A bill to amend title XIX of the Social Security Act to permit States, at their option, to require certain individuals to present satisfactory documentary evidence of proof of citizenship or nationality for purposes of eligibility for Medicaid, and for other purposes.

Mr. President, over the past few days I have introduced a series of bills that are part of my E4 Initiative, dubbed E4 because of its focus on economy, employment, education, and energy. Today I am introducing two bills that are part of this effort: the Community Revitalization Energy Conservation, CREC, Act of 2009 and the Energy and Technology Advancement, ETA, Act of 2009.

The newest among my E4 bills is the Community Revitalization Energy Conservation, CREC, Act of 2009. This bill will increase the amount of funding available to State and local governments for the rehabilitation and revitalization of the fledgling green economy, and also expand the types of eligible projects to cover energy efficiency improvements to privately owned buildings. While our country is facing its greatest economic challenge since the Great Depression, we have a tremendous opportunity to create jobs critical to addressing the energy challenges we face. The CREC Act amends the recently authorized Qualified Energy Conservation Bond, QECB, program to increase funding for important public-private partnerships to significantly invest in energy efficiency and conservation, a key national priority. It also offers States and local governments the opportunity to create jobs and stimulate their local economies.

First, my bill will more than quadruple the amount of bonds that can be issued under the Qualified Energy Conservation Bond program-- increasing the program from $800 million to $3.6 billion. This will provide the opportunity for private investors to partner with State and local governments to fund energy investments through State and locally issued tax credit bonds. As we give private investors the opportunity to participate in the green economy through Qualified Energy Conservation Bonds, we signal to the market that the Federal Government will continue to affirm the importance of investment in energy efficiency and conservation, as well as the development of new energy technologies. Helping these new energy technologies thrive is not only a promising way to develop the next generation of energy technology to reduce our energy consumption, it will also help to spur job creation as State and local governments embark on capital improvements.

Increasing the size of the program will support funding for eligible projects including energy efficiency improvements of publicly owned buildings; rural development of electricity from renewable sources; research facilities or grants for renewable technologies such as advanced automobile battery technology and nonfossil fuels; mass commuting facilities that reduce energy consumption; or financing qualified energy production projects such as wind, biomass, geothermal, landfill gas, and solar.

Secondly, my bill expands the types of eligible programs to ones that reduce energy consumption in privately owned buildings. It would allow States and local governments to help homeowners and businesses make improvements such as heating-fuel saving measures; electricity-saving measures; on-site renewable energy generating devices; or water-saving measures that reduce the energy use of the owner, renter or water provider. Gains in efficiency savings between 20-30 percent are easily achievable through improving lighting, insulation, HVAC equipment and controls for these items. These measures are often one-time and low maintenance or maintenance free once they have been installed. In terms of costs, implementing efficiency measures only costs about 3 cents per kWh of energy saved while implementing wind and solar projects can cost at least two to three times more.

Importantly, my bill will increase the success of these energy efficiency and conservation programs by ensuring the Qualified Energy Conservation Bond program can be used to promote novel payment structures in order to reduce the prohibitive upfront costs that homeowners and businesses must pay for energy efficiency and conservation upgrades. By eliminating expensive up-front costs for homeowners and businesses, we can eliminate one of the main obstacles to making significant energy efficiency gains. Furthermore, we can virtually eliminate what homeowners and businesses have to pay for the efficiency and conservation upgrades by not increasing their out-of- pocket expenses. For example, States and local governments can work with electric and water utilities to bill individuals or businesses monthly for the cost of the efficiency improvements based on the savings they receive. The payment for the efficiency improvements each month will be no more than the monthly energy-savings realized by the improvements, thereby keeping their monthly payments the same as before the energy improvements.

