Member of Congress

Blanche Lincoln

Role
Former Senator
State
AR
Party
Democrat

Speeches

DEPARTMENT OF THE INTERIOR AND RELATED AGENCIES APPROPRIATIONS ACT, 2004--Continued2003-09-23

Mrs. LINCOLN

Mrs. LINCOLN. What we are talking about here is stimulating the minds of children and fostering their aspirations to become our next great scientists and engineers. The education investments we make now can lead our country to the discovery of the next vital scientific finding, invention or cure. This is an opportunity to inspire our children to strive for greatness in science and mathematics and to harvest their creativity, curiosity and knowledge so they may one day help their fellow man and society at large.

Mrs. LINCOLN. I join my friend and colleague in supporting this project. I believe this will be a place that junior high and high school kids will truly enjoy and where they can be engaged. According to the Pew Foundation, academic achievement, student engagement, and teacher satisfaction all improve significantly when schools link academics with hands-on study of the surrounding environment and community and that is exactly what the Little Rock Audubon Nature Center will do. The Nature Center site is just a 15-minute school bus ride from 50 schools in southeast Little Rock, giving it the ability to serve as an outdoor classroom for thousands of school children. In short, this is a kid-friendly, cost-effective approach to reaching the underserved and teaching science and math. This is the kind of project this body must support to help our kids meet the challenges of the future.

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SENATE CONCURRENT RESOLUTION 68--HONORING THE LIFE OF JOHNNY CASH2003-09-15

Mrs. LINCOLN

Mrs. LINCOLN. Madam President, I rise to join Senators Alexander, Frist, and Pryor to introduce a resolution in honor of a great American, and one of our greatest Arkansans--Johnny Cash, who passed away on Friday, September 12, at the age of 71. John R. Cash was born in Kingsland, AR on February 26, 1932. When he was just 3 years old, his father moved the family to Dyess Colony, a New Deal program that set up new farming communities on uncleared land near the Mississippi River. The family had 20 acres upon which they farmed cotton and other seasonal crops and from the beginning, John was taught to work for a living. It was this time spent farming and living in Northeast Arkansas, that inspired songs such as ``Look at Them Beans'' and ``Five Feet High and Rising.'' At the age of six, he was hauling water for a road crew. At twelve he was chopping cotton. When he reached high school he was singing on the radio in Blytheville. Still, John didn't pick up a guitar until he was stationed in West Germany as a soldier in the Army. The instrument was so cheap, he said, that ``it didn't even have a brand name.'' When he returned from Germany, John moved to Memphis, determined to make it in the music industry. He sold appliances door-to-door and went to broadcasting school on the GI bill, playing music whenever he could. Finally, he managed to get an audition before Sam Phillips, the owner of the legendary Sun Records studio. The first time Phillips heard Cash sing, he turned him down, saying that he sounded ``too country.'' John returned with a more rockabilly sound and Phillips began to send his group out with another artist on the Sun Records label, Elvis Presley. Phillips also began to refer to John as Johnny, a name Cash disliked because he thought it made him sound too young. Johnny would go on to record some of his most cherished songs for the label, including such classics as ``Cry, Cry, Cry'' and ``I Walk the Line''. Over the next 5 decades, Johnny Cash recorded over 400 albums, with 48 hits on the Billboard Hot 100 and over 130 hits on the Billboard country music charts. In the process, the boy from Dyess Colony managed to sell over 50 million records. He is part of a distinguished group of musicians from Arkansas including: Conway Twitty, Sonny Boy Williamson, Glen Campbell, and Charlie Rich. Even though Johnny Cash and these other distinguished artists found fame outside of Arkansas, the experience of growing up in Arkansas gave them a unique perspective on the feelings of the common man and woman, working hard to just get by, a perspective which came through in their music. The number of artists he has influenced is immeasurable. He has been inducted into the Country & Western Hall of Fame, the Nashville Songwriter's Hall of Fame, and the Rock & Roll Hall of Fame. He received 11 Grammy Awards including the Lifetime Achievement Award, and has been honored by both the Kennedy Center for his contribution to American Culture and the United Nations, receiving the Humanitarian Award. The last two awards illustrate how Johnny Cash became so much more than a musician. His songs shined a light on aspects of American culture that are integral to our Nation's history but too often overlooked. He never forgot where he came from and the people he met along the way. He told stories about people who worked hard just to survive, people so poor they couldn't afford a car so they snuck out the parts to build one from the plant where they worked, ``One Piece At A Time''. And he told it all with a voice that once was described as ``the perfect voice for a man of his spirit. It's unmistakable. It doesn't sound like anybody else. And it sounds like the real thing, which is what he is.'' I ask that all my colleagues in the Senate join me in honoring a true American original, a prodigiously talented musician, with a conscience that matched those gifts. Our deepest condolences go out to his family and friends.

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ENERGY AND WATER DEVELOPMENT APPROPRIATIONS ACT, 20042003-09-15

Mrs. LINCOLN

Mrs. LINCOLN. Madam President, I ask unanimous consent to speak as in morning business.

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DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2004--Continued2003-09-09

Mrs. LINCOLN

Mrs. LINCOLN. Mr. President, I rise today to speak in support of the amendment of my colleague from West Virginia to increase funding for the title I program by $6.15 billion. By bringing the total up to $18.5 billion, title I would be funded at the level authorized in the No Child Left Behind Act for fiscal year 2004. The title I program is critical for disadvantaged students because it targets federal resources to the poorest school districts where Federal dollars are needed most. In my State of Arkansas, this funding is crucial because 67 percent of students attend title I schools. These schools depend on these important funds to upgrade technology, provide professional development for teachers, and implement school-wide programs. Like dozens of other States today, Arkansas is currently experiencing a serious budget crisis at the same time the State is expected to meet the new requirements we imposed in No Child Left Behind. To make the situation even more challenging for my State, the Arkansas Supreme Court ruled last November that the current funding level for education in Arkansas is inadequate and that the distribution of funding is inequitable. The AR Supreme Court gave the state until Jan. 1, 2004 to comply with its order. Arkansas is not alone. States all across the country are facing similar financial woes, which means title I funding is more important than ever. Like title I, additional funding for IDEA is also critical to students and school districts in my State. I hear more complaints from constituents about the Federal Government's failure to meet its obligation under IDEA than any other Federal education program. Even though Congress has increased funding for IDEA in recent years, the funding level in this bill falls far short of the promise we made in 1975 to pay 40 percent of the costs of providing a quality education to special needs students. Currently, IDEA is an unfunded mandate, which is profoundly unfair to school districts, teachers, and the students they serve. I am disappointed that an amendment offered last week by Senator Dayton to fully fund IDEA in fiscal year 2004 was not adopted. For the sake of the students who depend on the services provided under IDEA and the educators who are responsible for implementing the law, I am hopeful the Senate will have another opportunity to consider full funding either on this legislation or another bill before Congress adjourns this year. We also need to pass meaningful legislation that will encourage more students in Arkansas and the Nation to pursue a college education. I think that promoting post-secondary education is an essential element of any effort to prepare our workforce to meet the demands of today's global marketplace. I also believe we should continue to build on our success regarding Federal student financial assistance. That is why I am pleased to support an amendment to this bill by Senator Kennedy that would increase student financial aid in fiscal year 2004 by $2.2 billion, which is essential to keep up with the growth in college costs. One of the most worthwhile financial assistance programs is the Pell grant. Since its inception in 1972, students nationwide have received enormous benefits from Pell grants, so I think we need to continue to make a larger investment in this area. The higher education funding amendment would increase the maximum Pell grant by $450, which would give close to 2,000 more Arkansans access financial assistance for higher education. This higher education amendment also includes additional funding for the TRIO programs, which are particularly important to Arkansas. The TRIO programs are designed to help low-income, first-generation college students prepare for, enter, and graduate from college. While student financial aid programs help students overcome financial barriers to higher education, TRIO Programs help students overcome class, social and cultural barriers. Considering Arkansas has one of the lowest percentages of residents with a four-year college degree, the more than 50 TRIO programs currently serving participants in my state provide a critical source of encouragement and support to thousands of students who might otherwise never receive their college degree. As many of my colleagues know, for the last 3 years I have circulated a sign-on letter with the Senator from Maine to increase Federal support for the TRIO programs. Our goal is to increase the population served under these programs from 6 percent to 10 percent of eligible students. By passing the Kennedy higher education amendment, we would be making a significant downpayment on that goal. Nearly 40 percent of the children in this country attend rural schools. These schools face enormous challenges such as teacher recruitment and retention and small student populations. I am extremely disappointed that the Senate rejected an amendment that I supported which would have fully funded the Rural Education Achievement Program, REAP. This program recognizes the unique needs of small and rural schools while ensuring accountability. It provides essential funding that many of these schools rely on because they lack the personnel and resources to apply for competitive grants. Last year, well over half of Arkansas' school districts received approximately $5.6 million in total funding under this program to help meet critical educational needs. And this funding is needed now more than ever as schools strive to meet the new accountability measures of the No Child Left Behind Act. I want to close my remarks by emphasizing my strong belief that education can be and must be a high priority for our Nation. I was proud to support a bold reform plan for our Nation's public schools a few years ago because I believe firmly that every child deserves a chance to receive a quality education regardless of where they live or go to school. The approach I supported created a new contract between the Federal Government and local school districts--more funding and flexibility for public schools in return for greater academic achievement for all students. I said at the time that additional funding and reform go hand in hand--you can't have one without the other and expect to succeed. As many of the accountability requirements of No Child Left Behind take affect, it is critical for Congress to meet its obligation to provide schools and students with the resources they need to meet higher standards. I hope my colleagues will rise to the occasion during consideration of this bill and deliver on the promise of equal opportunity for all students. My greatest fear is that we won't meet our obligations to our children in this bill. In the years ahead, our children will provide the workforce and leadership for our nation. Indeed, our children are our future. We don't have the luxury of waiting to fund these programs adequately at some undetermined time in the future. We should fulfill our responsibility today.

