S6794 CONGRESSIONAL RECORD — SENATE May 17, 1995

there would not be any additional

votes today. We do not have that

agreement yet. As soon as we do, I will

notify my colleagues. Senator CHAFEE

has been working with Senator ROCKEFELLER and others. Hopefully, we will

be able to advise our colleagues in 10,

20 minutes.

I yield to the Senator from Rhode Island.

Mr. CHAFEE. The majority leader is

exactly right. We are working now

with staffs trying to see if we cannot

come to an agreement on the problems

raised by the Senator from West Virginia, Senator ROCKEFELLER. Everything seems to take longer than anybody thinks around here. So I would

say in the next half-hour, I hope, we

can have some information on whether

indeed there would be the necessity for

a vote.

Mr. DOLE. I think everything else

that we can take up has been taken up.

There is only one nomination on the

calendar. There is no other legislation

that we can take up at this time.

Tomorrow we will start on the budget. I understand the Democrats will

have a caucus at 10:30 in the morning

and, hopefully, they will allow us to

start on the budget at noon tomorrow.

Otherwise, we would have to wait until

tomorrow evening to start on the budget. There are 50 hours of debate. Of

course, it is more than just 50 hours.

We did indicate to and promise the

President that we would try to complete the antiterrorist legislation before Memorial Day. So we would have

to finish the budget by next Wednesday

night. I think we will need probably a

couple of days on the antiterrorism

legislation and then there would be the

Memorial Day recess, which could be

the last recess of the year, but I hope

not.

Unless we can work out some accommodation on some of these major bills,

the Senate will have no alternative but

to stay here for a considerable period

of time during what might have been

the August recess. If we can start on

the budget tomorrow—the House

should pass their budget tomorrow. We

will start on ours tomorrow and have

votes on tomorrow and on Friday and

on Monday. If I were Members, I would

be back on Monday; if there is ever a

Monday on which there will be votes, it

will be this Monday on the budget, and

on Tuesday and, hopefully, we can

complete action on Wednesday. The

final legislation would be the

antiterrorism legislation.

So I suggest that we complete action

on this bill, and if we can do it without

votes, we will do it. If not, Members

should not leave until they have some

final notice.

Mr. WELLSTONE. Mr. President, I

want the majority leader to know—and

I will share this amendment—I have

one amendment which I think may be

noncontroversial. I can limit it to 10

minutes. I would like to at least show

it to colleagues on the other side of the

aisle. It is on the Medicare Select.

Mr. President, I suggest the absence

of a quorum.

The PRESIDING OFFICER. The

clerk will call the roll.

The assistant legislative clerk proceeded to call.

Mr. DOLE. Mr. President, I ask unanimous consent that the order for the

quorum call be rescinded.

The PRESIDING OFFICER. Without

objection, it is so ordered.

A VETO OF THE RESCISSION BILL

Mr. DOLE. Mr. President, I was just

freading a wire story here. I find it hard

to believe that the House and Senate

have just completed action on a rescission bill which would save about $16.4

billion—actually savings around $9 billion, because of the $16.4 billion there

is additional money for disaster assistance in Oklahoma City and other programs. I am a little bit bewildered because the President indicates if we

send this bill to him—it will be back

from the House this week and we will

take it up next week—that he will veto

it. I am puzzled because the President

has said we ought to reduce spending.

So we finally get a little reduction in

spending and at his first opportunity,

he says: No, no; I am not going to sign

it. I am going to veto it. And at the

very time he is suggesting that he is

not going to do anything on the budget, not going to offer any budget of his

own. We will have a vote on the President’s budget. He is just going to be a

spectator and not participate in trying

to reduce the deficit.

So it seems to me the President had

a golden opportunity here to exercise

some leadership and demonstrate to

the American people that he wants to

reduce Federal spending, but he struck

out. He does not want to reduce Federal spending.

So what does he do? He tries to

blame Republicans. We have cut too

many programs or we have done this or

done that. It seems to me the President

ought to carefully review what he said

today and indicate to the Congress

that he will sign this rescission package. It is not easy to save money

around here. The taxpayers wonder

why we do not do more and this is a

good example. We have been working

on this rescission bill for weeks and

weeks and months, in many cases in a

bipartisan way, and before it even goes

to the President he says he is going to

veto it.

