Ben Nelson

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, I am speaking today on what I think is an extremely important issue that is getting a considerable amount of attention today, and that is the prescription drug benefit as part of the Medicare Program, which is also being considered in conference at this very moment. As the minority leader has said, very often it is possible to read more about what is going on in the conference on Medicare than it is to find out this kind of information here. I might point out, as a matter of personal interest, one of the major reasons Nebraska has a unicameral legislature is that they wanted to do away with the conference committee system. At times, that certainly appeals to me back here. I come to the floor today to discuss this critically important issue that is now being considered in the prescription drug bill, and that is retaining retiree health benefits. If this problem is not addressed-- and from some of the information I am receiving through various sources, it may be under consideration at this moment--but if it is not addressed and solved, my colleagues and I will be forced to choose between the impossible--the haves and the have-nots--those who have coverage as retirees, with benefits being provided by a former employer, and want to keep it, and those who don't have the coverage and need it. It will be a war between seniors. It is an impossible decision that should not have to be made. Our first priority should be first to do no harm. Usually, we are faced with decisions between children and seniors, between this group and that group--a group typically seeking additional help. It is always a double-edged sword, but it is an impossible decision that this Senate and this Congress should not and must not make. I know this issue is also important to the conferees. They have been grappling with trying to make sure that those who have coverage keep it while those who need coverage get it. News reports today suggest they are close to reaching some sort of deal on how to entice employers to continue to provide retiree benefits. I commend them for their work in trying to get that done and addressing that issue. I hope they are successful in being able to accomplish it. Employer-sponsored retiree health benefits are the single greatest source of coverage for retirees, providing drug coverage for one in three Medicare beneficiaries. Retiree coverage is declining, though, and it is declining dramatically. Just 34 percent of all large firms-- 200 or more workers--offered retiree benefits in 2002. That is down from 68 percent of all large firms in 1988. In a little more than 10 years, the number has been cut in half. But there are still those who presently receive the benefits, and we cannot ignore the fact that they do have those benefits. Drug costs continue to constitute 40 to 60 percent of employers' retiree health care costs, and steep price increases are prompting employers to eliminate drug benefits, cap their contributions, or drop retiree coverage altogether. The spiraling costs relating to prescription drugs continue to threaten the continued provision of those benefits. Due to budget constraints, the Senate and House bills use the definition of out-of-pocket costs that would not allow employer contributions to count for meeting the catastrophic cap on beneficiary spending. This means, in understandable terms, that retirees with employer- provided coverage will get less of a benefit than other seniors. In fact, under the Senate bill, retirees would need closer to $10,000 in drug costs before the stop-loss protection would apply, well after the $5,800 cap that applies to all other beneficiaries. And employers that choose to wrap around the Medicare benefit would be subject to a gap in coverage that doesn't end. As a result, the Congressional Budget Office has estimated slightly more than one-third of retirees will lose their employer coverage, making more than 4 million Medicare beneficiaries worse off at a time when we are trying to make them better off. Although Congress may claim this formula will save money for Medicare, any provision that encourages employers to drop their retiree benefits will only end up costing the Federal Government more and hurt millions of seniors in the process. Seniors who have retiree benefits have worked a lifetime and have made wage concessions over the years with the expectation that they would have retiree benefits in exchange. To change the rules of the game at this point and give them less than the other Medicare beneficiaries is, in a word, unfair. Congress must now enact a drug benefit that recognizes employers that are doing the right thing, continuing to provide their retirees these very important benefits, because to do otherwise will further threaten retiree coverage and will drive millions more seniors to Medicare for the coverage they used to get from their employers. This is a choice that might be put before us, but this is not a choice we should make. We should not have to decide between Lee and George and Mary and John. These are not decisions that this Congress should be forced to make. There are solutions. I am encouraged when I hear the conferees are looking at these solutions, but I encourage, in the most dramatic way possible, that they not only continue to work, but they find solutions that are workable, because without that the choice is an impossible one and I think threatens whether or not this body will pass a Medicare plan that provides prescription drugs for retirees. I yield the floor.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, I thank my colleague from Indiana for the opportunity to speak in support of this amendment. I thank my colleagues who are cosponsoring this amendment: Senators Ensign, Collins, Snowe, Lindsey Graham, and the Presiding Officer, Senator Chambliss. It is a pleasure to be working with them in a bipartisan way on what I think is an important point to the American people and an important point as a message to the world. When the President delivered his address announcing the $87 billion he would ask Congress to approve for postwar military operations and construction and reconstruction in Iraq, known as the supplemental, there was clearly a collective gasp from the American people. This was primarily because I do not believe the American public was prepared, before the war, for the cost of reconstruction after the war. Americans clearly want our mission in Iraq to succeed. We cannot fail. And we want our young men and women to come home safely. Now our No. 1 priority must be that we do everything in our power to make sure that happens in a fiscally responsible way for the United States and Iraq. The American role in the liberation of Iraq planted the seeds for democracy. The creation of the Coalition Provisional Authority, led by Ambassador Bremer, and the interim Iraqi Governing Council, have laid the foundation for what I hope will be a lasting Iraqi Republic. Now is the time to seek greater international support for security, perhaps through NATO, as I have previously suggested, and also to seek more international support through the United Nations, to help democracy and freedom in Iraq by the drafting of a constitution, the holding of legitimate elections, and the participation by all Iraqis in the political process. Funds for military operations must not be delayed and should be quickly appropriated so that the 140,000 American troops in theater, and those supporting them, will have the tools they need to do their job. Our soldiers should not be held hostage because of deliberations on controversial portions of this supplemental. The reconstruction funding the President requested may be the appropriate amount to accomplish our goals. However, as we have all indicated, we have concerns with the way the funding is being made to the Iraqis. The President's reconstruction request simply gives money to Iraq as a grant. It asks the American taxpayer to pick up the entire cost for postwar construction with the hope that we will get others to be donors in this process. It asks nothing from the international community at the present time, and certainly it asks nothing of Iraq in return. The United States liberated Iraq, but should reconstruction become the sole responsibility of the American people with the expectation and the hope we might get additional contributions from the donors conference? Furthermore, the question can be, Is that the best for Iraq? I don't think so. The amendment we offer today will ask that the international community do more to aid Iraq in their reconstruction, while simultaneously easing the financial burden that Iraq now carries because of the policies of a brutal tyrant. In contrast to the administration's proposed total direct grant, which does not ask Iraq to contribute financially to its own recovery, this amendment is both generous and fair. As my colleague from Indiana has indicated, the amendment first provides for a grant covering $5 billion for building Iraq's security services. That is a grant. And it provides $5.2 billion in emergency economic assistance. That is a grant. It also asks the administration to notify all relevant congressional committees of every $250 million obligated out of the $5.2 billion so that there is some transparency and accountability on how these dollars are going to be spent. Most importantly, our proposal asks America to negotiate with the world on behalf of Iraq. Iraq, unfortunately, due to the tyrannical powers and programs of Saddam Hussein, owes money in reparations to Kuwait and Saudi Arabia. It also has debts to France and Russia primarily for military purposes. France and Russia are owed $6 billion and $6.9 billion, respectively. Saudi Arabia is owed approximately $25 billion. This is debt that was incurred by Iraq as a result of the tyrannical forces, powers, and programs of Saddam Hussein. Our colleague from Oklahoma has proposed a sense-of-the-Senate resolution which will be voted on later this evening, as will this amendment. He