Olympia Snowe

Ms. SNOWE

Ms. SNOWE. We very much appreciate your willingness to advocate on our behalf, and on behalf of our State. The $6 million will be a critical down-payment on this ambitious project. Northstar Corridor Commuter Rail Project

Ms. SNOWE. As Senator Collins expressed, your efforts on behalf of our State are deeply appreciated. We are committed to improving the highway system in Aroostook County and therefore welcome your support for this project. Interstate 95's current termination point is more than one hundred miles away from Maine's northern-most communities, which inhibits their ability to interact and to transact with the rest of the State and beyond.

Ms. SNOWE. I thank the chairman and ranking member of the Appropriations Subcommittee on Transportation for working closely with me and Senator Collins on projects of importance to our state, as well as critical national priorities. Your efforts are very much appreciated. As you know, one issue of great importance to my home state of Maine, as a rural state with many small, remote communities, is the U.S. Department of Transportation Essential Air Service--EAS-- program. Air service in rural areas is not simply a luxury, it is an imperative. Any municipality or small business owner will tell that without quality, affordable air service, economic development is virtually impossible. The EAS program is designed to ensure that small communities that were served by commercial air carriers prior to deregulation maintain scheduled air service. Today, the EAS program serves over 80 rural communities nationwide. The reality of deregulated air service is that four of Maine's six commercial airports--including the State Capital's airport in Augusta--rely on EAS to have any service to all. Unfortunately, the Administration has proposed a change in the eligibility criteria for the program which would result in the elimination of air service to a number of rural communities nationwide, including Augusta.

Mr. SNOWE

Mr. SNOWE. Madam President, I rise today to introduce the Navy Regionalization Reporting Act, a bill that would benefit all Navy bases and their surrounding communities by providing ample notification of planned, through regular reports, and unplanned, through the Congressional notifications, funding and employment level changes due to the Navy's regionalization process. Earlier this year, it was brought to my attention that both funding and jobs at the Naval Air Station in Brunswick, ME, could be impacted by the Navy's reallocation of base operating functions as part of its regionalization program. The Navy's stated goal for the regionalization program is to consolidate functions by eliminating management and support redundancies with the end result being increased efficiency and decreased overhead costs for shore installations. As such, for the Navy's program to be successful, funding, as well as jobs, must be reduced in some areas. While I applaud Navy's intentions to increase efficiency and save taxpayer dollars, I can not support efforts that may lead to reduced service levels for our men and women in uniform. I am also concerned that the Navy has not been able to produce detailed projections on the impact regionalization will have on the Federal employees. To date, the Navy has been unable to answer questions regarding future employment levels and has not established a method to track or predict changes in budget and job allocations at its bases that take place as a result of the regionalization program. This legislation would require the Navy to establish a tracking and planning program to make these changes more transparent. The Navy would provide an initial baseline or historical report that includes the pre- regionalization budgets and staffing levels at each base or station in each Navy region by July 2002. Subsequently, the Navy would submit semi-annual reports with projected and actual losses, gains, or restructuring of budgets and staff for each base. Any deviation from the reported budget or staff projections would then require Congressional notification 30 days prior to implementation. Finally, in an effort to prevent the degradation of operational readiness and quality of life for our service members due to the redistribution of base support functions, this legislation includes a Sense of the Senate that the Navy should ensure the job and dollar distribution within each region is equitable and does not become concentrated at one location. To assure the benefits of the Navy's program are equitably realized at all bases and communities, I urge my colleagues to support the Navy Regionalization Reporting Act.

Ms. SNOWE

Ms. SNOWE. Mr. President, today I rise to support an amendment to increase the Coast Guard's funding by $46.1 million. Unfortunately, under the funding levels in the pending bill, the Coast Guard would be forced to reduce routine operations by 20 percent. The increase provided by our amendment will address the Coast Guard's current readiness needs and raise the Coast Guard's law enforcement capabilities to the levels enacted in the budget resolution. The past two national defense authorization bills mandated pay raises, new medical benefits, recruiting and retention incentives, and other entitlements that exceeded the funds appropriated during the consideration of the regular Transportation appropriations bills. Compounding this, the Coast Guard has had to face rising energy costs, aging assets, and missions that grow increasingly complex. To pay for these increases the Coast Guard has had to dip into its operational accounts resulting in reduced law enforcement patrols. Without the funding authorized in this amendment, the Coast Guard will again be forced to reduce its level of operations. These routine operations are extremely important. As you know, the Coast Guard is a branch of the Armed Forces, but on a day-to-day basis, they are a multi-mission agency. Last year alone, the Coast Guard responded to over 40,000 calls for assistance, assisted $1.4 billion in property, and saved 3,355 lives. These brave men and women risk their lives to defend our borders from drugs, illegal immigrants, and other national security threats. And in 2000, the Coast Guard seized a record 132,000 pounds of cocaine and 50,000 pounds of marijuana through successful drug interdiction missions. They also stopped 4,210 illegal migrants from reaching our shores. They conducted patrols to protect our valuable fisheries stocks and they responded to more than 11,000 pollution incidents. On April 6 Senior DeWine, myself, and 10 of the colleagues offered an amendment to the budget resolution which was adopted by the Senate that addressed this very issue. That amendment increased funding for the Coast Guard by $250 million. The amendment that we are offering today, will go a long way toward repairing the fundamental problems facing the Coast Guard. It will increase funding by $46.1 million in fiscal year 2002 so that the Coast Guard will not need to reduce its routine operations. Now, during the drafting of the fiscal year 2002 Transportation appropriations bill, Senators Murray and Shelby had a daunting task in crafting a bill that would cover a wide range of priorities within the allocations provided to their subcommittee. Fortunately, they both recognize the importance of the Coast Guard to their home States and the Nation and their bill provides a significant increase above the President's budget request accordingly. However, based upon the Coast Guard's estimates, this increase will not eliminate the need for operational cutbacks. The $46.1 million increase we are asking for in this amendment is well below the $250 million the Senate agreed to in April, but the Coast Guard has assured us that they have taken a careful look at the funding allocations provided in this bill and that this small increase is all that is needed to restore the Coast Guard's operations and readiness. This will allow the Coast Guard to address an alarming spare parts shortage, maintain operations, and take care of other basic readiness problems. By supporting this amendment, my colleagues will be saying that it is unacceptable to reduce these critical law enforcement missions and supplying the Coast Guard with the resources and tools they need to fulfill the mandates Congress has given them. It provides the Coast Guard with the foundation needed to do its job. This is a bipartisan amendment, and I thank Senators Graham and DeWine for their efforts on behalf of the Coast Guard. This is noncontroversial amendment, and I urge my colleagues to support it.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today along with my colleague from Maine to introduce legislation for the relief of Nancy Wilson of Bremen, ME, who has been denied widow's benefits from Social Security despite the very extenuating circumstances of her case. Nancy Wilson was denied Social Security widow's benefits because she had not been married to the late Alphonse Wilson for the required nine- month period prior to his death even though they had lived together as a couple for 19 years. Alphonse had been unable to marry Nancy earlier because Massachusetts law forbade him from divorcing his first wife, Edna, due to her being institutionalized with a mental illness. Upon Edna's death on April 12, 1969, Alphonse and Nancy were married just 20 days later, with Alphonse dying on December 5, 1969. While the nine-month requirement for receiving widow's benefits was understandably created to prevent marriages in anticipation of death, the reason for Nancy Wilson's delayed nuptials were clearly unique. Given the extenuating circumstances, I urge my colleagues to support this private relief bill for Nancy Wilson.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today along with my colleague from Maine to introduce legislation for the relief of Nancy Wilson of Bremen, ME, who has been denied widow's benefits from Social Security despite the very extenuating circumstances of her case. Nancy Wilson was denied Social Security widow's benefits because she had not been married to the late Alphonse Wilson for the required nine- month period prior to his death even though they had lived together as a couple for 19 years. Alphonse had been unable to marry Nancy earlier because Massachusetts law forbade him from divorcing his first wife, Edna, due to her being institutionalized with a mental illness. Upon Edna's death on April 12, 1969, Alphonse and Nancy were married just 20 days later, with Alphonse dying on December 5, 1969. While the nine-month requirement for receiving widow's benefits was understandably created to prevent marriages in anticipation of death, the reason for Nancy Wilson's delayed nuptials were clearly unique. Given the extenuating circumstances, I urge my colleagues to support this private relief bill for Nancy Wilson.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise to thank Senators Reid and Domenici for including the Snowe-Collins amendment in the Fiscal Year 2002 Energy and Water Development Appropriations today to help the Town of Ft. Fairfield, ME. My amendment should resolve a serious design problem that has arisen in connection with the construction of a small flood control levy project in Ft. Fairfield, which is located above the 46th parallel in Northern Maine, where the river freezes every fall and stays frozen well into spring. The proper functioning of the levy is vital to the town's economic viability and for protection against future flooding of the downtown area. My amendment should allow the Army Corp of Engineers to assume financial responsibility for a design deficiency in the project relating to the interference of ice with pump operation so that there will be no further and inappropriate cost to the Town. My amendment calls for the Secretary of the Army to investigate the flood control project and formally determine whether the Secretary is responsible. Since the Corps has already assumed responsibility for the design deficiency, the Secretary will then order the design deficiency to be corrected at 100 percent federal expense. Once again, I thank the Chairs for their continued support for the levy project in Ft. Fairfield over the years, and I am pleased that the town will now have the assurance that their flooding problems are behind them and can go forward with their economic development plans for their downtown area.

