Floor Statements

First, I commend my good friend from California for her excellent statement and revealing to the Nation the seriousness we have in the ability to provide jobs with qualified workers. Just this past decade, we brought 4 million workers into this country to take the high-skilled jobs of our Nation because we could not provide them from our own school systems. Yet we have thousands and thousands of unemployed and unskilled workers who have managed to get through our school systems without the necessary skills.

We have a crisis in this Nation, and we have had it for years, and that is in education. This administration is totally ignoring the fact that where we should be putting the funds is in preventing this necessity of having to bring in workers from foreign nations, whether it be from Europe or elsewhere. Most of them come from Asia now. Millions and millions are coming in. Yet our own young people in this country do not have the skills because their school systems are failing. And we are cutting back and back on the funding for education in this Nation.

This administration recognizes we have a problem and realizes our children need help; we have the Leave No Child Behind Program. But we have no funding to prevent the terrible situation that was just outlined by the Senator from California. I praise her for that. But let's wake up and do something about it rather than bringing in millions and millions of workers from Asia to take the jobs that our young people ought to have the skills to take.

Mr. President, I will spend a few minutes expressing my concerns about a serious public health crisis that this country faces due to mercury pollution.

Perhaps some of you have heard of the small fishing community of Minamata Bay in Japan. If you know this village, you know also that it was nearly devastated by mercury pollution.

Over 70 years ago, a chemical plant began dumping mercury waste into that bay. For the next 30 years, local citizens who depended heavily on the bay for commerce and daily sustenance saw strange and debilitating health problems emerge.

At first, those eating fish out of the bay began experiencing headaches, numbness, tremors, blurred vision, hearing loss, speech problems, spasms, and loss of consciousness. As fish consumption continued, more people became sick.

Plus, pets started becoming violent and birds fell from the sky. Naturally, the public's panic grew.

Then, a generation of children was born with shriveled limbs and severe physical deformities. The woman in this photograph is one of the survivors of what was called Minamata Disease.

In all, over nine hundred people died and thousands more were crippled by the poisoning. The Japanese government, which discovered the cause of these illnesses as early as 1956, hid the truth from the ailing public and refused to halt the industrial pollution. The dumping eventually stopped in 1968.

In other words, knowing this mercury pollution was deadly, the Japanese government allowed it to continue for another 12 years.

Surely such abandonment of the public's well-being would not happen today in our great country.

Surely our government would never delay protections from mercury pollution for a decade, while allowing industry to neglect its responsibilities.

Sadly, I am afraid this is exactly what is happening in our country today--over half a century after the lessons of Minamata Bay.

Fortunately, we are not faced with the same concentration of mercury pollution as that Japanese fishing village

so many years ago, where an estimated 27 tons of mercury compounds were dumped into the Bay. Although U.S. power plants emit almost twice that amount into the air each year, it is dispersed broadly, resulting in lower concentrations in any one place.

Some estimates show that almost 100 additional tons of this poison are emitted from other U.S. sources every year, bringing our air emissions total to almost 150 tons of mercury pollution annually.

Furthermore, the principal route of human and wildlife exposure, namely, the consumption of poisoned fish, is the same in this country as it was in Minamata. It is occurring at often dangerous levels.

Power plants are the largest unregulated source of mercury in the country, emitting almost 50 tons each year into our air. To put this amount into perspective, just one-seventieth of a teaspoon of annual mercury deposition can make fish in a 25 acre lake unsafe to eat. Utilities, amazingly, are releasing enough mercury into our air every year to contaminate 45 million lakes.

Medical and solid waste incinerators are also major mercury polluters, but they are regulated under the Clean Air Act. Because of these regulations, incinerators have reduced emissions by 95 percent in the last decade. Impressive. The act also requires any residual risk posed by these sources to be reduced with further emissions cuts.

When utilities burn coal, they release much of its mercury content into the air. This mercury falls with the rain into lakes, streams, and the ocean. It then transforms into a toxic compound called methyl mercury that does not break down easily, as this chart shows.

This toxic mercury is eaten by fish, and increases in concentration up the fish food chain as smaller fish are consumed by larger fish. Eventually, humans and other animals eat the fish, and the mercury too. Clearly, our consumption of larger fish can expose us to greater concentrations of mercury contamination than eating smaller fish. This cycle is depicted in the chart beside me.

The EPA estimates that although some atmospheric deposition of mercury in the United States is due to non-U.S. sources, 60 percent of what falls to Earth in our country is due to our own emissions.

We should take responsibility for the fact that most of our mercury deposition comes from our own country. And, for those sources abroad that affect our Nation's environment, I urge the administration to negotiate a treaty quickly to control non-U.S. emissions.

Mercury contamination of fish in the United States has very harmful impacts on our wildlife and our health. In waterfowl such ass loons, it interferes with vision and muscle coordination. It is toxic to their developing embryos and hinders reproduction. As a result, loon populations are declining, especially in the Adirondacks.

Other fish-eating wildlife like mink and otters are at risk as well.

In humans, once mercury is ingested it has the ability to enter our blood stream and cross the blood-brain barrier. Pregnant and nursing women then can pass the mercury on to developing fetuses and infants, who are at greatest risk for serious health problems.

The National Academy of Sciences has confirmed that prenatal mercury exposure is linked to the following: impaired memory and concentration; the inability to process and recall information; impaired visual and motor function; attention and language deficits; cerebral palsy; mental retardation; and other developmental effects.

