[Congressional Record Volume 149, Number 176 (Tuesday, December 9, 2003)]
[Senate]
[Pages S16122-S16140]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. GRAHAM of Florida:
  S. 1980. A bill to amend the Help America Vote Act of 2002 to require 
a voter-verified permanent record or hardcopy under title III of such 
Act, and for other purposes; to the Committee on Rules and 
Administration.
  (At the request of Mr. Daschle, the following statement was ordered 
to be printed in the Record.)
 Mr. GRAHAM of Florida. Mr. President, today I rise to 
introduce the Voter Confidence and Increased Accessibility Act.
  In 2000, Florida grabbed the national spotlight as an unfortunate 
example of an electoral process gone awry. The question of who would 
assume our Nation's highest office became contingent on such things as 
whether a chad was bulging or hanging. In the aftermath of that 
debacle, Americans demand that Congress improve the accuracy and 
integrity of our electoral process. Congress responded with the Help 
America Vote Act (HAVA), which we passed in 2002.
  HAVA aimed to modernize our electoral system and there have been some 
positive developments. Under the law, States have replaced punch card 
and lever voting systems with modern computer voting machines. 
Modernization, however, has failed to overcome all the pitfalls seen in 
recent elections. In 2002, Floridians were subject to another failure 
of our electoral process when a software error failed to court 
approximately 100,000 votes.
  As it now stands, computer-voting systems--including the popular 
touch screen models--are not mandated to include a paper record 
verifying voter intent. In the absence of a paper trail, confirming the 
accuracy of a computer voting machine is very difficult, sometimes even 
impossible. Further, voting irregularities, security intrusions and 
electronic errors can go unnoticed. We have a duty to our democracy to 
continue to address challenges that threaten to undermine the security 
and reliability of our electoral system.
  The Voter Confidence & Increased Accessibility Act renews our 
commitment to fulfilling that obligation. It will take us one step 
closer to our ultimate goal: ensuring that every vote really counts. 
This legislation responds to a set of challenges presented by computer 
voting systems. It would require all voting systems produce a 
verifiable paper record. States would also be given assistance in 
meeting this standard through funds dedicated to HAVA.
  The Voter Confidence & Increased Accessibility Act also stipulates 
several other provisions to ensure that every vote really counts. It 
would prohibit the use of unreported software and wireless 
communication devices in all voting systems. It would also restrict 
electronic communications from voting machines, permitting outgoing 
transmissions of vote totals only.
  The legislation specifies that voting systems must comply with these 
standards in time for the November 2004 general election. In the event 
that a locality is unable to get their computer voting systems 
compliant by this deadline, they are authorized to use a paper system 
as an interim measure. The Federal Government would be authorized to 
pay the cost of these paper systems for the November 2004 election.
  The Voter Confidence & Increased Accessibility Act also requires that 
individuals with disabilities must be accommodated with electronic 
voting systems by January 1, 2006, a year earlier than mandated by 
HAVA. While a paper record of a disabled persons vote is not expressly 
required, voting systems for disabled persons must include a means for 
voter verification. In the event a jurisdiction cannot meet this 
standard, disabled voters must be given the option to utilize a 
temporary paper system, with the assistance of an aide of their 
choosing.
  Finally, the legislation would require the Election Assistance 
Commission to conduct unannounced recounts in .5 percent of domestic 
jurisdictions and .5 percent of overseas jurisdictions. This way, 
Congress and America's voters can be assured that the election 
equipment is operating properly, and votes are really being counted.
  Creating these new standards will help ensure that our elections 
accurately reflect the intent of the voting public, and put into place 
an election system in which Americans can have full confidence.
                                 ______
                                 
      By Mrs. CLINTON:
  S. 1986. A bill to amend the help America Vote Act of 2002 to require 
voter verification and improved security for voting systems under title 
III of the Act, and for other purposes; to the Committee on Rules and 
Administration.
  Mrs. CLINTON. Mr. President, I rise to introduce the Protecting 
American Democracy Act of 2003, legislation that is vital to ensuring 
that the voting systems used in our Federal elections are as secure as 
possible while also ensuring that each and every voter in our Nation 
has an equal opportunity to verify his or her vote before that vote is 
cast and permanently recorded. At its core, this legislation will 
ensure that every vote is properly counted, ensuring the integrity of 
each vote, which is at the heart of our democracy.
  In recent months, there has been discussion about the increasing use 
of electronic voting systems such as direct recording electronic 
systems (DREs), the first completely computerized voting systems. 
Computerized voting systems can have many advantages. As the 
Congressional Research

[[Page S16123]]

Service has reported, they are arguably the most user-friendly and 
versatile of any current voting system. Among many features, such 
voting machines can be easily programmed to display ballots in 
different languages and can be made fully accessible for persons with 
disabilities, including the visually impaired. They can also prevent 
overvotes and spoilage of ballots due to extraneous marks since no 
document ballot is involved. In addition, fully computerized systems 
have the ability to notify voters of undervotes. Presently, no other 
kind of voting system possesses so many features. For this reason, it 
is expected that within the next two years, with funding authorized 
under the Help America Vote Act of 2002 (``HAVA''), state and local 
jurisdictions across the country will begin purchasing fully 
computerized systems.
  One of the disadvantages of these electronic voting systems, however, 
is that they do not give voters an opportunity to verify their votes--
to confirm that the voting machinery is registering the vote that the 
voter intended to cast--before the vote is cast and permanently 
recorded. In addition, electronic voting systems raise other concerns 
because of the ability of the software in the voting system to be 
compromised, or worse, maliciously attacked, by someone who may want to 
alter the voting results. Indeed, a number of recent studies, including 
the July 2001 study by Caltech/MIT, the July 2003 study by Johns 
Hopkins and Rice universities, the September 2003 study by the Science 
Applications International Corporation, requested by the Governor of 
Maryland, and the two November 2003 studies conducted by Compuware 
Corporation and InfoSENTRY, requested by the Ohio Secretary of State, 
pointed to significant and disturbing security risks in electronic 
voting systems and related administrative procedures and processes.
  That is why in addition to ensuring that voters have an opportunity 
to verify their vote, it is vital that we improve the security of 
voting system technology, and that means not only the kind of software 
that is used but also how, for example, that software is designed, 
stored, disseminated, updated, field tested, and used in an actual 
election. This is a developing consensus among computer security 
experts that not only is the security of electronic voting systems 
wholly inadequate, but that the security policies and procedures that 
State and local election officials, voting system vendors, and others 
use are non-existent, inadequate, or, if they exist, are not followed, 
which is the same as having no policy at all.
  Our Nation is the greatest Nation on earth and it is the leading 
democracy in the world. Central to that democracy is ability of 
Americans to have confidence in the voting system used to register and 
record their votes. This is a fundamental standard that must be met. I 
have concerns, however, that our Nation is falling short of that 
standard.
  That is why I am today introducing the ``Protecting American 
Democracy Act of 2003,'' which amends by adding a voter verification 
requirement for voting systems to give each voter an opportunity to 
verify his or her vote at the time the vote is cast. Voters will be 
given an opportunity to correct any error made by the voting system 
before the permanent voting record is preserved.
  While requiring that all election jurisdictions give voters the 
ability to verify their votes, this legislation also gives States and 
local jurisdictions the flexibility to employ the most appropriate, 
accurate, and secure voter verification technologies, which may include 
voter-verifiable paper ballots, votemeters, modular voting 
architecture, and/or encrypted votes, for their State or jurisdiction 
in a uniform and nondiscriminatory manner. Any voter verification 
method used must ensure that voters with disabilities and other 
affected voters have the ability to cast their vote in private, and 
language minorities must have equal access in verifying their vote. 
This is important if we are to ensure that all Americans--including the 
more than 20 million voters who are visually impaired, the more than 40 
million Americans who lack basic literacy skills, and millions of 
language minorities--will be able to exercise their constitutional 
right to vote.
  To address critical security issues, the ``Protecting American 
Democracy Act of 2003'' also amends HAVA by adding a security 
requirement for voting systems to ensure that voting systems are as 
secure as possible. Specifically, voting systems must adhere to the 
security requirements for Federal computer systems as required under 
current law or, alternatively, more stringent requirements adopted by 
the Election Assistance Commission. Currently no such requirement 
exists. I believe that, at minimum, the systems used by the people of 
the United States to exercise their constitutional right to vote, the 
hallmark of our democracy, should be at least as secure as the computer 
systems used by the Federal Government.
  The security requirements must also provide that no voting system 
shall contain any wireless device, which reduces the risk that hackers 
will be able to attack any electronic voting system. In addition, all 
software and hardware used in any electronic voting system must be 
certified by laboratories accredited by the Commission as meeting all 
security requirements.
  The Act also requires the Election Assistance Commission to report to 
Congress within 6 months of enactment regarding a proposed security 
review and certification process for all voting systems. Within 3 
months of enactment, the Government Accounting Office, unless the 
Commission has already completed the following report, must issue a 
report to Congress on the operational and management systems that 
should be employed to safeguard the security of voting systems, 
together with a schedule for how quickly each such measure should be 
implemented.
  Lastly, immediately upon enactment, the National Institute of 
Standards and technology (NIST) must provide security consultation 
services to State and local jurisdiction. Two million dollars in Fiscal 
Years 2004 through 2006 are authorized to be appropriated to assist 
NIST in providing these security consultation services.
  I cannot think of a more significant risk to our democracy than for 
Americans to lack complete confidence in the voting systems used to 
cast and count their votes in Federal elections. For all those who 
believe that in a democracy, there is no more important task than 
assuring the sanctity of votes, this should be an easy step to take to 
assure it. For this reason, I urge all of my colleagues to support this 
legislation. I ask unanimous consent that the text of this bill be 
printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 1986

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Protecting American 
     Democracy Act of 2003''.

     SEC. 2. REQUIRING VERIFICATION FOR VOTERS.

       (a) In General.--Section 301(a)(2) of the Help America Vote 
     Act of 2002 (42 U.S.C. 15481(a)(2)) is amended by adding at 
     the end the following new subparagraph:
       ``(C) Voter verification.--
       ``(i) The voting system shall provide a means by which each 
     individual voter must be able to verify his or her vote at 
     the time the vote is cast, and shall preserve each vote 
     within the polling place on the day of the election in a 
     manner that ensures the security of the votes as verified for 
     later use in any audit.
       ``(ii) The voting system shall provide the voter with an 
     opportunity to correct any error made by the system before 
     the permanent record is preserved for use in any audit.
       ``(iii) The verified vote produced under this subparagraph 
     shall be available as an official record.
       ``(iv) Any method used to permit the individual voter to 
     verify his or her vote at the time the vote is cast and 
     before a permanent record is created--

       ``(I) shall use the most accurate technology, which may 
     include voter-verifiable paper ballots, votemeters, modular 
     voting architecture, and encrypted votes, in a uniform and 
     nondiscriminatory manner;
       ``(II) shall guarantee voters with disabilities and other 
     affected voters the ability to cast a vote in private, 
     consistent with paragraph (3)(A); and
       ``(III) shall guarantee voters alternative language 
     accessibility under the requirements of section 203 of the 
     Voting Rights Act of 1965 (42 U.S.C. 1973aa-1a), consistent 
     with paragraph (4).''.

     SEC. 3. REQUIRING INCREASED SECURITY FOR VOTING SYSTEMS.

       (a) Section 301(a) of the Help America Vote Act of 2002 (42 
     U.S.C. 15481(a)) is amended by

[[Page S16124]]

     adding at the end the following new paragraph:
       ``(7) Increased security for voting systems.--
       ``(A) Voting system security requirement.--The voting 
     system shall adhere to security requirements for Federal 
     computer systems or more stringent requirements adopted by 
     the Election Assistance Commission after receiving 
     recommendations from the Technical Guidelines Development 
     Committee under sections 221 and 222. Such requirements shall 
     provide that no voting system shall contain any wireless 
     device. All software and hardware used in any electronic 
     voting system shall be certified by laboratories accredited 
     by the Commission as meeting the requirements of this 
     subsection.
       ``(B) Report to congress on security review.--The 
     Commission, in consultation with the National Institute of 
     Standards and Technology (NIST), shall report to Congress not 
     later than 6 months after the date of enactment of the 
     Protecting American Democracy Act of 2003 regarding a 
     proposed security review and certification process for all 
     voting systems.
       ``(C) General accounting office report.--Not later than 3 
     months after the date of enactment of the Protecting American 
     Democracy Act of 2003, the Government Accounting Office, 
     unless the Commission has previously completed such report, 
     shall issue a report to Congress on the operational and 
     management systems that should be employed to safeguard the 
     security of voting systems, together with a schedule for how 
     quickly each such system should be implemented.
       ``(D) Provision of security consultation services.--
       ``(i) In general.--On and after the date of enactment of 
     the Protecting American Democracy Act of 2003, the National 
     Institute of Standards and Technology (NIST) shall provide 
     security consultation services to State and local 
     jurisdictions.
       ``(ii) Authorization.--To carry out the purposes of this 
     subparagraph, $2,000,0000 is authorized for each of fiscal 
     years 2004 through 2006.''.

     SEC. 4. EFFECTIVE DATE.

       The amendments made by this Act shall take effect as if 
     included in the enactment of the Help America Vote Act of 
     2002.
                                 ______
                                 
      By Mr. LUGAR:
  S. 1987. A bill to implement the obligations of the United States 
under the Protocol Additional to the Agreement between the United 
States of America and the International Atomic Energy Agency for the 
Application of Safeguards in the United States of America, known as 
``the Additional Protocol'' signed by the United States on June 12, 
1998; to the Committee on Foreign Relations.
  Mr. LUGAR. Mr. President, at the request of the administration, I am 
pleased to introduce the Additional Protocol Implementation Act of 
2003. This important legislation is needed to implement the provisions 
of the Protocol to the Agreement of the International Atomic Energy 
Agency, IAEA, Regarding Safeguards in the United States.
  The United States signed the Additional Protocol in Vienna on June 
12, 1998. President Bush submitted the Additional Protocol to the 
Senate on May 9, 2002. The State Department sent the implementing 
legislation to us on November 19, 2003, and asked that it be considered 
in conjunction with the Senate's advice and consent on the Protocol. 
The adoption of this agreement is an important step in demonstrating 
U.S. leadership in the fight against the spread of nuclear weapons. The 
Additional Protocol will provide the United States and the IAEA with 
another tool as we attempt to secure broader inspection rights in non-
nuclear-weapon states that are parties to the Treaty on the 
Nonproliferation of Nuclear Weapons, NPT.
  When the Committee on Foreign Relations reported out the NPT in 1968, 
it noted that ``the treaty's fundamental purpose is to slow the spread 
of nuclear weapons by prohibiting the nuclear weapon states which are 
party to the treaty from transferring nuclear weapons to others, and by 
barring the non-nuclear weapon countries from receiving, manufacturing, 
or otherwise acquiring nuclear weapons.'' Since the Senate ratified the 
NPT, we have seen 188 states join the United States in approving the 
treaty. But recently we also have seen a disturbing increase in the 
global availability of nuclear materials and reprocessing and 
enrichment technology. To ensure that these materials and technologies 
are devoted only to peaceful purposes, the IAEA must have the power to 
conduct intrusive inspections at almost any location in a non-nuclear-
weapon state to verify state parties' commitments under the NPT.
  The world community has learned that existing safeguard arrangements 
in non-nuclear-weapon states do not provide the IAEA with a complete 
and accurate picture of possible nuclear weapons-related activities. It 
is critical that the IAEA have the ability to expand the scope of its 
activities in states that pose a potential proliferation threat. At 
this point, the only means at the IAEA's disposal, beyond existing 
safeguards arrangements, is the Model Additional Protocol.
  The United States, as a declared nuclear-weapon state party to the 
NPT, may exclude the application of IAEA safeguards on its nuclear 
activities. Under the negotiated Additional Protocol, the United States 
also has the right to exclude activities and sites of direct national 
security significance in accordance with its National Security 
exclusion. This provision is crucial to U.S. acceptance of the 
Additional Protocol and provides a basis for the protection of U.S. 
nuclear weapons-related activities, sites, and materials as a declared 
nuclear power.
  The Additional Protocol does not contain any new arms control or 
disarmament obligations for the United States. While there are 
increased rights granted to the IAEA for the conduct of inspections in 
the United States, the administration has assured the committee that 
the likelihood of an inspection occurring in the United States is very 
low. Nevertheless, should an inspection under the Additional Protocol 
be potentially harmful to U.S. national security interests, the United 
States has the right, through the National Security Exclusion, to 
prevent such an inspection.
  The Committee on Foreign Relations will hold hearings early next year 
to consider the Additional Protocol. I am confident the Committee will 
draft a resolution of ratification that will enjoy the support of the 
senate. Ratification of this treaty and passage of its implementing 
legislation would be an important demonstration of the U.S. commitment 
to vigorous and expansive authority for the IAEA in non-nuclear-weapon 
states.
  I am pleased to introduce this legislation today as a statement of 
the Committee's strong support for aggressive verification capabilities 
in the global fight against the spread of weapons of mass destruction. 
I look forward to working closely with my friend, Senator Hatch, 
Chairman of the Committee on the Judiciary, to construct legislation 
that protects U.S. national security interests, while strengthening the 
ability of the IAEA to discover illegal nuclear weapons activities.
  the package I send to the desk today contains a letter from the 
Department of State, the administration's implementing legislation, and 
a section-by-section analysis, all submitted by the administration.
  I ask unanimous consent that the referenced letter and analysis be 
printed in the Record.
  There being no objection, the additional material was ordered to be 
printed in the Record, as follows:
                                United States Department of State,
                                                   Washington, DC.
     Hon. Richard G. Lugar,
     Chairman, Committee on Foreign Relations, United States 
         Senate.
       Dear Mr. Chairman: On behalf of the President, I am pleased 
     to submit for consideration the Administration's recommended 
     text for legislation to implement the Protocol Additional to 
     the Agreement Between the United States of America and the 
     International Atomic Energy Agency for Application of 
     Safeguards in the United States of America (U.S.-IAEA 
     Additional Protocol). The U.S.-IAEA Additional Protocol, 
     signed in Vienna on June 12, 1998, is a bilateral treaty that 
     supplements and amends the Agency verification arrangements 
     under the existing Agreement Between the United States of 
     America and the International Atomic Energy Agency for the 
     Application of Safeguards in the United States of America of 
     November 18, 1977 (the ``Voluntary Offer''), which entered 
     into force on December 9, 1980.
       The U.S.-IAEA Additional Protocol contains a number of 
     provisions that require implementing legislation to give them 
     effect within the United States. These include:
       Declarations of U.S. civil nuclear activities and related 
     industry;
       Restrictions on disclosure of information; and
       International inspections of locations in the United 
     States.
       The President, in his letter of transmission dated May 9, 
     2002, stated that the U.S.-IAEA ``Additional Protocol is in 
     the best interests of the United States. Our acceptance of 
     this agreement will sustain our longstanding record of 
     voluntary acceptance of nuclear safeguards and greatly 
     strengthen our ability to promote universal adoption of the