So I think he has missed a golden opportunity and I know he will try to figure out some way to blame Republicans. But we cut programs that were

not high priority and in addition we

added spending for the disaster in

Oklahoma City and other programs the

President had requested.

So, Mr. President, if you have an opportunity to look at it one more time,

I suggest maybe you might want to reverse your position. Because if you are

not willing to even save $9 billion in

Federal spending, we are talking about

many, many, many, many times that

much in the budget resolution we are

going to start debating here tomorrow.

If this is any indication of the leadership in the White House, it is probably

a forgone conclusion that the President

will veto anything we send him on the

budget process.

So I would hope that this is not an

indication of the trend. I think they

have blown a very good opportunity

here to demonstrate to the American

people that if they are serious about

cutting spending, serious about reining

in the Government, serious about cutting back on some of the Federal Government which the American people

are tired of paying for, but unfortunately it appears the President of the

United States does not want to cut

anything—‘‘Don’t touch anything,

don’t do this, or don’t do that’’—he will

sit on the sidelines and he will watch

the Republicans as we try to bring the

budget into balance between now and

the year 2002.

Mr. President, I suggest the absence

of a quorum.

The PRESIDING OFFICER. The

clerk will call the roll.

The assistant legislative clerk proceeded to call the roll.

Mr. CHAFEE. Mr. President, I ask

unanimous consent that the order for

the quorum call be rescinded.

The PRESIDING OFFICER (Mr. JEFFORDS). Without objection, it is so ordered.

EXTENDED USE OF MEDICARE

SELECTED POLICIES

fMr. CHAFEE. Mr. President, I ask

unanimous consent that the Senate

now turn to the consideration of Calendar Order No. 92, H.R. 483, regarding

Medicare Select, and it be considered

under the following time agreement: 10

minutes on the bill, to be equally divided between the chairman and ranking minority member of the Finance

Committee; that one amendment be in

order to be offered by Senators PACKWOOD, CHAFEE, ROCKEFELLER, and KENNEDY, on which there will be 10 minutes

for debate equally divided in the usual

form; and that following the conclusion

of time, that the amendment—namely,

the Packwood-Chafee-Rockefeller-Kennedy amendment—be agreed to; and

that the bill be read a third time and

passed and that the motions to reconsider be laid upon the table all without

any intervening action or debate.

The PRESIDING OFFICER. Is there

objection? Without objection, it is so

ordered.

ORDER OF PROCEDURE

Mr. CHAFEE. Mr. President, since

this has been agreed to, I am authorized to say there will be no further rollcall votes today.

The PRESIDING OFFICER. The

clerk will report the bill.

The legislative clerk read as follows:

A bill (H.R. 483) to amend title XVIII of the

Social Security Act to permit Medicare Select policies to be offered in all States, and

for other purposes.
May 17, 1995 CONGRESSIONAL RECORD — SENATE S6795

The Senate proceeded to consider the

bill.

Mr. CHAFEE. Mr. President, I ask

unanimous consent that Senator DOLE

be added as a cosponsor of the amendment.

The PRESIDING OFFICER. Without

objection, it is so ordered.

The PRESIDING OFFICER. Who

yields time?

Mr. CHAFEE. Mr. President, the

Committee on Finance is hereby giving

a commitment to the distinguished

Senator from West Virginia, Senator

ROCKEFELLER, that there will be a

hearing on Medicare Select once the

Department of Health and Human

Services submits its report on this program.

What we are doing is extending Medicare Select to all 50 States for 18

months. This will continue unless the

Secretary of Health and Human Services determines one of the following:

That beneficiaries do not save dollars

compared to other MediGap policies or

that there are additional expenditures

under Medicare or that access to quality care is diminished.

Mr. President, there will be a GAO

study on whether or not beneficiaries

have a problem getting coverage under

another MediGap policy if they wish to

change policies and recommendations

if there are problems.

Mr. President, that is the arrangement here.

Mr. ROCKEFELLER addressed the

Chair.

The PRESIDING OFFICER. The Senator from West Virginia.

Mr. ROCKEFELLER. Is the Senator

from Rhode Island finished?

Mr. CHAFEE. I am.

