Ted Kennedy

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of H.R. 3580, received from the House and is at the desk.

Mr. KENNEDY. Mr. President, every day, families across America rely on the Food and Drug Administration in ways they barely realize. When they put dinner on the table, they are counting on FDA to see that it is free from contamination. When they care for a sick child, they are trusting FDA to make sure the drugs prescribed are safe and effective. From pacemakers to treatments for cancer to the foods we eat, FDA protects the health of millions of Americans, and oversees products that account for a quarter of the U.S. economy. The agency does all this on a budget that amounts to less than 2 cents a day for each citizen. Yesterday, the House of Representatives approved legislation on FDA reform by a broad bipartisan majority of 405 to 7. Our House colleagues from all parts of the political spectrum united to send that bill to the Senate with a resounding bipartisan endorsement. We cannot wait another month, another week--or even another day. We must take action here and take action now to send that bill to the President. The stakes could not be higher. Funding for the FDA's vital safety mission is reaching the breaking point. Unless we act, the FDA Commissioner will send a letter tomorrow to over 2,000 employees informing them that their jobs are slated for termination. This legislation provides nearly $500 million in new resources for FDA-- including over $50 million for drug safety and $6 million for review of direct to consumer ads. Americans are worried about the safety of the products they use--from food to toys to drugs--and they are right to be worried. Dangerous lapses in safety oversight have exposed American families to intolerable risks from lead paint in toys, to bacteria in foods, to drugs that cause unreported and lethal side effects. The right response is comprehensive, considered and bipartisan legislation--and that is what we have before us today. At the heart of our proposal is a new way to oversee drug safety that is flexible enough to be tailored the characteristics of particular drugs, yet strong enough to allow decisive action when problems are discovered. A second major element of our legislation is a public registry of clinical trials and their results. A complete central clearinghouse for this information will help patients, providers and researchers learn more and make better health care decisions. Now, the public will know about each trial underway, and will be able to review its results. Our bill recognizes that innovation is the key to medical progress by establishing a new center, the Reagan-Udall Foundation, to develop new research methods to accelerate the search for medical breakthroughs. The bill helps preserve the integrity of scientific review by improving FDA's safeguards against conflicts of interest on its scientific advisory committees, and it will end the abuse of citizens petitions that are too often used not for their intended purpose of brining important public health concerns to the attention of the FDA, but rather to delay the approval of generic drugs. The proposal before the Senate today strikes the right balance on this issue. It rightly states that the mere filing of a citizen petition should not be cause for delay, but allows FDA to delay the approval of a generic application if it determines that doing so is necessary to protect public health. This is the right approach. It prevents abuse, but protects health. The legislation also includes important reforms of direct-to- consumer, or DTC, advertising. I thank Senator Roberts and Senator Harkin for working with Senator Enzi and me and with many members of the committee on this important provision. Instead of the moratorium included in our original bill, the current proposal puts in place strong safety disclosures for DTC ads, coupled with effective enforcement. Under current law, safety disclosures can be an afterthought--a rushed disclaimer read by an announcer at the conclusion of a TV ad while distracting images help gloss over the important information provided. Our proposal requires safety announcements to be presented in a manner that is clear and conspicuous without distracting imagery. We also give FDA the authority to require safety disclosures in DTC ads if the risk profile of the drug requires them. Our legislation also takes important first steps toward a safer food supply. These are only first steps--our committee will work on a comprehensive package of food safety legislation in the fall--but they are important steps. Consumers and FDA have too little information about contaminated food. Our bill creates a registry and a requirement to report food safety problems. Consumers will have information about recalls at their fingertips, and FDA's response will not be slowed by antiquated and inefficient reporting systems. Our bill also establishes strong, enforceable quality standards for the food we give our pets, to guard against the problems of tainted pet food that we have seen in recent months. In this new era of the life sciences, medical advances will continue to bring immense benefits for our citizens. To fulfill the potential of that bright future, we need not only brilliant researchers to develop the drugs of tomorrow, but also strong and vigilant watchdogs for public health to guarantee that new drugs and medical devices are safe and beneficial, and that they actually reach the patients who urgently need them. Congress has ample power to restore the luster the FDA has lost in recent years, and this bipartisan consensus bill can do the job. I ask my colleagues to approve this needed legislation without delay. H.R. 3580, the Food and Drug Administration Amendments of 2007, does a great deal to improve the regulatory process and to strengthen FDA's ability to enforce drug safety standards, particularly in the postmarket period. A recent study by the Institute of Medicine described FDA's post-market drug safety authority as ``aging and inadequate.'' Currently, FDA's ability to address potential health problems that become known after the drug has gone on the market is very limited. This is a serious weakness in the present system that must be corrected. This legislation will give FDA the authority, for the first time, to compel a drug company to add warnings of newly discovered risks on the drug label. As a result, in many cases the health risks involved in using potentially dangerous drugs will be disclosed to the public much sooner than they are today. At the same time, this legislation makes clear that drug companies will continue to have the same independent responsibility to update the warning labels on their drugs in the future that they have under current law today. If a drug company learns of new dangers that its product potentially poses to the patients taking it, the company has a legal responsibility to immediately warn those patients of the risk of injury. By enacting this legislation, we do not intend to alter existing state law duties imposed on a drug manufacturer to obtain and disclose information regarding drug safety hazards either before or after a drug receives FDA approval or labeling. We do not believe that the regulatory scheme embodied in this act is comprehensive enough to preempt the field or every aspect of state law. FDA's approved label has always been understood to be the minimum requirement necessary for approval. In providing the FDA with new tools and enhanced authority to determine drug safety, we do not intend to convert this minimum requirement into a maximum. The Institute of Medicine and others have found that FDA's past performance has been inadequate. While we fully expect substantial improvement as a result of the enactment of this bill, we cannot and do not expect the FDA or this new process to identify every drug specific safety concern before a drug manufacturer becomes aware or should have become aware of such concerns. Nor are the bill's requirements that companies disclose certain safety information to the government intended to substitute for the disclosure requirements that may be required under state law. No one should be under the mistaken impression that the new authorities and resources provided under H.R. 3580 lessen in any way the obligation of a drug company to scrutinize