[Congressional Record Volume 152, Number 11 (Thursday, February 2, 2006)]
[Senate]
[Pages S512-S514]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      by Mr. LEVIN (for himself and Ms. Stabenow):
  S. 2240. A bill to amend title XVIII to reform the Medicare 
prescription drug program; to the Committee on Finance.
  Mr. LEVIN. Mr. President, today I am introducing ``The Medicare Part 
D Reform Act of 2006.'' This bill is necessary to address some of the 
major problems in the Medicare prescription drug benefit that took 
effect on January 1 of this year. As we all know, the reaction of our 
seniors has been widespread disappointment, mass confusion and 
downright anger.
  Let me describe some of the problems that I am hearing from people in 
Michigan about this new Medicare prescription drug benefit.
  First, many drug companies have previously issued discount cards and 
are currently providing drugs to low-income people and seniors at a 
nominal or no cost. These are individuals usually at 200 percent of the 
Federal poverty level, which is 19,600 for a single person or $26,400 
for a couple, while to qualify for the Medicare low-income subsidy, 
their income must be $14,700 for a single person or $19,800 for a 
couple. Many of these programs are being discontinued, and seniors are 
losing a vital method of obtaining low cost prescription drugs.
  Second, prescription drug plans can drop a drug from its list of 
covered drugs with 60 days notice at any time during the calendar year. 
This is particularly egregious for a senior who relied on a particular 
medication being available and covered when the senior chose that 
particular plan.
  Third, the situation of so-called ``dual eligibles'' is clearly worse 
now than before enactment of the prescription drug benefit. These are 
former Medicaid beneficiaries who are being forced into Medicare 
prescription drug coverage, often putting them in plans with more 
restrictive formularies and higher co-payments, in other words leaving 
them worse off.
  Fourth, many Michigan residents are retirees from good paying jobs 
and currently have a good prescription drug plan. This has changed for 
the worse with the creation of the new Medicare prescription drug 
benefit because many companies have decided to scale back or eliminate 
that retiree coverage. As a result, many of those retirees are worse 
off than they were before the bill became law.
  Fifth, Medicare is specifically barred from negotiating lower drug 
prices for all of its beneficiaries.
  Finally, the coverage gap from $2,250-$3,600 in prescription drug 
expenses per year, commonly referred to as the ``doughnut hole,'' is 
unconscionable. Many seniors do not yet understand that this huge 
coverage gap is looming in their future and that during this gap, they 
are still expected to pay their monthly premiums, although they are 
getting no prescription drug coverage assistance.
  To address many of these concerns I, along with my colleague Senator 
Stabenow, today am introducing the Medicare Part D Reform Act of 2006, 
and I hope the Senate will immediately consider these positive reforms. 
My legislation has four goals and I will briefly outline them.
  First, this legislation would prohibit prescription drug plans from 
removing drugs from the plan's list of covered drugs until January 1 of 
the following year. This will give seniors the opportunity to make an 
informed decision during open enrollment at the end of each year if one 
plan decides to remove a particular drug from the plan.
  Second, my legislation clearly states that the discount cards that 
pharmaceutical companies are providing to our lower income seniors are 
permissible and that seniors should be allowed to participate in these 
programs. There has been some confusion as to whether companies can 
legally continue these programs and, if companies do continue their 
assistance, questions have arisen as to whether that assistance will 
count towards the ``true-out-of-pocket'' costs for that beneficiary, 
which plunges them into the ``doughnut hole'' when they reach $2,250. 
My legislation mandates that there will be no negative consequences for 
pharmaceutical companies continuing to provide discount cards to our 
low-income seniors.
  Third, my legislation would allow former Medicaid beneficiaries now 
receiving their medications under Medicare to continue to receive their 
prescription drugs even if they cannot meet the worsened co-payment 
requirements.
  Lastly, the legislation would specifically give the Federal 
Government the authority to negotiate lower prescription drug prices 
for our seniors. Current Medicare law prohibits the Department of 
Health and Human Services from negotiating lower prices, as we do for 
veterans in our VA health programs. As a result, Medicare beneficiaries 
do not have the benefit of the bargaining power of Medicare.
  All of us are hearing from our constituents that we need to improve 
Medicare Part D. Congress needs to fulfill the promise it made that 
Medicare Part D would lower prescription drug prices, not increase 
them. This bill will help us begin to keep that promise.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 2240

       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 ``Medicare Part D Reform Act 
     of 2006''.

     SEC. 2. REMOVAL OF COVERED PART D DRUGS FROM THE PRESCRIPTION 
                   DRUG PLAN FORMULARY.

