Olympia Snowe

Ms. SNOWE

Ms. SNOWE. Mr. President, I introduce two bills for harbors in Maine, one to deauthorize the Federal Navigation Project in Northeast Harbor, and the second to redesignate the Upper Basin of the Union River Federal Navigational Channel as an anchorage. The bills, cosponsored by Senator Collins, will help strengthen the economic viability of these two popular Maine harbors. Because of changing harbor usage over the last 45 years, the Town of Mount Desert has requested that Northeast Harbor be withdrawn from the Federal Navigation Project. This removal will allow the town to adapt to the high demand for moorings and will allow residents to obtain moorings in a more timely manner. The Harbor has now reached capacity for both moorings and shoreside facilities and has a waiting list of over sixty people along with commercial operators who have been waiting for years to obtain a mooring for their commercial vessels. The Harbor was authorized in 1945 and constructed in 1954 as a mixed- use commercial fishing/recreational boating harbor--and it still is today. It was dredged in the early 1950s to provide more space for recreational boating and the U.S. Army Corps of Engineers has informed the town that Northeast Harbor would be very low on its dredging priority list as it has become primarily a recreational harbor. The town says it realizes that, once it is no longer part of the Federal Navigational Project, any further dredging within the harbor would be carried out at town expense. The language will not only allow for more recreational moorages and commercial activities, it will also be an economic boost to Northeast Harbor, which is surrounded by Acadia National Park, one of the nation's most visited parks--both by land and by water. My second bill supports the City of Ellsworth's efforts to revitalize the Union River navigation channel, harbor, and shoreline. The modification called for in my legislation will redesignate a portion of the Union River as an anchorage area. This redesignation will allow for a greater number of moorings in the harbor without interfering with navigation and will further improve the City's revitalization efforts for the harbor area. I have worked with the New England Division of the Corps to draft these bills and the language has been approved by Army Corps Headquarters in Washington. I look forward to working with my colleagues for their passage, either as stand alone bills or as separate provisions in the Corps reauthorization bill, the Water Resources Development Act of 2002, that Congress is currently drafting.

Ms. SNOWE

Ms. SNOWE. We are now creating a penalty on prescription drug coverage. May I ask unanimous consent for 2 more minutes.

Ms. SNOWE. I yield the floor.

Ms. SNOWE. Mr. President, I thank the Senator for yielding me the time. I concur with what has just been suggested by the Senator from Tennessee in terms of returning to the regular process so that we can go back and resume the negotiations and discussions that were well underway over the course of the weekend with Senators from across the aisle--Senators Kennedy, Baucus, and Wyden--even through Monday to reach an agreement that would provide for comprehensive coverage for Medicare beneficiaries. There is no reason we cannot have that discussion to develop the kind of plan that seniors deserve in the Medicare Program. As I said yesterday, we should not have this vote. Why entrench and polarize both sides on this issue? Why make it more intractable? Why not go back and begin the process of negotiations that were well underway using the tripartisan plan as a basis? It provides comprehensive coverage. There is no reason we can't begin that process. This doesn't have to be the last vote. With the Medicare give-back in the fall, we have an opportunity during this interim to begin this process anew so that we can achieve and craft a comprehensive plan that seniors need and deserve. Looking over this proposal, there are many troubling features. I think that we ought to deal with the facts. First of all, the proposal before us today, if you had told me more than a year ago--as the tripartisan group with Senator Breaux, Senator Jeffords, Senator Grassley, Senator Hatch, and myself, as members of the Senate Finance Committee invited all members of the Finance Committee to participate in this process--if somebody told me when we embarked on this legislative odyssey that somehow we would be considering in a serious way today a proposal that abandoned the basic precepts that had been the underpinning of the Medicare Program since its creation 37 years ago yesterday when President Johnson signed into law the Medicare Program--we never contemplated or considered during the course of this last year when we developed that tripartisan plan that we would abandon universal coverage. We never contemplated abandoning the ability to pay and resorting to a means-test program that is now before the Senate--a means-test program that places the low-income benefit in the Medicaid Program--not Medicare, in the Medicaid Program. These are huge departures from the principles that we have embraced here in Congress year after year. In fact, the vote last week, with 97 votes on both sides of the aisle, was for the original plan that we were embracing for universal coverage--the principles that AARP and the major organizations representing seniors in America have always and consistently embraced for the 37 years of Medicare existence. Now the proposal before us abandons all of those principles. It most certainly doesn't advance or improve the prescription drug debate. In fact, the bill before us today has not had the advantage of scrutiny by the Congressional Budget Office because the language of this amendment specifically has not been reviewed by the Congressional Budget Office in order to prepare a cost estimate on the proposal. I think we should understand that from the outset. There is no certainty because the language in this legislative initiative has not been reviewed by the Congressional Budget Office. Are we to have confidence in the process and the Congressional Budget Office when the analysts have not even had the text of the amendment? We are creating a new Federal program at a cost presumably of a minimum of $400 billion without knowing the true fiscal impact of this legislative proposal. Here is my first chart. One of my first major concerns about this initiative before us, which I think all Members of the Senate should readily understand, is that most seniors do not get a basic drug coverage under this plan because it is not a universal benefit. I think that needs to be understood. The Graham proposal does not offer a basic drug benefit for 70 percent of seniors who have incomes above $17,720 for an individual and $23,880 for a couple. This is according to the AARP data: The number of seniors who have incomes above 200 percent of the Federal poverty level. Seventy percent of seniors above 70 percent would not get basic coverage. They will have to spend $3,300 before they get any basic coverage. That is an important point. In fact, in the New York Times the other day there was an op-ed piece written by the Urban Institute--that is not a conservative think tank-- discussing the fact that most individuals usually have drug expenses between $2,000 and $3,300; and that many people are spending in that middle range, particularly on chronic illnesses such as high cholesterol, high blood pressure, and arthritis. But with a low-income catastrophic approach, that will provide very little help for most Medicare recipients with chronic illnesses. The chronically ill cannot get enough help under this type of an approach. Under our legislation, 80 percent would even exceed our benefit limit of $3,450, and we had a catastrophic coverage of $3,700. But the point here is that it now is 70 percent. In all States across the country, seniors are left behind. I heard this morning about how many seniors will be covered. But let us look at the other side of that equation and who won't be covered. If you look at these statistics, it is staggering. It is 71 percent in Maryland. In Oregon, 51 percent of seniors will be left behind. In my State of Maine, they will not get a basic drug benefit under this proposal; neither will 50 percent in Virginia, 67 percent in Arizona, 51 percent in Arkansas, 66 percent in Missouri, 72 percent in Washington, 64 percent in Iowa, 70 percent in Colorado, and 52 percent in Montana. These seniors will not get a basic drug benefit under the Graham plan because they earn at least $1 over the strict income limit for the comprehensive coverage offered to low-income seniors. Only those seniors with incomes below 200 percent of the Federal poverty level obtain real prescription drug coverage under the Graham plan. Let us look at chart 3. It is not a comprehensive benefit because it guts the most important part of any drug benefit program; that is, basic coverage. There is a huge gap. We were criticized for our gap between $3,450 and $3,700. But this is a canyon in terms of gap in coverage. You have no coverage from basically zero to $3,300 in out-of- pocket drug expenses--zero. Seniors above 200 percent will have to spend $3,300 before they receive any coverage at all. According to the Congressional Budget Office, two-thirds of seniors will not have prescription drug costs even has high as $3,000 or $2,500. That means that most of the 26 million Medicare beneficiaries with incomes above 200 percent of the Federal poverty level would never spend enough to receive any coverage--no coverage at all. It is not a comprehensive benefit. What about the 125 percent of seniors who will spend $4,000 annually on prescription drugs? They will not have any coverage for their prescription drug costs until about Thanksgiving Day after 10\1/2\ months with no coverage at all--no coverage at all for 10\1/2\ months. I am told that under this plan most seniors will only get a 35- percent discount off their drug costs through the Government-managed plan until they spend $3,300 a year. Private drug coverage plans get significantly larger discounts, anywhere from 20 to 40 percent, compared to a benefit such as this. I know the author of this amendment, Senator Graham, claims seniors will get up to a 30-percent discount, but I challenge him to show me where it says that in this legislative initiative we are considering in the Senate. It is not in this legislation. And study after study has shown that discount cards, such as the one offered for seniors in this coverage gap, do not offer discounts that high. What the typical senior actually gets from this plan is about $6 a month in help with drug costs. So the total annual benefit will be $72. What about the senior, as we said earlier, who is spending $2,000 to $3,000? They will get no coverage other than maybe this average of 5 percent off on discounted drugs, which will average about $6 a month. This does not offer a Medicare drug benefit, in all reality, in the Medicare Program. This program would, in reality, be administered by the State Medicaid Program. This means the States will experience a huge unfunded Federal mandate in the Graham plan because they are required to pick up a large share of the cost of this new program. An analysis conducted by the Centers for Medicare and Medicaid Services of the costs passed on to the States by this Graham amendment shows that many States across this country will be required to shoulder a sizable new financial burden. Let's just talk about a few of the States hardest hit. I have a list of them, but I will go through a few: Arizona, Arkansas, California, Colorado, Iowa, Louisiana, Montana, Oregon, South Dakota, Washington, West Virginia. Do you know what the annual impact will be on States, just in 1 year alone, based on our up-to-date analysis of the impact of this legislation? It is $5 billion in 1 year--$5.189 billion in 1 year--as an unfunded mandate on the States, for a grand total of $70 billion over 10 years. That is $70 billion over 10 years in an unfunded mandate to the States as a result of this low-income benefit now being placed, for the first time, in the Medicaid Program, not Medicare. States, that as we all know are struggling in a sea of red ink, will be forced to raise taxes to implement the drug benefit for low-income seniors. Ironically, this new unfunded mandate will create a new funding crisis for States that we just tried to correct with the Rockefeller-Collins amendment last week, which was designed to give emergency Medicaid funding to States so they are not forced to cut their existing health care programs. I might add, that was returning to the States $9 billion for a year and a half. We are talking about an unfunded mandate, in 1 year, of $5.1 billion, and $70 billion over 10 years, to the States. I might also say, this plan penalizes low-income seniors who earn extra income because it could mean they could lose their drug coverage. Only those beneficiaries who earn up to $17,720 for an individual and $23,880 for a couple will get comprehensive coverage, as I mentioned earlier. Any individual beneficiary who earns $17,720, plus $1, or a couple who earns $23,880, plus $1, gets no coverage. They are left to spend 18 percent of their income for prescriptions. Just 2 years ago--another irony here--we passed legislation, in March of 2000. The Senate voted 100 to 0 to repeal the Social Security earnings limit. Yet here we are today considering a plan that would effectively establish a new earnings limit almost identical to one we repealed. Here is another contradiction in legislative policy. So now we are going to penalize low-income seniors if they want to earn more money. Now we are creating a penalty----

