March 14, 1979
Page 4983
UP AMENDMENT NO. 47
(Purpose: To adjust the amount rescinded for health resources)
Mr. KENNEDY. Mr. President, I send a substitute amendment to the desk and ask for its immediate consideration.
The PRESIDING OFFICER. The amendment will be stated.
The assistant legislative clerk read as follows:
The Senator from Massachusetts (Mr. KENNEDY) (for himself and Messrs. SCHWEIKER,
HATCH, BUMPERS, RANDOLPH, STAFFORD, JAVITS, ZORINSKY, WEICKER, TSONGAS, and MCGOVERN) proposes UP amendment No. 47.
In lieu of the figure proposed to be inserted, insert the following: $12,750,000."
The PRESIDING OFFICER. The Senator from Massachusetts has 30 minutes and the Senator from Washington has 30 minutes.
Mr. KENNEDY. Mr. President, this amendment is offered in behalf of myself, Senator SCHWEIKER, who is the ranking member of the Health Committee, Senator HATCH, who is a member of our Health Committee, Senators BUMPERS, RANDOLPH, STAFFORD, JAVITS, ZORINSKY, WEICKER, TSONGAS, and MCGOVERN.
It effectively restores the funding for medical schools to what was actually appropriated and signed into law last year through the appropriations process.
I wish to point out to the membership that the amount which was actually appropriated last year under capitation was the exact same figure as was appropriated the year before, even though we were facing a 7-percent increase in the rate of inflation. So there was basically a cut in the amounts which were actuallyappropriated compared to the prior year.
We are now asking for a hold on that funding level, which is basically a cut in the support for medical, nursing, and other schools which are affected.
Mr. President, we cannot examine medical education and look only at this particular issue of capitation.
I have just been amazed at listening to my colleagues talk about the development of capitation and what it has meant to medical education over the period of recent years.
We effectively adopted capitation in 1970 for the purpose of increasing the numbers of medical students. We increased from 8,000 to 16,000 through the process of capitation. It worked very successfully.
In 1976, we imposed conditions on capitation.
I wish my colleagues would read what the conditions for capitation are for medical schools today. They include not to decrease the numbers. They include a move away from the specialization of medical practice. The fact is, Mr. President, that our medical schools were graduating specialists. Now we made an agreement with the medical schools in 1976. We said: "As a condition for capitation, teach primary care, and we will graduate what we need in this country, in primary care, and then we will work with the Area Health Education Centers and others to try to get doctors into under served areas."
I sponsored the program that would have required medical school graduates to serve in under served areas. There was no one in the Chamber who took a stronger position to bring about such a change. But the Senate rejected that and said, "We will not do by mandatory methods; we will do it through enticing medical students financially." OK. We were trying in 1976 to entice them financially, and we have seen a dramatic change in the medical schools from specialty areas to primary care. This change in the capitation program has only been in effect for 2 years.
But, Mr. President, we are not just talking about the impact of capitation rescissions on medical schools. We are talking about other steps that have been taken in the 1980 budget which are going to have an important impact on medical schools at the present time.
There has been no word from those who sponsored the earlier amendment or those who have even spoken briefly in opposition to it about the National Institutes of Health. The 1980 budget puts a ceiling on NIH. This means a significant reduction in medical school funding.
Are we now going to turn our backs on one of the greatest resources that any nation has in the world: Our research program. That is what we are talking about, Senator. We are talking about the quality of research, much of which is conducted in the medical schools and which is tied into the teaching process in those schools.
So we have the NIH held level, which will mean a reduction in the support of medical schools.
We also have OMB accounting regulation, and other Government restrictions that have an adverse impact on our medical schools.
Most of these negative impacts would occur this year. As the AAMC points out in a letter sent to me, and that has been made available to all my colleagues, the medical school flow charts start in July of this year. As the Senator from Arkansas has stated, some of the legislatures have gone home, so they will be unable to help out.
Mr. President, the proposed rescissions amount to a violation of contracts made with the States, and with the private institutions. As the Senator from Alaska pointed out very clearly, the capitation programs basically create a contract between the Federal Government and States and private institutions. That is what we are talking about. Breaching such contracts is, I think, intolerable.
