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By Mr. KENNEDY (for himself, Mr. HARKIN, Ms. MIKULSKI, Mrs. MURRAY, Mr. REED, Mr. LEVIN, Mr. LAUTENBERG, Mrs. BOXER, Mr. DORGAN, Mr. SCHUMER, Ms. CANTWELL, Mr. CORZINE, Mr. DAYTON, and Ms. STABENOW):
S. 1012. A bill to amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to protect consumers in managed care plans and other health coverage; to the Committee on Finance.
Mr. KENNEDY. Mr. President, it is time for a new effort in Congress to enact the Patients' Bill of Rights. The Senate has approved major bipartisan legislation to end the abuses of managed care and HMOs before, but final enactment of this important measure was blocked by the HMOs and the vested interests of the corporate world that deny working Americans their basic rights and a needed voice in challenging decisions that deny them basic medical care. It was blocked too by an administration that professes to support patients' rights, but does all it can to block legislation to guarantee those rights.
Despite our outstanding researchers and professionals, families across the country are overwhelmingly and justifiably concerned that medical decisions are too often made by insurance industry accountants, and not their doctors. HMO profits too often take priority over patient needs. It is time for Congress to end the abuses of patients and physicians by HMOs and the insurance industry. Too often, managed care is mismanaged care. No amount of distortions or smokescreens by insurance companies can change the facts.
The Patients' Bill of Rights can stop these abuses. For millions of Americans who rely on health insurance to protect them when serious illness strikes, the Patients' Bill of Rights is literally a matter of life and death.
It's important to remember what this debate is really about. It's not about lawyers. It's not about insurance companies. It's about patients--mothers and daughters, fathers and sons, sisters and brothers. It's about families around the country who will someday face the challenge of serious illness and deserve the best in health care--the same care that all members of the Senate want for ourselves and our loved ones. But too many families are denied the care they need and deserve because of abuses by HMOs and other insurance companies.
The legislation we are introducing today will end those abuses. Several of its provisions are especially important--specialty care, clinical trials, and prescription drugs.
In each of these areas, care is too often delayed or denied by insurance companies more interested in profits than patients. Access to specialty care for serious and complex illnesses is a critical element of good health care. Yet denial of needed specialists is one of the most common abuses in the current system.
Patients with cancer and other serious illnesses need specialty care. Often, their best hope for a cure or for precious extra years of life is participation in a clinical trial. But too often, both are lacking. Patients with cancer or other serious illnesses and their physicians must fight HMOs to take advantage of this opportunity.
Traditionally, insurance companies have paid for the routine costs of doctors and hospitals in clinical trials. But HMOs frequently refuse to do so, with devastating effects on patients and research alike. Our legislation will end this abuse.
Another abuse that will be ended by our plan is the denial of medically necessary drugs not on an HMO plan's list. One group that suffers from this denial is the mentally ill. Some of the most dramatic advances in medicine in recent years have been the development of effective drugs to treat persons with serious mental illness. Too often, however, they're told to settle for older, cheaper, less effective drugs with harmful side effects, because an HMO refuses to pay for the best standard of care.
Our legislation guarantees that patients can get medically necessary drugs, even if they are not on the HMO's list. Equally important, our bill guarantees that these drugs will be provided at a cost no greater than the normal cost-sharing for other medications. Access to needed drugs is a concern for every family, particularly when new cures are increasingly based on new drugs today.
The list of abuses goes on and on. People across the country know these abuses are wrong. Managed care practices that cause these tragedies cost lives, and ending these abuses is a matter of simple justice and common decency.
The Patients' Bill of Rights will protect families from insurance company bureaucracies that rob them of their peace of mind, their health, or even their lives. The bill is a guarantee that medical decisions will be made by doctors and patients, not managed care accountants. It is actively supported by doctors, nurses, patients, small businesses, religious organizations, and working families. The support is impressive in its breadth, its depth and its diversity.
