Floor Statements

Mr. President, I rise today to remember and celebrate Edward Moore Kennedy.

Senator Kennedy passed away, as we know, on August 25. The American people, in more ways than they will ever know--as so often happens in history with historic figures, people don't know what they had when they had it, and then when they no longer have it, they discover how great that person really was if one deserves to be so identified, and surely Ted Kennedy did--the American people lost a touchstone. The cause of justice lost one of its bravest and boldest champions, and I lost a very close friend.

I met Ted Kennedy back in about 1961, which is quite a long time ago, in Hyannis Port. His family invited me to come there for the weekend. He was still recovering from his back injury. He broke his back in 12 places. He was in one of those old-fashioned circle things where they sort of turned you so you wouldn't get bed sores. We had a nice conversation, and he wrote and thanked me with his hand for coming to see him.

Obviously, I have and will always be thinking about Vicki, his incredible wife, his children, and the entire Kennedy family who operates as one unit.

Because of Ted, I think all of us are better. I know I am. I think we are stronger. We are more inclusive as a nation. He caused us to be that way.

For 46 years, he was a legislative lion, as they say, who gave voice to the voiceless. That is not a cliche; that is an extraordinary and powerful deep fact from the junior Senator from the State of West Virginia. The people of West Virginia were given voice, and Ted Kennedy gave them that voice. He fought for working families, civil rights, women's rights, health care for all, and transformed the lives of children, seniors, Americans of all ages, all colors, all backgrounds. Everybody was part of his sphere, part of his responsibility.

In his private life he worked tirelessly to touch so many people with endless human acts of kindness that came naturally to him. He sort of had--he had to do it. I don't think he chose to do these things; he just had to do them and, therefore, did do them. People forget, those who didn't know about what he did, but he never stopped reaching out to help people at every turn, in sometimes very small ways.

Ted and his family reached amazing heights, and they inspired a nation. Each and every day of his life he honored the fallen heroes we always cherish.

This needs to be said: Ted traveled to West Virginia often. I was personally very grateful for that. It is a small State, not unlike that of the Presiding Officer. Our State has always had very close communication with the Kennedy family. We are them; they are us. You know, we put them over the top, we feel, in the 1960 election, and we did. When President Kennedy returned to West Virginia, he, at the State's centennial, said that classic phrase which we have heard so many times in West Virginia: ``The Sun does not always shine in West Virginia, but the people always do.''

People are still to this day moved by that statement. It is a sentiment I have always held near to my heart, that he and his brothers felt the way they did about West Virginia. I remember a picture of Bobby Kennedy sitting on a slag heap, a sort of pile of coal in southern West Virginia, just sort of thinking. He wasn't shaking hands, he was doing a typical Bobby Kennedy-type thing: thinking, deep in thought; philosophical, wondering about what to do in the world.

Over the last four decades, Ted's frequent visits not only strengthened West Virginia's bond with him and the Kennedy family, but he also provided enormous color, interest, and fun. I remember him at political rallies in West Virginia where some politician was going on and on. I have an album of photographs that were taken sequentially of different faces, very long and large speeches, and he is this way, he is wiping his brow. He enjoyed all of it. He just loved it.

Everywhere he went he found common ground. He spoke honestly. People came out to see him. He didn't hesitate to plunge into the crowd or jump on the back of a pickup truck. Indeed, the American worker knew a strong friend in Ted Kennedy. That much was clear in the tireless work he did as an advocate for our miners, for our seniors, for all of our people.

He has been with us in some of our very darkest hours. We had a mining tragedy several years ago. Johnny Isakson, who was speaking not long ago, was there as were several members of the HELP Committee, the Health, Education, Labor, and Pensions Committee. We had a cave-in and a blowup in a mine in Sago in Upshur County. He came down there. He sat with those families and watched them. I watched his hurt resonating against their hurt, and the words he spoke to them had deep comfort to them. As a result, we had the first major overhaul of mine safety laws at the Federal level since 1977. He, obviously, was driving the committee and driving that, as was Senator Johnny Isakson and Mike Enzi.

People liked Ted. They were drawn to his energy and his fundamental belief that America's best days were always ahead. I love that attitude because you can always pick it out. I just did a television thing and everybody was asking me about the person who spoke out last night, interrupting the President and saying something rather unusual, and the President just went right on ahead. He had bigger things to do. Ted was that way.

He had hard parts of his personal life and his own family life. He was the father of endless numbers of nieces and nephews, as well as his own children. Nothing ever stopped him.

People wanted to work with him. He never, ever talked about his own achievements. That is the incredible thing about him. As a result of the plane accident, he broke his back in 12 places. That is a lot of places to break a back. He never spent another day the rest of his life, he once told me fairly recently, without being in pain. You could see him walking across the floor of the Senate. He was always bent, and he walked quickly, sort of subconsciously, to cover up the fact that he was hurting. But he never said anything about it. He never said anything about himself. It was always: What is going on in your life? What is happening with you? What are your thoughts? What do you think we should be doing on such a subject? That was simply the way he was.

He refused to be slowed. He brought that iron will to everything he did. He never quit. He never gave up. He was a happy fighter. He loved life. He loved the battle, driven not out of anger but out of passion for people and the individual parts of their lives he wanted to improve. It just drove him. He didn't do it out of duty; he did it because he had to. It was a natural thing. For Ted, every day was new. Everything could be made better through hard work and dedication. Nearly every piece of legislation that has passed in this body bore his imprint or bears his imprint and reflected his commitment to making life better for every American.

