Medicare Hearing Health Care Enhancement Act of 2007

Mr. President, I rise today to introduce the Climate Change Adaptation Act of 2007.

Before I describe the merits of this bill, I would like to take a moment to commend many of my colleagues for their ongoing efforts to develop legislative solutions to meet the enormous challenges global warming poses to our Nation and our planet. I feel this bill helps address a somewhat overlooked, but key tool, to tackling this preeminent challenge facing our Nation.

I am proud that Washington State is taking the lead on the issue of global climate change. While my State's contribution to global warming is relatively small--because we are fortunate enough to derive about 70 percent of our electricity from inexpensive, emissions-free hydropower--global warming threatens to seriously impact our economy.

Ironically, one of the primary impacts of global warming on the Pacific Northwest will be to change our rainfall patterns in a way that reduces the amount of water available for hydropower production.

And these changes will not only harm electricity generation, they will also impact billions of dollars of economic infrastructure associated with irrigation systems, municipal water supplies, even ski resorts that depend on our historic snowfall patterns.

Faced with these possibilities, we must ask several simple questions: What are we doing to prepare for these changes? How are predicted sea level rises being incorporated into shoreline restoration projects, siting of public infrastructure, or disaster response plans, among many other examples? What tools do we need to give Federal, State, and local decisionmakers to take climate change into account on long-term, multibillion-dollar decisions?

Unfortunately, we don't have any answers.

As we discovered when I held a hearing on ocean acidification as chair of the Oceans, Atmosphere, Fisheries and Coast Guard subcommittee last May, our Government is ill-equipped to plan for the consequences of global climate change. We simply lack the tools to develop the strategies we need to adapt.

In August, the Government Accountability Office found that the Federal government is not providing Federal agencies with the proper tools or policy mandates to take climate change impacts into account in carrying out their responsibilities to manage public resources.

In September, the National Academy of Sciences concluded there is a tremendous need to improve the delivery of climate change information to Federal, regional, and local levels so they can take climate change impacts into account in planning and managing resources.

The reality is that even if we were somehow able to stop using fossil fuels today, a certain degree of warming and ocean acidification will still occur over the next 2 or 3 decades.

While my top priority is to move our Nation to a clean energy system, we must face the fact that global warming is happening already, and it is only going to get worse.

That is why I am pleased today to be introducing the Climate Change Adaptation Act--a bill to ensure that our government plans for the changes that global warming will inevitably bring. This bill will require the President to develop a national strategy for addressing the impacts that climate change will have on our natural resources. It will also specifically require NOAA to conduct vulnerability assessments on the impacts of climate change on coastal and ocean resources, and to prepare adaptation plans for those resources.

Planning for the future isn't just common sense--it's responsible government.

This bill is complementary to several bills under consideration by the Commerce Committee on which I serve, including the Kerry-Snowe bill that was under discussion at a Commerce Committee hearing earlier today. Their bill contains many provisions I believe are vitally important--including language I authored with Senator Collins on the need for a program to study the threat of abrupt climate change. I'm also proud to work with Senator Lautenberg on legislation combating ocean acidification.

I look forward to working with my colleagues to move all these critical bills out of the committee and through the Senate in the coming weeks.

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

Mr. President, I am pleased to introduce the Medicare Hearing Health Care Enhancement Act with my colleagues, Senators Harkin, Coleman, and Menendez. This legislation is the companion bill to legislation introduced in the House by Representative Mike Ross, with a number of cosponsors.

This legislation will provide Medicare beneficiaries with the same hearing care options available to veterans and Federal employees, including every member of this body. Under this bill, Medicare beneficiaries who experience hearing problems will have the option of going directly to an audiologist, rather than first visiting a physician. This is the policy for the health care programs administered by the Department of Veterans Affairs and the Office of Personnel Management. Direct access works well for our veterans and for Federal employees, including Members of Congress, and direct access should be available to senior citizens in the Medicare program.

