Mr. President, I send an amendment to the desk and ask for its immediate consideration. Mr. President, I ask unanimous consent that the reading of the amendment be dispensed with. Mr. President, I ask unanimous consent to add Senators…
Mr. President, I send an amendment to the desk and ask for its immediate consideration.
Mr. President, I ask unanimous consent that the reading of the amendment be dispensed with.
Mr. President, I ask unanimous consent to add Senators Rockefeller, Bingaman, Kennedy, Clinton, and Lautenberg as cosponsors of this amendment.
Mr. President, I have some serious concerns about the budget that is now before us.
To make our country strong again, we need to invest at home. What I see in this budget is a $35 billion cut from America's priorities, and I see that it will burden our children with a massive debt.
I am especially concerned this afternoon about what this bill will do to our most vulnerable in this budget and in the new Medicare prescription drug plan that is going to be implemented very soon.
This budget cuts $27 billion from Medicaid. That is a health care program, and it is a safety net for our country's most vulnerable and sickest. I think that cutting their health care is the wrong thing to do.
As I look ahead to this new Medicare prescription drug law, I see a time bomb that is ticking for more than 6 million Americans. A time bomb is ticking for our communities and for our health care providers. That fuse is set to detonate on January 1, 2006, in a few short months. We cannot stand by and let low-income seniors and the disabled lose their drug coverage. We cannot leave doctors, hospitals, and nursing homes unprepared for the biggest change in decades, and we cannot push hundreds of thousands of people who need care on to our local communities.
We cannot wait. We need to fix this problem today. That is why I am offering this amendment. I have been working with Senators Rockefeller, Bingaman, and Nelson to address this immediate crisis, and I want to thank them for their leadership.
I have also introduced my own bill to protect our most vulnerable. It is called the Medicare HEALS Act, S. 1822. I have been traveling around my home State of Washington this past month and meeting with people in Seattle, in Lakewood, Yakima, out in Aberdeen, and Olympia. Everywhere I have gone they have been angry, confused, and very worried and with good reason. Here are some of the concerns I heard. One senior told me:
Everyone I have talked to is totally confused--my doctor,
my pharmacist, even the Medicare number you are supposed to
call.
Another said:
If we can't understand this, this whole plan is going to
fail.
Everywhere I went, people were confused. There were questions I could not answer. When I turned to the doctors sitting next to me, they did not know the answer and neither did the pharmacists or the patient advocates that were there with us.
If Senators, doctors, and experts do not understand this bill, how can we expect an 80-year-old person with serious medical problems to understand this complicated new Medicare prescription drug plan? We cannot. So I believe we need more time and more resources to make this work.
One person I met with said:
Please give us more time, give us the chance to understand
this so we don't make a mistake when we sign up.
One panelist said to me:
Taking something away from those that need it the most . .
. is not the American way.
I could not agree more, and that is why today I am offering this amendment on this budget bill.
I have a lot of concerns with the Medicare prescription drug law. I was one of those who voted against it in 2003 because I think seniors deserve better, and I think America can do better for our seniors. I am very concerned about the complexity. I am concerned about the coverage gap, and I am concerned about whether needed drugs will actually be covered. I am concerned about the retirees who are losing the good coverage they have today, and I am concerned about the late enrollment penalty that is going to punish seniors who need more time to pick the right plan for themselves.
I am working with many other Senators to address those specific concerns. Today, the most urgent problem is the way that this new Medicare prescription drug law treats our most vulnerable: People with low incomes, the disabled, and those who face serious medical challenges such as AIDS.
This Medicare prescription drug law takes away the critical drug coverage that these people have today and puts them into this new program that could charge them more money in exchange for less drug coverage. If they do not sign up for a plan, they are going to be randomly assigned one. Either way, the prescriptions they need may not be covered. Because these are Americans who are living on the financial brink, an interruption of their drug coverage or a new copayment could keep them from getting the drugs they need to live. These people who are being affected do not know this is even going to happen to them. Their doctors and their pharmacists do not understand it and this entire mess is going to burst into the open on January 1, a few short weeks away.
