Floor Statements

Mr. President, today I am introducing the ``Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2005'' to make changes to a rule issued by the Centers for Medicare and Medicaid Services, (CMS) that would threaten the ability of rehabilitation hospitals to continue to provide critical care.

In my home State of Nebraska, Madonna Rehabilitation Hospital in Lincoln is a nationally-recognized premier rehabilitation facility that offers specialized programs and services for those who have suffered brain injuries, strokes, spinal cord injuries, and other rehabilitating injuries. If this rule is not updated, Madonna would not be able to offer the same critical care to its patients as it currently does.

When CMS first looked at whether facilities would qualify as an inpatient rehabilitation facility (IRF), a list of criteria was created to determine eligibility. The criteria, generally referred to as the ``75 Percent Rule,'' were first established in 1984. Initially ten categories were given. When the Rule was revised last year, three categories were added. To qualify as an IRF under the 75 Percent Rule, 75 percent of a facility's patients must be receiving treatment in one of these specified conditions.

On its face, it appeared that CMS expanded the Rule last year by increasing the number of conditions from 10 to 13 and giving facilities a phase-in period to adjust to the changes. Initially the threshold for compliance was set at 50 percent for the first year and continues to rise until it reaches 75 percent in July 2007.

Facilities are struggling to even meet the 50 percent compliance rate in part because the expansion of categories is illusory. The rule will, by CMS' own estimate, shift thousands of patients--both Medicare and non-Medicare--into alternative care settings that may be inappropriate. CMS projected a patient loss of 1,170 admissions in FY 2005. A recent Moran Company report showed that in the first year alone, hospitals have been forced to deny care to between 25,000-40,000 patients to maintain compliance with the new 75 Percent Rule. By the fourth year of the Rule, IRFs will be forced to turn away one out of every three patients in order to operate as a rehabilitation hospital or unit.

My legislation will ensure that patients across America will continue to have access to the rehabilitative care they need, and that experts in this community are organized to advise and make recommendations to Congress and the appropriate Federal agencies based on the realities and challenges facing the rehabilitative field today and in the future. The legislation provides an additional two years at the 50 percent threshold to give facilities additional time to adjust to the new categories and sets up a commission to advise Federal agencies on rehabilitative care and what categories are appropriate to be included in the 75 Percent Rule.

I am pleased that many prestigious organizations have joined me in supporting the legislation. The American Hospital Association, the American Academy of Physical Medicine and Rehabilitation, the Federation of American Hospitals, the American Medical Rehabilitation Providers Association and numerous other associations and advocacy groups have endorsed the legislation. Just as I have heard from patients and medical providers who have experienced problems with this Rule, the members of these associations are also witnessing the devastating effect the Rule is having on those who need this critical care. In addition, Senator Santorum is co-sponsoring this bipartisan effort.

I urge my colleagues to support this legislation, and I look forward to its passage.

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

Mr. President, today I am introducing the ``Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2005'' to make changes to a rule issued by the Centers for Medicare and Medicaid Services, (CMS) that would threaten the ability of rehabilitation hospitals to continue to provide critical care.

In my home State of Nebraska, Madonna Rehabilitation Hospital in Lincoln is a nationally-recognized premier rehabilitation facility that offers specialized programs and services for those who have suffered brain injuries, strokes, spinal cord injuries, and other rehabilitating injuries. If this rule is not updated, Madonna would not be able to offer the same critical care to its patients as it currently does.

When CMS first looked at whether facilities would qualify as an inpatient rehabilitation facility (IRF), a list of criteria was created to determine eligibility. The criteria, generally referred to as the ``75 Percent Rule,'' were first established in 1984. Initially ten categories were given. When the Rule was revised last year, three categories were added. To qualify as an IRF under the 75 Percent Rule, 75 percent of a facility's patients must be receiving treatment in one of these specified conditions.

On its face, it appeared that CMS expanded the Rule last year by increasing the number of conditions from 10 to 13 and giving facilities a phase-in period to adjust to the changes. Initially the threshold for compliance was set at 50 percent for the first year and continues to rise until it reaches 75 percent in July 2007.

