Nomination of Michael O. Leavitt to be Secretary of Health and Human Services

NOMINATION OF MICHAEL O. LEAVITT TO BE SECRETARY OF HEALTH AND HUMAN SERVICES -- (Senate - January 26, 2005)

The PRESIDING OFFICER. Under the previous order, the Senate will proceed to the consideration of the Executive Calendar, which the clerk will report.

The assistant legislative clerk read the nomination of Michael O. Leavitt, of Utah, to be Secretary of Health and Human Services.

The PRESIDING OFFICER. Under the previous order, there will be 2 hours of debate on the nomination.

The Senator from Iowa, Mr. Grassley, is recognized.

Mr. GRASSLEY. Madam President, in the tradition of the work of the Senate Finance Committee--and that is basically described in one word, bipartisanship--we bring this nomination to the floor. We bring it with the unanimous approval of everybody on the committee, saying that Governor Leavitt should be the Secretary of Health and Human Services. He is a person who is very well qualified for this position, and we look forward to working with him on all of the quality-of-life issues that come before Congress, whether they deal with Social Security, Medicare, Medicaid, welfare--issues that are under the jurisdiction of this new Secretary to administer, and issues that are under the jurisdiction of the Senate Finance Committee for oversight.

During his tenure as Governor, he reduced the number of uninsured children through his work on the Children's Health Insurance Program, he made significant improvements to the child welfare system, and he significantly increased the number of those with health insurance coverage. So some of the things he has done as Governor are some of the things that we are working on in this committee, and some laws are already passed. He will have a chance to continue his good work on these issues in conjunction with us as a committee and directly himself as Secretary of Health and Human Services.

I am not alone in my high estimation of Governor Leavitt. The people of Utah recognize his strong leadership capabilities in reelecting him to three consecutive terms as Governor. Certainly big challenges lie ahead for this Department, as it does for our committee, and strong leadership in that Department is needed. I am glad it comes with Governor Leavitt.

First and foremost, there are an estimated 45 million Americans who lack basic health coverage, and those numbers seem to have been increasing every year. As Secretary, his leadership will be called upon to propose innovative ways that we can help contain costs and increase access to health insurance and the health care resulting from that insurance.

The Medicaid Program will also be a key issue this year. Medicaid provides health care coverage and benefits for low-income individuals and families. It is now the largest Federal care program in terms of total spending and served about 51,000 people in 2002.

It was originally enacted in 1965, and many have suggested it has not kept up with the times. Increasingly, States have been forced to rely upon what we call the 1115 waiver process to manage the program to fit the needs of their State. These waivers are negotiated with little congressional oversight. I look forward to working with Governor Leavitt to ensure that the Medicaid Program is functioning as effectively as it ought to function.

There is the issue of SCHIP, the State Children's Health Insurance Program. Madam President, $1.1 billion in SCHIP allotments expired last year and were returned to the Treasury. In addition, there are anywhere from 4 million to 6 million children currently uninsured who could qualify for this program.

Over the next 3 years, a growing number of States, including my own State of Iowa, are projected to consume their Federal SCHIP allotment.

When this happens, they will lack the Federal funds necessary to provide their current level of coverage and also the level of benefits for low-income children.

We need to recapture the $1.1 billion in SCHIP funds, increase our outreach effort to enroll more children, and revitalize the SCHIP program so it is on firm financial footing.

Finally, we need to enact improvements to the 1996 welfare reform bill. We have debated this issue now for 3 years. It is time for action. The numerous short-term extensions are disruptive to the program. I look forward to working with Governor Leavitt to get a welfare bill sent to the President this year. I think that process is starting with the usual bipartisan cooperation between Senator Baucus's side of the aisle and his leadership and the Republicans who I lead.

The Department also has the important job of implementing the new Medicare prescription drug benefit. Under Dr. McClellan's leadership, the Centers for Medicare and Medicaid Services has accomplished an impressive workload over the last year.

Dr. McClellan and the staff at the Centers for Medicare and Medicaid Services are to be commended for their long hours, hard work, and, most importantly, a dedication to doing the best they can.

This is a crucial year for the drug benefit that was passed and signed by the President in 2003. I look forward to working with the Governor on this particular issue and continuing the close working relationship with Dr. McClellan.

Medicare still faces significant challenges to be sure. Medicare spending grew by 5.7 percent in 2003, and as spending continues to increase, there is a growing need to restrain its growth.

Many have said rising costs and health care can be contained and health care quality improved by paying providers based on their performance and by utilizing health information technology.

The Department has taken significant steps to reduce health care costs and provide better care through chronic care management initiatives and additional preventive benefits that were in the 2003 legislation.

The Department also called upon Dr. Brailer, as the National Coordinator for Health Information Technology, to develop, maintain, and oversee a plan focused on a nationwide adoption of health information technology in both the public and private sectors.

Bringing these initiatives together to reward quality and efficiency while reducing medical errors and duplication will be one of the major undertakings in health care over the next decade, and strong leadership at Health and Human Services is needed to make that happen.

Another issue on which the Governor's leadership is needed is the importation of prescription drugs from Canada and other developed nations. That surely is a controversial issue that hopefully we can debate in the Senate, because the law must be changed to make that happen. American consumers are demanding lower prices for prescription drugs, and I believe that legalizing importation under conditions that ensure safety is the right thing to do.

I look forward to working with my colleagues on both sides of the aisle to craft legislation that will pass Congress and be signed by the President.

I would also be remiss if I did not address an issue that continues to be of great concern. The frail and elderly residing in our Nation's nursing homes deserve high-quality care. I am confident that with Governor Leavitt's help, we can ensure that they receive no less.

Besides these issues, the Department faces other significant challenges. I have always taken responsibility of conducting oversight over the executive branch operations very seriously, and I will continue to do that as chairman again. Government truly is the people's business, and Americans have the right to know what their Government is doing and how it spends their money. Transparency in Government, coupled with aggressive oversight by Congress, is critically important in helping to make Government transparent, more effective, more efficient, and more accountable to the taxpayers, program participants, and beneficiaries.

I am also a firm and ardent supporter of whistleblowers. Historically, whistleblowers have been key to uncovering waste, fraud, and abuse. Unfortunately, whistleblowers are often as welcome in an agency as a skunk at a picnic.

I look forward to addressing these problems with Governor Leavitt. Taking a closer look at Medicaid, SCHIP improvement, implementation of the new drug benefit, importation of prescription drugs, enactment of welfare reform, and the advancement of information technology and quality in health care as a reimbursement tool are just some of the priorities I look forward to addressing with Governor Leavitt.

I close by urging my fellow colleagues to support Governor Leavitt in his nomination as Secretary of Health and Human Services. It is a major commitment that requires personal sacrifices on many levels, although I believe Governor Leavitt and his wife Jackie are the right team for this job. I also thank President Bush for his choice of such a qualified and competent candidate.

I thank Senator Baucus not only for his cooperation on this effort, but we have had 4 years now of cooperative effort, and we expect that to continue. I know he is committed to that.

I yield the floor.

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