Medicare Drug Formulary Protection Act

Mr. President, this is a special day to those of us who serve on the Commerce Committee and have served on the Commerce Committee ever since we have been in the Senate because today is the 10th anniversary of the Telecom Act of 1996. I want to talk about a bill I am introducing today as the Internet and Universal Service Act of 1996, or the NetUSA, if you will.

When I first came here and went to work, I was very much interested in telecommunications. The big reason is in my State of Montana we have only 900,000 people but we have 148,000 square miles. I remind my colleagues, if you drew a straight line from Yaak, MT, to Alzada, MT, it is farther than it is from Chicago to Washington, DC.

So we went to work in telecommunications for the simple reason we had to do something about distances, and we did. But it took almost 6 or 7 years before we came up with a bill that overhauled the old Telco Act of 1935. What we were trying to do is deal with the 1990s technology with a 1930 law and we found it almost impossible to do, so the whole act had to be rewritten.

Since the Telecom Act, the only thing that is certain is change. With change, several trends have emerged, including the development of new technologies, industry consolidation and convergence, and product bundling.

The pace of technological change has been astounding. We have a plethora of new technologies including WiFi and WiMAX, and all new words in telecommunications--wireless Internet access, voice over Internet protocol, which we refer to now as VOIP, the

telephone service using the Internet and broadband over powerline-- BPL--for Internet access via electrical lines.

While the Telecom Act promised industry and technology convergence, only recently is it materializing--with telephone, cable, and wireless companies invading one another's turf. Cable companies are offering television service over the Internet, telephone companies are offering video services over their facilities. New technologies have brought consumers a variety of choices for local, long distance, video, wireless, and Internet services, and many companies are offering bundled services.

The radical transformation of the industry has led some to call for a complete rewrite to the Telecom Act. Central issues in the debate today are the reform of the Universal Service Fund--the USF, reform of intercarrier compensation, franchising issues for video providers, and net neutrality are some among a whole host of other challenges.

As Congress begins working to rewrite the telecom laws, my central focus will be encouraging broadband deployment in every corner of the U.S. and preserving and improving universal service. Broadband deployment is more vital now than ever before, and it is a key to our future. In the 21st century, how do we compete against workers who work in economies of scale and their salaries are a little bit less than ours? We ensure that U.S. workers can obtain broadband services at affordable prices no matter where they live in this great country.

The GAO recently agreed, recommending the Government make more broadband infrastructure investments to improve the U.S. workforce's human capital and skill level. I think the President talked much about this in his State of the Union.

Technology provides a greater chance to live where you want and hold a good job. If a community does not have broadband, it is at a huge competitive disadvantage. It is just that simple.

Even though the technologies were developed in the United States, we still lag behind other countries in the deployment of broadband. We need to provide incentives for companies to continue to expand their broadband facilities and to ensure all Americans have access to the Internet, regardless of where they live--particularly since, although Internet penetration has grown in rural communities, a gap still exists between them and the suburban and urban communities.

One way I will provide such incentive is to continue my support of universal service, although it may take a little bit different direction in the distribution. The nearly 100-year commitment Congress and this Nation have had to USF has been indispensable in providing the same opportunities for rural America to participate in the Nation's education and health care systems that exist for Americans in urban areas, and for every American to participate fully in the Internet economy.

Just as rural electrification in the 1930s led to the surge in economic growth and raised the living standards across rural America, universal service plays the same role in the Internet era. We didn't get electricity on my farm until early in the 1950s. I can remember when you used to go to town and that electricity seemed like a pretty special thing. Had not the Government created the REC, or the rural electrics, I contend that out on the farm we would still be watching television by candlelight.

Without universal service support, phone bills in rural areas across the country, such as Montana, would increase dramatically. Universal service also helps to ensure that schools and libraries receive access to the Internet at rates they can afford. Because of universal service, the Internet now reaches almost all school-age children, no matter where they live. Universal service helped link rural health facilities to urban medical centers, promoting telemedicine. My State of Montana is on the cutting edge of that. Many people in remote communities would not have access to health care just using the Internet. The all- important issue in Montana is where these counties do not even have a doctor. I have 13 counties that have no physician.

For those who say universal service no longer makes sense, or that it should be repealed or scaled back, I encourage them to visit my State and see the fund in action. As one official from a carrier serving a remote corner of Alaska recently commented, universal service is ``more than a line item on a bill. . . . [It] provides a link to the outside world.''

