Congressional Record, Volume 153 Issue 59 (Thursday, April 12, 2007)

[Congressional Record Volume 153, Number 59 (Thursday, April 12, 2007)]
[Senate]
[Pages S4439-S4451]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

By Mr. DORGAN (for himself, Mr. Hagel, Mr. Johnson, Mr.
Brownback, Mr. Durbin, Mr. Conrad, Mr. Salazar, Mr.
Rockefeller, Mr. Coleman, Ms. Landrieu, Mrs. Lincoln, Mr.
Harkin, and Mr. Pryor):
S. 1093. A bill to reward the hard work and risk of individuals who
choose to live in and help preserve America's small, rural towns, and
for other purposes; to the Committee on Finance.
Mr. DORGAN. Mr. President, I am pleased to be joined by Senators
Hagel, Johnson, Brownback and nine of our colleagues today in re-
introducing the New Homestead Act of 2007. This legislation will help
address a serious threat to the economic future of rural America--the
loss of its residents and Main Street businesses.
I have previously described to my Senate colleagues the severe
economic and social hardships that population out-migration has had on
America's Heartland when businesses are shuttered up, schools and
churches are consolidated or closed altogether. Hundreds of thousands
of people have left small towns in rural areas throughout the Great
Plains. If you are a business owner, mayor, school board member,
minister or resident of one of these rural communities, you know
firsthand about this problem. People who are from these areas know that
you simply can't grow or run a business in an environment where the
overall economy is shrinking, current and potential customers are
leaving, and public and private investment is falling. Too many
communities in North Dakota and other rural States lack the critical
mass of people and resources it takes to keep a community alive and
growing.
Rural counties in North Dakota and heartland States have experienced
massive net out-migration in recent decades and this trend is
continuing today. Forty-seven of North Dakota's fifty-three counties
suffered net population losses between 2000 and 2005. My home county,
Hettinger, saw its population dwindle from 4,257 in 1980 to just 2,715
in 2000. Its population is projected to drop to just 1,877 by 2020.

[[Page S4440]]

However, this out-migration problem isn't limited to North Dakota.
Nearly all of America's Heartland is facing significant population
losses. Over the past fifty years or so, nearly two-thirds of rural
counties in the Great Plains lost at least one third of their
population.
One of the major problems caused by chronic out-migration is the
dwindling workforce of young people. A recent analysis and report
prepared by Dr. Richard Rathge at the North Dakota State Data Center
highlighted this concern. His report revealed that the steady out-
migration of young adults over the last half century or so has
significantly reduced the proportion of individuals age 20 to 34 in our
rural counties. The report predicts that between 2000 and 2020, the
prime working age population in North Dakota, those aged 35 to 54, will
decline from 183,435 to 146,717, a loss of nearly 37,000 people. If
this trend continues as predicted, there will be more elderly North
Dakotans age 65 and older in the year 2020 than individuals who are in
their prime working years. As the report concluded, this dwindling
labor pool could have a devastating economic impact on rural
communities that are already struggling from a loss of residents,
businesses and investments needed to survive.
We believe the bipartisan New Homestead Act will help reverse the
depopulation of our rural communities by giving people who are willing
to commit to live and work in high out-migration areas for 5 years tax
and other financial rewards to help them to buy a home, pay for
college, build a nest egg, and start a business. These incentives
include repaying up to $10,000 of a college loan, offering a $5,000 tax
credit for the purchase of a new home, protecting home values by
allowing losses in home value to be deducted from Federal income taxes,
and establishing Individual Homestead Accounts that will help people
build savings and have access to credit.
It also provides tax incentives to encourage businesses to move to or
expand their operations in high out-migration rural counties, including
tax credits for investments in rural buildings and to offset the cost
of equipment purchases and operating expenses of small businesses with
five or fewer employees. Very little, if any, private venture capital
is invested in out-migration rural counties, so the New Homestead Act
also establishes a new $3 billion venture capital fund with state and
local governments as partners to ensure that entrepreneurs and
companies in these areas get the capital they need to start and grow
their businesses.
The United States Senate has previously passed parts of the New
Homestead Act, but those and other provisions in the bill have not yet
been signed into law. But there is good reason to think we will make
significant progress on the New Homestead Act in the 110th Congress.
In March, the Senate passed S. Con. Res. 21, to establish a budget
plan for fiscal year 2008. This resolution allows for Senate action on
the kinds of policies provided in the New Homestead Act. Specifically,
Section 306 of the budget authorizes the Budget Committee Chairman to
revise the levels in the resolution by $15 billion for revenue-neutral
legislation that would, among other things, provide rural development
investment incentives for counties impacted by high rates of out-
migration.
The Senate's action on the budget signals that Federal policy makers
in the U.S. Senate do understand that rural out-migration is a serious
threat to the economic well-being of the Nation's Heartland. My
colleagues and I will work closely with the leaders of the Budget
Committee and the tax-writing Senate Finance Committee to secure
passage of New Homestead Act provisions in the coming year.
I urge my colleagues to support the New Homestead Act in the 110th
Congress by cosponsoring it and helping us move this important bill
forward in the legislative process.
______

By Mr. CORNYN (for himself, Mr. Craig, Mr. Akaka, and Mrs.
Hutchison):
S. 1096. A bill to amend title 38, United States Code, to provide
certain housing benefits to disabled members of the Armed Forces, to
expand certain benefits for disabled veterans with severe burns, and
for other purposes; to the Committee on Veterans' Affairs.
Mr. CORNYN. Mr. President, for the past several months, our Nation
has focused on the tragic stories of the shameful conditions our
wounded soldiers have faced as outpatients in Building 18 at Walter
Reed Army Medical Center, and the stories of the difficulty they faced
as they tried to navigate the military and veterans health care and
benefits systems following their return from Afghanistan and Iraq.
This morning, the chairman of the Senate Armed Services Committee and
the ranking member--the committee on which I serve--as well as the
Veterans' Affairs Committee had further hearings and detailed the work
we have to do to bring down another wall, and that is the wall that
separates our wounded warriors from the benefits they have earned by
their noble service.
Today I introduce the Veterans Housing Benefits Enhancement Act of
2007 that will provide immediate and tangible assistance to our wounded
servicemembers and their families by strengthening our current law.
This legislation provides explicit VA housing and automobile grant
eligibility to servicemembers and veterans with burn injuries, enhanced
eligibility for grant assistance during the Department of Defense-to-
Veterans' Administration transition, and requires the Secretary of the
Veterans' Administration to report on possible improvements to the
current law that would cover others with special disabilities, such as
those with traumatic brain injuries.
I am pleased to say the chairman of the Senate Veterans' Affairs
Committee, Senator Danny Akaka, and the ranking member, Senator Larry
Craig of Idaho, have joined me as original cosponsors of this
legislation, as well as my senior Senator from Texas, Mrs. Hutchison.
I grew up in a military family. My dad served for 31 years in the Air
Force. I saw firsthand the importance of treating our veterans in a
fair and equitable manner. The sacrifices our men and women in uniform
make every day must not be forgotten when they take that uniform off or
when they leave their active-duty military service. No veteran should
ever be left behind. The fundamental agreement--I would say even sacred
covenant--between our men and women in uniform and our Government does
not end when a servicemember is wounded or separates from the active-
duty military service and becomes a veteran.
Let there be no question about it, the conditions of these outpatient
housing facilities at Walter Reed were absolutely unacceptable. But
perhaps the story of that unacceptable condition has led us to finding
a way to serve our wounded warriors and their families better. The U.S.
military and the Department of Veterans Affairs must conduct a top-to-
bottom investigation of our entire military health system and take
immediate steps to address any and all problems that might exist.
It is sobering to know--as Senator Craig quoted during this morning's
hearings in the Senate Armed Services Committee and Veterans' Affairs
Committee--that the conclusions reached by GEN Omar Bradley some five
decades ago were not fundamentally different from those that are
tentative conclusions today about how we can improve that transition,
and still we know problems exist.
The President's Commission on Care for America's Returning Wounded
Veterans, led by Senator Bob Dole and Secretary Donna Shalala, is an
important component of this ongoing effort, which will not be a task
for the short-winded. We have an obligation and a duty to ensure that
the men and women who are serving and who have served in our military
are receiving the very best treatment and benefits for themselves and
their families. We cannot and we should not tolerate anything less. We
have to do whatever it takes, including providing both the necessary
resources and cutting the bureaucratic redtape, to best meet the
medical and other needs of those who have so nobly defended our
Nation's freedom.
In my State of Texas, my home of San Antonio, Brooke Army Medical
Center stands at the forefront of modern army medicine, second to none
in

[[Page S4441]]

the world. Without a doubt--and this is a personal judgment, and I know
my colleagues will indulge me--it is Brooke Army Medical Center that is
the crown jewel of modern military medicine. I have seen firsthand the
magnificent job our men and women are doing at Brooke Army Medical
Center to care for our servicemembers, and they deserve all the credit
and our firm support.
When I made my most recent visit to Brooke Army Medical Center, on
March 10, I had the chance to not only visit soldiers and their
families but I chaired a roundtable of hospital administrators,
veterans service organizations, and veterans themselves because I
wanted to learn from them what we needed to do here in Washington, DC
to craft the laws and policies of this Nation to serve them better. I
appreciate the strong opinions and advice expressed by these people who
participated in the roundtable, and others who have been a source of
information and feedback to me as I try to do what I can in my capacity
as their elected representative to accomplish these goals. The care and
support our Nation provides to these wounded warriors is a direct
reflection of the level of respect we have for both our military, our
military families, and our veterans, and will, in many ways, shape the
armed services, the all-volunteer services, for many years to come.
They depend not only on recruitment but retention.
In conjunction with my most recent visit to Brooke Army Medical
Center, I heard from many soldiers, families, and veterans about their
individual experiences, as I know the current occupant of the chair has
when he has traveled back to Colorado, and as all of us have when we go
back to learn more from our constituents about how we can improve our
response. I learned in particular of challenges that burn victims and
their families have faced because they have not received enough special
care and assistance for that particular type of injury in the area of
VA housing grants and automobile enhancements.
In particular, I want to recognize two women, heroes in my eyes, and
I am sure in the eyes of their families, people such as Christy Patton,
whose husband, U.S. Army SSG Everett Patton, is undergoing treatment at
Brooke Army Medical Center. He was wounded and badly burned by an IED,
an improvised explosive device, in Iraq while with the 172nd Stryker
Brigade from Alaska. The Pattons have five children.
Then there is Rosie Babin, whose son Alan, a corporal, a medic, was
shot while serving in the 82nd Airborne combat team in 2003, now
medically retired and living at home with his parents outside Austin,
TX. These two women--Christy Patton, who sought me out and explained to
me the difficult challenges that her husband and her family of five
children are having transitioning and dealing with these wounds and
transitioning from the military medical care into retirement and the
veterans system; as well as Rosie Babin, on behalf of her son Alan--are
the most fervent and effective advocates anyone could ever want to have
on your side. They have helped me a great deal as I have tried to craft
legislation which I have introduced today to help not only them,
because I know they didn't come to me advocating just for a solution
for their husband or their son, they came to me because they thought we
could craft a solution for wounded warriors and their families yet to
come. These families, though, are facing unique challenges as they deal
with the injuries of their loved ones, and we have a responsibility to
ensure they do not go it alone and that they get all the resources and
assistance our country can offer them so they can recover to the
maximum degree possible.