has asked that we request the countries that own the debt to forgive the debt. I think that is a start that is halfway to the conclusion that this amendment brings us. But it is only halfway. It is asking rather than providing leverage where I think we will absolutely have the opportunity to seek the forgiveness of this debt. So that if France, Russia, and others can forgive Iraq's debt, the international community would consider this as a positive step toward independence. This immense gesture would enable the Iraqi economic engine to become energized, free of a burden most Iraqis never wanted in the first place. It is estimated as well that Iraq's proven oil reserves are worth $2.8 trillion and its potential oil reserves might be worth $5.5 trillion. Freeing the Iraqis of their prewar debt would help them use their oil resources immediately to provide for their people and their reconstruction. Our amendment is the only amendment offered that directly addresses the issue of Iraqi debt. Our amendment provides an incentive to those nations to forgive Iraq of its Saddam-era debt. It is my hope the administration and the Iraqi Governing Council will be able to satisfactorily and successfully negotiate with the international community to eliminate 90 percent of the prewar bilateral Iraqi debt. If those negotiations are indeed successful, this amendment would provide that the remaining $10 billion in reconstruction funding to the Iraqi people would be in the form of a grant. It will be convertible from a loan to a grant in exchange for the forgiveness of 90 percent of the prewar bilateral Iraqi debt. If the negotiations are unsuccessful, which we hope they would not be, then the $10 billion will be appropriated as a long-term loan to the Iraqi Governing Council and all prewar debts will be subordinated to the U.S. postwar debt of $10 billion. This would allow the Iraqi people to get the same jump-start on rebuilding their country while delaying their payments to us and the world until this Iraqi nation has established an economy and can meet its responsibilities to the world community. The loan would be secured by revenues from Iraqi oil exports in the future. There are some who will charge that making reconstruction funds available as a loan is evidence that the United States is after Iraq's oil. In my estimation, they will hold that contention regardless of what we do or don't do in regard to funding reconstruction. In fact, the use of the funds to rebuild within Iraq is evidence to the contrary. But even if we can't prove to the rest of the world that we are not after the oil, we must pursue a loan approach as we are proposing. I can understand that the administration does not want to add to the debt of the Iraqi people. This isn't, as long as the prewar Saddam Hussein indebtedness is forgiven. We owe it to our taxpayers to be just as concerned about growing our budget deficit as we are about Iraq's deficit. I hope my colleagues will join in support of this generous and fair amendment, recognizing that those who said an entity doesn't exist, that that argument just doesn't wash. If it exists for a grant, it exists for a loan. There are those who have said we are loading it up with debt. It is just the opposite. They have even cited post-World War I Germany with the debt that was added there. The intent here is to clear the debt, to clear it up so we put Iraq on a firm financial footing as it moves forward. All we ask is the help of the other nations. This provides leverage to go to the donors conference and say: We are prepared to make a grant. We just want to make sure the debt that is existing prior to the war, the Saddam-era debt, is forgiven. I appreciate the opportunity. It is a pleasure to work with my colleagues. I thank my colleague from Indiana.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, I honor one of Nebraska's finest who recently gave his life in the line of duty. His service and sacrifice are an inspiration to us all and a reminder of the appreciation we have for our law enforcement officers and first responders. Officer Jason Pratt began his career with the Omaha Police Department in 1996 at the age of 23. He served honorably for 7 years and 2 days before being tragically killed in the line of duty on September 11, 2003. During his years on the force, his commitment and energy were recognized several times by his fellow officers, community members and superiors. In February of 1997, Officer Pratt began work as a patrol officer. By April of that year--less than a year on the job--members of the Leavenworth Neighborhood Association were already noticing Jason for the work he and his crew did in the area. Jason's dedication to service did not wane and in May of 2001, he was recognized by the Neighborhood Association again for his efforts. Jason followed that service with a year in the vice squad, a division of the intelligence unit. During this time, he kept family areas, such as neighborhood parks, safer for our families. Finally, he also spent time in the emergency response unit, placing himself in extreme danger on numerous occasions by taking high-risk offenders off the street. Officer Pratt will be well remembered for being an officer who always came as back up to help out other officers. In September of 2001, he assisted bike officers with a traffic stop that ultimately led to the suspect being booked on a number of felony charges. In another instance, in April of 2003, he was responding to a house fire where an adult and two children were trapped. Poor weather conditions delayed a second fire unit so Officer Pratt assisted firefighters in carrying gear up to the house. Because of his actions, there were no further injuries that day. Officer Pratt lost his life while trying to make our city safer. His sacrifices, and those of his family, are another reminder of the risks taken by police officers across the Nation to keep our cities and towns safe. Americans honor their commitment and we stand shoulder to shoulder with them when one is struck down. I am proud to have witnessed the outpouring of support for his family given by the people of Omaha. His two children, Madison and Jordyn, and his wife Stacy, have lost their father and husband and he can never be replaced. But the people of Omaha have shown again and again that they will do whatever necessary to help the Pratt family in the weeks, months and years to come. Officer Pratt will not be forgotten and all of Omaha will work to ensure his family is safe. Jason Pratt died doing what he always wanted to do. He died protecting his and our community through public service alongside his friends and fellow officers. In his memory, those officers will continue to serve every day knowing that if he were still alive; he would be standing at their side. I join with my fellow Nebraskans in thanking Officer Pratt and his family for all they have given to us and pledging to remember his work and his life and the difference he made in our community.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, today I would like to recognize the upcoming birthday of two native Nebraskans--both fine educators, loving mothers, and devoted wives. Veronica and Elizabeth Marron were born Oct. 14, 1933, to parents Harry and Pearl Marron, in Waterbury, NE. They were the last children of five, including Joe, Leonard and Gene. Fraternal twins, the girls were called Bonnie and Betty from childhood. The twins graduated from Newcastle High in 1951, with Betty earning valedictorian and Bonnie salutatorian and Girls' State honors. Although just 17-years-old, both quickly earned teaching certificates and started work in Dixon County's country schools. That was just the beginning of two lifetimes dedicated to education and twin, true passions for teaching. Both women taught for more than 30 years, with Bonnie ending her career at the O'Neill Public Schools and Betty at Falls City Elementary School. Bonnie married Jim Lowe of Ponca and had four children, Peggy, Paula, Ann and Patrick. Betty married Phil Slagle of Falls City and also had four children, Scott, Todd, Jeff and Jay. On October 14, 2003, Bonnie and Betty will celebrate 70 years of living ``the good life'' in Nebraska. I join their family and friends in wishing them a very happy birthday, and many more.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, I would like to express my concern with a proposed rule by the Centers for Medicare and Medicaid Services, CMS, that would threaten the ability of rehabilitation hospitals to continue to provide critical care. In my home State of Nebraska, Madonna Rehabilitation Hospital in Lincoln is a nationally recognized premier rehabilitation facility that offers specialized programs and services for those who have suffered brain injuries, strokes, spinal cord injuries, and other rehabilitating injuries. If this proposed rule goes into effect, Madonna would not be able to offer the same critical care to its patients as it currently does. When CMS first looked at whether facilities would qualify as an IRF, a list of criteria was created to determine eligibility. They current criteria, generally referred to as the 75 percent rule, were established in 1984 and have not been updated since then. To qualify as an IRF under the 75 percent rule, 75 percent of a facility's patients must be receiving treatment for one of 10 specified conditions. Because the rule has not been updated in almost 20 years, newer rehabilitation specialties are not reflected and, therefore, are not counted in determining facility compliance with the 75 percent rule. Since the 75 percent rule was implemented, IRFs have argued that the list of conditions should be expanded to reflect advances in modern rehabilitation medicine. The need for new rehabilitation specialties to treat cardiac, pulmonary, cancer, and other conditions was not even foreseeable when the 75 percent rule was implemented. Yet CMS has repeatedly refused to update the rule--even after implementing a payment system that specifically recognizes many more conditions