Mr. President, as the Senator from Louisiana stated, it is true that medical education is open to a relatively small group in our society. I doubt whether there is an entry barrier to a professional education that is higher than the barrier to a medical education. But the result of the amendment offered by the Senator from Louisiana or that offered by the Appropriations Committee is going to be to raise the barrier higher — make no mistake about it. We are barring access to every medical school, including the ones that serve blacks and lower middle income groups. We are basically taking a sign and saying "Closed." That is going to be the effect of this rescission.
A final point I want to make is just to commend my colleague and good friend from Washington (Mr. MAGNUSON). We differ on this particular issue, but he has been the giant in the Senate in his attention to health for the people of this country. I think all of us who have had an opportunity to work here with him know of his strong commitment to a decent quality of health. I welcome the opportunity to join him in about 95 percent of the time, if he will permit us to differ on this one.
Mr. MAGNUSON. I thank the Senator for his kind remarks.
Mr. KENNEDY. I withhold the remainder of my time.
Mr. MAGNUSON. I again want to put the RECORD straight. The Senator did make a statement that only the rich can go to medical school, if I understood him correctly. Well, we attack that not by capitation grants but by scholarships, which we upped. We denied the rescission on special projects and for health professional student loans. We denied all of the programs relating to the high priority advanced nurse training programs as well.
I just want to point out that all this talk about this 10 or 20 percent of the money, you would think this was cutting out everything, but there is still in the bill over $100 million for capitation grants, and those are still in the bill even with the 20 percent cut.
So I do not think the Kennedy amendment ought to be adopted. I think we made a wise decision. We came somewhere in between. The administration wanted to cut it in half or more than that. We just decided that this was enough money to take care of the situation as it is now. With the background that the Senator from Massachusetts well points out, I think this whole matter of capitation grants will have to be looked at next year.
So we do not think the Senator's amendment is a particularly good one. I generally agree with him on all these matters, but I think this is a reasonable approach, particularly when we rejected the rescission on scholarships, we rejected the rescission on nursing, and on most capitation grants for nursing. We have attacked this problem with respect to health manpower on all sides, except when we come down to the specifics of capitation grants for doctors. So I hope the amendment will be defeated here.
Several Senators addressed the Chair.
The PRESIDING OFFICER. The Senator from Massachusetts has 20 minutes, and the Senator from Washington has 27 minutes.
Mr. MAGNUSON. I yield to the Senator from Maine.
Mr. MUSKIE. Mr. President, I thank my good friend from Washington for yielding to me. I have listened with great interest to this debate. The distinguished Senator from Massachusetts, my good friend, is capable of impassioned support for the cause in which he believes. I think he and I and the Senator from Washington find ourselves more often than not on the same side in many cases, but I do have the responsibility of presenting this issue from the point of view of the Second Concurrent Budget Resolution which we adopted last fall, and it is for that purpose that I rise, Mr. President.
The rescissions in this bill, H.R. 2439, which total $723.6 million in fiscal year 1979 budget authority, and $29.9 million in outlays represent a meaningful reduction in appropriations for programs whose funding requirements are not as great as they seemed when we originally considered them.
This bill represents responsible fiscal management, Mr. President. It proves that the Congress does have the capacity to cut back on spending which is no longer as necessary as it once was.
This bill was jointly referred to the Appropriations Committee, the Budget Committee, and the relevant authorizing committees pursuant to the unanimous consent agreement of January 30, 1975. The Budget Committee reported favorably on H.R. 2349, as passed by the House, because it found that the bill did not adversely affect national priorities, and because enactment of the rescissions would help reduce pressure on the budget authority ceiling in the fiscal year 1979 second budget resolution.
The Budget Committee further recommended that the Appropriations Committee scrutinize the President's proposals for further savings, especially in light of the pressure on the second budget resolution spending ceilings resulting from supplemental requests, inflation, and high interest rates. I repeat that, Mr. President. Since we locked up the second budget resolution last September, there have been changes in the spending ceilings, forced by supplemental requests, inflation, and high interest rates. The Appropriations Committee took a close look, with the result that the bill before us today contains rescissions totaling $17.7 million more in budget authority and $8.0 million more in outlays than the House-passed bill.