It has been my honor to lock arms with him in our efforts, including the children's health program. Interestingly--we just found it--Senator Kennedy called it the most far-reaching step that Congress has ever taken to help the Nation's children and the most far-reaching advance in health care since the enactment of Medicare and Medicaid a generation ago. Now, in the Finance Committee we are trying to decide whether we are going to cast them into the melting pot along with all the other plans and take away the defined benefits. I am obviously very much against that. Eleven million children's health care is at stake.

Ted worked on the Higher Education Act of 1965 and to protect Federal student loans. Again, let me get back to the personal side.

I have a daughter. We only have one daughter and three sons. She is a teacher, and she is trained in special ed. She teaches--she did teach at Jackie Robinson Junior High School in Harlem. Ted was in New York. His chief of staff at that time was my daughter's best friend. She said: You know, Jay Rockefeller's daughter teaches there.

Ted said: Let's go in.

So here is my daughter teaching class in junior high school and in walks Ted Kennedy. Of course, the whole place just falls apart with happiness. He loved doing it. He does it in the District of Columbia; he does it in Massachusetts. He is always interacting with students. He greets them, talks with them, and learns from them.

The principal gave my daughter a very hard time. He said: Don't you ever bring a United States Senator into my school without telling me in advance.

Well, of course, that is the beauty of it. There is no way she could because it was just a natural act of Ted Kennedy.

It was that commitment to service that we celebrated just this spring when the President signed the Serve America Act which inspires young people to serve their country through public service. There are a lot of ways to remake America, but I think people, as the Presiding Officer has been in a variety of situations--people going abroad, people meeting other people who are unlike them, living with them, eating with them, sharing with them, coming to know them, coming to have very strong feelings about them--it is that kind of thing which makes people want to get into public service.

So he doubled the Peace Corps, he doubled Legal Aid, he doubled Vista, he doubled all of those programs, a lot of which were run by his brother-in-law, Sargent Shriver, who is one of the great men of America who is never discussed. He is a Kennedy, but he doesn't bear that as a last name.

He changed my life--the Kennedy family did. When I went to West Virginia as a Vista volunteer, I was trying to figure out what I was going to do in life, and I kind of wanted to be a Foreign Service officer. Frankly, I wanted to be America's first Ambassador to China. This was back in 1961, so it does really make sense. I had studied Chinese for a year, so I thought I was on my way. But Vista started and Sargent Shriver called me and said: Come work for me at the Peace Corps. And I did that. Then I went to southern West Virginia as a Vista volunteer and it told me what I wanted to do in life. This part of your gut knows when you are doing something that is meaningful to you and is something that you want to dedicate your life to. That was the effect of the Kennedys.

Ted Kennedy was a giant. There was not and never will be anyone like him in American history. He shaped this institution for decades by honoring its history and pushing us forward to be a better institution.

Now that he is gone, I know his legacy and inspiration make him a giant greater still, moving us to reach across the aisle, hopefully, and make a difference in people's lives. He was a great friend. We are all forever grateful for his service and his kind heart. We will miss him very dearly. Now he belongs to the ages.

Mr. President, we are in morning business, are we not?

I thank the Presiding Officer. I ask unanimous consent that the statement I am about to make about Senator Kennedy be placed in the Record along with the other statements that were made about him so that it can be a grouping.

I yield the floor and suggest the absence of a quorum.

Mr. President, 8 years since one of the most devastating attacks in our Nation's history, we still feel the pain and horror of that terrible day. We will never forget the nearly 3,000 lives lost on September 11, 2001, innocent victims of a heinous and cowardly terrorist attack on our country. We will be forever grateful to the countless first responders and fire fighters who courageously risked their lives to save so many.

In the wake of such a horrific tragedy, we came together to share our loss and seek a greater purpose. Our Nation was founded on the most enduring values of freedom, liberty, and opportunity that have made us resilient during even the greatest trials. We must continue to call on that great strength today, even as we continue to grieve for those we lost.

In West Virginia, we remember Dr. Paul Ambrose of Barboursville and Mary Lou Hague of Parkersburg. Their lives were taken too soon and their families remain in our hearts and prayers forever. I know that not even time can lessen the emptiness and pain they must feel.

For them, and so many others--parents and children, brothers, sisters, and friends, loved ones who died so needlessly--we pledge to keep our people safe, make our country stronger than ever before, and honor their memories always.

Mr. President, I rise today to announce my full support for the confirmation of Judge Sonia Sotomayor to be our Nation's 111th Supreme Court Justice. I am proud of Judge Sotomayor's dedication to her country, and I am impressed by her outstanding accomplishments. Today marks an historic occasion for our country, as Judge Sotomayor becomes only the third woman and first Hispanic ever to serve on the highest Court in the land.

The decision of whether to confirm a nominee for a lifetime appointment to the U.S. Supreme Court is one of the Senate's most significant and solemn duties under the Constitution. It will affect generations of Americans for years to come.

After 24 years of service to the people of West Virginia as their U.S. Senator, the nomination of Judge Sotomayor marks the 11th Supreme Court nominee under five Presidents that I have had the opportunity to consider. I have supported most nominees, but have opposed some. In each instance, I came to my decision after a careful and thorough process, and the same is true of my support for Judge Sotomayor.

The first question that must be answered about any nominee is: Does he or she possess the intellect, experience, and temperament to serve on the Supreme Court? For Judge Sotomayor, the clear answer is yes.

Her educational and professional background is impeccable. She was valedictorian of her high school class, graduated summa cum laude from Princeton University, and served as an editor of the Yale Law Journal while attending Yale Law School. Judge Sotomayor has served with distinction on almost every level of our judicial system as a prosecutor, civil litigator, district court judge, and appeals court judge. In her confirmation hearings before the Judiciary Committee, she showed herself to be an even-tempered and honest person, as well as a straightforward and critical thinker.

