i'd like to read a couple of those letters, if i could. i will read a few of these much there are many letter. my name is ada bennett. i suffered from a heart attack i'm a member of the silver sneakers. it has helped my life immensely. treatment i received at the silver sneakers greatly increased the quality of life after my heart attack. i hope that's not cut. that's medicare advantage. here's the last one i will read on this. i would like toak to express thd for the silver sneakers to continue. i have participated in three years. i cannot tell you the difference it has made since joining the program. i have not felt better healthwise since joining the silver sneakers program. my overall well-being has improved. i go to the gym three times a week. i look forward to this physical

activity. i feel better that my joints an body are in better shape than ever. i feel i have improved my immune system and go to the doctor less than when i did not participate in this program. i'm retired with a fixed income. and it would be difficult for me to have to pay for a gym membership if this program were to be eliminated. so i ask you to please consider keeping this program. look, the silver sneakers program is a prevention and wellness program. almost all of us, if honest about it, if we can get our seniors out there walking, exercising and doing the things that will help them to stay vibrant and alert an physically -- and physically well, and it saves us billions of dollars. it is a small part of medicare advantage. i thought i would cover it because it has been so maligned by some who when woo did it were really happy if you read at least the "help" bill, there is

a lot about wellness and taking care of yourself. well, in conclusion, i cannot support any bill that would jeopardize health care coverage for medicare beneficiaries. i believe if the bill before the senate becomes law, medicare recipients could be in serious trouble. i've been in the senate for over 30 years. i've co-authored man wh many heh care bills since i joined the senate in 1977. as almost everyone in this chamber, i want a health care as -- as much as anyone in chamber, i want a health reform bill to be enacted this year. every republican does. but we want it to be bipartisan. we want it to be something we can -- both sides can be proud of. like the chip bill that had a huge bipartisan vote. this is one-sixth of the american economy. if it doesn't get 75 to 80 votes, it's allowsy bill.

i want it to be done right. history shows that it needs to be done right. if it is done right, it needs to be a bipartisan vote that passes with a minimum of 75 to 80 votes. we did it in 2003 when we considered the medicare legislation, we did it on a raft of bills that i've been a major player in. there's never been a bill of this magnitude affecting so many american lives that has passed this chamber on an almost straight party line vote or maybe just a straight party line vote. the u.s. senate is not the house. this body has a different constitutional mandate than the house. we are the deliberative body. we are the body that has in the past and should today be working through these difficult issues to find clear consensus. true bipartisanship is what is needed here. in the past the senate has approved many bipartisan health care bills that have eventually been signed into law. i mentioned a few, the balanced budget act of 1997 which

included the chip program. that was a hatch-kennedy bill. the ryan white act. i named ryan -- the bill after ryan white who died from aids. with his mother sitting in the audience. i stood here and named it the ryan white act. the orphan drug aght. the american with disability conviction act. the hatch-waxman act which created the modern generic drug industry. these are a few of the success stories. i could go through a whole bunch of others. if the senate passes this bill in its current form with a razor shin margin of 60 votes, this will become one more example of the arrogance of power since the democrats secured a 06-vote majority in the united states senate and took over the house and white house. i dreamed someday of the republicans having 60 votes. i think we would have a total responsibility to get this country under control and i believe we would.

but we've never come close to that. there are essentially no checks or balances found in washington today. just an arrogance of power with one party ramming through unpopular and devastating proposals 1 after the other. let me talk now about other negative impacts of this bill at a time when we are in a terrible recession with a current unemployment rate of 10.2%. and that's not the real rate. can i tell you right now if you -- i can tell you right now if you take away some of part time and other statistics, we're really at an effective 17%. the reid bill is a job killer. it has a disproportionate impact on small businesses. this torve contains -- 2,074-pages contains taxes and fees which will affect small businesses, which is the 70% of small jobs are created by the business sector. according to the recent survey