The intent of the legislation which I have introduced today, along
with my cosponsors, is pretty straightforward. Let me describe briefly
what it does.
It would strengthen the present code to provide for the specific
needs of burn victims for housing and automobile grants. It would
ensure that wounded servicemembers and veterans with other specific
needs, such as traumatic brain injuries, are also covered by these
kinds of grants, if required. It would further strengthen the
Department of Defense-to-Veterans' Administration transition.
As the occupant of the chair knows, that has been one of the real
problems we have identified early on, is transitioning people from
active-duty military service into the Veterans' Administration, with
the duplicate bureaucracies and redtape and the different standards for
disability determination and the like. But this bill, in particular,
would strengthen the Department of Defense-to-Veterans Administration
transition by providing partial housing grants for those veterans
residing with a family member to cover servicemembers still on active
duty awaiting their final VA disability rating.
I have to say a word here about the family members. When I have been
to Walter Reed and when I have been to Brooke Army Medical Center in
San Antonio, I have seen young spouses, mostly women, who are attending
to their injured warrior husbands, or in the case of Rosie Babin, a
mother, a loving mother attending to the needs of her son, who was also
injured in 2003. It was brought home to me on a very human level what
these wounds mean not just to those who receive them but to the family
members, who basically sacrifice everything in order to attend to and
care for their loved ones. So we ought to do everything we can for our
warriors, such as Alan Babin, who are living in their parents' home, to
make sure these housing grants will cover servicemembers still on
active duty who are awaiting their Veterans' Administration disability
rating.
This legislation will also require the Veterans' Administration to
report on the need for a permanent housing grant for wounded veterans
who reside with family members; and, finally, it will adjust current
law to provide home improvements and structural alteration housing
grants to Department of Defense servicemembers who are awaiting final
VA disability ratings.
As a direct result of the care and concern of military family
members, such as Christy Patton and Rosie Babin, we now have a concrete
response to the very real concerns they have raised and ways that we
can, working together, strengthen the current law. I hope my colleagues
will support this legislation so we can work together on a bipartisan
basis, in unison, to support our wounded servicemembers and their
families better, particularly people such as the Babins and the
Pattons. With continued attention to our veterans, we can fashion a
revised system that best supports them and their families. I know we
all agree that they deserve nothing less. They are the very finest our
Nation has to offer.
______

By Mr. DOMENICI (for himself, Mr. Kennedy, Mr. Bingaman, Mr.
Harkin, Mr. Leahy, and Mr. Sanders):
S. 1098. A bill to amend the Public Health Service Act to revise the
amount of minimum allotments under the Projects for Assistance in
Transition from Homelessness program; to the Committee on Health,
Education, Labor, and Pensions.
Mr. DOMENICI. Mr. President, I rise today with my colleagues, Senator
Kennedy, Senator Bingaman, Senator Harkin, Senator Leahy and Senator
Sanders to introduce a bill that will raise the minimum grant amounts
given to States and territories under the PATH program. The PATH
program provides services through formula grants of at least $300,000
to each State, the District of Columbia and Puerto Rico and $50,000 to
eligible U.S. territories. Subject to available appropriations, this
bill will raise the minimum allotments to $600,000 to each State and
$100,000 to eligible U.S. territories.
When the PATH program was established in fiscal year 1991 as a
formula grant program, Congress appropriated $33 million. That amount
has steadily increased over the years with Congress appropriating $55
million this past year. However, despite these increases, States and
territories such as New Mexico that have rural and frontier
populations, have not received an increase in their PATH funds. Under
the formula, as it currently exists, many States and territories will
never receive an increase to their PATH program, even with increasing
demand and inflation. This problem is occurring in my home State of New
Mexico as well as twenty-five other States and territories throughout
the United States.
The PATH program is authorized under the Public Health Service Act

[[Page S4442]]

and it funds community-based outreach, mental health, substance abuse,
case management and other support services, as well as a limited set of
housing services for people who are homeless and have serious mental
illnesses. Program services are provided in a variety of different
settings, including clinic sites, shelter-based clinics, and mobile
units. In addition, the PATH program takes health care services to
locations where homeless individuals are found, such as streets, parks,
and soup kitchens.
PATH services are a key element in the plan to end chronic
homelessness. Every night, an estimated 600,000 people are homeless in
America. Of these, about one-third are single adults with serious
mental illnesses. I have worked closely with organizations in New
Mexico such as Albuquerque Health Care for the Homeless and I have seen
first hand the difficulties faced by the more than 15,000 homeless
people in New Mexico, 35 percent of whom are chronically mentally ill
or mentally incapacitated.
PATH is a proven program that has been very successful in moving
people out of homelessness. PATH has been reviewed by the Office of
Management and Budget and has scored significantly high marks in
meeting program goals and objectives. Unquestionably, homelessness is
not just an urban issue. Rural and frontier communities face unique
challenges in serving PATH eligible persons and the PATH program
funding mechanisms must account for these differences.
I look forward to working with my colleagues on this important issue.
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. 1098

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

SECTION 1. MINIMUM ALLOTMENTS UNDER THE PROJECTS FOR
ASSISTANCE IN TRANSITION FROM HOMELESSNESS
PROGRAM.

Section 524 of the Public Health Service Act (42 U.S.C.
290cc-24) is amended to read as follows:

``SEC. 524. DETERMINATION OF AMOUNT OF ALLOTMENT.

``(a) Determination Under Formula.--Subject to subsection
(b), the allotment required in section 521 for a State for a
fiscal year is the product of--
``(1) an amount equal to the amount appropriated under
section 535 for the fiscal year; and
``(2) a percentage equal to the quotient of--
``(A) an amount equal to the population living in urbanized
areas of the State involved, as indicated by the most recent
data collected by the Bureau of the Census; and
``(B) an amount equal to the population living in urbanized
areas of the United States, as indicated by the sum of the
respective amounts determined for the States under
subparagraph (A).
``(b) Minimum Allotment.--
``(1) In general.--Subject to paragraph (2), the allotment
for a State under section 521 for a fiscal year shall, at a
minimum, be the greater of--
``(A) the amount the State received under section 521 in
fiscal year 2006; and
``(B) $600,000 for each of the several States, the District
of Columbia, and the Commonwealth of Puerto Rico, and
$100,000 for each of Guam, the Virgin Islands, American
Samoa, and the Commonwealth of the Northern Mariana Islands.
``(2) Condition.--If the funds appropriated in any fiscal
year under section 535 are insufficient to ensure that States
receive a minimum allotment in accordance with paragraph (1),
then--
``(A) no State shall receive less than the amount they
received in fiscal year 2006; and
``(B) any funds remaining after amounts are provided under
subparagraph (A) shall be used to meet the requirement of
paragraph (1)(B), to the maximum extent possible.''.
______

By Ms. COLLINS (for herself and Mr. Harkin):
S. 1099. A bill to amend chapter 89 of title 5, United States Code,
to make individuals employed by the Roosevelt Campobello International
Park Commission eligible to obtain Federal health insurance; to the
Committee on Homeland Security and Governmental Affairs.
Ms. COLLINS. Mr. President. I rise to introduce a bill that would
solve a serious health-insurance problem for some Americans who work on
Campobello Island, Canada, near the Maine border, at a park that honors
the memory of President Franklin D. Roosevelt.
Ten residents of the State of Maine are employed on that beautiful
island by the Roosevelt Campobello International Park. The park centers
on the spacious summer cottage that FDR loved and visited often, from
his childhood in the 1880s up to his last trip in 1939. Today, the
Roosevelt cottage and the park draw thousands of visitors from around
the world.
The Roosevelt Campobello International Park was dedicated in 1964 as
a memorial to President Roosevelt, and is funded by both the U.S. and
the Canadian Governments under terms of a treaty.
Unfortunately, the drafters of the treaty did not address the need
for health insurance for park employees. As a result, the State
Department concluded in 1965 that those employees ``shall be subject to
the relevant Canadian labor laws.'' Based on that State Department
opinion, the U.S. Civil Service Commission--precursor of the Office of
Personnel Management--determined that the employees were not eligible
for Federal Employee Health Benefits Program coverage.
Meanwhile, even if the employees could join the Canadian health plan,
the park's location makes it impractical for them to seek medical
treatment in Canada. The closest doctors and hospitals are in Maine,
and the only access to the park is from the United States.
Consequently, the employees have relied on a small-group insurance
plan negotiated by the Park Commission and have paid for their own
insurance. But as with millions of other Americans, drastic increases
in premiums have made that small-group plan unaffordable for the Park
employees. The result is a genuine hardship for them and their
families.
My bill will resolve this problem simply, by making these employees
eligible for FEHBP health insurance. This is a matter of equal
treatment as well as compassion. Full-time employees of other joint-
responsibility parks on the U.S.A.-Canada border, like Glacier National
Park, are already eligible for coverage under the FEHBP.
Adding this handful of employees to the rolls is a negligible cost to
the government, but a huge relief for these deserving citizens.
I am pleased to be joined in this effort by Senator Harkin. He serves
ably on the Roosevelt Campobello International Park Commission, and so
understands the problem faced by my Maine constituents employed at the
park.
I hope that our colleagues will join us to support this bill so that
the American citizens maintaining a park honoring a great American
President will be treated fairly. I ask unanimous concent 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. 1099

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

SECTION 1. HEALTH INSURANCE.

Section 8901(1) of title 5, United States Code, is
amended--
(1) in subparagraph (H), by striking ``and'' at the end;
(2) in subparagraph (I), by inserting ``and'' after the
semicolon; and
(3) by inserting before the matter following subparagraph
(I) the following:
``(J) an individual who is employed by the Roosevelt
Campobello International Park Commission and is a citizen of
the United States,''.
______

By Mr. BINGAMAN (for himself, Mr. Smith, Mr. Kohl, Ms. Snowe,
Mrs. Lincoln, and Mr. Kerry):
S. 1102. A bill to amend title XVIII of the Social Security Act to
expedite the application and eligibility process for low-income
subsidies under the Medicare prescription drug program and to revise
the resource standards used to determine eligibility for an income-
related subsidy, and for other purposes; to the Committee on Finance.
By Mr. BINGAMAN (for himself, Mr. Smith, and Mr. Kerry):
S. 1103. A bill to amend title XVIII of the Social Security At to
include costs incurred by the Indian Health Service, a Federally
qualified health center, an AIDS drug assistance program, certain
hospitals, or a pharmaceutical manufacturer patient assistance program
in providing prescription drugs toward the annual out of pocket
threshold under part D of the Medicare program; to the Committee on
Finance.

