Jay Rockefeller

Mr. ROCKEFELLER

Mr. ROCKEFELLER. I yield 4 minutes to the Senator from the State of Florida.

Mr. ROCKEFELLER. Mr. President, this is an amendment regarding Medicare prescription drug benefits. Senators Graham of Florida, Wellstone, Kennedy, Harkin, Johnson, Kerry, Clinton, Dayton, and Stabenow are all listed as cosponsors, and I am sure there will be more. The amendment is an extraordinarily serious amendment. It was the amendment in the Finance Committee which got the second most votes of any of the amendments we did, and which I think should have passed. This amendment takes the top rate reduction of our income tax as proposed under the compromise bill and makes it contingent upon the passage of a prescription drug bill, a prescription drug benefit that would, in fact, be voluntary, accessible, affordable. This amendment, therefore, is in the most immediate terms about priorities. It is a classic choice that Senators are going to have to make that will say a lot to the American people. It is clearly saying the Medicare prescription drug benefit that every single political person on this Hill and those at the other end of the avenue who promised to the American people is just as important as a tax reduction for the wealthiest of our people. This amendment does not preclude the tax cut--I wish that to be clear--but, rather, shifts the debate back to the promise we have made and about which we have been very firm and talked about endlessly at hearings and years of fora. The amendment basically says the reduction in the top tax rate will not go into effect until and unless an accessible, comprehensive, universal prescription drug benefit is enacted. A vote for this amendment is not a vote against the tax cut. It is a vote in favor of the prescription drug amendment. The doing of the one does not preclude the doing of the other. It is just that you have to do the prescription drug benefit to get to the top rate. A vote in support of this amendment says you believe it is just as important that all Medicare beneficiaries who suffer all over this country in various ways and various forms against the devastating and ever-growing cost of prescription drugs, some of whom have to make terrible choices in their lives about this, that their plight is as important as those who are the wealthiest among us getting their top tax rate reduction. A vote in support of this amendment says you believe the drug benefits should take precedence over a tax cut. It does not say you cannot have a tax cut; it just says it should take precedence over a tax cut with a prescription drug benefit and you do not think seniors should be forced to make the choices they do now. We have made some progress. The budget resolution, thanks to the leadership of the Senator from the State of Iowa, the chairman of the Finance Committee, explicitly rejects President Bush's prescription drug benefit as being insufficient and accepts the principle that a prescription drug benefit should be available to all beneficiaries universally--not national in that sense, not nationalize, not socialize, just universal; everybody. It says that 39 million Americans who are Medicare beneficiaries and those who are disabled should have this benefit. It is a proposal that provides a premium subsidy to all Medicare beneficiaries, a proposal that ensures true catastrophic coverage against drug costs, a proposal that incorporates a new benefit into the Medicare Program. So it is just as reliable as all of the other benefits in the Medicare Program, a proposal that does not completely rely on private insurance because private insurance has failed Medicare beneficiaries in terms of delivering that benefit. I will close with this because there is little time and others want to speak. One group, which is bipartisan, says: We agree with you we cannot enact a tax break for the wealthiest Americans. We should be sure our vulnerable citizens receive the lifesaving drugs they must have. This is an absolutely classic choice that Americans need to make about prescription drugs. We are doing it on their behalf in this amendment. I hope my colleagues will support this amendment, and I hope there are other colleagues in the Chamber at this time who will speak for this amendment. I yield to the Senator from Florida. Mr. NICKLES addressed the Chair.

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

Mr. ROCKEFELLER. Mr. President, I have an amendment that I send to the desk and ask for its immediate consideration.

Mr. ROCKEFELLER. Mr. President, in the State this Senator represents, we are of moderate means. We can't afford a lot of charts. So when Senator Byrd and this Senator come to the floor, we don't usually use charts. We use whatever words we have. I don't mean to make any big point of that. But sometimes I think charts are helpful; sometimes I think they are not. I will say this. I agree with the Senator from North Dakota that the bill is not fair. I voted for all the amendments which were defeated, but I do think the chairman of the Finance Committee, Senator Grassley from the State of Iowa, was very fair in the way he conducted the hearing. I didn't agree with the result, but I thought his personal demeanor and the way he handled himself in the general disposition of the tax bill--that the Senator himself was personally very fair, and I respect that. I wanted to so say. I am baffled, also, by what the fairness concept is. One of the things that amazes me--and I am here to talk for the marriage penalty, and I will--but when they talk about the rich, this is sort of a mantra: If the rich make a lot of money, then they should get a tax credit because they did make a lot of money, which goes somehow on the idea that they really struggled their way through life and stock options and other things didn't help them. The point, of course, is that during these last years, the pretax income of the very wealthy has been so enormous that, obviously, they have paid more taxes. But the reason is that their pretax income was so much higher. Even after they did pay their taxes, their resulting net income was much higher than it had been previously. I think that is a very important point. I think another important point to be made, before I get to Senator Conrad's amendment, is that one of the things that, it seems to me, people have not focused on either in the press or, as I find it, in general conversation, is that once the Senate and the Congress, with the encouragement of the President, cut taxes to the extent that I believe we may, that is revenue forgone, not for a period of 10 years but probably 10, 15, or 20 years. There was a time when you could come in and say, well, we are at a certain crisis and, for a certain reason, we have to raise taxes. I think those times have passed. The American people are not going to stand for it if we lower their taxes and then come back in 3 years, as we did after a year and a half with the balanced budget amendment with the hospitals and other health care facilities, and say we made a mistake; we want to change the rules. The American people won't stand for that, nor should they. If we want to take a stand, now is the time we need to do that. The stand should be for fairness, and this bill doesn't meet any of those tests that I can find. I look upon the future of the country and upon the future of my State, West Virginia, and I worry about whether or not we are all going to make this. I think we are going to be back in very substantial double-digit deficits--triple digit, quadruple digit, multiple digit. I also think that the markets are going to take a very bad signal from this. They are going to think Congress has acted, as we are acting, in a very hasty manner. The Joint Tax Committee hasn't even scored a lot of the costs of this bill, even as we discuss this matter. The 20 hours is running, and we are going to vote on Monday, I presume. We really don't know what we are voting on. Very few Senators outside of the Finance Committee, and maybe not many on that committee, are enable to tell you that. So we have our votes and we think we are making substantial points, but most of this is flowing underneath the radar screen, under our feet, and the cost of it is going to be enormous. I fear for that because eviscerating the Federal budget may be attractive if one wants to diminish the size and role of Government in America, but there are, after all, some things the private sector cannot do and there are things the public sector does have to do--in Medicare, health care, FAA, FBI, and border control; all kinds of programs are a part of that. The Presiding Officer wants to see a third airport built in the State of Illinois. I happen to share his view. I also happen to share the view that there should be another runway built at O'Hare. Neither the Presiding Officer nor I are going to see that happen, unless there is money to make it happen. So having divested myself of those particular thoughts, I want to say that I strongly support the Conrad amendment and I think we need marriage penalty relief now. The proposal the Senator is making would make the marriage penalty available to couples in 2002. The way we did it in the Finance Committee was to make it available in 2006 and then, because of certain problems of scoring, et cetera, it was brought back to 2005. The point is, we are playing a budget gimmick and we are withholding something which people all over this country--couples--think they absolutely are going to have as soon as this bill passes, if indeed it does. So, in a sense, we are misleading them. We are grossly distorting what we have said to them, and they don't know it. It is only on occasions such as this when one has a chance to say it, but it is not usually reported because it is not considered newsworthy. But it will be very newsworthy to the American people when they discover they do not get marriage penalty tax relief until the year 2005. That is wrong. On the other hand, we can change it by simply saying we will take the two top tax brackets and put those off a little bit and make it available in the year 2002. That is what we promised we would do. That is what we campaigned on. That is what we discussed we would do, and we ought to do that. That is what the Conrad amendment, in fact, does-- charts or no charts. It does that. I think that is right and fair. I think the amendment is fiscally responsible because it is paid for; it is offset by delaying the reductions in the two top tax brackets. So we are leveling with the American people, but we are also doing something that they expect to happen. They know gasoline prices are going up and we are not doing anything about that. We told them we were going to give them marriage penalty relief, and we are not going to do that. Through this amendment, we can do that. I think it is something we should proceed to expeditiously, so that if we take our word to the American people about 2002 and marriage penalty tax relief, and doing it in a very good manner, then it would seem to me one would vote yes. If one values that less than the so-called sanctity of the two top tax brackets, then I suppose one would vote no. I intend to vote yes. I think it is a rather easy decision. I thank the Presiding Officer, and I yield the floor.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, today I introduce the Save the American Steel Industry Act of 2001. As you know, the domestic steel industry is currently faced with the most devastating crisis in its history, one that could lead to its decimation if the Administration fails to initiate action under Section 201 of our trade laws. Over two- thirds of our largest steelmakers have entered bankruptcy since 1997, and some analysts predict that almost half of existing U.S. steelmaking capacity may be idled by year's end if the President does not take immediate and decisive action to provide the industry with desperately needed relief. The surge of dumped, subsidized, and disruptive imports that was initially triggered by the onset of the Asian financial crisis has not abated, but has in fact worsened over the past few months. Steel prices have plummeted over the last 3 years, with no hopes of rebounding, and an additional five U.S. steel companies entered Chapter 11 in the first 4 months of this year, with more certain to follow absent Presidential action on Section 201. My State has two major steel facilities, one owned by Weirton and the other by Wheeling-Pittsburgh. Wheeling-Pitt is in bankruptcy and Weirton is struggling. Thousands of jobs and two important communities in a small, relatively poor State are threatened. It is a situation that is all too common in the American steel belt, and one that demands immediate attention. Throughout the steel belt, tens of thousands of jobs are at stake; more than 20,000 have already been lost. Hundreds of communities are endangered. Billions of dollars in wages and shareholder value are threatened. Most alarming, our national security is threatened. Unless we act decisively, the United States could soon be as dependent on foreign steel as we are on foreign oil. We are facing a permanent loss of capacity that has the potential to harm every heavy industry in this country, including automakers, defense contractors and, in my home State of West Virginia, aerospace companies. For some time now, I have advocated consolidation as one of the best ways to ensure the survival of the domestic steel industry in the face of this massive surge of imports. Merged companies create greater