The Senate Debate that led to Tricare for Life (TFL)
Extracted from the Congressional Record
NATIONAL DEFENSE AUTHORIZATION ACT FOR FISCAL YEAR 2001
(Senate - June 07, 2000)
Extracted from the Congressional Record
106th Congress
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Starting at AMENDMENT NO. 3191
AMENDMENT NO. 3191
(Purpose: To restore health care coverage to retired members of the uniformed services)
Mr. JOHNSON. Mr. President, I send an amendment to the desk and ask for its immediate consideration.
The PRESIDING OFFICER (Mr. BURNS). The clerk will report.
The assistant legislative clerk read as follows:
The Senator from South Dakota [Mr. JOHNSON], for himself, Mr. MCCAIN, Mr. BINGAMAN, Mrs. MURRAY, Mr. REID, and Mr. JEFFORDS, proposes an amendment numbered 3191.
Mr. JOHNSON. Mr. President, I ask unanimous consent that reading of the amendment be dispensed with.
The PRESIDING OFFICER. Without objection, it is so ordered.
The amendment is as follows:
For continuity of reading, the 3191 amendment has been moved to a separate web page.
Click here to see the amendment.
Use your browser back button to return here.
Mr. JOHNSON. Mr. President, I am pleased to be joined by Senators MCCAIN, BINGAMAN, MURRAY, REID, and JEFFORDS in offering an amendment dealing with military retiree health care. I first want to thank Senators WARNER and LEVIN for their continued hard work in the Armed Services Committee in attempting to address this critical and urgent issue.
Last year, the Senate began to address critical recruitment and retention problems currently facing our nation's armed services. The pay table adjustments and retirement reform enacted with my support in the fiscal year 2000 Department of Defense authorization bill were, frankly, long overdue improvements for our active duty military personnel.
However, these improvements did not solve our country's difficulty in recruiting and keeping the best and the brightest in the military. In order to maintain a strong military for now and in the future, our country must show that it will honor its commitment to military retirees and veterans as well.
Too often, military health care is treated as an afterthought rather than a priority. That's why on the first day of this legislative year, I introduced the Keep our Promise to America's Military Retirees Act, S. 2003. This legislation currently has 32 bipartisan cosponsors including 18 Republicans and 14 Democrats.
Companion legislation in the House has over 300 bipartisan cosponsors. The bill also has the strong support of military retirees across the country and organizations including the Retired Enlisted Association, the Retired Officers Association, the National Association of Uniformed Services, and the Disabled American Veterans.
The amendment I offer today is the same language as that contained in S. 2003. This legislation honors our nation's commitment to the men and women who served in the military by keeping our Nation's promise of health care coverage in return for their service and selfless dedication.
In doing so, it also illustrates to active duty men and women that our country will not abandon them when their military career ends.
Our country must honor its commitments to military retirees and veterans, not only because it's the right thing to do, but also because it's the smart thing to do.
We all know the history: For decades, men and women who joined the military were promised lifetime health care coverage for themselves and their families. They were told, in effect, if you disrupt your family, if you work for low pay, if you endanger your life and limb, we will in turn guarantee lifetime health benefits.
Testimony from military recruiters themselves, along with copies of recruitment literature dating back to World War II, show that health care was promised to active duty personnel and their families upon the personnel's retirement.
In fact, Chairman of the Joint Chiefs of Staff, General Henry Shelton, testified before the Senate Armed Services Committee and said:
Sir, I think the first thing we need to do is make sure that we acknowledge our commitment to the retirees for their years of service and for what we basically committed to at the time that they were recruited into the armed forces.
Defense Secretary William Cohen also testified before the Senate Armed Services Committee and said:
We have made a pledge, whether it's legal or not, it's a moral obligation that we will take care of all of those who served, retired veterans and their families, and we have not done so.
Prior to June 7, 1956, no statutory health care plan existed for military personnel, and the coverage which eventually followed was dependent upon the space available at military treatment facilities.
Post-cold war downsizing, base closures, and the reduction of health care services at military bases have limited the health care options available to military retirees.
That's right: Many of the people who helped us win the cold war have lost their health care because the cold war ended.
Some military retirees in South Dakota and other rural states are forced to drive hundreds of miles to receive care. Furthermore, military retirees are currently kicked off the military's TRICARE health care system when they turn 65.
This is a slap in the face to those men and women who have sacrificed their livelihood to keep our country safe from threats at home and abroad.
My amendment honors the promise of lifetime health care coverage. It does so in two ways:
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First, it allows military retirees who entered the armed services before June 7, 1956 (the date military health care for retirees was enacted into law) to enroll in the Federal Employees Health Benefits Program (FEHBP), with the United States paying 100 percent of the costs.
Second, military retirees who joined the armed services after space-available care was enacted into law on June 7, 1956 would be allowed to enroll in FEHBP or continue to participate in TRICARE--even after they turn 65. Military retirees who choose to enroll in FEHBP will pay the same premiums and fees--and receive access to the same health care coverage--as other Federal employees.
In my own family, my oldest son is in the Army and currently serves as a sergeant in Kosovo. I fully appreciate what inadequate health care and broken promises can do to the morale of military families.
This stress on morale not only effects the preparedness of our military units, but also discourages some of our most able personnel from reenlisting, making recruitment efforts more difficult.
I have long contended that all the weapons and training upgrades in the world will be rendered ineffective if military personnel and their families are not afforded a good ``quality of life'' in our nation's armed forces. I have been a strong advocate of better funding for veterans health care, military pay, active duty health care, education and housing.
The Johnson amendment continues these efforts led by Senator WARNER, Senator LEVIN, and others to address these important quality of life issues.
Senator WARNER's modified amendment incorporates an important part of S. 2003--the extension of TRICARE to Medicare-eligible retirees and dependents. I applaud the Senator for his work.
However, only my amendment fulfills the promise of health care for military retirees while illustrating to current active duty personnel that our country supports its commitments to men and women in the military.
I am also concerned that Senator WARNER's modified amendment terminates in 2004. This could leave military retirees once again wondering where their health care will come from. The Johnson amendment does not terminate.
I understand the rationale for Senator WARNER's amendment. I am going to support the amendment of Senator WARNER. It is a good-faith effort to do the best that can be done on the health care issues, within the context of the budgetary marching orders that have been imposed on Senator WARNER's committee. I understand that. I understand he is doing the best he can within the fiscal envolope that he has been afforded.
But it frustrates me, as I know it frustrates tens of thousands of military retiree and active duty personnel, that for years and years we have been told: Yes, we know we have a commitment to you for health care but we can't afford it. The Nation's budget is in the red. We are running deficits. We simply cannot afford to live up to those promises.
That was never entirely true. In fact, in the context of a $1.5 trillion budget, we could have reoriented priorities, I believe, in such a way that we could have kept our promises to military personnel and retirees. But there was an element of truth to the fact that we were running red ink and we were running massive deficits.
Those days are gone for a lot of different reasons. We have had much debate on this floor as to why we now find ourselves running significant budget surpluses over and above that attributable to Social Security and why those surpluses, projected out 10 years from now, will run in the $3 trillion range, some $700 billion to $1 trillion over and above what is required for Social Security because we are certainly in agreement we are not going to dip into anything that is attributable to Social Security. That is off the table, and rightfully so. There is the question about what will we do with the $700 billion to $1 trillion budget surplus that is being projected by both the White House and by the congressional budget experts.
The amendment pending is an expensive amendment. I understand that. It could run around $3 billion next year and $9 billion a year after that, according to our friends at the Congressional Budget Office. That is a significant expense. What I am asking is if this is not a time when we can afford to live up to our promises to our military retirees and our military personnel, then when will that time ever occur?
There are those who see other uses for that $700 billion to $1 trillion surplus over and above Social Security. I have other things I would like to do as well, including some tax relief. There are those who want tax relief in the range of essentially the entire surplus. I am suggesting there is room for tax relief, there is room for paying down the debt, there is room for education, and a number of other things. If we do this right, this is a once-in-a-lifetime opportunity to utilize some of that projected surplus to, in fact, finally--finally--live up to our commitment to our military personnel and
retirees, many of whom, frankly, have gone to their graves without the benefits they were promised. We do have that once-in-a-lifetime, unique opportunity this year to do something constructive, to make a commitment that we will fund this, not out of military readiness, not out of active duty budgets, but, in fact, out of this projected surplus that the CBO and OMB people tell us is headed our way.
Military retirees and veterans are our Nation's most effective recruiters. Unfortunately, poor health care options make it difficult for these men and women to encourage the younger generation to make a career of the military. In fact, in Rapid City, SD, which is outside of Ellsworth Air Force Base, a very significant B-1 military base in my State, I was talking to military personnel and talking to retirees who are as loyal and as patriotic, who have paid a price second to none for our Nation's liberty, and they told me: Senator, I can't in good faith tell my nephews, my children, young people whom I encounter, that they ought to serve in the U.S. military, that they ought to make a career of that service because I see what the Congress has done to its commitment to me, to my family, to my neighbors. The health care promises were never lived up to, and we don't think you ever will live up to them. You have no credibility with us. It has gone decades, it has gone generations, and you have not lived up to the health care obligations and responsibilities that you said, if we put our lives in danger, we would have. How can I in good faith tell these young people they ought to make a career of the military, that it is a distinguished professional option they ought to consider, when you treat us shabbily?