The Center on Wisconsin Strategy states that buildings account for 40 percent of total U.S. energy consumption, 70 percent of U.S. electricity consumption, and 43 percent of U.S. carbon emissions, a larger share than either transportation or industry. It is possible that the U.S. could realize more than $200 billion in annual savings from improved building efficiency alone. However, one of the challenges associated with implementing building efficiency measures is its prohibitive cost. Unfortunately, poor households devote a disproportionate share of income to home energy costs, often upwards of 10 percent, because they have less income and tend to live in less efficient buildings and use less efficient appliances. Through building retrofits we have the potential to generate about 10 person years of employment in direct installation of efficiency measures and another 3- 4 person years in the production of relevant materials for every $1 million spent on retrofits

Large cities and counties with populations over 100,000 would be eligible for Wisconsin's share, $65.7 million, that my bill would allow for. Eligible local governments in Wisconsin include: Milwaukee, Madison, Green Bay, and the counties of Milwaukee, Dane, Waukesha, Brown, Racine, Outagamie, Kenosha, Winnebago, Rock, Marathon, Washington, Sheboygan, La Crosse, and Walworth.

I commend the city of Milwaukee and the Center on Wisconsin Strategy--they have already begun to develop a

program to address retrofitting residential buildings with energy efficiency measures through Me2--Milwaukee Energy Efficiency. COWS' initial estimates suggest if you could retrofit nearly all of the existing housing stock in Milwaukee, an initial investment of just under $250 million could result in annual energy savings of over $80 million. Examples of other cities that are tackling the issue of energy efficiency in residential buildings include Berkeley, CA; Babylon, NY; and Brookhaven, NY.

All of these efforts to conserve energy require investments in time and money. By combining efforts on two of the challenges that we currently face--energy and employment--we can create great opportunities. Energy efficiency and conservation are in our national interest for our long term economic well-being, for the health and safety of our citizens and the world as we mitigate the effects of climate change, and for our independence and security.

I have urged the Treasury Department to quickly issue regulations for the Qualified Energy Conservation Bonds so the initial program can get up and running. Once regulations are finalized, States and local governments can begin applying to receive an allotment of the bonds to pursue projects that may have been shelved in our struggling economy.

The second energy bill I am introducing as part of my E4 Initiative is the Energy and Technology Advancement Act. This bill will increase partnerships between the Federal Government and businesses to help spur the commercialization of energy, forestry, and other technologies--in other words, to increase the ETA, or estimated time of arrival, for bringing new technologies to market.

Particularly in the area of energy, we must do more to make new energy solutions, like next generation biofuels, a reality. My bill will help make the Federal Government a better business partner for the many businesses that are researching and developing innovative technology solutions our country needs. We are squandering the Federal investment of billions into research and development by not doing enough to prevent new technologies from sitting on the shelf or being shipped to another country. Helping these new energy technologies get off the ground is not only a promising way to develop the next generation of energy technology that will help break our addition to oil, it will also help to spur job creation and enhance rural development.

One obstacle identified by the Forest Service's Wisconsin-based Forest Products Lab which conducts forestry and energy technology research with businesses and others, is lack of Federal support for moving technologies from the research and development phase to commercialization. My bill will bridge this gap by authorizing the U.S. Department of Agriculture, USDA, which includes the Forest Service, to work with businesses and provide access to resources to assist with getting technologies to market.

By encouraging the USDA to act as a ``business incubator,'' we can increase the rate of success and reduce the length of time for bringing technologies to the market. By providing a bridge to move new technologies beyond the research and development phase to commercialization, the Federal Government will accelerate the development of new technologies and create increased opportunities for small businesses, local and State government, and others.

All energy, forestry, and other technologies will benefit from my ETA Act because it will help new technologies come to the market. It does so by promoting the Federal Government as a better business incubator, encouraging the USDA to provide business support services, and authorizing USDA employees and private-sector employees to work together in Federal or private experimental or product facilities. My bill will also increase cooperation between the Federal Government and innovative businesses by encouraging the USDA to allow rental of Federal equipment and property for the development of new technology.

Lastly, a specific partnership encouraged by my Energy and Technology Advancement Act will spur the commercialization of biofuels. My bill requires the USDA to pursue a biorefinery pilot plant that will allow businesses to partner with the Federal Government to test various biofuels technologies derived from a variety of feedstocks, including woody and agriculture waste.