than the 10 listed in the 75 percent rule. On September 9, 2003, CMS published proposed modifications to the outdated 75 percent rule. I commend CMS for recognizing the need to update the regulation. Unfortunately, I believe that the proposed changes do not go far enough and may have serious consequences for Medicare beneficiaries and other patients who need inpatient rehabilitative care. On its face, it appears that CMS expanded the rule by increasing the number of conditions from 10 to 12 and by lowering the percentage threshold from 75 percent to 65 percent. However, this ``expansion'' is illusory. The proposed rule will, by CMS's own estimate, reduce Medicare payments to IRFs by $223 million annually and shift hundreds of thousands of patients--both Medicare and non-Medicare--into alternative care settings that may be inappropriate. It is worth noting that Congress gave CMS a directive to implement the rehabilitation prospective payment system in a budget-neutral manner. Yet this rule--without any congressional directive--seriously cuts rehabilitation hospital funding. Although CMS expanded the number of conditions from 10 to 12, it did so by replacing one of the existing conditions--polyarthritis--with three new conditions that collectively are much more narrow than the original condition. CMS acknowledges that the industry historically has understood hip and knee replacement cases to fall within the definition of ``polyarthritis.'' Unfortunately, CMS now proposes to count joint replacement cases only if the patient has made no improvement after an ``aggressive and sustained course of outpatient therapy.'' This means that, instead of being directly transferred from an acute care hospital to an IRF, the patient will be forced into a skilled nursing facility, SNF, and/or outpatient therapy before being eligible for inpatient rehabilitation. IRFs would become a setting of last resort, and patients who might have returned to function after a brief IRF stay will be forced to endure weeks if not months, of therapy in other settings that may be inappropriate before being admitted to an IRF. CMS also proposes to lower the threshold from 75 percent to 65 percent for a three-year period to give facilities time to come into compliance with the new criteria. Although this change is an improvement, it simply does not go far enough to prevent a significant negative impact on rehabilitation patients and providers. RAND data indicate that only about 25 percent of IRFs, at most, could meet a 65-percent threshold under the current list of 10 conditions. Since the proposed rule actually narrows the agency's interpretation of arthritis-related conditions, the percentage of facilities that could comply with the revised list of conditions is probably lower. This means that, even under a 65 percent standard, at least 75 percent of facilities will be deemed out of compliance if CMS finalizes the proposed rule. The proposed rule glosses over the negative impact that this dramatic shift will have on patients by assuming that all sites of care are equally effective and equally available. But I am very concerned about the impact that the proposed rule would have on patients living in rural areas, where alternative sites of rehabilitative care may be unavailable or highly inconvenient. Where SNF beds are scarce and few home health providers offer physical therapy services, these patients could be forced to travel long distances for daily outpatient care in a weakened state, risking reinjury and rehospitalization. Because compliance with the proposed rule will hinge on an IRF's total patient population, not just its Medicare population, CMS estimates that the proposed rule ``may have an effect'' on approximately 200,000 non-Medicare patients. CMS was not able to quantify or describe this effect because of inadequate information. In my opinion, it would be irresponsible to implement this rule without further studying its likely impact on Medicare beneficiaries, non- Medicare patients, rehabilitation providers, and the Medicare Program. The Medicare Payment Advisory Commission, MedPAC, agrees that the rule needs to be updated. In a July 7, 2003, letter to CMS Administration Tom Scully, MedPAC Chair Glenn Hackburth proposed that CMS lower the threshold to 50 percent for at least a year to enable an expert panel of clinicians to reach a consensus on the diagnoses to be included in the 75 percent rule. I agree with MedPAC and worked with Senator Jim Jeffords to file an amendment to the Labor, Health and Human Services and Education Appropriations bill that would have implemented MedPAC's recommendations. I decided against offering my amendment for a vote, but I leave open the possibility of offering the amendment on another vehicle if CMS does not take appropriate action. I hope that the 75 percent rule can be updated to ensure that my constituents and all Americans continue to have access to necessary medical rehabilitation services.

Mr. NELSON

Mr. NELSON. Mr. President, I begin by thanking my colleagues, Senators Akaka and Allen, for their efforts toward ensuring that young people in this country are able to access valuable mentoring services. As Governor, I helped the mentoring program TeamMates of Nebraska-- which was started by former Nebraska football coach, now Congressman, Tom Osborne--expand statewide. From your personal experience, I know that, like any youth-development strategy, mentoring works best when measures are taken to ensure quality and effectiveness. Programs must carefully recruit, screen, and train prospective volunteers, and then support them throughout the duration of the mentoring relationship. Inadequate funding directly impacts a mentoring organization's ability to operate a high-quality program. I strongly believe that we should recede to the House numbers on mentoring, which would provide $75 million to help match young people across the country with mentors. I'd like to share a quote from a Nebraska mentee, Ean Garrett. Ean is a participant in the ProPal Plus Mentoring Program in Omaha, Nebraska, and these are his own words: Mentoring shows us that we don't have to live day by day, that we live in a world full of opportunities. It teaches us that with imagination and a lot of hard work, we can go as far as we want. Mentoring helps us see that graduating from high school is not an option; it is a requirement. And mentoring helps us develop our skills so that we are successful well-rounded people who are major contributors to our community, our society, our country, the human race, and the world. Thanks to ProPal Plus and my mentor, the American dream is mine. The chairman and ranking member have faced a lot of tough choices in crafting this bill, and I am pleased they were able to find an increase for mentoring. I do think Ean's words help us all understand why we must find more. I will end there and yield time to the distinguished chairman and ranking member.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, it has become clear that welfare programs created in the 1960s to be safety nets became spider webs by the 1990s. The old welfare system provided monetary assistance but did not do enough to provide job training, education, and other paths towards self-sufficiency. The welfare reforms of 1996 changed the old system and gave States more freedom to attempt new and innovative approaches to move people from welfare to work. This legislation expired last year, and Congress must look to enhance the successes of the 1996 law. I am pleased today to join Senator Carper in cosponsoring the Building on Welfare Reform Act--a bill that will continue to help people move from welfare to work. During my time as Governor, Nebraska began programs like Employment First and Families First that provided much-needed assistance to low- income families and helped them find a way to leave the cycle of welfare dependency. The average time a family spent on assistance fell nearly two-thirds and Nebraska taxpayers saved $14 million. The best path to self-sufficiency is work. This bill increases the percentage of welfare recipients who must work from 50 to 70 over the next 5 years. The bill also requires a 32-hour workweek from able welfare recipients. States will receive credit for moving people from welfare to work, not just off welfare. This will encourage States to solve problems that present an obstacle to meaningful work and lasting independence from public assistance programs. Since 1996, welfare reform has been successful, not just because it requires work but also because it provides the resources to families to meet the work requirements. Our welfare reform proposal provides funding for childcare, transitional jobs, and public-private educational partnerships that will allow welfare recipients to gain the skills they need to advance in the workplace and become independent. Because a strong family is essential to breaking the cycle of poverty, our welfare reform proposal encourages families to stay together and provides assistance to families who do. Another provision provides additional funds to prevent teen pregnancy with a bonus to States that meet this goal. Given flexibility and resources, States have worked their own magic since the welfare program was revamped, and I will continue to support this approach as we embark on the next generation of welfare reform.