Mr. President, the spending ceilings of the fiscal year 1979 second budget resolution, particularly the ceiling on outlays, as pointed out by Senator JOHNSTON, are under very severe pressure.
The Congressional Budget Office is still in the process of updating its estimate of the current status of the fiscal year 1979 budget. However, it now appears likely that spending enacted to date plus remaining mandatory supplementals will cause the outlay ceiling to be exceeded by as much as $3 billion.
On the same basis, budget authority would remain below the budget resolution ceiling. However, if all the discretionary supplementals requested by the President are enacted, both the budget authority and the outlay ceilings would be exceeded by large amounts. And at least some of these so-called discretionary supplementals may be difficult to avoid.
While the pending rescission bill would not provide much help on the outlay problem, it would improve the budget authority situation — and frankly, we need all the help we can get.
The current tight budget situation is not attributable to any congressional action. In fact, it developed while Congress was not even in session.
When we put together the second budget resolution, inflation in 1979 was forecast to be 6.7 percent and the average interest rate on the 3-month Treasury bills was forecast at 7.4 percent.
Since then, the outlook for inflation has deteriorated and the administration and the Federal Reserve has taken several actions to strengthen the dollar abroad. We now expect inflation to be 8.2 percent and the interest rate on 3-month Treasury bills to be 9.1 percent.
Mr. President, I wish especially to commend the Appropriations Committee and its distinguished chairman, Senator MAGNUSON, for standing up to pressures from various interest groups opposing the rescissions in this bill — including educators, community developers, and health professionals.
There is one issue involved in this bill which disturbs me — that dealing with reductions in funding for health professions education. On balance, however, I must conclude that the minimal reduction proposed by the Appropriations Committee is justified. and I support it. Last fall, the Congress appropriated $263.1 million for various programs providing assistance to medical and nursing schools and students. These programs provide capitation grants to schools, as well as scholarships, fellowships, and various other forms of assistance.
The President proposed cutting the fiscal year 1979 funding for health professions education from $263.1 million to $95.2 million — a cut of $167.9 million, or 64 percent.
The House only took $24.8 million of the President's proposed rescission — for a reduction of 9 percent.
The Senate Appropriations Committee agreed to $46.4 million of the President's proposed cut — for an 18-percent reduction.
Moreover, the Appropriations Committee is proposing a smaller reduction in funding for nurses' capitation grants than was recommended by either the President or the House. While the President wanted to cut funding for this program by $30 million, and the House recommended a $10 million reduction, our Appropriations Committee supports only a $6 million cutback.
Mr. President, the purpose of health professions education programs is to produce more doctors and nurses — a goal deemed wise at the time of the programs' enactment.
However, it now appears that these programs have largely achieved their goal. Most health manpower analysts agree that existing and projected supplies of health practitioners, when considered in the aggregate, will be more than adequate to meet the Nation's needs.
For example, it is estimated that the number of practitioners in the major health professions categories will increase by 70 percent between 1975 and 1990. In every case, the supply increase will far exceed population growth, raising practitioner-to-population ratios well above current levels.
One study, cited by CBO in its analysisof this rescission, suggests that even if this rescission is adopted, the ratio of nurses to the general population would still increase by 23 percent over the 1976 level.
My own State of Maine enjoys a relatively high proportion of nurses — 464 per 100,000 population, as compared to a national ratio of 385 nurses per 100,000 population.
Mr. President, I ask unanimous consent that the President's rescission request and the CBO analysis be printed in the RECORD immediately following my remarks.
The PRESIDING OFFICER (Mr. EXON). Without objection, it is so ordered.
(See exhibit 1.)
Mr. JOHNSTON. Mr. President, will the Senator yield for a question?
Mr. MUSKIE. I will in a moment. I have just a few more words to complete my statement.
Rather than being a problem of aggregate supplies of health professionals, the problem now is one of distribution of these professionals. There are geographical areas with too many health professionals, and areas with too few. There are certain specialties with more practitioners than needed, others with too few.
So today's need is not to supply more total health professionals — rather, it is to fill the existing gaps.
