Floor Statements

I move to lay that motion on the table.

The motion to lay on the table was agreed to.

Mr. President, it is my understanding that we are now turning to consideration of the nomination of Thomas Ridge; is that correct?

Under the previous order, I yield myself such time as I may consume.

For the information of my colleagues, I expect my initial statement will not exceed 12 minutes.

Mr. President, I rise today in strong support of the nomination of Gov. Tom Ridge to be the first Secretary of the Department of Homeland Security. As

chairman of the Committee on Governmental Affairs, I assure my colleagues the committee thoroughly considered this nomination in an extensive hearing last Friday at which the nominee expertly and in a forthright manner answered all of the questions posed to him. Every member of the committee participated in the hearing at some point and each member was able to pose questions to Governor Ridge.

Subsequently, the committee voted unanimously to report Governor Ridge's nomination to the full Senate. I am very pleased we are taking up this important assignment today.

The United States has made substantial progress in improving homeland security since the terrorist attacks of September 11. The new Department of Homeland Security will provide the organizational framework to help our Nation better cope with the threat of a terrorist attack. September 11, 2001, underscored the concerns raised by many experts, including the members of the Hart-Rudman Commission who warned our Nation was not adequately prepared for 21st century threats but, rather, was still operating under a cold war threat environment. The nature of the threat has changed since the end of the cold war. Change has brought with it the need to reorganize the Government in a way that will enable us to better protect our Nation and its citizens.

September 11 focused our attention on homeland security. Now we understand all too well why it is a problem if our first responders do not have compatible communication systems. Interoperability has gone from being a buzzword to a matter of life and death. Now we understand the vulnerability posed by 17 million shipping containers arriving in the United States from ports all over the world with few of them ever being searched. Now we understand our Nation's 20,000 miles of land and sea borders present countless opportunities for those who would do us harm.

We also understand we can no longer rely on an ad hoc approach to homeland security. Currently, as many as 100 Federal agencies are responsible in some way for homeland security. But not one has homeland security as its primary mission. When that many entities are responsible, none is really accountable and turf battles and bureaucratic disputes are inevitable.

The new Department of Homeland Security will work to address these problems by better securing our ports, our borders, and our critical infrastructure. It will synthesize and analyze intelligence information from multiple sources. It will coordinate security activities now undertaken separately by agencies such as the Customs Service, the INS, and the Federal Emergency Management Agency. The new Department will help remedy many of the current organizational weaknesses in order to better protect us against future attacks.

Congress's passage of legislation creating this new Department was only the first step in what will be a long and difficult process. The homeland security effort will take all of us working together as a team--the administration, the new Secretary, and the Congress--to ensure the success of this massive reorganization. This effort will require the new Secretary to overcome unique challenges. The Department's leadership will have to address management and reorganization issues, as well as issues related to integrating the various agencies, each with differing work rules, information technology systems, and cultures.

In addition to these challenges, the new Secretary must also ensure that the nonhomeland security functions moving to the Department are not neglected. For example, it is critically important to my home State of Maine and to coastal communities throughout our Nation that the Coast Guard's new homeland security responsibilities not divert its attention from its traditional role, including search and rescue missions. In a given year, the Coast Guard performs over 39,000 search and rescue missions.

Just recently, the Coast Guard was involved in a rescue of two fishermen from a fishing island off the coast of Maine. On a typical day, the Coast Guard saves 10 lives, interdicts 14 illegal immigrants, inspects and repairs 135 buoys, and helps more than 2,500 commercial ships navigate into and out of U.S. ports.

Because of the vital importance of these functions, Senator Stevens and I worked with many of our colleagues on both sides of the aisle to include strong language in the new Homeland Security Act to ensure that the Coast Guard will continue to make search and rescue and other traditional missions a priority, not an afterthought.

Another challenge for the new Department will be to effectively support those men and women who are on the front lines, our Nation's 2 million first responders, including our police officers, our firefighters, and our emergency medical personnel. The Homeland Security Act establishes a new office for State and local government coordination, but it offers no assurance that the new Department will coordinate and communicate effectively with our Nation's first responders.

Ensuring that our partners at the State and local level have sufficient attention, resources, and cooperation will require more work.

This is another advantage that Governor Ridge brings to this important job. As a Governor, he understands better than most people how important the role played by State and local governments is to our national security.

The establishment of the Department of Homeland Security will be the most significant restructuring of the Federal Government in more than 50 years. It is the most important reorganization since Congress created the Department of Defense in 1947. It will involve the merger of 22 Federal agencies and some 170,000 employees. Managing this Department will pose extraordinary challenges.