It is time to guarantee these basic rights for patients. It is time for Congress to pass this bill. Every doctor knows it. Every nurse knows it. Every patient knows it. And every Senator knows it too.
I ask unanimous consent that the text of the bill be printed in the RECORD.
There being no objection, the bill was ordered to be printed in the RECORD, as follows:
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Mr. KENNEDY. Mr. President, It is a privilege to join my colleagues in introducing this bipartisan bill to reauthorize the Workforce Investment Act and increase the opportunities for workers to obtain the services and training they need to hold good jobs in the years ahead.
This bill strengthens the current One-Stop system we established in 1998, so that many more people can be served. The bill creates stronger partnerships with businesses to recruit new workers, collaborate in training current workers, improve career ladder opportunities, and work with local leaders to meet the changing needs of their community.
The One-Stop system is needed more than ever now, to serve hard-working Americans who have lost their jobs through no fault of their own as we struggle to rebuild our economy and adjust to the new century and the globalization forces that are transforming our society and our workforce. Current employees, especially the growing number of manufacturing workers, need effective training to be eligible for the available jobs in their area.
We have also worked to remove the sequencing of services for persons entering the workforce who face barriers to employment. Providers can move adults directly to skills training, or create training programs that include literacy and language skills as well, so that job training is not delayed.
The bill also encourages local providers to continue the training programs until employees can be self-sufficient. For those who start on the minimum wage, the support system should be there to help them qualify for the better-paying jobs that will enable them to support their families. Some men and women may obtain their first job through the system, and continue to participate as they move up their career ladders.
The bill will also help young people. Last summer, the youth unemployment rate rose to 17 percent and we were all acutely aware of the special challenges that young workers face in this economy. The youth program will continue to work with both in-school and out-of-school young men and women to help them obtain the education and the real job experience they need to be competitive.
The bill pays particular attention to the needs of people with disabilities. Their access to the program is essential if the system is to be truly universal. It's unacceptable today that hundreds of thousands of people with disabilities are unable to find employment. Workforce training programs must coordinate with vocational rehabilitation programs to provide many more opportunities for those with physical and mental challenges.
For over thirty years, since the Vocational Rehabilitation Act was first enacted in 1973, state vocational rehabilitation programs have brought new hope to individuals with disabilities throughout the country, so that they can reach their full potential and actively participate in their communities.
Through vocational rehabilitation, individuals with disabilities can obtain the training, counseling, support and job opportunities they need in order to have independent, productive, and fulfilling lives. For millions of these Americans, vocational rehabilitation is the difference between dependence and independence, between lost potential and a productive career.
In 1998, vocational rehabilitation became part of the state-wide workforce system in each state. This reauthorization will strengthen that partnership, so that many more working-age individuals with disabilities, even those with the most significant challenges, have realistic opportunities to obtain the services and support they need to reach their employment goals.
The legislation also strengthens other aspects of independent living, so that students and adults with disabilities can receive the services and support they need for community-based living.
Our goal in this reauthorization is to see that the talents and strengths of all individuals with disabilities are recognized, enhanced, and fairly rewarded in communities and workplaces across the nation.
The bill also contains the Adult Literacy Act, which funds critical programs for states to assist adults in obtaining the basic reading, writing, numeracy and English language skills that they need to be full participants in the workplace and in society.
We all know that education is the great equalizer. Improving basic literacy is a key component of job training. Large numbers of persons are on waiting lists across the country to be served under this program--25,000 people in Massachusetts alone--and we need to do more to serve adults who recognize their need to improve these skills in order to improve their lives.
I commend my colleagues and the many organizations representing governors, mayors, county officials, youth, women, and low-income persons who were so actively involved in preparing this legislation. We have tried to listen carefully to the many leaders who have practical experience in implementing these laws.
I look forward to continuing this bipartisan effort and to the early enactment of this needed legislation.