50% of small businesses pay taxes at the individual level through those who report income of $24,000 and will be hit hardest with their mandate, job killing employer mandate in this bill. this is small business. this isn't a large corporate world. it's small business where most of the jobs come from. every dollar lost in new taxes on these businesses will be a dollar taken away from job creation. the reid bill includes a job killing employer mandate. more specifically, it contains a $28 billion new tax penalty on employers for failing to provide coverage. economist an c.b.o. both agree this will hurt employee wages an job creation. that's economists and c.b.o., the congressional budget office. according to th -- to the congressional budget office, although this new tax is levied on employers, it is the -- quote -- workers in those

firms who would ultimately bear the burden of those fees." in the form of reduced compensation. the senate on budget and policy priorities has stated that the employer mandate will have a disproportionate impact on hiring practices for low and moderate-income families. this is the very most important segment in need of help. the reid bill increases the medicare payroll tax. in fact, it imposes a a $54 billion payroll tax increase at a time when we as a nation are struggling with an unemployment rate of 10.2% and an underemployment rate that i have been speaking about of 17.5%. in addition, the reid bill fails to lower premiums. instead of lowering skyrocketing health care premiums for small businesses across the nation, this $2.5 trillion bill, according to the congressional budget office, will largely maintain the status quo of 5% to 6% yearly increases in premiums for small businesses.

why? the combination of heavy-handed regulations and a laundry list of new taxes on everything from health plans to prescription drugs to medical devices, which according to the joint committee on taxation will simply be passed on to the consumers. the reid bill creates another brand-new washington-run plan. this washington-run plan comes at a time when families and businesses with private insurance are already paying as much as $1,800 a year more in premiums, which is nothing more than a hidden tax to make up for the underpayment by government programs like medicare and medicaid to health care providers. it's no secret some doctors aren't willing to take medicare patients and even medicaid patients because of the reimbursement programs. among other things. because of the bureaucracies. the bureaucratic problems, creating another government-run plan will only increase this hidden tax on families and small businesses to keep the private

coverage of their choice. and i believe it's important for my colleagues to hear what businesses are saying about the reid bill. the national federation of independent business, the premier small business organization in the country. they say -- "the senate bill fails small business." the u.s. chamber of commerce expresses -- quote -- "u.s. chamber expresses disappointment with senate health bill." the national association of wholesaler distributors, the wholesaler distributors say no to the reid health bill. the small business entrepreneurship council, "small business group says reid health bill more of the same. more taxes, mandates, big spending, and nothing to help lower health insurance costs." the associated builders and contractors, great employers in this country -- "a.b.c. critical of the democratic senate health care bill." the national association of manufacturers -- "n.a.m. says

congress is taking health care reform in the wrong direction." the international franchise association -- "franchise businesses oppose senate health care reform efforts." there is a better way to handle health care reform. for months i have been pushing a fiscally responsible step by step proposal that recognizes our current need for spending restraint while starting us on a path to sustainable health care reform. there are several areas of consensus that conform the basis for sustainable, fiscally responsible and bipartisan reform. these include -- let me just list them in order, or at least just a small smattering of them. we have got a lot of ideas over here. reforming the health insurance market for every american by making sure that no american is denied coverage simply based on a pre-existing condition. protecting the coverage for almost 85% of americans who already have coverage they like by making that coverage more affordable. this means reducing costs by

rewarding quality and coordinated care, giving families more information on the costs and choices of their coverage and treatment options, discouraging frivolous lawsuits, and promoting prevention and wellness measures. by the way, the other side isn't willing to do anything on tort reform that some estimate are as much as -- maybe costing us as much as -- in unnecessary costs as $300 billion a year. giving states flexibility to design unique approaches to health care reform. utah is not new york and new york is not utah. actually, what works in new york i've said on occasion will most likely not work in new york let alone utah. and as we move forward on health care reform, it is important to recognize that every state has its own unique mix of demographics and each state has developed its own institutions to address its challenges, and each has its own successes. i believe in 50-state laboratories where the states may be given the money by the federal government but they solve their own problems with

