A bill to require a pilot program on the use of community-based organizations to ensure that veterans receive the care and benefits they need, and for other purposes.

Mr. President, I rise today to join with my colleagues Senators Durbin, Coleman, and Lincoln, to introduce the landmark Small Business Health Options Program Act of 2008 or the SHOP Act because after more than 10 years of discussion in Congress of this No. 1 priority for America's small businesses, this bill should finally be the vehicle that brings us to the finish line in passing legislation that's critical not only to our small businesses but also to millions of America's uninsured.

This compromise proposal represents the culmination of 15 months of coming together, of reaching across the partisan divide, to fashion a workable solution to pass this year. So I want to thank Assistant Majority Leader Durbin for his steadfast and stalwart leadership on this issue--he has been a true champion in this cause--and Senator Lincoln, my esteemed colleague on the Senate Finance Committee--she and I had pledged to work together on small business health insurance at the start of this Congress--for her remarkable

dedication to making this moment possible. I also thank Senator Coleman, who recently held a Small Business Committee field hearing on health insurance reform in St. Paul, Minnesota, for joining us and for his staunch support of our Nation's small businesses.

As former chair and now ranking member of the Senate Small Business Committee, if there is one concern I have heard time and again--from small businesses in Maine and across the country--it is the exorbitant cost to small businesses of providing health insurance to their employees. Throughout America, health insurance premiums have increased by a staggering 78 percent since 2001--far outpacing inflation and wage gains. In Maine, annual premiums in the small group market now average an astronomical $4,868 for individual coverage and $14,605 for a family plan. Just recently a group of Maine small businesses told me that, incredibly, the most ``affordable'' insurance policies available to them included a $636 monthly premium with a $2,500 annual deductible

This is just simply unacceptable. And the reality of these unreal increases is that it perpetuates a vicious cycle of spiraling costs and declining access--as fewer and fewer small businesses can afford to offer health insurance to their employees. Today, only 45 percent of our smallest businesses are able to provide this workplace benefit--a 13-percent drop from 2002. No wonder that nearly 9 out of 10 to firms told the National Association of Manufacturers last year that the cost of health insurance is one of their top-three concerns--even above Government regulations and foreign competition. And when you couple all this with the fact there are already around 47 million uninsured in America, shouldn't we be helping to add to the rolls of the insured, rather than the uninsured? What exactly is there not to get when the status quo absolutely makes no sense?

That is why in the 108th and 109th Congresses, when I was chair of the Small Business Committee, I championed a Small Business Health Insurance Plan bill the full Senate considered back in May 2006--thanks largely to the stewardship of Senator Enzi--and we came up just a handful of votes short. At the same time, Senators Durbin and Lincoln advocated for a different approach, the Small Employer Health Benefits Program. Yet, regrettably, Congress has failed to muster the bipartisan support to pass either of these measures--despite overwhelming public support, on both sides of the aisle, to pass something.

Well, the clock has been ticking for far too long for America's small businesses--and with this bill, we believe their hour may have finally arrived because with the SHOP Act, we blend the best of the previous approaches and address the major concerns critics have expressed in a package that both the National Federation of Independent Businesses, the National Association of Realtors, and the Service Employees International Union agree on--and that is what I call a diverse base of support that speaks volumes for this bill's chances for success.

In short, we make health insurance more affordable and accessible by encouraging development of State-based purchasing pools backstopped by a voluntary, nationwide small business risk pool. The SHOP Act maintains the basic premise of allowing small businesses and the self- employed to pool together, across State lines--just as larger employers are able to do--to secure quality coverage that is more affordable, thanks to a reduction in administrative costs, which today account for an astonishing 25 percent of small business premiums--compared to just 10 percent for large employers.

So the creation of these purchasing pools will increase competition among insurers and provide more coverage choices for small businesses. And that is all the more critical as small group insurance markets-- like those in Maine--currently have no real competition. In fact, the largest insurers now control 43 percent of the small group markets, and in Maine, a sum total of 4 large insurers now control 98 percent of the small group market. This cannot be allowed to continue because no competition means higher costs. Higher costs mean no health insurance. And we need more insured in America, not fewer.

Moreover, under the SHOP Act, business and trade associations would serve as health plan ``navigators,'' helping employers and employees alike with enrollment in health insurance plans and in responding to questions and distributing information about SHOP. And to assist small employers who offer health insurance, we provide a targeted tax credit of up to $1,000 for each covered employee, and $2,000 for family coverage--with a bonus credit for employers who contribute more than 60 percent of the premium--encouraging our Nation's smallest businesses to offer health insurance for their employees as a workplace benefit.

