Medicare Rural Home Health Payment Fairness Act of 2005

Mr. President, it's a privilege to join Senator Frist, Senator Enzi, Senator Gregg, and Senator Bingaman in introducing the Foundation for the National Institutes of Health Improvement Act.

Our bill makes several improvements in the 1990 law that established the Foundation. Most significant, it assures the Foundation at least $500,000 annually from the NIH to support its administrative and operating expenses. These funds will enable the Foundation to use its own resources for the actual support of projects to strengthen NIH programs, rather than raise money for its own expenses. As the bill makes clear, the NIH Director and the Commissioner of Food and Drugs are ex officio members of the Foundation's board of directors.

Congress established the Foundation to raise private funds to support the research of the NIH. For every dollar the Foundation received from the NIH in 2003, it raised $426 in private funds. Since its creation, the Foundation has raised $270 million, or $68 in private support for every dollar from the NIH.

The Foundation is currently managing 37 programs supported by $270 million generated from private contributions. For example, the Edmond J. Safra Family Lodge on the NIH campus gives families of patients receiving in-patient treatment at the NIH Clinical Center a place to stay, at no cost to them.

In addition, the Foundation has formed partnerships with the NIH to develop new cancer treatments, to identify biochemical signs of osteoarthritis and Alzheimer's Disease, and to build on the promise of genomics. Through a public-private partnership, the Foundation helped accelerate the sequencing of the mouse genome. The Foundation is also collecting private funds to study drugs in children. In 2003, Bill Gates announced a gift to the Foundation of $200 million over the next 10 years to support research on global health priorities. Clearly, the Foundation's partnership with the NIH will grow productively in the coming years.

I urge my colleagues in the Senate to support this legislation, so that the Foundation can continue its effective support of the work and mission of the NIH.

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

Mr. President, it is a privilege to join Senator Snowe, Senator Prist, Senator Gregg, and Senator Enzi in introducing the Genetic Information Non-Discrimination Act. Today we take another step in our national journey to a fairer and more just America.

I particularly commend our colleague from Maine, Senator Snowe, for her dedication to this vital issue. Senator Snowe first proposed legislation on genetic discrimination in 1996. Hopefully, the bipartisan momentum we have built up in recent years will produce a consensus bill we can enact into law this year.

Two years ago, we celebrated an accomplishment that once seemed unimaginable--deciphering the entire sequence of the human DNA code. This amazing accomplishment will affect the 21st century as profoundly as the invention of the computer or the splitting of the atom affected the 20th century. But the extraordinary promise of science to improve health and relieve suffering is in jeopardy if our laws fail to provide adequate protections against misuse of genetic information.

Our bipartisan legislation prohibits health insurers from using genetic information to deny health coverage or raise premiums. It bars employers from using genetic information to make employment decisions.

Few kinds of information are more personal or more information than a person's genetic makeup. This information should not be shared by insurers or employers or be used in decisions about health coverage or a job. It should only be used by patients and their doctors to help them make the best possible decisions on diagnosis and treatment.

Breakthroughs in genetic science are bringing remarkable new opportunities for improving health care. But it also carries the danger that genetic information will be used as a basis for discrimination. I hope we can all agree that discrimination on the basis of a person's genetic traits is as unacceptable as discrimination on the basis of race or religion. No American should be denied health insurance or fired from a job because of a genetic test.

The vast potential of genetic knowledge to improve health care may go unfulfilled, if patients fear that information about their genetic characteristics will be used against them. Congress has a responsibility to guarantee

that genetic information remains private and is not used for improper purposes.

Experts in genetics are united in calling for strong protections to prevent this misuse and abuse of science. The HHS advisory panel on genetic testing--with experts in law, science, medicine, and business-- recommended unambiguously that Federal legislation is needed to prohibit discrimination in employment or health insurance based on genetic information. Last fall, witnesses testified about their first hand accounts of genetic discrimination. Heidi Williams' children were denied health insurance because they were carriers for a genetic disorder. Phil Hardt's children feared discrimination so much that they sought genetic tests in secret, paying out of their own pockets and not using their real names.

Francis Collins, the leader of the NIH project to sequence the human genome, said, ``Genetic information and genetic technology can be used in ways that are fundamentally unjust. Already, people have lost their jobs, lost their health insurance, and lost their economic well-being because of the misuse of genetic information.''

