[Congressional Record Volume 151, Number 66 (Wednesday, May 18, 2005)]
[Senate]
[Pages S5437-S5448]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mr. COLEMAN (for himself, Mr. Smith, Ms. Snowe, Mr. Dayton,
and Mr. Harkin):
[[Page S5438]]
S. 1060. A bill to amend the Internal Revenue Code of 1986 to allow a
credit against income tax for the purchase of hearing aids; to the
Committee on Finance.
Mr. COLEMAN. Mr. President, today I am introducing legislation to
help millions of Americans enjoy the gift of sound. I am pleased to be
joined by Senators Gordon Smith, Olympia J. Snowe, Mark Dayton, and Tom
Harkin, who I know care as deeply about these issues as I do.
Hearing loss is one of the most common and widespread health problems
affecting Americans today. In fact, thirty-three babies are born each
day with hearing loss, making deafuess the most common birth defect in
America. According to the National Council on Aging, as many as 70
percent of our elderly experience hearing loss. All told, 31.5 million
Americans currently suffer from some form of hearing loss.
The good news is that 95 percent of individuals with hearing loss can
be successfully treated with hearing aids. Unfortunately, however, only
22 percent of Americans suffering from hearing loss can afford to use
this technology. In other words, over 24 million Americans will live
without sound because they cannot afford treatment.
That is why we are introducing the Hearing Aid Assistance Tax Credit
Act.
This legislation provides help to those who need it most, our
children and seniors, by providing a tax credit of up to $500, once
every 5 years, toward the purchase of any ``qualified hearing aid'' as
defined by the Federal Food, Drug, and Cosmetic Act.
Hearing aids are not just portals to sound, but portals to success in
school, business, and life. That is why a number of diverse
organizations, including the Hearing Industries Association, Self Help
for Hard of Hearing People, the International Hearing Society, the Deaf
and Hard of Hearing Alliance, American Speech-Language-Hearing
Association, and the American Academy of Audiology support the Hearing
Aid Assistance Tax Credit Act.
I ask unanimous consent that their letters of support be printed in
the Record.
Hearing loss may be one of the most common health problems in the
United States, but it doesn't have to be. We can tackle the problem
head on with the Hearing Aid Assistance Tax Credit Act.
I look forward to working with my colleagues this Congress to approve
this commonsense solution to a serious problem.
There being no objection, the materials were ordered to be printed in
the Record, as follows:
Deaf and Hard of Hearing Alliance: A Coalition of
Consumer and Professional Organizations,
May 18, 2005.
Hon. Norm Coleman,
U.S. Senate,
Washington, DC.
Dear Senator Coleman: We, the undersigned, representing
both consumer and health professional organizations of the
Deaf and Hard of Hearing Alliance (DHHA), write to express
our strong support for the ``Hearing Aid Assistance Tax
Credit Act'' you are introducing in the Senate today. While
we support and encourage more comprehensive solutions, we
believe your legislation can aid some who presently have no
options but to pay out of pocket for these essential devices.
Enactment of your legislation will provide a tax credit of
up to $500 per hearing aid, available once every five years,
towards the purchase of a hearing aid(s) for individuals age
55 and over, or those purchasing a hearing aid for a
dependent.
As you have pointed out with the introduction of this bill,
special tax treatment would improve access to hearing aids
since only 22 percent of Americans who could benefit from
hearing aids currently use them. Approximately 1 million
children under the age of 18 and nearly 10 million Americans
over the age of 54 have a diagnosed hearing loss but are not
currently using a hearing aid.
The expense of the hearing aid is an important factor why
Americans with hearing loss go without these devices. Some 40
percent of individuals with hearing loss have incomes of less
than $30,000 per year. Nearly 30 percent of those with
hearing loss cite financial constraints as a core reason they
do not use hearing aids. In 2002, the average cost for a
hearing aid was over $1,400, and almost two-thirds of
individuals with hearing loss require two devices, thereby
increasing the average out of pocket expense to over $2,800.
The new tax credit you propose will assist many who might
otherwise do without and have limited options.
Hearing aids are presently not covered under Medicare, or
under the vast majority of state mandated benefits. In fact,
71.4% of hearing aid purchases do not involve third party
payments, placing the entire burden of the hearing aid
purchase on the consumer.
The need is real. Hearing loss affects 2-3 infants per
1,000 births. For adults, hearing loss usually occurs more
gradually, but increases dramatically with age. Ten million
older Americans experience age-related hearing loss. For
workers, noise induced hearing loss is the second most self-
reported occupational injury. Ten million young adults and
working aged Americans have noise-induced hearing loss.
Enactment of your bill will make a difference in the lives
of some people with hearing loss. Currently 1.28 million
Americans of all ages purchase hearing aids each year, with
many individuals requiring two devices, bringing the total
number of hearing aids purchased across all age groups to
approximately 2 million. This number has remained constant
over recent years. While the legislation is not intended to
cover the full cost of hearing aids, it will provide some
measure of financial assistance to the groups who are in need
of these devices but are unable to afford them.
Thank you for your leadership on this important issue. We
look forward to working with you to seek enactment of your
legislation during the 109th Congress.
Sincerely,
Alexander Graham Bell Association for the Deaf & Hard of
Hearing (AGBell), American Academy of Audiology (AAA),
American Speech-Language-Hearing Association (ASHA),
Conference of Educational Administrators of Schools and
Programs for the Deaf (CEASD), Cued Language Network of
America (CLNA), Media Access Group at WGBH.
National Association of the Deaf (NAD), National Court
Reporters Association (NCRA), National Cued Speech
Association (NCSA), Self Help for Hard of Hearing
People (SHHH), Telecommunications for the Deaf, Inc.
(TDI), TECHUnit.
____
May 17, 2005.
Hon. Norm Coleman,
U.S. Senate,
Washington, DC.
Dear Senator Coleman: The American Speech-Language-Hearing
Association (ASHA) commends you for your continued leadership
on behalf of the estimated 28 million American children and
adults with hearing loss by introducing legislation to
provide assistance to those purchasing hearing aids. The
Hearing Aid Assistance Tax Credit Act will provide financial
assistance to those who need hearing aids, but are unable to
afford them. This bill will provide much needed assistance to
those adults over 55 years of age and families with children
who experience hearing loss.
Studies indicate that when children with hearing loss
receive early intervention and treatment with devices such as
hearing aids, their speech and language development improves
dramatically, making the need for special education services
less likely and costly. Research has also shown that the
quality of life greatly improves for elderly individuals who
use hearing aids.
On behalf of the 118,000 audiologists, speech-language
pathologists, and hearing, speech, and language scientists
qualified to meet the needs of the estimated 49 million (or 1
in 6) children and adults in the United States with
communication disorders, we thank you for introducing this
important piece of legislation and look forward to working
with you and your staff.
Sincerely,
Dolores E. Battle,
President, American Speech-Language-Hearing Association.
____
International Hearing Society,
Livonia, MI, May 16, 2005.
Hon. Norm Coleman,
Hart Senate Office Building,
Washington, DC.
Dear Senator Coleman: On behalf of the International
Hearing Society (IHS), I write to enthusiastically endorse
the Hearing Aid Assistance Tax Credit Act. IHS represents the
vast majority of traditional hearing aid dispensers (hearing
aid specialists) in the United States. Hearing aid
specialists are licensed in 49 states (and registered in
Colorado) specifically to provide hearing health services.
Our members test hearing; select, fit and dispense hearing
aids; and provide hearing rehabilitation and counseling
services. Hearing aid specialists dispense approximately one-
half of all hearing aids in this country.
IHS is deeply appreciative of your interest in improving
access to hearing health care. Only approximately 20% of
those who could benefit from amplification actually utilize
hearing aids. Allowing a credit against tax for the purchase
of hearing aids would likely promote access to this effective
but dramatically underutilized device.
We look forward to working together to promote the nation's
hearing health, a vital component of overall health and well-
being. Please contact me or our Washington Counsel Karen S.
Sealander of McDermott Will & Emery with questions or for
further information.
Sincerely,
Harlan S. Cato,
President.
[[Page S5439]]
____
May 18, 2005.
Hon. Norm Coleman,
U.S. Senate,
Washington, DC.,
Dear Senator Coleman: On behalf of the Hearing Industries
Association (HTA) and the individuals with hearing loss
served by our members, I want to thank you for introducing
the Hearing Aid Assistance Tax Credit Act, and offer HIA's
strong endorsement and support for this worthwhile
legislation.
The Hearing Industries Association (HIA) is dedicated to
providing information about, promoting the use of, and
enhancing access to amplification devices in the United
States. These devices include externally worn hearing aids,
implantable hearing aids (cochlear, middle ear and brain
stem) and an array of assistive listening devices (both
personal and public area communication systems used in
auditoriums, theaters, classrooms and public buildings). Our
members work with the medical community and hearing aid
professionals to treat hearing loss in children and adults,
and we have seen firsthand the dramatic benefit that hearing
aids can provide in terms of greater safety, increased
ability to communicate, and an overall significantly enhanced
quality of life.
For the 31.5 million Americans who have some degree of
hearing loss, the vast majority (95%) can be treated with
hearing aids. Yet only 20% of those with hearing loss use
hearing aids, while a full 30% cite financial constraints as
the reason they do not use hearing aids. This modest bill
would help countless older adults and children who need
hearing aids, but simply cannot afford them. The benefits, in
terms of reduced special education costs for children, as
well as reduced injuries and psychological and mental
disorders associated with hearing loss in older adults, are
immense.
Again, on behalf of HIA and the individuals with hearing
loss whom we serve, we applaud your leadership in introducing
the Hearing Aid Assistance Tax Credit Act, and look forward
to working with you to pass the bill in the 109th Congress.
Sincerely,
Carole Rogin,
Hearing Industries Association.
____
Dear Senator Coleman: On behalf of Self Help for Hard of
Hearing People, the Nation's largest consumer group for
people with hearing loss, we would like to express our
support of the Hearing Aid Assistance Tax Credit Act.
More than 28 million Americans at all stages of life have
some form of hearing loss. If left untreated, hearing loss
can severely reduce the quality of one's personal and
professional life. A landmark study conducted by the National
Council on Aging (NCOA) concluded that hearing loss was
associated with, among other things: depression, impaired
memory, social isolation and reduced general health. For
infants and children left untreated, the cost to schools for
special education and other programs can exceed $420,000,
with additional lifetime costs of $1 million in lost wages
and other health complications, according to a respected 1995
study published in the International Journal of Pediatric
Otorhinolaryngology.
