Gordon Smith

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Madam President, I rise today to speak about hate crimes legislation I introduced with Senator Kennedy in March of last year. The Local Law Enforcement Act of 2001 would add new categories to current hate crimes legislation sending a signal that violence of any kind is unacceptable in our society. I would like to describe a terrible crime that occurred Aug. 3, 1997 in Fort Worth, TX. Two gay men were physically assaulted after leaving a gay bar. The assailants, two men, were heard to yell anti-gay epithets during the attack. I believe that government's first duty is to defend its citizens, to defend them against the harms that come out of hate. The Local Law Enforcement Enhancement Act of 2001 is now a symbol that can become substance. I believe that by passing this legislation and changing current law, we can change hearts and minds as well.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I rise today to speak about hate crimes legislation I introduced with Senator Kennedy in March of last year. The Local Law Enforcement Act of 2001 would add new categories to current hate crimes legislation sending a signal that violence of any kind is unacceptable in our society. I would like to describe a terrible crime that occurred July 16, 2000 in San Diego, CA. Seven teenage boys, ages 14 to 17, attacked five elderly Latino migrant workers. The boys chased, beat, and shot at migrants living in a makeshift encampment in an isolated canyon. Ethnic slurs were used during the attack. The boys were charged with hate crimes, assault, robbery, and elder abuse in connection with the incident. I believe that government's first duty is to defend its citizens, to defend them against the harms that come out of hate. The Local Law Enforcement Enhancement Act of 2001 is now a symbol that can become substance. I believe that by passing this legislation and changing current law, we can change hearts and minds as well.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. I thank Senator Kennedy, the manager of this bill, and my cosponsor of this legislation, Senator Graham, for the time. I say to the American people, what few may be up this morning watching these proceedings, that this is probably our last best chance to pass prescription drugs in the 107th Congress, and I think it is critical we do so. I am optimistic we are going to succeed, but if we do not, it will be because of that old maxim that the perfect is the enemy of the good. What Senator Graham and I have is the best we can produce for the greatest number of people, particularly the neediest, but for everyone in terms of discount cards and in terms of a catastrophic coverage. We have the best we can do with the financial constraints faced by this Government. We have produced a plan that is affordable for seniors and it is affordable for the U.S. Government. It is a plan at a minimum that we ought to pass. I thought what I would do in my remarks today was to try to give a comparison between our bill and the competing bill. Both of these bills can work. I have, in fact, voted for a version of the Grassley-Breaux bill. However, I am now on this bill because I think this is more in the realm of what is possible and workable. I will spend some time focusing on the health and financial security aspect, which is what is available to every American under our plan who is under Medicare, and then focus on the sickest and the poorest, the protection for the most vulnerable in our society. Let me start first with the most vulnerable in our society. Let's compare the low-income benefit. Under Grassley-Breaux, the low- income folks are covered at 150 percent of poverty; under the Graham- Smith bill, people 200 percent of poverty are covered. Under Grassley- Breaux, it includes an assets test which will drop 40 percent of otherwise income-eligible elderly; under Graham-Smith, there is no asset test. Under their proposal, beneficiaries below 200 percent of poverty can pay up to $3,700 due to copays, deductibles, and premiums. Under ours, beneficiaries out of pocket are limited to drug copays of $2 for generic and $5 for brands. That is an enormous difference in terms of what they will have to pay and who will be included. Under their plan, they provide more limited coverage than some elderly get in current employer programs or State pharmacy assistance programs. Under our plan, coverage for low-income elderly is as comprehensive as State pharmacy assistance programs. CBO estimates that no employer will drop coverage because of what we have. As to the catastrophic limit, their proposal kicks in at $3,700. Our proposal kicks in at $3,300, a very big difference, a 12-percent difference. That matters a great deal at the low end of the economic scale in our country. Some may say this does not cover enough people. Let me give a few examples of a few States and how much this plan helps. These are percentages of people in various States falling below 200 percent of poverty: In Vermont, 42 percent of their elderly fall below that; in the State of Mississippi, 46 percent; in the State of Maine, 37 percent; in the State of Ohio, 41 percent; in the State of Nevada, 41 percent; the State of Illinois, 41 percent also; the State of Nebraska, 43 percent; the State of Iowa, 38 percent; in the State of Louisiana, 52 percent; in the State of Indiana, 46 percent; in the State of Alabama, 56 percent; in the State of Pennsylvania, 43 percent; and the State of Rhode Island, 48 percent. These are dramatic numbers. There is hardly a State in the Union that falls below 40 percent of people who will be covered 100 percent by the Graham-Smith proposal. That is significant. That is an incredible start on a prescription drug program. Let me turn to the health and financial security aspects and compare both bills. The premiums and fees: Under Grassley-Breaux, the elderly will pay $288 per year or more. The premiums imposed are imposed monthly, despite periods when the beneficiary receives no benefit. Unknown premium amounts that can vary by area dramatically, year by year. Under ours, there is no monthly premium. Now to the deductible. Under theirs there is a $250 per year deductible. Under Graham-Smith there is no deductible. Universal coverage: Under Grassley-Breaux, only low-income and those choosing to pay monthly premiums are covered. Under ours, all seniors and covered disabled are covered after a $25 annual fee. As to employer coverage and crowding out private plans, the CBO estimates a third of current employer benefits will be dropped if Grassley-Breaux goes through. They estimate that under the Graham-Smith proposal all seniors and disabled will be covered, and they estimate no loss of current employer coverage. I think that is terribly significant. Ours overlays the existing program much better than the Grassley-Breaux proposal. Now as to guarantee of current coverage levels: Under Grassley- Breaux, some low-income elderly would receive reduced coverage than under the current State pharmacy programs. But under ours, low-income elderly are guaranteed a comprehensive benefit with a nominal cost sharing. CBO estimates under Grassley-Breaux one-third loss of current employer coverage, and coverage could be far worse than the elderly currently receive. CBO