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HONORING OUR ARMED FORCES2003-09-08

Mrs. LINCOLN

Mrs. LINCOLN. Mr. President, I today honor a true American hero from Arkansas--SGT James Sides of the U.S. Army. A native of Wynne, in east Arkansas, James recently returned from Iraq, where he was seriously wounded in action four months ago. On May 9, two Blackhawk ambulance helicopters with the 571st Medical Company were dispatched to rescue an 11-year old Iraqi child who had stepped on a land mine. As one helicopter landed to evacuate the boy, the other was circling above when it snagged on a power line while trying to avoid enemy fire from below. James a crew member, a flight medic, on the latter helicopter, which crashed into the Tigris River. Of the 4-member crew, 3 were killed. James was pulled from the wreckage after having been submerged in the water for an estimated five to seven minutes. He was unconscious and near death, with a broken bone in his upper arm and nerve damage. But thanks to swift emergency care from his fellow soldiers he was kept alive until he could be evacuated to a hospital. James was in a coma for a month afterward. He was hospitalized in Kuwait, Germany, and Washington, and spent time in a rehabilitation facility in Tampa. In July, SGT James Sides returned home to a richly deserved hero's welcome in Wynne. We're all glad to have him back home, but not more than his loving family: His parents, Carter and Leslie Sides; his wife, Rebecca Sides and his two sons, James Jr. and Devin. Upon his homecoming, James was interviewed by his local newspaper. He credited his survival to his faith and that of his family and friends. In his words: ``If it wasn't for prayers and the good Lord watching over me, I wouldn't be here. God took care of me. The prayers of everyone were answered and I just appreciate all of the prayers. There's no doubt in my mind that prayers get answered.'' He also noted that he's not a hero: ``If I'm a hero, where would that put the guys who are still over there? We can't forget them. They are the ones we should be thinking about.'' Well, James Sides may be too modest to call himself a hero, but the rest of us recognize him as just that--a man of tremendous courage, commitment, and patriotism whose service to his country has been exemplary. I ask that all my colleagues in the Senate join me in thanking SGT Sides for his service and for his sacrifice, which we can never sufficiently recognize or repay. We wish him a swift and full recovery. We wish all the best to him and his family.

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ENERGY POLICY ACT OF 20032003-07-31

Mrs. LINCOLN

Mrs. LINCOLN. Mr. President, I ask unanimous consent that after I complete my statement, the Senator from Louisiana be recognized for 15 minutes, and then the Senator from Texas, Mr. Cornyn, be recognized.

Mrs. LINCOLN. Fifteen minutes.

Mrs. LINCOLN. Mr. President, in March, Senator Hutchison from Texas and I joined to coordinate a daily tribute to the troops in recognition of the men and women serving in combat in Iraq. We developed these tributes as a way to honor the sacrifices of the soldiers serving in the Middle East as they fought to depose the brutal regime of Saddam Hussein. The response was impressive, and I thank Senator Hutchison for working with me on this initiative, not to mention all of our colleagues who contributed, who came to the floor to share with one another, as well as the rest of this Nation, the incredible sacrifices being made by the service men and women of this country. Given recent developments in Iraq, I wish to take a few minutes today to revisit the tribute to the troops. On Tuesday, I learned that Jonathan Marshall Cheatham, an Army PFC from Camden, AK, assigned to the 498th Engineer Battalion, died in Iraq on Saturday. Jonathan's convoy came under attack by enemy forces firing rocket- propelled grenades while traveling near Baghdad. Jonathan was killed in the attack. He was 19 years old. Our thoughts and our prayers--all of ours, not just mine as a Senator from Arkansas, but from all of the U.S. Senators--are with his mother Barbara Prochia and with his family and friends at this time of loss. Jonathan was one of 51 American soldiers who have been killed in combat since the President declared an end to major combat operations on May 1. In all, 164 U.S. soldiers have died in combat in Iraq. This is a stark and vivid reminder that, even though the major combat portion of the war may have been declared over, our troops are still fighting and they still face grave threats. Let us not forget the challenges that these troops are encountering. Marine Cpl Jason Smedley of Little Rock, who worked in my office prior to his service in Iraq, was wounded in combat on March 28. I am happy to report that Jason has recovered from his injuries and has returned to work as a member of my staff here in Washington, DC this week. Jason has regular contact with his friends and comrades with whom he fought in Iraq. Some have returned home. Many have spent months thousands of miles away from their homes and families, stationed in a desert where the mail does not flow regularly and where they receive little news of what is happening at home. For many of these young men and women, the undependable nature of communication causes tremendous stress and anxiety. Many of them, trained for combat, are frustrated that they lack the training and tools to meet the challenges of a peace-keeping mission. Others tell of the difficulties of being separated from their families. Jason tells me of one Marine, Sergeant Eric Johnson, whose wife gave birth to a child in February. Only recently did Sergeant Johnson hold his five-month-old son for the first time. I have no doubt that there are many other families trying to cope with similar difficulties. Among the reservists who are serving in Iraq, there are other pressures. Many of the troops serving in the Reserves have now been on active duty for up to 6 months or longer, meaning that they have been drawing only reserve pay over that time. Their families are struggling to make ends meet, but they have no idea when their tour of duty will end or when their financial difficulties will be alleviated. The sacrifices that these young men and women are making for their country are simply astonishing, and it is unlikely that we will ever be able to adequately repay the debt we will owe them. Earlier this month, I received word from a doctor, a native of northeast Arkansas, who is currently serving in Iraq. He and his unit were traveling to a military hospital about 45 miles north of Baghdad, where he would treat U.S. casualties. He wrote of a vehicle traveling in front of his in traffic being hit by a rocket-propelled grenade, killing one person and injuring three others critically. Upon arrival at the hospital, his camp received mortar fire three times in one night. He noted that ``luckily, the Iraqis are poor shots.'' On the Fourth of July, this young man was flown on short notice back to Baghdad, where extra surgeons were needed. He noted that after he departed for Baghdad, his camp was attacked yet again, and that a tent about 100 meters from his was hit by mortar. Ten casualties resulted from that attack, he reported. I point to this dramatic narrative because it illustrates a couple of important points I hope we do not lose sight of. First, the war in Iraq is far from over. I will note that each of the communications we have received from this brave young doctor, he has talked about coming under mortar fire from Iraqi irregulars, or watching coalition forces launch counter- attacks. A good part of his labor centers on treating men who have been wounded in combat. Clearly, even if the end of combat operations has been declared, the threat to our troops is ongoing. As casualties mount and our troops continue to face daily dangers, it is important that we redouble our efforts to stabilize the country and help Iraq on the way to become a democracy. Secondly, we should all recognize that, although our troops are faced with extremely difficult conditions, they continue their mission with courage and with a sense of duty and commitment. And they are making progress. We learned last week that Saddam Hussein's brutal sons and presumptive heirs were killed by coalition forces in a firefight near Mosul. Since then, coalition soldiers have received more tips and more information which will lead to the capture or elimination of Baath party holdouts and Iraqi guerrilla fighters. Indeed, each day brings news that the noose may be tightening around Saddam Hussein himself, as bodyguards, aides, and others close to the former dictator are captured and interrogated. We should do all we can to ensure that this progress continues, and we should ensure that our armed forces have the troops, materiel, and supplies they need to get the job done. Finally, I would like to note that a National Guard unit from Arkansas, the 39th Infantry Brigade from Little Rock, is expected to be deployed in Iraq in April of next year, to augment security and to allow for troop rotation so that troops currently stationed in Iraq can be relieved. With 3,400 people in the brigade, it is expected to be the largest deployment of National Guard troops from Arkansas in our State's history. These men and women are preparing to spend a year in Iraq, at great sacrifice to themselves and to their families, so that we can look forward to a more secure future. We owe all of them a tremendous, tremendous debt for their service. All of us in this body are proud of the service men and women who are serving under incredible circumstances, in incredible times, and doing the best they can possibly do. We wish them the best, and we wish they are able to finish the job and return home as soon as possible. I know my colleagues join me in again paying tribute to the troops, recognizing the incredible service of these service men and women who serve our Nation so proudly from each of our States. The different soldiers who are going out into battle, who are putting themselves in harm's way, we are lifting them up daily in our prayers, as well as their families, their needs, and their concerns. We hope we can bring this to a speedy end and we can make sure that they are all brought home as safely. I yield the floor.

