Jack Reed

Mr. REED

Mr. REED. Madam President, would the Senator yield for a parliamentary request? Madam President, at the conclusion of the remarks of the Senator from Maine, I ask unanimous consent to be recognized for 5 minutes, and then following me that Senator Isakson be recognized for 10 minutes.

Mr. REED. I thank the Senator and the Chair.

Mr. REED

Mr. REED. Madam President, I rise to recognize and honor the significant accomplishments of Special Olympics Rhode Island executive director Mike McGovern. Mike is retiring this month after 21 years of working to expand opportunities for Rhode Islanders with disabilities. He has been a lifelong friend, since grammar school and high school. He is someone I respect and admire immensely, and this respect and admiration is shared by the entire community of Rhode Island. He has demonstrated a lifelong commitment to upholding the mission and values of the Special Olympics. Mike's special dedication and enthusiasm have ensured that the Special Olympics Rhode Island remains one of the most impressive organizations in our State, providing year- round sports training and competitions to approximately 2,700 young and adult athletes across the State. Mike began his involvement with Special Olympics Rhode Island as a volunteer for 18 years, every year pitching in, helping out. That is the way he is--a generous heart, a great sense of community and neighborliness. He then served as assistant executive director for Special Olympics Rhode Island from 1988 to 1998, when he took over the role of executive director. Under his leadership, Special Olympics Rhode Island expanded the number of sports offered to 20. His athlete-centered approach helped the program experience a 40-percent increase in competitors. Mike has also worked hard to ensure that the funding goals of Special Olympics Rhode Island were achieved. During his time with Special Olympics Rhode Island, the organization built a budget surplus of over $1 million. He also helped launch a capital campaign to establish a permanent home for Special Olympics Rhode Island. His innovative spirit, which characterized his entire tenure, was evident in many different ways--particularly 33 years ago, when he and several friends cofounded the Penguin Plunge, which is an annual New Year's Day ritual in Jamestown, RI, where hardy souls, hundreds of them, brave the frigid waters of Narragansett Bay to raise money for Special Olympics Rhode Island and raise a feeling of camaraderie, fellowship, and good spirits to begin the year. Last month, Mike attended his final games as executive director. Held at the University of Rhode Island in Kingston, Special Olympics Rhode Island dedicated its 2009 State summer games to Mike McGovern for his outstanding, long-time commitment to the Special Olympics. Speaking at the games, he spoke of being inspired by the courage of the athletes through their ability to defy stereotypes, to compete, to strive--all of them--to win. We, too, are inspired by his commitment to a very noble cause. Through his presence at the organization, he imbued it with a special spirit. That spirit will be missed. But he will continue to serve because that is his nature. Thank you, Mike, for your exemplary service. You have been a strong advocate for thousands of Special Olympics athletes, both on and off the playing field. Your dedicated leadership and hard work have helped thousands of Rhode Islanders with disabilities achieve their goals. Also, you have been a great success in something as important--as a husband, as a father, as a friend. I wish you and your lovely family, your wife and your children, the best in your well-deserved retirement. Let me conclude by saying Rhode Island's special athletes have never had a more special friend than Mike McGovern. I yield the floor.

Mr. REED

Mr. REED. Mr. President, today I introduce, along with Senators Murkowski and Whitehouse, the Community Mental Health Services Improvement Act. For decades, we have known that people suffering from mental illness die sooner--on average 25 years sooner--and have higher rates of disability than the general population. People with mental illness are at greater risk of preventable health conditions such as heart disease and diabetes. With this legislation, we are taking steps to address these disturbing trends. We know that mental health and physical health are inter-related. Yet historically mental health and physical health have been treated separately. This legislation would integrate care in one setting. In a recent survey, 91 percent of community mental health centers said that improving the quality of health care is a priority. However, only one-third have the capacity to provide health care on site, and only one-fifth provide medical referrals off site. The centers identified a lack of financial resources as the biggest barrier to integrating treatment. Accordingly, this legislation provides grants to integrate treatment for mental health, substance abuse, and primary and specialty care. Grantees can use the funds for screenings, basic health care services on site, referrals, or information technology. This legislation also comprehensively responds to the well identified mental health workforce crisis by providing grants for a wide range of innovative recruitment and retention efforts, including loan forgiveness and repayment programs, to placement and support for new mental health professionals, and expanded mental health education and training programs. Finally, this legislation provides grants for tele-mental health in medically-underserved areas, and invests in health IT for mental health providers. These proposals address the twin goals of improving the quality of mental health treatment while expanding access to that treatment in rural and underserved areas. This bipartisan legislation has the overwhelming support of the mental health community. It has been endorsed by the National Council for Community Behavioral Healthcare, the National Alliance on Mental Illness, Mental Health America, the Campaign for Mental Health Reform, and the American Psychological Association. I am especially grateful for the support of the Rhode Island Council of Community Mental Health Organizations, whose members treat close to 15,000 Rhode Islanders of all ages. As a member of the Senate Committee on Health, Education, Labor, and Pensions, I look forward to our upcoming work on reforming our nation's health care system--and including important improvements to prevent and treat mental and physical illnesses and conditions. It is my hope that this year we can truly begin to address the challenge of comprehensively improving and expanding access to mental health services. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. REED

