A bill to designate the facility of the United States Postal Service located at 6110 East 51st Place in Tulsa, Oklahoma, as the `Dewey F. Bartlett Post Office'.

Mr. President, today I am introducing legislation to protect low-income Medicare beneficiaries from being penalized under the new Medicare Modernization Act. My legislation also gives all seniors and the disabled more time to make the right choice in selecting a drug plan.

My bill is called the Medicare HEALS Act, which stands for Help for Every beneficiary and Low Income Seniors. I am pleased to be joined today by Senator Cantwell in introducing this new bill.

My goal is to protect very low-income seniors who today are covered by both Medicare and Medicaid. The new drug law will impose new co- payments and premiums on these vulnerable patients, while--at the same time--covering fewer prescription drugs.

Worst of all, the law prohibits States from providing additional coverage, known as wrap-around coverage, to seniors, the disabled and low-income beneficiaries. I believe seniors deserve better. I believe low income working families deserve better, and that's why I've written this bill.

The new drug law will force painful changes on low income patients, and my bill will help protect our most vulnerable from the negative impacts of the drug law.

Let's start by looking at how low-income beneficiaries are covered today versus how they will be covered under the new law. Today, very low income seniors are eligible for coverage under both state Medicaid programs and the Federal Medicare program, so they are often referred to as ``dual eligibles.''

Today, their prescription drugs are covered by State Medicaid programs, and they are a good deal. For many seniors and the disabled, State Medicaid drug coverage involves limited co-payments, no premiums, and coverage for a broad range of medically-necessary drugs.

Once the new Medicare drug program is implemented, these vulnerable patients will lose their State Medicaid coverage. They will be shifted into the Federal Medicare program, which will impose higher co- payments, new premiums and fewer covered drugs. It's a bad deal for low-income seniors and to make matters worse, it's incredibly complicated to figure out which private drug plan meets their needs.

1 am concerned that these individuals will be unable to afford co- payments or tiered co-payments that will be part of many MMA plans.

I am concerned that these individuals will also be denied the most medically-appropriate treatments due to restrictions imposed by the plans or additional financial burdens that plans will use to drive down drug utilization costs.

In addition, I am not convinced that we have done enough to fully educate and prepare beneficiaries to the choices and implications of these choices that they face today.

Another problem with the Medicare drug law is that it will penalize anyone on Medicare who needs extra time to make a decision about which plan to choose or whether or not to join the program. For a new system that is as complex as this new drug law, it's unfair to force people to make a decision quickly and to penalize those who need extra time to make the right choice.

To solve these problems and to protect our most vulnerable, my legislation would repeal the prohibition included in MMA on the use of Medicaid funds to provide wrap around coverage for dually eligible.

While I still believe that additional delay is warranted in switching this population to private plans under Medicare, I do believe we need to ensure that States facing a huge backlash from this population can respond accordingly.

I have joined in support of legislation aimed at providing a 6-month transition period for dual eligibles to give these patients time to phase into these new plans, but I also think we must ensure that States have the ability to respond to lapses in coverage or financial barriers that will deny access to necessary and life saving drugs.

States would have the option of providing wrap-around coverage using both Federal and State Medicaid funds, as they do today.

My legislation would also deduct any State funds used to provide wrap-around coverage from the so-called clawback amount. As we know, the MMA legislation takes back much of the savings States will see by transferring these patients to Medicare. I do

not think it is fair to penalize States for trying to do the right thing.

Finally, my legislation would delay the late penalty enrollment from May 15, 2006 until January 1, 2008, for all beneficiaries. This will give all Medicare beneficiaries the time to fully evaluate the plans. The extension will provide beneficiaries with one full benefit year and the open enrollment period to determine if these plans offer them a good value or provide the kind of security we all expect from Medicare.

This extension is of particular importance to those seniors who may be eligible for assistance but have not yet applied. We know that full dual eligibles will be automatically enrolled in a plan if they fail to select one. However, those with incomes from 135 percent to 150 percent of the Federal poverty level could also qualify for assistance but will not be automatically enrolled.