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, today it is my great honor to recognize three outstanding Nebraska students who recently were named Gates Millennium Scholars by the Bill and Melinda Gates Scholarship Foundation. David Sanchez-Aparicio, from Oaxaca, Mexico, is the son of Benito and Juana Sanchez. Since he was a child, David's scholastic interest has been in computer technology. While a student at Lincoln High School in Lincoln, NE, David took part in the Information Technology Focus Program, specializing in computer programming, networking, and multimedia production. David played tennis and ran track, focusing on the 800-meter race. David also spent his time working at BryanLGH Medical Center in the cafeteria. In addition to rigorous coursework and extracurricular activities, David, whose mother passed away 2 years ago, has spent much of his high school career helping his father care for his younger siblings. David's teachers note that he is a quiet, yet diligent student who is dedicated to his studies and his family. David will attend the University of Nebraska-Lincoln in the fall where he plans to major in computer engineering. Codah Gatewood, 18, is the youngest of three children and a member of the Navaho, Omaha, and Santee Sioux tribes. His parents are Edison Gatewood and Belva Gatewood. Since he was a young boy, Codah's primary academic interest has been architecture. As a child, he would create intricate buildings with Legos; at Lincoln High School, he learned to use computer-aided-design, CAD, in technical design and architecture classes before tackling advanced architecture and engineering. Codah won an academic letter during his senior year of study for his mastery in pre-calculus, differentiated physics, advanced architecture, and applied economics. In his free time, Codah volunteers at the Indian Center of Lincoln, assisting in powwows and dinners. He also likes to experiment with mobile electronics on his car, frequently updating his own website with his success in modifications. Codah's teachers describe him as a self-reliant and high-ranking scholar. For his commitment to academic excellence, Codah has also earned a University of Nebraska Davis Scholarship, awarded to the most academically talented racial minority students. He will attend the university this fall. Huong Le, 18, came to Lincoln from Long An, Vietnam, 11 years ago with her parents, Vinh Le and Luong Nguyen, and sisters and brother. Long An is a small province in the Mekong Delta of South Vietnam. Huong spoke very little English when she arrived in Lincoln, but began to master the language while a student at Everett Elementary School. Huong was nominated for the Gates scholarship by her Lincoln High School chemistry teacher, who taught her a rigorous advanced chemistry course and saw promise in her passion for science. The following summer, Huong participated in a sophisticated research project, coordinated by the University of Nebraska, involving organic and biochemical processes of insects. While at Lincoln High School, she also played tennis for 4 years and was a member of the Asian Caucus, Upward Bound, and Youth Leadership Lincoln. Huong has also volunteered at the Lincoln Buddhist Temple, Lincoln Action Program and United Way. Huong plans to take English composition and calculus classes as part of the Summer of Promising Scholars Program. Huong will pursue a degree in pharmacy from the University of Nebraska. The Gates Millennium Scholarships aim to reduce the financial barriers for African-American, Hispanic, Native and Asian-Pacific students with high academic and leadership promise. They also increase representation of minority students in the targeted disciplines. The Gates Foundation will pay for the students to attend any college with any undergraduate major, and for a graduate education in mathematics, science, engineering, education, or library science. I am proud to represent these promising young students who are dedicated to excellence in the classroom and in the community. I am confident that these talented leaders will excel at the University of Nebraska and beyond. The city of Lincoln and the State of Nebraska are fortunate to have these three students as part of their community.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, Tom Allan wasn't born in Nebraska, but that didn't stop him from falling in love with my State or from making the entire State feel like part of his family. Tom traveled the highways and byways for over 40 years, seeing the beauty of Nebraska, making friends, and sharing his experiences through his often humorous and always insightful news articles. When he passed away recently there were Nebraskans in every city, town, and village that mourned him and fondly remembered their favorite Tom Allan stories. Tom Allan was born in Scotland and moved to Nebraska when he was only 9 years old. After graduating from high school and Ottawa College he served his Nation honorably in World War II with tours in the Philippines and Alaska. He retired as a major in the Nebraska National Guard. He began working for the Omaha World Herald in 1947 and became the paper's roving reporter in 1959. He traveled more than a million miles and wore out 20 cars while filing stories from every community in the State. He covered the occasional big news story, but Tom Allan specialized in simple stories that touched the heart. For readers in Omaha, Tom brought to life the unique people and small towns that can't be found on a map. Tom Allan outran tornados, trekked through the Amazon jungle, and even stood in for a U.S. Ambassador in Finland. He covered the State fair with such regularity that he was honored with ``Tom Allan Day'' at the Nebraska State Fair in 1997. His humor and humility were clear when he wrote, ``I'd rather they'd just given me a fat-hog blue ribbon and let it go at that.'' In that same column Tom described his job as the privilege of discovering what is over the next hill and who is around the next bend in the road along the byways of Nebraska. On behalf of all Nebraskans, I would like to thank Tom Allan for the privilege of his company and for the wonderful stories he shared with all Nebraskans for over 50 years. We will always remember his love for the State of Nebraska, and we are grateful that through his stories he taught us about Nebraska and helped us understand ourselves. Tom Allan passed away on June 27, 2003.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, the purpose of insurance is to help stabilize the market and spread costs and risk over an entire group of people. This amendment will help achieve that goal. It will reduce significantly the unpredictability of the premium and the unpredictability of the disparity of State premiums. It will bring certainty to the process. People will know that their rate cannot be greater than 10 percent of the national average. If we are going to manage care, we need to manage competition as well. This is one way of being able to do it. Just such as in Medicare, the insurance companies here, providing the new drugs, would decide what premiums to charge seniors based on experience within the State. What we would say is they have to take into account the national statistics and data in determining the rates. I think it will even it out, and the disparity between State 1 and State 2 will be significantly lower. Unpredictability will be reduced and the certainty that will be established will be beneficial to the people. It will give seniors peace of mind, as well, with the ability to pay and know what the future will bring. Stability and predictability is important in this particular program. We hope our colleagues will take a look at this and understand that the difference in the rate in New York should not be significantly different than the rate in Florida or Nebraska or wherever we may reside. I think we all have an interest in making sure this program works, that it is sustainable, and, therefore, I ask colleagues to be supportive of this amendment. I think it is in the best interests of the insuring public, and, in this particular case, our seniors.

Mr. NELSON of Nebraska. Mr. President, I appreciate the opportunity today to speak regarding the Daschle amendment. First, I want to commend my colleagues from Iowa and New Mexico, Senator Grassley and Senator Baucus, for doing truly an outstanding job with putting together a package of legislation to deal with the challenges we have all met and continue to sort out relating to prescription drug coverage for seniors. I commend them for an outstanding effort. In the midst of that commendation, I think--and others would admit-- that the pending legislation can be improved. I have yet to see a piece of legislation that could not have some amendment that at least some people would think would be an improvement. In this particular situation, I think the area that we could improve is in making sure the rate differentials among the States is not extraordinary. Therefore, the Daschle amendment sets a 10 percent variation of the national average, so that a State would not have a rate that would be 10 percent above what that national average is. What this provides is protection that the rate differential between States such as New York and Nebraska are not going to vary more than 10 percent. We all recognize if insurance is a focus to provide protection and stabilize across a broad base of individuals, to spread the costs and risks over that entire group of individuals, you will then have a rate that would be based on that spreading of the risk. This particular situation seeks to do that, but the spread of the risk seems to be more directed on a statewide basis, therefore giving the opportunity for a wide variation of rates between two States on a nationwide basis. I think this amendment will correct that and will assure that people living in whatever State they may reside are not going to be paying a substantially higher rate than other individuals. The proposed prescription drug plan promises an average premium of about $35 a month. But we cannot be sure that is a guarantee because just in the case of Medicare, managed care, Medicare+Choice, there is no set premium under the new prescription drug proposal. So all premiums will vary nationwide. Experience suggests that premiums could significantly--as they do with premiums for Medicare HMO plans--vary from $99 a month in Connecticut to $16 a month in Florida. Floridians might enjoy that, but residents of Connecticut might ask a question as to why we cannot have a balanced rate nationwide with variations of a much smaller amount. Spreading the risk is what insurance is all about. I think spreading the risk in this case involves spreading the costs as well. I think I speak for many of my colleagues when I say we want to have a prescription drug benefit that is well balanced, meets the needs of those who are the neediest and the sickest, but provides a fair amount of coverage for all American seniors who qualify. It is my duty to make sure that what we provide, whether for Nebraskans or Floridians, is truly a spread of the risk and cost. We need to ensure that the premiums are priced both fairly and equitably and that geographic concerns don't price seniors out of the market for coverage in any location. That is what I think we must find as the focus as we move forward. So, again, I commend my colleagues for putting together an outstanding package of benefits given the very difficult task of making the ends meet with $400 billion, but with needs that could exceed that several times over, putting together a package that I think truly represents what will take care of the prescription drug needs of our seniors. At the same time, we want to make sure the protection is also there against a wide disparity of rates from State to State. So I speak today on behalf of the Daschle amendment. I hope the people within this body will look at that and think about that in terms of their own States--not as to whether their State will get a better deal than others but where we all have an opportunity for an excellent deal and that the variations will be minimal at best. I thank the Chair and I yield the floor.