Mr. REED. Mr. President, today I introduce, along with Senators Murkowski and Whitehouse, the Community Mental Health Services Improvement Act. For decades, we have known that people suffering from mental illness die sooner--on average 25 years sooner--and have higher rates of disability than the general population. People with mental illness are at greater risk of preventable health conditions such as heart disease and diabetes. With this legislation, we are taking steps to address these disturbing trends. We know that mental health and physical health are inter-related. Yet historically mental health and physical health have been treated separately. This legislation would integrate care in one setting. In a recent survey, 91 percent of community mental health centers said that improving the quality of health care is a priority. However, only one-third have the capacity to provide health care on site, and only one-fifth provide medical referrals off site. The centers identified a lack of financial resources as the biggest barrier to integrating treatment. Accordingly, this legislation provides grants to integrate treatment for mental health, substance abuse, and primary and specialty care. Grantees can use the funds for screenings, basic health care services on site, referrals, or information technology. This legislation also comprehensively responds to the well identified mental health workforce crisis by providing grants for a wide range of innovative recruitment and retention efforts, including loan forgiveness and repayment programs, to placement and support for new mental health professionals, and expanded mental health education and training programs. Finally, this legislation provides grants for tele-mental health in medically-underserved areas, and invests in health IT for mental health providers. These proposals address the twin goals of improving the quality of mental health treatment while expanding access to that treatment in rural and underserved areas. This bipartisan legislation has the overwhelming support of the mental health community. It has been endorsed by the National Council for Community Behavioral Healthcare, the National Alliance on Mental Illness, Mental Health America, the Campaign for Mental Health Reform, and the American Psychological Association. I am especially grateful for the support of the Rhode Island Council of Community Mental Health Organizations, whose members treat close to 15,000 Rhode Islanders of all ages. As a member of the Senate Committee on Health, Education, Labor, and Pensions, I look forward to our upcoming work on reforming our nation's health care system--and including important improvements to prevent and treat mental and physical illnesses and conditions. It is my hope that this year we can truly begin to address the challenge of comprehensively improving and expanding access to mental health services. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. REED

Mr. REED. Madam President, I rise today in support of the Family Smoking Prevention and Tobacco Control Act, but first, I would like to take a moment to recognize the outstanding leadership of Chairman Kennedy on this important public health issue. This is not the first time he has ushered a bill on this topic from committee to the Senate floor. I am confident that my colleagues, in recognition of the tremendous, hazardous effects that tobacco has on children, adolescents, adults, and seniors, will join me in fulfilling one of chairman Kennedy's wishes, and mine, of finally seeing this bill signed into law. I would also like to thank Senator Dodd for his dedication in carrying out the aggressive schedule of the HELP Committee set forth by the chairman so we can bring this legislation to the floor. As a cosponsor of this legislation, I firmly believe that we cannot afford to wait another day for it to be enacted. This is not the first time that I have risen to speak on the importance of regulating the sale of tobacco products, but I am hopeful that with this legislation we will take a giant leap toward eradicating the use of nicotine, by discouraging our youth from ever lighting-up, and chip away at skyrocketing smoking-related healthcare costs. Every year that passes, and this legislation is not enacted, another 4,700 children in Rhode Island try a cigarette for the first time--that amounts to 1,400 children in my State alone becoming regular, daily smokers each year. These new smokers become part of the 8.6 million individuals nationwide suffering from smoking-caused illnesses; they become part of the 400,000 deaths every year attributed to tobacco use. We can and must do more to curb the use of this very serious and deadly poison. This is a public health emergency that demands action. Over the years, the tobacco industry has been confronted with opportunities to do the right thing--to be honest about the health effects of tobacco or even the intended targets of various marketing campaigns. In every instance they passed up that opportunity and actively fought to continue alluring generation after generation to use tobacco products. I would like to use the time that I have today to walk through some of those occasions in an attempt to demonstrate how important the Family Smoking Prevention and Tobacco Control Act is to the American people, not only to our health, but to our economic prosperity. In 1994, while I was in the House of Representatives, seven executives from the tobacco industry took an oath before a House committee that they would tell the truth about tobacco. In their statements and responses to questions from members on the committee, all seven individuals stated that they believed nicotine was not addictive, and that new marketing practices were not designed to reach younger and younger age groups, below the legal smoking age of 18. In order to support these claims, the executives cited research councils and institutes. But these statements were contrary to what many public health officials were saying, and what I believed. This further obscured the notion that smoking was a direct cause of disease. A total of 46 States--including my own--States in which the majority of my colleagues represent--then proceeded to call their bluff, one lawsuit at a time. Through these cases, the American people learned that the lies and deceit of the tobacco industry extended far beyond that of a Congressional hearing room. The suits unearthed that the tobacco industry had established and funded the councils and institutes claiming tobacco was not a health hazard; and had internal documents stating that No. 1, nicotine is addictive; No. 2, smoking is a habit of addiction; and No. 3, that in order to continue to prosper, cigarettes must be marketed to younger and younger age groups--below the legal smoking age of 18. The tobacco industry settled these lawsuits. The agreement, totaling nearly $206 billion, was ordered to be distributed to the States in an effort to recoup Medicaid dollars spent on smoking-related health care costs. While $206 billion seems like a lot to you and me, this amount of money only accounts for approximately 7 years of the Medicaid budgets of the 46 States. The fact that the industry did settle should have been a clear sign that tobacco production and marketing needs to be regulated. Unfortunately, around the same time that the settlement occurred, the Supreme Court narrowly ruled--on a 5-to-4 margin--that the FDA did not have such authority to regulate their products. The tobacco industry continued to aggressively market tobacco products. Nearly 10 years later, this past December, the Supreme Court upheld that tobacco firms could, in fact, be charged at the State level with deceptive advertising practices of cigarettes. We have on the one hand, no regulation; on the other hand, the possibility of State enforcement. These two Supreme Court decisions further complicate the message received by Americans regarding the use, marketing and distribution of tobacco. In essence, the industry could be held liable for certain advertising practices, but direct, regulatory oversight of those practices does not exist. Appropriate guidelines do not exist. With this bill, we have the opportunity to ensure that guidelines are established. To add yet another layer to this debate, only 2 weeks ago, the U.S. District Court of Appeals for the District of Columbia ruled that the tobacco industry falsely advertised ``light'' and ``low-tar'' cigarettes under the guise that they were less dangerous than other products. This ruling comes after 10 years from the date the suit was originally filed--10 years too late to prevent 10,000 Rhode Island children beginning to regularly use tobacco. Had we enacted the Family Smoking Prevention and Tobacco Control Act, or a similar version of this legislation, years ago, we could have prevented some of those in my State and across the country from ever smoking. Instead, the debate has dragged on for 10 years. Unfortunately, this debate will continue to drag on. The tobacco industry has already publicly stated that it will continue to argue the decision that was recently rendered. Rather than taking the tortuous, time-consuming and very expensive path of taking the case through litigation, I think we have to give the FDA the authority to regulate tobacco products. We have the opportunity before us to put an end to the courtroom drama. With the Family Smoking Prevention and Tobacco Control Act, we can give the FDA the authority to regulate tobacco, restrict illegal advertising practices targeting children, prevent the unlawful sale of tobacco to our Nation's youth, and strengthen warning labels. With this legislation, everyone wins. The tobacco industry would have clear guidance on advertising practices which could help them avoid lengthy litigation; young people will not be targeted by aggressive tobacco media campaigns; and the public health crisis caused by tobacco use--which costs the American people in health care dollars, in lost productivity, and in loss of loved ones--tremendous prices--would hopefully begin to fade. In preparation for our discussion, I looked back at some of the past statements that I have made in support of regulating tobacco--and one sticks out in my mind: the tobacco industry has worked hard to earn the trust of the American people. We must try to win that trust back. We must empower the FDA to regulate tobacco in order to rein in the use of tobacco by children, control the access that our children have to tobacco, and warn the American public about its dangers. The Senate is finally once again on the path to having a meaningful debate about our Nation's health care system. It is my hope that this debate will result in appropriate, high quality health care coverage and access for every American. Of course, we hope to do all of this at the lowest possible cost. If we are serious about reforming our health care system, why wait? Smoking-related health care costs are skyrocketing. Today the average cost of a pack of cigarettes in the country is about $5 but the social cost is much more. Every year, the public and private health care expenditures caused by smoking total approximately $100 billion, and $100 billion in lost productivity. These are staggering totals. I will repeat: we literally cannot afford to wait another day for this legislation to be enacted. We have the opportunity to begin charting a new course today. With this bill, we will begin to chip away at health care costs, steer our youth away from smoking, and pave the way for a healthier future for our Nation. I look forward to working with my colleagues to enact this important piece of legislation and set forth on this new path for a healthier and more prosperous America. I yield the floor and suggest the absence of a quorum.