estimates under ours, no loss of current employer coverage. Now, the stability of the delivery system. Grassley-Breaux imposes an untried and untested insurance model on our Nation's elderly and disabled and results in employer crowd-out. I assume this insurance program in the private sector could be developed, but it does not exist right now. So we are betting that it can be developed and that people would like it. In the State of Oregon, if you ask how they like their private insurance, it is not much; they do not like it much. While they complain about Medicare, they certainly want us to support it. Then on this issue of a stable delivery system: Senator Graham and I build upon current State and market-based delivery models, and we do not result in an employer crowd-out. What is the overall cost? The Grassley-Breaux approach is scored at somewhere between $375 and $400 billion over 10 years. Ours is scored at $390 billion over 10 years. So they are comparable in that regard. I conclude my remarks by saying we will hear this morning about the ``cliff''--that after 200 percent of poverty the people do not get anything; if you make $24,000 as a couple, you fall off a cliff. I wish we had a more graduated program, I grant that. There are many things about what Senator Graham and I have that I would change if I could, but I can't, and get something passed and into conference. So let's start here. Let me simply say to those who would describe this as a cliff, that you get nothing if you make more than $24,000 a year, to me it is not nothing to say that for $25 a year you get a discount card that, at a minimum, gives you 5 percent off all your prescriptions, but probably, because you get the benefit of pricing discounts, you get as much as 30 percent off every prescription drug, and, moreover, you add to that the fact that you never have to worry again as a senior in America that when you lose your health, you have to lose your home--you do not have to choose between food and medicine. That is significant. Tell me where in the private sector you can find an insurance policy that, for $25 a year, will do all of that. Have we done enough? No. Have we done a tremendous amount of good? Absolutely. I plead with my colleagues to vote to waive this point of order. We should not fail today. We should get this to the floor. People have ideas. We can perhaps make it better. But we can get on with the business that the seniors and citizens of this country are expecting. Let us get beyond the war of words and get to a prescription of wellness for the seniors and provide them a benefit that is workable, tried and true, affordable for them and our Government. I yield the floor.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, the events of the past 11 months have forced every American to become more vigilant against the threats to our nation's security. I want to commend the chairman, Senator Inouye, and the ranking member, Senator Stevens, for bringing to the floor a bill that responds to such threats by better protecting our Nation's citizens as well as our servicemen and women. Even before the attacks of September 11th of last year, however, our Nation's military began to see that traditional notions of warfare and defense would have to evolve to meet new and ever more dangerous threats. The bombing of the USS Cole in Yemen, for example, made clear to us that our naval forces must be equipped with the most advanced surveillance and response vessels available. It is for this reason that I have an amendment in support of the Navy's development and demonstration of the SeaLion craft. This vessel, designed for coastal area operations here in the United States and abroad, has already begun to prove itself capable of meeting the challenges faced by our Navy today, and well into the future. Military operations in coastal areas involve significantly different challenges from deep water operations, such as reduced operational space and environmental clutter. Accordingly, surveillance, weapon systems and naval tactics designed for deep water operations are inadequate for the complex environmental and dimensional aspects of the coastal battle space. In such areas, small boats can effectively protect coastal installations, combat blue water navies, and hinder freedom of navigation for these navies and their supply ships. The rapidly evolving nature of maritime warfare, the threat of terrorist activities against our naval forces abroad, and the need to protect our own ports here at home: each of these challenges require that the United States make a concerted effort to maintain a solid lead in the development of advanced technologies for coastal operations. The SeaLion craft is perfectly positioned to support this role. It is a high speed, low-radar-signature vessel whose unique versatility lends itself to a broad spectrum of mission applications, from surveillance to interdiction to engagement. The SeaLion has already received strong endorsement from the Naval Sea Systems Command for its utility in special operations, and is poised for further evaluation as part of the Navy's Littoral Combat Ship platform. This amendment would allow $8 million of funds appropriated by the bill to be used for the continued development, demonstration and evaluation of the SeaLion vessel. I ask for my colleagues' support.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I speak about hate crimes legislation I introduced with Senator Kennedy in March of last year. The Local Law Enforcement Act of 2001 would add new categories to current hate crimes legislation sending a signal that violence of any kind is unacceptable in our society. I would like to describe a terrible crime that occurred September 7, 2000 in Los Angeles, CA. A woman ran over a 65-year-old Hispanic man, Jesus Plascensia, twice in a parking lot. Authorities say that the perpetrator made comments about her hatred of Hispanics after the death and referred to the victim as ``dead road kill.'' The assailant was charged with murder and hate crimes in connection with the incident. I believe that government's first duty is to defend its citizens, to defend them against the harms that come out of hate. The Local Law Enforcement Enhancement Act of 2001 is now a symbol that can become substance. I believe that by passing this legislation and changing current law, we can change hearts and minds as well.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I rise today to speak about hate crimes legislation I introduced with Senator Kennedy in March of last year. The Local Law Enforcement Act of 2001 would add new categories to current hate crimes legislation sending a signal that violence of any kind is unacceptable in our society. I would like to describe a terrible crime that occurred May 14, 1995 in Brooklyn, NY. A gay man was attacked by another man who used anti- gay slurs. The assailant, John McHenry, 25, was charged with second- degree assault, criminal possession of a weapon, and harassment in connection with the incident. I believe that government's first duty is to defend its citizens, to defend them against the harms that come out of hate. The Local Law Enforcement Enhancement Act of 2001 is now a symbol that can become substance. I believe that by passing this legislation and changing current law, we can change hearts and minds as well.