Ms. SNOWE. Thank you, Mr. President. That is an important point, that we are now creating this type of penalty for low-income seniors, because if they earn $1 more, they lose their prescription drug coverage. Finally, employer-sponsored plans, labor-union sponsored plans, will be penalized under this legislation. There will be a disincentive for employers and labor unions to continue their coverage. You might ask, why? I will answer that question. Because now, under this legislation before us, they have revamped the standard for how you calculate your out-of-pocket cost for the catastrophic level of $3,300. These plans will not be counted toward the out-of-pocket costs. So employers will not have an incentive to continue these programs. And certainly employees would not want to because they would not want to lose their coverage. Labor unions will drop their plans. So that is another disincentive. Now 23 percent of retirees have such coverage. We do not want to create a disincentive for the continuation of those programs. But that is exactly what this Graham proposal will do that is before this Senate today. That is why I am urging my colleagues not to support this initiative. Allow us to go back to where we were on Friday, continuing the discussions we were holding across the aisle with our tripartisan group, with Senator Breaux, Senator Jeffords, Senator Grassley, Senator Hatch, Senator Baucus, Senator Kennedy, Senator Wyden, and others, so that we can have a comprehensive plan for all Medicare beneficiaries, with universal coverage that the AARP and all of us have embraced for the last 37 years with the existence of the Medicare Program. This isn't the last vote. This can be the beginning. And I cannot imagine this Senate, in September, considering a Medicare give-back to providers and not considering a prescription drug program for our Nation's seniors. They deserve better. And we can do better. Mr. President, I ask unanimous consent that the following material be printed in the Record.

Ms. SNOWE

Ms. SNOWE. Madam President, I rise today to discuss the issue of prescription drugs and how we intend to proceed on the Senate floor. I concur with my colleague from Louisiana, with whom I have had the privilege to work in crafting a tripartisan plan for more than a year, in hopes of avoiding a political showdown and confrontation on this most significant issue facing seniors in this country. I, too, agree with my colleague from Louisiana, in the hope that we can avoid having another vote on two competing plans that will not get the necessary 60 votes to proceed. I hope we can avoid a collision at the crossroads on this most significant domestic issue facing our Nation's seniors. We have been negotiating all weekend to try to work out an agreement. Senator Grassley is here in the Chamber, the ranking member of the Finance Committee. He has been working consistently and diligently to try to negotiate an agreement. Now we are faced with a political showdown; we are faced with a decision to either vote for the lowest common denominator or for no prescription drug coverage at all. I do not believe in letting the perfect become the enemy of the good, but we certainly should not countenance the political becoming the enemy of the practical, the attainable, and the doable. We should not find ourselves in this situation today because we have been working for more than a year and a half in developing a plan to avoid having politics undermine that process. That is why we reached across the political aisle, Republicans to Democrats and Independents, and vice versa, so that we can begin to sort out our ideas. That is not to say we had all the right ideas, but we did it to begin that process that should have begun in the Finance Committee--to debate, to amend, to work through competing ideas in order to achieve a consensus that would give impetus to the passage of this legislation. We should have had that markup. We have been saying that for weeks. In fact, we anticipated we would have a markup on that critical legislation. But we were denied that opportunity for unknown reasons. So now we are hearing we are going to have a vote regardless-- the all-or-nothing proposition that seems to overtake and mire the political process to the point that it really jams the monkey wrenches into this institution. I hope we will avoid having another vote for the sake of having a vote, drawing lines in the sand so people's positions become more intractable. I hope we can avoid that kind of situation and confrontation. We have been spending more than a week and a half on legislation that is very important to America. Using generics would save the American Government $8 billion. It would also save our Nation's consumers more than $60 billion over 10 years. We have been spending more than 2 weeks on that proposition in the Senate. It has had consideration in the committee of jurisdiction for several days as well. Compare that to our initiative on prescription drug coverage--no consideration in the Senate Finance Committee, up-or-down votes on the floor of the Senate on a $400 billion program--$400 billion. That is more than the annual spending of the Defense Department. It is more than the newly organized Department of Homeland Security that we will be considering as well. So now we are being asked to have one vote, as we did last week, on each competing plan on prescription drug coverage--it will presumably cost $400 billion over the next 10 years--with no committee consideration, no up-or-down votes on the Senate floor, no ability to amend--$400 billion. When was the last time we created a domestic program that cost $400 billion, with no consideration in the committee and hardly any consideration on the floor of the Senate? When? We have spent weeks and weeks in the committees considering the homeland security legislation. We have spent 2 weeks on the floor of the Senate on a bill that will save the Nation's consumers $60 billion over 10 years. And we have heard announced consideration for a domestic program that will cost our Government more than $400 billion. It is really hard to understand why we are in the circumstances that we are in today. That is why I ask that we put off any polarizing votes, so that we can further work to achieve a consensus on the broader plan. There were criticisms against the tripartisan plan--that it created a donut, it created a gap in coverage between $3,450 and $3,700 under catastrophic. The legislation being put forward by the Senator from Florida will only provide coverage to seniors at extremely high costs and low incomes, or very low income coverage. More than half of our Nation's seniors will have no coverage at all. Above 200 percent, there will be a cliff because an individual earning $17,721 will get zero coverage until they spend $3,300. A couple with an income of $23,880 will get zero coverage. So until they spend $3,300 in prescription drug coverage costs, they have no coverage whatsoever. Well, I would say that is an enormous gap in coverage. Our plan is to the contrary. It minimizes that gap in coverage. It is \50/50\ coverage above 150 percent, to $3,450; 80 percent will not even reach that benefit limit, and we provide a catastrophic coverage beginning at $3,700. Ninety-nine percent of all seniors will participate in our program, according to the Congressional Budget Office. But under the legislation proposed by the Senator from Florida, more than half of our Medicare beneficiaries will have no coverage at all. They will have no coverage at all. That is creating a huge gap in coverage. It is a huge gap, and I think we can do better. We have worked with the Senator from Massachusetts on concerns about the delivery mechanism in our legislation. So we have agreed to modify that to provide an absolute, ironclad agreement that there will be a fallback mechanism in the event the insurance risk delivery system fails. So there will be a guarantee, regardless of where you live in America, that you will have a benefit of the standard program that we offer in our legislation. But we even went further and agreed to increase our program from $370 billion to $400 billion. So we have been flexible. We are willing to work across party lines to avoid the political showdown by having this up-or-down vote at all costs, not trying to search for a common ground, not having an adequate, thorough debate in the committee and on the floor, and a $400 billion program. I would like to know, when is the last time the Senate has created a $400 billion social program that has had no consideration in the Senate Finance Committee, or any committee of the Senate, and has had virtually no consideration on the floor, no amendments, just an up-our- down vote? If you do not get your 60, tough luck: Is that what the Senate is all about, Madam President? Is that what it is all about? It is winning at all costs? Who is going to pay for those costs? Our Nation's seniors. Our Nation's seniors are going to pay the cost--that is what this is all about--and they are going to pay a high cost because so many will either have minimal coverage or no coverage at all. This is how many people, when one looks at this chart, will be omitted from coverage in the plan offered by the Senator from Florida: 26 million Medicare beneficiaries. I know we can do better. We worked for more than a year to create a plan that included Democrats, included our Independent, Senator Jeffords from Vermont, so that we could avoid this kind of impasse. I would hope that we would avoid this unnecessary political showdown today or tomorrow. I hope we can put aside our differences and forge solutions to the problems that our Nation's seniors face when it comes to catastrophic costs for our Nation's seniors who have a chronic illness. In fact, there was an op-ed piece in the New York Times yesterday which indicated that most people face costs of $1,200 to $1,500. They are the chronically ill. Guess what. Under the plan offered by the Senator from Florida, many of those individuals will not get any coverage until they spend $3,300. They will get no coverage whatsoever. Won't they be surprised when we pass a so-called prescription drug benefit coverage that says the Nation's seniors are now covered and when they find out, no, not exactly. You will pay an annual fee of $25 and then discover you do not have any coverage because, if you earn $17,721 as an individual, you get zero coverage until you spend $3,300. If you are a couple and earn $23,881 in income, then you have to spend $3,300 in prescription drugs before you get any coverage. That is a huge gap in coverage. Last week, in the two votes we did have on the two competing plans, there was a common thread. That common thread was continuing to embrace universal coverage in the Medicare Program, which is a principle that most of us--97 percent, 97 votes--supported continuing in the Medicare Program. If we take the approach of low income and catastrophic coverage solely as the kind of benefit we decide to enact in the Senate, we are abandoning the principle of universal coverage in the Medicare Program. I hope we do not plan to move in that direction. That clearly will be the wrong approach. It will be the wrong approach for Medicare and certainly will be the wrong approach for our Nation's seniors. We can do better, and I hope we will do better. We have the ability to do better. I urge my colleagues to reconsider and I urge the leadership to avoid any votes so we can continue to work on this issue, if it takes August and come back in September, if we cannot do it this week. But let's avoid the kind of confrontation that will manifest itself in the vote that is recommended on the one plan alone. I thank the Chair, and I yield the floor.