While fully 95 percent of individuals with hearing loss
could be successfully treated with hearing aids, only 22
percent currently use them, according to the largest national
consumer survey on hearing loss in America. Almost \1/3\ of
the individuals surveyed cite financial constraints as a core
reason they do not use hearing aids, which is not surprising
since hearing aids are not covered under Medicare, or under
the vast majority of state mandated benefits. In fact, over
71 percent of all hearing aid purchases involve no third
party payments, thereby placing the entire burden of the
purchase on the consumer.
The Hearing Aid Assistance Tax Credit Act offers a
practical, low cost, and common sense solution to help older
individuals who may not otherwise be able to afford to
purchase a hearing aid, or those purchasing a hearing aid for
their child. The bill is not intended to cover the full cost
of hearing aids, but would simply provide some measure of
financial assistance to the populations who are most in need
of these devices but may not be able to afford them: those
approaching or in retirement, and families with children.
This bipartisan initiative is endorsed by virtually the
entire spectrum of organizations and consumer groups within
the hearing health community. We view this legislation as an
effective and responsible means to encourage individuals to
treat their hearing loss in order to maintain or improve
quality of life.
We are pleased to offer you our support.
Respectfully,
Terry Portis,
Executive Director,
Self Help for Hard of Hearing People.
____
American Academy of Audiology,
Reston, VA, May 17, 2005.
Hon. Norm Coleman,
U.S. Senate, Hart Senate Office Building,
Washington, DC.
Dear Senator Coleman: The American Academy of Audiology,
the largest organization of audiologists representing over
9,700 audiologists, commends you on your leadership on
hearing health care issues and championing policies that
benefit individuals with hearing loss.
The Academy supports the Hearing Aid Assistance Tax Credit
Act which would provide a tax credit of up to $500 per
hearing aid, available once every five years, towards the
purchase of a hearing aid(s) for individuals age 55 and over,
or those purchasing a hearing aid for a dependent. As you
have pointed out with the introduction of this bill, special
tax treatment would improve access to hearing aids since only
22 percent of Americans who could benefit from hearing aids
currently use them. Approximately, 1 million children under
the age of 18 and nearly 10 million Americans over the age of
54 have a diagnosed hearing loss but are not currently using
a hearing aid.
Hearing aids are presently not covered under Medicare, or
under the vast majority of state mandated benefits. In fact,
71.4 percent of hearing aid purchases do not involve third
party payments, placing the entire burden of the hearing aid
purchase on the patient/consumer. This legislation is a
beginning step to helping some individuals with this expense
and raises the awareness of the impact that hearing loss has
on today's society.
In addition, the Academy endorses the Hearing Health
Accessibility Act (S. 277) to provide Medicare beneficiaries
with the option of going to an audiologist or a physician for
hearing and balance diagnostic tests. Direct access would
improve Medicare beneficiaries' access to hearing care
without diminishing the important role of medical doctors, or
expanding the scope of practice for audiology. The Academy
urges you to support this legislation as well.
The Academy appreciates the opportunity to work with you to
promote these important initiatives in the 109th Congress.
Again, we thank you for your leadership in introducing the
Hearing Aid Assistance Tax Credit Act and for your dedication
to the needs of individuals with hearing loss and the health
care professionals providing the services they need to fully
function in society.
Sincerely,
Richard E. Gans,
President.
____
S. 1060
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 ``Hearing Aid Assistance Tax
Credit Act''.
SEC. 2. CREDIT FOR HEARING AIDS FOR SENIORS AND DEPENDENTS.
(a) In General.--Subpart A of part IV of subchapter A of
chapter 1 of the Internal Revenue Code of 1986 (relating to
nonrefundable personal credits) is amended by inserting after
section 25B the following new section:
``SEC. 25C. CREDIT FOR HEARING AIDS.
``(a) Allowance of Credit.--In the case of an individual,
there shall be allowed as a credit against the tax imposed by
this chapter an amount equal to the amount paid during the
taxable year, not compensated by insurance or otherwise, by
the taxpayer for the purchase of any qualified hearing aid.
``(b) Maximum Amount.--The amount allowed as a credit under
subsection (a) shall not exceed $500 per qualified hearing
aid.
``(c) Qualified Hearing Aid.--For purposes of this section,
the term `qualified hearing aid' means a hearing aid--
``(1) which is described in section 874.3300 of title 21,
Code of Federal Regulations, and is authorized under the
Federal Food, Drug, and Cosmetic Act for commercial
distribution, and
``(2) which is intended for use--
``(A) by the taxpayer, but only if the taxpayer (or the
spouse intending to use the hearing aid, in the case of a
joint return) is age 55 or older, or
``(B) by an individual with respect to whom the taxpayer,
for the taxable year, is allowed a deduction under section
151(c) (relating to deduction for personal exemptions for
dependents).
``(d) Election Once Every 5 Years.--This section shall
apply to any individual for any taxable year only if such
individual elects (at such time and in such manner as the
Secretary may by regulations prescribe) to have this section
apply for such taxable year. An election to have this section
apply may not be made for any taxable year if such election
is in effect with respect to such individual for any of the 4
taxable years preceding such taxable year.
``(e) Denial of Double Benefit.--No credit shall be allowed
under subsection (a) for any expense for which a deduction or
credit is allowed under any other provision of this
chapter.''.
(b) Clerical Amendment.--The table of sections for subpart
A of part IV of subchapter A of chapter 1 of such Code is
amended by inserting after the item relating to section 25B
the following new item:
``Sec. 25C . Credit for hearing aids.''.
(c) Effective Date.--The amendments made by this section
shall apply to taxable years beginning after December 31,
2004.
______
By Mr. NELSON of Florida (for himself, Mr. Burns, and Mrs.
Clinton):
S. 1063. A bill to promote and enhance public safety and to encourage
the rapid deployment of IP-enabled voice services; to the Committee on
Commerce, Science, and Transportation.
Mr. NELSON of Florida. Mr. President, I rise today with my
colleagues,
[[Page S5440]]
Senators Burns and Clinton, to introduce the ``IP-Enabled Voice
Communications and Public Safety Act of 2005'' and 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. 1063
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 ``IP-Enabled Voice
Communications and Public Safety Act of 2005''.
SEC. 2. EMERGENCY SERVICE.
(a) 911 and E-911 Services.--Notwithstanding section 2(b)
or any other provision of the Communications Act of 1934, the
Commission shall prescribe regulations to establish a set of
requirements or obligations on providers of IP-enabled voice
service to ensure that 911 and E-911 services are available
to customers to IP-enabled voice service. Such regulations
shall include an appropriate transition period by which to
comply with such requirements or obligations and take into
consideration available industry technological and
operational standards, including network security.
(b) Non-discriminatory Access to Capabilities.--Each entity
with ownership or control of the necessary emergency services
infrastructure shall provide any requesting IP-enabled voice
service provider with nondiscriminatory access to their
equipment, network, databases, interfaces and any other
related capabilities necessary for the delivery and
completion of 911 and E911 calls and information related to
such 911 or E911 calls. Such access shall be consistent with
industry standards established by the National Emergency
Number Association or other applicable industry standards
organizations. Such entity shall provide access to the
infrastructure at just and reasonable, nondiscriminatory
rates, terms and conditions. The telecommunications carrier
or other entity shall provide such access to the
infrastructure on a stand-alone basis.
(c) State Authority.--Nothing in this Act, the
Communications Act of 1934, or any Commission regulation or
order shall prevent the imposition on or collection from a
provider of voice services, including IP-enabled voice
services, of any fee or charge specifically designated or
presented as dedicated by a State, political subdivision
thereof, or Indian tribe on an equitable, and non-
discriminatory basis for the support of 911 and E-911
services if no portion of the revenue derived from such fee
or charge is obligated or expended for any purpose other than
support of 911 and E-911 services or enhancements of such
services.
(d) Standard.--The Commission may establish regulations
imposing requirements or obligations on providers of voice
services, entities with ownership or control of emergency
services infrastructure under subsections (a) and (b) only to
the extent that the Commission determines such regulations
are technologically and operationally feasible.
(e) Customer Notice.--Prior to the compliance with the
rules as required by subsection (a), a provider of an IP-
enabled voice service that is not capable of providing 911
and E-911 services shall provide a clear and conspicuous
notice of the unavailability of such services to each
customer at the time of entering into a contract for such
service with that customer.
(f) Voice Service Provider Responsibility.--An IP-enabled
voice service provider shall have the sole responsibility for
the proper design, operation, and function of the 911 and
E911 access capabilities offered to the provider's customers.
(g) Parity of Protection for Provision or Use of IP-enabled
Voice Service.--
(1) Provider parity.--If a provider of an IP-enabled voice
service offers 911 or E-911 services in compliance with the
rules required by subsection (a), that provider, its
officers, directors, employees, vendors, and agents, shall
have immunity or other protection from liability of a scope
and extent that is not less than the scope and extent of
immunity or other protection from liability that any local
exchange company, and its officers directors, employees,
vendors, or agents, have under the applicable Federal and
State law (whether through statute, judicial decision,
tariffs filed by such local exchange company, or otherwise),
including in connection with an act or omission involving the
release of subscriber information related to the emergency
calls or emergency services to a public safety answering
point, emergency medical service provider, or emergency
dispatch provider, public safety, fire service, or law
enforcement official, or hospital emergency or trauma care
facility.
(2) User parity.--A person using an IP-enabled voice
service that offers 911 or E-911 services pursuant to this
subsection shall have immunity or other protection from
liability of a scope and extent that is not less than the
scope and extent of immunity or other protection from
liability under applicable law in similar circumstances of a
person using 911 or E-911 service that is not provided
through an IP-enabled voice service.
(3) PSAP parity.--In matters related to IP-enabled 911 and
E-911 communications, a PSAP, and its employees, vendors,
agents, and authorizing government entity (if any) shall have
immunity or other protection from liability of a scope and
extent that is not less than the scope and extent of immunity
or other protection from liability under applicable law
accorded to such PSAP, employees, vendors, agents, and
authorizing government entity, respective, in matters related
to 911 or E-911 communications that are not provided via an
IP-enabled voice service.