their own demographic needs. and fitting their own demographic needs rather than a one-size-fits-all big federal government program from here, which is what this bill is. there is an enormous reservoir of expertise, experience, and field-tested reform in the states. we should take advantage of that by placing states at the center of health care reform efforts so they can use approaches that best reflect their needs and challenges. my home state of utah has taken important and aggressive steps towards sustainable health care reform. the current efforts to introduce a defined contribution health benefits system and implement the utah health exchange are laudable accomplishments. a vast majority of americans agree a one-size-fits-all washington solution is not the right approach, and that is what this bill is bound to foist on us. unfortunately, the path we are taking in washington right now is to simply spend another

another $2.5 trillion of taxpayer money to further expand the role of the federal government. i don't know many people who believe that's what we really should do. i just wish the majority would take a step back, put their arrogance of power in check and truly work on a real bipartisan bill that all of us can support or at least a good percentage of us can support. not just one or two republicans, and i doubt if they will even get one or two because this bill is that bad. and the first step in achieving bipartisanship is to support my motion to recommit or to commit this bill so that medicare advantage beneficiaries may keep the benefits that they currently enjoy through medicare advantage plans. to me, it's only fair that the legislation we are currently considering hold true to the president's promise to the american people, that if they like what they have, they may keep it. well, i urge my colleagues to support my motion to commit so that that promise will also apply to medicare advantage

beneficiaries who have benefited greatly from what we did in a bipartisan way just a few years ago. with all kinds of democrat support, by the way, and i think by running down each of these states and showing you each state has a stake in keeping medicare advantage alive. i might add some of these outside groups have a stake in killing it because they can make more money off senior citizens. and i -- i hate to say it, but aarp is a prime example of that. it's not hard to see why they are really behind this great big, huge 2,074-page monstrosity of a bill. holy cow. no wonder they don't place this on every desk. maybe they will. when they do, they'll probably put it so that there are two

pages on one sheet so it will look a little smaller, but it will still be that thick at least. but it ought to be on every desk. we could even thumb through it while we're debating and while others are talking. just think what that would do for all of us members of the senate if we just thumb through some of the things that we're doing to america. remember, this is 1/6 of the american economy. we can wreck our country with this bill if we -- if we take this awful thing and we turn our future hundred% over to the almighty federal government that has already put these two wonderful programs, medicare and medicaid, almost in bankruptcy. those programs could be better. there's no question. but they're run by washington so naturally we're just going to call upon taxpayers over and over and over again to fund the excesses that this bureaucracy

here in -- or these bureaucracies -- it's not just a bureaucracies. these bureaucracies in washington impose upon all of us. the presiding officer: the senator's time has expired. mr. hatch: i yield the floor. mr. whitehouse: mr. president? the presiding officer: the senator from rhode island. mr. whitehouse: i know the senator from rhode island wishes to speak very shortly, and i will yield to him very shortly when he is present on the floor, but i did want to react to two points that were made by the very distinguished senator from utah, and i say that with true sincerity. he has been a friend to me since i have been in the senate. he sets a very valuable standard in this institution for collegiality and dignity and bipartisanship and scholarliness, and he comes from an extremely distinguished career prior to his

distinguished career in the senate as a lawyer, a leader of the utah bar. so -- but i do think that as much -- as easy as it is to make fun of a 2,074-page bill, the house bill, which is not significantly different in scale from this bill, was reviewed, and if you look at the substantive language in it. in a bill, of course, there is a lot of language that simply connects things into place and is tables and indexes and things like that. if you look at the actual language that you would read if you were interested in the substance of the bill on the house side and do a word count on it, it has fewer words than a harry potter novel.

i don't think it is too much to expect that members of the senate should be prepared to leaf through the equivalent of a harry potter novel when they are embarked on as significant an effort and endeavor as we are in reforming the health care system. i think it was about 256,000 words, if i'm not mistaken, and it's smaller print, admittedly, in a harry potter book because the way in which the bill is presented in its traditional format is very few words per page. so it looks big and one can make very entertaining demonstration was it on the floor. when you actually get down to reading it, it's the same as plowing through -- it's actually less than plowing through a

harry potter novel, and i don't think that should be too much to expect. i also suggest that the reason for the lack of current bipartisanship on this bill might very well be the arrogance of power of the democratic majority, might be, but i would suggest that the facts might also support a different hypothesis. and if you look back at the history of the development of this bill, it began in a very bipartisan -- on a very bipartisan basis. it began with senator baucus' prepare to launch program at the very beginning of the year, a full-day bipartisan effort to begin to focus on the delivery system reform issues. it began with a bipartisan group negotiating in the finance committee. it began with a "help" committee