Ms. SNOWE

Ms. SNOWE. I would be glad to yield further to my colleague from Louisiana.

Ms. SNOWE. Madam President, I ask unanimous consent to add 3 additional minutes to my 12.

Ms. SNOWE

Ms. SNOWE. Madam President, I will use 15 minutes, but I am happy to defer to the Senator from Louisiana to precede me if I may and ask unanimous consent, of course, to do so, and then I will take my 15 minutes.

Ms. SNOWE. May I ask unanimous consent to extend that by 3 minutes to 15 minutes and 5 minutes.

Ms. SNOWE. I am glad to yield 5 minutes.

Ms. SNOWE

Ms. SNOWE. Mr. President, a particular problem facing not only the American people but also the States themselves--and that certainly includes my home State of Maine--is the rising cost of health care. Today, Medicaid is the fastest growing component of State budgets, accounting for up to 20 percent of the average State budget, as costs increased by 11 percent last year and are expected to increase by another 13.4 percent this year. One of the components of this increase has been a corresponding increase in prescription drug costs as many states have discount prescription drug programs through Medicaid. In addition, the economic downturn has left many families out of a job and without their health insurance, forcing them to turn to Medicaid. This put an enormous strain on the States, which were already facing tough budget decisions. In an effort to address their budgetary obligations, 22 States have cut Medicaid spending and 16 have cut programs that help low-income people. The situation strained further by the fact that the Fiscal Year 02 FMAP allocations did not reflect the economic downturn and the resulting upswing in people needing assistance. In fact, due to the formula used to determine the match, 29 States found themselves with a smaller Federal match than in Fiscal Year 01. As a result, many states have scaled back eligibility, reduced benefits, increased beneficiary cost-sharing, and cut or delayed payments to providers. Additional reductions in health care assistance, as well as cuts in other State-funded programs that serve many of those affected by the economic downturn, are expected. At this point in Maine's financial crisis, savings have been found elsewhere in the budget. However, my Governor has already made a call for a special session of the State legislature, which adjourned back on April 25 of this year, so that they can hammer out a solution to the ballooning deficit. I am particularly concerned about the impact the State budget crunch will have on the Medicaid Program and the low-income children and families who rely on this program for essential health coverage. Last year, the House passed the Senate Centrists Economic Stimulus bill that I developed along with Senator Breaux and others, and that proposal contained about $4.5 billion in emergency Medicaid funding to the States. Unfortunately, we could not get a vote on the proposal in the Senate. In January, I voted to support an amendment by Senator Harkin to the compromise economic stimulus bill that would have increased the FMAP by 3 percent for all States and 1.5 percent for States with higher than average unemployment rates, but the amendment was defeated. Passage of this Rockefeller-Collins amendment would mean the infusion of about $54 million into my State of Maine--$36 million under the FMAP provisions alone. Maine is currently staring down the barrel of a $180 million budget shortfall. Many States face similar circumstances and still others face a figure many times that amount. We do not want, and we certainly do not need, our States to reduce essential health care and social services to people in need in order to balance their budgets. The low-income families and seniors of this Nation should be able to rely on the continuation of these programs on which they have come to depend. The states should receive the help they need to continue their programs offering prescription drugs to seniors and low-income individuals and families. During these difficult fiscal times, our States need more federal assistance in providing health care services through Medicaid, not less. I want to thank the Senator from West Virginia, Mr. Rockefeller, and my colleague, Ms. Collins, for offering this amendment and I urge my colleagues to support our States and this amendment.

Ms. SNOWE

Ms. SNOWE. Mr. President, the moment is at hand when the Senate will determine the fate of prescription drug coverage for our Nation's seniors. I hope we will not allow a 60-vote threshold to stand between us and the possibility of passing a meaningful benefit for our Nation's seniors. That would be doing a tremendous disservice to those seniors who desperately need prescription drug coverage. I hope we will avoid the procedural gymnastics and do what is right. The tripartisan plan is the only plan that has across-the-aisle political support. We worked on this endeavor for more than a year. I hope Members of the Senate will give it serious consideration. The facts speak for themselves on the tripartisan plan. Our plan is permanent. It does not sunset as the Graham proposal that sunsets after 2010. The language is right in the legislation. We have never, ever added a temporary benefit to the Medicare Program in its 37-year history, and we should not start now. It is providing a false hope to seniors who need this type of coverage. They should not have to beat the clock when it comes to their own health care. I guess you had better not get sick after 2010 because that benefit will expire. The tripartisan plan is universal, applying to seniors no matter where they live in America, with the lowest premium offered of any bill either in the House or the Senate, thanks to a 75-percent Federal subsidy, which is higher than what Federal employees get under their health care coverage. Our opponents' plan not only creates a higher premium, but they also increase the prices of prescription drugs. That is not our projection; it is the projection of the Congressional Budget Office that estimates it could be anywhere as high as 15 percent, but at least 8 percent, in driving up the cost of prescription drugs. It is also estimated under the tripartisan plan that 99 percent of seniors will participate, and 80 percent of those who do will never reach our benefit limit of $3,450. I remind Members that we have a catastrophic benefit of $3,700 to protect people's out-of-pocket costs that are very high. Seniors in our plan will pay less on copayments, less on copayments under our plan for 39 out of the top 50 prescribed drugs for seniors. And we cover all drugs--brand name, generics--unlike the plan offered by the Senator from Florida, Mr. Graham who leaves out most of the brand name prescriptions. In fact, only 10 percent of the brand name drugs will be covered under that legislation. Under the tripartisan plan, seniors will have access to all drugs. I ask unanimous consent for an additional minute.