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By Mr. MCCAIN (for himself, Mr. Kennedy, Mr. Brownback, Mr. Lieberman, Mr. Graham, and Mr. Salazar):
S. 1033. A bill to improve border security and immigration; to the Committee on the Judiciary.
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Mr. KENNEDY. Mr. President, it's an honor to join Senator MCCAIN and Congressmen GUTIERREZ, KOLBE, and FLAKE in introducing our bipartisan legislation to reform the Nation's immigration laws. The status quo is unacceptable, and legislation is urgently needed to deal with all the inadequacies in our current law, to end the suffering of long-separated families imposed by the broken system, and to do so in a way that reflects current realities.
We must modernize our broken immigration system to meet the challenges of the 21st century. And we need policies that continue to reflect our best values as a nation--fairness, equal opportunity, and respect for the rule of law.
One of the mistakes of the past is to assume that we can control illegal immigration on our own. A realistic immigration policy must be a two-way street. Under our plan, America will do its part, but we expect Mexico and other nations to do their part, too, to replace an illegal immigration flow with regulated, legal immigration.
Our bill will make our immigration policies more realistic and enforceable, restore legality as the prevailing norm, and make it easier for immigrants to cooperate with local authorities. It will protect the labor rights of all workers, and create an even playing field for employers. It will strengthen our economy, restore control of our borders, and improve national security.
Much of the Nation's economy today depends on the hard work and the many contributions of immigrants. Many industries depend heavily on immigrant labor. These men and women enrich our Nation and improve the quality of our lives. Yet, millions of today's immigrant workers are not here legally. They and their families live shadow lives in constant fear of deportation, and easy targets for abuse and exploitation by unscrupulous employers and criminals as well. Many risk great danger, and even death, to cross our borders.
Our bill offers practical solutions to deal with these basic problems. It contains an earned legalization program for immigrants who have been working in the United States for at least 6 years, a way to reduce the enormous backlog of petitions to unify immigrant families, and a revised temporary worker program. The bill also contains strict border security and enforcement provisions, and measures to ensure that other countries do their part by requiring them to help control the flow of their citizens to jobs in the United States.
We feel the bill is a realistic and practical solution to the complex immigration challenges facing the Nation for so long, and we've worked closely with as many interested groups as possible to make it fair to all.
Despite our compromises and bipartisan solutions, there are some who oppose these reforms. They misleadingly categorize our efforts as ``immigrant amnesty.'' They refuse to accept that these reforms simply create a legalization program for U.S. workers who have already been residing and working in the U.S. It is not a guarantee of citizenship, but an opportunity to continue working hard, start playing by the rules, and earn permanent residency.
And by bringing immigrants out of the shadows so they can earn a fair day's pay for a fair day's work, we are protecting American workers' rights and wages, too.
The legal status must be earned by proving past work contributions, making a substantial future work commitment, and paying of $2,000 in penalties.
First, workers will receive temporary resident status, based on their past work contributions. To earn permanent residence, they must work 6 more years. Otherwise, they will be dropped from the program and required to leave the country.
It's not an amnesty for them, because they have to earn it. We offer a fair deal: if they are willing to work hard for us openly, then we're willing to do something fair for them. It is the only realistic solution.
If there's any amnesty involved, it's what they have today--an acquiescence in their presence, because countless businesses could not function without them since no American workers can be found to fill their jobs. To be eligible for legal status, applicants must have no criminal or national security problems. All will be required to undergo rigorous security clearances. Their names will be checked against the government's criminal and terrorist databases, and the applicant's fingerprints will be sent to the FBI for a thorough background check.
It's long past time to put the underground economy above ground, and recognize the reality of immigrants in our workforce. It's the only way to achieve effective enforcement rules to protect and strengthen our labor system, and to stabilize our workforce for employers.
Our bill allows long-term, tax-paying immigrant workers to apply for earned adjustment of status. Studies show that there are now millions of illegal immigrants working in the U.S., and it would be irresponsible to continue to ignore this hidden past of our economic landscape.