Mr. ROCKEFELLER. Mr. President, I

want to thank the Senator from Rhode

Island and to say that I agree with

what he said and concur in the amendment and do gladly accept it, as it

were, and consider it good.

What this will do, I think, is what

was wanted on both sides of the aisle,

which is ideally what we strive for

around here and rarely achieve. I had

been reluctant to see the 14 States expanded to 50; the other side of the aisle

wanted to see the 50. I did not have

strong feelings about the 50 until I understood more about what the study,

which is going on now, will show. I also

wanted to make sure that if people

leave Medicare Select and want to go

to another MediGap Program, that

they are not precluded from being able

to join another program because of preexisting conditions, which, of course,

most older people have.

It seems to me this is a good compromise. This would allow all 50 States

to go into this, if they chose to do so.

There would be a period of about a year

and a half that that would take place.

Some people will say the insurance industry does not want to do that because a year and a half is not enough

time. There are 450,000 people in this

program now, so it must be sufficiently

interesting to the insurance companies.

I am pleased that there will be hearings on this. That was a part of my

original understanding with Senator

DOLE. Senator DOLE, who is chairman

of the Medicare Subcommittee that I

am ranking member on, so to speak, he

and I have agreed we will work out,

along with others who want to be involved—modifications to Medicare Select if the study and the experience

show that that should take place. I

think that is entirely proper and fair.

The GAO study itself, I think, is important because it would analyze the

problems that seniors are having in

switching MediGap policies. When we

talk about MediGap policies, not everybody necessarily tunes in on that,

but that is incredibly important. Most

seniors have MediGap policies to make

up for deficiencies in Medicare. These

policies are very important to seniors,

and that is why all of this be done

properly.

So, from my point of view, the compromise is a good one. It was carried

out in honorable and good fashion between the Senator from Rhode Island,

Senator CHAFEE, Senator PACKWOOD,

and, obviously, the majority leader and

myself, and Senator KENNEDY. I think

it is a good compromise. I yield back

the remainder of my time.

Mr. CHAFEE. I know the distinguished Senator from Texas wants to

speak briefly on this, and if she needs

a few minutes of extra time, I presume

the Senator from West Virginia will be

agreeable to that.

AMENDMENT NO. 1108

(Purpose: To extend the period for offering

Medicare Select policies for 2 years)

Mr. CHAFEE. Mr. President, I send

now to the desk an amendment in the

nature of a substitute, which is sponsored by Senators PACKWOOD, CHAFEE,

DOLE—does Senator HUTCHISON wish to

be listed likewise?

Mrs. HUTCHISON. Thank you.

Mr. CHAFEE. Senator HUTCHISON,

Senator ROCKEFELLER, and Senator

KENNEDY, and ask for its immediate

consideration.

The PRESIDING OFFICER. The

clerk will report.

The legislative clerk read as follows:

The Senator from Rhode Island [Mr.

CHAFEE], for Mr. PACKWOOD, for himself, Mr.

CHAFEE, Mr. DOLE, Mrs. HUTCHISON, Mr.

ROCKEFELLER, Mr. KENNEDY, and Mr. GORTON, proposes an amendment numbered 1108.

Mr. CHAFEE. Mr. President, I ask

unanimous consent that the reading of

the amendment be dispensed with.

The PRESIDING OFFICER. Without

objection, it is so ordered.

The amendment is as follows:

Strike all after the enacting clause and insert the following:

SECTION 1. PERMITTING MEDICARE SELECT

POLICIES TO BE OFFERED IN ALL

STATES FOR AN EXTENDED PERIOD.

Section 4358(c) of the Omnibus Budget Reconciliation Act of 1990, as amended by section 172(a) of the Social Security Act Amendments of 1994, is amended to read as follows:

‘‘(c) EFFECTIVE DATE.—(1) The amendments

made by this section shall only apply—

(A) in 15 States (as determined by the Secretary of Health and Human Services) and

such other States as elect such amendments

to apply to them, and

‘‘(B) subject to paragraph (2), during the 5

year period beginning with 1992.

‘‘(2)(A) The Secretary of Health and

Human Services shall conduct a study that

compares the health care costs, quality of

care, and access to services under medicare

select policies with that under other medicare supplemental policies. The study shall

be based on surveys of appropriate age-adjusted sample populations. The study shall

be completed by June 30, 1996.