These health effects are similar to those caused by lead poisoning. Indeed, mercury is very likely the next lead. We were able to find an effective solution to the lead problem relatively quickly. However, we can and should address mercury pollution even more swiftly and effectively. We have advanced technology that makes it possible and feasible now.

In 2003, the Centers for Disease Control and Prevention found that 1 in 12 women of childbearing age has mercury levels above EPA's safe health threshold, due primarily to consumption of poisoned fish. This totals almost 5 million women, and results in almost 300,000 newborns with increased risk of nervous system damage from exposure in the womb.

EPA recommends that pregnant women, or women who may become pregnant, eat only one serving of fish each week, and adhere to any State advisories that may call for further prohibitions.

What many Americans may not realize is that all other healthy children and adults are also at risk if they consume a large amount of fish. This group includes recreational anglers like this boy here, some Native American tribes, Asian Americans, and the poor. A United Nations Environment Programme report has linked mercury exposure to heart, thyroid, and digestive problems in adults.

This is truly a widespread health crisis. Yet, despite the fact that these at-risk groups can face mercury exposures two to five times higher than the general population, they are often the least informed about the dangers of mercury consumption.

Today we rely on a hodge podge of State advisories to protect citizens from eating too much poisoned fish. Currently, 43 States have advisories in effect.

These advisories cover over 12 million acres of lakes, 450,000 miles of river, 15,000 miles of coast, and more.

Multi-state water bodies are often covered by inconsistent warnings, leading to confusion for anglers and consumers alike. Many States do not even monitor their own rivers and lakes.

Some State advisories are based on EPA's safety threshold, which has been deemed scientifically justifiable by the National Academy of Sciences. However, others are based on the EPA's weaker standard. EPA itself does not issue advisories, but it offers guidance to States.

The FDA is responsible for warning consumers about mercury contamination of commercially available fish. However, FDA advisories are rarely posted where fish consumers can see them, at the grocery stores or fish markets. In fact, only this year did one State, California, require that stores begin posting warnings like this one.

This advisory says:

Warning--Pregnant and nursing women, women who may become

pregnant, and young children should not eat the following

fish: swordfish, shark, king mackerel, and tilefish. They

should also limit their consumption of other fish, including

fresh or frozen tuna.

Shamefully, the FDA does not make public the information it has collected from fish safety testing. Plus, in 1998, it ceased its mercury monitoring program for shark, swordfish, and tuna, and now does only limited testing.

Does this seem like an adequate way to inform the public about the risks of fish consumption? The FDA must act now to better protect Americans.

The good news is that the Clean Air Act is designed to protect us from some sources of mercury pollution. The bad news is that this administration seems determined to reverse or weaken such protections.

The Clean Air Act amendments of 1990, which I was proud to work on with the first President Bush, called on EPA to study the health and environmental impacts of mercury emissions from utilities by 1993.

Unfortunately, this vital study was not completed until the end of 1997.

The amendments also ordered EPA to explore available technologies for their emission reduction potential, and to regulate mercury and other air toxics, if deemed appropriate and necessary by the administrator.

Such a determination should have been made soon after release of the study, during the Clinton administration. However, the Clinton EPA did not issue such a finding until December 2000.

EPA Administrator Carol Browner found that mercury regulation was, in fact, appropriate and necessary, given the results of the prior EPA's study. This kicked off the drafting of maximum achievable control technology--or MACT--standards for mercury.

However, because EPA missed deadlines in the Act to make that determination, environmentalists sued and obtained a settlement creating a schedule for the development of MACT standards.

Now, the second Bush EPA must propose mercury emission standards for utilities by this December, and finalize them by next December. These standards must be met by the end of 2007 at each unit.

EPA could expedite finalization of the standard to give industry more

time to comply, but instead the Agency has opted for delays. I would also note that EPA is currently violating the Clean Air Act's schedule for air toxics controls for many other sources, sending millions more pounds of dangerous emissions into the air we breathe.

Mr. President, industry information shows that the technology exists today to reduce utility mercury emissions by 90 percent or more--down to about 5 tons per year. Under MACT, the EPA should set its standard to match the capability of the best utility performers.

Not coincidentally, a 90 percent cut in utility mercury emissions is guaranteed in my bill, the Clean Power Act of 2003.

However, the current Bush administration has proposed to derail EPA's mercury standard--in essence, to violate the intent of the Clean Air Act.

This administration's multi-pollutant plan, called Clear Skies, does away with the Clean Air Act's technology standard for mercury. In its place, Clear Skies calls for weaker standards and a 10-year delay in their achievement.

Plus, EPA is prevented from using its existing authority to require further reductions if residual risk from utility air toxics remains a problem.

Could it be that the administration is more interested in giving polluters a free ride than in protecting public health?

This harmful bias towards irresponsible industry is something we saw 50 years ago in Minamata Bay--and we should have learned a lesson about its ill effects.

The Clear Skies polluter payoff does not aim for this five ton goal by 2008, but for 15 tons in 2018 and on--for eternity. As this chart shows, compared to a strict interpretation of what the Clean Air Act could do for our health, this rollback totals 520 percent more toxic mercury in our environment and on our dinner tables before 2018, and 300 percent more mercury after 2018.

Why would we pass this risk on to our children? I have to believe that no compassionate parent- or grandparent-to-be would knowingly do that.

EPA has thoroughly studied the mercury threat and devised an adequate health threshold--which has been supported by the NAS. The agency must follow through with the law of the land and cut mercury emissions from utilities now. In fact, this administration does not have the authority to do any less. We in Congress must not and cannot in good conscience give them that authority through the Clear Skies rollback.

