[Congressional Record Volume 153, Number 144 (Wednesday, September 26, 2007)]
[Senate]
[Pages S12143-S12156]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mr. SANDERS:
S. 2094. A bill to increase the wages and benefits of blue collar
workers by strengthening labor provisions in the H-2B program, to
provide for labor recruiter accountability, and for other purposes; to
the Committee on the Judiciary.
Mr. SANDERS. Mr. President, today I am introducing the Increasing
American Wages and Benefits Act of 2007.
Since 2000, key economic indicators confirm that the economic
security of Americans is moving in the wrong direction: nearly 5
million more Americans are living in poverty; nonelderly household
income has declined by nearly $2,500; over 3 million manufacturing jobs
have been lost; and 8.6 million more Americans are without health
insurance. While the rich have gotten richer, every other income group
over the past 7 years has lost ground economically, with the middle
class and working families losing the most.
The Increasing American Wages and Benefits Act would begin to reverse
this downward economic trend for workers employed in construction,
forestry, ski resorts, stone quarries, asphalt paving, hotels,
restaurants, landscaping, housekeeping and many other industries by
reforming the H-2B guest-worker program.
Under current law and existing Federal regulations, employers
applying for H-2B visas must first certify that capable U.S. workers
are not available, efforts were made to recruit U.S. workers for these
positions first, and the employment of guest workers will not adversely
affect the wages and working conditions of similarly employed U.S.
workers.
As documented by the AFL-CIO, Change to Win, the Southern Poverty Law
Center and other groups, the H-2B program is frequently used by
employers to drive down the wages and benefits of U.S. workers, while
cheating H-2B workers out of earned benefits. These abuses have clearly
undermined the legislative and regulatory intent of this temporary
guest-worker program.
The Increasing American Wages and Benefits Act would reform the H-2B
program to ensure that workers receive the wages and benefits they
deserve and prevent employers from abusing the system.
Specifically, this legislation: requires employers to do a much
better job at recruiting American workers first at higher wages before
being able to hire H-2B guest-workers; provides the Department of Labor
with the explicit authority to enforce labor law violations pertaining
to the H-2B program; allows workers who have been directly and
adversely affected by the H-2B program
[[Page S12144]]
to have their day in court against unscrupulous employers; prohibits
companies that have announced mass lay-offs within the past year from
hiring H-2B guest-workers. Allows the Legal Services Corporation to
provide the same legal services to H-2B workers as it provides to H-2A
workers; requires employers to pay for the transportation expenses for
H-2B guest workers both to the United States and back to their country
of origin once the employment period ends; and provides other important
protections for H-2B guest-workers.
This legislation improves and strengthens the H-2B program so that it
can be used by employers during emergency labor shortages, while
increasing the wages and benefits for both American workers and guest-
workers.
I am proud that the Increasing American Wages and Benefits Act has
the strong support of the AFL-CIO; the Service Employees International
Union, SEIU; the International Brotherhood of Teamsters; the Southern
Poverty Law Center; the Building and Construction Trades Department;
the Laborers' International Union of North America; the United Food and
Commercial Workers; the International Brotherhood of Electrical
Workers; the Alliance of Forest Workers and Harvesters; the United
Farmworkers of America; and the Farmworkers Support Committee.
I ask unanimous consent to have printed in the Record letters of
support.
There being no objection, the material was ordered to be printed in
the Record, as follows:
American Federation of Labor and Congress of Industrial
Organizations,
Washington, DC, September 19, 2007.
Hon. Bernard Sanders,
Dirksen Senate Office Building,
Washington, DC.
Dear Senator Sanders: The AFL-CIO strongly supports the
``Increasing American Wages and Benefits Act of 2007,'' which
would strengthen necessary labor protections within the H-2B
seasonal non-agricultural guest worker program.
As demonstrated by a recent report issued by the Southern
Poverty Law Center, ``Close to Slavery,'' employers and
recruiters who seek to import seasonal workers through this
program have all too often engaged in questionable tactics
and subjected workers to exploitation. This exploitation
often goes undetected because the investigative and
enforcement mechanisms of the H-2B program are largely non-
existent.
Adequate enforcement of labor standards within the H-2B
seasonal guest worker program would not only help deter the
abuse of an imported foreign workforce, but would also
protect the wages and benefits offered to American workers,
who are unfairly forced to compete for jobs by employers who
appreciate the benefits of filling vacancies with a more
vulnerable workforce.
The suffering of one segment of our workforce has an
inevitable and damaging impact on every worker. We must stop
unscrupulous employers from padding their profit margins by
endangering workers and driving down wages and workplace
standards. We applaud your efforts to protect the living
standards of all who labor within our borders.
Sincerely,
William Samuel,
Director, Department of Legislation.
____
Immigrant Justice Project,
Southern Poverty Law Center,
Montgomery, AL, September 17, 2007.
Hon. Bernie Sanders,
U.S. Senate,
Washington, DC.
Dear Senator Sanders: I write on behalf of the Southern
Poverty Law Center in support of the legislation you recently
introduced to reform the H-2B guestworker program. The bill,
``The Increasing American Wages and Benefits Act,'' would
substantially improve the legal protections available to H-2B
workers and to American workers laboring in industries that
rely heavily on guestworkers.
Founded in 1971, the Southern Poverty Law Center is a civil
rights organization dedicated to advancing and protecting the
rights of minorities, the poor and victims of injustice in
significant civil rights and social justice matters. Our
Immigrant Justice Project represents low-income immigrant
workers in litigation across the Southeast.
During my legal career, I have represented and spoken with
literally thousands of H-2 guestworkers in many states.
Currently, the Southern Poverty Law Center is representing
workers in seven class action lawsuits on behalf of
guestworkers. We have also recently published a report about
the H-2 guestworker program in the United States entitled
``Close to Slavery,'' which can be accessed at http://
www.splcenter.org/pdf/static/SPLCguestworker.pdf.
Our report, which discusses in detail the abuses suffered
by guestworkers, is based upon thousands of interviews with
workers as well as a review of the research on guestworker
programs, scores of legal cases and the experience of legal
experts from around the country. As the report reflects,
guestworkers are systematically exploited because the very
structure of the program places them at the mercy of a single
employer and provides no realistic means for workers to
exercise the few rights they have.
The H-2B guestworker program permits U.S. employers to
import human beings on a temporary basis from other nations
to perform work when the employer certifies that ``qualified
persons in the United States are not available and . . . the
terms of employment will not adversely affect the wages and
working conditions of workers in the U.S. similarly
employed.'' Those workers generally cannot bring with them
their immediate family members, and their status provides
them no route to permanent residency in the United States.
The program is rife with abuses. The abuses typically start
long before the worker has arrived in the United States, with
the recruitment process, and they continue through and even
after his or her employment here. Unlike U.S. citizens, guest
workers do not enjoy the most fundamental protection of a
competitive labor market--the ability to change jobs if they
are mistreated. If guestworkers complain about abuses, they
face deportation, blacklisting or other retaliation.
Our report documents rampant wage violations, recruitment
abuses, seizure of identity documents and squalid living
conditions, among other things. H-2B workers simply have very
few legal protections under our current law.
In addition, H-2B workers cannot reasonably enforce the few
rights they have under our current system. Providing workers
a way to enforce promises made to them by employers and
giving them access to legal services attorneys are important
steps in helping workers combat abuse and protect their
rights.
In conclusion, current guestworker programs for low-skilled
workers in the United States lack adequate worker protections
and lack any real means to enforce the protections that do
exist under federal law. Vulnerable workers desperately need
Congress to take the lead in demanding reform of this system.
Passage of this bill would go a long way toward remedying the
abuses that vulnerable workers experience in U.S. guestworker
programs.
Sincerely,
Mary Bauer,
Director.
____
United Food & Commercial
Workers International Union, CLC,
Washington, DC, September 21, 2007.
Hon. Bernard Sanders,
U.S. Senate,
Washington, DC.
Dear Senator Sanders: On behalf of the 1.3 million members
of the United Food and Commercial Workers International Union
(UFCW), I am writing to thank you for introducing the
``Increasing American Wages and Benefits Act of 2007.'' UFCW
supports this legislation that will improve the legal
protections to H-2B seasonal non-agricultural workers.
It is clear that the current temporary non-immigrant
programs have not worked as intended and it is long past the
time for reform. UFCW has long advocated for reform of
existing guestworker programs. Many employers and recruiters
who recruit and hire workers through this program have
engaged in questionable tactics, and many of the workers have
been subjected to exploitation.
In addition, we believe that many of these jobs could and
would be filled by American workers, especially if the
employers offer appropriate wages and working conditions to
attract domestic workers. The ``Increasing American Wages and
Benefits Act'' will increase the enforcement for the program,
deter abuse of guestworkers, and would improve the wages,
benefits, and working conditions offered to these workers and
all American workers, who are unfairly forced to compete for
these jobs.
UFCW has been a long-time proponent of reforming
guestworker programs because, in spite of the theory, the
real world impact is that they have created an underclass of
workers, have held down wages, discouraged reporting of
workplace complaints, and reduced workers' ability to
organize and collectively bargain. In addition, the result of
the existing programs is that they have engendered
discriminatory attitudes toward individuals who are afforded
neither full rights nor benefits on the job, nor
participation in our society. Our experience is that no
matter how many worker protections have been written into
temporary worker programs, the approach inherently provides
employers with the opportunity to exploit workers and turn
permanent jobs into low-wage, no-benefit, and no-future jobs.
UFCW supports your reform efforts and we look forward to
working with you to enact this important legislation.
Sincerely,
Michael J. Wilson,
International Vice President, Director, Legislative and
Political Action Department.
[[Page S12145]]
____
Farmworker Justice,
Washington, DC, September 19, 2007.
Re reform of the H-2B Temporary Foreign Worker Program.
Senator Bernard Sanders,
U.S. Senate,
Washington, DC.
Dear Senator Sanders: Thank you for introducing the
Increasing American Wages and Benefits Act to reform the H-2B
guestworker program for seasonal employment Farmworker
Justice, a national advocacy and litigation organization for
agricultural workers, has had substantial experience helping
U.S. and foreign workers affected by the H-2B program as well
as the H-2A agricultural guestworker program. Our research
and direct experience cause us to conclude that substantial
reforms of the program are needed. We support the legislation
and hope that Congress enacts it immediately.
Currently, the H-2B law instructs the Department of Labor
to prevent employers that hire H-2B guestworkers based on
claimed labor shortages from displacing United States workers
and from adversely affecting their wages and working
conditions. The law's provisions fail to achieve these
objectives. The law also fails to prevent exploitation of
foreign citizens who, due to their poverty and the temporary,
nonimmigrant status of the H-2B visa, are vulnerable to
accepting substandard and often illegal employment
conditions. Further, the Department of Labor's policies and
actions fail to meet the statutory goals. The H-2B law must
be improved and your legislation would do so.
The need for strong protections in guestworker programs has
been demonstrated time and time again, in the hiring of
Chinese workers in the 1860's to 1870's, in the employment of
Mexican workers in the Bracero guestworker program in the
1940's to 1960's, and in the H-2A and H-2B guestworker
programs. Many employers find guestworkers advantageous
because they usually come from poor countries, where wages
are a small fraction of those in the U.S., and often will
work at very high productivity rates for significantly lower
wages than will U.S. workers. Guestworker programs have
displaced U.S. workers and depressed wage rates.
Your legislation is also important because it would begin a
process of regulating the international recruitment of
guestworkers by labor contracting firms that are hired by
employers in the United States. The guestworker recruitment
system often enables the ultimate employers to escape
responsibility for the mistreatment of the foreign citizens.
While we support reform of the H-2B program, we remain
skeptical that any guestworker program is consistent with
America's economic and democratic freedoms. We are a nation
of immigrants, not a nation of guestworkers. In America,
workers should have the freedom to switch employers, demand
better wages and working conditions, join unions and become
citizens with the right to vote. Although reform is one
critical step to protect U.S. workers from displacement and
wage depression and guestworkers from exploitation,
ultimately Congress should consider abolishing the program
and replacing it with a system based on a true immigration
status for workers who are needed in this country.