‘‘(B) The Secretary shall determine during

1996 whether the amendments made by this

section shall remain in effect beyond the 5

year period described in paragraph (1)(B).

Such amendments shall remain in effect beyond such period unless the Secretary determines (based on the results of the study

under subparagraph (A)) that—

‘‘(i) such amendments have not resulted in

savings of premiums costs to those enrolled

in medicare select policies (in comparison to

their enrollment in medicare supplemental

policies that are not medicare select policies

and that provide comparable coverage),

‘‘(ii) there have been significant additional

expenditures under the medicare program as

a result of such amendments, or

‘‘(iii) access to and quality of care has been

significantly diminished as a result of such

amendments.

(3) GAO study:

The GAO shall study and report to Congress, no later than June 10, 1996, on options

for modifying the MediGap market to make

sure that continuously insured beneficiaries

are able to switch plans without medical underwriting or new pre-existing condition exclusions. In preparing such options, the GAO

shall determine if there are problems under

the current system and the impact of each

option on the cost and availability of insurance, with particular reference to the special

problems that may arise for enrollees in

Medicare Select plans.’’.

Mr. CHAFEE. Mr. President, just in

summary then, what we have done is,

First, we have promised that in the Finance Committee we will have a hearing on Medicare Select once the HHS

report comes in; second, this legislation extends Medicare Select to all 50

States, the 15 that have it now plus any

others that want to come in over the

next 18 months, and that it will continue indefinitely, beyond the 18

months unless the Secretary of HHS

determines that the beneficiaries do

not save money compared to other

MediGap policies or there are additional expenditures by the Government

under Medicare, or access to or quality

of care is diminished. Finally, there

will be a GAO study on whether or not

the beneficiaries have a problem getting coverage under another MediGap

policy, if they wish to change policies.

Furthermore, the GAO would make

recommendations if there are problems.

So, Mr. President, I yield the floor.

Mrs. HUTCHISON addressed the

Chair.

The PRESIDING OFFICER. Who

yields time?

Mr. CHAFEE. I yield whatever time I

have.

The PRESIDING OFFICER. The Senator from Texas is recognized.

Mrs. HUTCHISON. Mr. President, I

do want to be a cosponsor of this substitute because I think this is one of
S6796 CONGRESSIONAL RECORD — SENATE May 17, 1995

the important positive things that we

can do for health care reform. This was

brought to my attention by Congresswoman JOHNSON last year when we

were afraid that this option for our

seniors in the 15 States using it might

be lost in the shuffle, and I called Senator CHAFEE and we worked to try to

make sure that this was extended. I am

very pleased that Senators ROCKEFELLER and CHAFEE have now come to

an accommodation to not only extend

it for the 50 States but to allow all people in all 50 States on Medicare to have

the option of selecting Medicare Select.

Medicare Select is health reform that

works. Since I have been in the Senate,

we have spent more time discussing the

problems in our health care system

than about the models of achievement

in the industry. What about the reform

that has accomplished savings in

health care? Medicare Select is a program we should encourage and promote, not to let die.

Medicare Select gives seniors an option to save money. In Texas, more

than 8,000 seniors are enrolled in Medicare Select plans and save an average

of 15 to 20 percent of the cost of Medicare supplemental plans. This is a significant savings for those on a fixed income. Nationwide, 400,000 people participate in this program in 15 States. If

we allowed this program to expire at

the end of this year, seniors would be

hit with higher premiums.

Medicare Select policies are highly

rated by Consumer Reports magazine.

In its August 1994 issue, Consumer Reports included 8 Medicare Select policies in the top 15 best value MediGap

products nationwide. In fact, almost

every health care reform bill introduced in this body last year contained

a permanent extension of this program

to 50 States.

The need to extend Medicare Select

Program is critical. If this program

were allowed to expire, premiums could

substantially increase for the current

Medicare Select enrollees and, more

importantly, would limit options for

new Medicare beneficiaries. With the

recent report by the trustees of the

Medicare trust fund telling us of the

dire straits of the Medicare Program, it

would be unthinkable to start eliminating cost-effective options for providing care to the Medicare beneficiaries.

