John Ensign

Mr. ENSIGN

Mr. ENSIGN. Mr. President, I ask unanimous consent the pending amendment be temporarily set aside.

Mr. ENSIGN. Mr. President, I ask unanimous consent I be permitted to offer four amendments en bloc, and I send those four amendments to the desk.

Mr. ENSIGN

Mr. ENSIGN. Mr. President, today I introduced a bill that would expand access to speech-language pathology care. Speech-language pathology, or speech therapy, includes services for patients with speech, hearing and language disorders, which result in communication disabilities. Speech therapy also includes the diagnosis and treatment of swallowing disorders, regardless of the presence of communications disability. Communications disabilities most frequently affect patients who suffer from a stroke, tumor, head injury, or have been diagnosed with Parkinson's disease, amyotrophic lateral sclerosis (ALS) , or other neuromuscular diseases. As a result of a legislative anomaly, patients cannot receive Medicare coverage for speech-language pathology care in a private practice setting. Under the Medicare program, the same patient is able to receive such care in a hospital, skilled nursing facility, or rehabilitation facility. This bill would not create a new benefit. Rather, it would provide a technical correction to a section of Medicare statute that originated more than 30 years ago. Under current law, physical therapy and occupational therapy care can be received by patients in the private practice setting. In 1972, speech-language pathology services were added to the Medicare statute under the physical therapy definition section. 14 years later, occupational therapy was defined under a separate section. Unlike speech-language pathology services, occupational therapy services were not incorporated within the physical therapy definition. As a result, a patient can receive both physical and occupational therapy care in an independent practice setting. The legislation I am introducing today would enable patients to likewise receive speech- language therapy services in private practice settings. Without this legislative fix, beneficiaries may confront situations in which they either do not have access to a Medicare-covered setting or do not meet the requirements to receive care from other settings. This can be especially problematic in rural communities with fewer hospitals, skilled nursing facilities, and rehabilitation facilities. For example, consider an elderly patient who is discharged from a hospital, but requires follow-up physical therapy and speech-language pathology care. The patient would be able to obtain necessary physical therapy care in an independent practice setting, but would not be able to receive necessary speech-language pathology care in the same setting. The patient would have to see the necessary speech-language pathology care in another Medicare setting, possibly having to travel farther distances to receive such care or not receive it all. Essentially, the legislation I am introducing today would ensure that patients have access to speech-language pathology services, particularly in rural areas. I urge my colleagues to join me in supporting this commonsense legislation. This legislation compliments the measure I introduced last month, called the Medicare Access to Rehabilitation Services Act (S. 438). Both bills ensure access to needed therapy care within the Medicare program. I am committed to working toward their enactment and believe that they will help Medicare beneficiaries obtain the quality health care that they deserve.

Mr. ENSIGN

Mr. ENSIGN. Mr. President, today I introduced a bill that would expand access to speech-language pathology care. Speech-language pathology, or speech therapy, includes services for patients with speech, hearing and language disorders, which result in communication disabilities. Speech therapy also includes the diagnosis and treatment of swallowing disorders, regardless of the presence of communications disability. Communications disabilities most frequently affect patients who suffer from a stroke, tumor, head injury, or have been diagnosed with Parkinson's disease, amyotrophic lateral sclerosis (ALS) , or other neuromuscular diseases. As a result of a legislative anomaly, patients cannot receive Medicare coverage for speech-language pathology care in a private practice setting. Under the Medicare program, the same patient is able to receive such care in a hospital, skilled nursing facility, or rehabilitation facility. This bill would not create a new benefit. Rather, it would provide a technical correction to a section of Medicare statute that originated more than 30 years ago. Under current law, physical therapy and occupational therapy care can be received by patients in the private practice setting. In 1972, speech-language pathology services were added to the Medicare statute under the physical therapy definition section. 14 years later, occupational therapy was defined under a separate section. Unlike speech-language pathology services, occupational therapy services were not incorporated within the physical therapy definition. As a result, a patient can receive both physical and occupational therapy care in an independent practice setting. The legislation I am introducing today would enable patients to likewise receive speech- language therapy services in private practice settings. Without this legislative fix, beneficiaries may confront situations in which they either do not have access to a Medicare-covered setting or do not meet the requirements to receive care from other settings. This can be especially problematic in rural communities with fewer hospitals, skilled nursing facilities, and rehabilitation facilities. For example, consider an elderly patient who is discharged from a hospital, but requires follow-up physical therapy and speech-language pathology care. The patient would be able to obtain necessary physical therapy care in an independent practice setting, but would not be able to receive necessary speech-language pathology care in the same setting. The patient would have to see the necessary speech-language pathology care in another Medicare setting, possibly having to travel farther distances to receive such care or not receive it all. Essentially, the legislation I am introducing today would ensure that patients have access to speech-language pathology services, particularly in rural areas. I urge my colleagues to join me in supporting this commonsense legislation. This legislation compliments the measure I introduced last month, called the Medicare Access to Rehabilitation Services Act (S. 438). Both bills ensure access to needed therapy care within the Medicare program. I am committed to working toward their enactment and believe that they will help Medicare beneficiaries obtain the quality health care that they deserve.

Mr. ENSIGN

Mr. ENSIGN. I move to lay that motion on the table. The motion to lay on the table was agreed to. Amendment No. 171

Mr. ENSIGN. Mr. President, very simply, the amendment I have offered for myself, Senator Craig, Senator Vitter, and Senator Hutchison increases the spending for veterans medical care by $410 million. The President had increased $751 million over last year's spending for veterans medical care, Chairman Gregg put in an additional $40 million, and we put in an additional $410 million, which in total is a $1.2 billion increase for veterans medical care. We did it without raising taxes. We did it with no new copays for the vets, and we did not increase the deficit. The Murray amendment increases taxes to provide for our veterans. We did it in a fiscally responsible way. We provide for our veterans. As my colleagues can see, the last several years we have dramatically increased spending for veterans and veterans medical care because we should do it. It is the right thing to do to make sure we take care of those who have sacrificed for you and me and for our freedom. I urge a ``yes'' vote on this amendment.