Ms. SNOWE

Ms. SNOWE. Mr. President, I am pleased to join with my friend and colleague, Senator Ron Wyden, in the introduction of the Seniors Prescription Insurance Coverage Equity Act of 2001, or ``SPICE.'' I want to thank him for his enthusiasm about and his commitment to this joint venture. It was just about two years ago now that Senator Wyden and I introduced this bill for the first time. SPICE 2001 is the product of almost three years of work and development. Since 1999, when we first tackled this issue, there has been much discussion about how to design a prescription drug coverage plan that is both comprehensive and affordable, that provides choice but guarantees availability of basic coverage. And, perhaps most importantly, one that is workable for seniors, the Medicare program and one that private providers will offer. We believe we have struck this balance in SPICE 2001. I believe that this bill is a benchmark for the Senate's consideration of a comprehensive out-patient prescription drug program under Medicare. I offer this bill today, with my friend Senator Wyden because it is the product of a three year collaborative effort to provide our Nation's seniors with prescription drug coverage, and I offer it with the hopes that it will be considered as part of a broader reform when the Senate takes one up. Americans age 65 and older are only 12 percent of the population but account for over 40 percent of all drug spending. Which isn't surprising considering that over the past five years, per capita drug spending for the Medicare population has approximately doubled, reaching an estimated $1,756 this year. This comes at a time where fewer retirees have health coverage from their former employers than ever before. In 1998, an estimated 66 percent of large employers offered retiree health coverage, fewer than 40 percent did so in 2000. At a time when fewer and fewer of our seniors have retiree health care coverage from their former employers, and when the cost of prescription drugs are skyrocketing, no one can argue that it isn't essential we ensure that Medicare beneficiaries have comprehensive coverage for outpatient prescription drugs. And, this is a problem, I might add, which will only grow when the 77 million Baby Boomers begin to enter Medicare in 2011. For the past several years, Senator Wyden and I have been united in our belief that we owe it to our seniors to develop the best and most practical solution. SPICE 2001 represents a straightforward, comprehensive, and responsible approach that should appeal to anyone who believes that seniors need prescription drug coverage. To accomplish these goals we have built upon the model of the first SPICE bill and added components that have continued to be part of the larger debate on this issue--that of public programs versus private competition. As a result, SPICE 2001 now creates a partnership between the Federal Government and private insurers to share the cost, and the risk, of offering outpatient prescription drug coverage for our senior population. Specifically, SPICE 2001 creates a prescription drug coverage program for all Medicare beneficiaries enrolled in both Part A and Part B, and who choose to enroll. SPICE offers a premium subsidy of at least 25 percent to all enrollees. To provide extra assistance to those who need it most, there is a 100 percent premium subsidy for those whose income is at or under 150 percent of poverty, $12,885 for a single person and $17,415 for a couple. Those whose income is between 150 percent and 175 percent of poverty, $15,033 for an individual and $20,318 for a couple, will receive a subsidy based on a sliding scale down to 25 percent of the cost of the premium. SPICE 2001 offers two choices in the coverage so they can pick a plan to best serve their needs. One option is basic coverage, with a $350 deductible and a 25 percent coinsurance requirement. This can be purchased with a Stop-loss plan of $3,000 or separately. The second option is stop-loss coverage. While only 17 percent of beneficiaries have costs above $3,000, they account for almost 54 percent of all spending on prescription drugs. This coverage is provided completely through the private insurer. According to CBO's January 2001 baseline projections, 83 percent of those enrolled in Medicare fee for service plans pay less than $3,000 for their drugs. For these seniors, they might only want to purchase the basic coverage. Those who need more than just the basic coverage can buy them both. For those who can manage their spending and only want to protect themselves from catastrophic expenses, they can purchase stop-loss coverage. And, importantly, all SPICE enrollees receive the benefit of the negotiated discount on the cost of their prescription drugs, starting with their first prescription. Choice is one of the cornerstones of this program. Seniors will not only have the choice of their level of coverage but will be able to choose from a variety to have their care delivered. SPICE can be run through Medigap, Medicare+Choice plans, or private entities. In areas where there are no insurers, the SPICE Board will have the authority to negotiate with entities to bring them into the market. One of the perennial arguments against government sponsored or assisted prescription drug coverage for our retirees has been that if we did it, employers wouldn't. We already know that fewer employers are offering retiree health benefits than just 12 years ago, this is a trend we hope to discourage. This is why the SPICE Board is authorized to provide the 25 percent premium subsidy as an incentive to employers who provide prescription drug coverage for their retirees. It is critical we encourage employers to continue to offer this type of coverage and we acknowledge that in this bill. According to a 1998 Wall Street Journal poll, 80 percent of retirees use a prescription drug every day. The average Medicare beneficiary fills a prescription 18 times a year. It is long past time that we ensure that these prescriptions are covered. SPICE 2001 offers something for everyone interested in providing our seniors with prescription drug coverage. It is a program that can be incorporated in existing health plans, will be run through a government Board whose sole purpose is ensuring that this program runs well, and will foster competition and allow for choice in both coverage and providers.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to introduce a bill along with Senator Collins, Jeffords and Leahy to provide the states of Maine and Vermont continued authority to expand access to discounted prescription drugs under Medicaid. Maine has instituted an innovative demonstration program called the ``Healthy Maine Prescriptions'' program that is leading the way in providing affordable prescription drugs for qualifying Maine residents. This was made possible because Maine is one of two States, along with Vermont, to have received approval from the Secretary of the Department of Health and Human Services for demonstration projects to expand access to prescription drugs under Medicaid. Thousands of individuals with no other prescription drug insurance benefits are enrolled in those programs. The sad truth is, many low-income individuals cannot afford to purchase the drugs prescribed by their doctors. The result is that these individuals either split the doses to make them last longer--in violation of doctors' orders; they cut back on other necessities like food or clothing; or they simply decide not to fill the prescription at all--surely a prescription for medical disaster. Not only does the inability to pay for medications have an adverse and potentially dangerous effect on individuals, it is also a detriment to the health care system in general when you consider the number and expense of ailments that could have been prevented with the proper prescription drug. The reason why we are introducing this legislation is that, unfortunately, last month, a three-judge panel of the U.S. Court of Appeals for the District of Columbia ruled against the Vermont program, finding that Vermont ``lacked the authority to offer the same prescription rebates offered under federal Medicaid insurance'' because Congress ``imposed rebate requirements to reduce the cost of Medicaid.'' More recently, because of that ruling, a complaint has been brought by PHARMA against the Secretary of Health and Human Services to provide injunctive relief in the case of Maine's program. This bill sets forth findings that support the need and legitimacy of the Maine and Vermont programs and provides, in statute, specific authority for these prescription drug discounts for states whose waivers were approved before January 31, 2001. Specifically, the bill amends Section 1115 of the Social Security Act--the portion of the act granting the Secretary of Health and Human Services the authority to approve demonstration projections. It makes clear that any expenditures the state may make under the demonstration project will be treated as payments made under the state plan under Medicaid for covered outpatient drugs for purposes of a rebate agreement, regardless of whether these expenditures by the state are offset or reimbursed, in whole or in part, by rebates received under such an agreement. It also makes clear that these projects are entirely consistent with the objectives of the Medicaid program. Finally, it states that the regular cost-sharing requirements under Medicaid do not have to apply in the instance of these programs. One of the objectives of the Medicaid program is ``to enable each State, as far as practicable under the conditions in such State, to provide medical assistance on behalf of families with dependent children and of aged, blind, or disabled individuals, whose income and resources are insufficient to meet the costs of necessary medical services.'' As part of carrying out this objective, every state has elected the option of providing prescription drugs as a benefit under the Medicaid program, thereby providing an important means of increasing the access of low-income individuals to drugs prescribed by their doctors. Furthermore, Section 1115 of the Social Security Act provides the Secretary of Health and Human Services with broad authority to approve demonstration projects that are likely to assist in promoting the objectives of the Medicaid program, and waive compliance with any of the state plan requirements of the Medicaid program. The fact of the matter is, Medicaid demonstration projects help promote the objectives of the Medicaid program, including obtaining information about options for increasing access to prescription drugs for low-income individuals. If indeed the States are truly laboratories of democracy--and I believe they are--these demonstration projects deserve the chance to work, to be examined, and to assist those that they are designed to assist. And there is no question of the need--in Maine, 50,000 people signed up within the first three weeks of the program. Under the ``Healthy Maine Prescriptions Program,'' Maine provides prescription drug discounts of up to 25 percent for all adults with incomes of up to 300 percent of the Federal Poverty Level. A second benefit offering discounts of 80 percent of the cost of prescription drugs is available for disabled citizens, and low-income adults over the age of 62 who have an income of up to 185 percent of the Federal Poverty Level. During this time when virtually everyone agrees that something must be done to increase access to affordable prescription drugs, we ought to be encouraging innovative programs like those in Maine and Vermont. Terminating Medicaid demonstration projects prior to their planned expiration dates may result in significant waste of public funds and may be detrimental to those who have come to rely on such projects. We ought to be doing all we can to provide relief to low-income Americans, and at the same time give ourselves the opportunity to evaluate what works and what doesn't. Maine and Vermont are to be commended for their efforts, not punished--they are entirely in keeping with the spirit and intent of Medicaid and I hope my colleagues will recognize the value of these demonstration projects.