But once a nominee's impressive credentials and integrity are established, my analysis of his or her fitness to serve on the Supreme Court cannot end. The tremendous responsibility that all Justices have to the Constitution--and their decisions' impact on all Americans requires further consideration of the nominee's core beliefs about our country and our justice system.

Before supporting a nominee, I need to know that he or she understands the consequences of the Supreme Court's decisions. I need to know that he or she will protect the best interests of West Virginians. And I need to know that he or she will uphold the fundamental rights and freedoms that all Americans enjoy under the Constitution and in our laws.

Every American needs to know that our courthouse doors are open for everyone, not just the wealthy, the powerful, or the well-connected. The Founders intended our courts to serve as a place where all citizens can go to resolve disputes, seek relief from injustices, and hold wrongdoers accountable. As members of our court of last resort, Supreme Court Justices have a particularly important role in upholding our constitutional freedoms, even when lawmakers or public opinion would limit them.

To understand the enormously important role of the Court in the lives of Americans, we need only look at cases such as Gideon v. Wainwright, in which the Court recognized the fundamental right of defendants to be represented by counsel, even those who cannot afford to hire an attorney; or Brown v. Board of Education, in which the Court struck down racial segregation in our

public schools. These are the types of decisions that require a deep respect for our Constitution and the courage to do what is right.

After meeting with Judge Sotomayor in person and reviewing her extensive judicial record, I firmly believe that she possesses those qualities, and will always put the American people first.

I also believe that she understands the real world implications of our laws and how they affect the lives of everyday people. She knows what it is like to overcome adversity and work against the odds to become a successful lawyer and judge. In her, I see someone who shares the values that are important to West Virginians: hard work; determination; love for her country; love for her family; and a sense of pride in her community. It is no surprise that her nomination is supported by Democratic and Republican officials; conservatives, liberals, and moderates; prosecutors and law enforcement organizations; civil rights organizations; former colleagues; and fellow jurists.

I am disappointed that some of my colleagues have suggested that Judge Sotomayor's comments in a few of her speeches indicate that she will let personal biases influence her decisionmaking. I could not disagree more. Her extensive judicial record reflects a fair, thoughtful, and careful approach to decisionmaking--one that is based on meticulous analysis of the facts and a close following of the law and precedent.

As a trial court judge, she presided over approximately 450 cases. As an appeals court judge, she participated in over 3000 decisions and authored approximately 400 published opinions. With 17 years of service on the bench, she brings more Federal judicial experience to the Supreme Court than any nominee in nearly 100 years.

Judge Sotomayor's record speaks for itself, and I commend President Obama for nominating such a highly qualified individual to serve my fellow West Virginians and Americans on the Supreme Court.

Mr. President, I rise today with the newest esteemed Member of this Chamber, Senator Al Franken, to introduce the Affordable Access to Prescription Medications Act of 2009. I think this is the first bill we have introduced together, and I look forward to working with him again in the future. The legislation we are introducing today is a critically important bill--one that protects all Americans from high out-of-pocket spending on prescription drugs.

With each passing year, Americans are paying more for their health care. Rising out-of-pocket costs are problematic for all patient populations, but are particularly burdensome for chronically ill and low-income individuals. The health insurance premiums and out-of-pocket costs for those below the federal poverty level are huge, with 28 percent paying more than ten percent of their income. Overall, out-of- pocket spending for individuals insured in the private insurance market is large and rapidly growing, with an increase of 45 percent between 2001 and 2006.

Prescription drugs represent the highest out-of-pocket cost for patients, comprising almost 31 percent of total out-of-pocket spending. The higher the out-of-pocket cost, the fewer individuals fill their needed medications. In fact, about 20 percent of individuals with out- of-pocket spending greater than $250 a month do not fill their prescriptions and, thereby further exacerbate their conditions. Out-of- pocket expenses are only getting worse, especially as prescription drug costs increase. A 2009 survey found that 53 percent of Americans have cut back on health care spending in the last twelve months, as the economy has worsened.

In Medicare specifically, beneficiaries enrolled in a prescription drug plan in 2007 spent $38 a month, on average, for prescription drug co-payments. However, for those on high-cost medications, the cost burden can be enormous. Ninety percent of Medicare prescription drug plans and ten percent of private insurance plans include what is referred to as a specialty tier for medications costing over $600 a month. For these medications, enrollees can be asked to pay up to 33 percent of the drug's cost in copayments.

The high cost of treatment, particularly for life-saving and life- sustaining treatment, poses an unreasonable and devastating barrier for sick patients that can force them to delay or entirely forgo necessary treatment. For one West Virginian, the chemotherapy drug he needs to treat his cancer is more than $13,500 for a 90-day supply. Under his Medicare prescription drug plan, he would have to pay $4000 of that cost. He didn't have $4000, so he chose not to be treated.

Another West Virginian with multiple sclerosis contacted my office recently, and told me that the drug to treat her disease, which allows her to continue to work, costs $1900 a month. Her private insurer changed its policy from a $20 flat copayment for each prescription to 25 percent co-insurance for each prescription, creating a financial burden for her of $475 per month. It should come as no surprise that she is struggling to pay this amount every month.

These West Virginians are just a couple of examples of the millions of Americans who pay their health insurance premiums every month for coverage that is supposed to protect them from such enormous financial losses--but, sadly, it does not. Providing access to affordable prescription drugs for the treatment of chronic diseases is critical to improving our nation's health care system, which is why we are introducing this legislation today. The Affordable Access to Prescription Medications Act will go a long way to address the growing problem of catastrophic prescription drug expenses.

First, this bill will establish a $200 cap on the amount a person could be charged for any one prescription, and a $500 cap on the total amount an individual could be charged for all prescriptions in any given month. These caps apply to all private and public insurance plans, including Medicare prescription drug plans.