       Section 1860D-4(b)(3)(E) of the Social Security Act (42 
     U.S.C. 1395w-104(b)(3)(E)) is amended to read as follows:
       ``(E) Removing drug from formulary or changing preferred or 
     tier status of drug.--
       ``(i) Limitation on removal or change.--Beginning with 
     2006, the PDP sponsor of a prescription drug plan may not 
     remove a covered part D drug from the plan formulary or 
     change the preferred or tiered cost-sharing status of such a 
     drug other than during the period beginning on September 1 
     and ending on October 31. Subject to clause (ii), such 
     removal or change shall only be effective beginning on 
     January 1 of the immediately succeeding calendar year.
       ``(ii) Notice.--Any removal or change under this 
     subparagraph shall not take effect unless appropriate notice 
     is made available (such as under subsection (a)(3)) to the 
     Secretary, affected enrollees, physicians, pharmacies, and 
     pharmacists. Such notice shall ensure that such information 
     is made available prior to the annual, coordinated open 
     election period described in section 1851(e)(3)(B)(iii), as 
     applied under section 1860D-1(b)(1)(B)(iii).''.

     SEC. 3. PHARMACEUTICAL PATIENT ASSISTANCE PROGRAMS.

       (a) Providing a Safe Harbor for Pharmaceutical Patient 
     Assistance Programs.--Section 1128B(b)(3) of the Social 
     Security Act (42 U.S.C. 1320a-7b(b)(3)) is amended--
       (1) in subparagraph (G)--
       (A) by inserting ``or under a patient assistance program 
     (including a pharmaceutical

[[Page S513]]

     manufacturer patient assistance program)'' after ``Indian 
     organizations)''; and
       (B) by striking ``and'' at the end;
       (2) in subparagraph (H), as added by section 237(d) of the 
     Medicare Prescription Drug, Improvement, and Modernization 
     Act of 2003 (Public Law 108-173; 117 Stat. 2213)--
       (A) by moving such subparagraph 2 ems to the left; and
       (B) by striking the period at the end and inserting ``; 
     and''; and
       (3) by redesignating subparagraph (H), as added by section 
     431(a) of the Medicare Prescription Drug, Improvement, and 
     Modernization Act of 2003 (Public Law 108-173; 117 Stat. 
     2287), as subparagraph (I) and moving such subparagraph 2 ems 
     to the left.
       (b) Exclusion of Expenditures Under Certain Pharmacy 
     Assistance Programs From TROOP.--Section 1860D-2(b)(4)(C)(ii) 
     of such Act (42 U.S.C. 1395w-102(b)(4)(C)(ii)) is amended by 
     inserting ``under a pharmaceutical manufacturer patient 
     assistance program,'' after ``a group health plan,''.
       (c) Effective Date.--The amendments made by this section 
     shall take effect on the date of enactment of this Act.

     SEC. 4. PROTECTION AGAINST COST-SHARING FOR FULL-BENEFIT DUAL 
                   ELIGIBLE INDIVIDUALS.

       (a) In General.--Section 1860D-14(a)(1)(D)(ii) of the 
     Social Security Act (42 U.S.C. 1395w-114(a)(1)(D)(ii)) is 
     amended--
       (1) in the heading, by striking ``Lowest income'';
       (2) by striking ``and whose income does not exceed 100 
     percent of the poverty line applicable to a family of the 
     size involved''; and
       (3) by adding at the end the following new sentence: ``In 
     the case of an individual who is unable to pay the copayment 
     applicable under the preceding sentence, such copayment shall 
     be waived.''
       (b) Effective Date.--The amendments made by this section 
     shall apply to drugs dispensed on or after the date of 
     enactment of this Act.

     SEC. 5. NEGOTIATING FAIR PRICES FOR MEDICARE PRESCRIPTION 
                   DRUGS.

       (a) In General.--Section 1860D-11 of the Social Security 
     Act (42 U.S.C. 1395w-111) is amended by striking subsection 
     (i) (relating to noninterference) and by inserting the 
     following new subsection:
       ``(i) Authority To Negotiate Prices With Manufacturers.--In 
     order to ensure that beneficiaries enrolled under 
     prescription drug plans and MA-PD plans pay the lowest 
     possible price, the Secretary shall have authority similar to 
     that of other Federal entities that purchase prescription 
     drugs in bulk to negotiate contracts with manufacturers of 
     covered part D drugs, consistent with the requirements and in 
     furtherance of the goals of providing quality care and 
     containing costs under this part.''.
       (b) Effective Date.--The amendment made by this section 
     shall take effect on the date of enactment of this Act.
                                 ______
                                 
