Floor Statements

Mr. President, I rise today to introduce the Justice for Medicare Beneficiaries Act of 2005, legislation that will ensure that Medicare beneficiaries who are denied health-related benefits can appeal these denials in a meaningful way. Very simply, this initiative will ensure that Medicare beneficiaries have access to timely, impartial, and in-person hearings before Administrative Law Judges.

Sec. 931 of the Medicare Prescription Drug, Improvement, and Modernization Act requires the transfer of the Medicare appeals process from the Social Security Administration (SSA) to the Department of Health and Human Services (HHS). A proposed rule recently put forth indicates that current HHS plans to bring about this transfer will significantly and negatively affect Medicare beneficiaries' ability to seek redress from the denial of benefits such as access to prescription medicines, home health services, and services provided at skilled nursing facilities.

Specifically, the Administration's proposed transfer plan, slated to go into effect in only a handful of days on July 1, will reduce the number of sites where these appeal hearings can take place to four from the more than 140 sites currently operating nationwide. Today, Medicare beneficiaries that have filed coverage appeals are granted a hearing before an Administrative Law Judge (ALJ). Under the proposed transfer plan, Medicare beneficiaries will now have their hearings heard via video- or teleconference (VTC) and will only be allowed to appear in person by request and if HHS determines that ``special or extraordinary circumstances exist.'' Moreover, beneficiaries granted an in-person hearing would not be assured that their cases would be heard within the 90-day window currently mandated by law. Lastly, the proposed transfer plan will endanger the independence and impartiality of Administrative Law Judges by requiring them to defer to program guidance provided by the Centers for Medicare and Medicaid Services (CMS) rather than on the Medicare statute and regulations, as they currently do.

Central to our system of justice is the right of aggrieved parties to appear before an impartial judge in person to have their cases heard. Appearing face-to-face before an impartial trier of fact is the best way to ensure that a full and fair hearing occurs. In person hearings allow parties to fully make their case. At the same time, they allow judges to best evaluate the demeanor and condition of the parties, and other aspects of a case. The Administration's proposed rule transferring the Medicare appeals process from SSA to HHS greatly endangers this right by gutting the current practice of guaranteeing the right of Medicare beneficiaries to appear in person before an ALJ when having their appeals heard and instead will now presume that these hearings will be heard via video- or teleconference.

Often when we talk about the denial of Medicare benefits, we are talking about the denial of services that literally have the ability to save lives. Medicare provides a critical safety net for millions of elderly and disabled beneficiaries and the proposed transfer plan's almost wholesale reliance on novel VTC technology may endanger the ability of many Medicare beneficiaries to accurately and personally portray the severity of their own health conditions.

The Justice for Medicare Beneficiaries Act of 2005 will ensure those Medicare beneficiaries that have filed coverage appeals have access to timely, impartial, and in-person hearings before Administrative Law Judges. Specifically, this initiative will ensure that Medicare appeals will be heard in person before an ALJ, as they presently are. While all Medicare beneficiaries will be entitled to appear in person for their hearing, any beneficiary may choose to have their hearing heard via video- or teleconference.

The legislation that I introduce today is in no way designed to prevent the adoption of the promising technology represented by VTC. Rather, this initiative simply seeks to preserve the critically important ability of Medicare beneficiaries to appear before the very judges charged with hearing their coverage appeals. By preventing the great majority of Medicare beneficiaries from appearing in person before the judge hearing their Medicare appeals, the Administration's proposed plan will greatly harm their ability to accurately and completely present all of the facts relevant to their case. And while I understand that many Medicare beneficiaries will choose to have their appeals heard via either video- or teleconference, I believe that we must preserve for Medicare beneficiaries the ability to appear in person before a judge when their cases are heard.

The legislation will also require that all Medicare coverage appeal hearings, regardless of whether a Medicare beneficiary appears in person or chooses to appear via video- or teleconference, will be heard within 90 days as mandated by the Benefits Improvement and Protection Act of 2000. All Medicare beneficiaries deserve to have their appeals heard in a timely manner regardless of whether their cases are heard in person or via utilizing VTC technology.

The Justice for Medicare Beneficiaries Act will also address the Administration's plans to reduce the number of sites where Medicare appeal hearings may be heard in person from the more than 140 sites currently available to four. This legislation will require at least one site for the hearing of in-person Medicare appeals in each state, the District of Columbia, and territory, with the nation's five largest states featuring two hearing sites geographically distributed throughout the state.

Lastly, this legislation will ensure the independence and impartiality of Administrative Law Judges by relieving them of the proposed transfer plan's mandate to grant ``substantial deference'' to CMS program guidance. Medicare beneficiaries appealing coverage decisions should be fully confident that the judges deciding their appeals are bound only by the merits of their case and not undue pressure from agency of administration interference.

I want to thank Senators Kennedy, Kerry, and Bingaman for joining me in sponsoring this important initiative. The Justice for Medicare Beneficiaries Act is also supported by a number of national and local organizations dedicated to preserving the continued ability of Medicare beneficiaries to access needed health care services. Endorsing the legislation that I introduce today are the Center for Medicare Advocacy located in my own state of Connecticut, the National Health Law Program, the National Senior Citizens Law Center, the Medicare Advocacy Project of Vermont Legal Aid, the Medicare Advocacy Project of Greater

Boston Legal Services, and the Senior Citizens' Law Office of Albuquerque, NM.

In Congress we far too rarely have the opportunity to stave off problems before they occur. Rather, too often we are forced to involve ourselves in matters only after they have already wreaked havoc on the lives of our constituents. With passage of the Justice for Medicare Beneficiaries Act of 2005, we have the opportunity to avoid the adverse impact that the Administration's proposed transfer plan will likely have on Medicare beneficiaries. This legislation will preserve for our nation's 41 million Medicare beneficiaries the ability to timely appear in person before judges who will impartially determine which health care services they're entitled to receive under Medicare. Medicare beneficiaries deserve no less than the vital protections offered by this act and I ask for the support of my colleagues for this critically important initiative.

Mr. President, I rise today to introduce the Justice for Medicare Beneficiaries Act of 2005, legislation that will ensure that Medicare beneficiaries who are denied health-related benefits can appeal these denials in a meaningful way. Very simply, this initiative will ensure that Medicare beneficiaries have access to timely, impartial, and in-person hearings before Administrative Law Judges.

Sec. 931 of the Medicare Prescription Drug, Improvement, and Modernization Act requires the transfer of the Medicare appeals process from the Social Security Administration (SSA) to the Department of Health and Human Services (HHS). A proposed rule recently put forth indicates that current HHS plans to bring about this transfer will significantly and negatively affect Medicare beneficiaries' ability to seek redress from the denial of benefits such as access to prescription medicines, home health services, and services provided at skilled nursing facilities.

Specifically, the Administration's proposed transfer plan, slated to go into effect in only a handful of days on July 1, will reduce the number of sites where these appeal hearings can take place to four from the more than 140 sites currently operating nationwide. Today, Medicare beneficiaries that have filed coverage appeals are granted a hearing before an Administrative Law Judge (ALJ). Under the proposed transfer plan, Medicare beneficiaries will now have their hearings heard via video- or teleconference (VTC) and will only be allowed to appear in person by request and if HHS determines that ``special or extraordinary circumstances exist.'' Moreover, beneficiaries granted an in-person hearing would not be assured that their cases would be heard within the 90-day window currently mandated by law. Lastly, the proposed transfer plan will endanger the independence and impartiality of Administrative Law Judges by requiring them to defer to program guidance provided by the Centers for Medicare and Medicaid Services (CMS) rather than on the Medicare statute and regulations, as they currently do.