Ms. SNOWE. That is an important feature because by excluding most of the brand names from coverage, that means you are denying seniors access to the most innovative and cutting-edge therapies available. That is not the kind of coverage we want to provide because that is a huge gap in coverage. Finally, I hope we will not allow this issue to die today here on the floor. I appeal to my colleagues to do everything they can to prevent killing this legislation. We need to get something done. These votes today are going to be very important in determining who wants the politics or who wants the issue. We want progress. The best way to get progress on this most vital issue to our Nation's seniors is by supporting the tripartisan plan that has bipartisan support in the Senate. I hope Members of this body will support this plan that will do more to help our Nation's seniors in providing them a much-deserved prescription drug benefit. I yield the floor.

Ms. SNOWE

Ms. SNOWE. Mr. President, I just want to make several comments in response to some of the issues we have discussed today regarding the two competing plans. What is most important about this debate is that we have the ability to discuss the programmatic differences in policies that each of our approaches have taken with respect to delivering this prescription drug benefit plan. First and foremost, I should say that the plan we are offering is a tripartisan plan. It was crafted by Senators Breaux, Jeffords, Hatch, Grassley, and myself as members of the Senate Finance Committee, primarily designed to overcome many of the partisan differences that might exist on this issue and, hopefully, to bridge the gap so that we have the opportunity to pass a prescription drug benefit this year. I heard mention the issue about a doughnut that exists in our bill; that is, the gap between the benefit limit of $3,450 and $3,700. First of all, 80 percent of those seniors who would be participating in this program--80 percent of the Medicare beneficiaries--would not even reach the benefit limit of $3,450. In fact, I recall back in 1999, President Clinton proposed a drug benefit that provided for an initial benefit of $2,000. We are at $3,450. He had a much greater gap in coverage between that initial coverage of $2,000 and a catastrophic benefit, which was about a $3,000 gap. We are talking about $3,450, and a catastrophic benefit threshold of $3,700. But what could be a greater gap than having this most critical benefit to seniors sunset in the year 2010? In 2010 it expires. According to the legislation: No obligation shall be incurred, no amounts shall be appropriated, no amounts expended for expenses incurred for providing coverage of covered outpatient drugs after December 31, 2010. The legislation goes on to say, provided, of course, the actual spending does not incur, so there is leftover you can use for a prescription drug benefit or the program itself results in lower expenditures. Nevertheless, it would require, in order to extend that most important benefit of prescription drug coverage, additional action by the Congress, obviously, to provide for the funding of that program. So it expires. The second gap in coverage provided in this legislation offered by Senator Graham is the fact there is a major omission of coverage for brand-name prescription drugs. There are more than 2,400 that exist. The Senator's legislation is limiting to, at most, two brand-name drugs in each therapeutic class. So it is going to be very limiting at best because it will deny a senior the ability to have access to an alternative medication if it is not called for under this legislation. It either has to be generic or one of the two prescribed brand names. As I mentioned earlier, there are many alternatives in a brand name category. Whether it is for arthritis or cholesterol or blood pressure, there are many options. I heard it suggested, if it is defined as medically necessary, then it goes through a major process. It has to go through the Secretary of Health and Human Services. There has to be an internal/external appeals process, so there will be a review process underway. I can imagine there would be quite a lineup if there were a number of views that would be required of the Secretary to make exceptions to this legislation. So there will be a whole process that would be required in order to allow somebody to take a prescribed medication that has not already been stipulated under law, according to this legislation. That is very explicit in this particular proposal. I think we want to provide coverage similar to what Members of Congress and Federal employees currently enjoy: options, choices, competition, variation. Frankly, the preference of variation is important because it then allows a plan, for example, to use innovation, providing for a certain type of drug or all generics, providing lower premiums than what we stipulate into law. In our proposal we do have a standard benefit package described. But what we also say is, we allow flexibility to design plans that can offer even a lower deductible than $250, even a lower premium than $24 a month. We want to vest that type of flexibility into the design of a plan that could provide the maximum amount of benefits to those seniors who need this type of coverage. There is no such thing as a one-size-fits-all. The point is, in the proposal we have crafted, there is a standard benefit. In fact, the Congressional Budget Office has indicated that our standards of equivalence are strict enough that the Medicare drug plans will have very little room to vary from premiums of cost sharing. But they have the flexibility to design an even lower benefit in terms of deductibles or premiums. And don't we want to allow seniors to have the benefit of that reduced price? That is a result of competition. That is why the Congressional Budget Office has indicated that prices for prescription drugs could actually increase under the Graham proposal, upwards of as much as 8 percent, if not higher, because there is no competition. As a result, there is no drive, no incentive to allowing for lower cost, because there are no competing plans. In a sense, the Government is delivering the plan through a pharmacy benefit manager, so restrictive that it does not allow for competing prices, and there is no incentive for keeping the prices of prescription drugs down. That is a major difference between our two plans. We want to offer the most choices, the most comprehensive, because we have preferred and nonpreferred drugs, lower copays in most all of the categories. We have the lowest premium per month. We have the maximum amount of benefits to low-income seniors. We cover the donor for under 150 percent of the poverty level or below for seniors. We provide catastrophic at $3,700 a month. It is a permanent, fully funded part of the Medicare Program. I hope Members of the Senate will consider very carefully the policy and programmatic differences that do exist between our two plans. They are very distinct. I know it has been suggested that our system is untried. That is not true. We benefit from a system that is comparable to what we have designed in the tripartisan proposal, and it offers the maximum choices to our seniors. We think it is important to create as a permanent part of the Medicare Program. To provide for any limitation of that type is doing a disservice to our seniors. It is giving them a false hope to say that your benefit expires in 7 years, unless, of course, future Congresses decide to make a change. So we are predicating their future, their health care, on whether or not a future Congress might decide to extend that program. I really don't think that is the type of precedent we want to take. We have never created a temporary benefit under the Medicare Program-- never. We have never created a temporary benefit, and we should not start now. I know there has been some question about the assets test included in the tripartisan proposal. First of all, this assets test was not something that was newly created. It is included in the Medicaid Program. Yes, this assets test is used for some Medicare beneficiaries, the dual eligibles, the qualified Medicare beneficiaries, QMBs, and specified low-income Medicare beneficiaries. So an assets test was included in our legislation that is the equivalent of the assets test in the Medicaid Program that was supported by this Senate back in 1987 and 1986 with overwhelming support. So this is not unprecedented. It is not unusual. It includes the same type of waivers that are included in the current Medicaid Program. I welcome the debate that has developed between the two competing proposals regarding prescription drugs. It is my sincere hope that we will have the ability to work through our differences beyond the threshold of tomorrow, the 60 votes. I hope, again, that this system and this process are not designed for failure, that neither side gets the 60 votes and, therefore, we move on to other issues and we defer this to another year. It has happened far too often. This benefit is long overdue for our Nation's seniors. We negotiated this compromise in good faith, in the hopes that we could have worked through with our colleague from Florida, who I know has worked very hard, who is very genuine in his interest in developing a prescription drug benefit for Medicare beneficiaries--I would have hoped we could have worked through the process in committee, but that was not to be. So we are at a point now of whether we can reconcile our differences to move beyond the 60 votes and be able to work through the various amendments and reach a conclusion. The seniors of this country deserve that. I honestly don't understand why we can't at this point in time agree to pass a prescription drug benefit program for Medicare beneficiaries. Our compromise wasn't designed to be an all or nothing or lines drawn in the sand. It was really an attempt in good faith, in the spirit of consensus building and compromise, because you can't do it without the other side of the aisle; there is no way you can possibly do it. That is why we started more than a year ago to develop this tripartisan proposal with the hope that we could have made this a reality for our Nation's seniors. I urge my colleagues to give very serious consideration to what we have provided in this particular proposal for our seniors. Hopefully, we can come together and pass this legislation that is such an urgent need for the more than 44 million Medicare beneficiaries. I yield the floor and suggest the absence of a quorum.