Thank you very much for introducing the Increasing American
Wages and Benefits Act.
Sincerely,
Bruce Goldstein,
Excecutive Director.
____
Comite de Apoyo a los Transbajadores Agricolas--
Farmworkers Support Committee,
Glassboro, NJ, September 19, 2007.
Re endorsement for the increasing American Wages and Benefits
Act.
Senator Sanders,
U.S. Senate,
Washington DC.
Dear Senator Sanders: CATA--El Comite de Apoyo a los
Trabajadores Agricolas, The Farmworker Support Committee, is
a grassroots migrant and immigrant worker organization whose
mission is to educate and empower workers so they are able to
defend their rights.
We at CATA acknowledge that the H-2B reform bill you have
prepared would provide greater protection to workers. Thank
you for your support in combating the abuse of current H-2B
workers.
We believe that maintaining equivalent wages between
American workers and guestworkers is critical for sustaining
appropriate working conditions and preventing the creation of
an underclass. We at CATA remain adamant that enforcement of
any legislation is key to its effectiveness at protecting
workers' rights.
We at CATA recommend further legislation to address the
portability of jobs to eliminate worker vulnerability under
the current law. We also insist on developing a mechanism for
H-2B workers to achieve permanent residence. Despite not
addressing these critical concerns that CATA has, the
Increasing American Wages and Benefits Act is a decisive step
forward for human rights.
Sincerely,
Nelson Carrasquillo,
Executive Director.
______
By Mr. DORGAN (for himself, Mr. Stevens, Mr. Schumer, Mr. Ensign,
Mr. Kerry, Mr. Kohl, Mr. Feingold, Mrs. Clinton, Mrs.
Feinstein, and Mr. Nelson of Florida):
S. 2096. A bill to amend the Do-Not-Call Implementation Act to
eliminate the automatic removal of telephone numbers registered on the
Federal ``do-not-call'' registry; to the Committee on Commerce,
Science, and Transportation.
Mr. DORGAN. Mr. President, today I am introducing, along with
Senators Stevens, Schumer, Ensign, Kerry, Kohl, Feingold, Clinton,
Feinstein, and Nelson of Florida, the Do-Not-Call Improvement Act of
2007. We seek with this bill to ensure that millions of Americans who
signed up for the ``Do-Not-Call'' registry do not face a resumption of
unwanted calls from telemarketers next year when registrations on the
registry begin to expire.
Most Americans are unaware that their registration on the list is set
to expire after 5 years. The expiration is unnecessary, most people who
initially wanted to be rid of telemarketing calls likely still want to
block these calls. The system automatically removes numbers that are
disconnected and reassigned.
The automatic expiration will only create a hassle for Americans as
they start receiving calls again and have to go through the process of
re-registering. The U.S. Government would have to spend money to let
people know they need to sign up again.
This bill would prevent the automatic expiration and removal of
numbers from the registry.
Congress established the ``Do Not Call'' registry in 2003. It quickly
became one of the most popular consumer protection programs in history.
Congress did not provide for automatic expiration of ``Do Not Call''
list registrations, but the FTC and FCC included an automatic five year
expiration for registrations when they wrote the rules for implementing
the program.
That was not what Congress intended. As things stand today, 52
million Americans will either have to re-register on October 1, 2008,
or get ready to hear their telephones ringing during supper time again
with unwanted, commercial solicitation calls.
Mr. President, 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
placed in the Record, as follows:
S. 2096
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 ``Do-Not-Call Improvement Act
of 2007''.
SEC. 2. PROHIBITION OF EXPIRATION DATE FOR REGISTERED
TELEPHONE NUMBERS.
The Do-Not-Call Implementation Act (15 U.S.C. 6101 note) is
amended--
(1) by inserting ``Such rule shall not provide any date of
expiration for telephone numbers registered on the `do-not-
call' registry, nor for any predetermined time limitation for
telephone numbers to remain on the registry.'' after the
first sentence in section 3; and
(2) by adding at the end the following:
``SEC. 5. PROHIBITION OF EXPIRATION DATE.
``In issuing regulations regarding the `do-not-call'
registry of the Telemarketing Sales Rule (16 C. F. R.
310.4(b)(1)(iii)), the Federal Trade Commission shall not
provide for any date of expiration for telephone numbers
registered on the `do-not-call' registry, nor for any
predetermined time limitation for telephone numbers to remain
on the registry.''.
______
By Mr. FEINGOLD:
S. 2097. A bill to modify the optional method of computing net
earnings from self-employment; to the Committee on Finance.
Mr. FEINGOLD. Mr. President, today I am introducing legislation to
address an injustice in the Tax Code that is threatening family farmers
and other self-employed individuals. Some of my constituents, primarily
Wisconsin farmers, have requested Congress's assistance to correct the
Tax Code so they can protect their families. The legislation I
introduce today, the Farmer Tax Fairness Act of 2007, is similar to
legislation I introduced in the last two Congresses and will solve the
problem for today and into the future.
Farming is vital to Wisconsin. Wisconsin's agricultural industry
plays a large and important role in the growth
[[Page S12146]]
and prosperity of the entire State. Wisconsin's status as ``America's
Dairyland'' is central to our State's agriculture industry. Wisconsin's
dairy farmers produce approximately 23 billion pounds of milk and lead
the Nation in cheese production with over 25 percent or 2.5 billion
pounds of cheese a year. But Wisconsin's farmers produce much more than
milk; they also are national leaders in the production of butter,
potatoes, ginseng, cranberries, various processing vegetables, and many
organic foods. So when the hardworking farmers of Wisconsin need help,
I will do all I can to assist.
One concern that I have heard from Wisconsin farmers is that the Tax
Code can limit their eligibility for social safety net programs,
including old age, survivors, and disability insurance, OASDI, under
Social Security and the hospital insurance HI part of Medicare. These
programs are paid for through payroll taxes on workers and through the
self-employment tax on the income of self-employed individuals. To be
eligible for OSADI and HI benefits an individual must be fully insured
and must have earned a minimum amount of income in the years
immediately preceding the need for coverage. Every year, the Social
Security Administration, SSA, sets the amount of earned income that
individuals must pay taxes on to earn quarters of coverage, QCs, and
maintain their benefits. An individual's eligibility requirements
depend upon the age at which death or disability occurs, but for
workers over 31 years of age, they must have earned at least 20 QCs
within the past 10 years.
Self-employed individuals can have highly variable income, and,
particularly for farmers who are at the whim of Mother Nature, not
every year is a good year. During lean years, individuals may not earn
enough income to maintain adequate coverage under OASDI and HI.
Therefore, the Tax Code provides options to allow self-employed
individuals to maintain eligibility for benefits. These options allow
individuals to choose to pay taxes based on $1,600 of earned income,
thus allowing self-employed entrepreneurs to maintain the same Federal
protections even when their income varies.
Unfortunately, both the options for farmers and nonfarmers, Social
Security Act Sec. 211(a) and I.R.C. Sec. 1402(a), have not kept pace
with inflation, and they no longer provide security to families across
the country. Decades ago, self-employment income of $1,600 earned an
individual four QCs under SSA's calculations. In 2001, the amount
needed to earn a QC rose to $830 of earned income, so individuals
electing the optional methods were only able to earn one QC per year;
making it much harder for them to remain eligible for benefits because
they must average 2 QCs per year to be eligible. With inflation, there
is no chance of the amount needed to earn a QC dropping on its own and
it has steadily risen since 2001, so legislation is needed to fix this
unanticipated erosion in this option for farmers and the self-employed.
Congress's failure to address this problem threatens the ability of
self-employed individuals to maintain eligibility for OASDI and HI. I
have heard from several of my constituent who want these options to be
fixed so they can make sure their families will be taken care of in the
event that something unforeseen occurs.
Therefore, I am introducing the Farmer Tax Fairness Act of 2007 in
order to provide farmers and self-employed individuals with a fair
choice. Under this bill, they will continue to be able to elect the
optional method if they so choose. When individuals do elect the
option, this legislation provides an update to the Tax Code so farmers
and self-employed individuals can retain full eligibility for OASDI and
HI benefits. It indexes the optional income levels to SSA's QC
calculations, allowing these farmers and self-employed individuals to
claim enough earned income to qualify for four OCs annually. In
addition, by linking the earned income level to SSA's requirements for
QCs, the bill will ensure that the amount of income deemed to be earned
under the optional methods will not need to be adjusted by Congress
again.
Along with providing security to self-employed individuals and
farmers across the country, this solution is fiscally responsible. It
could even provide a short run increase in U.S. Treasury revenues while
having negligible impact upon the Social Security trust fund in the
long run.
Let me take a moment to acknowledge the efforts of the Senator from
Iowa, Mr. Grassley, to address this problem in the 107th Congress. As
chairman of the Senate Finance Committee, he included similar
legislative language in the chairman's mark for the Small Business and
Farm Economic Recovery Act of 2002. The Senate Finance Committee held a
markup on the legislation on September 19, 2002, but the changes to the
optional methods did not become law.
When incomes fall, the Tax Code provides optional methods for
calculating net earnings to ensure that farmers and self-employed
individuals maintain eligibility for social safety net programs. When
these provisions were developed, Congress intended self-employed
individuals to have the ability to pay enough to earn a full 4 QCs.
Unfortunately the Tax Code has not kept up with the times and due to
inflation many farmers are losing eligibility for some of Social
Security's programs. Congress needs to provide security to farm
families and other self-employed individuals. I urge my colleagues to
support the Farmer Tax Fairness Act of 2007.
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
placed in the Record, as follows:
S. 2097
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 ``Farmer Tax Fairness Act of
2007''.
SEC. 2. MODIFICATION TO OPTIONAL METHOD OF COMPUTING NET
EARNINGS FROM SELF-EMPLOYMENT.
(a) Amendments to the Internal Revenue Code of 1986.--
(1) In general.--The matter following paragraph (15) of
section 1402(a) of the Internal Revenue Code of 1986 is
amended--
(A) by striking ``$2,400'' each place it appears and
inserting ``the upper limit'', and
(B) by striking ``$1,600'' each place it appears and
inserting ``the lower limit''.
(2) Definitions.--Section 1402 of such Code is amended by
adding at the end the following new subsection:
``(l) Upper and Lower Limits.--For purposes of subsection
(a)--
``(1) Lower limit.--The lower limit for any taxable year is
the sum of the amounts required under section 213(d) of the
Social Security Act for a quarter of coverage in effect with
respect to each calendar quarter ending with or within such
taxable year.
``(2) Upper limit.--The upper limit for any taxable year is
the amount equal to 150 percent of the lower limit for such
taxable year.''.
(b) Amendments to the Social Security Act.--
(1) In general.--The matter following paragraph (15) of
section 211(a) of the Social Security Act is amended--
(A) by striking ``$2,400'' each place it appears and
inserting ``the upper limit'', and
(B) by striking ``$1,600'' each place it appears and
inserting ``the lower limit''.
(2) Definitions.--Section 211 of such Act is amended by
adding at the end the following new subsection:
``Upper and Lower Limits
``(k) For purposes of subsection (a)--
``(1) The lower limit for any taxable year is the sum of
the amounts required under section 213(d) for a quarter of
coverage in effect with respect to each calendar quarter
ending with or within such taxable year.
``(2) The upper limit for any taxable year is the amount
equal to 150 percent of the lower limit for such taxable
year.''.
(3) Conforming amendment.--Section 212 of such Act is
amended--
(A) in subsection (b), by striking ``For'' and inserting
``Except as provided in subsection (c), for''; and
(B) by adding at the end the following new subsection:
``(c) For the purpose of determining average indexed
monthly earnings, average monthly wage, and quarters of
coverage in the case of any individual who elects the option
described in clause (ii) or (iv) in the matter following
section 211(a)(15) for any taxable year that does not begin
with or during a particular calendar year and end with or
during such year, the self-employment income of such
individual deemed to be derived during such taxable year
shall be allocated to the two calendar years, portions of
which are included within such taxable year, in the same
proportion to the total of such deemed self-employment income
as the sum of the amounts applicable under section 213(d) for
the calendar quarters ending with or within each such
calendar year bears to the lower limit for such taxable year
specified in section 211(k)(1).''.