That is the message I hear from active duty as well as retired military personnel in my State. It is the same in the mail and e-mail I get from all across the country saying: 2003 is the only legislative option we see that truly lives up to Congress' obligations.
No more excuses. The money is there. The only question is, Is the political will there? Is this a priority or is it not? I am pleased we are having this debate.
Mr. DORGAN. Will the Senator from South Dakota yield?
Mr. JOHNSON. I yield to my colleague.
Mr. DORGAN. Mr. President, Senator JOHNSON has been working on this issue for a long while. I ask unanimous consent to be added as a cosponsor.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. DORGAN. Mr. President, this amendment addresses a critical need. I ask him if he sees in South Dakota what we know and see in North Dakota with respect to the veterans' health care system. The system is not working. We have a fellow in north central North Dakota who went to Vietnam and took a bullet in the brain and is severely disabled for life. Because of that, he has muscle atrophy and a range of other health problems and had to have a toe removed.
The VA system said to his father: Haul him over to Fargo, ND, and we will do that in the VA system.
In other words, take this severely disabled person, put him in a car, drive him nearly 200 miles to the east and have this procedure done--not a major procedure--and then drive him 200 miles back, and that is the only way we will cover that expense.
The father said: Is this the way to treat a son who served
his country in
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Vietnam and was shot in the head and is now consigned to a very difficult life? Is this a way to treat him? It is not. The health care system is not working. The VA system is not able to meet the needs.
I ask the Senator from South Dakota, is it not the case, in his opinion, that the cost of veterans' health care is part and parcel of the cost of defending this country? It ought to be part of the cost of defense because it is a promise we made and have not kept to veterans in this country when we said: Serve your country, and we will provide you a health care system that works for your needs.
Mr. JOHNSON. Mr. President, the Senator is exactly right. We have a problem both on the VA health care side and on the military retiree side; that is, those who have served their 20 years in the military and rely on TRICARE currently, previously CHAMPUS, for their health care needs in both instances.
These people who have served this Nation in such an extraordinary fashion have, in all too many instances, not received the quality, the accessibility, or the affordability of health care they deserve. It is doubly difficult in rural States, such as our own, but it is a problem everywhere.
It is suggested as a compromise that we simply extend TRICARE to those who are age 65 and older. That is an additional option which I applaud, but that does not extend the Federal Employees Health Benefits System to either people prior to 65 or older and, frankly, up until now, TRICARE is not viewed in my State with great enthusiasm by many of our military retirees. I understand it is a new program, and it may improve as time goes on. Simply doing that alone falls far short of living up to the obligations Congress made during times of war when we were not sure if our Republic was going to survive World War II, when we did not know what would happen and we called these people into service, followed with Korea, Vietnam, and other conflicts, with people dying for our liberty. We were quick to make promises at that time: If you help us out, if you work for almost nothing, disrupt your families and serve this Nation, we will provide you with quality health care.
They did their share. They came home and we said: Wait a minute, this is a little more costly than we thought, and we have decided to forget about it.
We are not going to live up to those obligations. That is what this Congress has said through administrations of both political parties over the years.
We have an opportunity now to bring that, at last, to a halt and to deal with our military retirees with a spark of integrity, at last. That is what this amendment is about.
Mr. DORGAN. Will the Senator yield for a last question?
Mr. JOHNSON. Yes.
Mr. DORGAN. I appreciate the indulgence of the Senator from South Dakota.
I assume he agrees with me we are not in any way attempting to denigrate the wonderful men and women who work at the VA health care centers around the country. Many of them do an extraordinary job. But they are not funded well enough. We do not have the resources to do the job we should.
I just want to mention, on a Sunday morning some while ago, I was at a VA hospital presenting medals that had been earned, but never received by an American Indian. His family came, but also at this VA hospital, the doctors and the nurses came into his room. I pinned those medals on the pajama tops of this man named Edmund Young Eagle. He died 7 days later. He was very ill with cancer. But it was an enormously proud day for him because he served his country in Africa and Europe in World War II. The fact is, this man served this country around the world. He never complained about it.
The day I pinned the medals on his pajama tops, you could see the pride in his eyes. I appreciated the fact that at this VA hospital the doctors and nurses came around and were part of that small ceremony.
But there are so many people such as Edmund Young Eagle and others who served their country, have never asked for much, but then need health care, only to discover that the system for delivering that health care is not nearly funded well enough, while in the Congress, somehow we are more eager to say that defense relates to the things in the Defense Department and that the VA health care system is somehow not part of that obligation. It is part of that obligation. That is why I am pleased to support this amendment.
As I mentioned, I say to Senator JOHNSON, he has been working on these issues for a long while. I hope the Congress will embrace this approach now so that we can be as proud of what we are doing for veterans and for their health care needs as Edmund Young Eagle was proud that day of serving his country.
Isn't it the case that we have dramatic needs--underfunding in these facilities--and that the Senator's approach to dealing with this would say it is a priority in this Congress to address the health care needs of veterans and we believe the health care needs of veterans are part and parcel of this country's defense requirements?
Mr. JOHNSON. I think the Senator from North Dakota raises an excellent point. He himself has been a champion for veterans and military retirees.
Obviously, when we come to the point of the VA-HUD appropriations issues, we will do the very best we can within the VA context, while at the same time trying to address the military retiree issues. They go hand in hand. They are both very much part and parcel of our overall effort towards military
recruitment, retention, and readiness. They are part of that same package. I certainly commend the Senator from North Dakota for his leadership in that regard.
Mr. WARNER. Will the Senator yield?
Mr. JOHNSON. I certainly yield to the Senator from Virginia.
Mr. WARNER. I want very much for the Senator to have a full opportunity to present his viewpoints, of course, in the time remaining. But at some point I think it would be very helpful to the other Senators following this debate to frame exactly what the differences are between the Senator's approach and the approach I have in my amendment. If he could indicate in the course of his presentation when we can bring that into sharp focus for the benefit of our colleagues, I would like then to get into a colloquy, on my time for such portion of the colloquy as I expend in my statements.
Mr. JOHNSON. The chairman, the Senator from Virginia, has a very constructive suggestion. I certainly will not put words in his mouth relative to the interpretation of his legislation. I applaud him for his legislative efforts. But I will draw some distinctions as to his pending amendment and my amendment.
I intend to vote for both amendments. My amendment is farther reaching and, as I am sure the distinguished Senator from Virginia would note, is more costly. Because of that, it runs into additional parliamentary issues perhaps. But I will attempt, in closing, to draw some distinctions between what it is we are trying to do.
Mr. WARNER. If the Senator would indicate such time it would be convenient for him to proceed to questions, then I would seek recognition.
Mr. JOHNSON. Very good.
The opponents of S. 2003, in my amendment, again would claim that it simply costs too much; roughly $3 billion in fiscal year 2001, and, over 10 years, CBO estimates an average cost of $9 billion a year to fulfill our promise of health care for military retirees. This does not come cheaply. I am very up front on that fact. However, we are talking about a $200 billion budget surplus--$9 billion here; $200 billion surplus--$800 billion to $1 trillion over 10 years. That is a conservative estimate.
So if we look at the larger scheme of things, in terms of where this ought to be within our budget, and also with the possibility of some reprioritization of the existing budget, I believe the argument that we simply can no longer afford to live up to our promises to military personnel who sacrificed so much, including families of those who have died defending our right to be here debating this issue today, simply no longer holds.
We invest billions of dollars each year to build new weaponry, and rightfully so. But all the weapons in the world will be rendered useless or less useful without the men and women in uniform and without the high-quality, qualified personnel we need to operate them.
I believe a promise made should be a promise kept. We owe it to our country's military retirees to provide them
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with the health care they were promised. The effort behind this amendment has been 100-percent driven by military retirees taking action on the benefits to which they are entitled. It is the right thing to do. No more tests; no more demonstration projects; no more experiments.
I think we need to act now on a program that works, building on the Federal Employees Health Benefits Plan system. On average, 3,784 military retirees are dying each month. The time to act is now. These retirees have mobilized in a grassroots lobbying campaign throughout the country to fight for lifetime health care.
I hope we do not leave this floor today without giving true access to health care to these soldiers, sailors, and airmen who have patriotically served our country. We have a long way to go. I will continue to work with Senators WARNER and LEVIN, and my colleagues, to be sure that our country's active-duty personnel, military retirees, and veterans receive the benefits they deserve.
Senator WARNER has suggested we draw some clear distinctions between the amendments. I think that is a very constructive suggestion. I am sure he will elaborate on the differences.