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, today I would like to offer my best wishes and support for the beginning of a new organization--Mosaic. On July 1, 2003, Bethphage, founded in Axtell, NE, in 1914, and Martin Luther Home Society, founded in Sterling, NE, in 1925 will come together to form Mosaic. These two organizations bring decades' worth of experience to the field of developmental disabilities, and I applaud their previous efforts while looking forward to a successful partnership. I have enjoyed a great working relationship with Sharon Walters and Bethphage and appreciate the positive things they have brought to the State of Nebraska. Mosaic will be supporting and advocating for more than 3,700 people in 16 States with an annual budget of approximately $165 million. They also provide support in Great Britain, as well as participating in an international alliance called IMPACT. Congratulations, Mosaic.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, I rise today to offer my congratulations to a Nebraska native son. This gentleman is among the many who honor our Nation through their service in our Armed Forces and I am very pleased to have this opportunity to pay tribute to him. As our Nation faces threats abroad and our military men and women fight to keep us safe, it is important for us to never forget the sacrifices made in our defense. These men and women give up a great deal to protect our Nation and we owe them a debt of gratitude that can never be fully repaid. Today, it is my honor to offer my heartfelt congratulations to one of their number, CAPT Gabriel Griess, a hometown Nebraska hero. Captain Griess is a proud member of the U.S. Air Force and he has recently been named the 15th Air Force Company Grade Officer of the Year for 2002. This was no easy accomplishment as the criteria for the award ensures that only the best of the best are eligible for consideration. To meet those criteria, Captain Griess had to show clear drive, pursuit of self-improvement, and involvement in base and community activities. Captain Griess met and exceeded all expectations. He was awarded this title based on his dedication, leadership, and professionalism. Captain Griess' military history speaks volumes about the confidence placed in him by his superiors. He was deployed twice in 2002 in support of Operation Enduring Freedom; given missions such as tracking down al-Qaida leaders, and evacuating critically injured troops from combat zones. He provided support during Operation Anaconda by flying in critical supplies, destroying al-Qaida strongholds, and providing air support for ground troops. He has earned three Air Medals and two Aerial Achievement Medals for his valiant work. But perhaps more importantly, he has won the respect of his peers. As an instructor navigator with the 317th Airlift Group at Dyess Air Force Base in Texas, he is recognized as the ``go to'' guy, an officer who will work as part of the team to meet the challenges ahead. As our military efforts continue in Iraq, Afghanistan, and other regions around the world, we rely on the men and women in uniform to make our Nation safe. With soldiers, sailors, airmen, and marines of the caliber of Captain Griess, I can say with complete confidence our Nation is secure. I congratulate Captain Griess on this recognition he has so deservedly received. It is truly an honor for him and his family.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, thank you for the opportunity to appear here with my colleague from Utah to say how much I appreciate the opportunity to cosponsor with him and others this very important legislation. I should also say that when I went to the ranking member, Senator Leahy, a year or so ago and talked about how difficult an issue this was and how difficult it was becoming, he was gracious and granted a hearing, and he has worked very diligently to make certain this issue gets the kind of exposure it should. He has also worked toward finding solutions to it. Senator Dodd has also worked tirelessly on this issue, and they both remain very interested in finding a solution. My colleague from Utah has outlined very clearly much of the statistical support for this kind of legislation. Historically, in the early 1970s, lawsuits against the asbestos manufacturers opened the door for victims suffering from asbestos-related diseases to be justly compensated for their issues, and they were. When Johns-Manville--the largest asbestos manufacturer--filed for bankruptcy in 1982, there were fewer than 20,000 asbestos cases, most on behalf of individuals with severe asbestosis or mesothelioma--a vicious asbestos-related cancer. The system worked. Sick people and their families were given the financial security they deserved. But then the system stopped working. A flood of cases overwhelmed it--some from individuals who were not yet sick but could potentially get sick in the future. We don't want to prevent these individuals from recovering down the road, but we also need to work toward allowing those who are sick now to recover now. With the current docket load, that just isn't happening. Over 90,000 new asbestos lawsuits were filed in 2001 alone, representing an increase of 30,000 from the previous year. However, the American Academy of Actuaries estimates that there are only about 2,000 new mesothelioma cases filed each year, another 2,000 to 3,000 cancer cases that are likely attributable to asbestos, and a smaller number of serious asbestosis cases. As a result, we need to work toward finding a way to address the lawsuits of seriously ill individuals immediately without eliminating the ability for those who may become sick in the future to have their case addressed at the appropriate time. The unfortunate result of these tens of thousands of lawsuits is that people who are seriously sick and dying from asbestos must wait longer to recover less money than they deserve--if they can recover anything at all. After transaction costs and fees for both plaintiff and defense lawyers, only about one-third of the money spent on asbestos litigation will actually reach the claimants. Moreover, as insurance is depleted and an increasing number of these defendants declare bankruptcy, it is inevitable that many asbestos victims who develop cancer in the future will go uncompensated, unless we take the action this bill will provide. The economic fallout from this situation, though, extends beyond sick victims. Because every company that manufactured asbestos is now bankrupt, plaintiffs have been forced to seek alternative defendants to take their place. According to the Rand Institute for Civil Justice, 300 firms were listed as defendants in asbestos cases in 1983. But by 2002, Rand estimates that more than 6,000 independent entities have been named as asbestos liability defendants. More recently, another Rand Institute study has estimated that there is about $200 billion in pending asbestos claims. Many of these new defendants are small businesses located in every community across the country, with little or no actual connection to asbestos. I have heard from scores of small businesses in my State--local hardware stores, plumbing contractors, auto parts dealers, lumber yards--and none of these businesses manufactured it. Many did not sell it or install it. But these businesses and the jobs they represent are at stake. They are now afraid that as primary asbestos defendants declare bankruptcy, they will be next in line for the thousands of cases being filed and their businesses will not, therefore, survive. As the Wall Street Journal reported recently: Lawsuits are now piling up against consultants, engineering firms, plant owners, and maintenance and construction contractors, all of whom are being blamed for workers' exposure to asbestos. Also, part of this litigation is now being targeted at insurance providers. As the same story states: Many of the smaller [companies] lack resources to defend thousands of lawsuits or pay huge verdicts. But the companies do have one thing in common: plentiful insurance. As the number of asbestos claims filed each year has nearly tripled in the last 5 years, the pace of asbestos-related bankruptcies has also accelerated dramatically. Since 1998, more companies have filed for bankruptcy protection than in the previous 20 years combined; and in the first 7 months of 2002 alone, 12 companies facing significant asbestos liability went bankrupt--more than in any other 3-year period before 1999. Firms declaring bankruptcy since 1998 employed more than 120,000 workers prior to their filing, many