bill that allowed for 161, i believe was the number, republican amendments in a very open and complete bipartisan process. and then along came august and the town hall meetings and the beginning of the radicalization of the republican party, and we heard out of that process charged buzzwords such as death panels, socialized medicine, benefits for illegal immigrants, rationing of care. all these words that incite and inflame passions but make no reasoned case and advance no helpful alternative. we saw those words and those arguments presented with a crudeness and a venom that are, frankly, new to american politics. for example, the president portrayed with a hitler mustache

i don't recall for eight years president bush ever being portrayed with a hitler mustache . poor president obama comes in and within his first months, people are running around america portraying him with a hitler mustache because we want to reform health care. certainly, there are a great number of us who felt that president bush was less than truthful when he came and spoke to us about iraq and other subjects, but nobody yelled out "you lie." and president obama's first appearance, he was heckled from the floor of the congress of the united states. and this september, after the tea bag group, after the town hall death panel group had become active, 179 republicans in the house of representatives of the congress of the united states voted to support their heckler comrade.

something changed with the radicalization of the republican party. and i'm not the only one who have noticed this. a very well-regarded philadelphia columnist wrote recently of the republican rig right, "if they can get some mileage, nothing else matters." the columnist went on to decry what he called "the conservative paranoia and lunacy afoot in our national debate." the editor of "the manchester journal inquirer" editorial page wrote of the g.o.p., which he called -- and i quote -- "this once great and now mostly shameful party," that it -- quote -- "has gone crazy." that it is -- quote -- "more and more dominated by the line active fringe." and that it has -- i quote -- "poisoned itself with hate." he concluded they "no longer

want to govern. they want to emote." the respected maureen dawd of the "new york times" in her column eulogizing her friend, the late william sapphire, lamented the -- quote -- "vial and vitriol of today's howling pack of conservative pack of pundits." a nobel prize-winning economist has said -- and i quote -- "the takeover of the republican party by the irrational right is no laughing matter. something unprecedented is happening here and it's very bad for america." a well-regarded "washington post" writer with a quarter century of experience covering government and politics, married to a bush administration official saish so we're hardly talking about commentary from

the leftward fringe -- has noted this about the house health care bill and the argument surrounding it. she described -- and i quote -- "the appalling amount of misinformation being pedaled -- peddled by its opponents." she called it a -- and i quote -- "a flood of factual misstatements about the health care bill." and she noted that the "falsehood peddling began at the top of the republican party." her ultimate question was this: are the republican arguments against this bill so weak that they have to resort to these misrepresentations and distortions? even the respected head of the mayo clinic has recently described the health care antics that we have witnessed as mud

and scare tactics. so it is possible, as the distinguished senator from utah suggests, that the reason that bipartisanship is elusive is because democrats have been gripped by the arrogance of power. but as somebody who has been witness to intense efforts to try to recruit republican support for this bill, i think the evidence at least as well supports the theory that something has happened to the republican party in the past months as the radicalized republican right has emerged and taken over and provoked all of these responses from respected, neutral, seasoned veterans of observing the political scene.

and i would suggest that that is at least a possibility. i'd like to change the topic for just a moment, given that senator casey is not present at the moment, and i would like to make an additional point that i think merits mention and i will yield as soon as he -- as soon as he appears, to him. mr. hatch: would the senator yield for just a second? when the senator completes, i would just like to have a few minutes to wrap up. mr. whitehouse: of course. i would be glaitd t be delightee the senator that time. mr. hatch: i think i can do it in less than five minutes. mr. whitehouse: i would yield five minutes to the senator from utah right now. mr. hatch: i thank my always and friendly decent colleague. mr. whitehouse: would the senator yield back for just one moment? i had the opportunity to be on the floor yesterday and the time was all under agreement and my time was concluded and i was leaving the floor and the