Mr. ENSIGN. Mr. President, I thank the senior Senator from Texas for all the work she has done to strengthen our borders. Living in a border State, she understands the difficult issues of protecting our borders. Since 9/11, protecting our borders has taken on a completely different meaning and has only increased the importance of what our amendment is attempting to do. Mr. President, I rise to call for the Senate to stand by its commitment to increase border security by adding 2,000 new Border Patrol agents. In the decade before 9/11, al-Qaida studied how to exploit gaps and weaknesses in the border entry systems of the United States and other countries. This week, intelligence officials confirmed that the terrorist, Zarqawi, plans to infiltrate America through our porous borders and carry out attacks on soft targets--whether it is while we are taking our family to a movie theater, our friends to a restaurant, or our kids to school. Additionally, a yearlong investigation recently concluded after authorities captured 18 people in an alleged plot to smuggle grenade launchers, shoulder-fired missiles, and other Russian military weapons into this country. Let's face it, the dual threat of the illegal border crossing of people who wish to kill us and the weapons they need to do it on a large scale is very real. We are not dealing with rational actors. We are not dealing with people who respect life or freedom. We must continue to be diligent in our fight to defeat terror and to protect our homeland. The amendment we are offering ties directly to one of the important 9/11 Commission Report recommendations prohibiting terrorist travel to our country. Pre-9/11, INS had only 9,800 Border Patrol agents. With the priorities of the agency concentrated on immigration and narcotics, no major counterterrorism effort was underway. More than 3 years after the devastating terrorist attacks, the men and women who serve at the border's front line of defense are overwhelmed. Statistics show that with current personnel levels, our agents only catch about one-third of the estimated 3 million people who cross the border illegally each year. It only took 19 to change the course of this country. We must commit resources to block terrorists who attempt to enter our country. Last year, I sponsored an amendment to the National Intelligence Reform Act that authorized 2,000 new agents to patrol our borders each year for the next 5 years. Unfortunately, the President's budget this year only provides funding for 210 agents. This amendment allows Congress to fulfill its commitment by providing the additional $352.4 million needed to fully fund 2,000 Border Patrol agents, and it does it without raising taxes. It does it with an offset to what is called ``function 150,'' or the international relations function. Doubling the number of Border Patrol agents from pre-9/11 levels will allow increased protection on both our southern and our often neglected northern border, helping to thwart al-Qaida and prevent these terrorists from circumventing our security. The Commission found that many of the 19 9/11 hijackers, including known operatives, could have been watch-listed and were vulnerable to detection by border authorities. However, without adequate staff and coordinated efforts, the evildoers were allowed unhampered entry. The world has changed dramatically since 9/11, when terrorists used our open and trusting society against us. We cannot allow a repeat of that tragedy. This amendment will help give those who guard our frontiers the tools they need to ensure the safety of the citizens of the United States of America. Mr. President, I yield the floor and reserve the remainder of our time.

Mr. ENSIGN. Mr. President, I rise today to discuss the amendment that has been offered by Senators Specter and Harkin that would increase funding for the Individuals with Disabilities Education Act by $500 million. While I support bolstering special education by $500 million, I cannot support reducing defense and veterans spending at a time of war. In my time in the Senate, I have worked with my colleagues to almost double funding for IDEA. That increase has been echoed in my home state of Nevada, where the Federal investment in IDEA has almost doubled since 2001. I recognize that we have a long way to go toward reaching the Federal Government's promise of funding 40 percent of the excess costs to educate, but we have made great strides toward that goal. The Federal Government now funds about 20 percent of the excess costs States and school districts face when educating children in special education programs. We have an obligation to create the best education system for our children and their children--to do that we must eliminate waste and focus spending on programs that directly benefit our children. This budget accomplishes that goal. This budget, as did the President's budget, contains a $500 million increase for IDEA funding. While this is not the $1 billion increase many of us would like to see, it is a significant increase over last year's funding. During this time of large deficits and war in Iraq, it is necessary to temper funding increases. This includes funding for education. This budget provides generous funding for the Appropriations Committee to work with. It is then the appropriators' job to determine which programs receive cuts or increases in funding. I look forward to working with my colleagues on the Appropriations Committee to ensure that IDEA receives the increase in funding it needs to stay on track and meet the Federal Government's 40-percent promise.

Mr. ENSIGN

Mr. ENSIGN. Mr. President, I ask unanimous consent reading of the amendment be dispensed with.

Mr. ENSIGN. Mr. President, we are proposing an amendment today that will increase the spending on our veterans in this budget by $410 million this year. Some may ask: Why not the amount that the Democrats have proposed? Well, first, we are in tight budget times. And we are considering this amendment without raising taxes. We are taking the money out of the State Department and foreign aid budgets instead of taking the money out of the pockets of hard working Americans who are trying to make a living, trying to provide for their families. We can never spend as much money as the Democrats. There is no question about that. Every single time we offer an increase in this budget, the Democrats will try to outbid us. We understand that. We accept that. We are trying to be fiscally responsible, at the same time taking care of our veterans and not increasing taxes on working Americans. In the Democratic amendment, there is a $6.6 billion tax increase over the next 3 years--$6.6 billion in new taxes. That is one of the many amendments they are going to offer on this budget that will increase taxes. Of that, $2.8 billion goes for veterans care next year. But $6.6 billion in new taxes. Senator Murray from the State of Washington talked about some of her veterans and the problems with some of her veterans. Nevada has experienced some of the same problems. Nevada is the fastest growing State in the country. The problem, Mr. President, is not the amount of money we are spending, but rather the manner in which we are spending it. By that I mean that veterans are moving away from the Rustbelt to faster growing States like Nevada. A large number are moving to the west coast. A lot to the Sunbelt States. They have chosen to move, but a lot of the VA facilities are still located in the Rustbelt. Because of the way Congress works, Senators and Representatives work hard to keep a lot of money in their States, even though the veterans have moved away. So while States such as Washington and Nevada may have VA facilities that are packed to the gills, there are some VA facilities that have 20 to 30 percent occupancy in their beds. Frankly, some of them should be closed. This President has, with the CARES Commission, proposed reallocating some of the funds so that the veterans with the greatest needs will get the care they deserve. Our amendment recognizes that you cannot do this overnight. So we recognize we have to increase spending on veterans care. We have to keep our promise--the promise we made to the men and women who don the uniform of the U.S. military and say: I will lay my life on the line to protect your freedom. All our veterans ask in return is that we take care of those who come home with medical needs. This amendment is about keeping that promise to our veterans. I thank Senator Craig, chairman of the Veterans' Affairs Committee. He has done great work on behalf of veterans across America. We really owe him a debt of gratitude for the work he has done. This is just the opening chapter, I believe, in ensuring that every veteran gets the kind of quality medical care they deserve. We have to look at the whole VA system as we are transforming it, to make sure we best spend the dollars so that veterans will get the quality care they need. As a result of veterans coming home from the war, we are going to have to examine their needs. As we determine those needs, we may have to spend more. If we have to spend more, I know this body will step up to the plate and do what is necessary to take care of those heroes who fought for our freedom. The $410 million in our amendment will restore funding to maintain the prescription copays at $7 for veterans. It also restores funding required to prevent the imposition of a $250 enrollment fee on veterans. This amendment restores funding required to stop the scale back of State nursing home per diem payments made by the VA. It adopts the President's request to spend an additional $100 million for mental health services. Many of our homeless veterans are homeless because of mental health issues. The President has proposed another $100 million, and this budget will now meet that. We also adopt the President's request to spend an additional $100 million for prosthetics. With all the veterans who have been wounded in the war, we are going to need at least that much. Next year, we may have to spend even more than that. We also adopt the President's request for other nonmedical discretionary accounts, allowing for a $116 million increased funding for construction, an increase in disability claims, caseworkers, and the continued expansion of the National Cemetery System, the largest such expansion since the Civil War. Mr. President, I believe strongly that we must keep our word to our veterans, and we must take care of those men and women who have sacrificed so much while wearing the uniform of the U.S. military. This amendment helps keep the promise we have made to our veterans. I yield the floor.

Mr. ENSIGN. Mr. President, I send an amendment to the desk on behalf of myself, Senator Craig, Senator Vitter, and Senator Hutchison.