Genetic tests are becoming even cheaper and more widely available. If we don't ban discrimination now, it may soon be routine for employers to use genetic tests to deny jobs to employees, based on their risk for disease.

When Congress enacts clear protections against genetic discrimination in employment health insurance, all Americans will be able to enjoy the benefits of genetic research, free from the fear that their personal genetic information will be used against them. If Congress fails to see that genetic information is used only for legitimate purposes, we will squander the vast potential of genetic research to improve the Nation's health.

Effective enforcement will be essential. It makes no sense to enact legislation giving the American people the promise of protection against this form of discrimination and then deny them the reality of that protection.

President Bush recognizes the seriousness of this problem, and supports a ban on genetic discrimination. In his words, ``genetic information should be an opportunity to prevent and treat disease, not an excuse for discrimination. Just as our Nation addressed discrimination based on race, we must now prevent discrimination based on genetic information.'' I commend the President for his support, and I look forward to working with the administration to see that a strong bill on genetic discrimination is signed into law this year.

It is time for Congress to act, and I urge the Senate to do so without delay.

Mr. President, in his inaugural address and again in the state of the union President Bush promised to take on tyranny around the world. There's one corner of the world where tyranny is the currency of the realm, and where one country stands head and shoulders above the rest for its record of brutality towards its own people and hostility toward its neighbors. That country is Iran.

The lifeblood of the Iranian economy is oil. Oil accounts for 80 percent of Iran's export earnings, almost half of the government's budget and nearly one-fifth of the country's GDP. Every time the price of crude oil rises $1 a barrel, Iran gains about $900 million in export revenues. Crude oil prices rose around $15 over the course of 2004, giving Iran a hurricane-force revenue windfall last year.

Although most U.S. energy companies ceased dealing with Iran when President Clinton imposed sanctions against the regime in 1995, some appear unable to resist the lure of investing in a country that holds 10 percent of the world's proven oil reserves, is OPEC's second largest producer and has the world's second largest natural gas reserves, behind Russia.

In June of last year, for example, a grand jury in the U.S. issued a subpoena to Halliburton seeking information on the work in Iran of its Cayman Islands subsidiary. The Department of Justice has an ongoing criminal investigation into whether Halliburton violated any laws by trading with Iran through a subsidiary. Just a few days ago, Halliburton's CEO announced the company would withdraw its employees from Iran and end its business activities there when it fulfills its ongoing contracts, including a $35 million gas drilling project it just won last month. GE just made a similar announcement about its subsidiary's activities in Iran.

Foreign companies seeking profits from Iran's energy reserves do not have to worry about such impediments as economic sanctions. Indeed, their governments often bless and sometimes lend Them a hand to help win lucrative contracts. When U.S.-based Conoco had to terminate its $550 million contract to develop some offshore oil and gas fields in 1995, France's Total and Malaysia's Petronas jumped in. In March 1999, France's Elf Aquitaine and Italy's Eni/Agip won a $1 billion contract for a secondary offshore recovery program. In April 1999, TotalFinaElf teamed up with Eni and Canada's Bow Valley Energy to develop an offshore oil field. Shell, BP and Lukoil are also frequently mentioned as being in the chase for Iranian oil and gas contracts. The Economist Intelligence Unit estimates Iran has attracted $15-$20 billion in combined foreign investment in hydrocarbons.

Not only are foreign companies heavily invested in Iran's hydrocarbon sector, but Iran ships some 2.6 million barrels of oil a day to Japan, China, South Korea, Taiwan and Europe.

If President Bush is serious about chasing down tyrants around the globe, he should use every possible means. The legislation I am introducing today, the Investor in Iran Accountability Act, would give the President a powerful tool by holding accountable those

who lend the Iranian regime crucial financial assistance by investing in its energy sector.

First, the legislation would shine a spotlight on those American companies, like Halliburton, which have used the loophole in the Iran sanctions act to continue to do business with Iran in the energy sector. The bill would require the Treasury Secretary to publish a list of the United States companies whose subsidiaries continue to do energy deals with Iran. While I personally do not believe there should be any more backdoor deals with Iran, my view is that an informed American public is best equipped to hold these companies accountable.