Second, this bill establishes an exceptions process for specialty drugs. Currently, the most expensive prescription drugs in the Medicare prescription drug program that are included on specialty tiers are not subject to beneficiary exemption requests, but for all other Medicare- covered prescription drugs, a beneficiary can request an exemption to allow them access to needed drugs. High-cost, specialty drugs can be difficult to access and this bill will allow any beneficiary to request any needed prescription drug, including those in specialty tiers, through the exemption process.

Third, this bill requires the Medicare Payment Advisory Commission, MedPAC, to conduct two studies regarding discrimination and cost- sharing. The first study will review Medicare Part B, Part C, and Part D prescription drug polices to make sure they do not violate the non- discrimination rules passed as part of the 2003 Medicare law. Under 2003 law, plans are prohibited from discriminating against individuals based on medical condition. The second study will examine the impact of prescription drug cost-sharing on beneficiaries and their health, particularly for those who have already paid their way through the so- called doughnut hole.

If enacted, this legislation will protect Americans from high out-of- pocket spending on prescription drugs. Based on studies that explain the problem, this bill could potentially lower copayments for 2.5 to 10 percent of Americans with the highest prescription costs. It will protect all Americans from the risk of incurring extraordinarily high prescription drug costs.

The national cap on out-of-pocket spending for prescription drugs will reduce costs for the most vulnerable populations by over 50 percent. Given the rising costs of drugs, the prevalence of new drugs on the market, and the current economic recession, addressing the affordability of prescriptions drugs is vitally important.

We must act now to make prescription drugs more affordable for all Americans, but especially those with chronic diseases. I urge my colleagues to join me in support of this important bill.

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

Mr. President, I rise today with my colleagues, Senator Akaka and Senator Brown, to introduce the Medicare Prescription Drug Coverage Improvement Act, legislation that makes long overdue improvements to the Medicare prescription drug program, particularly for Medicare beneficiaries who are simultaneously enrolled in Medicaid. Know as ``dual eligibles,'' these individuals are among our nation's most vulnerable populations--and they have been overlooked for far too long.

Approximately 8.8 million Americans are simultaneously enrolled in Medicare and Medicaid, and they are among the sickest and poorest individuals covered by either program. Most dual eligibles are very low-income, in poor health, and have substantial health care needs. Seventy-one percent of dual eligibles have annual incomes below $10,000. Over half of all elderly dual eligibles are limited in activities of daily living and, in comparison to other Medicare beneficiaries, are three times more likely to be disabled. Dual eligibles also have higher rates of heart disease, pulmonary disease, diabetes, and Alzheimer's disease than the general Medicare population.

After passage of the Medicare prescription drug law, Members of Congress and health care advocates alike tried for more than a year to work with the Bush Administration to prevent prescription drug coverage barriers for dual eligibles and other low-income Medicare beneficiaries. I introduced the Medicare Dual Eligible Prescription Drug Coverage Act of 2005, S. 566. and the Requiring Emergency Pharmaceutical Access for Individual Relief, REPAIR, Act of 2006, S. 2183, to prevent disruptions in coverage for vulnerable seniors and individuals with disabilities.

Unfortunately, effective fail-safe mechanisms were not put into place by the previous Administration to address the transition of the dual eligibles to Medicare prescription drug coverage. Consequently, millions of elderly and disabled Medicare recipients continue to experience significant barriers to care.

Health care problems persist for the dually eligible largely because of poor coordination between Medicare and Medicaid--which have two different sets of providers, two different sets of benefits, and two different sets of enrollment policies. The legislation we

are introducing today will go a long way to provide dual eligibles with the right care, in the right setting, and at the right time.

Additionally, the Medicare Prescription Drug Coverage Improvement Act will provide more affordable and comprehensive prescription drug coverage for all Medicare beneficiaries.

First, this bill will create a new Federal Coordinated Health Care Office within the Centers for Medicare and Medicaid Services, CMS. The purpose of this new office will be to provide a much more integrated model of care for dual eligibles by coordinating their Medicare and Medicaid benefits.

Second, this bill contains two provisions to help make prescription drugs more affordable and accessible for all Medicare beneficiaries--it allows the Secretary of Health and Human Services to negotiate directly with pharmaceutical companies to lower prescription drug prices and it creates a Medicare-operated prescription drug plan.

The Secretary would be required to implement two or more of the following strategies on an annual basis to reduce the cost of prescription drugs covered by Medicare: direct price negotiation with pharmaceutical manufacturers, additional rebate agreements for Medicare prescription drugs that are consistent with the rebate agreements provided to states for Medicaid, comparative clinical effectiveness data, or prescription drug rates negotiated under the Federal Supply Schedule.

A Medicare-operated prescription drug plan would be created by the Secretary of HHS. This plan would be a stable and affordable option available to all Medicare beneficiaries. This plan would create a robust prescription drug formulary based on patient safety, efficacy and value. The formulary incentive process would be transparent and uniform. An advisory committee would be created to review petitions for drug inclusion and recommend formulary changes. This Medicare-operated plan will create fair-market competition and lead to less costly drug choices for Medicare recipients.

Third, this bill contains significant new requirements for Medicare Advantage Special Needs Plans. These plans serve extremely vulnerable populations, including dual eligibles; yet, they have very few standards that they are required to abide by. The Medicare Prescription Drug Improvement Act will require special needs plans to be accredited by the National Committee for Quality Assurance. Additionally, our legislation requires special needs plans to provide more robust prescription drug coverage, meet uniform standards for data collection and reporting, and offer better care coordination.

