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TRICARE, for a premium, regardless of their activation
status.
SEC. 504. SENSE OF THE SENATE REGARDING RESTRAINING
MEDICAID GROWTH.
(a) FINDINGS.—The Senate makes the following find-
ings:
(1) The Medicaid program provides essential
health care and long-term care services to more than
50,000,000 low-income children, pregnant women,
parents, individuals with disabilities, and senior citi-
zens. It is a Federal guarantee that ensures the most
vulnerable will have access to needed medical services.
(2) Medicaid provides critical access to long-term
care and other services for the elderly and individuals
living with disabilities, and is the single largest pro-
vider of long-term care services. Medicaid also pays
for personal care and other supportive services that
are typically not provided by private health insur-
ance or Medicare, but are necessary to enable individ-
uals with spinal cord injuries, developmental disabil-
ities, neurological degenerative diseases, serious and
persistent mental illnesses, HIV/AIDS, and other
chronic conditions to remain in the community, to
work, and to maintain independence.
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(3) Medicaid supplements the Medicare program
for more than 6,000,000 low-income elderly or dis-
abled Medicare beneficiaries, assisting them with their
Medicare premiums and co-insurance, wrap-around
benefits, and the costs of nursing home care that
Medicare does not cover. The Medicaid program spent
nearly $40,000,000,000 on uncovered Medicare serv-
ices in 2002.
(4) Medicaid provides health insurance for more
than 1⁄4 of America’s children and is the largest pur-
chaser of maternity care, paying for more than 1⁄3 of
all the births in the United States each year. Med-
icaid also provides critical access to care for children
with disabilities, covering more than 70 percent of
poor children with disabilities.
(5) More than 16,000,000 women depend on
Medicaid for their health care. Women comprise the
majority of seniors (71 percent) on Medicaid. Half of
nonelderly women with permanent mental or physical
disabilities have health coverage through Medicaid.
Medicaid provides treatment for low-income women
diagnosed with breast or cervical cancer in every
State.
(6) Medicaid is the Nation’s largest source of
payment for mental health services, HIV/AIDS care,
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and care for children with special needs. Much of this
care is either not covered by private insurance or lim-
ited in scope or duration. Medicaid is also a critical
source of funding for health care for children in foster
care and for health services in schools.
(7) Medicaid funds help ensure access to care for
all Americans. Medicaid is the single largest source of
revenue for the Nation’s safety net hospitals, health
centers, and nursing homes, and is critical to the
ability of these providers to adequately serve all
Americans.
(8) Medicaid serves a major role in ensuring
that the number of Americans without health insur-
ance, approximately 45,000,000 in 2003, is not sub-
stantially higher. The system of Federal matching for
State Medicaid expenditures ensures that Federal
funds will grow as State spending increases in re-
sponse to unmet needs, enabling Medicaid to help
buffer the drop in private coverage during recessions.
More than 4,800,000 Americans lost employer-spon-
sored coverage between 2000 and 2003, during which
time Medicaid enrolled an additional 8,400,000
Americans.
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(b) SENSE OF THE SENATE.—It is the sense of the Sen-
ate that the Finance Committee shall not report a reconcili-
ation bill that achieves spending reductions that would—
(1) undermine the role the Medicaid program
plays as a critical component of the health care sys-
tem of the United States;
(2) cap Federal Medicaid spending, or otherwise
shift Medicaid cost burdens to State or local govern-
ments and their taxpayers and health providers, forc-
ing a reduction in access to essential health services
for low-income elderly individuals, individuals with
disabilities, and children and families; or
(3) undermine the Federal guarantee of health
insurance coverage Medicaid provides, which would
threaten not only the health care safety net of the
United States, but the entire health care system.
SEC. 505. SENSE OF THE SENATE REGARDING TRIBAL COL-
LEGES AND UNIVERSITIES.
(a) FINDINGS.—The Senate finds the following:
(1) American Indians from over 250 federally
recognized tribes nationwide attend tribal college and
universities, a majority of whom are first-generation
college students.