Fortunately, we have before us a man of extraordinary capacity in Gov. Tom Ridge. Governor Ridge's resume is impressive. In addition to his current service as assistant to the President for homeland security, Governor Ridge twice was elected as Governor of Pennsylvania, served six terms in the Congress, and worked as an assistant district attorney in Pennsylvania. His resume speaks to the management and leadership skills that he possesses which will be necessary to make this effort successful.

Perhaps the clearest indication of Governor Ridge's character is something that you won't find on his resume. It is the story of his service in the U.S. Army during the Vietnam war. Governor Ridge was one of the few, if not the only, graduate of Harvard who served in Vietnam as an enlisted man, and he did so with great distinction. Infantry Staff Sergeant Ridge was awarded a Bronze Star for valor. These are impressive credentials that speak to the character of a remarkable man.

The new Department will not make us safer overnight, but its establishment must lead, and I believe will lead, to new capabilities that will make our Nation secure under the very capable leadership of Tom Ridge. Our goal must be a department that enables our country to better deter, detect, prepare for, and, if necessary, respond to a terrorist attack.

To attain this goal will require not only extraordinary leadership from the new Secretary but also the cooperation of the agencies transferred to the new Department and the full support of the Congress. Ultimately, the success of the new Department rests not just on the broad shoulders of Governor Ridge but on all of us.

Today I am hopeful the Senate will take an important step forward in making our homeland safer and more secure by promptly confirming Governor Ridge. We are asked to confirm Governor Ridge for a Cabinet post that may well be the most challenging position created by Congress during the last 50 years. I can't think of a better person to have at the helm of this new Department when it opens its doors this Friday than Governor Ridge.

For this reason it is important we act promptly so the new Department opens on Friday with a new Secretary firmly in control. I urge my colleagues to support the confirmation of Governor Ridge as Secretary of Homeland Security. In my judgment, the President could not have made a better choice for this critically important position.

I thank the Senator.

Mr. President, I yield as much time as he would like to the Senator from Pennsylvania.

Mr. President, I thank the Senator from Pennsylvania for his comments, for his introduction of Governor Ridge at the hearing last Friday, and for his participation as a member of the committee. We are indeed fortunate to have the benefit of his expertise.

Mr. President, I ask unanimous consent that after the Senator from North Dakota delivers his remarks, the Senator from Alabama be recognized next for as long as he needs, with a limit of 10 minutes.

Mr. President, I ask unanimous consent that after the Senator from Alabama has concluded his remarks, the Senator from Nebraska be recognized for up to 10 minutes.

Mr. President, I suggest the absence of a quorum.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, I ask unanimous consent that for the remainder of the debate on the nomination of Tom Ridge to be the new Secretary of Homeland Security, that any quorum calls be charged equally to both sides.

Mr. President, I suggest the absence of a quorum.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, I ask unanimous consent that the vote on the nomination of Tom Ridge occur at 12:10 today, with all the other parameters for debate remaining. Further, I ask unanimous consent that immediately following the vote, the Senate then stand in recess until 2:15 today. Finally, I ask unanimous consent that when the Senate reconvenes at 2:15 today, there be 5 minutes for debate equally divided between Senators Nickles and Reed or their designees prior to the scheduled vote.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, there has been a lot of discussion about the funding for homeland security. I agree with my colleagues that this is an area that is going to require more resources. In particular, we want to make sure that the resources flow down to the State and local levels, that they are available to the first responders, those who are first on the scene in the event of a terrorist attack.

I do want to point out, however, that H.J. Res. 2 contains significant new funding to strengthen our homeland security. For example, the omnibus bill provides over $5.3 billion for the Transportation Security Administration, which is a critical component in our efforts to secure our national transportation system and to ensure the freedom of movement of American people and commerce.

This funding amounts to a $1.84 billion increase over last year, or a 53-percent increase over fiscal 2002 figures. Of this funding, a minimum of $124 million will go toward buying explosive detection systems and trace detection systems; $250 million in funding will go toward the installation of airport detection systems. Many of us have noted the increased scrutiny of checked baggage in the recent weeks. One hundred million is for a very important purpose and that is for seaport security grants to port authorities.

In another area, let's look at the first responders, which are of special concern to me. The omnibus bill includes more than $1.6 billion for emergency planning and assistance to help prepare our first responders. This amounts to an increase of over $997 million from the level provided in the fiscal year 2002 budget. Of this money, $900 million is for the FIRE Grant Program, a very popular program in the State of Maine, that helps our firefighters equip themselves and prepare for future threats. In Maine, we found that the FIRE Grant Program is particularly useful to some of our small, rural communities, which simply would not have access to the resources needed to upgrade their equipment and their training.

