Max Baucus

Mr. BAUCUS

Mr. BAUCUS. Mr. President, I have several points to make. First, as a matter of personal privilege, on behalf of the people of Libby, MT, the Senator from Arizona made it sound as if the folks in Libby were getting some kind of a sweetheart deal. I wish the Senator would not leave so he can hear what is actually going on. I think the Senator from Arizona would agree with me that he would not want his constituents to suffer an environmental calamity. He would not want his constituents to not get some redress because of a declaration of public emergency due to contamination of asbestos. I assume the Senator from Arizona would very much stand up for his constituents. Let me explain. Congress passed a law in 1980 called CERCLA. That legislation said that whenever there was a declaration of a public emergency because of contamination at a Superfund site, the government has an opportunity to declare a public emergency and help those people get medical care because of contamination of asbestos; in this case especially, something called tremolite, which causes even greater damage than ordinary asbestos. I would assume the Senator from Arizona would want his constituents to get some help from contamination from asbestos.

Mr. BAUCUS. Absolutely.

Mr. BAUCUS. This is health care. Reclaiming my right to the floor.

Mr. BAUCUS. I reclaim my right to the floor because he doesn't want to deal in good faith with this issue. My second point. It is disrespectful, it is unseemly for Senators in this body to invoke the names of Ted Kennedy and Jack Kennedy in opposition to this bill. It is disrespectful and unseemly. I, frankly, am very much surprised that Senators would go to that level and invoke the names of Ted Kennedy and Jack Kennedy in opposition to this legislation. Talk about profiles in courage. I hear Senators on the other side say: Where is the courage of one Senator to stand up and vote against health care reform? That is what I keep hearing. Where is the courage? Where is the courage of one Senator on the Democratic side to stand up and vote against health care reform? Mr. President, I want to turn that around. ``Profiles in Courage''-- Jack Kennedy and Ted Kennedy were Senators who worked to try to find resolutions to agreements. They wanted to compromise. They wanted to work together to get just results. I ask, where is the Senator on that side of the aisle who has the courage to break from their leadership, break from the partisanship they are exercising on their side of the aisle to work together to pass health care reform? I ask, where is the courage? Where are the Senators who have the courage on that side of the aisle to stand up and work together on a bipartisan basis to get health care reform passed? Where? We on this side reached out our hands for bipartisan agreement on health care reform, probably to a fault. I say ``to a fault'' because for months and months this Senator, anyway, extended the hand to work with other Senators on a bipartisan basis. I know the current occupant of the chair knows that. He watched this. He saw it happen in the Finance Committee. Senator Grassley and I worked very hard to get Senators on both sides of the aisle to work to pass health care reform, very hard. Then after a while we had to work toward another approach. The Group of 6--3 Republicans, 3 Democrats--worked for months on a bipartisan basis to get health care reform passed. Do you know what happened? I watched it happen. Those Senators in the room were acting in good faith. They were in good faith. They wanted to mutually work together to pass health care reform. They asked good questions. Senator Enzi from Wyoming, for example, asked very good questions. Senator Snowe asked very good questions. Senator Grassley asked very good questions. We worked to get health care reform. But do you know what happened? I could feel it happening. One by one by one, they started to drift away. They wanted to pass health care reform. They wanted to act in a bipartisan basis. But they were pressured--pressured from their political party not to do it, not to do it, not to do it. Why were they pressured not to do it? Unfortunately, they gave in to the pressure because their leadership wanted to make a political statement. One of the Senators on the floor here said: Let's make health care Obama's Waterloo. They did not want to work with us, that side of the aisle. They did not want to work with us because they thought it was better to make a political statement: Attack the bill, attack the bill, attack the bill, attack the bill in order to make political points for the 2010 election. That is what they were trying to do. I ask, where is the courage? Where is the courage? Where is the Republican Senator who will stand up and say: Boy, let's work together to pass health care reform. Where is the Senator who will stand up and say: We want to work together to pass health care reform. This Senator tried mightily to get bipartisan support. Ask Senator Grassley from Iowa, with whom I have been working for a long, long time. They were pulled away. Senator Grassley--I don't want to speak for him, but I know he wanted to get health care reform passed on a bipartisan basis. I know that is the case. Frankly, he got pressured, pressured, and he just couldn't do it. I have the highest respect and regard for him, but he just couldn't do it.