A difference, as I understand it, is that my amendment would allow those who retired before June 7, 1956, to have fully paid participation in the Federal Employees Health Benefits Plan. That is the plan in which all Federal employees, including Members of this body, participate. Frankly, it is a very successful and very popular health system. Ask any Federal employee. They will tell you the Federal Employees Health Benefits Plan is an excellent one. It provides every citizen with an option, a menu, from a ``Cadillac'' to lower-priced option, depending on how extravagant they feel in relation to their share of premiums in the health care plan.
For those who retired before 1956, we will say, if you want to continue to participate in TRICARE, you certainly can, but your other option is to move over to the Federal Employees Health Benefits Plan, like other Federal employees and like your Senator. What is good for your Senator is good for you.
For those who retired after the magic date of June 7, 1956, we say, you, too, have the option of participating in the Federal Employees Health Benefits Plan, or you can continue to use TRICARE. You will, however, pay premiums similar to what Federal employees pay.
It is not entirely free, but you will have this additional option, and you may continue to stay there post age 65 in retirement.
Our plan builds on utilization of the Federal Employees Health Benefits Plan, fully premium paid for those older military personnel with premiums for the somewhat younger personnel, optional. And it is perpetual. This is not a pilot project. This is not an experiment. We will not take this away from you 2 years down the road because we ran out of money. This is a commitment. You have to decide what your retirement plans are. You have to plan for that. We don't want to be jerking the rug out from under you. We have a plan. It is there. You choose it, if you choose it. No more demonstration projects that apply to some parts of the country and not other parts or it is in for a couple years and then we will assess it and decide whether to continue it or not. We are not interested in that.
The Warner amendment, which I think is certainly a step ahead of where we are now, does move the health care benefits down the road in a constructive way. I applaud the Senator for that. But as I understand the Senator's amendment, it essentially allows those who are 65 and older, rather than to be pushed out of TRICARE on to Medicare, to continue their participation in TRICARE health care services post 65. That is an additional option. I am all for options. I think that is a good thing.
It does cost some money. Senator WARNER's amendment does fit within the current budget resolution, but in order to get it within the budget resolution, it would terminate in 2004. It may be, if this is successful, there will be additional revenue, and maybe we will continue it post-2004. But there is no certainty to that within the legislation. It fits within the current budget resolution because it has been chopped short in fiscal year 2004. So while TRICARE works better for some people than for others, it has not worked terribly well in my home State. My State is a rural State, which may be a bit different. Trying to make managed care work in my State is a little more difficult than it might be in other areas. I certainly concede that. But in my area, even if we gave people a continued TRICARE option, I am not sure they would beat a path to it particularly. Some may. Again, I certainly applaud the option.
That is the basic difference between Senator WARNER's amendment, which is constructive and does give an additional option to those who are post 65, and my plan, which builds on the Federal Employees Health Benefits Plan, applies both to pre-56 and post-56--pre-56 with premiums paid--and on into retirement, and gives people those options.
Frankly, most people I talked to, if they had a choice between TRICARE and the Federal Employees Health Benefits Plan, they would run as fast as they can go to the Federal Employees Health Benefits Plan, the plan their Senators and Congressman have, and, for that matter, all Federal employees in their hometown have.
As I see it, put very shortly and perhaps not with as much detail towards the plan of the senior Senator from Virginia, that is the basic difference from which we have to choose. They are not inconsistent necessarily, but I do believe that 2003 is a far, far more expansive and permanent approach to the urgent crisis we have for military retiree health care.
The distinguished Senator from Virginia has suggested that he may want to comment at this stage on his amendment. I think it is appropriate that we discuss both of them in this context.
Mr. President, I renew my request for the yeas and nays.
The PRESIDING OFFICER. Is there a sufficient second?
There appears to be a sufficient second.
The yeas and nays were ordered.
Mr. WARNER. I advise my colleagues that at an appropriate time someone from the Budget Committee on this side of the aisle will make a point of order.
Mr. President, we are almost parallel in thought here, certainly parallel in thought for the need to help the retirees. I have been privileged to be in this institution 22 years. This is the first time, I say to my colleague, we have ever taken a step to provide for retirees. No one can refute that. If I may say, to push aside a little humility, it came from this side of the aisle. It was not in President Clinton's budget. It hasn't been in any of his budgets. We took the initiative. We have done it carefully step by step. I commend my colleague for his leadership on this issue. Indeed, it is the interest in his bill which has been garnered across our land that has helped our committee to, step by step, begin to increase these provisions.
I see my colleague wishes to make a point.
Mr. LEVIN. I wonder if the Senator will yield for one quick comment?
Mr. WARNER. I will.
Mr. LEVIN. The provision in the bill that provides the prescription drug benefit for retirees was a bipartisan effort in our committee.
Mr. WARNER. Absolutely, Mr. President.
Mr. LEVIN. I think the Senator said it came from a certain side of the aisle. It was not in the President's budget, but it was a bipartisan effort in committee which I now believe the President supports.
Mr. WARNER. Mr. President, once we took the initiative on our side of the aisle in the committee, we had bipartisan support across the board. The Senator is absolutely right. The point is where we are. We are faced with constraints in military spending, as we are in all other avenues. Let's make it clear--let's see if the Senator and I can agree--the CBO, in costing out my bill, said it would be about $40 billion over 10 years. Will the Senator agree with that?
Mr. JOHNSON. That is as I understand it.
Mr. WARNER. The CBO, looking at the Senator's bill, said it would cost about $90 billion over 10 years.
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Mr. JOHNSON. Nine billion per year.
Mr. WARNER. Correct. So the difference between the two approaches is very significant in terms of dollars. In fact, the distinguished Senator's bill would cost along the following lines: He said $3 billion in fiscal year 2001; $5.7 billion in 2002; up to $8.3 billion in 2003; $9.4 billion in 2004; and going out to 2010, $12 billion. So those are the figures. I think we are in agreement as to the dollar consequences of the two bills.
Yesterday, my distinguished colleague, the ranking member of this committee, when I raised the amendment, said that a point of order would rest. The inference was clearly that it would be brought against my amendment. Whereupon, I thought it imperative that I take my amendment and amend it, which I did, to just go out to the year 2004. By so doing, the expenditures under my bill, as they flow out through these years, bring it within the Senate budget resolution and, therefore, does not make it subject to a point of order.
I think we can agree on that point.
Mr. JOHNSON. I am in agreement with the Senator on that issue.
Mr. WARNER. But my distinguished colleague proposing this amendment has decided not to try to take a similar action with regard to his amendment. Am I correct in that?
Mr. JOHNSON. The Senator is correct.
Mr. WARNER. The retiree community, in particular, following this, will say to the Senator from Virginia: Why did you cut short to 2004? I simply say: Because the likelihood of getting 60 votes was in doubt, and I didn't want to have that doubt. I wanted to make sure we got started on some major incremental series of benefits for retirees. That is why I did it. I made that calculation. I take full responsibility for having done it.
Now, let's see if we can narrow the differences between the approach of my colleague and the one I take. I summarize it as follows: I have provided in my bill, albeit only through 2004, every provision the Senator has. Particularly, I commend him for waiving the 1964 law--not waiving it, but taking it off--which was essential. We did that together.
The main difference is the coverage that is given to these retirees under the Federal Employees Health Benefits Program; would I be correct in that?
Mr. JOHNSON. I believe that is a key difference. Also is the fact that this legislation of mine does address the issue of free medical care.
Mr. WARNER. But my point is, had it been able to go out 10 years, we continue to use that baseline. I am absolutely confident that this issue of retiree health care will be injected into the Presidential campaign. Each candidate will be asked what position he wants to take on that. I am certain they will. And should my amendment be adopted by the Senate and become the law of the land, and given that it has to stop in 2004, the first question I would ask the candidates is, Are you going to support rewriting the Warner amendment such that it goes out in perpetuity? I forewarn the candidates to be prepared to answer that question.
I support, of course, that action by the Congress, with the support of the next President, to make it in perpetuity. But going back to the Senator's point, coverage under the Federal Employees Health Benefits Program is what takes my bill from $40 billion to yours to at $90 billion; are we correct on that? Let's address the situation.
We passed--I believe it was 2 years ago--a program to allow the retirees to decide whether or not they wanted to go into this Federal health program. Interestingly, we allowed up to 66,000 to enter under that experimental test program. Mr. President, astonishingly, only 2,500 of those eligible opted to do it, indicating to our committee that they felt if they could get the full benefits offered to them when they were on active duty in their retired status, they preferred to have that rather than to go into the Federal health program. What clearer evidence could there be? We offered 66,000 a chance to do it and only 2,500 accepted.
Mr. JOHNSON. If the Senator will yield on that point, apart from the fact that the military retiree organizations themselves are telling us in no uncertain terms that they prefer the Federal Employees Health Benefits Plan coverage, I think the following points need to be made. First, relative to this 66,000 test program, there was, in fact, I am told, a lack of timely delivery of accurate, comprehensive information about the Federal Employees Health Benefits Test Program. Some of those surveyed claimed that townhall meetings sponsored by the Department of Defense to promote the test were poorly planned and publicized. Many retirees noted the inability to get accurate information and forms from the Department of Defense call center.