But perhaps most significantly, what this bill does that others have not is it resolves the persistent policy concerns that have thwarted previous attempts to pass small business health insurance legislation in the Senate.

As we know, some have voiced concern that small business health insurance plans could offer stripped-down, ``bare-bones'' coverage plans that would leave out such key benefits as cancer screenings, diabetic supplies, mammograms, and maternity care. Well, we agree and we address this concern by requiring SHOP's nationwide plans to meet or exceed a minimum benefit ``floor'' to be developed by the nonpartisan and highly respected National Academies of Science's Institute of Medicine--based on clinically appropriate and affordable practices in today's small group market. So this issue of coverage should no longer be a legitimate roadblock.

Others have said that small business health insurance legislation could drive up premium costs for all those who don't participate in these new small business plans because these plans would be playing by different and more advantageous rules. They have been concerned that, as a result, companies would set up plans that would attract a healthier pool of individuals--who would pay lower premiums--while potentially relegating the less healthy to existing group or individual plans that would then have to raise premiums.

So we worked closely with the nonpartisan National Association of Insurance Commissioners to create strong incentives for states to ensure a level playing field for all plans--both inside and outside of SHOP. We say, if you want the small businesses in your State to be eligible for that targeted tax credit of up to $1,000 for individual employees and $2,000 for family coverage that's included in our bill, you must have rules prohibiting ``health status'' as a factor for varying insurance and reducing excessive variations for other factors. As an additional benefit to the self-employed, States must also ensure that those individuals have the option to purchase a small group plan-- rather than being left with only the far more expensive option of the individual insurance market.

Still others have expressed concerns about a potential role of the Federal Government in insurance regulation, which has traditionally been left to the States. So under the SHOP Act, we ensure that State insurance commissioners--not the Federal Government--would handle all consumer complaints about health plans and would be responsible for ensuring that all SHOP health plans operating in their State meet State requirements for financial solvency and for grievance claim and appeals procedures.

In conclusion, for all of these reasons I firmly believe they Small Business Health Options Program Act represents our best hope for achieving passage this Congress. By addressing the major concerns about previous legislation, frankly there is now no longer any good reason we cannot make it happen. I look forward to working with Chairman Baucus and Ranking Member Grassley on the Finance Committee to consider this bipartisan measure, so it can be passed by the full Senate.

Mr. President, I rise today, on the 1-year anniversary of the Supreme Court's landmark Massachusetts v. EPA decision on global warming pollution, to introduce the Greenhouse Gas Endangerment Finding Deadline and California Waiver Reconsideration Act. The bill would force the EPA and this administration to act--at long last--against global warming.

This legislation will impose two significant deadlines on the Environmental Protection Agency.

First, the legislation gives EPA 60 days to respond to the Massachusetts v. EPA ruling.

Second, this bill requires EPA to reconsider its unprecedented decision to deny the State of California a Federal waiver that would have allowed the State to limit tailpipe greenhouse gas pollution from cars and trucks.

Unfortunately, deadlines for EPA action are necessary in both cases.

In its landmark Massachusetts v. EPA ruling, issued 1 year ago today, the Supreme Court gave EPA a specific task: Determine whether the emissions of greenhouse gases endanger public health and welfare, and then comply with the Clean Air Act requirements that result from this determination.

Yet 1 year later, EPA has done nothing. EPA Administrator Johnson pledged to act by December, but that day came and went.

I wrote to Administrator Johnson in January asking for a timeline for action.

He wrote back to tell me he could not give me one.

Last month, when I asked Mr. Johnson how many people were working on this endangerment finding, he could not tell me if anyone was working on it.

In a March 27, 2008, letter to me and many of my colleagues, EPA indicated that it intends to begin soliciting comments from the public as the Agency ``considers'' regulations of greenhouse gas emissions.

EPA's letter indicates that it does not intend to determine whether greenhouse gases endanger public health and welfare, as the court instructed it to do, anytime in the near future.

Instead EPA's Administrator stated that ``implementing the Supreme Court's decision could affect many sources beyond just the cars and trucks considered by the Court,'' suggesting that the U.S. Supreme Court would have come to a different conclusion had it better understood the Clean Air Act.

The process will not begin until ``later this spring.''

EPA has no further timeline for action, nor has it set a deadline for completion.

The plaintiffs in the Massachusetts v. EPA case today returned to court to compel the EPA to act. This bill is intended to work in tandem with their suit, compelling EPA to take an action, which both the courts and the law indicate should not be unreasonably delayed. No one should interpret this bill as a substitute for the courts taking action to compel EPA to act without delay under existing law. Both the new lawsuit and this bill are prompted by the clear failure of EPA to act on a reasonable timeline.