Mr. REED. Madam President, I ask unanimous consent the order for the quorum call be rescinded.

Mr. REED

Mr. REED. Mr. President, today I introduce the Informed Health Care Decision Making Act of 2009. I am introducing this legislation along with my colleague Senator Mikulski because every American deserves to have the full information regarding drugs and devices prescribed by their provider. Even though the amount of money spent to reach the public about drugs and devices is greater than five billion dollars annually, the most fundamental information--information about how well the drug or device actually works--is generally absent. In 2007, the Institute of Medicine conducted a workshop regarding the public's understanding of drugs and confirmed the importance for patients and physicians of having standardized and quantitative information about the product before making health care decisions. Researchers at Dartmouth University have documented that replacing the current narrative information contained in drug advertisements with simplified, factual information, will enable patients to play an active role in health care decision making. In fact, similar to the nutrition facts boxes that are required on our Nation's packaged food supply, this research demonstrated that a drug facts box will actually help physicians make better health care choices. If the research is not enough proof that this type of streamlined information will be beneficial, the Food and Drug Administration's, FDA, Risk Communications Advisory Committee, a committee specifically designed to counsel the agency on how to strengthen the communication of risks and benefits of FDA-regulated products to the public, unanimously recommended that the FDA adopt standardized, quantitative summaries of risks and benefits in a drug facts box format. As such, the Informed Health Care Decision Making Act of 2009 would require the FDA to determine if the information provided in a drug facts box, or a similar format, would improve health care decision making by clinicians and patients, and report to Congress on that determination. If the report determines that a specific standardized, quantitative format would be beneficial, the FDA must issue regulations to implement the format. Regardless of the FDA's determination, it is important for clinicians and patients to be able to compare the similarities, differences, benefits, and risks of drugs and devices. As such, the legislation would require the Agency for Healthcare Research and Quality to establish a multi-stakeholder process for developing and periodically updating methodological standards and criteria for comparative clinical effectiveness research. This would include standards and criteria for the sources of evidence and the adequacy of evidence that are appropriate for the inclusion of comparative clinical effectiveness information in labeling and print advertisements. Upon completion of these standards, the legislation requires drug labels and print advertisements to include information on the clinical effectiveness of a product--compared to other products approved for the same health condition for the same patient demographic subpopulation-- or a disclosure that there is no such information, if another product has not been approved for the same use. The potential of such a disclosure should be a powerful incentive for manufacturers to fund comparative effectiveness research. It is my hope that as we embark upon meaningful health care reform, my colleagues will join me in supporting this bill and other initiatives to improve the health care decision making of both patients and clinicians. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. REED