      By Mrs. FEINSTEIN:
  S. 2241. A bill for the relief of Carmen Shahrzad Kulcsar; to the 
Committee on the Judiciary.
  Mrs. FEINSTEIN. Mr. President, I offer today private relief 
legislation to provide lawful permanent residence status to Carmen 
Shahrzad Kulcsar, a 15-year-old Australian national currently living 
with her aunt and uncle in San Marcos, CA.
  I have decided to offer private relief legislation on Carmen's behalf 
because I believe that removal from the United States would not only be 
tragically unfair to her, but also to her aunt and uncle who have taken 
Carmen into their home and treated her like a daughter after the tragic 
events that brought her to America. Furthermore, Carmen's removal could 
put her aunt's, her uncle's, and her own life in grave danger.
  Carmen's parents separated due to physical abuse, alcohol abuse, and 
allegations of affairs. In 1992, at the young age of two, Carmen 
witnessed her father shoot her mother point blank range in the head.
  Her father--David Kulcsar--was convicted of murder and sentenced to 
12 to 16 years in prison. Fortunately for Carmen, her American aunt 
Manieh Varner was granted sole guardianship and custody of her niece by 
an Australian court.
  Carmen entered the United States on a temporary Visitor's Visa and 
has resided here for the past 13 years with her aunt and uncle.
  Carmen is a model student at her high school. She takes honor classes 
and has worked hard to earn a cumulative grade point average of 3.5. 
Her report card has multiple comments regarding her outstanding 
citizenship and as being a pleasure to have in class.
  Carmen is a member of the competitive Academic Decathlon Team. Her 
future can be a bright one and it is unlikely that she will become a 
burden on the State or Federal Government.
  Carmen's aunt has always wanted to adopt her niece and begin the path 
to legal residency. However, there has always been one problem. 
Carmen's father never wanted Carmen to go with her aunt and made 
repeated threats for revenge against Mrs. Varner. Adopting Carmen 
requires notifying Mr. Kulcsar about the adoption and Mrs. Varner 
believed always, as she does now, that doing so would put her and 
Carmen's life in risk.
  Mrs. Varner cannot pursue adoption now because time constraints 
prevent the process from being completed before Carmen's 16th birthday; 
thus, adoption would have no bearing for immigration purposes.
  Mr. and Mrs. Varner have done their best to try and create a life for 
Carmen that would otherwise have been impossible for her in Australia.
  Both U.S. citizens, Mr. Varner is a high school teacher while Mrs. 
Varner is employed by the State of California's Department of 
Transportation. Along with a daughter of their own, they have made the 
best possible situation of a horrible tragedy.
  Unfortunately, if this private relief bill is not approved, the 
choices available to Carmen are grim. Clearly it would be impossible 
for her to go back to Australia.
  The only memory she has of that country is the memory of her mother's 
murder at the hands of her father. The only family in Australia is that 
of her unstable, recently released from prison father. She would be 
forced to live illegally in the United States through no fault of her 
own. America is the only land she has ever known. It is her home.
  Given these extraordinary and unique facts, I offer this private 
relief bill on behalf of Carmen Shahrzad Kulcsar. We have the 
opportunity to make a just and fitting solution for this wonderful 
family. Therefore, I ask my colleagues to support this private relief 
bill.
  I ask unanimous consent that the text of the legislation be printed 
in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 2241

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

     SECTION 1. PERMANENT RESIDENCE.

       Notwithstanding any other provision of law or any order, 
     for purposes of the Immigration and Nationality Act (8 U.S.C. 
     1101 et seq.), Carmen Shahrzad Kulcsar shall be deemed to 
     have been lawfully admitted to the United States for 
     permanent residence as of the date of enactment of this Act 
     upon the payment of the required visa fees.

     SEC. 2. REDUCTION OF NUMBER OF AVAILABLE VISAS.

       Upon the granting of permanent residence to Carmen Shahrzad 
     Kulcsar under section 1, the Secretary of State shall 
     instruct the proper officer to reduce by 1 the total number 
     of immigrant visas available during the current fiscal year 
     to natives of the country of the alien's birth under section 
     203(a) of the Immigration and Nationality Act (8 U.S.C. 
     1153(a)).
                                 ______
                                 
      By Mr. MENENDEZ:
  S. 2243. A bill to make college more affordable by expanding and 
enhancing financial aid options for students and their families and 
providing loan forgiveness opportunities for public service employees, 
and for other purposes; to the Committee on Finance.
                                 ______
                                 
      By Mr. MENENDEZ (for himself, Mr. Lautenberg, and Mr. Durbin):
  S. 2244. A bill to provide funding and incentives for caregiver 
support and long-term care assistance; to the Committee on Finance.
  Mr. MENENDEZ. Mr. President, I rise today to introduce The Caregiver 
Assistance and Relief Effort, CARE, Act and the College Access and 
Affordability Act because far too many families today are squeezed by 
the demands of caring for aging loved ones while working to give their 
children what all parents want for their kids--the opportunity to go to 
college and be successful. As a son helping to care for a mother with 
Alzheimer's disease and the proud parent of two college-age kids, I 
know personally the intergenerational demands families are facing and 
the sacrifices they are making to care for their loved ones. That's 
exactly why my first legislative initiatives in the United States 
Senate are to make higher education and long-term care more affordable 
and more accessible for New Jersey families and families across the 
country.