That is not to say that changes do not need to be made in universal service. They do need to be made. It is a different world. Technologies are different and we must respond. As the length of time that new technologies emerge shortens, we must be able to deal with them. As consumers switch to new technologies such as wireless service, e-mail, voice over IP, universal service is slowly taking in less money every year. Therein lies the problem.

At the same time, the amount of money we disburse is increasing. This situation is obviously not sustainable, nor is it acceptable to Congress.

Additionally, we need to ensure the universal service is distributed where it is needed. The Senator from Alabama understands universal service and the impact it has on rural Alabama. In revising universal service to adapt to the changing technology landscape, it is essential to maintain the commitment levels to universal service programs to foster the continued availability of telecom and advanced services in rural communities, and to strengthen and improve the overall fund.

My proposed legislation will speed up deployment of broadband in rural areas and preserve and improve universal service.

Some things my bill seeks to do are to ensure that companies that receive universal service funds will invest in deployed broadband services; to ensure that universal service support contributions are assessed in a fair and competitively neutral manner; ensuring the integrity of the Schools and Libraries Program to deter waste, fraud, and abuse by strengthening the FCC's management and oversight, including imposing sanctions on applicants or vendors who repeatedly and knowingly violate the rules. That is what my bill does, in part. Lastly, improving the effectiveness of rural health care programs. It is unbelievable what we can do for rural health care when we can move massive amounts of information.

I look forward to working with my colleagues to craft creative solutions to these issues that are so vital to our Nation's future. It is the 10th anniversary. It took us almost 50 years--in fact, a little over 50 years, to change the act in 1996. This time, we had to act a little bit quicker because emerging technologies wait for no man. They are there, they are being used, and we must deal with them as they emerge.

I thank the Senator from Alabama for allowing me this little time and I look forward to working with my colleagues on the passage of the universal bill in this body.

I yield the floor.

Mr. President, I rise today to introduce the Hurricane Katrina Working Family Tax Relief Act of 2006. I am proud to introduce this bill, along with Senators Landrieu, Durbin, and Kerry, to keep a promise the President made to rebuild the Gulf Coast in the wake of Hurricane Katrina. Last week the Senate approved a $70 billion bill laden with tax cuts for the wealthy and well-connected. This bill, which costs less than 1 percent as much, uses a proven tool in our tax code--the child tax credit--to extend aid to low-income working families affected by Hurricane Katrina.

Currently, the child credit allows families with qualifying children to receive a credit of $1,000 per child against their Federal income tax. Unfortunately, families that earn less than $11,000 get no benefit from the refundable child credit. That means that a child is left out of the credit even if her parent works full time at minimum wage, which has not increased since 1997. And the child doesn't get the full benefit of the $1,000 credit until her parent earns close to $18,000, or even more if the child has siblings. And if her parents' income does not keep up with inflation, for any reason, the

value of the credit drops or even disappears.

We all know of the devastation wrought by Hurricane Katrina. It will be a long time before families on the Gulf Coast can rebuild their lives. Many of them have seen their homes destroyed, their jobs eliminated, their families separated, and their lives irrevocably changed. Unfortunately, the Federal response so far has been inadequate to get these families effectively back on their feet. We are now learning of thousands of evacuees getting kicked out of their hotel rooms because FEMA has stopped paying the bills.

We can do better for these families. Life was hard for many of them even before Katrina hit. Prior to the hurricane, there were over 2 million people living below poverty in the affected States. In some of the affected counties and parishes, more than 1 in 4 children lived below the poverty level.

In Louisiana, Mississippi, and Alabama, for example, more than 900,000 children under 17-years-old were so poor that they got no child tax credit or only a partial credit. These States had among the highest rates in the Nation of children too poor to get the full credit.

This bill will provide necessary assistance to many of these families. The bill eliminates the income threshold that excluded all children in families with less than $11,000 of income. With this bill, the children of low-income working parents affected by Hurricane Katrina will no longer be denied the child credit.

It's simple: if you work, your kids get a benefit. This bill provides a partial credit starting with the first dollar of a parent's income for families who lived in the areas affected by Hurricane Katrina. You work, your kids get a benefit. If you don't work, no benefit.

That's a commonsense way to support families with children, especially families that have experienced the huge cost--psychological and financial--of a natural disaster.

This bill is also narrowly tailored and fiscally responsible. It provides short-term support targeted at families affected by the hurricane, and its costs can easily be absorbed within the $97 billion already committed to hurricane relief.