economies of scale and with their enhanced capacity and purchasing power, stand a better chance of competing against their heavily subsidized foreign competitors. While consolidation by itself will not relieve the hardships of the steel crisis for our steelworkers, their families and communities, the domestic industry can really only recover with the imposition of remedies under Section 201, I believe that it is a step in the right direction. Unfortunately, the pace of consolidation in the domestic industry has been slowed due to companies' fears of assuming the tremendous legacy and environmental compliance costs of acquired entities. Legacy costs, in particular, are a tremendous expense for companies, as there are more retired steelworkers than steelworkers currently employed. The burden of assuming such substantial costs has acted as a deterrent to industry consolidation, which I believe, gives our industry a much better chance of long-term survival. The Save the American Steel Industry Act of 2001 attempts to address these concerns. Title I of the Act establishes a Steel Retiree Health Care Board in the Department of Labor to administer a newly-created Health Care Benefit Costs Assistance Program. Under the program, the board will contribute funds to eligible steelworker group health plans equal to 75 percent of the qualified expenditures of such plans. The funds will be allocated from a Steelworker Retiree Health Care Trust Fund in the U.S. Treasury financed by a 2 percent Federal excise tax on all steel products sold in the United States. Title I is critical, because by some estimates, 10 percent of the cost of steel in the U.S. consists of payments to pension and retiree health care funds for workers laid off in the 70's and 80's. This new fund would be accessible to all steel companies providing health insurance to retirees and, as the pool of affected retirees declines, the tax will be reduced. In the meantime, U.S. companies will be at less of a disadvantage against competitors whose governments pick up the tab for health care and retirement costs. Title II of the Act allows merged companies to apply for grants of up to $200 million from the Commerce Department to help cover the costs of compliance with applicable environmental regulations. The Secretary of Commerce can only provide grants after it is determined that the merger promotes maximum retention of jobs and production capacity consistent with long-term viability. Specifically, at least 80 percent of the steelworkers employed by the merging companies, including a minimum 50 percent of steelworkers employed by the acquired company, must be retained to qualify for a grant. At least 80 percent of the steelmaking facilities of each party must be retained. The Act provides for substantial penalties if a company receiving a grant subsequently violates these thresholds. Together, these two actions could make a tremendous difference for many domestic steel mills, especially small and mid-sized operations by providing incentives for domestic steel companies to consider joining forces. The Health Care Benefit Costs Assistance Program proposed under Title I makes mergers more likely by ensuring that a large portion of legacy costs inherited in consolidation plans would be covered by the Federal Government. By providing domestic steelmakers with substantial funds to bring merged facilities into compliance with environmental laws, Title II of the bill provides further incentives for consolidation. At the same time, Title II ensures that steelworkers and their families are not sacrificed in the merger process by requiring that most jobs and production capacity are retained and by heavily penalizing companies that receive funding and subsequently do not stick to the agreement. The American steel industry has earned the respect and consideration of this body as an industry that took some very tough medicine not so very long ago. During the first steel crisis, the U.S. steel industry got very little sympathy. As the first great wave of imports washed across our coasts, the industry was told that it was too old, too inefficient, and too unresponsive to save. But rather than walk away, the American steel industry put itself through a wrenching, and almost miraculous revitalization, transforming century-old mills into miracles of modern production. No steel industry on earth gets more production per man hour than the U.S. industry. None has a cleaner environmental record. No one has been faster or more effective at integrating computer technology into its production. And yet, having done that, the industry finds itself threatened again--not by better steelmakers, but by subsidized producers. Companies who have the support of their governments are taking advantage of our traditional commitment to trade, to dump steel on a saturated market. Their competitive advantage lies in their government support, and not their manufacturing skill. It is not fair. It is not just. And I don't believe that our Government should stand by idly and let the painful years and billions of dollars our steel industry invested be stolen away by companies who do not play by the rules. The Save the American Steel Industry Act of 2001 represents the first step in the Federal Government's commitment to ensuring that the United States maintains our basic steelmaking capacity. While I do not believe that the industry can survive without a comprehensive Section 201 action on all steel products and ultimately, negotiation of a multilateral steel agreement with our trading partners to address the foreign overcapacity problem, this act provides greater incentives for domestic steel companies to consider consolidation, which, I believe, substantially enhances their chances of survival in today's increasingly turbulent steel marketplace. Failure to act now, in this Congress, would be a grave mistake.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I rise today to celebrate the recent accomplishment of one of West Virginia's finest health care facilities, the Schiffer Cancer Center at Wheeling Hospital. Wheeling Hospital just became one of only two community hospitals in the country and the ninth facility in the world to become a part of the Partnership in Science with the Division of Clinical Sciences of the National Cancer Institute in Bethesda, MD. This is an incredible and important accomplishment for this facility and the citizens of West Virginia. Wheeling Hospital, which is located in Wheeling, WV, is an acute care community hospital, which just celebrated its 150th anniversary last year. Located right in the heart of the northern pan-handle in Ohio County, the hospital serves Ohio County, parts of Brook and Marshall Counties, and eastern Ohio State residents bordering the Ohio River in addition to residents of southwestern Pennsylvania and across the State of West Virginia. I had the pleasure of visiting Wheeling Hospital in 1993 for the dedication of their Howard Long Wellness Center. The facility employs approximately 2,000 people and maintains five centers of excellence including: cancer; cardiac, including open heart surgery; women's health; trauma; and the Howard Long Wellness Center, which is 55,000 sq. feet. The recent partnership between Wheeling Hospital and the National Center Institute is one of the greatest achievements in cancer care that has happened in the Ohio Valley. With this partnership, qualified cancer patients in the area will be able to participate in a select number of new cancer research protocols without leaving home. They will also be empowered to consult with and obtain second, third, even fourth opinions about their condition and treatment. Additionally, the partnership increases education opportunities for physicians, nurses, and other health care professionals in the area. Residents of West Virginia, eastern Ohio, and southwestern Pennsylvania will all benefit from this partnership. I am so thankful to Wheeling Hospital, its CEO, Don Hofreuter, its doctors and nurses, and all of its employees for all of the amazing work that they continue to do to serve their community. The people of Ohio County, West Virginia, and the surrounding area are indeed fortunate to have you as part of our community. Congratulations on your 150th anniversary.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, Congress transformed the landscape of health care delivery for veterans with the Veterans' Health Care Eligibility Reform Act of 1996. This law eliminated barriers to outpatient care and encouraged the Department of Veterans Affairs, VA, to offer health care services to veterans in the most clinically appropriate setting. VA responded by shifting its emphasis from hospital-based treatment to outpatient care, and in just a few years has opened more than 250 new community-based outpatient clinics. I am enormously pleased that VA has opened community clinics in West Virginia and throughout the country. It is critical to bring health care services closer to veterans, especially as our veterans population continues to age. But it is not sufficient merely to increase the accessibility of care, we must also ensure that veterans receive the highest quality of care possible. Just as I fought to secure outpatient clinics for veterans, I will fight to ensure that these clinics are the very best that they can be. At my request, the Democratic staff of the Senate Committee on Veterans' Affairs surveyed more than 200 VA community-based outpatient clinics nationwide to evaluate the success, capacity, and quality of care in these clinics. This self-reported information from individual clinics offers Congress and VA an opportunity to assess services provided by the various clinics, and to determine where improvements can be made to ensure that veterans receive the best possible care. The Democratic committee staff report concludes that, although all clinics reported offering primary care, services varied markedly by clinic and by geographic location. VA's 22 regional network directors, rather than VA Headquarters, hold responsibility for activating, operating, and overseeing the community clinics. Although this provides flexibility to local VA managers, the variations in services described by clinic staff appear to result from varied management practices rather than deliberate adaptations to community needs. For example, staffing levels did not appear to be related to the number of patients seen, and varied among clinics and among networks. Some clinics served about 5,000 patients in the first half of fiscal year 2000 with the equivalent of 15 full-time health care providers, while others served the same number of patients with only six full-time staff. Some clinics operated with fewer than two full-time employees. Variations in staffing translated into differences in the types and levels of services provided, including basic mental health care. Less than half of the clinics surveyed offered even minimal mental health care, an issue of concern as VA continues to close its inpatient mental health care clinics. In several areas of the country, waiting times for an appointment for primary care ranged from 30 to 150 days. More than 60 percent of the community clinics lacked equipment and personnel to respond to a cardiac emergency, an issue of patient safety. VA's lack of a consistent, nationwide system for collecting and analyzing information on health care outcomes and treatment costs is an obstacle to measuring the success of VA's outpatient clinics. VA must develop tools to allow community clinics to monitor health outcomes, so that veterans can depend on a system that not only meets their needs but continues to improve their health status. Clinics must be able to combine this information on health outcomes with accurate data about costs of treatment, so that VA can ensure the effective and efficient use of resources at all clinics. I certainly do not expect community clinics to offer the full range of services available in a large medical center. However, it is reasonable to assume that a veteran seeking primary care through a VA outpatient clinic should be able to expect a minimum standard package of services and an acceptable quality of care, regardless of geographic location. Oversight by VA headquarters and by Congress is essential to ensuring consistency in the services and quality of care offered to veterans through community clinics. I have forwarded a copy of this report to VA Secretary Anthony Principi, and I look forward to working with him to make certain that veterans who turn to VA's community care clinics can expect not just access, but excellence. I ask unanimous consent that the text of the executive summary of the Democratic committee staff report be printed in the Record.