Central to our system of justice is the right of aggrieved parties to appear before an impartial judge in person to have their cases heard. Appearing face-to-face before an impartial trier of fact is the best way to ensure that a full and fair hearing occurs. In person hearings allow parties to fully make their case. At the same time, they allow judges to best evaluate the demeanor and condition of the parties, and other aspects of a case. The Administration's proposed rule transferring the Medicare appeals process from SSA to HHS greatly endangers this right by gutting the current practice of guaranteeing the right of Medicare beneficiaries to appear in person before an ALJ when having their appeals heard and instead will now presume that these hearings will be heard via video- or teleconference.

Often when we talk about the denial of Medicare benefits, we are talking about the denial of services that literally have the ability to save lives. Medicare provides a critical safety net for millions of elderly and disabled beneficiaries and the proposed transfer plan's almost wholesale reliance on novel VTC technology may endanger the ability of many Medicare beneficiaries to accurately and personally portray the severity of their own health conditions.

The Justice for Medicare Beneficiaries Act of 2005 will ensure those Medicare beneficiaries that have filed coverage appeals have access to timely, impartial, and in-person hearings before Administrative Law Judges. Specifically, this initiative will ensure that Medicare appeals will be heard in person before an ALJ, as they presently are. While all Medicare beneficiaries will be entitled to appear in person for their hearing, any beneficiary may choose to have their hearing heard via video- or teleconference.

The legislation that I introduce today is in no way designed to prevent the adoption of the promising technology represented by VTC. Rather, this initiative simply seeks to preserve the critically important ability of Medicare beneficiaries to appear before the very judges charged with hearing their coverage appeals. By preventing the great majority of Medicare beneficiaries from appearing in person before the judge hearing their Medicare appeals, the Administration's proposed plan will greatly harm their ability to accurately and completely present all of the facts relevant to their case. And while I understand that many Medicare beneficiaries will choose to have their appeals heard via either video- or teleconference, I believe that we must preserve for Medicare beneficiaries the ability to appear in person before a judge when their cases are heard.

The legislation will also require that all Medicare coverage appeal hearings, regardless of whether a Medicare beneficiary appears in person or chooses to appear via video- or teleconference, will be heard within 90 days as mandated by the Benefits Improvement and Protection Act of 2000. All Medicare beneficiaries deserve to have their appeals heard in a timely manner regardless of whether their cases are heard in person or via utilizing VTC technology.

The Justice for Medicare Beneficiaries Act will also address the Administration's plans to reduce the number of sites where Medicare appeal hearings may be heard in person from the more than 140 sites currently available to four. This legislation will require at least one site for the hearing of in-person Medicare appeals in each state, the District of Columbia, and territory, with the nation's five largest states featuring two hearing sites geographically distributed throughout the state.

Lastly, this legislation will ensure the independence and impartiality of Administrative Law Judges by relieving them of the proposed transfer plan's mandate to grant ``substantial deference'' to CMS program guidance. Medicare beneficiaries appealing coverage decisions should be fully confident that the judges deciding their appeals are bound only by the merits of their case and not undue pressure from agency of administration interference.

I want to thank Senators Kennedy, Kerry, and Bingaman for joining me in sponsoring this important initiative. The Justice for Medicare Beneficiaries Act is also supported by a number of national and local organizations dedicated to preserving the continued ability of Medicare beneficiaries to access needed health care services. Endorsing the legislation that I introduce today are the Center for Medicare Advocacy located in my own state of Connecticut, the National Health Law Program, the National Senior Citizens Law Center, the Medicare Advocacy Project of Vermont Legal Aid, the Medicare Advocacy Project of Greater

Boston Legal Services, and the Senior Citizens' Law Office of Albuquerque, NM.

In Congress we far too rarely have the opportunity to stave off problems before they occur. Rather, too often we are forced to involve ourselves in matters only after they have already wreaked havoc on the lives of our constituents. With passage of the Justice for Medicare Beneficiaries Act of 2005, we have the opportunity to avoid the adverse impact that the Administration's proposed transfer plan will likely have on Medicare beneficiaries. This legislation will preserve for our nation's 41 million Medicare beneficiaries the ability to timely appear in person before judges who will impartially determine which health care services they're entitled to receive under Medicare. Medicare beneficiaries deserve no less than the vital protections offered by this act and I ask for the support of my colleagues for this critically important initiative.

Mr. President, I am pleased to join Senator Hatch, Senator Burr, Senator Reed, and Senator Ensign in introducing legislation that will significantly benefit some of the most gravely ill patients--those in need of a blood stem cell transplant. By reauthorizing the national program for bone marrow, creating a similar program for umbilical cord blood, and expanding the national stockpile of umbilical cord blood units, this legislation will dramatically increase the chances that patients in need of a life-saving transplant will be able to find an appropriate genetic match.

The bill that we are introducing today is similar to legislation that Senator Hatch and I introduced earlier this year to create a national network of cord blood banks and a cord blood registry. However, there are two important differences. First, this legislation is consistent with recommendations made by the Institute of Medicine, IOM, in their recent report, ``Cord Blood: Establishing a National Hematopoietic Stem Cell Bank Program,'' about the structure of a national cord blood program. Second, and more importantly, this bill would also reauthorize the national bone marrow program, and put both bone marrow and cord blood under the auspices of a single national program. This structure reflects the complimentary nature of bone marrow and cord blood, and will ensure that physicians and patients can more easily find the best possible match for transplantation.

The therapeutic benefits of bone marrow are well established. Bone marrow transplants have been used for nearly half a century to treat patients suffering from diseases such as leukemia, Hodgkin's Disease, sickle cell anemia, and others. The use of cord blood as an alternative to bone marrow is a more recent development, but one that is just as promising and exciting.

The bill that we are introducing today will begin a new national commitment to the development of this technology which has the potential to reduce pain and suffering and save the lives of so many Americans afflicted with some of the most debilitating illnesses. Cord blood has already been used successfully in treating a number of diseases, including sickle cell anemia and certain childhood cancers. However, the use of cord blood is still in an early stage relative to the use of bone marrow, and may have even broader application in the II future.

Like many Americans, I had never heard of cord blood before the birth of my first daughter, almost 4 years ago. It is not widely used--at least in this country. Approximately 95 percent of all bone marrow reconstitutions are done using a bone marrow transplant--only 5 percent use cord blood. This figure is surprising when we consider the benefits of cord blood.

First, it can be very difficult to find a suitable bone marrow donor. According to a General Accounting Office, GAO, report, of the 15,231 individuals needing bone marrow transplants between 1997 and 2000 who conducted a preliminary search of the National Bone Marrow Donor Registry, NBMDR, only 4,056 received a transplant--a 27 percent success rate. This number is even lower for minorities. Cord blood would not only produce an additional source of donation; it also does not require as exact a genetic match as bone marrow.

In addition, cord blood is readily available. While it can take months between finding a bone marrow match and actually receiving a transplant, a unit of cord blood can be utilized in a matter of days or weeks. Cord blood also lowers the risk of complications for both the donor and the recipient. The need to extract bone marrow from the donor is eliminated, and the risk of infection or rejection by the recipient is significantly reduced. Finally, research has suggested that cord blood might produce better outcomes than bone morrow in children.

Why then, given all of these benefits, has the use of cord blood not become much more prevalent in the United States? In Japan, where the use of cord blood in clinical settings is more advanced, nearly half of all transplants now use cord blood rather than bone marrow.