(h) Delegation Permitted.--The Commission may, in the
regulations prescribed under this section, provide for the
delegation to State commissions of authority to implement and
enforce the requirements of this section and the regulations
thereunder.
SEC. 3. MIGRATION TO IP-ENABLED EMERGENCY NETWORK.
Section 158 of the National Telecommunications and
Information Administration Organization Act (as added by
section 104 of the ENHANCE 911 Act of 2004) is amended--
(1) by redesignating subsections (d) and (e) as subsections
(e) and (f), respectively; and
(2) by inserting after subsection (c) the following:
``(d) Migration Plan Required.--
``(1) National plan required.--No more than 18 months after
the date of the enactment of the ENHANCE 911 Act of 2004, the
Office shall develop and report to Congress on a national
plan for migrating to a national IP-enabled emergency network
capable of receiving and responding to all citizen activated
emergency communications.
``(2) Contents of plan.--The plan required by paragraph (1)
shall--
``(A) outline the potential benefits of such a migration;
``(B) identify barriers that must be overcome and funding
mechanisms to address those barriers;
``(C) include a proposed timetable, an outline of costs and
potential savings;
``(D) provide specific legislative language, if necessary,
for achieving the plan; and
``(E) provide recommendations on any legislative changes,
including updating definitions, to facilitate a national IP-
enabled emergency network.
``(3) Consultation.--In developing the plan required by
paragraph (1), the Office shall consult with representatives
of the public safety community, technology and
telecommunications providers, and others it deems
appropriate.''.
SEC. 4. DEFINITIONS.
(a) In General.--For purposes of this Act:
(1) 911 and e-911 services.--
(A) 911.--The term ``911'' means a service that allows a
user, by dialing the three-digit code 911, to call a public
safety answering point operated by a State, local government,
Indian tribe, or authorized entity.
(B) E-911.--The term ``E-911 service'' means a 911 service
that automatically delivers the 911 call to the appropriate
public safety answering point, and provides automatic
identification data, including the originating number of an
emergency call, the physical location of the caller, and the
capability for the public safety answering point to call the
user back if the call is disconnected.
(2) Ip-enabled voice service.--The term ``IP-enabled voice
service'' means an IP-enabled service used for real-time 2-
way or multidirectional voice communications offered to a
customer that--
(A) uses North American Numbering Plan administered
telephone numbers, or successor protocol; and
(B) has two-way interconnection or otherwise exchange
traffic with the public switched telephone network.
(3) Customer.--The term ``customer'' includes a consumer of
goods or services whether for a fee, in exchange for an
explicit benefit, or provided for free.
(4) Ip-enabled service.--The term ``IP-enabled service''
means the use of software, hardware, or network equipment
that enable an end user to send or receive a communication
over the public Internet or a private network utilizing
Internet protocol, or any successor protocol, in whole or
part, to connect users--
(A) regardless of whether the communication is voice, data,
video, or other form; and
(B) notwithstanding --
(i) the underlying transmission technology used to transmit
the communications;
(ii) whether the packetizing and depacketizing of the
communications occurs at the customer premise or network
level; or
(iii) the software, hardware, or network equipment used to
connect users.
(5) Public switched telephone network.--The term ``public
switched telephone network'' means any switched common
carrier service that is interconnected with the traditional
local exchange or interexchange switched network.
(6) PSAP.--The term ``public safety answering point'' or
``PSAP'' means a facility that has been designated to receive
911 calls.
(b) Common Terminology.--Except as otherwise provided in
subsection (a), terms used in this Act have the meanings
provided under section 3 of the Communications Act of 1934.
______
By Mr. COCHRAN (for himself, Mr. Kennedy, Mr. Warner, Ms.
Cantwell, Ms. Collins, and Mr. Dayton):
S. 1064. A bill to amend the Public Health Service Act to improve
stroke prevention, diagnosis, treatment, and rehabilitation; to the
Committee on Health, Education, Labor, and Pensions.
[[Page S5441]]
Mr. KENNEDY. Mr. President, the month of May is Stroke Awareness
Month, and it is a privilege to join Senators Cochran, Warner,
Cantwell, Collins, and Dayton in introducing the Stroke Treatment and
Ongoing Prevention Act of 2005. The STOP Stroke Act is a vital step in
building a national network of effective care to diagnose and quickly
treat victims of stroke and improve the quality of care for stroke
patients across America.
For over 20 years, stroke has been the third leading cause of death
in our country, affecting about 700,000 Americans a year and killing
approximately 163,000 a year. Every 45 seconds, another American
suffers a stroke. Every 3 minutes, another American dies. Few families
today are untouched by this cruel, debilitating, and often fatal
disease that strikes indiscriminately, and robs us of our loved ones.
Even for those who survive, a stroke can have devastating consequences.
Over half of all survivors are left with a disability.
Prompt treatment with clot-dissolving drugs within three hours of a
stroke can dramatically improve these outcomes. Yet, only 2-3 percent
of all stroke patients are treated with such a drug within those
crucial first three hours. Few Americans recognize the symptoms of
stroke, and crucial hours are often lost before a patient receives
treatment. Emergency room staffs are often not trained to recognize and
manage the symptoms, which further adds to the delay in treatment.
Patients at hospitals with primary stroke centers have nearly five
times greater chance of receiving clot-dissolving drugs.
Modern medicine is generating new scientific advances that increase
the chance of survival and at least partial or even full recovery
following a stroke. Physicians are learning to manage strokes more
effectively, and they are also learning how to prevent them in the
first place.
But science doesn't save lives and protect health by itself. We need
to do more to bring new discoveries to the patient and new awareness to
the public. That means educating as many people as possible about the
warning signs of stroke, so that they know enough to seek medical
attention. It means training doctors and nurses in the best techniques
of care. It means finding better ways to treat victims as quickly and
as effectively as possible--so that they have the best chance of full
recovery.
Our bill provides grants to States to implement statewide systems of
stroke care that will give health professionals the equipment and
training they need to treat this disorder. It also establishes a
continuing education program to make sure that medical professionals
are well trained and well aware of the newest treatments and prevention
strategies. The initial point of contact between a stroke patient and
medical care is usually an emergency medical technician. Grants under
this bill may be used to train these personnel to provide more
effective care to stroke patients in the crucial first few moments
after an attack.
The bill directs the Secretary of Health and Human Services to
conduct a national media campaign to inform the public about the
symptoms of stroke, so that more patients can recognize the symptoms
and receive prompt medical care. The bill also authorizes the Secretary
of HHS, acting through CDC, to operate the Paul Coverdell National
Acute Stroke Registry, which will collect data about the care of stroke
patients and assist in the development of more effective treatments.
The bill also provides new resources for states to improve the
standard of care for stroke patients in hospitals, and to increase the
quality of care in rural hospitals through improvements in
telemedicine.
On Monday, the Wall Street Journal published an excellent article on
the inadequate treatment that stroke patients often encounter when
ambulances bring them to hospitals with staffs not trained in the early
treatment of stroke or lacking the needed equipment to intervene early.
Over twenty years ago, the survival of trauma victims was very much
dependent on whether the ambulance took them to a hospital with a
trauma care center, or to a hospital not equipped to treat traumatic
injury. Congress passed the Trauma Care Systems Planning and
Development Act of 1990 that revolutionized the treatment for accident
victims. Now in 2005, it is long past time to see that state of the art
care is made available to stroke patients as quickly as possible.
Stroke is a national tragedy that leaves no American community
unscarred. Fortunately, if the right steps are taken during the brief
window of time available, effective treatment can make all the
difference between healthy survival and disability or death. We need to
do all we can to see that those precious few hours are not wasted. The
STOP Stroke Act is a significant step in reaching that goal. May is
Stroke Awareness Month, and I urge Congress to act quickly on this
legislation, and give stroke victims a far better chance for full
recovery.
I ask unanimous consent that the full text of a Wall Street Journal
article of May 9 on this issue be printed in the Record.
There being no objection, the article was ordered to be printed in
the Record, as follows:
[From the Wall Street Journal, May 9, 2005]
Stroke Victims Are Often Taken to Wrong Hospital
(By Thomas M. Burton)
Christina Mei suffered a stroke just before noon on Sept.
2, 2001. Within eight minutes, an ambulance arrived. Her
medical fate may have been sealed by where the ambulance took
her.
Ms. Mei's stroke, caused by a clot blocking blood flow to
her brain, occurred while she was driving with her family
south of San Francisco. Her car swerved, but she was able to
pull over before slumping at the wheel. Paramedics saw the
classic signs of a stroke: The 45-year-old driver couldn't
speak or move the right side of her body.
Had Ms. Mei's stroke occurred a few miles to the south, she
probably would have been taken to Stanford University Medical
Center, one of the world's top stroke hospitals. There, a
neurologist almost certainly would have seen her quickly and
administered an intravenous drug to dissolve the clot.
Stanford was 17 miles away, across a county line.
But paramedics, following county ambulance rules that
stress proximity, took her 13 miles north, to Kaiser
Permanente's South San Francisco Medical Center. There,
despite her sudden inability to talk or walk and her facial
droop, an emergency-room doctor concluded she was suffering
from depression and stress. It was six hours before a
neurologist saw her, and she never got the intravenous clot-
dissolving drug.
In a legal action brought against Kaiser on Ms. Mei's
behalf, an arbitrator found that her care had been negligent,
and in some aspects ``incomprehensible.'' Today, Ms. Mei
can't dress herself and walks unsteadily, says her lawyer,
Richard C. Bennett. The fingers on her right hand are curled
closed, and she has had to give up her main avocations:
calligraphy, ceramics and other types of art. Kaiser declined
to comment beyond saying that it settled the case under
confidential terms ``based on some concerns raised in the
litigation.''
Stroke is the nation's No. 1 cause of disability and No. 3
cause of death, killing 164,000 people a year. But far too
many stroke victims, like Ms. Mel, get inadequate care thanks
to deficient medical training and outdated ambulance rules
that don't send patients to the best stroke hospitals.
Over the past decade, American medicine has learned how to
save stroke patients' lives and keep them out of nursing
homes. New techniques offer a better chance of complete
recovery by dissolving blood clots and treating even more
lethal strokes caused by burst blood vessels in the brain.