Early estimates from the Social Security Administration and the Centers for Medicare and Medicaid Services (CMS) indicate that a number of seniors have failed to even apply for eligibility determination. I have been told from CMS that 18 to 19 million beneficiaries were mailed information and an application this summer to begin the eligibility determination. So far, only 3 million have even applied.

A recent USA Today/Gallup Poll shows that only 37 percent of beneficiaries understand the program somewhat, but 61 percent do not. Fifty-four percent of beneficiaries do not even plan on joining the program. Many seniors have simply chosen not to even try and navigate the process. For some, there are more than 20 different plans with premiums nationwide, ranging from $1.87 to $100 and deductibles from $0 to $250. This does not even get into restricted formularies or other restrictions that may be imposed.

It is clear that all beneficiaries need more time. Extending the late penalty enrollment deadline of May 15, 2006 is the simplest step we can take to give seniors time to evaluate these plans and this new benefit. The late enrollment penalty of 1 percent each month is a huge financial hit that punishes those who may need the help the most.

In Washington State, we could see thousands of frail, vulnerable beneficiaries paying significantly more for life saving drugs or simply going without. There are an estimated 86,167 full dual eligibles and an additional 22,869 who receive some assistance from Medicaid. The intent of MMA and this new benefit was to expand access to affordable drug coverage; however, the unintended consequence could be the disruption of care for millions of low income beneficiaries nationwide.

It is my understanding that dual eligibles in Washington State will be automatically enrolled into 1 of 12 plans. There are 31 plans participating as Medicare Advantage or Prescription Drug Plans (PDPs). Within these plans, there are often several different benefit packages. Premiums range from $0 to $120; deductibles can range from $0 to $2500; and many will have tiered co-payment structures. None of these plans will cover all top 100 drugs used by seniors. Some plans provide only 77 of the top 100 drugs.

While these plans may offer far better benefits than many receive today, it will be difficult to make this determination. The range of choices; the restrictions; the variations in out-of-pocket and the belief by many that this is not a good benefit overall, will lead many seniors to simply walk away.

But, even if seniors decide to sit down and do the calculation and evaluate each plan or option, they face challenges in the reliability of the information.

CMS has partnered with a number of outstanding groups in Washington State who are working hard to get information and help to seniors so they can make informed choices. But the task is made much more difficult when CMS announces that materials already mailed to beneficiaries are incorrect.

My office received notice this week from CMS that the area specific 2006 version of the ``Medicare and You Handbook'' already mailed to beneficiaries contains a rather large error. The error occurs in the comparison charts listing the Medicare Prescription Drug Plans (PDPs). In the last column of the comparison table, entitled ``If I qualify for Extra Help, will my full premium be covered?''

For each plan listed, the column should say yes if the plan's premium is at or below the regional benchmark, and a beneficiary who qualifies for the low income subsidy would pay no premium for this plan.

The column should show no if the plan's premium is above the regional benchmark and a beneficiary who qualifies for the low income subsidy would pay the difference between the regional benchmark and the plan's premium.

Due to an error, this column lists yes for every plan. Even if one could figure out what the regional benchmark is and the difference in the premium, they are still getting bad information.

How can anyone determine the value of a plan or benefit when the initial information is wrong?

There are other examples of information being provided by CMS that is incorrect or inconsistent. I think this has happened in part because this administration is in a race against time to enroll, enroll, enroll. This kind of pressure will only lead to more and more confusion and distrust.

As we saw with the temporary discount drug card, seniors simply refused to participate. Even those who would have qualified for $600 did not bother to enroll. The largest enrollment was done by States and private plans for those who qualified for the subsidy, but far more simply did not bother. The choices were too complex, there were too many rules or restrictions, and there was no way for beneficiaries to measure the value of these cards.

My legislation does not address every problem and every coverage gap, but it is a small step to protect the most vulnerable. I urge my colleagues to join me in making these small but necessary corrections today before beneficiaries lose their coverage and lose access to affordable life saving drugs.