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I rise today to urge my colleagues on both sides of the aisle to support the Graham-Smith amendment. This is our best and perhaps our last opportunity to come together and actually pass a meaningful prescription drug benefit in the Senate this year. I admit that this is a difficult issue. It is a privilege to work on it, though, because I hear of no single issue more on the minds of the American people--particularly our senior citizens-- than this issue. It is critical that we give them more than a war of words for yet another year--we must give them some results that work toward wellness rather than just rhetoric. I know I have colleagues on the left who don't believe we are spending enough. I know I have colleagues on the right who do not like the delivery system that is provided in this bill. But I believe it is critical we clear the 60-vote hurdle because if we don't, the seniors will get nothing for yet another year. That I think is unacceptable. We are running out of time. Seniors are running out of money to pay for their prescription drugs. They can't afford to wait another year for us to reach a compromise. We simply have to act now on a proposal Senator Graham and I bring to the floor that is affordable for them and affordable for the Government. I believe this is a focused plan that we all ought to support so we can at least keep this process going to get something to conference, so then we can get something to vote on in September, and so that our seniors can get the medicine they need. To review this bill: First and foremost, it is voluntary and it is comprehensive. Our bill focuses on providing a comprehensive benefit to our neediest low-income seniors--people who are least able to pay for their prescription drugs. Those who are below 200 percent of the Federal poverty level will never have to choose between food and lifesaving drugs again. I think that is a remarkable and significant proposal in itself. We voted on different iterations of that before. We are bringing it together again in this amendment. The latest figures from the Urban Institute say 47 percent of our Nation's seniors live with incomes below 200 percent of poverty, which translates into $17,720 for individuals and $23,880 for couples. We don't have the money for us to do everything in the world, to enact a prescription drug benefit that covers every cost for everybody. But under our plan, low-income seniors receive the most help because they need the most help, and they need it today. But even they have a copay. Some will say it is too small. But it is, I believe, enough to at least get the attention of low-income seniors when you ask them to pay $2 for a generic drug prescription or $5 to get a branded product. I think that promotes good consumerism among our seniors. Second, our proposal addresses the fear that millions of seniors feel every day--the fear that the loss of their health will result in the loss of their home. Our bill will ensure that no senior, no matter what their income, will ever have to pay more than $3,300 per year in prescription drug costs. I think that is significant. Some will describe it as a doughnut; others will say it is a cliff. But I will tell you that I believe seniors in this country appreciate that in this bill they will get a discounted price, a discount card, and those in combination may equal up to 30 percent of the cost of a prescription. Moreover, they get an insurance policy that says you don't have to lose your home if you lose your health because, as to your prescription drug costs, the Government will be there to make sure that doesn't happen. The Graham-Smith amendment will ensure that they don't have to spend themselves into poverty, but it does ask them to pay something in addition to the copay. Each American who voluntarily signs up for this bill will pay $25 per year. In terms of discounted prices, a discount card, and an insurance policy against catastrophic illness, $25 is a well priced policy. Finally, with this, every senior can expect, as I indicated before, somewhere between 20 percent to 35 percent of the cost of each of their drugs to flow to them in a discount. That is because we are using the delivery system--as all Republicans, or nearly all the Republicans, already voted on--in the Hagel-Ensign bill. The Graham-Smith amendment would allow all employer-sponsored plans, the Medicare supplemental plan, the Medicare+Choice plan, pharmaceutical benefit managers, PBMs, pharmacies, and even States working with private companies to compete to deliver the benefits. This market-based competition, which so many of my Republican colleagues have already supported, will generate lower prices for all of our seniors. Another provision we took from the Hagel-Ensign bill--a provision that was critical if this was to win my support--which all of my colleagues on this side of the aisle have already supported, was the Hagel-Ensign formulary language. When I first talked to Senator Graham about this, I told him my reluctance to vote for his bill in the first instance was, in large measure, over the formulary issue because, as set out in the bill previously before us, it essentially took 90 percent of current prescription drugs available to seniors and said they are not available under this plan. So 10 percent of available drugs, in my view, is too restrictive. While under the Hagel-Ensign language there is a formulary which is a part of this bill, we make no such restriction, but leave to the experts the ability to make a more liberal formulary plan that will serve the health needs of our seniors. We did not want to limit drug choices for seniors. I think this is an important part of this bill that ought to attract the support of many of my colleagues. Americans across the country are asking for our help. There are Americans who cannot afford to wait one more year because we have been unwilling to compromise on a prescription drug plan. This is our last chance to keep this process moving forward. I need 60 votes, America needs 60 votes on this bill, because seniors deserve more than lip service from the Senate. They deserve a prescription drug benefit from the U.S. Government--and a process and a plan that build on what we already have at a cost we can afford, at a cost that allows seniors to be included, and in a way that seniors themselves can afford this plan as well. It is critical that we do this now, so that during the August recess we stop the haggling over whether we have a bill in the Senate, but get something to conference so that we can work out with the House and the White House the kind of bill that ultimately will win the support and the hearts and the minds of the American people. I say to all of my friends in this body--whether you are a Republican or Democrat, whether you like this bill or not--it is the last train leaving the station, in my view. It has enough in it that ought to attract your support because it keeps the train moving instead of derailing it, to the great disadvantage and harm of the senior citizens of this country. I plead with you for your support. If we can get it up and get past 60 votes, we can make amendments. We can make improvements. Then we will get to the House of Representatives and a conference, and to the kind of product that ultimately can pass muster for the White House, the House, and all of us. I thank you for the time. I plead with my colleagues: Don't lose this opportunity. I ask for their votes and yield the floor.