Certainly one of today's greatest challenges--energy--is also one of tomorrow's greatest opportunities. Today, the transportation sector accounts for 70% of our oil consumption. However, there are promising efforts to significantly lessen our dependence on oil by reducing fuel consumption through increased efficiency and by aggressively pursuing renewable fuels, or biofuels. The commercialization of biofuels will also create job opportunities, support rural development and industries such as forestry, and develop the next generation of fuels that are sustainable and from diverse sources.

Given our current dire fiscal situation, it is more important then ever that we are careful stewards of taxpayer dollars. Not only are both of these new bills fully offset, so as not to worsen our current Federal deficit; they actually provide over a billion dollars in deficit reduction. That's yet another reason to pass them, and I look forward to working with my colleagues to do just that.

Mr. President, over the past half year, as the price of a barrel of oil has rocketed into the sky--all the way to $147 a barrel and in 1 day the price escalating $25--there have been a number of Senators on this floor and in committee meetings and in private discussions saying: Why won't people wake up and realize it is not the economic marketplace of supply and demand that is determining the price of oil? Who wants us to believe that? The oil companies, of course. In fact, the price of oil has escalated not because there is a tightness on the world marketplace of demand for oil. Indeed, at the very time of a 6-month period from the last quarter of last year until the first quarter of 2008--that 6-month period when the demand for oil was going down and the supply was going up, which would indicate the price should be going down if supply is greater than demand--exactly the reverse was true. The price kept rocketing to the Moon.

It defied the laws of supply and demand. Yet we had everybody running out saying, ``Oh, it is the tight world marketplace,'' and it was difficult to get people to listen to a group of Senators who said it was because the commodities futures exchanges had been deregulated and, therefore, unregulated oil futures contracts speculation was running wild.

Then, once it got up to $147 a barrel, what happened? The liquidity crisis hit, the economic crisis of confidence hit--not only in America but across the world. A lot of this was precipitated by the faulty mortgages, the subprime mortgages we are now not paying off in the revenue stream because people weren't paying their mortgages. Those mortgages had been bundled into securities and then bought and sold, and a lot of financial institutions, hedge funds, mutual funds and, indeed, big investments for pension funds started dumping those because they needed cash, and they started dumping their positions on oil futures commodities that they had purchased in this speculative frenzy that ran the price up to $147 a barrel. What happened? The exact reverse. The price of oil starts coming down. So what should we do about this? Well, we ought to do what a number of us have been saying: We ought to go back and reregulate what we have jurisdiction over, which is the Commodities Futures Trading Commission.

Now, why was it deregulated? It was deregulated in the dead of night before Christmas in the year 2000, and it was deregulated at the behest of the Enron Corporation. And once they deregulated that commodities futures trading market on energy, it allowed them to go out and speculate on energy contracts. What was the first result? In the early part of this decade we saw it happen in California. We saw the electricity contracts start a runup in speculative bidding, to which it went up--the cost of electricity--by as high as 300 percent in California. Once that started to unravel, then we know what happened: Enron started to unravel with all the shenanigans that had gone on there.

But here we are 7 and 8 years later, after the law was changed, and we haven't been able to get it changed back because people come out here and say: Oh, it is supply and demand in the world market for oil, and they come up with a simple slogan, as if that was going to handle the price of oil when it was hitting $147 and translated into about $4- gallon-gasoline. Their simple little slogan was ``drill baby, drill,'' as if that were going to solve the problem of the price of gasoline and the price of oil.

But now we hear--and people are starting to pay attention--we ought to reregulate this futures commodities trading. Now, what do we mean by regulate? I am talking about simple little things, such as you would have to use the oil that you are bidding on, such as an airline does. It locks in a future price for fuel by bidding on these future oil contracts. An airline, in fact, does use oil. By taking away the regulation, they have removed that ability. Or to give another example of regulation: A Commodities Futures Trading Commission could say you have to put a certain amount of money down if you are going to buy a future oil contract. Instead of getting it with nothing down, you have to put some skin in the game. But if you completely deregulate it, what you leave it to is the speculator to go in and bid that price up and up and up.