Facilities are struggling to even meet the 50 percent compliance rate in part because the expansion of categories is illusory. The rule will, by CMS' own estimate, shift thousands of patients--both Medicare and non-Medicare--into alternative care settings that may be inappropriate. CMS projected a patient loss of 1,170 admissions in FY 2005. A recent Moran Company report showed that in the first year alone, hospitals have been forced to deny care to between 25,000-40,000 patients to maintain compliance with the new 75 Percent Rule. By the fourth year of the Rule, IRFs will be forced to turn away one out of every three patients in order to operate as a rehabilitation hospital or unit.

My legislation will ensure that patients across America will continue to have access to the rehabilitative care they need, and that experts in this community are organized to advise and make recommendations to Congress and the appropriate Federal agencies based on the realities and challenges facing the rehabilitative field today and in the future. The legislation provides an additional two years at the 50 percent threshold to give facilities additional time to adjust to the new categories and sets up a commission to advise Federal agencies on rehabilitative care and what categories are appropriate to be included in the 75 Percent Rule.

I am pleased that many prestigious organizations have joined me in supporting the legislation. The American Hospital Association, the American Academy of Physical Medicine and Rehabilitation, the Federation of American Hospitals, the American Medical Rehabilitation Providers Association and numerous other associations and advocacy groups have endorsed the legislation. Just as I have heard from patients and medical providers who have experienced problems with this Rule, the members of these associations are also witnessing the devastating effect the Rule is having on those who need this critical care. In addition, Senator Santorum is co-sponsoring this bipartisan effort.

I urge my colleagues to support this legislation, and I look forward to its passage.

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

Mr. President, I rise today to honor PFC Eric Paul Woods of Omaha, NE.

Private First Class Woods served his country with the utmost bravery. A graduate of Urbandale High School in Urbandale, IA, Woods moved to Omaha 5 years ago, joining the Army in April 2004 as a medic with the G Troop, 2nd Squadron of the 3rd Army Cavalry. He was based out of Fort Carson, CO. Seven years earlier, Private First Class Woods met his wife Jamie, also of the Des Moines area. The two were wed a year later on their first anniversary as a couple. On March 8, 2005, Private First Class Woods was deployed for his first tour in Iraq.

On July 9, 2005, Private First Class Woods was killed in action while serving courageously in Iraq. While bravely attempting to save the life of a wounded soldier near Tal Afar, Iraq, he sustained fatal wounds as an improvised explosive device detonated near the side of the road. His courage should be an example to all, as days before he turned down an offer to be moved away from the front lines. His dedication to both his fellow soldiers and his country clearly display both his valor and resolve.

Private First Class Woods is survived by his wife Jamie and his 3- year old son Eric Scott, among numerous other friends, family, and countrymen who proudly honor and remember his sacrifice. I would like to offer my sincere thoughts and prayers to Private First Class Woods' family. His selfless commitment to his country will not be forgotten. Private First Class Woods will be remembered as a man who honored, served, and died for the liberties and freedoms of all Americans and Nebraskans.

Mr. President, I thank my colleague from Maine for the opportunity to rise in support of the Collins amendment today. I am also a cosponsor of the bill she and Senator Lieberman have introduced, S. 21, the Homeland Security Grant Enhancement Act of 2005. Each year since the attacks on the Pentagon and World Trade Center, many of us have come to the floor to remind our colleagues that terrorism is not only a threat faced by States with large urban populations but also States with large rural populations. Since September 11, States and communities of all sizes have made great strides in preparing for another possible terrorist attack.

Based on the National Strategy for Homeland Security's principle of shared responsibility, Federal, State, and local governments, together with the private sector and the American people, work in partnership to ensure our first responders are well equipped and well trained. States and local governments are responsible for preparing and implementing multiyear plans to ensure our Nation's first responders receive the equipment and training they require. This year we turn our attention to the fiscal year 2006 Homeland Security appropriations bill following the devastating terrorist attack on our closest ally in the global war on terrorism. The coordinated attacks in London last week remind us that Islamic totalitarianism is still a threat to our democratic values and ideals and not solely confined to the borders of Iraq or the Middle East. The bombings on the subway and bus lines in London underscore the fact that terrorists will attempt to attack us when they choose, how they choose, and where they choose. And because terror can strike us anywhere, it is vitally important that our first responders have the funding they need in order to prepare for most, if not every, imagined threat.