Second, the legislation would hold up to the light of public accountability those foreign companies that have more than $1 million invested in Iran's energy interests by requiring the Treasury Department to publish a list of those companies as well. Third, the legislation would give American investors for the first time an idea of those U.S. pension and retirement plans, mutual funds and other financial instruments that hold investments in these U.S. and foreign companies by requiring the Treasury Department to publish a list of all public and private U.S. financial interests that hold more than $100,000-worth of investment in these companies. Finally, because unilateral economic sanctions penalize American companies and open the field to foreign companies without inflicting any real economic pain on Iran, the bill directs the President to negotiate an end to foreign investment in Iran's energy sector with the appropriate foreign governments.

Some of my colleagues will remember that in the late 1970s and 1980s Congress struggled with ways to force the South African regime to abandon apartheid. One of the most effective tools in that fight was a public armed with information about which companies were doing business there so that American shareholders could choose to place their money elsewhere. The movement by American investors to rid their portfolios of holdings in companies that persisted in doing business with the apartheid regime in South African proved to be one of the most potent tools in the fight to end apartheid. This legislation will arm American investors with knowledge about which U.S. and foreign companies are supporting Iran's critical energy sector and which U.S. entities hold investments in them. With this knowledge, it is my hope that American investors will choose not to aid and abet the Iranian regime by continuing to hold shares in companies or funds that invest in the Iranian oil and gas sector.

The Iranian regime has made no secret of its desire to attract billions of dollars-worth of foreign investment, particularly to the energy sector. It even adopted a law in January 2003 specifically designed to attract foreign investors. Iran, which has recently discovered some new reserves of 30 billion barrels of crude oil, has ambitious plans to expand oil production from around 3.9 million barrels a day in 2004 to 5 million barrels a day in 2009. But with deteriorating equipment and the natural decline rate of existing wells, it simply cannot achieve those goals without significant foreign help.

In closing, I would point out that the Securities and Exchange Commission has determined that significant corporate operations in countries subject to U.S. economic sanctions, such as Iran, can represent a material risk to United States investors and that such investments should be properly disclosed. My bill would make sure this information is disclosed to the American public.

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

Mr. President, I rise to introduce the Sportsmanship in Hunting Act of 2005. This bill would prohibit the barbaric and unsporting practice of ``canned hunts.'' I am pleased to be joined by my cosponsors, Senators Biden, Kennedy, Levin, Corzine, Feingold, Kohl, Durbin, Schumer, Mikulski, and Akaka.

Canned hunts, also called canned shoots, take place on private land under circumstances that virtually assure a customer of a kill. Although they are advertised under a variety of names, such as hunting preserves or game ranches, canned hunts have two things in common: they charge a fee for killing an animal; and they violate the generally accepted practices of the hunting community, which are based on the concept of ``fair chase.'' Some canned hunts specialize in native species, such as white-tailed deer or elk, while others deal in exotic--non-native--animals that are either bred on-site or bought from dealers or breeders. Exotic animals include surplus animals bought from wild animal parks, circuses, and petting zoos. Many canned hunts offer both native and exotic species to their customers. The Humane Society of the United States estimates that there are more than 1000 canned hunt operations in at least 25 States.

Canned hunts cater to persons who lack the time, and sometimes the skill, for normal sports hunting. They do not require skill in tracking or shooting. For a price, many canned hunts quarantee a shooter a kill of the animal of his or her choice. A wild boar ``kill'' may sell for up to $1,000, a water buffalo for $3,500, and a red deer for up to $6,000.

The ``hunt'' of these tame animals occurs within a fenced enclosure, leaving the animal virtually no chance for escape. Fed and cared for by humans, these animals have often lost their instinctive impulse to flee from shooters who ``stalk'' them. In addition to fencing, canned hunts use other practices to assure their customers a kill. For example, they may bait them, using feeding stations to attract animals and make them easy targets from nearby shooting blinds or stands. These practices are prohibited by many State game commissions.