[[Page S4443]]

Mr. BINGAMAN. Mr. President, I rise today with my colleague Senator
Smith to introduce two pieces of vitally important, bipartisan
legislation that will ensure that low-income seniors have full access
to the benefits available to them under the Medicare Drug Benefit. The
first piece of legislation makes critical improvements in the Medicare
Part D Low-Income Subsidy (LIS) available to assist these individuals
in meeting cost sharing, premium, and deductible requirements under
Part D. The second will ensure that low-income seniors don't get caught
in the Medicare Part D coverage gap, or ``doughnut hole,'' simply
because of where they purchase their Part D pharmaceuticals.
These bills were developed in close collaboration with Senator Smith,
who also will be introducing two bills today to achieve other, critical
improvements in the Medicare program for low-income seniors. Together,
we believe this package of four bills will provide the reforms
necessary to ensure that the Medicare program and the LIS function as
they were intended, to ensure access to life-saving drug coverage for
some of the most vulnerable members of our society.
Data indicates that a shockingly low number of seniors eligible for
the LIS benefit are actually receiving the benefit. According to the
January 2007 report by the National Council on Aging (NCOA), The Next
Steps: Strategies to Improve the Medicare Part D Low-Income Subsidy,
only 35 percent to 42 percent of beneficiaries who could have
successfully applied for the LIS in 2006 were actually receiving it.
Exacerbating this problem, NCOA also reports that overall LIS
enrollment rates are slowing. In total for 2007, NCOA estimates that
between 3.4 and 4.4 million beneficiaries still must be identified and
enrolled in the LIS. Furthermore, data indicates that certain LIS
requirements result in many low-income seniors that should be eligible
for the benefit being denied enrollment in LIS. I believe the modest
policy changes created by the legislation I and Senator Smith are
introducing will ensure that all low-income beneficiaries have access
to the LIS.
The single most significant barrier to LIS eligibility is the asset
test, which accounts for approximately 41 percent of LIS denials. As
reported by NCOA, the asset test penalizes low income retirees who may
have very modest savings. For example, approximately half of the people
that failed the asset test have excess assets of $35,000 or less. These
people tend to be older, female, widowed, and living alone. In addition
the asset test is inherently discriminatory against certain categories
of people, e.g., people who rent their homes.
My legislation, the Part D Equity for Low-Income Seniors Act, will
dramatically improve this inequity by raising the asset test limits to
$27,500 for an individual and $55,000 for a couple. This will capture
about half of individuals and two-thirds of couples who have been
denied LIS because of excess resources.
As recommended by OIG in fall 2006, this legislation also allows the
Internal Revenue Service (IRS) to transfer tax filing information to
the Social Security Administration (SSA) so they can better target
beneficiaries who might be eligible for the LIS. In addition, this
legislation creates an expedited LIS application process for pre-
screened beneficiaries, prohibits the reporting of retirement account
balances, life-insurance policies and in-kind contributions when
determining a beneficiary's resource level, and prohibits LIS benefits
from being counted as resources for the purposes of determining
eligibility for other federal programs.
I also am introducing the Low-Income True Out-Of Pocket (TrOOP)
Expense under Part D Assistance bill, which ensures that low-income
Americans do not get ``stuck'' in the Part D ``doughnut hole'' simply
because of where they choose to purchase Part D pharmaceuticals.
Unbelievably, under current regulation and guidance, individuals who
are in the doughnut hole and receive Part D drugs from commercial
pharmacies are permitted to count waivers or reductions in Part D cost-
sharing to count towards their TrOOP. However, low-income individuals
who tend to receive Part D drugs from safety-net pharmacies and other
safety-net providers are not permitted to count similar waivers or
reductions in Part D cost-sharing by safety-net providers towards their
TrOOP. Thus, current law penalizes low-income individuals and makes it
easier for them to get stuck in the doughnut hole--never accessing the
catastrophic coverage to which they are entitled.
My legislation would undo this inequity and permit waivers and
reductions for beneficiaries receiving care from safety-net providers
to count towards beneficiaries' TrOOP. Specifically, the legislation
will count waivers and reductions by certain safety-net hospitals and
pharmacies, Federally Qualified Health Centers (FQHCs), AIDS Drug
Assistance Programs (ADAPs), Pharmacy Assistance Programs (PAPs), and
the Indian Health Service (IRS) toward TrOOP.
In closing, I would also like to offer my strong support for the two
bills on which we worked very closely with Senator Smith and that he is
introducing today. The first is the Medicare Part D Outreach and
Enrollment Enhancement Act, which creates a permanent 90-day special
enrollment period for any beneficiary who becomes eligible for the LIS.
It also requires CMS to provide such beneficiaries facilitated
enrollment into the plans allowing, within 90 days, the beneficiary to
be enrolled into the most appropriate plan for his or her needs. The
legislation also waives the late enrollment penalty for LIS
beneficiaries, provides a $1 per beneficiary authorization for State
Health Insurance Programs, and funds the National Center on Senior
Benefits and Outreach, which was created last year in the Older
Americans Act.
The second piece of legislation creates important equity between
institutionalized Part D beneficiaries dually eligible for Medicare and
Medicaid and those dual eligibles who avoid initialization through a
Home and Community Based Waiver (HCBW). Currently under Federal law,
Part D cost-sharing requirements are waived for dual-eligible
individuals that are institutionalized but are not waived for
individuals in HCBWs. Senator Smith's legislation would make an
important change to Federal law to all allow cost sharing under Part D
to be waived for dual eligibles regardless of whether they are
institutionalized or receiving care through HCBWs.
I also would like to express my gratitude for the assistance of
several key senior citizen advocates in crafting all four important
pieces of legislation, including: Paul Cotton and Kristen Sloan from
the American Association of Retired Persons, Howard Bedlin and Sara
Duda from the National Council on Aging, Lena O'Rourke and Marc
Steinberg from Families USA, Patricia Nemore and Vicki Gottlich from
the Center for Medicare Advocacy and Paul Precht, from the Medicare
Rights Center. I would also like to thank the Staff at the Social
Security Administration (SSA) for their prompt feedback and invaluable
assistance.
I urge my colleagues to join me in supporting these important pieces
of legislation, which will ensure that life saving pharmaceuticals are
available to low-income Americans.
I ask unanimous consent that the National Council on Aging Report,
and the text of these bills to be printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:

The Next Steps: Strategies To Improve the Medicare Part D Low-Income
Subsidy

The passage of the Medicare Modernization Act (MMA) was the
largest expansion of the Medicare program since its inception
in 1965 and over 90 percent of Medicare beneficiaries now
have prescription drug coverage due to unprecedented efforts
by the public and private sectors. However, millions of those
in greatest need have still not signed up for the Low-Income
Subsidy (LIS or Extra Help) program, which provides generous
financial assistance to beneficiaries with limited income and
resources, including coverage through the ``donut hole.'' HHS
has estimated that at least 75% of the Medicare beneficiaries
still without any prescription drug coverage are eligible for
the Low-Income Subsidy.
The challenge of finding and enrolling people with limited
means in needs-based programs is not new. After forty years,
take-up rates remain low for many federal means-tested
benefits. As a result of unprecedented efforts by the public,
non-profit and private sectors in the first year of the
program, NCOA estimates that 35% to 42% of beneficiaries who
could have successfully applied for the LIS in 2006 are
actually receiving it. While the LIS take-up rate so far is
on a par

[[Page S4444]]

with historic enrollment rates in other federal, needs-based
programs (especially after the first year of effort), there
are signs that overall enrollment rates are slowing. We
estimate that there are between 3.4 and 4.4 million
beneficiaries that we still need to find and sign up for the
program in 2007.
These are people who would benefit most from the coverage
that Part D and the LIS can offer them. With targeted
investments and modest policy changes, significantly higher
participation rates can be achieved in 2007.
This paper identifies recommended legislative,
administrative, and regulatory reforms that should be made to
the LIS to improve access to the program for seniors and
people with disabilities with limited means. Some of the key
legislative reforms recommended include: (1) eliminating the
asset test, as it is the single-most significant barrier to
Part D LIS eligibility; (2) enacting legislation to make the
LIS Special Enrollment Period (SEP) permanent and eliminate
the late enrollment premium penalty for this population; and
(3) establishing and funding a dedicated, nationwide network
of enrollment centers through the new National Center on
Senior Benefits Outreach and Enrollment in order to find and
enroll remaining LIS eligibles.
There are also significant administrative and regulatory
reforms recommended in this paper. Some of the reforms
include having the Social Security Administration (SSA): (1)
designate at least one dedicated worker in each field office
who is assigned specifically to process LIS applications
where practical; (2) amend the LIS application to allow
applicants to designate a third party to assist them through
the LIS application process and interact with SSA on their
behalf; and (3) maintain a link from the online LIS
application to a webpage that provides seniors and people
with disabilities--as well as their family members, friends,
or advocates--with state-specific information on other public
benefits for which they may be eligible.
In addition to implementing reforms to the Part D LIS
program, Prescription Drug Plans (PDPs) and Medicare
Advantage-Prescription Drug plans (MAPDs) should be required
to screen their member lists for individuals who are
potentially eligible for the Low- Income Subsidy. We estimate
that up to 1.1 million more people in plans could enroll in
the LIS if they knew they were eligible for the program and
received application assistance. PDPs and MA-PDs could
partner with nonprofit organizations to help screen their
members for LIS eligibility.
We commend CMS for its recent decisions to permit low-
income beneficiaries to sign up for LIS and enroll in a plan
throughout the remainder of 2007 without penalty. This action
is necessary, but not sufficient in itself to achieve higher
LIS enrollments in 2007. To reach the remaining LIS
eligibles, additional investment in proven strategies that
work is needed, along with progress on the other
recommendations included in this paper.
With the beginning of the second year of this program, the
Access to Benefits Coalition and NCOA call on the
Administration, foundations, corporations and advocacy groups
to renew their commitment to outreach and enrollment efforts
and to invest in effective strategies to help seniors and
people with disabilities in greatest need to receive the
important benefits available to them.
____

S. 1102

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 ``Part D Equity for Low-Income
Seniors Act of 2007''.

SEC. 2. EXPEDITING LOW-INCOME SUBSIDIES UNDER THE MEDICARE
PRESCRIPTION DRUG PROGRAM.