This Senate needs to take action now so we can prevent this catastrophe, which is just a few months away. To understand this problem, let us look at how our most vulnerable are getting their prescription drugs today and how that is about to change.
Today, about 6.4 million Americans with low incomes get help from two programs: Medicare at the Federal level and Medicaid at the State level. These individuals are what we call in Washington, DC, dual eligible because they are eligible for assistance from both Medicaid and Medicare.
What Medicare does not cover, States cover. For example, since the Federal program did not cover prescription drugs, the State programs filled that gap. This State coverage is often called wraparound coverage, and it is very critical for these vulnerable families. As a result, these individuals got the drugs they need, often without copayments or deductibles.
Now there is a big problem coming on January 1. The new prescription drug bill will prohibit States from providing this extra help these people need. Instead, what it does is take these people and move them into this new Medicare Program alone, which will require of them higher out-of-pocket payments and will probably cover fewer drugs.
To me, it does not make sense to take away the good coverage these vulnerable families have today, force them into a program that might not meet their needs, charge them more money in the process and then prohibit our States from helping out these most vulnerable residents. It does not make sense, but that is exactly what this new drug program will do, unless we fix it before January 1.
In fact, the new Medicare prescription drug program changes the coverage for our most vulnerable families in five ways: First, it is going to impose higher costs, higher premiums, copayments, and deductibles. These are our low-income families. They do not have the extra dollars.
Secondly, it is going to cover fewer drugs. Those drugs that they rely on right now for their health care, their mental health, may not be covered in the plan they are randomly assigned to.
Third, it blocks our States from providing extra help as they do today, and our States are the end here. They are the ones who are going to see the fallout if these people do not get the prescriptions they need.
Fourth, it provides no transition period to make sure that these low- income residents do not face gaps in their coverage.
Finally, it penalizes people who simply need more time to understand and pick the right plan for them. These are real people that we are talking about. I am going to introduce two of them.
Earlier this month in Seattle, I met a woman named Kathryn Cole. She is 36 years old. She is disabled, and she is living on Social Security disability. She fills about 15 prescriptions every month. Her monthly income is $757. That is what she lives on. Well, she told me: Even if this copay were only $5, that adds up to $75 a month out of her $757. She said:
I don't have that kind of extra money to squeeze out of my
budget.
Kathryn looked at me and she said, which week am I not supposed to eat?
People like Kathryn across this country today are living on the financial edge. They cannot afford to pay more for their medication. That is what America is about, making sure that the least among us are able to succeed in this country. Kathryn is one of those people.
In Olympia, in my State, I met a man named William Havens. He is 50 years old, and he is living with HIV/AIDS. He takes 43 pills a day. William told me:
For the first time I realize I'm going to have to make a
choice between pills and food.
It is outrageous that this Medicare prescription drug law is going to make
life so much harder for these people that I have met, such as Kathryn and William.
In addition to hurting these people, this new drug program, if enacted the way it is right now, is going to hurt our health care system. It is going to have a costly impact on our nursing homes, our doctors, our pharmacists, and our hospitals.
Many of these dual-eligible individuals live in nursing homes. Nursing homes are going to have to navigate through all of these new plans. In my home State of Washington, there are at least 14 of these new plans that the dual eligibles are going to be assigned. Each one of these plans has different costs and different formularies. Nursing home managers are going to have to see which plan their patient has and if the needed drugs are covered.
In Olympia, I met with a doctor named David Fairbrook. He is in private practice, and he is also the medical director at two of these skilled nursing facilities. He cares for about 150 patients. He is very concerned about his patients being randomly assigned to plans that do not meet their medical needs. He said patients may be denied needed drugs. They could be forced to change their medications, and they could very well face a time-consuming, stressful appeals process.