[[Page S16125]]

     Model Protocol, a central goal of my nuclear nonproliferation 
     policy. Widespread acceptance of the Protocol will contribute 
     significantly to our nonproliferation objectives as well as 
     strengthen U.S., allied and international security.'' We urge 
     the Senate to give early and favorable consideration to the 
     Protocol and the recommended implementing legislation.
       The Office of Management and Budget advises that there is 
     no objection to the submission of this proposal and its 
     enactment, is in accord with the President's program.
       We hope this information and the enclosed recommended 
     legislation and sectional analysis are helpful. Please let us 
     know if we can be of further assistance.
           Sincerely,

                                                Paul V. Kelly,

                                              Assistant Secretary,
     Legislative Affairs.
                                  ____


Section-by-Section Analysis of the Proposed Additional Protocol to the 
       U.S.-IAEA Safeguards Agreement Implementation Act of 2003


                                overview

       The Protocol Additional to the Agreement between the United 
     States of America and the International Atomic Energy Agency 
     (IAEA) for the Application of Safeguards in the United States 
     of America (the Additional Protocol) contains a number of 
     provisions that require legislation to give them effect 
     within the United States. These include provisions on the 
     submission to the United States Government of civil nuclear 
     and nuclear-related information by entities identified in 
     Article 2 of the Additional Protocol, and on civil and 
     criminal penalties for failure of such entities to keep or 
     provide such information. The proposed legislation also sets 
     forth procedures for inspections, or ``complementary 
     access,'' by the IAEA at U.S. locations under the Additional 
     Protocol.
       The proposed Additional Protocol to the U.S.-IAEA 
     Safeguards Agreement Implementation Act (the Act) contains 
     five miscellaneous sections and six titles. The five 
     miscellaneous sections concern the short title of the Act, 
     the table of contents, Congressional findings, definitions, 
     and a severability clause. Title I provides specific 
     authority for the President to implement and carry out the 
     Act and the Additional Protocol through directing the 
     issuance of necessary regulations. Title II authorizes 
     complementary access at U.S. locations consistent with the 
     Act, and establishes the terms upon which such access may 
     take place. For example, it addresses the notice that must be 
     given to the owner or operator of the inspected location, and 
     the procedures to be followed for seeking access--including 
     obtaining an administrative search warrant where necessary. 
     Title III restricts disclosure of certain information 
     provided pursuant to the Act or the Additional Protocol. 
     Title IV makes it illegal for entities willfully to fail to 
     report information required by regulations pursuant to the 
     Act, and Title V provides for criminal and civil penalties 
     for such violations. Finally, Title VI authorizes 
     appropriation of funds for the Agencies required to carry out 
     responsibilities under the Act.


                         miscellaneous sections

       The first part of the Act contains five miscellaneous 
     sections: the short title of the Act, the table of contents, 
     Congressional findings, definitions, and a severability 
     clause. The first two sections are standard provisions. The 
     third section contains seven Congressional findings, which 
     recognize the threat posed by nuclear proliferation, the 
     importance of the Nuclear Non-Proliferation Treaty (NPT), the 
     urgency of strengthening its safeguards system, and the need 
     to implement the U.S.-IAEA Additional Protocol as a means of 
     encouraging other NPT State Parties to accept stricter 
     verification measures. The fourth section provides 
     definitions of key terms as they are used in the Act. In many 
     instances, the same definitions appear in the Additional 
     Protocol, and are therefore cross-referenced. Finally, the 
     fifth section provides that, if any provision of the Act is 
     held invalid, the remainder of the Act shall remain in force. 
     The Administration believes that the Additional Protocol and 
     the Act are fully consistent with the U.S. Constitution, but 
     has included this section as a matter of prudence.


                         title i--authorization

       Title I authorizes the President to implement and carry out 
     the provisions of the Act and the Additional Protocol. This 
     is to be accomplished through an Executive Order designating 
     Agencies to promulgate regulations requiring, inter alia, 
     submission to the United States Government of information 
     specified under Article 2 of the Additional Protocol. This 
     information is necessary for the United States to fulfill its 
     Treaty obligation to provide the IAEA with a broad 
     declaration of its civil nuclear and nuclear-related 
     activities. While the Agencies most likely to issue or amend 
     such regulations are identified in Section 101(a) of the Act, 
     this list is not exclusive.


                     title ii--complementary access

       Title II sets forth the terms under which complementary 
     access may occur in the United States. Section 201 of the Act 
     makes clear that the IAEA may not conduct complementary 
     access in the United States without the authorization, in 
     accordance with the Act, of the United States Government. It 
     further directs that certain U.S. agencies may not 
     participate in complementary access. These agencies, 
     including the Environmental Protection Agency and the 
     Occupational Safety and Health Administration, are excluded 
     because their employees may detect violations of regulatory 
     schemes wholly unrelated to the Additional Protocol. Section 
     201 further requires the number of U.S. representatives be 
     kept to a minimum.
       Section 202 addresses procedures for complementary access. 
     For example, Section 202(b) sets forth the requirement for 
     the United States Government to provide ``actual written 
     notice'' of a complementary access request, as soon as 
     possible, to the owner, operator, occupant or agent in charge 
     of the location to be inspected. The notice must contain all 
     appropriate information provided by the IAEA concerning the 
     purpose of the access request, the basis for selection of the 
     location, the activities it intends to carry out, the time 
     and duration of the access, and the identities of inspectors. 
     In addition, Section 202(c) requires IAEA and U.S. personnel 
     participating in the complementary access to show their 
     credentials prior to gaining entry to the inspected location.
       Section 202(d)(1) states the general rule that IAEA 
     inspectors may conduct all activities specified under Article 
     6 of the Additional Protocol for the type of location being 
     inspected. However, there are several exceptions to this 
     rule. First, a warrant issued authorizing complementary 
     access at a location may restrict the activities that 
     inspectors may conduct. Second, as indicated in 202(d)(1), 
     the United States Government has certain rights under the 
     Additional Protocol to limit such access. In addition to its 
     right under Article 1(b) of the
       Protocol to deny IAEA access to activities with direct 
     national security significance or to location or information 
     associated with such activities, the United States may manage 
     access in connection with such activities, locations or 
     information. These rights are unilateral and absolute; they 
     are not subject to challenge by or negotiation with the IAEA. 
     Furthermore, Article 7 of the Additional Protocol provides 
     for managed access, under arrangements with the IAEA, to 
     prevent the dissemination of proliferation sensitive 
     information, to meet safety or physical protection 
     requirements, or to protect proprietary or commercially 
     sensitive information. Third, Section 202(d)(2) lists a 
     series of items that are specifically excluded from IAEA 
     access. This third set of exceptions, which are mainly 
     directed at protecting commercial information, may not 
     however be enforced if the Additional Protocol requires such 
     disclosure. Section 202(e) requires that all persons 
     participating in complementary access, including U.S. 
     representatives, observe all environmental, health, safety 
     and security regulations applicable for the inspected 
     location.
       Section 203 provides the legal framework for IAEA 
     inspectors to gain complementary access to U.S. locations 
     under the Additional Protocol. Section 203(a) sets forth 
     three grounds for such access: warrantless access, where the 
     Fourth Amendment of the U.S. Constitution does not require a 
     warrant; consent to the access by the owner/operator of the 
     location; or, where necessary, obtaining an administrative 
     search warrant. Section 203(a)(2) makes clear that the 
     legislation is intended to impose no warrant requirement 
     beyond that which is required by the Fourth Amendment. Where 
     such a warrant requirement exists, Section 203(a)(1) directs 
     the United States Government first to seek consent to access 
     from the location's owner or operator. The remainder of 
     Section 203 addresses the requirements for obtaining an 
     administrative search warrant, and what such a warrant should 
     contain. Section 203(b)(1) states that the United States 
     Government shall provide to the judge all appropriate 
     information it has received from the IAEA regarding its basis 
     for selecting a particular location for complementary access. 
     A ``judge of the United States'' is defined by the Act to 
     mean a judge or magistrate judge of a district court of the 
     United States. In addition, Section 203(b)(2) requires the 
     United States to submit to the judge a more detailed 
     affidavit showing, among other things, that the Additional 
     Protocol is in force in the United States, applicable to the 
     location to be inspected, and that the complementary access 
     requested is consistent with the provisions of the Additional 
     Protocol, including Article 4 regarding the purpose of the 
     access, and Article 6 regarding its scope. The affidavit must 
     also indicate the anticipated time and duration of the 
     inspection.
       Finally, the affidavit must show that the location to be 
     inspected was selected by the IAEA either (i) because there 
     is probable cause, on the basis of specific evidence, to 
     believe that information required to be reported regarding a 
     location pursuant to regulations promulgated under the Act is 
     incorrect or incomplete, and that the location to be accessed 
     contains evidence regarding that violation; or (ii) pursuant 
     to a reasonable general administrative plan developed by the 
     IAEA based upon specific neutral criteria. Selection based on 
     either of these approaches would meet U.S. Constitutional 
     requirements for issuance of a warrant. Section 203 directs 
     that a judge, upon receiving the affidavit, shall promptly 
     issue an administrative search warrant authorizing the 
     requested complementary access. The warrant is to specify the 
     same information as the affidavit, and shall, if known, also 
     include the identities of the IAEA complementary access

[[Page S16126]]

     team and accompanying U.S. representatives.


               title III--confidentiality of information

       Title III of the proposed implementing legislation 
     restricts the disclosure of information provided to the 
     United States Government, or to its contractor personnel, 
     pursuant to the Act or the Additional Protocol. For example, 
     Section 301(a) exempts from the Freedom of Information Act 
     (FOIA) disclosure information obtained by the United States 
     Government in implementing the provisions of the Additional 
     Protocol. Thus, information reported to the Government by 
     entities covered by Article 2 of the Additional Protocol, as 
     required by regulation, is not subject to release under the 
     FOIA.


                        title iv--recordkeeping

       Title IV of the proposed implementing legislation prohibits 
     the willful failure of any person to maintain records or 
     submit reports to the United States Government as required by 
     regulations issued under Section 101 of the Act. The 
     prohibitions of Title IV are necessary to implement the 
     Additional Protocol, as the United States is dependent on 
     such reporting to meet its Treaty obligations. A person is 
     defined by the Act very broadly to ensure that all possible 
     entities within the United States are covered.


                          title v--enforcement

       Title V of the proposed implementing legislation provides 
     for both civil and criminal penalties for failure to meet the 
     recordkeeping and reporting requirements of Title IV. 
     Violators shall be subject to imprisonment for not more than 
     five years, criminal fines, and civil penalties up to $25,000 
     per violation. While the Agency issuing the applicable 
     regulations is responsible for their enforcement, an entity 
     subject to civil penalty under this Title may seek judicial 
     review. Title V also provides United States district courts 
     with jurisdiction to specifically enforce Agency orders, 
     either by restraining or compelling action so as to avoid a 
     violation of Title IV.


                    title vi--authorization of funds

       Title VI of the proposed legislation authorizes the 
     appropriation of such sums as necessary to carry out the 
     purpose of the Act.
                                 ______
                                 
      By Mr. Daschle (for Mr. Kerry (for himself and Mr. Kennedy)):
  S. 1991. A bill to require the reimbursement of members of the Armed 
Forces or their family members for the costs of protective body armor 
purchased by or on behalf of members of the Armed Forces; to the 
Committee on Armed Services.
  (At the request of Mr. Daschle, the following statement was ordered 
to be printed in the Record).
 Mr. KERRY. Mr. President, it is the responsibility of the 
military departments to ``organize, train, and equip,'' the armed 
forces of the United States. Yet, reports indicate that nearly a 
quarter of the 130,000 U.S. troops in Iraq still wait for the latest 
``Interceptor'' body armor, which is a Kevlar vest with ``small-arms 
protective inserts''--boron carbide ceramic plates--that protect 
critical organs from weapons fired by assault rifles like the Ak-47s 
favored by Iraqi insurgents.
  While the Congress has taken measures to provide the latest personal 
protective gear to all U.S. forces in Iraq and Afghanistan, over the 
last several months we have heard alarming reports of family members 
scurrying to buy bullet-proof vests to send to their loved ones in 
Iraq. Military families are patriotic and selfless. Their devotion is 
no less than that of those serving in harm's way. They have more than 
enough to worry about, let alone whether or not they can find and buy 
the gear that might save their child's life. This is the responsibility 
of the Department of Defense, plain and simple. There is no excuse for 
their failure.
  On November 19, 2003, acting-Secretary of the Army Les Brownlee 
admitted to Congress that the administration failed to provide basic 
equipment, like body armor, to all of our forces in Iraq because, as he 
put it, ``Events since the end of major combat operations in Iraq have 
differed from our expectations and have combined to cause problems.'' 
The Washington Post reported recently that, ``Going into the war in 
Iraq, the Army decided to outfit only dismounted combat soldiers with 
the plated vests, which cost about $1,500 each. But when Iraqi 
insurgents began ambushing convoys and killing clerks as well as combat 
troops, controversy erupted.'' I ask unanimous consent that the full 
text of this article be included in the Record.
  Stories abound of family members, fathers and mothers, wives, and 
others paying for personal body armor out of their own pockets and 
shipping the much needed equipment to Iraq. Consider the case of Mimi 
McCreary of Victorville, CA, whose son Olaf received his bullet-proof 
vest not from his reserve unit, but from his colleagues on the Clinton, 
SC, police department. Or consider the 120 members of the National 
Guard from Marin County, CA, who were unsure of when their body armor 
would be made available. Instead of letting their neighbors go off to 
war, the men and women of law enforcement in Marin County donated more 
than 60 vests so that they would have ``at least some protection.'' Or 
consider Army Specialist Richard Murphy of Sciota, PA, whose parents, 
Susan and Joe Werfelman, purchased the ceramic plates missing from 
their son's vest. According to Murphy's step-father, he ``called us 
frantically three or four times on this . . . We said, ``If the Army is 
not going to protect him, we've got to do it.''
  We owe Mr. and Mrs. Werfelman and Mrs. McCreary and every other 
military family an incredible debt of gratitude. They raised children 
who believe in this country and are risking all in service to it. The 
last thing we should ask of them now is to take money out of their own 
pockets to buy the gear their kids should have had in the first place. 
But that's exactly what poor planning has led to.