(c) Effective Date.--The amendments made by this section
shall apply to taxable years beginning after the date of the
enactment of this Act.
[[Page S12147]]
______
By Mr. DORGAN (for himself and Mr. Conrad):
S. 2098. A bill to establish the Northern Plains Heritage Area in the
State of North Dakota; to the Committee on Energy and Natural
Resources.
Mr. DORGAN. Mr. President, today I am pleased to be joined by Senator
Conrad to introduce legislation called the Northern Plains Heritage
Area Act. This legislation would designate a core area of historically
significant resources in Burleigh, McLean, Mercer, Morton and Oliver
counties in North Dakota.
This National Heritage Area extends nearly the entire length of the
last of the free-flowing Missouri River in North Dakota, the last place
the river can be seen as it was seen by Lewis and Clark and the
ancestors of today's Mandan and Hidatsa tribes.
But what makes this area a particularly good fit for a National
Heritage Area designation is the distinction arising from the patterns
of human activity shaped by geography. This is the northern extremity
of Native agriculture on the Great Plains.
The scenic breaks of North Dakota's Missouri Valley overlook a rich
agricultural tradition stretching back a thousand years. Along the
length of the State's remaining free-flowing Missouri River, from Huff
National Landmark on the south to the Knife River Indian Villages
National Historic Site on the north, the Northern Plains Heritage Area
would encompass the ancient homeland of the Mandan and Hidatsa nations.
While farming methods have changed, the agricultural traditions and
the scenic, cultural and historic values remain. The same attributes of
geography and climate that attracted the Mandan and Hidatsa later
appealed to homesteading farmers and ranchers and the energy industry,
all of whom benefited from the natural resources of the land.
Mr. President, 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. 2098
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 ``Northern Plains Heritage
Area Act''.
SEC. 2. DEFINITIONS.
In this Act:
(1) Heritage area.--The term ``Heritage Area'' means the
Northern Plains Heritage Area established by section 3(a).
(2) Management entity.--The term ``management entity''
means the management entity for the Heritage Area designated
by section 3(d).
(3) Management plan.--The term ``management plan'' means
the management plan for the Heritage Area required under
section 5.
(4) Map.--The term ``map'' means the map entitled
``Proposed Northern Plains National Heritage Area''.
(5) Secretary.--The term ``Secretary'' means the Secretary
of the Interior.
(6) State.--The term ``State'' means the State of North
Dakota.
SEC. 3. ESTABLISHMENT.
(a) In General.--There is established in the State the
Northern Plains National Heritage Area.
(b) Boundaries.--The Heritage Area shall consist of--
(1) a core area of resources in Burleigh, McLean, Mercer,
Morton, and Oliver Counties in the State; and
(2) any sites, buildings, and districts within the core
area recommended by the management plan for inclusion in the
Heritage Area.
(c) Map.--A map of the Heritage Area shall be--
(1) included in the management plan; and
(2) on file and available for public inspection in the
appropriate offices of the National Park Service.
(d) Management Entity.--The management entity for the
Heritage Area shall be the Northern Plains Heritage
Foundation, a nonprofit corporation established under the
laws of the State.
SEC. 4. ADMINISTRATION.
(a) In General.--For purposes of carrying out the
management plan, the Secretary, acting through the management
entity, may use amounts made available under this Act to--
(1) make grants to the State or a political subdivision of
the State, nonprofit organizations, and other persons;
(2) enter into cooperative agreements with, or provide
technical assistance to, the State or a political subdivision
of the State, nonprofit organizations, and other interested
parties;
(3) hire and compensate staff, including individuals with
expertise in natural, cultural, and historical resources
protection and heritage programming;
(4) obtain money or services from any source, including
under any other Federal law or program;
(5) contract for goods or services; and
(6) carry out any other activity that--
(A) furthers the purposes of the Heritage Area; and
(B) is consistent with the approved management plan.
(b) Duties.--The management entity shall--
(1) in accordance with section 5, prepare and submit a
management plan for the Heritage Area to the Secretary;
(2) give priority to implementing actions covered by the
management plan, including assisting units of local
government, regional planning organizations, and nonprofit
organizations in carrying out the approved management plan
by--
(A) carrying out programs and projects that recognize,
protect, and enhance important resource values in the
Heritage Area;
(B) establishing and maintaining interpretive exhibits and
programs in the Heritage Area;
(C) developing recreational and educational opportunities
in the Heritage Area;
(D) increasing public awareness of, and appreciation for,
natural, historical, scenic, and cultural resources of the
Heritage Area;
(E) protecting and restoring historic sites and buildings
in the Heritage Area that are consistent with the themes of
the Heritage Area;
(F) ensuring that clear, consistent, and appropriate signs
identifying points of public access and sites of interest are
posted throughout the Heritage Area; and
(G) promoting a wide range of partnerships among
governments, organizations, and individuals to further the
Heritage Area;
(3) consider the interests of diverse units of government,
businesses, organizations, nonprofit groups, and individuals
in the Heritage Area in the preparation and implementation of
the management plan;
(4) conduct meetings open to the public at least
semiannually regarding the development and implementation of
the management plan;
(5) for any year for which Federal funds have been received
under this Act--
(A) submit an annual report to the Secretary that describes
the activities, expenses, and income of the management
entity, including any grants to any other entities;
(B) make available to the Secretary for audit all records
relating to the expenditure of the Federal funds and any
matching funds; and
(C) require, with respect to all agreements authorizing the
expenditure of Federal funds by other organizations, that the
organizations receiving the Federal funds make available to
the Secretary for audit all records concerning the
expenditure of the funds; and
(6) encourage by appropriate means economic viability that
is consistent with the Heritage Area.
(c) Prohibition on the Acquisition of Real Property.--The
management entity shall not use Federal funds made available
under this Act to acquire real property or any interest in
real property.
(d) Cost-Sharing Requirement.--The Federal share of the
cost of any activity carried out using any Federal funds made
available under this Act shall be 50 percent.
(e) Other Sources.--Nothing in this Act precludes the
management entity from using Federal funds form other sources
for authorized purposes.
SEC. 5. MANAGEMENT PLAN.
(a) In General.--Not later than 3 years after the date of
enactment of this Act, the management entity shall submit to
the Secretary for approval a proposed management plan for the
Heritage Area.
(b) Requirements.--The management plan shall--
(1) incorporate an integrated and cooperative approach for
the protection, enhancement, and interpretation of the
natural, cultural, historic, scenic, and recreational
resources of the Heritage Area;
(2) take into consideration State and local plans;
(3) include--
(A) an inventory of--
(i) the resources located in the core area described in
section 3(b)(1); and
(ii) any other property in the core area that--
(I) is related to the themes of the Heritage Area; and
(II) should be preserved, restored, managed, or maintained
because of the significance of the property;
(B) comprehensive policies, strategies and recommendations
for the conservation, funding, management, and development of
the Heritage Area;
(C) a description of actions that governments, private
organizations, and individuals have agreed to take to protect
the natural, historical and cultural resources of the
Heritage Area;
(D) a program of implementation for the management plan by
the management entity that includes a description of--
(i) actions to facilitate ongoing collaboration among
partners to promote plans for resource protection,
restoration, and construction; and
[[Page S12148]]
(ii) specific commitments for implementation that have been
made by the management entity or any government,
organization, or individual for the first 5 years of
operation of the Heritage Area;
(E) the identification of sources of funding for carrying
out the management plan;
(F) analysis and recommendations for means by which
Federal, State, and local programs may best be coordinated to
carry out this Act, including recommendations for the role of
the National Park Service in the Heritage Area; and
(G) an interpretive plan for the Heritage Area; and
(4) recommend policies and strategies for resource
management that consider and describe the application of
appropriate land and water management techniques, including
the development of intergovernmental and interagency
cooperative agreements to protect the natural, historical,
cultural, educational, scenic, and recreational resources of
the Heritage Area.
(c) Deadline.--If a proposed management plan is not
submitted to the Secretary by the date that is 3 years after
the date of enactment of this Act, the management entity
shall be ineligible to receive additional funding under this
Act until the date on which the Secretary approves a
management plan.
(d) Approval or Disapproval of Management Plan.--
(1) In general.--Not later than 180 days after the date of
receipt of the management plan under subsection (a), the
Secretary, in consultation with the State, shall approve or
disapprove the management plan.
(2) Criteria for approval.--In determining whether to
approve the management plan, the Secretary shall consider
whether--
(A) the management entity is representative of the diverse
interests of the Heritage Area, including governments,
natural and historic resource protection organizations,
educational institutions, businesses, and recreational
organizations;
(B) the management entity has afforded adequate
opportunity, including public hearings, for public and
governmental involvement in the preparation of the management
plan; and
(C) the resource protection and interpretation strategies
contained in the management plan, if implemented, would
adequately protect the natural, historical, and cultural
resources of the Heritage Area.
(3) Action following disapproval.--If the Secretary
disapproves the management plan under paragraph (1), the
Secretary shall--
(A) advise the management entity in writing of the reasons
for the disapproval;
(B) make recommendations for revisions to the management
plan; and
(C) not later than 180 days after the receipt of any
proposed revision of the management plan from the management
entity, approve or disapprove the proposed revision.
(4) Amendments.--
(A) In general.--The Secretary shall approve or disapprove
each amendment to the management plan that the Secretary
determines would make a substantial change to the management
plan.
(B) Use of funds.--The management entity shall not use
Federal funds authorized by this Act to carry out any
amendments to the management plan until the Secretary has
approved the amendments.
SEC. 6. RELATIONSHIP TO OTHER FEDERAL AGENCIES.
(a) In General.--Nothing in this Act affects the authority
of a Federal agency to provide technical or financial
assistance under any other law.
(b) Technical and Financial Assistance.--
(1) In general.--On the request of the management entity,
the Secretary may provide financial assistance and, on a
reimbursable or nonreimbursable basis, technical assistance
to the management entity to develop and implement the
management plan.
(2) Cooperative agreements.--The Secretary may enter into
cooperative agreements with the management entity and other
public or private entities to provide technical or financial
assistance under paragraph (1).
(3) Priority.--In assisting the Heritage Area, the
Secretary shall give priority to actions that assist in--
(A) conserving the significant natural, historic, cultural,
and scenic resources of the Heritage Area; and
(B) providing educational, interpretive, and recreational
opportunities consistent with the purposes of the Heritage
Area.
(c) Consultation and Coordination.--To the maximum extent
practicable, the head of any Federal agency planning to
conduct activities that may have an impact on the Heritage
Area is encouraged to consult and coordinate the activities
with the Secretary and the management entity.
(d) Other Federal Agencies.--Nothing in this Act--
(1) modifies or alters any laws (including regulations)
authorizing a Federal agency to manage Federal land under the
jurisdiction of the Federal agency;
(2) limits the discretion of a Federal land manager to
implement an approved land use plan within the boundaries of
the Heritage Area; or
(3) modifies, alters, or amends any authorized use of
Federal land under the jurisdiction of a Federal agency.
SEC. 7. PRIVATE PROPERTY AND REGULATORY PROTECTIONS.
Nothing in this Act--
(1) abridges the rights of any owner of public or private
property, including the right to refrain from participating
in any plan, project, program, or activity conducted within
the Heritage Area;
(2) requires any property owner to--
(A) permit public access (including access by Federal,
State, or local agencies) to the property of the property
owner; or
(B) modify public access to, or use of, the property of the
property owner under any other Federal, State, or local law;
(3) alters any land use regulation, approved land use plan,
or other regulatory authority of any Federal, State, or local
agency;
(4) conveys any land use or other regulatory authority to
the management entity;
(5) authorizes or implies the reservation or appropriation
of water or water rights;
(6) diminishes the authority of the State to manage fish
and wildlife, including the regulation of fishing and hunting
within the Heritage Area; or
(7) creates any liability, or affects any liability under
any other law, of any private property owner with respect to
any person injured on the private property.