But few patients receive this kind of treatment because most
hospitals lack specialized staff and knowledge, stroke
experts say. State and county rules generally require
paramedics to take stroke patients to the nearest emergency
room, regardless of that hospital's level of expertise with
stroke.
Stroke care is positioned roughly where trauma care was a
quarter-century ago. By 1975, surgeons expert at treating
victims of car crashes and other major accidents realized
that taking severely injured patients to the nearest
emergency room could mean death. So the surgeons led a push
to make selected regional hospitals into specialized trauma
centers and to overhaul ambulance protocols so that
paramedics would speed the most severely injured to those
centers. Now, in many areas of the U.S., accident victims go
quickly to a trauma center, and trauma specialists say this
change has saved lives and lessened disability.
Eighty percent or more of the 700,000 stokes that Americans
suffer annually are ``ischemic,'' meaning they are caused by
blockage of an artery feeding the brain, usually a blood
clot. Most of the rest are ``hemorrhagic'' strokes, resulting
from burst blood vessels in or near the brain. Although they
have different causes, both result in brain tissue dying
by the minute.
Several factors have combined to prevent improvement in
stroke care. In some areas, hospitals have resisted movement
toward a system of specialized stroke centers because
nondesignated institutions could lose business, according to
neurologists who favor the
[[Page S5442]]
changes. In addition, stroke treatment has lacked an
organized lobby to galvanize popular and political interest
in the ailment.
doctor ignorance
A big reason for the backwardness of much stroke treatment
is that many doctors know little about it. Even emergency
physicians and internists likely to see stroke victims tend
to receive scant neurology training in their internships and
residencies according to stroke specialists.
``Surprisingly, you could go through your entire internal
medicine rotation without training in neurology, and in
emergency medicine it hasn't been emphasized,'' says James C.
Grotta, director of the stroke program at the University of
Texas Health Science Center at Houston.
Many hospitals don't have a neurologist ready to deal with
emergencies. As a result, strokes aren't treated urgently
there, even though short delays increase chance of severe
disability or death. Even if doctors do react quickly, recent
research has shown that many aren't sure what treatment to
provide.
For example, a survey published in 2000 in the journal
Stroke showed that 66 percent of hospitals in North Carolina
lacked any protocol for treating stroke. About 82 percent
couldn't rapidly identify patients with acute stroke.
As with other life-threatening conditions, stroke patients
are better off going where doctors have had a lot of practice
addressing their ailment. A seven-year analysis of surgery in
New York state in the 1990s showed that patients with
ruptured blood vessels in the brain were more than twice as
likely to die--16% versus 7%--in hospitals doing few such
operations, compared with those doing them regularly. A
national study published last year in the Journal of
Neurosurgery showed a similar disparity.
Another major shortcoming of most stroke treatment,
according to many neurologists, is the failure to use the
genetically engineered clot-dissolving drug known as tPA.
Short for tissue plasminogen activator, tPA, which is made by
Genentech Inc., has been shown to be a powerful treatment
that can lessen disability for many patients. A study
published in 2004 in The Lancet, a prominent medical journal,
showed that the chances of returning to normal are about
three times greater among patients getting tPA in the first
90 minutes after suffering a stroke, even after accounting
for tPA's potential side effect of cerebral bleeding that can
cause death. But several recent medical-journal articles have
found that nationally, only 2% to 3% of strokes caused by
clots are treated with tPA, which has no competitor on the
market.
Some authors of studies supporting the use of tPA have had
consultant or other financial relationships with Genentech.
Skeptics of the drug point to these ties and stress tPA's
side-effect danger. But among stroke neurologists, there is a
strong consensus that the drug is effective.
One reason why many patients don't receive tPA is that they
arrive at the hospital more than three hours after a stroke,
the time period during which intravenous tPA should be given.
But many hospitals and doctors don't use tPA at all, even
though it has been available in the U.S. since 1996. The
dissolving agent's relatively high cost--$2,000 or more per
patient--is a barrier. Medicare pays hospital a flat
reimbursement of about $6,700 for stroke treatment,
regardless of whether tPA is used.
airport emergency
Glender Shelton of Houston had an ischemic stroke caused by
a clot at Los Angeles International Airport on Dec. 30, 2003.
In full view of other holiday travelers, Ms. Shelton, then
66, slumped over, and an ambulance was called. It was 4:45
p.m.
By 5:55 p.m., she arrived at what now is called Centinela
Freeman Regional Medical Center, four miles away in Marina
del Rey. Hospital records show that doctors thought Ms.
Shelton had suffered an ``acute stroke.'' But she didn't get
a CT scan, a recommended initial step, until 9 p.m. By then,
she was already outside the three-hour window for safely
administering intravenous tPA. Records also say she didn't
receive the drug ``due to unavailability of neurologist until
after the patient had been outside the three-hour time
window.''
Ms. Shelton's daughter, Sandi Shaw, was until recently
nurse-manager of the prestigious stroke unit at the
University of Texas Health Science Center at Houston. Ms.
Shaw says that at her unit, her mother would have had a CT
scan within five minutes of arriving, and tPA probably would
have been administered 30 or 35 minutes after that.
Today, according to her daughter, Ms. Shelton often can't
come up with words or relatives' names, can't take care of
her finances, and can't follow certain basic commands in
neurological tests.
Kent Shoji, an emergency-room doctor at Centinela Freeman
who handled Ms. Shelton's case, says, ``She was a possible
candidate for tPA,'' but a CT scan was required first. ``The
order was put in for a CT scan,'' Dr. Shoji says, ``I can't
answer why it took so long.''
A Centinela Freeman spokeswoman says, ``We did not have 24/
7 coverage with our CT scan, and we had to call, a technician
to come in. That's pretty common with a community hospital.''
The hospital has since been acquired by a larger health
system and now does have 24-hour CT capability.
`Parochial Interests'
A hospital-accrediting group has begun designating
hospitals as stroke centers, but that is only part of what is
needed, stroke experts assert. They say hospitals typically
have to come together to create local political momentum to
change state or county rules to that ambulances actually take
stroke patients to stroke centers, not the nearest ER. New
York, Maryland and Massachusetts are moving toward creating
stroke-care systems, and Florida recently passed a law
creating stroke centers. But in many places, short-term
economic interests impede change, some doctors say.
``There are still very parochial interests by hospitals and
physicians to keep patients locally even if they're not
equipped to handle them,'' says neurosurgeon Robert A.
Solomon of New York Presbyterian Hospital/Columbia.
``Hospitals don't want to give up patients.''
The University of California at San Diego runs one of the
leading stroke hospitals in the country. It and others in the
area that are well prepared to treat stroke patients have
sought for a decade to set up a regional system, but there
has been little progress, says Patrick D. Lyden, UCSD's chief
of neurology, ``Some hospitals are resisting losing stroke
business,'' he says. ``We have the same political crap as in
most communities. Paramedics still take people to the local
ER.''
Among the opponents of the stroke-center concept during the
1990s was Richard Stennes, the ER director at Paradise Valley
Hospital south of San Diego. In various public debates, Dr.
Stennes recalls, he argued that many apparent stroke patients
would be siphoned away from community hospitals even if they
didn't turn out to have strokes. Also, he argued that tPA
might cause more injury than it prevents. And then there was
the economic issue: ``Those hospitals without all the
equipment and stroke experts,'' he says, ``would be concerned
about all the patients going to a stroke center and taking
the patients away from us.'' Dr. Stennes has since retired.
``All hospitals and clinicians try to deliver the right
care to patients, especially those with urgent medical
needs,'' says Nancy E. Foster, vice president for quality of
the American Hospital Association, which represents both
large and small hospitals. ``Community hospitals may be
equally good at delivering stroke care, and it would be
important for patients to know how well prepared their local
hospital is.''
Stroke experts aren't proposing that every hospital needs
to specialize in stroke care but instead that in every
population center there should be at least one that does. In
Atlanta, Emory University's neuro-intensive care unit
illustrates the special skills that make for top care. Owen
B. Samuels, director of the unit, estimates that 20% to 30%
of patients it treats received poor initial medical care
before arriving at Emory, jeopardizing their futures or even
lives. Brain hemorrhages, for example, are commonly
misdiagnosed, even in patients who repeatedly showed up at
emergency rooms with unusually severe headaches, Dr. Samuels
says.
The Emory unit has 30 staff members, including two neuro-
critical care doctors and five nurse practitioners. A team is
on duty 24 hours a day. The unit handles about two dozen
patients most days, keeping the staff busy. On the ward,
nearly all patients are unconscious or sedated, so it's
eerily silent. Patients generally need to rest their brains
as they recover from stroke or surgery.
After a hemorrhagic stroke, blood pressure in the cranium
builds as blood continues to seep out of the ruptured vessel.
Pressure can be deadly, cutting off oxygen to the brain. Or
escaped blood can cause a ``vasospasm,'' days after the
original stroke, in which the brain reacts violently to
seeped-out blood. In the worst case, the brain herniates, or
squeezes out the base of the skull, causing death. To avoid
this, nurses at Emory constantly monitor brain pressure and
temperatures. They put in drain lines. They infuse medicines
to dehydrate, depressurize and stop bleeding.
Since Emory launched the neuro-intensive unit seven years
ago, 42% of patients with hemorrhagic strokes have become
well enough to go home, compared with 27% before. Fewer need
rehabilitation--31% versus 40%--and the death rate is down.
Damica Townsend-Head, 33, gave the Emory team a scare.
After surgery last fall for a hemorrhagic stroke, her brain
swelling was ``really out of control,'' Dr. Samuels says,
raising questions about whether she would survive. The staff
put a ``cooling catheter'' into a blood vessel, which allowed
the circulation of ice water to bring down the temperature in
her blood and brain. They intentionally dehydrated her brain
to lower pressure. A month later, she woke up and recovered
with minimal disability. She still walks with a cane and
tires easily, but her speech is normal and she hopes to
return soon to work. ``I consider her what we're in
business for,'' Dr. Samuels says.
public awareness
The public's low awareness of stroke symptoms--and the need
to respond immediately--can also hinder proper care. Ischemic
strokes, those caused by clots or other artery blockage,
cause symptoms such as muscle weakness or paralysis on one
side, slurred speech, facial droop, severe dizziness,
unstable gait and vision loss. People with this kind of
stroke are sometimes mistaken for being drunk. In addition to
intense head
[[Page S5443]]
pain, a hemorrhagic stroke often leads to nausea, vomiting or
loss of balance or consciousness. Still, many people with
some of these symptoms merely go to bed in hopes of improving
overnight, doctors say. Instead, they should go immediately
to a hospital and demand a CT scan as a first diagnostic
step.