I urge my colleagues to support this bill, which will enable hundreds of thousands of this country's most disadvantaged children to see an increase in their credit. Katrina offered a reminder of poverty in our own country. Let's not forget so quickly. We owe it to the American people to do something to provide a chance for our neediest children to rebuild their lives with dignity, hope, and opportunity.

Mr. President, today, I am introducing new legislation to build on the excellent work my colleagues began with the Honest Leadership and Open Government Act.

That bill would close the revolving door between Capitol Hill and lobbying jobs. It would end all lobbyist-funded gifts, meals, and travel, and it would shine a bright light of monitoring and public disclosure on lobbyists' operations, secret conference committee negotiations and last-minute special-interest provisions.

These are important steps forward that should be approved by this Congress and signed into law. The first bill I am introducing now builds on these steps by focusing on enforcement. We can pass all the new ethics rules in the world, but if we don't establish a body that can monitor and enforce those rules, it'll be easy to break them.

My legislation will establish a nonpartisan, independent Congressional Ethics Enforcement Commission that would investigate ethics violations and report their findings to the public.

The idea of an independent Commission to conduct initial investigations is not new. It is modeled on successful efforts in a number of States including Kentucky, Florida, and Tennessee. Similar commissions in those States have a track record of working well and making the ethics enforcement process much more effective.

My commission would be staffed with former judges and former members of Congress, and it would allow any citizen to report a possible ethics violation by lawmakers, staff, or lobbyists. It would have the authority to conduct investigations, issue subpoenas, and provide public reports to the Senate Ethics Committee or Department of Justice so that any wrongdoing can be punished accordingly.

To prevent this Commission from being manipulated for partisan political purposes, the bill establishes stiff sanctions for the filing of frivolous complaints, and prohibits the filing of complaints three months before an election.

Although, the ultimate power to reprimand members would remain with the Ethics Committees in Congress and the Department of Justice, the new Congressional Ethics Enforcement Commission would make these bodies more effective by removing political pressure from the initial fact- finding phase of ethics investigations. In addition, the Commission's independent capacity to issue public findings would encourage the Ethics Committees to act.

I am proud that this legislation has support across the political spectrum, earning the endorsement of both Common Cause and Norm Ornstein of the American Enterprise Institute. Ornstein said this about my enforcement bill: ``This approach to ethics enforcement is just the kind of balanced and reasonable alternative we need. . . . It deserves strong bipartisan support.''

I strongly encourage my colleagues to join me in creating this Commission to restore credibility to the body on the enforcement of ethics.

I am also introducing legislation to build on the CLEAN UP Act (S. 2179) that I introduced last month.

The CLEAN UP Act was written to provide for greater transparency in the legislative process and in conference committees in particular. It has won the support of eight of my colleagues, and I hope the Transparency and Integrity in Earmarks Act that I am introducing today will gain their support, as well as the rest of my colleagues.

The Transparency and Integrity in Earmarks Act would require that information about all earmarks, including the name of the lawmaker requesting it and a justification of why they want it, be disclosed 72 hours before they are considered by the full Senate.

The bill would also place some common-sense limits on earmarks. Members would be prohibited from advocating for an earmark if they have a financial interest in the project or its recipient. Earmarks also could not be used to secure promises from lawmakers in exchange for a vote on a bill. Finally, earmark recipients would have to disclose the amount that they spent on lobbyists in order to get their project passed. These earmark reforms won't solve every abuse, but the idea is this: if you're proud enough about an earmark to issue a press release about it, then you should be able to defend it to the public.

Several of these ideas are contained in a bill introduced by Rep. David Obey. I am grateful for his leadership on this issue in the House.

I know this is not the only proposal on earmarks before the Senate. But I believe this combines the best ideas without creating procedural roadblocks to legitimate projects in our communities. This is a balanced approach that I believe a majority of the Senate can--and should--support. Thank you.

Mr. President, today I am introducing legislation along with Senators Collins, Dorgan, Snowe, Bingaman, Chafee, Clinton, Schumer, Murray and Boxer to ensure that when a senior signs up for a Medicare prescription drug plan, the drugs covered by their plan cannot be removed or changed throughout that year.

Under the legislation, if you sign up for a plan in January, the drugs covered by your plan will continue to be covered the rest of that year.

If you become eligible for Medicare during the year, for instance you turn 65 in May, and you sign up for a plan, the drugs covered by your plan when you enroll in it will continue to be covered the rest of that year.

At the end of the year, if a plan wants to change its coverage, it can do that. The bill does nothing to prevent plans from changing their drug coverage for the coming year. However, that can only happen at the end of the year, at the time all Medicare beneficiaries have the option to switch plans.