Dr. Fairbrook predicted to me that there is going to be chaos for nursing staff regarding coordination of multiple suppliers, further duplicating their paperwork and documentation requirements. Chaos, he called it. There is a tremendous new administrative burden for understaffed and underfunded nursing homes and care providers.
In addition, unless we act, this new program is going to make the work of our pharmacists across the country a lot harder. Pharmacists, as we all know, are literally going to be on the front lines. They are going to be forced to deny coverage to these patients. CMS is telling us that pharmacists will be able to look up and see what plan someone has randomly been assigned to so when one of these patients comes into their pharmacy and says, I do not know who is covering me now, they are supposed to be able to look it up and tell them.
Frankly, given all the errors and mistakes that CMS has made so far, I do not have a lot of confidence that this is going to be a flawless transition. Remember, these people whom we are talking about do not have a financial cushion. So if they go into the pharmacy and all of a sudden they find out, much to their surprise, that they have to have a copay of $5 per prescription or more, they are living on fixed incomes, they do not have an extra $20 or $30 to say, fine, okay, I will pay this. They will turn away from the pharmacy counter, and they are not going to have the funds to pay for their drugs now and get reimbursed later when some kind of paperwork system gets sorted out. So we are going to see a huge impact at our pharmacies, and we are already hearing about it from them.
Doctors are going to be on the front line. Doctors are going to have to know which drugs are on the formulary, and they may need to help their patients appeal any denials. I remind my colleagues, most of the plans out there right now do not have a formulary. So people who are looking at this and making conscious decisions about which prescription drug plan they are going to sign up for cannot make a reasoned decision yet because they do not even know which plans cover what drugs. So doctors are telling us that they are going to have a real challenge as they try to help their patients work their way through these plans to make sure that their plan covers the prescriptions that are actually given to them.
One doctor I met with told me if doctors do not have the information they need on this yet, if their patients pick the wrong plan and their medicine is not covered, it can have serious medical harm.
Hospitals are also going to be impacted by this. They are going to have to navigate all of these new plans that are being offered. They are going to have to deal with patients who have not been able to get their prescriptions. In fact, for many of these poor families, the only place to get needed medicine is going to be the emergency room, and that is going to increase the cost of health care for all of us.
So this new drug law is going to impose an expensive and confusing administrative burden on doctors, on pharmacists, on hospitals, and on nursing homes. I think we can do a lot better than this. My amendment simply says let us fix this problem before people realize that they cannot get the prescriptions that they need.
The Murray-Rockefeller-Bingaman amendment simply provides a 6-month transition for low-income, dual-eligible beneficiaries. It does not delay the implementation of the Medicare Part D Program. It simply gives States, CMS, and the Social Security Administration 6 more months to ensure that all of those who currently have access to prescription drugs through Medicaid or who are eligible for Medicaid assistance are not lost in this transition.
Surely we can at least do that for these people.
According to CBO, this amendment could cost $130 million over 5 years. I say that is a very small price to pay when we are talking about the lives of 6.4 million Americans. In this budget, we are being asked to cut $27 billion from health care for the poor. I think it is worth spending less than 1 percent of that amount to make sure our most vulnerable do not lose their drug coverage in this transition.
Today we got another example of how easily our most vulnerable can fall through these cracks. Just today, CMS announced it is going to be sending a mailing to 86,169 dual eligibles in my home State of Washington. But according to the numbers I got from my State, there are actually 95,000 of these dual-eligible patients. So somehow 8,831 vulnerable people are not being counted. They are not going to get a letter. They are not going to get signed up for a plan. They are going to get lost in this transition, and on January 31 they will have no drug coverage. That is exactly why I am offering this amendment and telling my colleagues that we need to have a transition period to allow this to work.
I urge my colleagues to support this amendment and give our most vulnerable a few extra months to make sure they do not get lost in this transition.