SEC. 8. EVALUATION; REPORT.
(a) In General.--Not later than 3 years before the date on
which authority for Federal funding terminates for the
Heritage Area under section 10, the Secretary shall--
(1) conduct an evaluation of the accomplishments of the
Heritage Area; and
(2) prepare a report in accordance with subsection (c).
(b) Evaluation.--An evaluation conducted under subsection
(a)(1) shall--
(1) assess the progress of the management entity with
respect to--
(A) accomplishing the purposes of this Act for the Heritage
Area; and
(B) achieving the goals and objectives of the approved
management plan for the Heritage Area;
(2) analyze the Federal, State, local, and private
investments in the Heritage Area to determine the leverage
and impact of the investments; and
(3) review the management structure, partnership
relationships, and funding of the Heritage Area for purposes
of identifying the critical components for sustainability of
the Heritage Area.
(c) Report.--
(1) In general.--Based on the evaluation conducted under
subsection (a)(1), the Secretary shall prepare a report that
includes recommendations for the future role of the National
Park Service, if any, with respect to the Heritage Area.
(2) Required analysis.--If the report prepared under
paragraph (1) recommends that Federal funding for the
Heritage Area be reauthorized, the report shall include an
analysis of--
(A) ways in which Federal funding for the Heritage Area may
be reduced or eliminated; and
(B) the appropriate time period necessary to achieve the
recommended reduction or elimination.
(3) Submission to congress.--On completion of the report,
the Secretary shall submit the report to--
(A) the Committee on Energy and Natural Resources of the
Senate; and
(B) the Committee on Natural Resources of the House of
Representatives.
SEC. 9. AUTHORIZATION OF APPROPRIATIONS.
There is authorized to be appropriated to carry out this
Act $10,000,000, of which not more than $1,000,000 may be
made available for any fiscal year.
SEC. 10. TERMINATION OF AUTHORITY.
The authority of the Secretary to provide assistance under
this Act terminates on the date that is 15 years after the
date of enactment of this Act.
______
By Mr. BINGAMAN (for himself, Mr. Kerry, Mr. Salazar, and Ms.
Stabenow):
S. 2101. A bill to amend title XIX of the Social Security Act to
assist low-income Medicare beneficiaries by improving eligibility and
services under the Medicare Savings Program, and for other purposes; to
the Committee on Finance.
Mr. BINGAMAN. Mr. President, I rise today with Senators Kerry,
Salazar and Stabenow to introduce the Medicare Savings Program
Improvement Act of 2007. This legislation would make critical
improvements to the Medicare Savings Programs, which provide important
cost-assistance for low-income Medicare beneficiaries through the
Medicaid program and include the Qualified Medicare Beneficiary, QMB,
Specified Low-income Medicare Beneficiary, SLMB, and Qualified
Individuals-1, QI-1, programs.
One of the most significant improvements within this legislation is
to make permanent the QI-1 program, which expires at the end of this
month. This program provides vital assistance to low-income Medicare
beneficiaries in paying for Medicare Part B premiums. It was
established as part of the Balanced Budget Act of 1997 and was
authorized for 5 years. Unfortunately, every few years we in Congress
[[Page S12149]]
must act to reauthorize this program, providing unnecessary uncertainty
for beneficiaries and State Medicaid programs.
Congress should not participate in this annual last minute scramble
to try and extend the program for a few months or a year. It is a
disservice to the States, who must watch the Congress closely to
constantly prepare to send out disenrollment notices and lay off staff,
even though they are relatively certain the program will be extended.
But, more importantly, it is a disservice to the 185,000 beneficiaries
that need this important assistance, as many of those enrolled worry
this benefit will be taken away and many of those never enrolled are
not told of the benefit since States and advocates are spending their
time trying to get the program extended rather than conducting
outreach.
While I remain very hopeful that the Congress will pass an extension
of the QI-1 program for an additional period in the coming week, I am
introducing the Medicare Savings Program Improvement Act of 2007 today
in the hope that Congress will end this process of temporary extensions
and permanently authorize the program, as provided for in this
legislation.
Furthermore, the bill proposes several improvements to the Medicare
Savings Programs and application processes that will make these low-
income benefits both more efficient to administer and more accessible
to the individuals who need them. It would also seek to simplify the
process of applying for Medicare Savings Programs and make the Programs
more understandable to low-income senior citizens and people with
disabilities, as well as State and Federal Government officials.
Rates of enrollment in the Medicare Savings Programs are well below
those of other means-tested benefit programs. The Congressional Budget
Office estimates that only 33 percent of eligible people are
participating in the QMB program, and that the participation rate in
the SLMB program is only 13 percent--these figures exclude people who
are eligible for full Medicaid benefits. In comparison, participation
rates are estimated to be 75 percent in the earned income tax credit,
66 percent to 73 percent for Supplemental Security Income, and 66
percent to 70 percent for Medicaid.
In New Mexico, over 1,500 low-income Medicare beneficiaries receive
the QI-1 benefit, which saves them almost $1,000 in Medicare Part B
premium out-of-pocket costs annually. Unfortunately, according to
estimates made by the Medicare Rights Center using Census Bureau data,
over 11,000 are likely to be eligible. Many are completely unaware of
the assistance this program offers. This is usually because many
eligible individuals are difficult to reach or communicate with because
they are isolated, cannot read or speak English, have difficulty seeing
or hearing, or lack transportation.
To briefly describe the most critical aspects of the legislation,
Section 2 of the bill provides for one unified name for the Federal
programs that offer cost sharing and benefit assistance for low income
Medicare beneficiaries. Rather than separately referring to the QMB,
SLMB, and QI-1 programs, the bill provides one common name for all of
these programs, the ``Medicare Savings Programs.'' Aligning these
programs under one title helps to establish greater uniformity in
income and resource limits, simplifies the application process, makes
more people eligible for subsidies and increases the enrollment in
programs.
Low enrollment in these assistance programs is in large part due to
the lack of knowledge and understanding of the programs or benefits
offered. For example, 79 percent of non-enrolled eligible people have
ever heard of the Medicare Savings Programs and two thirds of enrollees
need assistance in completing the lengthy application form. This simple
change has been pilot tested with Medicare beneficiary groups and found
to elicit a positive response and interest from Medicare beneficiaries.
Section 3 of the legislation would make permanent the QI-1 category
by incorporating these individuals into the SLMB category at 100
percent Federal medical percentage, FMAP, matching rate. In addition to
simplifying and making permanent the program, such a change would
ensure funding for QI-1 cost-sharing.
Section 5 eliminates the limit on assets, which is set at $4,000 for
an individual and $6,000 for a couple and disqualifies millions of
Medicare beneficiaries with very low incomes from qualifying for
assistance. Many potential beneficiaries do not apply for benefits
because they incorrectly assume that they have too many assets to
qualify or fear losing their estate. Some States have waived or
disallowed the counting of some assets for the purposes of eligibility
determination and have seen much higher enrollment rates. The
requirements to document one's assets also makes the application
process burdensome and deters potential enrollees who might pass the
asset test.
Finally, section 8 eliminates some of the critical barriers to
enrollment. As I noted earlier, rates of enrollment in the Medicare
Savings Programs are well below those of other means-tested. benefit
programs. This section provides for several important enrollment
simplification procedures, such as allowing self-certification of
income and continuous eligibility, and expanded outreach efforts. For
instance, instead of requiring people to apply for benefits at the
state Medicaid office, the Social Security Administration took
applications and forwarded them to Medicaid offices for processing and
increased enrollment by 10 percent. Perhaps with more outreach efforts
provided within this bill, even more low-income Medicare beneficiaries
will receive the health care for which they are eligible.
I urge the Congress to pass a temporary extension of the QI-1 program
early next week, but then to immediately begin work to permanently
authorize the QI-1 program and to simplify and streamline all the
Medicare Savings Programs. Our Nation's low-income Medicare
beneficiaries and the States deserve nothing less.
Mr. President, 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. 2101
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Medicare
Savings Program Improvement Act of 2007''.
(b) Table of Contents.--The table of contents of this Act
is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. References to Medicare Savings Program.
Sec. 3. Increase in income levels for eligibility.
Sec. 4. Elimination of application of estate recovery for Medicare
Savings Program beneficiaries.
Sec. 5. Modification of asset test.
Sec. 6. Eligibility for other programs.
Sec. 7. Effective date of MSP benefits.
Sec. 8. Expediting eligibility under the Medicare Savings Program.
Sec. 9. Treatment of qualified medicare beneficiaries, specified low-
income medicare beneficiaries, and other dual eligibles
as Medicare beneficiaries.
Sec. 10. Medicaid treatment of certain medicare providers.
Sec. 11. Monitoring and enforcement of limitation on beneficiary
liability.
Sec. 12. State provision of medical assistance to dual eligibles in MA
plans.
SEC. 2. REFERENCES TO MEDICARE SAVINGS PROGRAM.
The low-income assistance programs for Medicare
beneficiaries under the Medicaid program under title XIX of
the Social Security Act now popularly referred to the ``QMB''
and ``SLMB'' programs are to be known as the ``Medicare
Savings Program''.
SEC. 3. INCREASE IN INCOME LEVELS FOR ELIGIBILITY.
(a) Increase to 135 Percent of FPL for Qualified Medicare
Beneficiaries.--
(1) In general.--Section 1905(p)(2) of the Social Security
Act (42 U.S.C. 1396d(p)(2)) is amended--
(A) in subparagraph (A), by striking ``100 percent'' and
inserting ``135 percent'';
(B) in subparagraph (B)--
(i) by striking ``and'' at the end of clause (ii);
(ii) by striking the period at the end of clause (iii) and
inserting ``, and''; and
(iii) by adding at the end the following:
``(iv) January 1, 2008, is 135 percent.''; and
(C) in subparagraph (C)--
(i) by striking ``and'' at the end of clause (iii);
(ii) by striking the period at the end of clause (iv) and
inserting ``, and''; and
(iii) by adding at the end the following:
``(v) January 1, 2008, is 135 percent.''.
(2) Application of income test based on family size.--
Section 1905(p)(2)(A) of such
[[Page S12150]]
Act (42 U.S.C. 1396d(p)(2)(A)) is amended by adding at the
end the following: ``For purposes of this subparagraph,
family size means the applicant, the spouse (if any) of the
applicant if living in the same household as the applicant,
and the number of individuals who are related to the
applicant (or applicants), who are living in the same
household as the applicant (or applicants), and who are
dependent on the applicant (or the applicant's spouse) for at
least one-half of their financial support.''.
(3) Not counting in-kind support and maintenance as
income.--Section 1905(p)(2)(D) of such Act (42 U.S.C.
1396d(p)(2)(D)) is amended by adding at the end the following
new clause:
``(iii) In determining income under this subsection,
support and maintenance furnished in kind shall not be
counted as income.''.
(b) Expansion of Specified Low-Income Medicare Beneficiary
(SLMB) Program.--
(1) Eligibility of individuals with incomes below 150
percent of fpl.--Section 1902(a)(10)(E) of the Social
Security Act (42 U.S.C. 1396b(a)(10)(E)) is amended--
(A) by adding ``and'' at the end of clause (ii);
(B) in clause (iii)--
(i) by striking ``and 120 percent in 1995 and years
thereafter'' and inserting ``, or 120 percent in 1995 and any
succeeding year before 2008, or 150 percent beginning in
2008''; and
(ii) by striking ``and'' at the end; and
(C) by striking clause (iv).
(2) Providing 100 percent federal financing.--The third
sentence of section 1905(b) of such Act (42 U.S.C. 1396d(b))
is amended by inserting before the period at the end the
following: ``and with respect to medical assistance for
medicare cost-sharing provided under section
1902(a)(10)(E)(iii)''.
(3) References.--Section 1905(p)(1) of such Act (42 U.S.C.
1396d(p)(1)) is amended by adding at and below subparagraph
(C) the following: ``The term `specified low-income medicare
beneficiary' means an individual described in section
1902(a)(10)(E)(iii).''.
