Veterans' Emergency Care Fairness Act of 2009

Mr. President, today we reintroduce the Artist-Museum Partnership Act, and once again, I am pleased to be joined in this effort by my good friend Senator Bennett from Utah.

This bipartisan legislation would enable our country to keep cherished art works in the United States and to preserve them in our public institutions. At the same time, this legislation will erase an inequity in our tax code that currently serves as a disincentive for artists to donate their works to museums and libraries. We have introduced this same bill in each of the past five Congresses, and I am hopeful that this will be our year. In the past, our bill has been included in the Senate-passed version of the 2001 tax reconciliation bill, the Senate-passed version of the 2003 Charity Aid, Recovery, and Empowerment Act, and the Senate-passed version of the 2005 tax reconciliation bill. I would like to thank Senators Bayh, Boxer, Brown, Cochran, Dodd, Durbin, Johnson, Kennedy, Sanders, Schumer, and Whitehouse for cosponsoring this non-partisan bill.

Our bill is sensible and straightforward. It would allow artists, writers, and composers to take a tax deduction equal to the fair market value of the works they donate to museums and libraries. This is something that collectors who make similar donations are already able to do. Under current law, artists who donate self-created works are only able to deduct the cost of supplies such as canvas, pen, paper and ink, which does not even come close to their true value. This is unfair to artists, and it hurts museums and libraries large and small that are dedicated to preserving works for posterity. If we as a nation want to ensure that works of art created by living artists are available to the public in the future for study and for pleasure this is something that artists should be allowed to do.

In my State of Vermont, we are incredibly proud of the great works produced by hundreds of local artists who choose to live and work in the Green Mountain State. Displaying their creations in museums and libraries helps develop a sense of pride among Vermonters, and strengthens a bond with Vermont, its landscape, its beauty, and its cultural heritage. Anyone who has contemplated a painting in a museum or examined an original manuscript or composition, and has gained a greater understanding of both the artist and the subject as a result, knows the tremendous value of these works. I would like to see more of them, not fewer, preserved in Vermont and across the country.

Prior to 1969, artists and collectors alike were able to take a deduction equivalent to the fair market value of a work, but Congress changed the law with respect to artists in the Tax Reform Act of 1969. Since then, fewer and fewer artists have donated their works to museums and cultural institutions. For example, prior to the enactment of the 1969 law, Igor Stravinsky planned to donate his papers to the Music Division of the Library of Congress. But after the law passed, his papers were sold instead to a private foundation in Switzerland. We can no longer afford this massive loss to our cultural heritage. Losses to the public like this are an unintended consequence of the 1969 tax bill that should be corrected.

Congress changed the law for artists more than 30 years ago in response to the perception that some taxpayers were taking advantage of the law by inflating the market value of self-created works. Since that time, however, the government has cut down significantly on the abuse of fair market value determinations.

Under our legislation, artists who donate their own paintings, manuscripts, compositions, or scholarly compositions would be subject to the same new rules that all taxpayer/collectors who donate such works must now follow. This includes providing relevant information as to the value of the gift, providing appraisals by qualified appraisers, and, in some cases, subjecting them to review by the Internal Revenue Service's Art Advisory Panel.

In addition, donated works must be accepted by museums and libraries, which often have strict criteria in place for works they intend to display. The institution must certify that it intends to put the work to a use that is related to the institution's tax exempt status. For example, a painting contributed to an educational institution must be used by that organization for educational purposes and could not be sold by the institution for profit. Similarly, a work could not be donated to a hospital or other charitable institution that did not intend to use the work in a manner related to the function constituting the recipient's exemption under Section 501 of the tax code. Finally, the fair market value of the work could only be deducted from the portion of the artist's income that has come from the sale of similar works or related activities.

This bill would also correct another disparity in the tax treatment of self-created works--how the same work is treated before and after an artist's death. While living artists may only deduct the material costs of donations, donations of those same works after death are deductible from estate taxes at the fair market value of the work. In addition, when an artist dies, works that are part of his or her estate are taxed on the fair market value.