Mr. BAUCUS. Absolutely.

Mr. BAUCUS. That is how they started out, that is true.

Mr. BAUCUS. Reclaiming my time.

Mr. BAUCUS. That is not what happened. I was in the room constantly. I talked to those Senators many times. That is not what happened. I will tell you what did happen. Your leadership pressured them, pressured them, pressured them not to work together. There was no European-style effort in that room. That is a totally untruthful statement--a totally untruthful statement. None whatsoever. We are passing a bill here that is a uniquely American solution. It provides competition. It helps the doctor-patient relationship. That assertion of working toward a European solution is entirely untrue. It is entirely false. The fact is, those Senators did not want to work with us. It is regrettable. It is highly regrettable. One of the biggest travesties here is there was not a good-faith effort on that side of the aisle to come up with a constructive, comprehensive alternative to the Democratic version of health care reform. If there had been a constructive, honest, alternative health care reform, we could have had a really good debate. What is the better approach to solving the health care problem? That did not ever happen. It did not ever happen at all. Rather, they didn't have anything. They didn't have a health care bill. None whatsoever. The only one that came up a little bit was over in the House. Because of all the criticism about Republicans not having an alternative, finally the Republicans in the House came up with an alternative. It was very small. There wasn't much to it. To be honest, the CBO said it would hardly increase any coverage whatsoever. It was not really a comprehensive health care reform bill. And there has been none in the U.S. Senate on the Republican side, no alternative for a comprehensive health care reform bill. I want the public to know we worked very hard to get a bipartisan bill. That side of the aisle started without working with us, but gradually they began to believe that politically they would have a better chance in the 2010 elections by just not working with us but just attack, attack, attack, attack, trying to score political points to defeat any honest effort to get health care reform. I now yield such time as he would like to the Senator from Nebraska.

Mr. BAUCUS. Mr. President, I yield 15 minutes to the Senator from Delaware.

Mr. BAUCUS. Mr. President, I want to begin by saying I agree with my colleague from Delaware. This partisanship has to stop. It is just too much. It is ironic, it is bittersweet that we are reaching a high point because we are going to pass health care reform legislation, but we are reaching a low point, too, in terms of partisanship. It is very unfortunate. Many of us over the last several days have been scratching our heads just trying to figure out what we can do to avoid this next year. Hope springs eternal. I know this Senator and I know the occupant of the chair want to try to find ways for this body to be much more civil. We are not just blowing smoke here. We really mean it. I thank very much the Senator from Delaware for raising that point. It is needed, and I do think this country is in trouble if we don't find some solution to handle this excessive partisanship which is certainly hurting our country. On another matter, some of my colleagues on the other side of the aisle have asserted that the penalty that is proposed under the bill before us for failing to maintain health coverage is unconstitutional. One Senator has raised a point of order--Senator Ensign--on that subject, and that is now pending. Those of us who voted to proceed to the health reform bill and who voted for cloture on the substitute amendment take seriously our oath to defend the Constitution. Every Senator here takes that oath of office very seriously. We have seriously looked at this question as well and have concluded that the penalty in the bill is constitutional. Those who study constitutional law as a line of work have drawn that same conclusion. Most legal scholars who have considered the question of a requirement for individuals to purchase health care coverage argue forcefully that the requirement is within Congress's power to regulate interstate commerce. Take Professor Erin Chemerinsky, a renowned constitutional law scholar, author of four popular treatises and casebooks on constitutional law and the dean of the University of California Irvine School of Law. Professor Chemerinsky has gone so far as to say that those arguing on the other side of the issue do not have ``the slightest merit from a constitutional perspective.'' In arguing that a requirement to have health care coverage falls within Congress's power to regulate interstate commerce, Professor Chemerinsky compares health care reform to the case of Gonzales v. Raich--often cited by the other side. In that case, the Supreme Court held that the Federal Government's commerce clause powers extend to the cultivation and possession of small amounts of marijuana for personal use. Professor Chemerinsky notes that the relationship between health care coverage and the national economy is even clearer than the cultivation and possession involved in Gonzalez v. Raich. Mr. President, I ask unanimous consent that Professor Chemerinsky's Los Angeles Times article be printed in the Record.