Mr. ENSIGN

Mr. ENSIGN. Mr. President, I am pleased to reintroduce the Medicare Access to Rehabilitation Services Act to improve the Medicare program for our senior citizens. The bill, which enjoyed the support of a majority of the Senate in the 108th Congress, would repeal the beneficiary cap on rehabilitation therapy care and ensure quality healthcare for Medicare patients. The beneficiary cap is really two separate therapy caps: one cap for occupational therapy and one for both physical therapy and speech- language pathology care combined. Congress has already shown its opposition to this arbitrary cap by placing a moratorium on enforcement of the cap in 1999, 2000, and 2003. The latest moratorium will expire on January 1, 2006. Without congressional action, the beneficiary cap on therapy services will be effective again in less than a year. It is time to repeal the cap once and for all. Each year, more than 3.7 million Medicare beneficiaries receive outpatient physical therapy, occupational therapy, and/or speech- language pathology services to regain their optimum level of function and independence. The Center for Medicare and Medicaid Services, CMS, completed a long-awaited analysis of the therapy cap policy. The report, prepared by AdvanceMed, estimates that for Calendar Year 2002, some 638,195 beneficiaries receiving physical therapy, occupational therapy, and/or speech-language pathology services would have exceeded the cap threshold. This represents 23.7 percent of the outpatient therapy expenditures for that year. Failure to address the issue this year in Congress will have a significant impact on the access beneficiaries will have to necessary rehabilitation services. It is clear from recent reports prepared for CMS that patients with debilitating illnesses and injuries would be severely impacted by enforcement of the therapy caps. Based on data from 2002, patients suffering from conditions such as stroke, Parkinson's disease, congenital heart failure, and Dysphasia were certain to be negatively impacted by enforcement of existing statutory limits on rehabilitation coverage. Action is needed to address the therapy caps this year. Last Congress, this bill attracted 51 Senators as cosponsors. As a member of the Senate Budget Committee, I realize the budgetary constraints that are upon Congress. I understand that we need to prioritize spending. I believe that a meaningful solution to address the rehabilitation needs of senior citizens and individuals with disabilities in the Medicare program should be a priority. I would like to thank my colleagues, Senator Blanche Lincoln, Senator Chuck Hagel, Senator Patty Murray, Senator Jeff Bingaman, Senator Jon Corzine, Senator Tim Johnson, Senator Susan Collins, and Senator Orrin Hatch for joining me in this effort. I stand ready to work with my colleagues to enact a solution to the therapy caps that ensures access to quality restorative services provided by qualified professionals.

Mr. ENSIGN

Mr. ENSIGN. Mr. President, last week, I reintroduced the HEALTH Act to address the national crisis our doctors, hospitals and those needing healthcare face today. Every day, patients in Nevada and across America are losing access to healthcare services. Several states are losing medical professionals at an alarming rate, leaving thousands of patients without a healthcare provider to serve their needs. Because of increasing medical liability insurance premiums, it is now common for obstetricians to no longer deliver babies, and for other specialists to no longer provide emergency calls or perform certain high-risk procedures. Women's health in Nevada and elsewhere in the country is in serious jeopardy as new doctors turn away from specialties and as practicing doctors close their doors. I have been told that one in seven fellows of the American Academy of Obstetricians and Gynecologists have stopped practicing obstetrics because of the high risk of liability claims. When Ms. Jill Forte of Las Vegas, found out that she was pregnant with her second child, she called her doctor. The doctor told her that because of insurance costs, she could no longer deliver her baby. So Jill started calling around. She was told the same thing by five different doctors. She even considered going to California for care. Fortunately, Ms. Forte was able to make a connection through a friend for a local doctor to take her case. She said: I was in total shock. I didn't know what was going on until it happened. Looking for a doctor, worried about finding a doctor when you're pregnant is a stress that is an unnecessary stress. It's a stress caused by frivolous and junk lawsuits. It doesn't make any sense to have a society that sues so often that expectant mothers are worried about finding a doctor. Unfortunately, her story is becoming too commonplace. Additionally, hundreds of emergency departments have closed in recent years. Emergency departments have shut down in Arizona, Florida, Mississippi, Pennsylvania, and Nevada, among others. During this same time, the number of visits to the Nation's emergency departments climbed more than 20 percent. While more Americans are seeking emergency medical care, emergency departments are losing critical staff and essential resources. In my home State of Nevada, our only Level I trauma care center closed for 10 days in 2002, leaving every patient within 10,000 square miles unserved by a trauma unit. In fact, Ms. Mary Rasor's father died in Las Vegas last year when he could not obtain access to emergency trauma care because of the closure. Doctors are also limiting their scope of services. More than 35 percent of neurosurgeons have altered their emergency or trauma call coverage because of the medical liability crisis. As a result, many hospitals, including Level II trauma centers, no longer have neurosurgical coverage 24 hours a day, 7 days a week. Consequently, patients with head injuries or in need of neurosurgical services must be transferred to other facilities, delaying much-needed care. An example of this problem was recently brought to my attention by Dr. Tony Alamo of Henderson, Nevada. During his tenure as chief of staff at Sunrise Hospital, Dr. Alamo was presented with a teenager suffering from a Myasthenia Gravis crisis in need of immediate medical treatment. This condition involves shortness of breath due to muscle weakness. Such shortness of breath can become severe enough to require hospitalization for breathing support, as well as treatment for the underlying infection. If the problem is not identified and treated correctly, it could lead to death. Dr. Alamo told me that because of the medical liability situation, there was no emergency room neurologist on call to assist this young woman. Many neurologists are afraid to become involved in difficult cases like this because of the high risks of medical liability. Consequently, Dr. Alamo had the young woman transported to California by helicopter to receive the care she needed. Because of the reasonable laws in California, neurologists aren't afraid to take call. The bottom line is that patients cannot get the healthcare they need when they need it most. By definition, this is a medical crisis. The crisis boils down to two factors: affordability and availability of medical liability insurance for providers. With regard to affordability, the Medical Liability Monitor found that in 2004, obstetricians in Dade County, FL, were paying as much as $277,241 in annual medical liability insurance premiums. Similarly, in Illinois, some obstetricians were paying more than $230,000 a year. In my home state of Nevada, some OB/GYNs were paying approximately $133,904 for medical liability insurance, an increase of 15 percent from 2003. Faced with increasing medical liability insurance premiums, some physicians are no longer accepting discounted rates for the services they provide. A legislative assistant in my office recently received a letter from her OB/GYN, which I would like to submit for the Congressional Record. The letter indicates that her physician's medical liability insurance premium for 2005 increased by over 50 percent to more than $250,000. Instead of closing the practice or choosing to stop delivering babies, the physician has decided to no longer accept discounted insurance reimbursements. I ask unanimous consent that the letter be printed in the Record at the conclusion of my remarks.

