Statements on Introduced Bills and Joint Resolutions
Floor Speech
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By Mr. DURBIN (for himself, Mr. Johnson of South Dakota, and Mr. Reed):
S. 1452. A bill to promote simplification and fairness in the administration and collection of sales and use taxes; to the Committee on Finance.
Mr. DURBIN. Mr. President, ``Level the Playing Field.''
When I ask small business owners what they would like the Federal Government to do to help them thrive, the answer I most frequently hear is, ``level the playing field.''
It may be a cliché, but there's truth to it. Most small businesspeople don't want a government handout. They don't want special treatment. They just want to be able to compete fairly against other businesses.
That is why I am introducing the Main Street Fairness Act.
If you are a small business owner in Peoria or Springfield or Alton, you compete against neighboring businesses down the street and, increasingly, with sellers on the internet. The businesses down the street have to collect the same State sales taxes that you do. But, many internet sellers don't.
That means internet sellers have a built-in price advantage. That isn't fair, and it's not a level playing field.
The Main Street Fairness Act would address that. The bill would give Congressional endorsement to the Streamline Sales and Use Tax Agreement, which 45 States and the District of Columbia created years ago to help make it feasible for businesses selling online to collect State and local sales taxes already owed.
Why is this Agreement necessary? The Supreme Court ruled in the early '90s that the maze of current sales tax rules and rates was too complex to expect online retailers to comply. The States worked together to address that problem.
The Main Street Fairness Act says that any State that wants to do so can require online retailers to collect the same sales taxes that Main Street businesses collect, provided that small online retailers are exempt, online retailers are compensated for any startup administrative costs associated with collecting sales taxes, and all retailers are treated equally regarding sales tax collection.
Let me be as clear as I can on one point: this bill is NOT a tax increase.
It doesn't amend the Internal Revenue Code in any way. It simply provides states the option to require all retailers to collect the sales taxes that are already owed.
The Main Street Fairness Act provides two other big benefits.
First, consumers will no longer be asked to itemize the sales taxes they owe from their online purchases on their year-end tax forms. Few consumers comply with the law today--most don't know they should--but the Main Street Fairness Act would eliminate the need to do so.
Second, State and local governments would collect taxes that are already owed.
It is no secret that many States and cities, including the State of Illinois and local governments across my State, are struggling to balance their budgets.
The State of Illinois estimates that we lose as much as $153 million each year in unpaid taxes on internet sales alone.
Passing the Main Street Fairness Act would help State and local governments balance their budgets without cutting spending or raising new taxes.
The Main Street Fairness Act is supported by the National Governors' Association, National Conference on State Legislatures, Governing Board of the Streamlined Sales and Use Tax Agreement, National Retail Federation, International Council of Shopping Centers, Retail Industry Leaders Association, and the National Association of Real Estate Investment Trusts.
The Main Street Fairness Act will level the playing field for our small businesses. I urge its passage.
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By Mr. DURBIN (for himself, Mr. COCHRAN, Mr. BROWN of Massachusetts, Mr. LEVIN, Mr. CARDIN, Mr. SCHUMER, and Mr. INOUYE):
S. 1454. A bill to amend title XVIII of the Social Security Act to provide for extended months of Medicare coverage of immunosuppressive drugs for kidney transplant patients and other renal dialysis provisions; to the Committee on Finance.
Mr. DURBIN. Mr. President, today I am introducing the ``Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act'' with my colleagues Senators COCHRAN, LEVIN, CARDIN, SCHUMER, INOUYE, and BROWN of Massachusetts.
The Centers for Disease Control and Prevention estimates that about 13 percent of American adults, 26 million people, have chronic kidney disease. Some of these individuals can improve their condition with medication and lifestyle changes, but approximately half a million of them have irreversible kidney failure, or end-stage renal disease, ESRD. These patients require dialysis or a kidney transplant to survive.
Organ transplantation is a medical success story. Thousands of transplants are done every year, and for the patients fortunate enough to receive a donated organ, the quality and length of their lives can be dramatically improved. Of the more than 28,000 transplants performed in 2010, over 16,898 of them were kidney transplants.
A large portion of these kidney transplants were paid for by the Medicare system, which provides healthcare to aged and disabled Americans, as well as those living with ESRD. Medicare also covers dialysis for patients who have not received a donor kidney and immunosuppressive drugs for kidney transplant recipients. Organ transplant recipients must take immunosuppressive drugs every day for the life of their transplant to reduce the risk of organ rejection.
In 2000, Congress wisely eliminated the 36-month time limitation for aged and disabled beneficiaries who had Medicare status at the time of transplant. So today, for an older or disabled person on Medicare, immunosuppressive drugs are covered by Medicare for the life of the transplant.
However, we still have an unfair and unrealistic gap in coverage for people with ESRD who are neither disabled nor elderly. For those transplant recipients, Medicare coverage, including coverage of immunosuppressive drugs, ends 36 months after transplantation. Without regular access to immunosuppressive drugs to prevent rejection, many patients find themselves back in a risky and frightening place, in need of a new kidney. This is economically inefficient and morally wrong.
Since Medicare covers the cost of the transplant for end stage renal disease, it makes sense for Medicare to preserve this investment by covering anti-rejection drugs. It would be far less expensive for Medicare to cover immunosuppressive drugs at a cost of $10,000 to $20,000 a year than to pay for dialysis at $78,000 a year or another transplant at a cost of $110,000 if a patient's kidney fails and he is once again eligible for Medicare coverage.
I am pleased to introduce the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act along with my colleagues. This legislation would allow kidney transplant recipients to continue Medicare coverage for the purpose of immunosuppressive drugs only. All other Medicare coverage would end 36 months after the transplant.
It is time to pass this legislation to provide continuous coverage for immunosuppressive drugs through Medicare. My legislation will reduce the need for dialysis and kidney re-transplants and provide reliable, sustained access to critically important, life-saving medications for thousands of Americans. In both moral and economic terms, this is the right decision.
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