of whom were significantly invested in their company's stock, pension, and 401(k) plans. According to Fortune magazine, for example: [A]t the time of the Federal-Mogul's bankruptcy filing [in 2001], employees held 16 percent of the company's stock, which had lost 99 percent of its value since January 1999. It was reported that Federal-Mogul employees lost over $800 million in their 401(k). Similarly, [A]bout 14 percent of Owens Corning's shares--which lost 97 percent of their value in the two years before its filing-- were owned by employees. I think we can all agree that those individuals with legal claims who are truly very sick need to be taken care of in the most timely and equitable manner possible. That must be our No. 1 priority. We must also work to ensure that those who are not sick now, but may become sick in the future, are not precluded from recovery and that there are still funds available for such a recovery. Mr. President, this bill, as it is currently, begins the process of doing just that. And as indicated by my colleague, it is a work in progress. There are many opportunities yet to modify and to improve it as we go through this process. That is what the hearing will be about, and that is what the negotiation would be about. I am a strong believer that every American has a right to their day in court, but I also believe people dying of asbestos-related disease deserve just compensation for themselves and their families. Fortunately, we are coming closer to being able to restore balance to the system. The fund is in the process of being created that will, I hope, provide a pool of lasting benefits for those with meritorious claims. At the same time, this fund will spread the burden of the cost more evenly and ensure the financial impact will not solely be directed at some parties due to their ability to pay rather than their true liabilities. There are a number of task that remain to be done, and we recognize that, and we welcome the opportunity to bring all those folks together to make sure we come together with the best possible bill that will do the best possible job for those who are truly sick and those who will become sick. We are now at a time, I believe, when this issue can be and should be resolved, perhaps not once and for all, as some would hope, but for a good long while, giving us a chance to restore stability and certainty to a very uncertain issue. While this may not be a perfect bill, as they say, we must not let our desire for the perfect become the enemy of the good. Much work remains to be done, but I hope the parties, the stakeholders, will come together and work with us to refine the bill. I look forward to working with Members on all sides who truly are striving to ensure that those who have been injured the most have an opportunity to make their cases heard. I thank the Chair and I yield the floor.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, I rise today to honor Mayor Don Wesely of Lincoln, Nebraska who on this day will relinquish his duties as leader of this great city in order to spend more time with his three children. After serving the Lincoln community for the past 25 years as mayor and a member of the Nebraska legislature, I believe Mayor Wesely has more than earned the opportunity. Don Wesely began his career in public service in 1978 at the tender age of 24, when he became the third youngest person ever to serve in the unicameral legislature. While serving the 26th legislative district of northeast Lincoln for 20 years, Don sponsored or cosponsored over 300 initiatives that eventually became State law. His accomplishments as the chairman of the Health and Human Services Committee for 14 years have had a lasting effect on the State of Nebraska and his focus on those most in need has inspired his colleagues and constituents. When Don retired from the legislature in 1998, he was the eighth longest serving State senator in Nebraska history and he was only 44 years old. As mayor, Don Wesely presided over the city during troubled economic times, but managed to leave the city on solid financial footing for his successors. Mayor Wesely is a strong supporter of the largest infrastructure project in the city's history the Antelope Valley Project and I can attest to his persistent advocacy of Federal assistance for all aspects of the project, including flood control, transportation improvements, and community development. Mayor Wesely was also instrumental in crafting a unique and historic public-private partnership that resulted in the baseball-softball complex that is now the home of the minor league Lincoln Salt Dogs baseball team. And in a true measurement of his success in office, Mayor Wesely was a tireless promoter of private investment in the Lincoln area. During his last 2 years in office, over 10,000 new jobs were created. I had the pleasure and honor of working with Don Wesely both when I was Governor of Nebraska and now during my time in the United States Senate, so I can say with conviction that he has served Lincoln and the State with distinction. I am proud to call Don Wesely a friend, and I join the Senate and all Nebraskans in wishing he and his children Sarah, Amanda, and Andrew all the best as they begin an exciting new chapter in their lives.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, I rise today to express my support for the Department of Defense Authorization Act for fiscal year 2004. I particularly thank Chairman Warner and ranking member Senator Levin for the extraordinary job they do each and every day to ensure our national security priorities are adequately addressed. I also thank them both for continuing to work in a bipartisan way to ensure that decisions are made in the best interests of the country. As the new ranking member for the Personnel Subcommittee, I have enjoyed working with the subcommittee chairman, Senator Chambliss. I hope the President will take note of the complimentary remarks I am going to make about the chairman. I congratulate him for the outstanding leadership of this subcommittee. Together we have kept our focus on doing what we can to improve the quality of life of our service members, Active and Reserve, their families, our retirees, and civilian employees. I particularly appreciate his personal attention and cooperation with me. I am particularly pleased about several provisions in the subcommittee mark that reflect our appreciation for the sacrifices of our service members and our desire to see they are adequately compensated when placed in harm's way. These include a minimum pay raise of 3.7 percent especially for the junior service members who have received less under the administration's proposal; a change in the high PERSTEMPO allowance that will actually put money in the pockets of our service members who deploy frequently; increases in imminent danger pay, family separation allowances and, as Senator Collins mentioned, the death gratuity; and authorization for full replacement coverage for lost or damaged household goods. Our mark also includes provisions that address concerns and needs of our Reserve and National Guard service members who are serving so successfully. These include extending survivor benefit plan annuities to surviving spouses of reservists who died from an injury or illness incurred in the line of duty during inactive duty training; a requirement for specially trained beneficiary counseling and assistance coordinators to help our National Guard and Reserve members and their families navigate the complex TRICARE health system; medical and dental screening and care for Reserve component members as soon as they are alerted for deployment; and a requirement for the Secretary of Defense to report on the mobilization of the reserves that will give us the data we need to make needed changes in the force mix and use of our Guard and Reserve personnel. I am also pleased the committee responded to legislation I introduced to provide a special pay incentive for Reservists, National Guard, and Active Duty service members who deploy for long durations. This incentive will help alleviate some of the hardships suffered by military families when their loved ones are called up for lengthy or numerous deployments. With the Armed Forces depending on military reserves for such a large percentage of troops, more and more sailors, soldiers, air personnel, and marines are facing long call-ups that keep them away from their regular employment. These call-ups produce a severe financial hardship for the troops as their normal employment lives and income are disrupted, often for months, and in some cases for up to 2 years. Finally, I fully endorse the supplemental impact aid contained in our mark. We simply have to ensure the schools that educate our sons and daughters of military personnel have adequate funding to provide for a quality education. Our service members will leave, and we will be unable to recruit if we don't provide this for their families. I greatly appreciate the bipartisan manner in which the chairman, Senator Chambliss, has chaired the Personnel Subcommittee, and I believe we have worked as a team and with a common goal of improving the lives of our soldiers, sailors, airmen, marines, DOD civilians, retirees, and the families of all these groups. I thank him for his excellent leadership, and also thank his staff, Dick Walsh and Mrs. Lewis, and Mr. Gary Leeling from the Democratic staff. I again thank Chairman Warner and Senator Levin for their leadership. I yield the floor.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. I, too, believe that there is no more important component of this bill than its fiscal relief provisions, and I have serious reservations over any dividends language that would further hurt the States that we are trying to help. I join my colleague from Maine in asking my colleagues, the distinguished chairmen of the Senate Budget and Finance Committees, for assurances that they will do all they can in conference to prevent States from losing revenue as a result of any dividends language.

