Jim Jeffords

Mr. JEFFORDS

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 President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I yield myself 2 minutes.

Mr. JEFFORDS. I yield 2 minutes to the Senator from Connecticut, Senator Dodd, and the remaining time after that to Senator Coats. Mr. DODD addressed the Chair.

Mr. JEFFORDS. Thank you. I yield the floor. Mr. KENNEDY addressed the Chair.

Mr. JEFFORDS. Mr. President, I want to most sincerely thank my colleagues for the tremendous vote to move forward on FDA reform. This is most rewarding. All of the proponents and supporters are pleased to know that we can go forward at this time. This is a tribute to a lot of hard work and compromise from a lot of Members on both sides of the aisle and both sides of the issue. The vote represents the best of bipartisanship from Senators who support it, and even from opponents and the administration. Today is just the first step, but it could hardly be a better one. We will need to debate this bill, consider amendments to it and, no doubt, improve it. I believe that there are still changes that can be made to accommodate the concerns that have been expressed here by the opponents. I know we can find solutions to those. We will need to debate this bill, consider amendments and, as I say, no doubt, improve it. But I hope by this time next week, the Senate will have given its resounding support to this bill. It is too important to the American people to let it languish. It is too important for us not to move it out as quickly as possible. Mr. President, I yield the floor. Mr. KENNEDY addressed the Chair.

Mr. JEFFORDS. I would like to speak for a few moments just to try to allow those of my colleagues who are viewing us here as to why all this controversy. We just saw a vote of 89 to 5 in favor of moving forward with a bill that has come out and is ready to be placed before the body. Why is that occurring with all of these horrible problems which we have just been hearing about? Take a look at this bill. This bill is 152 pages long--152 pages long. We are talking about four pages on cosmetics and two pages on medical devices. So we have to keep things in perspective. This bill has tremendous support because in almost every instance the issues that are of concern to people are taken care of. But why all of this discussion about cosmetics? Because nobody is doing anything. That is why the controversy. The question is who should do something. Now, the question is whether or not you want some uniformity, and that is the Federal Government, the FDA, which we have tremendous confidence in, to take on the issue of warning about the problems of cosmetics and to have a uniform approach, uniform labels and those things so, if you go from one place to another, you don't get confused about what you should or should not be using or doing. That is the question here. It revolves down to this. Right now, the States say, oh, my God, you can't tell us what we can do. Well, they haven't been doing anything, with the exception of California. It is not something we are moving into and pushing aside all existing regulations; there are none. The question is who ought to do it. Well, to California we said, OK, you have that so we will carve you out. Go forward. You have yours out there. That is fine. The Federal Government will not intervene, will not do away with that. So the bill presently says, California, what you have done is fine. The question is everyone else. Now, since nobody has moved into this, it is not like you have a whole bunch of States out there panicked because their existing rules and regulations are going to be superseded. It is natural for Governors and State legislatures to scream and say, oh, my gosh, you can't take our power away to do something. So where did we get down to before we came here? We got down to this close--this close. This is how close we are. We said, OK, if the FDA has not done something and has not established that this cosmetic is a dangerous one, then the States can move in. And if they feel differently, that it is and therefore we should do it, they have the power to do that. That is the way it is right now. But we say that if the FDA has acted, then we want uniformity and so we should try to make sure that people across the country will have uniformity. Then the issue was raised, well, suppose the FDA says that it is dangerous because it may cause problems on your face. Suppose the State believes it may have something to do with your blood system. Does that mean they cannot warn people that this cosmetic may be dangerous if it gets into your bloodstream? Well, that is the issue. That is how far apart we are. On the two pages that deal with devices, the issue is about as narrow as that. It comes down to the question of, if a manufacturer says this device is for this purpose, and the FDA says, well, maybe we want to make sure that we know all the other purposes it might be used for, so they should alert us to those. We are down that far on those two pages, and we are down to within a few lines on the other four pages, but the other 146 pages there isn't really much disagreement with. So I want to make sure we have things in perspective here. That is why the support, that is why we had the 89-to-5 vote on moving forward on this. But these are important issues. It is important for us to make sure that people know that with respect to cosmetics they are going to be protected and who is going to do it and what kind of awareness are we going to be able to have and what are the States rights versus the Federal Government. So that is where we are. I will go at length later, but right at this point I want to make sure we understand where we are and what the issue is. In cosmetics, nobody is doing anything now with the exception of the State of California. We think the FDA ought to get in there. They ought to make sure that the cosmetics that are advertised are safe, that we know what problems could be caused and that we have uniformity in the country, so that when you go one place to another, you will have the ability to be able to rely upon uniformity as to what the various products may or may not do to you. On the other hand, if the FDA does not take any action and a State thinks that this particular cosmetic or whatever is harmful, then they have the power to act. So that is where we are. I want to reassure people that this bill does not ignore the problem of cosmetics. For the first time it really emphasizes that the FDA and the States should do something. What should they do? That is not going to be taken care of in the legislation because we would not know. But we do know that there is a need out there and that the FDA should have the authority to act and that they should have the authority to provide uniformity. But, on the other hand, the States should not be stripped of their rights to protect their people in the event the FDA has not acted. Mr. President, I just wanted at this time to pause to try to make sure that everybody understands where we are and why we got the 89-to-5 vote to move forward. I yield the floor. Mr. KENNEDY addressed the Chair.

