A bill to amend Public Law 108-67 to correct a provision relating to the conveyance of the Lake Tahoe Basin Management Unit.

Mr. President, today I am proud to file the Medicare Part D Outreach and Enrollment Enhancement Act of 2006. This timely piece of legislation addresses two very targeted administrative issues that have come to light since Medicare's new prescription drug benefit became effective earlier this year. I am also pleased that Senator Bingaman is joining on this bill.

With more than 30 million beneficiaries now receiving coverage through Medicare Part D, the program is well on its way to helping deliver much needed access to lower cost prescription drugs. And with the close of the initial enrollment period on May 15 looming, the Centers for Medicare and Medicaid Services (CMS) and advocacy organizations across the country are working diligently to provide last minute assistance to those beneficiaries still wishing to enroll.

However, even after the May 15 deadline passes, beneficiaries will still need counsel on the program's benefits, including the availability of the low-income subsidy. For instance, dual eligible beneficiaries and those who previously received assistance through a Medicare Savings Program have the ability to change their prescription drug plan monthly. This particularly vulnerable group of beneficiaries likely will need extra assistance in choosing a plan that more appropriately meets their medical and financial needs.

There also are those beneficiaries who will age into Medicare throughout the year. They will be provided an initial enrollment period to choose a prescription drug plan once they turn age 65. And with the first regular enrollment cycle beginning in November, many beneficiaries will need advice as they evaluate new plan options or consider switching plans if their existing coverage has changed. We owe it to our seniors to provide them quality information so they can make the best possible prescription drug plan choice.

That is why I am asking for increased Part D outreach and education funding in the bill I am filing today. State Health Insurance Programs (SHIPs), which provide a range of valuable services, help beneficiaries select quality prescription drug plans, identify additional financial help with their drug costs, and resolve general enrollment difficulties.

This year, CMS supported the outreach work of SHIPs with a $30 million allotment. Despite this funding, there still remains a great need to raise further awareness about the new Part D benefit among beneficiaries and provide them assistance with selecting an

appropriate prescription drug plan. The Outreach and Enrollment Enhancement Act would allocate SHIPs an additional $13.5 million, bringing their total funding to $43.5 million, or, one dollar per Medicare beneficiary. To assure that the work of SHIPs is sufficiently supported in future years, the bill also creates a new funding authorization that is set to increase as the number of Medicare beneficiaries grows.

The legislation I am filing today also provides funding to the Area Agencies on Aging (AAA) and Native American aging programs that have absorbed an increased workload since the passage of the Medicare Modernization Act. In Oregon, the Multnomah County AAA has incurred $30,000 in expenses related to Medicare outreach since the beginning of this year, but they have received very little new funding in return. The bill recognizes the important role AAAs and Native American aging programs play in helping elderly Americans enroll in Medicare by providing new funding in the amount of $6.3 million this fiscal year.

Apart from increased funding for outreach and education, the bill addresses a very targeted problem with the current enrollment process that has recently become apparent. Beneficiaries who believe their income and asset levels may qualify them for extra help with their prescription drug costs may apply for a low-income subsidy (LIS) at any point during the year. If they submit an application to the Social Security Administration (SSA) during an initial enrollment period but do not receive notification of their eligibility before the enrollment deadline, they have one of two options available to them. They could enroll into a prescription drug plan before the deadline not knowing whether they will have to pay all or part of the costs of the monthly premium. This could place a beneficiary in the awkward position if they choose a plan that they ultimately are unable to afford.

Under a recent CMS administrative action, beneficiaries who have applied for the LIS subsidy could choose to delay their enrollment in the program until they receive notification of their eligibility for a subsidy. However, they still would be required to pay a late enrollment penalty. While enrolling late may allow a beneficiary to make a more informed decision regarding their prescription drug plan, it would not be fair to assess them a fee simply because there was administrative delay in processing their LIS application. Both of these scenarios place beneficiaries in an untenable position. For the enrollment process to be successful, beneficiaries need to have as much information available to them as possible so they may choose the prescription drug plan that best meets their preferences.