vigilantly the safety signals for their drugs and proactively study such signals or change their labels when the evidence supports such a change. This new postmarket authority for FDA is not intended to alter the drug companies' independent obligation to promptly warn consumers of a drug's risks. Under current FDA regulations, a drug company is required to add new warnings to its labels as soon as it learns about new risks potentially posed by its drugs. The company must add the new warning even if FDA has not required a labeling change. It is worth putting the situation in a little perspective. The legislation increases FDA's resources for post-market drug safety efforts significantly. FDA's current resources of about $25 million are increased by almost $55 million in the first year, to nearly $80 million. There will be increases in the next four years of $10 each year, so that FDA's post approval drug safety budget will be at about $120 million in 2012. This is the entire budget at the FDA to collect and analyze post-market safety information and respond with appropriate regulatory action. FDA must use these resources to police every prescription drug on the market--thousands of drugs. By contrast, the drug industry had annual revenues in 2005 of over $200 billion. To be sure, significant portions of these revenues support research and development, profits, and marketing of drug products, but a mere 1 percent of these sales exceeds the entire budget of the FDA. It exceeds the agency's budget for postmarket drug safety by a factor of over one thousand. Many major brand drugs have annual revenues that exceed FDA's annual budget for postapproval drug safety. Consider the top 200 selling drugs in 2006: Merck's drug Fosamax Plus D came in 200th in 2006, with U.S. sales of $140 million. Sales from this one drug alone exceed the entire $120 million FDA budget for drug safety in the last year of this program. The 100th drug, Abbott's Kaletra, had 2006 sales of $350 million, nearly three times the FDA's annual drug safety budget for 2012. Thirtyeight drugs had U.S. sales exceeding $1 billion in 2006. The top selling drug, Pfizer's Lipitor had 2006 sales of nearly $6.6 billion, an amount more than 50 times FDA's annual drug safety budget in 2012 under this legislation. Clearly, the resources of the drug industry to collect and analyze postmarket safety data vastly exceed the resources of the FDA, and no matter what we do, they will always have vastly greater resources to monitor the safety of their products than the FDA does. It is absurd to argue that the FDA, even with the enhanced resources and authorities provided by this legislation, commands the field when it comes to postmarket drug safety. The drug companies have the capacity to do a far more comprehensive job. If we are serious about quickly alerting the public to the health risks posed by drugs, the companies must be required to take the initiative in monitoring the safety of their products and immediately warning the public of newly discovered risks. Drug manufacturers cannot be allowed to ignore their responsibility and wait for the FDA to act. To be sure, the legislation gives FDA the authority to command some of the resources of a drug company. FDA can order an epidemiological study or even a clinical trial, but this authority is not unlimited. Certain standards must be met before FDA can act to require a drug company to investigate a safety signal. Importantly, a drug company has the ability and the responsibility to conduct these studies or clinical trials on its own initiative. Nothing in H.R. 3580 requires a company to wait and react to an order from the FDA for such a study or clinical trial, or to wait for FDA to order the company to change its label. The legislation retains the current, ongoing requirement, found in section 502(a) of the Federal Food, Drug, and Cosmetic Act, for a drug company to ensure that its label is not false and misleading. This statutory imperative is recognized in current FDA regulations. Section 901 of H.R. 3580 cites these regulations in the new section 505(o) of the Federal Food, Drug, and Cosmetic Act. These regulations obligate a company to propose a labeling change to enhance a warning or improve safety information without waiting to hear from FDA, and allow the company to implement the labeling change before the FDA has reviewed and approved the change. In most cases, a drug company will learn about new risks from its product before the FDA does. Usually, it is the manufacturer that possesses the information demonstrating a potential danger from the product. It is imperative that patients and health professionals learn about those new health risks as quickly as possible. For that reason, drug companies have, and must continue to have, an independent duty to warn drug users of the danger as soon as the company becomes aware of it. Otherwise, there will be long delays before consumers are alerted, and the number of injuries caused by the product will multiply. What should motivate a drug company to investigate drug safety signals and take appropriate action to mitigate a safety risk? You can find the answer in several places: from the simple moral duty to do the right thing; from the duty to one's customers, who use one's products with the understanding, often promoted by direct-to-consumer advertising, that the company's highest interest is to bring safe and effective cures to the sick and ill of the Nation; and from a duty under State law to offer products that are free of defects, with adequate warnings about their risks. This legislation changes none of these duties, in any way, whether they arise from simple ethics, principles of contract law, or of tort law. Rather, the legislation provides FDA with additional resources and authority to be better able to step in when a company fails to live up to these responsibilities. But some drug companies don't want to fully inform the public about these risks to patients' health, and they don't want to be held accountable when patients are injured or killed by their drugs. They would have liked this legislation to change the law to escape this responsibility. These drug companies wanted to convert FDA regulation from a safety floor into a ceiling, from a minimum safety standard designed to protect consumers into a liability shield designed to protect the drug companies. But Congress firmly rejected this approach. If companies were allowed to conceal safety information until the FDA ordered them to disclose it, consumers would continue taking these dangerous drugs without knowing their risks for months or even years after the risks were discovered. Then, when the public finally learned of the risk, the drug company would be immune from suit for failing to warn its customers. Those who were seriously injured by the drug would have no legal recourse, even though the company had concealed the risk. The company would completely escape accountability for its failure to warn consumers. That would be totally unacceptable, and is not what we intend by this legislation. Regulation by the Food and Drug Administration and product liability lawsuits against the manufacturers of harmful drugs work together to protect consumers. Both are needed to force drug companies to disclose health risks posed by their products as soon as those risks are discovered. Both are essential to identifying dangerous drugs and getting them off the market quickly. Effective regulation by the federal government and litigation by victims of dangerous drugs work hand-in-hand to keep patients safe and make drug companies more responsible. This legislation improves FDA oversight of postmarket drug safety, and does not undermine or preempt the efforts by injured patients to seek redress under State product liability law. Congress has stated very clearly in the legislation that we do not intend the new authority being given to FDA to preempt common law liability for a drug company's failure to warn its customers of health risks. The legal duty of drug companies to warn consumers of the health risks of their products as soon as those risks are discovered is essential to effectively protecting the public from dangerous drugs. Legislation designed to protect consumers from dangerous drugs must not be distorted into a shield protecting drug companies from accountability.