Mr. ENSIGN. We cannot afford to bury our heads in the sand and avoid this issue. Medical liability insurance premiums are affecting real people in need of timely and efficient healthcare services. On the issue of availability, thousands of doctors nationwide have been left with no liability insurance as major insurers are either leaving the market or raising rates to astronomical levels. Why are insurers raising rates and leaving the market? Because there is no stability in the marketplace for providing medical liability insurance. Why is there no stability in the marketplace? Because our healthcare system is being overrun by frivolous lawsuits and outrageous jury awards. This excessive litigation is leading to higher healthcare costs for every American and provides little piece of mind for our healthcare providers. Even medical students are affected by the current crisis. According to a recent American Medical Association survey, the current medical liability environment is a significant factor for students selecting a specialty. And, because the litigation system does not accurately judge whether an error was committed in the course of medical care, physicians are adjusting their behavior to avoid being sued. Many physicians are using defensive medicine practices to avoid lawsuits. They are providing patients with tests and treatments that they would not otherwise perform to protect themselves against the risk of possible litigation. Every unnecessary test and additional treatment poses a risk to the patient, and takes away funds that could be used to provide healthcare to those who need it most. A 2002 study by the Department of Health and Human Services found that defensive medicine is costing the Federal Government an estimated $28 billion to $47 billion per year in unnecessary health care costs. In addition to the Federal Government, who else is paying for these unnecessary costs? Every American with health insurance is paying for these unnecessary expenses in the form of higher out-of-pocket payments and premiums. Too often, medical costs are so great that employers have to stop offering health insurance coverage altogether, therefore increasing the number of uninsured in America. And who is paying for the uninsured to obtain health care services? We all are. And the cycle goes on and on. This cycle has to be stopped and we can do that by passing national medical liability reform right now. Comprehensive medical liability reform is essential on a national level because the existing medical crisis is not confined within State lines and because every American should have access to affordable high quality healthcare. Likewise, every responsible member of the healthcare community should not be afraid to provide high quality care because of the fear of litigation. In order to achieve these critical reforms, I am reintroducing the HEALTH Act. This legislation includes several reform provisions, including a $250,000 cap on noneconomic damages, joint liability and collateral source improvements, and limits on attorney fees according to a sliding award scale. In addition, my legislation includes an expert witness provision to ensure that relevant medical experts serve as trial witnesses instead of so-called ``professional witnesses'' who are used to further abuse the system. This legislation is modeled after California's successful Medical Injury Compensation Reform Act, also known as MICRA. MICRA has brought about real reform to California's liability system. The number of dubious and frivolous lawsuits going to trial has declined dramatically. Injured patients receive a larger share of their awards and disciplinary actions against incompetent healthcare providers have increased. The bottom line is that California's medical liability system works. These types of outcomes should be shared by every state, and ultimately every patient in America. It is important to recognize that neither MICRA, nor my legislation limits the amount of economic damages that an injured patient can recover. Like every other profession, mistakes are sometimes made by healthcare providers. Patients who suffer from these mistakes should have access to unlimited economic compensation and should be able to recover losses, such as loss of past and future earnings. Injured patients should also have access to punitive damages where providers are found to be grossly negligent. But, there is no way to quantify a patient's ``pain and suffering,'' and most often, no dollar amount is ever enough. Therefore, placing a reasonable limit on these non- economic damages helps bring accountability back to our civil justice system by weeding out frivolous lawsuits. This would allow physicians to concentrate fully on providing superior health care services, and help curb the skyrocketing costs of healthcare for patients. Every step Congress can take to help increase patient safety and maintain access to quality health care services should be taken, and we are on track to do that this year. Medical liability reform is not a Republican or Democrat issue or even a doctor verses lawyer issue. It is a patient issue. With the medical crisis occurring in Florida, Illinois, Pennsylvania, Nevada, and many more states around the Nation, our opportunity to enact true reform is here. Comprehensive medical liability reform is the right prescription and the time for action is now. Let's make sure that expectant mothers have access to ob-gyns and that trauma care victims have access to necessary services in their most critical hour of need. And, let's make sure we continue to provide patients in America with the opportunity to receive affordable, accessible, and high quality healthcare for years to come. Exhibit 1 Women OB/GYN Physicians, Washington, DC, December 1, 2004. To Our Patients: We have all been reading and talking about the crisis in our health care system. As your doctors, our most important commitment and mission is to provide you with the highest quality medical care. We are writing to tell you how the current situation is affecting our ability to practice medicine at the level you deserve and expect. Doctors in our area are being squeezed between decreased reimbursement from insurance carriers and steeply rising malpractice premiums. We were just notified that our malpractice premium for next year was increased by over 50 percent to more than $275,000. Faced with this increase we had to consider some difficult choices. We could close our practice. We could stop delivering babies--something we both love and at which we excel. We could markedly increase the number of patients we see each day and reduce the time we spend with each patient. This would mean insufficient time for discussion, education and thoughtful consideration of your individual needs. We rejected all of these options. Instead we chose to stop accepting extremely discounted rates for the services that we provide. Effective March 1, 2005 we will no longer participate with CareFirst BlueCross BlueShield. Therefore, we will not accept any discounted insurance reimbursements. Of course, We hope to continue to see our Blue Cross Blue Shield patients, but payment is expected at the time of service. We will then prepare a claim form that you can submit to your insurance carrier to streamline your reimbursement. As a courtesy, we will continue to submit claims for deliveries and surgeries to the insurance carriers on your behalf. We are committed to provide state-of-the-art women's health services in a caring, efficient, and professional manner. We look forward to our continued relationship. If there is any way we can help you with this transition, please let us know. Sincerely, Nancy Sanders, MD. Janet Schaffel, MD.

Mr. ENSIGN

Mr. ENSIGN. Mr. President, I am pleased to reintroduce the Medicare Access to Rehabilitation Services Act to improve the Medicare program for our senior citizens. The bill, which enjoyed the support of a majority of the Senate in the 108th Congress, would repeal the beneficiary cap on rehabilitation therapy care and ensure quality healthcare for Medicare patients. The beneficiary cap is really two separate therapy caps: one cap for occupational therapy and one for both physical therapy and speech- language pathology care combined. Congress has already shown its opposition to this arbitrary cap by placing a moratorium on enforcement of the cap in 1999, 2000, and 2003. The latest moratorium will expire on January 1, 2006. Without congressional action, the beneficiary cap on therapy services will be effective again in less than a year. It is time to repeal the cap once and for all. Each year, more than 3.7 million Medicare beneficiaries receive outpatient physical therapy, occupational therapy, and/or speech- language pathology services to regain their optimum level of function and independence. The Center for Medicare and Medicaid Services, CMS, completed a long-awaited analysis of the therapy cap policy. The report, prepared by AdvanceMed, estimates that for Calendar Year 2002, some 638,195 beneficiaries receiving physical therapy, occupational therapy, and/or speech-language pathology services would have exceeded the cap threshold. This represents 23.7 percent of the outpatient therapy expenditures for that year. Failure to address the issue this year in Congress will have a significant impact on the access beneficiaries will have to necessary rehabilitation services. It is clear from recent reports prepared for CMS that patients with debilitating illnesses and injuries would be severely impacted by enforcement of the therapy caps. Based on data from 2002, patients suffering from conditions such as stroke, Parkinson's disease, congenital heart failure, and Dysphasia were certain to be negatively impacted by enforcement of existing statutory limits on rehabilitation coverage. Action is needed to address the therapy caps this year. Last Congress, this bill attracted 51 Senators as cosponsors. As a member of the Senate Budget Committee, I realize the budgetary constraints that are upon Congress. I understand that we need to prioritize spending. I believe that a meaningful solution to address the rehabilitation needs of senior citizens and individuals with disabilities in the Medicare program should be a priority. I would like to thank my colleagues, Senator Blanche Lincoln, Senator Chuck Hagel, Senator Patty Murray, Senator Jeff Bingaman, Senator Jon Corzine, Senator Tim Johnson, Senator Susan Collins, and Senator Orrin Hatch for joining me in this effort. I stand ready to work with my colleagues to enact a solution to the therapy caps that ensures access to quality restorative services provided by qualified professionals.