Now, this is what we have been saying on the floor of this Senate for the last 6 or 8 months, a number of us--Senator Dorgan, Senator Cantwell, this Senator, and several other Senators--but it has been hard to get an audience that would listen. Well, no less a respected institution than CBS News ``60 Minutes'' last Sunday night broke it open and put it about as clearly as I have ever heard in posing this question: Did speculation fuel oil price swings?

And what they concluded was that 6 months ago, when oil hit its alltime high of $147, and gas was up around $4 a gallon, it created a frenzy that fed into irrational and false claims that the problem was just supply and demand and that the solution was to drill for more oil.

Well, it looks a lot different now. That frenzy that got mixed up in Presidential politics as well, with those simplified mantras of ``drill baby, drill,'' fueled by a slick public relations campaign, that was funded by deep-pocket oil companies. Yet those same oil companies testified in the spring of 2008 that if supply and demand were the sole driver of oil prices, that oil should cost no more than $55 a barrel. We had executives of two of the big major oil companies say the normal laws of supply and demand would say that oil ought to be in the range of $55 to $65 a barrel, and they testified, this Senator thinks, correctly.

So ask yourself: Could supply and demand justify the wild swings in prices? And in that one instance where oil jumped $25 in 1 day for a barrel of oil, ask yourself: Could the new oil demands by China and India, that have needs for new oil products, could that have suddenly caused that price to jump so much in a single day? And the answer, clearly, is: No. It was speculation that caused that bubble to grow. Wall Street investors shifted billions of dollars out of the stock market and into the commodities futures market

and ultimately into oil, and that is what was the biggest driver of running up the price of oil and gasoline.

What is even more powerful in demonstrating the influence of speculators on oil prices is examining what happened to those prices after we in the Senate, and down at the other end of the Capitol in the House, started threatening regulation again. Well, guess what happened. The prices went down. When Wall Street experienced a financial meltdown with the collapse of Lehman Brothers and the near collapse of AIG, prices fell even more as the Wall Street speculators got out of the oil futures markets to the tune of $70 billion. The speculative bubble in commodities, which was not only energy but agricultural commodities, all of a sudden bubble popped.

Demand for oil in the United States is down by 5 percent, but the price of oil is down 75 percent. So we shouldn't be fooled by the drop in prices. Some financial analysts, fortunately, are not fooled by the drop in prices. They are advising investors that low oil prices are a temporary phenomenon and that oil prices will average above $75 a barrel over the next 5 years.

Well, a number of us, months ago, filed a bill to stop the trading of oil and other energy commodities on the unregulated exchanges, and what the bill does is it turns the clock back to a change in law that was pushed by the Enron Corporation, known as the Enron loophole, which opened the way for a flood of speculative money in these commodity markets. I am introducing that bill again today, and I seek our colleagues' support.

We must be vigilant to ensure that Wall Street investors do not take advantage of the lax regulation to reap profits by driving up the price of oil and making driving a lot more expensive for the rest of us. Let us remember that we saw what happened with another form of unregulated financial instruments. That was those insurance policies that had a fancy name, called credit default swaps. They were unregulated. Look what happened: The collapse of AIG that had to come in to the tune of upward of a $100 billion rescue from the Federal Government. I don't believe it is simple coincidence that the same legislation that let those credit default swaps escape regulation also allowed energy traders to conduct their business in the shadows. We need to bring that industry out of the darkness and into the full light of day.

Mr. President, I wish to quote a couple lines from this Sunday's interview on CBS News ``60 Minutes.'' A representative of the Petroleum Marketers Association is interviewed, a Mr. Gilligan, and he says:

Approximately 60 to 70 percent of the oil contracts in the

futures markets are now held by speculative entities, not by

the companies that need oil, not by the airlines, not by the

oil companies, but by investors that are looking to make

money from their speculative positions.

Now, that is a representative of the oil companies that said that. Furthermore, the investigative reporter, Steve Kroft, quotes a fellow named Michael Masters, and he states:

In a five-year period, Masters said the amount of money

institutional investors, hedge funds and the big Wall Street

banks had placed in the commodities markets went from $13

billion to $300 billion. Last year, 27 barrels of crude were

being traded every day on the New York Mercantile Exchange

for every 1 barrel of oil that was actually being consumed in

the United States.