Mr. JEFFORDS. Mr. President, I yield such time as he may consume to the Senator from Indiana.

Mr. JEFFORDS. Mr. President, I salute the majority leader for moving the debate on the FDA modernization forward. We should no longer needlessly delay consideration of S. 830, the Food and Drug Administration Modernization and Accountability Act of 1997. S. 830 represents months of bipartisan effort to address serious shortcomings in the FDA's regulatory procedures. Two hearings were held. The measure passed the committee with a strong bipartisan 14-to-4 vote, and months of negotiations have ensued with dozens of accommodations made for Senator Kennedy and the administration. For almost 20 years, Congress, the General Accounting Office, and numerous advisory commissions have examined, reviewed, and made recommendations to modernize the FDA. During 1978 and 1979, Senator Kennedy championed legislation that would have required FDA to do some of the very same things we are requiring of it in S. 830. In 1982, the Commission on the Federal Drug Approval Process, convened at the request of Representatives Albert Gore and James Scheuer, recommended simpler investigational new drug requirements. The Commission recognized that drug effectiveness could be demonstrated by one study in appropriate cases, and it urged greater use of outside expert advice and improved interactions with industry. In 1989, the advisory committee on the FDA, on which Dr. David Kessler served, made a key recommendation. It said: . . . the agency should be guided by the principle that expeditious approval of useful and safe new products enhances the health of the American people. Approving such products can be as important as preventing the marketing of harmful or ineffective products. In 1991, Vice President Quayle's Council on Competitiveness recommended that the FDA expand the use of outside reviews and advisory committees, interpret efficacy with a more appropriate standard, and enhance internal agency management. More recently, Vice President Gore has used the President's ``reinventing Government'' initiative to improve the FDA product approval system and to eliminate outmoded FDA regulations for a variety of drugs, medical devices, and food products. Last year, the committee on Labor and Human Resources held four hearings on reforming the FDA. The witnesses testified about the same problems that have been described for 20 years, and they recommended many of the same solutions that have been recommended for 20 years. This year, the Labor Committee continued its effort to modernize the FDA. The committee held two hearings in early 1997. The first hearing was dedicated to the FDA, and the second hearing included representatives from patient and consumer coalitions and from the food, drug, and medical devices sector regulated by the FDA. It is no easy task that we ask FDA to perform. Americans want the FDA to hold the gate tightly shut against unsafe or ineffective products while opening it wide for the next generation of innovation. Clear statutory guidance is needed to assist the agency to find this delicate balance and to bring our food and drug laws and regulatory systems into the next century. S. 830 contributes significantly to reaching that balance. The measure embodies the bipartisan conclusions and recommendations reached for the past 20 years for accomplishing this difficult task of balancing risk and promise. Mr. President, a few have charged that this Congress is moving too fast. They ask, ``What's the rush?'' But they have asked the wrong question. For the past 20 years, every administration has sought to make FDA better--to make better, safe and more effective products more readily available. After almost 20 years, we must ask ourselves, why delay further? Why continue to delay reforms that have been studied, reviewed, recommended, restudied, and endorsed again and again for over 20 years? Clearly, the FDA should be modernized now.

Mr. JEFFORDS

Mr. JEFFORDS. This clearly sets out that, in their opinion, it would appear that, in its current form, our bill would not interfere or substantially negatively affect any of the FDA tobacco authority. In addition to that, just to be double and triple sure, we, in the bill, say it can't apply to tobacco and that the FDA has full authority in the tobacco area. So that is why we got the 89 to 5 vote today. Yet, I certainly commend the Senator from Massachusetts, and others, who want to make darn sure that we are really doing the job we think we are doing. I appreciate that and I think it is healthy. The harder that Senator Kennedy fights, the more the public will be aware of that, and I hope we have as good a vote this time. Mr. President, with that, on behalf of the majority, I will yield back the time that we have today, except that I will provide the Senator from Minnesota 5 minutes at his disposal, at such time as he is appropriately available to make a statement. I would be happy to make that time available for the Senator.