I know that this administration has resisted any efforts at fixing this program and has said the President would veto any legislation that delays implementation or changes the structure of the benefit. But, I am convinced we will be back making changes to this program over the next 2 years because seniors will demand action.

Maybe before all confidence in this program is gone and seniors are calling for repeal, the administration would look at small, humane fixes today, and that is the Medicare HEALS Act offers.

Mr. President, four years after 9/11, the government was supposed to be prepared for a crisis like Hurricane Katrina. Yet as we all saw, the government was not. We owe it to the American people to do better in the future.

Once again, the experts are warning us. This time, it's not about levees or terrorists. It's about another pandemic flu.

According to the experts, another pandemic flu is not a matter of if but a question of when. As Dr. Julie Gerberding of the Centers for Disease Control put it: ``. . . many influenza experts, including those at CDC, consider the threat of a serious influenza pandemic to the United States to be high. Although the timing and impact of an influenza pandemic is unpredictable, the occurrence is inevitable and potentially devastating.''

The devastation caused by Hurricane Katrina would pale in comparison to the potential consequences of a global pandemic. A respected U.S. health expert has concluded that 1.7 million Americans would die in the first year alone of an outbreak. A pandemic flu outbreak in the Untied States today could cost our economy hundreds of billions of dollars due to death, lost productivity and disruptions to commerce and society.

Perhaps the only thing more troubling than contemplating the possible consequences of an avian flu pandemic is recognizing that neither this Nation nor the world are prepared to deal with it.

Our National Pandemic Plan is still in draft stages. We lack the capacity to rapidly manufacture vaccines in mass

quantities. We barely have enough antiviral medication for 2 percent of our population. Our health care infrastructure is not prepared to handle a pandemic. And the medical community, businesses, and general public need to be better prepared.

These are just a few ways we are not as prepared as we should be.

America can do better. An avian flu pandemic may be inevitable, but the devastating consequences are not. We need to heed the warnings and take action immediately.

Last week, the Senate unanimously approved an amendment offered by Senators Harkin, Obama, Kennedy, Durbin and me that will begin to provide the resources necessary to protect Americans against this looming threat.

Today, I am proud to introduce, along with Senators Obama, Bayh, Kennedy, Harkin and Durbin, the Pandemic Preparedness and Response Act of 2005. This legislation builds on our commitment to protecting Americans by preparing for the possibility of a pandemic.

Specifically, the Pandemic Preparedness and Response Act will ensure that we have a national plan to address a flu pandemic. Under our bill, a new Director of Pandemic Preparedness and Response within the Executive Office of the President will be responsible for finalizing and carrying out the National Pandemic Influenza Preparedness Plan. There should be no question about who is in charge of preparing our nation for this looming threat. This new position will also ensure that, in the event of a pandemic, we will have a single senior official whose primary responsibility is to coordinate the federal government's response and ensure coordination between local governments and the private sector. This is serious responsibility, and our bill will ensure that the new Director is held accountable for preparing and protecting Americans against the threat of a pandemic.

Our bill will improve surveillance and international partnerships so we may detect the emergence of a flu strain with pandemic potential immediately. Specifically, our bill establishes and implements a comprehensive diplomatic strategy targeted at nations most at risk for an epidemic of avian influenza. It also provides assistance for international surveillance and medical care, and creates an International Fund to support pre-pandemic influenza control and relief activities in countries affected by avian influenza.

Domestic surveillance efforts will also be bolstered by our legislation. Our bill improves state surveillance capacity, and expands efforts by the Department of Agriculture to prevent pandemic avian influenza.

The Pandemic Preparedness and Response Act will improve our capacity to develop, produce and distribute a vaccine that will be effective against a pandemic flu. It will expand research at the National Institutes of Health so we may develop more efficient methods of producing vaccines. Our bill would enhance our vaccine production capacity by creating a guaranteed market for seasonal flu vaccine through a federal buyback program for a portion of unsold doses. And among other provisions, our bill will improve access to vaccinations during a pandemic by enhancing annual flu vaccination coverage for uninsured and underinsured adults and children.