Mr. President, $114 million of the money for FIRE Grant Program funding is for interoperable communications equipment for firefighters and EMS personnel. September 11 taught us very dearly how important it is for our first responders to be able to communicate with one another, to have compatible equipment.

Mr. President, $75 million is for urban search and rescue teams and another $75 million is for State and local emergency planning grants. We need to do so much more training and joint exercises at all levels of government to make sure we have a coordinated response to allow us to detect, prepare for, and, if necessary, respond to a terrorist attack more effectively.

Let's look at the area of bioterrorism, one of the major threats we face today. We learned right here in the Senate the amount of damage that an anthrax attack can inflict. The omnibus bill provides considerable funding for bioterrorism. It includes money for the CDC, for example, for a smallpox vaccine, for an evaluation and research on the anthrax vaccine, and it includes money to make our hospitals better able to respond to a bioterrorism attack.

I point out that the $3.7 billion for bioterrorism preparedness is exactly the same in this omnibus bill as in the Labor-HHS-Education bill authored under different leadership last July. The bioterrorism preparedness funding includes $940 million for upgrading State and local capacity. It includes $300 million for the National Pharmaceutical Stockpile. It includes $492 million for hospital preparedness. It includes $1.5 billion for bioterrorism-related research and construction at the National Institutes of Health.

My point is that there is significant and much needed new funding included in this legislation. So we are making a genuine effort to provide the resources that are necessary to make our Nation more secure. It is not going to happen overnight. Money alone does not solve

the problem, but money, clearly, is part of the solution, and we are making a major step forward in that regard through the funding provided by this bill, the billions of dollars in funding provided by this bill.

Finally, let me touch on the Coast Guard, which is of special concern to me. The omnibus appropriations bill includes more than $6 billion for the Coast Guard. This amounts to an increase of more than $1 billion from last year's enacted level. I stress this because it has been of great concern to me, Senator Stevens, and many other of my colleagues that we fully fund the Coast Guard so it does not jeopardize its traditional mission while it takes on increased responsibilities in the area of homeland security, particularly port security.

So I think it should be evident from a review of this bill that we are making a significant commitment of additional funding for homeland security. This is a very positive step forward. More resources undoubtedly will be needed and will be considered as part of the President's budget.

Mr. President, I suggest the absence of a quorum.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, I yield to the distinguished Senator from Utah, the chairman of the Judiciary Committee, for up to 6 minutes.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, the Senate is now about to vote on the nomination of Gov. Tom Ridge to be the new Secretary of Homeland Security. I urge all of my colleagues to vote yes on this nomination. He is truly an outstanding individual to head this important new Department.

I ask for the yeas and nays.

Mr. President, I ask unanimous consent that the Committee on Commerce, Science, and Transportation be authorized to meet on Wednesday, January 22, 2003, at 2:30 p.m., in SR-253, to consider the nomination of Asa Hutchinson to be Under Secretary of the Department of Homeland Security.

Madam President, when I left Maine earlier today, the forecast was for temperatures with a wind chill of 40 below zero tonight. We are facing a ``perfect storm'' of exceedingly cold winter weather, high energy prices, and a difficult economy.

This amendment is a modest amendment with very little budget impact. But it is an amendment that will make a real difference in the lives of low-income families in Maine and States across the Nation.

No one should have to choose between being warm in the winter, buying prescription drugs, or buying the food they need to remain healthy. This amendment will address the needs of thousands of low-income families across this Nation so that they will not be faced with those choices.

Madam President, I urge adoption of the amendment.

Mr. President, I ask unanimous consent that the following Senators be added as cosponsors to the LIHEAP amendment just adopted: Senators Grassley, Specter, Lieberman, Kohl, Baucus, and Lincoln.

I thank the Chair.

Mr. President, Senator Jack Reed and I have offered an amendment that provides for the immediate release of $300 million in funds for the Low Income Home Energy Assistance Program, also known as LIHEAP.

I thank the chair and ranking member of the Labor-HHS Appropriations Subcommittee, Senators Specter and Harkin, for their efforts in support of this critical program. Despite the extremely difficult fiscal constraints facing our Nation, Senators Specter and Harkin have managed to provide $1.7 billion in regular-year LIHEAP funds in the Omnibus Appropriations Act. This is $300 million more than the administration's request.

Unfortunately, while the bill before us provides more regular LIHEAP funds than the administration requested, the total funding, which includes both regular funding and emergency funding, is considerably less than was provided in fiscal year 2002. In fact, total LIHEAP funding in this bill falls $300 million below the total funding provided in fiscal year 2002. It is also $300 million below the total funds provided in the Labor-HHS appropriations bill which passed the Senate Appropriations Committee on July 18, 2002, by a vote of 29 to 0.