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I rise today to speak about hate crimes legislation I introduced with Senator Kennedy in March of last year. The Local Law Enforcement Act of 2001 would add new categories to current hate crimes legislation sending a signal that violence of any kind is unacceptable in our society. I would like to describe a terrible crime that occurred July 24, 1994 in New York, NY. Two gay men were assaulted by four men who made anti- gay remarks. The assailants, John Gorman and Kevin Shout, both 22, Michael Higgins, 21, and James Shout 27, were charged with assault and aggravated harassment in connection with the incident. I believe that government's first duty is to defend its citizens, to defend them against the harms that come out of hate. The Local Law Enforcement Enhancement Act of 2001 is now a symbol that can become substance. I believe that by passing this legislation and changing current law, we can change hearts and minds as well.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I rise today to speak about hate crimes legislation I introduced with Senator Kennedy in March of last year. The Local Law Enforcement Act of 2001 would add new categories to current hate crimes legislation sending a signal that violence of any kind is unacceptable in our society. I would like to describe a terrible crime that occurred May 14, 1994 in National City, CA. A gay man was beaten by four men who yelled anti-gay slurs. The assailants, Juan Gonzales and Maico Amon, both 20, were charged in connection with the incident. I believe that government's first duty is to defend its citizens, to defend them against the harms that come out of hate. The Local Law Enforcement Enhancement Act of 2001 is now a symbol that can become substance. I believe that by passing this legislation and changing current law, we can change hearts and minds as well.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, as I am sure many of my colleagues are aware, as I speak here today on the floor, fire continues to rage across the state of Oregon. At last count, there were no fewer than fifteen fires burning throughout the state, leaving behind hundreds of thousands of charred acres and a sobering path of destruction. As such, I stand here to salute and pay tribute to the benevolent Oregonians of the Red Cross who, throughout this tragedy, have responded with remarkable compassion and service to their communities. When fire first broke out near my own home in Pendleton, OR, the Umatilla Chapter of the Red Cross was there and opened an emergency shelter for residents of fire threatened homes. More than twenty paid and volunteer staff enlisted for what fortunately became a substantial ``cold start'' exercise. In Lake County, Oregon, where the Winter, Toolbox Complex, and Grizzly Complex fires have combined to form a 115,000 acre inferno, the Red Cross has been on the ground, organizing local residents and setting up a shelter to disseminate information and to provide aid to affected families. That shelter remains on standby status today, pending containment of the fire, which is not expected for another week. There are similar examples throughout the state and throughout the country of local Red Cross chapters responding to help friends and neighbors in need. For as tragic as this fire season has been to date, the staff and volunteers of the Red Cross have responded with an equal level of kindness and selflessness. This has been a very emotionally charged past few months. As a U.S. Senator and as an Oregonian, I am deeply proud of how the people in my state have responded to life-threatening crises. The generosity shown by so many truly reaffirms one's faith in the goodness of people. Today, I salute the workers and the volunteers who gave and continue to give of themselves to help our communities in need.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, it is my privilege today to say a few words about the reverend doctor who offered a word of prayer on behalf of this country and this institution this morning. The Rev. Dr. Fritz Pfotenhauer has given me permission to refer to him personally as Fritz, but he is a most distinguished pastor and minister of the gospel. He is the pastor of the Hilltop Lutheran Church in South Bend, IN. He is descended from a long line of Lutheran ministers in an unbroken father-son succession dating back to the time of the great reformer, Martin Luther. Dr. Pfotenhauer completed his Ph.D. in pastoral theology at the University of Notre Dame where he also taught for 20 years until his retirement recently. He will also retire at the end of this year as the pastor of Hilltop Lutheran after 36 years of service to that community and 46 years as an ordained minister. I think it is significant that this good brother is not just trained for the ministry and knows the ivory tower and knows the depths of theology, but he knows how it is to minister, how it is to change the human heart and help lift people from the wrong path. This is a man, as you meet with him, who can talk deep in terms of gospel principles but also knows personally what it is like to change the human heart and to set it on the course of righteousness. Pastor Pfotenhauer is the father of Kurt Pfotenhauer, who is my friend and my former chief of staff for nearly 6 years. Dr. Pfotenhauer's wife, Carolyn, is in the audience today. We welcome her. We honor her, as well as her grandsons, Jon and Ben, and her daughter- in-law, the pastor's daughter-in-law, Kurt's wife, Nancy. They are all with him today. We honor you, sir. We thank you for your service to us today. We thank God for your service to his children. I yield the floor.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Madam President, I rise today to speak about hate crimes legislation I introduced with Senator Kennedy in March of last year. The Local Law Enforcement Act of 2001 would add new categories to current hate crimes legislation sending a signal that violence of any kind is unacceptable in our society. I would like to describe a terrible crime that occurred on October 14, 2000 in Billings, MT. Chris Lehman, 23, shot Roderick Pierson, 44, with a BB gun. Mr. Lehman later admitted to shooting Pierson because he was black. Mr. Pierson was shot while walking with his 6 year-old daughter. I believe that government's first duty is to defend its citizens, to defend them against the harms that come out of hate. The Local Law Enforcement Enhancement Act of 2001 is now a symbol that can become substance. I believe that by passing this legislation and changing current law, we can change hearts and minds as well.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I say to the majority whip that there is one individual--Senator Gramm of Texas--who came by as I was about to speak and asked to speak before there is a vote or any final agreement. He intends to speak in opposition to my position. He made that clear. I will not speak for him, but as a courtesy to him I note his interest in making a statement in opposition.