Seniors deserve the peace of mind to know that the drug plan they enroll in will cover the drugs it says it will all year.

Under current law, a prescription drug plan can change its formulary as many times as it wants throughout the year so long as it gives notice to its enrollees.

However, seniors have no recourse other than going through a lengthy appeals process if their drug plan suddenly drops their medicines. At the end of that appeals process, there is still no guarantee that seniors will get their drugs.

Under current law, they have to wait until the next open enrollment period which may be as much as nine months away. That is unacceptable.

Seniors can't and shouldn't have to wait all year to obtain lifesaving and life sustaining drugs they thought would be covered by their drug plan.

The bill allows a prescription drug plan to add drugs to its formulary--for instance in cases where a new drug is approved by the FDA or a generic alternative to a brand name drug becomes available.

The bill also allows a prescription drug plan to remove a drug from its formulary if the FDA issues a clinical warning about the drug, if the FDA pulls a drug from the market like in the case of Vioxx, or if the drug has been determined to be ineffective.

But, in those instances, the prescription drug plan must notify the HHS Secretary, affected enrollees, physicians, and pharmacies of the change.

Seniors in California have an overwhelming array of prescription drug plan options. There are at least 110 drug plan options for Californians.

It can take days, if not weeks to determine which plan is best based on your drug needs and health status.

Unless this bill is approved, seniors have no guarantee that their drugs will be covered throughout the year.

I think that is wrong. This legislation will change that.

Some might argue why this bill is necessary now. We are one month into the new Medicare drug benefit and what we have witnessed throughout the Nation is widespread confusion. Seniors are being turned away at the pharmacy counters and they are being incorrectly asked to pay hundreds of dollars for their drugs.

States are absorbing the costs to provide drugs for a Federal program. So far, California has spent more than $18 million of its own money. I support efforts to reimburse States fully for the drug costs they've absorbed as a result of implementation errors by this Administration and I support transitional relief for the so-called ``dual eligible'' Medicare beneficiaries whose transition from Medicaid to Medicare has been disastrous.

The Administration contends that this legislation isn't necessary because plans can't change their formularies without notifying the Centers for Medicare and Medicaid Services (CMS) and enrollees first and that CMS won't allow plans to make changes to their formularies that hurt seniors.

This ``just trust us'' argument being used by the Administration is anything but reassuring, especially given all the major program implementation problems it has caused due to poor planning and inadequate foresight.

I believe seniors deserve more and they deserve the protections guaranteed under this legislation.

We must act now to protect all Medicare beneficiaries from the type of ``bait and switch'' tactics like signing up for a plan thinking you were getting certain drugs only to find out down the road that those drugs were no longer covered.

The bill is about parity for seniors. If seniors are prohibited from changing drug plans except during the annual open enrollment period, then they deserve to know that the plan they are locked in to is also locked in to covering the drugs it said it would.

I urge my colleagues to support this legislation.

Mr. President, today I am introducing legislation along with Senators Collins, Dorgan, Snowe, Bingaman, Chafee, Clinton, Schumer, Murray and Boxer to ensure that when a senior signs up for a Medicare prescription drug plan, the drugs covered by their plan cannot be removed or changed throughout that year.

Under the legislation, if you sign up for a plan in January, the drugs covered by your plan will continue to be covered the rest of that year.

If you become eligible for Medicare during the year, for instance you turn 65 in May, and you sign up for a plan, the drugs covered by your plan when you enroll in it will continue to be covered the rest of that year.

At the end of the year, if a plan wants to change its coverage, it can do that. The bill does nothing to prevent plans from changing their drug coverage for the coming year. However, that can only happen at the end of the year, at the time all Medicare beneficiaries have the option to switch plans.

Seniors deserve the peace of mind to know that the drug plan they enroll in will cover the drugs it says it will all year.

Under current law, a prescription drug plan can change its formulary as many times as it wants throughout the year so long as it gives notice to its enrollees.

However, seniors have no recourse other than going through a lengthy appeals process if their drug plan suddenly drops their medicines. At the end of that appeals process, there is still no guarantee that seniors will get their drugs.

Under current law, they have to wait until the next open enrollment period which may be as much as nine months away. That is unacceptable.

Seniors can't and shouldn't have to wait all year to obtain lifesaving and life sustaining drugs they thought would be covered by their drug plan.

The bill allows a prescription drug plan to add drugs to its formulary--for instance in cases where a new drug is approved by the FDA or a generic alternative to a brand name drug becomes available.

