Geriatricians Loan Forgiveness Act of 2004

Mr. President, I am pleased to cosponsor legislation introduced today that will reinstate a moratorium on State and local taxation of access to the Internet. Senators Alexander and Carper have worked very hard to craft legislation that will protect Americans from being taxed for using the Internet, while still respecting the States' need to raise revenue from traditional telecommunications taxes. As a fellow former Governor, I have been pleased to join them in this effort and hope that all of my colleagues who have supported a moratorium on taxation of Internet access will support this bill.

Until last fall, there was a moratorium in place prohibiting taxation of Internet access. Unfortunately, that lapsed before Congress was able to craft an extension. One of the reasons that extending the moratorium has been difficult is that we want to apply the lessons learned over the last few years. For example, the previous moratorium was not technology-neutral. That is, people who accessed the Internet using a DSL connection were not always treated the same as those who used dial- up service or a cable modem. This was clearly an unintended consequence of the way that the previous legislation was drafted. In addition, over the last few years, we have seen many States struggle with enormous budget deficits. Recognizing that a downturn in the economy can compromise a state's ability to provide vital services, including schools, firefighters, and police officers, we do not want to undermine any state's revenue base.

With these lessons in mind, Senators Alexander, Carper and others have crafted an extension of the previous moratorium that would ensure that no States impose new taxes on Internet access. The legislation specifically requires that all technologies be treated equally. And because the moratorium is limited to 2 years, it ensures that Congress will revisit the issue periodically as technologies develop and circumstances change.

As a former Governor, I do not take lightly any Federal action that limits the options available to local and State elected officials I recognize how hard it is to balance a State budget and am only willing to support a moratorium on Internet access taxes because I believe that we are dealing with a unique new service. The Internet has the power to connect Americans as the radio, telephone, and television did for previous generations. By sending e-mails, telecommuting, or banking online, Americans are communicating in a new way that makes our economy more productive and enhances our quality of life. If sparing Internet access from taxation increasing the ability of low and moderate income Americans to join the technology revolution, then it is certainly a worthy public policy goal.

Now, Senators Allen and Wyden have offered an alternative approach. They have proposed legislation that would permanently bar States ad cities from taxing Internet access, and they have defined the service broadly that many experts believe it will undermine some telecommunications taxes on which States currently depend. I am not interested in providing enormous tax breaks to the telecommunications industry, and so I oppose their approach. Taxes that businesses currently pay to access the Internet backbone are reasonable costs of doing business. I hope that my colleagues will not be intimidated by claims that those of us who oppose tax breaks for telecommuncations companies actually want to tax people's e-mails. That is a false argument, and anyone who resorts to it is surely trying to avoid the difficult issues that are addressed by the bill introduced today by Senators Alexander and Carper.

I would like to make one final point to my colleagues, and that is about fallibility. Every day we get fresh evidence that things are not always as they seemed and that we do not, in fact, know everything we thought we knew. If fallibility is part of being human, then surely it is part of any legislative body. If the moratorium that Congress had imposed 5 years ago had been permanent, then we would have had a difficult time reopening the issue to address the fact that certain technologies were not protected under the act. We ought not make that mistake now by thinking that we can accurately foresee the exciting technological developments on the horizon. It is appropriate for Congress to revisit this issue in two years, as the Alexander-Carper proposal allows.

I hope that all of my colleagues will join me in support of a new temporary moratorium on Internet access taxes. Enacting this legislation quickly will ensure that Americans are not hit with any taxes when they try to log on.

Mr. President, as our Nation's 76 million Baby Boomers near retirement age, the number of Americans over age 65 will double to 70 million--one-fifth of the population. Americans older than 85 represent the fastest growing segment of this population and membership in this once exclusive demographic group is projected to grow from four million Americans today to an estimated 19 million by 2050.

Unfortunately, our health care system is ill prepared to handle the strain of this enormous senior population, largely because we have a critical shortage of geriatricians. Fewer than 9,000 geriatricians practice in the U.S., far below the 20,000 or more needed to effectively care for the Nation's booming population of seniors. Ironically, the number of geriatricians is expected to shrink as many of these doctors retire at the same time baby boomers start qualifying for Medicare in large numbers.