Mr. SMITH of Oregon. Mr. President, first, I thank the Senator from West Virginia for his leadership in bringing together this coalition. The amendment, that I hope we soon adopt by an over 60-vote margin, is, in part, like what we adopted last December when, as part of the supplemental bill or the stimulus package, Senator Baucus and I authored an amendment that would have helped a great deal with respect to Medicaid in the States' use of these funds. This bill is broader. It allows States more discretion. Senator Ben Nelson, Senator Collins, Senator Tim Hutchinson, I, and others have come together to provide an amendment that our States desperately need us to adopt. Medicaid is an essential part of our health care safety net. Last year, the Medicaid Program provided health coverage for 44 million of the most vulnerable Americans 22.6 million children, 9.2 million adults in low-income families, and 12 million elderly and disabled. One in four American children are covered by this important program. Yet, despite the program's importance, states around the country are struggling to fund their share of their Medicaid programs. The National Governors' Association reported several weeks ago that States are in the worst financial situation in 20 years, and that they expect next year's situation to be even worse. During this current fiscal year, more than 40 States are experiencing budget shortfalls totaling $45 billion. To close the gaps in funding, many States are cutting public education, services to the elderly, and health care to the poor--Medicaid--even as families are struggling to get by in the weakened economy. Twenty-two States have already acted to cut costs by eliminating planned expansions of Medicaid or slashing current Medicaid eligibility. To keep State budgets in balance this year, Governors have cut spending in many departments, tapped ``rainy day'' funds, and depleted tobacco settlement funds. What this means is that, as we enter 2003, the one-time fixes have been used up. In the words of Idaho's Governor Kempthorne, ``The cupboard is bare.'' Going into legislative session this year, my home State of Oregon faced a budget shortfall of more than $800 million, and the majority of States are facing similar conditions. The cruel irony of this situation is that just as State revenues have dropped due to poor economic conditions, many more families are turning to Medicaid as their only source of health care. I know that in Oregon, the number of people on Medicaid has risen by more than 10 percent since June of last year, and I suspect that many of your States have experienced similar increases in demand. Last year, more than 40 million Americans lived and worked without health insurance, and it is estimated that the economic downturn will add another 4 million to the ranks of the uninsured. The amendment before the Senate today addresses a very real emergency. It will allow States to continue providing health care to our society's most vulnerable members in this economic downturn by providing a temporary increase in the federal medical assistance program, FMAP, funds States receive to pay their portion of the Medicaid bill. It will prevent the erosion of health insurance coverage and help maintain a strong health care safety net for vulnerable Americans during the economic downturn. By temporarily increasing the Federal portion of the Medicaid bill, the scope and depth of possible State budget cuts or tax increases will be lessened, minimizing the potential negative impact on the economy and our most vulnerable citizens across the country. Including funds for States to use for a variety of social services will also help provide services to the needy at a time when demand for such services is demonstrably on the rise. It is the right thing to do, and the right time to do it. I urge my colleagues to support our amendment so we can clear the 60- vote threshold. Again, I thank our colleague from West Virginia, Senator Rockefeller, for his leadership and look forward to joining him in support of this critical and timely amendment. I yield the floor.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I rise today to introduce a bill that will make Medicare's Social Health Maintenance Organization, SHMO, demonstration a permanent part of the Medicare+Choice, M+C, program. I am joined by my colleagues from Oregon, New York, Arizona, and California. The Social HMO demonstration was authorized 17 years ago to test models for improving care for frail seniors, expanding access to social and supportive services and better integrating these expanded benefits with medical services. Clearly, a seventeen year test is long enough--it's time for this successful program to become a permanent choice for Medicare beneficiaries. Close to 80 percent of national health care expenditures are for persons with chronic conditions. Medicare beneficiaries are disproportionately affected by chronic illness. About 85 percent of people 65 and older have one chronic condition, and two thirds have two or more. Fully a third of Medicare beneficiaries have four or more chronic conditions. This group accounts for almost 80 percent of all Medicare spending. Yet, despite the predominance of chronic illness among seniors, Medicare continues to operate as an acute care model. So many of the services that are central to the health care needs of seniors are not covered by Medicare, including a number of preventive services, care coordination and disease management services, and home and community-based support services. Social HMOs provide the care coordination and disease management services so critically important to frail and at-risk seniors with multiple chronic conditions and complex care needs. They are required to provide expanded care benefits such as prescription drugs, ancillary services such as eyeglasses and hearing aids, and community-based services such as personal care, homemaker services, adult day care, meals, and transportation. These services meet the chronic health care needs of seniors, helping them remain independent, while reducing Medicaid expenditures by avoiding or delaying nursing home placement. Several recent studies have shown that Social HMO members are about 40 percent to 50 percent less likely to have long-term nursing home placements than comparison group members. Further, in a recent survey of Social HMO beneficiaries, over three-quarter of respondents indicated that the special services offered by their Social HMO were important to allowing them to keep living at home. Enhanced