50, going back to school, many of them women, many of them with children. As a matter of fact, this is one of the ways in which many families get back on their feet. So those students who really have children feel this economic squeeze as well. I think this is just a critical vote, and I hope we will have a strong vote for it. I yield the floor and suggest the absence of a quorum and ask that the time be charged equally to both sides.

Mr. WELLSTONE. Madam President, I actually laid down these amendments on Friday. But I thought since we have a quorum call and time is being charged to both sides--this charged to our side--I want to focus attention on several of the amendments that I laid down Friday. One of those amendments which was a leadership amendment--and I compliment the Chair for her very, very important work dealing with higher education-- was an amendment that I introduced as a sense of a Senate that any tax cuts beyond tax credits for children and families ought to go for an annual up to $10,000 deduction that families can take to help pay for the cost of higher education, and that would include tuition, and also the interest that families find themselves paying on the debt. That interest is extremely important because now, unfortunately, as opposed to at least when I went to school, about 80 percent of the financial aid packages are now loans as opposed to grants. It used to be quite different. It has flip-flopped in the last 15 years, or so. I hope that this money will go to higher education making it more affordable for families, or it has to go to deficit reduction. I hope that this amendment really will receive strong bipartisan support. I laid the amendment down as an education Senator. Most of my adult life has been devoted to education. I laid this amendment down as a leadership amendment for my party. But, frankly, I think this is an amendment that is important to the Democrats and Republicans alike. Since we are going to have a rapid succession of votes on lots of amendments, I just wanted one more time to focus attention on this amendment. Amendment No. 3987 The second amendment that I might talk about very briefly was an amendment that I introduced at the beginning of 104th Congress and, frankly, I regret that it was passed finally on a voice vote. It just simply said that the Senate was taking the position that we would not pass any legislation that would create more hunger or homelessness among children. I actually lost on the vote on that amendment twice, and then it was passed by a voice vote. But given some of the budget proposals and given some of the, I think, fairly rigorous independent studies that have taken place suggesting that as a matter of fact we are in part taking some actions that will create more poverty among children, this time around I want to get a recorded vote. Amendment No. 3986 A third amendment I introduced, which is one that the Senator from Delaware has actually taken the lead on, just simply said that we ought to make a commitment that we will provide the full funding called for in the community police program--the COPS Program. I have to say to you, Madam President, that I have never received more positive reports with any Federal program in Minnesota than the COPS Program. A one-page form filled out by COPS going to Washington with money coming directly back to police chiefs and sheriffs used for really fine proactive preventive, important--not feel-good law enforcement--a real focus on domestic violence, a real focus on some of the neighborhoods most ravished by violence in our cities, and a real focus on youth, on some of the kids that are in the most trouble, not exclusive just to cities but in rural communities as well. So I hope that there will be very, very strong support for that. Amendment No. 3989 And then finally one other amendment that I want to talk about very briefly--one that my colleagues are probably less familiar with but I think it is an important amendment. And again, the Chair has taken real leadership on this. This issue has become unfortunately a more important issue in this country, and this issue deals with the central importance of our taking the steps that we need to take as a nation to reduce violence in homes. This amendment says that in the welfare reform we do we must allow States to take into account the special circumstances of a mother and her children who have been in homes where there has been violence; who have been battered. In other words, one size does not fit all. And my fear is that, if we are not careful, what we are going to do in the welfare reform area is we are going to be essentially saying to a mother that you have to work, and if you do not work that is it, without taking into account what has happened to her. Remember. It took Monica Seles 2 years to play tennis again after what happened to her. What is going to happen is we are going to force some of the women and children back into very dangerous homes? We have to take into account these circumstances. There have been several studies. The Taylor Institute came out with a study suggesting that a shockingly high percentage of welfare mothers in welfare to workfare programs right now have had to deal with this violence. So we must take that into account in the welfare reform area. I have used up my time. I yield the floor. Mr. BIDEN addressed the Chair.

Mr. WELLSTONE. Five minutes.

Mr. WELLSTONE. Madam President, I thought since we are in a quorum call I might just briefly summarize since time is being charged to both sides--and this will be charged to our side--several amendments that I have introduced just to focus colleagues' attention on those amendments.