Ms. SNOWE. That is correct.

Ms. SNOWE. I am delighted to yield to the Senator from Utah.

Ms. SNOWE. I would say to the Senator, that is correct. Obviously, the Government is going to make the determinations in terms of the types of drugs to be used, but the legislation already starts off in a very restrictive fashion. As a result, it will deny seniors their choices--not to mention that the whole program sunsets in 2010.

Ms. SNOWE. Mr. President, first, I express my appreciation to the Senator from Utah, who has done a yeoman's effort on behalf of this legislation, working in this past year to develop what has been known as the tripartisan legislation to develop a prescription drug benefit program. I am pleased we are able to finally begin the debate on this most critical issue. It is obviously a significant issue to seniors. I hope everybody understands that we, in attempts to draft this tripartisan legislation, had hoped to avoid developing a polarizing and politicizing of this issue before the Senate. I regret that the regular process of the committee has been bypassed because I think in so doing there was an obvious attempt to try to avoid building the consensus that is essential to passing this kind of legislation. Obviously, through the disruption of this process, we are here today, and I hope this process does not give anybody the excuse or the rationale to vote against a prescription drug bill because I think in the final analysis each of us will be accountable for our failure to do so in this institution. We have a chance--just maybe this is our year--to pass a Medicare prescription drug benefit after all. There is only one plan thus far that has bipartisan and tripartisan support. Senator Breaux, Senator Jeffords, Senator Grassley, Senator Hatch, members of the Finance Committee, and I began this effort more than a year ago in an attempt to draft a compromise proposal that bridges the differences between two sides in this debate, hoping to avoid the kind of scenario that has now unfolded on the floor. That is why we undertook this effort to craft this tripartisan solution, when partisan differences threaten to undermine any possibility of enacting a prescription drug benefit. We believed then, as we do now, that as seniors cannot afford to put off their illnesses, we cannot put off a solution to this problem. So we crossed the political divide to develop an innovative program that could become the basis for action. As I said, we had hoped we could start that process within the committee that could give us the best hope for developing and forging a consensus on this issue. We worked closely with the Congressional Budget Office for forecasting an accurate estimate of the cost of our legislation, working hand in hand with them up until the final days in introducing this legislation, to ensure that we had a stable, efficient, competitive program that would provide choices to the seniors in this country and at the same time give them the maximum benefits under any kind of prescription drug benefit that we could include as part of the Medicare Program. I have personally been working on this issue for the last 4 or 5 years, imploring Members of this Senate to pass a prescription drug benefit. It has been 4 long years. We have made some progress certainly in terms of estimating the cost and providing the type of appropriations that would be essential to supporting a generous prescription drug benefit. In 1999, as a member of the Senate Budget Committee, I worked with Senator Domenici, Senator Wyden, and Senator Smith of Oregon to include a reserve fund. At that time, then-President Clinton provided $28 billion in his budget. We went further and provided $40 billion to set aside for a prescription drug benefit over 5 years. Then we decided last year we would go to $300 billion because the prescription drug costs go up each and every year, as we well know. So on both sides of the political aisle, there was agreement again and the Budget Committee set aside $300 billion for a reserve fund. It was also acknowledged time and again in floor debate that $300 billion was where we needed to be to provide strong coverage for seniors in Medicare for a prescription drug benefit. So now we are at the stage of $370 billion, the tripartisan proposal, and approximately $600 billion in the proposal offered by Senator Graham from Florida. Everybody recognizes we need to enact a prescription drug program as part of Medicare. It is long overdue. Frankly, I do not think there is any difficulty in developing the policy, if there is the political will to do it. That is the big question--whether we have the desire to enact this kind of coverage for seniors in this country. We have two competing plans. I hope we can avoid a process that is designed to create a political showdown. I hope we are not going to go down that path this week, irrespective of the fact we have two votes tomorrow, one on each plan. Is that where it is going to end or is that where it is going to begin? I hope this is not about this election. I hope it is for the determination to do what we ought to do, and that is to design a program for prescription drug benefit coverage. It will not happen without bipartisanship and tripartisanship. That is what we did through the legislation we introduced and have been working on for more than a year. I would rather not spend my time talking about process. The process becomes important when we bypass the conventional means of consideration: Draft and amend legislation in order to create a consensus on a bill before it reaches the floor; at least it attempts to do what was done on the tax bill last year. No one could have predicted what the outcome would be in the committee, let alone on the floor, but it was through the amendment process, through debate and deliberation that we finally reached a consensus that yielded the 62-38 vote. We are in danger of not completing prescription drugs because of the process of cloaking political motives. We are looking at the procedural gymnastics that have occurred in this legislation. We could almost write the headlines: The Senate fails to muster 60 votes for a prescription drug plan; issue put off for another year. Is that what Members want? I do not want the Senate described in those terms. I do not want this issue put off another year. We have been putting it off year after year after year. I want to make headway, not headlines. That is why it is important people understand what is going on. I am the last person who wants to talk about inside the beltway gobbledygook, about the process. I am interested in talking about the truth and what deserves our attention in terms of policy differences, not designing the next political stroke. It is a disservice to the more than 40 million Medicare beneficiaries that see their prescription drug costs rise every year to the tune of 17 and 18 percent in annual costs just over the last 4 years. That is why we try to work on developing a middle ground approach and analyzing what could be the best plan, under the circumstances, to maximize the benefit, particularly those in the low-income scale, from all ranges of the political spectrum that could offer a comprehensive drug benefit that is affordable, comprehensive and available to all seniors, that provides the most in terms of benefits to low-income seniors and those especially without drug coverage. It must be a fully funded, permanent part of Medicare that does not threaten the stability or the solvency of the Medicare Program for future generations. We offer in our plan the lowest premium of any plan introduced, $24 a month. It provides a 75 percent Federal subsidy. That is more than Federal employees have under their current health care coverage. That yields $340 billion in Federal support over the next 10 years. People suggest the private sector will not be engaged in this process when the Federal Government provides an overall 75 percent