Mr. KENNEDY. Indeed, that was an important objective of the Food and Drug Administration Amendments Act, and I agree the citizens' petition language is an integral part of the final legislative effort.

Mr. KENNEDY. I do agree. Let us be clear: The citizen petition provision is designed to address attempts to derail generic drug approvals. Those attempts, when successful, hurt consumers and the public health. The citizen petition provisions are not intended to alter laws not amended by the provision. I thank the Senator. Medicare Claims Data

Mr. KENNEDY. It is a great pleasure to work with my distinguished colleagues from the Finance Committee on this reauthorization of important programs at the FDA. I know they have a deep interest in seeing that the medicines that Americans take are safe and effective. Senator Baucus and Senator Grassley have rightly raised a question regarding the interpretation of section 905 of this bill. Section 905 adds a new paragraph (3) to section 505(k) of the Federal Food, Drug and Cosmetic Act. This new paragraph establishes a system for FDA to query databases regarding information that may help detect adverse drug effects. It is essential to detect drug safety problems early, so that they may be corrected before people are hurt and an electronic drug safety system is one important tool for doing so. The Medicare claims database is listed as one of several possible sources of data in section 505(k)(3)(C)(i)(III)(aa). I want to assure my friends from Montana and Iowa that our intent is that Medicare's participation will be determined by provisions of the Social Security Act, over which the Finance Committee has exclusive jurisdiction. Nothing in this section is intended to infringe on that jurisdiction or to in any way preempt the ability of the Finance committee to act to specify the participation or nonparticipation of the Medicare claims data base in the system established under section 905. The matter before the Senate amends the Federal Food, Drug and Cosmetic Act. The section to which you have raised concerns authorizes use of Medicare data ``as available.'' I acknowledge that under current law, that is not possible.

Mr. KENNEDY. I appreciate that conforming amendments in the Federal Food, Drug and Cosmetic Act may be necessary as you point out. I agree to work with the Senator in the future on this issue.

Mr. KENNEDY. Mr. President, I ask unanimous consent that the bill be read a third time, passed, the motion to reconsider be laid upon the table, and that any statements relating to the bill be printed in the Record, without further intervening action or debate.

Mr. KENNEDY. Mr. President, the New England Journal of Medicine, which is probably the most distinguished medical journal in not only this country, probably in the world, has made the comment that this legislation is the greatest progress, in terms of drug safety, in a century. This ought to be reassuring for every family as to the safety of their prescription drugs and also in terms of their food.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I am cosponsoring this amendment because I strongly support the restoration of the right to habeas corpus for noncitizens detained as enemy combatants. This bill will reinstate one of the cornerstones of the rule of law. Habeas corpus protects one of our most fundamental guarantees: that the Government may not arbitrarily deprive persons of their liberty. President Bush and Congress undermined that guarantee last year by enacting the Military Commissions Act, which stripped courts of jurisdiction over habeas corpus petitions by enemy combatants. That legislation is a stain on our human rights record and an insult to the rule of law. It is almost surely unconstitutional. For centuries, the writ of habeas corpus has been a core principle of Anglo-American jurisprudence. Since the days of the Magna Carta in the 17th century, it has been a primary means for persons to challenge their unlawful government detention. Literally, the Latin phrase means ``have the body'' meaning that persons detained must be brought physically before a court or judge to consider the legality of their detention. The writ prevents indefinite detention and ensures that individuals cannot be held in endless detainment, without indictment or trial. It requires the Government to prove to a court that it has a legal basis for its decision to deprive such persons of their liberty. The Framers considered this principle so important that the writ of habeas corpus is the only common law writ enshrined in the Constitution. Article I, section 9, clause 2, specifically states, ``The Privilege of the Writ of Habeas Corpus shall not be suspended, unless when in Cases of Rebellion or Invasion the public Safety may require it.'' Mr. President, 9/11 was a tragic time for our country, but we did not set aside the Constitution or the rule of law after those vicious attacks. We did not decide as a nation to stoop to the level of the terrorists. In fact, we have always been united in our belief that an essential part of winning the war on terrorism and protecting the Nation is safeguarding the values that Americans stand for, both at home and throughout the world. Instead of standing by these principles, however, the Bush administration used 9/11 to justify abandoning this basic American value. It has consistently undermined habeas corpus, claiming that the Constitution, statutory habeas corpus, and the Geneva Conventions, which Alberto Gonzales described as ``quaint,'' do not apply to enemy combatants held at Guantanamo Bay or elsewhere. The administration even went so far as to establish detention facilities outside the United States to avoid the reach of U.S. courts and the application of basic legal protections such as habeas corpus. The administration's purpose was to hold these combatants indefinitely and try them in military commissions. The commissions, however, have severely limited the rights of alleged enemy combatants. The accused have no access to the evidence which the Government claims it possesses and no ability to provide a meaningful defense. The tribunals are a sham and an insult to the rule of law. The administration's lawlessness failed. Last year, the Supreme Court ruled in Hamdan v. Rumsfeld that Federal courts have jurisdiction over habeas corpus petitions brought by detainees at Guantanamo Bay. Justice Stevens reminded the administration that ``in undertaking to try Hamdan and subject him to criminal punishment, the Executive is bound to comply with the Rule of Law.'' In the face of this clear Supreme Court precedent, the administration and Congress recklessly responded with the Military Commissions Act, which eliminated the right of all noncitizens labeled by the executive as enemy combatants to be heard in an Article 3 court. This bill will repeal these disgraceful provisions of the Military Commissions Act and restore the right to habeas corpus for detainees held at Guantanamo Bay and elsewhere. I urge my colleagues to vote for the rule of law and to support this amendment.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, the war in Iraq has severely overstretched and strained our military personnel and their families. According to many of our foremost experts, we're actually in danger of breaking our military. Frequent and extended deployments are over-taxing our brave military men and women and their families and our support structures at home. It's reducing our ability to adequately train our soldiers, sailors, airmen and Marines. The men and women of our military forces signed up in the belief that they were going to defend America, and preserve our way of life. Instead, they find themselves entangled in an Iraqi civil war that is not theirs to win or lose. Their repeated and extended deployments breach the trust they have in their government. We as a Congress must do everything we can to ease the strain. The Department of Defense itself has set a goal of 2 years at home for every year deployed, and that makes sense. It gives servicemembers time to be with their families, and re-establish the bonds that we all take for granted. It also gives our servicemembers time to train--not just for a return to Iraq, but for other missions we may ask them to undertake. Because of the President's misguided war and his so-called surge, the Department of Defense can no longer meet this goal. As General Casey, Chief of Staff for the Army said last month, ``Today's Army is out of balance. We're consumed with meeting the current demands and we're unable to provide ready forces as rapidly as we would like for other contingencies; nor are we able to provide an acceptable tempo of deployments to sustain our soldiers and families for the long haul.'' What does the General mean when he says the army is ``consumed with meeting current demands?'' Over 1.4 million American troops have served in Iraq or Afghanistan; More than 420,000 troops have deployed more than once. The Army has a total of 44 combat brigades, and all of them except one--the First Brigade of the Second Infantry Division, which is permanently based in South Korea--have served at least one tour of duty in Iraq or Afghanistan, and the majority of these 43 brigades have done multiple tours: 17 brigades have had two tours in Iraq or Afghanistan; 13 brigades have had three tours in Iraq or Afghanistan; and 5 brigades have had four tours in Iraq or Afghanistan. Army recruiting is struggling to maintain the current force structure, let alone meet its goal of increasing its overall end strength over the next 5 years. The Army missed its recruiting goals for both May and June by a combined total of more than 1,750, and it's borrowing heavily on future commitments to meet its goals for this year. Spending on enlistment and recruitment bonuses tripled from $328 million before the war in Iraq to over $1 billion last year. The Commandant of the Marine Corps, James Conway, says his marines can't focus on conventional operations because training time is too scarce. It's an impossible situation. Our military is strained--some would say already broken--and we face a crisis in recruiting. We can't continue to sacrifice our Nation's security and the readiness of our forces while Iraq fights this civil war. This amendment will give General Conway and General Casey the time they need to make sure that our forces are ready and able to defend our country against any threat. It will also show our appreciation for the men and women who serve our country so well. I urge my colleagues to support this amendment.