Mr. JEFFORDS. Mr. President, first of all, Senator Mikulski will be here shortly. I would like to make a few comments before I turn the floor over to her. With respect to the devices, as I pointed out earlier and I just want to refresh everybody's recollection, the bill that we are dealing with is 152 pages long. The matters on devices are two pages. The matters on cosmetics are four. I thank the Senator from Illinois for bringing attention to some possible problems with respect to ensuring, as we all want to ensure, that there is no conflict of interest involved with any of the companies that they will be dealing with. I point out, first of all, that the FDA has total control over the third parties that will be allowed for the purposes of reviewing. They have total control over that. There are already regulations which propose to correct most of the problems, although a couple others have been raised, and we certainly are going to seriously consider amendments that will take care of those problems. Let me go through the provisions right now on the existing regulations for FDA: Can't own a device company; Can't have any ownership or financial interest in any medical device company; Can't participate in the development of medical products; Can't be a consultant; Can't prepare advice for companies; and Fees cannot be contingent on third-party recommendation. In addition, I emphasize that the FDA has a list of those they have examined, have gone through to make sure that they are appropriate for the purposes of assisting--assisting--FDA in coming to conclusions on these devices. There are some protections: Can't obtain reviews for the same product from more than one third- party organization; Can't contract for a substantial number of reviews, like more than 10 a year, from the same review organization on different devices; and Can't contract for reviews from the same review organization where the sum of fees is substantially like $50,000 one year when the other organizations have the same capacity. So there are many protections now. Of course, we are very concerned, along with the Senator from Illinois, and want to make sure we have taken care of every possible situation. With respect to the legislatures and the Governors, I will point out that the discussion in that regard has been very limited to certain provisions, but I want to enter into the Record a letter which came to the majority leader, Senator Lott, from Gov. Tom Carper from the State of Delaware, chairman of the Committee on Human Resources, and Gov. Tom Ridge, the vice chair of the Committee on Human Resources. I will read that for the Record: On behalf of the nation's Governors, we are writing to express our support for swift passage of bipartisan FDA reform and a reauthorization of the Prescription Drug User Fee Act (PDUFA). Better health care for all Americans is a paramount national goal that is strongly supported by the Governors. An important component to improved health care delivery is the development and approval of safe and effective new medical technology. New therapies, for example, have the potential to improve the lives of millions of Americans and may, in many instances, reduce health care costs. The Governors also recognize that the competitiveness of the U.S. pharmaceutical, biotechnology, and medical device industries--and the hundreds of thousands of people they employ in our states--is dependent on bringing products to market safely and quickly. Constructive reform will improve the efficiency of the approval process while continuing to protect the public's health and safety. We have the support of the Governors. They are not going to go through everything. Generally, they support what we are doing. That is why we had an 89-to-5 vote today to move forward. I ask unanimous consent that the letter be printed in the Record.

Mr. JEFFORDS. My present intention is to make some final remarks myself and then to yield back the time on behalf of the majority. It is my understanding, as the Senator has said, that he intends to proceed for some time and perhaps have one additional speaker, and it is my understanding at that time that he will yield back his time. I am not concerned for the presentation of the majority because we have another 4 hours on this on Monday morning, I believe, so we will have ample time--just to reassure the majority-- we will have ample time on Monday to take care of any situation which may arise. Before I complete my remarks, I want to refresh people where we are, especially on the critical issues that have been raised by the Senator from Massachusetts. I understand there are concerned people, and I am well aware of editorials and groups who have raised issues, most of which I have found not to be relevant to the bill which we are considering. Many of those problems were related to last year's bill and we are assured the whole country has available to them the bill before us here by having it on Web pages and all. I am hopeful those groups who have expressed their deep concerns will review the legislation that is before the Senate and not make conclusions or alarm the public based upon provisions which were in the bill which did appear before this body last year but of course were not voted on. First, I remind everyone we voted 89-5 to proceed on this legislation. It is clear that the large majority of the Members here believe and have full confidence that any problems that may exist in the bill will be taken care of. I remind everyone, as I hold this bill up, it is 152 pages long. The areas we are concerned with are two, basically. One is cosmetics. That is an area of deep concern to all of us and the present status of things without this legislation. That is four pages in the bill. There are another two pages on the problems which some see with respect to medical devices and the approval process for them. The issues there have been narrowed down to very small issues, but they are important. I do not diminish that at all. With respect to the cosmetics, and that is where the most concern has been expressed, and rightfully so because of the present situation with respect to cosmetics, there is little or no assistance or help to the public in understanding as to whether there are problems, health problems, created by cosmetics. The industry itself has done a great deal to work within the industry to try and ensure they have adequate understanding of what the contents of the cosmetics are and they have tried to eliminate to the extent possible any potential harm to individuals. That has apparently been fairly successful. On the other hand, the present situation with respect to governmental influence in trying to protect the public or trying to allow people to determine the safety of the utilization of cosmetics, there has really been no effort to do this which is satisfactory to us and to the American public generally. The issues are raised in a way that explain what the present situation is and make it look like that is what the bill is. That is not what the bill is. The bill is trying to take care of the concern that the public has with the present situation of not being aware or officially find ways to determine whether or not cosmetics are harmful. What the bill does is to say not only should the FDA get into this and reassure the public on cosmetics but that they should do that with an eye toward uniformity so that if you buy something in Vermont it does not tell you one thing and you find if you buy it in California, something else, or other places have no warnings. You do not have any way to judge if the product you may be using is one that is safe. Now, the States have had authority to move into this area and thus to point out that this will somehow interfere with the States. You have to remember they have had this authority forever, I guess, and only one State has taken it upon themselves to really do anything in this area to try and solve the problem--not the best of ways, to determine what cosmetics are good or bad for your health. What did we do? We said, ``OK, California, fine, we will not get involved with preempting you with respect to your laws that are on the books. We will allow those laws to stand. The FDA can work around that.'' But on the other hand, we will tell the other States that you are free, too, unless the FDA has moved in on those specific products and has made a determination and has exercised its authority, in which case you would be preempted. Now, that leaves a narrow problem we are dealing with and is one of the reasons, perhaps the only reason, we are here, and that is suppose a State should say no, not only is that cosmetic going to cause possibly skin cancer, it may also cause blood poisoning, and the FDA only includes skin cancer. Can we not tell our people they should be protected against blood poisoning? We have not quite resolved that. It does not seem irresolvable to me or make the bill horrible because I have that much confidence in the FDA. With respect to the devices, again, that is two pages of the bill. With respect to that, it gets down to another problem for the industry, and that is, when they have a device and they say we have studied it and this is the intended purpose of that device and the studies have gone on and it shows it is effective and safe for this purpose, FDA says, yes, but there may be some other uses of that, so we want to do studies on all possible uses of that device. The industry says, well, wait a minute, it is being produced for this purpose, being sold for this purpose, intended for this purpose; we should not have to run all these studies on other things that somebody dreams it may be used for. The issue of tobacco has been raised. We were concerned, also, that the tobacco devices--I don't know what they might be, but obviously filter-type things, or whatever else, I don't know. Anyway, we were concerned about that. So, first of all, we asked the CRS as to whether or not the bill, as presently drafted, in the device areas would in any way allow tobacco devices to be sold out from under the bill and, therefore, create problems and a very serious situation in tobacco. I have the CRS study that was done. I ask unanimous consent that this be printed in the Record.