  The legislation I introduce today with Senator Kennedy requires the 
Department of Defense to reimburse family members who paid money out of 
their own pockets to provide the personal body armor that the 
government failed to provide our troops. Lives and blood will always be 
the cost of war. But it is a dereliction of duty to send anyone into 
harm's way without basic protective gear, and it is disgusting for 
family members to have to take this burden of outfitting their loved 
ones for war. This grateful Nation must make right by those family 
members and reimburse their expenses in providing these materials to 
their sons and daughters, husbands and wives. Let families send 
pictures and letters from home. The Department of Defense should 
provide the gear.
  There being no objection, the letter was ordered to be printed in the 
Record, as follows:

                [From the Washington Post, Dec. 4, 2003]

                     Body Armor Saves Lives in Iraq

                   (By Vernon Loeb and Theola Labbe)

       Baghdad.--Pfc. Gregory Stovall felt the explosion on his 
     face. He was standing in the turret of a Humvee, manning a 
     machine gun, when the roadside bomb went off. At the time, he 
     was guarding a convoy of trucks making a mail run. In an 
     instant, Stovall's face was perforated by shrapnel, the index 
     finger on his right hand was gone, and the middle finger was 
     hanging by a tendon. But the 22-year-old from Brooklyn 
     remembers instinctively reaching for his chest and stomach--
     ``to make sure everything was there,'' he said. It was, 
     encased in a Kevlar vest reinforced by boron carbide ceramic 
     plates that are so hard they can stop AK-47 rounds traveling 
     2,750 feet per second. Thus, on the morning of Nov. 4, 
     Stovall became the latest in a long line of soldiers serving 
     in Iraq to be saved by the U.S. military's new Interceptor 
     body armor.
       This high-tech ``system''--the Kevlar vest and ``small-arms 
     protective inserts,'' which the troops call SAPI plates--is 
     dramatically reducing the kind of torso injuries that have 
     killed soldiers on the battlefield in wars past.
       Soldiers will not patrol without the armor--if they can get 
     it. But as of now, there is not enough to go around. Going 
     into the war in Iraq, the Army decided to outfit only 
     dismounted combat soldiers with the plated vests, which cost 
     about $1,500 each. But when Iraqi insurgents began ambushing 
     convoys and killing clerks as well as combat troops, 
     controversy erupted.
       Last month, Rep. Ted Strickland (D-Ohio) and 102 other 
     House members wrote to Rep. Duncan Hunger ( R-Calif.), 
     chairman of the House Armed Services Committee, to demand 
     hearings on why the Pentagon had been unable to provide all 
     U.S. service members in Iraq with the latest body armor. In 
     the letter, the lawmakers cited reports that soldiers' 
     parents had been purchasing body armor with ceramic plates 
     and sending it to their children in Iraq.
       The demand came after Gen. John Abizaid, head of the U.S. 
     Central Command and commander of all military forces in Iraq, 
     told a House Appropriations subcommittee in September that he 
     could not ``answer for the record why we started this war 
     with protective vests that were in short supply.''
       With the armor, ``it's the difference between being hit 
     with a fist or with a knife,'' said Ben Gonzalez, chief of 
     the emergency room at the 28th Combat Support Hospital in 
     Baghdad, the largest U.S. Army hospital in the country, which 
     treats the majority of wounded soldiers.
       Jonathan Turley, a law professor at George Washington 
     University, began investigating the Army's decision not to 
     equip all troops deploying to Iraq with Interceptor body 
     armor after learning that one of his students, reservist 
     Richard Murphy, was in the

[[Page S16127]]

     country with a Vietnam-era flak jacket. ``There's been an 
     overwhelming effort to get the military every possible 
     resource,'' Turley said. ``To have such an item denied to 
     troops in Iraq was a terrible oversight.'' Since he began 
     publicizing the lack of body armor, Turley said, he has been 
     deluged with e-mails from people offering to donate body 
     armor to U.S. troops.
       Joe Werfelman, the father of Turley's student, said he was 
     dismayed to learn that his son had been sent to Iraq in May 
     without ceramic plates. ``He called us frantically three or 
     four times on this,'' Werfelman said in an interview. ``We 
     said, `If the Army is not going to protect him, we've got to 
     do it.' '' So Werfelman, of Scotia, Pa., found a New Jersey 
     company that had the ceramic plates in stock, plunked down 
     $660 for two plates and a carrying case, and sent them to his 
     son. ``As far as I know, he's still using the ones that we 
     got him'' he said. ``Some units have the new plates and some 
     units don't.''
       At a hearing of the Senate Armed Services Committee on Nov. 
     19, Sen. John W. Warner (R-Va.), the committee's chairman, 
     told Acting Army Secretary Les Brownlee that the shortage of 
     body armor in Iraq was ``totally unacceptable.'' ``Now, where 
     was the error--and I say it's an error made in planning--to 
     send those troops to forward-deployed regions, and the 
     conflict in Iraq, without adequate numbers of body armor?'' 
     Warner asked. ``Events since the end of major combat 
     operations in Iraq have differed from our expectations and 
     have combined to cause problems,'' Brownlee said. Before 
     approving the administration's $87 billion supplemental bill 
     for Iraq and Afghanistan, Congress added hundreds of millions 
     of dollars for more body armor, armored Humvees, and other 
     systems to protect soldiers from roadside bombs and ambushes.
       Now, three manufacturers are working overtime to produce 
     the 80,000 vests and 160,000 plates required to outfit 
     everyone in Iraq by the end of the year. Assembly lines are 
     producing 25,000 sets a month.
       Commanders say the vests are changing the way soldiers 
     think and act in combat. ``I will tell you that the 
     soldiers--to include this one--experience some degree of 
     feeling a little indestructible, particularly in light of the 
     fact that we have seen the equipment work,'' said Lt Col. 
     Henry Arnold, a battalion commander and combat veteran in 
     the 101st Airborne Division in northern Iraq. ``It's a 
     security blanket,'' Stovall said from his hospital bed, 
     awaiting a medevac flight to Germany with his hand 
     bandaged. ``If only they had a glove, I might have my 
     finger, but I'm thankful that I'm here.''
       The product of a five-year military research effort aimed 
     at reducing the weight and cost of the plates while 
     increasing their strength, the body armor made its combat 
     debut last year in Afghanistan and was credited with saving 
     more than a dozen lives during Operation Anaconda. The 
     camouflage Kevlar vest, which alone can stop rounds from a 
     9mm handgun, weighs 8.4 pounds, while each of the plates 
     weighs 4 pounds. At 16.4 pounds, Interceptor body armor is a 
     third lighter than the 25-pound flak jacket from the Vietnam 
     era, but it provides far more protection.
       Consider the case of Charlie Company, 1st Battalion, 505th 
     Parachute Infantry Regiment of the 82nd Airborne Division. 
     During a foot patrol in Fallujah in late September, an Iraqi 
     insurgent suddenly emerged from an alleyway and fired an AK-
     47 at Spec. John Fox from point-blank range. Fox was hit in 
     the stomach as he returned fire, and the blast knocked him 
     off his feet. The bullet hit the middle of three ammunition 
     magazines hanging from the front of his Kevlar vet, igniting 
     tracer rounds and setting off a smoke grenade. A thick gray 
     plume poured from his vest where he lay. His squad mates, 
     having shot and killed the gunman, rushed to his side. ``Am I 
     bleeding? Am I bleeding?'' they recalled Fox asking. They 
     checked and discovered he was unharmed. His body armor had 
     protected him not only from the AK-47 round by also from his 
     own exploding munitions. ``Fox must have been only 10, 15 
     meters from this guy,'' recalled St. Roger Vasquez. ``And 
     this thing stopped the bullet.''
       A month later, two of those who had rushed to Fox's side, 
     Spec. Sean Bargmann and Spec. Joseph Rodriguez, were on a 
     mounted patrol in Fallujah, sitting atop a Humvee, when a 
     powerful roadside bomb exploded just feet away. ``It felt 
     like somebody took a Louisville Slugger to my head,'' 
     Bargmann said. Weeks after the attack, he and Rodriguez still 
     bore the outlines of their armor: The tops of their head, 
     protected by their Kevlar helmets, and their torsos, 
     protected by their body armor, were unscathed. But Bargmann 
     had a deep cut right below the helmet line, and Rodriguez had 
     three scars running down his right cheek and a scar above his 
     left eye.
       This often happens with body armor: Lives are saved, but 
     faces, arms and legs are punctured and scarred. Doctors are 
     treating serious wound to the extremities that are creating 
     large numbers of amputees--soldiers who in earlier wars never 
     would have made it off the battlefield. Gonzalez, the doctor 
     at the 28th Combat Support Hospital, is not complaining about 
     the number of amputations. ``The survival rate has increased 
     significantly,'' he said. ``In the past, you'd see head and 
     chest and abdominal injuries. They would die even before they 
     got to me.''
       Sgt. Gary Frisbee of the 2nd Armored Cavalry Regiment 
     remembers standing in the turret of a Humvee waiting to die. 
     His vehicle was bringing up the rear during a routine three-
     vehicle patrol in Sadr City, Baghdad's vast Shiite slum, when 
     hundreds of armed followers of the Shiite cleric Moqtada Sadr 
     opened fire on them with AK-47s and rocket-propelled 
     grenades. ``I knew it was all over; it was just a matter of 
     when,'' he recalled. ``You're bracing yourself, because 
     you're just waiting for the bullet to hit you. The volume of 
     AK fire was unreal, from the roofs, in front of your, and 
     behind you.'' Two of 10 soldiers on the patrol were killed; 
     four were wounded. During the battle, Frisbee felt something 
     hit the back of his Kelvar vest but kept on fighting. When 
     the smoke finally cleared, he pulled out the back plate to 
     see what had happened and found a bullet hole. It has been, 
     as he had thought, just a matter of time. He had been hit--
     and saved by boron carbide.
                                 ______
                                 
      By Mr. KENNEDY:
  S. 1992. A bill to amend the Medicare Prescription Drug, Improvement, 
and Modernization Act of 2003 to eliminate privatization of the 
medicare program, to improve the medicare prescription drug benefit, to 
repeal health savings accounts, and for other purposes; to the 
Committee on Finance.
  Mr. KENNEDY. Mr. President, today, along with Senator Bob Graham I am 
introducing the ``Defense of Medicare and Real Prescription Drug 
Benefit Act.'' Congressman John Dingell is introducing companion 
legislation in the House of Representatives.
  The more senior citizens learn about the legislation President Bush 
has just signed, the more concerned they are. It's a sweetheart deal 
for big insurance companies and pharmaceutical companies and a raw deal 
for senior citizens. It's not really a prescription drug bill. It's an 
anti-Medicare bill.
  Our legislation will reverse these destructive policies. Our 
legislation will protect and preserve Medicare--not turn senior 
citizens over to the un-tender mercies of HMOs and insurance companies. 
It will provide prescription drug benefit for senior citizens, without 
coverage gaps or hidden loopholes. It will protect senior citizens with 
good retirement coverage from a former employer, and it will protect 
the poorest of the poor on Medicaid. It will reduce prescription drug 
costs, by allowing safe importation of drugs from Canada and government 
negotiations with drug companies for discounts. And it will repeal the 
program of Health Savings Accounts that help the healthy, wealthy and 
insurance companies who have contributed heavily to the Republican 
Party, while harming every family that needs comprehensive, affordable 
health insurance.
  The legislation the President signed is designed to destroy Medicare 
and turn senior citizens over to the un-tender mercies of HMOs. Our 
legislation will protect Medicare.
  The legislation the President signed provides a skimpy, inadequate, 
and unreliable drug benefit. Our legislation provides comprehensive 
drug coverage and assures that senior citizens can get it everywhere in 
the country without having to join an HMO or other private plan.
  The legislation the President signed denies senior citizens the right 
to get safe drugs at lower prices from Canada and prohibits the 
government from negotiating with drug companies to get a good deal for 
senior citizens. This legislation eliminates those special interest, 
anti-senior provisions.
  The legislation the President signed allows unfettered Heath Savings 
Accounts. These accounts are a bonanza for the healthy, the wealthy, 
and for favored insurance companies, but they are a disaster for 
ordinary citizens who need comprehensive coverage and can't afford to 
put thousands of dollars aside to meet medical needs that insurance is 
supposed to cover. This legislation repeals this unwise policy.
  Senior citizens want prescription drug coverage under Medicare, and 
they deserve it. Instead, the President and the Republican Party used 
their control of Congress to attack Medicare itself and force senior 
citizens into HMOs and other private insurance plans. They want to 
privatize Medicare, and if they get away with it, they'll try to 
privatize Social Security too.
  Their legislation raises Medicare payments to HMOs so that Medicare 
can't compete. They use the elderly's own Medicare money to undermine 
the Medicare program they depend on. According to estimates of the 
Medicare Actuary, Medicare already pays 16 percent too much for every 
senior citizen

[[Page S16128]]

who joins an HMO or other private insurance plan, because these 
programs attract the healthiest elderly. IN addition, the Republican 
legislation raises the base payment to 109 percent of what it costs 
Medicare to care for an average senior citizen, without even taking 
into account the health selection bonus the HMOs receive. The total 
overpayment is 25 percent--a whopping $2,000 per senior citizen. And to 
top it all off, the legislation establishes a $12 billion slush fund 
for the new PPO program established by the bill. This isn't 
competition, its corporate welfare--and senior citizens and the 
Medicare program are the losers.
  Their legislation also creates a vast social experiment--called the 
``premium support'' program--using millions of senior citizens as 
guinea pigs. The sole purpose of the experiment is to raise Medicare 
premiums so that senior citizens have to give up their Medicare and 
join an HMO.
  Our legislation eliminates these indefensible overpayments and 
restores parity to the competition between conventional Medicare and 
private sector alternatives. It repeals the premium support program, so 
that senior citizens will have choice, not coercion, when they decide 
whether they prefer conventional Medicare or an HMO.
  The assistance with prescription drug costs their program provides is 
actually very little. Overall, it covers less than 25 percent of the 
drug expenses faced by the elderly. Senior citizens with $1,000 in drug 
expenses would pay 86 percent of the cost out of their own pockets. 
Those with $5,000 in drug expenses would pay 78 percent. When senior 
citizens' drug costs exceed $2,250, they get no benefits at all until 
their costs reach $5,100, even though they have to continue to pay 
premiums. And senior citizens won't necessarily have access to the 
drugs their doctor's prescribe, if they aren't on the formularies of 
the private insurance companies that will administer the benefit. A bus 
ticket to Canada would do more to reduce drug costs for senior citizens 
than this bill.
  Our legislation fills the gaps in the Medicare benefit, so that it 
truly meets the needs of the elderly and is comparable to the 
assistance provided under most private insurance plans and that is 
available to every member of Congress. It assures that the formularies 
offered by the insurance companies administering the program are not 
manipulated by the companies to exclude the drugs senior citizens need 
most.
  Nine million senior citizens--almost one of every four--will actually 
be worse off in their drug coverage under the Bush program than they 
are today. According to the nonpartisan Congressional Budget Office, 
almost 3 million senior citizens with good retiree drug coverage 
through a former employer will lose it as the result of this bill. Six 
million senior citizens and the disabled who have both Medicare and 
Medicaid--the poorest of the poor--will actually pay more and have 
reduced access to the drugs they need. The Bush plan establishes a 
cruel and demeaning assets test, so that millions of senior citizens 
with very low incomes are disqualified from the special assistance they 
need, simply because they have managed to save a little bit for a rainy 
day, or because they have a car that's worth too much or a burial fund, 
or personal property like jewelry or furniture.

  Our legislation addresses these problems. It ends the discriminatory 
treatment of senior citizens with private retirement coverage, so that 
employers do not have an incentive to drop this coverage. It restores 
benefits to dual eligibles--senior citizens with coverage under both 
Medicare and Medicaid--so that they will not be made worse off by the 
new program. It eliminates the assets test.
  The Republican bill does nothing about escalating drug prices. 
Republicans even had the nerve to include a specific prohibition on any 
role by the Federal government in any negotiation on drug prices. The 
Congressional Budget Office has estimated that drug prices will 
actually increase as the result of this bill. No wonder drug company 
stocks are soaring and senior citizens are concerned. Our legislation 
will allow reimportation of drugs from Canada--where drug prices are 
much lower--with stringent controls to assure that any imported drugs 
meet FDA standards. It will allow the Federal government to negotiate 
the best possible price for prescription drugs, so that senior citizens 
and the Medicare program are no longer victimized by exorbitant prices 
that have little relationship to costs or value.
  It's not just seniors who are very concerned. Younger Americans will 
be hurt too. A separate booby trap in the Republican program includes 
tax breaks for the healthy and wealthy to buy private policies with 
very high deductibles that will undermine health insurance for those 
who are not elderly. These tax breaks, called health savings accounts, 
encourage people to buy high deductible policies and put money aside in 
a tax-free savings account. Because the healthy people don't contribute 
to the cost of regular insurance, premiums skyrocket for people who 
can't afford thousands of dollars in out-of-pocket costs before their 
insurance kicks in. The Urban Institute and the American Academy of 
Actuaries have estimated that premiums for regular insurance policies 
could increase 60 percent or more. Our bill repeals this unjustified 
and destructive policy.
  The President's signing of the Republican legislation yesterday was 
the beginning of this fight, not the end. We will never rest until we 
have protected Medicare and provided senior citizens a prescription 
drug benefit that truly meets their needs.
  I ask unanimous consent that a summary of the ``Defense of Medicare 
and Real Prescription Drug Benefit Act'' be printed in the Record.
  There being no objection, the Summary was ordered to be printed in 
the Record, as follows:

   Summary: Provisions of the Defense of Medicare and Real Medicare 
                     Prescription Drug Benefit Act

                      Title 1: Defense of Medicare

  Repeals the premium support demonstration.
  Requires risk adjustment between private sector plans and Medicare. 
Medicare will pay private sector plans an amount reflecting Medicare's 
cost for covering an individual, rather than paying HMOs a large markup 
as a result of failing to adjust for the better health of senior 
citizens who join HMOs.
  Repeals PPO slush fund.
  Pays all private sector plans an amount equivalent to average 
Medicare costs, rather than paying an average of 109 percent of 
Medicare costs, as provided under the current legislation. Phased in 
over 5 years.
  Repeals Medicare spending cap.

   Title II: Establishment of Real Medicare Prescription Drug benefit

  Elminates coverage gap in 2006-2008, beneficiaries will pay 75 
percent coinsurance in the coverage gap. In 2009-2011, they will pay 50 
percent. In 2012 and subsequent years, they will pay the same 25 
percent copayment as under the initial coverage limit.
  Eliminates discriminatory treatment of employer plans.
  Allows Medicaid wrap-around for dual eligibles.
  Eliminates assets test.
  Requires two stand-alone prescription drug plans to avoid federal 
fallback.
  Secretary defines classes and categories under any formula.
  Repeals prohibition on Medigap coverage of prescription drugs. 
Modifies current Medigap policies covering drugs to wrap-around new 
benefit.
  Phases out elimination of state ``clawback.''

            Title III: Reduction in Prescription Drug Prices

  Allows reimportation from Canada with certification and inspection of 
Canadian exporters to assure safety of drugs.
  Repeals prohibition on government negotiating directly with drug 
companies for best prices and gives authority for such negotiations.

               Title VI: Repeals Health Savings Accounts

                                 ______
                                 
      By Mr. WARNER (for himself and Mrs. Clinton):
  S. 1993. A bill to amend title 23, United States Code, to provide a 
highway safety improvement program that includes incentives ot States 
to enact primary safety belt laws; to the Committee on Environment and 
Public Works.