Social HMO services, such as early detection of illness, development of coordinated care plans to address problems identified during routine assessments, screening, and ongoing monitoring of care, has paid off in improved health outcomes for beneficiaries. I am fortunate to represent one of the four original Social HMOs that were approved as part of the initial Medicare demonstration project in 1985. Senior Advantage II, offered by Kaiser Permanente's Northwest Division, currently serves about 4,300 Medicare beneficiaries from Salem, OR to Longview, WA, with its primary service area in Portland, OR. Since Kaiser opened its Social HMO program, it has served close to 15,000 beneficiaries with its enhanced benefits and special geriatric programs, which have led to fewer overall nursing home care days and a more consumer-oriented approach to care for frail or ill seniors. The legislation I am introducing with my distinguished colleagues today would make permanent the existing Social HMO plans, like Kaiser, and would lay the ground work for evaluating whether to expand and replicate this model. Our bill requires the Secretary to conduct a comparative study of beneficiary and family member satisfaction to see how Social HMOs compare to Medicare+Choice and fee-for-service Medicare. It also requires MedPAC to evaluate the cost-effectiveness of Social HMOs with respect to reduced nursing home admissions, reduced incidence of Medicaid spend-down, and other aspects of the model that represent potential cost-savings. If MedPAC finds that Social HMOs are cost-effective, it must make recommendations to Congress on expanding and replicating this model. To ensure that beneficiaries continue to receive the value added they have come to enjoy under this program, the Social HMOs must continue to provide the expanded benefit package currently offered under this legislation. Further, this benefit could not be changed by the Secretary without notification of Congress. Finally, to ensure that Social HMOs, which have significantly higher risk levels than average Medicare+Choice plans, can continue to finance a high level of benefits, any changes in plans' existing payments would need to go through a formal rulemaking process. The Social HMO demonstration project has been re-validated by six acts of Congress since its creation. It is time to make this program permanent and lend a measure of stability to the plans and beneficiaries served by this innovative model. This program represents a fiscally sound approach to helping manage the chronic health care needs of our Nation's seniors, and I urge all of my colleagues to join with me and the rest of this bill's cosponsors in support of this important legislation. I ask unanimous consent that the text of the bill be printed in the Record.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I rise today to introduce a bill that will make Medicare's Social Health Maintenance Organization, SHMO, demonstration a permanent part of the Medicare+Choice, M+C, program. I am joined by my colleagues from Oregon, New York, Arizona, and California. The Social HMO demonstration was authorized 17 years ago to test models for improving care for frail seniors, expanding access to social and supportive services and better integrating these expanded benefits with medical services. Clearly, a seventeen year test is long enough--it's time for this successful program to become a permanent choice for Medicare beneficiaries. Close to 80 percent of national health care expenditures are for persons with chronic conditions. Medicare beneficiaries are disproportionately affected by chronic illness. About 85 percent of people 65 and older have one chronic condition, and two thirds have two or more. Fully a third of Medicare beneficiaries have four or more chronic conditions. This group accounts for almost 80 percent of all Medicare spending. Yet, despite the predominance of chronic illness among seniors, Medicare continues to operate as an acute care model. So many of the services that are central to the health care needs of seniors are not covered by Medicare, including a number of preventive services, care coordination and disease management services, and home and community-based support services. Social HMOs provide the care coordination and disease management services so critically important to frail and at-risk seniors with multiple chronic conditions and complex care needs. They are required to provide expanded care benefits such as prescription drugs, ancillary services such as eyeglasses and hearing aids, and community-based services such as personal care, homemaker services, adult day care, meals, and transportation. These services meet the chronic health care needs of seniors, helping them remain independent, while reducing Medicaid expenditures by avoiding or delaying nursing home placement. Several recent studies have shown that Social HMO members are about 40 percent to 50 percent less likely to have long-term nursing home placements than comparison group members. Further, in a recent survey of Social HMO beneficiaries, over three-quarter of respondents indicated that the special services offered by their Social HMO were important to allowing them to keep living at home. Enhanced Social HMO services, such as early detection of illness, development of coordinated care plans to address problems identified during routine assessments, screening, and ongoing monitoring of care, has paid off in improved health outcomes for beneficiaries. I am fortunate to represent one of the four original Social HMOs that were approved as part of the initial Medicare demonstration project in 1985. Senior Advantage II, offered by Kaiser Permanente's Northwest Division, currently serves about 4,300 Medicare beneficiaries from Salem, OR to Longview, WA, with its primary service area in Portland, OR. Since Kaiser opened its Social HMO program, it has served close to 15,000 beneficiaries with its enhanced benefits and special geriatric programs, which have led to fewer overall nursing home care days and a more consumer-oriented approach to care for frail or ill seniors. The legislation I am introducing with my distinguished colleagues today would make permanent the existing Social HMO plans, like Kaiser, and would lay the ground work for evaluating whether to expand and replicate this model. Our bill requires the Secretary to conduct a comparative study of beneficiary and family member satisfaction to see how Social HMOs compare to Medicare+Choice and fee-for-service Medicare. It also requires MedPAC