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, it gives me great pleasure and pride to introduce today the MediKids Health Insurance Act of 2001. I am joined by my colleague Representative Stark, who is introducing companion legislation in the House. In 1997, we passed historic legislation which created the Children's Health Insurance Program. I was a proud sponsor of the CHIP legislation with our late-colleague Senator John Chafee. However, one thing which we have learned throughout the implementation process of CHIP is that while it provides a vehicle for insuring our nation's low-income children, it does not guarantee all of America's children health insurance coverage and access to affordable health care. I'm pleased to say that of the 26,000 West Virginia children without health insurance two years ago, according to the most recent state estimate nearly 20,000 have now enrolled in the CHIP program. But this is not enough. We can do better for our children to make sure they can count on access to the care they need to grow up healthy. It should not be so hard. Today, there remain more than 10 million children in America without health insurance, in spite of more and more children being enrolled in CHIP every day. Clearly, there is still much more that can and should be done to guarantee health coverage to all American children. Today, I offer a solution to ensure that all of our nation's children have access to health care. The MediKids program, which I propose, would create a new Medicare-like program for children which is separate from Medicare and will have no financial impact on the existing program. Every child would be enrolled at birth, just as every American is enrolled in the Medicare program at age 65. This ensures that all children will have coverage, avoiding difficult problems related to outreach and enrollment, or state-to-state variations. MediKids is a simple, direct and comprehensive approach to dramatically improve the health insurance safety net for America's Children. Eligibility for the program would be phased in over five years, covering children from birth to 5 years of age in the first year, 6 to 10 in the second, 11 to 15 in the third, 16 to 20 in the fourth, and 21 and 22 in the fifth and final year. By 2008, the legislation would provide every child in America access to consistent, continuous health insurance coverage. The benefits covered by the program would be very similar to those available to children under Medicaid now, including the screening and prevention services so critical to successful childhood development. The MediKids program would work in conjunction with CHIP and Medicaid, allowing children enrolled in those programs, and those children with private insurance coverage, to remain in those programs. CHIP and Medicaid are important programs, and essential for the insurance coverage of children. However, even with perfect enrollment in CHIP and Medicaid, there would still be a great number of children without health insurance. This is partially due to our increasingly mobile society, where parents frequently change jobs and families often move from state to state. When this occurs there is often a lapse in health coverage. Also, families working their way out of welfare fluctuate between eligibility and ineligibility for means-tested assistance programs. Another reason for the number of uninsured children is that the cost of health insurance continues to increase, leaving many working parents unable to afford coverage for themselves or their families. All of this adds up to the fact that many of our children do not have the consistent and regular access to health care which they need to grow up healthy. Under The MediKids program, all children would be enrolled automatically at birth, and have continuous, reliable health coverage from birth until their twenty-third birthday. A prescription drug benefit would be included as part of the program, and the Secretary of Health and Human Services will continue to develop age-appropriate benefits as needed. The legislation also contains provisions allowing the Secretary to review and update the benefits offered annually, with input from the pediatric community. During the first few years of the program, the costs can be fully covered by public funds such as tobacco settlement monies, the budget surplus, or other funds upon which we may agree. Over this period of time, the Treasury Secretary will have the necessary time to develop a package of progressive, gradual tax changes to fund the program. Parents will be responsible for a small premium which will account for one-forth of annual average cost per child, and will be exempt from the premium should they have comparable health coverage for their children through private insurance or enrollment in other federal programs. There will be no cost-sharing under the program for preventive and well child care, and there will be assistance for low-income families to meet their needs. Those families living at or below 150 percent of poverty will pay no premium and those living between 150 percent and 200 percent of poverty will receive a 50 percent discount on premiums. A family's premium obligation will be capped at 5 percent of its total income. Children are inexpensive to insure, yet the benefits of doing so would be enormous for our country. We have an opportunity now to guarantee that future generations of children grow up more healthy and ready to succeed than any before them. I am pleased to announce that I am joined today by a number of organizations whose support has been critical to the cause of ensuring health coverage for all children. I thank the many national organizations that have already lent their support and endorsement to this important legislation. The American Academy Pediatrics and the Children's Defense Fund have already begun to actively push for the MediKids Health Insurance Act of 2001. I am so pleased to have the support of these and other organizations which have dedicated themselves to children and children's health care in America. I learned a valuable lesson some thirty-five years ago as a VISTA volunteer in the small town of Emmons, West Virginia. I was taught that health care is not just something to be talked about, or debated here on the floor of the Senate. Health care is a fundamental right, its as necessary as food and shelter. I have learned this time and time again, and I have carried that lesson with me throughout my entire life in public service, as Chairman of the Pepper Commission on Comprehensive Health Care, and also on the National Commission on Children. The growing number of uninsured in this country is a very serious problem. The fact that some 10 million children, our nation's most vulnerable population, do not have access to affordable health insurance today is not just unfair, it is downright immoral. In a nation as wealthy as ours, it is wrong that poverty at birth can mean life-long illness or even early death, especially from easily treatable and preventable causes. What's more, children are the cheapest population in America to insure. But as I have said time and time again, I also believe it is important to not lose sight of the ideal, and our capacity to reach that ideal, of the United States of America joining every other industrialized nation by ensuring that its citizens have basic health insurance. I believe that we must not lose sight of that great ideal which I have spoken about here today, that every American have access to affordable health care. The MediKids Health Insurance Act is a tangible step toward achieving that ideal. I offer this legislation to enlist my colleagues in an effort to insist that all of our nation's children are insured as quickly as possible. I ask my colleagues from both sides of the aisle to join as co-sponsors. I ask unanimous consent that the text of the bill and a summary be printed in the Record.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, it gives me great pleasure and pride to introduce today the MediKids Health Insurance Act of 2001. I am joined by my colleague Representative Stark, who is introducing companion legislation in the House. In 1997, we passed historic legislation which created the Children's Health Insurance Program. I was a proud sponsor of the CHIP legislation with our late-colleague Senator John Chafee. However, one thing which we have learned throughout the implementation process of CHIP is that while it provides a vehicle for insuring our nation's low-income children, it does not guarantee all of America's children health insurance coverage and access to affordable health care. I'm pleased to say that of the 26,000 West Virginia children without health insurance two years ago, according to the most recent state estimate nearly 20,000 have now enrolled in the CHIP program. But this is not enough. We can do better for our children to make sure they can count on access to the care they need to grow up healthy. It should not be so hard. Today, there remain more than 10 million children in America without health insurance, in spite of more and more children being enrolled in CHIP every day. Clearly, there is still much more that can and should be done to guarantee health coverage to all American children. Today, I offer a solution to ensure that all of our nation's children have access to health care. The MediKids program, which I propose, would create a new Medicare-like program for children which is separate from Medicare and will have no financial impact on the existing program. Every child would be enrolled at birth, just as every American is enrolled in the Medicare program at age 65. This ensures that all children will have coverage, avoiding difficult problems related to outreach and enrollment, or state-to-state variations. MediKids is a simple, direct and comprehensive approach to dramatically improve the health insurance safety net for America's Children. Eligibility for the program would be phased in over five years, covering children from birth to 5 years of age in the first year, 6 to 10 in the second, 11 to 15 in the third, 16 to 20 in the fourth, and 21 and 22 in the fifth and final year. By 2008, the legislation would provide every child in America access to consistent, continuous health insurance coverage. The benefits covered by the program would be very similar to those available to children under Medicaid now, including the screening and prevention services so critical to successful childhood development. The MediKids program would work in conjunction with CHIP and Medicaid, allowing children enrolled in those programs, and those children with private insurance coverage, to remain in those programs. CHIP and Medicaid are important programs, and essential for the insurance coverage of children. However, even with perfect enrollment in CHIP and Medicaid, there would still be a great number of children without health insurance. This is partially due to our increasingly mobile society, where parents frequently change jobs and families often move from state to state. When this occurs there is often a lapse in health coverage. Also, families working their way out of welfare fluctuate between eligibility and ineligibility for means-tested assistance programs. Another reason for the number of uninsured children is that the cost of health insurance continues to increase, leaving many working parents unable to afford coverage for themselves or their families. All of this adds up to the fact that many of our children do not have the consistent and regular access to health care which they need to grow up healthy. Under The MediKids program, all children would be enrolled automatically at birth, and have continuous, reliable health coverage from birth until their twenty-third birthday. A prescription drug benefit would be included as part of the program, and the Secretary of Health and Human Services will continue to develop age-appropriate benefits as needed. The legislation also contains provisions allowing the Secretary to review and update the benefits offered annually, with input from the pediatric community. During the first few years of the program, the costs can be fully covered by public funds such as tobacco settlement monies, the budget surplus, or other funds upon which we may agree. Over this period of time, the Treasury Secretary will have the necessary time to develop a package of progressive, gradual tax changes to fund the program. Parents will be responsible for a small premium which will account for one-forth of annual average cost per child, and will be exempt from the premium should they have comparable health coverage for their children through private insurance or enrollment in other federal programs. There will be no cost-sharing under the program for preventive and well child care, and there will be assistance for low-income families to meet their needs. Those families living at or below 150 percent of poverty will pay no premium and those living between 150 percent and 200 percent of poverty will receive a 50 percent discount on premiums. A family's premium obligation will be capped at 5 percent of its total income. Children are inexpensive to insure, yet the benefits of doing so would be enormous for our country. We have an opportunity now to guarantee that future generations of children grow up more healthy and ready to succeed than any before them. I am pleased to announce that I am joined today by a number of organizations whose support has been critical to the cause of ensuring health coverage for all children. I thank the many national organizations that have already lent their support and endorsement to this important legislation. The American Academy Pediatrics and the Children's Defense Fund have already begun to actively push for the MediKids Health Insurance Act of 2001. I am so pleased to have the support of these and other organizations which have dedicated themselves to children and children's health care in America. I learned a valuable lesson some thirty-five years ago as a VISTA volunteer in the small town of Emmons, West Virginia. I was taught that health care is not just something to be talked about, or debated here on the floor of the Senate. Health care is a fundamental right, its as necessary as food and shelter. I have learned this time and time again, and I have carried that lesson with me throughout my entire life in public service, as Chairman of the Pepper Commission on Comprehensive Health Care, and also on the National Commission on Children. The growing number of uninsured in this country is a very serious problem. The fact that some 10 million children, our nation's most vulnerable population, do not have access to affordable health insurance today is not just unfair, it is downright immoral. In a nation as wealthy as ours, it is wrong that poverty at birth can mean life-long illness or even early death, especially from easily treatable and preventable causes. What's more, children are the cheapest population in America to insure. But as I have said time and time again, I also believe it is important to not lose sight of the ideal, and our capacity to reach that ideal, of the United States of America joining every other industrialized nation by ensuring that its citizens have basic health insurance. I believe that we must not lose sight of that great ideal which I have spoken about here today, that every American have access to affordable health care. The MediKids Health Insurance Act is a tangible step toward achieving that ideal. I offer this legislation to enlist my colleagues in an effort to insist that all of our nation's children are insured as quickly as possible. I ask my colleagues from both sides of the aisle to join as co-sponsors. I ask unanimous consent that the text of the bill and a summary be printed in the Record.