Each year we look for better ways to provide homeland security funding for States, be they large or small. The amendment offered by my colleague from Maine would achieve something that has not happened yet with respect to first responder funding. It would provide much needed predictability for our first responder planners. Because there has never been an authorization for this funding, each year, these programs are subject to great debate and amendments on the Senate floor, leaving our city and State officials without any sort of certainty in their preparedness planning. In the years since the attacks of September 11, 2001, the Federal Government has provided States with a share of available homeland security funds through the State Homeland Security Grant Program, SHSGP. This program has been the primary source of coordinated funding for first responders, allowing States and local governments to build a base capacity by funding essential prevention, preparedness, response, and recovery capabilities. In past years, States have been guaranteed a minimum of .75 percent of these funds.

The Collins amendment would modify the State funding program in three primary ways. First, it would combine three programs into one larger pot of funding. The SHSGP, with the Law Enforcement Terrorism and Prevention Program and the Urban Area Security Initiative, would now become one pool of money to be shared among the States. Second, it would authorize $2.9 billion in total funding for the three programs. This is important because the trend has clearly been to decrease this amount. Last year's bill included $2.7 billion in first responder funding, and this year's underlying Senate bill only includes $1.9 billion for these programs.

Third, it would set the funding formula so that each State would be guaranteed a minimum level of funding, .55 percent of the total funding of the program. The remainder of the funds would be distributed based on risk. This guaranteed funding stream is critical for all of our smaller States. For many of our States, this guaranteed minimum will be most, if not all, of our first responder funding. I am not advocating that homeland security funds be diverted from high risk areas. But, rather, I am saying that rural and smaller States also need assistance in securing their communities and preparing for a possible attack. States set their own priorities when it comes to preparing for terrorist attacks.

Mr. President, our amendment would give the smaller States the ability to have continuity and predictability in budgeting for their plans. I think it suffices to say that our country is only as safe as our weakest vulnerability. We need to make sure every part of the country is prepared, regardless of location or size. The citizens of America expect that everything possible is being done to prevent another terrorist attack, and they expect that if another tragedy were to occur, the response and recovery will be immediate, well coordinated, and well trained.

The Collins amendment will strengthen regional efforts and increase every State's ability to protect both its urban and rural critical infrastructure. Whether it is the protection of an urban shopping mall or the prevention of a rural bioterrorism incident that would affect our food and water supply, these infrastructures in every State must be protected. I urge my colleagues to support this important amendment.

I yield the floor.

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

There being no objection; the bill was ordered to be printed in the Record, as follows:

Mr. President, on June 17, 2005, more than a half-century baseball tradition continues in Omaha, NE. This is the 56th year in a row that Omaha plays host to what is officially named the NCAA Men's College World Series. Of course, baseball fans nationwide know it by its unofficial name--``The Road to Omaha.''

The Men's College World Series features the best teams that college baseball has to offer. Many of the players are the professional superstars of tomorrow. One has even gone on to become President of the United States.

As a student at Yale University, President George H.W. Bush played in the College World Series in Kalamazoo, MI, in 1948, 2 years before the games found their permanent home in Omaha.

In 2001, President George W. Bush came to Omaha to throw out the first ball at Johnny Rosenblatt Stadium. The stadium, named in honor of a former Omaha mayor and avid baseball fan, serves as the home ballpark for the Omaha Royals, which is the Pacific Coast League AAA farm team of the Kansas City Royals.

Since the College World Series came to Omaha in 1950, there have been 799 games played at Rosenblatt Stadium with 5,692,950 fans in attendance. The attendance shows remarkable growth from that first year when fewer than 18,000 fans showed up for the entire series. Today, the average attendance for the entire 10-day event approaches 230,000 with an average per-session attendance of nearly 23,000.

Credit for this phenomenal success story goes to College World Series of Omaha, Inc., a nonprofit organization which has captured the imagination of the people of Omaha, its business leaders, city officials and volunteers.

We are often asked by fans that follow their teams here and are attending their first College World Series, ``Why Omaha?'' The answer is easy. The entire city rolls out the red carpet for visiting teams and their supporters. Baseball fans, most from the Omaha area, fill the stadium for each game. They cheer all participating teams equally, making players, families and fans from other parts of the country feel welcome. Even when hometown favorites, the Nebraska Cornhuskers or Creighton Bluejays make it to the series, fans continue to cheer for teams coming from other States.

Many Omaha supporters take time off from work during the 10-day event, tailgating on the stadium grounds and attending games each day. They will often wait in line all night to buy tickets which remain low in price despite sellouts and the fact that games are telecast nationwide on ESPN and ESPN2. A book of 50 general admission tickets sells for $50. Even box seats for the championship games sell for only $30.