Mr. BAUCUS. Mr. President, as a second example, I refer my colleagues to an article by Mark Hall, a law professor at Wake Forest University. His article is a comprehensive peer-reviewed analysis of the constitutionality of a Federal individual responsibility requirement. In this article, Professor Hall concludes that there are no plausible 10th amendment or States' rights issues arising from the imposition by Congress of an individual responsibility to maintain health coverage. Professor Hall notes further that health care and health insurance both affect and are distributed through interstate commerce, and that gives Congress the power to legislate a coverage requirement using its commerce clause powers. Professor Hall notes that the Supreme Court indicated in its decision in U.S. v. Morrison and U.S. v. Lopez--two other cases relied on by the other side--that the noneconomic, criminal nature of the conduct in those cases were central to the Court's decisions in those cases that the government had not appropriately exercised power under the commerce clause. Health insurance, on the other hand, does not deal with criminal conduct. Health insurance is commercial and economic in nature and, to reiterate, substantially affects interstate commerce. Health insurance and health care services are a significant part of the national economy. National health spending is 17.6 percent of the economy, and it is projected to increase from $2.5 trillion in 2009 to $4.7 trillion in 2019. Private health insurance spending is projected to be $854 billion in 2009. It covers things such as medical supplies, drugs, and equipment that are shipped in interstate commerce. Health insurance is sold by national or regional health insurance carriers. Thus, health insurance is sold in interstate commerce. As well, claims payments flow through interstate commerce. The individual responsibility requirements, together with other provisions in the act, will add millions of new consumers to the health insurance market, increasing the supply and demand for health care services. Under existing health and labor laws, the Federal Government has a significant role in regulating health insurance. Other prominent legal scholars have also said that Congress has the constitutional authority to impose a requirement on individuals to maintain health coverage. Jonathan Adler, a professor of law at Case Western Reserve University School of Law, stated: In this case, the overall scheme would involve the regulation of ``commerce'' as the Supreme Court has defined it for several decades, as it would involve the regulation of health care markets. And the success of such a regulatory scheme would depend upon requiring all to participate. Doug Kendall of the Constitutional Accountability Center similarly concluded: The fundamental point behind pushing people into the private insurance market is to make sure that uninsured individuals who can pay for health insurance don't impose costs on other taxpayers. Professor Michael Dorf of the Cornell University Law School also noted: [T]he individual mandate is ``plainly adapted'' to the undoubtedly legitimate end of regulating the enormous and enormously important health care sector of the national economy. It is therefore constitutional. Robert Shapiro, a professor of law at Emory University School of Law, stated: When everyone thinks of the wisdom of an individual mandate, or of health care reform generally, it would be surprising if the Constitution prohibited a democratic resolution of the issue. Happily, it does not. Thus, Mr. President, the weight of authority is that health care and insurance represent interstate commerce. The individual responsibility requirement to maintain coverage would be within Congress's power to regulate interstate commerce. Mr. President, in the last hour, several Senators on the other side listed many organizations they claim oppose the bill before us. I will indicate many organizations that favor the health care reform bill. I will begin with the American Medical Association. That is the major doctors association that supports this legislation. In fact, the incoming president, the president-elect of AMA, at a press conference yesterday, made that statement very clear. In addition, the American Heart Association supports the legislation. They believe the many patient-centered provisions are a significant step toward meaningful health care. The American Hospital Association supports passage of the legislation. The American Cancer Society Action Network supports it. The Federation of American Hospitals also supports it. The National Puerto Rican Coalition supports this legislation. Mr. President, it would be unfair to say that these are all totally 100 percent endorsements. Rather, these are statements of support from these organizations. Some totally support it, and some say there are very good features in it. As far as I know, none of these groups totally oppose this legislation. Some would like to see some changes, but they favor the legislation. The American Association of Retired People supports this legislation. That is the largest seniors group. They think this is good--I am sure for a lot of reasons, but it extends the solvency to the Medicare trust fund for another 5 years. The Business Roundtable supports this legislation. They say: On behalf of the members of Business Roundtable, I want to commend you for your efforts to improve the health care reform legislation currently being considered by the United States Senate. The proposed legislation is a step toward our shared goal of providing high quality, affordable health care for all Americans. . . . As we understand it, the proposed legislation now will include provisions to accelerate and enhance the process for delivery reform for the Medicare system. . . . It strengthens the match between the insurance reforms and the individual obligation. . . . We will continue to work with you, the Congress and the Administration to ensure we achieve the goals we all set when this process began. The American Diabetes Association also supports this bill. They say it is ``long overdue improvements to our broken health care system.'' The Small Business Majority also believes the managers' amendment ``includes new provisions essential for small business protection and survival.'' Doctors for America supports passage of this bill. The National Hospice and Palliative Care Organization strongly supports this legislation. There has been confusion as to whether they did. But they strongly support it, saying: On behalf of hospice and palliative care providers and the more than 1.5 million patients, and their families . . . would like to express our strong support for the national effort to enact health care reform. We acknowledge the enormity and complexity . . . and we applaud your recognition of the importance of various provisions. . . . Families USA supports this legislation. I already mentioned AARP, which also supports it. Community Catalyst is another organization that supports it. U.S. PIRG supports it. The Center for American Progress supports it. Medco Health, Microsoft, a big company in the United States, makes a strong statement approving the measure we are considering here. Many organizations support this legislation. I am sure there are more, but this is an example of a few. How much time remains on our side?