Canned hunts violate the principles of the sport of hunting. The Boone and Crockett Club, a hunting organization founded by Teddy Roosevelt, defines ``fair chase'' as the ``ethical, sportsmanlike, and lawful pursuit and taking of any free-ranging wild, native North American game animal in a manner that does not give the hunter an improper advantage over such animals.'' Surely exotic animals held in canned hunt facilities can in no way be considered ``free-ranging,'' and the hunters at such facilities clearly have an enormous ``improper advantage'' over animals. As a result, many real hunters are opposed to the practice of canned hunting, believing it to make a mockery of their sport.

Canned hunts are strongly condemned by animal protection groups. Often, in order to preserve the animal as a ``trophy,'' customers will fire multiple shots into nonvital organs, condemning the animal to a slow and painful death. Because the animal cannot escape, the shooter has the time to place his shots. The Fund for animals has launched a national campaign against what it calls a ``cruel, unsporting, and egregious type of hunting.'' The Humane Society says that ``There is no more repugnant hunting practice than shooting tame, exotic mammals in fenced enclosures for a fee in order to obtain a trophy.'' The group believes that Federal legislation is needed ``to halt the cruel and unsportsmanlike business of canned hunts.''

In addition to being unethical, canned hunts may pose a serious health and safety threat to domestic livestock and native wildlife. Accidental escapes of exotic animals from game ranches is not uncommon, posing a danger to nearby livestock and indigenous wildlife. A dire threat to native deer and elk populations in this country is chronic wasting disease, the deer equivalent of cow disease. In some states, experts believe that canned hunts, with their high concentrations of animals, are encouraging transmission of this disease.

In recognition of these threats, several States have banned canned hunting of mammals. Unfortunately, most States lack laws to outlaw this practice. Because interstate commerce in exotic animals is common, federal legislation is essential to control these cruel practices.

My bill is essentially the same as legislation that was introduced in the 108th Congress, S. 2731, and legislation reported by the Judiciary Committee in the 107th Congress and sponsored by Senator Biden, S. 1655. It is similar to legislation that I introduced in the 106th, S. 1345, 105th, S. 995, and 104th, S. 1493, Congresses. The legislation that I am introducing today will target only canned hunt facilities that allow the hunting of exotic (nonnative) mammals. It is important to note what the bill does and does not do: 1. The bill does not regulate the hunting of native mammals, such as white-tail deer; 2. The bill does not regulate the hunting of any birds; 3. The bill protects only exotic (non-native) mammals in areas where they do not have an opportunity to avoid hunters, smaller than 1000 acres; and 4. The bill regulates the conduct of persons who operate canned hunts or traffic in exotic mammals used in such hunts, not the hunters who patronize canned hunt facilities. In summary, my bill would merely ban the transport and trade of non-native, exotic mammals for the purpose of staged trophy hunts.

The idea of a defenseless animal meeting a violent end as the target of a canned hunt is, at the very least, distasteful to many Americans. In an era when we are seeking to curb violence in our culture, canned hunts are certainly one form of gratuitous brutality that does not belong in society. I urge my colleagues to join me in supporting this legislation, which will help end this needless practice.

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

Mr. President, I am pleased to introduce today the Upper Connecticut River Partnership Act. This legislation will help bring recognition to New England's largest river ecosystem and one of our Nation's fourteen American Heritage Rivers.

The purpose of this legislation is to help the communities along the river protect and enhance their rich cultural history, economic vitality, and the environmental integrity of the river.

From its origin in the mountains of northern New Hampshire, the Connecticut River runs over 400 miles and eventually empties into Long Island Sound. The river forms a natural boundary between my home state of Vermont and New Hampshire, and travels through the States of Massachusetts and Connecticut. The river and surrounding valley have long shaped and influenced development in the New England region. This river is one of America's earliest developed rivers, with European settlements going back over 350 years. The industrial revolution blossomed in the Connecticut River Valley, supported by new technologies such as canals and mills run by hydropower.

I am pleased that the entire Senate delegations from Vermont and New Hampshire have cosponsored this bill. For years, our offices and our States have worked together to help communities on both sides of the river develop local partnerships to protect the Connecticut River valley of Vermont and New Hampshire. And, while great improvements have been made to the river, its overall health remains threatened by water and air pollution, habitat loss, hydroelectric dams, and invasive species such as the zebra mussel.

Historically, the people throughout the Upper Connecticut River Valley have functioned cooperatively and the river serves to unite Vermont and New Hampshire communities economically, culturally and environmentally.