Frankly, there has been a fear of the unknown with the test program. Retirees are being asked to change health programs for a test program that ends in 2002. Many retirees are worried they would have to simply change back at the end of the test period. One retiree responded to the military coalition survey by saying, ``I just could not risk having to try to get insurance at age 73 should the demonstration fail to be renewed.'' That may have been a misperception, but it was one that skewed the results of the 66,000-member test. There is no doubt about that.
Mr. WARNER. I say to my good friend, clearly some of that may have taken place. It is better that retiree organizations should certainly have tried to give them the information and
explain it. They have done a magnificent job in explaining what my colleague is offering in his amendment.
I wish to return to the following. Here we go. We are now taking the retirees who are given only Medicare, and the Warner bill now restores them to the full rights they had when they were on active duty in terms of health care. My good friend, Senator JOHNSON, wants to offer them also the chance to go into the Federal program, and the cost of that is largely borne by the Federal Government. That raises his amendment up to twice the cost of mine, using the 10-year average. But we are giving them both.
At the same time, I project that the Congress is going to be called upon, should the Warner amendment or the Senator's amendment become law, to begin to add funds for the existing military health care program so that it can absorb back this community. That is not an insignificant expenditure. Now, having done that, which we have to do under either amendment, then to offer them the chance to go into the Federal program, you put the infrastructure in place, they don't avail themselves of it, they go into the Federal employees program, and you have built a big medical program that will not be fully utilized.
Mr. JOHNSON. If the Senator will yield for a moment, one of the benefits of the Federal Employees Health Benefits Plan is it doesn't require a large, new infrastructure to be set up. People simply choose the insurance policy of their wish and they go to whomever they wish, whether managed care or fee for service, and you are not left with trying to create a new Federal bureaucracy or structure.
Mr. WARNER. The Senator is correct. But am I not also correct that if we mandate by law that the existing military health program has to absorb back into it this class of retirees, they will have to augment doctors, nurses, perhaps modest increase in facilities, and all of the other infrastructure that is necessary to give these people fair, good quality health care; am I not correct?
Mr. JOHNSON. I am not sure I understand the Senator's point on this. In fact, it would seem to me that more military retirees will have their own personal health care services taken care of, and there would be less reliance on the existing military health care structure.
Mr. WARNER. Mr. President, the number of retirees over 65 is roughly 1.4 million persons. Under the Warner amendment, as well as the Johnson amendment, they are now taken back into the existing infrastructure that cares for active duty and under-65 persons. Anyone would know that with 1.4 million now given the opportunity to come back in, you would have to augment and refurbish that system. This will be a justifiable issue before the Congress very quickly. I am certain the Secretary of Defense--the next Secretary--in the posture statement of the next President will say: All right, Congress; you said we are to take them back. We are happy to take them back, but give us the funds to refurbish and
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augment that system. That will be done.
That system will be prepared to take back these people, and at the same time, you are saying to these people while we put the infrastructure in place, you may decide not to use it and go off here and avail yourself of other taxpayer dollars--namely, paying a premium of 70-plus percent, in most cases, to go into the private sector. Of course, there is no augmentation to the private sector. The private sector could probably absorb
this class. There could be a competition between the private sector and the military infrastructure. But the military infrastructure has to be put into place. As you say, very little would have to be done in the private sector to absorb them.
So that is the reason, I say to my colleagues, no matter how laudatory the amendment would be. I suggest we go a step at a time in treating these people fairly. And we have taken the initiative to do it. Let's do it a step at a time and first refurbish the existing military system to accept them back and give it a period of several years under my amendment to see how it works before we take the next leap and put on the American taxpayers double the amount of money that my amendment would cost.
Mr. LEVIN. Will the Senator yield for a question?
Mr. WARNER. Yes.
Mr. LEVIN. This is to clarify the differences between the approaches. I understand there is another difference between the two, which is that TRICARE would be available to all over 65 under both proposals, but under the proposal of the Senator from Virginia, TRICARE would only be available for those who pay Part B.
Mr. WARNER. He is accurate in his statement.
Mr. LEVIN. Whereas, under the Johnson proposal, Part B would not have to be paid for by retirees in order to have TRICARE provided to them.
Mr. JOHNSON. The Senator is correct.
Mr. LEVIN. I believe the Senator indicated before that TRICARE was available to all retirees under both proposals, that this would be one difference in that regard, and that under your proposal, Part B would not have to be paid for by the retiree; whereas, under the proposal of the Senator from Virginia, it would have to be. I am not arguing the merits or demerits, but factually that is a difference; is that correct?
Mr. JOHNSON. The Senator is correct.
Mr. President, how much time do I have remaining?
The PRESIDING OFFICER. The Senator has 23 minutes.
Mr. WARNER. Mr. President, would you give both times?
The PRESIDING OFFICER. The Senator from Virginia has 46 minutes remaining.
Mr. WARNER. Mr. President, I yield such time as the distinguished Senator from Arkansas may require.
The PRESIDING OFFICER. The Senator from Arkansas is recognized.
Mr. HUTCHINSON. Mr. President, I join Chairman WARNER in expressing my gratitude to Senator JOHNSON for his leadership on this issue. He made some very salient points on which I hope to reflect in my comments in support of the Warner-Hutchinson amendment.
The question here is not one of sentiment. It is not one of seeing the problem. It is not one of wanting to act and to act now. The question is, What is the realistic way?
The fact that the Johnson amendment will cost over $90 billion and will be subject to a budget point of order, which Senator LEVIN saw fit to raise in regard to the underlying Warner-Hutchinson amendment which would have made this permanent but has not seen fit to raise against Senator JOHNSON, but undoubtedly that is going to happen, that is a huge barrier, as we know, and a big problem.
I think we have to do something this year. That is why I am glad to rise and join Senator Warner in introducing the Warner-Hutchinson amendment for the national defense authorization bill for fiscal year 2001.
I want to comment also on Senator DORGAN's points concerning the VA health care system; that it was this Congress last year that increased VA medical care spending by over 10 percent, the largest single increase in VA health care spending in over a decade; that, indeed, with our veterans, as well as with our military retirees, our credibility is in tatters when it has been this Congress that has been determined to take the steps necessary to restore that credibility and to restore that confidence--with the pay raise last year, with the 10-percent increase in VA medical spending, far above the President's budget request, and now with this enormous step. Let us not,
in comparing it with Senator JOHNSON's broad amendment, try to minimize the significance of the step that will be taken under the Warner-Hutchinson amendment. I am glad to be a sponsor of this amendment in introducing it.
In my experience as the Armed Services Committee Personnel Subcommittee chairman, and in my experience as a member of the Veterans' Affairs Committee--I have served on the Veterans' Affairs Committee in the House and in the Senate since I came to Congress--I visit regularly with retired military personnel on a broad range of topics.
Time and time again when speaking with military retirees, or responding to letters of concern, the subject of adequate health care coverage comes up. Senator JOHNSON is absolutely right about the feelings expressed by our military retirees and their concerns since we have broken our commitment and our promise to them.
The citizens of our country who have served proudly in the armed services prefer to be doing other things than spending their time petitioning Members of the Senate. They are mature, humble, and they are patriotic by nature. But in this situation, they simply must speak out. These fine Americans have been slighted as the years have passed. They have seen benefits erode. They have seen promises broken or the fulfillment of promises delayed.
No issue causes more distress than the lack of comprehensive medical care as part of their retirement benefits. Military retirees are annoyed. They are more than annoyed. They are distressed. They feel betrayed. They have witnessed bureaucratic stalling through trial programs and tests that serve no purpose and simply nibble around the edges of the problem. They do not provide the kind of permanent and tangible fixes to the inadequacies and shortfalls of the medical care system.
I want to share a couple of quotes from several of the thousands of heartfelt letters I have received on the subject of military retirees in my home State of Arkansas. These letters from Arkansans who have served faithfully in our Nation's Armed Forces are a mere representation of the sentiments expressed by military retirees all across the Nation.
Col. Bob Jolly, of Hot Springs, AR, echoes the feelings of many others when he writes:
Thousands of military retirees are dying each month while denied the health coverage our government willingly gives all other federal retirees. We older retirees, now in our sixties and seventies, cannot wait for your Senate colleagues to prescribe years of tests to receive the care we were promised and have earned through decades of fighting our nation's wars.
Then, in a letter Mr. Stewart Freigy, a retired Air Force pilot from Hardy, AR, writes:
My decision to make a career of the Air Force was based on two things. First a sense of patriotism instilled in me as a child. The second factor was a promise by my government that if I served twenty years, I would receive half of my base pay plus free medical and dental care for myself and my dependents for the rest of my life. By the time I retired, the dental benefits were already gone. Since then I have watched the erosion of my benefits through Champus and then through Tri-Care. In short, like many other military retirees, I feel I have been deceived by a government that I served faithfully.