[[Page S16129]]

  Mr. WARNER. Mr. President, I am pleased to introduce today with my 
distinguished colleague from New York, Senator Clinton, the National 
Highway Safety Act of 2003. It would be our intention in the course of 
the deliberations next year on the reauthorization or, as we call it, 
the successive piece of legislation to TEA-21, that this bill, which we 
introduce today, would be incorporated as an amendment.
  As the Congress prepares to consider legislation next year to enact a 
new 6-year surface transportation law to succeed TEA-21, our foremost 
responsibility, in my judgment and in the judgment of many, and in the 
judgment of the President of the United States, must be to improve 
highway safety for the driving public. Simply by increasing the number 
of Americans who will buckle up is the most effective step that can be 
taken to save the their lives and the lives of others. That is the 
single most important step.
  I am privileged to serve on the Environment and Public Works 
Committee that has now completed its markup of the TEA-21 
reauthorization bill. The bill addresses, as it should, highway safety 
measures, such as how to build safer roads, how to do use new 
technologies to improve safety. But, statistics show that the greatest 
measure of safety, again, to drivers, passengers, and possibly third 
parties not connected with the vehicle, is through the use of a 
seatbelt. It is remarkable, the lives that have been saved through the 
use of this simple device. I have, through my career in the Senate--I 
say with modesty--been associated with, and indeed I think in the 
forefront of, trying to move forward on seatbelt legislation. I will 
not belabor what this humble Senator has done working with others 
through the years, but we are very proud today that America has about a 
79 percent use rate of seatbelts. That has been translated into the 
saving of tens of thousands of lives and injuries in automobile 
accidents.
  Those are the facts. Are we just going to have a standstill, or are 
we going to move forward? Senator Clinton and I think we should move 
forward with this somewhat new approach. I will address the technical 
aspects as we go along.
  We have debated the benefits of seatbelt use on many occasions in 
this body, and elsewhere across America. And whether it is in the town 
forums we conduct, town meetings, or here on the floor of the Senate, 
there is always that individual who comes back: Don't tell me what I 
have to do. What does it matter to you, John Warner--or to any other 
colleague with whom I am privileged to serve--what does it matter to 
you whether I buckle up?
  Well, let's take a look. No one disputes that the absence of a 
seatbelt causes more serious loss of life and injury and, to some 
extent, crashes. The statistics show that with the impact associated 
with the crash, to the extent the driver can maintain, as best he can 
control of the vehicle in those fatal microseconds, often fatal, 
perhaps the severity of the crash, and perhaps the loss of life can be 
reduced by the use of a safety belt--simply said.
  Accidents involving unbelted drivers result in a significant cost to 
the wallet, out of your pocket. Many people are rushed from the 
accident scene to various emergency facilities. All of that has the 
initial cost of the law enforcement that responds, the rescue squads 
that respond, and eventually the emergency room or whatever medical 
facility you might have the good fortune to be taken to, to hopefully 
save you your life. That isn't free. There is a cost. Maybe it is a 
hidden cost in the budgets of the towns and the communities and the 
States, but there is definitely a cost. Regrettably, a number of 
persons who suffer those types of injuries are uninsured. Again, the 
cost often devolves down on the good old hard-working taxpayers; in 
most instances, the taxpayers who buckle up.
  This also is rather interesting and fascinating. When an accident 
happens, regrettably, on our roads and highways across this great 
Nation, we try to refrain from rubbernecking. Nevertheless, chances are 
that we take a glance. More often than not, the accident with the 
combined slowdown of those passing the accident causes significant 
congestion for some considerable portion of time. Either the lane in 
which we are traveling moves very slowly because of the accident or, 
indeed, we come to a standstill, as often is the case when a lane is 
closed to clear an accident. That standstill frequently is necessitated 
because of the severity of the injuries experienced in that accident. 
It takes the response team longer in their carefully trained steps to 
extricate the injured person, to give the initial treatment, and then 
to carefully transport that individual, if necessary, to a medical 
facility. That takes time. That road is backed up.
  That is lost time for your mission on the road, be it for business, 
family, or pleasure. That is lost time and productivity. Behind you 
often are trucks and other vehicles involved in commerce. That is lost 
time and delay due to the seriousness occasioned by injuries and 
accidents where there has been the lack of use of seatbelts. It is as 
simple as that.
  The legislation Senator Clinton and I are introducing today will take 
an important step forward for the States to adopt either a primary 
safety belt law, or take steps of their own devising to meet a 90 
percent seat belt use rate--not the Warner-Clinton bill or the 
legislative measure put forth by the administration upon which Senator 
Clinton and I draw for concepts of certain portions. The States can 
decide for themselves how they achieve a 90-percent goal of the use of 
seatbelts in their respective States. That is the purpose of this 
legislation--to move every State to a 90-percent use rate for safety 
belts.
  In a letter dated November 12, 2003, to Chairman Inhofe of the 
Committee on the Environment and Public Works, on which I am privileged 
to serve, Secretary Mineta states:

       President Bush and I believe that increasing safety belt 
     usage rates is the single most effective means to decrease 
     highway fatalities and injuries.

  That is explicit and clear. The Secretary goes on to say:

       The surest way for a State to increase safety belt usage is 
     through the passage of a primary safety belt law.

  I have had this debate with Governors, former Governors, even in this 
Chamber with former Governors. I think they would tell you that a 
primary safety belt law is a tough piece of State legislation to pass 
solely on its own. Frankly, it needs the impetus of Uncle Sam, the 
impetus of the Congress of the United States to move that process in 
the States forward, so the local politicians can shake their fist 
saying, it is Washington that has done it again--more regulation, more 
direction--you know the arguments. But I think quietly in the hearts of 
those State legislatures is the thought that we will improve safety in 
my State. We will improve the chance of survivability on the roads in 
my State. So that is why we are here today. I ask unanimous consent 
that the full text of Secretary Mineta's letter be printed in the 
Record at the conclusion of my remarks.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. WARNER. As provided in our legislation, the Warner-Clinton bill, 
States can increase seatbelt use either by enacting, as I said, a 
primary seatbelt law--everybody knows what a primary seatbelt law is 
and how it works. It means a law enforcement officer can literally stop 
a vehicle if they observe that the individual is not wearing his or her 
seatbelt. It is as simple as that. But a State, if they decide not to 
enact a primary safety belt law, can, by implementing their own 
strategies, whatever they may be--and there is a lot of innovation out 
in the States--that would result in a 90-percent safety belt use rate. 
So that is a challenge to the States.

  The current national belt use, as I said, is 79 percent. But many 
States--those that have the primary law are sometimes at 90, or even 
above 90, but those that do not have the primary seatbelt law are down 
sometimes in the 60 percentile. It is the weight of the primary States 
that carries the percentile and brings it up to 79 from those States 
that don't have an effective law. States with their primary safety belt 
law have the greatest success for drivers wearing seatbelts.
  On an average, States with the primary seatbelt law have a 10 to 15 
percent higher seatbelt use compared to those with a secondary system. 
This demonstrates that secondary seatbelt

[[Page S16130]]

laws are far more limited in their effectiveness than a primary law.
  Essentially, the secondary laws say that if a law enforcement officer 
has cause other than a perceived or actual seatbelt violation--namely, 
the driver didn't have it buckled--if they have cause to stop that car, 
for example, for a speeding offense or a reckless driving offense or 
indeed an accident and they observed there has been no use of the 
seatbelt, then in the course of proceeding to enforce the several laws 
of the State as regards speeding or reckless driving, or whatever the 
case may be, they can add a second penalty to address the absence of 
the use of the seatbelt in that State.
  Drivers are gamblers. They say: Oh, well, don't worry, I will not 
buckle up. State law doesn't require it. Unless they stop me--and they 
are not going to stop me today. It is that gambling attitude that, more 
often than not, will cause an accident. Then it is too late.
  So we come forward today to build on our national programs. We are 
building on what we did in TEA-21. I was privileged to be on the 
committee. I was chairman of the subcommittee 6 years ago. I worked 
with Senator Chafee, who was chairman of the full committee, and we 
drove hard to make progress with the seatbelt laws, and we did it. We 
basically put aside a very considerable sum of money to encourage 
States--again, using their own devices--to increase uses. As a direct 
consequence of what we did in TEA-21, there has been an 11 percent 
increase in these 6 years in the use of seatbelts.
  Sadly, traffic deaths in 2002 rose to the highest level in over a 
decade. It is astonishing. Of the nearly 43,000 people killed on our 
highways, over half were not wearing their seatbelts. That is according 
to the National Highway Traffic Safety Administration. And 9,200 of 
these deaths might have been prevented if the safety belt had been 
used.
  Those are alarming statistics. Automobile crashes are the leading 
cause of death for Americans age 2 to 34. Stop to think of that: age 2, 
that means a child; that means a parent neglected to buckle up a child. 
Automobile crashes are the leading cause of death for Americans age 2 
to 34. That is our Nation's youth. Do we have a higher calling in the 
Congress of the United States than to do everything we can to foster 
the dreams and ambitions and the productivity of our Nation's youth? I 
think not. And this is one of the ways.
  Last year, 6 out of 10 children who died in car crashes did not have 
the belt on--6 out of 10; that is over half. I plead with colleagues to 
join with me, join with the President who has taken this initiative.
  My primary responsibility in the Senate--and this is one of the 
reasons I got interested in this subject--is the welfare of the men and 
women in the Armed Forces. I say to colleagues, again, the statistics 
are tragic. Traffic fatalities are the leading non-combat cause of 
death for our soldiers, sailors, airmen, and marines. They are in that 
high-risk age category, 18 to 35.
  Someone even took a look at the statistics, the total of the 
fatalities last year, and said that represents in deaths approximately 
the size of the average U.S. Army battalion. That is several companies 
and maybe a reinforced element. Just think, that is the magnitude in 
one category of those who serve our United States, the men and women in 
the Armed Forces.
  I cannot think of any reason why we all cannot join behind this 
effort. That alone is a driving impetus for this Senator.
  The time is long overdue for a national policy to strengthen seatbelt 
use rates. I said a national policy, and that is what this bill 
represents, either through States enacting a primary seatbelt law or 
giving far greater attention to public awareness programs that result 
in more drivers and passengers wearing safety belts. Our goal is 90 
percent--90 percent.
  I have been privileged to serve on this committee 17 years, and I, 
together with many others, notably my dear friend and late chairman, 
Senator Chafee, addressed this issue. Our committee is rich in the 
history of focusing revenue from the highway trust fund on effective 
safety programs. It goes back through many chairmen and members of the 
committee.
  With jurisdiction over the largest share of the highway trust fund, 
our committee has had the vision to tackle important national safety 
problems. Regrettably, I report to you that the recent markup of the 
committee on the proposed successor to the TEA-21 legislation, which we 
will take up next year, does provide more funding to help build safer 
roads--that is a step forward--but it does not have, in my judgment, 
that provision which represents a step up from what we did in TEA-21, 
that provision that would represent a recognition for the President's 
initiative. He has taken a decidedly strong initiative to increase the 
use of seatbelts. It is absent from the bill, and that is why, I say 
respectfully to Chairman Inhofe and others on that committee, we need a 
provision to strengthen and to move forward the position of the 
Congress on the issue of increased use of safety belts. That is the 
purpose of this legislation.
  It is just unfortunate, but those with reckless intent quickly 
disregard responsible behavior and drive unbelted at excessive speeds 
and many times with the use of alcohol. So no increased dollars for 
improved road engineering, which is in this bill, can defy in many 
instances and the type of personal conduct that results in reckless 
behavior. It is as simple as that.
  Our automobiles now come equipped with crash avoidance technologies 
and are more crashworthy than ever before, but these advances are only 
part of the solution.
  In repeated testimony before the Environment and Public Works 
Committee, from the administration, our States, safety groups, and the 
highway insurance industry, we are told that three main causes of 
traffic deaths and injuries are unbelted drivers, speed, and alcohol.
  The formula we have devised in this legislation does have a reduction 
in the amount a State receives under this proposed bill that we will 
consider next year when they fail to achieve the 90 percent safety belt 
use rate. It is as simple as that. But the formula is patterned 
directly after the law that is on the books now with respect to the .08 
legal blood alcohol content level.
  The net effect of this legislation is simply to recognize we are 
asking that the same type of sanction policy with regard to one of the 
three major causes of death--alcohol--be equated to a second cause of 
death and injury, and that is absence of the use of seatbelts, bringing 
into parallel two of the three principal causes of death and injury on 
today's highways.
  The administration put forward an innovative safety belt program, as 
I said, under the leadership of the President that was a major 
component of their new core transportation program, the Highway Safety 
Improvement Program. Regrettably, this recommendation is not included 
in the bill that will come before my committee next year as a 
consequence of the markup seeking reauthorization of TEA-21.
  The proposed reauthorization bill also does not include the current 
program, the Safety Belt Incentive Grant program, that we even had in 
the previous highway bill, of which I was primarily one of the authors. 
Not only are we not going forward, but in a sense we are stepping 
backwards. I just cannot understand how we can, as a body, not observe 
our responsibility to do what we can to provide the necessary incentive 
to the States to take these steps.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1993

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``National Highway Safety Act 
     of 2003''.

     SEC. 2. HIGHWAY SAFETY IMPROVEMENT PROGRAM.

       (a) Safety Improvement.--
       (1) In general.--Section 148 of title 23, United States 
     Code, is amended to read as follows:

     ``Sec. 148. Highway safety improvement program

       ``(a) Definitions.--In this section:
       ``(1) Highway safety improvement program.--The term 
     `highway safety improvement program' means the program 
     carried out under this section.
       ``(2) Highway safety improvement project.--
       ``(A) In general.--The term `highway safety improvement 
     project' means a project described in the State strategic 
     highway safety plan that--

[[Page S16131]]