Finally, this bill will implement a number of technical fixes to facilitate enrollment in the Medicare prescription drug benefit for those who qualify. State and Federal officials will be required to clearly identify dual eligibles in all databases and electronically file eligibility information, so that these beneficiaries will not continue to fall through the cracks. Pharmacies will use a facilitated point-of-sale enrollment process and automatically enroll certain dual eligible individuals in the Medicare-operated prescription drug plan. New limits on cost-sharing and resource requirements for low-income beneficiaries will also be put into place. Prescription drug cost- sharing for dual eligibles who are using home and community-based services, instead of institutionalized care, will be eliminated.

We are in the midst of discussing sweeping changes to our health care system. In addition to provisions to help the uninsured, health care reform must also include provisions to improve the coverage that people have today. This is especially true for seniors and individuals with disabilities. The Medicare prescription drug program is extremely difficult to navigate and many enrollees are still denied access to the prescription drugs that they need. This legislation will make the Medicare prescription drug program much more manageable for seniors and individuals with disabilities, particularly those dually eligible for Medicare and Medicaid.

The time for action is now, and I urge my colleagues to join us in support of this important legislation.

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

Mr. President, I rise today with the newest esteemed Member of this Chamber, Senator Al Franken, to introduce the Affordable Access to Prescription Medications Act of 2009. I think this is the first bill we have introduced together, and I look forward to working with him again in the future. The legislation we are introducing today is a critically important bill--one that protects all Americans from high out-of-pocket spending on prescription drugs.

With each passing year, Americans are paying more for their health care. Rising out-of-pocket costs are problematic for all patient populations, but are particularly burdensome for chronically ill and low-income individuals. The health insurance premiums and out-of-pocket costs for those below the federal poverty level are huge, with 28 percent paying more than ten percent of their income. Overall, out-of- pocket spending for individuals insured in the private insurance market is large and rapidly growing, with an increase of 45 percent between 2001 and 2006.

Prescription drugs represent the highest out-of-pocket cost for patients, comprising almost 31 percent of total out-of-pocket spending. The higher the out-of-pocket cost, the fewer individuals fill their needed medications. In fact, about 20 percent of individuals with out- of-pocket spending greater than $250 a month do not fill their prescriptions and, thereby further exacerbate their conditions. Out-of- pocket expenses are only getting worse, especially as prescription drug costs increase. A 2009 survey found that 53 percent of Americans have cut back on health care spending in the last twelve months, as the economy has worsened.

In Medicare specifically, beneficiaries enrolled in a prescription drug plan in 2007 spent $38 a month, on average, for prescription drug co-payments. However, for those on high-cost medications, the cost burden can be enormous. Ninety percent of Medicare prescription drug plans and ten percent of private insurance plans include what is referred to as a specialty tier for medications costing over $600 a month. For these medications, enrollees can be asked to pay up to 33 percent of the drug's cost in copayments.

The high cost of treatment, particularly for life-saving and life- sustaining treatment, poses an unreasonable and devastating barrier for sick patients that can force them to delay or entirely forgo necessary treatment. For one West Virginian, the chemotherapy drug he needs to treat his cancer is more than $13,500 for a 90-day supply. Under his Medicare prescription drug plan, he would have to pay $4000 of that cost. He didn't have $4000, so he chose not to be treated.

Another West Virginian with multiple sclerosis contacted my office recently, and told me that the drug to treat her disease, which allows her to continue to work, costs $1900 a month. Her private insurer changed its policy from a $20 flat copayment for each prescription to 25 percent co-insurance for each prescription, creating a financial burden for her of $475 per month. It should come as no surprise that she is struggling to pay this amount every month.

These West Virginians are just a couple of examples of the millions of Americans who pay their health insurance premiums every month for coverage that is supposed to protect them from such enormous financial losses--but, sadly, it does not. Providing access to affordable prescription drugs for the treatment of chronic diseases is critical to improving our nation's health care system, which is why we are introducing this legislation today. The Affordable Access to Prescription Medications Act will go a long way to address the growing problem of catastrophic prescription drug expenses.

First, this bill will establish a $200 cap on the amount a person could be charged for any one prescription, and a $500 cap on the total amount an individual could be charged for all prescriptions in any given month. These caps apply to all private and public insurance plans, including Medicare prescription drug plans.

Second, this bill establishes an exceptions process for specialty drugs. Currently, the most expensive prescription drugs in the Medicare prescription drug program that are included on specialty tiers are not subject to beneficiary exemption requests, but for all other Medicare- covered prescription drugs, a beneficiary can request an exemption to allow them access to needed drugs. High-cost, specialty drugs can be difficult to access and this bill will allow any beneficiary to request any needed prescription drug, including those in specialty tiers, through the exemption process.

Third, this bill requires the Medicare Payment Advisory Commission, MedPAC, to conduct two studies regarding discrimination and cost- sharing. The first study will review Medicare Part B, Part C, and Part D prescription drug polices to make sure they do not violate the non- discrimination rules passed as part of the 2003 Medicare law. Under 2003 law, plans are prohibited from discriminating against individuals based on medical condition. The second study will examine the impact of prescription drug cost-sharing on beneficiaries and their health, particularly for those who have already paid their way through the so- called doughnut hole.

If enacted, this legislation will protect Americans from high out-of- pocket spending on prescription drugs. Based on studies that explain the problem, this bill could potentially lower copayments for 2.5 to 10 percent of Americans with the highest prescription costs. It will protect all Americans from the risk of incurring extraordinarily high prescription drug costs.

The national cap on out-of-pocket spending for prescription drugs will reduce costs for the most vulnerable populations by over 50 percent. Given the rising costs of drugs, the prevalence of new drugs on the market, and the current economic recession, addressing the affordability of prescriptions drugs is vitally important.

We must act now to make prescription drugs more affordable for all Americans, but especially those with chronic diseases. I urge my colleagues to join me in support of this important bill.