Mr. President, the amendment that Senator Reed of Rhode Island and I have offered would provide for the immediate release of an additional $300 million for low-income heating assistance by designating emergency funds provided in the Supplemental Appropriations Act of 2001 as regular-year funds for fiscal year 2003.

For that reason, our amendment is fiscally responsible. Because these funds were already made available, our amendment does not increase total spending in the omnibus appropriations bill. These are funds that were already approved. The effect of our amendment is for this $300 million to be released immediately.

Some might argue that these funds should not be released unless the President declares an emergency. Anyone who thinks that we don't currently have an emergency in home heating assistance should visit with a low-income family in Houlton, ME. Houlton recently experienced the coldest temperature of any place in the lower 48 States. A few days ago, temperatures in Houlton were 19 degrees below zero. Tonight, the forecast, with windchill, is for the temperature range to be from 20 to 40 below in some parts of my home State. When the temperature is that cold, and you do not have money in your budget to heat your home, that is an emergency.

Adding to the problem of exceptionally cold winter weather, energy prices have escalated dramatically. The cessation of oil exports from Venezuela, as well as the prospect of a war in the Middle East, have pushed the price of crude oil up by nearly $6 per barrel in the last month. Home heating oil inventories are near 5-year lows, and prices are 20 percent higher than last winter. The Energy Information Administration predicts that home heating oil prices could rise 45 percent by the time winter is over. The price of natural gas, kerosene, and other fuels are facing similar pressures.

In addition to a cold winter and high energy prices, we are also facing difficult economic times. Unemployment has reached an 8-year high. In Maine, as in many States, low-income and unemployed workers are struggling. Just last week, Great Northern Paper, the largest employer in northern Maine, filed for bankruptcy and laid off its workforce of more than 1,000 employees.

In short, we are facing a ``perfect storm'' of high energy prices, exceedingly cold weather, and a difficult economy. With little prospect for a quick resolution of the crises in Iraq and Venezuela, continued forecasts for a cold winter, and the dubious prospects for a very quick economic rebound, all of us living in cold weather climates will face challenges in order to heat our homes this winter.

This combination of factors strains everyone's pocketbook, but, of course, it places a particular burden on seniors living on limited incomes and on our low-income families. These families already carry a higher energy burden than most Americans. They can spend up to 20 or 25 percent of their entire income just paying their home energy bills. No one should have to choose between heating their homes or putting food on the table, having prescriptions in the medicine cabinet, or even staying in their homes altogether.

Experience has shown, however, that pressures to pay energy bills and the inability to pay have resulted in increased medical expenses for our elderly, malnutrition for our children, and even homelessness. As an indicator of just how difficult this winter has been in my home State, let me tell you that 10,000 more people in Maine have applied for low-income heating assistance this year compared to last year.

Unfortunately, even as the need has increased, the amount of assistance has declined. In Maine, the average household benefit has seen a steady decline over the last four winters. In the winter of 1999 to 2000, the average LIHEAP benefit for a Maine family was $491. The next year, it had fallen to $433. By last winter, the number had further declined to $358. Fortunately, with the approval of the Reed- Collins amendment, we can reverse this decline or at least ensure that more Maine families will be helped; otherwise, low-income Maine families struggling to heat their homes will only receive between $330 and $350 this winter, not nearly enough to help.

I would like to say a word about the history of the LIHEAP funds that our amendment addresses. The Supplemental Appropriations Act of 2001 provided an extra $300 million in LIHEAP funds in order to help low income families deal with high energy prices. Report language specifically directed that at least $150 million of these funds were to be used to address unmet needs resulting from high energy prices. The other half of the money was directed to be used to meet the most critical needs arising from energy cost increases and increases in unemployment, among other things.

I have been working for the better part of 2 years to secure the release of these funds. On August 13, 2001, I joined Senator Reed, Senator Kennedy, and a number of my colleagues in sending a letter to the President requesting the release of the very same $300 million in emergency funds from the fiscal year 2001 supplemental appropriations bill. On September 10, 2001, I again joined many of my colleagues in sending a letter to OMB director Mitch Daniels requesting the immediate release of these funds. On October 26, 2001, 17 Senators joined Senator Reed and me in a letter to the Senate Minority and Majority leader requesting legislative language to require the release of these funds. On October 30, 2001, I offered an amendment to the fiscal year 2002 Labor, Health and Human Services appropriations bill expressing the sense of the Senate that these funds should be released immediately. That amendment was supported by Senators Specter and Harkin and passed the Senate as part of the fiscal year 2002 Labor-HHS bill.