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ENERGY POLICY ACT OF 2003--Continued2003-07-31

Mrs. LINCOLN

Mrs. LINCOLN. Mr. President, I want to congratulate Chairman Grassley and Ranking Member Baucus on this package of energy tax incentives. But also I would like to raise two concerns with the bill, which I request they address in the House-Senate conference on the energy bill. On February 11 of this year, I introduced S. 358, the Capturing Landfill Gas for Energy Act of 2003. My bill is cosponsored by Senators Santorum and Hatch and would provide a credit under either Section 29 or 45 of the Tax Code for the production of energy from landfill gas, or LFG. In the past, Congress has recognized the importance of LFG for energy diversity and national security by providing a Section 29 credit in 1980 and extending it for nearly two decades. However, the bill before us provides no Section 45 credit for LFG, and it severely limits the Section 29 credit by applying a volume cap of 200,000 cubic feet per day. In contrast, the President proposed a Section 29 credit for LFG with no volume cap, and the House has passed a Section 45 credit for LFG. Both of these proposals would provide meaningful tax incentives to encourage the collection and use of LFG. Thus, the Senate bill falls well short of recognizing the importance of dealing with LFG, and I urge the Chairman to address this shortfall in the House-Senate conference. My second concern deals with a provision included in the Senate energy tax bill which would clarify the definition of ``landfill gas facility'' for purposes of Section 29. I am grateful to have worked with the chairman and ranking member of this provision, but I am concerned that we have not yet found the proper solution. Typically, a landfill is comprised of a number of ``cells.'' A cell is filled with trash, closed up, and then a new cell is filled. Over time, cells within the landfill begin to generate methane gas as the garbage decomposes. So a landfill produces methane gas in stages as the individual cells produce LFG, and new ``wells, pipes, and related components'' are run from the landfill gas facility to collect the gas. The Tax Code is unclear whether the new components run to cells in the landfill over time are considered part of the landfill gas facility, and thus, the question is raised whether gas from these cells are eligible for the Section 29 tax credit. Under S. 358, a landfill gas facility would include additional ``wells, pipes, and related components'' used to collect landfill gas. Further, the new components of the expansion would share the facility's placed in service date for purposes of Section 29. For example, the wells, pipes, and related components added to an eligible facility placed in service in 1997 would share the eligible facility's 1997 placed in service date and gas produced from the facility would receive the credit for the duration of the facility's credit pay out period. In contrast, the provision in the Senate Energy bill would include all wells, pipes, and related components added to the eligible facility, but for all expansions placed in service after date of enactment, the components would be treated as a new facility with a new placed in service date. The difference is critical since other provisions of the Senate Energy bill subject new LFG facilities to a new volume cap of 200,000 cubic feet per day. As I mentioned, this new volume cap will seriously curtail the use of Section 29 for LFG under the bill, and it was never my intention to deny payment of the full credit for gas produced from expansions of the original facility during the 10-year payout period. The potential energy and environmental benefits of future LFG projects are substantial, but they will be lost if we do not provide adequate provisions to support project development. I request that Chairman Grassley and Senator Baucus continue to work with me to make sure Americans garner all of these benefits.

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STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS2003-07-31

Mrs. LINCOLN

Mrs. LINCOLN. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

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Introductory Statement on S. 15372003-07-31

Mrs. LINCOLN

Mrs. LINCOLN. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

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STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS2003-07-23

Mrs. LINCOLN

Mrs. LINCOLN. Mr. President, I rise today to join my good friend Senator Crapo of Idaho in introducing legislation aimed at rehabilitating this Nation's public and private forestlands. Senator Crapo and I serve as the Chair and Ranking Member of the Agriculture Subcommittee on Forestry, and we have worked together extensively in watching over our Nation's forestlands. Our bipartisan legislation builds upon the Healthy Forest Restoration Act, which passed the House of Representatives earlier this year. Our bill will ensure that we can address the many problems affecting all of our Nation's forests--both on public and private forestlands, in southern and western forests, and throughout both hardwood and pine ecosystems. Our legislation is intended to be a marker for the direction we believe forest legislation should move in this country. Both Senator Crapo and I have been working closely with the Senate Agriculture Committee to ensure that the goals of our legislation are incorporated into the chairman's mark of the Senate's Healthy Forest legislation. Our legislation is intended to accomplish a few, very specific goals. First and foremost, we must provide the Forest Service with the tools necessary to immediately address the epidemic of oak decline and mortality in the Ozark highlands of Arkansas and Missouri. Oak decline is a natural occurrence in older forests or in areas where trees are stressed by conditions such as old age, over population of the forest, poor soil conditions, and the effects of several years of severe drought. And under normal conditions, oak decline is not necessarily fatal to the tree. However, these conditions have allowed insects such as the red oak borer to flourish throughout the forest and has led to an epidemic of oak mortality throughout our forests. In fact, many estimates now suggest that potentially up to one million acres of red oaks have been affected in Ozark highlands. And it is important to note that this epidemic has not been long in coming--it was only first discovered in the late 1990s. I am concerned that this epidemic will lead to a complete loss of red oak from the Ozark highlands and cause long-term changes to the health of the forest ecosystem. It is also important to remember that the epidemic has not been limited to public lands. Private forest landowners and homeowners throughout the Ozarks face the same problem. The past several years of extremely dry summer conditions have weakened trees throughout the region. The legislation also contains provisions that are intended to streamline and improve the environmental, administrative, and judicial review process for hazardous fuel reduction projects under this legislation. I join Senator Crapo in believing that the review process for hazardous fuel reduction projects, while necessary and beneficial, often consumes more time, effort, and resources than the initial intent of the project. I am also aware that there are ongoing discussions regarding these environmental, administrative, and judicial review issues. I look forward to working with my colleagues on the Agriculture Committee and in the entire Senate to modify and improve the environmental, administrative, and judicial review provisions of this legislation in order to address my colleagues' concerns. As we have seen with the epidemic of oak mortality in Arkansas, the Forest Service must have the ability to quickly respond to insect infestation in order to protect, preserve, and rehabilitate the entire forest. Streamlining of the environmental, administrative, and judicial review process for hazardous fuel reduction projects will ensure that we can quickly address what ails our forests. Secondly, our legislation also provides increased funding and direction for forestland research in this country. Our legislation will ensure that our Nation's colleges and universities are able to devote more research into the insects and diseases affecting our forests. We also require that any forestland research be conducted at a scale appropriate to the forest damage, and that it be conducted within the requirements of each individual forest management plan. Our legislation also includes requirements to ensure this research has clearly stated forest restoration objectives and is peer reviewed by scientific experts in forestland health. Our legislation includes authorization for a new upland hardwood research center designed to study the myriad of insects, disease, and problems affecting our ability to rehabilitate, restore, and utilize our upland hardwood forests. As we have seen, Arkansas was caught almost flatfooted as the epidemic of oak mortality swept through the Ozarks and severely endangered the health of our forests. Establishing this new research center will help ensure that this does not happen again. The new research center will specifically research the effects of pests and pathogens on upland hardwoods, hardwood stand regeneration and reproductive biology, upland hardwood stand management and forest health, threatened, endangered and sensitive aquatic and terrestrial fauna, ecological processes and hardwood ecosystem restoration, and education and outreach to nonindustrial private forest landowners and associations. The establishment of this new research center is necessary to ensure we can quickly identify and respond to the multitude of pests, disease, and other damaging agents that can dramatically affect our beloved forests. Third, our legislation also includes funding for emergency grants to immediately remove the invasive plants that have become so pervasive throughout this Nation's forests. And when we talk about invasive plant species in the South, we are talking about one thing--Kudzu. Some call it the vine that ate the South. Kudzu was brought into this country several decades ago to be used as cover for bare hillsides and has since spread to cover everything including shrubs, bushes, and entire trees. The grant program included in our legislation will provide the means for landowners to immediately remove kudzu and the myriad other invasive plants that are choking out our forests. Finally, our legislation also includes widely agreed upon language that would provide for grants to remove non-commercial biomass from our private forested watersheds, and provide for grants to establish private, healthy forest reserves throughout the nation. Many of these important provisions were included in the Senate-passed farm bill last year, but they were not included in the final legislation, unfortunately. Providing grants to remove noncommercial biomass will immediately reduce the amount of fuel on the forest floor and directly reduce the fire danger in our forests and around our communities. Similarly, providing grants to protect our forest watersheds will ensure that we can address our water quality concerns with a voluntary, incentive based approach. And finally, providing funding to establish new healthy forest reserves from willing private landowners will encourage the preservation and rehabilitation of this Nation's forestlands. Mr. President, I believe that our bipartisan legislation will focus needed attention on a number of extremely critical goals for our national forest policy. One lesson that we have learned over the years is that if we value our forests, if want to conserve our woodland and resources, if we want to preserve their natural beauty, if we want to ensure that the natural bounty of our forestlands is available to future generations, then it is important that we manage those lands and resources with a careful eye toward their long-term health.