I appreciate Senator CHAFEE’s and

Senator ROCKEFELLER’s leadership on

this. I think they are taking exactly

the right approach. I am glad to be a

cosponsor of this substitute. When we

talk about improving health care, here

is one of the key ways we can do it so

that we can provide options for all 50

States for our seniors to have the ability to add to their standard Medicare

plan options that they would want at

an affordable price.

I hope we will adopt this quickly. I

hope that the other seniors in the

States not now covered will look into

this option, because this is the way we

can do what this Congress has been trying to do for 2 years, and that is to provide more cost-effective health care

availability for our senior citizens.

Thank you, Senators CHAFEE and

ROCKEFELLER.

I yield the floor.

Mr. CHAFEE. Mr. President, I thank

the distinguished Senator from Texas

for her kind comments. She has been a

loyal supporter and active worker in

connection with this Medicare Select

effort. I congratulate her for what she

has done.

Mrs. FEINSTEIN. Mr. President, I

rise in support of Senate passage of the

Medicare Select bill, H.R. 483, which as

passed by the House would extend the

current demonstration program beyond

its June 30, 1995 cutoff date and expand

it from 15 States to the entire Nation.

While it has thus far been just a

small 3-year demonstration program,

the Medicare Select Program has been

a tremendous success in the 15 States

where it is offered, especially in California.

Medicare Select provides supplementary insurance—for copayments,

deductibles, and other out-of-pocket

costs—for 100,000 California Medicare

recipients (roughly 440,000 nationally).

Seniors enroll in the low-cost Medicare Select Program in exchange for

participation in a loose-knit managed

care plan.

This network of providers are used to

cut premium costs by 10–37 percent

over fee for service medigap products,

which translates into savings on

medigap premiums of up to $25 per

month, or $300 per year.

In California, more than 2,200 new enrollees are being added per month, because the Medicare Select Program can

provide low-cost, high-quality health

benefits, while still retaining a high

degree of choice over their physician.

There is no additional cost to the

Federal Government.

However, under current law, no new

Medicare recipients will be able to enroll in the program after July 1, 1995,

when the demonstration program that

was authorized in 1990 and extended for

6 months last year will end.

To make sure that select is continued in California, I joined Senator

CHAFEE and others in introducing Medicare Select legislation earlier this

year, and am pleased that the House

was easily able to pass legislation that

would extend the program for 5 years

and expand it to all 50 States, with a

bipartisan vote of 408 to 18.

This Medicare Select legislation

should not be confused or dragged down

with other, more contentious health

care insurance reform issues. Certainly, there are problems with the

current medigap insurance program

that must be addressed. However, this

is a simple, straightforward bill that

should not be used for those purposes.

The Medicare Select Program is entirely voluntary, and should not be

confused with programs and proposals

that would require seniors to join

HMO’s to get their Medicare. No seniors are being forced or fooled into

joining, Medicare Select seniors can

still receive service outside their plans,

and no insurers are being forced to sell

this type of product.

In fact, Consumer Reports has listed

Medicare Select products as among its

highest rated values, and extension of

the Medicare Select Program has been

endorsed by the California Commissioner of Insurance as well as the National Association of Insurance Commissioners.

Certainly, managed Medicare programs like Medicare Select must be

implemented carefully, in order to ensure that Medicare enrollees are appropriately informed of the benefits of

this program, provided with high-quality services, and ensured access to

highly trained physicians.

However, the matter at hand is

straightforward, and the most important thing is that Medicare Select be

extended. Therefore, I urge my colleagues to support the Medicare Select

legislation.

Mr. KOHL. Mr. President, I rise in

strong support of the Medicare Select

Program. The bill we are considering

extends Medicare Select for 5 years and

allows all States to participate. Fifteen States are currently allowed to

take part in this program which provides older Americans with a managed

care alternative to supplement their

Medicare benefits.

We have a strong managed care tradition in Wisconsin. Many seniors had

managed care options during their employment and wish to maintain that

choice of care as they retire. Medicare

Select provides that opportunity and is

very popular in my State.