(2) Tribal colleges and universities are located in
some of the most isolated and impoverished areas in
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the Nation and are the Nation’s most poorly funded
institutions of higher education. While the Tribally
Controlled College or University Assistance Act, or
‘‘Tribal College Act’’ provides funding based solely on
Indian students, the colleges have open enrollment
policies providing access to postsecondary education
opportunities to all interested students, about 20 per-
cent of whom are non-Indian. With rare exception,
tribal colleges and universities do not receive oper-
ating funds from their respective States for these non-
Indian State resident students. Yet, if these same stu-
dents attended any other public institutions in their
States, the State would provide basic operating funds
to the institution.
(b) SENSE OF THE SENATE.—It is the sense of the Sen-
ate that—
(1) this resolution recognizes the funding chal-
lenges faced by tribal colleges, and universities and
assumes that equitable consideration will be provided
to them through funding of the Tribally Controlled
College or University Assistance Act, the Equity in
Educational Land Grant Status Act, title III of the
Higher Education Act of 1965, and the National
Science Foundation, Department of Defense, and
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Housing and Urban Development Tribal College and
University Programs; and
(2) such equitable consideration reflects Congress
intent to continue to work toward statutory Federal
funding authorization goals for tribal colleges and
universities.
SEC. 506. SENSE OF THE SENATE REGARDING SUPPORT
FOR THE PRESIDENT’S REQUEST TO CON-
CENTRATE FEDERAL FUNDS FOR STATE AND
LOCAL HOMELAND SECURITY ASSISTANCE
PROGRAMS 
ON 
THE 
HIGHEST 
THREATS,
VULNERABILITIES, AND NEEDS.
It is the sense of the Senate that Congress supports
the President’s request to ‘‘Concentrat[e] Federal funds for
State and local homeland security assistance programs on
the highest threats, vulnerabilities, and needs. In dealing
with homeland security assistance grants that relate to port
security, Congress should (1) allocate port security grants
under a separate, dedicated program intended specifically
for port security enhancements, rather than as part of a
combined program for many different infrastructure pro-
grams that could lead to reduced funding for port security,
(2) devise a method to enable the Secretary of Homeland
Security to both distribute port security grants to the Na-
tion’s port facilities more quickly and efficiently and give
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ports the financial resources needed to comply with congres-
sional mandates, and (3) allocate sufficient funding for port
security to enable port authorities to comply with mandated
security improvements taking into consideration national,
economic, and strategic defense concerns, ensure the protec-
tion of our Nation’s maritime transportation, commerce
system, and cruise passengers, strive to achieve funds con-
sistent with the needs estimated by the United States Coast
Guard, and recognize the unique threats for which port au-
thorities must prepare.’’.
SEC. 507. SENSE OF THE SENATE REJECTING PROPOSED
ELIMINATION OF PER DIEM REIMBURSEMENT
TO STATE NURSING HOMES IN THE PRESI-
DENT’S BUDGET.
It is the sense of the Senate that Congress should reject
the President’s proposal to eliminate per diem payments
to State Veterans Homes for the vast majority of patients
that reside in these homes.
SEC. 508. SENSE OF THE SENATE REGARDING IMPACT AID.
It is the sense of the Senate that funding for Impact
Aid (Title VIII of Public Law 107–110) should be sufficient
to insure that all federally connected school districts are
provided a payment under sections 8002 and 8003 of that
Act that will allow them to address the increase in program
costs in recent years, as this is critical for school districts
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addressing the emotional and family needs of children of
military families who have a parent or parents engaged in
conflict in Iraq or Afghanistan.
SEC. 509. SENSE OF THE SENATE REGARDING MANDATORY
AGRICULTURAL PROGRAMS.
(a) FINDINGS.—The Senate finds the following:
(1) The mandatory farm programs administered
by United States Department of Agriculture under
the Food Security and Rural Development Act of
2002 provide an economic safety net, ensure the
availability of Federal crop insurance, fund conserva-
tion priorities, and enhance agriculture export market
opportunities for United States farmers and ranchers.
(2) The actual budget outlays for farm bill pro-
grams for fiscal years 2002–2004 have been about
$16,700,000,000 less than projected by the Congres-
sional Budget Office in August 2002, shortly after the
farm bill was passed.
(3) Over 72 percent of farm program payments
are currently received by only 10 percent of our Na-
tion’s program crop producers.
(4) Any agricultural policy modifications should
address the disproportionate share of farm program
payments received by the largest farming operations.