Mr. WELLSTONE

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

Mr. WELLSTONE. I yield the floor. I suggest the absence of a quorum.

Mr. WELLSTONE. Madam President, I thank the Chair. (The remarks of Mr. Wellstone, pertaining to the introduction of S. 1786, are located in today's Record under ``Statements on Introduced Bills and Joint Resolutions.'')

Mr. WELLSTONE. Madam President, I ask unanimous consent that Marty Gensler be permitted privileges of the floor for the duration of the debate.

Mr. WELLSTONE. I ask unanimous consent to have 2 minutes to speak as in morning business on a bill I am introducing.

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

Mr. WELLSTONE

Mr. WELLSTONE. I ask unanimous-consent that we go back to the higher education tuition tax deduction amendment.

Mr. WELLSTONE. Mr. President, I ask unanimous consent that the amendment be laid aside.

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

Mr. WELLSTONE. Mr. President, this next amendment that I am about to send to the desk I send on behalf of myself, Senator Murray and Senator Wyden. It says that it is the sense of the Senate that no welfare reform provision should be enacted by Congress unless until Congress considers whether such welfare reform provisions would exacerbate violence against women and their children, further endanger women's lives, make it more difficult for women to escape domestic violence, or further punish women victimized by violence. Any welfare reform measure enacted by the Congress should require that any welfare-to-work education or job placement programs being implemented by States address this impact of domestic violence on welfare recipients. One word of explanation, Mr. President. We have some fairly dramatic data that shows, in many cases, as many as 50 percent of women on welfare or in workfare programs have been or are victims of domestic violence. They have been battered. I suggest to my colleagues that any welfare reform provision that we enact must take into account these circumstances. It cannot be ``one size fits all.'' It took Monica Seles 2 years to play tennis again. Imagine what it is like for a woman and her children who have been beaten over and over and over again. We cannot pass a piece of legislation without any special allowance for these families that have gone through this violence, because we must not force these women and children back into very dangerous homes. That is what this amendment says. This Congress and this country have become much more focused, thank goodness, on the problems of domestic violence. When we consider welfare reform, we must take this interest into account. I repeat this. You cannot force a mother and her children, even if she is low income, back into a dangerous home where she could end up being murdered. I will repeat that once more. We cannot pass legislation without taking into allowance the problems of domestic violence, the problems of women who have been battered, the problems of children who have been battered. We cannot pass this legislation without understanding that one size does not fit all, because if we do, in the case of many families--and in the relatively short period of time I have next week, I will have some data to bring out--we will force many women and children back into dangerous homes. We are going to force many women and children into situations where they could lose their lives. Mr. President, that is not melodramatic, that is the case. So I hope there will be overwhelming support for this amendment. Mr. President, I send this amendment to the desk.

Mr. WELLSTONE. Mr. President, this amendment is very straightforward. What this amendment says is that we should sustain the same level of funding for the Low Income Home Energy Assistance Program. This has been a huge battle. I do not know that there has been an issue that I have worked harder on, and I cannot believe that every single time this comes up, we have to fight so hard to make sure that people do not go cold in the United States of America. So I want to get a strong affirmative vote on this amendment. Mr. President, I ask unanimous consent that this amendment be set aside.

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

Mr. WELLSTONE. Mr. President, I ask unanimous consent that this amendment be set aside, and I send another amendment to the desk.

Mr. WELLSTONE. Mr. President, this amendment simply says that the Senate will not enact any legislation that will increase the number of children who are hungry or homeless. And it also says that if, in fact, legislation passed by Congress does increase the number of homeless or hungry children by the end of fiscal year 1997, the Congress will revisit the provisions of the legislation which causes the increase and would, as soon as possible, adopt legislation to stop the increase. Mr. President, I have brought this amendment to the floor of the Senate before. It was defeated twice, believe it or not. It was then passed on voice vote. I deeply regret that I let it pass on a voice vote. I want to have a recorded vote on this because I believe, as a matter of fact, some of the decisions we are making, in terms of some of the cuts we are making, will create more hunger and homelessness among children, and I want all of us to be held accountable. Amendment No. 3988 (Purpose: To express the sense of the Senate with respect to maintaining current expenditure levels for the Low Income Home Energy Assistance Program (LIHEAP) for fiscal year 1997)