Ron Wyden

Mr. WYDEN

Mr. WYDEN. Mr. President, today I am reintroducing the Aaron's Law Act of 2015 to reform the Computer Fraud and Abuse Act, a sweeping anti-hacking law that criminalizes many forms of common Internet and computer use. This overly broad law currently allows breathtaking levels of prosecutorial discretion that invites serious overuse and abuse. Together with Senator Rand Paul, and my colleagues in the House of Representatives, we introduce legislation to fix the Computer Fraud and Abuse Act which is long overdue for reform. Aaron's Law would curb the abuses of this outdated law while still preserving the tools needed to prosecute malicious attacks. Our bill, inspired by the late Internet innovator and activist Aaron Swartz, who faced up to 35 years in prison for an act of civil disobedience, would reform the quarter-century-old law to better reflect computer and Internet activities in the digital age. Numerous and recent instances of heavy-handed prosecutions for non-malicious computer crimes have raised serious questions as to how the law treats violations of terms of service, employer agreement or website notices. Aaron's Law is smart legislation that keeps up with the constant evolution of the Internet, and honors the late Aaron Swartz. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, reserving the right to object, would the majority leader consider at this time modifying his request to drop the Kirk amendment No. 273?

Mr. WYDEN

Mr. WYDEN. Mr. President, I am here today standing up for the people of Oregon and recognizing their decision to legalize and regulate marijuana for recreational use in the State. Together with Senators Merkley and Bennet, I am introducing the Small Business Tax Equity Act, which will provide more equitable Federal tax treatment for small marijuana businesses who comply with State law. This comes after more than 56 percent of Oregonians voted for marijuana legalization. Congressman Blumenauer is introducing a companion bill in the House. Unlike its treatment of all other legal businesses, the tax code currently denies these marijuana businesses, legitimate businesses, the ability to deduct ordinary expenses. Expenses, such as employee pay and rent, that are essential to operating any successful small business. This is one piece of the equation as Federal tax inequalities for marijuana businesses extend beyond deductions. For example, other businesses are also eligible for the Work Opportunity Tax Credit for hiring veterans. Therefore the inability to make deductions, combined with other lost credits, often leads to these businesses paying an effective tax rate ranging from 65-75 percent; compared with other businesses who pay between 15-30 percent. This issue is not unique to Oregon. Oregon is one of four States, along with the District of Columbia, where voters have passed measures that permit the legal adult use and retail sale of marijuana. Oregon is one of 23 States, along with the District of Columbia, have passed laws allowing for the legal use of medical marijuana. Unfortunately, Federal law has not caught up with changing State laws, creating contradictions, and leaving these legal businesses in a tough position. Today, I am introducing a bill to fix this problem. Marijuana businesses operating legally under state law should be able to deduct ordinary business expenses just like any other businesses. Voters have legalized their product, now let's help create a more level playing field that recognizes their business operations. It is the right thing to do. It is only fair that Federal tax law respect the decision Oregonians, and citizens from other States and the District of Columbia, made at the polls. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, I am here today standing up for the people of Oregon and recognizing their decision to legalize and regulate marijuana for recreational use in the State. Together with Senators Merkley and Bennet, I am introducing the Small Business Tax Equity Act, which will provide more equitable Federal tax treatment for small marijuana businesses who comply with State law. This comes after more than 56 percent of Oregonians voted for marijuana legalization. Congressman Blumenauer is introducing a companion bill in the House. Unlike its treatment of all other legal businesses, the tax code currently denies these marijuana businesses, legitimate businesses, the ability to deduct ordinary expenses. Expenses, such as employee pay and rent, that are essential to operating any successful small business. This is one piece of the equation as Federal tax inequalities for marijuana businesses extend beyond deductions. For example, other businesses are also eligible for the Work Opportunity Tax Credit for hiring veterans. Therefore the inability to make deductions, combined with other lost credits, often leads to these businesses paying an effective tax rate ranging from 65-75 percent; compared with other businesses who pay between 15-30 percent. This issue is not unique to Oregon. Oregon is one of four States, along with the District of Columbia, where voters have passed measures that permit the legal adult use and retail sale of marijuana. Oregon is one of 23 States, along with the District of Columbia, have passed laws allowing for the legal use of medical marijuana. Unfortunately, Federal law has not caught up with changing State laws, creating contradictions, and leaving these legal businesses in a tough position. Today, I am introducing a bill to fix this problem. Marijuana businesses operating legally under state law should be able to deduct ordinary business expenses just like any other businesses. Voters have legalized their product, now let's help create a more level playing field that recognizes their business operations. It is the right thing to do. It is only fair that Federal tax law respect the decision Oregonians, and citizens from other States and the District of Columbia, made at the polls. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, I rise in opposition to the Lee amendment. Colleagues, the Lee amendment is the bluntest possible instrument that would cut spending across government on every possible program. The SGR, the doctors reimbursement formula, has always been a fake. The $140 billion in this bill eliminates the budget fakery that Democrats and Republicans believe has gotten out of hand. The underlying bill gets rid of the budget fakery. I urge colleagues on both sides of the aisle to reject the amendment, and I yield back.