Mr. JEFFORDS. Mr. President, we have given Members time to notify us that they desire to speak. I have received no requests from my side or supporters of the bill for a presentation here. I believe the same is true for Senator Kennedy, but I defer to him for that.

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

Mr. JEFFORDS. I thank the Senator from Maryland whose untiring efforts have enabled us to come forward here with an excellent piece of legislation, her undying efforts on behalf of FDA and the people of Maryland and the rest of the country to ensure that they are an effective, efficient operation and they do all that is possible and appropriate to protect the interests of others. There is no one I relied on more who has done more to bring about this bill in the shape that it is in and in a position where I feel confident that it can pass. So I thank the Senator very, very much for her effort. Mr. President, I know of no other Members on my side of the aisle who desire to speak and I do not believe there are those on the other side, other than Senator Kennedy. I make a point of order that a quorum is not present for the purpose of allowing other Members to notify me if they do desire to come and speak and we will certainly accommodate them. I will wait for at least 5 minutes for a response. I suggest the absence of a quorum.

Mr. JEFFORDS. With that, I see Senator Mikulski is here. I would, therefore, yield to her such time as she may desire.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, for the information of all Members, this morning, the Senate will immediately begin debate on the motion to proceed to S. 830, the FDA reform bill, with the time until 9:50 a.m. equally divided in the usual form. As previously ordered, a cloture vote on the motion to proceed to the FDA bill will occur at 9:50 a.m. Also by previous consent, if cloture is invoked, the Senate will immediately begin 8 hours of debate equally divided between Senators Jeffords and Kennedy on the motion to proceed. In addition, there will be an additional 4 hours of debate on the motion to proceed remaining on Monday. As a reminder to all Members, there will be a cloture vote on the motion to proceed to the FDA reform bill at 9:50 a.m. today. I thank my colleagues for their attention. Mr. President, how much time do we have?

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I rise today to join with the distinguished chairman of the Labor, Health and Human Services, and Education Appropriations Subcommittee, Senator Specter and the subcommittee's ranking member Senator Harkin, in opposition to Senator Kyl's amendment to cut funding for the Low-Income Home Energy Assistance Program [LIHEAP]. While I applaud the Senator from Arizona's goal to increase funding for Pell grants, I can not sanction a move that would essentially gut the LIHEAP program, effectively depriving millions of the disadvantaged, elderly, and disabled of critical assistance. Mr. President, the appropriation for LIHEAP has declined more than 50 percent over the past decade, down from $2.1 billion in fiscal 1985. During that time, the eligible population has grown from 23 to 30 million. In Vermont, Federal cutbacks have forced the State to push back the deadline for applying for fuel aid to September 2. Mr. President, I strongly disagree with the contention that the need for fuel assistance has declined since the program's founding. Last winter, two-thirds of the 1,400 Vermonters who missed the State's benefits deadline were denied assistance; and the number of people who ran out of fuel and requested emergency aid doubled. Mr. President, Federal cutbacks since 1995 have reduced the number of families in Vermont that receive assistance from over 24,000 to around 12,000 this year. These families should not face the prospect of further cutbacks. Mr. President, I want to emphasize to the program's critics that LIHEAP helps the neediest of the needy. As others have already stated, almost 70 percent of recipient families have an annual income of less than $8,000, and 44 percent have at least one member who is elderly and 20 percent have one member who is disabled. Currently, only 5 million families are being served nationally, a million less than 2 years ago. Mr. President, this is a time to increase funding for LIHEAP not decrease it. Last month, as cochair of the Northeast-Midwest Senate Coalition, I spearheaded a letter to Senators Specter and Harkin that asked for an increase in regular funding for LIHEAP so that the program is not forced to rely on releases of emergency funds to meet basic needs. Fifty-five Senators signed on to this letter. Mr. President, the Appropriations Committee should be commended for recognizing that the need for LIHEAP is greater than current resources. The committee has included $1.2 billion in so-called advance funds for fiscal 1999. I urge my colleagues to overwhelmingly reject this amendment to cut LIHEAP and support Senators Specter and Harkin in their effort to increase LIHEAP funding in fiscal 1999. Mr. President, I yield the floor and suggest the absence of a quorum.