America must plan for the burdens the baby boomers demographic shift will place on our health care system and health care providers. Our first step is ensuring the country has an adequate number of well- trained geriatricians.

I first introduced legislation to address the national shortage of geriatricians during the 105th Congress. While I am encouraged that greater attention has been focused on this issue, little has been accomplished to improve the shortage of geriatricians.

Today, I am re-introducing legislation that will encourage more doctors to become certified in geriatrics. The Geriatricians Loan Forgiveness Act would forgive $20,000 of education debt incurred by medical students for each year of advanced training required to obtain a certificate of added qualifications in geriatric medicine or psychiatry.

Geriatric medicine is the foundation of a comprehensive health plan for our most vulnerable seniors. Geriatrics, by focusing on assessment and care coordination, promotes preventive care and improves patients' quality of life by allowing them greater independence and eliminating unnecessary and costly trips to the hospital or institutions. But this kind of specialized care is complicated and demanding. Many doctors inclined to study and practice geriatric medicine are dissuaded from doing so because treating the elderly takes more time and carries financial disincentives for doctors.

Medical training takes time, so we need to lay the groundwork now to have enough qualified geriatricians in place in ten years from now. This legislation is a commonsense approach and cost-effective investment. We must take these steps today to meet our needs for tomorrow.

I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I rise today for myself and Senator Ensign to introduce the University of Nevada at Las Vegas Research Foundation Reinvestment Act, which enhances the long-term viability of the University of Nevada at Las Vegas by allowing proceeds from leases of the University of Nevada at Las Vegas Research Foundation property to be reinvested.

Mr. President, through provisions of the Southern Nevada Public Land Management Act of 1998, the Clark County Department of Aviation acquired land that was formerly owned by the Federal Government. A subsequent law, the Clark County Conservation of Public Land and Natural Resources Act of 2002, transferred this land to the University of Las Vegas Research Foundation for construction of a research park and technology center.

Under current law, only 10 percent of the proceeds from the sale, lease, or conveyance of this land may be reinvested. This restriction hinders efforts to promote research and development at the research park.

Mr. President, the bill that I am introducing today amends the Clark County Conservation of Public Land and Natural Resources Act of 2002 to allow the proceeds of the Foundation's research park leases to be used to carry out the foundation's research mission.

The foundation's research park and technology center in the greater Las Vegas area will enhance the research mission of the university, increasing the potential for the high-tech industry and entrepreneurship in the State. It provides the public with opportunities for high-tech education and research, and at the same time provides the State with opportunities for competition and economic development in the high-tech field. It is imperative that sufficient funds are always available to maintain and enhance the center.

Mr. President, I ask unanimous consent that the full text of the bill be printed in the Record.

Mr. President, it is a privilege to introduce a joint resolution commemorating the 60th anniversary of the June 6, 1944 landings in Normandy that paved the way for the liberation of Europe. Operation Overlord, code named D-Day, was the culmination of months of planning and strategic air attacks. Under cover of darkness 18,000 British and American airborne forces were deployed in the initial phase of the operation commanded by Supreme Allied Commander General Dwight D. Eisenhower. Combined Allied forces landed at Utah, Omaha, Gold, Juno and Sword as part of the largest air, land, and sea invasion ever undertaken. In all, over 5,000 ships and landing craft, 10,000 airplanes and 150,000 Allied forces took part in the operation.

An estimated 70,000 Americans took part in D-Day operations, including 225 U.S. Rangers who scaled the cliffs at Pointe du Hoc to capture German heavy artillery emplacements. American troops also landed at Utah beach, and at Omaha beach where they faced a myriad of challenges, including high seas, mines and elite German infantry forces.

In a radio address and prayer to the American people on the evening of June 6, President Franklin D. Roosevelt laid out the mission undertaken by G.I.s and Allied forces: ``They fight not for the lust of conquest, They fight to liberate. They fight to let justice arise, and tolerance and goodwill among all Thy people. They yearn but for the end of battle, for their return to the haven of home.'' During the evening of June 6, 1944 church bells tolled throughout America and in Philadelphia the Liberty Bell was rung as Americans awaited word from the rocky battlefield of northern France.