(a) In General.--Section 1860D-14 of the Social Security
Act (42 U.S.C. 1395w-114) is amended by adding at the end the
following new subsection:
``(e) Expedited Application and Eligibility Process.--
``(1) Expedited process.--
``(A) In general.--The Commissioner of Social Security
shall provide for an expedited process under this subsection
for the qualification for low-income assistance under this
section through a request to the Secretary of the Treasury as
provided in subparagraph (B) for information described in
section 6103(l)(21) of the Internal Revenue Code of 1986.
Such process shall be conducted in cooperation with the
Secretary.
``(B) Currently eligible individuals.--The Commissioner of
Social Security shall, as soon as practicable after
implementation of subparagraph (A), screen such individual
for eligibility for the low-income subsidy provided under
this section through such a request to the Secretary of the
Treasury.
``(2) Notification of potentially eligible individuals.--
Under such process, in the case of each individual identified
under paragraph (1) who has not otherwise applied for, or
been determined eligible for, benefits under this section (or
who has applied for and been determined ineligible for such
benefits based only on excess resources), the Commissioner of
Social Security shall send a notification that the individual
is likely eligible for low-income subsidies under this
section. Such notification shall include the following:
``(A) Application information.--Information on how to apply
for such low-income subsidies.
``(B) Description of the lis benefit.--A description of the
low-income subsidies available under this section.
``(C) Information on state health insurance programs.--
Information on--
``(i) the State Health Insurance Assistance Program for the
State in which the individual is located; and
``(ii) how the individual may contact such Program in order
to obtain assistance regarding enrollment and benefits under
this part.
``(D) Attestation.--An application form that provides for a
signed attestation, under penalty of law, as to the amount of
income and assets of the individual and constitutes an
application for the low-income subsidies under this section.
Such form--
``(i) shall not require the submittal of additional
documentation regarding income or assets;
``(ii) shall permit the appointment of a personal
representative described in paragraph (4); and
``(iii) shall allow for the specification of a language
(other than English) that is preferred by the individual for
subsequent communications with respect to the individual
under this part.
If a State is doing its own outreach to low-income seniors
regarding enrollment and low-income subsidies under this
part, such process shall be coordinated with the State's
outreach effort.
``(3) Hold-harmless.--Under such process, if an individual
in good faith and in the absence of fraud executes an
attestation described in paragraph (2)(D) and is provided
low-income subsidies under this section on the basis of such
attestation, if the individual is subsequently found not
eligible for such subsidies, there shall be no recovery made
against the individual because of such subsidies improperly
paid.
``(4) Use of authorized representative.--Under such
process, with proper authorization (which may be part of the
attestation form described in paragraph (2)(D)), an
individual may authorize another individual to act as the
individual's personal representative with respect to
communications under this part and the enrollment of the
individual under a prescription drug plan (or MA-PD plan) and
for low-income subsidies under this section.
``(5) Use of preferred language in subsequent
communications.--In the case an attestation described in
paragraph (2)(D) is completed and in which a language other
than English is specified under clause (iii) of such
paragraph, the Commissioner of Social Security shall provide
that subsequent communications to the individual under this
part shall be in such language.
``(6) Construction.--Nothing in this subsection shall be
construed as precluding the Commissioner of Social Security
or the Secretary from taking additional outreach efforts to
enroll eligible individuals under this part and to provide
low-income subsidies to eligible individuals.''.
(b) Disclosure of Return Information for Purposes of
Determining Individuals Eligible for Subsidies Under Medicare
Part D.--
(1) In general.--Subsection (l) of section 6103 of the
Internal Revenue Code of 1986 is amended by adding at the end
the following new paragraph:
``(21) Disclosure of return information to carry out
medicare part d subsidies.--
``(A) In general.--The Secretary shall, upon written
request from the Commissioner of Social Security under
section 1860D-14(e)(1) of the Social Security Act, disclose
to officers and employees of the Social Security
Administration return information of a taxpayer who
(according to the records of the Secretary) may be eligible
for a subsidy under section 1860D-14 of the Social Security
Act. Such return information shall be limited to--
``(i) taxpayer identity information with respect to such
taxpayer,
``(ii) the filing status of such taxpayer,
``(iii) the gross income of such taxpayer,
``(iv) such other information relating to the liability of
the taxpayer as is prescribed by the Secretary by regulation
as might indicate the eligibility of such taxpayer for a
subsidy under section 1860D-14 of the Social Security Act,
and
``(v) the taxable year with respect to which the preceding
information relates.
``(B) Restriction on use of disclosed information.--Return
information disclosed under this paragraph may be used by
officers and employees of the Social Security Administration
only for the purposes of identifying eligible individuals
for, and, if applicable, administering--
``(i) low-income subsidies under section 1860D-14 of the
Social Security Act, and
``(ii) the Medicare Savings Program implemented under
clauses (i), (iii), and (iv) of section 1902(a)(10)(E) of
such Act.
``(C) Termination.--Return information may not be disclosed
under this paragraph after the date that is one year after
the date of the enactment of this paragraph.''.
(2) Conforming amendments.--Paragraph (4) of section
6103(p) of the Internal Revenue Code of 1986 is amended--
(A) by striking ``(14) or (17)'' in the matter preceding
subparagraph (A) and inserting ``(14), (17), or (21)''; and
(B) by striking ``(15) or (17)'' in subparagraph (F)(ii)
and inserting ``(15), (17), or (21)''.

[[Page S4445]]

SEC. 3. MODIFICATION OF RESOURCE STANDARDS FOR DETERMINATION
OF ELIGIBILITY FOR LOW-INCOME SUBSIDY.

(a) Increasing the Alternative Resource Standard.--Section
1860D-14(a)(3)(E)(i) of the Social Security Act (42 U.S.C.
1395w-114(a)(3)(E)(i)) is amended--
(1) in subclause (I), by striking ``and'' at the end;
(2) in subclause (II)--
(A) by striking ``a subsequent year'' and inserting
``2007'';
(B) by striking ``in this subclause (or subclause (I)) for
the previous year'' and inserting ``in subclause (I) for
2006'';
(C) by striking the period at the end and inserting a
semicolon; and
(D) by inserting before the flush sentence at the end the
following new subclauses:

``(III) for 2008, $27,500 (or $55,000 in the case of the
combined value of the individual's assets or resources and
the assets or resources of the individual's spouse); and
``(IV) for a subsequent year the dollar amounts specified
in this subclause (or subclause (III)) for the previous year
increased by the annual percentage increase in the consumer
price index (all items; U.S. city average) as of September of
such previous year.''; and

(3) in the flush sentence at the end, by inserting ``or
(IV)'' after ``subclause (II)''.
(b) Exemptions From Resources.--Section 1860D-14(a)(3) of
the Social Security Act (42 U.S.C. 1395w-114(a)(3)) is
amended--
(1) in subparagraph (D), in the matter preceding clause
(i), by inserting ``subject to the additional exclusions
provided under subparagraph (G)'' before ``)'';
(2) in subparagraph (E)(i), in the matter preceding
subclause (I), by inserting ``subject to the additional
exclusions provided under subparagraph (G)'' before ``)'';
and
(3) by adding at the end the following new subparagraph:
``(G) Additional exclusions.--In determining the resources
of an individual (and their eligible spouse, if any) under
section 1613 for purposes of subparagraphs (D) and (E) the
following additional exclusions shall apply:
``(i) Life insurance policy.--No part of the value of any
life insurance policy shall be taken into account.
``(ii) In-kind contributions.--No in-kind contribution
shall be taken into account.
``(iii) Pension or retirement plan.--No balance in any
pension or retirement plan shall be taken into account.''.
(c) Effective Date.--The amendments made by this section
shall take effect on the date of enactment of this Act.

SEC. 4. INDEXING DEDUCTIBLE AND COST-SHARING ABOVE ANNUAL
OUT-OF-POCKET THRESHOLD FOR INDIVIDUALS WITH
INCOME BELOW 150 PERCENT OF POVERTY LINE.

(a) Indexing Deductible.--Section 1860D-14(a)(4)(B) of the
Social Security Act (42 U.S.C. 1395w-114(a)(4)(B)) is
amended--
(1) in clause (i), by striking ``or'';
(2) in clause (ii)--
(A) by striking ``a subsequent year'' and inserting
``2008'';
(B) by striking ``this clause (or clause (i)) for the
previous year'' and inserting ``clause (i) for 2007''; and
(C) by striking ``involved.'' and inserting ``involved;
and'';
(3) by adding after clause (ii) the following new clause:
``(iii) for 2008 and each succeeding year, the amount
determined under this subparagraph for the previous year
increased by the annual percentage increase in the consumer
price index (all items; U.S. city average) as of September of
such previous year.''; and
(4) in the flush sentence at the end, by striking ``clause
(i) or (ii)'' and inserting ``clause (i), (ii), or (iii)''.
(b) Indexing Cost-Sharing.--Section 1860D-14(a) of the
Social Security Act (42 U.S.C. 1395w-114(a)) is amended-
(1) in paragraph (1)(D)(iii), by striking ``exceed the
copayment amount'' and all that follows through the period at
the end and inserting ``exceed--

``(I) for 2006 and 2007, the copayment amount specified
under section 1860D-2(b)(4)(A)(i)(I) for the drug and year
involved; and
``(II) for 2008 and each succeeding year, the amount
determined under this subparagraph for the previous year
increased by the annual percentage increase in the consumer
price index (all items; U.S. city average) as of September of
such previous year.''; and

(2) in paragraph (2)(E), by striking ``exceed the copayment
or coinsurance amount'' and all that follows through the
period at the end and inserting ``exceed--
``(i) for 2006 and 2007, the copayment or coinsurance
amount specified under section 1860D-2(b)(4)(A)(i)(I) for the
drug and year involved; and
``(ii) for 2008 and each succeeding year, the amount
determined under this clause for the previous year increased
by the annual percentage increase in the consumer price index
(all items; U.S. city average) as of September of such
previous year.''.

SEC. 5. NO IMPACT ON ELIGIBILITY FOR BENEFITS UNDER OTHER
PROGRAMS.

(a) In General.--Section 1860D-14(a)(3) of the Social
Security Act (42 U.S.C. 1395w-114(a)(3)), as amended by
section 3(c)(3), is amended--
(1) in subparagraph (A), in the matter preceding clause
(i), by striking ``subparagraph (F)'' and inserting
``subparagraphs (F) and (H)''; and
(2) by adding at the end the following new subparagraph:
``(H) No impact on eligibility for benefits under other
programs.--The availability of premium and cost-sharing
subsidies under this section shall not be treated as benefits
or otherwise taken into account in determining an
individual's eligibility for, or the amount of benefits
under, any other Federal program.''.
(b) Effective Date.--The amendments made by this section
shall take effect on the date of enactment of this Act.
____

S. 1103

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 ``Helping Fill the Medicare Rx
Gap Act of 2007''.

SEC. 2. INCLUDING COSTS INCURRED BY THE INDIAN HEALTH
SERVICE, A FEDERALLY QUALIFIED HEALTH CENTER,
AN AIDS DRUG ASSISTANCE PROGRAM, CERTAIN
HOSPITALS, OR A PHARMACEUTICAL MANUFACTURER
PATIENT ASSISTANCE PROGRAM IN PROVIDING
PRESCRIPTION DRUGS TOWARD THE ANNUAL OUT OF
POCKET THRESHOLD UNDER PART D.