The relatively infrequent use of cord blood in our country is at least partly attributable to the lack of a national infrastructure for the matching and distribution of cord blood units. There are a handful of cord blood banks around the country doing excellent work, but there is a much more developed infrastructure for bone marrow. This is thanks to legislation passed by Congress in 1986 that established a national registry for bone marrow, which this bill would reauthorize. Our bill

would create a similar infrastructure for cord blood, operating under the auspices of a newly established Bone Marrow and Cord Blood Cell Transplantation Program. In addition to connecting physicians and patients with a suitable bone marrow donor or cord blood unit, the program would be required to educate the general public about cord blood and bone marrow, and encourage an ethnically diverse population of donors.

Our bill would also provide grants to qualified cord blood banks to acquire 150,000 new cord blood units. This number is consistent with recommendations made by the IOM, and should be sufficient to provide a suitable match for 90 percent of the U.S. population.

Finally, the legislation authorizes an appropriation of $15 million for each of fiscal years 2007 through 2010 for the cord blood inventory grants, and $186 million over the next 5 years for the establishment and maintenance of the Bone Marrow and Cord Blood Cell Transplantation Program.

Before finishing today I would like to make it clear that, just as I believe that cord blood should act as a complement to, not a replacement for, bone marrow, I also believe that cord blood does not eliminate the need for research into the potential benefits of embryonic stem cells. Just as cord blood seems to be preferable to bone marrow for treating certain individuals or conditions--and the reverse is certainly true as well--the same may prove to be true for embryonic stem cells. Certainly, we should provide doctors with the best tools to help cure their patients, whether those tools come from bone marrow, cord blood, embryonic stem cells, or another source entirely.

I firmly believe that the strengthening of our national infrastructure for bone marrow and the creation of a similar infrastructure for cord blood will save the lives of thousands of gravely ill Americans. I urge my colleagues to support this legislation.

Mr. President, I am pleased to join Senator Hatch, Senator Burr, Senator Reed, and Senator Ensign in introducing legislation that will significantly benefit some of the most gravely ill patients--those in need of a blood stem cell transplant. By reauthorizing the national program for bone marrow, creating a similar program for umbilical cord blood, and expanding the national stockpile of umbilical cord blood units, this legislation will dramatically increase the chances that patients in need of a life-saving transplant will be able to find an appropriate genetic match.

The bill that we are introducing today is similar to legislation that Senator Hatch and I introduced earlier this year to create a national network of cord blood banks and a cord blood registry. However, there are two important differences. First, this legislation is consistent with recommendations made by the Institute of Medicine, IOM, in their recent report, ``Cord Blood: Establishing a National Hematopoietic Stem Cell Bank Program,'' about the structure of a national cord blood program. Second, and more importantly, this bill would also reauthorize the national bone marrow program, and put both bone marrow and cord blood under the auspices of a single national program. This structure reflects the complimentary nature of bone marrow and cord blood, and will ensure that physicians and patients can more easily find the best possible match for transplantation.

The therapeutic benefits of bone marrow are well established. Bone marrow transplants have been used for nearly half a century to treat patients suffering from diseases such as leukemia, Hodgkin's Disease, sickle cell anemia, and others. The use of cord blood as an alternative to bone marrow is a more recent development, but one that is just as promising and exciting.

The bill that we are introducing today will begin a new national commitment to the development of this technology which has the potential to reduce pain and suffering and save the lives of so many Americans afflicted with some of the most debilitating illnesses. Cord blood has already been used successfully in treating a number of diseases, including sickle cell anemia and certain childhood cancers. However, the use of cord blood is still in an early stage relative to the use of bone marrow, and may have even broader application in the II future.

Like many Americans, I had never heard of cord blood before the birth of my first daughter, almost 4 years ago. It is not widely used--at least in this country. Approximately 95 percent of all bone marrow reconstitutions are done using a bone marrow transplant--only 5 percent use cord blood. This figure is surprising when we consider the benefits of cord blood.

First, it can be very difficult to find a suitable bone marrow donor. According to a General Accounting Office, GAO, report, of the 15,231 individuals needing bone marrow transplants between 1997 and 2000 who conducted a preliminary search of the National Bone Marrow Donor Registry, NBMDR, only 4,056 received a transplant--a 27 percent success rate. This number is even lower for minorities. Cord blood would not only produce an additional source of donation; it also does not require as exact a genetic match as bone marrow.

In addition, cord blood is readily available. While it can take months between finding a bone marrow match and actually receiving a transplant, a unit of cord blood can be utilized in a matter of days or weeks. Cord blood also lowers the risk of complications for both the donor and the recipient. The need to extract bone marrow from the donor is eliminated, and the risk of infection or rejection by the recipient is significantly reduced. Finally, research has suggested that cord blood might produce better outcomes than bone morrow in children.

Why then, given all of these benefits, has the use of cord blood not become much more prevalent in the United States? In Japan, where the use of cord blood in clinical settings is more advanced, nearly half of all transplants now use cord blood rather than bone marrow.

The relatively infrequent use of cord blood in our country is at least partly attributable to the lack of a national infrastructure for the matching and distribution of cord blood units. There are a handful of cord blood banks around the country doing excellent work, but there is a much more developed infrastructure for bone marrow. This is thanks to legislation passed by Congress in 1986 that established a national registry for bone marrow, which this bill would reauthorize. Our bill

would create a similar infrastructure for cord blood, operating under the auspices of a newly established Bone Marrow and Cord Blood Cell Transplantation Program. In addition to connecting physicians and patients with a suitable bone marrow donor or cord blood unit, the program would be required to educate the general public about cord blood and bone marrow, and encourage an ethnically diverse population of donors.

Our bill would also provide grants to qualified cord blood banks to acquire 150,000 new cord blood units. This number is consistent with recommendations made by the IOM, and should be sufficient to provide a suitable match for 90 percent of the U.S. population.

Finally, the legislation authorizes an appropriation of $15 million for each of fiscal years 2007 through 2010 for the cord blood inventory grants, and $186 million over the next 5 years for the establishment and maintenance of the Bone Marrow and Cord Blood Cell Transplantation Program.

Before finishing today I would like to make it clear that, just as I believe that cord blood should act as a complement to, not a replacement for, bone marrow, I also believe that cord blood does not eliminate the need for research into the potential benefits of embryonic stem cells. Just as cord blood seems to be preferable to bone marrow for treating certain individuals or conditions--and the reverse is certainly true as well--the same may prove to be true for embryonic stem cells. Certainly, we should provide doctors with the best tools to help cure their patients, whether those tools come from bone marrow, cord blood, embryonic stem cells, or another source entirely.

I firmly believe that the strengthening of our national infrastructure for bone marrow and the creation of a similar infrastructure for cord blood will save the lives of thousands of gravely ill Americans. I urge my colleagues to support this legislation.

Mr. President, I am pleased to join my colleague from California, Senator Feinstein, as a cosponsor of an amendment to ensure there is State authority in the siting of liquified natural gas (LNG) facilities.

I am troubled by section 381 of the underlying Senate energy bill that preempts State authority and gives exclusive authority to the Federal Energy Regulatory Commission (FERC) to approve or deny an application for the siting, construction, expansion, or operation of LNG facilities within state boundaries. Extreme care must be taken to ensure that no energy project undermines the economic and environmental well-being of a State. The provision in the energy bill undercuts the rights of States to determine how best to protect their natural resources, economy and residents. It erodes State authority under the Coastal Zone Management Act, the Clean Air Act, and the Federal Water Pollution Control Act, to name but a few landmark environmental pieces of legislation that have established and affirmed the critical role of States in setting energy policy.