The College World Series in Omaha has become as much of a tradition as baseball itself. Even the name, Omaha, has become synonymous with championship baseball. Instead of referring to it as the College World Series or the NCAA Division I Baseball Championship, teams competing to play here all refer to Regional and Super Regional tournaments as the ``Road to Omaha.''

In the same year that baseball returned to Washington, DC, I am proud that the College World Series returns to Omaha for its 56th consecutive year with contractual assurances that it will remain here at least through 2010.

I'd like to extend a warm Nebraska invitation to all of my colleagues and baseball fans everywhere to come to Omaha from June 17 through 27 to enjoy college baseball's finest tradition. You are certain to enjoy yourselves, and like many of the players who earn the right to participate in the College World Series, you, too, will find yourself part of the ``Road to Omaha'' experience.

Mr. President, I thank the Chair for giving me this brief opportunity to speak about the renewable fuels provisions in the Energy bill. I thank my colleagues, Senators Frist and Reid, for their leadership, and Senators Lugar, Harkin, Talent, and so many others for their efforts in developing this important legislation.

I am here today to support the renewable fuels provision in the Senate Energy bill. This legislation is one of the pillars for economic development for rural America, one segment of the population that lagged behind in the economic surge of the 1990s, yet a segment positioned to play such an integral role in fueling our Nation.

It is rare when legislation benefits all. It is rare when legislation creates only winners. It is clear that the production and use of renewable fuels is a win/win situation--a win for farmers from rural communities, a win for consumers, and a win for the environment. That is why as Governor of Nebraska, I invited other Governors interested in creating a group devoted to the promotion and increased use of ethanol to join me in Nebraska. In September of 1991, we met, and the Governors' Ethanol Coalition emerged. Membership in the coalition doubled from 9 to 19 States during the first year, and now stands at 30 States, with international representatives from Brazil, Canada, Mexico, Sweden, and Thailand--30 States, red and blue States.

First, I mentioned this legislation is a win for farmers in rural communities. Three years ago, we completed the farm bill which at the time was characterized as one very important part of the economic revitalization plan for rural America. Economic stimulus can come in many forms and the production of renewable fuels is certainly a viable option for rural America, especially--and candidly--in my State of Nebraska.

It is as simple as this: Demand for corn to create ethanol raises prices for corn. Demand for sorghum to create ethanol raises prices for sorghum. Demand for soybeans to create biodiesel raises prices for soybeans. Added to the important feature of farm profitability is the idea that increased grain prices result in less assistance to producers under the farm bill in the form of loan deficiency payments and countercyclical payments--yes, less government assistance. Merging the realities of agricultural economics and farm policy into energy legislation is the type of responsible legislation the voters sent us here to enact.

I am unabashedly proud of what my home State has accomplished in this area. Within the State of Nebraska, 11 ethanol plants currently produce 523 million gallons of ethanol per year or 12 percent of the Nation's total. The benefits of the ethanol program in Nebraska don't just involve grain producers. It involves investment in industry, the creation of jobs related to plant construction, operation, and maintenance. It includes permanent jobs at the ethanol facilities and stimulates the economic engines in small rural communities. In Nebraska alone, more than 270 million bushels of corn and grain sorghum is processed at the plants annually. These economic benefits and others have increased each year during the past decade due to plant expansion, employment increases, and additional capital investment.

Next, a win for consumers: A study released by the Consumer Federation of America points out that motorists could be saving as much as 8 cents per gallon of gasoline at the pump if oil refiners would blend more ethanol into their gasoline supplies.

I ask unanimous consent to print in the Record a copy of the Consumer Federation of America Report.

The recent decline in ethanol prices, coupled with surging pump prices for gasoline, have created a market dynamic in which increased ethanol use could help curtail record high gas prices. Consumers in many parts of the country where ethanol can be delivered to existing storage and terminal facilities are not receiving lower cost supplies and are paying as much as 8 cents a gallon more at the pump than they would if oil refiners purchased ethanol to blend. Blending high-priced gasoline with more modestly priced ethanol results in a more affordable final product. By using ethanol, oil refiners have an opportunity to pass along real savings to consumers during this period of high gasoline prices.