That is Mr. Kroft's analysis on ``60 Minutes,'' and he was referring to a former Wall Street trader named Michael Masters.

I wish to end by further quoting Mr. Kroft from 60 Minutes:

A recent report out of MIT analyzing world oil production

and consumption also concluded that the basic fundamentals of

supply and demand could not have been responsible for last

year's runup in oil prices.

Another quote from an interviewee: ``From quarter four of '07 until the second quarter of '08''--that is a 6-month period--``the Energy Information Administration said that supply went up, worldwide supply went up, and worldwide demand went down . . . This was the period of the spike'' in oil prices ``so you had the largest price increase in history during a time when actual demand was going down and actual supply was going up during that same period. The only thing that makes sense that lifted the price was investor demand''--in other words, the speculators making an artificial demand.

I think it is clear. That is why I am introducing this legislation. I look forward with great optimism to the passage of this kind of legislation.

Mr. President, I ask unanimous consent that the text of the bill and a ``60 Minutes'' transcript be printed in the Record.

Mr. President, today I am proud to introduce The Harriet Tubman National Historical Park and The Harriet Tubman Underground

Railroad National Historical Park Act. I am joined by Mrs. Clinton, Ms. Mikulski, and Mr. Schumer as original co-sponsors. We originally introduced nearly identical legislation last summer, but the press of legislative business did not allow for consideration of this important legislation. This year we will work for its prompt consideration and enactment.

The woman, who is known to us as Harriet Tubman, was born Araminta ``Minty'' Ross approximately 1822 in Dorchester County, Maryland. She spent nearly 30 years of her life as a slave on Maryland's Eastern Shore. As an adult she took the first name Harriet, and when she was 25 she married John Tubman.

Harriet Tubman escaped from slavery in 1849. She did so in the dead of night, navigating the maze of tidal streams and wetlands that are a hallmark of Maryland's Eastern Shore. She did so alone, demonstrating courage, strength and fortitude that became her hallmarks. Not satisfied with attaining her own freedom, she returned repeatedly for more than 10 years to the places of her enslavement in Dorchester and Caroline counties where, under the most adverse conditions, she led away many family members and other slaves to their freedom. Tubman became known as ``Moses'' by African-Americans and white abolitionists. She was perhaps the most famous and most important conductor in the network of resistance known as the Underground Railroad.

During the Civil War, Tubman served the Union forces as a spy, a scout and a nurse. She served in Virginia, Florida, and South Carolina. She is credited with leading hundreds of slaves from those slave States to freedom during those years.

Following the Civil War, Tubman settled in Auburn, NY. There she was active in the women's suffrage movement, and she also established the one of the first incorporated homes for aged African-Americans. In 1903 she bequeathed the home to the African Methodist Episcopal Zion Church in Auburn. Harriet Tubman died in Auburn in 1913 and she is buried there in the Fort Hill Cemetery.

Slaves were forced to live in primitive buildings even though many were skilled tradesmen who constructed the substantial homes of their owners. Not surprisingly, few of the structures associated with the early years of Tubman's life still stand. The landscapes of the Eastern Shore of Maryland, however, remain evocative of the time that Tubman lived there. Farm fields and forests dot the landscape, which is also notable for its extensive network of tidal rivers and wetlands. In particular, a number of properties including the homestead of Ben Ross, her father, Stewart's Canal, where he worked, the Brodess Farm, where she worked as a slave, and others are within the boundaries of the Blackwater National Wildlife Refuge.

Similarly, Poplar Neck, the plantation from which she escaped to freedom, is still largely intact in Caroline County. The properties in Talbot County, immediately across the Choptank River from the plantation, are today protected by various conservation easements. Were she alive today, Tubman would recognize much of the landscape that she knew intimately as she secretly led black men, women and children to their freedom.

In New York, on the other hand, many of the buildings associated with Tubman's life remain intact. Her personal home, as well as the Tubman Home for the Aged, the church and rectory of the Thompson Memorial AME Zion Episcopal Church, and the Fort Hill Cemetery are all extant.