       ``(i) corrects or improves a hazardous road location or 
     feature; or
       ``(ii) addresses a highway safety problem.
       ``(B) Inclusions.--The term `highway safety improvement 
     project' includes a project for--
       ``(i) an intersection safety improvement;
       ``(ii) pavement and shoulder widening (including addition 
     of a passing lane to remedy an unsafe condition);
       ``(iii) installation of rumble strips or another warning 
     device, if the rumble strips or other warning devices do not 
     adversely affect the safety or mobility of bicyclists and 
     pedestrians;
       ``(iv) installation of a skid-resistant surface at an 
     intersection or other location with a high frequency of 
     accidents;
       ``(v) an improvement for pedestrian or bicyclist safety;
       ``(vi)(I) construction of any project for the elimination 
     of hazards at a railway-highway crossing that is eligible for 
     funding under section 130, including the separation or 
     protection of grades at railway-highway crossings;
       ``(II) construction of a railway-highway crossing safety 
     feature; or
       ``(III) the conduct of a model traffic enforcement activity 
     at a railway-highway crossing;
       ``(vii) construction of a traffic calming feature;
       ``(viii) elimination of a roadside obstacle;
       ``(ix) improvement of highway signage and pavement 
     markings;
       ``(x) installation of a priority control system for 
     emergency vehicles at signalized intersections;
       ``(xi) installation of a traffic control or other warning 
     device at a location with high accident potential;
       ``(xii) safety-conscious planning;
       ``(xiii) improvement in the collection and analysis of 
     crash data;
       ``(xiv) planning, equipment, operational activities, or 
     traffic enforcement activities (including police assistance) 
     relating to workzone safety;
       ``(xv) installation of guardrails, barriers (including 
     barriers between construction work zones and traffic lanes 
     for the safety of motorists and workers), and crash 
     attenuators;
       ``(xvi) the addition or retrofitting of structures or other 
     measures to eliminate or reduce accidents involving vehicles 
     and wildlife; or
       ``(xvii) installation and maintenance of signs (including 
     fluorescent, yellow-green signs) at pedestrian-bicycle 
     crossings and in school zones.
       ``(3) Primary safety belt law.--The term `primary safety 
     belt law' means a law that authorizes a law enforcement 
     officer to issue a citation for the failure of the operator 
     of, or any passenger in, a motor vehicle to wear a safety 
     belt as required by State law, based solely on that failure 
     and without regard to whether there is any other violation of 
     law.
       ``(4) Safety project under any other section.--
       ``(A) In general.--The term `safety project under any other 
     section' means a project carried out for the purpose of 
     safety under any other section of this title.
       ``(B) Inclusion.--The term `safety project under any other 
     section' includes a project to--
       ``(i) promote the awareness of the public and educate the 
     public concerning highway safety matters; or
       ``(ii) enforce highway safety laws.
       ``(5) State highway safety improvement program.--The term 
     `State highway safety improvement program' means projects or 
     strategies included in the State strategic highway safety 
     plan carried out as part of the State transportation 
     improvement program under section 135(f).
       ``(6) State strategic highway safety plan.--The term `State 
     strategic highway safety plan' means a plan developed by the 
     State transportation department that--
       ``(A) is developed after consultation with--
       ``(i) a highway safety representative of the Governor of 
     the State;
       ``(ii) regional transportation planning organizations, if 
     any;
       ``(iii) representatives of major modes of transportation;
       ``(iv) local traffic enforcement officials;
       ``(v) persons responsible for administering section 130 at 
     the State level;
       ``(vi) representatives conducting Operation Lifesaver;
       ``(vii) representatives conducting a motor carrier safety 
     program under section 31104 or 31107 of title 49;
       ``(viii) motor vehicle administration agencies; and
       ``(ix) other major State and local safety stakeholders;
       ``(B) analyzes and makes effective use of State, regional, 
     or local crash data;
       ``(C) addresses engineering, management, operation, 
     education, enforcement, and emergency services elements of 
     highway safety as key factors in evaluating highway projects;
       ``(D) considers safety needs of, and high-fatality segments 
     of, public roads;
       ``(E) considers the results of State, regional, or local 
     transportation and highway safety planning processes in 
     existence as of the date of enactment of this section;
       ``(F) describes a program of projects or strategies to 
     reduce or eliminate safety hazards;
       ``(G) is approved by the Governor of the State or a 
     responsible State agency; and
       ``(H) is consistent with the requirements of section 
     135(f).
       ``(b) Program.--
       ``(1) In general.--The Secretary shall carry out a highway 
     safety improvement program.
       ``(2) Purpose.--The purpose of the highway safety 
     improvement program shall be to achieve a significant 
     reduction in traffic fatalities and serious injuries on 
     public roads.
       ``(c) Eligibility.--
       ``(1) In general.--To receive funds under this section, a 
     State shall have in effect a State highway safety improvement 
     program under which the State--
       ``(A) develops and implements a State strategic highway 
     safety plan that identifies and analyzes highway safety 
     problems and opportunities as provided in paragraph (2);
       ``(B) produces a program of projects or strategies to 
     reduce identified safety problems; and
       ``(C) evaluates the plan on a regular basis to ensure the 
     accuracy of the data and priority of proposed improvements.
       ``(2) Identification and analysis of highway safety 
     problems and opportunities.--As part of the State strategic 
     highway safety plan, a State shall--
       ``(A) have in place a crash data system with the ability to 
     perform safety problem identification and countermeasure 
     analysis;
       ``(B) based on the analysis required by subparagraph (A), 
     identify hazardous locations, sections, and elements 
     (including roadside obstacles, railway-highway crossing 
     needs, and unmarked or poorly marked roads) that constitute a 
     danger to motorists, bicyclists, pedestrians, and other 
     highway users;
       ``(C) adopt strategic and performance-based goals that--
       ``(i) address traffic safety, including behavioral and 
     infrastructure problems and opportunities on all roads and 
     bridges on the Federal-aid system;
       ``(ii) focus resources on areas of greatest need; and
       ``(iii) are coordinated with other State highway safety 
     programs;
       ``(D) advance the capabilities of the State for traffic 
     records data collection, analysis, and integration with other 
     sources of safety data (such as road inventories) in a manner 
     that--
       ``(i) complements the State highway safety program under 
     chapter 4 and the commercial vehicle safety plan under 
     section 31102 of title 49;
       ``(ii) includes all roads and bridges on the Federal-aid 
     system; and
       ``(iii) identifies hazardous locations, sections, and 
     elements on public roads that constitute a danger to 
     motorists, bicyclists, and pedestrians;
       ``(E)(i) determine priorities for the correction of 
     hazardous road locations, sections, and elements (including 
     railway-highway crossing improvements), as identified through 
     crash data analysis;
       ``(ii) identify opportunities for preventing the 
     development of such hazardous conditions; and
       ``(iii) establish and implement a schedule of highway 
     safety improvement projects for hazard correction and hazard 
     prevention; and
       ``(F)(i) establish an evaluation process to analyze and 
     assess results achieved by highway safety improvement 
     projects carried out in accordance with procedures and 
     criteria established by this section; and
       ``(ii) use the information obtained under clause (i) in 
     setting priorities for highway safety improvement projects.
       ``(d) Eligible Projects.--
       ``(1) In general.--A State may obligate funds apportioned 
     to the State under this section to carry out--
       ``(A) any highway safety improvement project on any--
       ``(i) road or bridge on the Federal-aid system; or
       ``(ii) publicly owned bicycle or pedestrian pathway or 
     trail; or
       ``(B) as provided in subsection (e), for other safety 
     projects.
       ``(2) Use of other funding for safety.--
       ``(A) Effect of section.--Nothing in this section prohibits 
     the use of funds made available under other provisions of 
     this title for highway safety improvement projects.
       ``(B) Use of other funds.--States are encouraged to address 
     the full scope of their safety needs and opportunities by 
     using funds made available under other provisions of this 
     title (except a provision that specifically prohibits that 
     use).
       ``(e) Flexible Funding for States With a Strategic Highway 
     Safety Plan.--
       ``(1) In general.--To further the implementation of a State 
     strategic highway safety plan, a State may use up to 25 
     percent of the amount of funds made available under this 
     section for a fiscal year to carry out safety projects under 
     any other section as provided in the State strategic highway 
     safety plan.
       ``(2) Other transportation and highway safety plans.--
     Nothing in this subsection requires a State to revise any 
     State process, plan, or program in effect on the date of 
     enactment of this section.
       ``(f) Reports.--
       ``(1) In general.--A State shall submit to the Secretary a 
     report that--
       ``(A) describes progress being made to implement highway 
     safety improvement projects under this section;
       ``(B) assesses the effectiveness of those improvements; and
       ``(C) describes the extent to which the improvements funded 
     under this section contribute to the goals of--

[[Page S16132]]

       ``(i) reducing the number of fatalities on roadways;
       ``(ii) reducing the number of roadway-related injuries;
       ``(iii) reducing the occurrences of roadway-related 
     accidents;
       ``(iv) mitigating the consequences of roadway-related 
     accidents; and
       ``(v) reducing the occurrences of roadway-railroad grade 
     crossing accidents.
       ``(2) Contents; schedule.--The Secretary shall establish 
     the content and schedule for a report under paragraph (1).
       ``(g) Federal Share of Highway Safety Improvement 
     Projects.--The Federal share of the cost of a highway safety 
     improvement project carried out with funds made available 
     under this section shall be 90 percent.
       ``(h) Use of Funds.--
       ``(1) Projects under section 402.--For fiscal year 2005 and 
     each fiscal year thereafter, 10 percent of the funds made 
     available to a State under this section shall be obligated 
     for projects under section 402, unless by October 1 of the 
     fiscal year, the State--
       ``(A) has in effect a primary safety belt law; or
       ``(B) demonstrates that the safety belt use rate in the 
     State is at least 90 percent.
       ``(2) Withholding.--
       ``(A) In general.--For fiscal year 2007, the Secretary 
     shall withhold 2 percent, and for each fiscal year 
     thereafter, the Secretary shall withhold 4 percent, of the 
     funds apportioned to a State under paragraphs (1), (3), and 
     (4) of section 104(b) and section 144 if, by October 1 of 
     that fiscal year, the State does not--
       ``(i) have in effect a primary safety belt law; or
       ``(ii) demonstrate that the safety belt use rate in the 
     State is at least 90 percent.
       ``(B) Restoration.--If, within 3 years after the date on 
     which funds are withheld from a State under subparagraph (A), 
     the State has in effect a primary safety belt law or has 
     demonstrated that the safety belt use rate in the State is at 
     least 90 percent, the apportionment of the State shall be 
     increased by the amount withheld.
       ``(C) Lapse.--If, within 3 years after the date on which 
     funds are withheld from a State under subparagraph (A), the 
     State does not have in effect a primary safety belt law or 
     has not demonstrated that the safety belt use rate in the 
     State is at least 90 percent, the amount withheld shall 
     lapse.''.
       (2) Allocations of apportioned funds.--Section 133(d) of 
     title 23, United States Code, is amended--
       (A) by striking paragraph (1);
       (B) by redesignating paragraphs (2) through (5) as 
     paragraphs (1) through (4), respectively;
       (C) in paragraph (2) (as redesignated by subparagraph 
     (B))--
       (i) in the first sentence of subparagraph (A)--

       (I) by striking ``subparagraphs (C) and (D)'' and inserting 
     ``subparagraph (C)''; and
       (II) by striking ``80 percent'' and inserting ``90 
     percent'';

       (ii) by striking subparagraph (C);
       (iii) by redesignating subparagraphs (D) and (E) as 
     subparagraphs (C) and (D), respectively; and
       (iv) in subparagraph (C) (as redesignated by clause (iii)), 
     by adding a period at the end; and
       (D) in paragraph (4)(A) (as redesignated by subparagraph 
     (B)), by striking ``paragraph (2)'' and inserting ``paragraph 
     (1)''.
       (3) Conforming amendments.--
       (A) Chapter 1 of title 23, United States Code, is amended 
     by striking the item relating to section 148 and inserting 
     the following:

``148. Highway safety improvement program.''.

       (b) Apportionment of Highway Safety Improvement Program 
     Funds.--Section 104(b) of title 23, United States Code, is 
     amended--
       (1) in the matter preceding paragraph (1), by inserting 
     after ``Improvement program,'' the following: ``the highway 
     safety improvement program,''; and
       (2) by adding at the end the following:
       ``(5) Highway safety improvement program.--
       ``(A) In general.--For the highway safety improvement 
     program, in accordance with the following formula:
       ``(i) 25 percent of the apportionments in the ratio that--

       ``(I) the total lane miles of Federal-aid highways in each 
     State; bears to
       ``(II) the total lane miles of Federal-aid highways in all 
     States.

       ``(ii) 40 percent of the apportionments in the ratio that--

       ``(I) the total vehicle miles traveled on lanes on Federal-
     aid highways in each State; bears to
       ``(II) the total vehicle miles traveled on lanes on 
     Federal-aid highways in all States.

       ``(iii) 35 percent of the apportionments in the ratio 
     that--

       ``(I) the estimated tax payments attributable to highway 
     users in each State paid into the Highway Trust Fund (other 
     than the Mass Transit Account) in the latest fiscal year for 
     which data are available; bears to
       ``(II) the estimated tax payments attributable to highway 
     users in all States paid into the Highway Trust Fund (other 
     than the Mass Transit Account) in the latest fiscal year for 
     which data are available.

       ``(B) Minimum apportionment.--Notwithstanding subparagraph 
     (A), each State shall receive a minimum of \1/2\ of 1 percent 
     of the funds apportioned under this paragraph.''.
       (c) Elimination of Hazards Relating to Highway 
     Facilities.--
       (1) Funds for protective devices.--Section 130(e) of title 
     23, United States Code, is amended--
       (A) in the heading, by striking ``Protective Devices'' and 
     inserting ``Railway-Highway Crossings'';
       (B) by striking the first sentence and inserting the 
     following:
       ``(1) In general.--For each fiscal year, at least 
     $200,000,000 of the funds authorized and expended under 
     section 148 shall be available for the elimination of hazards 
     and the installation of protective devices at railway-highway 
     crossings.''; and
       (C) by striking ``Sums authorized'' and inserting the 
     following:
       ``(2) Obligation.--Sums authorized''.
       (2) Biennial reports to congress.--Section 130(g) of title 
     23, United States Code, is amended in the third sentence--
       (A) by inserting ``and the Committee on Commerce, Science, 
     and Transportation,'' after ``Public Works''; and
       (B) by striking ``not later than April 1 of each year'' and 
     inserting ``every other year''.
       (3) Expenditure of funds; apportionment.--Section 130 of 
     title 23, United States Code, is amended by adding at the end 
     the following:
       ``(k) Expenditure of Funds; Apportionment.--Funds made 
     available to carry out this section shall be--
       ``(1) available for expenditure on compilation and analysis 
     of data in support of activities carried out under subsection 
     (g); and
       ``(2) apportioned in accordance with section 104(b)(5).''.
       (d) Transition.--
       (1) Implementation.--Except as provided in paragraph (2), 
     to qualify for funding under section 148 of title 23, United 
     States Code (as amended by subsection (a)), a State shall 
     develop and implement a State strategic highway safety plan 
     as required by subsection (c) of that section not later than 
     October 1 of the second fiscal year after the date of 
     enactment of this Act.
       (2) Interim period.--
       (A) In general.--Before October 1 of the second fiscal year 
     after the date of enactment of this Act and until the date on 
     which a State develops and implements a State strategic 
     highway safety plan, the Secretary shall apportion funds to a 
     State for the highway safety improvement program and the 
     State may obligate funds apportioned to the State for the 
     highway safety improvement program under section 148 for 
     projects that were eligible for funding under sections 130 
     and 152 of that title, as in effect on the day before the 
     date of enactment of this Act.
       (B) No strategic highway safety plan.--If a State has not 
     developed a strategic highway safety plan by October 1 of the 
     second fiscal year after the date of enactment of this Act, 
     but demonstrates to the satisfaction of the Secretary that 
     progress is being made toward developing and implementing 
     such a plan, the Secretary shall continue to apportion funds 
     for 1 additional fiscal year for the highway safety 
     improvement program under section 148 of title 23, United 
     States Code, to the State, and the State may continue to 
     obligate funds apportioned to the State under this section 
     for projects that were eligible for funding under sections 
     130 and 152 of that title, as in effect on the day before the 
     date of enactment of this Act.
       (C) Penalty.--If a State has not adopted a strategic 
     highway safety plan by the date that is 2 years after the 
     date of enactment of this Act, funds made available to the 
     State under section 1101(6) shall be redistributed to other 
     States in accordance with section 104(b) of title 23, United 
     States Code.

                                   Secretary of Transportation

                                Washington, DC, November 12, 2003.
     Hon. James Inhofe,
     Chairman, Committee on Environment and Public Works, U.S. 
         Senate, Washington, DC.
       Dear Mr. Chairman: With almost 43,000 people dying every 
     year on our nation's highway, it is imperative that we do 
     everything in our power to promote a safer transportation 
     system. The Bush Administration's proposal to reauthorize 
     surface transportation programs, the Safe, Accountable, 
     Flexible and Efficient Transportation Equity Act of 2003 
     (SAFETEA), offers several bold and innovative approaches to 
     address this crisis.
       President Bush and I believe that increasing safety belt 
     usage rates is the single most effective means to decrease 
     highway fatalities and injuries. As a result, SAFETEA's new 
     core highway safety program provides States with powerful 
     funding incentives to increase the percentage of Americans 
     who buckle up every time they get in an automobile. Every 
     percentage point increase in the national safety belt usage 
     rate saves hundreds of lives and millions of dollars in lost 
     productivity.
       Empirical evidence shows that the surest way for a State to 
     increase safety belt usage is through the passage of a 
     primary safety belt law. States with primary belt laws have 
     safety belt usage rates that are on average eight percentage 
     points higher than States with secondary laws. Recognizing 
     that States may have other innovative methods to achieve 
     higher rates of belt use, SAFETEA also rewards States that 
     achieve 90% safety belt usage rates even if a primary safety 
     belt law is not enacted. I urge you to consider these 
     approaches as your Committee marks up reauthorization 
     legislation.
       While safety belts are obviously critical to reducing 
     highway fatalities, so too is a data

[[Page S16133]]

     driven approach to providing safety. Every State faces its 
     own unique safety challenges, and every State must be given 
     broad funding flexibility to solve those challenges. This is 
     a central theme of SAFETEA, which aims to provide States the 
     ability to use scarce resources to meet their own highest 
     priority needs. Such flexibility is essential for States to 
     maximize their resources, including the funds available under 
     a new core highway safety program.
       I look forward to working with you on these critically 
     important safety issues as development of a surface 
     transportation reauthorization bill progresses.
           Sincerely yours,
                                                 Norman Y. Mineta.

  Mr. DeWINE. Mr. President, let me first congratulate my colleague 
from Virginia, Senator Warner, for the very fine statement he just made 
a moment ago about the bill that he and Senator Clinton are introducing 
with regard to the primary seatbelt law. This is something I have been 
interested in for some time. I congratulate them for their very fine 
bill and Senator Warner's very fine statement. He is absolutely 
correct. If we are serious about saving lives on our highways in this 
country, there really is nothing more important that we can do than to 
get our fellow citizens to buckle up.
  We have made great progress in this area, but the fact that many of 
our States do not have a primary seatbelt law on the books costs us 
thousands and thousands of lives each year. As my colleague from 
Virginia so eloquently stated in this Chamber a few minutes ago, all 
the experts--everyone who knows anything about highway safety--will 
tell you that the most important thing that we could do and the easiest 
thing we could do would be to have every State of the Union tomorrow, 
instantly, have a primary seatbelt safety law.
  That simply means if law enforcement, instead of having to wait for 
another type of violation before they could cite someone for not 
wearing a seatbelt could cite someone directly for not using a 
seatbelt, the use of seatbelts would dramatically increase in this 
country. That is what has happened in every single State that has had 
these laws enacted. Seatbelt use dramatically goes up almost overnight.
  We know there is an inverse relationship between the use of seatbelts 
and auto fatalities. Thousands and thousands of Americans' lives would 
be saved every single year. I wanted to come to the floor this 
afternoon after I listened to my colleague's speech in my office. I 
wanted to thank him. He has been a real leader in the area of highway 
safety and this is certainly one more example of his leadership.
  When we take up the highway safety bill next year, there are a number 
of highway safety initiatives on which I have been working. I intend to 
bring them to the floor and talk about them and offer them as 
amendments, offer them as initiatives. Frankly, there is nothing as 
important as what my colleague from Virginia has suggested.
  I hope the Senate will take this very seriously. This is a great 
opportunity we will have to save thousands and thousands of lives every 
year. So I salute my colleague from Virginia.
                                 ______
                                 
      By Mr. DASCHLE (for Mr. Feingold):
  S. 1994. A bill to amend part D of title XVIII of the Social security 
Act to strike the language that prohibits the Secretary of Health and 
Human Services from negotiating prices for prescription drugs furnished 
under the Medicare program; to the Committee on Finance.
  (At the request of Mr. Daschle, the following statement was ordered 
to be printed in the Record.)
  Mr. FEINGOLD. Mr. President, today I am introducing a bill 
that will fix one of the fundamental flaws in the new Medicare 
prescription drug benefit. The ``Efficiency in Government Health Care 
Spending Act'' will remove language included in the new benefit that 
prohibits the Medicare program from negotiating prescription drug 
prices with manufacturers. The new Medicare prescription drug benefit 
does far too little to bring down the prices of prescription drugs. In 
fact, it actually takes away one of the best tools the Medicare program 
could use in bringing down prescription drug prices by denying the 
government the ability to negotiate price discounts on behalf of 
Medicare beneficiaries. My bill will allow the Federal Government to 
take advantage of the purchasing power of the Medicare program 
Medicare, saving millions of taxpayers' dollars while reducing the 
costs of prescription drugs for Medicare beneficiaries.
  I ask unanimous consent that the text of this legislation be printed 
in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1994

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Efficiency in Government 
     Health Care Spending Act''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) Prohibiting the Federal Government from negotiating 
     prescription drug prices with manufacturers fails to take 
     advantage of the purchasing power of the Medicare program.
       (2) Negotiating prescription drug prices can reduce the 
     costs of prescription drugs for both the Medicare program and 
     taxpayers.
       (3) A 2002 study by the inspector general of the Department 
     of Health and Human Services found that--
       (A) both the Medicare program and the beneficiaries of the 
     Medicare program continually pay too much for medical 
     equipment and medical supplies; and
       (B) if the Medicare program paid the same prices for 16 
     health care supplies as the Department of Veterans Affairs, 
     which directly negotiates prices with manufacturers, pays for 
     those supplies, the Federal Government could save 
     $958,000,000 each year.