Mr. President, if we do not act on

this legislation, Medicare Select will

terminate on June 30. Over 26,000 Medicare recipients in Wisconsin will face

increased premiums and limited

choices. 450,000 older Americans in the

15 States will be hit with higher costs

if the program is not extended.

At a time when the majority party is

pursuing a budget proposal that cuts

Medicare by $256 billion—which would

greatly increase out-of-pocket costs for

older American’s and ration care—we

should not kill a program that currently saves money for older Americans and expands their options.

Detractors from this bill suggest that

before we act, we should wait until a

study being conducted for the Department of Health and Human Services is

completed later this summer. Or will it

be completed in December? No one

seems to know when it will be ready.

The fact is, Mr. President, the study

was due this past January. What’s the

holdup?

There is one date that I am certain

of—June 30, 1995—the date when Medicare Select will terminate.

I am eager to see the results of the

study I just mentioned. I believe it will

have important ramifications on the

future of managed care and Medicare.
May 17, 1995 CONGRESSIONAL RECORD — SENATE S6797

But we must not hold Medicare Select

beneficiaries hostage until a date uncertain.

During debate today, concerns have

been raised about premium rating

based on age and one-time open enrollment periods under medigap policies. I

agree that these concerns should be addressed. However, these issues relate to

all MediGap policies, not just Medicare

Select. We should not single out those

who benefit from Medicare Select in

order to iron out differences in overall

MediGap policy. We can and should review these issues under Medicare reform and broader health care reform

legislation.

Medicare Select works for older people in Wisconsin. It saves beneficiaries

from 20 to 30 percent in premium costs

than under traditional medigap policies.

Medicare Select plans are subject to

the same regulations as other medigap

policies which are regulated by the

States. Select plans must offer sufficient access, have an ongoing quality

assurance program, and provide full

disclosure of network requirements.

The program saves money for Medicare recipients, does not cost the Federal Government, and perhaps most importantly, provides many beneficiaries

and providers their first exposure to

managed care.

Mr. President, time is running out. I

urge my colleagues to support and extend Medicare Select.

Mr. CHAFEE. Mr. President, I thank

Senator ROCKEFELLER, the Senator

from West Virginia, for all of his help.

I am glad we were able to work this

out. It looked a little sticky at first,

but we have done it. I look forward to

working with him on the Finance Committee as we have the hearings next

fall or whenever the report comes in

from HHS.

Mr. ROCKEFELLER. I yielded the remainder of my time, so if the Senator

will yield.

Mr. CHAFEE. I yield. The Senator

may take as much of my time as he

wants.

Mr. ROCKEFELLER. There are two

points I want to make that I think are

very important to those who might be

listening and who might be confused at

this point. One is that we went from a

5-year extension to a year-and-a-half

extension. Then, as the Senator from

Rhode Island pointed out, the yearand-a-half extension would then become automatic unless the Secretary

of HHS had objections or found problems or whatever. That means that basically—I do not want this to be taken

the wrong way—Donna Shalala who is

watching this closely—I do not think

destructively but constructively—18

months would pass and she would still

be there. So that for some of the colleagues who might be worried that this

is an automatic extension, it is not, except as the merit allows that. I think

that is a matter of great comfort to

me, and it is another reason why I appreciate the Senator from Rhode Island. I thank him.

Mr. CHAFEE. Mr. President, I yield

back the remainder of my time.

The PRESIDING OFFICER. If there

be no further amendment to be proposed, the question is on agreeing to

the committee amendment in the nature of a substitute.

The committee amendment was

agreed to.

The PRESIDING OFFICER. The

question is on the engrossment of the

committee amendment and third reading of the bill.

The amendment was ordered to be

engrossed, and the bill to be read a

third time.

The bill was read a third time.

The PRESIDING OFFICER. The bill

having been read the third time, the

question is, Shall the bill pass?

So the bill (H.R. 483), as amended,

was passed.

H.R. 483

Resolved, That the bill from the House of

Representatives (H.R. 483) entitled ‘‘An Act

to amend title XVIII of the Social Security

Act to permit medicare select policies to be

offered in all States, and for other purposes’’,

do pass with the following amendment:

Strike out all after the enacting clause and

insert:

SECTION 1. PERMITTING MEDICARE SELECT

POLICIES TO BE OFFERED IN ALL

STATES FOR AN EXTENDED PERIOD.