The well-funded American Heart Association, established in
1924, has made many people aware of heart attack symptoms and
thereby saved many lives. In contrast, the American Stroke
Association was started only in 1998 as a subsidiary of the
heart association. The stroke association spent $162 million
last year out of the heart association's $561 million overall
budget.
Justin Zivin, another University of California at San Diego
stroke expert, says the stroke association ``is a terribly
ineffective bunch. When it comes to actual public education,
I haven't seen anything.''
The stroke association counters that it is buying
television and radio ads promoting awareness, similar to ones
produced in 2003 and 2004. The group also sponsors research
and education, including an annual international stroke-
medicine conference.
It's not just the general public that fails to recognize
stroke symptoms. Often, emergency-room doctors and nurses
don't either. Gretchen Thiele of suburban Detroit began
having horrible headaches last May, for the first time in her
life. ``She wasn't one to complain, but she said, `I can't
even lift my head off the pillow.' '' recalls her daughter,
Erika Mazero. Ms. Thiele, 57, nearly passed out from the pain
one night and suffered blurred vision. When the pain recurred
in the morning, she went to the emergency room at nearby St.
Joseph's Mercy of Macomb Hospital. Ms. Mazero says that
during the six hours her mother spent there, she was given a
CT scan, but not a spinal tap, which could definitively have
shown she had a leaking brain aneurysm, meaning a ballooned
and weakened artery in her brain. After the CT, Ms. Thiele
was given a muscle relaxant and pain medicine and sent home,
her daughter says.
Two months later, the blood vessel burst. Neurosurgeons at
William Beaumont Hospital in Royal Oak, Mich., did emergency
surgery, but Ms. Thiele suffered massive bleeding and died.
Ali Bydon, one of the neurosurgeons at Beaumont, says a CT
scan often is inadequate and that her condition could have
been detected earlier with a spinal tap, also called a lumbar
puncture. ``Had she had a lumbar puncture and perhaps an
operation earlier, it might have saved her life,'' says Dr.
Bydon. ``In general, a person who tells you, `I usually don't
get headaches, and this is the worst headache of my life,' is
something that should alarm you.''
In addition, he says Ms. Thiele ``absolutely'' was
experiencing smaller-scale bleeding in May that foreshadowed
a more serious rupture. If doctors identify this kind of
bleeding early, he says, chances of death are ``minimal.''
But when a rupture occurs, he says, ``25% of patients
never make it to the hospital, 25% die in the hospital and
25% are severely disabled.''
A St. Joseph's hospital spokeswoman says the hospital has
``very aggressive standards for treatment, and we met this
standard.'' declining to elaborate.
determined nurse
Paramedics did the right thing after Chuck Toeniskoetter's
stroke, but only because of some extraordinary intervention.
Mr. Toeniskoetter, then 55, was on a ski trip, Dec. 23, 2000,
at Bear Valley, near Los Angeles. He had just finished a run
at 3:30 p.m. when, in the snowmobile shop, he began slurring
his words and nearly fell over. Kathy Snyder, the nurse in
the ski area's first-aid room quickly diagnosed stroke. She
called a helicopter and an ambulance.
Ms. Snyder says she knew the closest hospital with a stroke
team was Sutter Roseville Medical Center in Roseville, CA.
The helicopter pilot was planning to take Mr. Toeniskoetter
to a closer ER, but Ms. Snyder says she stood on the
helicopter runners, demanding the patient go to Sutter. The
pilot eventually relented. Mr. Toeniskoetter went to Sutter,
where he promptly received tPA. Today, he has no disability
and is back running a real estate-development business in the
San Jose area. ``Trauma patients go to trauma centers, not
the nearest hospital,'' he says. ``Stroke victims, too,
require a real specialized sort of care.''
One-third of all strokes are suffered by people under 60,
and hemorrhagic strokes in particular often strike young
adults and children. Vance Bowers of Orlando, Fla., was 9
when he woke up screaming that his eyes hurt, shortly after 1
a.m. on Jan. 8, 2001. Malformed blood vessels in his brain
were bleeding. He was in a coma by the time an ambulance
delivered him at 1:57 a.m. to the nearest emergency room, at
Florida Hospital East Orlando.
Emergency-room doctors soon realized Vance had a
hemorrhagic stroke. But neurosurgery isn't performed at that
hospital. A sister hospital 14 minutes away by ambulance,
Florida Hospital Orlando, did have neurosurgical capability.
But in part because of administrative tangles, Vance didn't
get to the second hospital until 4:37 a.m., more than two
hours after his arrival. Surgery began at 6:18 a.m. ``This
delay may have cost this young man the possibility of a
functional survival,'' Paul D. Sawin, the neurosurgeon who
operated on Vance, said in a letter to the hospitals' joint
administration.
Florida Hospital, an emergency-medicine group and an ER
doctor recently agreed to settle a lawsuit filed against them
in Orange County, Fla., Circuit Court by the Bowers family.
The defendants agreed to pay a total of $800,000, court
records show. Monica Reed, senior medical officer of the
hospital, says the care Vance received was ``stellar'' and
that any delays weren't medically significant. Vance's
stroke, not the care he received, caused his injuries, she
said.
Vance, now 13, survived but is mentally handicapped and
suffers daily seizures, his mother, Brenda Bowers, says. Once
a star baseball player, he goes by wheelchair to a class for
disabled children. He speaks very slowly but not in a way
that many people can understand. ``He remembers playing
baseball with all of his friends,'' his mother says but they
rarely come around any more. ``He really misses all that.''
______
By Mr. THUNE (for himself and Mrs. Clinton):
S. 1065. A bill to amend title 10, United States Code, to extend
child care eligibility for children of members of the Armed Forces who
die in the line of duty; to the Committee on Armed Services.
Mr. THUNE. Mr. President, today I rise with my distinguished
colleague from New York, Senator Clinton, to introduce legislation that
will provide a surviving spouse with two years of child care
eligibility on any military instillation or Federal facility with a
child care center. The legislation was inspired by our work on the
Senate Armed Services Committee. In February the committee held an
important hearing on improving survivor benefits and the government's
role in helping survivors cope with the loss of a loved one. All too
often surviving spouses are forced to make difficult, life changing
decisions alone. Both Senator Clinton and I are determined to provide
as much help as possible to those who must bear the burden of loss,
particularly those with young children. By providing two years of child
care eligibility, our goal is to ensure that a surviving spouse has the
time and tools necessary to make a healthy adjustment to life after the
servicemember's death. Many decisions face survivors, most importantly,
how to make a living. Often that means having to re-enter the work
force after years of being a working mother. The question of how to
adequately care for young children while trying to find employment or
restart a career should not be an issue. Further, we have expanded this
eligibility to include access to child care centers in other Federal
facilities. This will aide surviving spouses with children if they are
in the process of relocating to an area of the country without a
military base nearby, but in the proximity of a local Federal building.
I am honored that Senator Clinton is working with me on this
legislation and I encourage my colleagues to support this important
measure.
______
By Mr. VOINOVICH (for himself, Ms. Stabenow, Mr. Bunning, Mr.
Levin, Mr. Alexander, Mr. DeWine, Mr. McConnell, and Mr.
Frist):
S. 1066. A bill to authorize the States (and subdivisions thereof),
the District of Columbia, territories, and possessions of the United
States to provide certain tax incentives to any person for economic
development purposes; to the Committee on Finance.
Mr. VOINOVICH. Mr. President, I rise today to introduce the Economic
Development Act of 2005 to authorize States to provide tax incentives
for economic development purposes.
This legislation is crucial to preserve tax incentives as an
important tool for State and local governments to promote economic
development in the wake of last year's decision by the Sixth Circuit
Court of Appeals in Cuno v. DaimlerChrysler.
In its decision in Cuno, the Sixth Circuit struck down Ohio's
manufacturing machinery and equipment tax credit, which I helped enact
while I was Governor of Ohio, on grounds that it violated the
``dormant'' Commerce Clause of the U.S. Constitution. The court ruled
that the tax incentive violated the Commerce Clause of the U.S.
Constitution because it granted preferential tax treatment to companies
that invest within the State rather than in other States.
The Cuno decision has had severe repercussions across the country.
The decision immediately cast doubt on the constitutionality of tax
incentives presently offered by all fifty States. As
[[Page S5444]]
a result, States and businesses have been reluctant to go forward with
new projects that depend on the availability of tax incentives out of
concern that the Cuno decision may be used to invalidate those
incentives. This legal uncertainty has worsened an already challenging
economic environment. Furthermore, the decision threatens to undermine
federalism by dramatically restricting the ability of States to craft
their tax codes to promote economic development in the manner they
determine is best. If left standing, this decision will handcuff the
States in the Sixth Circuit, as well as States in other circuits where
the court chooses to follow Cuno, in their efforts to promote economic
growth and create jobs. Additionally, it will cripple their ability to
compete internationally. In today's competitive economic environment,
we can not afford to unilaterally discard the use of tax incentive to
attract business to this country. As a former Governor who had to
compete against Japan, Canada, China and Europe for new business
projects, I know just how important a role tax incentives can play in
attracting new businesses. I can assure you that our competitors are
certainly not going to stop using tax incentives. Neither should we.
Fortunately, the U.S. Constitution gives Congress the power to
determine which State actions violate the Commerce Clause. The purpose
of the Economic Development Act of 2005 is therefore to have Congress
override the decision in Cuno by authorizing States to provide tax
incentives for economic development purposes. The legislation would
remove the legal uncertainty surrounding tax incentives created by the
Cuno decision and preserve the States' power to design their tax codes
to promote economic development.
The history of the tax incentive struck down in Cuno demonstrates the
important role tax incentives can play in promoting economic
development. When I was Governor of Ohio, at my request and as part of
my jobs incentive package, the Ohio Legislature enacted the
manufacturing machinery and equipment tax incentive to encourage
businesses to expand their operations in Ohio and to help draw new
businesses to Ohio. It worked. Between 1993 and 1997, Ohio was ranked
number one in the Nation by Site Selection and Industrial Development
magazine three times for highest number of new facilities, expanded
facilities, and new manufacturing plants. Since the program's
inception, businesses have been eligible to claim a total of $2 billion
in credits toward $34 billion in new equipment investments.