senator from utah had the occasion to offer some very kind words about me, and because of the procedural posture we were in, i did not have the chance to reply or respond at that time. this is the first time we've been on the floor together since then when i have had the chance to have the floor, and i do want to let him know how -- how much i value what he had to say. i know that there are very well-established standards of protocol here in which we say nice things about each other, but i felt that what he had to say was not just protocol but was sincere and heartfelt and it really does mean a lot to me and it is reciprocated on my part. i think that senator hatch brings enormous, as i said earlier, dignity, erudition, principle, collegiality, many, many good characteristics to this floor. he is a force for good in this

body and i am delighted to have him count me a friend. and with that, i yield him for the next five minutes. mr. hatch: i really thank my colleague. i appreciate the eloquence of my dear friend. i have to say just again that i'm going to find some fault with some of the things you've said but i have to say that i am very grateful to have the distinguished senator from rhode island with us. he's one of the great additions to the senate, in my opinion, a very, very good lawyer. he's had tremendous experience in the state government. it's amazing to me that he is supporting this awful bill, this monstrosity of a bill, but i can live with that. i've seen a lot of decent, honorable people be deceived b by -- by their desire on the democratic side to continue to build a federal government at the expense of all the states and everybody else. but i will say this, i really enjoy my colleague. i have a lot of respect for him. but i have to take issue with his harry potter comments. just think about that.

i like the fact that the distinguished senator from rhode island compares this -- this itty-bitty bill here to a "harry potter" novel. perhaps pretty appropriate, because both of them are what i consider to be works of fantasy and fiction. this thing has 14 pages of table of contents alone. you notice how my voice goes up as i'm holding it. it just puts that my pressure on your speech diaphragm. so i just -- just wish that it was as valuable and would be as valuable to the american people as these "harry potter" novels have been. but let me just say one last thing before i close and leave the floor. again, i appreciate my colleague

and i appreciate his graciousness in all ways. we've worked closely together on the intelligence committee, the judiciary committee and in many other ways, and i think he's one of the great additions to the united states senate. and in spite of his -- his dogged determination to support this awful bill, i still think greatly, very highly of him. but let me just make a few things clear to my democratic colleagues. i'm not a great believer that we should follow the polls at all but i think it's interesting sometimes to see what the american people are thinking. and my colleagues seem to think that some of these people who did the tea parties and some of these other things are just right-wing crazies. no. i know a lot of them. they're really good people. they're up in arms. they're really upset. they're people from all walks of life. some of them are very far right. some of them are far left. but the fact of the matter is, is that they're sincere. they feel what's going to happen here is a denigration of our country.

and unfortunately, i feel the same way. i think the more we rely totally upon the federal government, the worse this country's going to be off. now, my colleagues on the other side love the federal government. i love it too. i'd love to keep it in its place. but they -- but they -- it's much easier to control things when you can control them through washington. but it's also a way of stifling good ideas if you don't have the best benefits of the 50 state laboratories that our federalist system actually provides for. and i just notice that the most recent gallup poll, 53% of the people -- of the independents in this country, according to gallup, who has been polling for years, is not republican, or democrat or independent, 53% of them are opposed to this bill. these are the independents in this country. 37% support the bill. now, these are not radical americans, these independents.

they are just tired of the tax-and-spend policies of washington, d.c. and there are people of both parties who are guilty of that. but i have to say, democrats are much better at spending federal dollars than republicans are. in the sense that they spend a lot more of them. they're not better in watching them. now, even a kaiser poll, which is thinking but conservative, had 59% of the people in this country opposed to this bill. now, i -- if i was -- if i was in the position of the democrats, i'd be a little concerned about the independents in this country. they're not crazies. they're not people who are out of line. and i might add, neither are these conservatives who are up in arms. i met with a off the tea party people in utah recently, and they are fiscal conservatives, there's no question about it, and they're very concerned about it. the presiding officer: the senator's time has expired.