Mr. REED. Mr. President, today I introduce the Informed Health Care Decision Making Act of 2009. I am introducing this legislation along with my colleague Senator Mikulski because every American deserves to have the full information regarding drugs and devices prescribed by their provider. Even though the amount of money spent to reach the public about drugs and devices is greater than five billion dollars annually, the most fundamental information--information about how well the drug or device actually works--is generally absent. In 2007, the Institute of Medicine conducted a workshop regarding the public's understanding of drugs and confirmed the importance for patients and physicians of having standardized and quantitative information about the product before making health care decisions. Researchers at Dartmouth University have documented that replacing the current narrative information contained in drug advertisements with simplified, factual information, will enable patients to play an active role in health care decision making. In fact, similar to the nutrition facts boxes that are required on our Nation's packaged food supply, this research demonstrated that a drug facts box will actually help physicians make better health care choices. If the research is not enough proof that this type of streamlined information will be beneficial, the Food and Drug Administration's, FDA, Risk Communications Advisory Committee, a committee specifically designed to counsel the agency on how to strengthen the communication of risks and benefits of FDA-regulated products to the public, unanimously recommended that the FDA adopt standardized, quantitative summaries of risks and benefits in a drug facts box format. As such, the Informed Health Care Decision Making Act of 2009 would require the FDA to determine if the information provided in a drug facts box, or a similar format, would improve health care decision making by clinicians and patients, and report to Congress on that determination. If the report determines that a specific standardized, quantitative format would be beneficial, the FDA must issue regulations to implement the format. Regardless of the FDA's determination, it is important for clinicians and patients to be able to compare the similarities, differences, benefits, and risks of drugs and devices. As such, the legislation would require the Agency for Healthcare Research and Quality to establish a multi-stakeholder process for developing and periodically updating methodological standards and criteria for comparative clinical effectiveness research. This would include standards and criteria for the sources of evidence and the adequacy of evidence that are appropriate for the inclusion of comparative clinical effectiveness information in labeling and print advertisements. Upon completion of these standards, the legislation requires drug labels and print advertisements to include information on the clinical effectiveness of a product--compared to other products approved for the same health condition for the same patient demographic subpopulation-- or a disclosure that there is no such information, if another product has not been approved for the same use. The potential of such a disclosure should be a powerful incentive for manufacturers to fund comparative effectiveness research. It is my hope that as we embark upon meaningful health care reform, my colleagues will join me in supporting this bill and other initiatives to improve the health care decision making of both patients and clinicians. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. REED

Mr. REED. Mr. President, I rise to introduce the Rating Accountability and Transparency Enhancement, RATE, Act to strengthen the Securities and Exchange Commission's, SEC's, oversight of credit rating agencies and improve the accountability and accuracy of credit ratings. Credit ratings have taken on systemic importance in our financial system, and have become critical to capital formation, investor confidence, and the efficient performance of the U.S. economy. However, in recent months we have witnessed a significant amount of market instability stemming in part from the failure of these agencies to accurately measure the risks associated with mortgage-backed securities and other more complex products. As the Chairman of the Securities, Insurance, and Investment Subcommittee of the Senate Banking, Housing, and Urban Affairs Committee, I chaired a hearing in September of 2007 to examine the role of credit rating agencies in the mortgage crisis, and these issues were also addressed at a hearing by the full Committee last year. From these hearings, it is clear that problems at credit rating agencies contributed to the significant financial sector instability our country has been experiencing. In fact, an SEC investigation last summer found that credit rating agencies such as Moody's, Standard & Poor's, and Fitch Ratings conducted weak analyses and failed to maintain appropriate independence from the issuers whose securities they rated. Credit rating agencies are in the business of providing investors with unbiased analysis, but the current incentive structure gives them too much leeway to hand out unjustifiably favorable ratings. Let us be clear: not every rating is suspect and these firms provide crucial information for investors and the marketplace, but credit rating agencies like any other industry should be held accountable if they knowingly or recklessly mislead investors. According to a mortgage industry trade publication, the three major credit rating agencies have each downgraded more than half of the subprime mortgage-backed securities they originally rated between 2005 and 2007. Ratings agencies made these mistakes in part because of conflicts of interest and other problems with internal controls, underscoring the need for enhanced oversight of this industry. The bill I introduce today gives the SEC strong new authority to oversee and hold rating agencies accountable for conflicts of interest and other internal control deficiencies that have weakened ratings in the past. The bill includes a carefully crafted liability provision that allows investors to take action when a rating agency knowingly or recklessly fails to review key information in developing the rating. It also enhances disclosure requirements to allow investors and others to learn about the methodologies, assumptions, fees, and amount of due diligence associated with ratings. It requires rating agencies to notify users and promptly update ratings when model or methodology changes occur. Finally, the bill requires ratings agencies to have independent compliance officers, and to take other actions, to prevent potential conflicts of interest. I hope my colleagues will join me in helping improve the accountability and transparency of credit ratings that are so critical to the functioning of our financial markets. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. REED