Mr. KENNEDY

Mr. KENNEDY. I thank the Senator from New Mexico for his tremendous leadership on this bill. He has fought for this legislation for many years, and I am grateful for his commitment to getting this bill passed. This legislation represents the culmination of more than a year's negotiations involving lawmakers, mental health, insurance and business organizations to craft compromise legislation. During the markup of the bill last February, my colleague Senator Dodd raised very important issues regarding the effects of the preemption language in the legislation. Since then, he was joined by several other Senators, attorneys general, and State insurance commissioners who have voiced concerns about unintended consequences of the bill. It was never the intent of the bill to harm or weaken State insurance laws but in response to concerns raised by several of my colleagues and insurance experts, the language pertaining to preemption was stricken from the legislation.

Mr. KENNEDY. Mr. President, today is a landmark day in our nation's struggle to achieve access to mental health services for all Americans. The Mental Health Parity Act of 2007 reflects a major agreement by the mental health community, business leaders, and the insurance industry to guarantee that persons with mental health needs receive fair and equitable health insurance. Its passage will mean dramatic new help for 113 million Americans who today are without mental health care and treatment. Access to such care and treatment is one of the most important and neglected civil rights issues facing the nation. For too long, persons living with mental disorders have suffered discriminatory treatment at all levels of society. They have been forced to pay more for the services they need and to worry about their job security if their employer learns of their condition. Sadly, in America today, patients with biochemical problems in their livers receive better care and greater compassion than patients with biochemical problems in their brains. This bill will help end such unacceptable discrimination. As we have seen in the recent bipartisan CHIP legislation, no one questions the need for affordable treatment of physical illnesses, but those who suffer from mental illnesses face serious barriers in obtaining the care they need at a cost they can afford. Like those suffering from physical illnesses, persons with mental disorders deserve the opportunity for quality care. The failure to obtain treatment can mean years of shattered dreams, unfulfilled potential and broken lives. The need is clear. One in five Americans will suffer some form of mental illness this year, but only a third of them will receive treatment. Millions of our fellow citizens are unnecessarily enduring the pain and sadness of seeing a family member, friend, or loved one suffer illnesses that seize the mind and break the spirit. Battling mental illness is a difficult process, but discrimination against persons with such illnesses is especially cruel, since the success rates for treatment often equal or surpass those for physical conditions. According to the National Institute of Mental Health, clinical depression treatment can be 70 percent successful, and treatment for schizophrenia can be 60 percent successful. Eleven years ago, a bipartisan majority in Congress approved the original Mental Health Parity Act. That legislation was an important first step in bringing attention to discriminatory practices against the mentally ill, but it did little to correct the injustices that so many Americans continue to face. This bill takes the actions needed to end the long-standing discrimination against persons with mental illness. Over the years we have heard compelling testimony from experts, activists, and patients about the need to equalize coverage of physical and mental illnesses. Some of the most forceful testimony came several years ago from Lisa Cohen, a hardworking American from New Jersey, who suffers from both physical and mental illnesses, and is forced to pay exorbitant costs for treating her mental disorder, while paying very little for her physical disorder. Lisa is typical of millions of Americans for whom the burden of mental illness is compounded by the burden of unfair discrimination. No Americans should be denied equal treatment for an illness because it involves the brain instead of the heart, the lungs, or other parts of their body. Mental health parity is a good investment for the Nation. The costs from lost worker productivity and extra physical care outweigh the costs of implementing parity for mental health treatment. Study after study has shown that parity makes good financial sense. Mental illness imposes a huge financial burden on the Nation. It costs us $300 billion each year in treatment expenses, lost worker productivity, and crime. This country can afford mental health parity. What we can't afford is to continue denying persons with mental disorders the care they need. But equal treatment of those affected by mental illness is not just an insurance issue. It is a civil rights issue. At its heart, mental health parity is a question of simple justice. Today is a turning point. We are finally moving toward ending this shameful form of discrimination in our society--discrimination against persons with mental illness. This bill is a true commitment by the insurance industry, business industry and the mental health community to bring fairness and dignity to the millions of Americans who have been second class patients for too long. The 1996 act was an important step towards ending health insurance discrimination against mental illness. This bill takes another large step to close the loopholes that remain. We would not be here without the strong commitment and skillful determination of the late Senator Paul Wellstone and Senator Pete Domenici. They deserve immense credit for their bipartisan leadership on mental health parity. I also commend the staff, both Democrat and Republican, who worked so long and hard on this legislation. I particularly thank Carolyn Gluck of Senator Reid's office and all the Democratic staff who worked in recent weeks to help us produce the bill we have today. I also commend Ed Hild of Senator Domenici's staff and Andrew Patzman of Senator Enzi's staff for the many hours they spent with my staff to negotiate the bill. On my staff, I especially commend several who worked so long and hard and well on this legislation--Michael Myers, Carmel Martin, Kelsey Phipps, Daniel Dawes, Jennie Fay, Ches Garrison, and above all Connie Garner, whose passion, counsel and commitment I value so highly on this and many other issues. Without her dedicated guidance, we would not be at this important threshold today. My hope is that as we improve access to mental health services for all Americans, we will also help end the stigma and discrimination against those with mental illness. Mental illnesses are treatable and curable, and it is high time to bring relief to those who suffer from them. Mr. President, I yield the floor.