Therefore, while I support health professions education programs, I must support the small rescission recommended by the Appropriations Committee. These reductions will help to free up resources to meet today's problem of maldistribution of health manpower.
We must respond flexibly to these changing needs. We must face up to the fact that existing programs may no longer fill the bill, and try to find new programs to meet new needs.
Mr. President, what is at issue here is a very basic fact which is at the heart of the budget process — the necessity for choice.
It was a fact we confronted in the last Congress when the issue before us was whether to continue funding for the B-1 bomber. At that time I spoke in favor of rescinding the B-1 bomber funding, saying:
The simple fact is that we cannot afford to commit the Federal budget in every direction at once. In defense and in domestic affairs, we must make choices among attractive alternatives.
Otherwise, we will become bankrupt as a Nation.
Clearly, we must make choices. If we are to demonstrate to the American public that we have the will to control spending at all, we must reduce expenditures in both defense and domestic programs wherever we can in order to conserve sufficient resources to meet the most pressing needs of our society.
Mr. President, the American public — and the State legislatures — are watching our actions here today. They have virtually given up on our ability to manage the Nation's affairs. So we must take that into account, as never before during the life of our budget process, as we make budget decisions. If we really want to avoid precipitating constitutional amendments and proposals for constitutional conventions, which could precipitate constitutional crises, we must put on a demonstration of fiscal responsibility and the ability to make choices. I think the time is here. I think Congress demonstrated those characteristics last year.
We must continue to do so. I am against the constitutional formulas which have been proposed. I am for men who are thoughtful, who are passionate, for men who are making intelligent choices here in the Senate. That is not to say that each of us knows what is right all of the time. It is only after such debate as this that we can hope to make the wise decision.
I rise as chairman of the Budget Committee to remind myself and my colleagues that a very high priority today in our budget process is how we are perceived by our people in the careful use of the resources they make available to us.
EXHIBIT 1
PROPOSED RESCISSION OF BUDGET AUTHORITY
[Table omitted]
Justification: During the 1960's and 1970's, there was a major increase in the supply of health manpower, partly as a result of increased Federal institutional and student assistance to support expanded numbers of health professions students and training programs. It is estimated that the number of practitioners in the major health professions categories will increase by another 70% between 1975 and 1990. In every case, the supply increase will far exceed population growth, raising the practitioner-to-population ratios well above current levels.
The ratio of physicians to population is projected to rise from about 177 per 100.000 in 1975 to 241 per 100,000 in 1990, a 37% increase. Moreover, the number of active nurses has more than doubled since 1957 to over 1,000,000 in 1978. The outlook is also good for adequate growth in the supply of nurses during the coming decade. The current adequate supply and projected increases in the numbers of health professionals underscore the fact that special Federal subsidies are no longer required merely to increase the supply of particular categories of health professionals.
Federal support for health professions training is being redirected as part of a national health plan strategy to address the needs of the poor and underserved. The President's 1979 Budget emphasized support for service commitment scholarships rather than continued funding for institutional subsidies or non-service-related student assistance. Moreover, increased emphasis is being placed on the needs-based student assistance grant and loan programs of the Office of Education and undergraduate health professions training, e.g., nurse training.
The $167,893,000 in health professions training funds proposed for rescission in 1979 includes funding for capitation grants, nursing student and institutional assistance, health professions non-service student loans, and emergency medical training grants. These funds have been identified as unnecessary to program needs for meeting the goal of providing health services to the medically underserved. This is in keeping with the strategy further articulated in the President's 1980 Budget to terminate capitation grants and initiate a phaseout of other institutional subsidies and student assistance programs that in the past have served to increase the supply of health professionals without regard to specialty or geographic shortages. There are more efficient and effective means for addressing health manpower needs in shortage areas than the programs supported by the training funds proposed for rescission. The Administration supports numerous approaches, including service commitment
Estimated effects: Federal support for health professions training will continue at a level of nearly $375 million in 1979, including $77 million for service commitment scholarships. These scholarships will support health professions training in return for service in medically under served areas. The proposed rescission of $168 million in institutional subsidies and non-service related student assistance would not affect the goal of providing services to the medically under served.