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Introductory Statement on S. 14492003-07-23

Mrs. LINCOLN

Mrs. LINCOLN. Mr. President, I rise today to join my good friend Senator Crapo of Idaho in introducing legislation aimed at rehabilitating this Nation's public and private forestlands. Senator Crapo and I serve as the Chair and Ranking Member of the Agriculture Subcommittee on Forestry, and we have worked together extensively in watching over our Nation's forestlands. Our bipartisan legislation builds upon the Healthy Forest Restoration Act, which passed the House of Representatives earlier this year. Our bill will ensure that we can address the many problems affecting all of our Nation's forests--both on public and private forestlands, in southern and western forests, and throughout both hardwood and pine ecosystems. Our legislation is intended to be a marker for the direction we believe forest legislation should move in this country. Both Senator Crapo and I have been working closely with the Senate Agriculture Committee to ensure that the goals of our legislation are incorporated into the chairman's mark of the Senate's Healthy Forest legislation. Our legislation is intended to accomplish a few, very specific goals. First and foremost, we must provide the Forest Service with the tools necessary to immediately address the epidemic of oak decline and mortality in the Ozark highlands of Arkansas and Missouri. Oak decline is a natural occurrence in older forests or in areas where trees are stressed by conditions such as old age, over population of the forest, poor soil conditions, and the effects of several years of severe drought. And under normal conditions, oak decline is not necessarily fatal to the tree. However, these conditions have allowed insects such as the red oak borer to flourish throughout the forest and has led to an epidemic of oak mortality throughout our forests. In fact, many estimates now suggest that potentially up to one million acres of red oaks have been affected in Ozark highlands. And it is important to note that this epidemic has not been long in coming--it was only first discovered in the late 1990s. I am concerned that this epidemic will lead to a complete loss of red oak from the Ozark highlands and cause long-term changes to the health of the forest ecosystem. It is also important to remember that the epidemic has not been limited to public lands. Private forest landowners and homeowners throughout the Ozarks face the same problem. The past several years of extremely dry summer conditions have weakened trees throughout the region. The legislation also contains provisions that are intended to streamline and improve the environmental, administrative, and judicial review process for hazardous fuel reduction projects under this legislation. I join Senator Crapo in believing that the review process for hazardous fuel reduction projects, while necessary and beneficial, often consumes more time, effort, and resources than the initial intent of the project. I am also aware that there are ongoing discussions regarding these environmental, administrative, and judicial review issues. I look forward to working with my colleagues on the Agriculture Committee and in the entire Senate to modify and improve the environmental, administrative, and judicial review provisions of this legislation in order to address my colleagues' concerns. As we have seen with the epidemic of oak mortality in Arkansas, the Forest Service must have the ability to quickly respond to insect infestation in order to protect, preserve, and rehabilitate the entire forest. Streamlining of the environmental, administrative, and judicial review process for hazardous fuel reduction projects will ensure that we can quickly address what ails our forests. Secondly, our legislation also provides increased funding and direction for forestland research in this country. Our legislation will ensure that our Nation's colleges and universities are able to devote more research into the insects and diseases affecting our forests. We also require that any forestland research be conducted at a scale appropriate to the forest damage, and that it be conducted within the requirements of each individual forest management plan. Our legislation also includes requirements to ensure this research has clearly stated forest restoration objectives and is peer reviewed by scientific experts in forestland health. Our legislation includes authorization for a new upland hardwood research center designed to study the myriad of insects, disease, and problems affecting our ability to rehabilitate, restore, and utilize our upland hardwood forests. As we have seen, Arkansas was caught almost flatfooted as the epidemic of oak mortality swept through the Ozarks and severely endangered the health of our forests. Establishing this new research center will help ensure that this does not happen again. The new research center will specifically research the effects of pests and pathogens on upland hardwoods, hardwood stand regeneration and reproductive biology, upland hardwood stand management and forest health, threatened, endangered and sensitive aquatic and terrestrial fauna, ecological processes and hardwood ecosystem restoration, and education and outreach to nonindustrial private forest landowners and associations. The establishment of this new research center is necessary to ensure we can quickly identify and respond to the multitude of pests, disease, and other damaging agents that can dramatically affect our beloved forests. Third, our legislation also includes funding for emergency grants to immediately remove the invasive plants that have become so pervasive throughout this Nation's forests. And when we talk about invasive plant species in the South, we are talking about one thing--Kudzu. Some call it the vine that ate the South. Kudzu was brought into this country several decades ago to be used as cover for bare hillsides and has since spread to cover everything including shrubs, bushes, and entire trees. The grant program included in our legislation will provide the means for landowners to immediately remove kudzu and the myriad other invasive plants that are choking out our forests. Finally, our legislation also includes widely agreed upon language that would provide for grants to remove non-commercial biomass from our private forested watersheds, and provide for grants to establish private, healthy forest reserves throughout the nation. Many of these important provisions were included in the Senate-passed farm bill last year, but they were not included in the final legislation, unfortunately. Providing grants to remove noncommercial biomass will immediately reduce the amount of fuel on the forest floor and directly reduce the fire danger in our forests and around our communities. Similarly, providing grants to protect our forest watersheds will ensure that we can address our water quality concerns with a voluntary, incentive based approach. And finally, providing funding to establish new healthy forest reserves from willing private landowners will encourage the preservation and rehabilitation of this Nation's forestlands. Mr. President, I believe that our bipartisan legislation will focus needed attention on a number of extremely critical goals for our national forest policy. One lesson that we have learned over the years is that if we value our forests, if want to conserve our woodland and resources, if we want to preserve their natural beauty, if we want to ensure that the natural bounty of our forestlands is available to future generations, then it is important that we manage those lands and resources with a careful eye toward their long-term health.