If any of my colleagues doubt the potential benefits of the current Clean Air Act, I suggest they ask this administration for its long overdue economic analysis of today's best technologies--what the Act would require utilities to install.

My colleagues should know that they won't get an honest, fair, or timely response, because that response would show that, by comparison, Clear Skies is just a license to keep sending uncontrolled mercury into our air.

It is hard for me to grasp why any administration would want to keep Congress and the public in the dark about the real benefits of the Clean Air Act. Could it be that the administration wants to distort the perceived benefits of any proposed changes.?

To make matters worse, in a recent hearing in the Environment and Public Works Committee, an official from the Council of Economic Advisors suggested that the administration now wants Congress to modify the mercury cap in their air pollution giveaway to make it even less protective.

Instead of capping mercury at twenty-six tons in 2010, the administration would like us to consider a cap as high as 46 tons.

This is an outrage. Utilities today emit about 48 tons of toxic mercury every year. So the modified Clear Skies cap would mean only more inaction.

Candidate George W. Bush started with a four-pollutant bill, then dropped carbon in 2001 to get to three pollutants. Now, his administration is more or less admitting they support merely a 2- pollutant bill. Is that what they consider progress?

Why on earth would we allow them to go forward with this plan?

The scientific evidence about the dangers of mercury exposure mounts annually. The technologies exist today to dramatically reduce emissions and the associated risk. To do otherwise abdicates the administration's and our responsibility to protect public health.

We have a vital choice to make in Congress this year. Either we uphold the law as written in the Clean Air Act or we shut our eyes while the pollution and damage to our health and environment goes on.

The delays and distortion must stop. This in not the 1950s, as much as the administration would like it to be. I have no doubt there will be misguided efforts to stall the mercury standards, which are already late. I promise that I will keep a watchful eye. But I urge all mothers and fathers to pay heed as well--your children's and grandchildren's health hangs in the balance.

I have my own health advisory to post on the walls of Congress today: The administration appears less interested in protecting mothers and children from mercury poisoning, and more interested in protecting the polluters' bottom line. This may explain why they are trying to replace current law with Clear Skies.

Mr. President, I rise today to express my strong support for the good government amendments that my colleague, Senator Byrd, shall be offering later today. The public is looking to the Department of Homeland Security to ensure that our country is prepared to the best of its ability for any future terrorist attack.

What must the public think when they see individuals who recently worked for Secretary Ridge turning around and lobbying for a specific special interest? What do they think when individuals who run companies competing for government contracts from the Department of Homeland Security are appointed to a special advisory council to that same Department?

These events may not be hindering our preparations against another terrorist attack, but they surely raise an appearance of am impropriety.

To ensure that the public has full confidence in the Department of Homeland Security and the actions that are taken to prepare the country, the Senate should pass these important amendments.

I thank my colleague, Senator Byrd, for raising these important issues. I urge my colleagues to support these good government amendments.

I yield the floor.

Mr. President, I am pleased to note that the Foreign Relations Committee has included a very important provision on global climate change in S. 925, as reported. This provision, section 813, expresses the sense of Congress that the United States should take responsible action to ensure significant and meaningful reductions in emissions of greenhouse gases from all sectors. I strongly support this provision. Its inclusion in this legislation should be a signal to all the conferees on this bill and to the world that the Senate strongly supports such reductions.

The findings preceding the articulation of the sense of Congress in section 813 are also very important. They clarify that it is Congress' position that evidence continues to demonstrate that increases in atmospheric concentrations of man-made greenhouse gases are contributing to global climate change.

This assertion is supported by reports from the National Academy of Sciences, the International Panel on Climate Change, and testimony before various Senate committees, including the Senate Environment and Public Works Committee of which I am the ranking member. We have heard repeatedly that increasing greenhouse gas emissions increase the risks associated with global climate change and warming.

I believe it is prudent and practicable to manage these risks now by reducing our emissions as swiftly as possible. Based on the work of many highly respected scientists, I believe we must endeavor to prevent a doubling of atmospheric concentrations of carbon. That means dramatic changes in the way we use, produce and consume fossil fuels in the next 10 to 15 years.

Nearly every single climate expert and scientist believes that the facts require us to take prudent actions now to reduce emissions and thereby reduce the risks of climate change. In a December 2002 resolution, the American Geophysical Union said the following: ``AGU recommends the development and evaluation of strategies such as emissions reduction, carbon sequestration, and adaptation to the impacts of climate change. AGU believes that the present level of scientific uncertainty does not justify inaction in the mitigation of human-induced climate change and/or the adaptation to it.''

As much as some people would like to continue debating whether or not global warming is occurring and whether or not man-made emissions are contributing to that warming, there is not a real debate on this matter in the scientific community. They have moved on, as Congress and the Administration should, to trying to define the magnitude of the probable disruption to earth and human systems, and to designing emissions reductions and adaptation programs to avert the negative effects of that disruption to our quality of life, the environment, and the economy.

I ask unanimous consent that four short documents be printed in the Record following my remarks.

Mr. President, as we debate the Prescription Drug and Medicare Improvement Plan of 2003, I would like to take a few minutes today to speak in support of the overall bill, but I would also like to highlight several provisions in the bill that are of particular importance to me and my State of Vermont.