In 1999, the Congress approved legislation authorizing a Special Resource Study to determine the appropriateness of establishing a unit of the National Park Service to honor Harriet Tubman. The Study has taken an exceptionally long time to complete, in part because of the lack of remaining structures on Maryland's Eastern Shore. There has never been any doubt that Tubman led an extraordinary life. Her contributions to American history are surpassed by few. Determining the most appropriate way to recognize that life and her contributions, however, as been more difficult. Eventually, the Park Service came to realize that determined that a Park that would include two geographically separate units would be appropriate. The New York unit would include the tightly clustered Tubman buildings in Auburn. The Maryland portion would include large sections of landscapes that are evocative of Tubman's time and are historically relevant. The Harriet Tubman National Historical Park and The Harriet Tubman Underground Railroad National Historical Park Act, S. 3383, was first introduced on July 31, 2008. The Special Resource Study will be finalized and released in the near future.

The legislation I am introducing today establishes two parks. The Harriet Tubman National Historical Park includes important historical structures in Auburn, New York. They include Tubman's home, the Home for the Aged that she established, the African Methodist Episcopal AME Zion Church, and the Fort Hill Cemetery where she is buried.

The Harriet Tubman Underground Railroad National Historical Park includes historically important landscapes in Dorchester, Caroline, and Talbot counties, Maryland, that are evocative of the life of Harriet Tubman. The Maryland properties include about 2,200 acres in Caroline County that comprise the Poplar Neck plantation that Tubman escaped from in 1849. The 725 acres of viewshed across the Choptank River in Talbot County would also be included in the Park. In Dorchester County, the parcels would not be contiguous, but would include about 2,775 acres. All of them are included within the Blackwater National Wildlife Refuge boundaries or abut that resource land. The National Park Service would not own any of these lands.

The bill authorizes $11 million in grants for the New York properties for their preservation, rehabilitation, and restoration of those resources.

The bill authorizes an additional $11 million in grants for the Maryland section. Funds can be used for the construction of the State Harriet Tubman Park Visitors Center and/or for easements or acquisition of properties inside or adjacent to the Historical Park boundaries.

Finally, the bill also authorizes a new grants program. Under the program, the National Park Service would award competitive grants to historically Black colleges and universities, predominately Black institutions, and minority serving institutions for research into the life of Harriet Tubman and the African-American experience during the years that coincide with the life of Harriet Tubman. The legislation authorizes $200,000 annually for this scholarship program.

Harriet Tubman was a true American patriot. She was someone for whom liberty and freedom were not just concepts. She lived those principles and shared that freedom with hundreds of others. In doing so, she has earned a nation's respect and honor. That is why I am so proud to introduce this legislation, establishing the Harriet Tubman National Historical Park and the Harriet Tubman Underground Railroad National Historical Park.

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

Mr. President I rise today with my colleague Senator Akaka to introduce legislation today designed to make several very important changes to current law to ensure that U.S. citizens receive the Medicaid to which they are entitled.

Since July 1, 2006, most U.S. citizens and nationals applying for or renewing their Medicaid coverage face a new Federal requirement to provide documentation of their citizenship status. Recent reports indicate that tens-of-thousands of U.S. citizens, and in particular children, inappropriately are being denied Medicaid benefits simply because they don't have access to newly required documentation. The articles below and report by the Center on Budget and Policy Priorities highlight this very serious problem. Hospitals, physicians, and pharmacies may not be willing to treat these individuals until they have a source of payment, but they cannot qualify for Medicaid until they produce a birth certificate and ID.

This new Federal requirement was added to Medicaid by the Deficit Reduction Act of 2005, DRA, enacted February 8, 2006. The Tax Relief and Health Care Act of 2006, TRHCA, signed into law December 20, 2006, included some amendments to the DRA citizenship documentation requirement, primarily to exempt certain groups. Prior to enactment of the DRA, states were permitted to use their discretion in requiring such citizenship documentation.

