Statements On Introduced Bills And Joint Resolutions

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS -- (Senate - January 04, 2007)

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Ms. COLLINS. Mr. President, I rise today to join my colleagues in cosponsoring S. 1, a bill to provide greater transparency in the legislative process.

The recent elections sent a clear message to Congress that the American people have lost confidence in their government. Without the support of the people, we cannot tackle the difficult issues that this Congress must face. This bill, then, is a critical part of restoring the people's trust by reforming ethics and lobbying rules.

It is important to remember that the conduct of most Members and their staffs is beyond reproach. Likewise, it is important to recognize that lobbying--whether done on behalf of the business community, an environmental organization, a children's advocacy group, or any other cause--can provide us with useful information and analysis that aids, but does not dictate, the decision-making process. Unfortunately, in the minds of many Americans, ``lobbying' has come to be associated with expensive paid vacations masquerading as fact-finding trips, special access to Members and staff that an ordinary citizen could never hope to have, and undue influence that leads to decisions made in the best interest of the lobbyist and his or her client instead of the American people.

S. 1 which is nearly identical to a bill that was the product of bipartisan efforts by the Senate Committee on Homeland Security and Governmental Affairs and the Senate Committee on Rules and Administration and that was passed by this Senate just last year--includes a number of important provisions that will help to restore the public image of the United States Congress.

S. 1 bans gifts from lobbyists. This is clear, brightline rule that diminishes the appearance of impropriety that gifts can create.

S. 1 requires greater disclosure of the sponsors of and the purposes for earmarks included in a bill so that the people can know where tax dollars are being spent and why.

S. 1 eliminates floor privileges for former Members who are seeking to lobby other members. They will enjoy no more access to Senators and Congressmen than any other citizen.

S. 1 will eliminate the practice of anonymous holds in the Senate so that we can bring debate into the open and not simply kill a bill with a secret hold.

S. 1 will require enhanced disclosure of the activities of groups lobbying Congress so that the public can easily find out which interests are trying to influence the decisions we make.

S. 1 will slow the revolving door between the Hill and the private sector by limiting the ability of departing Members and staff to lobby their former colleagues.

While I am pleased to be a cosponsor of this bill, I also believe strongly that it would be improved by the addition of an independent Office of Public Integrity within the Legislative Branch. This Office would be able to conduct nonpartisan investigations of possible ethics violations. These investigations would help to promote public confidence in the enforcement of any laws that we pass to enhance congressional ethics. During debate on this bill last year, an amendment that Senator LIEBERMAN, Senator MCCAIN, and I offered to create this Office was defeated. However, I hope my colleagues have taken the lessons of the recent elections to heart and that the idea of an Office of Public Integrity will be approved this year. To that end, I am also cosponsoring Senator MCCAIN's lobbying reform package, which he has introduced today and which contains a number of the provisions of S. 1 as well as creating an independent Office of Public Integrity.

I once again commend my colleagues on recognizing the importance of this issue by making it our first priority in the 110th Congress. I urge the Senate to work quickly to get this legislation finished so that we can move on from the task of governing ourselves and get down to the business of governing our Nation.

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By Ms. COLLINS (for herself and Ms. LANDRIEU):

S. 158. A bill to expand access to affordable health care and to strengthen the health care safety net and make health care services more available in rural and underserved areas; to the Committee on Finance.

Ms. COLLINS. Mr. President, I am pleased to join with my colleague from Louisiana, Senator LANDRIEU, in introducing the Access to Affordable Health Care Act, a comprehensive plan that builds on the strengths of our current public programs and private health care system to make affordable health care available to millions more Americans.

One of my priorities in the Senate has been to expand access to affordable health care. There are still far too many Americans without health insurance or with woefully inadequate coverage. As many as 46 million Americans are uninsured, and millions more are underinsured.

Maine is in the midst of a growing health insurance crisis, with insurance premiums rising at alarming rates. Whether I am talking to a self-employed fisherman, a displaced worker, the owner of a struggling small business, or the human resource manager of a large company, the soaring costs of health insurance is a common concern.

These cost increases have been particularly burdensome for small businesses, the backbone of the Maine economy. Maine small business owners want to provide coverage for their employees, but they are caught in a cost squeeze. They know that if they pass on premium increases to their employees, more of them will decline coverage. Yet these small businesses simply cannot afford to absorb double-digit increases in their health insurance premiums year after year.