Ms. SNOWE

Ms. SNOWE. Madam President, my colleague from Maine and I would like to engage the subcommittee chairman and ranking member if we may.

Ms. SNOWE. I also want to thank my colleagues for their support for Atlantic salmon recovery. As the Senators know, the fiscal year 2001 Interior appropriations bill provided the funding to establish the National Fish and Wildlife Foundation's Atlantic salmon grant program. The program, which has leveraged an even greater amount of non-federal money, has been extremely successful at identifying and supporting innovative projects that will help with the recovery effort.

Ms. SNOWE. The money that was provided last year has been utilized to engage a wide range of stakeholders, including local community groups as well as aquaculture, agriculture, and forestry companies in cooperative restoration efforts. They have worked hard to aid the rebuilding process. It is a reflection of the strong commitment of everyone in Maine that we have far more projects being proposed than funding to accommodate them all. I can assure you that the money you are providing today will make a significant impact. I thank the subcommittee chairman and the ranking member for their courtesy and continued support.

Ms. SNOWE. Madam President, Senator Kerry of Massachusetts and I have introduced the Kerry-Snowe Georges Bank amendment to the fiscal year 2002 Interior Appropriations bill today to make absolutely certain that language in the fiscal year 2002 Interior Appropriations bill before us is modified to ensure that there will be no pre-leasing activities on Georges Bank. Language in the bill does prohibit the expenditure of funds by the Department of Interior for activities related to offshore leasing in the North Atlantic area, but I wanted the guarantee that pre-leasing activities would be out of bounds as well. Currently, both the United States and Canada have moratoria on oil and gas exploration until 2012 for the ecologically sensitive Georges Bank. What the Kerry-Snowe amendment does is include language in the Senate bill to prohibit any pre-leasing activities for the Georges Bank area, such as is included for the Mid- and South Atlantic. We are adding this language for the North Atlantic as well because of indications over the past few months that the administration could be considering legal and administrative groundwork for accessing Georges Bank. Report recommendations to the Secretary of Interior by the Subcommittee on Natural Gas on the U.S. Outer Continental Shelf included a recommendation that the Mineral Management Service, in consultation with industry and affected States, identify the five top geologic places for natural gas reserves in the moratoria areas, where industry would most likely explore, and where seismic data could be collected. Georges Bank is reported to be one of these prospects. Our added pre-leasing language for the North Atlantic area makes Section 107 of the bill consistent with Section 110 of the bill that does not allow Interior Department funding to conduct oil and natural gas pre-leasing, leasing and related activities in the Mid-Atlantic and South Atlantic planning areas. As I recently wrote the President, I strongly believe that the moratoria should not be lifted on this 185-mile-long bank that stretches from Nova Scotia to Cape Cod--five-sixths of which is owned by the U.S. This broad, shallow fishing ground is one of the world's most productive, and current available natural gas reserves in the U.S. dwarf those which are projected to be available on the Georges Bank. I want to sincerely thank the Interior Appropriations Subcommittee Chairs Byrd and Burns for accepting the Kerry-Snowe amendment as part of the Managers amendment.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to introduce a bill along with Senator Collins, Jeffords and Leahy to provide the states of Maine and Vermont continued authority to expand access to discounted prescription drugs under Medicaid. Maine has instituted an innovative demonstration program called the ``Healthy Maine Prescriptions'' program that is leading the way in providing affordable prescription drugs for qualifying Maine residents. This was made possible because Maine is one of two States, along with Vermont, to have received approval from the Secretary of the Department of Health and Human Services for demonstration projects to expand access to prescription drugs under Medicaid. Thousands of individuals with no other prescription drug insurance benefits are enrolled in those programs. The sad truth is, many low-income individuals cannot afford to purchase the drugs prescribed by their doctors. The result is that these individuals either split the doses to make them last longer--in violation of doctors' orders; they cut back on other necessities like food or clothing; or they simply decide not to fill the prescription at all--surely a prescription for medical disaster. Not only does the inability to pay for medications have an adverse and potentially dangerous effect on individuals, it is also a detriment to the health care system in general when you consider the number and expense of ailments that could have been prevented with the proper prescription drug. The reason why we are introducing this legislation is that, unfortunately, last month, a three-judge panel of the U.S. Court of Appeals for the District of Columbia ruled against the Vermont program, finding that Vermont ``lacked the authority to offer the same prescription rebates offered under federal Medicaid insurance'' because Congress ``imposed rebate requirements to reduce the cost of Medicaid.'' More recently, because of that ruling, a complaint has been brought by PHARMA against the Secretary of Health and Human Services to provide injunctive relief in the case of Maine's program. This bill sets forth findings that support the need and legitimacy of the Maine and Vermont programs and provides, in statute, specific authority for these prescription drug discounts for states whose waivers were approved before January 31, 2001. Specifically, the bill amends Section 1115 of the Social Security Act--the portion of the act granting the Secretary of Health and Human Services the authority to approve demonstration projections. It makes clear that any expenditures the state may make under the demonstration project will be treated as payments made under the state plan under Medicaid for covered outpatient drugs for purposes of a rebate agreement, regardless of whether these expenditures by the state are offset or reimbursed, in whole or in part, by rebates received under such an agreement. It also makes clear that these projects are entirely consistent with the objectives of the Medicaid program. Finally, it states that the regular cost-sharing requirements under Medicaid do not have to apply in the instance of these programs. One of the objectives of the Medicaid program is ``to enable each State, as far as practicable under the conditions in such State, to provide medical assistance on behalf of families with dependent children and of aged, blind, or disabled individuals, whose income and resources are insufficient to meet the costs of necessary medical services.'' As part of carrying out this objective, every state has elected the option of providing prescription drugs as a benefit under the Medicaid program, thereby providing an important means of increasing the access of low-income individuals to drugs prescribed by their doctors. Furthermore, Section 1115 of the Social Security Act provides the Secretary of Health and Human Services with broad authority to approve demonstration projects that are likely to assist in promoting the objectives of the Medicaid program, and waive compliance with any of the state plan requirements of the Medicaid program. The fact of the matter is, Medicaid demonstration projects help promote the objectives of the Medicaid program, including obtaining information about options for increasing access to prescription drugs for low-income individuals. If indeed the States are truly laboratories of democracy--and I believe they are--these demonstration projects deserve the chance to work, to be examined, and to assist those that they are designed to assist. And there is no question of the need--in Maine, 50,000 people signed up within the first three weeks of the program. Under the ``Healthy Maine Prescriptions Program,'' Maine provides prescription drug discounts of up to 25 percent for all adults with incomes of up to 300 percent of the Federal Poverty Level. A second benefit offering discounts of 80 percent of the cost of prescription drugs is available for disabled citizens, and low-income adults over the age of 62 who have an income of up to 185 percent of the Federal Poverty Level. During this time when virtually everyone agrees that something must be done to increase access to affordable prescription drugs, we ought to be encouraging innovative programs like those in Maine and Vermont. Terminating Medicaid demonstration projects prior to their planned expiration dates may result in significant waste of public funds and may be detrimental to those who have come to rely on such projects. We ought to be doing all we can to provide relief to low-income Americans, and at the same time give ourselves the opportunity to evaluate what works and what doesn't. Maine and Vermont are to be commended for their efforts, not punished--they are entirely in keeping with the spirit and intent of Medicaid and I hope my colleagues will recognize the value of these demonstration projects.