The Consumer Federation of America cites several reasons for the dramatic increase in gasoline prices, including tight crude oil inventories, inadequate oil refinery capacity, lack of competition, and the oil industry's increasing market power. In contrast to gasoline prices, ethanol prices have actually fallen during the past 6 months.

As an example, the price of ethanol on the Chicago spot market hit $1.82 per gallon in November 2004 but averaged about $1.18 per gallon last month. At these prices, why don't oil companies blend more ethanol to lower consumer prices? We have an opportunity to see that consumers benefit from cleaner burning, affordable, and domestically produced fuel.

Finally, a win for the environment: For environmental and health concerns, the Nation decided to clean up the fuels which have powered America for nearly a century. The Clean Air Act identified numerous areas of the country which must reduce or eliminate their pollution levels. Those areas have been meeting the challenges of the Clean Air Act through changing the gasoline and diesel fuels used, either year- round or seasonally. Studies show ethanol reduces emissions of carbon monoxide and hydrocarbons by 20 percent, and particulates by 40 percent in 1990 and newer vehicles. In 2001 alone, ethanol reportedly reduced greenhouse gas emissions by 3.6 million tons or the equivalent of removing more than 520,000 vehicles from the road.

Now and through the next several years, cleaner and cleaner fuels such as ethanol, natural gas, propane, and biodiesel will be used in cars, trucks, and buses. Today's key issue is to determine which alternatives will extend or replace gasoline and diesel fuel to reduce pollution.

We need to be working hard to craft a comprehensive rural development plan that will spur investment in agribusiness and promote economic activity in the agricultural sector. This Energy bill, and the renewable fuels standard contained within, is an important part of such a rural development plan and is key to reversing the realities of outmigration in the rural areas.

If passed, this fuels language will establish a 4.0-billion-gallon renewable fuels standard in 2006, growing every year until it reaches 8 billion gallons by 2012. This is a responsible approach to meeting the demands of an ever-increasing demand for fuel sources. Additional benefits to this legislation include the displacement of foreign supplies of crude oil, reduction in the U.S. trade deficit, and the creation of tens of thousands of jobs throughout the United States.

It is quite apparent that increased use of ethanol will do much to boost a struggling U.S. agricultural economy and at the same time will help establish a more sound national energy policy.

A choice for renewable fuels is a choice for America, its energy consumers, its farmers, and its environment. It will help us to reverse our 100-year-old reliance on fossil fuels, a more pressing concern than ever given the unrest in the Middle East and increased competition for energy from growing economies throughout the world.

If each State were to produce 10 percent of its own domestic renewable fuel as Nebraska does, America will have turned the corner away from dependence on foreign sources of energy. When you take a hard look at the facts, you will see that this legislation is nothing but beneficial for America.

The Fuels Security Act is balanced, comprehensive, and is the result of the dedication of so many, especially Senator Lugar and Senator Harkin.

Now I ask my colleagues to join me in promoting new opportunities for the technologies that will put our Nation and our world's transportation fuels on solid, sustainable, environmentally enhancing ground. We owe it to our country now and to future generations to pass this legislation.

Mr. President, I yield the floor and I suggest the absence of a quorum.

I move to lay that motion on the table.

The motion to lay on the table was agreed to.

Mr. President, I am here today to pay tribute to a great American and a great Nebraskan. J. James Exon served with distinction in the United States Senate from 1979 to 1996 an as Governor of Nebraska from 1970 to 1978. Senator Exon passed away in his hometown of Lincoln, NE last Friday at the age of 83. His funeral services are tomorrow in Lincoln.

Jim Exon understood Nebraskans like no one else which explains his popularity with the people of his State. He loved them and they loved him back.

He was a Democrat in a highly Republican State, yet he never lost an election in 2 campaigns for Governor and 3 for United States Senate. He understood that Nebraska is a populist state more than it is a partisan state. Most Nebraskans judged him on what he said and what he did, not on his political registration.

Jim Exon was a common man. Nebraskans will remember Jim Exon as one of the greatest leaders Nebraska ever had. Anyone who travels around Nebraska today can see the continuing legacy from his quarter century of public service.

Jim Exon built on the Nebraska tradition of working together. In that way he carried on the legacy of another giant in Nebraska history, Senator George Norris. Norris founded the unicamera legislature in an effort to improve the workings of government and to achieve results. Jim Exon had the same philosophy.