Mr. REED. Mr. President, I rise to introduce the Rating Accountability and Transparency Enhancement, RATE, Act to strengthen the Securities and Exchange Commission's, SEC's, oversight of credit rating agencies and improve the accountability and accuracy of credit ratings. Credit ratings have taken on systemic importance in our financial system, and have become critical to capital formation, investor confidence, and the efficient performance of the U.S. economy. However, in recent months we have witnessed a significant amount of market instability stemming in part from the failure of these agencies to accurately measure the risks associated with mortgage-backed securities and other more complex products. As the Chairman of the Securities, Insurance, and Investment Subcommittee of the Senate Banking, Housing, and Urban Affairs Committee, I chaired a hearing in September of 2007 to examine the role of credit rating agencies in the mortgage crisis, and these issues were also addressed at a hearing by the full Committee last year. From these hearings, it is clear that problems at credit rating agencies contributed to the significant financial sector instability our country has been experiencing. In fact, an SEC investigation last summer found that credit rating agencies such as Moody's, Standard & Poor's, and Fitch Ratings conducted weak analyses and failed to maintain appropriate independence from the issuers whose securities they rated. Credit rating agencies are in the business of providing investors with unbiased analysis, but the current incentive structure gives them too much leeway to hand out unjustifiably favorable ratings. Let us be clear: not every rating is suspect and these firms provide crucial information for investors and the marketplace, but credit rating agencies like any other industry should be held accountable if they knowingly or recklessly mislead investors. According to a mortgage industry trade publication, the three major credit rating agencies have each downgraded more than half of the subprime mortgage-backed securities they originally rated between 2005 and 2007. Ratings agencies made these mistakes in part because of conflicts of interest and other problems with internal controls, underscoring the need for enhanced oversight of this industry. The bill I introduce today gives the SEC strong new authority to oversee and hold rating agencies accountable for conflicts of interest and other internal control deficiencies that have weakened ratings in the past. The bill includes a carefully crafted liability provision that allows investors to take action when a rating agency knowingly or recklessly fails to review key information in developing the rating. It also enhances disclosure requirements to allow investors and others to learn about the methodologies, assumptions, fees, and amount of due diligence associated with ratings. It requires rating agencies to notify users and promptly update ratings when model or methodology changes occur. Finally, the bill requires ratings agencies to have independent compliance officers, and to take other actions, to prevent potential conflicts of interest. I hope my colleagues will join me in helping improve the accountability and transparency of credit ratings that are so critical to the functioning of our financial markets. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. REED

Mr. REED. Madam President, I wish to make some remarks with respect to this pending legislation. First, I wish to commend Senator Dodd and Senator Shelby for developing this bipartisan legislation. It will bring more fairness to the credit card market and provide more predictability to the many Americans who use credit cards, which is practically all Americans today. Families are being squeezed on every side. The unemployment rate continues to rise. The situation, we hope, is beginning to stabilize across the country. However, in my State of Rhode Island, there is still a significant 10.5-percent unemployment rate. That is unacceptable. Individuals are still working, but they are receiving pressure to take pay cuts. Home values have fallen precipitously. As a result, people can no longer call upon their biggest investment and their biggest source of wealth: their home. All of this is adding to the dilemma that is facing working families across this country. At a time of declining home prices, rising unemployment, and the pressures of daily life, individuals are faced with higher and higher credit card interest rates, which makes it even more difficult to make ends meet. People who have never missed a payment are facing double-digit interest rate increases because card issuers are currently permitted to increase rates at any time for any reason. Our small business owners are struggling. The Federal Reserve April 2009 survey of senior loan officers shows that banks continue to tighten standards for credit for small business lending and to decrease existing credit lines. With few viable alternatives, many small business owners must use their personal credit cards just to keep the lights on in their company and to stay afloat, and they also are subject to these arbitrary increases of their interest rates. The Dodd-Shelby substitute restores balance to a market that has lacked adequate consumer protections for far too long. This legislation codifies the rules the Federal Reserve recently issued by prohibiting double-cycle billing, retroactive interest rate increases on credit card holders in good standing, and other questionable practices. It will institute commonsense rules that will make a meaningful difference for consumers, and this is a very important and very positive first step. These Federal Reserve rules have done that. But this bill goes further. It requires that penalty fees be reasonable and proportional to the cost of the violation. It requires that any interest rate increases on new purchases be reviewed every 6 months so that consumers can return to a previous rate if conditions change. It also protects consumers who have temporarily fallen on hard times by requiring 60 days before penalty interest rates can be imposed. It shields young people from taking on more debt than they can handle by limiting prescreened offers to young consumers. It also gives consumers more access to the information they need to make wise financial decisions, such as requiring full disclosure about due dates, penalties, and changes in terms. I am pleased that much of the bill will take effect just 9 months from enactment. This is an aggressive but achievable effective date-- something I pushed for, along with my colleagues, particularly Senators Dodd and Shelby. When the Federal Reserve first announced that its rules would not be implemented until July 2010, I wrote to Chairman Bernanke urging him to reconsider the effective date in light of the economic crisis. This legislation is careful to try to make changes in a way that preserves consumer access to credit. Implementation is staggered in recognition that some of these changes are very narrow in scope and others are more far-reaching. For instance, an important provision requiring a 45-day notice before any interest rate increase will take effect in 3 months. Other changes, which may require more time to be implemented appropriately, will be instituted on a different timeline. This is a sensible and rational way to quickly address issues that are clear cut. It will also place more difficult issues on a timeline that will provide relief but give an opportunity to effectively implement these changes. I am, however, disappointed that the ban on retroactive interest rate increases will not take effect until 15 months after the bill is enacted. I think we should do that much more quickly. I point out that 15 months is even later than the date included in the Federal Reserve's original rules, although we are improving upon their original approach. This bill goes further than the Federal Reserve's rules, and in that sense I think it is important and timely and effective. This bill will stop the exploitation of credit cardholders, there is no doubt. But we must acknowledge that when card issuers return to careful underwriting standards because they can no longer change interest rates at will, credit may become tighter. As a result, for some consumers, a credit card will be harder to come by. We have to recognize that. That is something which I think should be explicit rather than implicit. One more point. Our first priority is protecting consumers, but what should not get lost in the debate is that robust consumer protections benefit the whole economy. We are now seeing what happens when some financial institutions are able to pursue profits without reasonable safeguards for borrowers, without prudent underwriting, without effective due diligence. The short-run gain quickly turns into long-run pain for the economy. That is precisely what has happened over the last several months. Not only did consumers suffer, but also the institutions that originally underwrote these products suffered. All of this having been said, the legislation before us is timely. It will provide long-overdue protections to Americans--individuals, households, families, and businesses. I urge my colleagues to support this important legislation. I yield the floor.