[Table omitted]
HEALTH RESOURCES ADMINISTRATION
HEALTH RESOURCES
Of the funds provided for "Health resources" for fiscal year 1979 in the Departments of Labor and Health, Education, and Welfare Appropriations Act, 1979, and in P. L. 95-482, $167,893,000 are rescinded.
CONGRESSIONAL BUDGET OFFICE — RESCISSION MEMORANDUM
Rescission Number: R79-4.
Agency and Bureau Affected:
U.S. Department of Health, Education, and Welfare., Health Resources Administration, Bureau of Health Manpower.
Appropriation Title and Symbol (program): Health Resources, 7590712, 756/90712.
Amount Proposed for Rescission: $167,893,000.
Budget Function and Subfunction: Health (550) /Education and Training of the Health Care Work Force (553).
Appropriation Account: 75-0712-0-1-550.
Type of Accounts: Annual, Multiple-year.
PROGRAM BACKGROUND
The Health Professions Educational Assistance Act of 1976 (HPEA) and the Nurse Training Act of 1975 (NTA) authorize a variety of programs to assist schools that train students in medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, pharmacy — sometimes abbreviated as MODVOPP — and in registered nursing. Only those programs that would be affected by the proposed rescission are described in this memorandum. Table 1 lists these programs, their current funding levels and their funding levels under the proposed rescission.
The major federal program of institutional assistance to eligible MODVOPP and nursing schools provides formula grants that are awarded on the basis of student enrollment; these are referred to as capitation grants. The amounts of the capitation awards are varied to reflect differences in educational costs among types of schools. In fiscal year 1979, MOD schools are authorized to receive as much as $2,050 for each full-time student. For each full-time student enrolled, as much as $1,450 may be received by veterinary medicine schools, $765 by optometry schools, $965 by podiatry schools, and $695 by pharmacy school. Nursing schools receive somewhat less: $400 for each third- or fourth-year baccalaureate student, $275 for each second-year associate student, and $138 for each first-year associate student, and $250 for each diploma student.
In addition to capitation grants, other types of federal support are provided to MODVOPP and nursing schools and students. Nursing schools receive grants for special projects that may improve nursing education and practice, for the operation of advanced (graduate) nursing programs, and for research. Both MODVOPP and nursing schools receive federal funds so that they may award low interest loans to students. The federal government also pays the outstanding loans of eligible nursing students who agree to practice in designated under served areas, and provides graduate traineeships and research fellowships for advanced nursing students.
Finally, the Administration has proposed that grants for programs that train health personnel to provide emergency medical services be rescinded.
ADMINISTRATION JUSTIFICATION
The President has proposed that $178.8 million be rescinded from fiscal year 1979 appropriations for health manpower education and training programs.
The Administration justification for a phase out or termination of capitation grants, other types of institutional assistance, and student assistance is based on the belief that the current supply and projected increases in the supply of health manpower will be adequate to meet future needs. As a result, special federal subsidies are no longer necessary to encourage increases in the supply of particular categories of health professionals. Further, the Administration contends that there are more effective means to address the more pressing problems of specialty and geographic shortages and that programs that address the needs of the poor and under served are stressed rather than continued funding for institutional subsidies and non-service related student assistance.
CBO ANALYSIS
As a result of the proposed rescission, MODVOPP schools would lose approximately 30 percent of the institutional assistance for health manpower education that would otherwise be provided to them under the HPEA in fiscal year 1979. Nursing schools would lose about 70 percent of the funds that would otherwise be provided to them under the NTA for both institutional and student assistance.
The Administration estimates that the proposed rescission would reduce fiscal year 1979 budget outlays by $30 million. This estimate appears reasonably low since awards made to health professions schools would normally be made late in the 1979 fiscal year and, for the most part, spent in fiscal year 1980.
Important issues with respect to this rescission proposal are its effects on: The financial stability of health professions schools that now receive federal aid; the future adequacy of the health manpower supply, and health professions students.
[Table omitted]
An abrupt discontinuation of institutional assistance may disrupt the operation of a significant number of health professions schools since these schools believed that fiscal year 1979 funds would be available for their use (as a result of the passage of the HEW-Labor fiscal year 1979 appropriation act and the fiscal year 1979 continuing resolution by the 95th Congress).