This is a life-or-death issue for many people. We cannot rip away the last remaining safety net for these people. We owe them at least this one very small fix. Time is running out. On January 1, millions of vulnerable Americans are going to be forced into a new system they do not understand and that does not meet their needs. I believe we can avoid this train wreck. People's lives are hanging in the balance, and I urge my colleagues to at least allow these people who are dual eligible a transition period so they are not lost as this plan is implemented.
I retain the remainder of my time.
Mr. President, how much time remains?
Mr. President, I will have more to say on this issue, but I would like to use my remaining time to enter into a colloquy with the Senator from Wyoming.
I ask unanimous consent to set the pending amendment aside.
With time being charged. We can charge it against our side. That is fine.
Mr. President, I rise today to talk about an issue I have been working on for the past year--ending a runaway subsidy in the student loan program.
I ask unanimous consent that Senators Durbin and Clinton be added as cosponsors to amendment No. 2353.
Mr. President, currently students are enjoying low interest rates on their loans.
That was not always the case. In the 1980s, lenders were promised a rate of return at 9.5 percent on their loans when interest rates were high, but we were trying to keep costs down for students. In 1993, when interest rates were coming down, extra payments to lenders on 9.5 percent loans were supposed to phase out. However, they did not start phasing out and were rapidly increasing until I took action with my colleagues to end this practice.
Last year, I along with my colleagues, including Senators Kennedy and Durbin, who support closing this loophole passed the Teacher-Taxpayer Act. The Teacher-Taxpayer Act took aim at some of the most egregious abuse of this runaway subsidy and returned that money to student's pockets. However, while the Teacher-Taxpayer Act took great strides forward on this issue, the Federal government is still paying out $1 billion a year on the 9.5 percent loans. I believe we are far overdue in ending this practice.
I have filed an amendment to fully and permanently end the remaining 9.5 percent subsidy loophole, which according to the Congressional Budget Office will provide a savings of approximately $500 million. I have stated my intent repeatedly to finally close the remaining loophole. The Higher Education Act reauthorization bill moving through the House of Representatives closes this loophole and Education Secretary Spellings have called for the ending this remaining loophole.
Certainly.
I would agree with that assessment, yes.
I thank the Senator. We may not fully agree on this issue but I commend my colleague's efforts to develop a bipartisan Higher Education Act reauthorization and the challenges in moving such a bill through the Senate on a reconciliation bill.
I thank my colleague Senator Kennedy for his leadership on this issue, and I look forward to working with him and the chairman through conference on this issue. I appreciate the chairman's commitment to work with me through that process to make sure my voice is heard and interests are met. I think it is critical that, as we work with the House in conference on this issue and others, that we ensure protection and improvement of student benefits, and that any savings generated on this issue be returned to students. We must also work to advance and protect diversity in the lending market, which leads to the competition that provides for improving student benefits in lending.
I thank my colleague for his commitment to working with me and look forward to working with him and Senator Kennedy through that process.
Mr. President, to make our country strong again, we need to invest here at home, and that is why I oppose this budget. It is a bill that will cut $35 billion from America's priorities and burden our children with massive debt. Simply put, I think America can do better.
I will vote against this flawed budget, just as I did in the Budget Committee last week, because it starves our highest priorities. Not only that, this bill opens up the Arctic National Wildlife Refuge to oil drilling, which will not solve our energy problems. And I have serious concerns about a House proposal--which could be added to the House version of this bill--to split the Ninth Circuit into two smaller circuits.
Mr. President, a budget is a statement of priorities. As I look at the challenges facing our country--and as I listen to people in my home State of Washington--it is clear that our top priority now must be making America strong again. To do that, we need to invest here at home.
Today, too many people don't feel secure. They feel like they are one step away from losing their job or their pension or their healthcare. They are worried about high gas prices and how they are going to heat their homes this winter. They are worried about the men and women in uniform, who are returning home and can't find a job or healthcare. They are worried they won't be able to afford college tuition for their children. Many people are worried about the new prescription drug program, which will make life harder for so many vulnerable families.