Under Section 6036 of the DRA, citizens applying for or renewing their Medicaid coverage must provide ``satisfactory documentary evidence of citizenship or nationality.'' The DRA specifies documents that are acceptable for this purpose and authorizes the HHS Secretary to designate additional acceptable documents. No Federal matching funds are available for services provided to individuals who declare they are citizens or nationals unless the state obtains satisfactory evidence of their citizenship or determines that they are subject to a statutory exemption.

According to a CRS Report for Congress updated April 15, 2008, ``Based on a recent survey by the Government Accountability Office, GAO, 22 of 44 states report declines in enrollment due to the new citizenship documentation requirement. Based on another survey by the Kaiser Commission on Medicaid and the Uninsured, 13 states report a significant negative impact on enrollment and another 24 states report a modest impact. Among seven states detailed in an earlier report from the Center on Budget and Policy Priorities, only Wisconsin has a data system that

can identify denials and terminations due to a lack of citizenship documentation, and it reports that about 19,000 people had their Medicaid eligibility denied or terminated for this reason between July 31, 2006, and March 1, 2007.''

A second wave study conducted from September 2007-March 2008 by the Department of Health Policy at the George Washington University School of Public Health published October 2008, ``Another distressing finding is the impact the citizenship documentation requirements appear to be having on SCHIP. Many states, for important reasons, use joint applications for both Medicaid and separate SCHIP programs. The effect, however, is to apply the citizenship documentation requirements to both programs, thereby delaying coverage for both groups of children.''

``Even if most or all of the reported Medicaid enrollment declines are due to the citizenship documentation requirement, a key question is whether the people who are being denied, terminated, or deterred from applying are U.S. citizens, rather than unauthorized aliens or other ineligible noncitizens. Of the 22 states reporting enrollment declines to GAO, a majority (16 states) attribute them to Medicaid coverage delays or losses for people who appear to be U.S. citizens.''

It is important to note that citizenship documentation requirements do not affect Medicaid rules relating to immigrants--they apply to individuals claiming to be citizens. Most new legal immigrants are excluded from Medicaid during their first five years in the U.S. and undocumented immigrants remain eligible for Medicaid emergency services only.

The legislation I am introducing would make several very important changes to current law to ensure that U.S. citizens receive the Medicaid to which they are entitled.

First, the legislation would restore citizenship verification to a state option. Specifically, states would be permitted to determine when and to what extent citizenship verification is required of U.S. Citizens. States would also be permitted to utilize the standards most appropriate to the their population as long as such standards were no more stringent than those currently used by the Social Security Administration and includes native American tribal documents when appropriate.

Second, the legislation would ensure that individuals are afforded a reasonable time period to provide citizenship documentation utilizing the same reasonable time period standard that is available to legal immigrants to provide satisfactory evidence of their immigration status.

Third, the legislation protects children who are U.S. citizens by virtue of being born in the United States from being denied coverage after birth because of citizenship verification requirements.

Fourth, the legislation also clarifies ambiguities in Federal law to ensure that these citizen children, regardless of the immigration status of their parents, are treated like all other low-income children born in the United States and are deemed eligible to receive Medicaid services for one year.

Finally, the legislation also ensures that the thousands of citizen children and adults, who were erroneously denied Medicaid coverage, may receive retroactive Medicaid eligibility for coverage they were inappropriately denied because of citizenship verification requirements.

I urge my colleagues in the Senate to support this critical legislation, which protects low-income U.S. citizens from being inappropriately denied Medicaid coverage because of lack of documentation.

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

Mr. President I rise today with my colleague Senator Akaka to introduce legislation today designed to make several very important changes to current law to ensure that U.S. citizens receive the Medicaid to which they are entitled.

Since July 1, 2006, most U.S. citizens and nationals applying for or renewing their Medicaid coverage face a new Federal requirement to provide documentation of their citizenship status. Recent reports indicate that tens-of-thousands of U.S. citizens, and in particular children, inappropriately are being denied Medicaid benefits simply because they don't have access to newly required documentation. The articles below and report by the Center on Budget and Policy Priorities highlight this very serious problem. Hospitals, physicians, and pharmacies may not be willing to treat these individuals until they have a source of payment, but they cannot qualify for Medicaid until they produce a birth certificate and ID.