On February 12, 2002, I joined my colleague Senator Snowe in sending a letter to the President again requesting the release of these same funds. On September 23, 2002, Senator Reed and I were joined by Senator Specter, Senator Harkin, and 35 of our colleagues in a letter to the President requesting the release of $200 million in emergency funds that were made available as part of the fiscal year 2002 Labor-HHS Appropriations Bill. These funds expired without ever being spent. Finally, on December 23, 2002, half of our colleagues joined Senator Reed and me in sending a letter to the administration requesting a total of $2 billion in fiscal year 2003 funding--which is the same amount made available by combining the $300 million in my amendment with the $1.7 billion already in the bill.

The LIHEAP program is essential in helping many low-income families get through the winter months. This has been an unusually cold winter. This has been a year where home heating prices have soared. This has been a year where the economy has been difficult. The combination of those three factors calls out for us to provide this additional assistance.

I am very pleased that our colleagues have joined together with an overwhelming vote. I hope very much this provision will be retained in the final conference report.

Mr. President, I yield back the remainder of my time.

Mr. President, I am pleased to join my colleagues from New York and Arizona in introducing the Greater Access to Affordable Pharmaceuticals Act, which will make prescription drugs more affordable by promoting completion in the pharmaceutical industry and increasing access to lower-priced generic drugs. The bipartisan bill that we are introducing today is identical to the compromise legislation that overwhelmingly passed the Senate last July by a vote of 78 to 21. That compromise was based on an amendment I Offered in the Health, Education, Labor and Pensions Committee with my colleague form North Carolina, Senator Edwards.

Prescription drug spending in the United States has increased by 92 percent over the past 5 years to almost $120 million. These soaring costs are a particular burden for the millions of uninsured Americans, as well as those seniors on Medicare who lack prescription drug coverage. Many of these individuals are simply priced out of the market, or forced to choose between paying the bills or buying the pills that keep them healthy.

Skyrocketing prescription drug costs are also putting the squeeze on our Nation's employers who are struggling in the face of double-digit annual premium increases to provide health care coverage for their workers. And they are exacerbating the Medicaid funding crisis that all of us are hearing about from our Governors back home as they struggle to bridge growing shortfalls in their State budgets.

The legislation that we are introducing today will make prescription drugs more affordable for all Americans. The nonpartisan Congressional Budget Office estimates that are bill will cut our Nation's drug costs by $60 billion over the next 10 years. That is why the legislation is supported by coalitions representing the Governors, insurers, businesses, organized labor, senior groups, and individual consumers who are footing the bill for these expensive drugs and whose costs for popular drugs like Cardizem CD, Cipro, Prilosec, and Zantac could be cut in half if generic alternatives were available.

The 1984 Hatch-Waxman Act made significant changes in our patent laws that were intended to encourage pharmaceutical companies to make the investments necessary to develop new drug products, while simultaneously enabling their competitors to bring lower-cost, generic alternatives to the market. To that end, the legislation has succeeded to a large degree. Prior to Hatch-Waxman, it took 3 to 5 years for generics to enter the market after a brand-name patent had expired. Today, lower-cost generics often enter the market immediately upon the expiration of the patent. As a consequence, consumers are saving anywhere from $8 to 10 billion a year by purchasing generic drugs.

Moreover, there are even greater potential savings on the horizon. Within the next 4 years, the patents on brand name drugs with combined sales of $20 billion are set to expire. If Hatch-Waxman were to work as it was intended, consumers could expect to save between 50 and 60 percent on these drugs as lower cost generic alternatives become available as these patents expire.

Despite its past success, however,it is becoming increasingly apparent that the Hatch-Waxman Act has been subject to abuse. While many pharmaceutical companies have acted in good faith, there is mounting evidence that some brand name generic drug manufacturers have attempted to ``game'' the system by exploiting legal loopholes in the current law.

Too many pharmaceutical companies have maximized their profits at the expense of consumers by filing frivolous patents that have delayed access to lower priced generic drugs. Currently, brand-name companies can delay a generic drug from going to market for years. A ``new'' patent for an existing drug can be awarded for merely changing the color of a pill or its packaging. For example, Bristol Myers-Squibb delayed generic competition on Platinol, a cancer treatment, by filing a patent on the brown bottle that it came in.

Another example cited by the Chairman of the Federal Trade Commission, Timothy Muris, in testimony before the Senate Commerce Commission, involved the producer of the heart medication Cardizem CD, which brought a lawsuit for patent and trademark infringement against the generic manufacturer in early 1996. Instead of asking the generic company to pay damages, however, the brand name manufacturer offered a settlement to pay the generic company more than $80 million in return for keeping the generic drug off the market. Meanwhile, users of Cardizem--which treats high blood pressure, chest pains and heart disease--were paying about $73 a month when the generic would have cost about $32 a month.