Over the last several days, we have focused much of our discussion on the aspects of this bill related to prescription drugs and the Medicare Advantage Program. These are clearly among the most important provisions of this bill and these issues warrant the attention and debate they are receiving. I especially appreciate the close relationship this bill has to last year's tripartisan effort--which effectively is the parent of the current bill Last year, my friends-- Senators Grassley, Snowe, Hatch, and Breaux--and I set out to design a bill that provided a prescription drug benefit along with other improvements, what we called ``enhancements,'' to the basic operations of the Medicare Program. The tripartisan bill was good legislation-- something all of its original cosponsors were very proud to work on together.

This year, I am pleased to say that the Grassley-Baucus bill is even better than our effort from last year, and I commend Chairman Grassley and Ranking Member Baucus for their leadership and initiative in bringing it to the Senate floor.

One of the most important reasons that the Prescription Drug and Medicare Improvement Act is stronger than the tripartisan plan from last year is because it includes provisions that begin to resolve longstanding inequities in payments to rural doctors, hospitals, and other provisions. This problem can be stated simply. Rural health care providers are paid less than providers in more densely populated areas for the same exact services. Earlier this year, I joined with my colleagues, Senators Hatch, Grassley, Lincoln, and Bingaman, in introducing the legislation that addressed geographic inequities for physician services by changes to the physician reimbursement formulas.

As many of our colleagues are aware, Senator Grassley fought to include these rural provisions in the recent tax bill that was signed by the President. And although I strongly disagreed with enacting further tax cuts, I was doubly disappointed to see the rural health provisions stripped out in the conference with the House. These unfair geographic differences in reimbursement rates have gone on far too long, and I am especially pleased to see reimbursement issues for rural providers getting the attention they deserve--including the commitment from the President to my friend from Iowa pledging his support for rural health relief as part of the effort we have underway. I am, therefore, very pleased to see that these provisions are included in the chairman's mark and are now part of this bill.

I am also glad that Chairman Grassley and Ranking Member Baucus have worked with me to address another inequity in the system. Critical access hospitals provide care in the most remote regions of my State of Vermont and all other rural States. These hospitals are small, yet serve as critical resources to their communities. The managers have agreed to include a provision in their amendment that will make a technical correction to current law, allowing hospitals like the Mt. Ascutney Hospital in Windsor, VT, to expand access to psychiatric and rehabilitative services to the most vulnerable citizens in that community.

I would also like to speak today in support of a provision in this bill that establishes Medicare demonstration programs to improve health care quality. I heard my friend from Montana speak yesterday about quality and geographic disparities, and I know how committed he is to improving the quality of services delivered under Medicare. Earlier in this Congress, I was pleased that Senators Frist, Beaux, and Gregg joined me in introducing S. 1148, the Medicare Quality Improvement Act. I want to thank Chairman

Grassley and Ranking Member Baucus for including this provision in this bill.

I became concerned about the issue of health care quality after reading the work of Dr. Jack Wennberg of Dartmouth, which has shown that higher levels of Medicare spending do not lead to better health outcomes. Let me repeat this finding. Higher levels of Medicine spending do not lead to better health outcomes. Instead, spending tends to vary by region--generally reflecting the availability of physicians and hospitals--rather than the health or needs of the population.

I have followed Dr. Wennberg's work for a very long time. One of his early studies looked at rates of surgical procedures at Vermont hospitals. He found that communities in Vermont that had many more medical procedures were not necessarily healthier. I saw how this result led Vermont health care providers to join with the business community in achieving high quality, supportable outcomes. I also saw how our State government used this effort to improve health care across our State. Today, I am happy to say that Vermonters enjoy some of the highest quality health care in the United States, at a cost that is among the lowest in the country.

As we prepare to vote for the bill before us, I think it is critically important for us to consider some of the lessons learned from Vermont. Some of my colleagues have expressed concern about the costs of the bill before us. Others have expressed concern that the bill does not go far enough. The quality demonstration program in this bill will give us some of the answers we need to these funding questions.

The need for these demonstrations is critical. RAND Health published a study today in the New England Journal of Medicine that describes the problems with overuse and underuse of needed medical care services in the United States. The RAND study will make it clear that every American is at risk--not only for failing to receive needed medical care, but also for receiving care that is not needed and may even be harmful. This is a problem that belongs to each and every one of us, and we must find ways to fix it.

The legislation before us closes a significant gap in the health benefit package available to our Nation's seniors. However, providing coverage for health care services is not enough. We must do a better job of ensuring that people are getting the care they need, and also that they need the care they get.

In closing, I would like to urge my colleagues from both sides of the aisle to support this bill as we move forward. This bill will establish a drug benefit that is universal, comprehensive, affordable, and sustainable. This bill restores necessary and long-needed fairness to our physicians and providers in rural areas. And, the bill will improve the quality of care offered under Medicare.

Mr. President, this bill is a landmark piece of legislation the most significant modernization of the Medicare Program since its inception in 1965. Its passage by the Senate is a major accomplishment on the path toward enacting a prescription drug benefit for our Nation's seniors. It is the result of years of bipartisan, I might even say tripartisan, effort and it puts in place many long- sought changes. It has many significant features for the citizens of my home State of Vermont. It provides a sustainable, universal, and comprehensive prescription drug benefit. It guarantees access to traditional Medicare for all beneficiaries. It allows Medicare beneficiaries to participate, if they choose, in new systems of care that better reflect today's dynamic health care environment. The bill recognizes the high cost of providing quality care in rural settings and closes the reimbursement

gap between rural providers and their urban counterparts. Finally, it contains a provision that will allow us to better understand how to provide quality health care--not care driven by using more and more resources, but instead one based on ensuring quality patient outcomes.