Mr. BAUCUS. Mr. President, I yield 10 minutes to the Senator from Pennsylvania.

Mr. BAUCUS. Mr. President, I see no Senator seeking recognition. I ask unanimous consent that the next block of time begin immediately.

Mr. BAUCUS. Reserving the right to object, and I hope my colleague will let me say a word or two in my reservation, the underlying bill, while certainly objective, was crafted with the guidance of CMS, the Office of the Inspector General, HHS, and the Justice Department for stronger antifraud. It would give CMS new screening authority to provide resources to CMS for new screening authority. It also limits providers in other ways but more oversight when fraud is suspected, such as limiting durable medical equipment providers because we know it is fraught with fraud. We also require providers to have compliance programs, make sure providers know the rules. There are increased penalties for fraudulent activity in the bill as well. Most importantly, we will give CMS, HHS, OIJ, and DOJ more tools at their disposal to preserve and protect the program's integrity. The bill does a lot to protect fraud. I might say, I know this is on his time, but this procedure has been unusual. I appreciate the indulgence of the Chair, as well as the indulgence of the Senator from Florida. You will not believe the number of amendments that were offered on a bipartisan basis in the Finance Committee, as well as in the HELP Committee. They were adopted in both committees. It was very transparent, open, bipartisan. Unfortunately, by the time the bill got to the floor, it became apparent we were facing less than the nature of legitimate amendments, more message amendments. So the majority leader resorted to a procedure to move this bill expeditiously. I am taking advantage of the Senator's time to explain all this. That is not the proper procedure. There are strong antifraud provisions in this legislation, and very respectfully I must object.

Mr. BAUCUS. I ask the Senator if he might yield using time on our side. I fully agree with the Senator. It is unfortunate we cannot proceed at this moment. But I pledge my support next year to work aggressively with very strong oversight to boost our antifraud measures even more than they are in this bill. There will be an awful lot of oversight necessary when the bill is passed to make sure all the provisions that are intended come true. In fact, we think we are working hard to get it passed; frankly, I think we have to work harder next year to make sure the provisions work. I pledge my support to work aggressively in that area.

Mr. BAUCUS. I would be happy to engage Senator Lincoln in a colloquy. I commend her for all her leadership over the years on this issue, because she recognizes that it is important to reimburse pharmacies adequately for the generic medications they dispense to Medicaid patients. In rural States like ours, Medicaid patients need access to their community pharmacies to obtain their medications. Sometimes community pharmacies are the only health care providers for many miles. So, it is important that we permanently fix in this health care reform bill the problems for pharmacies caused by the severe reimbursement cuts from the Deficit Reduction Act of 2005.

Mr. BAUCUS. I would say to my colleague that the language indicating that the Secretary could set the Federal upper limit at no less than 175 percent the weighted average average manufacturer price could be used in those types of circumstances. It would give the Secretary flexibility to set the Federal upper limits in cases where there is a need to provide states with a higher match in order to assure that appropriate payment is made to pharmacies to encourage the use of generic drugs.