Last July, the Federal Trade Commission released a long-awaited report that found that brand-name drug manufacturers have misused legal loopholes to delay the entry of lower-cost generics into the market. The FTC found that these tactics have led to delays of between four and 40 months--

over and above the first 30-month stay provided under Hatch-Waxman--for generic competitors of at least eight drugs since 1992. Moreover, six of the eight delays have occurred since 1998.

The FTC report points to two specific provisions of the Hatch-Waxman Act--the automatic 30-month stay and the 180-day market exclusivity for the first generic to file a patent challenge--as being susceptible to strategies that could delay the entry of lower-cost generics into the market. According to the report, these loopholes ``continue to have the potential for abuse,'' and, if left unchanged, ``may have more significance in the future.'' These are the very loopholes that the legislation we are introducing today would close.

The original Hatch-Waxman Act was a carefully constructed compromise that balanced an expedited FDA approval process to speed the entry of lower-cost generic drugs into the market with additional patent protections to ensure continuing innovation. The bipartisan bill that we are introducing today restores that balance by closing the loopholes that have reduced the original law's effectiveness in bringing lower- cost generic drugs to market more quickly, and I urge all of my colleagues to join us as cosponsors.

Mr. President, I am pleased to join with my colleague from Louisiana, Senator Landrieu, in introducing the Access to Affordable Health Care Act, a comprehensive, seven-point plan that builds on the strengths of our current public programs and private health care system to make quality, affordable health care available to millions more Americans.

One of my top priorities in the Senate has been to expand access to affordable health care for all Americans. There are still far too many Americans without health insurance or with woefully inadequate coverage. More than 41 million Americans do not have health care coverage, including more than 150,000 in Maine.

Health insurance matters. The simple fact is that people with health insurance are healthier than those who are uninsured. People without health insurance are less likely to seek care when they need it, and to forgo services such as periodic check-ups and preventive services. As a consequence, they are more likely to be hospitalized or require costly medical attention for conditions that could have been prevented or treated at a curable stage. Not only does this put the health of these individuals at greater risk, but it also puts additional pressure on our hospitals and emergency rooms, many of them already financially challenged.

Compared with people who have health coverage, uninsured adults are four times, and uninsured children five times, more likely to use the emergency rooms. The costs of care for these individuals are often absorbed by providers and passed on to the covered population through increased fees and insurance premiums.

Maine is in the midst of a growing health insurance crisis, with insurance premiums rising at alarming rates. Whether I am talking to a self-employed fisherman, the owner of a struggling small businesses, or the human resource manager of a large company, the soaring costs of health insurance is a common concern.

Maine's employers are currently facing premium increases of as much as 40 percent a year. These premium increases have been particularly burdensome for small businesses, the backbone of the Maine economy. Many small business owners are caught in a cost squeeze: they know that if they pass on the premium increases to their employees, more of them will decline coverage. Yet, these small businesses simply cannot afford to absorb double-digit increases of 20, 30 or 40 percent, year after year.

The problem of rising costs is even more acute for individuals and families who must purchase health insurance on their own. Monthly insurance premiums often exceed a family's mortgage payment. Clearly, we must do more to make health insurance more available and affordable.

The Access to Affordable Health Care Act, which we are introducing today, it a seven-point plan that combines a variety of public and private approaches to make quality health care coverage more affordable and available. The legislation's seven goals are: One, to expand access to affordable health care for small businesses; two, to make health insurance more affordable for individuals and families purchasing coverage on their own; three, to strengthen the health care safety net for those without coverage; four, to expand access to care in rural and underserved areas; five, to increase access to affordable long-term care; six, to promote healthier lifestyles; and seven, to provide more equitable Medicare payments to Maine providers to reduce the Medicare shortfall, which has forced hospitals, physicians and other providers to shift costs onto other payers in the form of higher charges, which, in turn drives up health care premiums.

Let me discuss each of these seven points in more detail.

First, our legislation will help small employers cope with rising health care costs.

Since most Americans get their health insurance through the workplace, it is a common assumption that people without health insurance are unemployed. The fact is, however, that most uninsured Americans are members of families with at least one full- time worker. As many as 82 percent of Americans who do not have health insurance are in a family with a worker.

Uninsured working Americans are most often employees of small businesses. In fact, some 60 percent of uninsured workers are employed by small firms. Smaller firms generally face higher costs for health insurance than larger firms, which makes them less likely to offer coverage. Small businesses want to provide health insurance for their employees, but the cost is often just too high.