Mr. JEFFORDS

Mr. JEFFORDS. I speak in favor of the Coats amendment and I urge its adoption. I do have problems with the underlying amendment. On the other hand, I recognize that the large majority of Members desire to tell NIH what they should be doing with respect to Parkinson's disease. I also recognize it is a serious problem for those that have Parkinson's disease, and many of my friends across the country do so. I think the Coats amendment is an important addition to let NIH know that they have to at least be more forthcoming with respect to the processes they use in determining how they should expend the money in research. I, therefore, commend Senator Coats for bringing this to our attention, and as a way to prevent the need for amendments such as the underlying amendment as we move toward the future. I yield the floor.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, today I am submitting, along with Senators Kennedy, DeWine, and Wellstone, a Senate resolution to congratulate the Federal Mediation and Conciliation Service on its 50th anniversary. The Federal Mediation and Conciliation Service [FMCS] was created in 1947, as an independent agency, by the Labor-Management Relations Act [Taft-Hartley]. FMCS was established by Congress to resolve collective bargaining disputes which threaten the free flow of commerce and to promote the development of sound and stable labor-management relations. The primary focus of the agency's work is on labor-management relations, mediating contract negotiation disputes between companies and the unions representing their employees, and providing training in cooperative processes to help build better labor-management relations. FMCS also was authorized under the Dispute Resolution Act of 1990 to share its expertise in all aspects of mediation, facilitation, and conflict resolution with Federal, State, and local governmental bodies and agencies. In addition to dispute mediation services, FMCS provides preventive mediation services, administers a grants program which provides funding for the creation and operation of joint labor- management committees, and also provides an arbitration service, when disputes arise between the parties over the interpretation of their collective bargaining agreement. For 50 years, the men and women of the FMCS have worked tirelessly, and successfully, to accomplish the mission of the Agency, the promotion of ``sound and stable industrial peace and the advancement of the general welfare, health and safety of the Nation.* * *'' Our resolution recognizes, and commends, the Federal Mediation and Conciliation Service for its 50 years of dedicated service to the Nation.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I am pleased to introduce legislation with Senator Rockefeller that will ensure that health insurance policies cover at least $10 million in lifetime benefits. This bill, the Lifetime Caps Discrimination Prevention Act, will help fulfill the promise of real health security and is an appropriate sequel to last year's Kassebaum-Kennedy health insurance reform legislation. Through our reform legislation, families can be spared the loss of their health insurance when they need it the most. All of us are at risk of incurring high-cost injuries or illnesses-- the very kind of situations that most people want covered by their health insurance polices. A $1 million cap was adequate when it was established by the insurance industry in the early 1970's. Since then, however, inflation has sent medical costs skyrocketing, and today, thousands of Americans have hit their payment ceiling. A majority of those who exceed their lifetime limits must turn to public assistance. While waiting for a determination of eligibility, many individuals are forced to go without medical treatment. This legislation would keep within the private sector those who most need health coverage and would keep them off Medicaid. Most of us assume that our health insurance will be there when we need it most--when we are very sick. Unfortunately, many people do not read the fine print in their insurance policies. The average lifetime cost of care for a person who has a spinal cord injury and is ventilator dependent--just like Christopher Reeve--is over $5 million. For someone like Jim Brady, who had a severe head trauma injury, the average cost is about $4 million, and that is in 1990 dollars. As Christopher Reeve said, ``I didn't think it could happen to Superman.'' The Lifetime Caps Discrimination Prevention Act fulfills a promise of real health security by raising the lifetime cap from the typical limit of $1 million--a dollar figure selected in the 1970's--to $5 million in 1998, and then in 2002 to $10 million, which is the real dollar equivalent today. Currently, the vast majority of health maintenance organizations and approximately one-quarter of employer-sponsored health plans have no aggregate lifetime limit. The Federal Employee Health Benefit plans removed lifetime maximums in 1995. According to a Price Waterhouse study, employers with a workforce of 250 employees would experience a mere 1 percent increase in premiums. This is a small price to pay for real health insurance security for people covered in the group market. Our legislation excludes employers with fewer than 20 employees. The Lifetime Caps Discrimination Prevention Act was originally introduced as an amendment to the Kassebaum-Kennedy health insurance legislation passed during the 104th Congress. The amendment enjoyed strong bipartisan support, but it was defeated due to the strategy of opposing amendments to that bill. We believe that this legislation is worthy of reintroduction in the 105th Congress, and we are hopeful that it will attract even broader support as another step that can be taken in strengthening Americans' health security. Over 150 national health-related groups, including the American Medical Association, the American Cancer Society, the United Cerebral Palsy Association, and the National Association of Professional Insurance Agents, have expressed their support for our efforts to increase lifetime limits on health insurance benefits. The insurance industry standard of $1 million, adopted in 1970, was right for those times but today is financially unrealistic. Today, the time has come to protect thousands of individuals from suffering the emotional, medical, and financial consequences of exceeding their caps by adopting a new lifetime limit for health insurance coverage.