Mr. WYDEN. Mr. President, I rise in opposition to this amendment. Today, the Medicare Program is a fee-for-volume system. The underlying bill junks this and turns out the lights on millions of users. The underlying bill before the Senate says the future will be about rewarding value and good quality care for our Medicare patients. The Cotton amendment embraces the outdated status quo and says there is no need to coordinate care, no need to pay for value, no need to pay for quality for our Medicare patients. I urge my colleagues to oppose this amendment.

Mr. WYDEN. Mr. President, I urge colleagues to oppose this amendment. What Senator Cornyn seeks to do is to strike an idea that originally came from the Heritage Foundation. If it is adopted, sick people will definitely sign up, healthy people will stay on the sidelines, premiums will skyrocket, according to the Congressional Budget Office, by as much as 20 percent, and start then what amounts to a death spiral for the affordability of American health care. I urge my colleagues to oppose this amendment.

Mr. WYDEN. Mr. President, I will be very brief. I think tonight is a milestone for the Medicare Program--a lifeline for millions of older people. That is because tonight the Senate is voting to retire the outdated, inefficiency-rewarding, commonsense-defying Medicare reimbursement system. As Senator Hatch noted, it has been bipartisan; it has long been bipartisan. I think this is an important night for the Senate and it is going to be long remembered. I yield the floor.

Mr. WYDEN

Mr. WYDEN. H.R. 2 moves the physician payment system from one that rewards volume to one that rewards value. I look forward to extending value-based policies across the entire spectrum of Medicare. I agree, it is important to reward all providers and all Medicare Advantage plans that provide high value and high quality care. I look forward to working with the Senator and the entire Finance Committee to achieve these goals.

Mr. WYDEN. Mr. President, while my colleague is on the floor, I want to commend Senator Cantwell for her superb work on this legislation. Senator Cantwell has really been the leader in the effort to get the Secretary of Health and Human Services to look at alternative payment models in the Medicare Advantage Program. This is a hugely important program for us in the Northwest. It is also, by the way, very extensively used in Minnesota. I think my colleague from Washington State has done particularly important work in also looking, as part of this discussion, at what is called a value-based modifier. Mr. President, I have some thank-yous to make--and I will be very brief--but before I do that, I ask unanimous consent to enter into a colloquy with Senator Cantwell.

Mr. WYDEN. Just a couple of quick thank-yous, and then I want to let my colleague wrap up for our side. It is pretty clear, Mr. President, that a bill of this magnitude does not happen by osmosis. It comes about because of scores of hearings, roundtables, briefings, and countless hours of staff time. I am just going to take a couple of minutes to thank some people who did so much to make this possible. First, I thank Leader Reid and his very capable health care staffer Kate Leone. When there is a big health care issue before the Senate, Kate Leone is the person you want to have in the trenches with you. I want to thank Senator Reid, because during the short tenure in which I was the chair of the Senate Finance Committee, we started working closely together on reforming the Medicare reimbursement system, and his leadership is very much a part of the success of this evening. Second, there was staff at the various congressional support agencies who provided technical assistance. We are talking about CMS, the Congressional Budget Office, the Congressional Research Service, legislative counsel, and the Medicare Payment Advisory Commission. I would also like to note the efforts made by Ira Burney, Anne Scott, and Jennifer Druckman in the CMS Office of Legislation and Tom Bradley and Lori Housman of the Congressional Budget Office. I would also like to recognize Chairman Hatch and his very capable and dedicated staff. They worked many, many months on this issue, constantly reaching across the aisle--and former Hatch staffer, Dan Todd, current Hatch staffers Kristin Welsh and Erin Dempsey particularly deserve recognition. I want to close by thanking my staff, our finance staff and personal staff, affectionately known as the health team. Some, such as Karen Fisher, Matt Kazan, Juan Machado, and former staffer David Schwartz have survived two Democratic chairmen and more doc fixes than they could possibly wish to remember. So this is an especially significant moment for them. Others, like Anne Dwyer, Hannah Hawkins, and Jennifer Phillips, provided invaluable insight and counsel along the way. One last point, if I might. Having tried for years to specialize in health care, going back to the days when I was codirector of the Oregon Gray Panthers, I thought that over the years that I picked up a little bit with respect to health care policy and came to really understand the issues--not so much, particularly when I think about the extraordinary work of two very talented individuals in our office who have really been the leaders, in my view, on this SGR reform cause. One was our health chief Liz Jurinka. She deserves special notice for her persistent leadership, creativity, and focus and, secondly, her colleague, Jocelyn Moore, whom we had the good fortune--who came to us from Senator Rockefeller. She brings great expertise and years of experience to the field. Certainly, what I have learned from them, after a career of trying to specialize in these issues, has done so much to assist the committee, assist me, and I want to express my gratitude to them. The work of the bipartisan Finance Committee staff--through all its fits and starts--is what got us here today. I want to thank all of them, and I think it is very appropriate that my colleague from Washington State, Senator Cantwell, who has done so much good work on these issues, is going to close today.