Mr. President, it is time we let retired military personnel know that the Senate hears their plea for justice and equity. How we handle this issue will not only send a message to these Americans that correction is on the way, but it will also send the proper message to those on active duty and to those young people who are considering whether or not they want to enter the Armed Forces or whether they want to make a career of the military.
I have heard from recruiters time and time again since I assumed the position as chairman of the Personnel Subcommittee that the most important pool from which to attract military recruits is the children of those who had
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careers in the military. When their parents feel betrayed, it becomes increasingly less likely that they are going to make the choice to go into the military themselves. It is important that Congress and the American people demonstrate that we are going to honor our promises to our military personnel.
The Warner-Hutchinson amendment will permit military retirees to be served by the military health care system throughout their lives regardless of age and active duty or retirement status. That is an incredibly huge and important step for this Congress to take. Under our proposal, the current age discrimination will be eliminated. No one will be kicked out of the military health care system just because they turn 65.
Let us not minimize and let us not underestimate the dramatic step of the Warner-Hutchinson proposal: No more age discrimination, no more kicking military retirees out of the health care system and forcing them to leave the doctors and the system with which they have been served for many years and with which they are familiar. Beneficiaries will continue their health care coverage in a system with which they are comfortable and will not be forced to pay the high cost of supplemental insurance premiums to ensure their health care needs are adequately provided. Medicare will pick up what Medicare pays for, and TRICARE will be the supplemental plan to pick up the remainder.
It is a dramatic, important, and positive step and commitment we are making. This initiative will act as a statement of our absolute commitment to the promises made to those who have faithfully served the United States of America in our Armed Forces.
As Senator WARNER stated, improving the military health care system has been the top priority of the Senate Armed Services Committee this year.
Last year, we did the pay raise. Personnel chiefs tell me that has made an enormous difference in their ability to go out and recruit. It has improved morale in the Armed Forces. This is the next big step: Improving the health care system both with the prescription drug component as well as this very major step we are taking for our retired military. Hearings have been held on this issue, and input from retirees has been received and has been heard loud and clear.
Time and again, our extensive review of the situation has highlighted the importance of retiree access to the health care system and to pharmaceuticals, with pharmaceuticals and prescription drugs being the No. 1 concern for retirees. This already addresses the issue of pharmaceutical actions by providing a pharmacy benefit with no enrollment fee for both the retail and mail order programs. On a bipartisan basis, that has been included. It is an important provision with overwhelming support.
The Warner-Hutchinson amendment complements that pharmacy benefit and continues the efforts of the committee to provide a comprehensive solution to the issue of health care for America's deserving military retirees. By adopting this amendment the Defense authorization bill will provide a comprehensive health care benefit for all of our country's military retirees.
As chairman of the Personnel Subcommittee, I am well aware of the other legislative alternatives that have been proposed. There has been a very positive, productive colloquy and debate on the floor on these alternatives. However, I believe strongly that the Warner-Hutchinson amendment provides the most effective and realistic remedy in a fiscally responsible manner. America's military retirees were promised a health care benefit. They served our country and we, as a nation, need to fulfill our duty by honoring the commitments made to them. This amendment does that.
I applaud Senator WARNER and his leadership on this issue, his willingness to take this bold step. I believe this amendment will pass with overwhelming support. I appreciate Senator JOHNSON's continued leadership. I know this will be a debate that continues in the years to come. It should not preclude first taking this step. I urge my colleagues to support this amendment.
I yield the floor.
Mr. JOHNSON. I applaud the work the Senator from Arkansas and the Senator from Virginia have done.
Mr. LEVIN. If the Senator will yield.
Mr. JOHNSON. I certainly yield to the ranking member.
Mr. LEVIN. I assure my friend from Arkansas, when I inquired yesterday about whether or not the amendment of the Senator from Virginia was subject to a point of order, that was the only amendment that was at the desk to which I could make such an inquiry to which the Parliamentarian could respond.
Now that the Johnson amendment is there, I ask the same question: Is the Johnson amendment subject to a point of order?
The PRESIDING OFFICER (Mr. HUTCHINSON). In the opinion of the Parliamentarian, it is.
Mr. LEVIN. While we are on the subject, there is now apparently some indication that there may still be a point of order problem with the Warner amendment which we are trying to assert.
Mr. WARNER. At this time, I will address that issue. In the course of our floor consideration, we frequently ask the CBO for their estimates. They gave me estimates yesterday which they have now revised this morning.
AMENDMENT NO. 3173, AS FURTHER MODIFIED
Mr. WARNER. I ask unanimous consent that the Senator from Virginia may modify his amendment. I have sent to the desk such an amendment, which reduces the year of my amendment from 2004 to 2003.
The PRESIDING OFFICER. Is there objection?
Mr. LEVIN. Mr. President, reserving the right to object, and I will not, so we are all very clear, because there has been some discussion as to the differences between the two amendments, if this modification is made, the length of time that the Warner provision would be in effect, then, would be the years 2002 and 2003 instead of 2002, 2003, and 2004. Is that correct?
The PRESIDING OFFICER. That is correct.
Mr. LEVIN. I have no objection. I think it is important everyone understand.
Mr. WARNER. I thank my colleague from Michigan. We all have to rely on these estimates.
The PRESIDING OFFICER. Without objection, the amendment is so modified.
The amendment (No. 3173), as further modified, is as follows:
For continuity of reading, the 3173 amendment has been moved to a separate web page.
Click here to see the amendment.
Use your browser back button to return here.
Mr. WARNER. My amendment is now modified so it is not subject to a point of order.
Our distinguished colleague is subject to a point of order, and at an appropriate time he will raise that point of order.
The PRESIDING OFFICER. The Senator from South Dakota.
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AMENDMENT NO. 3191
Mr. JOHNSON. Mr. President, I make a clarification relative to my amendment. There may have been some confusion earlier. I wish to make it very clear that under my amendment those who entered the armed services prior to June 7, 1956, would be eligible for Federal employee health benefit plan coverage with the Government paying 100 percent of the premiums. Those who entered the armed services after June 7 of 1956 can choose Federal employee health benefit plans with premiums or TRICARE. I want to make sure that point is very clear.
There has been reference to points of order, and the Senator from Virginia is very correct that a point of order will be raised on my amendment. My amendment does cost more. It does more and it costs more. It is perpetuating. It is not a 2-year commitment.
A point of order, while not taken up lightly, is simply an opportunity to determine whether 60 votes in this body believe the issue at hand is of sufficient importance that it ought to have that first level of concern, that priority.
The question is, Are we going to pass or waive a point of order with 60 votes and invade surplus dollars that otherwise are available for tax cuts or are we going to put our money where our mouth is? Do we have the 60 votes to say we will use those dollars, at least that part of it that is required, that $90 billion out of the $800 billion or so that is available, for this purpose?
One of the things that makes this debate interesting, and the parliamentary process interesting, I don't know if we have the 60 votes to waive the order or not. After all these years of Veterans Day and Memorial Day rhetoric about how important
our veterans are, this at last will be an opportunity for every Member of this body to stand up and be counted. Is that rhetorical support or are you willing to put these priorities ahead of other budget priorities, including tax relief? Are you willing to waive the Budget Act and make this happen or not? If you are not, I respect your views. Members can go home and explain that. That is certainly your prerogative.
It is long overdue. We have an opportunity for some accountability for the American public to understand who is willing to truly make this a budget priority and who is not. If you are not, then you have those justifications that you can make. That is what the nature of this is. This is not because it is more costly, that this is an impossible program. It will require 60 votes, assuming that the point of order is raised, rather than the 50 votes of the Senator from Virginia.
It will allow the Senate to make a determination in this body whether these priorities are ahead of other priorities that people have, a thousand other things for which they want to use the budget surpluses. No doubt almost all of them are worthy causes. But is this only one of many, many causes, one that we are going to cut short after only 2 years, and then provide less than the full level of commitment to the promises made to our veterans or is this, in fact, a first priority and we are complying with our promises, albeit belatedly, but a full commitment permanently, and in order to do that invade into surpluses dollars that no doubt other people on both sides of the aisle have other purposes for which they can use the dollars? That is the question with which ultimately we have to contend.
My colleague from New York has come to the floor and has a 1 minute request on an unrelated issue. I ask unanimous consent the Senator from New York be permitted 1 minute.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. WARNER. Mr. President, let's have clarified the amount of time remaining under the control of the Senator from South Dakota and the amount of time under my control.
The PRESIDING OFFICER. The Senator from Virginia has 33 minutes. The Senator from South Dakota has 17 minutes.
Mr. WARNER. That is 17 and 33. I say to my friend, I am prepared to yield back a considerable amount of my time because I think our caucuses are about to meet. It is very important. If he would give me some estimate of what he desires, and I will just do basically half that time remaining and do a quick wrapup?
Mr. JOHNSON. Mr. President, I say to the distinguished Senator from Virginia, we have no additional speakers on my side. I agree we ought to expedite this debate at this point, unless the Senator has other speakers to whom I would choose to respond.