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to join Senator Specter of Pennsylvania in support of the Dairy Consumers and Producers Protection Act of 2001. We are joined by 37 of our colleagues from New England and throughout the Mid-Atlantic and the Southeast. This legislation reauthorizes the very successful Northeast Interstate Dairy Compact which allows the producers of milk to, as a dairy farmer from York Country, ME, recently said, set a little higher bottom for the price of locally produced fresh milk. The current Compact only adds a small incremental cost to the current Federal milk marketing order system that already sets a floor price for fluid milk in New England. The bill also gives approval for States contiguous to the participating New England States to join, in this case, Pennsylvania, New York, New Jersey, Delaware, and Maryland. The legislation also grants Congressional approval for a new Southern Dairy Compact, made up of 14 States: Alabama, Arkansas, Georgia, Kansas, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Virginia, and West Virginia. This issue is really a State rights issue more than anything else, Mr. President, as the only action the Senate needs to take is to give its congressional consent under the Compact Clause of the United States Constitution, Article I, section 10, clause 3, to allow the 25 States to proceed with their two independent compacts. All of the legislatures in these twenty-five States have ratified legislation that allows their individual States to join a Compact, and the Governor of every State has signed a compact bill into law. Half of the States in this country, await our Congressional approval to address farm insecurity by stabilizing the price of fresh fluid milk on grocery shelves and to protect consumers against volatile price swings. All of the Northeast and Southern Compact States together make up about 28 percent of the Nation's fluid milk market--New England production is only about 3\1/2\ percent of this. This is somewhat comparable to Minnesota and Wisconsin which together make up to 24 percent of the fluid milk market. California makes up another 20 percent. Over ninety-seven percent of the fluid milk market in New England is contained within the area, and fluid milk markets are local due to the demand for freshness and because of high transportation costs, so any complaints raised in other areas about unfair competition simply does not hold water. The existence of the Northeast Dairy Compact does not threaten or financially harm any other dairy farmer in the country. Nor is there one penny of Federal funds involved--not one cent. Only the consumers and the processors in the New England region pay to support the minimum price to provide for a fairer return to the area's family dairy farmers and to protect a way of life important to the people of the Northeast. Importantly, under the Compact, New England retail milk prices have been among the lowest and the most stable in the country. No wonder other States want to follow our lead. When Congress wants to try something new, it often sets up a pilot program to test out an idea in a particular locality or region, and then appraises the outcome to see if the project was successful. This is how the Northeast Dairy Compact originated as it was included in the 1996 Farm bill as a three year pilot program--to sunset on April 4, 1999--at the same time as the adoption of the required consolidation of Federal milk marketing orders. The milk marketing orders were extended until October 1, 1999 in the Omnibus Appropriations of FY 1999, which also automatically extended the Compact until October 1, 1999. Because of efforts by myself and other Compact supporters, we fought to receive a two-year extension of the Northeast Compact, which was incorporated in the Omnibus spending bill funding several government agencies for FY 2000. The Compact will expire on September 30 of this year if no further action is taken by this body. I want to make it clear to my colleagues how important the continuation of the Northeast Dairy Compact is to me and the dairy farmers and consumers in Maine. I stand here not with my hand outstretched for federal farm dollars for Maine--of all income received by farmers in my State, only about 9 percent comes from Federal funding, unlike other States whose income received through Federal dollars is well over 75 percent--rather to urge you to support a very successful program that does not cost the federal government one penny--not one cent, and is supported by the very people who are affected by it. I plan to use every avenue open to me to make sure the Compact continues to operate as, once the Compact Commission is shut down even temporarily, it cannot magically be brought back to life again. It would take many months if not a year to restore the successful process that is now in place. I will not gamble with the livelihoods of the dairy farmers of Maine in that irresponsible fashion. All during the time of the Northeast Compact, fluid milk prices in New England have been among the lowest and have reflected great price stability. The consumers of New England have been spending a few extra pennies for fresh fluid milk--a recent University of Connecticut report recently estimated no more than 4.5 cents a gallon--to ensure a safety net for dairy farmers so that they can continue a historic way of life that is helpful to the regional economy. I have been pleasantly surprised that, while my mail certainly reflects discontent when gasoline prices rise by pennies, I have not received any swell of outrage of consumer complaints about milk prices over the last 3\1/2\ years that the Compact has been in place. The reality is that the initial pilot Compact project we so thoughtfully created has been a huge success. In 2000, dairy farmers in Maine received on average, $10,500 per dairy farm from the Compact Commission, the governing body set up to keep overproduction of fluid milk in check, and among other duties, ensure that the Federal nutrition programs, such as the Women, Infants, and Children Program, or WIC, are held harmless under the Compact. In fact, the advocates of these federal nutrition programs support the Compact and serve on its commission. The Northeast Interstate Dairy Compact has provided the very safety net that we had hoped for when the Compact passed as part of the omnibus farm bill of 1996. The Dairy Compact has helped farmers maintain a stable price for fluid milk during times of volatile swings in farm milk prices. Also, consider what has happened to the number of dairy farms staying in business since the formation of the Dairy Compact. It is now known that, throughout New England, there has been a decline in the number of dairy farmers going out of business. In Maine, for instance, the loss of dairy farms was 16 percent from 1993 to 1997. The Compact then went into effect and from that time until now, the loss of dairy farms has dropped to 9 percent. The Compact has given dairy farmers a measure of confidence in the near term for the price of their milk so they have been willing to reinvest in their operations by upgrading and modernizing facilities, acquiring more efficient equipment, purchasing additional cropland and improving the genetic base of their herds. Without the Compact, farmers would not have had the courage to do these things and their lenders would not have had the willingness to meet their capital needs. The Compact has also protected future generations by helping local milk remain in the region and preventing dependence on milk a single source of milk that can lead to higher milk prices through increased transportation costs and increased vulnerability to natural catastrophes. The bottom line is, the Compact has helped the economies of the New England States. The presence of farms are protecting open spaces critical to every State's recreational, environmental and conservation interests. These open spaces also serve as a buffer to urban sprawl and boost tourism so important to my home state of Maine. Through its bylaws, the Compact has also preserved State sovereignty by adopting the principle of ``one state--one vote,'' requiring that any pricing change be approved by two-thirds of the participating states in the Compact. There are compensation procedures that are implemented by the New England Dairy Commission specifically to protect against increased production of fresh milk. The Compact requires that the Compact Commission take such action as necessary to ensure that a minimum price set by the commission for the region over the Federal milk marketing order floor price does not create an incentive for producers to generate additional supplies of milk. When there has been a rise in the Federal floor price for Class I fluid milk, the Compact has automatically shut itself off from the pricing process. Since there is no incentive to overproduce, there has been no rush to increase milk production in the Northeast as was feared by Compact opponents. No other region should feel threatened by a dairy compact for fluid milk produced and sold mainly at home. The consumers in the Northeast Compact area, the now in the Mid- Atlantic area and the Southeast area, have shown their willingness to pay a few pennies more for their milk if the additional money is going directly to the dairy farmer. Environmental organizations have also supported dairy compacting as Compacts help to preserve dwindling agricultural land and open spaces. I urge my colleague not to look success in the face and turn the other way, but to support us in passing this legislation that half of our states have requested.