On that fateful day, 1,465 Americans laid down their lives on the field of battle. Another 3,184 were wounded, 1,928 missing, and 26 captured. In the days and weeks to follow, thousands more would spill their blood on French soil to liberate Europe. D-Day ushered in a series of battles over the next three months until the liberation of Paris in late August 1944.

In a very real sense, the fate of Europe hung in the balance of the success or failure of the D-Day operations. As a senior member of the Committee on Veterans Affairs, I am especially mindful of the tremendous sacrifice made by those men and women of the uniformed services who served with distinction at D-Day and throughout the course of World War II. Almost forty percent of U.S. service men and women were volunteers, with the duration of service for all troops averaging 33 months. Nearly 300,000 Americans made the supreme sacrifice during World War II, including the valiant troops that took part in D-Day.

I would take this opportunity to recognize the World War II military service of current members of the United States Senate: the Senator from Hawaii, Mr. Inouye; the Senator from South Carolina, Mr. Hollings; the Senator from Alaska, Mr. Stevens; the Senator from Virginia, Mr. Warner; the Senator from New Jersey, Mr. Lautenberg; and the Senator from Hawaii, Mr. Akaka.

As Chairman of the Commission on Security and Cooperation in Europe, I had the privilege to lead a delegation of colleagues to the Normandy American Cemetery in July 2001, where we participated in ceremonies honoring Americans killed in D-Day operations. Maintained by the American Battle Monuments Commission, the cemetery is the final resting place for 9,386 American service men and women and honors the memory of the 1,557 missing. The superintendent of the cemetery noted that each year the sea surrenders the remains of Americans who fought and died in the service of freedom at home and abroad.

The Normandy American Cemetery, Mr. President, is the resting place for 100 Coloradans who gave their lives on the field of battle. From Toffoli and Sweeney to Martinez the roster is a testament to diversity of those from my home state of Colorado who answered the call to defend freedom along the rocky coast of a distant land.

I urge my colleagues to act quickly on this resolution which will commemorate the 60th anniversary of D-Day and honor those who so bravely served in that effort.

I ask unanimous consent that the text of the resolution be printed in the Record.

Mr. President, it is a privilege to join my colleagues, Senators Daschle, Reid, Leahy, Dodd, Harkin, Kerry, Feingold, Mikulski, Schumer, Murray, Durbin, Edwards, Clinton, Sarbanes, Lautenberg, Corzine, Landrieu, and Cantwell today in introducing the ``Fairness and Individual Rights Necessary to Ensure a Stronger Society: the Civil Rights Act of 2004''. This legislation, the ``Fairness Act,'' is vital to realizing the full promise of, the numerous Federal laws that have been enacted to guarantee civil rights and fair labor practices for all our citizens.

2004 is an especially significant year in commemorating the historic landmarks in America's struggle for civil rights. On January 15, we celebrated the 75th anniversary of the birth of Dr. Martin Luther King. On May 17, we will celebrate the 50th anniversary of the Supreme Court's historic decision in Brown v. Board of Education. And on July 2, we will celebrate the 40th Anniversary of the Civil Rights Act of 1964.

These historic milestones make this year not only a time for celebration, but also a time to reaffirm our commitment to the cause of civil rights, which is still the unfinished business of America. We must continue moving toward the goal for which so many have given so much across the years. The bipartisan civil rights laws that have been enacted over the past forty years have made our Nation stronger, better, and fairer. Civil rights is at its heart the ongoing, daily struggle to live up to what is best about America--our fundamental belief in equal opportunity and equal justice for all.

The Fairness Act is part of that continuing effort. Its goal is to guarantee that victims of discrimination and unfair labor practices have access to the courts when necessary to enforce their rights and to obtain effective remedies. As Congress has long realized, full enforcement of civil rights and fair labor practices is possible only if individuals are able to petition the courts. Our proposals will strengthen existing protections, often in cases where the courts have let us down by adopting unacceptably narrow interpretations of existing law. We recognize as well that Congress has not always made its intent clear in enacting specific and detailed provisions of these laws.