The problem of rising costs is even more acute for individuals and families who must purchase health insurance on their own. Monthly health insurance premiums in Maine often exceed a family's mortgage payment. Clearly, we must do more to make health insurance more available and affordable.

The Access to Affordable Health Care Act, which we are introducing today, is a seven-point plan that combines a variety of public and private approaches. The legislation's seven goals are: one, to expand access to affordable health care for small businesses; two, to make health insurance more affordable for individuals and families purchasing coverage on their own; three, to strengthen the health care safety net for those without coverage; four, to expand access to care in rural and underserved areas; five, to increase access to affordable long-term care; six to promote healthier lifestyles; and seven, to provide more equitable Medicare payments to Maine providers to reduce the Medicare shortfall, which has forced hospitals, physicians and other providers to shift costs onto other payers in the form of higher charges, which in turn drives up health care premiums.

Let me discuss each of these seven points in greater detail.

First, our legislation will help small employers cope with rising health care costs.

Since most Americans get their health insurance through the workplace, it is a common assumption that people without health insurance are unemployed. The fact is, however, that as many as 83 percent of Americans who do not have health insurance are in a family with a worker.

Uninsured working Americans are most often employees of small businesses. In fact, some 63 per cent of uninsured workers are employed by small firms. Smaller firms generally face higher costs for health insurance than larger firms, which makes them less likely to offer coverage. The Access to Affordable Health Care Act will help these employers cope with rising costs by creating new tax credits for small businesses to make health insurance more affordable. It will encourage those small businesses that do not offer health insurance to do so and will help employers that do offer insurance to continue coverage for their employees even in the face of rising costs.

Our legislation will also provide grants to provide start-up funding to States to help businesses to form group purchasing cooperatives. These cooperatives will enable small businesses to band together to purchase health insurance jointly. This will help to reduce their costs and improve the quality of their employee's health care.

The legislation would also authorize a Small Business Administration grant program for States, local governments and non-profit organizations to provide information about the benefits of health insurance to small employers, including tax benefits, increased productivity of employees, and decreased turnover. These grants would also be used to make employers aware of their current incentives under State and Federal laws. While costs are clearly a problem, many small employers are simply not aware of laws that have already been enacted by both States and the Federal government to make health insurance more affordable. For example, in one survey, 57 percent of small employers did not know that they could deduct 100 percent of their health insurance premiums as a business expense.

The legislation would also create a new program to encourage innovation by awarding demonstration grants in up to 10 States conducting innovative coverage expansions, such as alternative group purchasing or pooling arrangements, individual or small group market reforms, or subsidies to employers or individuals purchasing coverage. The States have long been laboratories for reform, and they should be encouraged in the development of innovative programs that can serve as models for the Nation.

The Access to Affordable Health Care Act will also expand access to affordable health care for individuals and families. One of the first bills that I sponsored when I came to the Senate was legislation to establish the State Child Health Insurance Program, which provides insurance for the children of low-income parents who cannot afford health insurance, yet make too much money to qualify for Medicaid. Since 1997, this program, which is known as SCHIP, has contributed to a one-third decline in the uninsured rate of low-income children. Today, over six million children--including approximately 14,500 in Maine--receive health care coverage through this remarkably effective health care program.

First, our legislation will shore up the looming shortfalls in SCHIP funding that 17 states--including Maine--will face in Fiscal Year 2007 to ensure that children currently enrolled in the program do not lose their coverage. Just prior to adjournment in December, the Congress approved legislation to partially address these shortfalls. That legislation, however, provides only about one-fifth of the funds needed. Our legislation will close that gap.

Our legislation also builds on the success of the SCHIP program and gives States a number of new tools to increase participation. The bill authorizes new grants for States and non-profit organizations to conduct innovative outreach and enrollment efforts to ensure that all eligible children are covered. States would also have the option of covering the parents of the children who are enrolled in programs like MaineCare. States could also use funds provided through this program to help eligible working families pay their share of an employer-based health insurance plan. In short, the legislation will help ensure that the entire family receives the health care they need.

And finally, to help make health coverage more affordable for low and middle-income individuals and families who do not have employer-provided coverage and who are not eligible for the expanded programs, our legislation would provide an advanceable, refundable tax credit of up to $1,000 for individuals earning up to $30,000 and up to $3,000 for families earning up to $60,000. This could provide coverage for up to six million Americans who would otherwise be uninsured for one or more months, and will help many more working lower-income families who currently purchase private health insurance with little or no government help.