Our amendment seeks to provide dual jurisdiction for States and the Federal Government, with respect to LNG facilities, similar to the provisions of the Deepwater Port Act of 1974 and as last amended in 2003. We are not inventing any new authority. Our straightforward amendment would require that FERC shall not approve an LNG license without the approval of a Governor. It defies common sense to have the voice of the States silenced by the Federal Government. The will of the people must be heard.

Frankly, I do not see the need to turn our siting authority on its head. It is my understanding that as many as six LNG facilities have recently been approved by FERC and two additional facilities have been approved by the Maritime Administration (MARAD). These new facilities would join the 4 currently operating LNG facilities--facilities that have been in existence for many years. In February, the current FERC Chairman stated that he expected at least eight new terminals for LNG to be built in the next 5 years. That many have already received FERC clearance, but there are another 16 proposals with FERC, 7 proposals with MARAD and another 10 potential sites identified by project sponsors.

I understand the need for increasing our supply of natural gas. But I am concerned that an over-reliance on LNG will simply shift this country from a reliance on foreign oil to a reliance on foreign sources of LNG. It is my understanding that Iran, Qatar and Russia hold more than half of the world's natural gas reserves. In April, Qatar, Iran, Egypt, Nigeria, Venezuela, and other natural gas producing nations met to discuss LNG pricing concerns, leading many to believe there is a will to some day form an OPEC-like structure.

One of those LNG proposals before FERC would be located in Long Island Sound. While this structure is not onshore, it is still within State boundaries. It would tentatively be positioned about 11 miles from Connecticut and 9 miles from New York. According to the company's own pre-filing with FERC, the floating storage and regasification unit (FSRU) would be about 1,200 feet long and 180 feet wide. That is longer than 3 football fields and a bit wider than one field. The structure would stand 100 feet above the surface of the water. That is about one- third the height of the Capitol from the base to the top of the Statue of Freedom. After warming the LNG to a gas, it would be transported in a NEW pipeline under Long Island Sound to an existing underwater pipeline. The structure would receive LNG shipments every 3 to 4 days and these tankers are projected to be nearly 1,000 feet long.

These are not benign actions. The construction of the LNG structure and a new pipeline, combined with the ongoing tanker activity would have an immediate and immense impact on Long Island Sound and the states of Connecticut and New York. Tanker activity alone could cause such an exclusion zone that normal commerce and recreation on Long Island Sound could be dramatically impaired. It is imperative that the governor have authority to determine whether this project is safe, economic and reliable.

Let us not forget, this proposed structure would be smack in the middle of Long Island Sound. Any attempt to move it away from Connecticut only moves it closer to New York and vice versa. Long Island Sound is an estuary of national significance, but it is only 21 miles at its widest. There is not a lot of wiggle room for this structure. More than 8 million people live and vacation on or around Long Island Sound. Connecticut and New York have already spent millions of dollars and dedicated millions more to restore the health of the Long Island Sound ecosystem. A healthy habitat ensures a prosperous recreational and commercial fishing industry, boating, swimming, and an overall thriving tourism industry. Long Island Sound provides an economic benefit of more than $5 billion to the regional economy.

So, as this process moves along, decisions regarding the siting of an LNG facility must take into account its safety and security, its environmental impact, its actual energy benefits and its general fit within Long Island Sound. LNG facilities must be sited smartly and our governors must have a final say. I ask my colleagues to support this amendment.

Mr. President, I am pleased to join my colleagues from Florida, Senator Nelson and Senator Martinez, as a cosponsor of their amendment to strike the OCS inventory language from the Energy bill.

I want to commend Senator Domenici and Senator Bingaman for working hard to craft a bipartisan bill, but I have a number of concerns with it, including the OCS inventory language.

Since 1982, Congress and the Executive branch have prohibited new offshore leases in the OCS. The moratoria began with California and was expanded to include the rest of the west coast, Georges Bank, New England, the mid-Atlantic, part of the eastern Gulf, and portions of Alaska. Both President George H. W. Bush and President Clinton upheld the OCS moratoria.

Let us be very clear. While an inventory sounds benign, it is a costly endeavor that will cause irreparable harm to our coastal waters and set us on a slippery slope to drilling and exploration in these environmentally sensitive areas. Why else would the Federal Government propose to spend nearly $1 billion to conduct seismic drilling activities if it did not intend to go forward with further coastal exploration? To suggest otherwise strains credulity. Further, nowhere in the underlying bill does it say how the Federal Government is going to pay for this $1 billion inventory. I contend that there are better ways to invest $1 billion--health care, education, infrastructure improvements, energy efficient technology, and renewable resources come immediately to mind, than on a misguided attempt to open our coastal areas to oil and gas exploration.

As I mentioned, conducting an inventory would entail seismic drilling that would have a ripple effect up and down our coastline. We already know that this type of activity has a devastating impact on marine life, including whales.

I am concerned that any seismic drilling or other similar activities along the North Atlantic and mid-Atlantic coast would have a tremendous negative impact on the health and well-being of Long Island Sound and the coastal areas of Connecticut.

Long Island Sound is an estuary of national significance with not one, but two openings to the sea. It is bordered by Connecticut and New York, running 110 miles long and 21 miles across at its widest. More than 8 million people live and vacation on or around Long Island Sound. Connecticut and New York have already spent millions of dollars and dedicated millions more to restore the health of the Long Island Sound ecosystem. A healthy habitat ensures a prosperous recreational and commercial fishing industry, boating, swimming, and an overall thriving tourism industry. Long Island Sound provides an economic benefit of more than $5 billion to the regional economy.

Therefore, I am deeply concerned that any attempt to inventory the

Mr. President, I ask unanimous consent to speak as in morning business.

I thank the Chair.

(The remarks of Mr. Dodd are printed in today's Record under ``Morning Business.'')

I suggest the absence of a quorum.

Madam President, last evening, something rather extraordinary happened here in the waning minutes of the session. My very good friend from Kansas, the distinguished chairman of the Intelligence Committee, took the floor to discuss the Bolton nomination--an issue, I say to my colleagues, no one wants to be resolved more quickly than the Senator from Connecticut. I have been involved in this for two straight months. The Presiding Officer and I are both on the Committee on Foreign Relations. This goes back to April 11, the day we had hearings. My hope is that we can resolve this matter sooner rather than later.

Last night, my friend from Kansas took the floor and announced that he knew what names the members of the Senate Foreign Relations Committee were concerned about when dealing

with the Bolton nomination. This is the matter of the intercepts Mr. Bolton requested--some 10 of them--involving 19 names of U.S. citizens, Americans, on those 10 intercepts. We made the request earlier on to allow the chairman and ranking member of the Intelligence Committee, as well as the chairman and ranking member of the Foreign Relations Committee, to review the raw data on those 10 intercepts to determine whether there were any problems associated with Mr. Bolton's desire to see those intercepts, since there has been a basis of information concerning efforts by Mr. Bolton to intimidate a number of people within the intelligence community--of both the intelligence and research division of the State Department, as well as the CIA-- concerning certain intelligence conclusions. Therefore, it is a matter of concern to many of us on the committee that we have an opportunity to review whether there has been any further intimidation.

I offered initially that we have the four Senators I mentioned review the matter. That was rejected by the administration. I then suggested why not just submit the names we are interested in and have the Intelligence Director inform us as to whether those names were part of the intercepts. If they were not, end of matter. If they were, we might want to proceed further to determine why those names were sought out. That was also rejected because the number of names requested to be reviewed was some 36 names. The reason I made the request for 36 names is because we had no idea specifically what these 10 intercepts involved. We were even denied a synopsis of what may be involved. We were flying in the dark about this information.