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

Mr. President, I rise today with my colleagues, Senator Akaka and Senator Brown, to introduce the Medicare Prescription Drug Coverage Improvement Act, legislation that makes long overdue improvements to the Medicare prescription drug program, particularly for Medicare beneficiaries who are simultaneously enrolled in Medicaid. Know as ``dual eligibles,'' these individuals are among our nation's most vulnerable populations--and they have been overlooked for far too long.

Approximately 8.8 million Americans are simultaneously enrolled in Medicare and Medicaid, and they are among the sickest and poorest individuals covered by either program. Most dual eligibles are very low-income, in poor health, and have substantial health care needs. Seventy-one percent of dual eligibles have annual incomes below $10,000. Over half of all elderly dual eligibles are limited in activities of daily living and, in comparison to other Medicare beneficiaries, are three times more likely to be disabled. Dual eligibles also have higher rates of heart disease, pulmonary disease, diabetes, and Alzheimer's disease than the general Medicare population.

After passage of the Medicare prescription drug law, Members of Congress and health care advocates alike tried for more than a year to work with the Bush Administration to prevent prescription drug coverage barriers for dual eligibles and other low-income Medicare beneficiaries. I introduced the Medicare Dual Eligible Prescription Drug Coverage Act of 2005, S. 566. and the Requiring Emergency Pharmaceutical Access for Individual Relief, REPAIR, Act of 2006, S. 2183, to prevent disruptions in coverage for vulnerable seniors and individuals with disabilities.

Unfortunately, effective fail-safe mechanisms were not put into place by the previous Administration to address the transition of the dual eligibles to Medicare prescription drug coverage. Consequently, millions of elderly and disabled Medicare recipients continue to experience significant barriers to care.

Health care problems persist for the dually eligible largely because of poor coordination between Medicare and Medicaid--which have two different sets of providers, two different sets of benefits, and two different sets of enrollment policies. The legislation we

are introducing today will go a long way to provide dual eligibles with the right care, in the right setting, and at the right time.

Additionally, the Medicare Prescription Drug Coverage Improvement Act will provide more affordable and comprehensive prescription drug coverage for all Medicare beneficiaries.

First, this bill will create a new Federal Coordinated Health Care Office within the Centers for Medicare and Medicaid Services, CMS. The purpose of this new office will be to provide a much more integrated model of care for dual eligibles by coordinating their Medicare and Medicaid benefits.

Second, this bill contains two provisions to help make prescription drugs more affordable and accessible for all Medicare beneficiaries--it allows the Secretary of Health and Human Services to negotiate directly with pharmaceutical companies to lower prescription drug prices and it creates a Medicare-operated prescription drug plan.

The Secretary would be required to implement two or more of the following strategies on an annual basis to reduce the cost of prescription drugs covered by Medicare: direct price negotiation with pharmaceutical manufacturers, additional rebate agreements for Medicare prescription drugs that are consistent with the rebate agreements provided to states for Medicaid, comparative clinical effectiveness data, or prescription drug rates negotiated under the Federal Supply Schedule.

A Medicare-operated prescription drug plan would be created by the Secretary of HHS. This plan would be a stable and affordable option available to all Medicare beneficiaries. This plan would create a robust prescription drug formulary based on patient safety, efficacy and value. The formulary incentive process would be transparent and uniform. An advisory committee would be created to review petitions for drug inclusion and recommend formulary changes. This Medicare-operated plan will create fair-market competition and lead to less costly drug choices for Medicare recipients.

Third, this bill contains significant new requirements for Medicare Advantage Special Needs Plans. These plans serve extremely vulnerable populations, including dual eligibles; yet, they have very few standards that they are required to abide by. The Medicare Prescription Drug Improvement Act will require special needs plans to be accredited by the National Committee for Quality Assurance. Additionally, our legislation requires special needs plans to provide more robust prescription drug coverage, meet uniform standards for data collection and reporting, and offer better care coordination.

Finally, this bill will implement a number of technical fixes to facilitate enrollment in the Medicare prescription drug benefit for those who qualify. State and Federal officials will be required to clearly identify dual eligibles in all databases and electronically file eligibility information, so that these beneficiaries will not continue to fall through the cracks. Pharmacies will use a facilitated point-of-sale enrollment process and automatically enroll certain dual eligible individuals in the Medicare-operated prescription drug plan. New limits on cost-sharing and resource requirements for low-income beneficiaries will also be put into place. Prescription drug cost- sharing for dual eligibles who are using home and community-based services, instead of institutionalized care, will be eliminated.

We are in the midst of discussing sweeping changes to our health care system. In addition to provisions to help the uninsured, health care reform must also include provisions to improve the coverage that people have today. This is especially true for seniors and individuals with disabilities. The Medicare prescription drug program is extremely difficult to navigate and many enrollees are still denied access to the prescription drugs that they need. This legislation will make the Medicare prescription drug program much more manageable for seniors and individuals with disabilities, particularly those dually eligible for Medicare and Medicaid.

The time for action is now, and I urge my colleagues to join us in support of this important legislation.

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

Mr. President, for the Committee on Commerce, Science, and Transportation I report favorably the following nomination list which was printed in the Record on the date indicated, and ask unanimous consent, to save the expense of reprinting on the Executive Calendar that this nomination lie at the Secretary's desk for the information of Senators.

Mr. President, as our Nation wrestles with the impacts of a changing climate, we need strong science to inform our decision-making. Today, I am introducing two bills to support that effort.