Today people across America worry about being safe here at home. They look around their communities and see aging and unsafe highways, roads and bridges. After what happened in the Gulf Coast with Hurricane Katrina, they are worried their own communities are not protected. There is a coastline, or a volcano, or a fault line, or an aging dam in every State in this
Nation, and this budget doesn't make the right investments in prevention or protection.
This budget has the wrong priorities. I believe we should be providing greater investments in the tools that spur economic growth and help all Americans--education, health care, transportation, and job training. In short, we should be making Americans more secure. Unfortunately, the package before us today does just the opposite. It cuts $35 billion from areas like healthcare and education.
And what is more, this is only the first step in the reconciliation process. You will not hear much about it from the other side of the aisle, but in the coming weeks, the Senate is scheduled to take up the next piece of the reconciliation process--a massive tax giveaway that's even bigger than the cuts we're considering this week.
So what's happening here today is we're being asked to make painful cuts for average Americans so that in a few weeks we can turn around and give massive giveaways to the most well off. That is what's really going on here.
The massive tax cut package that's coming soon would give billions away to the richest people in our country. Multi-millionaires and special interests will reap the benefits from these budget-busting tax breaks, including capital gains and dividends tax breaks. In fact, the upcoming tax breaks exceed the spending cuts we're considering this week by more than $30 billion.
And who benefits? 53 percent of the benefits of capital gains and dividends go to those with incomes greater than $1 million. Listen to the facts. On average, those who make more than $1 million would get tax cuts of more than $35,000. But those with income under $50,000 would get just $6.
Something is clearly out of whack.
The Senate leadership wants to impose painful cuts on average families today. Why? So that in a few weeks they can give massive tax cuts to the most well off. That is wrong.
Today people are hurting on the Gulf Coast. People are concerned for their safety--be it by terrorist attack or flu epidemic and instead of meeting these important priorities, the Senate will cut spending, give away tax cuts, and increase the amount of debt each American owes.
Taken together, these efforts represent the core values and priorities of the Republican Congress, but not of the American people. America can do better. The bill before us this week cuts important programs while doing almost nothing to address the real priorities facing our nation.
First let me talk about Medicaid--a health care program, a safety net for our country's most vulnerable and sickest. This bill cuts Medicaid spending for those least among us by $27 billion. At the same time, Republican members of this body are refusing to take up and pass bi- partisan Medicaid relief for Americans affected by Hurricane Katrina, they want to slash spending on the program here today.
What about agriculture--programs that make sure we can feed our Nation? This bill also cuts agriculture investments by $3 billion, and that will have a painful impact on our family farmers who are struggling today. Just last week, I sat down with farmers from Washington State, and I can tell you they are reeling from drought and high fuel and fertilizer prices. This bill makes their lives even harder by retracting the support that helps family farms get by and will impact our country's ability to ensure we will be able to feed our Nation and keep our country strong. These farm families need our help, but Republicans just say no.
This bill also undermines the pension plans of millions of hard- working Americans. This is a top anxiety for people everywhere I go. Is my retirement gone? What happened to my security?
This bill will increase the financial burden on companies and drive more employers into bankruptcy and out of the defined benefit pension system. It more than doubles the Pension Benefit Guaranty premiums, and it will index those payments in the future. This budget we are debating today undermines the carefully crafted bipartisan pension reform bill that the HELP Committee bill recently passed unanimously. America's pension policy should be driven by what is best for American workers, retirees and employers--not by the need to meet an arbitrary budget target.
And of course, this budget opens ANWR up to shortsighted drilling. This misguided effort is especially troublesome, and is worth a few minutes of time here on the Senate floor. We are all concerned about the high cost of energy. It's a tremendous burden for families, businesses and farmers. We should use that concern to make wise choices that will actually help our country. Instead, this bill takes shortsighted steps in the wrong direction. The responsible way to address our energy problems is to focus on long term solutions like reducing our need for oil, and investing in clean, renewable energy sources.