Section 4358(c) of the Omnibus Budget Reconciliation Act of 1990, as amended by section

172(a) of the Social Security Act Amendments of

1994, is amended to read as follows:

‘‘(c) EFFECTIVE DATE.—(1) The amendments

made by this section shall only apply—

‘‘(A) in 15 States (as determined by the Secretary of Health and Human Services) and such

other States as elect such amendments to apply

to them, and

‘‘(B) subject to paragraph (2), during the 5

year period beginning with 1992.

‘‘(2)(A) The Secretary of Health and Human

Services shall conduct a study that compares

the health care costs, quality of care, and access

to services under medicare select policies with

that under other medicare supplemental policies.

The study shall be based on surveys of appropriate age adjusted sample populations. The

study shall be completed by June 30, 1996.

‘‘(B) The Secretary shall determine during

1996 whether the amendments made by this section shall remain in effect beyond the 5 year period described in paragraph (1)(B). Such amendments shall remain in effect beyond such period

unless the Secretary determines (based on the

results of the study under subparagraph (A))

that—

‘‘(i) such amendments have not resulted in

savings of premiums costs to those enrolled in

medicare select policies (in comparison to their

enrollment in medicare supplemental policies

that are not medicare select policies and that

provide comparable coverage),

‘‘(ii) there have been significant additional expenditures under the medicare program as a result of such amendments, or

‘‘(iii) access to and quality of care has been

significantly diminished as a result of such

amendments.

‘‘(3) The GAO shall study and report to Congress, no later than June 10, 1996, on options for

modifying the Medigap market to make sure

that continuously insured beneficiaries are able

to switch plans without medical underwriting or

new pre-existing conditions exclusions. In preparing such options, the GAO shall determine if

there are problems under the current system and

the impact of each option on the cost and availability of insurance, with particular reference to

the special problems that may arise for enrollees

in Medicare Select plans.’’.

Mr. CHAFEE. Mr. President, I move

to reconsider the vote.

Mr. ROCKEFELLER. I move to lay

that motion on the table.

The motion to lay on the table was

agreed to.

Mr. CHAFEE. Mr. President, I ask

MORNING BUSINESS

fthat we now have a period for morning

business.

The PRESIDING OFFICER. Without

objection, it is so ordered.

Mr. DEWINE addressed the Chair.

The PRESIDING OFFICER. The Senator from Ohio [Mr. DEWINE] is recognized.

Mr. DEWINE. I thank the Chair.

(The remarks of Mr. DEWine pertaining to the introduction of S. 816 are located in today’s RECORD under ‘‘Statements on Introduced Bills and Joint

Resolutions.’’)

Mr. DEWINE. I yield the floor.

Mr. LEVIN addressed the Chair.

The PRESIDING OFFICER (Mr.

FRIST). The Senator from Michigan.

Mr. LEVIN. Mr. President, first let

me thank our colleague from Ohio for

his usual courtesy for giving me that

little heads up so I can get ready to address the Senate.

AUTOMOTIVE TRADE

NEGOTIATIONS

fMr. LEVIN. Mr. President, the purpose of the recently collapsed automotive trade negotiations between the

United States and Japan and the administration’s subsequent announcement to impose reciprocal restrictions

on Japanese products and file an unfair

trade complaint with the World Trade

Organization is simple That purpose is

to open Japan’s closed and protected

auto and auto parts markets.

Yesterday, the administration took

an important step toward opening Japan’s automotive market to American

products by announcing the specific

list of Japanese products to be sanctioned in retaliation for the unfair exclusion of American products from

Japan. We have listened to 25 years of

trade rhetoric from one administration

after another promising to open Japan’s automotive markets to United

States products. Endless talks and endless negotiations have not produced results. Japan’s markets remain almost

totally closed, and we have lost huge

numbers of jobs during this period.

I have a little chart here which shows

the statements of American Presidents

since 1971. Every President of both parties has had promises made to him and,

in turn, has assured the American people that we are going to act to open up

Japanese markets to American products.

President Nixon in 1971 said:

Japan has accelerated its program of liberalizing its restrictions on imports.

When President Nixon said that, the

deficit with Japan was $1.3 billion.