I had the honor of serving in then-Governor Jim Exon's cabinet as Nebraska Director of Insurance. He has been a friend and mentor ever since even as I have followed him as Governor and U.S. Senator. I would frequently call him to seek advice and he would often call to offer it. Now, those calls will cease but I don't think I'll ever stop learning from Jim Exon.

The people of Nebraska always appreciated Jim Exon in life as they do now in death. We will miss him but we can all take comfort in the fact that his fingerprints are on more than a quarter century of our history and Nebraska and the United States of America are far better places because of his generous service.

As a former poker partner of Jim Exon, I can say that the man was driven to win. He was surprised by those who didn't try to beat him. That attitude carried over into his public life and is ``part and parcel'' of the reason so many Nebraskans are fond of him. He made you feel like he was on your side. He made you feel your issues were important. And most of all, he made you feel proud to be a Nebraskan.

Those in public life must face the last great scrutiny when they leave this world for the next. Their careers are examined again. Their friends and foes get one last unanswered say. In the case of Big Jim Exon, who liked to have the last word, I know this must be driving him crazy.

In the case of Jim Exon the last word goes to Nebraska, the State and the people he loved so dearly. The State of Nebraska will miss Jim Exon, his wisdom, his humor and his common sense. He is one Nebraskan who from start to finish, and through every day, truly did lead ``the good life.''

I ask unanimous consent to have printed in the Record two editorials from Nebraska newspapers that captured the essence of Jim Exon so eloquently, one from my hometown paper, the McCook Gazette and another from the Omaha World Herald.

Mr. President, when I was running for the Senate in 2000, I pledged to put partisanship aside to do what is right for Nebraska. I told Nebraskans that if they elected me they could count on me to carefully consider the issues and ultimately do what I think is best.

From tax cuts, to Medicare reform to campaign finance reform and now to the battle over stalled judicial nominations, I have distanced myself from the partisan atmosphere in Washington to get things done.

Over the past few months and with great intensity over the past two weeks, I have been working with a bipartisan group of moderate-minded

Senators to craft an alternative to the ``nuclear option''--the partisan and political attempt to force a change in the rules of the Senate to end filibusters against judicial nominations.

The nuclear option is a temporary political fix to a very serious and ongoing problem: The Senate's failure to confirm more than 60 nominations during the last administration and the filibustering of ten of President Bush's nominations. To address this problem, I would prefer a permanent rules change to the Senate over a temporary procedural maneuver like the nuclear option that can be reversed if the White House or the Congress changes hands.

The Senate was designed by our Founding Fathers to act as a counter balance to the House of Representatives which represented States based on population. The Senate was the chamber where each State would have equal representation, two Senators and two votes. The intent was to prevent the power in Congress from becoming concentrated in large population States like New York, California, Florida and Texas. In the Senate, a Senator from Nebraska has the same power as a Senator from any other State.

As a former Governor and a firm believer in the power of the executive branch to appoint Cabinet members, judges and other officials, I do not support filibustering nominations. In fact, as Nebraska's Senator, I have voted against filibustering judicial appointments in every case but one where I was denied access to background information on the nominee. However, I also do not think the nuclear option is the solution to the impasse over judicial nominations.

We have built consensus behind a plan whereby seven Republican Senators pledge to vote against the nuclear option in exchange for an agreement from seven Democrats to allow most of the stalled nominations to get up-or-down votes as well as a pledge to not support filibusters of future nominations except in extraordinary circumstances.

Our compromise would be constructed completely within the existing rules of the Senate; it would prevent the nuclear option and the expected fallout of bringing all Senate business, including the energy bill and other important legislation, to a halt; and would preserve the rights of the Senate minority not only for this Congress but for future Congresses regardless of who is in the majority. Protecting the Senate's minority rights might seem to go against the concept of democracy and majority rule. In reality and without the spin on this issue that the special interest groups from both extremes put on this matter, the Senate's minority rights are part of the system of checks and balances that keep any branch of government from dominating the others.

The minority rights aren't always about party politics either. Many filibusters throughout history were conducted by Senators who disagreed with the president or the majority of Senators. Filibusters also give small States such as Nebraska an important tool to protect itself from the will of the larger States.

The debate over these judges has consumed the Senate and all of Washington. When I am in Nebraska most folks do not ask me about the judicial nomination process. Nebraskans tell me they want an energy bill that will boost ethanol production and reduce our dependence on foreign oil. Nebraskans are concerned about the President's plan to divert Social Security funds to private accounts and a myriad of other important legislative priorities.