Mr. BAUCUS. I thank the Senator. I would be pleased to enter into a colloquy with the Senators from Wisconsin on this subject.

Mr. BAUCUS. I thank the Senator for the question. Yes, that is correct, and it is my understanding of the legislation as well.

Mr. BAUCUS. Yes. I thank the Senator.

Mr. BAUCUS

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

Mr. BAUCUS. Mr. President, I wish to take a few moments this morning to talk about a provision in this package about which I am particularly proud. This would finally follow through on the Federal Government's responsibility to provide screening and medical care to residents at Superfund public health emergency sites. The term ``public health emergency'' is defined by the Comprehensive Environmental Response Compensation and Liability Act of 1980, otherwise known as CERCLA. People call that the Superfund law--CERCLA. That law reserves the declaration of public health emergency for the most hazardous Superfund sites. These are sites where the release or potential release of a hazardous substance rises to the level of an emergency. When a public health emergency is declared, the law requires that the Secretary of Health and Human Services provide screening and medical care services to people who have been exposed. But to date, the government has not created a mechanism to allow the Secretary to deliver the screening and medical care required under current law. The bill before us finally provides that mechanism. First, it authorizes a grant program for the screening services. These screenings would determine if a medical condition is present that is attributable to environmental exposure. Then, it allows those individuals with a diagnosed medical condition due to the environmental exposure at the site to get medical care services. It also establishes a pilot program to provide additional medical care appropriate for the residents of the Superfund site at Libby, MT. This language responds to Libby's rural nature and the lack of access to traditional care. This provision is important because it will provide vital medical services to Americans who, through no fault of their own, have suffered horrible effects from their exposure to deadly poisons. It will provide the vital medical services we owe these Americans under our commitment in prior legislation; that is, the Superfund Act. This provision is especially important to me for a special reason. The Environmental Protection Agency currently has 1,270 sites designated where pollution contamination presents a danger to public health and welfare. Throughout the history of the program, the EPA has found only one site where conditions are so severe and the contamination so pervasive to have it warranted a declaration of a ``public health emergency.'' That declaration occurred on June 17 of this year. EPA Administrator Jackson found that a public health emergency exists at the Superfund site in Libby, MT. Many Senators have heard me speak about Libby. Libby, MT, is a beautiful little town, a small town in northeastern Montana, surrounded by millions of acres of Federal forest lands. It appears to be an idyllic spot. It is home to families of all ages. It is a place where people spend their lives creating a sense of community not often found in the country today. It is also a town that has gone through lots of stress, lots of economic difficulties. The timber industry has virtually shut down Libby, one of the mainstays in Libby. Mining there is not quite what it used to be in years past. Here the people work together. They love Libby. It is tucked away, almost isolated in the northeastern part of Montana. Most people in Montana have never been to Libby, and some don't even know where Libby is, but they have this wonderful sense of community in their own town. However, Libby is also a Superfund site. It is the home of a big mine. It is a place where hundreds of people have grown sick and died-- died due to pervasive presence of asbestos spewed from the vermiculite mining and milling operations of W.R. Grace. Gold miners discovered vermiculite in Libby in 1881. In the 1920s, the Zonolite Company formed and began mining vermiculite. In 1963, W.R. Grace bought the Zonolite mining operations, operated it, and made a lot of money, frankly, and the mine closed in 1990. The EPA first visited Libby in 1999. In October 2002, EPA declared it a Superfund site. Cleanup was begun. It was very pervasive, very difficult, and it was a hard time getting the trust between the EPA and the people in the community. A lot of people didn't trust that EPA was doing the right job, not doing it the right way. In fact, I had to get so involved in so many ways in holding EPA's feet to the fire because they weren't doing something such as a base-level study. They didn't know how clean clean was. They did not do a very good job. A guy named Paul Peronard was the onsite coordinator, who was finally able to convince EPA back in Denver what they had to do. In my personal judgment, they didn't send Paul back because he was doing such a good job. Anyway, cleanup began in 2002, and we still have a long way to go. For decades, the W.R. Grace operation belched 5,000 pounds of asbestos into the air in and around Libby every