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PRESCRIPTION DRUG AND MEDICARE IMPROVEMENT ACT OF 20032003-07-11

Mrs. LINCOLN

Mrs. LINCOLN. Mr. President, I rise today to reflect on the recently passed Prescription Drug and Medicare Improvement Act of 2003, S.1. I am pleased to support this bipartisan effort both in the Senate Finance Committee and here on the floor. I believe this bill represents a positive compromise and a good start for America's senior citizens and individuals with disabilities who have relied on the Medicare Program for generations. I hope that the conferees act deliberately and fairly in the coming weeks to embrace what is good about this bill and to retain its bipartisan spirit. This process has been a long road for many of us who have worked on this issue for years but it has been an even longer road for America's seniors, who have watched drug prices escalate while Washington failed to act. Like all legislative products, this bill is not perfect. I have worked to improve this bill for Arkansas seniors in many ways, and I am committed to correcting any problems with it as it is implemented. Despite its shortcomings, which I will detail later, S. 1 is much better for Arkansans than the plan President Bush proposed earlier this year. First and foremost, S. 1 gives all Medicare beneficiaries access to a prescription drug benefit. Under President Bush's proposal, Arkansas seniors who wanted a drug benefit would have been forced to drop out of traditional Medicare and enroll in a private HMO instead, even though such a plan may not have been available in their area. Under the President's plan, seniors who remained in traditional Medicare would have received nominal discounts on prescriptions and a limited catastrophic benefit if they had extremely high drug expenses. I have said all along that it is simply unfair to deny a prescription drug benefit to beneficiaries in traditional Medicare. All 442,000 Medicare beneficiaries in Arkansas are currently enrolled in traditional Medicare with no access to Medicare + Choice because private insurance companies found the profit margin of health care insurance in rural areas to be too small. That is why Medicare needs to be there as a safety net. That is why prescription drug coverage must be a part of traditional Medicare. That is why the guarantee in S. 1 that traditional Medicare will pick up the slack where private insurers decline to operate needs to remain in the final version of this new policy. Second, I helped ensure that S. 1 provides special assistance to our State's most vulnerable seniors--those with low incomes. Over 40 percent of Medicare beneficiaries in Arkansas have incomes below 160 percent of the Federal Poverty Level--in 2003, $14,368 for a single and $19,392 for a couple--and simply cannot afford to fill their prescriptions. These are the seniors who struggle to pay for food, heat, and other necessities in order to afford their lifesaving drugs, and I hear from them often. I fought in the Senate Finance Committee to ensure that seniors under 160 percent of poverty would get special assistance with their premiums, deductibles, and cost-sharing. Those with very low incomes who also qualify for an assets test would receive more generous help. I helped improve the low-income provisions even more on the Senate floor by working with Senators Bingaman and Domenici to increase the asset test levels from $4,000 to $10,000, adjust these levels yearly for inflation, and reduce the paperwork burden for eligible seniors. Because this amendment passed, many more seniors in Arkansas will receive help with the cost-sharing imposed under this bill. Today, lower income seniors only fill about 20 prescriptions per year, compared to an average of 32 for those with prescription drug insurance. These provisions will help ensure that lower-income beneficiaries will be able to afford to fill their prescriptions, keeping them healthier and helping them live longer. I succeeded in including in S. 1 a number of other provisions that will improve the Medicare Program for Arkansans for many years to come. Two such provisions are based on legislation I introduced earlier this year, the Geriatric Care Act, S. 387. My first provision would provide for a 3-year demonstration project in Arkansas and five other sites on complex, chronic care management. Once this demonstration project is completed, S. 1 allows the Secretary of Health and Human Services, HHS, to use its findings to add this service as a part of traditional Medicare from 2009 to 2013 as long as it costs no more than $6 billion. More than 80 percent of Medicare dollars are spent on Medicare beneficiaries with three or more chronic conditions like Alzheimer's disease, cancer, or diabetes. Better care management for these seniors should improve patients' overall quality of life and reduce the need for expensive hospitalizations for chronic conditions. It is my hope that this further, more extensive study of chronic care management provided by geriatricians and their health care teams will prove this. We in Arkansas are blessed to have the Donald W. Reynolds Department of Geriatrics and the Center on Aging at the University of Arkansas for Medical Sciences, whose geriatric specialists have vastly improved the care for seniors across our State. These provisions will make it easier for our medical school and others across the country to better care for patients with chronic conditions while also training more physicians in geriatrics. The other provision included in S. 1 provides the Secretary of HHS with the authority to clarify that geriatric training programs are eligible for 2 years of fellowship support under Medicare. This change would help maintain incentives for fellows to continue into second-year training, a critical pathway to careers in academics and geriatric research. S. 1 also allows the Secretary of HHS to cover preventive benefits that aren't currently covered under traditional Medicare between the years 2009 to 2013. I have long fought to add new preventive services to Medicare, such as cholesterol screening, medical nutrition therapy services for beneficiaries with cardiovascular disease, counseling for cessation of tobacco use, and diabetes screening. These benefits are especially important for women, who are the majority of Medicare recipients and who make up 71 percent of the Medicare population over 85 years of age. By encouraging women to get screened for diseases like heart disease, osteoporosis, and breast cancer, we can save and improve lives. I also succeeded in including my legislation, S. 1114, to provide Medicare coverage for kidney disease education services. Each year, some 80,000 people are diagnosed with chronic kidney failure--also known as end-stage renal disease (ESRD). Patients with ESRD require regular kidney dialysis treatments or a transplant to survive, and most are entitled to have this care paid for by the Medicare Program. Unfortunately, many of these renal patients are never informed that, prior to kidney failure, there are a number of steps they can take to improve their chances of having better outcomes with dialysis. Medicare currently requires that ESRD patients receive education on treatment options--but not until after the patient is already under the care of a dialysis clinic. Unfortunately, by then it is essentially too late to take advantage of much of the information. My provision makes counseling available to patients before dialysis is initiated to help patients understand all the therapies available for the treatment of ESRD. My amendment will save money and improve patient care. I also succeeded in including an important amendment to ensure Medicare coverage for insulin syringes. Before my amendment, S. 1 provided no coverage for insulin syringes although it did provide coverage for insulin. Roughly 40 percent of the senior population with diabetes, or 1.8 million seniors, use syringes to inject insulin into their bodies to control their diabetes every day. Without coverage, syringe purchases--which can be especially expensive for seniors on fixed incomes--would not count towards cost-sharing and yearly maximum out-of-pocket expenses. My amendment changed that. Now, the bill ensures coverage for syringes and other necessary medical supplies associated with administering insulin as determined by HHS. Providing coverage for insulin syringes will help diabetic seniors who take insulin keep their disease under control. Syringe coverage will help seniors manage or prevent long-term complications of diabetes like kidney failure, blindness, and amputations by helping to keep blood glucose levels in a normal range. I was also able to include a 3-year, 5-site demonstration project to determine the merits of allowing Medicare beneficiaries direct access to physical therapists' services within the Medicare Program, as authorized by State law. Currently, some 37 States, including Arkansas, allow direct access to physical therapist services. While non-Medicare patients can directly access such services in these States, Medicare beneficiaries are restricted from such access by the requirement that they obtain a referral from another practitioner. Requiring a referral is unnecessary and limits access to timely and medically necessary physical therapist services. This demonstration, which is designed to be budget neutral, will determine if direct access does in fact improve patient care and save Medicare money. I also worked with Senator Craig Thomas to include a bill we sponsored together, S. 310, to provide Medicare coverage of licensed professional counselors and marriage and family therapist services. Although the rate of suicide among seniors is higher than for any other age group, fewer than 3 percent of seniors report seeing mental health professionals for treatment. Lack of access to mental health providers is one of the primary reasons why older Americans don't get the mental health treatment they need. Not surprisingly, this problem is exacerbated in rural areas. Licensed professional counselors are often the only mental health specialists available in rural communities. This is true in Arkansas, where 91 percent of Arkansans reside in a mental health professional shortage area. This provision will significantly increase the number of Medicare-eligible mental health providers in Arkansas, providing better access for patients. I was successful in working with Senator Cantwell on an amendment that will restrict pharmacy benefit managers (PBMs), and require the Department of Justice and the Health and Human Services Inspector General to review PBM financial practices for any potential collusion between PBMs and drug manufacturers on drug pricing and availability. I also supported an amendment with Senator Enzi to ensure that pharmacists have the option of offering 90-day prescriptions when they are also offered by mail order. I sponsored an amendment with Senator John Ensign to repeal the $1,590 cap on outpatient physical therapy, occupational therapy, and speech-language pathology. The current therapy cap discriminates against the most vulnerable of Medicare beneficiaries. While the majority of enrollees will not exceed an annual $1,590 limitation on rehabilitation services, approximately 13 percent of seniors and individuals with disabilities covered by Medicare will be forced to pay for medically necessary services out of pocket. This is a particularly burdensome situation for beneficiaries living in rural communities. Most likely to be harmed are beneficiaries who have experienced a stroke or hip fracture or who have Parkinson's disease or other conditions that require extensive rehabilitation following injury or illness. Before Senator Ensign and I withdrew our amendment to repeal this cap, we discussed the amendment on the floor with the chairman of the Finance Committee, Senator Grassley, who promised to work in the conference committee to enact a moratorium on the therapy cap. I also succeeded in including a number of my amendments during debate of the bill in the Senate Finance Committee. The committee adopted my amendment to waive temporarily the late enrollment penalty for military retirees and their spouses who sign up for Medicare Part B and to permit year-round enrollment so that retirees can access the new benefits immediately. Currently, military retirees and their spouses who do not join Medicare Part B when initially eligible can only do so during the annual open enrollment season. This amendment was needed because many retired beneficiaries previously saw no value in enrolling in Medicare Part B because they believed they were promised lifetime health care in military treatment facilities, many of which were subsequently closed due to base realignment and closure. The committee also adopted my amendment to establish an adult day services demonstration project for home health beneficiaries. A bill I introduced earlier this year, S. 1238, would give Medicare beneficiaries the option to receive their Medicare home health services in an adult day setting. This would be a substitution, not an expansion, of services and is designed to be budget neutral. The option of Medicare home health services in an adult day location has a number of important advantages for beneficiaries and their families, including: increased social interaction, therapeutic activities, nutrition, health monitoring, medication management, and enabling family caregivers to continue working, since care would be provided all day. More than 22 million families nationwide, or nearly one in four families, serve as caregivers for aging seniors, providing close to 80 percent of the care to individuals requiring long-term care. Nearly 75 percent of people providing care for aging family members are women who also maintain other responsibilities, such as working outside of the home and raising young children. The average loss of income to these caregivers has been shown to be over $650,000 in wages, pension, and Social Security benefits. The loss of productivity in U.S. businesses ranges from $11 to $29 billion a year. The services offered in adult day care facilities provide continuity of care and an important sense of community for both the senior and the caregiver. This important demonstration project will benefit women of all ages. The bill also includes my amendment to ensure that Medicare Quality Improvement Organizations (QIOs), can assist providers, practitioners, benefit administrators and plans to improve the quality of care under the new Medicare drug benefit system. This will be consistent with the role that QIOs already play in ensuring quality health care. These initiatives, among others, will dramatically improve the Medicare Program. I am also pleased that S. 1 includes a number of provisions that I have cosponsored over several years that will significantly help rural health care providers in Arkansas keep their doors open to Medicare beneficiaries. By correcting a disparity in the way the Medicare physician fee schedule values physician work, practice expenses, and professional liability insurance, Medicare will pay rural physicians more fairly for treating Medicare patients. Also, the bill contains several provisions contained in my bill with Senators Conrad and Thomas, S. 816, to correct the disparities in Medicare payments to rural hospitals. Rural physicians and hospitals in Arkansas will receive millions of dollars of extra Medicare reimbursements under this bill. And now that I have discussed some of the positive aspects of this bill, I would like to focus on some of my concerns regarding other provisions. I am concerned that private, drug-only plans may not provide the stability or predictability that seniors want and need. The insurance companies have told me they don't want to offer a prescription drug- only plan. The administrator of the Centers for Medicare and Medicaid Services has said such a plan ``doesn't exist in nature.'' And, quite frankly, I believe we have proven through the Medicare, Medicaid, and Veteran's program that the Government can do it in a more cost- effective manner. That is why I am glad the bill contains a Medicare guaranteed drug plan--or safety net--called the fallback. However, the fallback is that it is available for seniors for only 1 year at a time. That means if private insurers decide to test whether they want to offer the benefit in a community, seniors lose access to the fallback plan, even if the new plan is significantly more expensive for them or more restrictive. I offered an amendment to S. 1 that would have provided more stability for seniors by giving the fallback a 2-year contract instead of one. This would prevent seniors from having to switch plans from year to year with no end in sight. Although my amendment failed on a narrow margin, I will continue to try to improve the stability of the drug benefit by enacting this small, but important change to the fallback before the benefit starts in 2006. I am also concerned about the fact that drug plans will vary throughout the country, meaning that seniors in Arkansas may have different premiums, cost-sharing, and formularies than seniors in other States. And, even worse, these plans can change their premiums, cost- sharing, and formularies every other year. I voted for many amendments to make the prescription drug benefit less volatile for seniors. For example, to reduce the variance in premiums across the country, I supported an amendment to limit variations in the amount seniors have to pay in premiums to only 10 percent above the national average, no matter where they live. I felt that we should give seniors some assurance that their premiums will not vary or increase unreasonably. Currently, all Medicare beneficiaries pay a $58.70 premium for physician services no matter where they live. Seniors should have this same stability in the drug benefit. I am concerned that under S.1, seniors in rural areas, who are often older and sicker, will pay higher premiums than seniors in urban areas. Unfortunately, this amendment to stabilize the premium was defeated. However, I succeeded in the Senate Finance Committee in passing an amendment with Senator Snowe to encourage the Secretary of Health and Human Services to geographically adjust payments to plans to account for differences in drug utilization across service areas so that premiums wouldn't vary as much. I voted for many other amendments to strengthen the drug benefit in this bill but they failed. I voted to make the drug benefit more attractive to seniors by closing the ``coverage gap'' that exists in S. 1. This gap may penalize sick seniors. Once a senior's total drug spending reaches $4,500 for the year, the benefit shuts down until her total drug expenditures reach at least $5,813, unless the senior qualifies for low-income protections. I voted to allow employer- sponsored retiree health plans contributions to count in this gap. I voted to eliminate the coverage gap altogether. I voted to prevent seniors from paying premiums when they are in the coverage gap. Unfortunately, all these amendments were defeated. I will seek to work with my colleagues to close this coverage gap before the benefit starts. I also voted for amendments to contain the skyrocketing costs of prescription drugs. One measure that I supported, which passed, seeks to increase access to more affordable and equally effective generic drugs. I also voted for an amendment, which failed, to help consumers better compare the cost-effectiveness of prescription drugs. Finally, I voted for a successful amendment to allow wholesalers and pharmacists to import prescription drugs from Canada, which will provide substantial savings to consumers while ensuring their safety. Another concern I have about S. 1 is its $6 billion experiment that starts in 2009 to test whether private insurance plans are more efficient and less costly than Medicare. To me and many others, the evidence we have already speaks to the fact that Medicare is more efficient. The Congressional Budget Office, the General Accounting Office, and outside experts all agree that private, preferred provider organizations and managed care plans cannot achieve the efficiencies Medicare can due to their need to make profits. Given these findings, I wonder how much of the ``savings'' this demonstration project seeks to achieve will come from privatization and how much will come from shifting more costs to seniors and health care providers? More importantly, I wonder why we couldn't have used the $6 billion to reduce drug costs to seniors by making the benefit better? Medicare provides health care for a special population of Americans-- millions of seniors, individuals with disabilities, and people with kidney failure--those who are uninsurable in the private market. Congress created Medicare in the first place because private insurance plans were failing to provide affordable health care coverage for this high-risk population. I wonder why we must turn back the clock and commit billions of taxpayer dollars to again test whether the private insurance market wants to insure this population. In conclusion, much has been accomplished but more needs to be done. I look forward to the deliberations of the conference committee and urge my colleagues to engage with me and others in the Senate who are eager to get a good bill signed into law. I hope my friends on the conference committee will retain the Senate low-income assistance provisions, for they are far superior to those in the House bill. This low-income assistance is of special importance to our nation's older women. Of the 19.5 million female Medicare beneficiaries over age 65, 12.4 percent or 2.4 million enrollees live on incomes that are below 100 percent of the Federal Poverty Level. Another 3.2 million, 16 percent, live on incomes between 100 percent and 150 percent of poverty. Of senior men, on the other hand, only 7 percent are below poverty and another 11 percent are between 100 percent and 150 percent of poverty. Medicare seniors are disproportionately women and disproportionately poor, and will be far better served by the Senate's low-income provisions. Our parents and grandparents are depending on us, and we must not let them down once again. I hope that partisan politics do not stand in the way of a drug benefit that is available to all seniors under traditional Medicare.