Mr. NELSON of Nebraska. I, too, thank my colleagues for their assurances. Colloquy between Senator Ensign and Chairman Grassley on the Depreciation Treatment of Hospitality Business

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, I rise today to congratulate Officer Keith P. Thompson of the Omaha Police Department on his selection as Officer of the Month for March 2003 by the National Law Enforcement Officers Memorial Fund. After receiving his initial training in law enforcement as military police officer in the U.S. Army, Officer Thompson joined the Omaha Police Department where he served the people of Omaha honorably until a tragic event occurred on August 28, 1996. On that day a stolen vehicle collided with Officer Thompson's cruiser. Miraculously, both he and his partner, Officer Mark Negrete, survived the crash. While Officer Negrete escaped with only minor injuries, the accident left Officer Thompson in a coma for 20 days. Against all odds, he survived the collision, the coma, and the surgery that followed, but complications left him paralyzed. It would have been easy for Officer Thompson to give up on his law enforcement career at that point. But instead, he fought back through months of grueling therapy, battling paralysis, memory loss, and difficulties with his speech. After rejuvenating his memory and fine motor skills, Officer Thompson enrolled in Goodwill's Head Injury Rehabilitation and Employment, or HIRE, program where he mastered computer keyboarding. Through it all, Officer Thompson's wife Ann and their three children believed in him and were at his side helping him overcome the challenges and obstacles that had been set in his path. On September 25, 1997, less than 13 months after the accident, Officer Thompson returned to duty at Omaha's Central Police Headquarters. He currently serves as the first line in nonemergency communications with the community as part of the Information Service Unit's Telephone Response Squad. He also speaks regularly to recruit classes about the dangers of high, speed pursuits. Officer Thompson serves his community every day he goes to work, but he also serves as an inspiration to all those who meet him or hear his story. He is living proof that with courage, determination, and heart, all obstacles can be overcome. I congratulate Mr. Thompson on the recognition he has deservedly received. It is truly an honor for him, his family, the Omaha Police Department, and the State of Nebraska.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Madam President, I come to the floor today to support and urge my colleagues to join in support of the amendment before the Senate for State fiscal relief. I begin by thanking my friend and colleague from Maine, Senator Collins, who has been stalwart in pushing for State fiscal relief for 2-plus years. We have worked very carefully, very closely to bring about this amendment that is before us today. On two other occasions, we have had overwhelming support. We believe this amendment will potentially have that same level of support. I thank her for all of the work and leadership she has provided in making this possible. I thank also the distinguished chairman of the Finance Committee, my friend to the east of Nebraska in Iowa, Senator Grassley. He has been a man of his word. We have worked very carefully, very closely on this issue and others. I thank him for contributing significantly to our effort to bring this amendment to the body. Most of what needs to be said has been said already. I do want to emphasize, as Senator Grassley has, that this is temporary. It is for a 2-year period. And why is it temporary? Because one would expect that if we are going to grant stimulus programs to grow the economy, that after a reasonably short period of time, the economy will respond. That is the hope, that is the expectation, and that clearly is the goal, not only of this amendment but of the entire growth package before the Senate. Our goal is to make sure that we grow the economy faster than we grow the deficit. It doesn't make a lot of sense to cut taxes in Washington and ignore what is happening in the State capitals. ether it is in Juneau or Lincoln or wherever it may be, what happens in State capitals with the State legislatures does matter. Over the weekend, I was home in Nebraska and the local news media was covering in great detail the travail of the Nebraska Legislature in trying to take care of a growing budget deficit caused by declining revenues and increasing costs. Therefore, the news was replete on the subject day in and day out. So if we are going to try to change the attitude and improve the economy with active results in Washington, DC, it does not make sense to ignore what is happening in the State capitals. We only have one tax pocket. The Federal Government is trying to put in some money. States have their hand in taking more out. That certainly is counterproductive to the goal we have if we ignore what is happening at the State level. I have said that it is the equivalent of trying to drive a car with one foot on the accelerator and the other on the brake. We don't want what we are attempting to do here negated by what is going on in State capitals. This will permit us to do as much as we can to help avoid that. There is the human side. Quite honestly, in Nebraska, for example, with this projected budget shortfall, the University of Nebraska, the State colleges are all taking significant cuts. Nebraska teachers are out of work because of lower State aid to education. In fact, when it comes to health care coverage and child care options, more than 15,000 children have already been cut from Medicaid benefits and another 2,000 families have lost their child care. More harsh cuts are on the way unless we do something to help fill the revenue gap. This amendment does that. Some have suggested that this is bailing out the States or somehow it is a gift that we are doing out of the generosity of Washington. I have encountered the generosity of Washington, generally, as a former Governor when things were given to us. They were called underfunded and unfunded Federal mandates. This is not what we are about today. We recognize that one of the best ways to help the States with their problems today is to take care of these needs and make sure that we don't have what we are doing here negated by action at the State level, which is to respond by supporting additional FMAP funding for a period of 2 years, as well as recognizing that the State and local governments are also feeling the pinch with the fast growing requirements due to hometown security under homeland security requirements. They do not have the luxury to run deficits, nor should they. Therefore, what we propose is $10 billion to be split between the States and local governments on a block grant basis. This will help provide some relief from property taxes that would otherwise most assuredly rise as the cost of local governments are passed on to taxpayers. As we look at this package, as we look at State fiscal relief, I hope we will continue to have the bipartisan support we have had in the past. Whether it is 75 or 80 votes is secondary. I certainly hope it would be overwhelming support for this effort. For those who would say what kind of stimulus will come from this effort, there are studies that show that 1.24 will be returned in one year. From my perspective, a 24-percent return on this sort of investment to take back to the States is a good return, and it is certainly a stimulus to the economy. Therefore, it is a stimulus to the future of this great country. I appreciate the opportunity. I thank my colleague, the Senator from Maine, for her support, for her constant counseling on how we should go about this effort. I thank her for the time to speak on this very important amendment. I yield the floor to the Senator from Maine.

Mr. NELSON of Nebraska. I am glad my friend from Maine has asked that question so that I can provide some assurances to our colleagues. On behalf of our group of Senators offering this amendment, let me be clear: We have drafted this provision in such a way that the increase in the FMAP will end June 30, 2004. My colleagues will be glad to know that there is precedent for Congress passing short-term Medicaid matching rate increases that have not become permanent. In 1981, the Omnibus Budget Reconciliation Act reduced Medicaid matching rates for 3 years, while also creating exemptions for States that had high unemployment rates, special hospital review programs, or strong fraud and abuse recovery systems. At the time when this was enacted, some in Congress worried that these changes would be permanent, but these provisions expired on schedule without any particular controversy or efforts to extend them. There is even a more recent example: The Omnibus Consolidated Rescissions and Appropriations Act of 1996 granted a temporary increase in the FMAP to Louisiana. The State's matching rate rose from the normal rate of 72.08 percent to a special enhanced rate of 84.28 percent in State fiscal year 1995-96 and from the normal rate of 71.49 percent to an enhanced rate of 81.46 percent in State fiscal year 1996-97. This temporary State relief was granted because the Omnibus Budget Reconciliation Act of 1993 tightened disproportionate share hospital payment policies and posed a hardship for Louisiana at a time when the State's economy was faring badly. The State was able to use these temporary funds to avoid disruptions in essential services. The temporary increase in Louisiana's FMAP expired as scheduled. These provisions expired as planned after fulfilling their mission of temporary relief to help these States transition through a difficult period. Congress has been able to maintain discipline in the past. There is no evidence that a temporary increase in Medicaid matching rates will inevitably become permanent. In fact, because our amendment in no way adjusts how future FMAPs are calculated, it does not effect a permanent change in FMAPs for States.