Bottom Line: Responding to the Supreme Court's remand cannot and should not be delayed for an undefined period of time.

EPA has had a full year to collect public comment and consider the implications of its response, and it has done so. EPA staff told Congress that they spent thousands of hours writing an endangerment finding and proposed regulations this past autumn. A draft has already been submitted to the White House Office of Management and Budget.

This legislation puts EPA on the clock to finish the job it was assigned by the highest court in the land.

The second deadline in this legislation requires the EPA Administrator to reconsider, and either confirm or reject, EPA Administrator Johnson's December decision to deny California a Clean Air Act waiver.

Without the waiver, California and 15 other States are unable to control greenhouse gas emissions from automobiles.

EPA Administrator Johnson denied this waiver even though EPA's legal and technical staff unanimously recommended that the waiver be issued.

EPA's attorneys had told Mr. Johnson that a waiver denial in this case would ``in effect, amend the Clean Air Act by Administrative Action.''

They told him that EPA would be sued and ``was likely to lose suit.''

The decision was made before the legal justification had been written. EPA staff had been cut out of the process entirely.

His official legal document, issued more than 2 months after Mr. Johnson issued the decision, asserts that the waiver was denied based almost entirely on the legislative history of the 1967 Clean Air Act. His legal document made no mention of the fact that Congress rewrote the operative section in 1977.

In hearing after hearing, Mr. Johnson has asserted that he made this decision himself. Apparently he read the law differently than every one of his agency's experts and attorneys--a different reading he has never explained. But even he has acknowledged that the process under which this decision was made was unusual.

I believe that an unusual process led to an unusual result.

This bill would give EPA the opportunity to reconsider this decision. And with this reconsideration we will see whether a normal process will produce a different result.

This legislation sets firm deadlines by which EPA must complete its work. It instructs the administration to act in the face of climate change. It brings an end to the delay and obfuscation that impede progress.

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

Mr. President, I am pleased to introduce legislation today that will help the Department of Veterans Affairs reach out to underserved veterans, through collaboration with community organizations.

The Department of Veterans Affairs is the second largest cabinet level Federal department, operating the Nation's largest health care system. VA provides benefits and health care to millions of veterans and their families every year. Without question, VA helps countless veterans through its various programs every day, largely thanks to its employees, who make it their mission to serve those who served their country honorably.

Unfortunately, while VA makes a positive impact on the veterans it serves, many others are left underserved. Far too often, these are veterans already in difficult circumstances, those who could benefit most from VA support. For example, veterans from rural areas must do without the kind of local support systems urban and suburban veterans often enjoy. Many veterans from racial and ethnic minority groups also remain underserved by VA, regardless of their physical proximity to veterans' programs.

More must be done for these veterans, who look at VA and see a system either out of reach or out of touch. The legislation I have introduced today pursues one potential solution: VA partnerships with community based organizations.

If enacted, this bill would require VA to work with community based organizations to reach out to veterans who are underserved. Five community organizations, chosen by VA, would be selected for pilot partnerships. Special consideration would be given to rural communities and areas with a high proportion of minorities and other underserved veterans. The five pilots, each in partnership with a VA medical center, would focus on providing support to their underserved group by helping servicemembers transition from military service to veteran status, and helping them navigate the complicated veterans' health care and benefits system. Also, the pilot programs would reach out to the families of veterans, in recognition of the central role that families play in helping veterans readjust and reintegrate.

As Mental Health America, the country's oldest and largest mental health nonprofit, has pointed out, America's newest generation of veterans is returning from combat with invisible wounds that require care. These and other complicated injuries place new challenges on VA to provide the quality health care and benefits veterans have earned through their service. I hope that through the partnerships outlined in this legislation, VA will be better able to provide services to veterans who deserve support, yet are underserved.

Mr. President, today I introduce legislation requested by the Secretary of Veterans Affairs, as a courtesy to the Secretary and the Department of Veterans Affairs. Except in unusual circumstances, it is my practice to introduce legislation requested by the administration so that such measures will be available for review and consideration.

This ``by-request'' bill would authorize $1.87 billion in construction projects in various areas of the country in fiscal year 2009. It also would authorize one new polytrauma center in San Antonio, TX, and upgrades to the polytrauma center in Palo Alto, CA.

The bill would also extend and increase the total authorizations for new VA Medical Centers in Denver, CO, and New Orleans, LA.

Finally, this bill authorizes $60 million in leases for 12 outpatient clinics in various States and territories.

I am introducing this bill for the review and consideration of my colleagues at the request of the administration. As chairman of the Committee on Veterans' Affairs, I have not taken a position on this legislation.