mr. hatch: i will ask for another minute and then i'll hang it up. the presiding officer: without objection. mr. hatch: and i met with people of the so-called 912 group. now, they're more concerned with social issues as well as economic issues, but they're well-intentioned, very well-thought-out people who are sick and tired of what's happening here in washington. and the only way they can really get their ideas heard in their eyes is by raising cain about it. and, frankly, i think they're right to do so. so we all better stop and take a look although theslook at thesef we can, as honest democrats honduraandhonest republicans, gr and get a bill that broad support of at least 75 or 80 senators. i'd like it to be more. naturally, i'd like it to be

more. that's what we want to do. and this bill is not the way to get there. i want to thank my colleagues about his gracious remarks about me. i feel exact the same way about him. he's a good friend, a great colleague, a great attorney, and a wonderful addition to the senate and i tend sphwoand workh him in any way i can. if you can tell your side that this is baloney, i think we're going to work this out. and i think we'll get this done. i yield the floor. the presiding officer: the senator from rhode island. mr. whitehouse: mr. president, i see the distinguished senator from iowa on the floor as well as the distinguished senator from pennsylvania, and whichever one of them would like to proceed, i'm prepared to yield to. it looks like it will be the distinguished senator from iowa. and we are delighted to have him here on the floor. i had the very great honor of serving on the "help" committee during the time that the "help" committee section of this bill was prepared.

one of the most vital and important elements of this bill is its new focus on wellness and prevention to help americans stay healthy so that it truly is health care and not just sick care. so that the medical establishment is not incented to add more and more and more tests and procedures -- because that's what they get paid for -- but won't have an e-mail contact or won't have a phone call to help talk a patient through something because they can't get reimbursed for that. and the -- the potential value of wellness and prevention in this country is astonishing, and it's been underinvested in, because the people who are responsible for making those choices really don't get the benefit of them under our present perverse system. and so the senator from iowa has

shown great, great leadership. he is now the chairman of the "help" committee but he certainly chaired through the committee deliberations, the health and wellness portions, and it was my honor to watch him in action and see the astonishing results that he achieved. so i yield the floor to him and i would ask unanimous consent that at the conclusion of the distinguished senator from iowa's remarks, the senator from pennsylvania, senator casey, be recognized. the presiding officer: without objection. mr. whitehouse: the senator from iowa. mr. harkin: mr. president, just a parliamentary inquiry. under what rule are we right now? how much time do we have? are we under any time constraints? the presiding officer: under the previous order the senator controls the time until 8:00 p.m." so approximately 15 minutes." mr. harkin: mr. president, i

want to thank my -- my colleague for all of the work he did on our committee, i'm sorry that he is still not on our committee, but the good work we have in our bill is due to senator whitehouse's involvement in the development of this bill. a great member of our committee. as chair, i wish he would come back, that's all i will say. thank you for all the great work you did on this bill and especially for all the wonderful work you did on getting us the public option we had in our bill that was adopted by the house, but also all the great work you did on making sure we had a robust prevention and wellness program in our bill. i've always said that has been the best way for the cost curve to keep them healthy in the first place and keep them out of the hospital. i thank my colleague for all his great work on the bill.

mr. president, i'd like to engage with my friend from pennsylvania, a little discussion here on one part of the bill that was mentioned earlier today but it really hasn't received much attention. i think there's some misconception about what it does. it's called the class act. and basically the class act is -- is a bill that was championed by senator kennedy for many, many years. it has its genesis in the kind of convoluted system we have now in how we provide for people who become disabled. -- disabled either through their work, an accident, illness, or whatever, people become disabled. as you know, we have a portion of that under the social security system, disability

insurance. but, in fact, it does not take care of any kind of long-term care. and so senator kennedy, for many years, championed the idea of giving people the ability to set aside some money during their working years that would be sort of like social security. it would vest. and then if, god forbid, they became disabled, they would then have a certain monthly income that would enable them to live in their own homes, live in their own communities, and to ease some of the burdens of -- of their disability. and so before he passed away, senator kennedy talked to all of us on the committee about his dream and his hope that we would

have this incorporated in our health reform bill. well, we did this in the "help" committee. we brought it forward. we had it scored. we know exactly how it operates. it is -- we will -- as we will make clear in our colloquy, it is a -- it is a -- it is a program that is -- can be paid for. it's voluntary, as we said. it will stand on its own two feet. it's not another entitlement program, as i heard someone say here earlier today. in fact, it has to be self-financing by the premiums that people pay in during their working years. it's an affordable long-term care program. again, it will allow families to plan for any possibility of a chronic illnes illness without g the fear of being put in a nursing home.