Our legislation will ensure that we have enough antivirals, vaccines and other essential medications and supplies in the Strategic National Stockpile. Specifically, our bill requires that we procure enough antiviral medication to cover a minimum of 50 percent of the population for the Strategic National Stockpile. This legislation will protect Americans from the price-gouging of medications during a pandemic, and establishes a mass tracking and distribution system for vaccines and antiviral medications so we can direct medications and vaccines to where they are needed the most.

The Pandemic Preparedness and Response Act will also improve our surge capacity so that the American people can be assured there will be an adequate supply of health care providers and institutions to care for them in the event of a pandemic. Our bill will also ensure that public education and awareness campaigns targeted to businesses, health care providers and the American public related to pandemic preparedness are conducted.

And finally, the Pandemic Preparedness and Response Act will ensure that adequate resources are available to address this looming threat.

I hope that my colleagues will join me in supporting this legislation so we may ensure that we do everything possible to prepare and protect Americans from the threat of a global flu pandemic.

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

Mr. President, I rise today to address a serious threat facing our Nation--illegal immigration. Despite successful efforts by me and other Members to increase border patrol forces, add new detention facilities, and improve border monitoring, the problem of individuals entering our country illegally continues to impact communities across the country. Just last year, the number of immigrants entering our country illegally outnumbered those entering through legal means. While legal immigration contributes to the diversity and uniqueness of our society, illegal immigration undermines the system and weakens the legitimate process by which people can enter our country. With the Census Bureau estimating that 10 to 11 million people reside in our country illegally, clearly our strategy in confronting this issue must change.

Immigration and naturalization are constitutionally defined powers granted to the Federal Government. As such, many view the issue of immigration as strictly a Federal burden, to be addressed by Federal legislation, policies, and payment. While immigration policy is certainly initiated at the Federal level, one cannot ignore the inherent truth that the impact of illegal immigration is predominantly manifested in our State and local communities, often in the form of overwhelmed emergency rooms, overburdened school systems, and overcrowded prisons. Our local communities often find themselves with little recourse or ability to address the pervasive and crippling effects of a broken immigration system. These effects, of course, are not confined to our southern border regions,

but rather they reverberate across the country.

The country's immigration system is long overdue for a comprehensive overhaul, and I commend the efforts being made by a number of my colleagues to generate attention to the need for comprehensive immigration reform. Ideas are being proposed to improve avenues for legal immigration, enhance enforcement capabilities, and address the growing presence of illegal immigrants with nationalities other than Mexican. While I applaud these proposals and eagerly await our opportunity to discuss them, I believe it is essential that we recognize the role our State and local communities can have in addressing illegal immigration, particularly when it comes to the area of enforcement. As such, I am introducing legislation today to solidify the right and opportunity of our State and local governments to enforce the law--immigration law.

Historically, the authority for State and local law enforcement officials to enforce immigration law has been limited to the criminal provisions of the Immigration and Nationality Act; these include acts such as physically crossing the border illegally. By contrast, the enforcement of the act's civil provisions, which include apprehension and removal of deportable aliens already in the country, has been strictly a Federal responsibility, with States playing an incidental supporting role. This view was recently reinforced when a community in New Hampshire attempted to prosecute illegal immigrants for criminal trespass but was thwarted when a judge ruled it was constitutionally impermissible, stating that Congress has exclusive jurisdiction on civil immigration issues.

Enforcing the laws of our country should not be confined to Federal authorities when the illegal behavior specifically impacts the State and local communities. Just as State and local officials can arrest, detain, and prosecute for illicit drug violations, so they should be able to for illegal immigration violations. The legislation I propose today would enable State and local officials to arrest, detain, and prosecute illegal immigrants for all Federal immigration violations, both civil and criminal, and would authorize States to create immigration enforcement provisions in accordance with Federal immigration law. My proposal preserves the Federal Government's constitutionally delegated authority to determine immigration status, a determination to which the States would defer. Allowing communities to take enforcement actions based on their own needs, while working within limits set under Federal law, is sound, appropriate policy.