Mr. WYDEN

Mr. WYDEN. Madam President, I ask unanimous consent to speak in morning business for up to 15 minutes.

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

Mr. WYDEN

Mr. WYDEN. Madam President, it is my hope that soon the Senate will be about to start voting on legislation that in one fell swoop will improve health care for millions of Americans. This discussion should start with a Medicare milestone. That milestone is abolishing once and for all the outdated, inefficiency-rewarding, commonsense-defying system of paying physicians under the Medicare Program. As my colleague from New Hampshire knows, what I am talking about in the technical lingo of health care is the SGR, the sustainable growth rate. It is a horrendously flawed formula for paying doctors and providers who treat our Medicare patients. Yet despite this very sour pedigree, it has dominated much of the discussion about Medicare since 1997. I wish we had put this flawed reimbursement system in the dustbin of history last year. As some of my colleagues know, I had sought to do that, along with the support of others. But I think now we have reached the point, on a bipartisan basis, where we have a chance for seniors and their providers to cross the victory line and be better off and have a better system for all Americans. I thought I would take a minute or two before discussing some of the other health care efforts that I hope will go forward today to describe how this happens. A little over a year ago, there was not much reason to think we would not just keep passing this leaky boat. That is essentially what the Senate had been doing for years and years with this flawed program. In fact, I remember one of our younger Members of this body was where the Presiding Officer of the Senate is sitting. I said: At this rate, we are probably going to be on patch No. 70 or 80 by the time we get around to really fixing this. So people were not very optimistic a little over a year ago. Since then, however, since that 17th patch, we saw Members on both sides of the aisle saying: It is time to start getting serious and getting traction for a permanent repeal-and-replace of this flawed reimbursement system. In January of this year, momentum finally began to grow. In other words, we used that period in 2014 as a springboard. Discussions began with Speaker Boehner and Leader Pelosi. Their discussions were really based on the bipartisan, bicameral framework that was developed in 2014 when leaders in the other body and the Senate got together: Finance Members, Ways and Means Members, the Energy and Commerce Members. The combination of that work and Speaker Boehner and Leader Pelosi coming together leads us to where I hope we will be here before long, and that is, once and for all abolishing this flawed reimbursement system. If we did not take this action--and in effect it really has to be done now--without taking people through the root canal work of how the reimbursement system works at the Medicare center, what is called CMS, we do know that if Congress does not intervene, we would see physicians cut 21 percent. That would, in my view, cast a very strong shadow over our ability to serve America's older people. I mean, particularly in the rural areas of this country, we have a lot of those practices that serve older people walking on an economic tightrope right now. They are trying to figure out how to pay the staff and pay for equipment and lighting and everything else. A 21-percent cut would be enough, in my view, to really put some of those small rural practices out of business. So it was the judgment of this bicameral group that worked through 2014, that Leader Pelosi and Speaker Boehner picked up on this year, to come up with a very different kind of model to replace the Medicare reimbursement system that was so flawed, the SGR, with a merit-based incentive payment that rewards those who provide high- quality, high-value care. That, in my view, is how we get the best value for America's seniors who, of course, want to get the right amount of care at the right time. They want it to be of high quality. A major part of this legislation will, in my view, help to promote better coordination of care. American health care is so fragmented and so strewn, kind of hither and yon, very often a senior can be treated by a variety of providers. No one really rides point on it. The senior ends up in the hospital emergency room. At that point, when providers say: Who should we be in contact with? The senior is not even sure of all of the people, particularly if that senior has multiple chronic conditions--perhaps diabetes and a heart problem--the senior will not even know the array of providers they have seen, let alone have someone coordinate their care. The good thing about this reform is it promotes that kind of care coordination. Also, physicians, as part of this, will have clear incentives to enter alternative payment models that are going to promote team services, services where there is a team of health care providers. It will require more Medicare transparency, more information about various services that are provided to older people so that there is some sunlight on this incredibly complicated system, particularly the Medicare Program that takes over $500 billion a year and spends it in a way that has not been particularly transparent. I want to thank Senator Grassley for working with me closely on this for a number of years. Finally, this legislation also makes permanent what is called the QI Program, again fancy health care lingo for an important program that pays the premiums, the outpatient premiums, for low-income older people. I think that is especially important, because it says for older people, particularly those of modest income, that there is going to be some assistance for the outpatient services, what is called Part B, which are so critical in terms of keeping older people out of long-term care facilities. My guess would be in New Hampshire and Oregon--like in my home State of Oregon--having that kind of assistance for low-income people in the community is really key to avoiding institutional care. I do want to note that I think all of us are going to say this bill does not meet the test of perfection. I happen to believe the bill would have been stronger had this body been involved in all of the negotiations. But clearly to have a milestone for Medicare--and that is what I think you get when you eliminate what really pretty much is a fraud. The Medicare reimbursement system has been honored more in the breach than in the observance. Every year it is waived, it is patched. I think to replace it with what I have