Our bill is also about fairness. It ensures that the rights of all workers are protected--that the rights to organize, to change jobs between employers, and to have fair wages, fair hours, and fair working conditions--cannot be denied. Through this legislation, America can be proud again that our Nation protects the safety and rights of all our workers.
Our legislation is also about protecting families. Family unity has always been a fundamental cornerstone of America's immigration policy. Yet, millions of individuals today are waiting for immigrant visas to join with their families.
Our bill will allow these families to be reunited more quickly and humanely. It also removes and amends unnecessary obstacles in current law that separate families, such as the affidavit-of-support requirements and the rigid bars to admissibility. Our bill contains provisions that will expedite visas to reunite spouses and children of legal immigrants with their loved ones. It also provides measures to clear up the backlog of employment-based visas.
In addition, this bill recognizes the need for strong border protection and enforcement as part of immigration reform. It directs the Secretary of Homeland Security to develop and implement a National Strategy for Border Security to coordinate the efforts of Federal, State, local, and tribal authorities on border management and security. The Strategy will identify the areas most in need of enforcement and propose cost-effective ways to defend the border, including better ways of technology, improved intelligence-sharing and coordination. It also includes plans to combat human smuggling.
To further improve border enforcement, the bill improves the security of Mexico's southern border and assesses the needs of Central American governments in securing their borders. It provides a framework for better management, communication, coordination, and immigration control for all our governments, and encourages other governments to control alien smuggling and trafficking, prevent the use and manufacture of fraudulent travel documents, and share relevant information.
The bill also encourages so-called circular migration patterns. It provides for unprecedented cooperation with the governments of the United States, Canada, Mexico, and other Central American countries on issues of migration. It asks foreign countries to enter into agreements with the U.S. to help control the flow of their citizens to jobs in the U.S., with emphasis on encouraging the re-integration of citizens returning home.
It also encourages the U.S. government to partner with Mexico to promote economic opportunity back home and reduce the pressure for its citizens to immigrate to the U.S. It encourages partnership between the U.S. and Mexico on health care, so that we are not unfairly burdened by the cost of administering health care to Mexican nationals.
Further, the bill mandates that immigration-related documents issued by DHS be biometric, machine-readable, and tamper-resistant. It creates an Employment Eligibility Confirmation System, so that employers can verify an employee's identity and employment authorization, and an improved system to collect entry and exit data to determine the status of aliens after their arrival to and departure from the U.S. It protects against immigration fraud by improving regulations on who may appear in immigration matters.
Another important component of our bill is its State Criminal Alien Assistance Program, to reimburse states for the direct and indirect costs of incarcerating illegal aliens.
We know that these reforms are long overdue. The illegal workers here today are not leaving, and new ones continue to come in. A significant part of the workforce in many sectors of the economy, especially agriculture, is undocumented. Massive deportations are unrealistic as policy, impractical to carry out, and unacceptable to businesses that rely heavily on their labor.
Americans want and deserve realistic solutions to the very real immigration problems we face. They don't want open borders, and they don't want closed borders. They want smart borders, which mean fair and realistic immigration laws that can actually be enforced, immigration laws that protect our security, respect our ideals, and honor our heritage as a Nation of immigrants.
America has been the Promised Land for generations of immigrants who have found haven, hope, opportunity and freedom here. Immigrants have always been an indispensable part of our Nation. They have contributed immensely to our communities, created new jobs and whole new industries, served in our armed forces, paid their taxes, and help make America the continuing land of promise it is today.
It's obvious why the Nation's founders chose ``E Pluribus Unum''--``out of many, one'' as America's motto two centuries ago. These words, chosen by Benjamin Franklin, John Adams, and Thomas Jefferson, referred to their ideal that tiny quarreling colonies could be transformed into one Nation, with one destiny. That basic ideal applies to individuals as well. Our diversity is our greatest strength.
We are a Nation of immigrants, and we always will be, and our laws must be true to that proud heritage. Our bipartisan bill attempts to do that, and I look forward to working with the Administration and our colleagues on both sides of the aisle to enact it into law.
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