Mr. WARNER. No, I am ready.
Mr. JOHNSON. I will be open to conveying back my time.
Mr. WARNER. At this point?
Mr. JOHNSON. Yes.
Mr. WARNER. Fine. Let's clarify one other thing. Senator LEVIN brought up the points of order.
Mr. President, I ask unanimous consent at this time that it be in order for the Senator from Virginia to raise a point of order that the Johnson amendment, No. 3191, violates section 302(F) of the Budget Act, and that would take effect after my vote. Then there would be a point of order, and the Senator could, at this time, ask for the waiver.
Mr. JOHNSON. Mr. President, I move to waive the point of order. Mr. President, I ask for the yeas and nays.
The PRESIDING OFFICER. Is there a sufficient second?
There is a sufficient second.
The yeas and nays were ordered.
Mr. WARNER. So at the conclusion of the brief remarks from my colleague, say not more than 2 minutes on my behalf, we then proceed to the votes as they have been ordered previously? That order, of course, is we will vote--I think the Presiding Officer should state the order of votes.
The PRESIDING OFFICER. The first vote will be on the Warner amendment No. 3173, followed by a vote on the waiver of the budget point of order. If the waiver vote is successful, that is to be followed by a vote on the Johnson amendment. If it is not successful, the vote will be on the Warner amendment, No. 3184, followed by a vote on the Kerrey amendment.
Mr. WARNER. I thank the Chair.
Does the Senator have anything further? Otherwise, I will just say two words.
Mr. JOHNSON. It is my understanding, then, the Johnson amendment, the waiver vote on the Johnson amendment, will be the first vote? If that is successful----
The PRESIDING OFFICER. That will be the second vote, following the vote on the Warner amendment.
Mr. JOHNSON. The Warner vote then is the first vote?
The PRESIDING OFFICER. The Senator is correct.
Mr. JOHNSON. Followed by the point of order on the Johnson amendment?
The PRESIDING OFFICER. The waiver.
Mr. JOHNSON. Yes. And we would each be permitted 2 minutes apiece at that time, at the time of that vote--that is my understanding--if that is acceptable?
Mr. WARNER. Mr. President, I will follow my colleague with maybe 2 minutes of remarks if he has any concluding remarks before we proceed to the sequence of votes.
Mr. JOHNSON. That is satisfactory.
Mr. WARNER. At this time, you yield such time under your control?
I am prepared to yield my time, reserving a minute and a half.
The PRESIDING OFFICER. Time is yielded back.
Mr. WARNER. I simply say once again I thank the Senator from South Dakota. He has been a leader on this issue. Indeed, his amendment has been widely supported throughout the retirement community.
I have come in with the second-degree simply to say we should take these steps incrementally, one after another. Let us bring the retirees back into the fold of the military health care system. Let us build the infrastructures necessary to take care of them and try that out in the light that only 2,500 ever opted for the Federal program out of 66,000 eligible. Let us try that out for the 2 or 3 years my program would be in effect.
The next President will have to address this situation. The next Congress will address this situation. But we will have made enormous progress if the Senate will adopt the Warner amendment. Indeed, it represents well over two-thirds of the amendment by our distinguished colleague from South Dakota.
The only thing remaining is whether or not we should give both at this point in time, which would double the cost over a 10-year period. It would double
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the cost if we gave them the option of the Federal program in addition to what we are giving them under the Warner amendment; namely, now back into the
system which has taken care of them for the period of their active duty and that period between the termination of their active duty and retirement up to age 65.
Mr. BYRD. Mr. President, the Senate is making important strides in working to improve health care benefits for our military retirees. A case in point is the Defense Authorization measure before the Senate today, which includes significant improvements in pharmacy benefits for military beneficiaries as well as several demonstration projects intended to evaluate long range health care solutions for military retirees.
But more needs to be done. We recognize that, and we are working to remedy the current situation. Senator WARNER's proposal to permit military retirees aged 64 or older to remain under CHAMPUS and TRICARE by requiring these plans to be secondary payers to Medicare is a good step in the right direction, a responsible step, and I strongly support it.
I also commend Senator JOHNSON for the laudatory goal of his amendment, but absent a plan to pay for such a sweeping reform, I fear that we are getting ahead of ourselves. The Senate has not set aside any money to pay for this proposal, and without a sure source of funding, we are offering our military retirees little more than an empty promise. For this reason, I am opposed to waiving the budget point of order against the Johnson amendment.
The Senate has been moving toward improved medical benefits for all members of the military, active and retired, over the past several years. Health care benefits remain a top priority. Senator WARNER's proposal to provide specific enhanced health benefits for older retirees for a three-year period while continuing to explore, test, and evaluate a long term solution is a prudent course of action. It gives us the opportunity to address the immediate health care needs of military retirees, while also giving Congress needed time to assess the best long-term solution, and to provide the necessary funding for whatever solution we reach.
Mr. DASCHLE. Mr. President, the Senate has just spoken on one of the most important national security issues facing this Nation today--the quality of health care services we provide for those who have so selflessly served this Nation. As pointed out during this debate, we promised millions of Americans lifetime, quality healthcare as partial compensation for their service to this country. Sadly, for far too many of America's veterans, this promise remains unfulfilled.
The amendments just voted on by the Senate represent efforts by their supporters to keep that commitment. These measures adopted a fundamentally different approach toward solving this problem. And although I had some reservations about each, I supported both.
I would like to briefly discuss my reasons for doing so. However, before getting into the specifics of these very different amendments, I would like to commend the efforts of Senators JOHNSON and WARNER. As a result of their hard work, we are much closer than ever before to keeping our health care commitment to this Nation's veterans. They are both to be commended for keeping this issue alive and forcing the Senate to deal with it on the bill currently before us.
Under current law, military retirees under the age of 65 are eligible to enroll in TRICARE Prime or to use TRICARE's insurance programs. Those who use TRICARE's insurance may also seek care at a military treatment facility, MTF, on a space-available basis. Once retirees turn 65, they are no longer eligible to use TRICARE, though they may continue to seek care at an MTF when space is available. The same eligibility rules apply to survivors of veterans. Unfortunately, the shortcomings of the current system are well known to thousands of America's veterans. I receive letters virtually every week describing the failures of TRICARE.
Senator JOHNSON's amendment would address some of these failures and increase health insurance benefits for retirees. Specifically, retirees who entered military service before June 7, 1956 and their spouses would be able to use military health insurance and enroll in the Federal Employees Health Benefits Program, FEHBP. Those enrolling in FEHBP would pay no out-of-pocket premiums. Military retirees who entered the service after June 7, 1956 and their survivors would be eligible for increase coverage regardless of their age. They could either enroll in FEHBP or use TRICARE's insurance program.
Senator JOHNSON's amendment clearly would provide better health care coverage for millions of veterans. My concerns with it are twofold and both are cost-related. First, I am somewhat troubled by the overall cost of this proposal. Although I believe no price is too high to keep our commitment to America's veterans--and Senator JOHNSON's amendment certainly represents a giant step in that direction--I wonder whether there may be a more cost effective means of doing so. Second, I am concerned that for those retirees who entered service after 1956 and who choose FEHBP, the Government would only pick up about 70 percent of the premium. Retirees and their families would be expected to pick up the remaining 30 percent. Depending on the plan chosen, this could represent an annual out-of-pocket expense of $2,000 or more--not an insignificant expenditure for many.
Senator WARNER's amendment also has merit as well as one fundamental flaw. Under the Warner amendment, all Medicare-eligible retirees would be allowed to remain in TRICARE. In other words, TRICARE would be a second-payer to Medicare, covering certain costs above and beyond those covered by Medicare. This change would greatly improve the quality of health care provided to our Nation's veterans. Unfortunately, in order to comply with a flawed Republican budget resolution, Senator WARNER was forced to sunset this new benefit in 2003. In other words, the Warner amendment provides veterans a new health benefit with one hand and, two years later, takes it away with the other.
As I said at the outset, I supported both of these amendments despite the flaws I have just discussed. I did so because I believe it is important we focus on the forest and not the trees and because both of these amendments would bring us closer to keeping this Nation's commitment to its military retirees. And I did so because I believed it was the right thing to do. I commend Senators WARNER and JOHNSON for their work on behalf of our veterans and look forward to working with them to fulfill the promise we made to those who sacrificed so much to serve this Nation.
Mr. KENNEDY. Mr. President, I support the amendment by the distinguished Chairman of the Armed Services Committee, Senator WARNER. It takes the next step toward honoring the promise of lifetime health care for our military retirees. It removes the Title 10 provision that limits eligibility for military health care benefits to retirees under the age of 65.
The amendment expands health care benefits for Medicare-eligible military retirees by removing the age limitation on who qualifies for military health care programs. It gives all military retirees one consistent health care benefit, with TRICARE supplementing Medicare after the retiree reaches the age of 65. This is the right thing to do for our retirees.