(c) Effective Date.--
(1) Except as provided in paragraph (2), the amendments
made by this section shall take effect on January 1, 2008,
and, with respect to title XIX of the Social Security Act,
shall apply to calendar quarters beginning on or after
January 1, 2008.
(2) In the case of a State plan for medical assistance
under title XIX of the Social Security Act which the
Secretary of Health and Human Services determines requires
State legislation (other than legislation appropriating
funds) in order for the plan to meet the additional
requirements imposed by the amendments made by this section,
the State plan shall not be regarded as failing to comply
with the requirements of such title solely on the basis of
its failure to meet these additional requirements before the
first day of the first calendar quarter beginning after the
close of the first regular session of the State legislature
that begins after the date of the enactment of this Act. For
purposes of the previous sentence, in the case of a State
that has a 2-year legislative session, each year of such
session shall be deemed to be a separate regular session of
the State legislature.
SEC. 4. ELIMINATION OF APPLICATION OF ESTATE RECOVERY FOR
MEDICARE SAVINGS PROGRAM BENEFICIARIES.
(a) In General.--Section 1917(b)(1)(B)(ii) of the Social
Security Act (42 U.S.C. 1396p(b)(1)(B)(ii)) is amended by
inserting ``(but not including medical assistance for
medicare cost-sharing or for benefits described in section
1902(a)(10)(E))'' before the period at the end.
(b) Effective Date.--The amendment made by subsection (a)
shall apply to actions commencing on or after January 1,
2008.
SEC. 5. MODIFICATION OF ASSET TEST.
(a) For QMBs.--Section 1905(p) of the Social Security Act
(42 U.S.C. 1396d(p)) is amended--
(1) in paragraph (1), by amending subparagraph (C) to read
as follows:
``(C) whose resources (as determined under section 1613 for
purposes of the supplemental income security program, except
as provided in paragraph (6)(C)) do not exceed the amount
described in paragraph (6)(A).'';
(2) by redesignating paragraph (6) as paragraph (7); and
(3) by inserting after paragraph (5) the following:
``(6)(A) The resource level specified in this subparagraph
for--
``(i) for 2008 is six times the maximum amount of resources
that an individual may have and obtain benefits under the
supplemental security income program under title XVI; or
``(ii) for a subsequent year is the resource level
specified in 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.
Any dollar amount established under clause (ii) that is not a
multiple of $10 shall be rounded to the nearest multiple of
$10.
``(B) In determining the resources of an individual (and
their eligible spouse, if any) under section 1613 for
purposes of paragraph (1)(C) (relating to qualified medicare
beneficiaries) or section 1902(a)(10)(E)(iii) (relating to
individuals popularly known as specified low-income medicare
beneficiaries), the following additional exclusions shall
apply--
``(i) No part of the value of any life insurance policy
shall be taken into account.
``(ii) No balance in any pension or retirement plan or
account shall be taken into account.''.
(b) For SLMBs.--
(1) Permitting greater assets.--Section 1902(a)(10)(E)(iii)
of such Act (42 U.S.C. 1396b(a)(10)(E)(iii)) is amended by
inserting before the semicolon the following: ``or but for
the fact that their resources exceed the resource level
specified in section 1905(p)(6)(A) but does not exceed the
resource level specified in section 1905(p)(6)(B)''.
(2) Higher resource level specified.--Section 1905(p)(6) of
such Act, as inserted by subsection (a)(3), is amended by
inserting after subparagraph (A) the following new
subparagraph:
``(B) The resource level specified in this subparagraph
for--
``(i) for 2008, is $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
``(ii) for a subsequent year is the applicable resource
level specified in 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.
Any dollar amount established under clause (ii) that is not a
multiple of $10 shall be rounded to the nearest multiple of
$10.''.
(c) Effective Date.--
(1) Except as provided in paragraph (2), the amendments
made by this section shall apply to calendar quarters
beginning on or after January 1, 2008.
(2) In the case of a State plan for medical assistance
under title XIX of the Social Security Act which the
Secretary of Health and Human Services determines requires
State legislation (other than legislation appropriating
funds) in order for the plan to meet the additional
requirements imposed by the amendments made by this section,
the State plan shall not be regarded as failing to comply
with the requirements of such title solely on the basis of
its failure to meet these additional requirements before the
first day of the first calendar quarter beginning after the
close of the first regular session of the State legislature
that begins after the date of the enactment of this Act. For
purposes of the previous sentence, in the case of a State
that has a 2-year legislative session, each year of such
session shall be deemed to be a separate regular session of
the State legislature.
SEC. 6. ELIGIBILITY FOR OTHER PROGRAMS.
(a) In General.--Section 1905(p) of the Social Security Act
(42 U.S.C. 1396d(p)), as amended by section 4(a), is
amended--
(1) by redesignating paragraph (7) as paragraph (8); and
(2) by inserting after paragraph (6) the following new
paragraph:
``(7) Medical assistance for some or all medicare cost-
sharing under this title 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 subsection (a)
shall apply to eligibility for benefits on or after January
1, 2008.
SEC. 7. EFFECTIVE DATE OF MSP BENEFITS.
(a) Providing for 3 Months Retroactive Eligibility.--
(1) In general.--Section 1905(a) of the Social Security Act
(42 U.S.C. 1396d(a)) is amended, in the matter preceding
paragraph (1), by striking ``described in subsection (p)(1),
if provided after the month'' and inserting ``described in
subsection (p)(1) or a specified low-income medicare
beneficiary described in section 1902(a)(10)(E)(iii), if
provided in or after the third month before the month in
which the individual expresses an interest in applying to
become such a beneficiary, as determined in the manner
provided for assistance under section 1860D-14''.
(2) Conforming amendments.--(A) The first sentence of
section 1902(e)(8) of such Act (42 U.S.C. 1396a(e)(8)), as
amended by section 4(c)(2), is amended by striking ``(8)''
and the first sentence.
(B) Section 1848(g)(3) of such Act (42 U.S.C. 1395w-
4(g)(3)) is amended by adding at the end the following new
subparagraph:
``(C) Treatment of retroactive eligibility.--In the case of
an individual who is determined to be eligible for medical
assistance described in subparagraph (A) retroactively, the
Secretary shall provide a process whereby claims which are
submitted for services furnished during the period of
retroactive eligibility and during a month in which the
individual otherwise would have been eligible for such
assistance and which were not submitted in accordance with
such subparagraph are resubmitted and re-processed in
accordance with such subparagraph.''.
(b) Effective Date.--The amendments made by this section
shall take effect on January 1, 2008, but shall not result in
eligibility for benefits for medicare cost-sharing for months
before January 2008.
SEC. 8. EXPEDITING ELIGIBILITY UNDER THE MEDICARE SAVINGS
PROGRAM.
(a) Increasing Eligibility Through the Social Security
Office.--
(1) In general.--Title XVIII of the Social Security Act is
amended by inserting after section 1808 the following new
section:
[[Page S12151]]
``EXPEDITED ENROLLMENT UNDER THE MEDICARE SAVINGS PROGRAM THROUGH
SOCIAL SECURITY OFFICES
``Sec. 1809. (a) In General.--The Secretary shall provide,
in cooperation with the Commissioner of Social Security, for
an expedited process under this section for individuals to
apply and qualify for benefits under the Medicare Savings
Program. For purposes of this section, the term `Medicare
Savings Program' means medical assistance for medicare cost-
sharing (as defined in section 1905(p)(3)) for qualified
medicare beneficiaries and specified low-income medicare
beneficiaries under title XIX.
``(b) Process.--The process shall be consistent with the
following:
``(1) Coordination with social security and medicare
enrollment process.--The application shall be part of the
process for applying for benefits under title II and this
title.
``(2) Simplified application process.--The application may
be made over the Internet, by telephone, or by mail, without
the need for an interview in person by the applicant or a
representative of the applicant.
``(3) Contents of application.--The application shall
contain a description (in English, Spanish and other
languages determined appropriate by the Secretary) of the
availability of and the requirements for obtaining benefits
under the Medicare Savings Program.
``(4) Training.--Employees of the Social Security office
involved shall be trained to assist individuals completing
such applications.
``(5) Self-certification and verification.--In determining
whether an individual is eligible for benefits under the
Medicare Savings Program, the Secretary shall permit
individuals to qualify on the basis of self certifications of
income and resources meeting applicable standards without the
need to provide additional documentation. The Secretary shall
verify that information provided in the application is
correct.
``(6) Transmittal of application.--
``(A) Eligible applicants.--In the case of an applicant
determined by the Social Security office to be eligible for
benefits under the Medicare Savings Program based on income
and resources meeting the standards otherwise applicable, the
office shall transmit to the applicable State Medicaid office
the application so that the applicant can be enrolled within
30 days based on the information collected by the office.
``(B) Use of electronic transfer system.--Not later than
two years after the date of implementation of improvements of
the electronic data transfer system under section 8(c) of the
Medicare Savings Program Improvement Act of 2007, the process
under this paragraph shall use the such system for
information transmittal.
``(C) Ineligible applicants.--In the case of other
applicants whose income and resources do not meet such
standards, the Social Security office shall transmit to the
applicable State Medicaid office the application so that the
application may be considered under State standards that may
be more generous than the standards otherwise generally
applicable.
The process under this subsection shall be established and
implemented one year after the date of the enactment of this
section.
``(c) Distribution of Application Form.--The Secretary
shall distribute the application form used under subsection
(b) to any organization that requests them, including
entities receiving grants from the Secretary for programs
designed to provide services to individuals 65 years of age
or older and people with disabilities. The Commissioner of
Social Security shall make such forms available at local
offices of the Social Security Administration.
``(d) State Response and Application Process.--
``(1) In general.--In the case of an application
transmitted under subsection (b)(6), the State agency
responsible for determinations of eligibility for benefits
under the State's Medicare Savings Program--
``(A) shall make a determination on the application within
30 days of the date of its receipt; and
``(B) shall notify the applicant of the determination
within 10 days after it is made.
``(2) Use of simplified application process.--In the case
of an application other than an application transmitted under
subsection (b)(6), a State plan under title XIX shall provide
that an application for benefits under the Medicare Savings
Program may be made over the Internet, by telephone, or by
mail, without the need for an interview in person by the
applicant or a representative of the applicant.
``(e) Expedited Application and Eligibility Process.--
``(1) Expedited process.--
``(A) In general.--As part of the expedited process for
obtaining benefits under the Medicare Savings Program, the
Secretary shall through a request to the Secretary of the
Treasury to obtain information sufficient to identify whether
the individual involved is likely eligible for such benefits
based on such information and the type of assistance under
the Medicare Savings Program for which they would qualify
based on such information. Such process shall be conducted in
cooperation with the Commissioner of Social Security.
``(B) Opt in for newly eligible individuals.--Not later
than 60 days after the date of the enactment of this
subsection, the Secretary shall ensure that, as part of the
Medicare enrollment process, enrolling individuals--
``(i) receive information describing the Medicare Savings
Program provided under this section; and
``(ii) are provided the opportunity to opt-in to the
expedited process described in this subsection by requesting
that the Commissioner of Social Security screen the
individual involved for eligibility for the Medicare Savings
Program through a request to the Secretary of the Treasury
under section 6103(l)(21) of the Internal Revenue Code of
1986.
``(C) Transition for currently eligible individuals.--In
the case of any Medicare Savings Program eligible individual
to which subparagraph (B) did not apply at the time of such
individual's enrollment, the Secretary shall, not later than
60 days after the date of the implementation of subparagraph
(B), request that the Commissioner of Social Security screen
such individual for eligibility for the Medicare Savings
Program provided under this section through a request to the
Secretary of the Treasury under section 6103(l)(21) of the
Internal Revenue Code of 1986.
``(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 the Medicare
Savings Program (or who has applied for and been determined
ineligible for such benefits based only on standards in
effect before January 1, 2008), the Secretary shall send them
a letter (using basic, uncomplicated language) containing the
following:
``(A) Eligibility.--A statement that, based on the
information obtained under process under this section, the
individual is likely eligible for benefits under the Medicare
Savings Program.