This new Federal requirement was added to Medicaid by the Deficit Reduction Act of 2005, DRA, enacted February 8, 2006. The Tax Relief and Health Care Act of 2006, TRHCA, signed into law December 20, 2006, included some amendments to the DRA citizenship documentation requirement, primarily to exempt certain groups. Prior to enactment of the DRA, states were permitted to use their discretion in requiring such citizenship documentation.

Under Section 6036 of the DRA, citizens applying for or renewing their Medicaid coverage must provide ``satisfactory documentary evidence of citizenship or nationality.'' The DRA specifies documents that are acceptable for this purpose and authorizes the HHS Secretary to designate additional acceptable documents. No Federal matching funds are available for services provided to individuals who declare they are citizens or nationals unless the state obtains satisfactory evidence of their citizenship or determines that they are subject to a statutory exemption.

According to a CRS Report for Congress updated April 15, 2008, ``Based on a recent survey by the Government Accountability Office, GAO, 22 of 44 states report declines in enrollment due to the new citizenship documentation requirement. Based on another survey by the Kaiser Commission on Medicaid and the Uninsured, 13 states report a significant negative impact on enrollment and another 24 states report a modest impact. Among seven states detailed in an earlier report from the Center on Budget and Policy Priorities, only Wisconsin has a data system that

can identify denials and terminations due to a lack of citizenship documentation, and it reports that about 19,000 people had their Medicaid eligibility denied or terminated for this reason between July 31, 2006, and March 1, 2007.''

A second wave study conducted from September 2007-March 2008 by the Department of Health Policy at the George Washington University School of Public Health published October 2008, ``Another distressing finding is the impact the citizenship documentation requirements appear to be having on SCHIP. Many states, for important reasons, use joint applications for both Medicaid and separate SCHIP programs. The effect, however, is to apply the citizenship documentation requirements to both programs, thereby delaying coverage for both groups of children.''

``Even if most or all of the reported Medicaid enrollment declines are due to the citizenship documentation requirement, a key question is whether the people who are being denied, terminated, or deterred from applying are U.S. citizens, rather than unauthorized aliens or other ineligible noncitizens. Of the 22 states reporting enrollment declines to GAO, a majority (16 states) attribute them to Medicaid coverage delays or losses for people who appear to be U.S. citizens.''

It is important to note that citizenship documentation requirements do not affect Medicaid rules relating to immigrants--they apply to individuals claiming to be citizens. Most new legal immigrants are excluded from Medicaid during their first five years in the U.S. and undocumented immigrants remain eligible for Medicaid emergency services only.

The legislation I am introducing would make several very important changes to current law to ensure that U.S. citizens receive the Medicaid to which they are entitled.

First, the legislation would restore citizenship verification to a state option. Specifically, states would be permitted to determine when and to what extent citizenship verification is required of U.S. Citizens. States would also be permitted to utilize the standards most appropriate to the their population as long as such standards were no more stringent than those currently used by the Social Security Administration and includes native American tribal documents when appropriate.

Second, the legislation would ensure that individuals are afforded a reasonable time period to provide citizenship documentation utilizing the same reasonable time period standard that is available to legal immigrants to provide satisfactory evidence of their immigration status.

Third, the legislation protects children who are U.S. citizens by virtue of being born in the United States from being denied coverage after birth because of citizenship verification requirements.

Fourth, the legislation also clarifies ambiguities in Federal law to ensure that these citizen children, regardless of the immigration status of their parents, are treated like all other low-income children born in the United States and are deemed eligible to receive Medicaid services for one year.

Finally, the legislation also ensures that the thousands of citizen children and adults, who were erroneously denied Medicaid coverage, may receive retroactive Medicaid eligibility for coverage they were inappropriately denied because of citizenship verification requirements.

I urge my colleagues in the Senate to support this critical legislation, which protects low-income U.S. citizens from being inappropriately denied Medicaid coverage because of lack of documentation.

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