At any rate, my colleague and friend from Kansas proceeded to say he was familiar with what the six or seven names would be that we should be interested in. As a result, he proceeded to publicly name five of the seven individuals he identified. Not surprisingly, he also announced he consulted with Director Negroponte, who informed my friend that none of the names Senator Roberts provided to the administration were among the names Mr. Bolton and his staff were given by the National Security Agency.

What is remarkable about what happened last evening is that the Senator from Kansas is not a member of the Senate Foreign Relations Committee--the committee of jurisdiction with respect to the Bolton nomination. The Senator did not participate in more than 10 hours of hearings on the nomination. I sincerely doubt whether our colleague reviewed the more than 1,000 pages of transcripts from more than 30 interviews conducted by the bipartisan staff who jointly conducted those interviews. I know of no one on the committee who was consulted by our friend from Kansas to provide any input to the list that was settled upon.

I do believe we owe our colleague from Kansas a debt of gratitude, because the administration has at least now accepted the principle of cross-checking names against the list of names reviewed by Mr. Bolton. If the administration, in a matter of hours can cross-check seven names offered up by Senator Roberts, chairman of the Intelligence Committee, why is it a problem to cross-check the 36 names we have drawn up based on our own participation in the 10 hours of committee hearings and review of over 1,000 pages of interview?

We are not on some fishing expedition here at all to derail the Bolton nomination. We have not opened the State Department phonebook and selected names at random. There is a very specific rationale for each of the names on the list of 36 developed as a result of 10 hours of hearings, 1,000 pages of transcripts, and some 30 interviews.

The report of Mr. Bolton's hearing quite clearly and starkly paints a picture of an individual who is an ideologue determined to have his own way. We know what he tried to do with the underlings at the State Department and CIA--that is not in debate--who dared resist his efforts to endorse as fact what was not supported by available intelligence. Mr. Bolton tried to crush them. We know what he tried to do with other career State Department employees who ran afoul of him for inexplicable reasons. He sought to have them excluded in legal deliberations in areas of their responsibility or blackballed them from being assigned positions within the Department.

Mr. Bolton was a very driven individual when he sought to get his way with underlings. He even went so far as to propose a CIA analyst be denied country clearance so that he could not undertake official foreign travel.

He even sought to have the same individual's State Department building pass revoked. I do not need to go over these matters in detail, but the fact is, there is more than ample justification for seeking these 36 names, as well as the information that Senator Biden has raised regarding the raw data, the draft speeches dealing with testimony before the House committees on Syria.

These are not difficult requests to satisfy. As I said a minute ago, my friend from Kansas submitted seven names to the Department, and he was told within a matter of hours or less that they were not on the 10 intercepts. So whether or not the 36 names sought by the Foreign Relations Committee are included on those intercepts should also be a question that can be answered in a reasonable amount of time.

I have not told anyone, despite a number of requests, the names of the 36 people we would like to have checked out. I think acknowledging certain names is dangerously close to bordering on revealing the importance of the intercept traffic. When certain names are mentioned and then excluded, there is an implication that maybe they should be on those lists. So I would caution Members from publicly talking about the names. We have made no effort to do so. We, of course, want to limit the number of Senators who would actually be able to review this matter to four Senators out of the 100 in this body.

In all my years here, I have never faced such a situation where a coequal Member of this body has presumed to speak on behalf of another--in this case, suggesting that he knew which names we should request. Having submitted those names, he then discovered, of course, that those names were not on the intercept list that we saw.

So I am still hopeful this matter can be resolved. I do not think it should take that long. Certainly, if the administration would just respond to the two requests regarding the draft statements-- congressional testimony by Mr. Bolton--and check out the names that we have requested regarding these intercepts, if that information is provided and clears up those two matters, then I think this body is ready to vote up or down on Mr. Bolton.

Perhaps he behaved more judiciously in dealing with his peers and superiors than he did with those below him in rank. Perhaps the information he requested from the NSA was routine and solely to carry out his responsibilities as Under Secretary of State for Arms Control and International Security.

But given Mr. Bolton's zealotry on proliferation, on North Korea, on Libya, on Syria and other policy areas, it is not unreasonable to worry that he used all tools at his disposal to advance his causes. That is what we seek to find out through a cross checking of our names of concern against the names provided to Mr. Bolton.

As a matter of institutional right, we have, I think, an absolute right, as a coequal branch of Government, to solicit information that directly pertains to the qualifications of this individual to be confirmed by the Senate for the position to which he has been nominated. So I would hope that the information would be forthcoming and that we would be able to get the answers and move on.

Mr. President, I rise to congratulate Elizabeth Kelly and Sadie Hartell, of Willington, CT. Both Elizabeth and Sadie will be presenting projects this week in Washington in celebration of National History Day this Wednesday, June 15.

Elizabeth and Sadie, both of whom attend Hall Memorial School, were selected as 2 of 19 students who will be presenting their projects this week. These students are part of a larger group of 2,300 finalists, who were selected from more than half a million participants in National History Day activities across our Nation.

National History Day is an initiative to promote the learning of history by American students in junior high and high schools. It encourages students not only to read their textbooks but to visit libraries, museums, and archives, and to create exhibits and participate in performances based on historical themes. This year marks the 25th anniversary of the National History Day initiative.

The students who competed in the National History Day competition have spent months doing in-depth research on topics they have selected, and preparing their presentations.

Elizabeth Kelly's project is titled, ``The Second American Revolution: Elizabeth Cady Stanton and Her Fight.'' As part of her research, Elizabeth interviewed Colin Jenkins, a relative of Stanton's, who gave her original letters by Stanton that Elizabeth incorporated into a 10-minute dramatic performance, which she will be presenting at the National Museum of American History.

Sadie Hartell's project is titled, ``The Beatles Communicating to Their Generation.''

She will be presenting an exhibit and showing a short movie. Sadie did her research at both the University of Connecticut Music Library, as well as at Hall Memorial's school library. Her project, which she will be presenting at the Renwick Gallery of the Smithsonian American Art Museum, focuses on how the Beatles used their music to express sentiments about the Vietnam War.

I congratulate Elizabeth and Sadie, as well as all those students who participated in National History Day. Knowledge of our history as a nation is critical to our understanding of our present, and our future. They have both demonstrated tremendous dedication and commitment, and it is my hope that their achievements inspire others to learn more about our Nation's rich and storied history. I wish them much success in their studies and their future endeavors.

Mr. President, I rise today with Senators Jeffords, Kerry and Feingold to introduce the Medical Education Affordability Act, MEAA. The purpose of this bill is to make medical and dental education more affordable.

Upon graduation from college, students who demonstrate economic hardship are eligible to extend their student loan deferment for up to 3 additional years. Using the economic hardship deferment, a formula that takes into account earnings and debt level, the majority of medical and dental residents defer repayment of their student loans until the end of their residency period. Unfortunately, for those specialties that require a residency of more than 3 years--OB/GYN, psychiatry, and general surgery to name a few--student loan repayment begins before a resident's medical or dental education is completed. This situation creates an enormous financial burden for residents who have, in most cases, incurred significant debt. In 2004, the average indebtedness for graduating medical students was $115,000, for graduating dental students it was $122,263. While lenders are currently required to offer forbearance to medical and dental students, this is an expensive option as interest continues to accrue and may be capitalized more often.