Over the past 2 weeks, I have applauded the work of my colleagues who have labored over this bill. Today, I have the pleasure of congratulating them on their success and thanking them for their efforts.

I have worked for more than 3 years with my good friends, Chairman Grassley and Senators Snowe, Breaux, and Hatch. In many meetings over many months, we delved into the details of what came to be called the Tripartisan Bill. This has been one of the finest experiences of my many years in Congress. I am very proud to have been a part of that group and that our efforts led the way to our success today.

I especially want to salute the efforts of Senator Baucus and Senator Kennedy without whose hard work and commitment to working through an agreement we would not have accomplished this remarkable victory, and they deserve our accolades.

A bill such as this is the result of great effort on the part of many different people who are not elected to this body, but upon whom we all rely. I would like to recognize the staff members who have worked so hard on this bill and deserve much of the credit for its successful passage.

On Senator Grassley's staff: Ted Tottman, Linda Fishman, Colin Roskey, Mark Hayes, Jennifer Bell, and Leah Kegler, and on Senator Baucus' staff Jeff Forbes, Liz Fowler, Jon Blum, Pat Bousliman, Kate Kirschgraber, and Andrea Cohen deserve considerable recognition for their tireless efforts. Catherine Finley, Tom Geier, and Carolyn Holmes from my friend Senator Snowe's staff; Patricia DeLoatche and Trecia Knight of Senator Hatch's office; and most especially Senator Breaux's legislative director Sarah Walters deserve enormous credit for this bill. Finally, we would not be claiming a victory today if it were not for the contributions of Senator Kennedy's staff, especially, David Nexon and Michael Meyers.

On my own staff, I particularly want to recognize the contributions of Paul Harrington during the last Congress, and most especially the work of Sean Donohue who took up that effort on the tripartisan bill and who has continued to see it through to today's success, with the recent assistance of Daniel Crimmins, our Robert Wood Johnson Health Policy Fellow. Each and all have worked tirelessly to gather the input, analyze the issues, and build a consensus toward achieving this final product.

Mr. President, will the Senator yield for a question?

I was obviously on this issue with the Senator from North Dakota. We were forced into providing an ``out'' for them so we could get the bill to the floor that said the Secretary would have the authority to be able to set the bill aside and prevent this coming in. I don't think they would be required to make any rationalization. But, obviously, it was something we had to accept at the time in order to get the bill voted on. And then what happened?

I thank the Senator.

Mr. President, as Senators, we are accustomed to the glare of the public spotlight and there are even some members of Congress who crave such attention. In general though, we are here because we share a deep desire to serve our country and to help ensure that our government and its laws are true to the spirit of America.

We sometimes forget that we are also part of a Senate community filled with people who believe in that same kind of public service. Though they do not share the spotlight with us, we could not do our jobs without them and the nation would suffer.

So, I want to recognize the contributions made by all staff, and in particular the experts in the Office of Senate Legislative Counsel that help keep us true to the law, its structure and its functioning. They help put our ideas into real form and maintain the integrity of the code.

That is why it is very very difficult today to note the passing of Janine Johnson, Assistant Counsel in Office of Legislative Counsel. She was an integral and crucial part of that office.

Her professionalism, her deft grasp of complicated statutes, her work ethic, and above all, her pleasant manner and bearing, will be sorely missed by that office, but also by me, my office and in particular, my Environment and Public Works Committee staff.

Many of my staff have worked with Janine for a decade or more and have been uniformly impressed by her unparalleled skill and commitment to her job.

Janine had a knack for taking even the most complicated concepts and proposals and breaking them down into manageable parts. Then, she found ways to integrate them into existing statutes. To many staff, she was a legislative magician.

One did not need to know Janine for very long to see that she shone with a pure and intense inner light that made the way clearer and easier for others. But, the memory of her kindness and delicate humor will live on and inspire those who follow her.

Janine was a talented woman and a lawyer's lawyer. She had a green thumb and many days brought one of her prized amaryllis plants in to brighten the front office. She also spoke many languages, including beginning Russian which I believe she started in Middlebury, VT.

The Senate has suffered a great loss with the passing of Janine Louise Johnson. I wish her family and friends all the best in coping with the pain. However, I want to note that her significant contributions to the Senate and to the nation will not be forgotten and that she should serve as a model for us all.

Mr. President, it is not hyperbole to start by saying that we are engaging in a truly historic Medicare debate--one that has the potential to rival the 1965 creation of the Medicare Program. Over the next 2 weeks, we will have the opportunity to consider and enact the most significant Medicare modernization in 37 years. We have the chance to do more for the health care and well-being of our Nation's elderly than has been accomplished through any recent Medicare legislation.

I commend Senator Grassley and Senator Baucus for their work in bringing this measure to the Senate floor.

The Prescription Drug and Medicare Improvement Act is a landmark improvement to the Medicare Program

and our colleagues deserve a great deal of credit for reaching this bipartisan agreement--I would say tripartisan.

This is a large and complex bill--measuring over 600 pages. It is not at all unusual for a proposal of that size to have issues remaining and I know there are some of our colleagues for whom these issues need to be debated and addressed. So we should not be Pollyanna about the outcome. Work remains to be done.