Currently, this incentive is part of an incentive package being
offered to automobile manufacturer DaimlerChrysler in support of its
plans for a $200 million expansion of their Jeep plant. The ruling by
the Sixth Circuit in Cuno, however, puts that expansion in jeopardy and
threatens to undermine Ohio's competitiveness in attracting new
businesses.
In the Cuno decision, the Sixth Circuit ruled that the manufacturing
machinery and equipment tax incentive, given by Ohio to DaimlerChrysler
as part of its incentive package, violated the Commerce Clause of the
U.S. Constitution because it discriminated against interstate
commerce by granting preferential tax treatment to companies that
expanded within the State rather than in other States.
The Cuno decision is troubling for several reasons. First, I believe
the Sixth Circuit failed to appreciate the need for States to condition
the availability of certain tax incentives on the undertaking of the
specified economic activity within a State. In the case of the
manufacturing machinery and equipment tax incentive, Ohio needed to
limit the availability of the tax incentive to the investments
undertaken in the State. Otherwise, Ohio would have been giving
companies a tax incentive for activity that did not benefit the State.
In other words, Ohio would have been effectively subsidizing investment
in other States. We all know that in economics there is no free lunch
and States should not be forced to provide a free lunch when they
choose to give tax incentives. If Ohio or any other State is willing to
forego tax revenue, it should be allowed to receive something in
return, namely investment or other economic activity in the State.
Accordingly, Ohio's tax incentive did not discriminate against
interstate commerce. It merely required companies, if they chose to
take advantage of the incentive, to undertake the investment in Ohio,
the same State that would be foregoing tax revenue to provide the
incentive.
There is also a little legal fiction present in the Cuno decision.
The court states that Ohio could have provided a direct subsidy to
companies that undertook investment in the State. Because Ohio decided
to structure the program as a tax credit, however, the court said that
it ran afoul of the Commerce Clause. I do not see how a direct subsidy
does not violate the dormant Commerce Clause, but a tax credit does.
They are economically the same.
If left standing, the Cuno decision will have a particularly
detrimental effect on the U.S. manufacturing sector. From rising energy
and health care costs to frivolous lawsuits and unfair international
trade practices, the U.S. manufacturing sector and the hard working men
and women who drive it are getting squeezed from all sides. Despite all
they are up against, it's a testament to their ability and
determination that they are still the most productive manufacturers in
the world. This Sixth Circuit decision, however, is a new roadblock
that threatens to take away one of the most effective and efficient
means for assisting manufacturers who want to create new jobs here in
America. The Economic Development Act of 2005 will make sure that
manufacturers don't lose key tax incentives just when such incentives
are needed the most.
The Cuno decision also sets a bad precedent that, if not checked,
could upset our carefully balanced federal system. One of the most
ingenious aspects of the U.S. Constitution is that it leaves a great
deal of power with the States. It gives the States flexibility to
devise their own solutions and, in the process, fosters innovation in
government. Thus, the States are the laboratories of our democracy and
an innovation they have developed to help create jobs and prosperity
are programs that encourage new growth through tax incentives for
training, job creation, and investment in new plants and equipment. The
availability of tax incentives was critical to our success in Ohio and
in being number one in new plant construction and expansion. Because
Ohio had the ability to devise tax incentives that fit its economic
development needs, we were able to create thousands of new jobs. My
legislation will guarantee that the States remain our engines of
innovation.
This legislation is something that Congress should have done a long
time ago. The courts are not well-suited to making the often complex
policy decisions regarding whether a tax incentive truly discriminates
against interstate commerce and hinders the creation of a national
market, or whether a tax incentive actually fosters innovation and job
growth. Such decisions necessarily involve a careful weighing of
competing and often mutually exclusive interests, and therefore should
be made by Congress. Moreover, judicial decisions often fail to provide
bright lines on which incentives run afoul of the dormant Commerce
Clause, injecting uncertainty about the validity of certain tax
incentives that makes businesses weary of relying on them and reduce
their effectiveness. Indeed, the Supreme Court itself has called its
dormant Commerce Clause jurisprudence a ``quagmire.'' Hence, it is time
that Congress provide some clear rules on the treatment of tax
incentives under the Commerce Clause.
As Supreme Court Justice Felix Frankfurter stated nearly a half-
century ago:
At best, this Court can only act negatively; it can
determine whether a specific state tax is imposed in
violation of the Commerce Clause. Such decisions must
necessarily depend on the application of rough and ready
legal concepts. We cannot make a detailed inquiry into the
incidence of diverse economic burdens in order to
determine the extent to which such burdens conflict with
the necessities of national economic life. Neither can we
devise appropriate standards for dividing up national
revenue on the basis of more or less abstract principles
of constitutional law, which cannot be responsive to the
subtleties of the interrelated economies of Nation and
State.
The problem calls for solution by devising a congressional
policy. Congress alone can provide for a full and thorough
canvassing of the multitudinous and intricate factors which
compose the problem of the taxing
[[Page S5445]]
freedom of the States and the needed limits on such state
taxing power. Congressional committees can make studies and
give the claims of the individual States adequate hearing
before the ultimate legislative formulation of policy is made
by the representatives of all the States. . . . Congress
alone can formulate policies founded upon economic realities.
. . .
The Economic Development Act of 2005 is a good first step toward
providing the prudent and carefully considered legislation that Justice
Frankfurter urged the Congress to pass nearly a half century ago.
At its core, the Economic Development Act of 2005 recognizes that
decisions should be made, if possible, at the State and local level.
States make and should make decisions about the programs and services
they want to provide with their tax dollars, not the least of which are
economic development programs. Highway funding, education funding,
welfare funding, and funding for seniors programs all vary from state
to state because State legislatures, acting on behalf of their
citizens, make choices and set priorities. This has allowed government
policy to reflect the diversity of interests in our great republic and
results in better and more responsive government. Accordingly, states
should be allowed to prioritize economic development in an effort to
create jobs and prosperity for their citizens, and, yes, attract
business from outside their State. If States choose to use tax
incentives to promote economic development, then that is not a
violation of the interstate commerce clause, that's simply their
choice. It is called federalism, and it should not be thwarted by the
courts.
There are a couple of points about this legislation that I would like
to discuss. First, this legislation is carefully crafted to protect the
most common and benign forms of tax incentives, but not to authorize
those tax incentives that truly discriminate against interstate
commerce. I believe this bill strikes the right balance between
protecting States' tax rights and preserving long-established
protections against truly discriminatory State tax practices. Second,
this legislation does not invalidate any tax incentives. It only
authorizes tax incentives. Any tax incentive not covered by the
legislation's authorization is simply subject to the traditional
dormant Commerce Clause review by the courts. Third, this legislation
does not require any state to provide tax incentives. Although I had
success using tax incentives to foster economic growth in Ohio while I
was Governor, I recognize that some states have concerns about whether
and how to offer tax incentives and therefore believe it should be left
to the states to resolve these concerns.
I am pleased that this legislation is being co-sponsored by all of
the Senators representing States in the Sixth Circuit. We all realize
that the right of states to make their own decisions about the programs
and services they offer within their boundaries is their own and should
not be taken away. Moreover, if the Supreme Court fails to review the
Cuno decision, then our States, the States in the Sixth Circuit, will
be at a competitive disadvantage in attracting businesses against other
states which are not affected by the Cuno decision and can offer tax
incentives.
The bill has also been endorsed by Governor Bob Taft of Ohio, the
National Governors Association, the National League of Cities, the
National Association of Counties, the National Conference of Mayors and
the Federation of Tax Administrators, as well as by broad-based
business coalitions and the Teamsters.
I am hopeful that the seriousness of this issue, and the severity of
the ruling's possible ramifications, will allow us to see quick and
positive consideration of my bill. The States are in a crisis mode
because of this ruling. In Ohio, as I'm sure is the case across the
country, many important projects have been put on hold as we await the
court's further action.
The challenges that manufacturers and workers face today are daunting
but surmountable. The last thing we need, however, is an artificial
legal hurdle that threatens to trip us up. I urge my colleagues to
support the Economic Development Act of 2005 so that we can preserve
the ability of the States to foster economic development and help put
our economy, and especially our manufacturing industries, back on the
road to recovery and prosperity.
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. 1066
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 ``Economic Development Act of
2005''.
SEC. 2. AUTHORIZATION.
Congress hereby exercises its power under Article I,
Section 8, Clause 3 of the United States Constitution to
regulate commerce among the several States by authorizing any
State to provide to any person for economic development
purposes tax incentives that otherwise would be the cause or
source of discrimination against interstate commerce under
the Commerce Clause of the United States Constitution, except
as otherwise provided by law.
SEC. 3. LIMITATIONS.
(a) Tax Incentives Not Subject to Protection Under This
Act.--Section 2 shall not apply to any State tax incentive
which--
(1) is dependent upon State or country of incorporation,
commercial domicile, or residence of an individual;
(2) requires the recipient of the tax incentive to acquire,
lease, license, use, or provide services to property
produced, manufactured, generated, assembled, developed,
fabricated, or created in the State;
(3) is reduced or eliminated as a direct result of an
increase in out-of-State activity by the recipient of the tax
incentive;
(4) is reduced or eliminated as a result of an increase in
out-of-State activity by a person other than the recipient of
the tax incentive or as a result of such other person not
having a taxable presence in the State;
(5) results in loss of a compensating tax system, because
the tax on interstate commerce exceeds the tax on intrastate
commerce;
(6) requires that other taxing jurisdictions offer
reciprocal tax benefits; or
(7) requires that a tax incentive earned with respect to
one tax can only be used to reduce a tax burden for or
provide a tax benefit against any other tax that is not
imposed on apportioned interstate activities.
(b) No Inference.--Nothing in this section shall be
construed to create any inference with respect to the
validity or invalidity under the Commerce Clause of the
United States Constitution of any tax incentive described in
this section.
SEC. 4. DEFINITIONS; RULE OF CONSTRUCTION.