The legislation we are introducing today will help small employers cope with rising costs, by providing new tax credits for small businesses to help make health insurance more affordable. It will encourage those small businesses that do not currently offer health insurance to do so and will help employers that do offer insurance to continue coverage for their employees even in the face of rising costs.

Our legislation will also help increase the clout of small businesses in negotiating with insurers. Premiums are generally higher for small businesses because they do not have as much purchasing power as large companies, which limits their ability to bargain for lower rates. They also have higher administrative costs because they have fewer employees among whom to spread the fixed cost of a health benefits plan. Moreover, they are not as able to spread the risks of medical claims over as many employees as large firms.

Our legislation will help address these problems by authorizing federal grants to provide start-up funding to States to assist them with the planning, development, and operation of small employer purchasing cooperatives. These cooperatives will help to reduce health care costs for small employers by allowing them to band together to purchase health insurance jointly. Group purchasing cooperatives have a number of advantages for small employers. For example, the increased numbers of participants in the group help to lower the premium costs for all. Moreover, they decrease the risk of adverse selection and spread the cost of health care over a broader group.

The legislation would also authorize a Small Business Administration grant program for States, local governments and non-profit organizations to provide information about the benefits of health insurance to small employers, including tax benefits, increased productivity of employees, and decreased turnover. These grants would also be used to make employers aware of their current rights under State and Federal laws. While costs are clearly a problem, many small employers are not fully aware of the laws that have already been enacted by both States and the Federal Government to make health insurance more affordable. For example, in one survey, 57 percent of small employers did not know that they could deduct 100 percent of their health insurance premiums as a business expense.

The legislation would also create a new program to encourage innovation by awarding demonstration grants in up to 10 states conducting innovative coverage expansions, such as alternative group purchasing or pooling arrangements, individual or small group market reforms, or subsidies to employers or individuals purchasing coverage. The States have long been laboratories for reform, and they should be encouraged in the development of innovative programs that can serve as models for the nation.

The Access of Affordable Health Care Act will also expand access to affordable health are for individuals and families.

One of the first bills I cosponsored as a Senator was legislation to establish the State Children's Health Insurance Program, S-CHIP, which provides insurance for the children of low-income

parents who cannot afford health insurance, yet make too much money to qualify for Medicaid. This important program has provided affordable health insurance coverage to over four million children nationwide, including over 12,000 who are currently enrolled in the MaineCare program. Even so, nationwide, hundreds of thousands of qualified children have yet to be enrolled in this program, many because their parents simply don't know that they are eligible for the assistance.

Our legislation builds on the success of this program and gives States a number of new tools to increase participation. For example, the bill gives States the option of covering the parents of the children who are enrolled in programs like MaineCare. States could also use funds provided through this program to help eligible working families pay their share of an employer-based health insurance plan. In short, the legislation will help ensure that the entire family receives the health care they need.

The legislation will also allow States to expand coverage to eligible legal immigrants through Medicaid and SCHIP. Maine is one of a number of states that is currently covering eligible legal immigrant pregnant women and children under Medicaid using 100 percent state dollars. Giving States the option of covering these children and families under Medicaid will enable them to receive matching federal funds, and will help relieve the pressure that most a State budgets are currently experiencing due to the economic downturn and rising Medicaid costs.

Many people with serious health problems encounter difficulties in finding a company that is willing to insure them. To address this problem, the Access to Affordable Health Care Act authorizes Federal grants to provide money for states to create high-risk pools through which individuals who have pre-existing health conditions can obtain affordable health can obtain affordable health insurance.

And finally, to help make health coverage more affordable for low and middle-income individuals and families who do not have employer- provided coverage and who are not eligible for the expanded public programs, our legislation would provide an advanceable, refundable tax credit of up to $1,000 for individuals earning up to $30,000 and up to $3,000 for families earning up to $60,000. This could provide coverage for up to 6 million Americans who would otherwise be uninsured for one or more months, and will help many more working lower-income families who currently purchase private health insurance with little or no government help.

The Access to Affordable Health Insurance Act will also help to strengthen our nation's health care safety net by doubling funding over five years for the Consolidated Health Centers program, which includes community, migrant, public housing and homeless health centers. These centers, which operate in underserved rural and urban communities, provide critical primaary care services to millions of Americans regardless of their ability to pay. About 20 percent of the patients treated at Maine's community health centers have no insurance coverage and many more have inadequate coverage, so these centers are a critical part of our Nation's health care safety net.

The problem of access to affordable health care services is not limited to the uninsured, but it also shared by many Americans living in rural and underserved areas where there is a serious shortage of health care providers. The Access to Affordable Health Care Act therefore includes a number of provisions to strengthen the National Health Service Corps, which supports doctors, dentists, and other clinicians who serve in rural and inner city areas.