More than 31 million Americans have some type of hearing problem, making hearing loss the third most common health problem in the U.S. Many of them are older Americans, and this statistic is fast increasing with the aging of the ``baby boomers.'' Yet half of all hearing impaired persons are under age 65. With 80 to 90 percent of hearing problems not medically or surgically treatable, it seems only reasonable that Medicare patients be allowed to consult with an audiologist without first seeing another health care provider. It is part of regular audiological practice to refer patients for medical management when clinical indicators are present.

In 1992, the Department of Veterans Affairs, VA, changed its health care policy to allow for the option of direct access to a licensed audiologist. The VA reports: ``the policy has provided and continues to provide high quality, cost effective, and successful hearing health care to veterans.'' The VA did not experience increased utilization of audiology services due to the policy change and instead found, ``the policy did not increase the number of visits beyond what would be expected in the aging veteran population.''

In 2003, the Congress in the Appropriations Conference Report number 108-10 recommended that the Center for Medicare and Medicaid Services make this change. We have since learned that CMS does not have the authority to do so under current law. Therefore, I hope that we can all agree that this is a common sense idea whose time has come, and move this legislation forward to enactment.

Direct access would facilitate access to hearing care without expanding the scope of practice for audiologists. This legislation will make it easier for Medicare beneficiaries, particularly in rural America, to have the same high quality hearing care provided by the VA and OPM. It is also important to point out that both the Medicare and Medicaid programs now recognize State licensure as the appropriate standard for determining who is a qualified audiologist.

This legislation enjoys the support of a large number of organizations including the American Academy of Audiology, the American Speech-Language and Hearing Association, the National Association of the Deaf and the National Rural Health Association. I commend this legislation to the attention of my colleagues and urge them to lend their support by cosponsoring this bill.

Mr. President, I am pleased to introduce the Medicare Hearing Health Care Enhancement Act with my colleagues, Senators Harkin, Coleman, and Menendez. This legislation is the companion bill to legislation introduced in the House by Representative Mike Ross, with a number of cosponsors.

This legislation will provide Medicare beneficiaries with the same hearing care options available to veterans and Federal employees, including every member of this body. Under this bill, Medicare beneficiaries who experience hearing problems will have the option of going directly to an audiologist, rather than first visiting a physician. This is the policy for the health care programs administered by the Department of Veterans Affairs and the Office of Personnel Management. Direct access works well for our veterans and for Federal employees, including Members of Congress, and direct access should be available to senior citizens in the Medicare program.

More than 31 million Americans have some type of hearing problem, making hearing loss the third most common health problem in the U.S. Many of them are older Americans, and this statistic is fast increasing with the aging of the ``baby boomers.'' Yet half of all hearing impaired persons are under age 65. With 80 to 90 percent of hearing problems not medically or surgically treatable, it seems only reasonable that Medicare patients be allowed to consult with an audiologist without first seeing another health care provider. It is part of regular audiological practice to refer patients for medical management when clinical indicators are present.

In 1992, the Department of Veterans Affairs, VA, changed its health care policy to allow for the option of direct access to a licensed audiologist. The VA reports: ``the policy has provided and continues to provide high quality, cost effective, and successful hearing health care to veterans.'' The VA did not experience increased utilization of audiology services due to the policy change and instead found, ``the policy did not increase the number of visits beyond what would be expected in the aging veteran population.''

In 2003, the Congress in the Appropriations Conference Report number 108-10 recommended that the Center for Medicare and Medicaid Services make this change. We have since learned that CMS does not have the authority to do so under current law. Therefore, I hope that we can all agree that this is a common sense idea whose time has come, and move this legislation forward to enactment.

Direct access would facilitate access to hearing care without expanding the scope of practice for audiologists. This legislation will make it easier for Medicare beneficiaries, particularly in rural America, to have the same high quality hearing care provided by the VA and OPM. It is also important to point out that both the Medicare and Medicaid programs now recognize State licensure as the appropriate standard for determining who is a qualified audiologist.

This legislation enjoys the support of a large number of organizations including the American Academy of Audiology, the American Speech-Language and Hearing Association, the National Association of the Deaf and the National Rural Health Association. I commend this legislation to the attention of my colleagues and urge them to lend their support by cosponsoring this bill.

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