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I rise today to pay tribute to Senator Jennings Randolph on the anniversary of the passage of the 26th Amendment. In 1971, a young West Virginian named Debbie Phillips skipped a day of high school. Skipping school is usually frowned upon by parents and teachers, but Debbie, then 18, was anything but another student trying to ditch chemistry, algebra, and history. In fact, Debbie was missing school in order to make history: that day, she registered to vote under the newly-ratified 26th Amendment to the Constitution at the Kanawha County Court House in Charleston, WV. A year later, the 26th Amendment also allowed Debbie to seek an appointment as a delegate at a national convention, making her the first West Virginian under 21 years of age to file for public office. I was the Secretary of State in West Virginia at the time, so Debbie came to my office to register. Her actions, and those of millions of other young Americans who have accepted the 26th Amendment's invitation to participate in the political process, show how critical young people are to our democracy. These extraordinary developments were made possible by a great man and a friend of mine--Senator Jennings Randolph, my predecessor as Senator form West Virginia and the ``Father of the 26th Amendment.'' Senator Randolph drafted the amendment and worked tirelessly for its passage, based on his belief that America's youth had a right to be part of our political process. The ratification of the amendment marked a great moment in our country's history. It has allowed young adults to speak for themselves and have their voices heard in the greatest democratic society in the world. Thirty years ago Saturday, the State of West Virginia ratified the 26th Amendment. This action came in the midst of the Vietnam War, in which nearly half of all the soldiers that America lost were younger than 21. Despite making the ultimate sacrifice for their country, those young soldiers had been unable to vote for the President that was sending them to war. In addition, they were paying taxes and participating in society in every other way; yet they were unable to vote. Senator Randolph changed that forever. Tomorrow, West Virginia Secretary of State Joe Manchin is holding an event at our State Capitol encouraging schools to register voters under his West Virginia SHARES program--Saving History and Reaching Every Student. It is so important that young people realize what an awesome power Senator Randolph's crusade brought them. Young Americans were excited to have the right to vote in the early 1970s, but today many 18- to 21-year-olds do not even bother to register. With the exception of 1996, voter participation among citizens between the ages of 18 and 24 has decreased in each Presidential election. Secretary of State Manchin's project is therefore of utmost importance. It is essential that we let young people know of their right, and indeed their responsibility, to vote, and help them register to do so. Again, I salute Senator Randolph for his tireless efforts to allow Debbie Phillips and countless other young people to improve our democracy.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am committed to focusing a spotlight on the good work of the Department of Veterans Affairs, VA, in the area of long-term care. VA has hidden its light under a barrel for too long. The federally funded VA health care system, out of necessity, has developed some of the most innovative ways to care for older people. The necessity arises because approximately 34 percent of the total veteran population is 65 years or older, compared with approximately 13 percent of the general population. And by the year 2010, 42 percent of the veteran population will be 65 years or older. As a result of this demand, VA has led the nation in developing adult day health care programs, standardized clinical treatment protocols and specialized units for Alzheimer's patients, home-based services, and respite care. Our older veterans are leading richer lives because of these innovations. Today, I wish to highlight the Alzheimer's unit at the Salem VA hospital, which has received extraordinary praise from the son of a veteran who was treated there for Alzheimer's. I know firsthand how difficult it is to care for a loved one afflicted by Alzheimer's. The special needs of Alzheimer's patients are all too frequently misunderstood and therefore go unmet. It seems, however, that the VA is up to the challenge. The family members of this particular veteran found the care at the VA hospital to be first-rate, humane and loving. By all accounts, the veteran suffering from Alzheimer's was well cared for up until the very end. To quote from the article, ``His daily needs were met by the staff less from obligation or duty than from true, honest caring. His aimless wandering was confined behind secured doors, without restraints, thank goodness. Dad's sleepless nights and constant babbling were `normal' there. The staff was unshaken by any of his peculiar behavior.'' The Salem VA Alzheimer's unit is not one of a kind, thankfully. Approximately 56 VA hospitals have specialized programs for the care of veterans with dementia. These programs include inpatient and outpatient dementia diagnostic programs, behavior management programs, adapted work therapy programs for patients with early to mid-stage dementia, Alzheimer's special care units within VA nursing homes (like Salem's) and transitional care units, and model inpatient palliative care programs for patients with late stage dementia. There are also various programs for family caregivers. While VA has developed significant expertise in long-term care over the past 20-plus years, it has not done so with any mandate to share its learning with others, nor has it pushed its program development beyond that which met the current needs at the time. For VA's expertise to be of greatest use to others, it needs both to better capture what it has done and to develop new learning that would be most applicable to other health care entities. Those who would benefit by capitalizing on VA's long-term care expertise are the health organizations, including academic medicine and research entities, with which VA is now connected, and the rest of the U.S. health care system. Ultimately, this expertise can benefit all Americans who will need some form of long-term care services. As Ranking Member of the Committee on Veterans' Affairs, I am enormously proud of VA's efforts in end-of-life care. However, I have always been dismayed that my colleagues here in the Senate remain for the most part unaware of VA's good work in this area. Those of us in the health policy arena should sit up and take notice. We simply must stay ahead of the curve and explore the various ways to provide such care, so all Americans will have the best choices available to them at the time they need them. I ask consent that a Roanoke Times article on VA Alzheimer's care by Wayne Slusher, son of a veteran cared for at the Salem VA hospital, be printed in the Record along with a press release on VA's newest end-of- life care program, a fellowship in palliative care. The material follows: [From the Roanoke (VA) Times, Apr. 1, 2001] Succumbing to Alzheimer's--In the Hands of the VA, a Declining Father Got Genuine Care (By Wayne Slusher) It started out seemingly innocent enough. Wrong turns on familiar roads, daily tasks forgotten and numerous other little things not so significant as to send up red flags, but still enough that it registered in the back of the mind that something was not quite right. In the years following, it got worse. Faucets left on, asking for dinner an hour after leaving the table, inability to use the phone, failing to recognize home, and on and on. It had happened, ``If anything ever happens to me,'' my father would say time and time again, ``you take me to the VA.'' It was a frequent topic, since Dad was a deacon in his church and spent a great deal of time visiting with the sick and the elderly members in the community. You spend your whole life hearing it, but reject the idea that you'll actually have to act on it, much less take him to the Veterans Affairs Medical Center so far from his home. Even well-intentioned friends asked, ``Why the VA?'' But then, it had happened, and we decided that going to the VA for help was what he had always wanted. There was something so intrinsically important about honoring his wish, especially when he was at a point of mental incapacity such that he could no longer contribute to decision-making even about himself. So, in the middle of the night, we took him to the emergency room. As we sat in the waiting room, Dad thought he was in a train station on his way to visit old Army buddies, and he was deliriously happy. Instead, the visit was with a doctor who quickly determined that admission to the hospital was warranted. We doubt Dad ever fully understood what transpired that evening. Leaving him there was one of the most difficult tasks any of us had ever had to do. That would be the beginning of our relationship with the VA and, in particular, the staff providing services for those with various levels of dementia. Right away, we learned that the building to which he was assigned was filled not only with people just like himself, but also employed a staff of extremely skilled health-care professionals who began the difficult job of taking care of my father. His daily needs were not met by the staff less from obligation or duty than from true, honest caring. His aimless wandering was confined behind secured doors--without restraints, thank goodness. Dad's sleepless nights and constant babbling were ``normal'' there. The staff was unshaken by any of his peculiar behaviors. The specially designed area provided as much of a homelike atmosphere as possible, with bright colors, hanging plants and murals on walls. The unit was always clean, always tidy. The initial few weeks were full of all sorts of cognitive tests, blood tests and scans. As the results of each test came in, they ruled out, one by one, any chemical imbalances or other underlying culprit that might bring on his state of confusion. If there was a remote possibility, it was tested for. Indeed, the unthinkable had happened. Only now it had an official name: Alzheimer's. In the months that followed, we watched the VA staff do everything it could for Dad: bathing, dressing, feeding, changing and hundreds of other daily tasks. Different medications were tried, and in different combinations and at different dosages, but his dementia had a mind of its own, for lack of a better term. What had worked yesterday didn't work today. Each visit, Dad would be brought out to the visitation area--a bright, sunny room with lots of plants, park benches and a garden scene painted on the walls by the gifted wife of another patient. The staff was always as glad to see us as we were to see them, and it was during those months that we began to realize that Dad, for all those years, had been absolutely right about where he needed to be if it ever happened. The doctors, physician assistants, nurses, social workers, occupational therapists, dieticians and others associated with dementia services became more like family. It was medicine administered in equal portions from the head and from the heart. As Dad's mental state skidded deeper into a quagmire, not one member of the staff ever complained. They looked out for us just as much as they looked after my father. When it appeared at one point that he might be stable enough to consider releasing him to a long-term-care facility, we were dismayed to think he might not receive the same level of care he'd been getting at the VA. These folks had come to know my father's needs, and we trusted them fully with his care. But the stability was short-lived and all too soon interrupted by more difficulties. In particular, he's lost his ability to swallow. In those last days and hours, he was made as comfortable as possible. Even into the wee hours of that final morning, the staff kept almost as constant a vigil by his side as did the family. The VA, we found, is full of immensely compassionate, caring professionals who could not have done more for my father. We think, too, perhaps they do not get recognition and praise from the community as often as they should. With my father's personal nightmare over, the staff at the VA continues to care for others just as they cared for him. They deal daily with patients who have long forgotten how to say thank you. The staff never really knew my ``real'' father, a man who would have been so humbled and grateful for their help. We hope we said thank you enough on his behalf. We will never forget their kindness.