I also support the amendment offered by Senator JOHNSON. It corrects an inconsistency in access to the Federal Employees Health Benefits Program. Currently, our retired service members do not have the opportunity to participate in this program. While the out-of-pocket costs for some health plans offered under FEHBP may make this approach less attractive to senior military retirees, they should be given the option to join. Again, this is only fair. One, consistent health care program for all beneficiaries makes sense and is the right thing to do.
I commend Senator WARNER and Senator JOHNSON for their leadership in this important area. I support their amendments, and I urge my colleagues to approve them.
This year is, indeed, the Defense Department's ``Year of Health Care!'' In the Armed Services Committee, we began the year considering how to improve health care for active duty service members and their families, and to address the well-documented health
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care needs of military retirees, especially those over the age of 65.
The Administration's budget request was a major positive step for active duty service members and their families. It proposed to expand TRICARE Prime to the families of service members who live far from military hospitals. It also proposed to eliminate the co-payments by active duty service members' families for medical care by civilian health care providers in TRICARE Prime.
We heard testimony from Secretary Cohen, General Shelton, the Service Secretaries, and each of the Service Chiefs, that the availability of health care for senior military retirees is a serious problem. They are conducting a variety of TRICARE demonstration programs to find the best way to address it. We also heard from retirees and the organizations that represent them that the problem is urgent, and that Congress needs to act now.
A promise of lifetime health care was made to our service members at the time of their enlistment. We have an obligation to meet that commitment. It is wrong that service men and women who have dedicated their lives serving and defending our country should lose their military health care benefits when they reach the age of 65. We must fix this injustice, and we must do it now.
The pending DOD Authorization Bill takes a first step towards honoring this promise by giving military retirees a retail and mail-order pharmacy benefit. Almost a third of them already have this benefit. 450,000 military retirees over the age of 65 have a pharmacy benefit under the base closing agreement. It provides a 90-day supply of prescription drugs by mail for an $8 co-payment, or a 30 day supply of prescription drugs from a retail pharmacy network for a 20 percent co-payment. The pending Defense Authorization Bill expands this benefit to all 1.4 million Medicare-eligible retirees. It makes sense, and it is fair that all military retirees over 65 have the pharmacy benefit, not just those affected by the base closing process.
This pharmacy benefit addresses one of the most important concerns of the military retiree community--the high cost of prescription drugs.
All of us are pleased that the Senate is taking this step to make good on our promise of health care to military
retirees. But we should not forget the millions of other senior citizens who need help with prescription drugs too.
It's long past time for Congress to mend another broken promise the broken promise of Medicare. Medicare is a guarantee of affordable health care for America's senior and disabled citizens. But that promise is being broken every day because Medicare does not cover prescription drugs. It is time to keep that promise.
When Medicare was enacted in 1965, only three percent of private insurance policies offered prescription drug coverage. Today, ninety-nine percent of employment-based health insurance policies provide prescription drug coverage--but Medicare is caught in a 35-year-old time warp.
Fourteen million elderly and disabled Medicare beneficiaries--one-third of the total have no prescription drug coverage today. The most recent data indicate that only half of all senior citizens have drug coverage throughout the entire year.
The only senior citizens who have stable, secure, affordable drug coverage today are the very poor, who are on Medicaid. The idea that only the impoverished elderly should qualify for needed hospital and doctor care was rejected when Medicare was enacted. Republicans say they want to give prescription drugs only to the poor. But senior citizens want Medicare, not welfare.
Too many seniors today must choose between food on the table and the medicine they need to stay healthy or to treat their illnesses.
Too many seniors take half the pills their doctor prescribes, or don't even fill needed prescriptions--because they cannot afford the high cost of prescription drugs.
Too many seniors are paying twice as much as they should for the drugs they need, because they are forced to pay full price, while almost everyone with a private insurance policy benefits from negotiated discounts.
Too many seniors are ending up hospitalized--at immense cost to Medicare--because they aren't receiving the drugs they need at all, or cannot afford to take them correctly.
Pharmaceutical products are increasingly the source of miracle cures for a host of dread diseases. But millions of Medicare beneficiaries will be left out and left behind if Congress fails to act. In 1998 alone, private industry spent more than $21 billion in conducting research on new medicines and bringing them to the public. These miracle drugs save lives--and they save dollars too, by preventing unnecessary hospitalization and expensive surgery.
All patients deserve affordable access to these medications. Yet, Medicare, which is the nation's largest insurer, does not cover outpatient prescription drugs, and senior citizens and persons with disabilities pay a heavy price for this glaring omission.
The ongoing revolution in health care makes prescription drug coverage more essential now than ever. Coverage of prescription drugs under Medicare is as essential today as was coverage of hospital and doctor care in 1965, when Medicare was enacted. Senior citizens need that help--and they need it now.
So I say to my colleagues--while we are making good on broken promises, it's long past time to cover prescription drugs under Medicare for all elderly Americans. If we can cover military retirees, we can cover other senior citizens too.
Elderly Americans need and deserve prescription drug coverage under Medicare. Any senior citizen will tell you that--and so will their children and grandchildren. It is time to make this need a priority as well.
Mr. MCCAIN. Mr. President, I rise today to voice my support for the need for responsible military health care reform.
There is a critical need for real military health care reform. I am concerned that if this amendment passes today, that this body, as well as the lower chamber, will wipe their hands of this problem and move on to other issues. Our servicemembers past, present, and future deserve a world class military health care delivery system, and the Congress should accept no less.
When the defense bill before us today came out of committee, I voted against it for several reasons. One of the most pressing reasons was that the health care legislation included in the defense authorization bill did not address the broken ``promise'' of lifetime medical care, especially for those over age 65. Voting for its passage would have been an abrogation of my responsibility as a Senator to let our declining military health care system continue without a responsible legislative remedy.
One of the areas of greatest concern among military retirees and their families is the ``broken promise'' of lifetime medical care, especially for those over age 65. While the Committee included some key health care provisions, they failed to meet what I think is the most important requirement, the restoration of this broken promise.
This week, we recognize the anniversary of the invasion of the European continent to free hundreds of millions of people from the grasp of a tyrannical dictator. Our servicemembers have served courageously in Korea, Vietnam, the Persian Gulf, and other locations throughout the world. We owe our servicemembers, past, present, and future a health care delivery system that adequately supports those who have served with honor and courage throughout the years.
Today, our military health care delivery system is facing some very difficult and costly challenges. One of these is how best to reconfigure the military health care delivery system so that it might continue to meet its military readiness and peace-time obligations at a time of continuous change for the armed forces. In the process of deciding how to proceed, I have met with and heard from many military family members, veterans and military retirees from around the country. I have been inundated with suggestions for reform.
In every meeting and in every letter, I encountered retired service men and women who have problems with every aspect of the military medical care system--with long waiting periods, with access to the right kind of care, with access to needed pharmaceutical drugs, and with the broken promise of lifetime health care for military retirees and their spouses. I heard these
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concerns expressed as I have traveled across the United States over the past year. I was proud to introduce S. 2013, the Honoring Health Care Commitments to Service Members Past
and Present Act of 2000.
S. 2013 was drafted with the help of the Military Coalition and the National Military and Veterans Alliance. The Military Coalition has strongly endorsed S. 2013, stating, ``We applaud your leadership in introducing comprehensive legislation aimed at correcting serious inequities in the military health care benefit.'' I am proud of the work on S. 2013, and I was prepared to re-introduce key provisions of this bill as an amendment to the defense authorization bill.
However, the Warner amendment, and the more comprehensive Johnson, Coverdell, and McCain amendment, are coming up for a vote today, and I would like to comment on their attributes and my concerns.
I would like to commend my colleagues, Senators JOHNSON and COVERDELL, whose amendment fully restores the ``broken promise'' to our military retirees and their families. I am proud to be an original cosponsor of this amendment, as well as their companion bill, S. 2003.
This amendment fully restores the ``broken promise'' by providing free military medical health care to military retirees and their spouses. I am a strong proponent of this amendment, because it gives the retirees what they were promised, military medical health care for life. This health care would be provided through the Federal Employees Health Benefits Program (FEHBP). I urge my colleagues to vote for this amendment. Our service members deserve our support, and we have an obligation not to renege on a promise made to them many years ago.
As I have mentioned, I was prepared to offer an amendment today--a version of S. 2013--that builds on the limited health care improvements provided in the defense authorization bill. However, I have decided to withhold my amendment at this time to fully support the Johnson amendment, as well as vote for the Warner amendment. The Warner amendment provides a substantial increase in the health care benefit provided to over-65 military retirees and their families that current law and the Armed Services Committee-reported bill, S. 2549, have failed to address. The Warner amendment is not a perfect solution, but it is a step in the right direction.
Mr. President, I commend my colleagues for their efforts to address many of these important military health care challenges. Not lost on any of us is the urgent need to address the over-age-65 issue, since there are reportedly 4,000 World War II, Korean and Vietnam War-era military retirees dying every month. It is imperative that as changes are made to our nation's armed forces, Congress not only stay focused on bringing health care costs under control, but that steps be taken to retain the health care coverage so critical to our nation's active duty personnel, their families, retirees, and survivors.