described really is something that when the history of Medicare is written, people are going to look back and say: This was an important day. These were sensible changes. Improving care coordination, putting a new focus on quality, data transparency, coordination of health care teams, the kinds of things that this proposal does, are very much in the interests of seniors, providers, and taxpayers. I think this day will be remembered for making a very important contribution in the history of Medicare. I do want to mention several other amendments that I hope will be offered. I also feel very strongly about the need for this legislation to reaffirm and strengthen health care in America for our most vulnerable children. There are more than 100,000 of these youngsters in my home State alone. I am talking about the Children's Health Care Insurance Program, what is known as CHIP. My hope is we will have a chance here to vote to expand on what the other body has done and have a children's health program that will be extended for 4 years and not just 2. The CHIP program has the support of almost 40 Governors. They span the philosophical spectrum. They have achieved such strong support because these Governors who are right on the front lines with a program that involves very close coordination by the Federal Government and the State governments want some certainty and predictability. They don't want vulnerable kids and their families to be in limbo. So I am very hopeful that amendment will be offered and that it will get the support of our colleagues. Third, I hope there will be an amendment to improve health care for women. I believe we have all followed this debate that I think is needlessly divisive. There are so many Senators who want to find common ground to improve health care. We have gotten bogged down and somehow virtually all the bills now seem to be a magnet for a debate about abortion. My colleague, Senator Murray, wishes to offer a very important amendment to expand health care services and the availability of reproductive health services for women, community-based care. I am very hopeful that will be offered as well. Finally, on a bipartisan basis, Senators Cardin and Collins wish to offer legislation to really set aside what are very outdated approaches with respect to how Medicare provides services, therapy services, for our citizens. We are talking about physical therapy, occupational therapy, services with respect to speech. Senators Cardin and Collins want to get rid of these arbitrary therapy caps. I am very hopeful their amendment will be able to be offered as well. One last point, on a matter that is not health care related, this legislation carries an additional program that is particularly important to the people whom I represent, and that is the Secure Rural Schools Program would be extended for 2 years. I wrote this law in 2000 with our former colleague, the Senator from Idaho, Mr. Craig, because in most of our States--States where the Federal Government owns much of the lands, heavily forested--as a result of changes in environmental policy and other changes, a lot of these rural communities didn't have the money they needed for schools, roads, law enforcement, and basic services. We have extended it since 2000. We have had testimony indicating we are going to need that safety net for some time, even as you try to get the harvest up in a sustainable way. I am very pleased this program, an economic lifeline to rural communities across Oregon and other States, is going to be extended for 2 years. I think that provides us an opportunity to come up with fresh strategies, both with respect to the safety net. I would like to--in the future, in the Senate Budget Committee-- support it. I believe my colleague, the Presiding Officer, was interested to link Secure Rural Schools with the Land and Water Conservation Program and the PILT Program. We have bipartisan support for that. I would like to see us use these 2 years to strengthen the safety net and get the harvest up in a sustainable way. I wanted to make mention of that before I wrap up. In closing, I think the health legislation--that I hope will be voted on shortly--represents one of those rare moments on a major issue. I mean, I would go so far as to say--having worked with older people since my days with the Gray Panthers--I think what we are doing with the abolition of this outdated Medicare reimbursement system is laying the foundation for what will be the future of Medicare. The future of Medicare is not going to be what it was about in the 1960s when it began--a senior in New Hampshire might need the hospital for a serious injury, maybe they would see a physician, get Medicare Part B if they broke their ankle. The future of Medicare is going to be about dealing with chronic disease. It is going to be about diabetes, cancer, heart disease, and stroke. The reality is that Medicare has not kept up with the times. I think it is worth noting that in the big debate about the Affordable Care Act, chronic disease was hardly mentioned at all, not by anybody. That is going to be the foundation of Medicare for the future. More than 90 percent of the Medicare dollars in the future, based on the challenge of dealing with older people with these chronic conditions, is going to be about chronic disease. The reality is, when you abolish this flawed Medicare reimbursement system and start promoting coordinated care, what would happen in the State of New Hampshire is you would start seeing teams--perhaps a nurse, a physician, a pharmacist--a team in New Hampshire or in Oregon come together, particularly where there aren't the Medicare Advantage plans, and say we can give, as our colleague from Georgia noted not long ago, Senator Isakson, better care at lower cost and do it for what is likely to be the type of health care services that dominates Medicare in the future, which is chronic disease. We will be better able to tackle that with the abolition of SGR. So my hope is shortly we will vote to take that action that I believe constitutes a Medicare milestone, reaffirms our commitment to America's youngsters, improves health care services for women--from one end of America to another--and gets rid of this outdated system of therapy caps that are restricting what those who need physical therapy, occupational therapy, and others could get. This could finally be a punctuation mark in this, the 50th year of Medicare, and an opportunity for all Senators to see that they were part of adopting a fresh set of policies to provide a brighter and healthier future for all our people. I yield the floor. I suggest the absence of a quorum.