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

Mr. REED

Mr. REED. Mr. President, today I introduce the Immunization Improvement Act of 2009. The recent outbreak of H1N1 influenza makes this legislation timelier than ever before. While a vaccine has not yet been developed to protect us against this flu strain, one is currently in the works. This outbreak is a reminder of the important role that immunizations provide in protecting us against harmful or even deadly viruses, like the measles, polio, and seasonal human influenza. Vaccinations have been proven to be clinically effective in improving health, and providing population-based immunity. Routine childhood immunizations, for example, prevent over 14 million individual cases of disease and over 33,500 deaths over the lifetime of children born in any given year. However, significant and persistent gaps in public and private health insurance coverage of immunizations remain. Approximately 11 percent of young children and 21 percent of adolescents are underinsured for immunizations. Nearly 2/3 of adults are underinsured for immunizations--17 percent are uninsured. Each year, vaccine-preventable diseases cause the deaths of more than 42,000 people and hundreds of thousands of cases of illness. Congress will soon embark upon meaningful health care reform. This debate will provide the opportunity for us to eliminate the obstacles-- lack of insurance and high cost-sharing--to accessing routine immunizations. We must shift to a system that will make routine preventive care, like immunizations, affordable. In fact, it is in the best interest of Government and society to ensure coverage of routine vaccinations, as these preventive vaccinations currently result in an annual cost savings of $10 billion in direct medical costs and over $40 billion in indirect societal costs. Expanding immunization coverage will enhance these savings over the long term. The Immunization Improvement Act would remove barriers to immunization. First, it would enable states to access routine vaccinations for adults at a discount negotiated by the Federal Government. Currently, 36 States and New York City are able to buy vaccines using the Federal discount, but these contracts are about to expire. The Immunization Improvement Act would ensure that states can continue to purchase adult vaccines under CDC contracts. It would also provide for Medicaid coverage of adult immunizations that are recommended for routine use and prohibit any cost-sharing for them. There are a host of routinely recommended vaccinations for the Medicare population, as well. Unfortunately, Medicare Part B only covers influenza, pneumonia, and hepatitis B vaccines. Medicare beneficiaries are eligible for additional vaccines that are covered by Part D, but few of these vaccines are covered by prescription drug plans. Moreover, physicians have difficulties billing plans for the incurred costs. As such, the Medicare Payment Advisory Commission, MedPAC, has recommended that all immunizations recommended for routine use among the Medicare population be covered under Part B. The Immunization Improvement Act would codify that recommendation. Inadequate reimbursement for administering immunizations also prevents children, adolescents, and adults from receiving necessary vaccinations. According to the National Vaccine Advisory Committee, the Centers for Medicare and Medicaid Services, CMS, and CDC should review and update the maximum allowable fees for administering routine vaccinations, and publish and update the actual fees for vaccination administration paid by each State--in an effort to encourage consistency across state lines. This legislation would also reimburse providers for administering vaccines to children who are eligible for vaccination through the Vaccines for Children program, but not Medicaid. This would enable both uninsured and underinsured children to become vaccinated in an effort to get all children vaccinated. Finally, as we look to reform our health care system, we must also hold private health insurers accountable for covering vaccinations recommended for routine use--without any cost-sharing. The Immunization Improvement Act would require this coverage upon the enactment of health reform. Given the current circumstances, it is evident that vaccinations can and truly do eradicate the spread of preventable diseases. However, we must do more to ensure comprehensive coverage of immunizations. It is my hope that my colleagues will join me in supporting this legislation. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. REED

Mr. REED. Mr. President, today I introduce the Immunization Improvement Act of 2009. The recent outbreak of H1N1 influenza makes this legislation timelier than ever before. While a vaccine has not yet been developed to protect us against this flu strain, one is currently in the works. This outbreak is a reminder of the important role that immunizations provide in protecting us against harmful or even deadly viruses, like the measles, polio, and seasonal human influenza. Vaccinations have been proven to be clinically effective in improving health, and providing population-based immunity. Routine childhood immunizations, for example, prevent over 14 million individual cases of disease and over 33,500 deaths over the lifetime of children born in any given year. However, significant and persistent gaps in public and private health insurance coverage of immunizations remain. Approximately 11 percent of young children and 21 percent of adolescents are underinsured for immunizations. Nearly 2/3 of adults are underinsured for immunizations--17 percent are uninsured. Each year, vaccine-preventable diseases cause the deaths of more than 42,000 people and hundreds of thousands of cases of illness. Congress will soon embark upon meaningful health care reform. This debate will provide the opportunity for us to eliminate the obstacles-- lack of insurance and high cost-sharing--to accessing routine immunizations. We must shift to a system that will make routine preventive care, like immunizations, affordable. In fact, it is in the best interest of Government and society to ensure coverage of routine vaccinations, as these preventive vaccinations currently result in an annual cost savings of $10 billion in direct medical costs and over $40 billion in indirect societal costs. Expanding immunization coverage will enhance these savings over the long term. The Immunization Improvement Act would remove barriers to immunization. First, it would enable states to access routine vaccinations for adults at a discount negotiated by the Federal Government. Currently, 36 States and New York City are able to buy vaccines using the Federal discount, but these contracts are about to expire. The Immunization Improvement Act would ensure that states can continue to purchase adult vaccines under CDC contracts. It would also provide for Medicaid coverage of adult immunizations that are recommended for routine use and prohibit any cost-sharing for them. There are a host of routinely recommended vaccinations for the Medicare population, as well. Unfortunately, Medicare Part B only covers influenza, pneumonia, and hepatitis B vaccines. Medicare beneficiaries are eligible for additional vaccines that are covered by Part D, but few of these vaccines are covered by prescription drug plans. Moreover, physicians have difficulties billing plans for the incurred costs. As such, the Medicare Payment Advisory Commission, MedPAC, has recommended that all immunizations recommended for routine use among the Medicare population be covered under Part B. The Immunization Improvement Act would codify that recommendation. Inadequate reimbursement for administering immunizations also prevents children, adolescents, and adults from receiving necessary vaccinations. According to the National Vaccine Advisory Committee, the Centers for Medicare and Medicaid Services, CMS, and CDC should review and update the maximum allowable fees for administering routine vaccinations, and publish and update the actual fees for vaccination administration paid by each State--in an effort to encourage consistency across state lines. This legislation would also reimburse providers for administering vaccines to children who are eligible for vaccination through the Vaccines for Children program, but not Medicaid. This would enable both uninsured and underinsured children to become vaccinated in an effort to get all children vaccinated. Finally, as we look to reform our health care system, we must also hold private health insurers accountable for covering vaccinations recommended for routine use--without any cost-sharing. The Immunization Improvement Act would require this coverage upon the enactment of health reform. Given the current circumstances, it is evident that vaccinations can and truly do eradicate the spread of preventable diseases. However, we must do more to ensure comprehensive coverage of immunizations. It is my hope that my colleagues will join me in supporting this legislation. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. REED