Unfortunately, recent court decisions have limited the private right to seek relief and to obtain effective remedies under many of our civil rights and labor laws. Cases like Alexander v. Sandoval and Kimel v. Florida Board of Regents have effectively closed the courthouse door on many persons seeking relief they deserve from discriminatory practices.

Key elements of our proposals will make it easier for working women to enforce their right to equal pay for equal work. We enhance protections against discrimination in federally funded services and enact needed safeguards for students who are harassed because of their national origin, gender, race, or disability. We also make

sure that victims of discrimination and unfair labor practices can receive meaningful damages where appropriate. Our legislation will allow enable members of our armed forces to enforce their federal right to be free from discrimination by States because of their military status.

In addition, our proposals will ensure that older workers who suffer age discrimination are not denied the chance to seek relief merely because they work for a state government. We also stop employers from requiring workers to sign away their right to bring discrimination claims and fair labor claims to court, in order to get a job or keep a job.

These and other important proposals included in the Fairness Act are an essential part of our commitment to make Dr. King's dream a reality for everyone in every community in our country.

To those who say that now is not the time to seek this new progress, we reply, as Dr. King himself replied, now is always the time for civil rights. We know our cause is just. As Dr. King reminded us, ``the arc of the moral universe is long, but it bends toward justice.'' I urge all of my colleagues to support this important legislation.

I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I rise today with Senator Kennedy to introduce the Family Reunification Act, a measure designed to remedy a regrettable injustice in our immigration laws. A minor oversight in the law has led to an unfortunate, and likely unintended, consequence. Parents of U.S. citizens are currently able to enter the country as legal permanent residents, but our laws do not permit their minor children to join them. Simply put, the Family Reunification Act will close this loophole by including the minor siblings of U.S. citizens in the definition of ``immediate relative.'' This legislation will ensure that our immigration laws can better accomplish one of the most important policy goals behind them--the goal of strengthening the family unit.

Congress took an important first step in promoting family reunification when it enacted the Immigration and Nationality Act. By qualifying as ``immediate relatives,'' this law currently offers parents, spouses and children of U.S. citizens the ability to obtain immigrant visas to enter this country legally.

This we can all agree is good immigration policy. Unfortunately, a

``glitch'' in this law has put numerous families in an uncomfortable predicament. One of these unlucky families lives in my home Sate of Wisconsin. Effiong and Ekom Okon, both U.S. citizens by birth and graduates of the University of Wisconsin-Madison, requested that their parents be admitted to the United States from Nigeria as ``immediate relatives.'' The law clearly allows for this. Their father, Leo Okon, has already joined them in Wisconsin, and their mother, Grace, is currently in possession of an immigrant visa. However, Grace is unable to join her husband and sons in the United States because her six-year- old daughter, Daramfon, does not qualify as an ``immediate relative'' under current immigration law. Because it would be unthinkable for her to abandon her small child, Grace has been forced to stay behind in Nigeria, separated from the rest of her family.

This family is truly an American success story, one of first- generation citizens graduating from a top University. They want to continue to contribute to society and want to bring their family with them. Unfortunately, current immigration law only permits some members of their immediate family to join them, but not all. This is clearly wrong.

It is difficult to determine the scope of this problem. Because minor siblings do not qualify for visas, the Department of Homeland Security does not keep track of how many families have been adversely affected. However, DHS employees have assured us that the Okons are not unique. In fact, this is an all too common occurrence. If only one family suffers because of this loophole, changes must be made. The fact that there have been numerous cases demands changes now.

Many parts of our immigration laws are outdated, unfair, and in need of repair. The definition of ``immediate relative'' is no different. Congress' intent when it grated ``immediate relatives'' the right to obtain immigrant visas was to promote family reunification, but the unfortunate oversight highlighted has interfered with many families' opportunities to do just that. The legislation introduced today would expand the definition of ``immediate relatives'' to include the minor siblings of U.S. citizens. By doing so, we can truly provide these families with the ability to reunite and the chance to take advantage of the many great opportunities our country has to offer. This is a simple and modest solution to an unthinkable problem that too many families have already had to face.