Those who do mention judges and nominations express concern about where the Senate seemed to be headed. Many expressed to me the desire to stop the bickering and get on with the Senate's business. Others offered encouraging words in support of the compromise effort and those comments made me feel that Nebraskans were appreciative of our efforts.

The business, that we as Senators are tasked with carrying out for the American people would cease in the Senate if the majority leader follows through on his threats to employ the nuclear option. Nebraskans waiting for the energy bill, a Federal budget, asbestos litigation reform and even confirmation of future judicial nominations are the ones who will suffer if the nuclear option is detonated.

With our compromise everybody wins. Those seeking to protect minority rights win. Those seeking to confirm judicial nominations win. Small States win.

We accomplished this by working together with common purpose and shared concern for the future of this body. I am proud of what we have accomplished and I will treasure the new friends I made in the process. I thank you, all of you, for working with me, for trusting me, and for joining me in this great challenge.

I would like to include all the names of the signatories on the memorandum of understanding as part of my statement. These brave senators are: Senator John McCain, Senator John Warner, Senator Robert Byrd, Senator Mary Landrieu, Senator Olympia Snowe, Senator Ken Salazar, Senator Mike DeWine, Senator Susan Collins, Senator Mark Pryor, Senator Lincoln Chafee, Senator Lindsey Graham, Senator Joseph Lieberman, and Senator Daniel Inouye.

Mr. President, I thank my colleague from Texas, Senator Pryor, and others for supporting and cosponsoring this legislation, which I think is extremely important. There are several points that need to be made about it. One is to point out what it does not do. It does not prevent tolling. Tolling on new construction and on additional construction on existing highways will be continued to be permitted. What it does do, as a matter of fairness, is it stops the equivalent of double taxation on existing highways already paid for by the Federal gas tax and in many cases State gas tax dollars.

What this will avoid having is an additional tax now put on those highways in the name and in the form of a toll, perhaps a little less ominous sounding than a tax. If one looks at the net effect of putting a toll on an already

paid-for stretch of highway, it amounts to an additional tax, in this case double taxation.

The second point that is important to make about this bill is it is a matter of highway safety. All studies will indicate very clearly that if there is a choice between a toll road and a nontoll road, it is most likely that truckers and other drivers will seek to use that nontoll road. In many cases, that is not going to present a matter of safety, but in all too many cases it will redirect traffic and reroute traffic to older, smaller, and less capable roads of handling that additional traffic. That not only will be a burden for the roads and will deteriorate the roads at a faster rate than was originally planned in their construction, but it will also raise the amount of traffic in many cases on two-lane highways or smaller highways and will increase the safety factor. I think it is pretty clear that we would ordinarily not take away the right of a State to do this. But under these circumstances, where we are allowing tolling of existing lanes on the Interstate Highway System, that is bad policy and it is absolutely unfair.

This amendment does not affect the State's ability to finance new construction using tolls, as perhaps some thought. But it does affect the right to do it in the case of existing highways.

I urge my colleagues to support this amendment. We worked out the questions that have been raised with respect to the State of Virginia. We believe that has now been handled, and this legislation should pass as part of this important bill.

I yield the floor.

Mr. President, today I join Senator Brownback in introducing The Rural Community Hospital Assistance Act. This legislation is intended to ensure the future of small rural hospitals by restructuring the way they are reimbursed for Medicare services by basing the reimbursements on actual costs instead of the current pre- set cost structure.

Current law allows for very small hospitals--designated Critical Access Hospitals (CAH) to receive cost-based Medicare reimbursements. To qualify as a CAH the facility must have no more than 25 acute care beds.

In rural communities, hospital facilities that are slightly larger than the 25 bed limit share with Critical Access Hospitals the same economic conditions, the same treatment challenges, the same disparity in coverage area but do not share the same reimbursement arrangement. These rural hospitals have to compete with larger urban-based hospitals that can perform the same services at drastically reduced costs. They are also discouraged from investing in technology and other methods to improve the quality of care in their communities because those investments are not supported by Medicare reimbursement procedures.

The legislation would provide enhanced cost-based Medicare reimbursement by creating a new ``rural'' designation under the Medicare reimbursement system. This new designation would benefit five Nebraska hospitals. Hospitals in McCook, Beatrice, Columbus, Holdrege and Lexington would fall under this new designation, and would have similar benefits provided to nearly sixty other Nebraska hospitals classified under the CAH system.