Mr. REED. Mr. President, I thank the chairman. My amendment makes it very clear that when financial institutions repay their TARP funds, the Secretary of the Treasury is not required to liquidate or surrender the warrants. Warrants were issued to the Department of Treasury in conjunction with the capital injections under TARP. They are valuable financial instruments. They are separate from the TARP funds. I think it is the responsibility of the Secretary of the Treasury to balance many factors, but one factor they must consider is obtaining a substantial return for the taxpayers because of their investment of funds. This will allow him the discretion to do that. It will be an important way in which the Treasury Department can recoup some of the investments of the taxpayers in this program. I thank the chairman.

Mr. REED

Mr. REED. Yes, that is the case. We are open to finding ways to quantify the number of individuals and families experiencing housing instability and look forward to working with the Senator and the administration to do so. I thank the Senator for her questions, and I look forward to working together on improving the prevention of homelessness and the provision of services to homeless individuals and families in order to break the cycle of homelessness.

Mr. REED. Mr. President, this is a bipartisan effort to reform our homeless programs. This amendment would simplify the application process, give greater flexibility and accountability at the local level. It would also provide additional resources to prevent homelessness. We are in the midst of a huge crisis in terms of people who literally cannot find housing. We have pictures in newspapers of tent cities sprouting up all across the country. We need to act. This amendment is bipartisan and is supported by Senator Bond and, before him, Senator Allard, and Senators Boxer, Collins, Durbin, Kerry, Lautenberg, Lieberman, Schumer, and Whitehouse. It is good, sensible reform legislation that will make our programs more effective and, hopefully, prevent people from losing their homes and keep them away from these tent cities that are sprouting up. I urge its passage.

Mr. REED. Certainly, Mr. President.

Mr. REED. I thank the Senator for her important question. The definition of homelessness in the HEARTH Act in no way seeks to replace or change the definition of homelessness in any other statute. The definition of homelessness in the Education for Homeless Children and Youths program is critical to ensuring that homeless students have access to supports and services for their success in school. The definition of homelessness in the HEARTH Act does not and should not change or replace that education definition.

Mr. REED. Yes, that is my intent, and it is the intent of the amendment. We continue to work on, particularly with your leadership, encouraging strong communication and coordination between the Department of Housing and Urban Development and the Department of Education on the issue of serving homeless youth. It is my intent to continue to encourage that collaboration and to work to the utmost degree, not just to prevent lapses, but to strengthen education services for homeless students while implementing the HEARTH Act.

Mr. REED

Mr. REED. Madam President, there will be an amendment that I propose that will help qualify the status of warrants that are currently held by the Department of Treasury with respect to TARP. It will give the Secretary of the Treasury discretion to dispose of those warrants when he feels it is appropriate. Right now, under language that was adopted in the context of our debates over the recent amendments to TARP, there is a mandatory requirement for the Secretary to surrender or dispose of the warrants if the TARP funds are returned by a financial institution. I believe the Secretary should have the discretion to hold these warrants if he thinks it is in the best interests of the taxpayers. The whole point of the warrants, and a point I insisted upon in the original legislation for the TARP bill last September, indeed a point that I found to resonate with many of our colleagues on the Republican side--Spencer Bachus, the ranking Republican on the House Financial Affairs Committee cited this specifically as one of the reasons why the TARP program could be supported--and that is, in addition to our investment in preferred stock which pays dividends, the Government would also have the right to obtain warrants; that would be the right to acquire stock in the future. Interestingly enough, at the time we were debating the TARP bill, Warren Buffett, who was a very sophisticated and is a very sophisticated investor, made a preferred stock investment in a large financial institution and also received warrants. So this is typically how many of these deals are done. At this juncture the institutions receiving TARP funds have the right at any time to pay it back. That is an issue that has been settled. It is the policy of the United States. But I believe the Secretary of the Treasury should have the discretion, because these are separate instruments, to hold those warrants, to maximize, if he can, the market price that he will receive on behalf of the taxpayers. This, again, is an issue that was very critical to many of us in the initial adoption of the TARP legislation. We are not mandating that the Secretary of the Treasury surrender the warrants, nor are we mandating that he keep them. It will be discretionary. He and his colleagues have, and I believe must exercise, the judgment when it is an appropriate time to surrender these warrants or to take other actions under the contracts under which they were issued, to ensure value for taxpayers. We have made very significant investments in the financial system through the TARP program. The premise, again, was that not only would the direct investment be repaid, but taxpayers would benefit from the recovery of these institutions. We are seeing that recovery now. We have a ways to go but we are seeing some encouraging signs. I believe, again, that having assumed risks, taxpayers should benefit from the rewards of a revived financial institution and in that case we are simply making this discretionary with the Secretary of the Treasury so that he can judge whether and when the appropriate time is to surrender the warrants, to receive fair market price for the warrants, and to ultimately help benefit the taxpayers who have put up the money to deal with a huge financial crisis. At the appropriate time I believe there will be a consent to move forward on this amendment. I hope it would be supported and adopted, but I wanted to make that point at this juncture.