to evaluate the cost-effectiveness of Social HMOs with respect to reduced nursing home admissions, reduced incidence of Medicaid spend-down, and other aspects of the model that represent potential cost-savings. If MedPAC finds that Social HMOs are cost-effective, it must make recommendations to Congress on expanding and replicating this model. To ensure that beneficiaries continue to receive the value added they have come to enjoy under this program, the Social HMOs must continue to provide the expanded benefit package currently offered under this legislation. Further, this benefit could not be changed by the Secretary without notification of Congress. Finally, to ensure that Social HMOs, which have significantly higher risk levels than average Medicare+Choice plans, can continue to finance a high level of benefits, any changes in plans' existing payments would need to go through a formal rulemaking process. The Social HMO demonstration project has been re-validated by six acts of Congress since its creation. It is time to make this program permanent and lend a measure of stability to the plans and beneficiaries served by this innovative model. This program represents a fiscally sound approach to helping manage the chronic health care needs of our Nation's seniors, and I urge all of my colleagues to join with me and the rest of this bill's cosponsors in support of this important legislation. I ask unanimous consent that the text of the bill be printed in the Record.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, the late Oregon Governor Tom McCall once said, ``Heroes are not giant statues framed against a red sky. They are people who say, `This is my community and it's my responsibility to make it better.' '' I rise today to pay tribute to Patricia Obradovich, a remarkable Oregonian who was a true hero, because she dedicated her entire career to making her community, her State, and her Nation a better place. Patricia passed away last month at the young age of 44, after a courageous battle against cancer. Her legacy, however, will continue long into the future. Patricia dedicated her entire professional life to working for the Federal Government. I have long believed that government service is a high and important calling. The hours are often long, the pressures are great, and the monetary compensation is frequently lower than what is available in the private sector. Patricia was one of those individuals who was more concerned with making a difference than making a fortune. Patricia joined the U.S. Army Corp of Engineers as an economist with the Portland, OR District in May of 1981, and continued with the Corps for 21 years. In that time, she served in many roles, including Chief of Economics, Acting Chief of Planning, and Outreach Coordinator. During her two decades of service, Patricia earned a reputation in Oregon and across the Nation as a public servant of great intelligence and integrity. She played a leadership role in formulating policy on many projects of national significance, including salmon restoration and navigation projects along the Oregon coast and the Columbia River. As an employee of the Federal Government, Patricia received a remarkable 26 awards, including an Achievement Medal for Civilian Service. I had the occasion to meet Patricia several times, and know the very high regard in which she was held by her co-workers, her countless friends, and her loving family. It is my hope they will take solace in the fact that through two decades of doing the day-to-day work of democracy, Patricia Obradovich truly earned the title of ``hero.''

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I rise today to speak about hate crimes legislation I introduced with Senator Kennedy in March of last year. The Local Law Enforcement Act of 2001 would add new categories to current hate crimes legislation sending a signal that violence of any kind is unacceptable in our society. I would like to describe a terrible crime that occurred July 16, 2001 in Newmarket, NH. Thung Phetakoune, 62, a man of Laotian descent, died of injuries he suffered in an attack apparently motivated by racial hatred. According to authorities, Richard Labbe, 35, assaulted the victim amid an anti-Asian tirade. Phetakoune died from injuries stemming from a fractured skull, subsurface bleeding, and swelling of the brain. I believe that government's first duty is to defend its citizens, to defend them against the harms that come out of hate. The Local Law Enforcement Enhancement Act of 2001 is now a symbol that can become substance. I believe that by passing this legislation and changing current law, we can change hearts and minds as well.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I rise today to speak about hate crimes legislation I introduced with Senator Kennedy in March of last year. The Local Law Enforcement Act of 2001 would add new categories to current hate crimes legislation sending a signal that violence of any kind is unacceptable in our society. I would like to describe a terrible crime that occurred in November 2000 in Bloomington, MN. Cecil John Reiners, 57, attacked a Hispanic man for speaking Spanish at work. Witnesses told police that Reiners, the business owner, was upset when a 23 year-old employee was speaking Spanish with two others at a break table. Reiners went to the warehouse with a wood post and severely beat the victim, who was treated for severe skull fractures and clots at the hospital. ``All I wanted was for that Mexican to leave my property,'' Reiners said. Mr. Reiners was later convicted of felony first-degree assault in connection with the incident. I believe that government's first duty is to defend its citizens, to defend them against the harms that come out of hate. The Local Law Enforcement Enhancement Act of 2001 is now a symbol that can become substance. I believe that by passing this legislation and changing current law, we can change hearts and minds as well.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I rise today to speak about hate crimes legislation I introduced with Senator Kennedy in March of last year. The Local Law Enforcement Act of 2001 would add new categories to current hate crimes legislation sending a signal that violence of any kind is unacceptable in our society. I would like to describe a terrible crime that occurred August 23, 1993 in Brooklyn, NY. An Irish Gay and Lesbian Organization leader was stabbed. The assailant, a minor, yelled an anti-gay slur during the incident. I believe that government's first duty is to defend its citizens, to defend them against the harms that come out of hate. The Local Law Enforcement Enhancement Act of 2001 is now a symbol that can become substance. I believe that by passing this legislation and changing current law, we can change hearts and minds as well.