Ms. SNOWE

Ms. SNOWE. Mr. President, the resolution that Senator Kerry and I are submitting is very timely and important. As we work here in the Senate today, representatives of nations from around the globe are preparing for the 53rd Annual Meeting of the International Whaling Commission to be held in London July 23-27, 2001. At this meeting, the IWC will determine the fate of the world's whales through consideration of proposals to end the current global moratorium on commercial whaling. The adoption of any such proposals by the IWC would mark a major setback in whale conservation. It is imperative that the United States remain firm in its opposition to any proposals to resume commercial whaling and that we, as a nation, continue to speak out passionately against this practice. It is also time to close one of the loopholes used by nations to continue to whale without regard to the moratorium or established whale sanctuaries. The practice of unnecessary lethal scientific whaling is outdated and the value of the data of such research has been called into question by an international array of scientists who study the same population dynamics questions as those who harvest whales in the name of science. This same whale meat is then processed and sold in the marketplace. These sentiments have been echoed by the Scientific Committee of the IWC which has repeatedly passed resolutions calling for the cessation of lethal scientific whaling, particularly that occurring in designated whale sanctuaries. They have offered to work with all interested parties to design research protocols that will not require scientists to harm or kill whales. Last year, Japan expanded their scientific whaling program over the IWC's objections. The resolution that we are offering expresses the Sense of the Senate that the United States should continue to remain firmly opposed to any resumption of commercial whaling and oppose, at the upcoming IWC meeting, the non-necessary lethal taking of whales for scientific purposes. Commercial whaling has been prohibited for many species for more than sixty years. In 1982, the continued decline of commercially targeted stocks led the IWC to declare a global moratorium on all commercial whaling which went into effect in 1986. The United States was a leader in the effort to establish the moratorium, and since then we have consistently provided a strong voice against commercial whaling and have worked to uphold the moratorium. This resolution reaffirms the United States' strong support for a ban on commercial whaling at a time when our negotiations at the IWC most need that support. Norway, Japan, and other countries have made it clear that they intend to push for the elimination of the moratorium, and for a return to the days when whales were treated as commodities. The resolution would reiterate the U.S. objection to activities being conducted under reservations to the IWC's moratorium. The resolution would also oppose all efforts made at the Convention on International Trade in Endangered Species, CITES, to reopen international trade in whale meat or to downlist any whale population. In addition, the IWC, as well as individual nations including the United States, has established whale sanctuaries that would prevent whaling in specified areas even if the moratorium were to be lifted. Despite these efforts to give whale stocks a chance to rebuild, the number of whales harvested has increased in recent years, tripling since the implementation of the global moratorium in 1986. This is a dangerous trend that does not show signs of stopping. Domestically, we work very hard to protect whales in U.S. waters, particularly those considered threatened or endangered. Our own laws and regulations are designed to give whales one of the highest standards of protection in the world, and as a result, our own citizens are subject to rules designed to protect against even the accidental taking of whales. Commercial whaling is, of course, strictly prohibited. Given what is asked of our citizens to protect against even accidental injury to whales here in the United States, it would be grossly unfair if we retreated in any way from our position opposing commercial, intentional whaling by other countries. Whales migrate throughout the world's oceans, and as we protect whales in our own waters, so should we act to protect them internationally. Whales are among the most intelligent animals on Earth, and they play an important role in the marine ecosystem. Yet, there is still much about them that we do not know. Resuming the intentional harvest of whales is irresponsible, and it could have ecological consequences that we cannot predict. Therefore, it is premature to even consider easing conservation measures. The right policy is to protect whales across the globe, and to oppose the resumption of commercial whaling. I urge my colleagues to support swift passage of this resolution.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to join Senator Specter of Pennsylvania in support of the Dairy Consumers and Producers Protection Act of 2001. We are joined by 37 of our colleagues from New England and throughout the Mid-Atlantic and the Southeast. This legislation reauthorizes the very successful Northeast Interstate Dairy Compact which allows the producers of milk to, as a dairy farmer from York Country, ME, recently said, set a little higher bottom for the price of locally produced fresh milk. The current Compact only adds a small incremental cost to the current Federal milk marketing order system that already sets a floor price for fluid milk in New England. The bill also gives approval for States contiguous to the participating New England States to join, in this case, Pennsylvania, New York, New Jersey, Delaware, and Maryland. The legislation also grants Congressional approval for a new Southern Dairy Compact, made up of 14 States: Alabama, Arkansas, Georgia, Kansas, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Virginia, and West Virginia. This issue is really a State rights issue more than anything else, Mr. President, as the only action the Senate needs to take is to give its congressional consent under the Compact Clause of the United States Constitution, Article I, section 10, clause 3, to allow the 25 States to proceed with their two independent compacts. All of the legislatures in these twenty-five States have ratified legislation that allows their individual States to join a Compact, and the Governor of every State has signed a compact bill into law. Half of the States in this country, await our Congressional approval to address farm insecurity by stabilizing the price of fresh fluid milk on grocery shelves and to protect consumers against volatile price swings. All of the Northeast and Southern Compact States together make up about 28 percent of the Nation's fluid milk market--New England production is only about 3\1/2\ percent of this. This is somewhat comparable to Minnesota and Wisconsin which together make up to 24 percent of the fluid milk market. California makes up another 20 percent. Over ninety-seven percent of the fluid milk market in New England is contained within the area, and fluid milk markets are local due to the demand for freshness and because of high transportation costs, so any complaints raised in other areas about unfair competition simply does not hold water. The existence of the Northeast Dairy Compact does not threaten or financially harm any other dairy farmer in the country. Nor is there one penny of Federal funds involved--not one cent. Only the consumers and the processors in the New England region pay to support the minimum price to provide for a fairer return to the area's family dairy farmers and to protect a way of life important to the people of the Northeast. Importantly, under the Compact, New England retail milk prices have been among the lowest and the most stable in the country. No wonder other States want to follow our lead. When Congress wants to try something new, it often sets up a pilot program to test out an idea in a particular locality or region, and then appraises the outcome to see if the project was successful. This is how the Northeast Dairy Compact originated as it was included in the 1996 Farm bill as a three year pilot program--to sunset on April 4, 1999--at the same time as the adoption of the required consolidation of Federal milk marketing orders. The milk marketing orders were extended until October 1, 1999 in the Omnibus Appropriations of FY 1999, which also automatically extended the Compact until October 1, 1999. Because of efforts by myself and other Compact supporters, we fought to receive a two-year extension of the Northeast Compact, which was incorporated in the Omnibus spending bill funding several government agencies for FY 2000. The Compact will expire on September 30 of this year if no further action is taken by this body. I want to make it clear to my colleagues how important the continuation of the Northeast Dairy Compact is to me and the dairy farmers and consumers in Maine. I stand here not with my hand outstretched for federal farm dollars for Maine--of all income received by farmers in my State, only about 9 percent comes from Federal funding, unlike other States whose income received through Federal dollars is well over 75 percent--rather to urge you to support a very successful program that does not cost the federal government one penny--not one cent, and is supported by the very people who are affected by it. I plan to use every avenue open to me to make sure the Compact continues to operate as, once the Compact Commission is shut down even temporarily, it cannot magically be brought back to life again. It would take many months if not a year to restore the successful process that is now in place. I will not gamble with the livelihoods of the dairy farmers of Maine in that irresponsible fashion. All during the time of the Northeast Compact, fluid milk prices in New England have been among the lowest and have reflected great price stability. The consumers of New England have been spending a few extra pennies for fresh fluid milk--a recent University of Connecticut report recently estimated no more than 4.5 cents a gallon--to ensure a safety net for dairy farmers so that they can continue a historic way of life that is helpful to the regional economy. I have been pleasantly surprised that, while my mail certainly reflects discontent when gasoline prices rise by pennies, I have not received any swell of outrage of consumer complaints about milk prices over the last 3\1/2\ years that the Compact has been in place. The reality is that the initial pilot Compact project we so thoughtfully created has been a huge success. In 2000, dairy farmers in Maine received on average, $10,500 per dairy farm from the Compact Commission, the governing body set up to keep overproduction of fluid milk in check, and among other duties, ensure that the Federal nutrition programs, such as the Women, Infants, and Children Program, or WIC, are held harmless under the Compact. In fact, the advocates of these federal nutrition programs support the Compact and serve on its commission. The Northeast Interstate Dairy Compact has provided the very safety net that we had hoped for when the Compact passed as part of the omnibus farm bill of 1996. The Dairy Compact has helped farmers maintain a stable price for fluid milk during times of volatile swings in farm milk prices. Also, consider what has happened to the number of dairy farms staying in business since the formation of the Dairy Compact. It is now known that, throughout New England, there has been a decline in the number of dairy farmers going out of business. In Maine, for instance, the loss of dairy farms was 16 percent from 1993 to 1997. The Compact then went into effect and from that time until now, the loss of dairy farms has dropped to 9 percent. The Compact has given dairy farmers a measure of confidence in the near term for the price of their milk so they have been willing to reinvest in their operations by upgrading and modernizing facilities, acquiring more efficient equipment, purchasing additional cropland and improving the genetic base of their herds. Without the Compact, farmers would not have had the courage to do these things and their lenders would not have had the willingness to meet their capital needs. The Compact has also protected future generations by helping local milk remain in the region and preventing dependence on milk a single source of milk that can lead to higher milk prices through increased transportation costs and increased vulnerability to natural catastrophes. The bottom line is, the Compact has helped the economies of the New England States. The presence of farms are protecting open spaces critical to every State's recreational, environmental and conservation interests. These open spaces also serve as a buffer to urban sprawl and boost tourism so important to my home state of Maine. Through its bylaws, the Compact has also preserved State sovereignty by adopting the principle of ``one state--one vote,'' requiring that any pricing change be approved by two-thirds of the participating states in the Compact. There are compensation procedures that are implemented by the New England Dairy Commission specifically to protect against increased production of fresh milk. The Compact requires that the Compact Commission take such action as necessary to ensure that a minimum price set by the commission for the region over the Federal milk marketing order floor price does not create an incentive for producers to generate additional supplies of milk. When there has been a rise in the Federal floor price for Class I fluid milk, the Compact has automatically shut itself off from the pricing process. Since there is no incentive to overproduce, there has been no rush to increase milk production in the Northeast as was feared by Compact opponents. No other region should feel threatened by a dairy compact for fluid milk produced and sold mainly at home. The consumers in the Northeast Compact area, the now in the Mid- Atlantic area and the Southeast area, have shown their willingness to pay a few pennies more for their milk if the additional money is going directly to the dairy farmer. Environmental organizations have also supported dairy compacting as Compacts help to preserve dwindling agricultural land and open spaces. I urge my colleague not to look success in the face and turn the other way, but to support us in passing this legislation that half of our states have requested.