Make no mistake, retiree health care is a readiness issue as well. Today's servicemembers are acutely aware of retirees' disenfranchisement from military health coverage, and exit surveys cite this issue with increasing frequency as one of the factors in members' decisions to leave service. In fact, a recent GAO study found that ``access to medical and dental care in retirement'' was a significant source of dissatisfaction among active duty officers in retention-critical specialties.
Mr. President, this year will be, in the words of the Joint Chiefs, the year of health care reform. Whether we are successful or not will depend on several factors: Congress' ability to realize real health care reform and provide the necessary resources, the Pentagon's ability to work with private industry to control costs on pharmaceuticals and health insurance plans, and the military retirees who utilize the system coming together and galvanizing support for the future of military health care.
VOTE ON AMENDMENT NO. 3173, AS FURTHER MODIFIED
Mr. WARNER. Mr. President, I ask for the yeas and nays on the Warner amendment.
The PRESIDING OFFICER. Is there a sufficient second?
There is a sufficient second.
The question is on agreeing to amendment No. 3173, as further modified.
The clerk will call the roll.
The assistant legislative clerk called the roll.
Mr. NICKLES. I announce that the Senator from New Mexico (Mr. DOMENICI) and the Senator from Idaho (Mr. CRAPO) are necessarily absent.
Mr. REID. I announce that the Senator from Iowa (Mr. HARKIN) is necessarily absent.
The PRESIDING OFFICER (Mr. ENZI). Are there any other Senators in the Chamber who desire to vote?
The result was announced--yeas 96, nays 1, as follows:
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The amendment (No. 3173), as further modified, was agreed to.
Mr. COVERDELL. Mr. President, the Senate just conducted two very significant and unprecedented votes--unprecedented in the respect that, as the good chairman of the Senate Armed Services committee has pointed out, this is the first time that the Congress has taken steps to provide health care equity for our Nation's military retirees. This effort was not led by the White House. It was led by Congress and by military retirees across the country.
I have been deeply involved in this issue for many years now. As my colleagues know, I am the lead cosponsor of S. 2003, Senator JOHNSON's bill to restore the broken promise of lifetime health care made to military retirees. The mere presence of this bill, as Chairman WARNER noted, drove the debate on military retiree health care this year and moved us to the point where we are today--on the verge of enacting the first comprehensive solution to the military retiree health care issue. This is a matter of fairness for military retirees, but our goal must be accomplished without destroying the fiscal discipline that has made this day possible.
As a result, even though I am the lead cosponsor of S. 2003 and fully support its objectives, I could not vote to waive the budget point of order raised against the amendment today. The Senate has budget rules that must be protected if we want to ensure, year-in and year-out, that all of the Nation's priorities are fairly and appropriately funded. These are the fiscal rules of the road that have enabled us to balance the budget, to create unprecedented surpluses for the first time in decades, and to contemplate any funding for a military health care proposal such as this. Once the rules are broken, fiscal discipline will evaporate. Deserving long-term priorities would be pitted against the politically popular causes of the moment in a rush to tap the surplus dollars first.
We must also remember that we are working with the fourth consecutive balanced budget that protects Social Security--a tremendous exercise in fiscal restraint that the Senate must not abandon. Preserving Social Security has been a priority for the American people for a long time and it took the Congress many years to make it a reality. If we begin our fiscal work by
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eviscerating the budget rules, we will put the Social Security surplus and the retirement benefits for millions of senators at great risk.
I could have taken the politically expedient route, the easy route by casting my vote to waive the budget rules. But that vote would not have changed the outcome or brought us closer to passage of S. 2003. Had the motion to waive the budget rules prevailed, it would have set a dangerous precedent and ultimately would make it more difficult to protect the funding needed to restore the broken promise. My vote today to preserve the budget rules, notwithstanding my strong support for military retirees, represents my view that the work of the Nation must move forward and that it will not unless the Senate works responsibly within the budget process in order to balance competing demands for funding.
There is no doubt in my mind that the gains on this issue today would not have been achieved without the introduction of S. 2003. At the beginning of this Congress, we were at ground-zero on this issue--the same place as in every previous Congress. We made headway this year in the Armed Services Committee and with our colleagues on the Budget Committee. Today, Senator WARNER's amendment, while not everything we wanted, did take an important step forward by giving military retirees one part of what they deserve--the ability to keep their military health benefits when they reach Medicare eligible age. I believe the Senate has demonstrated a new found commitment to our Nation's military retirees and I look forward to continuing our work to restore the broken promise in full.
AMENDMENT NO. 3191
Mr. WARNER. We are ready for the vote on a point of order.
I ask unanimous consent, on behalf of the two leaders, that the next two votes be limited to 10 minutes.
The PRESIDING OFFICER. Without objection, it is so ordered.
There will be 2 minutes of debate equally divided.
Mr. WARNER. Mr. President, a point of order has been raised on the amendment of the Senator from South Dakota. I would like to have Senator GRAMM of Texas recognized to argue that point of order and that his name replace my name on having made it. He is on the Budget Committee. I simply made it on behalf of the Budget Committee. He makes it in his own right, my name to be deleted.
The PRESIDING OFFICER. The Senator from Texas.
Mr. GRAMM. Mr. President, let me remind everyone that 4 years ago we moved to begin to correct an injustice in military medicine, and the injustice was that if you served in the military for 20 or more years, you received a commitment, at least in your mind and I believe in reality, that you and your dependents would have access to military medicine for the rest of your life. When Medicare came in and the federal government started making the military pay Medicare payroll taxes, it stopped allowing retirees over 64 to use military medicine. That was a breach of faith. Then we started an experiment 4 years ago to allow them to use their Medicare coverage to obtain treatment at base hospitals again. The Warner amendment we just adopted will allow people who served a career in the military to get treatment at base hospitals from military doctors, and have Medicare pay the cost. It is a good idea and I strongly support it.
Now, Senator JOHNSON has offered an amendment that on its face has merit, and that is to put military retirees into FEHBP. Maybe in the long run that is the answer to the problem. But the problem with Senator JOHNSON's amendment today is that it busts the budget by $92 billion. So I urge my colleagues, whether they support the FEHBP solution or not, to not bust the budget today. Let's stand with the taxpayers today, and let's also complete the Medicare subvention experiment, and let's take up Senator JOHNSON's proposal when we know how to pay for it. I thank the chair.
The PRESIDING OFFICER. The Senator from South Dakota.
Mr. JOHNSON. Mr. President, I join Senator MCCAIN and the other cosponsors in support of this legislation. We have a fundamental question before us, and that is whether the military retirees of this Nation deserve to have the same kind of health care system that Members of this body have, or other Federal employees, through the Federal Employees Health Benefits Plan. That is the amendment that the military retiree organizations are asking to have and we can, once and for all, be done with the question about whether we are going to live up to our commitment to our military personnel in terms of the medical care that they were promised and which they deserve.
I think there is an across-the-board agreement in this body that if we are truly going to live up to this obligation, this legislation is what we have to pass. It would involve a waiver, and the fundamental question we have, then, is whether we have 60 votes in this body to get into the surplus dollars, or whether those surplus dollars will remain available for tax cuts and other purposes.
If you believe that military health care is a first priority, ought to come first, rather than the crumbs that come after we have made other budget decisions, you will support the Johnson-McCain amendment.
Mr. WARNER. Mr. President, we had a very good debate on this. I see it slightly different. What we are doing in the Johnson amendment is giving two health care programs to military retirees. We are giving them the military health care program and then asking the taxpayers to add on the tax burdens of the Federal program. So it is not the same as we get; we do not get the military program. I have to correct the Senator. There are two systems if you vote for that. That is why his is $90 billion over 10 years versus the Warner amendment, which is $40 billion.
Mr. JOHNSON. Mr. President, given Senator WARNER's observation, I ask unanimous consent for 10 seconds.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. JOHNSON. Saying our military retirees would beat a path to the Federal system offering TRICARE as an alternative--frankly, that is an unpopular option. This Johnson amendment is what the military retirees want and deserve.
Mr. GRAMM. Mr. President, the issue before us is whether we are going to waive the budget point of order. I insist on the point of order and ask for the yeas and nays.
The PRESIDING OFFICER. Is there a sufficient second?
There is a sufficient second.
The question is on agreeing to the motion to waive the Buget Act. The clerk will call the roll.
The legislative clerk called the roll.
Mr. NICKLES. I announce that the Senator from New Mexico (Mr. DOMENICI) and the Senator from Idaho (Mr. CRAPO) are necessarily absent.
The yeas and nays resulted--yeas 52, nays 46, as follows:
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The PRESIDING OFFICER. On this question, the yeas are 52 and the nays are 46. Three-fifths of the Senators duly chosen and sworn not having voted in the affirmative, the motion is rejected. The point of order is sustained.
Mr. GRAMM. I move to reconsider the vote.
Mr. WARNER. I move to lay that motion on the table.
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The motion to lay on the table was agreed to.
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