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I rise today to speak about hate crimes legislation I introduced with Senator Kennedy in March of last year. The Local Law Enforcement Act of 2001 would add new categories to current hate crimes legislation sending a signal that violence of any kind is unacceptable in our society. I would like to describe a terrible crime that occurred September 17, 1997, in Chicago, IL. Two minors pushed a gay man down a flight of stairs because of his sexual orientation. The assailants used anti-gay obscenities during the attack. I believe that government's first duty is to defend its citizens, to defend them against the harms that come out of hate. The Local Law Enforcement Enhancement Act of 2001 is now a symbol that can become substance. I believe that by passing this legislation and changing current law, we can change hearts and minds as well.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, ever since the days of the pioneers, when folks from miles around would gather to participate in community barn-raisings, the spirit of neighbor helping neighbor has been part of the Oregon story. That spirit is alive and well today, as in every Oregon community you can find individuals who give their time and their talent to make that community a better place in which to live, work, and raise a family. For the past 35 years, in the community of Grants Pass, that individual was Larry Brown, who passed away last week after a courageous fight against cancer. Larry was a forester by profession, and served in leadership positions for the Southern Oregon Timber Industries Association, the Oregon Small Woodland Owners Association, and the Oregon Board of Forestry Forest Practices Commission. Larry was not only dedicated to growing healthy trees, he was also dedicated to growing healthy children. He served 5 years on the Grants Pass School Board, and was a passionate advocate for programs benefitting youth during his many years of service and leadership in the Grants Pass Rotary Club. Larry's love for his country could be seen in his 20 years of service in the Oregon National Guard. Larry retired from the National Guard as a major in 1982, and during his service he was awarded the Meritorious Service Medal and the Army Commendation Medal with 5 bronze oak leaf clusters. Larry was also a passionate Republican. I am just one of many elected officials who was constantly calling on Larry to organize an event or a meeting. I knew that when I called on Larry, I was calling on someone who knew and loved his community, and who would get the job done right. Oliver Wendell Holmes once said, ``To live fully is to be engaged in the passions of one's time.'' There can be no doubt that Larry Brown lived a full life, because he truly made a difference in the passions of his time. I extend my condolences to Larry's wife, Georgette, who continues the family tradition of public service through her service as Josephine County Clerk, and to his daughters Monique and Martie. I am just one of many elected officials who relied on Larry's counsel, advice, and friendship.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I rise today to speak about hate crimes legislation I introduced with Senator Kennedy in March of last year. The Local Law Enforcement Act of 2001 would add new categories to current hate crimes legislation sending a signal that violence of any kind is unacceptable in our society. I would like to describe a terrible crime that occurred April 13, 2001 in San Antonio, TX. A 39 year old man was attacked because he was thought to be a homosexual, according to police. The victim was attacked in a park by a man with a knife. The man held the victim in a bear hug before stabbing him in the chest with what was described as a three-inch Buck knife. The suspect was heard to call the victim anti- gay names as he stabbed him. I believe that government's first duty is to defend its citizens, to defend them against the harms that come out of hate. The Local Law Enforcement Enhancement Act of 2001 is now a symbol that can become substance. I believe that by passing this legislation and changing current law, we can change hearts and minds as well.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I rise today to speak about hate crimes legislation I introduced with Senator Kennedy in March of last year. The Local Law Enforcement Act of 2001 would add new categories to current hate crimes legislation sending a signal that violence of any kind is unacceptable in our society. I would like to describe a terrible crime that occurred February 6, 1995, in West Hollywood, CA. A gay man was punched and kicked by several youths who made anti-gay remarks. The assailants, three teens, were charged with battery and interference with civil rights. I believe that government's first duty is to defend its citizens, to defend them against the harms that come out of hate. The Local Law Enforcement Enhancement Act of 2001 is now a symbol that can become substance. I believe that by passing this legislation and changing current law, we can change hearts and minds as well.

Mr. SMITH of Oregon

Mr. SMITH of Oregon. Mr. President, I rise today to speak about hate crimes legislation I introduced with Senator Kennedy in March of last year. The Local Law Enforcement Act of 2001 would add new categories to current hate crimes legislation sending a signal that violence of any kind is unacceptable in our society. I would like to describe a terrible crime that occurred August 1, 2001 in Roanoke, VA. Two men and the pastor of a predominantly gay church were attacked by three men after a Bible study and prayer meeting, police and the pastor said. The Rev. Catherine Houchins was struck in the face as she tried to call 911 on her cellular phone after the initial attack. The attackers, who came out of an alley as the victims were getting into their cars, were heard to yell obscenities related to the victims' sexual orientation. I believe that government's first duty is to defend its citizens, to defend them against the harms that come out of hate. The Local Law Enforcement Enhancement Act of 2001 is now a symbol that can become substance. I believe that by passing this legislation and changing current law, we can change hearts and minds as well.