But I have been listening to our colleagues as they have come to the floor to discuss this bill and I am encouraged by the largely positive tone of their remarks. I am encouraged because this year I sense a cautious optimism among our colleagues that this Congress--this year-- we will be successful.

As our colleagues know, I have been working on various efforts to modernize Medicare and to provide a prescription drug relief for our elders for many years. Most recently, I had the pleasure and honor to work with several of our colleagues on what came to be known as the tripartisan bill. I joined with Senator Grassley, Senator Breaux, Senator Snowe, and Senator Hatch in a 2-year effort at drafting a compromise measure that we felt could gain a majority of votes in the Senate.

It was a true pleasure working with my friends in the tripartisan group and although we were not ultimately successful last year, I am convinced that much of our effort then has contributed to the bill we are debating now. So it is with a great deal of satisfaction that I am here to speak in favor of S. 1, the Grassley-Baucus, Prescription Drug and Medicare Improvement Act of 2003.

S. 1 provides for a comprehensive, universal and affordable prescription drug benefit under Medicare. It also pioneers new arrangements with private sector-based health plans that promise to integrate traditional medical care with innovations in the areas of disease prevention and chronic disease management.

The drug benefit, in particular though, meets four principles that have guided me throughout this effort. First, this program provides a universal benefit; it is available to all Medicare beneficiaries. While I believe it is critical to provide a benefit to the poor and those with catastrophic costs, all seniors, regardless of income, will benefit from this plan.

Second, this program is comprehensive. Beneficiaries will have access to the best medicines, and will not be limited to only the cheapest ones for the sake of saving money.

Third, this Medicare drug benefit is affordable--for both beneficiaries and the Government.

Finally, for a drug benefit to be truly successful it must be sustainable. It will do little good to repeat the catastrophic failure of years past by beginning a program that we cannot carry on.

This program, which combines seniors' contributions with a Government guarantee, will have the best chance of enduring into the future.

I believe this bill meets these four standards. It is universal, comprehensive, affordable, and sustainable.

Could it be improved? Probably. And that is why we will debate and possibly amend it this week. But this approach is a good compromise. It offers a respectable and responsible plan within the budget limitations we face. It is a good compromise. I support this bill and urge the Members here to support it as well.

In closing, I also thank several of our other colleagues who contributed so much to this effort. I think again, that the work of our tripartisan group from last year did much to pave the way to today's bill--so I thank my colleagues for letting me join with them in seeking a tripartisan solution.

Again, I thank Senators Grassley, my friend of over 28 years. We have worked on this issue and many others in the past. I think this will be one of our proudest achievements.

Also, this bill would not have the balance that it does without the contributions of other members including Senators Baucus, Daschle, Graham, and Rockefeller of the Finance Committee and of Senator Kennedy's efforts to bridge the divides where they existed.

As I close for today, I would like to mention that the measure we are debating this week contains many more significant provisions than just those related to prescription drugs. So I will look forward to returning to the Senate floor at a later time to discuss those provisions with our colleagues.

Mr. President, I yield the floor.

Mr. President, I ask unanimous consent to allow floor privileges for Daniel Crimmins, a Robert

Woods Johnson health policy fellow in my office during deliberations on this measure.

I rise in support of the amendment offered by Senator Bingaman.

His amendment does not go as far as I would wish, because it does not fully preserve the integrity of NEPA or the Endangered Species Act.

These two Federal statutes, which are under the jurisdiction of the Environment and Public Works Committee, have been cornerstones for the protection of environmental quality for decades. Section 2604 of the bill negates or weakens application of these laws to most energy development on tribal lands.

Section 2604 would allow tribes to grant leases or rights-of-way for mineral development, electric generation, transmission or distribution facilities or facilities to process energy resources of any sort on tribal lands.

The tribes could do this without the approval of the Secretary of the Interior.

This would effectively remove the current legislative authority of the Department of the Interior over these matters.

Under existing law, the oversight of the Secretary of the Interior over energy development on tribal lands triggers a variety of Federal permitting requirements which will ensure that NEPA, section 7 of the Endangered Species Act, and a variety of other Federal laws will apply to these activities.

Removal of the Secretary's approval authority over many of these actions would have a number of consequences.

First, it would mean that Federal NEPA laws would no longer apply. It would also mean that the section 7 Federal consultation provisions of the Endangered Species Act would cease to apply.

This is particularly significant in that tribal lands are often adjacent to some of the most protected and pristine Federal lands, including wildlife refuges, wilderness areas, and National Parks. Wholesale changes in the application of the Federal mineral leasing and development laws--and potentially a host of environmental laws--to tribal lands, could have significant impacts on adjacent sensitive lands, air quality, water quality and wildlife.

Because of their sovereign immunity and special trust status, tribes are also generally exempt from many State environmental and other laws, to which private lands are subject.

Section 2604 represents a sweeping reversal of years and years of established environmental and energy laws, many of which are within the jurisdiction of the Senate Environment and Public Works Committee. Our committee has never held hearings on this, nor had the opportunity to examine the extent to which this language would weaken or amend Federal environmental laws, or laws relating to the development of commercial nuclear power.

My preference would be to insert language which I filed yesterday, which would clarify that Federal environmental and nuclear laws would continue to apply to these tribal lands, regardless of removing the approval of the Secretary of the Interior under the Indian Mineral Development Act.

However, because I think that the language offered by Senator Bingaman has a greater chance for success, I will vote in favor of his amendment.