To strengthen our nation's health care safety net, the Access to Affordable Health Care Act calls for a doubling of funding over five years for the Consolidated Health Centers program, which includes community, migrant, public housing and homeless health centers.

These centers, which operate in underserved urban and rural communities, provide critical primary care services to millions of Americans, regardless of their ability to pay. About 20 percent of the patients treated in Maine's community health centers have no insurance coverage and many more have inadequate coverage, so these centers are a critical part of our nation's health care safety net.

The problem of access to affordable health care services is not limited to the uninsured, but is also shared by many Americans living in rural and underserved areas where there is a shortage of health care providers. The Access to Affordable Health Care Act therefore calls for increased funding for the National Health Service Corps, which supports doctors, dentists, and other clinicians who serve in rural and inner city areas.

The legislation will also give the program greater flexibility by allowing National Health Service Corps participants to fulfill their commitment on a part-time basis. Current law requires all National Health Service Corps participants to serve full-time. Many rural communities, however, simply do not have enough volume to support a full-time health care practitioner. Moreover, some sites may not need a particular type of provider on a full-time basis. Our bill therefore gives the program additional flexibility to meet community needs.

As the Senate co-chair of the bipartisan Congressional Task Force on Alzheimer's Disease, I am particularly sensitive to the long-term care needs of patients with chronic diseases like Alzheimer's and their families.

Long-term care is the major catastrophic health care expense faced by older Americans today, and these costs will only increase with the aging of the baby boomers. Most Americans mistakenly believe that Medicare or their private health insurance policies will cover the costs of long-term care should they develop a chronic illness or cognitive impairment like Alzheimer's Disease. Unfortunately, far too many do not discover that they do not have coverage until they are confronted with the difficult decision of placing a much-loved parent or spouse in long-term care and facing the shocking realization that they will have to cover the costs themselves.

The Access to Affordable Health Care Act will provide a tax credit for long-term care expenses of up to $3,000 to provide some help to those families struggling to provide long-term care to a loved one. It will also encourage more Americans to plan for their future long-term care needs by providing a tax deduction to help them purchase long-term care insurance.

Health insurance alone is not going to ensure good health. As noted author and physician Dr. Michael Crichton has observed, ``the future of medicine lies not in treating illness, but preventing it.' Many of our most serious health problems are directly related to unhealthy behaviors--smoking, lack of regular exercise, and poor diet. These three major risk factors alone have made Maine the state with the fourth highest death rate due to four largely preventable diseases: cardiovascular disease, cancer, chronic lung disease and diabetes. These four chronic diseases are responsible for 70 percent of the health care problems in Maine.

Our bill therefore contains a number of provisions designed to promote healthy lifestyles. An ever-expanding body of evidence

shows that investments in health promotion and prevention offer returns not only in reduced health care bills, but in longer life and increased productivity. The legislation will provide grants to States to assist small businesses wishing to establish ``worksite wellness' programs for their employees. It would also authorize a grant program to support new and existing ``community partnerships,' such as the Healthy Community Coalition in Maine's Franklin County, to promote healthy lifestyles among hospitals, employers, schools and community organizations. And, it would provide funds for States to establish or expand comprehensive school health education, including, for example, physical education programs that promote lifelong physical activity, healthy food service selections, and programs that promote a healthy and safe school environment.

And finally, the Access to Affordable Health Care Act would promote greater equity in Medicare payments and help to ensure that the Medicare system rewards rather than punishes states like Maine that deliver high-quality, cost-effective Medicare services to our elderly and disabled citizens.

The Medicare Modernization Act of 2003 and subsequent legislation did take some significant steps toward promoting greater fairness by increasing Medicare payments to rural hospitals and by modifying geographic adjustment factors that discriminated against physicians and other providers in rural areas. The legislation we are introducing today will build on those improvements by establishing State pilot programs that reward providers of high- quality, cost-efficient Medicare services.

The Access to Affordable Health Care Act outlines a blueprint for reform based on principles upon which I believe a bipartisan majority in Congress could agree. The plan takes significant strides toward the goal of universal health care coverage by bringing millions more Americans into the insurance system and by strengthening the health care safety net.

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