Ms. SNOWE

Ms. SNOWE. The Senator from Ohio is exactly correct. We are treating all employers the same. In this instance, in this particular category, it is those employers who do not have a designated decisionmaker. That is the intent of this particular provision: To treat them equally so they are not subjected to liability when it comes to contractual matters, whereas other employers are not who contract with insurance companies and have a designated decisionmaker. That is what the intent is of this legislation. It is to treat them all equally and to draw that bright line. We could say, let's not address the self-insured and self- administered programs. I do not think that is fair either because, obviously, they have a different kind of program, and we want to encourage that. We commend them for the kind of benefits they are providing their employees. They happen to be large employers, and they want to design their own internal program. But we don't want to subject them to litigation to which other employers are not going to be subjected. So that is the reason for the intent of this particular provision that happens to include union plans that are designed similarly.

Ms. SNOWE. The Senator from Ohio is making exactly the correct point. This particular provision was intended for those insurers, self-insured and self-administered plans, that obviously do not have a designated decisionmaker. I should further emphasize, all employers are treated equally when it comes to the idea that they participate in medical decisions on behalf of their employees. They are all treated the same. This particular area of the legislation is with respect to contractual decisions. We are attempting to craft out for self-administered, self- insured plans, and that includes union health plans that conform to that particular organization, that they would not be subjected to litigation that other employers would not be subjected to because they had designated decisionmakers. We know self-insured, self-administered plans do not have designated decisionmakers. So we did not want to expose them to that kind of litigation in this particular section that delineates the causes of action. We were trying to treat all of the employers equally.

Ms. SNOWE. Will the Senator yield?

Ms. SNOWE. Madam President, I ask unanimous consent that the reading of the amendment be dispensed with.