The Outreach and Enrollment Enhancement Act provides a solution to this dilemma. The legislation creates a special 30-day enrollment period that begins on the day a beneficiary receives a decision regarding their LIS eligibility. Most importantly, the late enrollment penalty that would be imposed upon them under current law would be waived during the special enrollment period, in addition to the time it takes SSA to process their application. This small, yet significant, change to the existing enrollment process will allow LIS beneficiaries sufficient time to effectively consider and evaluate prescription drug plan options with all necessary information. We cannot afford to undermine seniors' trust in Medicare's prescription drug program by penalizing a certain group of beneficiaries for a problem that is created by the federal government.

I understand that many of my colleagues prefer to address administrative issues with Medicare Part D at a later date, so that the initial implementation process can run its full course without undue interference from Congress. While I would agree with that argument in principle, there are a number of existing problems that only serve to tarnish Medicare's image if we allow them to linger much longer. I believe providing additional resources for outreach and educational services and correcting the LIS enrollment issue are two such problems that Congress should address immediately--before the May 15 deadline passes.

The SSA has estimated that 80,000 beneficiaries might not have been notified of their LIS eligibility by the close of the first regular enrollment period. It would be entirely unfair to assess even one of these beneficiaries a late enrollment penalty, when by their understanding, they were playing by the rules CMS and SSA set forth regarding the low-income subsidy.

I ask the Majority Leader and my colleagues to support my call for the Outreach and Enrollment Enhancement Act to be treated as an emergency measure and provide it quick passage in the Senate. By taking up this very targeted measure, Congress can demonstrate to America's seniors that we are committed to the continued success of the Medicare prescription drug program.

Mr. President, I introduce legislation today to protect the state home program and expand the

ability of states and the Department of Veterans Affairs (VA) to care for veterans. I truly believe that the state home program is an incredibly valuable asset as we grapple with how best to care for our aging veterans. The program has proven time and time again that it is cost effective.

VA involvement in the state home program dates back to 1888 when Congress first authorized Federal grants-in-aid for veterans in State homes. Today, there are 119 State-operated Veterans' Homes in 47 States and the Commonwealth of Puerto Rico. State homes provide nursing home care in 114 of these homes and domiciliary care in 52 of these locations.

As many of my colleagues know, the State home program is supported in two ways by VA--construction grants and per diem payments. Subject to available funding, VA provides construction matching-grant funding for up to 65 percent of the cost of constructing or rehabilitating homes, with at least 35 percent covered by State funding commitments.

The per diem portion of the program provides current reimbursement to State homes--currently $63.40 for a day of nursing home care. This amount equates to less than 30 percent of the total cost to provide this care. Yet, VA is currently authorized to provide up to 50 percent of States' costs.

In January of this year, Chairman Craig and I held field hearings in my State of Hawaii. The hearing on the island of Kauai focused exclusively on long-term care in rural settings. We heard from two witnesses who spoke about the benefits of the State home program and ways to improve upon it, so as to specifically care for rural veterans.

Tom Driskill, the President and CEO of Hawaii Health Systems Corporation, testified about the soon-to-be-built State home in Hilo. He said, ``The synergy of a combined Federal and State funding of the home has been the catalyst for making this dream a reality.'' The Hilo home will be Hawaii's first State home and will house 95 beds and will serve veterans throughout the State.

The Committee also heard testimony about an innovative approach to fill significant gaps in long-term care services to veterans due to the nature and geography of certain States. Bob Shaw, the National Legislative Chairman for the National Association of State Veterans' Homes, testified that large State homes are not appropriate for the more remote locations in Hawaii. Instead, he argued, we should look to how Alaska has managed the challenge.

Rather than building large new homes, the State of Alaska is using its own Pioneer Homes, which provide nursing care to older Alaskans, in order to care for veterans. Similarly, Hawaii could use existing beds in the community and deem such beds as part of the State home program. Doing so would trigger per diem payments from VA to help defray the cost of nursing home care.