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ACCELERATING THE INCREASE IN THE REFUNDABILITY OF THE CHILD TAX CREDIT--MOTION TO PROCEED2003-07-09

Mrs. LINCOLN

Mrs. LINCOLN. Mr. President, I rise today to speak on behalf of an issue we are getting ready to vote on at 2. This is an issue we have had a lot of debate on. We have certainly discussed the issue in great detail about how important it is to provide the kind of tax relief to all working Americans trying to raise a family. This is an issue, of course, of the refundability of the child tax credit. I do not know what it is going to take for this body and the other body to send a bill to the President, who has already said he would sign this initiative. It is less than 1 percent of the overall tax package that was passed and sent to the President to be signed. The fact is multitudes of Americans are going to get tax relief in the next couple of weeks and 12 million children in this country are going to be left out. These are hard-working American families who are playing by the rules. They do not even qualify for this unless they have a working income and they have children. This is a special opportunity we have. If one individual in the House of Representatives can hold up providing relief to 12 million children, 200,000 military families, not to mention well over 50 percent of the population of my State, there is no reason we should be here to begin with. I encourage my colleagues, let's move to proceed to the bill to provide the refundability of the child credit to all working families and those who are working desperately to provide for their children and our great Nation.

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VETERAN'S MEMORIAL2003-07-09

Mrs. LINCOLN

Mrs. LINCOLN. Mr. President, I rise today on behalf of all Arkansans to recognize the veterans who have served in our Armed Forces. A beautiful memorial in Saline County, AK, has been built, and will be dedicated on July 10, to honor those who have protected and served our country. All service men and women are being honored, including my father, who served in Korea. He taught me at a very early age to have tremendous respect for those who have fought to defend our freedom. Not only will this memorial honor our veterans, it will also remind future generations of the sacrifices that were made for this great country. I also wish to recognize those who brought this day together for our Veterans. Judge Lanny Fite, State Representative Dwight Fite, the Saline County Veteran's Board, Jack McCray, Gary Ballard, and many others have given of themselves to make this memorial possible. I am grateful for their efforts to honor the men and women who serve our Nation in uniform. This memorial is a fitting tribute of which Saline County and our entire State can be proud.

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PRIVILEGES OF THE FLOOR2003-07-09

Mrs. LINCOLN

Mrs. LINCOLN. Mr. President, I ask unanimous consent that the privilege of the floor be granted to Matt Linstroth and Jason Wolf during consideration of the Child Tax Credit legislation.