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I rise today to pay tribute to Robert A. Starr, Chair of the Vermont House Agriculture Committee and true Vermonter. I pay this tribute in recognition of Mr. Starr's unyielding support for the Northeast Dairy Compact, which on August 20, 1997, provides the first over-order payments so desperately needed by Vermont's dairy farmers. ``Bobby'', as he is known far and wide throughout Vermont, has given lifelong public service to the Vermont agricultural community. Raised on a dairy farm during and after the Second World War, knowledge of hard times and a capacity for hard-bitten labor were ingrained in Bobby, traits which continue to distinguish the character of our hill farmers. After schooling at Vermont Technical College, Bobby followed the lead of his grandfather and became a member of the Vermont House of Representatives in 1979. Bobby became a member of the House Agriculture Committee his first year, and has been there ever since. He became Chair in 1987, and has sponsored and provided leadership on a host of initiatives to promote the interests of Vermont agriculture. Bobby has lent his leadership to the variety of Vermont's agricultural pursuits, but it is the dairy industry which has remained at the heart of his vision. Certainly Bobby's upbringing and his strong dairy farm constituency provide the foundation of his knowledge and commitment to the interests of the State's dairy farmers. Yet his vision is broader than just his home district, and indeed has expanded beyond the boarders of Vermont to all of New England. It is this unique expansive vision which spawned the dairy compact. Many of us in this body are intimately familiar with the dairy compact, yet few of us may know that the dairy compact was originally sponsored by Bobby Starr in the Vermont Legislature in 1989. Few initiatives in my memory have sparked such a vigorous policy debate as the dairy compact. I am proud to have sponsored the compact on behalf of all by colleagues from the New England delegation. Adoption of the compact could not have happened without their hard work here in Congress, and without the years of dedicated work of a veritable army of compact supporters from throughout New England. In all, the compact reflects the true spirit of commitment to our dairy farmers. The compact's first payment is a tribute to the hard work and the tireless commitment of Bobby Starr.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, the impending passage of this balanced budget agreement is a historic moment for our nation. This legislation represents a real victory for all Americans. Children, students, families and senior citizens will all benefit from our actions today. This budget not only puts us on a financially responsible path but also protects the Federal social safety net. This legislation is built on consensus, and no plan built on compromise can make everyone happy. There are certain provisions that I wish were in this bill and there are other provisions that I feel could have been changed. Overall, though this budget package provides benefits that will strengthen our economy, reduce the tax burden on individuals and families, and eliminate spiraling deficits. The measure provides tax relief to families and children, with a permanent $500 per child tax credit under the age of 17. The bill creates incentives for savings and investment with expanded individual retirement accounts, reducing capital gains and increased deductions for small business. But most importantly, this legislation furthers our efforts to provide health care and education for all children. This conference report will establish a new $24 billion health care coverage program for as many as 5 million uninsured children. I would like to express my special appreciation to Senator Roth and Senator Lott for including in the children's health initiative a provision that will allow States, like Vermont, whose Medicaid coverage for children already extends beyond 200 percent of poverty, to cover children with incomes 50 percentage points higher than their Medicaid cutoff. I feel this section will give these pioneering States the necessary flexibility and resources to continue moving forward toward the goal of ensuring that all children have access to quality health care. With $35 billion in education tax incentives, the bill will ease the burden on students and families paying for higher education. These tax incentives will help families save for college, pay tuition costs while students are in college, and repay funds borrowed to pay for college. The bill's education tax incentives are not limited to college expenses. The bill has a life-long education tax credit to help workers who want to brush-up on their job skills or learn new employment skills. In addition, the children's tax credit in this bill will result in meaningful savings for families. For a family with two children, this bill will result in a 1999 tax bill that's $1,000 less than they would have otherwise owed. This agreement also recognizes the critical relationship between education and our national economic well-being. In a day and age beset by downsizing, when job skills are constantly becoming outmoded by technological advances and break-throughs in learning, education will be a lifetime endeavor. I am happy that the bill recognizes this, and makes lifetime learning more easily affordable. Aid to education is not limited to tax incentives; the tax incentives are supplemented by meaningful spending increases for scholarship grants and literacy programs. Throughout my years in the Congress, first on the Education and Labor Committee in the House, and now as chairman of the Senate Labor and Human Resources Committee, I have worked to make education more readily affordable and more easily accessible. This bill represents an important step in that direction. During my tenure in Congress I have tried hard to put our fiscal house in order while protecting programs that are important to the nation. I am pleased to cast my vote in favor of this agreement, which I believe does just that. Today, this body is taking a giant step closer to insure the future economic security of our children and the next generation.