I want to thank my colleagues again for cosponsoring this bipartisan legislation. The time has come for us to correct an unintended consequence of the 1969 law and encourage rather than discourage the donations of art works by their creators. This bill will make a crucial difference in an artist's decision to donate his or her work, rather than sell it to a private party where it may become lost to the public forever.

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

Mr. President, I have sought recognition today to introduce Nino's Act, to provide for the continuance of successful treatment for children who are required to leave National Institutes of Health, NIH, research studies. The NIH provides the greatest medical research in the world on innumerable diseases, including cancer, Alzheimer's, Parkinson's. The NIH also conducts excellent research on diseases that affect children. To conduct that research many brave children must partake in research studies including observational, or natural history, studies and clinical trials to test experimental therapies. This participation is critical to understanding diseases and ultimately finding cures at the NIH.

To participate in the trials and studies, children and their families often make considerable sacrifices. Families will travel great distances to receive treatment that may provide relief from the child's illness. In many cases, parents and doctors will have tried many treatments for the child's disease about which little may be known or understood. The NIH studies represent an opportunity for both the medical community to learn more about the disease and the child to be studied and potentially treated by the best researchers in the world.

When the experimental treatments are successful, it is cause for great celebration for the child. The joy, however, can end quickly as the studies come to end but the children who have been part of them continue to be stricken by these terrible illnesses.

Nino's Act seeks to transition children out of the NIH studies as they end so they don't experience a gap in their important treatment. This legislation continues the successful treatment initiated in NIH studies by providing access to the same prescription drugs for children who are required to leave NIH clinical studies due to the studies ending, researcher leaving, or other reason. Often drugs that are used successfully in these studies have not yet been approved by the Food and Drug Administration or have not been approved for treatment of the child's specific disease. As such, it is nearly impossible for children to get access or insurance coverage for these drugs. This bill makes that access possible by requiring Medicaid to cover the cost of treatment in the event that the children's health insurance does not.

On occasion, insurers will cover the cost of the treatment for these children if they have adequate insurance and the FDA has approved the drug for off-label uses. More often than not, however, children do not have health insurance, or have insufficient insurance to obtain these drugs. As a result, children suffer their diseases without relief from the treatment as established in the clinical NIH studies. To ensure that these children have access to successful care post-study, Nino's Act requires Medicaid to cover the cost of treatment for these children. While Medicaid access is traditionally based on income, due to the importance of these drugs to the child's well-being the income component will be waived. To ensure Medicaid is not unnecessarily covering medication, Nino's Act requires the physicians participating in the research to certify the treatment as successful and essential.

This important issue was introduced to me by Lori Todaro of Newville, PA. Lori's son Nino suffers from Undifferentiated Auto-Inflammatory Periodic Fever Syndrome. This disease takes a devastating toll on those who suffer from it. The auto-inflammatory disease can cause joint inflammation arthritis, Crohns, colitis, irritable bowel syndrome, and cyclical high fevers. Treatment for Periodic Fever Syndrome is experimental at best; Lori and Nino have visited a number of doctors and tried many medications in an effort to control the disease.

In 2003, Nino was fortunate to be selected to take part in an observational study at NIH in Bethesda, Maryland for Undifferentiated Auto-Inflammatory Periodic Fever Syndrome. During the course of the study, Nino was given a new medication and his condition greatly improved. Before he participated in the study he was being fitted for wheelchairs and was home schooled because his symptoms were so disruptive and unpredictable. The NIH treatment allowed him to resume a normal life and enabled him to attend school and play soccer. While Nino's treatment was successful he could not remain part of the study indefinitely and was encouraged to seek coverage for his treatments through his private insurer. Initially, the Todaro's insurer would not agree to cover the cost of the experimental drug and only after an intense lobbying effort by Lori, did the insurer agree to cover Nino's prescriptions.