``(B) Amount of assistance.--A description of the amount of
assistance under such program for which the individual would
likely be eligible based on such information.
``(C) Attestation.--A one-page 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 benefits under the
Medicare Savings Program. Such form--
``(i) shall not require the submittal of additional
documentation regarding income or assets; and
``(ii) 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 title and title XIX.
``(D) Information on outreach groups.--Information on how
the individual may contact the a State outreach effort or
other groups that receive grants from the Secretary to
conduct outreach to individuals to receive benefits under the
Medicare Savings Program.
``(3) Follow-up communications.--If the individual does not
respond to the letter described in paragraph (2) by
completing an attestation described in paragraph (2)(C) or
declining to do so, the Secretary shall make additional
attempts to contact the individual to obtain such an
affirmative response.
``(4) Hold-harmless.--Under such process, if an individual
in good faith and in the absence of fraud executes an
attestation described in paragraph (2)(C) and is provided
benefits under the Medicare Savings Program on the basis of
such attestation, if the individual is subsequently found not
eligible for such benefits, there shall be no recovery made
against the individual because of such benefits improperly
paid.
``(5) Use of preferred language in subsequent
communications.--In the case an attestation described in
paragraph (2)(C) is completed and in which a language other
than English is specified under clause (ii) of such
paragraph, the Secretary shall provide that subsequent
communications to the individual under this subsection shall
be in such language.
``(6) Construction.--Nothing in this subsection shall be
construed as precluding the Secretary from taking additional
outreach efforts to enroll eligible individuals under the
Medicare Savings Program.
``(f) Electronic Communication Between Social Security and
State Medicaid Agencies and the Secretary.--
``(1) Notice by social security to secretary and state
medicaid agencies.--In the case of a determination of
eligibility of an individual under section 1860D-
14(a)(3)(B)(i) by the Commissioner of Social Security, the
Commissioner shall provide for notice, preferably in
electronic form, to the Secretary and to State medicaid
agency under title XIX of such determination for purposes of
enabling the individual to automatically qualify for benefits
under the Medicare Savings Program under such title through
the operation of section 1905(p)(8).
``(2) Notice by states to secretary.--In the case that the
State determines that an individual is a qualified medicare
beneficiary or a specified low-income medicare beneficiary
under title XIX, the State shall provide for notice,
preferably in electronic form, to the Secretary of such
determination for purposes of enabling the individual to
automatically qualify for low-income subsidies under section
1860D-14 through the operation of section 1905(a)(3)(G).
[[Page S12152]]
``(3) Deadline.--Each State (as defined for purposes of
title XIX) and the Secretary shall establish the notification
process described in this subsection not later than 1 year
after the date of the enactment of this section.''.
(2) Disclosure of return information for purposes of
screening individuals for eligibility for benefits under the
medicare savings program.--
(A) 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 for purposes of
providing benefits under the medicare savings program.--
``(A) Return information from internal revenue service to
social security administration.--The Secretary, upon written
request from the Commissioner of Social Security under
section 1809(e)(1)(A) of the Social Security Act, shall
disclose to the Commissioner with respect to any taxpayer
identified by the Commissioner--
``(i)(I) whether the adjusted gross income, as modified in
accordance with specifications of the Secretary of Health and
Human Services for purposes of carrying out such section, of
such taxpayer and, if applicable, such taxpayer's spouse, for
the applicable year, exceeds the amounts specified by the
Secretary of Health and Human Services in order to apply the
135 and 150 percent poverty lines under section 1905(p) and
section 1902(a)(10)(E)(ii) of such Act;
``(II) the adjusted gross income (as determined under
subclause (I)), in the case of a taxpayer with respect to
which such adjusted gross income exceeds the amount so
specified for applying the 135 percent poverty line and does
not exceed the amount so specified for applying the 150
percent poverty line;
``(III) whether the return was a joint return for the
applicable year; and
``(IV) the applicable year; or
``(ii) if applicable, the fact that there is no return
filed for such taxpayer for the applicable year.
``(B) Definition of applicable year.--For the purposes of
this paragraph, the term `applicable year' means the most
recent taxable year for which information is available in the
Internal Revenue Service's taxpayer data information systems,
or, if there is no return filed for such taxpayer for such
year, the prior taxable year.
``(C) Restriction on individuals for whom disclosure is
requested.--The Commissioner of Social Security shall only
request information under this paragraph with respect to
individuals who have requested that such request be made
under section 1809(e) of the Social Security Act.
``(D) Return information from social security
administration to department of health and human services.--
The Commissioner of Social Security shall, upon written
request from the Secretary of Health and Human Services,
disclose to the Secretary of Health and Human Services the
information described in clauses (i) and (ii) of subparagraph
(A).
``(E) Permissive disclosure to officers, employees, and
contractors.--The information described in clauses (i) and
(ii) of subparagraph (A) may be disclosed among officers,
employees, and contractors of the Social Security
Administration and the Department of Health and Human
Services for the purposes described in subparagraph (F).
``(F) Restriction on use of disclosed information.--Return
information disclosed under this paragraph may be used only
for the purposes of identifying eligible individuals for, and
administering--
``(i) low-income subsidies under section 1860D-14 of the
Social Security Act; and
``(ii) the Medicare Savings Program implemented under
clauses (i) and (ii) of section 1902(a)(10)(E) of such
Act.''.
(B) Confidentiality.--Paragraph (3) of section 6103(a) of
such Code is amended by striking ``or (20)'' and inserting
``(20), or (21)''.
(C) Procedures and record keeping related to disclosures.--
Paragraph (4) of section 6103(p) of such Code is amended by
striking ``or (20)'' each place it appears and inserting
``(20), or (21)''.
(D) Unauthorized disclosure or inspection.--Paragraph (2)
of section 7213(a) of such Code is amended by striking ``or
(20)'' and inserting ``(20), or (21)''.
(b) Two-Way Deeming Between Medicare Savings Program and
Low-Income Subsidy Program.--
(1) Medicare savings program.--Section 1905(p) of the
Social Security Act (42 U.S.C. 1396d(p)), as amended by
sections 4(a) and 5(a), is amended--
(A) by redesignating paragraph (8) as paragraph (9); and
(B) by inserting after paragraph (7) the following new
paragraph:
``(8) An individual who has been determined eligible for
premium and cost-sharing subsidies under--
``(A) section 1860D-14(a)(1) is deemed, for purposes of
this title and without the need to file any additional
application, to be a qualified medicare beneficiary for
purposes of this title; or
``(B) section 1860D-14(a)(2) is deemed, for purposes of
this title and without the need to file any additional
application, to qualify for medical assistance as a specified
low-income medicare beneficiary (described in section
1902(a)(10)(E)(iii)).''.
(2) Low-income subsidy program.--Section 1860D-14(a)(3) of
such Act (42 U.S.C. 1395w-104(a)(3)) is amended by adding at
the end the following new subparagraph:
``(G) Deemed treatment for qualified medicare beneficiaries
and specified low-income medicare beneficiaries.--
``(i) Qmbs eligible for full subsidy.--A part D eligible
individual who has been determined for purposes of title XIX
to be a qualified medicare beneficiary is deemed, for
purposes of this part and without the need to file any
additional application, to be a subsidy eligible individual
described in paragraph (1).
``(ii) Slmbs eligible for partial subsidy.--A part D
eligible individual who has been determined to be a specified
low-income medicare beneficiary (as defined in section
1905(p)(1)) and who is not described in paragraph (1) is
deemed, for purposes of this part and without the need to
file any additional application, to be a subsidy eligible
individual who is not described in paragraph (1).''.
(3) Effective date.--The amendments made by this subsection
shall apply to eligibility for months beginning on or after
January 2008.
(c) Improvements in Electronic Communication Between Social
Security, State Medicaid Agencies, and the Secretary of
Health and Human Services.--
(1) In general.--Not later than two years after the date of
the enactment of this Act, the Commissioner of Social
Security, the Secretary of Health and Human Services, and the
directors of State Medicaid agencies shall implement
improvements to the electronic data transfer system by which
they communicate directly and electronically with each other
with respect to individuals who have enrolled for benefits
under any part of the Medicare Savings Program in order to
ensure that each of them has exactly the same list of
beneficiaries who are signed up for the Medicare Savings
Program.
(2) Increased administrative match.--In order to implement
paragraph (1)--
(A) the Medicaid administrative match under section
1903(a)(7) of the Social Security Act shall be increased to
75 percent with respect to expenditures made in carrying out
such paragraph; and
(B) there is appropriated to the Commissioner of Social
Security and the Secretary of Health and Human Services, from
any amounts in the Treasury not otherwise appropriated,
$2,000,000 each for each of fiscal years 2008 and 2009 to
implement paragraph (1).
(3) Use of system.--After the implementation of the
improvements to the electronic data transfer system under
paragraph (1), the Commissioner of Social Security, State
Medicaid agencies, and the Secretary of Health and Human
Services shall primarily use this system for the Commissioner
and the Secretary to inform the State Medicaid agencies to
enroll a beneficiary for the Medicare Savings Program.
(d) Improved Coordination With State, Local, and Other
Partners.--
(1) State grants.--
(A) In general.--The Secretary of Health and Human Services
shall enter into contracts with States (as defined for
purposes of title XIX of the Social Security Act (42 U.S.C.
1396 et seq.) to provide funds to States to use information
identified under subsection (c), and other appropriate
information, in order to do ex parte determinations or
utilize other methods for identifying and enrolling
individuals who are potentially--
(i) eligible for benefits under the Medicare Savings
Program (under sections 1905(p) of the Social Security Act,
42 U.S.C. 1396d(p)); or
(ii) entitled to a premium or cost-sharing subsidy under
section 1860D-14 of such Act (42 U.S.C. 1395w-114).
(B) Authorization of appropriations.--There are authorized
to be appropriated such sums as may be necessary to the
Secretary of Health and Human Services for the purpose of
making contracts under this paragraph.
(2) Funding of state health insurance counseling and
similar programs.--
(A) Authorization of appropriations.--In addition to any
other funds authorized to be appropriated, there are
authorized to be appropriated $3,000,000 for each of calendar
years 2008 through 2012 to carry out activities described in
subparagraph (B).
(B) Activities described.--The activities described in this
subparagraph are the following:
(i) Activities under section 4360 of the Omnibus Budget
Reconciliation Act of 1990 for the purpose of outreach to
low-income Medicare beneficiaries to assist in applying for
and obtaining benefits under the Medicare Savings Program
(under title XIX of the Social Security Act) and the low-
income subsidy program under section 1860D-14 of such Act.
(ii) Activities of the National Center on Senior Benefits
Outreach and Enrollment (as described in section
202(a)(20)(B) of the Older Americans Act of 1965 (42 U.S.C.
3012(a)(20)(B)).
(iii) Similar activities carried out by other qualified
agencies designated by the Secretary of Health and Human
Services.
SEC. 9. TREATMENT OF QUALIFIED MEDICARE BENEFICIARIES,
SPECIFIED LOW-INCOME MEDICARE BENEFICIARIES,
AND OTHER DUAL ELIGIBLES AS MEDICARE
BENEFICIARIES.
(a) In General.--Section 1862 of the Social Security Act
(42 U.S.C. 1395y) is amended by adding at the end the
following new subsection:
[[Page S12153]]
``(n) Treatment of Qualified Medicare Beneficiaries (QMBs),
Specified Low-Income Medicare Beneficiaries (SLMBs), and
Other Dual Eligibles.--Nothing in this title shall be
construed as authorizing a provider of services or supplier
to discriminate (through a private contractual arrangement or
otherwise) against an individual who is otherwise entitled to
services under this title on the basis that the individual is
a qualified medicare beneficiary (as defined in section
1905(p)(1)), a specified low-income medicare beneficiary, or
is otherwise eligible for medical assistance for medicare
cost-sharing or other benefits under title XIX.''.
(b) Effective Date.--The amendment made by subsection (a)
shall apply to items and services furnished on or after the
date of the enactment of this Act.
