American Recovery And Reinvestment Act Of 2009
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Mr. SPECTER. Mr. President, I seek recognition to support an amendment being offered by Senator Schumer to reverse a recent Centers for Medicare and Medicaid Services, CMS, regulation reducing payments to hospice service providers. This amendment is also cosponsored by Senators ROCKEFELLER, STABENOW, WYDEN and ROBERTS.
In October 2008, CMS finalized a rule that cut hospice reimbursement under Medicare. This reduction limits the ability of hospice providers to provide comprehensive, high quality end-of-life care to Medicare beneficiaries and their families. In 2008, an independent study from Duke University, clearly demonstrating the cost savings associated with hospice care, noted, ``Given that hospice has been widely demonstrated to improve quality of life of patients and family members ..... the Medicare program appears to have a rare situation whereby something that improves quality of life also appears to reduce costs.''
During the 110th Congress, in response this regulation, I introduced S.3484, the Hospice Protection Act, to reverse the CMS regulation. The bill received bipartisan support and garnered thirty five cosponsors however we were not able to move the legislation forward. The economic stimulus legislation offers an opportunity to correct a misguided regulation that has put an estimate 3,000 individuals out of work. During these economic times the Federal Government should not be putting forth regulations that not only hurt beneficiaries but harm the workforce.
While this amendment provides a number of jobs, I am concerned that the amendment is not offset and the cost of the bill may increase the cost of the overall bill. As a cosponsor of this legislation, I will work to ensure that the cost of this amendment is paid for without increasing the cost of the bill. I encourage my colleagues to support this amendment and to work with the sponsor and cosponsors of this amendment to ensure its inclusion in the economic stimulus package.
ARMY CORPS OF ENGINEERS
Mr. President, I seek recognition to comment on my cosponsorship of an amendment to H.R. 1, the Economic Recovery Act, which would increase funding in the bill for the U.S. Army Corps of Engineers by $4.6 billion. I am cosponsoring this amendment, offered by Senator Landrieu, because the funding will support construction of critical infrastructure projects across the Nation. At the Port of Pittsburgh alone, there is over $580 million worth of shovel-ready lock and dam work that could be started in 6 months. These structures support the transportation of bulk commodities to industries that depend on them. Failure at any of these locks and dams would have dramatic economic consequences, as the Port of Pittsburgh generates over $13 billion in economic activity and supports over 200,000 jobs. Not only does the long-term modernization of these structures increase the economic competitiveness of domestic manufacturing industries, but they create immediate jobs in the construction industry. This is just one example of the type of economic stimulus that funding for the U.S. Army Corps of Engineers can provide. There are more examples across Pennsylvania and the Nation.
However, despite my cosponsorship of this amendment due to its potential for stimulus, I am not committed to voting for it without an offset. Since adopting this amendment would add $4.6 billion to the size of the bill and increase the national deficit, an offset to reduce spending elsewhere in the bill by an equal amount would be preferable. We should make every effort to identify offsets to reduce the total size of the economic recovery bill.
RESCISSION OF HIGHWAY FUNDS
Mr. President, I seek recognition to comment on my cosponsorship of an amendment to prevent Federal highway funds from being rescinded. SAFETEA-LU requires that $8.7 billion in unobligated contract authority balances held by States be rescinded on September 30, 2009. This rescission will cut Pennsylvania's road and bridge program by $380 million in fiscal year 2010. That is why I am cosponsoring an amendment offered by Senators BAUCUS and BOND to prevent this rescission from happening.
However, I am not committed to voting for this amendment if it does not contain an offset. Since preventing this rescission will add $8.7 billion in new budget authority, an offset is needed to make its budgetary impact neutral. We should make every effort to identify offsets to reduce the total size of the economic recovery bill.
Mr. President, I seek recognition to speak on an amendment I am offering to the American Recovery and Reinvestment Act of 2009. This amendment would provide $3 billion for the purpose of redeveloping Brownfields and neglected urban properties. The $3 billion would be equally divided between the EPA Brownfields Program, the Brownfields Economic Development Initiative at the Department of Housing and Urban Development and the Urban Development Action Grant Program, also at HUD.
In 2001, I cosponsored the Brownfield's Revitalization and Environmental Restoration Act. This legislation led to the creation of the EPA Brownfields Program, and a similar program at the Department of Housing and Urban Development.
Abandoned industrial sites are common blight on the landscape in many towns and cities across Pennsylvania and the nation. Turning these industrial sites into developments, either for residential or commercial use, provides an obvious benefit: an eyesore is replaced by a new community, and economic growth is generated.
Traditional lenders are reluctant to lend initial money to brownfield development projects for a number of reasons. Liability concerns, and the fact that the cleanup costs may exceed the property's actual value, are among them. By providing seed money that redevelopers are often unable to obtain from traditional sources, the Brownfield Program spurs development and economic growth in struggling regions throughout the country.
It is estimated that every $1 invested in brownfield redevelopment leads to $15 to $20 in economic activity. I am told an investment in traditional infrastructure yields about $1.56 for every $1 invested. The proposed economic stimulus legislation provides $100 million for Brownfield redevelopment. Of that amount, the Congressional Budget Office projects that 85% could be spent within the two year time frame.
This number is insufficient. I recently met with a Pennsylvania company specializing in brownfields redevelopment. This company alone has fifteen projects that could break ground within 120 days if granted approximately $280 million in support. These projects alone could create tens of thousands of jobs and billions of dollars in economic activity.
The Congressional Budget Office has estimated that 85 percent of the funding provided by the stimulus could be spent within the 2-year window. They base their figure off the historic spending patterns at the program.
In light of the economic benefit of these projects, I recommend that we provide $3 billion to these programs.
Mr. President, I seek recognition on my amendment to remove the prompt pay provision from the calculation of Medicare Part B drug pricing.
The prompt pay discount is a discount from the pharmaceutical manufacturer to the wholesaler for prompt payment on prescription drugs. The current Medicare payment calculation requires that this prompt pay discount be included in the calculation of average sales price, which forms the basis for the Medicare drug reimbursement provided by the manufacturer. This effectively lowers the average sales price thus artificially lowering drug reimbursement to physicians. This amendment would remove the prompt pay discount from ASP, requiring CMS to reimburse physicians based on the price they actually pay for drugs without the inclusion of discounts.
The reduced payment for Medicare Part B drugs has adversely affected physicians since its implementation. This compounded with the current economic downturn. is resulting in cancer clinic closings and staff layoffs. It is estimated that in medical specialties that have the highest usage of Medicare Part B drugs, over 12,000 individuals are at risk of losing their jobs. This not only harms the economy, it hurts cancer care.
I am very concerned that the cost of the economic stimulus bill is growing too large. To ensure that this does not contribute to that growth I am offsetting the cost of this bill by reducing funds to the Office of the Secretary of Health and Human Services. After the estimated cost of this bill of $400 million, the Office of the Secretary will still receive $700 million to examine comparative clinical effectiveness. I encourage my colleagues to support this amendment.
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