(a) In General.--Section 1860D-2(b)(4)(C) of the Social
Security Act (42 U.S.C. 1395w-102(b)(4)(C)) is amended--
(1) in clause (i), by striking ``and'' at the end;
(2) in clause (ii)--
(A) by striking ``such costs shall be treated as incurred
only if'' and inserting ``subject to clause (iii), such costs
shall be treated as incurred if'';
(B) by striking ``, under section 1860D-14, or under a
State Pharmaceutical Assistance Program'';
(C) by striking ``(other than under such section or such a
Program)''; and
(D) by striking the period at the end and inserting ``;
and''; and
(3) by inserting after clause (ii) the following new
clause:
``(iii) such costs shall be treated as incurred and shall
not be considered to be reimbursed under clause (ii) if such
costs are borne or paid--

``(I) under section 1860D-14;
``(II) under a State Pharmaceutical Assistance Program;
``(III) by the Indian Health Service, an Indian tribe or
tribal organization, or an urban Indian organization (as
defined in section 4 of the Indian Health Care Improvement
Act);
``(IV) by a Federally qualified health center (as defined
in section 1861(aa)(4));
``(V) under an AIDS Drug Assistance Program under part B of
title XXVI of the Public Health Service Act;
``(VI) by a subsection (d) hospital (as defined in section
1886(d)(1)(B)) that meets the requirements of clauses (i) and
(ii) of section 340B(a)(4)(L) of the Public Health Service
Act; or
``(VII) by a pharmaceutical manufacturer patient assistance
program, either directly or through the distribution or
donation of covered part D drugs, which shall be valued at
the negotiated price of such covered part D drug under the
enrollee's prescription drug plan or MA-PD plan as of the
date that the drug was distributed or donated.''.

(b) Effective Date.--The amendments made by subsection (a)
shall apply to costs incurred on or after January 1, 2008.
______

By Mr. KENNEDY (for himself, Mr. Smith, Mr. Leahy, Mr. Specter,
Ms. Mikulski, Ms. Collins, Mr. Menendez, Ms. Snowe, Mr. Brown,
Mr. Kerry, Mr. Durbin, Mr. Lautenberg, Mr. Dodd, Mr. Nelson of
Nebraska, Mrs. Feinstein, Mr. Levin, Mr. Harkin, Mr.
Whitehouse, Ms. Stabenow, Mr. Biden, Mrs. Murray, Mr. Bayh, Ms.
Cantwell, Mr. Cardin, Mr. Lieberman, Mr. Reed, Mr. Schumer, Mr.
Obama, Mrs. Boxer, Ms. Klobuchar, Mr. Akaka, Mr. Bingaman, Mrs.
Clinton, Ms. Landrieu, Mr. Rockefeller, Mrs. Lincoln, Mr.
Casey, Mrs. McCaskill, Mr. Inouye, Mr. Nelson of Florida, Mr.
Salazar, and Mr. Johnson):
S. 1105. A bill to provide Federal assistance to States, local
jurisdictions, and Indian tribes to prosecute hate crimes, and for
other purposes; to the Committee on the Judiciary.
Mr. KENNEDY. Mr. President, hate crimes violate everything our
country stands for. They send the poisonous message that certain
Americans deserve to be victimized solely because of who they are.
These are crimes committed against entire communities, the Nation as a
whole and the very ideals upon which our country was founded.
The vast majority of Congress agrees. In 2000, 57 Senators voted in
support of this bill. In 2002, 54 Senators voted with us, and, in 2004,
we had 65 votes. Today, we are re-introducing this bicameral,
bipartisan bill with the support of 39 original cosponsors, and we have
the

[[Page S4446]]

votes to get cloture. We have the votes in the House too. This year, we
are going to get it done.
Our legislation is supported by a broad coalition of over 210 law
enforcement, civic, religious and civil rights groups, including the
International Association of Chiefs of Police, the National Sheriffs
Association, the Anti-Defamation League, the Interfaith Alliance, the
U.S. Conference of Mayors, the Leadership Conference on Civil Rights,
the National District Attorneys Association, and the National Center
for Victims of Crime.
Data from the National Crime Victimization Survey are especially
disturbing because they indicate that a large number of hate crimes go
unreported. The data indicates that an average of 191,000 hate crimes
take place every year, but only a small percentage are reported to the
police.
We obviously need to strengthen the ability of Federal, State and
local governments to investigate and prosecute these vicious and
senseless crimes. The existing Federal hate crime statute was passed in
1968, soon after the assassination of Dr. Martin Luther King, Jr. It
was such an important step forward at the time, but it is now a
generation out of date.
The absence of effective legislation has undoubtedly resulted in the
failure to solve many hate-motivated crimes. The recent action of the
Justice Department in reopening 40 civil-rights-era murders
demonstrates the need for adequate laws. Many of the victims in these
cases have been denied justice for decades, and for some, justice will
never come.
This bill corrects two major deficiencies in current law--one, the
excessive restrictions requiring proof that victims were attacked
because they were engaged in certain ``federally protected
activities,'' and, two, the limited scope of the law, which covers only
hate crimes based on race, religion, or ethnic background, excluding
violence committed against persons because of their sexual orientation,
gender, gender identity, or disability.
The federally protected activity requirement is outdated, unwise and
unnecessary, particularly when we consider the unjust outcomes that
result from this requirement. Hate crimes can occur in a variety of
circumstances, and citizens are often targeted during routine
activities that should be protected.
For example, in June 2003, six Latino teenagers went to a family
restaurant on Long Island. They knew one another from their involvement
in community activities and were together to celebrate one of their
birthdays. As the group entered the restaurant, three men who were
leaving the bar assaulted them, pummeling one boy and severing a tendon
in his hand with a sharp weapon. During the attack, the men yelled
racial slurs and one identified himself as a skinhead.
Two of the men were tried under the current Federal law for
committing a hate crime and were acquitted. The jurors said the
government failed to prove that the attack took place because the
victims were engaged in a federally protected activity--using the
restaurant. The result in this case is only one example of the
inadequate protection under current law. The bill we introduce today
will eliminate the federally protected activity requirement. Under this
bill, the defendants who left the courtroom as free men would almost
certainly have left in handcuffs through a different door.
The bill also recognizes that hate crimes are also committed against
people because of their sexual orientation, their gender, their gender
identity, or their disability. It's up to Congress to make sure that
tough Federal penalties also apply to those who commit such crimes as
well. Passing this bill will send a loud and clear message. All hate
crimes will face Federal prosecution. Action is long overdue.
Examples of the problem abound. Two years ago, a 52-year-old Alabama
man was beaten on the head with a hammer because he was gay. Still
waiting for justice, the man lies in a coma as a result of that attack.
In 1993, a 21-year-old transgender man, Brandon Teena was raped and
beaten in Humboldt, NE, by two male friends. The local sheriff refused
to arrest the offenders, and they later shot and stabbed Brandon to
death.
In 1999, four women in Yosemite National Park were targeted by a man
who admitted to having fantasized about killing women for most of his
life. The current hate crime law did not apply to this horrific crime
because enjoyment of a Federal park is not a federally protected right.
In 2001, Fred C. Martinez, Jr., a Navajo, openly gay, transgender
youth, was murdered while walking home from a party in Cortez, CO. The
perpetrator, Shaun Murphy, had traveled from New Mexico to Colorado
with a friend in order to sell illegal drugs. He met Fred at a carnival
that night, and the next morning, while driving, he saw Fred walking
down the street. Shaun and his friend offered Fred a ride and dropped
him off close to home. Shortly thereafter, Shaun attacked Fred and beat
him to death with a large rock. His body was discovered several days
later. The attackers bragged about this vicious crime, describing the
victim with vulgar epithets.
The perpetrator could not be charged with a hate crime because no
State or Federal law protecting gender identity existed. He received a
40-year sentence under a plea agreement and he will be eligible for
parole in 25 years. His victim did not live long enough to see his 20th
birthday. If the defendant had been charged with a Federal hate crime,
he could have received a life sentence. If the prosecutor had greater
aid for his investigation under the proposed legislation, he could have
had a stronger case against the defendant and prosecuted him more
effectively.
In October 2002, two deaf girls in Somerville, MA--one of whom was
wheelchair bound due to cerebral palsy--were harassed and sexually
assaulted by four suspected gang members in a local park. Although the
alleged perpetrators were charged in the incident, the assaults could
not be charged as hate crimes because there is no Federal protection
for hate crimes against disabled individuals.
These examples graphically illustrate the senseless brutality that
our fellow citizens face simply for being who they are. They also
highlight the importance of passing this legislation, which is long
overdue.The vast majority of us in Congress have recognized the
importance of this legislation since it was first introduced--nearly 10
years ago. This year, we have an opportunity to pass it in both the
Senate and the House, and enact it into law. Let's make the most of
this opportunity, and do all we can to end these senseless crimes.
I ask unanimous consent to print in the Record this list of
organizations who support the Matthew Shepard bill.
There being no objection the material was ordered to be printed as
follows:

1. American-Arab Anti-Discrimination Committee.
2. American Association of University Women.
3. American Civil Liberties Union.
4. American Jewish Committee.
5. American Psychological Association.
6. Anti-Defamation League.
7. Asian American Justice Center.
8. Center for the Study of Hate and Extremism.
9. Human Rights Campaign.
10. Interfaith Alliance.
11. International Association of Chiefs of Police.
12. Japanese American Citizens League.
13. Jewish Council for Public Affairs.
14. Leadership Conference on Civil Rights.
15. Matthew Shepard Foundation.
16. National Association for the Advancement of Colored
People.
17. National Council of Jewish Women.
18. National District Attorneys Association.
19. National Sheriffs' Association.
20. People for the American Way.
21. Religious Action Center of Reform Judaism.
22. SALDEF (Sikh American Legal Defense and Education
Fund).
23. Unitarian Universalist Association.
24. The United States Conference of Mayors.
25. Group Letter: Religious Organizations: African American
Ministers in Action, American Jewish Committee. Anti-
defamation League, Buddhist Peace Fellowship, Catholics for a
Free Choice, Church Women United, The Episcopal Church,
Hadassah, Hindu American Foundation, The Interfaith Alliance,
Jewish Council for Public Affairs, Jewish Women
International, Muslim Public Affairs Council, NA'AMAT USA,
National Council of Churches of Christ, National Council of
Jewish Women, North American Federation of Temple Youth,
Presbyterian Church USA, Sikh Council on Religion and
Education, United Church of Christ Justice and Witness
Ministries, Union for Reform Judaism, United Methodist Church
General Board of Church and Society, Unitarian Universalist
Association of Congregations,

[[Page S4447]]