Ms. SNOWE. Madam President, I rise today to offer an amendment along with my colleagues Senator DeWine, Senator Lincoln, and Senator Nelson, who worked so hard, so diligently in crafting this compromise. Senator McCain and Senator Specter are coauthors of this amendment as well. The amendment we are offering today is designed to bridge the gap that exists between the supporters of the McCain-Edwards-Kennedy approach to employer liability in the Breaux-Frist-Jeffords bill. I commend Senators McCain, Edwards, and Kennedy for their willingness as well as their patience to work with us on resolving the many issues that are associated with employer liability. Everyone involved has had the same goal essentially, and that is to protect employers from liability when they are not participating in making decisions concerning the health care of employee beneficiaries. The discussion has really focused on how best to achieve that goal. This is an incredibly complex liability issue that has far-reaching consequences, and everyone who has been part of this discussion and this effort to reach this consensus recognizes that fact and has worked in good faith to arrive at a solution that we can live with and, more importantly, employers can live with and not denying care that patients rightly deserve. This is an issue that is significant on a number of different levels. First of all, to what extent will employers that voluntarily offer health insurance be exposed to liability. To what extent will employers be involved in the decisionmaking process in terms of the provisions of health care for their employee beneficiaries, and perhaps more important, will patients have legal recourse should they have a grievance concerning the care they receive through their health care plan. The goal we all share in designing and crafting this amendment to the McCain-Kennedy-Edwards legislation is how best we protect patients for their medical care without creating an expansive bureaucracy adding to the cost of providing that health care and generally creating an incentive to drive away employers from providing health care insurance to their employees which, as I said earlier, they do so on a voluntary basis. We should be commending employers for providing these benefits, not penalizing them. We should also take great care to write a provision under which employees remain insured through their employers, while also protecting the employees' rights under their health insurance plans. What we do not want to do is create unintended consequences for employers by leaving legal questions open that can leave employers exposed to liability over matters in which they have no control and over matters in which they have not participated and having the resulting decision. That is all the more significant when we realize there are more than 43 million Americans who remain without any insurance, and of those who have insurance, employers voluntarily provide health coverage to more than 172 million Americans. Obviously, what we do today is significant, and it will matter. We cannot afford to have employers suddenly opting out of providing insurance to their employees because we do not want to create the unintended consequence that adds to the rolls of the uninsured in America. I think that is something on which we all can agree, and that is a very real risk. In fact, there was a recent poll taken of businesses in America, and it said that 57 percent of small businesses said they would drop coverage rather than risk a lawsuit. As one businessman in my State wrote to me recently: We're not an HMO or an insurance company. We are an employer. We cannot afford the time, expense, and aggravation of litigation. And, please, make no mistake, that is what this is about. So we approach the issue of reconciling the differences between the two approaches by addressing the question: What language will deliver us to that mutual goal? We assess what was really the best qualities of the McCain-Edwards-Kennedy legislation, as well as the Breaux-Frist- Jeffords issues. Ultimately, the solution we came to was a melding of the two approaches. The result was to provide employers with varying levels of liability protection depending on their involvement in the decisionmaking process but regardless, patients will have the legal recourse they deserve, no matter what. There are many other issues that need to be resolved in this legislation. I realize this represents one facet, the liability question, that has been raised by others with respect to this legislation, and this is not intended to address all of those questions, but clearly it does address a most important issue when it comes to subjecting employers to litigation and liability. Let me take a moment to explain the differences between the McCain- Edwards-Kennedy legislation and the Breaux-Frist-Jeffords approach and the approach we are taking in the amendment we have offered to S. 1052 and how our amendment affects the underlying legislation and addresses the concerns that have been raised about the net legal impact on employers. Essentially, there are several categories we are attempting to address today when it comes to employer-sponsored health care insurance. First, there are employers that contract with an insurance company that, in turn, pays beneficiary claims and administers the plans and the benefits. Second, there are employers that fund a plan but leave the actual administration of the plan to an outside entity, generally an insurance company. Third, there are those who both self-insure and self-administer, in essence creating their own insurance company within their existing business. The McCain-Edwards-Kennedy legislation as written allows a suit against any employer if it directly participates in a decision that harms or results in the death of a patient. Direct participation is defined as the actual making of a medical decision or the actual exercise of control in making such a decision or in the conduct constituting the failure. The bill then goes on to offer specific circumstances that do not constitute direct participation, including any participation by the employer or other plan sponsor in the selection of the group health plan or health insurance coverage involved or the third party administrator or other agent, or any engagement by the employer or other plan sponsor in any cost-benefit analysis undertaken with the selection of or continued maintenance of the plan or coverage involved. While the bill language does not provide an exhaustive list of exceptions, it does allow an employer to offer into evidence in their defense that they did not directly participate in decisions affecting the beneficiaries of the health care plan. That suggests while employer protections would be provided under the legislation, an employer would still have to go to court to make its defense. As with any such legal language, direct participation obviously can be open to legal interpretation, and that precisely is the circumstance which we are seeking to avoid and prevent. Under the Breaux-Frist-Jeffords legislation that was introduced, the language provides for a designated decisionmaker, or DDM, which in most cases would be the insurance company an employer contracted with to be the party that is liable for medical decisions and, therefore, the party could be subject to liability. In other words, the employer would designate the DDM as the responsible party to shield itself from that liability. If an employer chose not to designate a DDM, they would have no protection from that liability. An argument that has been made against the Breaux-Frist-Jeffords language is if the DDM is a person designated within a company that self-insures, for example, they could under the employment law attempt to escape liability by claiming that ultimate decision came from the employer; that they, as a DDM, did not make a final decision on a particular beneficiary's case. In an effort to improve the Breaux- Frist-language, we designate that when a contract is signed with the employer, the DDM cannot mount any such defense, that somehow they defer the liability, defer the suggestions that the employer somehow participated in making the decision. In an effort to improve the employer liability provisions, we encompassed key provisions of both models in the legislation while addressing their inherent weaknesses so we can attain our shared goals. First, our amendment allows employers that turn their health care coverage to