The bill also allows a prescription drug plan to remove a drug from its formulary if the FDA issues a clinical warning about the drug, if the FDA pulls a drug from the market like in the case of Vioxx, or if the drug has been determined to be ineffective.

But, in those instances, the prescription drug plan must notify the HHS Secretary, affected enrollees, physicians, and pharmacies of the change.

Seniors in California have an overwhelming array of prescription drug plan options. There are at least 110 drug plan options for Californians.

It can take days, if not weeks to determine which plan is best based on your drug needs and health status.

Unless this bill is approved, seniors have no guarantee that their drugs will be covered throughout the year.

I think that is wrong. This legislation will change that.

Some might argue why this bill is necessary now. We are one month into the new Medicare drug benefit and what we have witnessed throughout the Nation is widespread confusion. Seniors are being turned away at the pharmacy counters and they are being incorrectly asked to pay hundreds of dollars for their drugs.

States are absorbing the costs to provide drugs for a Federal program. So far, California has spent more than $18 million of its own money. I support efforts to reimburse States fully for the drug costs they've absorbed as a result of implementation errors by this Administration and I support transitional relief for the so-called ``dual eligible'' Medicare beneficiaries whose transition from Medicaid to Medicare has been disastrous.

The Administration contends that this legislation isn't necessary because plans can't change their formularies without notifying the Centers for Medicare and Medicaid Services (CMS) and enrollees first and that CMS won't allow plans to make changes to their formularies that hurt seniors.

This ``just trust us'' argument being used by the Administration is anything but reassuring, especially given all the major program implementation problems it has caused due to poor planning and inadequate foresight.

I believe seniors deserve more and they deserve the protections guaranteed under this legislation.

We must act now to protect all Medicare beneficiaries from the type of ``bait and switch'' tactics like signing up for a plan thinking you were getting certain drugs only to find out down the road that those drugs were no longer covered.

The bill is about parity for seniors. If seniors are prohibited from changing drug plans except during the annual open enrollment period, then they deserve to know that the plan they are locked in to is also locked in to covering the drugs it said it would.

I urge my colleagues to support this legislation.

Mr. President, I am pleased to join Senators Feinstein, Collins and a number of my other colleagues to introduce the Medicare Drug Formulary Protection Act of 2006. This legislation will improve the new Medicare prescription drug benefit by preventing prescription drug plans from unexpectedly dropping coverage of prescription drugs that were covered when seniors enrolled in the plan.

Although seniors enrolled in the new Medicare drug program are only able to change their health plans once a year, nothing prevents insurers from dropping drugs from their plans on a whim. Under current law, prescription drug plans can change which drugs they cover as long as they provide 60 days notice to their enrollees.

It is difficult enough for seniors to navigate the confusion and complexity the Administration has built into the Medicare prescription drug benefit. They ought to be able to do so secure in the knowledge that once they have picked a plan, the plan will not change on them midstream. Seniors need the protection and certainty this legislation extends to them.

I had some hopes for this new Medicare plan, but it has become a complete and utter mess. In North Dakota, we have 41 different plans being offered by 17 different companies, and we have the highest percentage of senior citizens in the nation with no prescription drug coverage.

In North Dakota, 68 percent of seniors still do not have prescription drug coverage. With the sign-up period nearly one-third over, only 9,000 seniors in North Dakota have voluntarily signed up for the program. More than 70,000 seniors still lack coverage.

Other States in the northern Great Plains region are not far behind. Fully 67 percent of South Dakota seniors have no prescription drug coverage and in Montana 65 percent lack coverage. Wyoming also ranks high, with 61 percent of its seniors without prescription drug coverage.

I have asked Secretary Leavitt to dispatch a survey team to North Dakota and neighboring States to determine why enrollment rates in the new Medicare prescription drug program are among the lowest in the nation in our region of the country.

In the meantime, we need to enact the Medicare Drug Formulary Protection Act and other commonsense reforms like the Medicare Informed Choice Act and the Medicare State Recovery Act.

The Medicare Informed Choice Act would extend the enrollment deadline until December 31, 2006. We need to enact this legislation right away. Seniors need more time to evaluate their options. Extending the enrollment deadline will also give Congress time to address some of the problems that have kept more seniors from enrolling in the benefit.

The Medicare State Recovery Act will ensure States are reimbursed for the cost of prescriptions for low-income seniors and people with disabilities who were improperly denied coverage under Medicare.

I want this new benefit to work. That is why I urge my colleagues to support these efforts to improve the benefit and make it less confusing for seniors.