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

Mr. President, I rise today to introduce the Rio Grande Pueblos Irrigation Infrastructure Improvement Act of 2008. This legislation is based on recommendations made by the 2000 report by the Bureau of Reclamation and Bureau of Indian Affairs entitled Pueblo Irrigation Facilities Rehabilitation Report. This report identifies the serious needs that exist in rehabilitating Pueblo Indian irrigation infrastructure, and more importantly, the lack of any existing program to meet these challenges.

The 18 Pueblos of the Rio Grande basin have historically sustained themselves through agriculture, irrigating their crops with water from the Rio Grande watershed. However, the number of Pueblo irrigation works in serious disrepair has placed this way of life in jeopardy. In many cases, diversion structures and other facilities are unsafe, barely operable, and wholly inefficient, thereby preventing the irrigation of historical farmland. Despite the time and effort the Pueblo people have committed to operating and maintaining these irrigation systems, the tribes lack the financial and technical resources to carry out the necessary improvements by themselves.

Unfortunately, according to a recent GAO Report on the Bureau of Indian Affairs' irrigation program, it appears that the BIA also lacks the resources necessary to maintain irrigation infrastructure on Indian land. Given this and the BIA's historical lack of attention to the issue, it is clear that the Bureau of Reclamation may be best suited to provide the technical expertise needed to assist the Pueblos. Over the last 5 years, Reclamation has funded a number of water conservation efforts within its irrigation projects in New Mexico. The work that's been done has been highly beneficial, and it's time to include the Rio Grande Pueblos in that effort.

Accordingly, this bill directs the Secretary of the Interior, through the Bureau of Reclamation, to work with the eighteen Pueblos in the Rio Grande basin to assess Pueblo irrigation infrastructure and initiate projects to rehabilitate and repair such infrastructure on Pueblo lands. Moreover, the activity authorized in the bill is consistent with the goals of Reclamation's Water 2025 program. Recognizing the limited resources available within Reclamation, though, the bill directs the Secretary of the Interior to work with BIA, the Natural Resources Conservation Service, and the Army Corps of Engineers to identify opportunities to use the authorities of those agencies to collaborate on projects that make sense to all involved.

By focusing Federal resources and expertise on this problem now, the federal government, as part of its trust responsibility, will help prevent further deterioration of Pueblo irrigation systems and any additional rehabilitation costs in the future. The Rio Grande Pueblos will benefit markedly from increased agricultural productivity, increased water conservation, and overall safer facilities. More importantly however, these improvements have the capacity to assist the Pueblos in sustaining their historical way of life, both economically and culturally. Finally, the overall health of the Rio Grande basin will likely benefit through increased efficiency in water use. For these reasons, I urge my colleagues to support this legislation.

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

Mr. President, I am pleased to introduce legislation today that will help the Department of Veterans Affairs reach out to underserved veterans, through collaboration with community organizations.

The Department of Veterans Affairs is the second largest cabinet level Federal department, operating the Nation's largest health care system. VA provides benefits and health care to millions of veterans and their families every year. Without question, VA helps countless veterans through its various programs every day, largely thanks to its employees, who make it their mission to serve those who served their country honorably.

Unfortunately, while VA makes a positive impact on the veterans it serves, many others are left underserved. Far too often, these are veterans already in difficult circumstances, those who could benefit most from VA support. For example, veterans from rural areas must do without the kind of local support systems urban and suburban veterans often enjoy. Many veterans from racial and ethnic minority groups also remain underserved by VA, regardless of their physical proximity to veterans' programs.

More must be done for these veterans, who look at VA and see a system either out of reach or out of touch. The legislation I have introduced today pursues one potential solution: VA partnerships with community based organizations.

If enacted, this bill would require VA to work with community based organizations to reach out to veterans who are underserved. Five community organizations, chosen by VA, would be selected for pilot partnerships. Special consideration would be given to rural communities and areas with a high proportion of minorities and other underserved veterans. The five pilots, each in partnership with a VA medical center, would focus on providing support to their underserved group by helping servicemembers transition from military service to veteran status, and helping them navigate the complicated veterans' health care and benefits system. Also, the pilot programs would reach out to the families of veterans, in recognition of the central role that families play in helping veterans readjust and reintegrate.

As Mental Health America, the country's oldest and largest mental health nonprofit, has pointed out, America's newest generation of veterans is returning from combat with invisible wounds that require care. These and other complicated injuries place new challenges on VA to provide the quality health care and benefits veterans have earned through their service. I hope that through the partnerships outlined in this legislation, VA will be better able to provide services to veterans who deserve support, yet are underserved.