Mr. KENNEDY. I thank the senior Senator from Connecticut and appreciate his leadership on this issue. He raised a number of important issues during the consideration of this bill. I believe we have addressed those concerns in the legislation and I am pleased that he is now a strong supporter of the legislation.

Mr. KENNEDY. Yes, nothing in this bill affects any State law or State regulation of any company or issuer who performs utilization review or other medical management services. The changes made to the preemption section of S. 558 mean that the current HIPAA standard would apply to this legislation, just like it applies to existing law passed in 1996. By using existing preemption language, we mean only the narrowest preemption of State laws. A minimum standard of Federal protection allows States to provide additional protection for their citizens. State laws designed to regulate medical management or utilization review to protect plan participants are not preempted under the bill because they do not ``prevent the application'' of the substantive provisions of this bill.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, today's debate involves one of the most important issues in our democracy. Dr. Martin Luther King called the right to vote ``civil right number one.'' Yet hundreds of thousands of Americans who live in the Nation's Capital have been denied an equal voice in our democracy. Citizens in the District of Columbia live in the very shadow of the Capitol Building, but they have no representative who can vote their interests within these halls. It is long past time for us to finally correct this basic wrong. I commend Senators Lieberman, Hatch, and Bennett for their strong leadership on this legislation. Since the Revolutionary War, ``No taxation without representation'' has been a fundamental American principle. It is a famous phrase in our history. James Otis said it first in a historic speech in Massachusetts in 1763, and it was so inspiring that John Adams later said, ``Then and there, the child `independence' was born.'' Yet more than two centuries later, citizens who live in the Nation's Capital still bear the unfair burden of taxation without representation. The more than half a million District of Columbia residents pay significant Federal taxes each year. In fact, DC residents have the second-highest per capita tax burden in the Nation. Yet they have no say in how Federal taxes are spent, and they have no role in writing the Nation's tax laws. Residents of the District have fought and died in every war to defend American interests. Two hundred thirty seven DC residents died in the Vietnam war. Today, while we debate whether DC citizens deserve a vote in Congress, many brave Americans who live in the District are fighting for voting rights in Iraq. Since the beginning of the current wars in Iraq and Afghanistan, 2813 DC residents--2110 members of the Active Duty military and 703 members of the Reserve Forces--have been deployed in Iraq and Afghanistan. In the course of these conflicts, 28 DC residents have been wounded or killed. Citizens of the District of Columbia have no voice when Congress considers whether to go to war. The brave soldiers from the Nation's Capital have no representation in Congress when the votes are counted on funding levels for our troops and other issues relating to the war. When Congress debates assistance to war veterans or considers how to improve conditions at Walter Reed Hospital, the patriotic veterans who live in this city have no vote. It is unconscionable. If we are for democracy in Iraq and Afghanistan, we should certainly be for democracy in the District of Columbia as well. I have long been a strong supporter of DC representation in Congress. In 1978, I worked with Walter Fauntroy and many others on a constitutional amendment to correct this basic injustice. We finally passed the constitutional amendment in Congress, but we weren't able to get it ratified by a sufficient number of States to take effect. Because we weren't successful then, the issue remains just as urgent today. Fortunately, a constitutional amendment isn't the only option. The Constitution's District clause provides another, legal means for providing citizens of the District of Columbia a vote in Congress. As respected constitutional scholars have made clear, article I, section 8 of the Constitution gives Congress the authority ``to exercise exclusive Legislation, in all Cases whatsoever, over such District'' of Columbia. The Supreme Court has ruled that Congress's exclusive authority over the District of Columbia is broad and ``national in the highest sense.'' Some have questioned the constitutionality of this approach. Although I supported a constitutional amendment in the past, I disagree that a constitutional amendment is the only valid option. Nothing in the Constitution explicitly denies residents of this city a voice in Congress. Judges Patricia Wald and Kenneth Starr, both of whom served on the respected U.S. Court of Appeals for the DC Circuit, have studied this approach to giving the District a vote in the House of Representatives. Both have concluded that it is constitutional. As they and others have noted, the Supreme Court has recognized that Congress has the power to treat District of Columbia citizens as citizens of a State in other contexts. For instance, the District is treated as a State for purposes of diversity jurisdiction in Federal courts, although article III, section 2 of the Constitution provides for diversity jurisdiction in suits ``between citizens of different States.'' It is impossible to believe that the Founding Fathers, having just finished a war to ensure democratic representation in America, would then insist on denying that representation to citizens living in the capital of their new Nation. Granting the District a vote in Congress is consistent with the spirit, as well as the letter, of our Constitution. Even if you disagree about the bill's constitutionality, we should not filibuster this important measure. Surely even my colleagues who have a different view of the constitutionality can agree that this issue is important enough to deserve an up-or-down vote. The Senate's filibuster of the landmark Voting Rights Act of 1965 was one of its darkest days. We should not repeat that mistake now. This is not a Republican or a Democratic issue. When we passed the constitutional amendment in 1978, we had strong support from Republicans like Senators Goldwater, Dole, and Thurmond, in addition to Democrats. Today, the bill has strong bipartisan support in both the House and Senate. That is because this issue is so obviously an issue of simple justice. The Senate Judiciary Committee recently held a hearing to celebrate the 50th anniversary of the Civil Rights Act of 1957. We heard moving testimony in favor of this bill from Congressman John Lewis, our distinguished colleague in the House of Representatives and a leader in the continuing struggle for equal voting rights. At the age of only 23, Congressman Lewis headed the Student Nonviolent Coordinating Committee and helped organize a march on Washington. He and others were brutally assaulted during the fateful voting rights march at the Edmund Pettis Bridge, but their sacrifices helped inspire the progress that was to come. Congressman Lewis reminded us of the sacrifices of those who gave their lives for equal voting rights in this country, and called on us to pass the DC Voting Rights Act. He reminded us of our obligation to give the District a vote in Congress. I urge my colleagues to vote for cloture on this important bill and then vote for final passage of the bill so that we can finally correct this historic wrong and to do it on our watch.