Accordingly, my legislation would authorize VA to provide construction grants and per diem payments for small long-term care units, approximately 10 to 30 beds, in pre-existing health care facilities. Such units would address gaps in long-term care services for veterans living in remote and rural regions including Alaska, Wyoming, Idaho, Montana, Kansas and other large, rural States.

I am quite proud of the changes we made to VA long-term care as part of the Millennium Act, which provides nursing home care to veterans who are 70 percent or more service-connected. I think we can expand the locations where such mandatory nursing home care is available. Currently, there is no mechanism in current law to permit VA to pay State homes for care provided to service-connected veterans. My legislation would authorize VA to place severely disabled service- connected veterans directly in State homes and would require VA to reimburse State homes for the cost of such care.

The legislation would also authorize severely disabled, service- connected veterans in State homes to receive VA's comprehensive medication benefit. Currently, such veterans are eligible to receive VA's full medication benefit if they are residing in community nursing homes but not if they reside in State homes. We need to ensure equitable coverage of medication needs.

Finally, this legislation mandates consultation and reporting requirements for VA prior to implementation of proposed changes to the current per diem system. Such requirements should include, at a minimum, consultations with Congress, State governments, and State homes. In addition, VA should be required to report to Congress how any such proposed changes would affect the long-term viability of the State home program before any such changes take effect. As part of the FY 06 budget, the Administration proposed dramatic restrictions to current per diem payments so as to only include a small portion of the veterans currently in State homes. Such a proposal, if enacted, would have devastated care in the homes.

Mr. President, we can give States and VA more tools to deal with burgeoning long-term care needs of veterans. I urge my colleagues in the Senate to join me in supporting this legislation.

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

Mr. President, I rise today with Senators Kyl and Sununu to introduce a bill to strike the ethanol import tariff.

With record high gas prices and demand for ethanol growing faster than expected, I believe we need to act now to ease the ethanol supply crunch.

As many of my colleagues know, I have been strongly opposed to the ethanol mandate that was included in the energy bill enacted last August.

Today, more than ever, I believe that the time has come to end unwarranted subsidies to ethanol producers.

They include: $4.5 billion in agricultural subsidies in 2004 alone that benefit corn farmers (Environmental Working Group); a 51 cent per gallon tax credit for ethanol producers; and a 7.5 billion gallon ethanol mandate that was included in the energy bill.

The current 51 cent per gallon subsidy is costing American taxpayers $2 billion per year, and will cost even more after 2012--almost $4 billion per year--when the use of ethanol is mandated to nearly double.

Now that the ethanol mandate is law, it is time for the subsidies to cease.

I believe we need to start by striking the 54 cent per gallon ethanol import tariff.

Ethanol imports are extremely limited, even though production costs for ethanol in foreign countries are significantly lower than in the United States.

For example, according to the Congressional Research Service, Brazilian productions costs are 40 to 50 percent lower than in the United States. Yet the tariff raises the cost of ethanol enough to pose a significant barrier to imports.

It is egregious to put such a high tariff on ethanol importation. It makes it impossible for U.S. consumers to purchase the lowest-cost ethanol.

And with the refineries choosing to phase-out MTBE this year, the demand for ethanol is even greater than was expected.

It is not clear if the domestic supply will be able to meet that growing demand.

Any ethanol supply disruption will hurt drivers on the east and west coasts the most.

Right now, ethanol is produced in the Midwest and must be trucked or railed to the coasts. According to news reports, ethanol delivery from the Midwest is currently being hindered by strong demand for limited rail time and a shortage of trucks and drivers.

If we strike the tariff, refineries can have more economic and efficient access to ethanol.

So, it's time to eliminate this 54 cent tariff and give consumers a break at the pump.

And we are not alone in this effort. Just last week, the President asked that Congress consider eliminating the tariff.

If they are going to be forced to use ethanol, our refineries should have the ability to buy it from the cheapest seller. They should not be constrained by artificial protectionist tariffs.

I hope my colleagues will join with me to strike this tariff.

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

There being no oblection, the text of the bill was ordered to be

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

There being no oblection, the text of the bill was ordered to be