The Medical Education Affordability Act would solve this problem by extending the economic hardship deferment to cover the entire length of a medical or dental residency. By altering the definition we are removing a significant financial obstacle facing students with residency periods longer than 3 years. I want to stress again, residents will still have to demonstrate economic hardship--MEAA only extends the deferment for borrowers that continue to meet the debt-to- income requirements of the economic hardship deferment.

Mr. President, I hope my colleagues will join me in support of medical education by signing onto this bill. By working together, I believe that the Senate as a body can act to ensure that more individuals are able to pursue a full range of medical specialties.

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

Mr. President, I rise to introduce, along with Senators Mikulski, Landrieu, Levin, Cantwell and Kerry, the Youth Service Scholarship Act. This Act would authorize the Secretary of Education to award college scholarships of up to $5,000 a year to high school students and undergraduates who perform community service.

A recent study titled Community Service and Service Learning in U.S. Public Schools reveals that 66 percent of public schools involve students in community service. This means that approximately 54,000 public schools in America currently engage about 13.7 million students in community service each year. Other studies have shown that nearly 84 percent of high school students participate in volunteer activities either in or out of school and two-thirds of college students have recently participated in volunteer activities.

The Youth Service Scholarship Act is designed to assist low-income students who dedicate a significant portion of their time to volunteer service with money for college. This Act would authorize the Secretary of Education to award college scholarships of up to $5,000 to high school students who perform over 300 hours of community service in both their junior and senior years. In order to be considered, high school applicants must maintain a 3.0 grade point average, submit character recommendations, and write an essay

on the nature of their community service. Additional money will be available if the student continues to participate in a significant amount of community service once they are in college.

Voluntarism not only brings support and services to communities in need, it provides significant benefits to the students who participate. Research has shown that students who volunteer are 50 percent less likely to use drugs and alcohol or engage in destructive behavior. Additionally, students who volunteer are more likely to receive good grades, be philanthropic, graduate, and be interested in going to college.

In the 21st Century, higher education is not a luxury, it is a necessity. For many of our low-income youth, finding money to pay for college is an obstacle to enrollment. This scholarship program provides aid to motivated and inspired youth.

I urge my colleagues to join me in supporting the Youth Service Scholarship Act. I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I rise today with Senators Jeffords, Kerry and Feingold to introduce the Medical Education Affordability Act, MEAA. The purpose of this bill is to make medical and dental education more affordable.

Upon graduation from college, students who demonstrate economic hardship are eligible to extend their student loan deferment for up to 3 additional years. Using the economic hardship deferment, a formula that takes into account earnings and debt level, the majority of medical and dental residents defer repayment of their student loans until the end of their residency period. Unfortunately, for those specialties that require a residency of more than 3 years--OB/GYN, psychiatry, and general surgery to name a few--student loan repayment begins before a resident's medical or dental education is completed. This situation creates an enormous financial burden for residents who have, in most cases, incurred significant debt. In 2004, the average indebtedness for graduating medical students was $115,000, for graduating dental students it was $122,263. While lenders are currently required to offer forbearance to medical and dental students, this is an expensive option as interest continues to accrue and may be capitalized more often.

The Medical Education Affordability Act would solve this problem by extending the economic hardship deferment to cover the entire length of a medical or dental residency. By altering the definition we are removing a significant financial obstacle facing students with residency periods longer than 3 years. I want to stress again, residents will still have to demonstrate economic hardship--MEAA only extends the deferment for borrowers that continue to meet the debt-to- income requirements of the economic hardship deferment.

Mr. President, I hope my colleagues will join me in support of medical education by signing onto this bill. By working together, I believe that the Senate as a body can act to ensure that more individuals are able to pursue a full range of medical specialties.

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

Mr. President, I rise to introduce, along with Senators Mikulski, Landrieu, Levin, Cantwell and Kerry, the Youth Service Scholarship Act. This Act would authorize the Secretary of Education to award college scholarships of up to $5,000 a year to high school students and undergraduates who perform community service.

A recent study titled Community Service and Service Learning in U.S. Public Schools reveals that 66 percent of public schools involve students in community service. This means that approximately 54,000 public schools in America currently engage about 13.7 million students in community service each year. Other studies have shown that nearly 84 percent of high school students participate in volunteer activities either in or out of school and two-thirds of college students have recently participated in volunteer activities.

The Youth Service Scholarship Act is designed to assist low-income students who dedicate a significant portion of their time to volunteer service with money for college. This Act would authorize the Secretary of Education to award college scholarships of up to $5,000 to high school students who perform over 300 hours of community service in both their junior and senior years. In order to be considered, high school applicants must maintain a 3.0 grade point average, submit character recommendations, and write an essay

on the nature of their community service. Additional money will be available if the student continues to participate in a significant amount of community service once they are in college.

Voluntarism not only brings support and services to communities in need, it provides significant benefits to the students who participate. Research has shown that students who volunteer are 50 percent less likely to use drugs and alcohol or engage in destructive behavior. Additionally, students who volunteer are more likely to receive good grades, be philanthropic, graduate, and be interested in going to college.

In the 21st Century, higher education is not a luxury, it is a necessity. For many of our low-income youth, finding money to pay for college is an obstacle to enrollment. This scholarship program provides aid to motivated and inspired youth.

I urge my colleagues to join me in supporting the Youth Service Scholarship Act. I ask unanimous consent that the text of the bill be printed in the Record.

About 5 minutes.

Mr. President, I thank my colleague from Iowa.

Mr. President, I wish to take a couple of minutes to review for my colleagues what has transpired over the last several days on the pending matter of the nomination of John Bolton to be our ambassador to the United Nations.

I know there has been a lot of talk about whether goalposts have been moved in our efforts to resolve the outstanding matters concerning information which the Foreign Relations Committee seeks from the administration regarding the Bolton nomination, information that will not be shared with all Members of this body, but shared with the appropriate members of the Intelligence Committee and the chairman and ranking member of the Foreign Relations Committee.

We have not been expanding the goalposts but, rather, shrinking them. I want to review what has happened since April 11, since the issue was first raised regarding the nomination of John Bolton.

There are two issues on which the Senate Foreign Relations Committee seeks additional information. One has to do with 10 intercepts involving the names of 19 Americans that Mr. Bolton sought as the Under Secretary of State. We have tried since April 11, since the issue was raised on April 11, to have the appropriate members of the Foreign Relations Committee and the Intelligence Committee review those intercepts, much as Mr. Bolton did. The administration has refused to allow that to occur.

I then offered as a counterproposal, rather than the appropriate members looking at the intercepts, that at least the names of people we believe may be on those requests from Mr. Bolton be sent down to the administration for them to review. If they are on the list, we would want to pursue that a bit further to find out why Mr. Bolton sought information about them. If they are not, then that would end the matter.

A second matter of equal importance is a request Senator Biden has made, and that has to do with draft testimony before the Congress regarding Syria and the possibility of weapons of mass destruction being located in Syria.

Both requests are rather simple to comply with and should not take much time. But my colleagues on both sides ought to be aware that this is now a matter beyond the consideration of Mr. Bolton. Either the Senate has a right to receive pertinent and important information regarding this nomination or it does not.

Certainly my colleagues on both sides of the aisle know historically that other Members have sought information from other administrations they thought was critical to completing their task either on a matter of public policy or a nomination.

As I said earlier, we began on April 11. On April 14 of this year, questions were submitted. Again on April 22. On April 29, Senator Biden wrote to the administration requesting information regarding Syria.

On May 4, Senator Lugar sent letters to Secretary Rice which implied that she need not comply with all of the requests but certainly some of them.