Mr. KENNEDY

Mr. KENNEDY. Madam President, earlier in the day, there was the attempt of my friend and colleague, Senator Smith, to at least try to propose an amendment that deals with hate crimes and try to get it into an order and to be able to have consideration of that amendment during the Defense authorization bill. There has been objection. I can understand the importance of the underlying amendment. I certainly believe that underlying amendment has great significance and importance, and we are going to have an opportunity, I believe, tomorrow to vote on it. I wish to indicate I have every intention, with Senator Smith, of offering at some time the hate crimes legislation. I know the question comes up: Why are we offering hate crimes legislation on a Defense authorization bill? The answer is very simple: The Defense authorization bill is dealing with the challenges of terrorism, and the hate crimes issue--to try to get a handle on the problems of hate crimes, we are talking about domestic terrorism. We have our men and women who are over in Iraq and Afghanistan and around the world fighting for American values. One of the values we have as Americans is the recognition that we do not believe individuals ought to be singled out because of their race, religion or sexual orientation and be the subject of hate attack. This has been an ongoing and continuing issue for our country. At another time, I will get into greater detail about the nature of the challenges we are facing on this particular issue. We passed hate crime legislation at the time of Dr. King, but it was somewhat restrictive in terms of its application. We have been reminded about this challenge probably most dramatically with Mr. Shepard out in the Wyoming countryside, who was selected to be a victim of a hate crime and suffered a horrific death. I, for one, and I think others do, understand we have voted on this on other Defense authorization bills. It has been carried on other Defense authorization bills. I know my friend and colleague, Senator Smith, would not have taken an unreasonable period of time. We have voted on this issue. We voted in 2004 and in 2000 on this issue. Members are familiar with the substance of the issue. So we don't need a great deal of time. We are glad to cooperate with the floor managers in terms of the time. I didn't want to let the afternoon go by and leave any doubt. I have had the opportunity to mention this to Senator Levin on other occasions. I mentioned it, as well, to our majority leader, Senator Reid, who has been supportive. I know Senator Levin has been supportive of the substance of it. It seems to me we are talking about Defense authorization and we are talking effectively about the national security and about the values of our country and why our men and women are involved in defending our country and these values. Certainly, we ought to be able to say, as we are dealing with the problem of hatred and violence around the world, that we will battle hatred and violence as it is applied here at home. As I mentioned, at another time I will go into detail on the history of the legislation and, again, the reasons for it and the facts on this particular issue in recent times. At a time when our ideals are under attack by terrorists in other lands, it is more important than ever to demonstrate that we practice what we preach, and that we are doing all we can to root out the bigotry and prejudice in our own country that leads to violence here at home. Crimes motivated by hate because of the victim's race, religion, ethnic background, sexual orientation, disability, or gender are not confined to the geographical boundaries of our great Nation. The current conflicts in the Middle East and Northern Ireland, the ethnic cleansing campaigns in Bosnia and Rwanda, or the Holocaust itself demonstrate that violence motivated by hate is a world-wide danger, and we have a special responsibility to combat it here at home. This amendment will strengthen the Defense Authorization Act by protecting those who volunteer to serve in the military. The vast majority of our soldiers serve with honor and distinction. These men and women put their lives on the line to ensure our freedom and for that, we are truly grateful. Sadly, our military bases are not immune from the violence that comes from hatred. In 1992, Allen Schindler, a sailor in the Navy was viciously murdered by two fellow sailors because of his sexual orientation. Seven years later, PFC Barry Winchell, an infantry soldier in the Army, was brutally slain for being perceived as gay. These incidents prompted the military to implement guidelines to prevent this type of violence, but there is more that we can do. We have to send a message that these crimes won't be tolerated against any member of society. A disturbing trend has also been discovered in the military. Last year, the Southern Poverty Law Center reported that members of hate groups have been entering into the military. As recruiters struggle to fulfill their quotas, they are being forced to accept recruits who may be extremists, putting our soldiers at higher risk of hate motivated violence. This can't be tolerated. We must stem the tied of hatred and bigotry by sending a loud and clear message that hate crimes will be punished to the fullest extent of the law. Since the September 11 attacks, we've seen a shameful increase in the number of hate crimes committed against Muslims, Sikhs, and Americans of Middle Eastern descent. Congress has done much to respond to the vicious attacks of September 11. We have authorized the use of force against terrorists and those who harbor them in other lands. We have enacted legislation to provide aid to victims and their families, to strengthen airport security, to improve the security of our borders, to strengthen our defenses against bioterrorism, and to give law enforcement and intelligence officials enhanced powers to investigate and prevent terrorism. Protecting the security of our homeland is a high priority, and there is more that we should do to strengthen our defenses against hate that comes from abroad. There is no reason why Congress should not act to strengthen our defenses against hate that occurs here at home. Hate crimes are a form of domestic terrorism. They send the poisonous message that some Americans deserve to be victimized solely because of who they are. Like other acts of terrorism, hate crimes have an impact far greater than the impact on the individual victims. They are crimes against entire communities, against the whole nation, and against the fundamental ideals on which America was founded. They are a violation of all our country stands for. Since the September 11 attacks, the Nation has been united in our effort to root out the cells of hatred around the world. We should not turn a blind eye to acts of hatred and terrorism here at home. Attorney General Ashcroft put it well when he said: Just as the United States will pursue, prosecute, and punish terrorists who attack America out of hatred for what we believe, we will pursue, prosecute and punish those who attack law-abiding Americans out of hatred for who they are. Hatred is the enemy of justice, regardless of its source. Now more than ever, we need to act against hate crimes and send a strong message here and around the world that we will not tolerate crimes fueled by hate. The Senate should not hesitate in condemning countries that tolerate crimes motivated by the victim's race, religion, ethnic background, sexual orientation, disability, or gender. Hate is hate regardless of what nation it originates in. We can send a strong message about the need to eradicate hate crimes throughout the world by passing this hate crimes amendment to the Defense Department Authorization Bill. We should not shrink now from our role as the beacon of liberty to the rest of the world. The national interest in condemning bias- motivated violence in the United States is great, and so is our interest in condemning bias-motivated violence occurring world-wide. The hate crimes amendment we are offering today condemns the poisonous message that some human beings deserve to be victimized solely because of their race, religion, or sexual orientation and must not be ignored. This action is long overdue. When the Senate approves this amendment, we will send a message about freedom and equality that will resonate around the world. I suggest the absence of a quorum.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I welcome this opportunity to commend my friend and colleague in Massachusetts, State representative William Pignatelli, who represents the fourth Berkshire district. In addition to his tireless dedication to the people of western Massachusetts, Smitty, as we all call him, has also shown his extraordinary commitment to public service by going far above and beyond the call of duty to help people in New Orleans devastated by Hurricane Katrina. During a trip to New Orleans last December, Smitty met Stanley Stewart and his family of 12, who had just moved into a FEMA trailer after 16 horrific months of suffering. The family had been rescued from the second-floor balcony of their home in the city after spending 2 days without food, water, and plumbing. Distressed by the plight of Stanley and his family, Smitty decided to help them rebuild their home and has already made a number of trips to New Orleans to do what he can. Now he has decided to spend his fall vacation in New Orleans to finish the job. On September 30, he will be taking a group of volunteer builders from the Berkshires to New Orleans to do so. With these generous acts of kindness, Smitty has shown us extraordinary dedication to those less fortunate. As my brother Robert F. Kennedy said, ``Each time a man stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope, and crossing each other from a million different centers of energy and daring, those ripples build a current which can sweep down the mightiest of oppression and resistance.'' I commend Smitty for the remarkable ripple of hope he is sending forth. A recent article in the Berkshire Eagle describes this amazing chapter in Smitty's life. I believe the article will be of interest to all my colleagues in the Senate, and I ask unanimous consent to have the article printed in the Record.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I congratulate Jim Billington on two decades of service as Librarian of Congress. For 20 years, he has presided over this prestigious institution that serves Congress so well but is truly America's national library. It houses documents and artifacts that date to the earliest days of our democracy and, at the same time, manages the U.S. Copyright Office that maintains an ongoing record of America's creative heritage. Jim Billington had a brilliant career in the academic world before beginning his responsibilities at the Library of Congress. He was highly respected at Harvard, at Princeton and, immediately before becoming Librarian of Congress, as director of the Woodrow Wilson Center. Throughout his career, Jim Billington has brought a dynamic integrity to the scholarly world. Under his leadership, the Library of Congress was not a dormant collection of books and artifacts. He undertook a new initiative to digitize its collections and make them more accessible and more permanent. He also established the Madison Council to bring outside support and wise counsel to the Library, and created a center for advanced scholars in the humanities. His tenure as Librarian is noteworthy for his many achievements and innovations, his dedication to the historic role of the Library and its unique relationship to Congress, and, most importantly, his extraordinary vision of what the Library could become. Through his work, Jim has made unparalleled contributions to enhance the role that American culture plays in our national life. On this special anniversary, I commend him for all that he has accomplished. I am especially grateful for the support and wise counsel he has given to the Kennedy Center for the Performing Arts. As Librarian of Congress, he has served as a member of the board of trustees for the center for two decades, and has been a source of consistent leadership and guidance throughout that time. All of us in Congress owe Jim Billington an immense debt of gratitude for his outstanding public service, and we look forward to many more years of his leadership. On this 20th anniversary of his becoming Librarian of Congress, I join my colleagues in extending my warmest congratulations and deepest appreciation for his achievements.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I thank the Senator from Washington for giving me an opportunity to make a response to the Senator from South Carolina on this issue of prevailing wage that guides the wage for Federal construction. This idea and concept goes back to the 1930s--1931. What is the prevailing wage? It is effectively the local average wage. Why was this decided, that we are going to have the average wage? Because it was decided then, with a Republican Congress, a Republican Congress and Republican President, that we do not want the Federal Government interfering with what is happening in local community wages. If they are going to be less in South Carolina than they are in Massachusetts, they ought to use the local prevailing wage. Is this complicated? No, it is not complicated at all. All you have to do is go look on the Web and find out what the prevailing wage is in South Carolina and what it is in Boston, MA. This was the basic concept. What has been the result of having the prevailing wage? The prevailing wage gives assurances to families. The Federal highway system was such an extraordinary national system developed and proposed by President Eisenhower. It has meant all the difference to the American economy. What the Davis-Bacon program is saying is we are going to pay the average wage to workers under the Davis-Bacon program, but those individuals who are going in those programs, by and large, almost all of them, have gone through various apprenticeship programs and are skilled workers. That is why the University of Utah study of nine southwestern and mountain States has pointed out that the cost of using Davis-Bacon was actually cheaper, less costly to the taxpayer than it would have been if they had not had prevailing wages. An analysis of Federal Highway Administration data in 2004 reached a similar conclusion--that states paying higher wages had lower highway construction costs and higher labor productivity. We want to make sure that when we have our highways and bridges, they are going to be safe and they are going to be secure and they are going to be made by those individuals who have the skills to do the job and do it right and do it well and do it for the protection of American families, whether it is the workers who drive in to work or the children who come back in the various buses from schools all over the community. That is what we are talking about--skilled work, competent work, on-time work done by people who have training and follow a very important tradition. These people are out there working night and day; in the cold of the winter working out there at night, and in the day in the heat of the summer. What is the average wage we are talking about in this whole debate? The median construction wage in this country is $35,000. Does that seem so outrageous, for someone who has a skill, $35,000? Are we going to try to say with all of the challenges and problems we have in our transportation system, this $35,000 is so much we want to try to reduce those wages for working men and women in this country? Is this so outrageous, with the challenges we have seen, in terms of what people are being paid in the United States of America today? Of course not. This is a very dangerous industry. More men and women are killed in construction than in any other industry. Do you hear me? More men and women are killed in construction than in any other industry. Three times more men and women are killed in construction than the national average for other industries, and for some of those who are building bridges, it's even more dangerous. The fatality rate for structural iron and steel workers is 13 times more than the average industry. These are high-risk jobs and we are talking about paying people $35,000 a year? In terms of the important issues we are facing, it makes no sense. We want to make sure that when the Federal taxpayer dollar is expended, it is going to get quality work, it is going to get productivity, it is going to get results, it is going to have accountability. That is what Davis-Bacon has provided over the period of years. Mr. President, how much time do I have remaining?