The first, the Black Carbon, S. 1538, and Other Aerosols Research Act, S. 1539, would direct research dollars towards improving our understanding of a major component of climate change--atmospheric aerosols. We need more information about how aerosols, including black carbon, impact climate change and how limiting their emissions will ultimately affect the rate of melting in the Arctic and overall climate change. Emerging research shows that black carbon and other aerosols have a major impact on global climate change. In fact, the effect of black carbon is thought to be second only to carbon dioxide. In order to reduce the impacts of aerosols on climate and air quality, we need to better understand their effects. Improved aerosols monitoring, measurements, and models are therefore necessary to improve our response to climate change. This legislation would authorize a program within the National Oceanic and Atmospheric Administration to observe, monitor, and model black carbon and other aerosols to better understand the roles of black carbon and other aerosols in climate change.

Identifying and quantifying human and natural emissions of greenhouse gases are necessary to make informed decisions about emission reduction strategies. Effective policy to address climate change requires monitoring and validation of emissions from specific sources and projects. Given the investments required to meet the challenge of greenhouse gas reductions, it is critical that efforts to reduce emissions be verifiable at local, regional, national, and international levels and consistent with evidence in the atmosphere. The second bill I am introducing today, the Greenhouse Gas Observing and Analysis System Act, would establish a robust monitoring and analysis program to provide more precise and verified estimates of the amount of greenhouse gases in the atmosphere. This would help us monitor the effectiveness of programs and policies designed to reduce emissions.

We need continued research investments to answer the ``hows,'' and the ``whys,'' regarding climate change. How are we going to be impacted? Why is our atmosphere and planet responding the way it is? We need sound answers to these questions to be agile and to adapt to the changes our globe is experiencing. These bills will help us answer these and many other questions.

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

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

Mr. President, as our Nation wrestles with the impacts of a changing climate, we need strong science to inform our decision-making. Today, I am introducing two bills to support that effort.

The first, the Black Carbon, S. 1538, and Other Aerosols Research Act, S. 1539, would direct research dollars towards improving our understanding of a major component of climate change--atmospheric aerosols. We need more information about how aerosols, including black carbon, impact climate change and how limiting their emissions will ultimately affect the rate of melting in the Arctic and overall climate change. Emerging research shows that black carbon and other aerosols have a major impact on global climate change. In fact, the effect of black carbon is thought to be second only to carbon dioxide. In order to reduce the impacts of aerosols on climate and air quality, we need to better understand their effects. Improved aerosols monitoring, measurements, and models are therefore necessary to improve our response to climate change. This legislation would authorize a program within the National Oceanic and Atmospheric Administration to observe, monitor, and model black carbon and other aerosols to better understand the roles of black carbon and other aerosols in climate change.

Identifying and quantifying human and natural emissions of greenhouse gases are necessary to make informed decisions about emission reduction strategies. Effective policy to address climate change requires monitoring and validation of emissions from specific sources and projects. Given the investments required to meet the challenge of greenhouse gas reductions, it is critical that efforts to reduce emissions be verifiable at local, regional, national, and international levels and consistent with evidence in the atmosphere. The second bill I am introducing today, the Greenhouse Gas Observing and Analysis System Act, would establish a robust monitoring and analysis program to provide more precise and verified estimates of the amount of greenhouse gases in the atmosphere. This would help us monitor the effectiveness of programs and policies designed to reduce emissions.

We need continued research investments to answer the ``hows,'' and the ``whys,'' regarding climate change. How are we going to be impacted? Why is our atmosphere and planet responding the way it is? We need sound answers to these questions to be agile and to adapt to the changes our globe is experiencing. These bills will help us answer these and many other questions.

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

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

Mr. President, I wish to recognize Deborah Weinstein, executive director of the Coalition on Human Needs, for her leadership and commitment to the needs of low-income and other vulnerable populations.

On July 29, the coalition will honor Ms. Weinstein for her extraordinary 30-plus years of advocacy work on a wide range of issues at both the State and Federal level. Throughout her distinguished career, Debbie Weinstein has been a tireless advocate for children, families, and those Americans most in need. She has been an architect of various coalitions, which is essential in promoting and enacting good public policy.

Over the years, I have been proud to work with Debbie and the Coalition on Human Needs on programs of mutual interest and concern like the earned income tax credit, child support enforcement, child nutrition, child care, and temporary assistance for needy families, TANF. The outreach and work of the coalition under Ms. Weinstein's strong leadership has played an important role in educating grassroots advocates and helping them convey their beliefs to policymakers on the Hill. It is an important role that has been done quite well for many years by Debbie Weinstein.

As executive director of the Coalition on Human Needs, Debbie has earned the respect and support of her colleagues. Recognition by ones peers is a strong endorsement indeed. It is my honor and privilege today to recognize Debbie Weinstein's compassion for the most vulnerable among us, and I thank her for that commitment.

Mr. President, I take this opportunity to discuss the recent decisions by General Motors and Chrysler to eliminate thousands of automobile franchises across America. This is an extremely important issue: GM's and Chrysler's actions have had a negative impact on small businesses, employees, consumers, and communities in every corner of my State, West Virginia.

Although I do not question the automakers' need to restructure their companies and become financially viable, I do have serious concerns about the way they have handled these dealership terminations. Neither company has been fully transparent in explaining why they needed to terminate dealerships or how they decided which ones to eliminate. Neither company has provided dealers with an adequate opportunity to fully appeal their terminations--in fact, Chrysler has not established an appeals process at all. And though both companies claim that dealers will be fairly compensated for vehicles, parts, and specialty tools, the reports I continue to receive from terminated Chrysler dealers is that they still have hundreds of thousands of dollars in parts and specialty tools and many have received ``no response at all'' from Chrysler to their ``numerous requests for assistance.''

I also continue to hear the argument that ``this is how things happen in the normal bankruptcy process.'' But GM's and Chrysler's bankruptcies are anything but normal. How many bankruptcies are funded with billions of taxpayer dollars? How many bankruptcies result in the government obtaining a majority interest in the restructured companies? Under these circumstances, the thousands of small business owners whose franchise agreements have been summarily revoked deserve more from the companies that would not exist but for taxpayer support.