Mr. JEFFORDS. Mr. President, the impending passage of this balanced budget agreement is a historic moment of our Nation. The vote that my colleagues and I are making in support of this balanced budget agreement is a vote that each American should take pride in. This legislation represents a real victory for all Americans. Children, students, senior citizens, and families will all benefit from our actions today. This conference report will put this country on a financially responsible path while also taking the necessary steps to protect Medicare and provide health care coverage to our Nation's uninsured children. This legislation is built on consensus, and no plan built on compromise can make everyone happy. There are certain provisions that I wish were in this bill and there are other provisions that I feel could have been changed. However, it is more important that we move the process forward instead of shutting down the system. Overall, though this budget package provides benefits that will strengthen our economy, reduce the tax burden on individuals and families and eliminate spiraling deficits. The measure provides tax relief to families by providing a permanent $500-per-child tax credit for children under the age of 17. The bill creates incentives for savings and investment with expanded individual retirement accounts, reducing capital gains and increased deductions for small business. The legislation provides for estate tax relief which will affect many residents of my home state of Vermont. The bill will impose roughly $297 billion in savings over the next 5 years and $900 billion over the next 10 years while still protecting programs that are vital to the interest of all Americans. But most importantly, this legislation furthers our efforts to provide health care and education for children. Mr. President, there is no resource more precious than the children who are right now playing in the school yards from Vermont to California. I worked closely with my colleagues Senator Hatch, Senator Kennedy, Senator Chafee, and Senator Rockefeller to develop legislation that would provide health care coverage for our Nation's uninsured children. This conference report will establish a new $24 billion health care coverage program for as many as 5 million uninsured children. The establishment of this coverage is not the end but only the beginning to ensure that every child born in this country will have a healthy start in order for them to fulfill their own personal American dream. I would like to express my special appreciation to Senator Roth and Senator Lott for including in the Children's Health Initiative a provision that will allow States like Vermont whose Medicaid coverage for children already extends beyond 200 percent of poverty to cover children with incomes 50 percentage points higher than their Medicaid cutoff. I feel this section will give these pioneering States the necessary flexibility and resources to continue moving forward toward the goal of ensuring that all children have access to quality health care. In addition, the children's tax credit in this bill will result in meaningful savings for families. For a family with two children, this bill will result in a 1999 tax bill that's $1,000 less than they would have otherwise owed. The children's tax credits in this bill will result in meaningful savings for families with children. For a family with two children, this bill will result in a 1999 tax bill that's $1,000 less than they would have otherwise owed. In addition, the bill recognizes the critical relationship between education and our national economic well- being. With $39 billion in education tax incentives, the bill will ease the burden on families paying for higher education. These tax incentives will help families save for college, pay tuition costs while students are in college, and repay funds borrowed to pay for college. And the bill's education tax incentives are not limited to college expenses. The bill has a life-long education tax credit to help workers who want to brush up on their job skills or learn new employment skills. This agreement also recognizes the critical relationship between education and our national economic well-being. In a day and age beset by downsizing, when job skills are constantly becoming outmoded by technological advances and breakthrough in learning, education will be a lifetime endeavor. I am happy that the bill recognizes this, and makes lifetime learning more easily affordable. Aid to education is not limited to tax incentives; the tax incentives are supplemented by meaningful spending increases for scholarship grants and literacy programs. Throughout my years in the Congress, first on the Education and Labor Committee in the House of Representatives, and now as chairman of the Senate Labor and Human Resources Committee, I have worked to make education more readily affordable and more easily accessible. This bill represents important steps in that direction. During my tenure in Congress, I have tried hard to put our fiscal house in order while protecting programs that are important to the Nation. I am pleased to cast my vote in favor of this agreement, which I believe does just that. This plan finally puts four walls and a roof on a foundation toward a balanced budget that this Congress has been building over the last 15 years. Today, this body is taking giant steps closer to ensure the future economic security of our children and the next generation.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I rise today to bring to your attention an important report on child abuse and neglect. This report, released in April of this year, examines current research being conducted or supported by the National Institutes of Health [NIH] into the area of child abuse and neglect. The report proposes ground- breaking recommendations for improving the coordination of child maltreatment research across the NIH, with other divisions within the Department of Health and Human Services, and with other federal agencies. In addition, the report addresses the current gaps in research, identified in the National Research Council's 1993 report, ``Understanding Child Abuse and Neglect.'' The April, 1997, report by NIH emphasizes the need to provide more attention to training new research in the field and disseminating research results to the agencies and practitioners who are working on the frontlines. We are all concerned about the prevalence of child abuse and neglect. According to a 1995 state-by-state survey conducted by the National Committee to Prevent Child Abuse, over 3.1 million children were reported to be abused or neglected. Child abuse fatalities have increased by 39 percent from 1985 to 1995. The Department of Health and Human Services Third