Mr. KENNEDY. To show what the difference is in terms of prevailing wages for local workers, for ironworkers in Greene, AL, the prevailing wage is $13.67 per hour. An ironworker in Greene, AL makes $21,872 a year. For ironworkers in Denver, CO, the prevailing wage is $22.50, annually $36,000. In Des Moines, ironworkers make $20.60 an hour; $32,960 per year. The average wage in El Paso is $12.03 an hour; they make $19,248, $19,248 a year. Are we trying to say in Texas, in El Paso, we are going to try to undermine individual workers who are making $19,000? By and large most of them are skilled workers who have had apprenticeship programs. Is this the greatest challenge we are facing in our transportation system? No, it is not. The list goes on. This chart here shows construction is one of the most dangerous industries, with over 1,100 fatalities and over 410,000 work-related injuries. This is a dangerous industry and that is why it is so important we have programs, apprenticeship programs to teach these workers their skills but also teach them safety and security. Regarding the injuries, prevailing wage laws lower construction injuries by 10 to 20 percent. If you have prevailing wages, if they are put into place, the number of individuals who are going to be involved in injuries, death, and serious injuries is actually reduced. Why? Because these workers have skills and have better training. More injuries mean higher workers' compensation costs. Without the Federal prevailing wage, workers would suffer up to 76,000 additional injuries leading to 675,000 more lost workdays. This hasn't been an issue that has been a partisan issue. When this was passed in 1931, author James Davis was a Republican Senator and Robert Bacon, another author, was a Republican from the House of Representatives. It was a Republican House majority that passed it. The Republican Senate passed the bill, and Republican President Herbert Hoover signed the bill into law. It is very simple. This is necessary because of the importance of having high-skilled work being done on the bridges and roads of this country. The American taxpayer's dollar is a scarce dollar. We ought to make sure it is not going to be used by fly-by-night operations. We want to make sure those people who are going to receive it are going to have the skills and training to make sure the roads and bridges are going to be safe and secure. That is what Davis-Bacon does. It takes into consideration what the local wages are. Prevailing wages are published on the Internet. It is easy for any of the construction companies to understand it. They all understand it. We don't get complaints that they don't understand it. It is just in many instances they would rather get fly-by-night operations. If you look at the various studies that have been done, time in and time out, about prevailing wages, whether it is from the University of Utah--not a flaming liberal kind of university--looking at the western States, when they had the prevailing wage versus not having the prevailing wage, they show that using the prevailing wage actually resulted in the savings of taxpayer resources. I hope this amendment will not be accepted. We have a tried and true system. We are talking about people, as I mentioned earlier, whose median income is $35,000. It is not excessive. It is difficult to make a good living today, $35,000 today, when you look at the cost of health care, the cost of tuition, the cost of the gasoline, the cost of heating oil--if you live in our part of the country, $35,000 doesn't go a long way. It does seem we want to make sure American taxpayers are going to get what their hard-earned taxes have been collected for and make sure they are going to be expended for skilled work. Davis-Bacon gives that assurance to working families. I see the Senator from Washington. I don't know how much time I have, but I yield the remaining time to her.