Furthermore, many, if not all, of these schools have come to view capitation grants as entitlements and may question whether it is fair for the federal government to discontinue funding when it encouraged them to build up the capacity to train more students.
There is evidence that at least a few health professions schools are currently having financial difficulty and would be disadvantaged by a loss of federal support. Some schools may be able to compensate, however, by obtaining additional support from parent universities or colleges, state governments, or private sources. Schools would probably respond by raising tuition charges in order to gain additional revenues, laying off some faculty or discontinuing less than essential activities until other sources of support could be obtained. A dilution of the quality of some training programs might therefore result. Nursing schools are likely to cut back sharply on graduate nursing programs.
Supply adequacy
The effects of cutbacks in capitation grants and other sources of institutional support on the adequacy of the future supply of MODVOPP and nursing professionals is uncertain and depends, in part, on how successful schools are at obtaining other sources of aid. If they are unsuccessful, enrollments in health professions schools might be lower than they would otherwise be, but the future supply of providers is likely to increase above current levels. The adequacy of the supply of dentists and optometrists would be most vulnerable if these schools were to substantially reduce their enrollments (see Table 3). The supply of these provider types as well as primary care physicians and podiatrists might also be somewhat less than desirable if a comprehensive national health insurance plan were implemented. Nevertheless, the health provider to population ratio has increased dramatically in the last decade and will probably continue to do so through 1990. For example, in one study, the long run impact of a discontinuation of capitation grants on the supply and demand for registered nurses was analyzed. The results of one simulation, assuming that the survival of a number of nursing schools were endangered due to the loss of federal support, suggested that the number of registered nurses employed in 1990 might be 7 percent below what it might otherwise be. The nurse to population ratio, however, was still 23 percent above the 1976 level. If this were the experience of MODVOPP schools as well, MODVOPP per population ratios would still be well above current levels.
Given that a loss of federal dollars would likely mean substantial tuition increases, a major determinant of future enrollment levels in health professions schools, however, may be the availability of financial aid for students.
Student assistance
MODVOPP and nursing students would likely have higher educational costs as a result of the proposed rescission. For example, if medical schools increased tuition charges by the full amount they would lose as a result of the proposed rescission, average 1979–1980 academic year tuition charges in public medical schools could increase by roughly 45 percent and in private medical schools by roughly 12 percent. There are several federal student assistance programs, however, from which MODVOPP and nursing students may obtain aid. The health professions graduate student insured loan program (HPGSLs) provides insured loans to MODVOPP students, while nursing students are eligible for guaranteed student loans (GSLs) and basic educational opportunity grants (BEOGs). Some financially needy students who currently receive aid from a variety of federal sources might be disadvantaged, however, by rising tuitions. A major reason is that current federal assistance programs have limits on the amount of assistance that a student may obtain. These students would likely be prevented from attending the more expensive schools. This is particularly true for nursing students who are ineligible for HPGSLs that provide the highest borrowing limits of the federal student assistance programs.
Mr. MUSKIE. I am happy to yield to my good friend from Louisiana.
Mr. JOHNSTON. I thank the distinguished Senator from Maine for yielding for a question.
The PRESIDING OFFICER. Does the Senator from Washington yield time?
Mr. MAGNUSON. Yes, I yield time.
The PRESIDING OFFICER. The Senator from Louisiana.
Mr. JOHNSTON. I ask my distinguished colleague, the chairman of the Budget Committee, on what does he base the statement, with which I agree, that the spending in outlays is likely to exceed the second concurrent resolution by some $3 billion.
Mr. MUSKIE. That figure has several elements. First, there is a one-time increase attributable to higher interest rates on the national debt resulting from the Federal Reserve Board's action in its monetary policy to strengthen the dollar. The Congress was out of session. The effect of that action was to increase the cost of interest on the Federal debt by roughly $5 billion over the cost in the second budget resolution.
Mr. JOHNSTON. So as of this point, would the Senator say that there is no doubt that we have exceeded the second concurrent resolution by this interest rate increase?
Mr. MUSKIE. That appears to be true. But, I would point out that the Congressional Budget Office, which provides technical support to the Congress on all budget estimates, is still in the process of reviewing all of the fiscal year 1979 estimates and has not yet formally given the Budget Committee its final opinion on the bottom line for fiscal year 1979.