On May 18, Senator Biden sent a letter directly to Ambassador Negroponte requesting information regarding the intercepts; again on May 26, on June 1, on June 2, on June 3, on June 8, on June 9, and as late as today on June 14.

There has been a long effort to try and work out some compromise, including the request I made to Mr. Negroponte, to allow us to submit the names. If John Negroponte reported back that there was no correlation between those names and the intercepts sought by Mr. Bolton, then I was going to be satisfied with that answer.

It is ironic, in a way, that the administration is filibustering their own nominee.

I want to get to a vote on John Bolton. We can do it in 24 or 48 hours, in my view, by simply responding to the request we have made, in the modified form we have made it, and responding to Senator Biden's request regarding the testimony on Syria. Both of those matters have been sought now for almost 2 months, and yet the administration continues to stonewall on those two requests.

I think it is important that the Senate be heard on these matters. I think it is dangerous for us not to be. There is pertinent information that could relate to the decisions by Senators to vote for or against this nominee.

In short, we have reached out a hand of compromise to the administration. And in response, the administration has given us the back of theirs. They have given us nothing--no counteroffer, just more stonewalling.

It is rather ironic that it is the administration that is filibustering its own nominee.

As my colleagues are well aware, on May 26, just before the Memorial Day recess, the Senate, by a vote of 56 to 42, did not invoke cloture on the motion to proceed to a vote on the nomination of John Bolton to the position of United States Representative to the United Nations.

The reason that the Senate did not invoke cloture was that sufficient numbers of our colleagues have supported the Foreign Relations Committee's efforts to make sure that all relevant information has been made available to the Senate related to this nomination before the Senate casts an up or down vote.

The administration has offered no rationale for refusing to provide the NSA intercepts or the information about the consultant. With regard to the Syria documents, it has argued that they are not relevant to our inquiry. In other words, the administration is telling the Senate what it may investigate. It has also said that providing the information will have a ``chilling effect'' on the deliberative process; yet the committee has already received numerous deliberative process materials.

The administration claims that they have already given the necessary information related to the intercepts request to the committee of jurisdiction, namely the Select Committee on Intelligence.

First, the Bolton nomination is within the jurisdiction of the Foreign Relations Committee, not the Intelligence Committee.

Second, we know from Senators Roberts and Rockefeller that General Hayden refused to provide them with the very names that Mr. Bolton and Mr. Bolton's staff were allowed to see.

Moreover, in a letter to the chairman and ranking member of the Foreign Relations Committee, Senator Rockefeller stated that Mr. Bolton may have shared the NSA intercepts with others at State without prior authorization from NSA.

So to be clear, Mr. Bolton was apparently free to share this unedited information with members of his staff, but the chairman and ranking members of the Intelligence and Foreign Relations Committees have been denied access to this same information.

I also want my colleagues to understand that the areas of inquiry that the committee is pursuing were not dreamt up by us last night or last week. The administration has been aware for some time what we were seeking and how strongly we felt about these materials being provided.

Let me lay out the chronology of our requests.

On April 11, during the first hearing on Mr. Bolton, that I first raised questions about the NSA intercepts.

On April 14, I submitted a question for the record inquiring about this Issue.

On April 22, I sent a letter directly to the NSA requesting this information.

On April 29, Senator Biden sent a letter, which also requested the information related to Syria.

On May 4, Senator Lugar sent a letter to Secretary Rice which implied that she should not feel obligated to respond to all of the Committee's requests.

On May 18, Senator Biden sent a letter directly to Ambassador Negroponte, our new Director of National Intelligence, requesting these NSA intercepts.

On May 26, he sent a second letter to Negroponte, again making the same request.

On June 1, I called Ambassador Negroponte to offer a proposal for resolving the intercept issue.

On June 2, I sent a letter to Ambassador Negroponte which laid out in writing the June 1 verbal proposal.

On June 3, Ambassador Negroponte called me to say, ``no deal.''

On June 8, Senator Roberts approached me and suggested that pursuing my idea of a giving a list of names to the administration might bear fruit. He also proposed a role for the Select Committee on Intelligence in the process. That seemed reasonable to me. After consultation with Senator Biden he did, too.

On June 9, Senator Biden and I sent a letter laying out our understanding on how names might be provided to the administration, and what the role for the chair and cochair might be in the process.

On June 14, Senator Roberts replied in writing to our letter saying he could not support our proposal. I would add that our colleague Senator Rockefeller has said he believes our proposal is eminently reasonable.

Through all of this, no one from the White House has contacted me or my colleague Senator Biden to offer any proposal for moving this process along.

In short, the administration has made no effort to meet Senator Biden and me halfway or even one-quarter of the way. The answer is either no or even worse, silence.

I ask my colleagues: If there is nothing in all of these documents, why have they not been provided? If there is nothing in them, then surely, providing them would clear up some of our concerns rather quickly. And make it possible to move forward with an up or down vote on the nomination.

And so if there is culpability for the delay in the Senate's consideration of the Bolton nomination, that culpability rests with the Bush administration. They have the ability to unlock this nomination by cooperating with this Senate as they did during the consideration of nominations during President Bush's first term in office.

I stand ready to listen to any proposal from the administration to resolve this matter. I know my colleague Senator Biden does as well. But the institutional prerogatives of the Senate are at stake here, and I believe we have the responsibility of protecting those prerogatives for this Congress and future Congresses. I am pleased and grateful that sufficient numbers of our colleagues appear to feel the same way.

I hope all Senators, regardless of whether they believe John Bolton will be a great man at the United Nations or not, realize this is a matter of constitutional equity. Either the Senate, as a coequal branch of Government, has the right to request and receive through appropriate Members and appropriate committees pertinent information relating to a critical nomination or not, and if we do not, then I think this body suffers in its ability to perform its constitutional duties.

That is what we are requesting. It can be satisfied in a matter of hours, and then the Senate, as a body, can vote up or down on John Bolton to send him to the U.N. or not send him to the U.N. But to stonewall this institution on information we have a right to receive I think is wrong and I think it jeopardizes the relationship between the Senate and the White House.

My hope is the White House will respond to the modified requests we have made so we can get about the business of voting on this nomination and moving to other matters before the Senate.

I thank my colleagues from Iowa and Illinois for being generous with their time.

Mr. President, I am pleased to join with my colleague from Maine, Senator Collins, and my colleague from Vermont, Senator Leahy, to introduce legislation today to protect America's children from the vicious criminals who prey on them.

While we've made some progress in the last few years, anyone who picks up a newspaper today can see that far too many of our kids are still too vulnerable.

The most recent annual data shows that about 58,000 children were abducted by nonfamily members, usually people who are strangers to the children. The most frequent victims were teenage girls. Almost one-half of these victims were sexually molested.

Our bill, ``The Prevention and Recovery of Missing Children Act of 2005'', will take 3 common-sense steps to better protect the children of America.

First, it will require that information on a missing child be disseminated throughout the country within 2 hours through the National Crime Information Center database. The reason for this requirement is that time is of the essence. In cases where a child is killed, the evidence shows that the child died within the first three hours of being kidnapped. The more quickly that police throughout the country can be alerted, the more likely it is that we can save a child before a child is harmed.

Second, the bill will make it tougher for convicted sex offenders to escape the law and the watchful eye of the community in which they live. We know that far too many jurisdictions rely essentially on the voluntary actions of the convicted sex offender to register his residence, his car and license plate, and other pertinent information. Moreover, requirements vary from state to state and jurisdiction to jurisdiction.