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, earlier today I filed an amendment to the Budget Resolution to increase funding for the Federal Bureau of Investigation by $39 million a year, adjusted for inflation. As a new member of the Senate Select Committee on Intelligence, and as a Senator representing a rural state that has encountered FBI staffing shortfalls for many years, I believe it is imperative that among our national budget priorities we include adequate funding to address the threat of international terrorism and the spread of urban crime to our rural towns and counties. In the past few years, Congress has increased the number and scope of federal criminal laws, thereby increasing the responsibilities of the FBI, as well as other federal law enforcement agencies. Because of these changes, and the assistance and technical expertise these agencies give to local law enforcement agencies throughout the country, federal law enforcement resources have been stretched thin. In the Fiscal Year 2001 Commerce-State-Justice Appropriations process, we recognized the need to keep the FBI fully staffed, and we required the Bureau to fully fund salaries and benefits for all authorized ``workyears'' for special agents and support staff. In order to do this, Director Freeh and his staff were required to reprogram $42 million from the agency's equipment and infrastructure accounts to satisfy this need. Given the expanded responsibilities of the Bureau, this type of ``robbing Peter to pay Paul'' would be troubling enough. However, the budgetary gymnastics required of the FBI to get through this fiscal year is just a small example of a much more dangerous trend in our funding of federal law enforcement agencies. Unless we address this funding issue, by the end of the current fiscal year the FBI will have suffered the net loss of 521 special agents since the beginning of Fiscal Year 2000. In preparation of its budget request for Fiscal Year 2002, Director Freeh determined that in order to maintain salary and benefit levels, the Bureau would need to reduce its staffing by 336 agents and 521 support staff. This force reduction will require the cancellation of almost all of the New Agent training classes for the remainder of this year, and may put in jeopardy another 182 special agent positions and 248 support positions planned for Fiscal Year 2002. This situation is simply untenable for rural states like my home state of West Virginia. After discussions with our U.S. Attorneys over the past few years, I have come to share their frustration over difficulties in carrying out law enforcement activities in West Virginia because of a shortage of resident agents in all of the federal agencies operating in the state. Having too few federal agents in West Virginia has affected numerous federal criminal investigations and prosecutions. Joint state-federal drug interdiction operations in West Virginia, although successful, require a level of participation by federal law enforcement agencies that current staffing levels sometimes prevent. Perhaps in the past, it made sense to concentrate our federal agents in big cities. Today, unfortunately, many of the crime problems of our cities have infected rural America. Sadly, West Virginia is not immune from this contagion. I believe the funding increase I have outlined here is absolutely necessary to provide West Virginia and other rural states with the federal law enforcement resources they will need to investigate, fight, and hopefully, prevent crime. Mr. President, as the Ranking Member of the Committee on Veterans Affairs, I must voice my concern about the level of funding for veterans' health care and benefits proposed in the Senate Concurrent Resolution on the FY 2002 Budget. If the Department of Veterans Affairs is funded at the level that the Budget Resolution provides, a $1 billion increase over the FY 2001 appropriation, which might appear generous at first glance, we can expect VA to eliminate staff, delay providing health care and benefits, and slash vital programs. Much, if not all, of this proposed increase would be consumed in merely overcoming inflation in the costs of providing medical care. It simply will not meet VA's needs in the next fiscal year. As we strive to cut taxes in a responsible manner, we must also anticipate and address the concerns of the men and women who served this Nation. The alliance of veterans service organizations that authors the Independent Budget for Fiscal Year 2002, AMVETS, the Disabled American Veterans, the Paralyzed Veterans of America, and the Veterans of Foreign Wars, rightly concluded that ``more must be done to meet the increasing needs of an aging veteran population, adapt to the rising cost of health care, enhance and facilitate benefits delivery, and maintain the continuity of funding for VA programs as a whole.'' The Budget Resolution before us would not allow us to fulfill those obligations. We must ensure VA a level of funding that will minimize the impact of inflation, fund existing initiatives, and allow the system to move forward in the ways we all expect. Urgent demands on the VA health care system make increased funding essential. The landmark Veterans Millennium Health Care and Benefits Act of 1999 significantly expanded VA noninstitutional long-term care, which for the first time is available to all veterans enrolled with the VA health care system. As we contend with the dilemma of developing long-term care for all Americans, VA will begin this effort with our Nation's veterans. The Congressional Budget Office estimates that the VA noninstitutional extended care program will cost more than $400 million a year. We must supply adequate funds to fulfill this legislative mandate. The Millennium Act also ensures emergency care coverage for veterans with no other health insurance options. Necessity demands this costly provision: nearly 1 million veterans enrolled with the VA are uninsured and in poorer health than the general population. Although this new benefit has not yet been either implemented or publicized, claims are already mounting. Medical inflation and wage increases, factors beyond VA's control, have been estimated to devour nearly $1 billion of VA's budget annually. At the same time, more and more veterans are turning to the VA for health care. In my own state of West Virginia, the number of veterans seeking care from VA has increased, despite a declining total number of veterans statewide. As an example, the Martinsburg VAMC saw its new enrollees increase by 24.7 percent over the last 2 years. Rapidly expanding enrollment at all four West Virginia VA medical centers has jeopardized their ability to provide high quality care in a timely fashion. Unfortunately, similar examples can be found throughout the Nation. Between new initiatives, long-term care and emergency care coverage, and simply maintaining current services, we must secure an increase of $1.8 billion for health care alone. Unfortunately, maintaining current services may not be enough to ensure that VA can meet veterans' health care needs. The aging veterans population faces chronic illnesses and newly recognized challenges, such as the disproportionate burden of hepatitis C, that will further strain VA facilities. We must anticipate the difficulties of treating complex diseases and ensure that we do not neglect the needs of veterans with multiple, coincident medical problems. If we simply maintain current services, can we expect VA to restore the capacity for PTSD and spinal cord injury treatment to the 1996 legislatively mandated level? In West Virginia, many veterans not only wait months for specialty care, they have to travel hundreds of miles to get it. We can depend on community outpatient clinics to increase veterans' access to primary health care, but we must also ensure that the many veterans who require more intensive, specialized services can turn to adequately funded inpatient programs. VA research not only contributes to our national battle against disease, but enhances the quality of care for veterans by attracting the best and brightest physicians. The Budget Resolution allows, at best, for a stagnant research budget. Not only will this slow the search for new and better medical treatments, but it could weaken efforts to protect human subjects in VA-sponsored studies. As increase of $47.1 million will be required merely to offset the costs of inflation and to monitor compliance with increasingly stringent research guidelines. Savings may be gained through more resourceful management of VA hospitals and clinics, a possibility that VA is pursuing through its Capital Asset Realignment and Enhancement Studies, CARES. In the meantime, efficiencies should not come at the expense of veterans who turn to the VA health care system for needed treatment, nor should VA neglect essential repairs and maintenance of its infrastructure while awaiting the outcome of the CARES process. Accommodating the backlog of urgently needed construction projects will require an increase of $280 million. A shortsighted focus on immediate gains, by delaying essential projects or neglecting existing facilities, may compromise patient safety and prove even more costly to VA and veterans in the long run. The Veterans Benefits Administration also faces challenges that require additional funding for staffing. One of these challenges results from an aging workforce. Projections suggest that 25 percent of current VBA decisionmakers will retire by 2004. These losses would be in addition to the staff that has already left service. It takes 2-3 years to fully train a new decisionmaker. Therefore, it is critical that VBA hire new employees now to fully train them before the experienced trainers and mentors have retired. In addition to this looming succession crisis, extensive new legislation enacted in 2000 will severely affect VBA's workload. Sweeping enhancements to the Montgomery GI Bill are expected to double VA's education claims work. New legislation reestablishing the ``duty to assist'' veterans in developing their claims, regulations presumptively connecting diabetes to Agent Orange exposure in Vietnam veterans, and new software systems intended to improve the quality of decisionmaking have severely affected VBA's workload and slowed output. West Virginia veterans are already receiving letters from the VA regional office warning them to expect a 9-12 month delay for even initial consideration of their new claims. If VBA is unable to hire new staff, the increasing backlog of claims, which is already unacceptable, would reach abominable levels. Without an increase in staffing, the backlog of claims is expected to grow from the current 400,000 claims, up from 309,000 in September 2000, to 600,000 by March 2002. VBA will need a minimum increase of $132 million to acquire the tools, staffing and technology, to avert this escalating disaster. The mission of the National Cemetery Administration, NCA, providing an honorable resting place for our Nation's veterans, is becoming more difficult as we face the solemn task of memorializing an increasing number of World War II and Korean War veterans. It is estimated that 574,000 veterans died last year. The aging of the veterans population is placing additional demands on NCA in interments, maintenance, and other operations. VA has attempted to meet this demand by opening four cemeteries over the last 2 years and planning construction of the six new cemeteries authorized by Congress in 1999. It is estimated that an increase of $21 million will be required to develop these cemeteries. Increases are also required to maintain the VA's National Shrine Commitment. We must preserve our national cemeteries so that they do not dishonor those who died serving their country. Sunken graves, damaged headstones, and even structural deficiencies cannot be tolerated. We applaud VA's commitment to this initiative and encourage VA to continue the project. In order to rise to this task and operate its current facilities, NCA will require an increase of at least $13 million for a total appropriation of $123 million. While we consider the best way to cut taxes responsibly, we mustn't lose sight of our obligations. We all need to agree on how much should go to tax cuts and how much should be saved to strengthen Medicare, invest in education, and fully address the needs of the men and women who have served our country. I anticipate that during the debate on the budget resolution, the Senate will be asked to increase the funding for VA. I urge you all to remember our nation's promise to our veterans and their families as we deliberate on the critical priorities that will shape their future.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I ask unanimous consent that I be added as a cosponsor of the Wellstone amendment.