SEC. 10. MEDICAID TREATMENT OF CERTAIN MEDICARE PROVIDERS.
(a) In General.--Section 1902(n) of the Social Security Act
(42 U.S.C. 1396a(n)) is amended by adding at the end the
following new paragraph:
``(4) A State plan shall not deny a claim from a provider
or supplier with respect to medicare cost-sharing described
in subparagraph (B), (C), or (D) of section 1905(p)(3) for an
item or service which is eligible for payment under title
XVIII on the basis that the provider or supplier does not
have a provider agreement in effect under this title or does
not otherwise serve all individuals entitled to medical
assistance under this title.''.
(b) Effective Date.--The amendment made by subsection (a)
shall apply to items and services furnished on or after the
date of the enactment of this Act.
SEC. 11. MONITORING AND ENFORCEMENT OF LIMITATION ON
BENEFICIARY LIABILITY.
Section 1902(n) of the Social Security Act (42 U.S.C.
1396b(n)), as amended by section 9(a), is further amended by
adding at the end the following new paragraph:
``(5)(A) The Inspector General of the Department of Health
and Human Services shall examine, not later than one year
after the date of the enactment of this paragraph and every
three years thereafter, whether providers have attempted to
make qualified medicare beneficiaries liable for deductibles,
coinsurance, and co-payments in violation of paragraph
(3)(B). The Inspector General shall submit to the Secretary a
report on such examination and a finding as to whether
qualified medicare beneficiaries have been held liable in
violation of such paragraph.
``(B) If a report under subparagraph (A) includes a finding
that qualified medicare beneficiaries have been held liable
in violation of such paragraph, not later than 60 days after
the date of receiving such report the Secretary shall submit
to Congress a report that includes a plan of action on how to
enforce provisions of such paragraph.''.
SEC. 12. STATE PROVISION OF MEDICAL ASSISTANCE TO DUAL
ELIGIBLES IN MA PLANS.
(a) In General.--Section 1902(n) of the Social Security Act
(42 U.S.C. 1396b(n)), as amended by section 10, is further
amended by adding at the end the following new paragraph:
``(6)(A) Each State shall--
``(i) identify those individuals who are eligible for
medical assistance for medicare cost-sharing and who are
enrolled with a Medicare Advantage plan under part C of title
XVIII; and
``(ii) for the individuals so identified, provide for
payment of medical assistance for the medicare cost-sharing
(including cost-sharing under a Medicare Advantage plan) to
which they are entitled.
``(B)(i) The Inspector General of the Department of Health
and Human Services shall examine, not later than one year
after the date of the enactment of this paragraph and every
three years thereafter, whether States are providing for
medical assistance for medicare cost-sharing for individuals
enrolled in Medicare Advantage plans in accordance with this
title. The Inspector General shall submit to the Secretary a
report on such examination and a finding as to whether States
are failing to provide such medical assistance.
``(ii) If a report under clause (i) includes a finding that
States are failing to provide such medical assistance, not
later than 60 days after the date of receiving such report
the Secretary shall submit to Congress a report that includes
a plan of action on how to enforce such requirement.''.
(b) Effective Date.--
(1) Except as provided in paragraph (2), the amendment made
by subsection (a) shall apply to calendar quarters beginning
on or after the date of the enactment of this Act.
(2) In the case of a State plan for medical assistance
under title XIX of the Social Security Act which the
Secretary of Health and Human Services determines requires
State legislation (other than legislation appropriating
funds) in order for the plan to meet the additional
requirements imposed by the amendment made by subsection (a),
the State plan shall not be regarded as failing to comply
with the requirements of such title solely on the basis of
its failure to meet these additional requirements before the
first day of the first calendar quarter beginning after the
close of the first regular session of the State legislature
that begins after the date of the enactment of this Act. For
purposes of the previous sentence, in the case of a State
that has a 2-year legislative session, each year of such
session shall be deemed to be a separate regular session of
the State legislature.
______
By Mr. BINGAMAN (for himself, Mr. Obama, Mr. Salazar, Mr. Brown,
Mr. Kerry, Ms. Stabenow, Ms. Cantwell, and Mrs. Clinton):
S. 2102. A bill to amend title II of the Social Security Act to phase
out the 24-month waiting period for disabled individuals to become
eligible for Medicare benefits, to eliminate the waiting period for
individuals with life-threatening conditions, and for other purposes;
to the Committee on Finance.
Mr. BINGAMAN. Mr. President, I rise today to introduce bipartisan
legislation entitled ``Ending the Medicare Disability Waiting Period
Act of 2007 with Senators Obama, Salazar, Brown, Kerry, Stabenow,
Cantwell, and Clinton. This legislation would phase-out the current 2
year waiting period that people with disabilities must endure after
qualifying for Social Security Disability Insurance SSDI. In the
interim or as the waiting period is being phased out, the bill would
also create a process by which the secretary can immediately waive the
waiting period for people with life threatening illnesses.
When Medicare was expanded in 1972 to include people with significant
disabilities, lawmakers created the 24-month waiting period. According
to a April 2007 report from the Commonwealth Fund, it is estimated that
over 1.5 million SSDI beneficiaries are in the Medicare waiting period
at any given time, ``all of whom are unable to work because of their
disability and most of whom have serious health problems, low incomes,
and limited access to health insurance.'' Nearly 39 percent of these
individuals do not have health insurance coverage for some point during
the waiting period and 26 percent have no health insurance during this
period.
The stated reason at the time was to limit the fiscal cost of the
provision. However, Mr. President, I would assert that there is no
reason, be it fiscal or moral, to tell people that they must wait
longer than two years after becoming severely disabled before we give
provide them access to much needed health care.
In fact, it is important to note that there really are actually three
waiting periods that are imposed upon people seeking to qualify for
SSDI. First, there is the disability determination process through the
Social Security Administration, which often takes many months or even
longer than a year in some cases. Second, once a worker has been
certified as having a severe or permanent disability, they must wait an
additional five months before receiving their first SSDI check. And
third, after receiving that first SSDI check, there is the 2-year
period that people must wait before their Medicare coverage begins.
What happens to the health and well-being of people waiting more than
2\1/2\ years before they finally receive critically needed Medicare
coverage? According to Karen Davis, president of the Commonwealth Fund,
which has conducted several important studies on the issue,
``Individuals in the waiting period for Medicare suffer from a broad
range of debilitating diseases and are in urgent need of appropriate
medical care to manage their conditions. Eliminating the 2-year wait
would ensure access to care for those already on the way to Medicare.''
Again, we are talking about individuals that have been determined to
be unable to engage in any ``substantial, gainful activity'' because of
either a physical or mental impairment that is expected to result in
death or to continue for at least 12 months. These are people that, by
definition, are in more need of health coverage than anybody else in
our society. The consequences are unacceptable and are, in fact, dire.
The majority of people who become disabled were, before their
disability, working full-time jobs and paying into Medicare like all
other employed Americans. At the moment these men and women need
coverage the most, just when they have lost their health, their jobs,
their income, and their health insurance, Federal law requires them to
wait two full years to become eligible for Medicare. Many of these
individuals are needlessly forced to accumulate tens-of-thousands of
dollars in healthcare debt or compromise their health due to forgone
medical treatment. Many individuals are forced to
[[Page S12154]]
sell their homes or go bankrupt. Even more tragically, more than 16,000
disabled beneficiaries annually, about 4 percent of beneficiaries, do
not make it through the waiting period. They die before their Medicare
coverage ever begins.
Removing the waiting period is well worth the expense. According to
the Commonwealth Fund, analyses have shown providing men and women with
Medicare at the time that Social Security certifies them as disabled
would cost $8.7 billion annually. This cost would be partially offset
by $4.3 billion in reduced Medicaid spending by Medicaid, which many
individuals require during the waiting period. In addition, untold
expenses borne by the individuals involved could be avoided, as well as
the costs of charity care on which many depend. Moreover, there may be
additional savings to the Medicare program itself, which often has to
bear the expense of addressing the damage done during the waiting
period. During this time, deferred health care can worsen conditions,
creating additional health problems and higher costs.
Further exacerbating the situation, some beneficiaries have had the
unfortunate fate of having received SSI and Medicaid coverage, applied
for SSDI, and then lost their Medicaid coverage because they were not
aware the change in income when they received SSDI would push them over
the financial limits for Medicaid. In such a case, and let me emphasize
this point, the government is effectively taking their health care
coverage away because they are so severely disabled.
Therefore, for some in the waiting period, their battle is often as
much with the Government as it is with their medical condition,
disease, or disability.
Nobody could possible think this makes any sense.
As the Medicare Rights Center has said, ``By forcing Americans with
disabilities to wait 24 months for Medicare coverage, the current law
effectively sentences these people to inadequate health care, poverty,
or death. . . . Since disability can strike anyone, at any point in
life, the 24-month waiting period. should be of concern to everyone,
not just the millions of Americans with disabilities today.''
Although elimination of the Medicare waiting period will certainly
increase Medicare costs, it is important to note that there will be
some corresponding decrease in Medicaid costs. Medicaid, which is
financed by both Federal and State governments, often provides coverage
for a subset of disabled Americans in the waiting period, as long as
they meet certain income and asset limits. Income limits are typically
at or below the poverty level, including at just 74 percent of the
poverty line in New Mexico, with assets generally limited to just
$2,000 for individuals and $3,000 for couples.
Furthermore, from a continuity of care point of view, it makes little
sense that somebody with disabilities must leave their job and their
health providers associated with that plan, move on to Medicaid, often
have a different set of providers, then switch to Medicare and yet
another set of providers. The cost, both financial and personal, of not
providing access to care or poorly coordinated care services for these
seriously ill people during the waiting period may be greater in many
cases than providing health coverage.
Finally, private-sector employers and employees in those risk-pools
would also benefit from the passage of the bill. As the Commonwealth
Fund has noted, ``. . . to the extent that disabled adults rely on
coverage through their prior employer or their spouse's employer,
eliminating the waiting period would also produce savings to employers
who provide this coverage.''
To address concerns about costs and immediate impact on the Medicare
program, the legislation phases out the waiting period over a 10-year
period. In the interim, the legislation would create a process by which
others with life-threatening illnesses could also get an exception to
the waiting period. Congress has previously extended such an exception
to the waiting period individuals with amyothrophic lateral sclerosis,
ALS, also known as Lou Gehrig's disease, and for hospice services. The
ALS exception passed the Congress in December 2000 and went into effect
July 1, 2001. Thus, the legislation would extend the exception to all
people with life-threatening illnesses in the waiting period.
Mr. President, 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. 2102
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Ending the
Medicare Disability Waiting Period Act of 2007''.
(b) Table of Contents.--The table of contents of this Act
is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Phase-out of waiting period for medicare disability benefits.
Sec. 3. Elimination of waiting period for individuals with life-
threatening conditions.
Sec. 4. Institute of Medicine study and report on delay and prevention
of disability conditions.
SEC. 2. PHASE-OUT OF WAITING PERIOD FOR MEDICARE DISABILITY
BENEFITS.
(a) In General.--Section 226(b) of the Social Security Act
(42 U.S.C. 426(b)) is amended--
(1) in paragraph (2)(A), by striking ``, and has for 24
calendar months been entitled to,'' and inserting ``, and for
the waiting period (as defined in subsection (k)) has been
entitled to,'';
(2) in paragraph (2)(B), by striking ``, and has been for
not less than 24 months,'' and inserting ``, and has been for
the waiting period (as defined in subsection (k)),'';
(3) in paragraph (2)(C)(ii), by striking ``, including the
requirement that he has been entitled to the specified
benefits for 24 months,'' and inserting ``, including the
requirement that the individual has been entitled to the
specified benefits for the waiting period (as defined in
subsection (k)),''; and
(4) in the flush matter following paragraph
(2)(C)(ii)(II)--
(A) in the first sentence, by striking ``for each month
beginning with the later of (I) July 1973 or (II) the twenty-
fifth month of his entitlement or status as a qualified
railroad retirement beneficiary described in paragraph (2),
and'' and inserting ``for each month beginning after the
waiting period (as so defined) for which the individual
satisfies paragraph (2) and'';
(B) in the second sentence, by striking ``the `twenty-fifth
month of his entitlement' refers to the first month after the
twenty-fourth month of entitlement to specified benefits
referred to in paragraph (2)(C) and''; and
(C) in the third sentence, by striking ``, but not in
excess of 78 such months''.