That is why I have been fighting from the beginning to find a better resolution for the thousands of terminated auto dealers throughout this country. And although we have seen improvements on behalf of dealers so far, I must admit that I am thoroughly disappointed that GM and Chrysler have refused to do more. For that reason, I am cosponsoring S. 1304, the Automobile Dealer Economic Rights Restoration Act of 2009.

I fully understand the serious concerns that have been raised about this bill. But the reality is that GM and Chrysler need to understand that they cannot ignore repeated requests by Congress and the American people to treat terminated dealers fairly. It is my hope that by cosponsoring this bill, I can help the automakers better appreciate that very important point and ultimately come to the table. They should work with Congress and the dealers on a reasonable resolution--one that provides dealers with fair compensation and a meaningful opportunity to challenge their terminations. That is what the people of West Virginia and America expect, and that is what the terminated dealers deserve.

Mr. President, I rise in clear, strong opposition to this amendment. Let me just say that the fact that this is located in West Virginia is not part of my consideration. I am thinking about national security, Border Patrol. I served as chairman of the Intelligence Committee. I know something about these things. What the Senator from Arizona wants to do doesn't make any sense at all.

What we are talking about is a one-of-a-kind. It is the only one in the country that trains senior officers as well as others in border protection, customs, and other things regarding homeland security. There is no other place in the country that does this. There are 3,300 students there now. They are planning on 5,000 next year. There is no other place where this can be done. If we cut this, there is no substitute. We talk about border control. We talk about all those things. Particularly senior officers side, this is where people are trained. There is a huge master plan which I will not hold up. It has been approved by the Office of Management and Budget, by the homeland security folks, and was submitted to Congress in 2007. The facility is used to train officers on waterborne tactics and operating ports of entry, things which are obscure but essential to national security. It includes a firing range which is not only used by CPB officers but local law enforcement, DEA, Fish and Wildlife personnel, as well as the Capitol Police. It is the only facility of its kind in the Nation. These are crucial jobs. There is no place to take its place. If we cut it, there is no way to make it up and carry out our responsibilities for homeland security.

It is a very grievously formulated amendment. I strongly urge my colleagues to vote against it.

Mr. President, today I honor the recipients of the West Virginia School of Excellence award for the 2008-2009 academic school year. This is a prestigious award given to schools for providing rigorous curricula, innovative programs, and exhibiting an overall high standard of learning. Those receiving the award this year were Ben Franklin Career and Technical Center in Kanawha County; Poca Middle School in Putnam County; Eagle School Intermediate in Berkeley County; Davis Creek, Village of Barboursville, and Martha Elementary Schools all of Cabell County; Cottageville Elementary in Jackson County; and Stratton Elementary in Raleigh County. They are all incredibly impressive schools that are challenging their students. I would like to take a little time to highlight how each school is preparing their pupils for future success.

Ben Franklin Career and Technical Center, located in Dunbar, centers its curriculum on the principle of preparing all students for the 21st century by training them to operate efficiently in a complex economy. It offers career preparation programs, short-term skill courses, and customized training for local businesses.

Poca Middle School is based on the principles of allowing students to ``master basic academic skills and to explore and identify their own interests and talents.'' It is a school that prides itself on offering students various opportunities to explore the arts and to actively pursue their interest by attending a wide range of classes and school events. It has allowed students to experience a more personal learning environment by implementing an online math program. The school's use of online learning is just the beginning of the many expanded learning programs that West Virginia schools will be implementing in the near future.

Eagle School Intermediate, located in Martinsburg, is dedicated to ``providing educational opportunities for all students to reach their highest academic potential.'' Eagle School Intermediate was one of the first schools in West Virginia to allow parents to track their student's progress via online grade checking. This is just another example of how West Virginia is expanding its boundaries towards providing the most in-depth academic technology to its students and their parents.

Davis Creek Elementary School, located in Barboursville, is an extraordinary representation of the Mountain State's flourishing primary education programs. For the 2006-2007 school year, the Cabell County public school was declared a National Blue Ribbon School. Davis Creek served 169 students in grades K-5 and has also been named a West Virginia Exemplary School.

Village of Barboursville Elementary School, located in Barboursville as well, is an institution that is focused on cohesive learning among students and faculty. It boasts a strikingly high parental approval rating. The school focuses its curriculum on providing students with the opportunity not only to learn inside the classroom, but also to develop proper social skills that can be taken and used to develop a stronger bond with the community.

Martha Elementary School, also located in Barboursville, is an institution founded on cooperation between parents and students to create an environment conducive to learning. This 300-student rural school focuses on endowing students with the opportunity to follow their dreams. The dedicated faculty uses innovative programs to assist students on an individual basis, allowing for a more personalized educational experience. The school strives to create an atmosphere of support among family, the school, and the community.

Cottageville Elementary, located in Cottageville, is dedicated to providing ``equity and excellence in education.'' The school bases its curriculum on the belief that all students should be held to a high standard and endowed with the resources necessary to receive an excellent education. Teachers and faculty strive to provide their students with the skills necessary to excel academically by creating a support system that includes the school, family, and the community.

Stratton Elementary, located in Beckley, strives to afford all of its students the opportunity to learn at a pace that is the best match for each individual. Stratton offers many gifted programs and online learning portals that allow students to take more advanced courses and to have access to one-on-one help around the clock.

Once again, I congratulate these eight schools for receiving the West Virginia School of Excellence award, a distinction each school undoubtedly deserves. I commend them on their impressive achievements and applaud all of the administrators, teachers, and students for the wonderful example they set for all West Virginians.