I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I am proud to cosponsor the Fairness and Individual Rights Necessary to Ensure a Stronger Society: The Civil Rights Act of 2004, known as the Fairness Act. In recent years. the Supreme Court has worked to chip away at civil rights laws. This legislation is designed to address many of these decisions, particularly with respect to statutes governing recipients of federal assistance.

This bill is important to all Americans because it ensures that everyone will be treated with fairness and equity under the laws of this country. As a longstanding advocate for disability rights, I am particularly pleased that this bill will reverse some decisions that have limited civil rights protections for people with disabilities.

For example, this legislation will reverse some Supreme Court cases which limit the damage awards for intentional discrimination. A recent egregious example is Barnes v. Gorman, 536 U.S. 181, 2002. This case was brought by an individual who used a wheelchair and was forced into a police van that was not equipped with the proper restraints. Despite his objections to the officers, the individual was strapped in with improper belts that came loose, throwing him to the floor. The Supreme Court held that this individual could not seek punitive damages under the Americans with Disabilities Act and Section 504 of the Rehabilitation Act for this mistreatment. The Fairness Act will restore his rights and those of others who have suffered discrimination.

It will also reverse Buchannon Bd. & Care Home, Inc. v. West Virginia Dep't of Health & Human Resources, 532 U.S. 598, 2001. In that case, the defendant had been sued under the ADA and the Fair Housing Act. The Court held that even if the lawsuit causes the defendants to voluntarily make changes, the plaintiff cannot recover attorneys' fees unless he or she has been awarded relief by a court. This case has made it extremely difficult to find attorneys to take disability cases.

The Fairness Act will also clarify that passengers with disabilities may sue for violations of the Air Carriers Access Act, ACCA, and its regulations. A circuit court recently applied the Supreme Court's decision in Alexander v. Sandoval, 532 U.S. to prohibit suits under the ACAA. Congress intended that individuals have the ability to seek redress for violations of this statute.

The bill, however, does not address individuals with disabilities in some areas because Congress already has provided clear protection for them. So, for example, Congress has clearly indicated that a private right of action exists to enforce disparate impact disability-based discrimination under Section 504 of the Rehabilitation Act. Congress approved of the regulations promulgated to implement section 504 and incorporated these regulations into the statutory requirements of the Americans with Disabilities Act of 1990.

The bill also does not address the disability-specific negative decisions of the Supreme Court. These decisions have undermined the ADA by dramatically narrowing those who are covered under the Act and imposing other restrictions. As the lead sponsor of the ADA in the Senate, I believe that these cases directly conflict with congressional intent. I am working with the disability community and others to address these cases.

The Fairness Act is aptly named. It is designed to ensure that everyone is treated equally under the law and that America will be a Nation that protects and enforces the civil rights of all its citizens.

Mr. President, today I am introducing the Senior Elder Care Relief and Empowerment Act--the SECURE Act. The SECURE Act provides eligible taxpayers with a non-refundable tax credit equal to 50 percent of qualified expenses incurred on behalf of senior citizens above a $1,000 spending floor.

The Senate Special Committee on Aging has held several hearings on different facets of the growing long-term care crisis in this country. A major concern of mine is that the Federal long-term care policy mix may not have the right incentives--especially when it comes to the tough choices faced by families who want to care for their frail and aging relatives.

Earlier this week, we held a hearing in the Senate Special Committee on Aging on a growing issue of national importance--the issue of family caregiving for America's seniors.

Witnesses at the hearing highlighted the emotional stress and financial challenges faced by family caregivers of aging and vulnerable relatives; and testified favorably about the SECURE Act. Trudy Elliott, a witness at the hearing from North Idaho, talked about the stress and financial challenges she and her husband faced while caring for her mother, sister, and father. Her testimony was very moving. Mrs. Elliott, who also works for a company in the home health field, testified that her experience was not unique. More and more families are facing the stress and financial difficulties that come with caring for their aging parents.