At a minimum, his amendment would remove any implicit waiver of Federal environmental laws and would create an environmental review process to be conducted by tribes to ensure at lease some modicum of public involvement in what could possibly be massive energy development on tribal lands.

Section 2604 creates an unprecedented lack of Federal oversight for development with potentially massive environmental impacts, and I urge my colleagues to adopt Senator Bingaman's amendment.

Madam President, I rise today to introduce the ``Marine Turtle Conservation Act of 2003''.

Marine turtles were once abundant, but now they are in serious trouble. Six of the seven recognized species are listed as threatened or endangered under the Endangered Species Act, and all seven species have been included in Appendix I of the Convention on International Trade in Endangered Species of Wild Flora and Fauna, CITES. Because marine turtles are long-lived, late-maturing, and highly migratory, they are particularly vulnerable to the impacts of human exploitation and habitat loss. In addition, for some species, illegal trade seriously threatens wild populations. Because of the immense challenges facing marine turtles, the resources available to date have not been sufficient to cope with the continued loss of nesting habitat due to human activities and the resulting diminution of marine turtle populations.

The Marine Turtle Conservation Act of 2003 is modeled after the successful Asian Elephant Conservation Act, the African Elephant Conservation Act, and the Rhinoceros and Tiger Conservation Act. These acts have established programs within the Department of the Interior to assist in the conservation and preservation of these species around the world. More than 300 projects have been funded and generated millions of dollars in private matching funds from sponsors representing a diverse group of conservation organizations. The projects range from purchasing anti-poaching equipment for wildlife rangers to implementing elephant conservation plans to aerial monitoring of the Northern white rhinoceros.

The Marine Turtle Conservation Act of 2003 will assist in the recovery and protection of marine turtles by supporting and providing financial resources for projects to conserve nesting habitats of marine turtles in foreign countries and marine turtles while they are found in such habitats, to prevent illegal trade in marine turtle parts and products, and to address other threats to the survival of marine turtles. The bill authorizes $5 million annually to implement the program.

This legislation will help to preserve this ancient and distinctive part of the world's biological diversity.

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

Mr. President, I want to state my opposition to the Federal Communications Commission's scheduled June 2nd vote to overhaul current broadcast media ownership rules of newspapers, television ,and radio stations. I am disappointed that FCC Chairman Michael Powell has refused to hold a single public hearing regarding the proposed changes to these rules, or to entertain further public comment on what is turning out to become a historic rulemaking.

The public needs to be heard from, and the public needs to know what will happen if the changes that Chairman Powell has proposed become reality. The biennial review required by the 1996 Telecommunications Act requires the FCC to review its rules every 2 years, but this review should not be used as an excuse to radically alter the way our constituents receive their news from the media.

Not only am I disappointed at how this situation has come to pass, but I am also dismayed at what the FCC proposes. There are a number of changes that I disagree with--and this is just from what we have learned last week.

For instance, we have learned that the FCC is considering to allow the major broadcast networks to purchase more television stations and strip them of local control. The FCC is also proposing to ease ``cross- ownership'' rules and allow a media company to own a newspaper and television company in the same community.

I urge everyone to reflect on this and how this will impact communities throughout this country. In my State of Vermont, we have a very proud tradition of grassroots activism. Our local Vermont media knows this and reports the day's events with a Vermont audience in mind. If more Vermont media companies are controlled by out-of-state, or out-of-country owners, I fear a significant deterioration in the coverage of local news.

The Vermont Press Association and the Vermont State Legislature have concerns similar to mine. The Vermont Press Association has written a letter to the FCC explaining its position, and the Vermont State Legislature passed unanimously a joint resolution regarding this matter.

I ask unanimous consent that both documents be printed in the Record.

Mr. President, I am very pleased to introduce the Champlain Valley National Heritage Act of 2003. I am joined by Senator Leahy and Senators Schumer and Clinton of New York. This bill will establish a National Heritage Partnership within the Champlain Valley. Passage of this bill will culminate a process to enhance the incredible cultural resources of the Champlain Valley.

The Champlain Valley of Vermont and New York has one of the richest and most intact collections of historic resources in the United States. Fort Ticonderoga still stands where it has for centuries, at the scene of numerous battles critical to the birth of our Nation. Revolutionary gunboats have recently been found fully intact on the bottom of Lake Champlain. Our cemeteries are the permanent resting place for great explorers, soldiers and sailors. The United States and Canada would not exist today but for events that occurred in this region.

We in Vermont and New York take great pride in our history. We preserve it, honor it and show it off to visitors from around the world. These visitors are also very important to our economy. Tourism is among the most important industries in this region and has much potential for growth.

The Champlain Valley Heritage Partnership will bring together more than one hundred local groups working to preserve and promote our heritage. Up to $2 million a year will be made available from the National Park Service through the Lake Champlain Basin Program to support local efforts to preserve and interpret our heritage and present it to the world. Most of the funding will be given to small communities to help preserve their heritage and develop economic opportunities.

This project has taken many years for me to bring to the point of introducing legislation. This has been time well spent working at the grass-roots level to develop a framework to direct federal resources to where it will do the most good. I am confident that we have found the best model. This will be a true partnership that supports each member but does not impose any new federal requirements.

The Champlain Valley National Heritage Partnership will preserve our historic resources, interpret and teach about the events that shaped our nation and will be an engine for economic growth. I am hopeful that this bill, which was considered by the Senate last year, will become law during this Congress.