United Synagogues of Conservative Judaism and Women of Reform
Judaism.
26. Group Letter: Consortium for Citizens with
Disabilities: Alexander Graham Bell Association for the Deaf
and Hard of Hearing, American Association on Health and
Disability, American Association on Intellectual and
Developmental Disabilities, American Association on Mental
Retardation, American Association of People with
Disabilities, American Council of the Blind, American
Counseling Association, American Dance Therapy Association,
American Medical Rehabilitation Providers Association,
American Music Therapy Association, American Network of
Community Options and Resources, American Occupational
Therapy Association, American Psychological Association,
American Therapeutic Recreation Association, American
Rehabilitation Association, Association of Tech Act Projects,
Association of University Centers of Disabilities, Autism
Society of America, Bazelon Center for Mental Health Law,
Council for Learning Disabilities, Council of State
Administrators of Vocational Rehabilitation, Easter Seals,
Epilepsy Foundation, Hellen Keller National Center, Learning
Disabilities Association of America, National Alliance on
Mental Illness, National Association of Councils on
Developmental Disabilities, National Coalition on Deaf-
Blindness, National Disability Rights Network, National Down
Syndrome Society, National Fragile X Foundation, National
Rehabilitation Association, National Respite Coalition,
National Structured Settlement Trade Association, NISH,
Paralyzed Veterans of America, Research Institute for
Independent Living, School Social Work Association of
America, Spina Bifida Association, The Arc of the United
States, United Cerebral Palsy, United Spinal Association,
World Institute on Disability.
27. Group Letter: National Partnership for Women and
Families: 9to5 Bay Area, 9to5 Colorado, 9to5 Poverty Network
Initiative (Wisconsin), 9to5 National Association of Working
Women, AFL-CIO Department of Civil, Human and Women's Rights,
American Association of University Women, Atlanta 9to5, Break
the Cycle, Coalition of Labor Union Women, Colorado Coalition
Against Sexual Assault (CCASA), Communications Workers of
America AFL-CIO, Democrats.com, Equal Rights Advocates,
Feminist Majority, Gender Public Advocacy Coalition, Gender
Watchers, Hadassah the Women's Zionist Organization of
America, Legal Momentum, Los Angeles 9to5, NA'AMAT USA,
National Abortion Federation, National Asian Pacific American
Women's Forum, National Association of Social Workers,
National Center for Lesbian Rights, National Congress of
Black Women, National Council of Jewish Women, National
Council of Women's Organizations, National Organization for
Women, National Partnership for Women and Families, National
Women's Conference, National Women's Committee, National
Women's Law Center, Northwest Women's Law Center, Sargent
Shriver National Center on Poverty Law, The Women's Institute
for Freedom of the Press, Washington Teachers Union, Women
Employed, Women's Law Center of Maryland, Women's Research
and Education Institute, YWCA USA.
28. Excerpts of Support for the Hate Crime Prevention Act
of 2007.
29. General List of Supporting Organizations 2007.

Mr. BAYH. Mr. President, like acts of terrorism, hate crimes have an
impact far greater than the impact on the individual victim. They are
crimes against entire communities, the whole Nation, and the ideals of
liberty and justice upon which America was founded.
First enacted nearly 40 years ago after the assassination of Martin
Luther King, Federal hate crime laws have provided an important basis
for prosecuting those who commit violent acts against another due to
the person's race, color, religion or national origin.
Current law, however, makes it unnecessarily difficult to investigate
and prosecute these and other insidious hate crimes. Consequently, the
time has come to remove some of these hurdles and to expand the scope
of Federal law so Americans who fall victim to hate crimes can receive
protection under Federal law.
That is why I have cosponsored the Local Law Enforcement Hate Crimes
Act of 2007, a bipartisan bill with broad political support that has
been endorsed by 210 law enforcement, civil rights, civic, and
religious organizations.
The bill will strengthen the ability of Federal, State, and local
governments to investigate and prosecute hate crimes based on race,
ethnic background, religion, gender, sexual orientation, disability,
and gender identity.
The bill will also provide grants to help State and local governments
meet the extraordinary expenses involved in hate crime cases.
This bill, while adding to Federal authority, properly leaves with
the State or local law enforcement officials the primary responsibility
of protecting citizens against crimes of violence. The bill authorizes
actual Federal prosecutions only when a State does not have
jurisdiction, when a State asks the Federal Government to take
jurisdiction, or when a State fails to act. It is a Federal back-up for
State and local law enforcement.
While State and local governments should continue to have the primary
responsibility for investigating and prosecuting hate crimes, an
expanded Federal role is necessary to ensure an adequate and fair
response in all cases. The Federal Government must have jurisdiction to
address those limited, but important cases in which local authorities
are either unable or unwilling to investigate and prosecute.
Failure to pass Federal hate crimes legislation would signify our
failure as a nation to accord each of our citizens the respect and
value they deserve.
According to FBI statistics, 27,432 people were victims of hate-
motivated violence over the last three years. That's an average of over
9,100 people per year, with nearly 25 people being victimized every day
of the year, based on their race, religion, sexual orientation, ethnic
background, or disability. But it is estimated that the vast majority
of hate crimes goes unreported. Survey data from the biannual National
Crime Victimization Survey suggests that an average of 191,000 hate
crime victimizations take place per year.
While hatred and bigotry cannot be eradicated by an act of Congress,
as a nation, we must send a strong, clear, moral response to these
cowardly acts of violence. I believe that the Federal Government must
play a leadership role in confronting criminal acts motivated by
prejudice.
All Americans have a stake in responding decisively to violent
bigotry. We must pull together to combat ignorance and hatred. The
devastation caused by hate crimes impacts the victims, members of his
or her family, as well as entire communities, and the Nation as a
whole.
I am reminded of the great wisdom of Martin Luther King, ``Darkness
cannot drive out darkness; only light can do that. Hate cannot drive
out hate; only love can do that. Hate multiplies hate, violence
multiplies violence, and toughness multiplies toughness in a descending
spiral of destruction. The chain reaction of evil--hate begetting hate,
wars producing wars--must be broken, or we shall be plunged into the
dark abyss of annihilation.'' Strength to Love, 1963.
I urge my colleagues to stand up against ignorance and intolerance
and vote for the Local Law Enforcement Hate Crimes Prevention Act.
Mr. SCHUMER. Mr. President, I am proud to be a co-sponsor of the
Local Law Enforcement Hate Crimes Prevention Act of 2007, and I commend
my friend and colleague, Senator Kennedy, for his leadership and
determination on this issue. We have tried for the better half of a
decade to get this legislation passed, signed, and enacted into law.
Today represents our strongest effort to date, and it is long past time
that crimes based on hate be recognized and criminalized under Federal
law. The need for Federal hate crimes legislation has been apparent for
years as hate crimes know no State borders and--in part because their
impacts often affect the very fabric of our society--they are a problem
that affects all Americans.
This act sends the message that we will not tolerate acts of
aggression and violence towards targeted communities or individuals who
become victims of violence merely for being themselves. Perpetrators of
this type of violence will now be subject to Federal prosecution under
this act. Before we had to rely on the States to act, and some simply
have failed to do enough to stem this type of criminal behavior. This
act recognizes that hate crimes have national consequences and are not
mere localized occurrences.
Put simply, a hate crime tends to impact an entire community, as
opposed to being limited to the victim or the victim's family. It is a
crime against a particular group, and must be treated as such. In
essence, there are two crimes--one against he victim, and one against
the victim's group or community. Some have asked, ``But aren't all
crimes based on hate?'' No, they are not. Hate crimes are unique
because they cut at the very fabric of our national values; they
undermine shared

[[Page S4448]]

principles like tolerance and equal protection under the law, and in so
doing, harm us all. It is the responsibility of the Federal Government
to address this issue and arm prosecutors with the tools they need to
seek justice, promote order and provide all American with equal
protection under the law.
The framework of the Constitution provides a sound basis for our
actions today--both the Commerce Clause and the Thirteenth Amendment
are implicated by these crimes. The effects of hate crimes do not end
at a State's border, but rather transcend those borders. These crimes
implicate a citizen's ability to move and travel freely. Additionally,
violence based on someone's race, religion, sexual orientation, or the
other characteristics noted in the act are reminiscent of the ultimate
hate crime--slavery. As such, the 13th Amendment allows for Federal
action to remedy this problem. The courts have ruled time and time
again that discrimination in housing and discrimination in contractual
agreements could be remedied through Federal statutes promulgated under
the authority of the Thirteenth Amendment. It matters not what the
discrimination is based on, what matters is the, discrimination itself.
In an attempt to rid the last vestiges of slavery from our society, the
courts have allowed the 13th Amendment to be the basis of such
legislation.

Let us be very clear, we are not criminalizing speech. Violent acts
against an African American, a woman, or a Sikh because of who they are
do not constitute free expression. Nor are we are criminalizing evil
thoughts. We are only criminalizing action--harmful and violent action
that cuts against our society and against the very meaning of what it
is to be an American. Congress and local law enforcement are not
becoming the ``thought-police.'' Rather, we are criminalizing the
violent actions of closed-minded and hateful individuals.
In today's society, we see all too frequently violence based on the
person's race, religion, sexual orientation, or other characteristics.
We must act to address these injustices. This is not about special
rights to any particular group. Actually, it is quite the contrary.
This is about equal rights. This is about going after those individuals
who act on their harmful beliefs. By committing hate crimes, they are
attempting to relegate certain people to second-class citizenship. They
think they can do this through violence. But they are wrong, and this
legislation is a forceful statement that this country will not tolerate
this behavior.
The victims of these crimes have done nothing to bring on this
violence. Because of these crimes, the victims' communities frequently
live in fear. Unfortunately, these crimes are not few and far between.
These crimes are all too common, and when committed, they send a
shockwave that can be felt across the country. Matthew Shepard and
James Byrd are just two of the many thousands of victims of hate crimes
whose deaths horrified this country. Additionally, we mustn't forget
the thousands of loyal and patriotic Americans, who after 9/11, were
attacked by ruthless thugs, all because they ``looked'' like--or were--
Muslims or Arab Americans. We saw many of these attacks in New York,
and let me say, those attacks were not just a New York problem, they
were an American problem. Every State experienced similar violence in
the months after 9/11, and that is one reason why Federal legislation
is appropriate.
The Act not only makes hate crimes a Federal crime, but it also
serves to benefit local police departments as well, considering they
are the front line of defense and prevention. This Act delivers much
needed financial assistance to local police departments who may be
struggling to deal with the crimes. It will also assist them in helping
the community which they protect.
The point is, that we should be protecting communities who are
targets of this shameful violence, and this Act today marks a great
step in that direction. I urge all of my colleagues to vote for this
Act and look forward to working with you all to see this Act gets
passed and signed into law.
______

By Mr. SMITH (for himself, Mr. Bingaman, Mr. Nelson of Florida,
Mrs. Clinton, Ms. Collins, Mrs. Lincoln, Mrs. Boxer, and Mr.
Kerry):
S. 1107. A bill to amend title XVIII of the Social Security Act to
reduce cost-sharing under part D of such title for certain non-
institutionalized full-benefit dual eligible individuals; to the
Committee on Finance.
______