Mr. ENSIGN

Mr. ENSIGN. Mr. President, I rise to reintroduce the Animal Fighting Prohibition Enforcement Act, legislation that garnered the support of 51 Senate cosponsors and 201 House cosponsors in the 108th Congress but didn't quite make it over the finish line. I thank my colleagues for their support in this endeavor to protect the welfare of animals and express my hope that we will get the job done early in this session. This legislation targets the troubling, widespread, and often underground activities of dogfighting and cockfighting where dogs and birds are bred and trained to fight to the death. This is done for the sheer enjoyment and illegal wagering of the animals' handlers and spectators. These activities are reprehensible and despicable. Our States' laws reflect this sentiment. All 50 States have prohibited dogfighting. It is considered a felony in 48 States. Cockfighting is illegal in 48 States, and it is a felony in 31 States. In my home State of Nevada, both dogfighting and cockfighting are considered felonies. In fact, it is a felony to even attend a dogfighting or cockfighting match. Unfortunately, in spite of public opposition to extreme animal suffering, these animal fighting industries thrive. There are 11 underground dogfighting publications and several above-ground cockfighting magazines. These national magazines advertise and sell animals and the materials associated with animal fighting. They also seek to legitimize this shocking practice. During the consideration of the farm bill in 2001, a provision was included that closed loopholes in the Federal animal fighting law. Both the House and the Senate also increased the maximum jail time for individuals who violate this law from 1 year to 2 years, making any violation a Federal felony. However, during the conference, the jail time increase was removed. Then in 2003, I offered an amendment to the Healthy Forests bill that would have had the same effect as the bill I am introducing today. The Senate agreed to this amendment by unanimous consent, but it was again taken out in conference. Now, I am hoping the third time is the charm. In the form that is being introduced today, this legislation passed the House Judiciary Committee in September 2004. It is ripe for enactment early in the 109th Congress. This legislation has been endorsed by the USDA, the American Veterinary Medical Association, more than 150 State and local police and sheriffs departments across the country, and a host of others. The only groups opposing it are the cockfighters and the dogfighters. The bill seeks to do two things. First, it increases the penalty to the felony level--up to 2 years jail time for offenders. I am informed by U.S. attorneys that they are hesitant to pursue animal fighting cases with merely a misdemeanor penalty. The USDA has received innumerable tips from informants and requests to assist with State and local prosecutions but has only been able to help in a handful of cases since Congress first passed the Federal animal fighting law in 1976. For example, in my own State last year, law enforcement authorities raided an ongoing cockfight involving about 200 people from Nevada and other States. The USDA wanted to pursue Federal charges, to complement the local effort, but the U.S. Attorney's Office declined to prosecute because the Federal crime was only a misdemeanor. Increased penalties will provide a greater incentive for Federal authorities to pursue animal fighting cases. Second, the bill prohibits the interstate shipment of cockfighting implements, such as razor-sharp knives and gaffs. The specific knives are commonly known as ``slashers.'' The slashers and icepick-like gaffs are attached to the legs of birds to make the cockfights more violent and to induce bleeding of the animals. These weapons are used only in cockfights. Since Congress has restricted shipment of birds for fighting, it should also restrict implements designed specifically for fights. This is commonsense, long-overdue legislation. It does not expand the Federal Government's reach into a new area but simply aims to make current law more effective. It is explicitly limited to interstate and foreign commerce, so it protects States rights in the two States, Louisiana and New Mexico, where cockfighting is still allowed. Further, it protects States rights in the other 48 States where weak Federal law is compromising their ability to keep animal fighting outside their borders. Mr. President, this legislation is needed for humane reasons. But it is also urgently needed to protect poultry health and public health. In 2002 to 2003, we had an outbreak of exotic Newcastle disease among poultry in my home State of Nevada, as well as in California, Arizona, and Texas. According to the USDA, this deadly disease was spread in large part by illegal cockfighters. It cost taxpayers about $200 million to contain and cost the poultry industry many millions more in lost export markets. In Asia, at least four children died last year due to exposure to bird flu from cockfighting activity, according to news reports. One Malaysian news agency noted that surveys by the ``Veterinary Department show that irresponsible cock-fighting enthusiasts are the main `culprits' for bringing the avian influenza virus into the state.'' Fortunately, bird flu has not yet jumped the species barrier in this country, but we ought to do all we can to minimize the risk. One of the ways to ensure greater protection against the spread of these dangerous avian diseases is to enforce the ban on interstate and foreign shipment of birds for the purpose of fighting. Our bill ensures that penalties are in place to encourage meaningful enforcement of this ban. I appreciate the strong support of Senators Specter, Cantwell, Feinstein, DeWine, Kennedy, Kyl, Kohl, Lugar, Vitter, Leahy, and Santorum in this effort and look forward to the overwhelming support of my other colleagues in the Senate. I also wish to recognize Representative Mark Green for his leadership in reintroducing an identical bill in the House today. Surely, this is an issue that must be addressed as soon as possible. We cannot allow this barbaric practice to continue in our civilized society.

Mr. ENSIGN

Mr. ENSIGN. Mr. President, in the November 2004 elections, Nevadans entered a new frontier for casting their votes. We became the first state in the nation to require that voter-verified paper audit trail printers be used with touch-screen voting machines. Not only did our election go off without a hitch, but voters across Nevada left the polls with the knowledge that their vote would be counted and that their vote would be counted accurately. I understand better than most the importance of the integrity of the ballot box. I was at the mercy of a paperless-machine election in my 1998 race for the U.S. Senate. When the votes were tallied with a difference of only a few hundred, I asked for a recount in Clark County, the only county at the time using electronic voting machines. The result of the recount was identical to the first count. That is because there was nothing to recount. After rerunning a computer program, the computer predictably produced the same exact tally. I conceded that race and was elected to Nevada's other Senate seat in 2000. But that experience made me realize the importance of ensuring Americans that their votes will count--it is absolutely fundamental to our democracy. That is why I led the fight for voter verification paper trails in the Help America Vote Act (HAVA) that President Bush signed into law in 2002. A voter-verified paper trail would allow voters to review a physical printout of their ballot and correct any errors before leaving the voting booth. This printout would be preserved at the polling place for use in any recounts. This is exactly what Nevadans experienced when they voted in November. Unfortunately, the language that is contained in HAVA has not resolved this issue for most other states. Now, I am working to ensure voting integrity across the country. By introducing the Voting Integrity and Verification Act, I want to ensure that HAVA is clear-- voters must be assured that their votes will be accurate and will be counted properly. A paper trail provides just such an assurance. Technology has transformed the way we do many things--including voting. But we cannot simply sit on the sidelines and assume that our democracy will withstand such changes. We recently witnessed the birth of democracy in Afghanistan and Iraq and watched as citizens risked their lives to cast their votes. Our continued work to ensure that each vote counts here in the United States underscores the idea that we must always be vigilant in protecting democracy--whether it is brand new or more than 200 years old. The Voting Integrity and Verification Act protects democracy by protecting the sanctity of our vote.