Nino's story is a successful one, but also serves to highlight the issue that children and their families are facing as they transition out of NIH studies. For many, NIH trials are a source of hope for relief from the worst diseases known to man. The excellent doctors and research teams at NIH make invaluable contributions to our understanding of complex and debilitating diseases. This legislation seeks to amplify the NIH's contributions by allowing America's sickest children to continue their successful treatment under Medicaid coverage. I encourage my colleagues to work with Senator Casey and me to move this legislation forward promptly.

Mr. President, today I introduce legislation to correct a deficiency in the law governing health care for veterans. Under current law, originally enacted on November 30, 1999, a veteran who is enrolled in VA's health care system can be reimbursed for emergency treatment received at a non-VA hospital. However, the statute only permits such VA reimbursement if the veteran has no other outside health insurance, no matter how limited that other coverage might be.

This sole payor provision means that a veteran who has any insurance is not entitled to reimbursement from VA for emergency medical treatment received at a non-VA facility. This is true even if the veteran's insurance policy does not cover the full amount owed.

The bill I am introducing would amend current law so that a veteran who has outside insurance would be eligible for reimbursement in the event that any outside insurance does not cover the full amount of the emergency care. VA would be authorized to cover the difference between the amount the veteran's insurance will pay and the total cost of care. In essence, VA would become the payor of last resort in such cases. This would keep the veteran from being burdened by exorbitant medical fees with no insurance with which to pay them.

In addition to amending current law in a prospective manner, this legislation would also allow the Secretary of Veterans Affairs to retroactively apply this law to emergency treatment received between the effective date of the current law and the date of enactment of the legislation I am introducing today.

One example of the sort of case to which this discretionary authority might apply is one that came to the Committee's attention involving a disabled Vietnam veteran who was in a serious motorcycle accident which led to a medical bill for emergency room care of over $100,000. This veteran, who lived in Illinois, had state mandated auto insurance which included a medical benefit of $10,000. Since he had this other insurance, VA was precluded from paying for his care and the veteran was personally responsible for the difference between the amount covered by his state-required policy and the total charge for his care. Had this veteran

had no insurance at all, VA would have paid the entire amount.

I urge our colleagues to cosponsor this legislation and to work with me and the other members of the Veterans' Affairs Committee to address this gap in VA benefits.

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

Mr. President, today, as Chairman of the Senate Committee on Veterans' Affairs, I introduce the Veterans' Compensation Cost-of- Living Adjustment Act of 2009. This measure would direct the Secretary of Veterans Affairs to increase, effective December 1, 2009, the rates of veterans' compensation to keep pace with the rising cost-of-living in this country. The rate adjustment is equal to that provided on an annual basis to Social Security recipients and is based on the Consumer Price Index.

All of my colleagues on the Committee on Veterans' Affairs, including Senators Burr, Rockefeller, Murray, Sanders, Brown, Webb, Tester, Begich, Burris, Specter, Isakson, Wicker, Johanns, and Graham join me in introducing this important legislation. I appreciate their continued support of our nation's veterans.

Congress regularly enacts an annual cost-of-living adjustment for veterans' compensation in order to ensure that inflation does not erode the purchasing power of the veterans and their families who depend upon this income to meet their daily needs. This past year Congress passed, and the President signed into law, Public Law 110-324, which resulted in a COLA increase of 5.8 percent for 2009. The 2010 COLA has not yet been determined.

The COLA affects, among other benefits, veterans' disability compensation and dependency and indemnity compensation for surviving spouses and children. Many of the more than 3 million recipients of those benefits depend upon these tax-free payments not only to provide for their own basic needs, but those of their spouses and children as well. Without an annual COLA increase, these veterans and their families would see the value of their hard-earned benefits slowly diminish, and we, as a Congress, would be neglecting our duty to ensure that those who sacrificed so much for this country receive the benefits and services to which they are entitled.

It is important that we view veterans' compensation, including the annual COLA, and indeed all benefits earned by veterans, as a continuing cost of war. It is clear that the ongoing conflicts in Iraq and Afghanistan will continue to result in injuries and disabilities that will yield an increase in claims for compensation. Currently, there are nearly 3 million veterans in receipt of VA disability compensation.