day. Deadly asbestos coated the town and its inhabitants. People used raw vermiculite ore or expanded vermiculite to fill their gardens, their driveways, they put the stuff on the high school track, the little league ballfield, and put the stuff up in their attics. It was used everywhere, this stuff. People sort of sensed there was something not quite right with all this vermiculite and asbestos, but it was kind of hard to put your finger on. One day, I visited Libby, and I will never forget, when I went to the mine, I was stunned to see these miners come off the mine and into their buses. They were caked with dust. I mean, it added new meaning to a dustbin. They were just caked with the stuff on their clothes. They got on the bus, went home. The one person I talked to and who got me interested in doing something about this--a guy named Les Scramsted--told me, when he got off the bus, he would go home--caked with dust--and embrace his wife, his kids would jump in his lap, and guess what: Les is now dead from asbestos-related vermiculite. His wife is ill, and one of his children has died as a consequence. Think of the pain he went through. He died because of mesothelioma asbestos. Also, even worse, he caused his wife to be ill and caused his son to die because of this disease. Mine workers brought the dust home with them, as I mentioned, on their clothing. They contaminated their own families without knowing the dust was poison. We knew something was wrong, but we didn't know it was that wrong. I think the company knew exactly what it was doing. In fact, I might say, the company has been subject to a criminal action against their officers, with allegations the officers knew they were contaminating the people and didn't disclose it. That suit went on for a year. It is true the officers were acquitted not long ago, but in my personal judgment, it was because of a lousy prosecution. But it is an example where somebody thought--a lot of people thought--not only did the officers of this company contaminate people, but they knew they were contaminating people at Libby, MT. Asbestos was everywhere in Libby for decades. I must say, W.R. Grace Company sure did not help matters. I might say, parenthetically, this is the same company that is the subject of a book and a movie called ``Civil Action,'' where W.R. Grace contaminated the water in Woburn, MA. In my judgment, they knew what they were doing. It is clear they knew what they were doing. As I recall, a big civil judgment was rendered against W.R. Grace because it was clear they knew what they were doing. They are now bankrupt. W.R. Grace shoved all their assets to another location so the plaintiffs in the suit against W.R. Grace could not attach their assets--and all the shenanigans this company undertook for their own benefit and at the expense of the people in Libby. The type of asbestos in Libby is particularly deadly, and so many people in Libby are dead, dying, and sick because of this tremolite asbestos, an especially vicious, pernicious form of asbestos. This is not regular asbestos, such as chrysotile, this was tremolite asbestos mined at Libby, MT, where the fibers are deeper and they are stronger. They get in your lungs and they cause more damage and it takes longer to detect. It is that vicious. The effect on Libby has been severe. Today, we know that nearly 300 residents of Libby have died--300. It is a small town. Thousands more have become sick with asbestos-related disease. That is 291 deaths in a county of 18,000. Lincoln County, MT, home to Libby, has the highest age-adjusted death rate due to asbestosis in the Nation. Libby is an isolated community with limited access to health care. The median household income in Libby in 2007 was $30,000. When I say ``isolated community with limited access to medical care,'' what do I mean? There is just not that much there. And the company has reneged on its insurance policies. The company had mediocre insurance policies for folks, but as time goes on, the company just backs off--backs off. It is really what is happening in the health care reform here. They rescind--renege on their policies for one reason after another. The poor folks, when they know they have asbestos-related--either cancer or other lung-related disease, they do not have the resources to go to get the medical attention. I have been at this for years. It is so frustrating, it is so wrong what has happened to the people of Libby, MT. It is this combination of devastating characteristics that led the EPA Administrator in June to find that the public health emergency does exist at the Libby Superfund site. This finding was based on years of work, having originally been recommended by the EPA in 2001. I might say, I read the transcripts between EPA Administrators and OMB back in those years. The EPA Administrator under the Republican administration recommended that this action be taken, but it was squelched at the White House by OMB. The correspondence is clear. This is exactly what happened back then in a previous administration. That is why EPA has never used this authority, and the Agency indicates there are currently no sites on the National Priorities List that come close to the conditions at Libby. It is worth highlighting