outside insurance companies, that their insurance company will automatically be their designated decisionmaker unless they specifically choose not to have a DDM. This is built directly on the Breaux-Frist-Jeffords model in which the decisionmaking authority shifts to the DDM, which will in most cases be the insurance company. Under this approach, an employer would not have to take the extra steps to secure a designated decisionmaker and would not be required to go to court to file papers or to make defenses against any actions they may have taken. In other words, they would not have to do anything different than what they are doing today with a contract with an insurance company. When they sign up with an insurance carrier that will provide benefits to their employees and administer the benefits, they are then signing up with, essentially, a designated decisionmaker, and they are signing up as well for a safe harbor from liability in both medical as well as contractual decisions. Where we depart from the existing Breaux-Frist language is we clarify since the DDM, which is also the insurance company, has assumed full responsibility at the time the employer and the insurance company signed a contract, the designated decisionmaker would be prevented from turning around and assigning the employer for some failure that resulted in a lawsuit from a beneficiary. In other words, the dedicated decisionmaker can't transfer liability to the employer because of something the employer does or failed to do. The legislation we have introduced today to modify the McCain- Edwards-Kennedy legislation delineates specifically that the dedicated decisionmaker is responsible for a contractual arrangement as well as exclusive authority for any medically reviewable decisions. For employers that choose not to have a dedicated decisionmaker, for whatever reason, and for those employers that prefer to continue to be self-insured but contract out the administration of their health care plan, we leave in place the general McCain-Edwards model in the underlying bill that protects employers insofar as they do not directly participate in the medical decisionmaking process. Again, as I outlined earlier, direct participation is defined as the actual making of a medical decision, the actual exercise of control in making such a decision or in the conduct constituting the failure. These are two of the changes we have made in the amendment we are presenting today from the underlying McCain-Edwards legislation. In our amendment, we eliminate one element of the bill that would have potentially led to the filing of lawsuits on a variety of grounds unrelated to specific medical decisions impacting individual beneficiaries. The language is, in layman's terms, broad and nonspecific and potentially exposes a defendant to a wide array of nonlegal actions. If additional grounds for lawsuit should be added to the legislation, we should delineate and specify them and not have broad language that essentially leads to a legal potpourri. Striking this language does not affect the ability of the patient to seek remedy in court for medical decisions made in their particular circumstance. But it does prevent a whole new arena of lawsuits from being created that would heighten an employers' exposure to liability. In addition, our amendment also modifies the underlying legislation to ensure that self-insured, self-administered plans, employers, and union health care plans will not be subject to lawsuits under Federal law simply because of contractual disputes. This change is critically important when considering that self-insured, self-administered plans do not have the ability to assign liability to a dedicated decisionmaker. As a result, they may opt to simply stop offering insurance for employees altogether rather than risk a substantial judgment on a contractual matter. That is a result, again, we simply cannot afford if we are going to ensure that people have the kind of health insurance plans in America in which they will continue to be insured, and that employers are the ones providing predominantly the health insurance in America today. To describe our amendment in another way, we essentially are saying as an employer that is not self-insured, you can hand over all your decisionmaking and therefore your liability to a dedicated decisionmaker which will, in all likelihood, be your insurance company when you sign your contract with your insurance company. There is nothing more you need to do to protect your business from liability for the decisions that are made. For the self-insured and for those who do not self-insure as an employer, you would still have the protections afforded under the underlying legislation if you don't directly participate in those decisions. In other words, employers who contract out their health insurance have a clear choice under our amendment, although once again I stress that under this amendment patients will still have the legal recourse regarding questions over appropriate medical care and medical decisions related to the beneficiary's plan, no matter which option the employer chooses. The bottom line is we seek to protect employers from liability in cases where they are not making the medical decisions that harm patients or result in death while still protecting parents rights, which after all is the goal of this legislation. Finally, let me assure my colleagues, under this amendment, dedicated decisionmakers would have to demonstrate they are financially capable of fulfilling their responsibilities as the party liable in causes of action. They could not be shell entities or sham individuals or organizations without the ability to actually pay the event of lawsuits. The criteria the Secretary of Health and Human Services will require relating to the financial obligations of such an entity for liability should also include an insurance policy or other arrangements secured and maintained by the dedicated decisionmaker to effectively insure the DDM against losses arising from professional liability claims, including those arising from service as a designated decisionmaker. A DDM would have to show evidence of minimum capital and surplus levels that are maintained by an entity to cover any losses as a result of liability arising from its service as a designated decisionmaker. It would have to show that they themselves have coverage adequate to cover potential losses resulting from liability claims or evidence of minimum capital and surplus levels to cover any losses. Once again, I think we have designed an amendment that represents a workable approach, that addresses some of the more serious and significant concerns that had arisen in the various pieces of legislation that had been introduced here in the Senate and with the underlying legislation we are seeking to amend today. We try to meld the best of both approaches, to balance the concerns of businesses that do seek to voluntarily provide this most important, critical benefit to their employees. That is an incentive we want to maintain and reinforce in every possible way. But we also understand there are going to be those circumstances in which the employee has received inappropriate care that has resulted in significant harm, injury, or even death, and that they should have the opportunity to seek legal redress for that inappropriate care or denial of care. That is the kind of consideration we want to ensure in this legislation, without creating the unintended consequences or the disincentive for employers to say we just simply cannot afford to provide this health insurance for our employees anymore because we are going to be subject to litigation, to endless losses, and we do not want to put ourselves in the position of that kind of exposure. I think this approach has been examined on both sides of the political aisle. More important, I think it has been embraced by this bipartisan group in the Senate, my colleague Senator DeWine, who has worked so hard, Senator Lincoln whom I see on the floor, and Senator Nelson. They have worked very diligently on behalf of this amendment to assure that we address all facets, all potential implications and ramifications associated with this approach, to hopefully address it in a way that will ultimately yield the best effect for both the employer as well as the employees. I yield the floor. I will be glad to yield time to my colleague.

Ms. SNOWE. Will the Senator yield?

Ms. SNOWE. Will the Senator yield on that point?