Federal subsidy. Seniors above 150 percent will see an annual savings on their prescription drugs of more than $1,600, which is a 53 percent savings. Those below 135 percent will see 98 percent savings on their prescription drugs. Ninety-nine percent of Medicare beneficiaries will be covered under our program; 93 percent estimated by CBO will participate in this program, and 6 percent will remain with their current coverage. That is extraordinary. Eighty percent will not even hit our benefit limit of $3,450. We eliminate the so-called doughnut, the gap in coverage between the $3,450 benefit limit and catastrophic coverage of $3,700; 11.7 million beneficiaries with incomes below 150 percent are exempt from the benefit limit of $3,450. There are 10 million Medicare beneficiaries with incomes under 135 percent who will see 80 to 98 percent of prescription drug costs covered by this plan with no monthly premium, no deductible, and have average coinsurance of $1 to $2 per prescription and will have no cost beyond the catastrophic level. All other enrollees above 150 percent of the income level will have access to discounted prescription drugs after reaching the $3,450 benefit limit. Everybody under Medicare will be protected against catastrophic costs. The drug benefit will be offered by the private drug plans. They accept part of the risk for managing this prescription drug program with the Federal Government accepting most of the risk. Seniors will have clout. They can vote with their feet. If they do not like the plan, they can select another plan. We believe, and CBO agrees, that the real competition will hold down drug costs and make this benefit more affordable for seniors and taxpayers. Creating a new prescription drug benefit is absolutely essential to be part of our Medicare Program. AARP said in their testimony before the Senate Finance Committee, we need to have a dependable drug plan. That is exactly what we are providing. It is permanent and it is fully funded. That is a big difference from a plan that is sunsetted. I do not know how you explain to seniors in this country that the good news is you will have a prescription drug program starting in 2005, but the bad news is it expires in 2010. That is exactly the scenario established by the Graham-Daschle-Kennedy bill, which simply rides off into the sunset. It certainly will not be a happy new year on December 31, 2010 for any senior citizen who uses prescription drug coverage to learn their benefit has disappeared over the horizon--it is gone. Is that the kind of stability, certainty, and predictability we want to give our seniors when it comes to one of the most vital benefits we could provide and need to provide? You might wonder why it sunsets under the Graham legislation in 2010. That is a very good question. The answer is because they ran out of money. They knew if they continued, the sticker shock of their plan and the impact of their program, already facing serious financial concerns, would cause more than a few to raise strenuous objections because of the ultimate impact it could have on the solvency of the Medicare Program. Seniors have said they have two major priorities. One, they want to make sure the program is universal; two, it has the lowest monthly premium and at the same time it does not affect the financial stability of the future for Medicare. That is a question about the choice we have tomorrow. Are we serious about providing a prescription drug benefit to seniors that will be sunsetted in 2010? That is a significant question that each Member must address in casting his or her vote in the Senate with the two competing plans. The plan we have offered was consistent with the priorities of seniors in this country, indeed the priorities of AARP, the major representative of seniors in America, that they wanted a dependable prescription drug benefit as part of Medicare. We offer it. It is fully funded, and it is part of Medicare in perpetuity. There are other problems we have to address when we are looking at the Graham proposal. One is the issue of the nonpreferred drugs. In the original plan that was offered by Senator Graham, there were the preferred drugs and the nonpreferred drugs. In fact, the copayments are lower under our plan. For the top 50 preferred drugs, we have lower copays under 39. To put it the other way around the Graham proposal is higher on all but 11 of the top 50 preferred drugs--higher in copayments. In the original Graham plan, there were the nonpreferred drugs. Again, we were lower in copayments in all categories except 1 out of the top 50. Now, under the newly revised plan, none of the nonpreferred drugs is even covered--none, not one. You might ask, what does that mean? That means it won't be available for seniors. That means, by virtue of the fact that the nonpreferred drugs are not covered under the Graham-Daschle-Kennedy plan, they are not going to be available to seniors. They will not have choices in the types of plans that include both the preferred and the nonpreferred. It means if your doctor prescribes a different brand prescription and it is not on the preferred list, you are out of luck because under Senator Graham's proposal they will cover generics and only two brand names in every therapeutic category. So here are a few examples of how the Government's strict limits on drug coverage under the Graham-Daschle-Kennedy plan would interfere with the drugs your doctor prescribes. The examples are taken from drug classes in the ``Physicians Desk Reference'' explicitly described in the bill as a model for determining the therapeutic classes in which only one or, at most, two drugs will be covered. Let's take high cholesterol as an example. If you take Advicor, Baycol, Colestid, Lipitor, Mevacor, Pravachol, Tricor, WelChol, Zocor, or other drugs to lower cholesterol, and the Government plan says Lescol, you get no coverage at all. And even if you take Lescol XL, the more convenient extended-release form, then you get no coverage at all. What about treatment for arthritis? Well, if you take Bextra, Cataflam, Celebrex, Clinoril, Feldene, Lodine, Lodine XL, Relafen, Tolectin, Tolectin SR, Trilisate, Vioxx, Voltaren, or Voltaren-SR for your arthritis, and the Government plan covers prescription-strength Advil, then you get no coverage at all, none. You have high blood pressure? Well, if you take Accupril, Adalat, Aldoclor, Aldomet, Altace, Captopril, Cardizem, Cardura, Catapres, Corzide, Cozaar, Diovan, Diuril, Hyzaar, Lotensin, Maxzide, Minipress, Norvasc, Procardia, Tenormin, Toprol-XL, Univasc, Vasotec, Zebeta, Zestril, or any of dozens of other effective medications for high blood pressure that work best for you, and the Government plan covers Accuretic, then you get no coverage at all. So it is far more restrictive than what the private sector offers today. Most private sector plans and the Federal employees plan would never consider being so restrictive as to provide no coverage at all for nonpreferred or off-formulary drugs. Moreover, to restrict covered drugs to no more than two in each class of drugs--generally these plans do the opposite, by providing some coverage for off-formulary drugs through tiered copays or off-formulary incentives. What happens if I really need it? What happens if the doctor thinks that is the only option, the only drug that is going to be best for your treatment? It would require an explicit review and approval from the Secretary of Health and Human Services, right here in the plan that is offered by Senator Graham, in order for the Government plan to offer a lower copayment or to provide coverage on additional drugs. Beyond these strict limits, the Secretary must determine that it will not result in an increase in expenditures by the Government. Since when do we essentially decide we would rather have the Secretary of Health and Human Services writing prescriptions for American seniors? But that is what this comes down to.