(b) Schedule for Phase-Out of Waiting Period.--Section 226
of the Social Security Act (42 U.S.C. 426) is amended by
adding at the end the following new subsection:
``(k) For purposes of subsection (b) (and for purposes of
section 1837(g)(1) of this Act and section 7(d)(2)(ii) of the
Railroad Retirement Act of 1974), the term `waiting period'
means--
``(1) for 2008, 18 months;
``(2) for 2009, 16 months;
``(3) for 2010, 14 months;
``(4) for 2011, 12 months;
``(5) for 2012, 10 months;
``(6) for 2013, 8 months;
``(7) for 2014, 6 months;
``(8) for 2015, 4 months;
``(9) for 2016, 2 months; and
``(10) for 2017 and each subsequent year, 0 months.''.
(c) Conforming Amendments.--
(1) Sunset.--Effective January 1, 2017, subsection (f) of
section 226 of the Social Security Act (42 U.S.C. 426) is
repealed.
(2) Medicare description.--Section 1811(2) of such Act (42
U.S.C. 1395c(2)) is amended by striking ``entitled for not
less than 24 months'' and inserting ``entitled for the
waiting period (as defined in section 226(k))''.
(3) Medicare coverage.--Section 1837(g)(1) of such Act (42
U.S.C. 1395p(g)(1)) is amended by striking ``of the later of
(A) April 1973 or (B) the third month before the 25th month
of such entitlement'' and inserting ``of the third month
before the first month following the waiting period (as
defined in section 226(k)) applicable under section 226(b)''.
(4) Railroad retirement system.--Section 7(d)(2)(ii) of the
Railroad Retirement Act of 1974 (45 U.S.C. 231f(d)(2)(ii)) is
amended--
(A) by striking ``, for not less than 24 months'' and
inserting ``, for the waiting period (as defined in section
226(k) of the Social Security Act); and
(B) by striking ``could have been entitled for 24 calendar
months, and'' and inserting ``could have been entitled for
the waiting period (as defined is section 226(k) of the
Social Security Act), and''.
(d) Effective Date.--Except as provided in subsection
(c)(1), the amendments made by this section shall apply to
insurance benefits under title XVIII of the Social Security
Act with respect to items and services furnished in months
beginning at least 90 days after the date of the enactment of
this Act (but in no case earlier than January 1, 2008).
SEC. 3. ELIMINATION OF WAITING PERIOD FOR INDIVIDUALS WITH
LIFE-THREATENING CONDITIONS.
(a) In General.--Section 226(h) of the Social Security Act
(42 U.S.C. 426(h)) is amended--
[[Page S12155]]
(1) by redesignating paragraphs (1), (2), and (3) as
subparagraphs (A), (B), and (C), respectively;
(2) in the matter preceding subparagraph (A) (as
redesignated by paragraph (1)), by inserting ``(1)'' after
``(h)'';
(3) in paragraph (1) (as designated by paragraph (2))--
(A) in the matter preceding subparagraph (A) (as
redesignated by paragraph (1)), by inserting ``or any other
life-threatening condition identified by the Secretary''
after ``amyotrophic lateral sclerosis (ALS)''; and
(B) in subparagraph (B) (as redesignated by paragraph (1)),
by striking ``(rather than twenty-fifth month)''; and
(4) by adding at the end the following new paragraph:
``(2) For purposes of identifying life-threatening
conditions under paragraph (1), the Secretary shall compile a
list of conditions that are fatal without medical treatment.
In compiling such list, the Secretary shall consult with the
Director of the National Institutes of Health (including the
Office of Rare Diseases), the Director of the Centers for
Disease Control and Prevention, the Director of the National
Science Foundation, and the Institute of Medicine of the
National Academy of Sciences.''.
(b) Effective Date.--The amendments made by this section
shall apply to insurance benefits under title XVIII of the
Social Security Act with respect to items and services
furnished in months beginning at least 90 days after the date
of the enactment of this Act (but in no case earlier than
January 1, 2008).
SEC. 4. INSTITUTE OF MEDICINE STUDY AND REPORT ON DELAY AND
PREVENTION OF DISABILITY CONDITIONS.
(a) Study.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall request
that the Institute of Medicine of the National Academy of
Sciences conduct a study on the range of disability
conditions that can be delayed or prevented if individuals
receive access to health care services and coverage before
the condition reaches disability levels.
(b) Report.--Not later than the date that is 2 years after
the date of enactment of this Act, the Secretary shall submit
to Congress a report containing the results of the Institute
of Medicine study authorized under this section.
(c) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section $750,000 for the
period of fiscal years 2008 and 2009.
______
By Mr. BINGAMAN (for himself, Mr. Obama, Mr. Salazar, Ms.
Collins, and Mr. Lieberman):
S. 2103. A bill to amend title XVIII of the Social Security Act to
eliminate the in the home restriction for Medicare coverage of mobility
devices for individuals with expected long-term needs; to the Committee
on Finance.
Mr. BINGAMAN. Mr. President, I rise today with Senators Obama,
Salazar, Collins, and Lieberman to introduce the Medicare Independent
Living Act of 2007. This legislation would eliminate Medicare's ``in
the home'' restriction for the coverage of mobility devices, including
wheelchairs and scooters, for those with disabilities and expected
long-term needs. This includes people with multiple sclerosis,
paraplegia, osteoarthritis, and cerebrovascular disease that includes
acute stroke and conditions like aneurysms.
As currently interpreted by the Centers for Medicare and Medicaid
Services, CMS, the ``in the home'' restriction only permits
beneficiaries to obtain wheelchairs that are necessary for use inside
the home. As a result, seriously disabled beneficiaries who would
primarily utilize a wheelchair outside the home are prevented from
receiving this critical and basic equipment through Medicare. For
example, this restriction prevents beneficiaries from receiving
wheelchairs to access their work, the community-at-large, place of
worship, school, physician's offices, or pharmacies.
On July 13, 2005, 34 senators wrote Secretary Leavitt asking the
Department of Health and Human Services, or HHS, to modify the ``in the
home'' requirement so as to ``improve community access for Medicare
beneficiaries with mobility impairments.'' Unfortunately, CMS continues
to impose the ``in the home'' restriction on Medicare beneficiaries in
need of mobility devices.
As the Medicare Rights Center in a report entitled ``Forced
Isolation: Medicare's `In The home' Coverage Standards for
Wheelchairs'' in March 2004 notes, ``This effectively disqualifies you
from leaving your home without the assistance of others.''
Furthermore, in a Kansas City Star article dated July 3, 2005, Mike
Oxford with the National Council on Independent Living noted, ``You
look at mobility assistance as a way to liberate yourself.'' He added
that the restriction ``is just backward.''
In fact, policies such as these are not only backward but directly
contradict numerous initiatives aimed at increasing community
integration of people with disabilities, including the Americans with
Disabilities Act, the Ticket-to-Work Program, the New Freedom
Initiative, and the Olmstead Supreme Court decision.
According to the Medicare Rights Center update dated March 23, 2006,
``This results in arbitrary denials. People with apartments too small
for a power wheelchair are denied a device that could also get them
down the street. Those in more spacious quarters get coverage, allowing
them to scoot from room to room and to the grocery store. People who
summon all their willpower and strength to hobble around a small
apartment get no help for tasks that are beyond them and their front
door.''
In New Mexico, I have heard this complaint about the law repeatedly
from our State's most vulnerable disabled and senior citizens. People
argue the provision is being misinterpreted by the administration and
results in Medicare beneficiaries being trapped in their home.
The ITEM Coalition adds in a letter to CMS on this issue in November
25, 2005, ``There continues to be no clinical basis for the `in the
home' restriction and by asking treating practioners to document
medical need only within the home setting, CMS is severely restricting
patients from receiving the most appropriate devices to meet their
mobility needs.''
My legislation would clarify that this restriction does not apply to
mobility devices, including wheelchairs, for people with disabilities
in the Medicare Program. The language change is fairly simple and
simply clarifies that the ``in the home'' restriction for durable
medical equipment does not apply in the case of mobility devices needed
by Medicare beneficiaries with expected long-term needs for use ``in
customary settings such as normal domestic, vocational, and community
activities.''
This legislation is certainly not intended to discourage CMS from
dedicating its resources to reducing waste, fraud, and abuse in the
Medicare system, as those efforts are critical to ensuring that
Medicare remains financially viable and strong in the future. However,
it should be noted that neither Medicaid nor the Department of Veterans
Affairs impose such ``in the home'' restrictions on mobility devices.
Mr. President, I ask unanimous consent that the text of the bill and
a letter sent to Secretary Leavitt be printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
S. 2103
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 Independent Living
Act of 2007''.
SEC. 2. ELIMINATION OF IN THE HOME RESTRICTION FOR MEDICARE
COVERAGE OF MOBILITY DEVICES FOR INDIVIDUALS
WITH EXPECTED LONG-TERM NEEDS.
(a) In General.--Section 1861(n) of the Social Security Act
(42 U.S.C. 1395x(n) is amended by inserting ``or, in the case
of a mobility device required by an individual with expected
long-term need, used in customary settings for the purpose of
normal domestic, vocational, or community activities'' after
``1819(a)(1))''.
(b) Effective Date.--The amendment made by subsection (a)
shall apply to items furnished on or after the date of
enactment of this Act.
____
July 13, 2005.
Senate Letter Opposing In Home Restriction
Hon. Michael O. Leavitt,
Secretary, Department of Health and Human Services,
Washington, DC.
Dear Secretary Leavitt: The undersigned members write to
request that you modify the ``in the home'' requirement in
Medicare's wheeled mobility benefit to improve community
access for Medicare beneficiaries with mobility impairments.
We commend CMS for its dedication to reducing waste, fraud
and abuse in the Medicare system, particularly under the
mobility device benefit, and fully support your intention to
protect precious Medicare funds and resources. Additionally,
we commend the agency for recently taking on the task of
creating a new and, hopefully, more appropriate Medicare
coverage criteria for mobility devices. However, we are
concerned that CMS' current interpretation of the ``in the
[[Page S12156]]
home'' requirement may continue to act as an inappropriate
restriction in meeting the real-life mobility needs of
Medicare beneficiaries with physical disabilities and
mobility impairments.
Recently CMS announced a final National Coverage
Determination (NCD) for mobility assistance equipment (MAE)
that fails to adequately address the concerns of
beneficiaries and other parties with the ``in the home''
restriction.
In order to ensure that the ``in the home'' requirement
does not act as a barrier to community participation for
Medicare beneficiaries with disabilities and mobility
impairments; we ask that you modify this requirement through
the regulatory process. Additionally, if your agency
concludes that the ``in the home'' requirement cannot be
addressed through the regulatory process, we request that you
respond with such information as quickly as possible, so that
Congress may begin examining legislative alternatives.
We thank you for your consideration of this matter.
Sincerely,
Jeff Bingaman; Rick Santorum; John Kerry; Joseph I.
Lieberman; Barbara Mikulski; Maria Cantwell; Edward M.
Kennedy; Patty Murray; Evan Bayh; Mark Dayton; Jack
Reed; Johnny Isakson; Sam Brownback; Jon S. Corzine;
James M. Talent; Pat Roberts; Frank Lautenberg; James
M. Jeffords; Christopher S. Bond; Mike DeWine; Daniel
K. Akaka; Mary L. Landrieu; Debbie Stabenow; Charles E.
Schumer; Ron Wyden; Herb Kohl; Patrick J. Leahy; Arlen
Specter; Hillary Rodham Clinton; Christopher J. Dodd;
John McCain; Carl Levin; Tom Harkin; Olympia J. Snowe.
____________________