a few parts of the Administrator's findings. Let me indicate what they are. The Administrator has said: The Libby Asbestos Site is unique with respect to the multiplicity of exposure routes [all ways this stuff gets to them], the cumulative exposures experienced by community members, and the adverse health effects from asbestos exposure already present and documented in the residents. Investigations performed by the Agency for Toxic Substances and Disease Registry (ATSDR) have found hundreds of cases of asbestos-related disease in this relatively small community. ATSDR documented a disease and death rate from asbestosis in the Libby area significantly higher than the national average for the period from 1979-1998. The occurrences of disease are not limited to vermiculite facility workers or their families, but are spread throughout the population. This is pervasive in the town--ballfields, tracks, lawns; it is awful. Medical care in Libby has historically been limited due to Libby's isolated location and economic situation, thus reducing the chance of early detection and treatment of asbestos-related disease. This piece bears repeating: Let me refine that point. For a long time, we have been talking to lung specialists across the country about the Libby tremolite asbestos, and we got just so-so responses about how dangerous it was. Why? Because virtually none of those doctors had experience dealing with the pernicious kind of asbestos we have in Libby, MT. It took a long time to get their attention. We finally got some doctors to say this stuff in Libby is wicked stuff. That is why, frankly, EPA has started to understand how bad this really is. Essentially, the lack of access to health care services in Libby--I will say it again--has actually worsened the effects of this contamination. It just worked to their disadvantage. The language before us today helps to solve this. It allows us to fulfill the commitment we made to the people of Libby when we passed the Superfund Act 30 years ago. Heaven forbid, if in the future another Superfund site like Libby emerges, the bill before us today will allow the Secretary to use the authorities in this provision to fulfill our commitment to provide health care services for those residents as well. I can never talk about Libby without remembering my friend Les Skramsted. I mentioned his name a few moments ago. I first met Les in the year 2000 at the home of Gayla Benefield. Les was there, Gayla was there, and lots of other miners were there pleading for help, for some attention: We are dying. Someone pay attention to us. We are a small, isolated community up here in northwestern Montana. Please, someone, pay attention to us. This did get our attention. I was stunned by the stories they told. I was talking to Les over coffee and huckleberry pie--a very popular pie up in Libby. Les was watching me very closely when I said: You bet, I will help do something about this. He was very wary. After his neighbors and friends had finished telling me their stories, I will never forget that Les came up to me and said: Senator, a lot of people have come to Libby, and they told us they would help. Then they leave and nothing happens. He told me, I remember, I think at that instant--you know, in life sometimes you find four, five, six, seven instances, man to man, whatever it takes, you are going to make sure they get justice; whatever it takes, whatever it takes. Such a commitment. That was one. I said to myself: Boy, I am going to do whatever it takes to take care of this because these people of Libby deserve justice. They have not received it. He said: Senator, I heard you say that, but I will be watching you. I knew he would watch. I knew that would help. I didn't actually say it because I was going to do it anyway. I accepted Les's offer, and I have a big photograph of Les behind my desk. Les passed away a couple or 3 years ago. I spent a lot of time with him and his family at the hospital. I have a wonderful picture of Les Skramsted that reminds me what we have to do for the people of Libby but also for all the people in the Nation, people like Les Skramsted. It means that much to me. I have not forgotten Les. I will not forget Les. That is why this provision is in here. I think Les, right now, up there, may be smiling, saying: Yup, he did not forget Libby, he did not forget Les. That is what this provision is all about. This is a photograph behind me of Les Skramsted in Libby, MT. He is in a cemetery there, graves of lots of people in Libby who died. Les played a pretty mean guitar. He was a great guy--still is, always will be. I yield to my colleague from Montana, Senator Tester.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, I ask unanimous consent that the Senate proceed en bloc to the following bills: Calendar Nos. 235 through 242; that the bills be read a third time and passed en bloc, the motion to reconsider be laid upon the table, with no intervening action or debate, and that any statements relating to these matters be printed in the Record.

Mr. BAUCUS. These are post office bills.

Mr. BAUCUS

Mr. BAUCUS. I yield 20 minutes to the chairman of the HELP Committee, Senator Harkin, and 18 minutes to the Senator from Colorado, Senator Bennet.