By Mr. SMITH (for himself, Mr. Bingaman, Ms. Snowe, Mrs. Lincoln,
and Mr. Kerry):
S. 1108. A bill to amend title XVIII of the Social Security Act to
provide a special enrollment period for individuals who qualify for an
income-related subsidy under the Medicare prescription drug program and
to provide funding for the conduct of outreach and education with
respect to the premium and cost-sharing subsidies under such program,
and for other purposes; to the Committee on Finance.
Mr. SMITH. Mr. President, today I am proud to join my colleague,
Senator Bingaman, to introduce a package of four bills aimed at helping
seniors get the assistance they need with their Medicare prescription
drug costs. Thirty-nine million individuals now have access to
affordable prescription drug therapies through Medicare Part D, many
for the very first time. But low-income beneficiaries still are
experiencing difficulties taking full advantage of the program's
benefits. I believe the bipartisan package of legislation we have
developed will go a long way to removing programmatic barriers that are
limiting seniors from getting the help we intended them to have when we
created Medicare Part D Prescription Drug Program.
The low-income subsidy (LIS) is one of the best features of
Medicare's new prescription drug benefit. Over the past few years, I
have conducted extensive oversight of the program's implementation,
especially through my work as Chairman and now Ranking Member of the
Special Committee on Aging. Through hearings and staff-level
investigations, I have identified a number of concerns with both the
administration and the overall effectiveness of Medicare Part D's LIS.
The Centers for Medicare and Medicaid Services (CMS) and the Social
Security Administration (SSA) have made a great deal of progress to
ensure that the benefit is working well for all beneficiaries. But
their efforts can only go so far. Ultimately, it is Congress'
responsibility to ensure that all low-income seniors who have
difficulty paying their prescription drugs costs get the help they
need.
Two of the four bills that Senator Bingaman and I are filing today
are based upon initiatives that I introduced during the 109th Congress.
The first is a measure that would create parity in the cost-sharing
charged beneficiaries living in nursing homes and assisted living
facilities. Under current law, dual-eligible Medicare beneficiaries,
those who qualify for both Medicaid and Medicare coverage, receive a
subsidy from the government to pay the benefit's required $250
deductible. These individuals also qualify for reduced copayments for
both generic and brand named drugs in the amount of one and three
dollars respectively. If a dual-eligible beneficiary receives long-term
care services in an institutional setting, such as a nursing home, he
or she is exempt from paying the required copayment. Congress decided
to provide this assistance because dual-eligible beneficiaries residing
in nursing homes live off of very limited incomes. For instance, in
Oregon the personal needs allowance beneficiaries receive each month
for incidentals, including medications, is only $30. As many
institutionalized beneficiaries are on multiple medications, they would
not be able to meet their share of drug costs.
This is the very reason Congress provided institutionalized dual-
eligible beneficiaries with an exemption from all copayments under
Medicare Part D. However, many dual-eligible beneficiaries choose to
receive long-term care services in home or community-based settings,
such as assisted living or resident care program facilities. Almost all
states have chosen to establish Home and Community Based Services
(HCS) Medicaid demonstration projects that have expanded access to
community based alternatives to an even greater number of low-income
elderly Americans. The State of Oregon operates one of the Nation's
most successful HCS waivers, serving an average of 23,500 dual-eligible
beneficiaries

[[Page S4449]]

each year. My state has a thriving community based care industry that
has provided many dual-eligible Oregonians the freedom to choose the
care setting that best meets their own physical and social needs.

While dual-eligible beneficiaries are exempted from prescription drug
copayments under Medicare Part D, those choosing community-based
alternatives are required to pay them. This is despite the fact that
beneficiaries choosing community based care options typically live off
of the same limited incomes as those residing in nursing homes. While
some states provide HCS beneficiaries' a larger personal stipend each
month, many may have greater financial demands. At the end of the day,
they are in no better position to pay the costs of prescription drugs
than those beneficiaries living in nursing homes.
I also should note that their less restrictive living environments
may require them to take additional medications to support their daily
routines. It is not uncommon for dual-eligible beneficiaries in
community-based care settings to be on 8 to 10 medications at a given
time. At that level, even minimal copayments create a significant
financial burden to these individuals.
The current dual-eligible copayment exemption policy not only is
creating inequity in Medicare Part D, it is potentially restricting
access to life-saving medications. This is not what Congress intended.
I believe we need to do everything possible to support choice in long-
term care, and by applying the current institutional copayment
exemption more uniformly, Congress will ensure the Medicare drug
benefit does not adversely affect beneficiaries' choices.
The second measure I am introducing today is based upon a bill I
filed last year. That legislation sought to provide beneficiaries
applying for LIS extra time to enroll into Part D if they had not
received notification of their eligibility status by the time an open
enrollment period ended. The bill also would have also waived the late
enrollment penalty assessed to all beneficiaries who enroll outside of
an enrollment period. Fortunately, CMS enacted an administrative
solution to this problem, and allowed all LIS eligible beneficiaries to
enroll into Medicare Part D at any point during 2006, and later
extended that policy into 2007.
Now that Medicare Part D is fully implemented and policymakers have
had an opportunity to assess how well the program is working, I believe
that the administrative actions taken by CMS last year to create a
special enrollment period for LIS beneficiaries should be made
permanent. The Medicare Part D Outreach Enrollment Enhancement Act of
2007 does just that. It would create a 90-day special enrollment period
for any beneficiary who applies and is approved for the LIS at any
point during the year. It also would allow them to undergo a
facilitated enrollment process overseen by CMS, so they get the help
they need to select a prescription drug plan that best meets their
needs.
Additionally, the bill exempts low-income beneficiaries from Medicare
Part D's late enrollment penalty. While an enrollment penalty can be an
effective means of helping drug plans better assess their risk in a
given period, it is not fair to ask our low-income seniors--many who
struggle with a number of challenging healthcare problems--to pay a
higher cost simply because they need additional time to enroll in the
program. Selecting a prescription drug plan can be a challenging feat,
and it can be even more complicated if you are trying to make your
limited income stretch as far as it can. We need to guarantee that
beneficiaries have sufficient time to choose the most affordable plan
that also meets all their prescription drug needs.
The measure also would create a new authorization to support the
valuable work of State Health Insurance Programs (SHIPs). SHIPs provide
a range of services to our nation's seniors, such as help choosing a
quality prescription drug plan, applying for financial assistance with
their drug costs and resolving general problems experienced with the
drug benefit. Unfortunately, funding for SHIPs has not kept pace with
the number of beneficiaries that age into Medicare each year. To remedy
that, my bill creates a new authorization that increases funding in
conjunction with growth in enrollment. The bill also provides funding
for the new National Center of Senior Benefits and Outreach, created in
the Older Americans Act last year. The Center is charged with
developing ways to assist organizations like SHIPs to better target
their efforts so that all seniors are fully aware of the benefits that
might be available to them.
The next bill in the package we are filing today addresses a problem
low-income seniors encounter if and when they enter into the drug
benefit's coverage gap. While beneficiaries still have access to
medications through their drug plans during the coverage gap, they may
have to pay more for them. For those living on fixed incomes, this
could present a serious problem as the out-of-pocket cost of many
common prescription drugs can be quite steep. Fortunately, many safety-
net programs, like community health centers and the AIDS Drug
Assistance Program (ADAP), provide assistance to eligible low-income
beneficiaries during the coverage gap. Effectively, they fill the role
of the drug plan in providing beneficiaries access to their medications
at a heavily subsidized cost.
This scenario presently works well for a number of low-income
beneficiaries, but it is simply unsustainable in the long-run for two
key reasons. First, from the perspective of beneficiaries, it is not
right to ask them to continue paying premiums to their drug plans
during the coverage gap when they are unable to generate sufficient
out-of-pocket expenses to qualify for the program's catastrophic
benefit. Many low-income beneficiaries who get ``caught'' in the
coverage gap struggle with significant health problems, such as cancer
or HIV/AIDS. These conditions often require costly treatment that a
low-income beneficiary would likely have to forge without the
assistance of a safety-net provider.
Second, the current scenario is placing a disadvantageous strain on
the safety-net programs that assist low-income beneficiaries with their
drug costs during the coverage gap. One of the primary reasons Medicare
Part D was created was to provide relief to states and other safety-net
providers who bore a lion's share of the responsibility of providing
access to drug therapies for the Nation's seniors. While Part D has
gone a long way to fulfill that intention, there is still much that can
be done to help our safety-net providers. It is not right that service
providers like community health centers and ADAP have been forced to
provide discounted medications to low-income beneficiaries during the
coverage gap, especially when the beneficiary has no way of accruing
enough out-of-pocket costs for their Part D coverage to resume.

The bill Senator Bingaman and I are filing today resolves both these
problems. It would allow safety net providers' drug costs to count
toward a beneficiary's out-of-pocket costs so they are able to reach
Medicare Part D's catastrophic benefit at some point. This will ensure
that low-income beneficiaries have access to the full range of coverage
under the program and will provide much needed fiscal relief to already
strained safety net providers. Congress intended for all
beneficiaries--especially those with limited incomes--to have full
access to the benefits through Medicare Part D. This bill will
guarantee that happens.
Despite the progress we have made in providing low-income seniors
access to affordable prescription drugs, I find it troubling that
recent estimates still show that there may be at least three million
seniors eligible for the low-income subsidy who have yet to apply for
it. While CMS, SSA and their community partners continue their vital
outreach to capture these seniors, I believe the existing LIS
application is too complex and is preventing seniors from getting the
help they need. We need a simpler process that better reflects the true
levels of assets and resources held by low-income seniors.
The last bill in the package I am filing today does just that. The
Part D Equity for Low-Income Seniors Act is the product of months of
bipartisan collaboration with representatives of groups like AARP, the
National Council on Aging and Families USA. It aims to help SSA better
target potentially

[[Page S4450]]

eligible beneficiaries and make the application process much simpler to
complete.
First, drawing from a recommendation from the Health and Human
Services Office of Inspector General, SSA is given the authority to use
select tax information to help determine which Medicare beneficiaries
might be eligible for extra help with their drug costs. With this data,
they would be able to more efficiently contact beneficiaries and
prescreen them for potential eligibility. I realize that some of my
colleagues might have privacy concerns with such an arrangement, but I
want to make clear that my bill is not giving SSA access to any data
that they already do not have. In order to implement the Part B subsidy
adjustment, the Medicare Modernization Act requires that the Internal
Revenue Service (IRS) send tax data to the SSA--they are legally
prohibited from using it for any other purpose than Part B. We simply
are establishing the same process for data exchange that already exists
between the IRS and SSA so that SSA can more efficiently conduct its
outreach work for Medicare Part D's low-income subsidy.
The bill also seeks to make the LIS application easier for seniors to
complete. I have heard a number of complaints that the current form
uses confusing verbiage and is overly burdensome in its reporting
requirements. As a remedy, we eliminate the reporting of retirement
account balances, the face value of life savings policies and in-kind
contributions. This not only will make the form easier to complete, it
will prevent seniors from the pressure of having to determine whether
they should sacrifice their retirement income or long-term risk
protection in order to pay their healthcare bills. I believe we need to
be encouraging seniors to save for their later years in life, not
requiring them to liquidate their futures to fill their prescriptions.