Mr. KENNEDY. I move to lay that motion on the table. The motion to lay on the table was agreed to. Amendments Nos. 2812, 2813, and 2814 En Bloc

Mr. KENNEDY

Mr. KENNEDY. Mr. President, when we passed the Children's Health Insurance Program a decade ago, we made a promise to working families to do more to help them obtain decent health insurance for their children. Today, we are keeping that promise. The Senate has passed a bipartisan CHIP reauthorization to strengthen the program, bring health care to at least four million more children, and strengthen the outreach and funding for the program. CHIP has been a great success for children who obtain its coverage. Over the last decade, the percentage of uninsured children has dropped from 22 percent in 1997 to 13 percent today. And that's in spite of the fact that more and more parents have been losing insurance coverage through their jobs, because employers decide to reduce it or drop it entirely. But 9 million children in the United States still lack health insurance because they are not aware of their eligibility for coverage, or because eligibility is too restrictive. The CHIP reauthorization bill will make a real difference in closing this unacceptable gap so that no parents are faced with the decision of whether they can afford to take their sick child to a doctor. The Bush administration, however, is bent on blocking this progress. The Center for Medicare and Medicaid Services has issued a new guidance that will make it virtually impossible for States to expand coverage to children in with household incomes above 250 percent of the Federal poverty level. The guidance will be especially disruptive and unfair to CHIP coverage in 18 states, including Massachusetts, which now allows for children in families with income levels over 250 percent of poverty. No State should be forced to cut health insurance coverage for children. Once again, the Administration has shown itself to be out of touch and out of step with the priorities of working Americans. The Administration's action denies the promise of good health care to countless children in communities across America. That is why today, along with Senators Smith, Rockefeller and Snowe, I am introducing legislation to nullify the new rule from the Centers for Medicare and Medicaid Services and allow each State to cover children at the income level that is most appropriate for their State. Simply, children in all States should be able to obtain the quality health care they need in order to grow and thrive. The administration should be ashamed of its cruel attempt to revoke this needed coverage, and Congress should not allow the new rule to stand.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, when we passed the Children's Health Insurance Program a decade ago, we made a promise to working families to do more to help them obtain decent health insurance for their children. Today, we are keeping that promise. The Senate has passed a bipartisan CHIP reauthorization to strengthen the program, bring health care to at least four million more children, and strengthen the outreach and funding for the program. CHIP has been a great success for children who obtain its coverage. Over the last decade, the percentage of uninsured children has dropped from 22 percent in 1997 to 13 percent today. And that's in spite of the fact that more and more parents have been losing insurance coverage through their jobs, because employers decide to reduce it or drop it entirely. But 9 million children in the United States still lack health insurance because they are not aware of their eligibility for coverage, or because eligibility is too restrictive. The CHIP reauthorization bill will make a real difference in closing this unacceptable gap so that no parents are faced with the decision of whether they can afford to take their sick child to a doctor. The Bush administration, however, is bent on blocking this progress. The Center for Medicare and Medicaid Services has issued a new guidance that will make it virtually impossible for States to expand coverage to children in with household incomes above 250 percent of the Federal poverty level. The guidance will be especially disruptive and unfair to CHIP coverage in 18 states, including Massachusetts, which now allows for children in families with income levels over 250 percent of poverty. No State should be forced to cut health insurance coverage for children. Once again, the Administration has shown itself to be out of touch and out of step with the priorities of working Americans. The Administration's action denies the promise of good health care to countless children in communities across America. That is why today, along with Senators Smith, Rockefeller and Snowe, I am introducing legislation to nullify the new rule from the Centers for Medicare and Medicaid Services and allow each State to cover children at the income level that is most appropriate for their State. Simply, children in all States should be able to obtain the quality health care they need in order to grow and thrive. The administration should be ashamed of its cruel attempt to revoke this needed coverage, and Congress should not allow the new rule to stand.

Mr. KENNEDY

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

Mr. KENNEDY. Mr. President, I ask unanimous consent that the time under the quorum be equally divided.