Therefore the legislation we are introducing today will provide tough national standards that will require these criminals to register before they are released from prison. It will require, within 48 hours of moving to a new residence, that these individuals report to local law enforcement and provide information about their residence, a current photograph, DNA sample, as well as report the make, model, and license plate number of his or her vehicle and get a drivers license or ID. Every 90 days, they would have to verify their registry information and annually provide a new photograph. Failure to comply with these requirements would subject the criminal to a felony.

These new requirements are tough, but our children's safety is far too important to be left to patchwork laws and the voluntary action of convicted criminals whose likelihood of repeating the crime is extremely high.

Third, the legislation removes a current requirement that the names of missing children be deleted from the national database when those children turn 18. Just because a child turns 18 doesn't mean that our country should not try to find that child and certainly doesn't mean that the child should be forgotten.

Nothing we do as a Nation is more important than building a better future for our children. And, nothing is more important to building that future than keeping our children safe today.

Therefore, in my view, no legislation is more important to be enacted in this Congress than this legislation to protect our children from every parent's nightmare. I ask unanimous consent to have a brief summary of the bill printed in the Record.

Mr. President, today I am pleased to announce the reintroduction of the Information Technology for Health Care Quality Act. By encouraging health care providers to invest in information technology (IT), this legislation has the potential to bring skyrocketing health care costs under control and improve the overall quality of care in our nation.

We are facing a health care crisis in our country. According to the Census Bureau, 45 million Americans were without health insurance in 2003--an increase of 1.4 million over 2002. In many respects, we have the greatest health system in the world, but far too many Americans are unable to take advantage of this system.

The number of uninsured continues to rise because the cost of health care continues to soar. Year after year, health care costs increase by double-digit percentages. The cost of employer-sponsored coverage increased by 11 percent last year, after a 14-percent increase in 2003. Employers are dropping health care coverage because they can no longer afford to foot the bill.

One of the ways to provide health care coverage to every American is to reign in health care costs. And expanding the use of IT in health care is the best tool we have to control costs. Studies have shown that as much as one-third of health care spending is for redundant or inappropriate care. Estimates suggest that up to 14 percent of laboratory tests and 11 percent of medication usage are unnecessary. Finally, and perhaps most disturbingly, we know that it takes, on average, 17 years for evidence to be incorporated into clinical practice. Along these same lines, a recent study showed that patients receive the best evidence-based treatment only about half the time.

Significant cost-savings will undoubtedly be realized simply by moving away from a paper-based system, where patient charts and test results are easily lost or misplaced, to an electronic system where data is easily stored, transferred from location to location, and retrieved at any time. With health IT, physicians will have their patients' medical information, at their fingertips. A physician will no longer have to take another set of X-Rays because the first set was misplaced, or order a test that the patient had six months ago in another hospital because she is unaware that the test ever took place. The potential for cost-savings from simply eliminating redundancies and unnecessary tests, and reducing administrative and transaction costs, is substantial.

Of course, when we consider the improved quality of care and patient safety that will result from wider adoption of health IT, the impact on cost is even greater. For example, IT can provide decision support to ensure that physicians are aware of the most up-to-date, evidence-based best practices regarding a specific disease or condition, which will reduce expensive hospitalizations. Given all of these benefits, estimates suggest that Electrontc Health Records (EHRs) alone could save more than $100 billion each year. The full benefits of IT could be multiple hundreds of billions annually. Such a significant reduction in health care costs would allow us to provide coverage to millions of uninsured Americans.

The benefits of IT go beyond economics. I am sure that all of my colleagues are familiar with the Institute of Medicine (IOM) estimate that up to 98,000 Americans die each year as a result of medical errors. A RAND Corporation study from last year showed that, on average, patients receive the recommended care for certain widespread chronic conditions only half of the time. That is an astonishing figure. To put it in a slightly different way, for many of the health conditions with which physicians should be most familiar, half of all patients are essentially being treated incorrectly.

Most experts in the field of patient safety and health care quality, incuding the IOM, agree that improving IT is one of the crucial steps towards safer and better health care. By providing physicians with access to patients' complete medical history, as well as electronic cues to help them make the correct treatment decisions, IT has the potential to significantly impact the care that Americans receive. It is impossible to put a value on the potential savings in human lives that would undoubtedly result from a nationwide investment in health care information technology.

It might seem counterintuitive that we can realize tremendous cost savings while, at the same time, improving care for patients. But in fact, improving patient care is essential to reducing costs. IT is the key to unlocking the door--it has the potential to lead to improvements in care and efficiency that will save patients' lives, reduce costs, and reduce the number of uninsured.

Unfortunately, despite the impact that IT can have on cost, efficiency, patient safety, and health care quality, most health care providers have not yet begun to invest in new technologies. The use of IT in most hospitals and doctors' offices lags far behind almost every other sphere of society. The vast majority of written work, such as patient charts and prescriptions, is still done using pen and paper. This leads to mistakes, higher costs, reduced quality of care, and in the most tragic cases, death.

There is no question in my mind that the federal government has a significant role to play in expanding investment in health IT. The legislation that I am introducing today defines that role. First, this bill would establish federal leadership in defining a Nationai Health Information Infrastructure (NHII) and adopting health IT standards. While I am pleased that the administration has already appointed a National Coordinator for Health Information Technology, I believe that the authority given to the Coordinator and the resources at his disposal are not equal to the enormity of his task. That is why my legislation creates an office in the White House, the Office of Health Information Technology, to oversee all of the Federal Government's activities in the area of health IT, and to create and implement a national strategy to expand the adoption of IT in health care.

This office would also be responsible for leading a collaborative effort between the public and private sectors to develop technical standards for health IT. These standards will ensure that health care information can be shared between providers, so that a family moving from Connecticut to California will not have to leave their medical history behind. At the same time, this bill would ensure that the adopted standards protect the privacy of patient records. While the creation of portable electronic health records is an important goal, privacy and confidentiality must not be sacrificed.

This legislation would also provide financial assistance to individual health care providers to stimulate investment in IT, and to communities to help them set up interoperable IT infrastructures at the local level, often referred to as Local Health Information Infrastructures--LHIIs. IT requires a huge capital investment. Many providers, especially small doctors offices, and safety-net and rural hospitals and health centers, simply cannot afford to make the type of investment that is needed.

Finally, this legislation would provide for the development of a standard

set of health care quality measures. The creation of these measures is critical to better understanding how our health care system is performing, and where we need to focus our efforts to improve the quality of care. IT has the potential to drastically improve our ability to capture these quality measures. All recipients of Federal funding under this bill would be required to regularly report on these measures, as well as the impact that IT is having on health care quality, efficency, and cost savings.

The establishment of standard quality measures is also the first step in moving our nation towards a system where payment for health care is more appropriately aligned--a system in which health care providers are paid not simply for the volume of patients that they treat, but for the quality of care that they deliver. To this end, my legislation would require the Secretary of Health and Human Services to report to Congress on possible changes to Federal reimbursement and payment structures that would encourage the adoption of IT to improve health care quality and patient safety.

I know that many of my colleagues, including Senator Enzi, Senator Kennedy, Senator Clinton, Senator Frist and Senator Gregg, have an interest in this issue. I look forward to working with all of them to move legislation this year. It is time for our country to make a concerted effort to bring the health care sector into the 21st century. We must invest in health IT systems, and we must begin to do so immediately. The number uninsured, the skyrocketing cost of care, and the number of medical errors should all serve as a wake-up call. We have a tool at our disposal to address all of these problems, and there is no more time to waste. I urge my colleagues to support this legislation.

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