For example, taxing students adversely affects their financial incentive to participate in the National Health Services Corps and provide health care services in underserved communities. The tax bill passed by the last Congress provided a tax deduction for National Health Service Corps scholarship recipients to deduct all tuition, fees and related educational expenses from their income taxes. The deduction did not extend to loan repayment recipients however, so loan repayment amounts are still taxed as income. Participants in the loan repayment program are actually given extra payment amounts to help them cover their tax liability which, frankly, is a little ridiculous. It makes much more sense to simply exempt them from taxation in the first place.

In addition, the legislation will allow National Health Service Corps participants to fulfill their commitment on a part-time basis. Current law requires all National Health Service Corps participants to serve full time. Many rural communities, however, simply do not have enough volume to support a full-time health care practitioner. Moreover, some sites may not need a particular type of provider, for example, a dentist, on a full-time basis. Some practitioners may also find part- time service more attractive, which, in turn, could improve recruitment and retention. Our bill will therefore give the program additional flexibility to meet community needs.

Long-term care is the major catastrophic health care expense faced by older Americans today, and these costs will only increase with the aging of the baby boomers. Most Americans mistakenly believe that Medicare or their private health insurance policies will cover the costs of long-term care should they develop a chronic illness or cognitive impairment like Alzheimer's Disease. Unfortunately, far too many do not discover that they do not have coverage until they are confronted with the difficult decision of placing a much-loved parent or spouse in long-term care and facing the shocking realization that they will have to cover the costs themselves.

The Access to Affordable Health Care Act will provide a tax credit for long-term care expenses of up to $3,000 to provide some help to those families struggling to provide long-term care to a loved one. It will also encourage more Americans to plan for their future long-term care needs by providing a tax deduction to help them purchase private long-term care insurance.

Health insurance alone is not going to ensure good health. As noted author and physician Dr. Michael Crichton has observed, ``the future of medicine lies not in treating illness, but preventing it.'' Many of our most serious health problems are directly related to unhealthy behaviors, smoking, lack of regular exercise and poor diet. These three major risk factors alone have made Maine the state with the fourth highest death rate due to four largely preventable diseases: cardiovascular disease, cancer, chronic lung disease and diabetes. These four chronic diseases are responsible for 70 percent of the health care problems in Maine.

Our bill therefore contains a number of provisions designed to promote health lifestyles. An ever-expanding body of evidence shows that these kinds of investments in health promotion and prevention offer returns not only in reduced health care bills, but in longer life and increased productivity. The legislation will provide grants to States to assist small businesses wishing to establish ``worksite wellness'' programs for their employees. It would also authorize a grant program to support new and existing ``community partnerships,'' such as the Healthy Community Coalition in Franklin County, to promote healthy lifestyles among hospitals, employers, schools and community organizations. And, it would provide funds for States to establish or expand comprehensive school health education, including, for example, physical education programs that promote lifelong physical activity, healthy food service selections and programs that promote a healthy and safe school environment.

And finally, the Access to Affordable Health Care Act would promote equity in Medicare payments and help to ensure that the Medicare system rewards rather than punishes states like Maine that deliver high- quality, cost effective Medicare services to our elderly and disabled citizens.

According to a recent study in the Journal of the American Medical Association, Maine ranks third in the nation when it comes to the quality of care delivered to our Medicare beneficiaries. Yet we are 11th from the bottom when it comes to per-beneficiary Medicare spending.

The fact is that Maine's Medicare dollars are being used to subsidize higher reimbursements in other parts of the country. This simply is not fair. Medicare's reimbursement systems have historically tended to favor urban

areas and failed to take the special needs of rural states into account. Ironically, Maine's low payment rates are also the result of its long history of providing high-quality, cost-effective care. In the early 1980s, Maine's lower than average costs were used to justify lower payment rates. Since then, Medicare's payment policies have only served to widen the gap between low and high-cost states.

As a consequence, Maine's hospitals, physicians and other providers have experienced a serious Medicare shortfall, which has forced them to shift costs on to other payers in the form of higher charges. The Medicare shortfall is one of the reasons that Maine has among the highest health insurance premiums in the nation. The provisions in the Access to Affordable Health Care Act provide a complement to legislation that I introduced in the last Congress with Senator Russ Feingold to promote greater fairness in Medicare payments to physicians and other health professionals by eliminating outdated geographic adjustment factors that discriminate against rural areas.

The Access to Affordable Health Care Act outlines a blueprint for reform based upon principles upon which I believe a bipartisan majority in Congress could agree. The plan takes significant strides toward the goal of universal health care coverage by bringing millions more Americans into the insurance system, by strengthening the health care safety net, and by addressing the inequities in the Medicare system.