National Incidence Study of Child Abuse and Neglect, released in September, 1996, estimated that the number of child abuse and neglect cases in this country doubled between 1986 and 1993. One critical and necessary step to stop child maltreatment is to support research that will enhance our understanding of the underlying causes of child abuse and neglect. This research also will improve our ability to identify and define abuse and neglect, and discover which intervention techniques are most successful in preventing and treating child maltreatment. The proposals for future NIH activities contained in the report give new meaning to the concept of knowledge translation and research application. The most important characteristic of the proposals are the efforts to move scientific knowledge from the research lab and demonstration site into professional practice. Parents, child welfare agencies, and practitioners will all benefit from this information and technology transfer. In the exchange, NIH researchers will benefit from the lessons learned by practitioners and be better able to target their research. Everyone will benefit from the increased coordination that is integral to the NIH effort. But most important, fewer children will suffer from abuse and neglect, once marriage between the research and practice is accomplished. This is a goal upon which we can all agree. I want to commend Dr. Harold Varmus, Director of NIH, for his leadership in this critical area. Under the direction of Dr. Varmus, Dr. Peter Jensen, Chief-Child and Adolescent Disorders Branch, at the National Institutes of Mental Health established a trans-NIH Working Group on child abuse and neglect. I would also like to thank the organizations which brought this issue to my attention and encouraged the formation of the Working Group--the National Association of Social Workers, National Child Abuse Coalition, Institute for the Advancement of Social Work Research, and the American Psychological Society. The Working Group has developed a bold plan for advancing research on child abuse and neglect, as evidenced by the April, 1997 report. This plan will make the optimal use of federal dollars though better coordination of NIH research activities and dissemination of research results to those who can make a difference in children's lives.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I rise today with Senator Snowe to introduce legislation to aid the growth of commerce throughout New England. The Older Industrial Region Rail and Port Access and Modernization Act aims to improve northern New England's aging rail infrastructure and ocean ports to speed delivery of goods and people throughout the region. New England was built by the railroads. But in our modern economy, highways have captured a majority of the commerce, supplanting rail. As we reach the end of this century, our region has begun to recognize the importance of railroads, and their vital role in our expanding economy. Efficient highways run north to south in northern New England, but we have no east to west roads sufficient to handle growing trade and commerce. As Vermont, New Hampshire, and Maine work together to compete in this global economy, our success is dependent on our mutual efforts to improve access to markets. We will succeed only if modern freight railroads can serve the entire region and through our ports bring goods to market across the Nation and around the world. Rail lines throughout northern New England have been neglected for many years. Crumbling rail beds and constricted passage has limited the movement of freight and passenger trains and restricted rail access to deep water ports. Older bridges, deteriorated tracks, inadequate tunnels all contribute to a rail system that fails to fulfill the needs of the three-State area. As a result, commerce throughout the region suffers. A recent report by Cambridge Systematics, entitled ``New England Transportation Initiative,'' indicates that northern New England's economy cannot fully expand without a carefully planned and implemented intermodal strategy. The study predicts that Maine's ports will gradually lose business to southern ports, primarily in New Jersey and New York, because of inadequate rail transportation and port access. In addition, the study predicts that business and jobs in New Hampshire and Vermont will not keep pace with other regions without a better strategy to efficiently move goods and people. An exhaustive analysis by the Eastern Border Transportation Coalition regarding the trade and traffic flows across the eastern United States- Canada border projected a trade increase of close to 200 percent by the year 2015. The report also outlines that this increase could be hampered by a lack of adequate transportation options and overcrowded roads and highway border stations. To avoid this setback, rail options must be available. Without proper infrastructure development, New England's chance to take advantage of such economic growth will diminish. The legislation we introduce today will authorize Federal spending to rehabilitate rail beds in Vermont, Maine, and New Hampshire, enabling them to improve their freight rail traffic and better handle the movement of goods and people with their borders. States will be able to apply separately to the U.S. Secretary of Transportation for individual grants. Grant funding is provided for a variety of categories: Port development and access; bridge and tunnel obstruction repair and replacement; repair of railroad beds; and development of intermodal facilities, including intermodal truck-train transfer facilities. Revitalization of these resources will allow freight and passenger trains to move freely throughout the region, reconnecting railroad towns long separated by the hazards of unpassable tracks. The bill also establishes a loan assistant program. Railroad companies in Vermont, Maine, and New Hampshire will be able to access low interest loans to improve their rail lines in the region. The loans can be used for purchase of rolling stock, development of maintenance facilities, and many other capital improvements. Without this legislation, Vermont, New Hampshire, and Maine may fail to benefit from future growth opportunities. Even though international shipping trade is expected to increase by 20 percent in the next 5 years, New England is less likely to benefit from the influx of business and jobs because of its decaying rail and port infrastructure. Improving rail lines will bring new life to our region, strengthening our industries and thereby our economies. Mr. President, I would urge action on this legislation, because, as we are learning, ports and railroads are the life lines that will help to ensure the well-being of all of northern New England.