     SEC. 3. ELIMINATION OF PROHIBITION OF NEGOTIATION OF PRICES.

       (a) Repeal of Noninterference Provision.--
       (1) In general.--Subsection (i) of section 1860D-11 of the 
     Social Security Act, as added by section 101 of the Medicare 
     Prescription Drug, Improvement, and Modernization Act of 
     2003, is repealed.
       (2) Conforming amendment.--Subsection (j) of section 1860D-
     11 of the Social Security Act, as added by section 101 of the 
     Medicare Prescription Drug, Improvement, and Modernization 
     Act of 2003, is redesignated as subsection (i).
       (b) Effective Date.--The amendments made by this section 
     shall take effect as if included in the enactment of section 
     101 of the Medicare Prescription Drug, Improvement, and 
     Modernization Act of 2003.
                                 ______
                                 
      By Mr. DASCHLE (for Mr. Feingold):
  S. 1995. A bill to amend title XVIII of the Social Security Act to 
repeal the MA Regional Plan Stabilization Fund; to the Committee on 
Finance.
 Mr. FEINGOLD. Mr. President, today I am introducing a bill 
that will remove the multi-billion dollar ``stabilization fund'' from 
the new Medicare prescription drug benefit. This stabilization fund is 
in essence a slush fund that gives billions of dollars to private 
insurance companies. This is not an efficient use of taxpayers' 
dollars. In fact, it's not clear why it's even necessary. If private 
managed care plans are successful in bring costs down, as backers of 
the new Medicare bill expect, and if seniors supposedly want to choose 
private plans, as backers of the new Medicare bill believe, then why 
should American taxpayers pay private companies more money to get more 
people to enroll in them?
  We should not be subsidizing private health insurance companies in 
the name of Medicare reform. It is fiscally irresponsible, in a time of 
record deficits, to use taxpayers' dollars as a giveaway to private 
insurance companies. By removing this multi-billion slush fund, my bill 
will save the American taxpayers billions of dollars. Many analysts 
predict that the new Medicare prescription drug benefit will surpass 
the $400 billion budgeted for it. We need to look carefully at how we 
spend Medicare dollars, so that we can ensure that the program remains 
solvent for future generations.
  I ask unanimous consent that the text of this legislation be printed 
in the Record.
  (At the request of Mr. Daschle, the following statement was ordered 
to be printed in the Record.)
  There being no objectin, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1995

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. REPEAL OF MA REGIONAL PLAN STABILIZATION FUND.

       (a) Purpose of Section.--The purpose of this section is to 
     reduce the Federal budget deficit and to more efficiently use 
     taxpayer dollars in health care spending.
       (b) Repeal of MA Regional Plan Stabilization Fund.--Section 
     1858 of the Social Security Act, as added by section 221(c) 
     of the Medicare Prescription Drug, Improvement, and 
     Modernization Act of 2003, is amended--

[[Page S16134]]

       (1) by striking subsection (e);
       (2) by redesignating subsections (f), (g), and (h) as 
     subsections (e), (f), and (g), respectively; and
       (3) in subsection (e), as so redesignated, by striking 
     ``subject to subsection (e),''.
       (c) Conforming Amendment.--Section 1851(i)(2) of the Social 
     Security Act (42 U.S.C. 1395w-21(i)(2)), as amended by 
     section 221(d)(5) of the Medicare Prescription Drug, 
     Improvement, and Modernization Act of 2003, is amended by 
     striking``1858(h)'' and inserting ``1858(g)''.
       (d) Effective Date.--The amendments made by this section 
     shall take effect as if included in the enactment of the 
     Medicare Prescription Drug, Improvement, and Modernization 
     Act of 2003.
                                 ______
                                 
      By Mr. DASCHLE:
  S. 1996. A bill to enhance and provide to the Oglada Sioux Tribe and 
Angostura Irrigation Project certain benefits of the Pick-Sloan 
Missouri River basin program; to the Committee on Indian Affairs.
  Mr. DASCHLE. Mr. President, today I am introducing the Oglala Sioux 
Tribe Angostura Irrigation Project Rehabilitation and Development Act. 
I have worked with the leadership of the Oglala Sioux Tribe to develop 
this legislation, which is intended to benefit the Lakota people by 
restoring critical water resources and promoting economic development 
on the Pine Ridge Indian Reservation.
  The Angostura Unit of the Bureau of Reclamation was first authorized 
by Congress under the Water Conservation and Utilization Act of 1939, 
and later continued under the Flood Control Act of 1944, otherwise 
known as the Pick-Sloan Missouri River Basin Project. The program 
consisted primarily of building the six mainstem dams on the Missouri 
River, to be operated by the U.S. Army Corps of Engineers, along with 
several Bureau-operated irrigation and water development projects. The 
Angostura Unit was designed to provide irrigation to 12,218 acres of 
farm and ranch land in the Angostura Irrigation District, as well as 
flood control, fish, and wildlife benefits.
  Tribes in South Dakota existed long before the creation of the Bureau 
of Reclamation or the implementation of the water development projects 
in South Dakota today. Tribes therefore have a vested interest in the 
operation of these projects. While the projects have been helpful in 
meeting their authorized goals, they also contribute to adverse 
economic and environmental conditions on tribal reservations. In 
particular, the Missouri River reservoirs managed by the Corps led to 
the taking of thousands of acres of fertile river land from Indian 
tribes, and with that taking, the tribes lost valuable natural 
resources.
  Federal agencies were directed through subsequent acts to provide for 
the rehabilitation of the lost fish and wildlife habitat and to 
generally improve conditions on the reservations, but results were slow 
in coming, and often never materialized. Legislation was enacted 
several years ago to finally address some of these issues, but much 
more remains to be done before South Dakota's tribes realize the 
benefits that Bureau of Reclamation and Corps projects have provided 
other parts of the state.
  In addition to the irrigation benefits the Angostura Unit provides to 
ranchers and agricultural producers in the area, a substantial 
recreation industry has developed around the reservoir, including 
boating and fishing. However, members of the Oglala Sioux on the Pine 
Ridge Indian Reservation have not seen equal economic benefits from the 
Angostura Unit as those experienced from the recreation and irrigation 
in Fall River County. The Cheyenne River forms the northern boundary of 
the reservation, which is just 20 miles downstream from the reservoir, 
and is an important natural resource for the tribe. The river is 
essential to the survival of riparian vegetation, traditional medicinal 
plants, fish, and wildlife habitat. The impoundment of water in the 
reservoir has curbed the Cheyenne River's natural flow, and water 
quality is reduced. This, coupled with the worst drought the region has 
seen in a decade, severely affects water resources on the reservation.
  The Oglala Sioux Tribe's leadership has long had a desire to address 
these problems, and this legislation is an important manifestation of 
their effort. During revision of the Angostura Unit's water management 
plan in 2002, the Bureau of Reclamation considered a variety of 
alternatives for future operations, but the tribe felt their concerns 
about the economic and environmental effects the reservoir has on the 
reservation were not adequately addressed. One alternative considered 
by the Bureau of Reclamation during this review would return natural 
flows to the Cheyenne River, and would provide more water downstream 
for the tribe and would improve reservation conditions. The Bureau took 
a different approach, however--one that calls for improved irrigation 
operations and a more efficient distribution of water resources in the 
irrigation district. These improvements would help free up additional 
water resources and hopefully lead to improved conditions on the 
Cheyenne River that would benefit the tribe.
  The Angostura Irrigation Project Rehabilitation and Development Act 
would authorize the efficiency improvements proposed by the Bureau of 
Reclamation, benefitting both existing water users and the tribe. The 
legislation also would authorize the creation of a trust fund to 
compensate the tribe for the economic impacts and lost natural 
resources caused by the operation of the Angostura Unit. This trust 
fund will be used by the tribe to promote economic development, improve 
infrastructure, and enhance the education, health, and general welfare 
of the Oglala Lakota people. This dual track will both help ensure 
continued and efficient operation of the Angostura Unit and the 
Angostura Irrigation District, while helping to mitigate the problems 
facing the Oglala Sioux Tribe, and providing the tribe with the natural 
and financial resources it needs to plan for the future and improve the 
quality of life for all tribal members.
  This legislation is just one small, yet important, step toward 
ensuring that U.S. natural resource policies are fair to American 
Indians, and I look forward to working with my colleagues to enact it.
  I ask unanimous consent that the text of the legislation be printed 
in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1996

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Oglala Sioux Tribe Angostura 
     Irrigation Project Rehabilitation and Development Act''.

     SEC. 2. FINDINGS.

       Congress finds that--
       (1) Congress approved the Pick-Sloan Missouri River basin 
     program by passing the Act of December 22, 1944 (commonly 
     known as the ``Flood Control Act of 1944'') (33 U.S.C. 701-1 
     et seq.)--
       (A) to promote the economic development of the United 
     States;
       (B) to provide for irrigation in regions north of Sioux 
     City, Iowa;
       (C) to protect urban and rural areas from devastating 
     floods of the Missouri River; and
       (D) for other purposes;
       (2) the Angostura Unit--
       (A) is a component of the Pick-Sloan program; and
       (B) provides for--
       (i) irrigation of 12,218 acres of productive farm land in 
     the State; and
       (ii) substantial recreation and fish and wildlife benefits;
       (3) the Commissioner of Reclamation has determined that--
       (A) the national economic development benefits from 
     irrigation at the Angostura Unit total approximately 
     $3,410,000 annually; and
       (B) the national economic development benefits of 
     recreation at Angostura Reservoir total approximately 
     $7,100,000 annually;
       (4) the Angostura Unit impounds the Cheyenne River 20 miles 
     upstream of the Pine Ridge Indian Reservation in the State;
       (5)(A) the Reservation experiences extremely high rates of 
     unemployment and poverty; and
       (B) there is a need for economic development on the 
     Reservation;
       (6) the national economic development benefits of the 
     Angostura Unit do not extend to the Reservation;
       (7) the Angostura Unit may be associated with negative 
     affects on water quality and riparian vegetation in the 
     Cheyenne River on the Reservation;
       (8) rehabilitation of the irrigation facilities at the 
     Angostura Unit would--
       (A) enhance the national economic development benefits of 
     the Angostura Unit; and
       (B) result in improved water efficiency and environmental 
     restoration benefits on the Reservation; and
       (9) the establishment of a trust fund for the Oglala Sioux 
     Tribe would--

[[Page S16135]]

       (A) produce economic development benefits for the 
     Reservation comparable to the benefits produced at the 
     Angostura Unit; and
       (B) provide resources that are necessary for restoration of 
     the Cheyenne River corridor on the Reservation.

     SEC. 3. DEFINITIONS.

       In this Act:
       (1) Angostura unit.--The term ``Angostura Unit'' means the 
     irrigation unit of the Angostura irrigation project developed 
     under the Act of August 11, 1939 (16 U.S.C. 590y et seq.).
       (2) Fund.--The term ``Fund'' means the Oglala Sioux Tribal 
     Development Trust Fund established by section 201(a).
       (3) Pick-sloan program.--The term ``Pick-Sloan program'' 
     means the Pick-Sloan Missouri River basin program approved 
     under the Act of December 22, 1944 (commonly known as the 
     ``Flood Control Act of 1944'') (33 U.S.C. 701-1 et seq.).
       (4) Plan.--The term ``plan'' means the development plan 
     developed by the Tribe under section 201(f).
       (5) Reservation.--The term ``Reservation'' means the Pine 
     Ridge Indian Reservation in the State.
       (6) Secretary.--The term ``Secretary'' means the Secretary 
     of the Interior.
       (7) State.--The term ``State'' means the State of South 
     Dakota.
       (8) Tribal council.--The term ``Tribal Council'' means the 
     governing body of the Tribe.
       (9) Tribe.--The term ``Tribe'' means the Oglala Sioux Tribe 
     of South Dakota.

                        TITLE I--REHABILITATION

     SEC. 101. REHABILITATION OF FACILITIES AT ANGOSTURA UNIT.

       The Secretary may carry out the rehabilitation and 
     improvement of the facilities at the Angostura Project 
     described in the report entitled ``Angostura Unit Contract 
     Negotiation and Water Management Final Environmental Impact 
     Statement'', dated August 2002.

     SEC. 102. DELIVERY OF WATER TO PINE RIDGE INDIAN RESERVATION.

       The Secretary shall provide for--
       (1) to the maximum extent practicable, the delivery of 
     water saved through the rehabilitation and improvement of the 
     facilities of the Angostura Unit to the Pine Ridge Indian 
     Reservation; and
       (2) the use of that water for purposes of environmental 
     restoration on the Pine Ridge Indian Reservation.

     SEC. 103. EFFECT ON OTHER LAW.

       Nothing in this title affects--
       (1) any reserved water rights or other rights of the Tribe;
       (2) any service or program to which, in accordance with 
     Federal law, the Tribe, or an individual member of the Tribe, 
     is entitled; or
       (3) any water rights in existence on the date of enactment 
     of this Act held by any person or entity.

     SEC. 104. AUTHORIZATION OF APPROPRIATIONS.

       There is authorized to be appropriated such sums as are 
     necessary to carry out this title, to remain available until 
     expended.

                         TITLE II--DEVELOPMENT

     SEC. 201. OGLALA SIOUX TRIBAL DEVELOPMENT TRUST FUND.

       (a) Oglala Sioux Tribal Development Trust Fund.--There is 
     established in the Treasury of the United States a fund to be 
     known as the ``Oglala Sioux Tribal Development Trust Fund'', 
     consisting of any amounts deposited in the Fund under this 
     title.
       (b) Funding.--On the first day of the 11th fiscal year that 
     begins after the date of enactment of this Act, the Secretary 
     of the Treasury shall, from the General Fund of the Treasury, 
     deposit in the Fund--
       (1) such sums as the Secretary of the Treasury, in 
     consultation with the Secretary, the Secretary of Health and 
     Human Services, and the Tribal Council, are necessary to 
     carry out development under this title; and
       (2) the amount that equals the amount of interest that 
     would have accrued on the amount described in paragraph (1) 
     if that amount had been invested in interest-bearing 
     obligations of the United States, or in obligations 
     guaranteed as to both principal and interest by the United 
     States, on the first day of the first fiscal year that begins 
     after the date of enactment of this Act and compounded 
     annually thereafter.
       (c) Investment of Trust Fund.--
       (1) In general.--The Secretary of the Treasury shall invest 
     such portion of the Fund as is not, in the judgment of the 
     Secretary of the Treasury, required to meet current 
     withdrawals.
       (2) Acquisition of obligations.--Such investments may be 
     made only in interest-bearing obligations of the United 
     States or in obligations guaranteed as to both principal and 
     interest by the United States.
       (3) Interest.--The Secretary of the Treasury shall deposit 
     interest resulting from such investments into the Fund.
       (d) Payment of Interest to Tribe.--
       (1) Withdrawal of interest.--Beginning on the first day of 
     the 11th fiscal year after the date of enactment of this Act 
     and, on the first day of each fiscal year thereafter, the 
     Secretary of the Treasury shall transfer the aggregate amount 
     of interest deposited into the Fund for the fiscal year to 
     the Secretary for use in accordance with paragraph (3).
       (2) Availability.--Each amount transferred under paragraph 
     (1) shall be available without fiscal year limitation.
       (3) Payments to tribe.--
       (A) In general.--The Secretary shall use the amounts 
     transferred under paragraph (1) only for the purpose of 
     making payments to the Tribe, as such payments are requested 
     by the Tribe pursuant to tribal resolution.
       (B) Limitation.--Payments may be made by the Secretary of 
     the Interior under subparagraph (A) only after the Tribe has 
     adopted a plan under subsection (f).
       (C) Use of payments by tribe.--The Tribe shall use the 
     payments made under subparagraph (B) only for carrying out 
     projects and programs under the plan prepared under 
     subsection (f).
       (e) Limitation on Transfers and Withdrawals.--Except as 
     provided in subsections (c) and (d)(1), the Secretary of the 
     Treasury shall not transfer or withdraw any amount deposited 
     under subsection (b).
       (f) Development Plan.--
       (1) In general.--Not later than 18 months after the date of 
     enactment of this Act, the governing body of the Tribe shall 
     prepare a plan for the use of the payments to the Tribe under 
     subsection (d).
       (2) Contents.--The plan shall provide for the manner in 
     which the Tribe shall expend payments to the Tribe under 
     subsection (d) to promote--
       (A) economic development;
       (B) infrastructure development;
       (C) the educational, health, recreational, and social 
     welfare objectives of the Tribe and members of the Tribe; or
       (D) any combination of the activities described in 
     subparagraphs (A) through (C).
       (3) Plan review and revision.--
       (A) In general.--The Tribal Council shall make available 
     for review and comment by the members of the Tribe a copy of 
     the plan before the plan becomes final, in accordance with 
     procedures established by the Tribal Council.
       (B) Updating of plan.--
       (i) In general.--The Tribal Council may, on an annual 
     basis, revise the plan to update the plan.
       (ii) Review and comment.--In revising the plan, the Tribal 
     Council shall provide the members of the Tribe opportunity to 
     review and comment on any proposed revision to the plan.
       (C) Consultation.--In preparing the plan and any revisions 
     to update the plan, the Tribal Council shall consult with the 
     Secretary and the Secretary of Health and Human Services.
       (4) Audit.--
       (A) In general.--The activities of the Tribe in carrying 
     out the plan shall be audited as part of the annual single-
     agency audit that the Tribe is required to prepare pursuant 
     to the Office of Management and Budget circular numbered A-
     133.
       (B) Determination by auditors.--The auditors that conduct 
     the audit under subparagraph (A) shall--
       (i) determine whether funds received by the Tribe under 
     this section for the period covered by the audit were 
     expended to carry out the plan in a manner consistent with 
     this section; and
       (ii) include in the written findings of the audit the 
     determination made under clause (i).
       (C) Inclusion of findings with publication of proceedings 
     of tribal council.--A copy of the written findings of the 
     audit described in subparagraph (A) shall be inserted in the 
     published minutes of the Tribal Council proceedings for the 
     session at which the audit is presented to the Tribal 
     Council.
       (g) Prohibition of Per Capita Payments.--No portion of any 
     payment made under this title may be distributed to any 
     member of the Tribe on a per capita basis.