I oppose drilling in ANWR because the potential benefits do not outweigh the significant environmental impacts. The Arctic National Wildlife Refuge is an important and unique national treasure. It's the only conservation system in North America that protects a complete spectrum of arctic ecosystems. It's the most biologically productive part of the Arctic Refuge. And it's an important calving ground for a large herd of caribou, which are vital to many Native Alaskans. Energy exploration in ANWR would have a significant impact on this unique ecosystem.
Further, development will not provide the benefits being advertised. Proponents claim that energy exploration has become more environmentally friendly in recent years. While that may be true, there are still significant environmental impacts for this sensitive region. Exploration means a footprint for drilling, permanent roads, gravel pits, water wells, and air strips. We recognize that our economy and lifestyle require significant energy resources, and we are facing some important energy questions. However, opening ANWR to oil and gas drilling is not the answer to our energy needs.
And let's keep in mind that drilling in ANWR will not make us less dependent on foreign oil. As a Nation, the only way to become less dependent on foreign oil is to become less dependent on oil overall. The oil reserves in ANWR are not enough to significantly reduce our dependence on foreign oil.
There are better ways to meet America's energy needs--including boosting fuel efficiency, expanding the use of homegrown renewable and alternative fuels, investing in new technologies like fuel cells, developing and deploying more energy efficient technologies, and improving conservation and energy efficiency. Drilling in ANWR is not a serious answer to our country's serious energy challenges, and it should not be included in this budget bill.
Another reason I am voting against this bill is because it will clearly get much worse in conference--through steeper cuts in critical investments. This budget bill already cuts $35 billion from America's priorities. And on the House side, leaders are working to cut an additional $15 billion from infrastructure, education and healthcare. That would move this bill even further in the wrong direction.
Finally, I am very concerned about a possible attempt in the House-- which we may see next week--to split the 9th Circuit.
As a member of the West Coast delegation, I strongly oppose this change. The House proposal is not warranted by the facts and is not supported by the judges on the circuit. Back in 1980, when Congress split the 5th Circuit, all of the judges supported that move. But today, that is not the case. I understand that a majority of judges on the 9th Circuit oppose the split. I've spoken with some of them, and they have said a split could create new problems.
They pointed out that splitting the circuit would impose new costs for facilities, staff and administration. The efficiency we have today would turn to duplication tomorrow if the circuit is divided. There would be significant costs to establish a new circuit headquarters and to create a duplicate administration system. In an era of limited budgets, this makes little sense. As the ranking member on the subcommittee that funds the Judiciary, I know we don't have extra money to spend to duplicate administrative services.
A split would also lead to a duplication of cases. Today, by deciding cases for nine States, the circuit provides
clear, uniform guidance to district courts. That prevents a duplication of cases. If the circuit is divided, issues decided in the new 9th Circuit would have to be decided again in the new 12th Circuit, doubling the use of judicial resources and costing even more money. And in addition to the massive cost associated with splitting the 9th Circuit, the change would split the West Coast Technology Corridor into two different circuits. That could have a paralyzing effect on IT and technology growth since there would be a weaker judicial foundation.
I share my concerns about this because next week there may be an effort in the House of Representatives to attach the judicial provision to the House version of this bill. I want House Members to know that as a member of the affected delegation--and as the ranking member of the subcommittee that funds the Judiciary--I oppose this change.
Mr. President, this budget plan has the wrong priorities and that is why I am voting against it. We need to make America stronger and invest here at home. This budget does just the opposite--cutting key investments in the things that our people need. Why? To have money for tax cuts for the wealthiest. America can do better. I urge my colleagues to reject these flawed priorities and work to invest in that which will make our country and our people strong.