Mr. REED. Madam President, I believe they are working on an appropriate consent to adopt it.

Mr. REED. Madam President, Senator Coburn has been working very diligently over the last several years to deal with the issue of property disposition. We have established over many decades now certain priorities to access Federal properties, and included in those are very low-priority agencies that provide shelter for homeless people. Prior to these, in my recollection of the distribution of the properties, is the right of State and local governments to buy property at a discounted price. Madam President, as Governor, you have probably considered this option many times. It is my understanding that this underlying bill would exempt a number of the properties from the Federal Property Act provisions that would allow, in fact, State and local governments to access these properties at prices that are reasonable, particularly now, given the budget pressures of local governments. But, in addition, this 5-year pilot program would encompass the largest and potentially most valuable properties that are held in surplus by the United States. It is far from a pilot program. What our colleagues in the House are talking about is a true pilot program--a limited number of properties to validate and really legitimize the approach Senator Coburn and others are suggesting. I know the Senator has been working very diligently and sincerely with colleagues on both sides of the aisle, but this represents a version, an early version, I believe, that, at least in terms of discussion with others, has been changed somewhat. One point I wish to make with respect to the underlying amendment that is important is that we are not attempting to deal with the issue of property distribution, which cuts across the entire spectrum of Federal properties--practically every agency in the Federal Government. That encompasses not only the rights--very limited rights--of homeless groups to acquire property but fundamentally the rights of State and local communities to acquire this property. In fact, for many State and local communities, this program is a major source of economic development. Again looking at the Chair, who was the Governor of the State of New Hampshire, Pease Air Force Base was surplus property which is now a dynamic economic development tool. My guess, again, was that it was obtained by the State, probably using at least in part some of these powers. All of that would be altered in this pilot program that would give, in fact, public lands managers wide discretion to dispose of properties. Again, it is a pilot program, but it is so long term. Five years is not exactly a short-term, let's do an experiment, evaluate it, and see what can be done. Our legislation, the underlying amendment, is the result of many years of bipartisan effort to deal with the issue of homelessness, not the distribution or disposition of public property. I think it would represent an extraordinary improvement in the current system. It is more efficient, it consolidates applications, it gives flexibility to local communities, and it deals with the problem that I think is equally compelling for the children of today. There are thousands of children who don't have a home. We have to be cognizant of the future. We have to take prudent steps--and I wish, looking back over the last 8 years, some of my colleagues on this side would have been much more prudent in their fiscal policies that took a surplus in 2001 and turned it into a huge deficit in 2008, 2009. So the ability to look ahead is not exclusive to one side of the aisle. But the legislation I have proposed, along with Senator Bond, represents a reauthorization of McKinney-Vento, which will give the States and localities better tools to deal with the current crisis of countless families who are without homes. My concern is not only with the breadth of this amendment, with its focus on one part of a much more complicated puzzle, but also the fact that I think it could seriously jeopardize the passage of what is important legislation--the McKinney-Vento reauthorization. I do believe, because of the Senator's efforts, because of his sincere and energetic and consistent advocacy of this, that this issue is resonating on both sides--both with our colleagues in the House and here in the Senate. I would be extraordinarily disappointed if we were to miss a great opportunity to fundamentally reform the program. We worked with the Senator last Congress. We had bipartisan support, led by Senator Allard. We had, in fact, the clear endorsement of President Bush and the Housing and Urban Development Department under the Bush administration for our homelessness proposal, but it failed because this legislation, the Reed amendment, was embroiled in this controversy of property disposition which spans every agency of the Federal Government. It is not just HUD, it is the Department of Defense, the Department of Agriculture, the Department of the Interior. I think if we are going to do something this comprehensive, let's not single out the homelessness initiative as sort of the wedge or the fulcrum or the lever. Let's step back, work collectively, collaboratively, and pass legislation that will apply across the board and will do so in a principled and practical way. There is no opposition to that. I would also note, as the Senator alluded to, that at an appropriate moment there will be a point of order raised on the legislation. But I would hope that, again, we could move through this proposed second degree, pass the underlying amendment, and not forget but in fact redouble our efforts to approach this in a comprehensive way. I know many colleagues--not only Senator Coburn but Senator Carper--are sincerely and enthusiastically interested in having reform of the way we dispose of property. I am certainly also in a position to say personally that I think if we do this, we have to take into consideration the equities of all the parties. This is not just about homeless groups that get grants, this is about State and local governments, this is about the way we have established over many years the disposition of Federal property. Can it be improved? Yes, it can. Should we improve it? Yes, we should. But I think to essentially target the homeless population as sort of the lever for this change is the wrong approach. So I would, at the appropriate moment, either myself or the manager, raise a point of order. With that, I yield the floor. Madam President, I do have another amendment which I would like to call up, but I see the Senator from Oklahoma is here, and he should have an opportunity to speak.

Mr. REED

Mr. REED. Mr. President, I ask unanimous consent that Randy Fasnacht, a detailee from the Subcommittee on Securities, Insurance, and Investment, be granted the privilege of the floor for the remainder of the day during consideration of this bill.