     SEC. 202. ELIGIBILITY OF TRIBE FOR CERTAIN PROGRAMS AND 
                   SERVICES.

       No payment made to the Tribe under this title shall result 
     in the reduction or denial of any service or program with 
     respect to which, under Federal law--
       (1) the Tribe is otherwise entitled because of the status 
     of the Tribe as a federally recognized Indian tribe; or
       (2) any individual who is a member of the Tribe is entitled 
     because of the status of the individual as a member of the 
     Tribe.

     SEC. 203. AUTHORIZATION OF APPROPRIATIONS.

       There are authorized to be appropriated such sums as are 
     necessary to pay the administrative expenses of the Fund.
                                 ______
                                 
      By Mr. BYRD (for himself, Mr. Bayh, and Mr. Rockefeller):
  S. 1997. A bill to reinstate the safeguard measures imposed on 
imports of certain steel products, as in effect on December 4, 2003; to 
the Committee on Finance.
  Mr. BYRD. Mr. President, last week, the Bush administration--in what 
has become its normal pattern--ignored the pleas of thousands of 
hardworking Americans. It lifted the steel tariffs it had promised the 
U.S. steel industry and imposed on foreign imports back in March of 
2002.
  Despite its earlier pledge to stand by America's steelworkers, the 
White House, in typical fashion, decided to turn its back on our 
highest valued workers and most vulnerable retirees. In a fit of pique 
and hard-hearted hubris, the White House decided to lift U.S. tariffs 
on foreign steel imports 15

[[Page S16136]]

months ahead of time, instead of letting the tariffs stay in place 
until March 2005, as is permitted by U.S. law.
  Why? Why would the White House betray America's steel industry--the 
backbone of America's industrial base--particularly during this time of 
war? Of national emergency? No. Because the President feared 
retaliation from America's trading partners, he quivered at the threat 
that they would retaliate against U.S. exports if he did not lift the 
201 tariffs. He cowered in the face of exactly those nations whose 
steel exports to the United States have driven 42 U.S. steel companies 
to their knees and into bankruptcy. His resolve collapsed in the face 
of retaliatory threats from America's most virulent competitors, whose 
illegal trade against the United States has already cost nearly 50,000 
steelworkers their jobs.
  America's foreign trade opponents gambled that this President lacked 
the resolve to stand up to them and to the WTO. Do you know? They were 
right. They were sadly correct.
  But this President, George W. Bush, did not need to cave like a 
``weak willy'' in the face of belligerent foreign bullies. Instead, he 
could have invoked Article XXI of the GATT, a viable trade tool that 
has been legitimately and successfully employed by the United States in 
the past to exempt itself from the GATT, now the WTO, in a time of war 
or national emergency. The President on July 31, 2003, formally 
proclaimed our Nation to be in a continued state of emergency. As a 
result of the President's own misguided and ill-advised actions, we 
remain engaged militarily in Iraq.
  On July 31, 2003, President Bush formally declared that, in 
accordance with section 202(d) of the National Emergencies Act, he was 
``continuing for one year the national emergency with respect to 
Iraq.'' We also continue to face an ongoing war against terrorism, both 
here at home and abroad.
  So, President Bush had--and has--ample authority to invoke a 
provision of GATT 1994, negotiated by the United States and available 
to all WTO Members, that would permit him to exempt protections for the 
U.S. steel industry from retaliation by foreign countries.
  But this President has so far lacked the foresight or the fortitude 
to take that step. Confronted with real threats of economic retaliation 
by determined competitors, the President folds like a house of cards 
astride the San Andreas fault.
  That is why, today, I am introducing a bill that will do what the 
President refused to do. It will reinstate the 201 relief and reimpose 
the 201 tariffs against foreign steel imports. Under my bill, the 201 
tariffs will be put back in place to stop foreign import surges, just 
as they did before the President so ill-advisedly lifted the tariffs 
last Thursday. And the tariffs will remain in place through March 5, 
2005.
  This administration should not have been bullied into abandoning the 
U.S. steel industry. Our steel industry is key to the national economic 
security of our Nation. Without steel, we cannot guarantee America's 
national security. Without steel, we could not have rebuilt after 
September 11. And I am not the only one who thinks that steel is 
integral to America's economic and national security. Just a few days 
before that fateful September day, on August 26, 2001, President Bush 
told America's steelworkers: ``If you're worried about the security of 
the country and you become over reliant upon foreign sources of steel, 
it can easily affect the capacity of our military to be well supplied. 
Steel is an important jobs issue; it is also an important national 
security issue.''
  With an annual take deficit of almost $500 billion, Americans have a 
right to expect that international trade rules with work for them; not 
against them. They also have a right to know that the United States can 
respond as it must to the type of trade crises that have been suffered 
by America's steel industry for years.
  There was absolutely no reason to lift the steel 201 tariffs. They 
are fully consistent with both U.S. law and our international 
agreements--regardless of the view of the WTO. The purpose of 201 
relief is to give the domestic industry time to adjust to import 
competition. Our valiant steel industry is doing just that by pursuing 
unprecedented restructuring and new investment. Since the 201 tariffs 
were imposed, flat-rolled steel producers alone have invested more than 
$3 billion to enhance their productivity.
  Critics of the 201 relief have been proved wrong on every significant 
fact concerning that relief. They said that once the tariffs were 
imposed, steel prices would go through the roof. Yet, prices have risen 
only modestly, and much less than abroad. The critics claimed that U.S. 
steel companies would do nothing to improve their competitiveness. But 
our Nation is witnessing the most dramatic restructuring in the 
industry's history. The critics also claimed that the tariffs would be 
bad for the U.S. economy, but the non-partisan U.S. International Trade 
Commission, ITC, recently found that the potential costs are 
minuscule--only about 2 percent of what Americans spend each month at 
McDonald's--and not even a drop in the bucket compared to the value we 
gain by restoring a critical U.S. industry to long-term 
competitiveness.
  Other nations' actions in this Section 201 dispute have been truly 
disgraceful. The European Union originally threatened to retaliate 
against the United States immediately upon the President's application 
of the safeguard measures in March 2002. In the end, it hesitated. But 
its threat was sufficient to extort from the administration nearly 
unlimited exclusions from the tariffs to benefit foreign producers.
  Acquiescing to this type of bullying jeopardizes the future of the 
U.S. steel industry, and it undermines the integrity of, and support 
for, the entire international trading system. Americans cannot be 
expected to support a system that works against them, rather than for 
them.
  By lifting the tariffs, the administration is allowing Brazil, the 
European Union, Japan, and other nations, once again, to flood the U.S. 
market with imports. The Bush administration could have stood up for 
America's steelworkers like those at Weirton, WV, and Wheeling-
Pittsburgh Steel in West Virginia, and demanded that other countries 
respect the legitimate rights of the United States in the world trading 
system. But this administration chose to back down, to lose face, to 
sit back and watch, once more, while thousands of additional U.S. steel 
jobs are destroyed by wave after wave of foreign imports.
  The administration does not seem to care if the U.S. steel industry 
is destroyed at a time of war and in the midst of a national emergency. 
President Bush did not even care enough to personally inform the U.S. 
steel industry, its workers, and their families of his decision to lift 
the tariffs. No!! Instead, he sent a trade negotiator, Mr. Zoellick, to 
do his dirty work. Ambassador Zoellick had the audacity to tell us that 
the tariffs are ``no longer necessary.'' No longer necessary. And why 
did he say that they are no longer necessary? They are no longer 
necessary because, he said, ``these safeguard measures have achieved 
their purpose.''
  The only purpose that I can see in this decision to shut the tariff 
program down is to succumb to threats and demands from abroad. The only 
effect will be the loss of more steel manufacturing jobs here at home.
  On October 27, 2000, Mr. Dick Cheney--do you know him? He is now Vice 
President of the United States--just a few days before the elections he 
came to Weirton, WV, to campaign for the Bush-Cheney ticket. During 
that visit, Mr. Cheney forcefully pledged to help America's 
steelworkers. He said, ``We will never lie to you. If our trading 
partners violate our trading laws, we will respond swiftly and 
firmly.''
  Promise made, promise broken. Unfortunately, like so many commitments 
this administration has made, its pledge to help America's steel 
industry got off to a headline-grabbing start, but has now been 
discarded, out of the glare of the campaign spotlight.
  So now, only 3 years after Mr. Cheney's campaign-season vow of 
honesty to America's steelworkers, this White House has taken an axe to 
the 201 tariffs and betrayed the trust of thousands of American 
families whose paychecks depend on the U.S. steel industry.
  Mr. President, the Bush White House has absolutely failed the working 
families across this country. This White House has traded the best 
interests of the American people for the big special interests of 
corporate campaign contributors. It is no surprise that the Bush 
Administration would turn its back on steelworkers.

[[Page S16137]]

  When the Bush-Cheney ticket needed West Virginia's votes in 2000, it 
pledged to help our steel industry. At first, it appeared as though the 
administration would follow through on that promise. The White House 
applied the steel tariffs, for which West Virginia was thankful and for 
which I and other Senators congratulated, commended and thanked the 
administration. But then the President exempted import after import 
from those tariffs. Now the President has eliminated the tariffs 
completely.
  The Bush White House may have forgotten the promise made to the steel 
industry in West Virginia, but thousands of West Virginians and other 
steelworkers across the Nation will not forget. The recognize a fair-
weather friend when they seen one.
                                 ______
                                 
      By Mr. BINGAMAN (for himself, Ms. Snowe, Mr. Schumer, Mr. Leahy, 
        Mrs. Clinton, Mr. Nelson of Nebraska, Mrs. Lincoln, Mr. Hagel, 
        Mr. Jeffords, Mr. Domenici, Mr. Harkin, and Mr. Pryor):
  S. 1998. A bill to amend title 49, United States Code, to preserve 
the essential air service program; to the Committee on Commerce, 
Science, and Transportation.
  Mr. BINGAMAN. Mr. President, I rise today to introduce the bipartisan 
Essential Air Service Preservation Act of 2003. I am pleased to have my 
colleague Senator Snowe as the principal cosponsor of the bill. Senator 
Snowe has been a long-time champion of commercial air service in rural 
areas, and I appreciate her continued leadership on this important 
legislation. Senators Shumer, Leahy, Clinton, Ben Nelson, Lincoln, 
Hagel, Jeffords, Domenici, and Harkin, are also cosponsors of the bill.
  Congress established the Essential Air Service Program in 1978 to 
ensure that communities that had commercial air service before airline 
deregulation could continue to receive scheduled service. Without EAS, 
many rural communities would have no commercial air service at all.
  Our bill is very simple. It preserves Congress's intent in the 
Essential Air Service program by repealing a provision in the FAA 
reauthorization bill that would for the first time require communities 
to pay for their commercial air service.
  Congress has already barred the Department of Transportation from 
implementing any cost sharing requirements on Essential Air Service 
communities for one year. This bill would now make the ban permanent. I 
believe that implementing any mandatory cost sharing is the first step 
in the total elimination of scheduled air service for many rural 
communities.
  It is indeed a sad commentary on this Congress that my colleagues and 
I have to introduce this bill at all. Time and again Congress has gone 
on record opposing mandatory cost sharing for EAS communities, yet it 
keeps coming back.
  In June, during consideration of the FAA reauthorization bill, 
Senator Inhofe and I, with 13 bipartisan cosponsors, offered an 
amendment that struck out a provision in that bill imposing mandatory 
cost sharing on some EAS communities.
  I was pleased the full Senate agreed and voted to eliminate mandatory 
cost sharing from the FAA reauthorization bill. In parallel, the full 
House of Representatives adopted a similar amendment to the FAA bill. 
Thus, the bills that were sent to conference required no cost sharing 
for EAS communities.
  Most students of government would tell you that when a majority of 
both houses of Congress have voted against a particular measure, the 
conferees couldn't arbitrarily put it back in. Well, they did. In 
another example of this Congress's secret back room dealing, the 
conferees excluded the minority members, flagrantly ignored the will of 
the majority in the House and the Senate, and restored the very cost-
sharing language both houses one month before had voted to reject. I 
believe adding this extraneous and objectionable provision was an 
egregious violation of the conference process.
  When cost sharing showed up in the FAA conference report, Congress, 
with bipartisan support, stopped the Department of Transportation from 
implementing the measure for one year by barring the use of 2004 
appropriations for that purpose. The bill we are introducing today 
permanently repeals the mandatory cost-sharing requirements that the 
conferees reinserted into the FAA reauthorization bill after both the 
House and Senate had voted not to include them. I hope both houses of 
Congress will again do the right thing by passing our bill.
  All across America, small communities face ever-increasing hurdles to 
promoting their economic growth and development. Today, many rural 
areas lack access to interstate or even four-lane highways, railroads 
or broadband telecommunications. Business development in rural areas 
frequently hinges on the availability of scheduled air service. For 
small communities, commercial air service provides a critical link to 
the national and international transportation system.
  The Essential Air Service Program currently ensures commercial air 
service to over 100 communities in 34 states. EAS supports an 
additional 33 communities in Alaska. Because of increasing costs and 
the current financial turndown in the aviation industry, particularly 
among commuter airlines, about 28 additional communities have been 
forced into the EAS program since the terrorist attacks in 2001.
  In my State of New Mexico, five cities currently rely on EAS for 
their commercial air service. The communities are Clovis, Hobbs, 
Carlsbad, Alamogordo and my hometown of Silver City. In each case 
commercial service is provided to Albuquerque, the State's business 
center and largest city.
  I believe this ill-conceived proposal requiring cities to pay to 
continue to have commercial air service could not come at a worse time 
for small communities already facing depressed economies and declining 
tax revenues.
  As I understand it, the mandatory cost-sharing requirements in the 
FAA reauthorization bill could affect communities in as many as 22 
states. Based an analyses by my staff, the individual cities that may 
be affected are as follows:

       Alabama--Muscle Shoals; Arizona--Prescott, Kingman; 
     Arkansas--Hot Springs, Harrison, Jonesboro; Colorado--Pueblo; 
     Georgia--Athens; Iowa--Fort Dodge, Burlington; Kansas--
     Salina; Kentucky--Owensboro; Maine--Augusta, Rockland; 
     Michigan--Iron Mt.; Mississippi--Laurel; Nebraska--Norfolk; 
     New Hampshire--Lebanon; New Mexico--Hobbs, Alamogordo, 
     Clovis; New York--Saranac Lake, Watertown, Jamestown, 
     Plattsburgh; Oklahoma--Ponca City, Enid; Pennsylvania--
     Johnstown, Oil City, Bradford, Altoona; South Dakota--
     Brookings, Watertown; Tennessee--Jackson; Texas--Victoria; 
     Vermont--Rutland; Washington--Moses Lake.

  As I see it, the choice here is clear: If we do not preserve the 
Essential Air Service Program today, we could soon see the end of all 
commercial air service in rural areas. The EAS program provides vital 
resources that help link rural communities to the national and global 
aviation system. Our bill will preserve the essential air service 
program and help ensure affordable, reliable, and safe air service 
remains available in rural America. Congress is already on record 
opposing mandatory cost sharing. I hope all Senators will once again 
join us in opposing this attack on rural America.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1998

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Essential Air Service 
     Preservation Act of 2003''.

     SEC. 2. REPEAL OF EAS LOCAL PARTICIPATION PROGRAM.