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PRESCRIPTION DRUG AND MEDICARE IMPROVEMENT ACT OF 2003--Continued2003-06-26

Mrs. LINCOLN

Mrs. LINCOLN. Mr. President, I would like the opportunity to join my colleague from Nevada to speak in support of repealing the caps on outpatient physical therapy, occupational therapy, and speech-language pathology. The current therapy cap discriminates against the most vulnerable of Medicare beneficiaries. While the majority of enrollees will not exceed an annual $1,590 limitation on rehabilitation services, approximately 13 percent of seniors and individuals with disabilities covered by Medicare will be forced to pay for medically necessary services out of pocket. This is a particularly burdensome situation for beneficiaries living in rural communities. Most likely to be harmed are beneficiaries who have experienced a stroke or hip fracture or who have Parkinson's disease or other conditions that require extensive rehabilitation following injury or illness. I urge the Chairman and Ranking Member of the Finance Committee to work with me and my colleague, the Senator from Nevada, on repealing this cap or at least suspending it for 1 or 2 years. My colleague and I have sponsored legislation (S. 569) to permanently repeal this cap. Our bill has been cosponsored by 41 members of the Senate. Again, I appreciate the opportunity to join my colleagues from Nevada today. It is my sincere hope, Mr. President, that we will be able to address the issue of the burdensome $1,590 cap on outpatient therapy services.

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PRESCRIPTION DRUG AND MEDICARE IMPROVEMENT ACT OF 20032003-06-25

Ms. LINCOLN

Ms. LINCOLN. I thank the Senator. Amendment No. 1030

Mrs. LINCOLN

Mrs. LINCOLN. Madam President, I thank my colleague from Wyoming. I am extremely pleased to offer this amendment with him to help our seniors by ensuring that local pharmacists can continue providing their services under the new prescription drug program created under this bill. I compliment him on his leadership--as well as the hard work of his staff--in crafting a very plausible solution to many of our problems. I was proud to have supported another amendment offered by my friend Senator Enzi and Senator Reed of Rhode Island which sought to ensure that PBMs can't force seniors into mail order programs. For those of us, such as the Presiding Officer and others, who represent large tracts of rural areas in our States, it is important to know that all seniors across this great Nation are going to get a fair shake when it comes to a prescription drug package. We want to make sure that the package we design and the law we produce are going to ensure that every senior has the same quality of care, the same quality of product, and the same quality of access through this prescription drug package. Many Arkansas pharmacists, including Gene Boeckmann, owner of Wynne Apothecary, have explained to me the many problems with mail order pharmacy operations. For one, it weakens the personal contact between customer and pharmacist, a vital connection when it comes to one's health and particularly when you live in a rural area where medical professionals may not be there full time. I know many of our communities--the one just mentioned--have medical facilities that are satellites of hospitals from larger communities. Consequently, many of their medical professionals are not full-time residents. Oftentimes the only medical professional they have happens to be the pharmacist, someone they can call on a weekend or late at night if they run into problems. Mail order pharmacies that are owned by PBMs also take money out of local communities. In many small towns across Arkansas, pharmacists such as Mr. Boeckmann are the ones paying the taxes. They support the local community baseball and softball teams. They donate money so the school band can go to competitions. They are serving their communities. They have the right and responsibility to do that and, through this bill, we want them to continue. Our communities need leaders such as Mr. Boeckmann. It is for this reason I am proud to support the Enzi- Reed amendment. As we began drafting the amendment, we attempted to include a provision to prevent conflicts of interest. I hope we will be able to address this issue in conference. Our original amendment would have prohibited a PBM from favoring a mail order contractor it owns. Regrettably, we could not work out language agreeable to everyone, but I do hope we can continue to address the conflict of interest issue in conference. I will be working diligently with others to see that we can. The amendment seeks to build on that effort by ensuring that seniors have access to their community pharmacists. Over the many years of this debate, I have heard from countless seniors who have told me how important their community pharmacist is to their health care. I have told them time and time again, they are preaching to the choir with me. I can look back in my own life to when my grandmother was diagnosed with cancer. She lived with us the last 2 years of her life in the back of the house in the room next to mine. I can remember when she would suffer from discomfort, she didn't want to talk to the doctor. She knew what her ailment was. She wanted to talk to the pharmacist. She would call him. He would say: Mrs. Adne, you need to stop taking your blue pill and keep your yellow pill, but remember it is going to upset your stomach if you don't take it with a glass of milk or a biscuit. She found great relief in the knowledge that the pharmacist could provide her. There was nothing more the doctors could do for her. Yet the pharmacist could provide her that information. I look back on the journey my family had with my own father when we traveled down almost 10 years of a road through the disease of Alzheimer's, recognizing very little could be done by the physicians. Yet the pharmacist was the one we could call in our small community who actually could tell us how we could provide relief, ways we could enhance the quality of life for my father as he lived out those last few years and then those last few days in his own home, in the very woods he grew up in as a little boy. These are the qualities of life we are talking about for our families, for our loved ones in rural areas, to make it possible essentially for them to be able to do that. What we are talking about is really putting common sense into the bill and recognizing how important it is to maintain that contact in rural areas. Seniors like my late grandmother or my father don't need a mail order service with a 1-800 number and a recording. They need their local pharmacist to talk to. This amendment seeks to guarantee seniors convenient access to pharmacists. ``Convenient access'' would be defined as access standards that are at least as favorable as the Department of Defense's TRICARE program, to which Senator Enzi referred. That should be the minimum level of access. The TRICARE program requires that at least 90 percent of beneficiaries in urban areas have access to a network pharmacy within 2 miles, 90 percent of beneficiaries in suburban areas have access to a network pharmacy within 5 miles, and 70 percent of beneficiaries in rural areas have access to a network pharmacy within 15 miles. Second, our amendment seeks to prevent PBMs from tying one contract with a pharmacist to another contract. The practice of committing pharmacists with one contract to another simply ties their hands from being able to provide the kind of service they should be able to provide. As several of my colleagues have mentioned, PBMs play a major role in the negotiating process between pharmacists and drug companies. Some PBMs have the market power to require a pharmacy provider to accept one contract rate as a condition of participating in a totally unrelated program. This ``tying,'' as it is termed, of one contract to another is an abuse of market power, and it should be prohibited in the Medicare Program. Our amendment would prohibit tying. I encourage my colleagues to join us by supporting this important amendment that will make Medicare a better program for our seniors and for our pharmacists. Let's make this easier for the seniors and keep the pharmacists in the business. As I urge my colleagues to support the amendment Senator Enzi and I have offered, I also encourage them to think back to a circumstance, perhaps, in which they found themselves or a story they have heard from one of their rural constituents who can best describe to them in their own words how vital it is to have these important health care providers remain in our communities. I thank my colleague from Wyoming for his great leadership and the hard work of his staff. I am proud to join him in offering the amendment. I do encourage all of our colleagues to support it and to support rural America so that all seniors across the Nation will have a benefit that will be equal in terms of access and for the information they need in order to find quality of life through the prescription drug package we believe they can.

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PRESCRIPTION DRUG AND MEDICARE IMPROVEMENT ACT OF 2003--Continued2003-06-24

Mrs. LINCOLN

Mrs. LINCOLN. Mr. President, I plead with my colleagues to take a very serious look at the amendment before us. I know they are hearing differently from downtown perhaps, but I want them to take a look at a recent CBO study that has indicated to us there is negligible impact in giving parity to the fallback plan. CBO has given us a recent study that indicates there is negligible impact on the private plans in allowing parity with the fallback plans that may be needed in some of our rural areas to ensure that all of our citizens across this great land get the same benefit in a prescription drug package. Fifteen of our States have no Medicare+Choice or private plans currently. We know it is going to be difficult. Let's make sure a fallback plan is there for seniors, that the continuity is there for them. All we want to do is make sure they will have the same 2-year contract cycle that the private plans will have. Again, approximately 80 percent of the people in this country are in fee-for-service plans. Let's make sure those who are in our rural States are going to see the parity in these two plans. Just remember, if the private plans are not there or happen to be there, there will be no fallback plan, so you do not have any problem with that. I thank the Chair.