It is critical to note that families, not government, provide 80 percent of long-term care for older persons in the United States. This is an enormous strength of our long-term care system. The U.S. Administration on Aging reports that about 22 million people serve as informal caregivers for seniors with at least one limitation on their activities of daily living.

These caregivers often face extreme stress and financial burden-- especially those we call the sandwich generation. The sandwich generation refers to those sandwiched between caring for their aging parents and caring for their own children.

It is difficult for families to balance caring for children and saving or paying for college, while at the same time struggling with financing care for frail and aging parents.

The SECURE Act should not preclude seniors or those near retirement from purchasing long-term care insurance. The Act provides tax relief for high-risk seniors who cannot qualify for long-term care insurance policies.

For many families, the nursing home is the only solution for providing long-term care, and that can be a good choice. For other families, keeping aging and vulnerable relatives in their own home or in the caregiver's home makes sense.

An that is why I am introducing the SECURE Act. Families facing high levels of stress and eldercare expenses deserve tax relief as they freely care for their frail and aging parents.

We also heard from witnesses at the Aging Committee hearing that the SECURE Act will increase the eldercare choices available to families and has the potential to reduce the number of seniors forced to spend down their nest-egg in order to qualify for Medicaid services.

Family caregiving for aging and vulnerable relatives requires a flexible national response to ensure seniors and their families have the most appropriate high quality choices.

I invite my colleagues to cosponsor this compassionate legislation. I ask unanimous consent that the text of the bill and a brief description be printed in the Record.

Mr. President, according to a Kaiser Family Foundation and Harvard School of Public Health survey of non-elderly Americans with private health insurance, one-half reported that they had a problem with their health insurance plans in the previous year. They cited delays and denials of coverage or care as their two most common problems. They also said they worried that if they became sick, their health plans would be more concerned about saving money than providing the best treatment. For those in managed care plans, such as HMOs, over two-thirds had this concern.

And they have good reason to be concerned. Let me tell you about two of the many people, who were hurt when HMO decided it needed to save money. Ruby Calad had a hysterectomy and her doctor recommended that she stay in the hospital longer than a day. Cigna, Ruby's insurance company said one day was enough. So Ruby went home, but she was soon in the emergency room because she had developed serious complications. Had Ruby been able to stay in the hospital longer, as recommended by her doctor, this would not have happened.

Juan Davila suffers from diabetes and arthritis. His doctor prescribed VIOXX for his arthritis because it had a lower rate of bleeding and ulcers than drugs on the formulary developed by Aetna. But instead of approving the VIOXX, Juan was required to enter a step program and try two other medications before VIOXX could be approved. He was given naprosyn--a cheaper drug--and three weeks later was rushed to the hospital. He had developed bleeding ulcers, which caused a heart attack and internal bleeding. Juan survived but now cannot take any pain medication that is absorbed by the stomach.

These examples show why medical decisions should be made by doctors, not HMO bureaucrats, and in 2001, the Senate, in a bipartisan vote of 59-36, passed S. 1052, the Bipartisan Patient Protection Act to make sure that happened. Yet, intransigence from the House leadership and the White House prevented that bill from becoming law. Nearly 3 years later, we still have not acted. So, today, I am introducing the exact same bipartisan bill that passed in the Senate in 2001.

This bill provides comprehensive protections to all Americans in all health plans. It says to all Americans who have health insurance, you have rights and protections. It says to HMOs, you have responsibilities and will be held accountable for your wrongful and harmful actions.

This bill ensures that patients have the right to have medical decisions made by their doctors and not HMO bureaucrats. Patients will have the right to see a specialist and go to the closest emergency room for treatment. They will be able to keep the same doctor throughout their medical treatment and appeal adverse claim decisions to an independent reviewer. And if they are injured by a decision made by the HMO, they will have the right to hold their HMO accountable in a court.

A meaningful patients bill of rights is long overdue. I urge my colleagues to support this legislation.