Citizens on both sides of the river know just how special this region is and have worked side by side for years to protect it. Efforts have been underway for some time to restore the Atlantic salmon fishery, protect threatened and endangered species, and support urban riverfront revitalization

In 1993, Vermont and New Hampshire came together to create the Connecticut River Joint Commissions--a unique partnership between the states, local businesses, all levels of government within the two states and citizens from all walks of life. This partnership helps coordinate the efforts of towns, watershed managers and other local groups to implement the Connecticut River Corridor Management Plan. This Plan has become the blueprint for how communities along the river can work with one another with Vermont and New Hampshire and with

the federal government to protect the river's resources.

The Upper Connecticut River Partnership Act would help carry out the recommendations of the Connecticut River Corridor Management Plan, which was developed under New Hampshire law with the active participation of Vermont citizens and communities.

This Act would also provide the Secretary of the Interior with the ability to assist the States of New Hampshire and Vermont with technical and financial aid for the Upper Connecticut River Valley through the Connecticut River Joint Commissions. The Act would also assist local communities with cultural heritage outreach and education programs while enriching the recreational activities already active in the Connecticut River Watershed of Vermont and New Hampshire.

Lastly, the bill will require that the Secretary of the Interior establish a Connecticut River Grants and Technical Assistance Program to help local community groups develop new projects as well as build on existing ones to enhance the river basin.

Over the next few years, I hope this bill will help bring renewed recognition and increased efforts to conserve the Connecticut River as one of our nation's great natural and economic resources.

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

Mr. President, I rise today to introduce the Medicare Rural Home Health Payment Fairness Act to extend the additional payment for home health services in rural areas for 2 years. This 5 percent add-on payment is currently scheduled to sunset on April 1st of this year.

Home health has become an increasingly important part of our health care system. The kinds of highly skilled--and often technically complex--services that our Nation's home health caregivers provide have enabled millions of our most frail and vulnerable older and disabled citizens to avoid hospitals and nursing homes and stay just where they want to be--in the comfort and security of their own homes. I have accompanied several of Maine's caring home health nurses on their visits to some of their patients. I have seen first hand the difference that they are making for Maine's elderly.

Surveys have shown that the delivery of home health services in rural areas can be as much as 12 to 15 percent more costly because of the extra travel time required to cover long distances between patients, higher transportation expenses, and other factors. Because of the longer travel times, rural caregivers are unable to make as many visits in a day as their urban counterparts. The Executive Director of the Visiting Nurses of Aroostook in Northern Maine, where I am from, tells me her agency covers 6,600 square miles with a population of only 73,000. Her costs are understandably much higher than other agencies' due to the long distances her staff must drive to see clients. Moreover, her staff is not able to see as many patients in one day as she would like.

Agencies in rural areas are also frequently smaller than their urban counterparts, which means that their relative costs are higher. Smaller agencies with fewer patients and fewer visits mean that fixed costs, particularly those associated with meeting regulatory requirements, are spread over a much smaller number of patients and visits, increasing overall per-patient and per-visit costs.

Moreover, in many rural areas, home health agencies are the primary caregivers for homebound beneficiaries with limited access to transportation. These rural patients often require more time and care than their urban counterparts, and are understandably more expensive for agencies to serve. If the extra rural payment is not extended, agencies may be forced to make decisions not to accept rural patients with greater care needs. That could translate into less access to health care for ill, homebound seniors. The result also would likely be that these seniors would be hospitalized more frequently and would have to seek care in nursing homes, adding considerable cost to the system.

Failure to extend the rural add-on payment will only put more pressure on rural home health agencies that are already operating on very narrow margins and could force some of these agencies to close their doors altogether. Many home health agencies operating in rural areas are the only home health providers in large geographic areas. If any of these agencies were forced to close, the Medicare patients in that region could lose all their access to home care.

The bipartisan legislation that I am introducing today with Senators Feingold, Lugar, Bond, Landrieu, Burns, Murkowski, Thomas, Cochran, Santorum, Lincoln, Jeffords, Conrad and Leahy will help to ensure that Medicare patients in rural areas continue to have access to the home health services they need. I urge all of our colleagues to join us as cosponsors.