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PRESCRIPTION DRUG AND MEDICARE IMPROVEMENT ACT OF 20032003-06-24

Mrs. LINCOLN

Mrs. LINCOLN. I am extremely proud to offer this amendment with my colleagues, Senators Conrad and Miller. Our amendment seeks to make the drug benefit more predictable and reliable for seniors by allowing them to remain for 2 years instead of 1 year in what we are calling the fallback plan that is outlined in S. 1. As I mentioned when I began speaking this morning, Medicare is here because over 40 years ago more than a majority of seniors in this Nation were uninsurable. We were finding that private industry was not finding this group of individuals profitable enough to actually be in the marketplace and provide them a plan. So I think it is critical, as we look at what we are trying to do today in reforming Medicare and providing a prescription drug plan, that we look at what history has shown us and that we are careful to make sure the plan we provide is going to meet the needs as well as to be fair for all seniors in this great Nation and across the demographics of our country. Senator Conrad and I raised this issue in the Finance Committee several weeks ago, since our States are primarily rural and have not historically been attractive to the private insurance industry. This amendment we are offering today simply requires the same 2-year contracting cycle for fallback plans as is required for the private drug-only insurance plan. We want to make sure the private plans that can come in for a 2-year contract for our seniors who are out in rural areas, who are disproportionately low income, who are less attractive in many ways for these private entities to serve, will have the same opportunity and the same stability other regions of the Nation will have because those fallback plans will be there for the same amount of time as the private insurance industry. In the underlying bill, Senators Grassley and Baucus took a number of steps to encourage private drug-only insurance plans to contract with Medicare and deliver the drug benefit. They created a special transition risk corridor in the first 2 years to encourage these plans to participate, and they gave the administrator of CMS additional tools to get the plans in there. If the administrator determines that at least two plans cannot stomach accepting the minimum requirements for accepting risks described in the bill, then the administrator can reduce the amount of risk plans needed to assume. Alternatively, the administrator can increase the reinsurance percentage or the subsidies to encourage drug-only insurance plans to participate. By doing all of these things, this bill acknowledges these plans currently do not exist in nature, as has been the statement of our current CMS administrator, and they must be enticed to come in and do the job. In other words, we have basically bent over backwards in this bill to bring private plans into this arena of Medicare prescription drugs, particularly in areas where they traditionally have not come. However, there is still no guarantee they will. That is why I am glad Senator Grassley and Senator Baucus created a Medicare-guaranteed drug plan, or safety net, called the fallback. If the administrator exhausts all his options and still no two plans want to come in and deliver drugs to our elderly, then a Medicare-guaranteed plan or a fallback plan will deliver that drug benefit. The only problem I have with the fallback is it is available for seniors for only 1 year at a time. This means if private insurers decide to test whether they want to offer the benefit in a community, seniors lose access to the fallback plan even if the new plan is significantly more expensive for them and/or more restrictive. What does this mean in real life? Imagine this scenario in this chart. We have it on a chart so it certainly makes a lot of sense. There is an 85-year-old senior in rural Arkansas who enrolls in a fallback plan, fallback No. 1, in 2006 because there is only one private drug-only plan that is available in that area. Then in 2007, another private drug-only plan B enters the region so she must leave the fallback and enroll in one of them even if the new plans are not better for her. She chooses private plan A. She suddenly has a different premium, a different cost sharing, a different formulary, and a different set of preferred network pharmacists. She must figure out if her drugs are going to be covered or not and where they must go to get them. Then the next year, in 2008, private plan A leaves so she must again leave her plan. She enrolls then in plan B and gets used to the new premium, the new formulary. But then plan B departs in 2009. With no plans in the area, she enrolls in a new fallback plan with a whole new premium, a whole new formulary and pharmacy network, and it could go on and on. I don't usually use charts, but I feel very comfortable with this chart because we have seen this happen before. We have seen it in rural areas where Medicare+Choice has come in, they have enticed our seniors, and then they have left very quickly, leaving seniors without any kind of coverage, having to go back to the traditional Medicare product. We know it can exist because we have seen it before. What we want to do is to simply give seniors, particularly in rural areas, more stability in what we are proposing in this Medicare prescription drug plan. This is certainly a very real circumstance that could happen as the seniors move in and out--the fact that even in the fallback plans there is no standard design, so even when a fallback plan leaves and comes back 2 years later, it will still be a whole new scenario. Both in the caring for my aging parent and my husband's aging parents, as well as my husband's grandmother who will be 106 this year--which is amazing in itself--providing them with more confusion is not where we want to go. We want to make this as simple as possible. We want to make it as easy a transition as we possibly can. Their management of multiple diseases or chronic problems is heavy enough in terms of the weight on their shoulders and their emotion. Providing them every year with the unfortunate circumstances of having to find a new formulary, find a new premium, a new pharmacist provider is absolutely not what we are trying to do. I plead with my colleagues, I don't want to be in such a horrible position as this. I don't want to force my constituents in it either. It would be confusing to me. All we are asking of our colleagues is to give the fallback plan the same opportunity to succeed as we are giving those private plans, to make sure it will be there in a way that seniors will have some stability. I hope our amendment can be adopted. It simply requires that 2-year contract, putting it in line with the current private sector business practices that happen in the real world. After all, that is what we are trying to do, make sure we provide a plan that is common in the real world. We use the analogies of plans that already exist--the FEHBP plan that we have as Federal employees. We look at what already exists in a traditional Medicare plan now. We want to make sure we provide as much continuity for our seniors as we possibly can. This amendment goes a long way to ensure more consistency and stability for our seniors. This amendment improves seniors' choices by providing them the option not to bounce back and forth between plans with different benefits and premiums. It improves fairness by allowing seniors in both drug-only and fallback plans to remain in those plans for the same 2-year timeframe. It improves the stability of the benefit package by reducing the year-to-year variability in premiums, in cost sharing, in formularies, in local pharmacists. I don't know how many questions other Members get from their seniors, but I get a ton of them. In my State offices, seniors call all the time for help with benefits and concerns about things that are not covered currently under Medicare. If you have not got it already, you can well imagine what the barrage on your staff and your offices is going to be when these seniors find themselves, particularly in rural areas, where they are flip-flopping back and forth from one plan to another every year without an understanding of what that plan actually is going to provide. This amendment also aligns contract cycle with current business practices. The PBMs serving the private sector typically have 3- to 5- year contracts. Requiring the fallback plans to have a 2-year contract better reflects the real-world practices and increases the guarantee they will bid to serve regions where drug-only plans have failed to come. It also continues to allow seniors to enroll in drug-only plans even if a fallback plan is available for 2 years. Nothing prevents a senior from enrolling in a private drug-only plan if one is available in the region. That goes back to one of the best arguments for this plan. That is, if the private plans are there and are working, you do not have to worry; the fallback plan is not even going to be there to begin with. It is not even going to exist if there are two competing private drug- only plans in the region. This is completely hypothetical if, in fact, the underlying premise that the private drug-only plans are going to reach out to every region of the country and they will be there offering a good benefit to all of our seniors. The problem is we have history. We know it traditionally has not worked in our rural areas. We want to make sure our seniors get the same consideration other seniors in this great country get. It continues to give drug-only plans first bidding rights. Fallback plans only come to the regions after the CMS administrator has determined that two private drug-only plans will not be available, after he has exhausted all of these tools, of which we have given him many in order to entice these plans in there. It has a very minimal scoring impact. This amendment buys a lot in making the system more stable but costs almost nothing. It is very reasonable in cost, and we pay for it, so there is no problem in terms of what we are talking about doing. I am very proud to have worked on this amendment with my colleague, Senator Conrad, who will speak about the importance of the amendment in making the drug benefit more predictable and reliable for seniors. I am pleased Senator Miller has joined. Many other Senators I have visited are anxious to know about the policy we begin in this drug package for Medicare seniors, that we absolutely enter into what we are doing with the knowledge that legislation we work on here we understand is not a work of art, it is a work in progress; as we move through these processes to improve legislation, that we will take the time to understand small details. If we can supply the fallback the same opportunity, then we can also make sure this bill is going to be good for everybody. We know as we move through the debate on this bill, as we move through the implementation, there will be multiple changes that will occur. It is important, as we take the time as we initially debate this issue, that we recognize all parts of our Nation are not exactly alike, that a one-size-fits-all is not going to fit every region of this Nation. Most importantly, every senior in this great country is just as important as the other. If you are a low-income senior living in a rural part of this Nation and have worked hard your entire life and want to retire in the same area in which you grew up and where you raised your children, you are not going to be slighted in a prescription drug package simply because of where you live or the fact you worked at a lower income job and may not have as much to retire on as other seniors across this Nation. I hope as we move forward in this amendment and in this bill, we will recognize there are places where we can improve it. We will lead the charge, knowing that is what our job is, that is what this great deliberative body is for. It is to make the improvements along the way and to push a bill forward that, in the long term, will provide a better benefit for people across this Nation. But, most importantly, we must recognize our Nation is diverse. That is a huge part of its strength. Those of us who come from rural areas recognize that sometimes our needs are met in different ways. I encourage my colleagues to take a look at this very simple amendment that doesn't cost much but can make up a great deal of ground in this bill in bringing parity for all seniors across this Nation. Mr. President, I yield the floor.

Mrs. LINCOLN. Mr. President, I ask unanimous consent that the reading of the amendment be dispensed with.

Mrs. LINCOLN. Mr. President, at this time I send an amendment to the desk.

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