Mr. ENSIGN

Mr. ENSIGN. Mr. President, in the November 2004 elections, Nevadans entered a new frontier for casting their votes. We became the first state in the nation to require that voter-verified paper audit trail printers be used with touch-screen voting machines. Not only did our election go off without a hitch, but voters across Nevada left the polls with the knowledge that their vote would be counted and that their vote would be counted accurately. I understand better than most the importance of the integrity of the ballot box. I was at the mercy of a paperless-machine election in my 1998 race for the U.S. Senate. When the votes were tallied with a difference of only a few hundred, I asked for a recount in Clark County, the only county at the time using electronic voting machines. The result of the recount was identical to the first count. That is because there was nothing to recount. After rerunning a computer program, the computer predictably produced the same exact tally. I conceded that race and was elected to Nevada's other Senate seat in 2000. But that experience made me realize the importance of ensuring Americans that their votes will count--it is absolutely fundamental to our democracy. That is why I led the fight for voter verification paper trails in the Help America Vote Act (HAVA) that President Bush signed into law in 2002. A voter-verified paper trail would allow voters to review a physical printout of their ballot and correct any errors before leaving the voting booth. This printout would be preserved at the polling place for use in any recounts. This is exactly what Nevadans experienced when they voted in November. Unfortunately, the language that is contained in HAVA has not resolved this issue for most other states. Now, I am working to ensure voting integrity across the country. By introducing the Voting Integrity and Verification Act, I want to ensure that HAVA is clear-- voters must be assured that their votes will be accurate and will be counted properly. A paper trail provides just such an assurance. Technology has transformed the way we do many things--including voting. But we cannot simply sit on the sidelines and assume that our democracy will withstand such changes. We recently witnessed the birth of democracy in Afghanistan and Iraq and watched as citizens risked their lives to cast their votes. Our continued work to ensure that each vote counts here in the United States underscores the idea that we must always be vigilant in protecting democracy--whether it is brand new or more than 200 years old. The Voting Integrity and Verification Act protects democracy by protecting the sanctity of our vote.

Mr. ENSIGN

Mr. ENSIGN. Mr. President, I rise to speak about the recent historic elections in Iraq--elections that had been anticipated by an anxious global community for some time. This election is the story of true patriots who knew the odds and decided to beat them. This is the story of the millions of Iraqis who defied the threats and the intimidation of `` terrorists to cast their votes for a brighter future in Iraq. News reports are flush with first-hand accounts from observers. The reports paint a picture of a people acting on their innate desire to be free. One such account details the determination of Samir Hassan, who at 32 lost his leg in a car bomb blast last October. Hassan said, ``I would have crawled here if I had to. I don't want terrorists to kill other Iraqis like they tried to kill me. Today I am voting for peace.'' The act of voting by ordinary Iraqis in the face of extreme danger confirms President Bush's belief that people around the globe, when given a chance, will choose liberty and democracy over enslavement and tyranny. Human beings crave freedom at their core. Early estimates by Iraq's Independent Electoral Commission show that about 8 million of the nearly 14 million registered voters cast their ballot on Sunday--a turnout almost equal to the number of Americans who voted last November without the threat of snipers or suicide bombers. In the words of Arkan Mahmoud Jawad, who came to vote with his mother and younger brother, ``This is the salvation for the Iraqis. I hate the terrorists, and now, I am fighting them by my vote.'' These are people who were beaten down by the brutal regime of Saddam Hussein. That is exactly why they want to reclaim their country through these elections. They know what the cost of failure would be. And they know all too well that tyranny breeds isolation. Any dissent from Saddam Hussein's regime could result in torture or death. Neighbors couldn't trust neighbors. Families were torn apart. All this leaves scars on a nation that may take generations to heal. I believe that voting is the first act of building a community as well as building a country. With the election we saw a peaceful majority reclaiming their birthright. We saw people gaining courage from realizing that they were not alone--that their friends and neighbors and relatives were going to vote--and that they could vote too. Together they are building their future. Here is one description of how voting progressed: The first Iraqis on the streets seemed tense as well, not smiling and not waving back. But as the day unfolded, and more and more voters took to the streets, a momentum seemed to gather, and by mid-morning Karada's main street was jammed with people who had voted and people on their way to vote. Some Iraqis, walking out of the polling places, used their cellphones to call friends and urge them to come. Some banged on their neighbors' doors and dragged them out of bed. Old men rolled up in wheelchairs. Women came in groups, lining up in their long, black, head-to-toe abayas. The outpouring, which filled Karada's streets with Shiites, Christians and even some Sunnis, surprised the Iraqis themselves. When Ehab Al Bahir, a captain in the Iraqi Army, arrived at Marjayoon Primary School, he braced himself for insurgent attacks. The mortar shells arrived, as he anticipated, but so did the Iraqi voters, which he did not. Voting was an act of defiance against the terrorists and an affirmation that Iraqis control their own destiny through self- government. The people of Iraq realize that a stable, successful, democratic Iraq can only come about if average Iraqis are willing to sacrifice to build it. On Sunday, they rose to the occasion. Some lost their lives, but their lives were not lost in vain. I am convinced that a country by the Iraqi people and for the Iraqi people will be built on the foundation laid down by the voters on Sunday. And having sacrificed to gain a democratic Iraq, they won't let it go easily. Baghdad's mayor was overwhelmed by the turnout of voters at city hall where thousands were celebrating and holding up their purple ink- stained fingers with pride. The mayor said, ``I cannot describe what I am seeing. It is incredible. This is a vote for the future, for the children, for the rule of law, for humanity, for love.'' It is truly a new beginning for Iraq. The election in Iraq clearly demonstrates that Iraqi people are like people everywhere. They desire to create a future in an environment that is safe and allows them to reach their full potential as human beings, whatever that potential may be. The election did not occur in a vacuum. It is the latest and most dramatic example of Iraqis taking control of their country's destiny. In less than a year, the Iraqi Regular Army and Intervention Forces have grown from one operational battalion to 21 battalions, with six more scheduled to become operational over the next month. Last month, the Iraqi National Guard was incorporated into the Army, making a total of 68 Iraqi battalions conducting operations. Today, the Iraqi Police Service has over 55,000 trained and equipped police officers, more than double the amount of just 6 months ago. More than 38,000 additional police are on duty and scheduled for training. As of last month, more than 108,000 local Iraqis had been hired to work on U.S.-funded reconstruction projects, using as many local subcontractors as possible. Yes, things are, indeed looking up for Iraq and the Iraqi people. But there is still hard work ahead. It is a difficult process to transform a society that has never known democracy. One hopeful sign occurred earlier this week when influential figures from the Sunni community signaled their willingness to engage the new Iraqi government and play a role in drafting the constitution. Thirteen parties, including a representative of the powerful Association of Muslim Scholars and other parties that boycotted the vote, agreed Thursday to take part in the drafting of the constitution, which will be the transitional parliament's main task. The leading Shiite candidate to be Iraq's new Prime Minister welcomed these overtures and said he was willing to ``offer the maximum'' to involve Sunni Arabs in the new government. Yes, change takes time, and only time will tell if the Iraqi election will go down as one of the most important dates in modern history. I'm inclined to believe it will. But between now and when the history books are written it was enough, for me, to stand in awe of the courage of a free people half a world away.