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

Mr. President, I am pleased to join with my colleagues Senators Hatch, Grassley, Lincoln, and Bingaman in introducing the Medicare Physician Payment Equity Act of 2003. This bill corrects a longstanding inequity in the Medicare Part B reimbursement methodology that pays rural physicians less than what is received by physicians for more densely populated areas who provide the same exact service. I am pleased that we are able to offer a legislative solution to this payment inequity.

Establishing Medicare reimbursement for physician services is a complex process and many factors go into setting rates. Without going into all of the intricacies of how fees are set, let me note that, for any specific service, the physician fee schedule has three components-- physician work, practice expenses, and the cost of malpractice insurance. Each of these components is further subjected to a geographic adjustment, which is lower for rural areas than for urban areas.

In my own State of Vermont, we face a chronic shortage of doctors in our rural areas. Yet, when we need to find a physician for a rural clinic, we compete in a national market to find providers. The inequities in payments these physicians receive, however, makes it all the more difficult to recruit and retain physicians. Rural physicians have the same training, spend the same time with patients, and manage the same office pressures as their urban counterparts. Their work should be valued equally, and that is what this bill accomplishes.

I've heard from many people in Vermont about this issue. Tim Thompson, M.D., President of the Vermont Medical Society, expressed his concern that while Vermonters pay the same premiums as other Americans to support the Medicare program, our doctors are paid less. This occurs without regard to the quality or efficiency of health care services they provide. In fact, according to the Center for Medicare Services, Vermont physicians provide the second highest quality care in the country, but the State is ranked forty-fourth in payments per Medicare beneficiary. We should do more to reward quality health care regardless of whether it is provided in an urban or rural setting. The Vermont Medical Society has told me that they strongly support the Medicare Physician Payment Equity Act of 2003 as an important first step in reducing the existing inequities in payment levels.

I look forward to working with my colleagues to pass the Medicare Physician Payment Equity Act of 2003.

Mr. President, I am very pleased to introduce the Champlain Valley National Heritage Act of 2003. I am joined by Senator Leahy and Senators Schumer and Clinton of New York. This bill will establish a National Heritage Partnership within the Champlain Valley. Passage of this bill will culminate a process to enhance the incredible cultural resources of the Champlain Valley.

The Champlain Valley of Vermont and New York has one of the richest and most intact collections of historic resources in the United States. Fort Ticonderoga still stands where it has for centuries, at the scene of numerous battles critical to the birth of our Nation. Revolutionary gunboats have recently been found fully intact on the bottom of Lake Champlain. Our cemeteries are the permanent resting place for great explorers, soldiers and sailors. The United States and Canada would not exist today but for events that occurred in this region.

We in Vermont and New York take great pride in our history. We preserve it, honor it and show it off to visitors from around the world. These visitors are also very important to our economy. Tourism is among the most important industries in this region and has much potential for growth.

The Champlain Valley Heritage Partnership will bring together more than one hundred local groups working to preserve and promote our heritage. Up to $2 million a year will be made available from the National Park Service through the Lake Champlain Basin Program to support local efforts to preserve and interpret our heritage and present it to the world. Most of the funding will be given to small communities to help preserve their heritage and develop economic opportunities.

This project has taken many years for me to bring to the point of introducing legislation. This has been time well spent working at the grass-roots level to develop a framework to direct federal resources to where it will do the most good. I am confident that we have found the best model. This will be a true partnership that supports each member but does not impose any new federal requirements.

The Champlain Valley National Heritage Partnership will preserve our historic resources, interpret and teach about the events that shaped our nation and will be an engine for economic growth. I am hopeful that this bill, which was considered by the Senate last year, will become law during this Congress.

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

Mr. President, I am pleased to join with my colleagues Senators Hatch, Grassley, Lincoln, and Bingaman in introducing the Medicare Physician Payment Equity Act of 2003. This bill corrects a longstanding inequity in the Medicare Part B reimbursement methodology that pays rural physicians less than what is received by physicians for more densely populated areas who provide the same exact service. I am pleased that we are able to offer a legislative solution to this payment inequity.

Establishing Medicare reimbursement for physician services is a complex process and many factors go into setting rates. Without going into all of the intricacies of how fees are set, let me note that, for any specific service, the physician fee schedule has three components-- physician work, practice expenses, and the cost of malpractice insurance. Each of these components is further subjected to a geographic adjustment, which is lower for rural areas than for urban areas.

In my own State of Vermont, we face a chronic shortage of doctors in our rural areas. Yet, when we need to find a physician for a rural clinic, we compete in a national market to find providers. The inequities in payments these physicians receive, however, makes it all the more difficult to recruit and retain physicians. Rural physicians have the same training, spend the same time with patients, and manage the same office pressures as their urban counterparts. Their work should be valued equally, and that is what this bill accomplishes.

I've heard from many people in Vermont about this issue. Tim Thompson, M.D., President of the Vermont Medical Society, expressed his concern that while Vermonters pay the same premiums as other Americans to support the Medicare program, our doctors are paid less. This occurs without regard to the quality or efficiency of health care services they provide. In fact, according to the Center for Medicare Services, Vermont physicians provide the second highest quality care in the country, but the State is ranked forty-fourth in payments per Medicare beneficiary. We should do more to reward quality health care regardless of whether it is provided in an urban or rural setting. The Vermont Medical Society has told me that they strongly support the Medicare Physician Payment Equity Act of 2003 as an important first step in reducing the existing inequities in payment levels.

I look forward to working with my colleagues to pass the Medicare Physician Payment Equity Act of 2003.