Mr. ROCKEFELLER. Mr. President, as the Ranking Member of the Committee on Veterans' Affairs, I ask my colleagues to support an amendment offered by Senators Wellstone and Johnson to S. Con. Res. 20, the concurrent resolution on the fiscal year 2002 Budget. The budget resolution provides for an increase of $1 billion for all veterans funding from the fiscal year 2001 amount. The Wellstone-Johnson amendment goes further and provides for an overall increase of $2.6 billion for veterans' health care. If the Department of Veterans Affairs is funded at the level that the Budget Resolution provides, a $1 billion increase over the fiscal year 2001 appropriation, which might appear generous at first glance, we can expect VA to eliminate staff, delay providing health care and benefits, and slash vital programs. While some may describe the funding included in this resolution as a major increase, I must disagree. Much, if not all, of this proposed increase would be consumed in merely overcoming inflation in the costs of providing medical care. After spending vast sums for a tax cut for the wealthiest Americans, there simply isn't enough money to meet VA's needs in the next fiscal year. The alliance of veterans service organizations that authors the Independent Budget for Fiscal Year 2002--AMVETS, the Disabled American Veterans, the Paralyzed Veterans of America, and the Veterans of Foreign Wars, rightly concluded that ``more must be done to meet the increasing needs of an aging veteran population, adapt to the rising cost of health care, enhance and facilitate benefits delivery, and maintain the continuity of funding for VA programs as a whole.'' The budget resolution before us would not allow us to fulfill those obligations. We must ensure VA a level of funding that will minimize the impact of inflation, fund existing initiatives, and allow the system to move forward in the ways we all expect. Urgent demands on the VA health care system make increased funding essential. The landmark Veterans Millennium Health Care and Benefits Act of 1999 significantly expanded VA noninstitutional long-term care, which for the first time is available to all veterans enrolled with the VA health care system. As we contend with the dilemma of developing long-term care for all Americans, VA will begin this effort with our Nation's veterans. The Congressional Budget Office estimates that the VA noninstitutional extended care program will cost more than $400 million a year. We must supply adequate funds to fulfill this legislative mandate. The Millennium Act also ensures emergency care coverage for veterans with no other health insurance options. Necessity demands this costly provision: nearly 1 million veterans enrolled with the VA are uninsured and in poorer health than the general population. Although this new benefit has not yet been either implemented or publicized, claims are already mounting. Medical inflation and wage increases, factors beyond VA's control, have been estimated to devour nearly $1 billion of VA's budget annually. At the same time, more and more veterans are turning to the VA for health care. In my own state of West Virginia, the number of veterans seeking care from VA has increased, despite a declining total number of veterans statewide. As an example, the Martinsburg VAMC saw its new enrollees increase by 24.7 percent over the last 2 years. Rapidly expanding enrollment at all four West Virginia VA medical centers has jeopardized their ability to provide high quality care in a timely fashion. Unfortunately, similar examples can be found throughout the Nation. Between new initiatives--long-term care and emergency care coverage, and simply maintaining current services, we must secure an increase of $1.8 billion for health care alone. Unfortunately, maintaining current services will not be enough to ensure that VA can meet veterans' health care needs. The aging veterans population faces chronic illnesses and newly recognized challenges, such as the disproportionate burden of hepatitis C, that will further strain VA facilities. We must anticipate the difficulties of treating complex diseases and ensure that we do not neglect the needs of veterans with multiple, coincident medical problems. If we simply maintain current services, can we expect VA to restore the capacity for PTSD and spinal cord injury treatment to the 1996 legislatively mandated level? In West Virginia, many veterans not only wait months for specialty care, they have to travel hundreds of miles to get it. We can depend on community outpatient clinics to increase veterans' access to primary health care, but we must also ensure that the many veterans who require more intensive, specialized services can turn to adequately funded inpatient programs. VA research not only contributes to our national battle against disease, but enhances the quality of care for veterans by attracting the best and brightest physicians. The Budget Resolution allows, at best, for a stagnant research budget. Not only will this slow the search for new and better medical treatments, but it could weaken efforts to protect human subjects in VA-sponsored studies. An increase of $47.1 million will be required merely to offset the costs of inflation and to monitor compliance with increasingly stringent research guidelines. The $2.6 billion increase proposed by Senators Wellstone and Johnson in the amendment before us will ensure that VA has the resources required to provide veterans with the high quality health care that they need. Savings may be gained through more resourceful management of VA hospitals and clinics, a possibility that VA is pursuing through its Capital Asset Realignment and Enhancement Studies, CARES. In the meantime, efficiencies should not come at the expense of veterans who turn to the VA health care system for needed treatment, nor should VA neglect essential repairs and maintenance of its infrastructure while awaiting the outcome of the CARES process. Accommodating the backlog of urgently needed construction projects will require an increase of $280 million. A shortsighted focus on immediate gains, by delaying essential projects or neglecting existing facilities, may compromise patient safety and prove even more costly to VA and veterans in the long run. The Veterans Benefits Administration also faces challenges that require additional funding for staffing. One of these challenges results from an aging workforce. Projections suggest that 25 percent of current VBA decisionmakers will retire by 2004. These losses would be in addition to the staff that has already left service. It takes 2-3 years to fully train a new decisionmaker. Therefore, it is critical that VBA hire new employees now to fully train them before the experienced trainers and mentors have retired. In addition to this looming succession crisis, extensive new legislation enacted in 2000 will severely affect VBA's workload. Sweeping enhancements to the Montgomery GI Bill are expected to double VA's education claims work. New legislation reestablishing the ``duty to assist'' veterans in developing their claims, regulations presumptively connecting diabetes to Agent Orange exposure in Vietnam veterans, and new software systems intended to improve the quality of decisionmaking have severely affected VBA's workload and slowed output. West Virginia veterans are already receiving letters from the VA regional office warning them to expect a 9-12 month delay for even initial consideration of their new claims. If VBA is unable to hire new staff, the increasing backlog of claims--which is already unacceptable--would reach abominable levels. Without an increase in staffing, the backlog of claims is expected to grow from the current 400,000 claims (up from 309,000 in September 2000) to 600,000 by March 2002. VBA will need a minimum increase of $132 million to acquire the tools, staffing and technology, to avert this escalating disaster. The mission of the National Cemetery Administration, NCA, providing an honorable resting place for our Nation's veterans--is becoming more difficult as we face the solemn task of memorializing an increasing number of World War II and Korean War veterans. It is estimated that 574,000 veterans died last year. The aging of the veterans population is placing additional demands on NCA in interments, maintenance, and other operations. VA has attempted to meet this demand by opening four cemeteries over the last 2 years and planning construction of the six new cemeteries authorized by Congress in 1999. It is estimated that an increase of $21 million will be required to develop these cemeteries. Increases are also required to maintain the VA's National Shrine Commitment. We must preserve our national cemeteries so that they do not dishonor those who died serving their country. Sunken graves and damaged headstones cannot be tolerated. We applaud VA's commitment to this initiative and encourage VA to continue the project. In order to rise to this task and operate its current facilities, NCA will require an increase of at least $13 million for a total appropriation of $123 million. If we fail to amend the Budget Resolution before us, we tacitly place the needs of affluent Americans before our obligations to our veterans. While we consider the best way to cut taxes responsibly, we mustn't lose sight of our obligations. We all need to agree on how much should go to tax cuts and how much should be saved to strengthen Medicare, invest in education, and fully address the needs of the men and women who have served our country. I urge you all to support this amendment so that we can fulfill our Nation's promise to our veterans.

Mr. ROCKEFELLER. Let's be very clear. The Senator from Minnesota is correct. For the Department of Veterans Affairs, under the budget resolution which is proposed, there will be tremendous damage to the Veterans' Administration and to the veterans of our country. It is axiomatic that the increase that is contemplated in the budget resolution simply will not work. It does not come close. If there is anything which is an immutable fact, it is that the cost of health care and the cost of paying those who deliver it goes up by more than a billion dollars a year, just for health care alone. That is across America, and that is true for the veterans. Beyond that, we have a very difficult problem of disability claims. We need $132 million for staffing and technology. My veterans in West Virginia are being told they are going to have to wait for a full year even for a preliminary examination of their disability claims. Lastly, we cannot forget our commitment to the final resting places of honor for our veterans. Our Nation's veterans cemeteries are falling apart in many cases. Graves are sinking. Tombstones are breaking. That may seem incidental to some. It does not seem incidental to any veteran's family. I urge all to remember our promise to our veterans and support the Wellstone amendment. I thank the Chair and yield the floor.