[[Page S514]]

  The CARE Act would provide tax credits to those caring for ailing 
family members and loved ones, and encourage individuals to plan and 
invest in their own long-term care by offering a tax deduction for 
long-term care insurance. In addition, it would double the funding for 
the existing National Family Caregiver Support Program, which supports 
a wide range of important services for older persons.
  There are an estimated 44.4 million caregivers in the U.S., which is 
21 percent of the adult population. My home State of New Jersey has 
over 830,000 caregivers, ranking it 9th in the country.
  Caregiving families face unique strains. They are challenged with 
additional costs, and often caregivers must sacrifice their job or cut 
back on their hours at work. Almost 6 in 10 caregivers either work or 
have worked while providing care, and 62 percent of caregivers report 
having had to make work-related adjustments ranging from going in late 
and leaving early to having to give up work entirely. Caregivers are 
also a valuable asset to keeping health care costs down. They are 
providing $257 billion in care annually, more than double the annual 
spending on home care and nursing home care combined. Their compassion, 
dedication, and selflessness come at a price to their families and are 
a benefit to the greater good of our State and Nation. This legislation 
is aimed at addressing their hard work, sacrifice, and contributions to 
society.
  The other bill I'm introducing today, the College Access and 
Affordability Act, will help open the doors to higher education for 
more young people by making financial assistance more flexible for 
students and by expanding and enhancing existing financial aid options.
  I know the difference a college education can have on a young 
person's life. As the first in my family to go to college, and later 
law school, I had opportunities that would not have been available to 
me had I not been able to go to college. But financing a higher 
education was not an easy thing for my family. Federal financial aid 
helped ensure that I could go to college and that I could pursue my 
dreams. I know first-hand the important benefits of receiving Federal 
aid--not only did it help me finance my dreams of college, but it also 
gave me the extra confidence that I needed to succeed.
  So, I am committed to ensuring that other promising young people get 
the same chance that I did and that we, as a Nation, will be there to 
help everyone in this country achieve their dreams of college, 
regardless of background, race, language, or income level. One of the 
great foundations of this country is that the doors of opportunity are 
open to anyone who works hard. We must follow through on that promise 
by providing a path for young people to have access to and attend 
college. If we do not lead the way to ensure that our colleges are full 
of the brightest minds and fullest potential, we are failing to prepare 
our future generations and we are jeopardizing the future of our 
Nation.
  The College Access and Affordability Act will make financial aid more 
flexible and accessible to more students, such as extending Pell Grant 
eligibility to students who attend school year-round. It will also make 
substantial changes to the Hope Scholarship Tax Credit, a useful tool 
in helping cover the costs of a higher education. Since the Credit was 
enacted in 1997, the maximum credit has not increased to reflect the 
rising cost of tuition. This bill would raise the award by $1,000 and 
allow the credit to be claimed for all 4 years of college, instead of 
the current 2 years. It will also make more families eligible for the 
credit by expanding the eligibility limits.
  Finally, in recognizing that many of our communities are in need of 
qualified individuals to serve in essential public service positions, 
this bill would help attract dedicated college graduates who serve low-
income communities in positions such as science, math, bilingual, or 
special education teachers; nurses; first responders; and child welfare 
workers.
  Too many students do not pursue a college education because they 
think it is out of their reach. We must commit to providing sensible 
tools and adequate resources so that financing a college education is 
not more of a burden on families, and achieving the dreams of a higher 
education is not beyond the reach of our Nation's young people.
  On any given day, families across New Jersey, and indeed, across this 
country, face the daunting challenges of making ends meet--putting food 
on the table, clothing their children, and putting a roof over their 
head. If that weren't enough, add the challenge of trying to pay for 
college or care for an aging parent, or in many cases, both, and you 
have what many times is an insurmountable challenge. But that's exactly 
what's happening to more and more people everyday. And the 
intergenerational demands will only increase as the baby boom 
generation grows older and our life expectancy increases. We need to 
work now to address the challenges on both fronts--from providing 
affordable long-term care and encouraging future retirees to plan for 
their own long-term care, to ensuring that anyone who is willing to 
work hard has the opportunity to go to college and succeed. That's what 
this country is all about, and that's why I've made these initiatives 
my first priorities in the U.S. Senate. I'm hopeful that we will be 
able to work in a bipartisan fashion to address these important 
challenges facing American families.

                          ____________________