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, this important renewable fuels legislation is one of the pillars for economic development for rural America--one segment of the population that has lagged behind during the economic surge of the 1990s and is suffering under the combined effects of the current economic slowdown and a 2-year devastating drought--Drought David. This legislation is important for rural America. Last year, we completed the farm bill--the first part of the economic revitalization plan for rural America. And while the Midwest has been blessed with rain over the past month, we continue to struggle with the ongoing effects of drought. Economic stimulus can come in many forms, and renewable fuels is certainly one of the viable options for increased economic stimulus in rural America, especially in my home State of Nebraska. We need to be working hard to craft a comprehensive rural development plan that will spur investment in agribusiness and promote economic activity in the agriculture center. This bill, the Fuels Security Act of 2003, is an important part of such a rural development plan. It is clear that use of ethanol, as part of a renewable fuels standard is a win-win-win situation: a win for farmers, a win for consumers, and a win for the environment. That is why I rise as an original cosponsor and strong supporter this renewable fuels legislation. If passed, the Fuels Security Act will establish a 2.3-billion-gallon renewable fuels standard in 2004, growing every year until it reaches 5 billion gallons by 2012. There are many benefits to this legislation. It will dispute 1.6 billion barrels of oil over the next decade; reduce our trade deficit by $34.1 billion; increase new investment in rural communities by more than $5.3 billion; boost the demand for feed grains and soybeans by more than 1.5 billion bushels over the next decade; create more than 214,000 new jobs throughout the U.S. economy; and expand household income by an additional $51.7 billion over the next decade. It is quite apparent that increased use of ethanol will do much to boost a struggling U.S. agriculture economy and will help establish a more sound national energy policy. The greater production of ethanol will also be beneficial to the environment. Studies show ethanol reduces emissions of carbon monoxide and hydrocarbons by 20 percent and particulates by 40 percent in 1990 and newer vehicles. In 2001 ethanol reduced greenhouse gas emissions by 3.6 million tons, the equivalent of removing more than 520,000 vehicles from the road. A choice for ethanol is a choice for America, and its energy consumers, its farmers and its environment. Enactment of the Fuel Security Act--along with other provisions in this bill that emphasize new sources of energy production from renewables like wind power, as well as conservation to further reduce our dependence upon foreign sources of energy--will help us to reverse our 100-year-old reliance on fossil fuels a more pressing concern than ever given the possibility of military conflict in the Mideast and the continuing economic turmoil in Venezuela. I am unabashedly proud of what my home State has accomplished in this area. Within the State of Nebraska, during the period from 1991 to 2001, seven ethanol plants were constructed and several of these facilities were expanded more than once during the decade. Specific benefits of the ethanol program in Nebraska include: $11.15 billion in new capital investment in ethanol processing plants; 1,005 permanent jobs at the ethanol facilities and 5,115 induced jobs directly related to plant construction, operation, and maintenance--the permanent jobs alone generate an annual payroll of $44 million----and more than 210 million bushels of corn and grain sorghum is processed at the plants annually. These economic benefits and others have increased each year during the past decade due to plant expansion, employment increases, and additional capital investment. If each State produces 10 percent of its own domestic, renewable fuel, as Nebraska does, America will have turned the corner away from dependence on foreign sources of energy. When you take a hard look at the facts, you will see that this legislation is nothing but beneficial for America. The Fuels Security Act is balanced, comprehensive, and is the result of the dedication of so many, especially Senator Daschle and Senator Lugar. Now I ask my colleagues to join me in promoting new opportunities for the technologies that will put our Nation and the world's transportation fuels on solid, sustainable, and environmentally enhancing ground. We owe it to our country now--and to future generations-in pass this legislation.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. I commend the 20,000 registered nurses working in Nebraska as we celebrate National Nurses Week. From May 6- 12, we recognize the diverse ways in which registered nurses, the largest health care profession, are working to improve health care. From bedside nursing in hospitals and long-term care facilities to the halls of research institutions, State legislatures, and Congress, the depth and breadth of the nursing profession is meeting the expanding health care needs of American society. I also urge more Nebraskans to consider nursing as a career. Although nursing is one of the most noble professions, more nurses are desperately needed. The Department of Health and Human Services predicts that the number of nursing vacancies nationwide will rise from its current total of 126,000 to 275,000 in 2010. The shortage of nurses in Nebraska is also reaching epidemic proportions, with one in 10 nursing positions unfilled. My colleagues and I want to provide more educational opportunities for people who want to become nurses. In response to the national nursing shortage, the Nurse Reinvestment Act of 2002 was signed into law in August 2002. The Nurse Reinvestment Act provides scholarships to nursing students who agree to provide 2 years of service in a health care facility with a critical nursing shortage. It also allows for the canceling of up to 85 percent of a student's graduate studies loans if they later teach at a school of nursing. The act also provides grants to improve nurse education, practice, and retention as well as a program for training and education in geriatric care that will enable nurses to better serve the growing population of older Americans. State and national public service announcements will promote nursing and raise awareness of the financial assistance that is available. A loan forgiveness program is also available. The Nurse Education Loan Repayment Program will pay 60 percent, or up to $30,000, of an RN's student loan balance in exchange for 2 years of service. If an eligible participant elects to stay for another year, an additional 25 percent of the loan, or up to $7500, will be repaid. Nebraska also has a loan forgiveness program for nursing students. A limited amount of $1,000 loans are awarded each year. The loan is forgiven if the graduate practices nursing in Nebraska for at least 1 year following graduation. Again, I commend the work of Nebraska's nurses and send my best wishes during National Nurses Week.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, today I join Senator Brownback in introducing the Rural Community Hospital Assistance Act. This legislation is intended to ensure the future of small rural hospitals by restructuring the way they are reimbursed for Medicare services by basing the reimbursements on actual costs instead of the current pre- set cost structure. Current law allows for very small hospitals--designated Critical Access Hospitals, CAH, to receive cost-based Medicare reimbursements. To qualify as a CAH the facility must have no more than 15 acute care beds. In rural communities, hospital facilities that are slightly larger than the 15 bed limit share with Critical Access Hospitals the same economic conditions, the same treatment challenges, the same disparity in coverage area but do not share the same reimbursement arrangement. These rural hospitals have to compete with larger urban-based hospitals that can perform the same services at drastically reduced costs. They are also discouraged from investing in technology and other methods to improve the quality of care in their communities because those investments are not supported by Medicare reimbursement procedures. The legislation would provide cost-based Medicare reimbursement by creating a new ``rural'' designation under the Medicare reimbursement system. This new designation would benefit seven Nebraska hospitals. Hospitals in McCook, Alliance, Broken Bow, Beatrice, Columbus, Holdrege and Lexington would fall under this new designation, and would have similar benefits provided to nearly sixty other Nebraska hospitals classified under the CAH system. The legislation would also improve the hospitals with critical access status. Nearly sixty existing CAH facilities in Nebraska already receive cost-based reimbursements for inpatient and outpatient services. The legislation would further assist these existing CAH facilities by allowing them a return on equity for technology and infrastructure investments and by extending the cost-based reimbursement to certain post-acute services. Rural hospitals cannot continue to provide these services without having Medicare cover the costs. If something is not done, the larger hospitals may be forced to cut back on the number of beds they keep--and the number of people they care for, and others may be forced to close their doors. These hospitals provide jobs, good wages, health care and economic development opportunity for these communities. Without access to these hospitals, these communities would not survive. The Rural Community Hospital Assistance Act will ensure that the community has access to high quality health care that is affordable to the patient and the provider.

Mr. NELSON of Nebraska

Mr. NELSON of Nebraska. Mr. President, today I join Senator Brownback in introducing the Rural Community Hospital Assistance Act. This legislation is intended to ensure the future of small rural hospitals by restructuring the way they are reimbursed for Medicare services by basing the reimbursements on actual costs instead of the current pre- set cost structure. Current law allows for very small hospitals--designated Critical Access Hospitals, CAH, to receive cost-based Medicare reimbursements. To qualify as a CAH the facility must have no more than 15 acute care beds. In rural communities, hospital facilities that are slightly larger than the 15 bed limit share with Critical Access Hospitals the same economic conditions, the same treatment challenges, the same disparity in coverage area but do not share the same reimbursement arrangement. These rural hospitals have to compete with larger urban-based hospitals that can perform the same services at drastically reduced costs. They are also discouraged from investing in technology and other methods to improve the quality of care in their communities because those investments are not supported by Medicare reimbursement procedures. The legislation would provide cost-based Medicare reimbursement by creating a new ``rural'' designation under the Medicare reimbursement system. This new designation would benefit seven Nebraska hospitals. Hospitals in McCook, Alliance, Broken Bow, Beatrice, Columbus, Holdrege and Lexington would fall under this new designation, and would have similar benefits provided to nearly sixty other Nebraska hospitals classified under the CAH system. The legislation would also improve the hospitals with critical access status. Nearly sixty existing CAH facilities in Nebraska already receive cost-based reimbursements for inpatient and outpatient services. The legislation would further assist these existing CAH facilities by allowing them a return on equity for technology and infrastructure investments and by extending the cost-based reimbursement to certain post-acute services. Rural hospitals cannot continue to provide these services without having Medicare cover the costs. If something is not done, the larger hospitals may be forced to cut back on the number of beds they keep--and the number of people they care for, and others may be forced to close their doors. These hospitals provide jobs, good wages, health care and economic development opportunity for these communities. Without access to these hospitals, these communities would not survive. The Rural Community Hospital Assistance Act will ensure that the community has access to high quality health care that is affordable to the patient and the provider.