November 19,1999

Roth Statement on the Consolidated Appropriations Package

WASHINGTON -- Senate Finance Committee Chairman William V. Roth, Jr. (R-DE) today submitted the following statement to the record on the consolidated appropriations packages which includes the Medicare, Medicaid & SCHIP Refinement Act of 1999.

"Mr. President, I intend to support the consolidated appropriations package. This large legislative package - the result of hard work by many on both sides of the aisle - provides funding for a number of programs which are important and affect people in a direct way. This bill includes funding for programs under the D.C. Appropriations bill, the Interior Appropriations bill, the Foreign Operations Appropriations Bill, the Commerce-Justice-State Appropriations bill, and the Labor-Health and Human Services-Education Appropriations bill.

"In addition, incorporated in the legislation are other important measures including the Satellite Competition and Consumer Protection Act, provisions important for dairy farmers in my State, the State Department Authorization bill, and our Medicare refinement plan. As with any product this large and with as many compromises which were necessary to move the process forward, there will be provisions with which one will disagree.

"While this is certainly a substantial legislative undertaking, I would point out that nearly all of the matters contained in this package have previously been debated in full by the Senate and passed by wide margins.

"Mr. President, I would like to highlight some provisions contained in this legislation for which I have advocated. This legislation will continue the Trade Adjustment Assistance program.

"Earlier this month, my distinguished colleague on the Finance Committee, Senator Moynihan, and I, stressed the importance of this program for our American workers during the debate on the Africa Trade bill. The Africa Trade bill passed by the Senate extended the authority for the TAA program which lapsed in June of this year. As time did not permit us to resolve our differences with the House on the trade package, we needed to insure that the benefits to workers displaced from their jobs as a result of trade activity be continued. I am very pleased that this provision is included in this package.

"The package also includes the Satellite Copyright, Competition, and Consumer Protection Act. My state has over 30,000 households which depend on satellite dishes for their television programming and I have long advocated a modernization of the laws affecting satellite television programming. I am also pleased that an agreement was reached to have the Senate consider legislation which will facilitate satellite local to local service in small and rural markets, as this will be important to bring local programming to my constituents.

"I have joined with my colleague from Delaware, Joe Biden, in sponsoring legislation to continue the important programs he has championed - the COPS program and the Violence Against Women Act. This measure provides funding for these programs. Also contained in the package is funding for the State Side program under the Land and Water Conservation Fund. I had joined with our late colleague, Senator Chafee, in sponsoring legislation to provide these funds for the first time in several years to promote open space and recreation opportunities at the discretion of our State governments.

"The package maintains the commitment we made with the passage of the Balanced Budget Act in 1997 to prioritize education. Since the passage of the 1997 bill, we have followed through with substantial increases in funding for our important education programs and have done so in a manner which promotes flexibility.

"Finally, Mr. President, I would like to discuss the Finance Committee's Medicare, Medicaid, & SCHIP Refinement Act of 1999, H.R.3426.

"A little more than two years ago Congress passed and the President signed into law the historic Balanced Budget Act of 1997. This important legislation has been instrumental in making possible the budget surpluses we are beginning to see materialize.

"However, not all of the consequences of the Balanced Budget Act have been positive, and many of them were unintended. Two years of implementation allowed us to identify some areas, particularly related to Medicare provider reimbursement, that needed to be revisited.

"The Finance Committee carefully monitored the impact of the Balanced Budget Act on various categories of health care providers. In fact, this year the Committee held a number of hearings on Medicare and Medicaid matters.

"Throughout the course of these hearings, providers presented us with compelling testimony about significant fiscal and patient care-related problems that have resulted, unintentionally, from decisions the Congress made in the Balanced Budget Act of 1997.

"Mr. President, let me be clear that we should be proud of the program improvements and the corresponding savings achieved through the Balanced Budget Act. We had no intention of fundamentally undoing that work.

"However, there were problems that needed to be addressed to make sure we pay providers appropriately to meet the real health care needs of Medicare beneficiaries. At passage, the 1997 BBA reduced Medicare and Medicaid spending by nearly $120 billion. This package restores $27 billion over 10 years to address unintended consequences of the original law.

"New provisions in this bill restore some $17 billion in funding over 10 years. Accordingly, in October, the Committee marked up and overwhelmingly passed a package of payment adjustments to fine tune the policies enacted through the Balanced Budget Act. This package was developed in a bipartisan manner with the close cooperation of Senator Moynihan and his staff.

"For the past several days, we have been working to reconcile this Finance Committee package with a similar bill passed by the House of Representatives last Friday.

"The bill before us today represents an excellent compromise between the House and Senate bills, with input from the Administration.

"The payment adjustments included in the House-Senate compromise package will benefit Medicare beneficiaries by improving payment to all sectors of the health care market place - including hospitals, physicians' offices, nursing facilities, community health centers, and home health care agencies, among many others. In addition, the package includes other technical adjustments to Medicaid and the State Children's Health Insurance Program.

"The provisions included in the package are consistent with a few basic goals I have tried to work toward from the beginning of this process. First, I felt that the overriding purpose of this package should be to address the most significant problems resulting from BBA policies.

"In my view, larger Medicare reform continues to be an important objective. However, even the White House ultimately agreed this was neither the moment nor the legislative vehicle by which to pursue that goal.

"The Senate Finance Committee will continue in its efforts to develop a bipartisan consensus on broader Medicare reform when we resume our work in January. That will be the time and place to consider lasting and far-reaching Medicare reforms.

"Second, we sought to keep payment adjustments focused on areas in which we face demonstrated problems resulting from the Balanced Budget Act. Furthermore, we tried to make short-term adjustments in payment practices without revisiting the underlying policies set forth in the BBA.

"Finally, it was particularly important to me not to let this become a partisan process. These are not partisan issues and I have tried to resist any effort to make them so. I am hopeful that this compromise can be supported by all Senators.

"The provisions included in the package reflect the priorities of Senators on and off the Finance Committee. In addition, like all of you I have consulted extensively with my own constituents in Delaware, as well as with national health care and beneficiary organizations. They are strongly supportive.

Mr. President, the provisions included in this conference agreement make some significant contributions to protecting the care provided to seniors in nursing homes. We provide increased funding for medically complex patients and for rehabilitation services in nursing homes, and we help these facilities' transition to the new payment systems required under the Balanced Budget Act. The Agreement also includes something I consider to be of vital importance to Medicare beneficiaries; we put a moratorium on the arbitrary annual dollar cap on the amount of rehabilitation therapy services a beneficiary could access.

In addition, we mitigate the impact of scheduled reductions for home health agencies, increase funding and regional payment equity for teaching hospitals, and enhance programs for rural health care facilities.

"The Conference Agreement also includes important protections for hospitals as the new outpatient prospective payment system goes into effect next year. I am especially pleased at the steps we have taken to stabilize the Medicare+Choice program, so that beneficiaries can count on Medicare health plan choices in the future.

"Mr. President, today we have an opportunity to solve the problems that have been interfering with the ability of the provider community to make sure our constituents receive the high quality health care they deserve, without retreating from the important policy reforms enacted in the Balanced Budget Act. I ask all of you to join me in supporting this important legislation."