Ms. SNOWE. How much time is remaining, Mr. President, on our side?

Ms. SNOWE. Thank you, Mr. President.

Ms. SNOWE. That is correct. In fact, in our copays, on those that are covered, the top 50, we are lower or, the converse, in Senator Graham's legislation their copays will be higher in 39 out of the 50 categories in terms of copayments. Then in the nonpreferred drugs, they are not even covered, and they are covered under our legislation because plans will be designed to include choices.

Ms. SNOWE

Ms. SNOWE. Mr. President, I object on behalf of the leadership.

Ms. SNOWE

Ms. SNOWE. Madam President, I rise today to begin a discussion on the prescription drug benefit and specifically the one that has been introduced by the tripartisan group including Senator Grassley, Senator Breaux, Senator Jeffords, Senator Hatch, and myself. Before I proceed, I express my support for the amendment offered by Senator Dorgan regarding reimportation. I have long supported that initiative. Many of my seniors in the State of Maine have to travel across the border into Canada in order to get prescription drugs that are offered lower there than in the United States. It is a tragedy that compels seniors to be put in a situation where they have to cross the border in order to do that. I hope we can support that amendment so they can have the benefit of those lower priced prescription drugs in the United States. It is the only fair approach. It is one way of addressing the issue of controlling costs and making costs competitive so they can have the benefit of lower prices. I am very pleased to talk about the tripartisan proposal. I regret we have not had the opportunity in the Senate Finance Committee to be able to consider competing proposals, certainly the one that has been introduced by the ranking member, Senator Grassley, Senator Breaux, Senator Jeffords, and Senator Hatch and myself, along with other proposals, that obviously has the support of other members of the committee. We should do everything we can to have the opportunity to explore, to debate, to consider the various proposals. Obviously, that starts within the committee process. It is unfortunate at this point as we begin to debate the other issues in the underlying bill, which is an important piece of legislation, that we are not in a position of being able to consider a prescription drug benefit plan. That is not the way the process ought to work. If you look at what happened on the tax bill last year, no one knew what the vote would be in the committee, let alone on the floor, but we had the opportunity to address the issue within the Senate Finance Committee. It ultimately passed 14 to 6. When it came to the floor, it had 53 votes and ultimately yielded a vote of 62 to 38. That is the way the process works. We did not write the ending first. The prologue begins in the committee. In this case, one of the most significant social domestic issues facing this country today, prescription drug benefits, Medicare authorization, and we have not been able to have a markup in the committee of jurisdiction, the Senate Finance Committee, we are told, because it does not have 60 votes. How many bills that are marked up in the committee have 60 votes before they hit the floor of the Senate? How do we know? How do we know until we begin the process of debating, analyzing, considering various issues? That is what this process is all about. I truly regret we have not had the chance to be able to consider this bill in the manner it deserves and in the manner it deserves for the seniors of this country who are dealing with the overwhelming burden of the high costs of prescriptions. Why are we allowing this to be politicized? Why are we allowing this to be a matter of partisanship? We have come a long way just on the funding issue alone. I have been working on this issue in the Senate Budget Committee with then-Chairman Domenici, Senator Wyden, Senator Smith, and others, and we were able to develop a reserve fund. We started with $40 billion, which was more than then-President Clinton had proposed. We are up to $300 billion, and our tripartisan proposal is $370 billion, recognizing that as every year passes, the price goes up and up. We have come a long way in even understanding that we are going to have to spend more to provide a strong benefit to seniors, and we must start now. Some people might just want the issue for the next election. Maybe that is what it is all about. Maybe some people want to see a headline that says: Senate fails to muster the 60 votes; the issue is put off for another year. I do not want to see that kind of headline. I do not think it is fair to the seniors in this country because I know this institution can do better, and that is why we put forward this tripartisan proposal because we did not want partisan differences, political differences, philosophical differences to impede our ability to address this most important issue to the seniors in this country. That is why we undertook this effort more than a year ago in our tripartisan group to see what we could agree to that would provide a most substantial benefit to the seniors in this country. Seniors cannot put off their illnesses. We should not be putting off a solution, and we crossed the political divide to develop our tripartisan proposal. We worked closely with the Congressional Budget Office to ascertain the precise cost of our proposal so we do not jeopardize the solvency of the Medicare Program for future generations. We developed a competitive, efficient model to yield the best results for seniors as well as for the Government. I do not want partisanship to jeopardize our ability to send a bill to the President, Madam President. I want to break the logjam here and now. Seniors have heard the excuses. How can we do anything less than give this our full effort here and now, particularly for the one-third of the Medicare beneficiaries who have no coverage whatsoever? The Medicare Program is outdated, given the fact that it does not include a prescription drug benefit first and foremost, and we need to bring Medicare into the 21st century. The best way we can do it is by adding a prescription drug benefit. It is simply unconscionable in a country of our means and wealth that older Americans should ever have to choose between filling their cupboards and filling their prescriptions. That is not hyperbole; that is not exaggeration; that is the truth. It certainly is the truth in my State. People are forced to make those tragic choices, and we have within our means right here and now, Madam President, to make the difference so seniors are no longer forced to make that terrible choice. That is why we have offered the plan that we have. That is why I do not want to bypass the committee, because I know that is our best opportunity to pass a prescription drug benefit when we complete the process that begins in the committee. We should not have any political motivations or maneuvers to bypass the process. I have been told: We cannot consider a bill in the committee that does not have 60 votes. Since when has that been a precondition for any markup in the committee? Then I am told: We cannot have a bill that is not supported by the Democratic leadership. I never thought that prevented us from doing our job; that eventually we could reach results. We are not saying our bill is written in concrete. We are saying this is a beginning. It is a basis for action. Henry Ford used to tell his Model T customers that they could have any color they wanted for a car as long as it was black. It sort of reminds me of the situation we are in today: We will consider a prescription drug bill as long as it is ours. We are saying let's bring out the proposals in the committee, let's go through the committee process, and then let's report out a bill to the floor. The tripartisan bill has the support of 12 members of the committee as we speak--12 members of the 21. We have the support in the committee, but let's go through the committee process. Let's do what we need to do. Refusing to have a markup in the Senate Finance Committee is hiding behind false pretenses that we should only act if we have 60 votes. Madam President, I want to discuss the tripartisan proposal and what it is. First and foremost, it is a plan that offers an affordable, comprehensive, and available prescription drug benefit to seniors. It maximizes the benefits for the low-income seniors, and finally, it is a fully funded, permanent part of the Medicare process. There will be no sunsets. Providing a sunset in legislation, as has been recommended by the other competing plan offered by the Senator from Florida, is really providing a false hope to seniors. How can we tell them: Oh, by the way, in 7 years your benefit will expire? I think that is doing a tremendous disservice to seniors in this country, saying we are only willing to give this benefit for 7 years, so you had better not have an illness because we are not going to be able to give you a benefit in 7 years. Our plan is fully funded and a permanent part of Medicare. It has been scored and estimated for cost by the Congressional Budget Office. They have vetted every aspect of our proposal. It is right here in a major legislative initiative. It is right here for everybody to review and to evaluate. The plan is universal. It is offered to every Medicare beneficiary. That was a major priority for us, and it was a major priority for the seniors in this country in all the discussions we had with seniors and AARP. They wanted a universal, at the lowest possible monthly premium, and that is exactly what our benefit provides. It is lower than any other proposal that has been offered: A monthly premium of $24. It will be offered to seniors whether they live in urban areas or rural areas. They will have a choice of a minimum of two plans, no matter where they live in America. The plan is targeted for seniors between 135 percent and 150 percent of the poverty level. That is about $18,000 for an elderly couple. They will receive coverage for about $12 a month at 150 percent of the poverty level. Below 135 percent they will pay no premium, no deductible whatsoever. The plan is comprehensive. They will have access to every drug, whether it is a generic drug or the most advanced innovative therapies. It also will provide relief from catastrophic costs from high annual prescription drug costs. Most of all, the plan will save the seniors real money, anywhere from 33 percent to 98 percent in out-of-pocket expenses, with the average senior saving more than $1,600 every year, as my colleagues can see on this chart. The average spending for seniors without any drug benefit in 2005 will be $3,059 per year; more than a quarter of Medicare beneficiaries spend more than $4,000. The average savings under our proposal for seniors above 150 percent of the poverty level will be more than 53 percent. For those below 135 percent, they will save 98 percent--98 percent--in their costs of prescription drugs. But no matter, the average savings to seniors will be at least one-half, more than $1,600. Our plan eliminates the so-called donut for lower income seniors, the seniors hardest hit by high drug costs. There are 11.7 million Medicare beneficiaries who have incomes below 150 percent of the poverty level, and they are exempt from the $3,450 benefit limit. The enrollees between 135 percent and 150 percent of the poverty level will have a monthly premium based on a sliding scale that ranges from anywhere from zero to 24 percent. The 10 million Medicare beneficiaries who have incomes below 135 percent of the poverty level will see, as I said, 98 percent of their prescription drug costs covered by this plan with no monthly premium. These seniors are exempt from the deductible and will pay an average coinsurance of anywhere from $1 to $2 for prescription drugs. They also have the protection of catastrophic limits, which will be $3,700 under our legislation. That is where the catastrophic benefit limit will begin, at $3,700. And they will have full protection against all drug costs with no coinsurance. All enrollees will have access to discounted prescription drugs after reaching the $3,450 benefit limit and before the $3,700 catastrophic benefit limit. They will all still have access to discounted drugs between the $3,450 and the $3,700 catastrophic benefit. In fact, 80 percent--let me repeat, 80 percent--of the enrollees will never be affected by the benefit limit of $3,450. As you can see from this chart, I want to repeat, it has the lowest premium of any of the comprehensive proposals that have been introduced, at $24. Ninety-nine percent of Medicare beneficiaries, according to CBO, will be participating under this program--99 percent. Let me repeat, 99 percent. The coinsurance paid for the top 50 drugs is $21. I want to compare that to the proposal offered by the Senator from Florida, because under the nonpreferred drug plan, of the top 50 drugs, we provide a lower coinsurance on all but one. And for the top 50 drugs in the preferred drug list, we provide a lower coinsurance than the proposal offered by Senator Graham of Florida on all but 11 of the 50 drugs on the top 50 list. So we are not only more substantial when it comes to providing the coinsurance on all of these preferred and nonpreferred drugs--as you see listed on the chart are the preferred drugs. For all but 11 out of the 50 drugs, we are lower in our copays than the proposal offered by Senator Graham of Florida. And for the nonpreferred drug list, we are lower for all but 1 out of the 50 drugs. In other words, for 49 out of the 50 we are lower. We provide a lower copay for these prescription