In order to make the LIS benefit more accurately reflect the assets
and resources low-income seniors possess, our bill also proposes
raising the current asset test limit to $27,500 for an individual and
$55,000 for a couple. According to data from the SSA, this increase
should help capture almost 40 percent of the individuals who are
ineligible for the LIS benefit due to excess resources, and 50 percent
of the couples. I realize this can be a sensitive issue for some of my
colleagues--especially on my side of the aisle. We want to ensure that
only those beneficiaries who truly are in need of help with their drug
are eligible for government assistance. But, I also believe that we can
be too heavyhanded and prevent those with legitimate need from getting
it. The new asset/resource limits Senator Bingaman and I have proposed
represent a good, bipartisan solution to the problem. I know many would
like to see the full asset test repealed, but this year that may be a
difficult feat to accomplish politically and financially. This is a
reasonable step forward, one the advocates support. I hope my
colleagues will as well.
I believe that the Medicare Prescription Drug Program is working for
America's seniors and that we should not undertake a significant
overhaul of the new benefit in this Congress. However, there is room
for improvement, especially in regard to making the program work better
for America's low-income seniors. I firmly believe that if Congress
does not address some of these lingering problems this year, Medicare's
long-term public image could be severely tarnished in the eyes of the
very people it was created to serve.
One can learn a great deal about the character of a society by
looking at how well it cares for its poor and vulnerable citizens. I
believe my four bills that improve upon how Medicare Part D serves low-
income beneficiaries will help cement the United States as a country
that looks out for its citizens in need. I hope my colleagues will join
me in supporting the full package and assist me in moving it through
the process.
I ask unanimous consent that the text of these bills be printed in
the Record.
There being no objection, the bills were ordered to be printed in the
Record, as follows:

S. 1107

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 ``Home and Community Services
Copayment Equity Act of 2007''.

SEC. 2. ELIMINATION OF PART D COST-SHARING FOR CERTAIN NON-
INSTITUTIONALIZED FULL-BENEFIT DUAL ELIGIBLE
INDIVIDUALS.

(a) In General.--Section 1860D-14(a)(1)(D)(i) of the Social
Security Act (42 U.S.C. 1395w-114(a)(1)(D)(i)) is amended--
(1) in the heading, by striking ``Institutionalized
individuals.--In'' and inserting ``Elimination of cost-
sharing for certain full-benefit dual eligible individuals.--

``(I) Institutionalized individuals.--In''; and

(2) by adding at the end the following new subclauses:

``(II) Certain other individuals.--In the case of an
individual who is a full-benefit dual eligible individual and
who is a resident of a facility described in subclause (III)
or who is receiving home and community-based services in a
home setting provided under a home and community-based waiver
approved for the State under section 1915 or 1115, the
elimination of any beneficiary coinsurance described in
section 1860D-2(b)(2) (for all amounts through the total
amount of expenditures at which benefits are available under
section 1860D-2(b)(4)).
``(III) Facility described.--For purposes of subclause
(II), a facility described in this subclause is--

``(aa) an assisted living facility or a resident care
program facility (as such terms are defined by the
Secretary);
``(bb) a board and care facility (as defined in section
1903(q)(4)(B)); or
``(cc) any other facility that is licensed or certified by
the State and is determined appropriate by the Secretary,
such as a community mental health center that meets the
requirements of section 1913(c) of the Public Health Service
Act, a psychiatric health facility, a mental health
rehabilitation center, and a mental retardation developmental
disability facility.''.
(b) Effective Date.--The amendments made by subsection (a)
shall apply to drugs dispensed on or after the date of
enactment of this Act.
____

S. 1108

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 Outreach and
Enrollment Enhancement Act of 2007''.

SEC. 2. SPECIAL ENROLLMENT PERIOD FOR INDIVIDUALS ELIGIBLE
FOR AN INCOME-RELATED SUBSIDY.

(a) Special Enrollment Period.--Section 1860D-1(b)(3) of
the Social Security Act (42 U.S.C. 1395w-101(b)(3)) is
amended by adding at the end the following new subparagraph:
``(F) Eligibility for low-income subsidy.--
``(i) In general.--Subject to clause (iii), in the case of
an applicable individual (as defined in clause (ii)).
``(ii) Applicable individual defined.--For purposes of this
subparagraph, the term `applicable individual' means a part D
eligible individual who is determined to be a subsidy-
eligible individual (as defined in section 1860D-14(a)(3)),
including such an individual who was enrolled in a
prescription drug plan or an MA-PD plan on the date of such
determination.
``(iii) Timing of special enrollment period.--The special
enrollment period established under this subparagraph shall
be for a 90-day period beginning on the date the applicable
individual receives notification of such determination.''.
(b) Enrollment Process for Subsidy-Eligible Individuals
Eligible for Special Enrollment Period.--Section 1860D-
1(b)(1) is amended by adding at the end the following new
subparagraph:
``(D) Special rule for subsidy-eligible individuals
eligible for special enrollment period.--The process
established under subparagraph (A) shall include, in the case
of an applicable individual (as defined in clause (ii) of
paragraph (3)(F)) the following:
``(i) Facilitated enrollment.--During the 90-day period
described in clause (iii) of such paragraph, a process for
the facilitated enrollment of the individual in the
prescription drug plan or MA-PD plan that is most appropriate
for such individual (as determined by the Secretary). At the
end of such 90-day period, the individual shall be enrolled
in such plan unless the individual declines enrollment in the
plan or in the program under this part, or chooses to enroll
in another plan selected by the individual prior to the end
of such 90-day period.
``(ii) One-time change of enrollment.--The opportunity to
change enrollment with a prescription drug plan or an MA-PD
plan not less than once during a plan year. Nothing in the
previous sentence shall limit the ability of a part D
eligible individual who is a full-benefit dual eligible
individual (as defined in section 1935(c)(6)) to change
enrollment under subparagraph (C)''.
(c) Waiver of Late Enrollment Penalty.--Section 1860D-13(b)
of the Social Security Act (42 U.S.C. 1395w-113(b)) is
amended by adding at the end the following new paragraph:
``(8) Waiver of penalty for subsidy-eligible individuals.--
In no case shall a part D eligible individual who is
determined to be a subsidy-eligible individual (as defined in
section 1860D-14(a)(3)) be subject to an increase

[[Page S4451]]

in the monthly beneficiary premium established under
subsection (a).''.
(d) Effective Date.--The amendments made by this section
shall take effect on January 1, 2008.

SEC. 3. OUTREACH AND EDUCATION FOR PREMIUM AND COST-SHARING
SUBSIDIES UNDER PART D.

(a) Additional Funding for Outreach and Assistance.--
(1) State health insurance assistance programs.--There are
authorized to be appropriated for each of fiscal years 2008,
2009, 2010, and 2011, an amount equal to $1 multiplied by the
total number of individuals entitled to benefits, or
enrolled, under part A of title XVIII of the Social Security
Act, or enrolled under part B of such title during the fiscal
year (as determined by the Secretary of Health and Human
Services, based on the most recent available data before the
beginning of the fiscal year) to be used to provide
additional grants to State Health Insurance Assistance
Programs (SHIPs) to conduct outreach and education related to
the Medicare program under such title.
(2) National center on senior benefits outreach and
enrollment.--
(A) In general.--There are appropriated $4,000,000 to the
National Center on Senior Benefits Outreach and Enrollment
established under section 202(a)(20)(B) of the Older
Americans Act of 1965 (42 U.S.C. 3012(a)(20)(B)) to be used
to provide outreach and enrollment assistance with respect to
premium and cost-sharing subsidies under the Medicare
prescription drug program under part D of title XVIII of the
Social Security Act (42 U.S.C. 1395w-101 et seq.).
(B) Coordination.--The National Center on Senior Benefits
Outreach and Enrollment shall coordinate outreach and
enrollment assistance conducted under subparagraph (A) with
activities conducted by State Health Insurance Assistance
Programs (SHIPs) and other appropriate entities that conduct
outreach and education related to such premium and cost-
sharing subsidies.
(b) Encouraging States to Direct Subsidy-Eligible
Individuals to Organizations Providing Assistance.--
(1) In general.--The Secretary of Health and Human Services
shall encourage States to direct applicable individuals to
appropriate organizations and entities that provide
assistance with respect to--
(A) applying for premium and cost-sharing subsidies under
section 1860D-14 of the Social Security Act (42 U.S.C. 1395w-
114); and
(B) enrolling in a prescription drug plan or an MA-PD plan
under part D of title XVIII of the Social Security Act (42
U.S.C. 1395w-101 et seq.).
(2) Applicable individuals defined.--In this subsection,
the term ``applicable individual'' means an individual the
State believes to be, or determines to be, eligible for
premium and cost-sharing subsidies under section 1860D-14 of
the Social Security Act (42 U.S.C. 1395w-114).

SEC. 4. SCREENING BY COMMISSIONER OF SOCIAL SECURITY FOR
ELIGIBILITY UNDER MEDICARE SAVINGS PROGRAMS.

(a) In General.--Section 1860D-14(a)(3)(B)(i) of the Social
Security Act (42 U.S.C. 1395w-114(a)(3)(B)(i)) is amended by
inserting after the first sentence the following: ``As part
of making an eligibility determination under the preceding
sentence for an individual, the Commissioner shall screen for
the individual's eligibility for medical assistance for any
medicare cost-sharing described in section 1905(p)(3) and, if
the screening indicates the individual is likely eligible for
any such medicare cost-sharing, transmit the pertinent
information to the appropriate State Medicaid agency for the
determination of eligibility and enrollment of the individual
for such medicare cost-sharing under the State plan (or under
a waiver of such plan).''.
(b) Effective Date.--The amendment made by this section
shall take effect on the date of enactment of this Act.

SEC. 5. ADMINISTRATION ON AGING STUDY AND REPORT ON SCREENING
PROCESSES USED BY GOVERNMENT NEEDS-BASED
PROGRAMS.

(a) Study.--
(1) In general.--The Assistant Secretary of the
Administration on Aging (in this section referred to as the
``Assistant Secretary'') shall conduct a comprehensive study
of screening processes used by government needs-based
programs.
(2) Matters studied.--In conducting the study under
paragraph (1), the Assistant Secretary shall--
(A) assess any duplications of effort under existing
screening processes used by government needs-based programs;
(B) determine the feasibility of creating a uniform
screening process for such needs-based programs;
(C) determine how the Federal government, State
governments, and community-based organizations can better
coordinate existing screening processes in order to
facilitate the enrollment of seniors into need-based
programs;
(D) include a cost-benefit analysis with respect to
creating a uniform screening process or better streamlining
existing screening processes; and
(E) determine the feasibility of using the Internet to
administer screening processes, as well as the costs and
benefits of migrating to on online system.
(b) Report.--Not later than 1 year after the date of
enactment of this Act, the Assistant Secretary shall submit a
report to Congress containing the results of the study
conducted under subsection (a), together with
recommendations--
(1) to streamline and improve the effectiveness of
screening processes used by government needs-based programs;
and
(2) for such legislation or administrative action as the
Assistant Secretary determines appropriate.
(c) Authorization.--There are authorized to be appropriated
such sums as are necessary to carry out this section.

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