Mr. ROCKEFELLER. Mr. President, I rise today to join my colleagues in advocating passage of the Bond and Mikulski amendment on science and technology research funding. This amendment recognizes the critical importance of Federal science and technology funding in expanding the frontiers of science and laying the groundwork for economic success. The Bond-Mikulski amendment will increase the funding for the National Science Foundation, the Department of Energy's R&D activities, and NASA. Importantly, the increase to NSF would return us to a path to double that agency's funding over the next five years. I have worked for many years with Senators Frist, Lieberman and others on the Federal Research Investment Act, which would double federal funding government- wide for science and technology research. That bill has passed the Senate twice, but has yet to become law. This year I hope that it will pass both Houses and become law. This amendment contributes to that larger overall effort by maintaining our funding trajectory for several agencies for the current budget. The Federal Research Investment Act is still necessary to reach our goal on the larger group of agencies that together represent our nation's overall commitment to federal science support, and to ensure that funding will be adequate over a longer time period. Senators Bond, Mikulski, Frist, Lieberman, and I are not alone in our call for more substantial funding for science and technology research. The House Science Committee, CEOs of our high technology companies, Presidents of our leading universities, our top scientists and economists, and representatives of labor organizations have all made it clear that Congress must make significantly higher long-term investments in science and technology research. Congressional failure to appropriate more funding for science and technology research will threaten America's competitive advantage in information technology, biotechnology, health science, new materials, and other critical technology-intensive fields. As we all know, many of our best economic thinkers, including Alan Greenspan, MIT economist Lester Thurow, and Harvard Business School professor Michael Porter, have asserted that our country's leadership in these areas is a critical ingredient for future economic success. This amendment gives us a chance to make an important investment in our country's future and to lay the groundwork for continued American high-tech leadership. I urge my colleagues to heed our high-tech, academic, and labor leaders' call to action on federal R&D support and work together to pass this important amendment.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, today is a special day in our office. We are joining our science fellow, Russ Lefevre, in celebrating the 99th birthday of his mother, Mary Samson Lefevre. She was born on April 4, 1902 and lived on a farm in North Dakota for her early years. Her parents were second generation French-Canadian immigrants, and she was one of eight children. She went to grade school at a Catholic elementary school in a small farming community but dropped out of school after the 8th grade to help on her parents' farm. She married Ernest Lefevre in 1934. They lived in a small town in North Dakota. She worked most of her life in a bakery, retiring at age 74. Mrs. Lefevre lives in a care center in Maplewood, MN near her daughter. She is in good health and good spirits, as she participates in the many activities in the center. She continues her interest in national affairs. While she had to leave school early, as often happened at that time, Mrs. Lefevre places great value on education. One of her sources of pride is that all three of her children are college graduates. This is largely due to her strong encouragement. Russ has a Ph. D. in Electrical Engineering. Shirley has a B.S. in Education and teaches in the White Bear Lake, MN Elementary Schools. Robert has a Bachelors degree in Mathematics and worked in the Software industry for over 35 years. A 99th birthday is a special occasion for her, as well as her family and friends. Over the course of her long life, Mrs. Lefevre has seen an amazing transition in our country and our culture. Such experience brings a wisdom and knowledge that enriches the lives of her loved ones. Such a celebration is also a chance for each of us to take a moment to appreciate our own family and our own family traditions.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am proud to be an original cosponsor of the bipartisan Railroad Retirement and Survivors' Improvement Act 2001, and I hope to work closely with Senators Hatch and Baucus and the bipartisan coalition to get this legislation enacted into law this year. In West Virginia, we have over 11,000 retirees and their families depending on railroad retirement. Almost 3,500 West Virginians are working for the railroads and will need their railroad retirement at some point in the future. Nationwide, there are about 673,000 railroad retirees and families, and about 245,000 active rail workers. They deserve a better retirement program, and I want to work with them to promote this historic package supported by both rail labor and rail management. There can be no doubt that improving retirement benefits for railroad workers, retirees, and their families must be one of our top priorities, and I am fully supportive of that effort. Right now, it takes ten years of service before a railroad worker becomes vested in the retirement plan, while private companies covered by Employee Retirement Income Security Act, ERISA, vest their employees in just five to seven years. The need to dramatically improve benefits for widows and widowers is obvious and has gone unaddressed for too long. It is tragic to slash the benefits of the widow of a railroad retiree upon the death of her spouse, as the current policy does. I understand the importance of these and other changes in retirement benefits for workers. Today, experts predict that the Railroad Trust Funds are solvent for the next twenty-five years, and existing policy guarantees benefits to railroad retirees and their families. Under the new plan, the railroads would pay a lower sum of taxes into the Railroad Retirement Trust Funds, but the fund would create an investment board to invest its reserves in private equities so the increased rate of returns would cover the expanded benefits. Under the plan, there is a provision to increase railroad taxes in the future, when necessary, to fully fund the railroad retirement benefits. As a member of the Senate Finance Committee, I want to enact legislation that will improve benefits for railroad retirees and their families, and I will be working with my colleagues to achieve that goal.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am proud to be an original cosponsor of the bipartisan Railroad Retirement and Survivors' Improvement Act 2001, and I hope to work closely with Senators Hatch and Baucus and the bipartisan coalition to get this legislation enacted into law this year. In West Virginia, we have over 11,000 retirees and their families depending on railroad retirement. Almost 3,500 West Virginians are working for the railroads and will need their railroad retirement at some point in the future. Nationwide, there are about 673,000 railroad retirees and families, and about 245,000 active rail workers. They deserve a better retirement program, and I want to work with them to promote this historic package supported by both rail labor and rail management. There can be no doubt that improving retirement benefits for railroad workers, retirees, and their families must be one of our top priorities, and I am fully supportive of that effort. Right now, it takes ten years of service before a railroad worker becomes vested in the retirement plan, while private companies covered by Employee Retirement Income Security Act, ERISA, vest their employees in just five to seven years. The need to dramatically improve benefits for widows and widowers is obvious and has gone unaddressed for too long. It is tragic to slash the benefits of the widow of a railroad retiree upon the death of her spouse, as the current policy does. I understand the importance of these and other changes in retirement benefits for workers. Today, experts predict that the Railroad Trust Funds are solvent for the next twenty-five years, and existing policy guarantees benefits to railroad retirees and their families. Under the new plan, the railroads would pay a lower sum of taxes into the Railroad Retirement Trust Funds, but the fund would create an investment board to invest its reserves in private equities so the increased rate of returns would cover the expanded benefits. Under the plan, there is a provision to increase railroad taxes in the future, when necessary, to fully fund the railroad retirement benefits. As a member of the Senate Finance Committee, I want to enact legislation that will improve benefits for railroad retirees and their families, and I will be working with my colleagues to achieve that goal.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am proud to join my colleagues in supporting the Working Families package to invest in a series of bipartisan initiatives to support and encourage families that are ``playing by the rules,'' but struggling to make ends meet as they raise their children. This legislation combines key legislative proposals to help working families, including a targeted expansion of the Earned Income Tax Credit, EITC, for families with three or more children. It is simple common sense that parents with more children need more help in making ends meet. This bill would give the most needy families up to $496 more in the EITC to help working families live with dignity. Our legislation also includes key provisions to streamline and improve the EITC, which is one of our most effective programs to combat child poverty. Another key component of this package would reauthorize and expand the Safe and Stable Families Act with an additional $200 million a year, as proposed by President Bush. I helped to create this program in 1993 with Senator Bond, and it was expanded and improved in 1997 as part of the Adoption and Safe Families Act. Since this act became law, we have dramatically increased the number of adoptions from foster care. Therefore, we need to increase funding for adoption services and to help the children and their new families overcome the years of abuse and neglect. Further, the bill would improve the Chafee Independent Living program by offering a $5000 scholarship to teens from foster care to encourage them to attend college or pursue vocational training. Abused and neglected children are among the most vulnerable in our society and they deserve our support and care. For many years, I have worked closely with Senator Graham and a bipartisan coalition to restore funding to the Social Service Block Grant, a flexible program to enable states to provide support for needy children, families, seniors and the disabled. During the welfare reform debates, we promised flexibility to the states and full funding of the Social Services Block Grant at $2.38 billion, and we should keep that promise and restore funding. Providing provisions to improve our child support system to get payments to the families first has been a longstanding priority for me. Fatherhood is a major issue for our families, and from my work on the National Commission on Children over a decade ago, I know that children do best in families with committed, caring parents. Investing in quality child care is an obvious concern as we continue our efforts on welfare reform and face the challenges of our new economy in which most mothers work. We should be working together to help our children and our families, so I hope that we will be able to promote this package of bipartisan initiatives that are targeted to some of our most vulnerable families, who are working hard but need help to raise their children with dignity.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am proud to join my colleagues in supporting the Working Families package to invest in a series of bipartisan initiatives to support and encourage families that are ``playing by the rules,'' but struggling to make ends meet as they raise their children. This legislation combines key legislative proposals to help working families, including a targeted expansion of the Earned Income Tax Credit, EITC, for families with three or more children. It is simple common sense that parents with more children need more help in making ends meet. This bill would give the most needy families up to $496 more in the EITC to help working families live with dignity. Our legislation also includes key provisions to streamline and improve the EITC, which is one of our most effective programs to combat child poverty. Another key component of this package would reauthorize and expand the Safe and Stable Families Act with an additional $200 million a year, as proposed by President Bush. I helped to create this program in 1993 with Senator Bond, and it was expanded and improved in 1997 as part of the Adoption and Safe Families Act. Since this act became law, we have dramatically increased the number of adoptions from foster care. Therefore, we need to increase funding for adoption services and to help the children and their new families overcome the years of abuse and neglect. Further, the bill would improve the Chafee Independent Living program by offering a $5000 scholarship to teens from foster care to encourage them to attend college or pursue vocational training. Abused and neglected children are among the most vulnerable in our society and they deserve our support and care. For many years, I have worked closely with Senator Graham and a bipartisan coalition to restore funding to the Social Service Block Grant, a flexible program to enable states to provide support for needy children, families, seniors and the disabled. During the welfare reform debates, we promised flexibility to the states and full funding of the Social Services Block Grant at $2.38 billion, and we should keep that promise and restore funding. Providing provisions to improve our child support system to get payments to the families first has been a longstanding priority for me. Fatherhood is a major issue for our families, and from my work on the National Commission on Children over a decade ago, I know that children do best in families with committed, caring parents. Investing in quality child care is an obvious concern as we continue our efforts on welfare reform and face the challenges of our new economy in which most mothers work. We should be working together to help our children and our families, so I hope that we will be able to promote this package of bipartisan initiatives that are targeted to some of our most vulnerable families, who are working hard but need help to raise their children with dignity.