drugs, not to mention the fact that we provide a lower monthly premium of $24 a month for those who are 150 percent above the poverty level. For those that are below 135 percent of the poverty level, they pay zero. And more importantly, our proposal is not sunsetted. CBO estimated, as I said, that 99 percent of seniors will have coverage under this proposal--99 percent of seniors. I think it is important for everybody to understand that if we are going to offer a prescription drug benefit, and if we are serious about making sure it is part of the Medicare Program, then, clearly, it is important that we make sure that it never expires, that we do not resort to budget gimmicks or artificial sunset requirements that provide a false hope to seniors. Seniors deserve better than a false hope of a drug benefit that expires after 7 years with no guarantee of further coverage. I think that would be regretable if we decided to take that approach. That is why we initiated this effort more than a year ago, to provide a benefit that was generous, that would help the low incomes first and foremost, that was universal, that was affordable, that did not jeopardize the future financial stability of the Medicare Program-- because, obviously, that has to be the foremost concern to all of us as well as to seniors--and that we had the maximum benefits possible for seniors against high annual drug costs. So I hope we will have the opportunity to have an honest, thorough debate on a prescription drug benefit that can be included as a permanent part of the Medicare Program. Seniors are struggling under the burden of high prescription drug costs. We cannot allow election year politics to overwhelm any chances, any possibilities of getting a Medicare drug benefit through the Senate this year. We must allow a full debate to occur on this issue both in the committee and on the floor. The Finance Committee should be a part of this process. Each of us has a stake--individually and collectively--about the kind of process we are willing to embrace in the Senate. It does make a difference as to whether or not we are going to choose to bypass the committees repeatedly and bring up significant legislation on the floor without having the benefit of the committee process and for those Members who serve on those respective committees to be part of that process. So each of us has a responsibility to that process, and, most critically, when it comes to such an important issue to millions of Americans: Those who are struggling under the weight of high prescription drug costs and those who can expect to face the same problem in the future. I think each of us here knows that without a markup in the committee we are creating a predetermined train wreck. We are heading for a train wreck because we are creating a process designed for failure. It is designed for politics. It is not designed for creating a solution to a serious problem. I think if we continue to resort to these ill-advised procedures and political maneuvers and charades, and if we continue to allow this political choreographing which sort of superficially addresses the issue but does not really because we do not really want to create a consensus and a compromise because we want the issue for this year's elections, then we have failed and this Senate has abrogated its responsibility to do what is right. That is what it is all about. It is whether or not we choose to do what is right. I think we all know what is right. Those of us in our tripartisan group--I am not saying that our proposal, as I said earlier, is written in stone. It is not a finite product, but it is a serious product. It is one that has evolved for more than a year. It is one that has been evaluated by the Congressional Budget Office. And it is the only proposal that has been introduced that has bipartisan, tripartisan support, and the only one that has been scored by the Congressional Budget Office. It is the only one that has the lowest monthly premium. And it is the one that is not sunsetted. It is a permanent part of Medicare. Getting back to this chart, seniors pay less for the top 50 prescriptions under the tripartisan plan versus the Graham-Kennedy- Miller proposal. They pay less. So they pay less on their monthly premium, and they pay less in their copays for the top 50 prescriptions, either on the preferred drug list or on the nonpreferred drug list. Those are the facts. I just hope that we will have the opportunity to consider this legislation and other competing proposals--such as the one offered by the Senator from Florida, Senator Graham--in committee; utilizing the committee process to amend, to debate and to vote on a final measure. My proposal, as it stands, has the votes in the committee. But let us go through the committee process. We would be more than happy to evaluate other issues and other amendments of the members of the committee. I just do not understand why we can't have a markup in the Senate Finance Committee. We are here to do our job. That is our responsibility. That is why we have the committee process. I want to be able to legislate the best solution to the problem. We have come up with a proposal. Others have other proposals. But let us have a competition of ideas and debate in the committee that allows for the best hope for getting a bill through on the floor of the Senate that will yield the 60 votes, that will go to conference, and the differences worked out with the House. As others have said, let us get a bill to the President for his signature this year. I don't want another year to go by. That is what I have been hearing every year. I have been hearing it every year now. Four years ago, they said next year. Next year turns into 2 years, 4 years, 6 years. How long do we think seniors can wait for this prescription drug benefit? How long? How long is it going to take? Why is it that we have to have these political machinations? Our group-- Senator Grassley, Senator Breaux, Senator Jeffords, Senator Hatch--has worked long and hard for more than a year. Why can't we have a markup in the committee on this issue? I would like to have a reasonable answer to that question. But I don't think I am going to get a reasonable answer. There is nothing to justify precluding us from doing our jobs in the committee. There is nothing acceptable by what is happening here. I am here to legislate. I don't expect everybody to agree with my thoughts or my ideas or my proposals. But I do expect that we will honor the process by which we have the ability to do our job. Otherwise, we have all failed. I don't care if it is a day before the election. I don't care. The time is now. To be frank with all of you, I think that we should reach the limits of our frustration with this process. Why do we continue to say it is acceptable? The same machinations existed with the health care proposal back in 1994. It is exactly the process it took. It bypassed the committee process and came to the floor. Guess what. Nothing happened. Here we are in the year 2002--2002. We don't have a bill. The same is going to happen with prescription drugs. People will say next year: We can't do it. We are getting paid to do our jobs now--not next year. We were elected to do our job now. Senator Grassley has worked long and hard. Senator Grassley, the ranking member of the Senate Finance Committee, has gone the extra mile to reach out to both sides, to the chairman, to other members of the committee, and to others here on the Senate floor across the aisle, and as he did in this tripartisan proposal. Senator Breaux and Senator Jeffords have also worked with us. We have been working together because we know this is the only way we can accomplish this most important issue for the seniors of this country. I hope we will do the right thing. Let's begin this process in the Finance Committee so that we can consider the proposals on the floor which will ultimately yield the best results, not only in terms of policy but for the seniors of this country. I yield the floor.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to speak in support of the legislation we are considering, S. 2673, the Public Company Accounting Reform and Investor Protection Act of 2002. Last fall, we watched as a company once in the top 10 of the Fortune 500 imploded from the weight of its own complex efforts to mask debt and hide losses. We watched as the company stock-laden retirement plans of Enron's loyal employees dwindled by $1 billion. Meanwhile, company executives cashed out their own shares while these employees were barred from doing so. And finally, in congressional hearings, we watched and listened as former Enron executives either chose to remain silent, or pointed fingers of blame at everyone's actions except their own. Tragically, the bankruptcy of Enron was no anomaly in the business sector. Rather, it was only the beginning. It ultimately proved to be a watershed event, as several other companies have reevaluated their own business and accounting methods, and found significant indiscretions. Global Crossing, a telecommunications company, is being investigated by the SEC and FBI in regard to questionable accounting practices used to artificially inflate revenue. Adelphia Communications, a cable company, is now in bankruptcy proceedings due to investigations by the SEC and two federal grand juries for off-balance sheet loans to the company's founders. More recently, Xerox announced that it would restate 5 years of results which could affect the true nature of what had been reported as $6 billion in revenues. And on June 25, WorldCom announced that it had misrepresented $3.8 billion in expenses over five quarters, therefore allowing the company to report financial gain, when in reality, the company was experiencing a net loss. While the downward spiral of each of these companies was unique, common threads are woven through each of their failures. First, the insistence by executives that, above all else, stock price remain high was an integral part of the creation of the financial woes of each company; in essence, this short-term focus compromised the long-term viability of these entities. What has also been disturbing as these revelations have come to light is the role played by the so-called independent auditors of the companies under investigation. While the accountants are not the sole perpetrators of the financial deception that has occurred, the apparent lack of scrutiny of the financial statements of the aforementioned companies has created an inherent mistrust in the accuracy and integrity of the true nature of corporate earnings. Furthermore, the practice of allowing auditing companies to perform non-audit services can have the ultimate effect of allowing such companies to audit the work of their own personnel. This practice defeats the purpose of having an unbiased entity objectively reviewing the merits and accuracy of financial statements. The legislation we are considering in the Senate includes crucial provisions that will play a pivotal role in restoring confidence in our market system, and enhancing the public and private sector controls that are in place to monitor the relevant entities. The legislation creates a Public Accounting Oversight Board, which will be an entity solely focused on companies that audit and account for publicly traded firms. This oversight authority will include the ability to investigate and punish any wrongdoing by companies under SEC jurisdiction as well as their auditors. The bill also disallows simultaneous auditing and consulting, while providing for the Board to approve certain exceptions to non-specified non-audit services under this rule. The pending legislation also makes important strides in ensuring that any gain made by company executives be subject to retrieval if the company has to prepare an accounting restatement due to certain noncompliance with SEC regulations. As Treasury Secretary Paul O'Neill so aptly states in response to the actions of Enron executives, ``I really do believe that the CEO is in effect the steward for all the people who work in their organization. And that with that responsibility goes a commitment that the people come first and that the practices are open and above board and without reproach.'' These executives should not be able to leave their beleaguered companies, pockets stuffed with profits from cashed out stock options, while investors and employees suffer the consequences of questionable company practices. With the unanimous passage of the Leahy amendment, the Senate recognized the need to strengthen penalties for the punishment of those involved in corporate crime. For example, the amendment created a new felony for persons involved in the destruction of evidences--to address in the future such indiscretions as the document shredding perpetrated by Arthur Andersen's Enron Audit team. In addition, the Leahy amendment grants important whistleblower protections to company employees--like Enron's Sherron Watkins--who bravely report wrongdoing occurring within their own corporation. The bottom line is that integrity and trust are at the core of a successfully functioning market system. These recent business scandals have severely damaged this foundation. And as with any foundation in disrepair, leaving unaddressed the damage caused by lost faith in the system will lead to continued instability, or worse. Therefore, we in Congress have an obligation to do what we can to maintain and build investor confidence and faith in our free market system. I believe that the legislation we are considering today is a crucial first step toward that end, as well as ensuring the full rebound of our floundering economy.