Further, in order to strengthen border security and reduce the strain on local and Federal border officials, my bill allows the Secretary of Homeland Security to create a Volunteer Border Marshal Program The program will assist the Department in securing our borders by using trained, State-licensed peace officers in a volunteer capacity. These volunteers would be assigned to the Border Patrol on temporary missions to identify and control illegal immigration, as well as human and drug trafficking.

In order to properly tackle the problem of illegal immigration, Federal, State, and local authorities must work as partners. Our communities must have the tools necessary to fight it effectively. My legislation will empower States and communities with a new weapon to combat illegal immigration and thereby reinforce our legal naturalization process. I encourage my colleagues to support this sensible approach to addressing this serious problem. I ask unanimous consent that the text of my bill be printed in the Record.

Mr. President, today I am introducing the Strengthen the Earned Income Tax Credit Act of 2005. Since 1975, the EITC has been an innovative tax credit which helps low-income working families. President Reagan referred to the EITC as ``the best antipoverty, the best pro-family, the best job creation measure to come out of Congress.'' According to the Center on Budget and Policy Priorities, the EITC lifts more children out of poverty than any other government program.

It is time for us to reexamine the EITC and determine where we can strengthen it. Census data released in August and the events of Hurricane Katrina reiterated the fact that there is a group of Americans that are not benefiting from the economic recovery. The Census data shows the number of people who work, but live in poverty increased by 563,000. Four million more people were poor in 2004 than in 2001, when the economy hit bottom. The poverty rate in 2004 remains higher than the rate in 2001, the year of the recession.

Hurricane Katrina affected many individuals who were already faced with difficult economic situations. Mississippi, Louisiana, and Alabama are the first, second, and eighth poorest States in the Nation. The income of the typical household in these three States is well below the national average. In the hardest hit counties, 18.6 percent of the population is poor and the national average is 12.4 percent.

Time after time, the Republican controlled Congress has passed tax cuts which are skewed towards those with the most. The Urban Institute- Brookings Institution Tax Policy Center reports that households with incomes of more than $1 million a year--the richest two-tenths of the population--receive tax cuts of an average of $103,000 a year. These individuals do not have to worry about how they will have to pay for a roof over their heads or enough gas to fill the tank. We should not be focused on tax cuts which help those who do not have to worry about living pay check to pay check.

We need to help the low-income workers who struggle day after day trying to make ends meet. They have been left behind in the economic policies of the last 4 years. We need to begin a discussion on how to help those that have been left behind. The Earned Income Tax Credit is the perfect place to start.

The Strengthen the Earned Income Tax Credit Act of 2005 strengthens the EITC by making the following four changes: Reduce marriage penalty; increase the credit for families with

three or more children; slow down the phase-out for individuals with no children; and permanently extend the provision which allows members of the armed forces to include combat pay as income for EITC computations. By making these changes, more individuals and families would benefit from the EITC.

First, the legislation increases marriage penalty relief and makes it permanent. In the way that the EITC is currently structured, many single individuals that marry find themselves faced with a reduction in their EITC once they are married. The tax code should not penalize individuals who marry.

Second, the legislation increases the credit for families with three or more children. This proposal would make the credit more generous for families with 3 or more children. Increasing the credit rate results in an increase in the phase-out range. More families would be able to benefit from the EITC. The poverty level for an adult living with three children is $19,233. Under current law, an adult living with three children and eligible for the maximum EITC with income equivalent to the phase-out income level would still have income below the poverty level. This provision would lift this family above the poverty level. Some 36 percent of all children live in families with at least three children and more than half of poor children live in such families.

Third, the legislation would slow down the phase-out rate for individuals without children. It would result in more individuals without children eligible for the credit. For 2005, an individual with earnings above $11,750 would not be eligible for the EITC. Under the proposal, an individual with earnings above $16,950 would not be eligible for the EITC. The EITC for individuals with no children only offsets a portion of federal taxes. Giving more individuals the EITC would help provide an incentive to work.

Fourth, the Working Families Tax Relief Act of 2004 included a provision which would treat combat pay as earned income for purposes of computing the child credit. This provision expires at the end of the year. This legislation makes this provision permanent. There is no reason why a member of the armed services should lose their EITC when they are mobilized and serving their country.