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I thank the Senator from North Dakota. As the able Senator from Montana has indicated, we desperately need a prescription drug benefit. The question is, What form is it going to take? Are we going to fund it fully enough so it really has any meaning? If we go with a prescription drug benefit of about $153 billion, the fact is we are going to end up with deductibles that could be anywhere between $2,000 and $15,000 for people who are sick. You cannot do that. If you are going to do a prescription drug benefit, you have do it properly, fund it adequately, so all people are able to take advantage of it. That is done in the Baucus amendment because he, the Senator from Montana, puts it at $311 billion over a period of 10 years. It does the job. It means you are not going to have people paying so much out-of- pocket expense that they simply cannot afford to go down and get prescription drugs at all. I would say, in the panoply of things that are needed by Americans, a prescription drug benefit, the prospect thereof, the psychological benefit thereof, the medical benefit thereof, is virtually at the top of the list. We very recently passed something called a Coal Miners' Health Benefit Fund Program. It was approved by OMB, which never does that kind of thing, because they believe that a prescription drug benefit used on people of average age 80 years will in fact save money for Medicare, keep people out of hospitals, and keep people from having to use other parts of Medicare, thus saving money overall for Medicare. We are never going to find out what we can do with prescription drugs, how much cost we can either save or not, until we do something and do it fully. The Baucus amendment does that, and I hope it is successful. I yield the floor.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am proud to be the author of the CHAMPVA for Life Act of 2001. Last year, Congress finally enacted legislation to restore the promise of providing lifetime health care to our military retirees. TRICARE for Life, as it is known, is long overdue. However, an equally worthy group has been left out of the reform. The Civilian Health and Medical Program of the Department of Veterans Affairs, CHAMPVA, provides health care coverage to several categories of individuals who have paid dearly for that right: dependents of veterans who have been rated by VA as having a total and permanent disability; survivors of veterans who died from VA-rated service- connected conditions; and survivors of servicemembers who died in the line of duty. As such, CHAMPVA provides a measure of security to a group of persons who have indisputably given a great deal to our country. CHAMPVA is intended to serve as a safety net for dependents and survivors of severely disabled veterans who, because of their disabilities, were unable to provide health insurance benefits to their families through employment. The safety net mission of CHAMPVA has not changed, but this law must change, since under current law, CHAMPVA beneficiaries lose their eligibility for coverage when they turn 65. The TRICARE for Life law passed last year specifically allows military retirees and their dependents to remain in the TRICARE program after they turn age 65, as long as they are enrolled with Part B of Medicare. TRICARE will cover those expenses not covered under Medicare. It also provides for retail and mail-order pharmaceutical coverage for Medicare-eligible military retirees. There is no doubt that TRICARE and CHAMPVA beneficiaries should retain similar eligibility for health care coverage. What TRICARE does for the families of military retirees should be no less readily available to the survivors and dependents of severely disabled veterans and those service-members who died in the line of duty. Simple justice and equity demand this. Just last week, I received a letter from a constituent from Nutter Fort, WV, that hammered home this very point. She asked in her letter, ``Why aren't the CHAMPVA beneficiaries offered the same program recently approved for those on TRICARE who are now eligible for Medicare?'' Indeed, title 38 of the United States Code reflects this view by requiring the Secretary to provide medical care ``in the same or similar manner and subject to the same or similar limitations as medical care furnished to certain dependents and survivors of active duty and retired members of the Armed Forces.'' And up until enactment of the new, highly valued TRICARE for Life provisions just last fall, the two programs were, indeed, similar. An argument could be made that since TRICARE was modified to remove the limitation on eligibility, legislation is not necessary to equate the two programs. However, VA has not yet embraced CHAMPVA for Life. The bill simply clarifies that the CHAMPVA and TRICARE programs should continue to operate in a similar manner, with similar eligibility. This would mean that Medicare-eligible CHAMPVA beneficiaries who enroll in Part B of Medicare would retain secondary CHAMPVA coverage, and beneficiaries would receive the same pharmacy benefit as CHAMPVA beneficiaries who are under age 65. The failure of Congress to enact prescription drug coverage under Medicare only underscores the need to enact this CHAMPVA reform. However serious a gap it was for Medicare to lack prescription drug benefit in 1965, incredible advances in drug therapy, combined with staggering inflation in prescription drug costs, have made the need for affordable prescription drug coverage even more important today. CHAMPVA beneficiaries who have sacrificed so much already should not be forced to sacrifice anything more to purchase needed prescription drugs. Nothing brings this closer to home for me than another letter I received recently, this one from a Korean War veteran and his wife in Alderson, WV. They were upset to learn that when the wife turned 65, she lost all of her CHAMPVA benefits. As a result, she was forced to pay more than $300 per month for her diabetes and heart medications, in addition to all the other new costs for care not covered by Medicare. With Social Security and disability compensation as their only income, this couple is struggling to absorb this enormous new expense in their modest budget. The husband, a 100-percent disabled veteran, wrote poignantly to me, ``. . . it would help us out so much if CHAMPVA would continue to cover my wife's medical care.'' In closing, I thank the Gold Star Wives Association for their dedication and for bringing this issue to my attention. We must never forget that the costs of military service are borne not only by the servicemember alone, but by their families as well. I hope the Committee on Veterans' Affairs will expedite passage of this bill out of committee. CHAMPVA beneficiaries are depending upon it.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, the problem of the uninsured continues to plague our Nation, and it is particularly severe for older Americans who are facing the loss of health coverage but who are not yet eligible for Medicare. Today, over 40 million Americans are without health insurance. Adults between the ages of 55 to 65 are the fastest growing group of uninsured. Individuals 55 and older who have been laid off or retire early are particularly vulnerable to loss of health insurance. They have a difficult time buying health insurance on their own because they tend to have more chronic health problems that can result in either the denial of coverage, limited coverage, or very expensive policies. This is the age group where early detection and access to preventative care become crucial. For example, only 16 percent of uninsured women report having had a mammogram in the past year, compared to 42 percent of insured women. Because regular preventative care is not received, the uninsured are more likely to be diagnosed at a more advanced stage of cancer, over 40 percent more likely to be diagnosed with late stage breast and prostate cancer, and more than twice as likely to be diagnosed with late stage melanoma than the insured. The uninsured are more likely than those with insurance to be hospitalized for conditions that could have been avoided, such as pneumonia and uncontrolled diabetes. Delaying or not receiving treatment can lead to more serious illness and avoidable health problems, which has a direct impact on the health care needs of this segment of the population as they become old enough for Medicare coverage. Lack of insurance and gaps in coverage affect more than just those without insurance. There is a cost to society, as well. When an uninsured person goes to a public hospital or clinic, and emergency room, or a private physician for care and cannot pay the full cost, some of the bill is passed on to those who do pay, through higher insurance premiums and in the form of taxes supporting our public insurance programs. One way or another, we all pay indirectly for having a large and growing uninsured population. With the aging of the baby boom generation, this particularly vulnerable age group is expected to increase significantly. In 1999, there were 23.1 million Americans in this age group. This is expected to increase to 35 million Americans by the year 2020. Unless we effect positive change to address the barriers facing the growing number of uninsured in this age group, this problem will only get worse. I join Senators Kennedy, Daschle, and Sarbanes, and Representatives. Stark, Brown, Gephardt, Rangel, Dingell, and a number of their colleagues today to introduce an improved version of the Medicare Early Access Act. Our legislation will create an opportunity for people between ages 55 and 64 to purchase Medicare coverage, which is really the only affordable option for this group, because of their age and the likelihood of chronic and/or preexisting conditions. The Medicare Early Access and Tax Credit Act would reduce the number of uninsured Americans by more than 500,000. This bill provides new insurance coverage options through a Medicare buy-in for people aged 55 through 64 or through a special COBRA continuation program for workers aged 55 through 64 whose employers reneged on the promise of retiree health coverage. This legislation improves upon the existing Medicare Early Access Act by adding a new 50 percent federal tax credit to the program to make it more affordable for people age 55 and over to obtain health insurance coverage. By including a tax credit, we are making this option available to a broader range of people. A survey released last session by the Commonwealth Fund finds that one in five people from age 50-64 reported a period of time when they were without health insurance coverage since turning age 50. Access to employer insurance is reduced as people approach age sixty-five and retire. Consequently, older Americans rely most heavily on individual insurance, which is expensive and limited for people with serious health problems. Because average health expenses increase sharply with age, people closest to age sixty-five face the greatest risk of being uninsured and being charged the highest premiums in the individual market. Clearly, we need to take real steps to address the needs of this population. The Commonwealth survey also found that, when asked what source they would trust more to provide health insurance for adults ages 50 to 64, Medicare outranked employer-sponsored coverage and direct purchase of private individual health insurance. Half of uninsured adults ages 50- 64 said they would trust Medicare the most as a source of coverage. The Medicare Early Access and Tax Credit Act provides an insurance option for people who are unable to purchase health insurance in the private market either because of pre-existing conditions, age related premium increases, or both. The Medicare Early Access and Tax Credit Act is not the solution to solving America's health insurance coverage problems. But, it is a simple and obvious step to take to open new doors to a vulnerable segment of our population who are lacking affordable coverage elsewhere, and who need the opportunity to buy in to Medicare. I urge my colleagues to join us in making health insurance a reality for people in their later years of life, who are not yet eligible for the safety net of Medicare. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.