Mr. JOHNSTON. I ask the Senator, if that is so then would it be equally true that the amendment of the Senator from Massachusetts increasing spending as it does would further increase or further pierce the second budget resolution?
Mr. MUSKIE. Let me finish my earlier answer first. The second element in the potential $3 billion overage is the increased cost of indexed accounts. As the Senator knows, many accounts are indexed by law against inflation. So when inflation goes up, then the cost of those entitlement programs also goes up. So the $3 billion preliminary estimate covers both higher interest rates and higher inflation costs.
I would also point out that the preliminary estimate of $3 billion assumes enactment of about $5 billion of mandatory supplemental requirements which were assumed in the second budget resolution ceiling but which no longer can be fully accommodated within the ceiling because of actions outside congressional control that have occurred in other programs.
Mr. JOHNSTON. Really, the ultimate question, and I might as well ask it now, is this: Is not the Kennedy amendment really subject to a point of order since we have already exceeded the outlays in the second concurrent resolution and this would simply further exceed that second concurrent resolution? Would the Senator give his opinion on that?
Mr. MUSKIE. If what we had was an outlays ceiling about to be pierced by an appropriations bill, then the answer clearly would be yes. The appropriations which are involved here were enacted into law last year. So a rescission would not give rise to a point of order. I do not believe, either, given that these intervening events are not yet reflected in the current scorekeeping system — and will not be until mid-March — that a new appropriation under the present circumstances would trigger a point of order under the Budget Act.
Mr. JOHNSTON. I think there are two questions here involved. First, it is the legal question of whether an amendment to a rescission which increases the action of the Budget Committee is subject to a point of order. That is one question Then, second, there is the question of whether the facts we know to be, that is, that the second concurrent resolution has already been exceeded — we know that to be a fact because of the reasons the Senator has stated — since that has not yet appeared in print, whether or not that furnishes the predicate for a point of order.
Would the Senator be prepared to speak to the second question? I believe the Parliamentarian would be prepared to prove on the first question that an amendment which adds to the action of the Budget Committee if the second concurrent resolution is already exceeded would be subject to a point of order. I believe the problem of the Parliamentarian is on the second question. That is, has the second concurrent resolution been pierced.
The PRESIDING OFFICER. The Chair has been advised that this does not deal with new budget authority. It rescinds a prior authority. Therefore, it would not be subject to a point of order. The Chair rules that it does not come under the Budget Act, as such.
Mr. JOHNSTON. Whether or not the second resolution has already been pierced?
The PRESIDING OFFICER. That is correct.
Mr. JOHNSTON. I thank the Chair.
Mr. MUSKIE. May I make another point on that? The Budget Committee reported to the Appropriations Committee with a recommendation that the committee endorse the House figure and that,in addition, the Appropriations Committee examine the remaining rescissions proposed by the President to determine whether or not it might approve others. Actually, the Appropriations Committee has reported more rescissions than the House, a greater cut than the House.
May I say this in addition: There are some supplementals that are going to create problems with respect to the ceiling on budget authority. If they breach that ceiling, then a point of order will lie — a point of order on the supplementals when they come along. All of us must closely examine these supplementary requests for budget authority which are coming down the pike because they conceivably could breach the ceiling of the budget resolution.
With respect to the impact of higher interest rates and inflation after Congress went out of session, that presents a clear policy question for the Congress to decide. Should programs assumed in the second budget resolution last year be cut because events over which Congress had no control, which took place after Congress went out of session, had the effect of boosting outlays? If outlay ceilings determined by the Congress are to be fixed and unchangeable, then unavoidably programs would have to be cut below levels for which they were appropriated last year if the outlay ceiling is to be held.
In effect, that gives the Federal Reserve Board an indirect impact which I am sure it did not intend. The action of the Board may necessitate a cutback in congressional appropriations without any program evaluations or evaluational need in order to stay within the ceilings of the second budget resolution.
That is a tough judgment, but that is where we are with this case and that is where the budget resolution is with the facts as they have developed.
Finally, I should like again to commend my good friend from Washington for what I think is a masterful job.