[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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