       (a) In General.--Subchapter II of chapter 417 of title 49, 
     United States Code, is amended by striking section 41747, and 
     such title shall be applied as if such section 41747 had not 
     been enacted.
       (b) Conforming Amendment.--The analysis for subchapter II 
     of chapter 417 of title 49, United States Code, is amended by 
     striking the item relating to section 41747.
                                 ______
                                 
      By Mr. DASCHLE (for himself, Ms. Stabenow, Mr. Graham of Florida, 
        Mr. Kennedy, Mr. Pryor, Mr. Dorgan, Mrs. Boxer, Mr. Lautenberg, 
        Mr. Bingaman, Ms. Mikulski, Mr. Johnson, Mr. Schumer, Mr. Kohl, 
        Ms. Cantwell, and Mr. Rockefeller):

[[Page S16138]]

  S. 1999. A bill to amend part D of title XVIII of the Social Security 
Act, as added by the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003, to provide for negotiation of fair prices 
for medicare prescription drugs; to the Committee on Finance.
  Mr. DASCHLE. Mr. President, yesterday, the President signed the 
Medicare Prescription Drug, Improvement, and Modernization Act of 2003. 
But the name of that Act is completely misleading. In fact, the Act 
fundamentally damages the successful and popular Medicare program--a 
long-term Republican goal. And this Act does more to ensure that drug 
prices remain high than it does to assist beneficiaries in paying for 
their drugs.
  Why? Because drug companies want it that way. Republicans with 
financial ties to the industry are protecting drug company interests 
over the interests of seniors and people with disabilities.
  America's seniors pay the highest drug prices in the world, even 
though American taxpayers subsidize the research that produces many of 
those drugs. The Medicare bill signed by the President squanders our 
chances of remedying that inequity. Not only does the bill effectively 
prohibit the reimportation of more affordable drugs from other 
countries, it actually prohibits Medicare from using its tremendous 
bargaining power to ensure that beneficiaries pay lower prices and that 
our scant resources are most effectively used.
  Today, Senate Democrats are siding with the seniors. We are 
introducing legislation that would repeal the provision barring 
Medicare from negotiating for lower prices. The Medicare Prescription 
Drug Price Reduction Act would give Medicare the authority to negotiate 
with drug companies to obtain the lowest possible prices for seniors 
and people with disabilities. House Democrats introduced a companion 
bill yesterday. Together, we will fight for the goal of giving Medicare 
beneficiaries the drug benefit and lower prices they deserve.
                                 ______
                                 
      By Mrs. CLINTON:
  S. 2003. A bill to amend the Public Health Service Act to promote 
higher quality health care and better health by strengthening health 
information, information infrastructure, and the use of health 
information by providers and patients; to the Committee on Finance.
  Mrs. CLINTON. Mr. President, today, I am introducing a bill that 
seeks to begin a dialogue on one of the most important yet neglected 
aspects of our health care system--health care quality. this is an 
enormous issue that affects every single one of us who has ever needed 
medical care, and it affects all taxpayers because quality care has 
such potential to avoid waste and save millions of dollars in health 
care costs. I have raised many of these ideas as amendments in other 
contexts, such as the Medicare debate on S. 1, and the debate over S. 
720, the Patient Safety and Quality Improvement Act of 2003. I intend 
to continue working with my colleagues on improving these ideas and 
proposing additional concepts. But with this bill today, I seek to put 
forward a package of ideas, provoke conversation, and present this as a 
first step in making quality a focus of my health care efforts next 
year. My goal with these efforts is to both improve quality and 
outcomes, and reduce costs by encouraging care that is more effective.
  There is no reason why we cannot achieve this. We have the most 
advanced medical system in human history--the finest medical 
institutions, the newest treatments, the best trained health care 
professionals. But in spite of the best intentions of clinicians and 
patients, our health care system is plagued with underuse, overuse, and 
misuse. currently, only about 50 percent of care that is known to be 
effective is provided, and the care given is supported by solid 
scientific evidence, and the pace of dissemination of new evidence is 
painfully slow. It may take up to 17 years for treatments found to be 
effective to become common practice.
  Much of the overuse or misuse of health services stems from the 
fragmentation of our system. In a recent study in Santa Barbara, CA, 20 
percent of lab tests and x-rays were conducted solely because previous 
results were unavailable. One in seven hospitalizations occurs because 
information is unavailable, and a shocking percentage of the time, 
physicians do not find patient information that had previously been 
recorded in a paper-based medical record.
  Despite all of our Nation's medical advances, health quality is 
becoming even more endangered in some respects. Nursing care which is 
often shown to be a decisive factor for hospital patient outcomes, its 
in grave shortage, and a majority of U.S. physicians surveyed by the 
Commonwealth Fund perceive their ability to provide quality care as 
having worsened over the last 5 years.
  Additionally, even as the quality of health care we purchase lags, 
our spending on inadequate and wasteful care is spiraling out of 
control. Premiums increased 13 percent last year, and health care costs 
are increasing at nearly 10 times the rate of inflation. To make 
matters worse, the public health system is straining to meet the 
challenges of bioterrorism or emerging infections, the number of 
uninsured Americans is rising, clinicians are leaving practice, and the 
older adult population is set to double by 2040.
  The reason is not because doctors aren't trying hard enough, or 
hospitals are at fault. That we're able to get good health care at all 
is testament to the genius and heroism of doctors and nurses who 
deliver care, despite all the obstacles, despite every effort of the 
system to hinder them.

  But what our medical system requires of providers is a little like 
asking pilots to routinely land planes without any information from the 
control tower. The best of them can do it--they could land a plane with 
one arm around their backs missing key information and confirmations, 
but why force them to do it? Why deny them critical information when it 
could be easily available? There is no plausible reason for denying 
needed information, especially when life and death are at stake.
  That's unfortunately exactly what our health care system says to 
doctors, nurses, and hospitals. Physicians for example spend four years 
in medical school, and then several years more in their residency 
training, cramming medical information into their heads. Then we expect 
them to look at a patient taking four different drugs, with a heart 
condition, and immediately remember any drug-drug interactions that 
could occur. We ask them to do it without looking up any reference 
materials. We ask them to do it in the few minutes that they have with 
each patient given the ever-shorter visits, and ever-increasing patient 
and paperwork load. Moreover, in their free time, they are expected to 
keep up with all the new journal articles and learn about every new 
drug.
  Yet hand-held computers can now allow the doctor to pull up up-to-
date information immediately, right at the bedside, if he or she has 
any question. And NIH spends billions of dollars in research to 
generate that information. Shouldn't that investment reap results for 
the patient as quickly as possible? This bill seeks to provide the 
direction that would support such technology and make it widely 
available to physicians.
  Right now, doctors, nurses, and hospitals are holding the health care 
system up, preventing utter collapse by sheer, heroic, force of will. 
Instead of the clinicians supporting the system, we should build a 
system that supports clinicians instead.
  The premise of this legislation is that information, in the hands of 
the right people at the right time, drives quality and value. We need 
to empower patients and health care providers to make the right 
choices. And to do that, health care decisionsmakers--providers, 
payers, and patients--need to have access to the right information, 
where and when it is needed, securely and privately.
  This legislation seeks to: 1. Generate information about health 
quality through increased research, increased public reporting along 
key quality measures, and standardization of those measures to assure 
comparability and usability of reported information; 2. Ensure that 
payers, providers and patients get information in a usable form so they 
can make effective decisions; and 3. Reduce barriers to the development 
of an IT infrastructure that is so critical to achieving those first 2 
goals.
  Eighty percent of the care delivered today is not backed by sound 
clinical

[[Page S16139]]

research. That is why we need to do more research, and see if the care 
we provide today has sound justification in science. But even where we 
know what to do, we don't always do it because the information is 
insufficiently disseminated and utilized. Studies have shown some 
procedures being performed even when they have not met accepted 
criteria for appropriateness: In one study, of all the non-emergent, 
noncancerous hysterectomies performed, only 30 percent had been 
properly worked up and met the full medical criteria for necessity. In 
another study, about one-fourth of coronary angiographies and upper 
gastrointestinal endoscopies did not meet standards of medical 
appropriateness.

  On the flip side, in situations where the benefits of an intervention 
are clear, many patients do not receive the indicated care: Very few 
hospitalized patients at-risk for pneumococcal pneumonia who had not 
been previously vaccinated end up being vaccinated during their 
hospital stay. Routine peak flow measurements are conducted in only 28 
percent of pediatric patients with asthma. And only one-half of 
diabetics receive an annual eye exam.
  We know what good health care means in these areas, but we don't 
practice it, in part because that information may not be readily 
available, and regardless, there is no incentive for quality. We are 
suggesting--track the outcomes, share that information with patients, 
providers, and insurers, and ultimately, pay for performance.
  This bill will help us become better purchasers of care, and help us 
take the first steps toward aligning the incentives so that higher 
quality is rewarded. I ask unanimous consent that the attached article 
from last week's New York Times be printed in the Record showing how 
our current reimbursement system is gravely misaligned. Under the 
current system, higher quality can be penalized, while worse care can 
ironically be more profitable.
  Today, by introducing these ideas for the purpose of seeking feedback 
from my colleagues and experts in the field, I am taking the first step 
toward improving our health care system for everyone and saving money. 
I invite interested colleagues to join me in partnership on this 
important venture and look forward to taking strong, positive action 
next year to improve health quality for all Americans.
  There being no objection, the article was ordered to be printed in 
the Record, as follows:

                [From the New York Times, Dec. 5, 2003]

     Hospitals Say They're Penalized by Medicare for Improving Care

                           (By Reed Abelson)

       Salt Lake City.--By better educating doctors about the most 
     effective pneumonia treatments, Intermountain Health Care, a 
     network of 21 hospitals in Utah and Idaho, say it saves at 
     least 70 lives a year. By giving the right drugs at discharge 
     time to more people with congestive heart failure, 
     Intermountain saves another 300 lives annually and prevents 
     almost 600 additional hospital stays.
       But under Medicare, none of these good deeds go unpunished.
       Intermountain says its initiatives have cost it millions of 
     dollars in lost hospital admissions and lower Medicare 
     reimbursements. In the mid-90's, for example, it made an 
     average profit of 9 percent treating pneumonia patients; now, 
     delivering better care, it loses an average of several 
     hundred dollars on each case.
       ``The health care system is perverse,'' said a frustrated 
     Dr. Brent C. James, who leads Intermountain's efforts to 
     improve quality. ``The payments are perverse. It pays us to 
     harm patients, and it punishes us when we don't.''
       Intermountain's doctors and executives are in a swelling 
     vanguard of critics who say that Medicare's payment system is 
     fundamentally flawed.
       Medicare, the nation's largest purchaser of health care, 
     pays hospitals and doctors a fixed sum to treat a specific 
     diagnosis or perform a given procedure, regardless of the 
     quality of care they provide. Those who work to improve care 
     are not paid extra, and poor care is frequently rewarded, 
     because it creates the need for more procedures and services.
       The Medicare legislation that President Bush is expected to 
     sign on Monday calls for studies and a few pilot programs on 
     quality improvement, but experts say that it does little to 
     reverse financial disincentives to improving care.
       ``Right now, Medicare's payment system is at best neutral 
     and, in some cases, negative, in terms of quality--we think 
     that is an untenable situation,'' said Glenn M. Hackbarth, 
     the chairman of the Medicare Payment Advisory Commission, an 
     independent panel of economists, health care executives and 
     doctors that advises Congress on such issues as access to 
     care, quality and what to pay health care providers.
       In a letter published in the current edition of Health 
     Affairs, a scholarly journal, more than a dozen health care 
     experts, including several former top Medicare officials, 
     urged the program to take the lead in overhauling payment 
     systems so that they reward good care.
       ``Despite a few initial successes, the inertia of the 
     health system could easily overwhelm nascent efforts to raise 
     average performance levels out of mediocrity,'' they wrote. 
     ``Decisive change will occur only when Medicare, with the 
     full support of the administration and Congress, creates 
     financial incentives that promote pursuit of improved 
     quality.''
       Medicare's top official is quick to agree that the payment 
     system needs to be fixed. ``It's one of the fundamental 
     problems Medicare faces,'' said Thomas A. Scully, who as the 
     administrator of the Centers for Medicare and Medicaid 
     Services has encouraged better care by such steps as 
     publicizing data about the quality of nursing home and home-
     health care and by experimenting with programs to reward 
     hospitals for their efforts.
       But the steps taken so far have been small, and many 
     experts say that rather than paying for more studies, 
     Congress should start making significant changes to the way 
     doctors and hospitals are paid.
       ``They're splashing at the shallow end of the pool,'' said 
     Dr. Arnold Milstein, a consultant for Mercer Human Resource 
     Consulting and the medical director for the Pacific Business 
     Group on Health, an association of large California 
     employers. He would like to see as much as 20 percent of what 
     Medicare pays doctors and hospitals linked to the quality of 
     the care they provide and their efficiency in delivering 
     treatment.
       Two decades ago, Medicare led a revolution in health care. 
     By setting fixed payments for various kinds of treatment--a 
     coronary bypass surgery or curing a pneumonia or replacing a 
     hip--rather than simply reimbursing doctors and hospitals for 
     whatever it cost to deliver the care, it encouraged shorter 
     hospital stays and less-expensive treatments.
       But today, many health care executives say, Medicare's 
     payment system hinders attempts to improve care. Dr. James, 
     the Intermountain executive, said that he wrestled with the 
     situation every day.
       By making sure its doctors prescribe the most effective 
     antibiotic for pneumonia patients, for example, and thereby 
     avoiding complications, Intermountain forgoes roughly $1 
     million a year in Medicare payments, he estimated. When a 
     pneumonia patient deteriorates so badly that the patient 
     needs a ventilator, Intermountain collects about $19,000, 
     compared with $5,000 for a typical pneumonia case. And while 
     it makes money treating the sicker patient, Dr. James said, 
     it loses money caring for the healthier one.
       Nor is Intermountain rewarded for sparing someone a stay in 
     the hospital--and for sparing Medicare the bill. Shirley 
     Monson, 74, of Ephraim, Utah, said that she expected to be 
     hospitalized when she developed pneumonia last year. 
     Instead, Sanpete Valley Hospital, part of Intermountain, 
     sent Mrs. Monson home with antibiotics, and she recovered 
     over the next two weeks. Such visits produce just token 
     payments for hospitals.
       In addition to losing revenue each time it avoids an 
     unnecessary hospital stay, Intermountain is penalized for 
     treating only the sickest patients, Dr. James said. 
     Medicare's payments for pneumonia are based on a rough 
     estimate of the cost of an average case and assume a hospital 
     will see a range of patients, some less sick--and therefore 
     less expensive to treat--than others. But because 
     Intermountain now admits only the sickest patients, its 
     reimbursements fall short of its costs, Dr. James said, 
     resulting in an average loss this year of a few hundred 
     dollars a case.
       Similarly, averting hospital stays for congestive heart 
     patients by prescribing the right medicines costs 
     Intermountain nearly $4 million a year in potential revenues, 
     according to Dr. James. And every adverse drug reaction 
     Intermountain avoids deprives it of the revenue from treating 
     the case.
       ``We are really rewarded for episodic care and maximizing 
     the care delivered in each episode,'' said Dr. Charles W. 
     Sorenson Jr., Intermountain's chief operating officer.
       Like the visit majority of the nation's hospitals, 
     Intermountain is a nonprofit organization, and executives 
     here say financial penalties do not damp their desire to 
     provide the highest quality care, which they see as their 
     central mission. But Intermountain, which operates health 
     plans and outpatient clinics in addition to its hospitals, 
     says it beds to keep hospital beds filled and make money 
     where it can to subsidize unprofitable services and pay for 
     charity care.
       Outside of Medicare, Intermountain often benefits from its 
     quality initiatives, executives said, because it gets to 
     pocket much of the savings they produce. For example, 
     Intermountain has generated about $2 million annually in 
     savings by reducing the number of deliveries that women 
     choose to induce before 39 weeks of pregnancy--and thereby 
     reducing the risk of complications to the mother or baby. 
     According to Dr. James, almost all that money has been spent 
     on other kinds of care.
       Hospital executives elsewhere say that they, too, have come 
     up against the cold reality of the Medicare payment system. 
     Partners HealthCare, the Boston system that includes 
     Massachusetts General and Brigham

[[Page S16140]]

     and Women's Hospitals, has taken steps to reduce the number 
     of unnecessary diagnostic tests it conducts at outpatient 
     radiology centers, though executives know that smarter care 
     will cut into their revenues.
       ``That's where you're smack up against the perverseness of 
     the system,'' said Dr. James J. Mongan, chief executive of 
     Partners.
       Medicare's payment policies have stymied efforts in the 
     private sector to improve care, as well.
       For example, the Leapfrog Group, a national organization of 
     large employers concerned about health issues, has tried to 
     encourage more hospitals to employ intensivists--specialists 
     who oversee the care provided in intensive-care units. Though 
     studies show that such doctors significantly improve care, 
     Medicare does not pay for them, and employers and insurers 
     are having difficulty persuading some hospitals to take on 
     the added expense.
       ``It's going to be very hard to compete with the incentives 
     and disincentives in Medicare,'' said Suzanne Delbanco, the 
     group's executive director.
       Others argue that hospitals and doctors should not be paid 
     extra for doing what they should be doing in the first place.
       Helen Darling, the executive director of the National 
     Business Group on Health, a national employer group, said 
     Medicare instead should take a firmer stance in demanding 
     quality. The program had a significant effect, she noted, 
     when it said that only hospitals meeting a minimum set of 
     standards could be reimbursed by Medicare for heart 
     transplants.
       ``The payment system drove quality,'' Ms. Darling said.
       Medicare itself is taking some other tentative steps, 
     including an experiment that pays certain hospitals an extra 
     2 percent for delivering the highest-quality care, as 
     measured, for example, by administering antibiotics to 
     pneumonia patients quickly and giving heart attack patients 
     aspirin. But some hospital industry executives question 
     whether that is enough money to offset the costs of improving 
     care.
       ``It can only be a motivator if you really have an 
     incentive,'' said Carmela Coyle, an executive with the 
     American Hospital Association, who noted that hospitals on 
     average are paid only 98 cents for each dollar of Medicare 
     services they provide.
       Mr. Scully, the Medicare administrator, defends the 
     experiment, saying that the agency's goal is to determine if 
     it is using the right measures to reward quality. ``If this 
     works, we'll do a bigger demonstration,'' he said.
       But many policy analysts and employer groups want Medicare 
     to do more. ``Today, Medicare needs to step out front,'' said 
     Peter V. Lee, chief executive of the Pacific Business Group 
     on Health, who argues that how hospitals and doctors are paid 
     is a critical component of motivating them to improve care. 
     ``There needs to be money at play.''

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