This legislation will help those who most need our help. It will put more money in their pay check. We need to invest in our families and help individuals who want to make a living by working. We are all aware of our fiscal situation and we should legislate in a responsible manner. It is a time for shared sacrifice. We do not need to extend tax cuts or allow tax cuts to go forward that only benefit those earning over $200,000. We cannot keep adding to the deficit

Thank you for your consideration.

Mr. President, I rise today to talk about a critical issue--the possibility of an avian influenza pandemic.

When I started talking about this 7 months ago, not too many folks paid attention. Perhaps because the shorthand for this looming crisis is the ``bird flu,'' people assume it is just going to get birds and animals sick.

In reality, however, what is at stake here is the potential of a pandemic that we have not seen in the United States since 1918. As has already been stated, our top scientists and medical personnel, including the heads of the NIH, CDC, and the Department of Health and Human Services, all agree that it is almost inevitable that an avian flu pandemic will strike.

The key question is the extent of the damage, especially in terms of lives lost. The answer to this question will, in large measure, depend on our level of preparedness and the amount of resources we are willing to immediately commit to deal with this looming crisis.

After Katrina, I hope we all learned a lesson about the critical value of preparedness.

I rise today to introduce, along with Senators Reid, Bayh, and Kennedy, S. 1821, legislation that dramatically enhances the ability of the United States and international community to prevent and respond to an avian flu pandemic.

The bill we are introducing today--the Pandemic Preparedness and Response Act or PPRA--incorporates much of my AVIAN Act, and has a number of new and important provisions, that will protect Americans from pandemic flu.

The PPRA establishes leadership at the very top level by requiring the President to name a national director for Pandemic Preparedness and Response, who will sit in the executive office. This director will be in charge of all preparedness and response activities at the national level, including coordinating the activities and programs of each Federal agency.

It is not enough for the Department of Health and Human Services and Department of Homeland Security to be ready; we must have a commerce plan, a transportation plan, a diplomatic plan aimed at our foreign partners, and a plan for our military personnel and veterans.

We have asked this director to procure enough antivirals to cover 50 percent of the populations, and sufficient vaccines and other supplies we need for the Strategic National Stockpile. The director will also create a national tracking and distribution system to ensure the fair and equitable allocation of drugs and vaccines when the pandemic strikes.

On the State level, we have asked the Director of the CDC and HRSA to work with States and give them the help they need to make sure they are ready to respond as well. Our success at preventing or containing an outbreak of avian flu will depend on the preparedness of our State and local partners.

Understanding that international collaboration and cooperation is key to surveillance and quick response, we have created an international pandemic fund, and requested the Secretary of State develop and implement a diplomatic policy aimed at the Southeast and East Asian countries. Senator Lugar and I have been hard at work on this last point for months.

Finally, we recognize that this Nation will never have enough vaccines, or the ability to produce sufficient vaccines, if we don't create the incentives for more drug manufacturers to get into the vaccine business. We just have three domestic flu vaccine manufacturers, and that is unacceptable. This bill authorizes the Secretary to enhance vaccine production capacity by creating a guaranteed market for seasonal flu vaccine through a Federal buyback program for unsold doses of seasonal flu vaccine. It also increases public education and outreach activities for Americans, to stimulate demand for the seasonal flu vaccine.

An outbreak of the avian flu could occur in a year, 5 years, 10 years, or if we were incredibly lucky not happen at all. But the one good thing about investing in measures to deal with this looming crisis is--and I will end on this point--if we spend the money now, it will pay dividends, even if this particular strain of the avian flu outbreak does not occur.

Why is this the case?

This is not--no pun intended--a case of Chicken Little.

The risk of some sort of pandemic, and the mutations of flus for which we have no immunity, is almost inevitable. The H5N1 strain may not be the strain that leads to a full blown pandemic. But, another strain could easily come along and cause serious damage in the future.

My point is this: undertaking these measures is going to be a wise investment that will help protect the lives of millions of people here in the United States and across the globe. This legislation gets at the heart of this issue.