Mr. ENSIGN

Mr. ENSIGN. Mr. President, I rise today to talk about a process that many Americans face each year. Imagine your average American family with paper and pencil in hand, gathered around the kitchen table discussing their budget for the year. Their funds are limited--and going into a deficit is not an option for them, like it is for their Government. They must choose their priorities, cut the wasteful spending, and make sure that their spending does not add up to more than their income. Here in the U.S. Congress, we've been tasked with the same job. Those taxpaying families that toil over their own budgets expect us to put the same thoughtfulness into how we spend their hard-earned money here in Washington, DC. And for too long, we have been largely irresponsible with how we spend their money. First, we have to prioritize our spending--and that means making tough choices. Our Our top priority today must be our security. That includes the security of our borders and the safety of the brave servicemen and women in Iraq, Afghanistan, and around the world who are helping secure our borders and our freedom. We must be vigilant in making sure that our military has the tools it needs to get the job done. We also cannot afford to turn our backs on the economic growth that we have been experiencing. Economic growth continued job creation are what will help bring increased revenue into the Government coffers and ultimately help reduce our deficit even further. Now some critics of the President's budget in the Senate might say that we should raise taxes on the American family to reduce the deficit. I don't think that takes us in the right direction. That kind of thinking fails to recognize how the tax cuts of 2001 and 2003 have helped our economy grow. This growth has resulted in 20 straight months of increased employment. In 2004 alone, America created 2.2 million new jobs. Each of these workers is gainfully employed and taking care of their own family. They are also paying taxes. In fact, as a result of increased employment, even with lower tax rates, individual income tax revenue will increase almost $73 billion this year. Overall revenue is expected to increase by almost $125 billion this year. I think this is proof that the tax cuts worked. This is one important reason we have to make sure that we don't raise taxes on American families this year and in the years to come. After we decide what our priorities are when it comes to spending, we have to make more difficult decisions about what we will cut from our budget. As we would tell our children and as we must sometimes remind ourselves, ``Money doesn't grow on trees.'' Our budget must reflect the understanding that there are limits to how much we can spend--as is true for the typical family creating a budget. Although it might be easier to continue throwing money at failing programs, it is not the right thing to do. If a program is not effective, it cannot expect to cruise on the Federal dole indefinitely. We must demand accountability, and we must focus on programs that are making a difference. I applaud President Bush for taking the position that ``. . . a taxpayer dollar must be spent wisely, or not at all.'' That is the leadership we need in order to make these difficult reductions. All Americans can work together to reduce Federal spending. Every taxpaying American should demand spending reform, demand that earmarks and pork barrel spending in the appropriations bills be eliminated, and call on Congress to eliminate the ineffective programs. Rather than having lobbyists and activists calling on Congress to increase spending for every program, Congress should force these groups to identify cost savings too. For example, it you want more spending for one of the more successful housing programs, housing activists should be forced to identify a housing program that is a failure. That way Congress can reallocate resources to the better run programs. This goes for every federally funded program. It should no longer be acceptable in America for our elected officials not to ask that hard question before increasing spending from one year to the next. The future of America's financial house demands a changed way of thinking. I yield the floor and suggest the absence of a quorum.

Mr. ENSIGN

Mr. ENSIGN. The current method of assessing proposed changes in tax policy, static scoring, assumes tax cuts or tax hikes have no effect on how taxpayers work, save, and invest their money. This model implies that tax policy changes have no effect on our economy, never produce higher or lower revenues, and never cause resources to shift within our federal budget. This is simply incorrect. Tax policy changes can have a huge impact on our economy. The idea that tax relief and investment incentives will strengthen our economy is not a new one. On April 15, 1986, President Reagan spoke about the positive effects tax relief can have on economic growth. He stated: ``whatever you want to call it, supply side economics or incentive economics . . . it's launching the American economy into a new era of growth and opportunity. . . .'' What President Reagan stated so eloquently in 1986 holds true today. Economic growth is more easily achieved in an atmosphere where more Americans are able to save and invest their money. Tax relief provides economic growth. When we draft legislation, we should understand not only the cost of tax relief to the federal budget but also the benefits that tax relief provides to the economy. To create jobs. And to ultimately increase tax revenue for the federal government in the long run. Tax relief provides jobs and profits, no matter who is in the White House and no matter who holds the majority in Congress. It is time for Congress to make choices with a better understanding of the real-world implications of those choices. This will better enable us to determine how much relief we can afford to give to American families. The debate on dynamic versus static scoring may sound like an inside- the-Beltway squabble but as I have said today, the decision on how to estimate revenues does have important real-world implications. For example, better revenue estimating methods would make it easier to implement tax rate reductions. This would put more money into the pockets of taxpayers, which would have a very real positive effect on our economy. Today, American families face the challenge of providing food, clothing, and shelter for their children; saving for their children's education; and paying for health care. When government raises taxes, we force parents to work even harder so that they can meet these obligations and have money left over to enjoy a family vacation or put money away for their retirement. I believe in the American family because it is these families that make America great. I trust the American family and believe that they can far better take care of their needs when Congress demands less of what they earn. I should clarify that this legislation does not negate Congress' use of the currently used static scoring model. This bill simply directs CBO and the Joint Tax Committee to develop both static and dynamic scoring estimates for Congress to consider. This will create a system that will allow Congress a side-by-side analysis of both scoring methods so that Congress can better make decisions regarding tax policy that will grow our economy and create jobs. I ask unanimous consent that the text of the bill be printed in the Record.

Mr. ENSIGN. Mr. President, I rise today to introduce legislation to require the Joint Committee on Taxation and the Congressional Budget Office to use dynamic scoring, in addition to traditional static scoring, when estimating the effects of tax policy changes. For too long, Congress has debated changes to the tax code without the benefit of knowing how those changes might affect the Federal Government's revenue and the overall economy. I have believed that Washington, DC should consider the dynamic effect of tax cuts ever since I was first elected to Congress. This is why I am introducing this legislation today and why I first introduced this bill back in 2003. On January 24, 2005, The Wall Street Journal published an article that explained the need for dynamic scoring. I agree with the article: certain tax cuts can stimulate our Nation's economy, and in turn, increase the Federal Government's revenue. What the article explains is that a dollar in tax cuts does not necessarily result in a dollar of lost revenue. The right type of tax cut will encourage growth and job creation and will expand the economy. This expansion will in turn increase tax revenue. I would ask unanimous consent that the text of that article be reprinted in the Record.