(a) Definitions.--For purposes of this Act--
(1) Compensating tax system.--The term ``compensating tax
system'' means complementary taxes imposed on both interstate
and intrastate commerce where the tax on interstate commerce
does not exceed the tax on intrastate commerce and the taxes
are imposed on substantially equivalent events.
(2) Economic development purposes.--The term ``economic
development purposes'' means all legally permitted activities
for attracting, retaining, or expanding business activity,
jobs, or investment in a State.
(3) Imposed on apportioned interstate activities.--The term
``imposed on apportioned interstate activities'' means, with
respect to a tax, a tax levied on values that can arise out
of interstate or foreign transactions or operations,
including taxes on income, sales, use, gross receipts, net
worth, and value added taxable bases. Such term shall not
include taxes levied on property, transactions, or operations
that are taxable only if they exist or occur exclusively
inside the State, including any real property and severance
taxes.
(4) Person.--The term ``person'' means any individual,
corporation, partnership, limited liability company,
association, or other organization that engages in any for
profit or not-for-profit activities within a State .
(5) Property.--The term ``property'' means all forms of
real, tangible, and intangible property.
(6) State.--The term ``State'' means each of the several
States (or subdivision thereof), the District of Columbia,
and any territory or possession of the United States.
(7) State tax.--The term ``State tax'' means all taxes or
fees imposed by a State.
(8) Tax benefit.--The term ``tax benefit'' means all
permanent and temporary tax savings, including applicable
carrybacks and carryforwards, regardless of the taxable
period in which the benefit is claimed, received, recognized,
realized, or earned.
(9) Tax incentive.--The term ``tax incentive'' means any
provision that reduces a State tax burden or provides a tax
benefit as a result of any activity by a person that is
enumerated or recognized by a State tax jurisdiction as a
qualified activity for economic development purposes.
(b) Rule of Construction.--It is the sense of Congress that
the authorization provided in section 2 should be construed
broadly and the limitations in section 3 should be construed
narrowly.
SEC. 5. SEVERABILITY.
If any provision of this Act or the application of any
provision of this Act to any person or circumstance is held
to be unconstitutional, the remainder of this Act and the
application of the provisions of this Act to any
[[Page S5446]]
person or circumstance shall not be affected by the holding.
SEC. 6. EFFECTIVE DATE.
This Act shall apply to any State tax incentive enacted
before, on, or after the date of the enactment of this Act.
______
By Mr. HARKIN:
S. 1074. A bill to improve the health of Americans and reduce health
care costs by reorienting the Nation's health care system toward
prevention, wellness, and self care; to the Committee on Finance.
Mr. HARKIN. Mr. President, for more than a decade, I have spoken out
about the need to fundamentally reorient our approach to health care in
America--to reorient it towards prevention, wellness and self care.
I don't think you'll find too many people who would argue with the
statement that if you get sick, the best place in the world to get the
care you need is here in America. We have the best trained, highest-
skilled health professionals in the world. We have cutting-edge, state-
of-the-art equipment and technology. We have world-class health care
facilities and research institutions.
But, when it comes to helping people stay healthy and stay out of the
hospital, we fall woefully short. In the U.S., we spend in excess of
$1.8 trillion a year on health care. Fully 75 percent of that total is
accounted for by chronic diseases--things like heart disease, cancer,
and diabetes. And what these diseases have in common is that--in so
many cases--they are preventable.
In the United States, we fail to make an up-front investment in
prevention. So we end up spending hundreds of billions on
hospitalization, treatment, and disability. This is foolish--and,
clearly, it is unsustainable. In fact, I've long said that we don't
have a health care system here in America, we have a ``sick care''
system. And it is costing us dearly both in terms of health care costs
and premature deaths.
Consider the cost of major chronic diseases--diseases that, as I
said, are so often preventable.
For starters the annual cost of obesity is $117 billion. For
cardiovascular disease is about $352 billion. For diabetes it's $132
billion. For smoking it's more than $75 billion. And for mental illness
it's $150 billion; indeed, major depression is the leading cause of
disability in the United States.
Now, if I bought a new car, drove that car off the lot, and never
maintained it--never checked the oil, never checked the transmission
fluid, never got it tuned up--you'd think I was crazy, not to mention
grossly irresponsible. The common-sense principle with an automobile
is: ``I pay a little now to keep the car maintained, or I pay a whole
lot later.''
Well, it's the same with our national health priorities. Right now,
our health care system is in a downward spiral. We are not paying a
little now; so we are paying a whole lot later.
For example, we are failing to address the nation's growing obesity
epidemic. Today 65 percent of our population is overweight or obese.
Obesity is associated with numerous health problems and increased risks
of diabetes, heart disease, stroke, and several types of cancer, to
name just a few.
Another contributing factor to our health crisis is tobacco. We don't
hear as much about the dangers of tobacco use, today, as we used to.
That's because there is a perception that we've turned the corner--that
we've done all that we need to do. But that perception is not accurate.
In 2002, 46 million American adults regularly smoked cigarettes--that
26 percent of our population. Nearly 40 percent of college-aged
students smoke. What this means is that after decades of education and
efforts to stop tobacco use, more than one in every four Americans is
still addicted to nicotine and smoking.
Mental health is another enormous challenge that we are grossly
neglecting. Mental health and chronic disease are intertwined. They can
trigger one another. It is about time we stop separating the mind and
body when discussing health. Prevention and mental health promotion
programs should be integrated into our schools, workplaces, and
communities along with physical health screenings and education.
Surely, at the outset of the 21st century, it's time to move beyond the
lingering shame and stigma that often attend mental health.
Seventy percent of all deaths in the U.S. are now linked to chronic
conditions such as heart disease, cancer, and diabetes. In so many
cases, these chronic diseases are caused by poor nutrition, physical
inactivity, tobacco use, and untreated mental illness. This is
unacceptable.
After many months of meetings and discussions with Iowans and experts
across the nation, today I am re-introducing comprehensive legislation
designed to transform America's ``sick care'' system into a true health
care system--one that emphasizes prevention and health promotion.
I am calling this bill the HeLP America Act, with HeLP as an acronym
for Healthy Lifestyles and Prevention. The aim is to give individuals
and communities the information and tools they need to take charge of
their own health.
Because if we are serious about getting control of health-care costs
and health-insurance premiums, then we must give people access to
preventive care . . . and we must give people the tools they need to
stay healthy and stay out of the hospital.
This will take a sustained commitment from government, schools,
communities, employers, health officials, and the tobacco and food
industries. But a sustained effort can have a huge payoff--for
individuals and families, for employers, for society, for government
budgets, and for the economy at large.
As I said, the HeLP America Act is comprehensive legislation. It a
very complex, multifaceted bill. But, this afternoon, I'd just like to
outline the bill's major elements:
The first component addresses healthy kids and schools. Prevention
and the development of a healthy habits and lifestyles must begin in
the early years, with our children. Unfortunately, today, we are
heading in exactly the wrong direction. More and more children all
across America are suffering from poor nutrition, physical inactivity,
mental health issues, and tobacco use.
For example, just since the 1980s, the rates of obesity have doubled
in children and tripled in teens. Even more alarming is the fact that a
growing number of children are experiencing what used to be thought of
primarily as adult health problems. Almost two-thirds--60 percent--of
overweight children have at least one cardiovascular disease risk
factor. Recent studies of children have shown that increasing weight,
greater salt consumption from fast food, and poor eating habits have
contributed to the rise in blood pressure, higher cholesterol levels,
and a shockingly rapid increase in adult-onset diabetes.
The HeLP America Act will more than double funding for the successful
PEP program, which promotes health and physical education programs in
our public schools. I find it disturbing that more than one third of
youngsters in grades 9 through 12 do not regularly engage in adequate
physical activity. This is a shame, because studies show that regular
physical activity boosts self-esteem and improves health.
The HeLP America Act will also expand the Harkin Fruit and Vegetable
Program to provide more free fresh fruits and vegetables in more public
schools. The bill will also encourage give schools incentives to create
healthier environments, including goals for nutrition education and
physical activity.
The HeLP America Act would also establish a grant program to provide
mental health screenings and prevention programs in schools, along with
training for school staff to help them recognize children exhibiting
early warning signs. It will improve access to mental health services
for students and their families.
New to the HeLP Act this year is a strong focus on breastfeeding
promotion. Sound nutrition begins the moment a baby is born and there
is a vast body of scientific evidence that shows beyond a shadow of a
doubt that mom's milk is the ideal form of nutrition to promote child
health. But in the U.S. we don't do enough to encourage breastfeeding.
The HeLP America Act seeks to remove some of those barriers and to
encourage new mothers to breastfeed.
The second broad component of the HeLP American Act addresses Healthy
Communities and Workplaces. For example, the bill aims to create a
healthier workforce by providing tax
[[Page S5447]]
credits to businesses that offer wellness programs and health club
memberships. Studies show that, on average, every $1.00 that is
invested in workplace wellness returns $3.00 in savings on health
costs, absences from work, and so on.
At a field hearing in Iowa last year, I heard from Mr. Lynn Olson,
CEO of Ottumwa Regional Health Center. The Center offers a
comprehensive wellness program for its employees, including reduced
health insurance premiums for those employees who meet individual
health goals. The Center has seen tremendous savings from their
investment in health promotion.
My bill also creates a grant program for communities, encouraging
them to develop localized plans to promote healthier lifestyles. For
example, we want to support efforts like those going on in Webster
County and Mason City, IA, where mall walking programs have been
expanded into community-wide initiatives to promote wellness.
At the same time, the bill provides new incentives for the
construction of bike paths and sidewalks to encourage more physical
activity, especially walking. It is shocking that, today, roughly one-
quarter of walking trips take place on roads without sidewalks or
shoulders. And bike lanes are available for only about 5 percent of
bike trips.
As my colleagues know, I have been a longstanding advocate for the
rights of people with disabilities. So I have given special attention
to health-promotion programs and activities that include this
population. I just mentioned the bill's incentives to create bike lanes
and sidewalks on newly constructed roads. This will make a big
difference to people with disabilities, who often are forced to travel
in the street alongside cars because there are no sidewalks or bike
lanes available for wheelchairs.