The legislation would also improve the hospitals with critical access status. Sixty CAH facilities in Nebraska already receive enhanced cost- based reimbursements for inpatient and outpatient services. The legislation would further assist these existing CAH facilities by extending the enhanced cost-based reimbursement to certain post-acute and ambulance services and eliminating the current 35-mile test.

Rural hospitals cannot continue to provide these services without having Medicare cover the costs. If something is not done, the larger hospitals may be forced to cut back on the number of beds they keep-- and the number of people they care for, and others may be forced to close their doors. These hospitals provide jobs, good wages, health care and economic development opportunity for these communities. Without access to these hospitals, these communities would not survive. The Rural Community Hospital Assistance Act will ensure that the community has access to high quality health care that is affordable to the patient and the provider.

Mr. President, today I join Senator Brownback in introducing The Rural Community Hospital Assistance Act. This legislation is intended to ensure the future of small rural hospitals by restructuring the way they are reimbursed for Medicare services by basing the reimbursements on actual costs instead of the current pre- set cost structure.

Current law allows for very small hospitals--designated Critical Access Hospitals (CAH) to receive cost-based Medicare reimbursements. To qualify as a CAH the facility must have no more than 25 acute care beds.

In rural communities, hospital facilities that are slightly larger than the 25 bed limit share with Critical Access Hospitals the same economic conditions, the same treatment challenges, the same disparity in coverage area but do not share the same reimbursement arrangement. These rural hospitals have to compete with larger urban-based hospitals that can perform the same services at drastically reduced costs. They are also discouraged from investing in technology and other methods to improve the quality of care in their communities because those investments are not supported by Medicare reimbursement procedures.

The legislation would provide enhanced cost-based Medicare reimbursement by creating a new ``rural'' designation under the Medicare reimbursement system. This new designation would benefit five Nebraska hospitals. Hospitals in McCook, Beatrice, Columbus, Holdrege and Lexington would fall under this new designation, and would have similar benefits provided to nearly sixty other Nebraska hospitals classified under the CAH system.

The legislation would also improve the hospitals with critical access status. Sixty CAH facilities in Nebraska already receive enhanced cost- based reimbursements for inpatient and outpatient services. The legislation would further assist these existing CAH facilities by extending the enhanced cost-based reimbursement to certain post-acute and ambulance services and eliminating the current 35-mile test.

Rural hospitals cannot continue to provide these services without having Medicare cover the costs. If something is not done, the larger hospitals may be forced to cut back on the number of beds they keep-- and the number of people they care for, and others may be forced to close their doors. These hospitals provide jobs, good wages, health care and economic development opportunity for these communities. Without access to these hospitals, these communities would not survive. The Rural Community Hospital Assistance Act will ensure that the community has access to high quality health care that is affordable to the patient and the provider.

Mr. President, today I rise to introduce a bill designating a Jacksonville courthouse as the John Milton Bryan Simpson United States Courthouse.

John Milton Bryan Simpson was born in Kissimmee, FL, in 1903. He was nominated to the Southern District Court of Florida by President Truman in 1950 and to the Federal court of appeals by President Johnson in 1966.

Designating this courthouse after the late Judge Simpson is a fitting tribute to a man whose judicial decisions were instrumental in desegregating public facilities in Jacksonville, Orlando, and Daytona Beach.

It is important that we remember not only his name but also his legacy of courage during that period of our history.

I hope that other members of the Senate will join me in honoring Judge Simpson, a man who was not only a hero to the state of Florida, but a national hero.

Mr. President, today I rise to introduce a bill designating a Jacksonville courthouse as the John Milton Bryan Simpson United States Courthouse.

John Milton Bryan Simpson was born in Kissimmee, FL, in 1903. He was nominated to the Southern District Court of Florida by President Truman in 1950 and to the Federal court of appeals by President Johnson in 1966.

Designating this courthouse after the late Judge Simpson is a fitting tribute to a man whose judicial decisions were instrumental in desegregating public facilities in Jacksonville, Orlando, and Daytona Beach.

It is important that we remember not only his name but also his legacy of courage during that period of our history.

I hope that other members of the Senate will join me in honoring Judge Simpson, a man who was not only a hero to the state of Florida, but a national hero.