Mr. WYDEN

Mr. WYDEN. Mr. President, I ask unanimous consent that the pending amendment be set aside in order to call up my amendment No. 1026.

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

Mr. WYDEN. I ask for the yeas and nays.

Mr. WYDEN. Mr. President, earlier in this week I was encouraged when Republicans voted with Democrats to approve an amendment I introduced with Senator Sanders that would protect Medicaid beneficiaries from benefit cuts under the budget. But when we actually look at the Republican budget on Medicaid, it is impossible to square that budget, which has $1.2 trillion in cuts, with the vote that was held earlier this week to protect Medicaid. And we can't get those savings without cutting reimbursements for nursing homes and long-term care services. Medicaid pays 40 percent of all nursing home care. Colleagues, let us be consistent with our Medicaid vote that was cast earlier this week, and support my amendment.

Mr. WYDEN. Mr. President, I call up amendment No. 968, and I urge Senators to support this amendment because it will cut taxes on the middle class and give millions of Americans a new ladder of economic opportunity. This amendment rewards hard work, makes college more affordable, and helps parents who have a tough time making ends meet. Let's create a new path upward for the middle class and those who want to be middle class. Support this amendment. I yield back.

Mr. WYDEN. Mr. President, I think the Senator, through the Chair, would yield to me for a moment.

Mr. WYDEN. Mr. President, I ask for the yeas and nays.

Mr. WYDEN. Mr. President, more than 5 years after being signed into law, the Affordable Care Act is improving the health and well-being of millions of Americans. Many of the Affordable Care Act's greatest successes are getting lost in the noise of political attack ads. The Affordable Care Act has expanded health care coverage to millions of Americans. These people no longer have to go to bed at night worried about the possibility of bankruptcy if they get sick. Americans who had coverage already are benefiting from new protections. Women now pay the same premiums as men. Preexisting conditions can no longer be used as an excuse to deny coverage, and health plans no longer put lifetime caps on benefits. This amendment would require insurers to disclose all of the benefits afforded to consumers through the Affordable Care Act. I strongly urge my colleagues to support this amendment.

Mr. WYDEN. Mr. President, I will be very brief. I support this amendment. President Obama favors lowering this tax rate, and I believe the reason he does is because he thinks this will provide another opportunity to reduce offshoring. I support the amendment.

Mr. WYDEN

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

Mr. WYDEN. Mr. President, I ask unanimous consent to set aside the pending amendment to call up my amendment No. 708.