The Centers for Disease Control has funded a program called Living
Well with a Disability, which has actually decreased secondary
conditions and led to improved health for participants. The program is
an eight-session workshop that teaches individuals with disabilities
how to change their nutrition and level of physical activity. The
program not only increases healthy activities for people with
disabilities, but has also led to a 10 percent decline in the cost for
medical services, particularly emergency-room care and hospital stays.
In addition, my bill includes a Working Well with a Disability
program, which will build partnerships between employers and vocational
rehabilitation offices with the aim of developing wellness programs in
the workplace.
Mr. President, the third component of the HeLP America Act addresses
Responsible Marketing and Consumer Awareness. Having accurate, readily
available information about the nutritional value of the foods we eat
is the first step toward improving overall nutrition. Unfortunately,
because of all the gimmicks and hype that marketers use to entice us to
buy their products, determining the nutritional value of the foods we
buy can be problematic--especially in restaurants. This is why the HeLP
America bill proposes to extend the nutritional labeling requirements
of the National Labeling and Education Act, which currently covers the
vast majority of retail foods, to restaurants foods as well, which were
exempted from the NLEA when it first passed.
The marketing of junk food--especially to kids--is out of control. It
was estimated that junk food marketers, alone, spent $15 billion in
2002 promoting their fare. And, I don't have to tell you, they are not
advertising broccoli and apples. No, the majority of these ads are for
candy and fast food--foods that are high in sugar, salt, fat, and
calories.
Children--especially those under 8 years of age--do not always have
the ability to distinguish fact from fiction. The number of TV ads that
kids see over the course of their childhood has doubled from 20,000 to
40,000. The sad thing is that, way back in the 1970s, the Federal Trade
Commission recommended banning TV advertising to kids. And what was
Congress's response? We made it even harder for the FTC to regulate
advertising for children than it is to regulate advertising for adults.
My bill will restore the authority of the FTC to regulate marketing to
kids, and it encourages the FTC to do so.
The fourth component of the HeLP American Act addresses
Reimbursements for Prevention Services. Right now, our medical system
is setup to pay doctors to perform a $20,000 gastric bypass instead of
offering advice on how to avoid such risky procedures. The bill will
reimburse and reward physicians for practicing prevention and
screenings. It will also expand Medicare coverage to pay for counseling
for nutrition and physical activity, mental health screenings, and
smoking-cessation programs. It also would establish a demonstration
project in the Medicare program, long overdue in my opinion, under
which we can learn how best to use our health care dollars to prevent
chronic diseases rather than just manage them once they've occurred.
Frankly, it's a little embarrassing that we haven't done this before.
Finally, let me point out that the HeLP America Act will be paid for
by creating a new National Health Promotion Trust Fund paid for through
penalties on tobacco companies that fail to cut smoking rates among
children, by ending the taxpayer subsidy of tobacco advertising, and
also by reinstating the top income tax rates for wealthy Americans.
It's time for the Senate to lead America in a new direction. We need
a new health care paradigm--a prevention paradigm.
Some will argue that avoiding obesity and preventable disease is
strictly a matter of personal responsibility. Well, we all agree that
individuals should act responsibly. I'm all for personal
responsibility. But I also believe in government responsibility.
Government has a responsibility to ensure that people have the
information and tools and incentives they need to take charge of their
health. And that is what the HeLP America Act is all about.
Of course, this description of my bill just scratches the surface.
The HeLP America Act is comprehensive. It is ambitious. And I fully
expect an uphill fight in some quarters of Congress.
But just as with the Americans with Disabilities Act 14 years ago, I
am committed to doing whatever it takes--and for as long as it takes--
to pass this critically needed legislation.
It's time to heed the Golden Rule of Holes, which says: When you are
in a hole, stop digging. Well, we have dug one whopper of a hole by
failing to emphasize prevention and wellness. And it's time to stop
digging.
______
By Mr. THUNE (for himself, Ms. Snowe, Mr. Bingaman, Ms. Collins,
Mr. Domenici, Mr. Gregg, Mr. Johnson, Mr. Lott, Ms. Murkowski,
Mr. Stevens, and Mr. Sununu):
S. 1075. A bill to postpone the 2005 round of defense base closure
and realignment; to the Committee on Armed Services.
Mr. THUNE. Mr. President, I rise today to introduce a bill that would
delay the implementation of the 2005 round of the Defense Base Closure
and Realignment report issued by the Department of Defense on May 13,
2005. The bill would postpone the execution of any decisions
recommended in the report until certain anticipated events, having
potentially large or unforeseen implications for our military force
structure, have occurred, and both the department and Congress have had
a chance to fully study the effects such events will have on our base
requirements.
The bill identifies three principal actions that must occur before
implementation of BRAC 2005. First, there must be a complete analysis
and consideration of the recommendations of the Commission on Review of
Overseas Military Structures. The overseas base commission has itself
called upon the Department of Defense to ``slow down and take a
breath'' before moving forward on basing decisions without knowing
exactly where units will be returned and if those installations are
prepared or equipped to support units that will return from garrisons
in Europe, consisting of approximately 70,000 personnel.
Second, BRAC should not occur while this country is engaged in a
major war and rotational deployments are still ongoing. We have seen
enough disruption of both military and civilian institutions due to the
logistical strain brought about by these constant rotations of units
and personnel to Iraq and Afghanistan without, at the same time,
initiating numerous base closures and the multiple transfer of units
and missions from base to base. This is simply too much to ask of our
military, our communities and the families of our
[[Page S5448]]
servicemen and women, already stretched and over-taxed. And frankly,
our efforts right now must be devoted to winning the global war on
terrorism, not packing up and moving units around the country.
Our bill would delay implementation of BRAC until the Secretary of
Defense determines that substantially all major combat units and assets
have been returned from deployment in the Iraq theater of operations,
whenever that might occur.
Third, to review or implement the BRAC recommendations without having
the benefit of either the Commission or Congress studying the
Quadrennial Defense Review, due in 2006, and its long-term planning
recommendations seems counter-intuitive and completely out of logical
sequence. Therefore, the bill requires that Congress receive the QDR
and have an opportunity to study its planning recommendations as one of
the conditions before implementing BRAC 2005.
Fourth and Fifth: BRAC should not go forward until the implementation
and development by the Secretaries of Defense and Homeland Security of
the National Maritime Security Strategy; and the completion and
implementation of Secretary of Defense's Homeland Defense and Civil
Support Directive--only now being drafted. These two planning
strategies should be key considerations before beginning any BRAC
process.
Finally, once all these conditions have been met, the Secretary of
Defense must submit to Congress, not later than one year after the
occurrence of the last of these conditions, a report that assesses the
relevant factors and recommendations identified by the Commission on
Review of Overseas Base Structure; the return of our thousands of
troops deployed in overseas garrisons that will return to domestic
bases because of either overseas base reduction or the end of our
deployments in the war; and, any relevant factors identified by the QDR
that would impact, modify, negate or open to reconsideration any of the
recommendations submitted by the Secretary of Defense for BRAC 2005.
This proposed delay only seems logical and fair. There is no need to
rush into decisions, that in a few years from now, could turn out to be
colossal mistakes. We can't afford to go back and rebuild installations
or relocate high-cost support infrastructure at various points in this
country once those installations have been closed or stripped of their
valuable capacity to support critical missions. I, therefore, introduce
this legislation today and call upon my colleagues to join us in
supporting its passage.
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. 1075
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. POSTPONEMENT OF 2005 ROUND OF DEFENSE BASE CLOSURE
AND REALIGNMENT.
(a) Postponement.--Effective May 13, 2005, the Defense Base
Closure and Realignment Act of 1990 (part A of title XXIX of
Public Law 101-510; 10 U.S.C. 2687 note) is amended by adding
at the end the following:
``SEC. 2915. POSTPONEMENT OF 2005 ROUND OF DEFENSE BASE
CLOSURE AND REALIGNMENT.
``(a) In General.--Notwithstanding any other provision of
this part, the round of defense base closure and realignment
otherwise scheduled to occur under this part in 2005 by
reasons of sections 2912, 2913, and 2914 shall occur instead
in the year following the year in which the last of the
actions described in subsection (b) occurs (in this section
referred to as the `postponed closure round year').
``(b) Actions Required Before Base Closure Round.--(1) The
actions referred to in subsection (a) are the following
actions:
``(A) The complete analysis, consideration, and, where
appropriate, implementation by the Secretary of Defense of
the recommendations of the Commission on Review of Overseas
Military Facility Structure of the United States.
``(B) The return from deployment in the Iraq theater of
operations of substantially all (as determined by the
Secretary of Defense) major combat units and assets of the
Armed Forces.
``(C) The receipt by the Committees on Armed Services of
the Senate and the House of Representatives of the report on
the quadrennial defense review required to be submitted in
2006 by the Secretary of Defense under section 118(d) of
title 10, United States Code.
``(D) The complete development and implementation by the
Secretary of Defense and the Secretary of Homeland Security
of the National Maritime Security Strategy.
``(E) The complete development and implementation by the
Secretary of Defense of the Homeland Defense and Civil
Support directive.
``(F) The receipt by the Committees on Armed Services of
the Senate and the House of Representatives of a report
submitted by the Secretary of Defense that assesses military
installation needs taking into account--
``(i) relevant factors identified through the
recommendations of the Commission on Review of Overseas
Military Facility Structure of the United States;
``(ii) the return of the major combat units and assets
described in subparagraph (B);
``(iii) relevant factors identified in the report on the
2005 quadrennial defense review;
``(iv) the National Maritime Security Strategy; and
``(v) the Homeland Defense and Civil Support directive.
``(2) The report required under subparagraph (F) of
paragraph (1) shall be submitted not later than one year
after the occurrence of the last action described in
subparagraphs (A) through (E) of such paragraph.
``(c) Administration.--For purposes of sections 2912, 2913,
and 2914, each date in a year that is specified in such
sections shall be deemed to be the same date in the postponed
closure round year, and each reference to a fiscal year in
such sections shall be deemed to be a reference to the fiscal
year that is the number of years after the original fiscal
year that is equal to the number of years that the postponed
closure round year is after 2005.''.
(b) Ineffectiveness of Recommendations for 2005 Round of
Defense Base Closure and Realignment.--Effective May 13,
2005, the list of military installations recommended for
closure that the Secretary of Defense submitted pursuant to
section 2914(a) of the Defense Base Closure and Realignment
Act of 1990 shall have no further force and effect.
____________________