Mr. ENSIGN

Mr. ENSIGN. Mr. President, I rise this morning to speak about a man whose life and career embody principles that are uniquely, and proudly, American. He is the grandson of immigrants who overcame language and cultural barriers to carve out an existence through manual labor and faith. Through his commitment to education, his firm belief in the law, and a dedication to public service, he has risen to the top of his profession and now seeks to serve his country at the highest level. Mr. President, I rise this morning to speak about Alberto Gonzales and to urge bipartisan support for his confirmation as Attorney General of the United States. Alberto Gonzales's qualifications speak for themselves. He is a graduate of Harvard Law. He served as Secretary of State for the State of Texas and as a justice on Texas' Supreme Court before being named White House Counsel by President Bush in 2001. Mr. Gonzales was recently inducted into the Hispanic Scholarship Fund Alumni Hall of Fame and has been honored with the Good Neighbor Award from the United States-Mexico Chamber of Commerce. Henry Cisneros, the former Secretary of Housing and Urban Development, calls Alberto Gonzales a person of sterling character and says that Mr. Gonzales's confirmation by this body will be part of America's steady march toward liberty and justice for all. It is a march that, for Alberto Gonzales, started in a two-bedroom house shared by ten people with no hot running water or telephone. But what Alberto Gonzales and his family lacked in comfort they made up for in vision and hard work. Alberto was the first person in his family to go to college. He served in the United States Air Force and attended the United States Air Force Academy. But Alberto Gonzales is about more than an impressive resume. Each experience in his life has prepared him for the great honor of serving as the next Attorney General of the United States--a job he is extremely qualified for and a job that I know he will perform with honor and dignity. As the Nation's chief law enforcement officer, Alberto Gonzales will take the lessons from his positions as Counsel to the President, Texas Supreme Court Justice, Texas Secretary of State, and General Counsel to the Governor and work to protect Americans from terrorism while protecting our Constitutional rights. He will also work to reduce crime, reform the FBI, and protect Americans from discrimination. Alberto Gonzales has come a long way since his days growing up in Humble, Texas. He has accomplished so much, but he has never forgotten from where he came. He has been committed to the Latino community throughout his career, and they have recognized him for his community service and the impact he has made. Today, many of the largest national Latino organizations are standing in staunch support of his nomination and looking forward with great anticipation to the swearing-in of the first Latino Attorney General for the United States. For Alberto Gonzales, the march toward liberty and justice started in Humble, TX, and continued through many ambitious goals. Alberto Gonzales has defied the odds and surpassed expectations time and time again. His successes have created a foundation that will serve our Nation well and inspire a new generation to aspire and conquer. I urge my colleagues to join me as we continue the march toward liberty and justice by voting to confirm Alberto Gonzales as the next Attorney General of the United States.

Mr. ENSIGN

Mr. ENSIGN. Mr. President, I rise today to offer legislation to correct an inequity with the United States Tax Code that affects thousands of taxpayers every year. The bill I am offering is the Fuel Tax Equalization Credit for Substantial Power Takeoff Vehicles Act which will correct an injustice for owners of ready mixed concrete and sanitation trucks. Our Tax Code imposes a Federal tax on fuel sold for use in highway vehicles. This makes sense because vehicles that use our roads cause wear and tear. The money raised from the fuel tax goes directly into the Highway Trust Fund and is used for road repair and maintenance. The Code provides fuel tax exemption for ``off highway'' use so that fuel used by non-highway vehicles is not taxed. The principle is simple. Fuel used to move vehicles on our roads is taxed; fuel used for ``off- road'' purposes is not. Mixed concrete and sanitation trucks are ``dual-use'' vehicles. In addition to consuming fuel for roadway travel, they use fuel for a secondary purpose such as turning the mixer drum or lifting a dumpster and compacting trash. This is known as a ``Power Takeoff Function.'' In the past, this function was performed by a second fuel-driven engine. But times have changed. Today, sanitation and cement trucks are more efficient and use one engine for both tasks. Today's vehicles create the situation where technology is in the fast lane but our tax system lags behind in the slow lane. The environment benefits with the use of one engine instead of two as a result of decreased fuel use and exhaust emissions. Using one engine reduces the truck's weight which means these trucks can haul more cargo without violating weight restrictions. This decreases the number of trips these trucks must take which results in less wear and tear on the roads. Until recently, owners of dual-use vehicles would estimate the amount of fuel taxes they paid for fuel related to off-road use and would claim a tax credit for that amount. The Tax Code does not recognize ``dual-use'' vehicles but recent IRS regulations support the idea that the fuel tax did not apply to fuel used for non-highway purposes. Despite the regulations, the IRS argued in a recent tax court case that estimating fuel consumption was too difficult to administer. In other words, the IRS dismissed its own regulations. Unfortunately for taxpayers who own dual use vehicles, the tax court agreed with the IRS's position. This decision has had the effect of penalizing efficiency, conservation and good environmental practices. Mr. President, by establishing an annual $250.00 per vehicle tax credit my bill resolves this inequity. This legislation should not be seen as creating a new tax break. It restores tax fairness to owners of dual-use vehicles without resorting to an elaborate fuel measurement scheme that would create administrative difficulties. The amount of the tax credit is less than the estimated amount of fuel taxes paid for non-highway purposes for these vehicles. In order to receive this credit, a vehicle would have to be registered, licensed and insured in the vehicle owner's respective State. This is a measure that will simply restore fairness to a situation involving the fuel tax where Congress never intended the tax to apply in the first place.

Mr. ENSIGN

Mr. ENSIGN. Mr. President, I rise today to offer legislation to correct an inequity with the United States Tax Code that affects thousands of taxpayers every year. The bill I am offering is the Fuel Tax Equalization Credit for Substantial Power Takeoff Vehicles Act which will correct an injustice for owners of ready mixed concrete and sanitation trucks. Our Tax Code imposes a Federal tax on fuel sold for use in highway vehicles. This makes sense because vehicles that use our roads cause wear and tear. The money raised from the fuel tax goes directly into the Highway Trust Fund and is used for road repair and maintenance. The Code provides fuel tax exemption for ``off highway'' use so that fuel used by non-highway vehicles is not taxed. The principle is simple. Fuel used to move vehicles on our roads is taxed; fuel used for ``off- road'' purposes is not. Mixed concrete and sanitation trucks are ``dual-use'' vehicles. In addition to consuming fuel for roadway travel, they use fuel for a secondary purpose such as turning the mixer drum or lifting a dumpster and compacting trash. This is known as a ``Power Takeoff Function.'' In the past, this function was performed by a second fuel-driven engine. But times have changed. Today, sanitation and cement trucks are more efficient and use one engine for both tasks. Today's vehicles create the situation where technology is in the fast lane but our tax system lags behind in the slow lane. The environment benefits with the use of one engine instead of two as a result of decreased fuel use and exhaust emissions. Using one engine reduces the truck's weight which means these trucks can haul more cargo without violating weight restrictions. This decreases the number of trips these trucks must take which results in less wear and tear on the roads. Until recently, owners of dual-use vehicles would estimate the amount of fuel taxes they paid for fuel related to off-road use and would claim a tax credit for that amount. The Tax Code does not recognize ``dual-use'' vehicles but recent IRS regulations support the idea that the fuel tax did not apply to fuel used for non-highway purposes. Despite the regulations, the IRS argued in a recent tax court case that estimating fuel consumption was too difficult to administer. In other words, the IRS dismissed its own regulations. Unfortunately for taxpayers who own dual use vehicles, the tax court agreed with the IRS's position. This decision has had the effect of penalizing efficiency, conservation and good environmental practices. Mr. President, by establishing an annual $250.00 per vehicle tax credit my bill resolves this inequity. This legislation should not be seen as creating a new tax break. It restores tax fairness to owners of dual-use vehicles without resorting to an elaborate fuel measurement scheme that would create administrative difficulties. The amount of the tax credit is less than the estimated amount of fuel taxes paid for non-highway purposes for these vehicles. In order to receive this credit, a vehicle would have to be registered, licensed and insured in the vehicle owner's respective State. This is a measure that will simply restore fairness to a situation involving the fuel tax where Congress never intended the tax to apply in the first place.