Disbursement of disability compensation to our nation's veterans constitutes one of the central missions of the Department of Veterans Affairs. It is a necessary measure of appreciation afforded to those veterans whose lives were forever altered by their service to this country.

I urge our colleagues to support passage of this COLA increase. I also ask our colleagues for their continued support for our nation's veterans.

Mr. President, I rise today with Senator Baucus, Senator Lincoln, Senator Burr, and Senator Collins to introduce the Keeping Our Promise to America's Military Veterans Act. Quite simply, my colleagues and I strongly believe that Congress must remain focused on fully supporting our veterans and their families in the 111th Congress. As we begin this new Congress, our legislative priorities should reflect the unending gratitude of the American people for the sacrifices of our veterans and their families in defending the Nation and our way of life.

To date, the war on terrorism has already generated nearly 1 million discharged veterans and their ranks will grow with nearly 300,000 new veterans per year. The Congress must not waver in our commitment of support for their service, as well as the service and sacrifices of each of our citizens who have taken that extra step and donned the uniform of this great Nation. The bill that we are introducing would express the sense of Congress that legislation should be enacted in the 111th Congress to improve the lives of our Nation's veterans and their families and provide them with the opportunity to achieve the American dream, including legislation to assure funding for medical care and for timely and accurate adjudication of all benefit claims, to assure accesses to high quality treatment for PTSD and TBI conditions, and to assure a seamless transition for veterans and their families from military to civilian life.

As we consider legislation for this Congress, I point out, for example, the problem of providing the VA health care system with funding in a timely and predictable manner. With the exception of last year, VA appropriations have historically not met this simple standard. To correct this problem, I have supported, and will continue to support measures to make VA appropriations mandatory, or to provide advance appropriations to the VA. Neither are new budget concepts, but rather a means of achieving timely, predictable, and sufficient funding of VA health care via the current annual appropriations process. I joined with a number of senators in the last Congress, including then-Senator Barack Obama, on legislation to provide advance appropriations to the VA, and will continue to work to this end in the 111th.

Of the many challenges on which this Congress must act in the weeks and months ahead, we believe that it is imperative that we not waver in our support for our Nation's veterans and their families. I sincerely hope that my colleagues will join Senator Baucus, Senator Lincoln, Senator Burr, Senator Collins, and me and offer their support for this important legislation.

Mr. President, today I introduce legislation to correct a deficiency in the law governing health care for veterans. Under current law, originally enacted on November 30, 1999, a veteran who is enrolled in VA's health care system can be reimbursed for emergency treatment received at a non-VA hospital. However, the statute only permits such VA reimbursement if the veteran has no other outside health insurance, no matter how limited that other coverage might be.

This sole payor provision means that a veteran who has any insurance is not entitled to reimbursement from VA for emergency medical treatment received at a non-VA facility. This is true even if the veteran's insurance policy does not cover the full amount owed.

The bill I am introducing would amend current law so that a veteran who has outside insurance would be eligible for reimbursement in the event that any outside insurance does not cover the full amount of the emergency care. VA would be authorized to cover the difference between the amount the veteran's insurance will pay and the total cost of care. In essence, VA would become the payor of last resort in such cases. This would keep the veteran from being burdened by exorbitant medical fees with no insurance with which to pay them.

In addition to amending current law in a prospective manner, this legislation would also allow the Secretary of Veterans Affairs to retroactively apply this law to emergency treatment received between the effective date of the current law and the date of enactment of the legislation I am introducing today.

One example of the sort of case to which this discretionary authority might apply is one that came to the Committee's attention involving a disabled Vietnam veteran who was in a serious motorcycle accident which led to a medical bill for emergency room care of over $100,000. This veteran, who lived in Illinois, had state mandated auto insurance which included a medical benefit of $10,000. Since he had this other insurance, VA was precluded from paying for his care and the veteran was personally responsible for the difference between the amount covered by his state-required policy and the total charge for his care. Had this veteran

had no insurance at all, VA would have paid the entire amount.

I urge our colleagues to cosponsor this legislation and to work with me and the other members of the Veterans' Affairs Committee to address this gap in VA benefits.

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