as i said, it's voluntary. the c.b.o. gave us a scoring on this that it was actuarially sound for 75 years. actuarially sound for 75 years. what that means is the premiums paid in and the benefits paid out will be kept in proper alignment. it will be fully solvent. and, quite frankly, senator gregg, the senator from new hampshire on our committee, basically talked about this and here's what he said. "i offered an amendment which was ultimately accepted that would require the class act premiums to be based on a 75-year actuarial analysis of the program's costs. my amendment ensures that instead of promising more than we can deliver, the program will be fiscally solvent and we won't be passing the buck -- or really passing the debt -- to future generation. i'm pleased the "help" committee

unanimously accepted this amendment." well, we did. and that's why i make the point that this is not another entitlement program. as was said earlier today. the -- and even better the c.b.o. believed the class program, the class act, will save medicaid $1.4 billion in the first four years alone. $1.4 billion in the first four years alone as a result of families who will be paying into and then using the class benefit instead of medicaid. -- medicaid to similarly pay for the help that they need to remain at home. and that's really what -- that's really what people want. people want to stay in their own communities. they don't want to have to go to a nursing home. the class act would provide people with money for assisted transportation, in-home meals, help with household chores, professional help getting ready

for work, adult day care, professional personal care. will it pay for all of those things? well, no, it won't pay for all of those things. but it will give you enough of a basic support so that coupled with other things, you would be able to stay at home and maybe -- maybe even go to work. maybe -- maybe -- you may be disabled, but you may not be so disabled that you can't do work, so, therefore, you need a little bit of help at home to get out in the morning to go to work. or maybe you just need some personal assistance care that would enable you to stay in your own home rather than going to gnawing home. so that's -- going to a nursing home. that's why this is so important. it is voluntary. long overdue. it will give people the peace of mind after they pay into the system after five years of vesting, they will be able to then -- be able to access this

program in case they get disabled. so, mr. president, i -- i see my colleague and my friend from pennsylvania's on the floor, a strong supporter of the class act and what we're trying to do here in terms of giving people the ability to maintain themselves if, god forbid, they should become disabled. i would be delighted to yield whatever time he needs to the gentleman from pennsylvania and engage in any equal keys -- equal keys he would like. the presiding officer: the senator from pennsylvania. mr. casey: i would like to thank senator harkin, who is a member of the health, education, labor and pension committee, taking over for senator kennedy. i know he feels an obligation not only to get the health bill passed, but feels an obligation to the american people, as i think most people do in this chamber when it comes to health

care. in particular, i wanted to commend senator harkin for his great support for this legislation over a long period of time. and, in particular, for the last act. one of the best moments in our deliberations this summer was when senator harkin told a story about a relative of his. and in a few minutes, if he would tell that story, it brought home to me how important this program is and how it relates to the american people and what they don't have now especially those americans with -- with disability conviction. when i step back -- disabilities. when i step back and look at this program, a couple of things come to mind. a couple of themes, really one is the word dignity. the dignity of work. so many americans by -- by one estimate five million americans under the age of 65 -- under age 65 are living in our country that have long-term care needs and they're all over -- there

are over 70,000 workers with severe disabilities in the nation who need daily assistance to maintain their jobs and independence. so we're talking about a program which allows them to continue working with a disability. it allows them to overcome or surmount the barrier that's in front of them. why would anyone not want to support this kind of a program just in that brief description. but it's a lot more than that. it is about the dignity of work. it is about having independence, the ability to continue working even with a disability. but it's also a very strong program for other reasons as well. one is, as senator harkin said so well, and senator kennedy led us on this program for many years advocating for this

approach, one important feature of this, as senator harkin said, it's voluntary. it's a voluntary self-funded -- self-funded insurance program with enrollment for people who are currently employed. so we're talking about enabling and helping people to work and maintain their dignity and contribute to our economy. that's what we're talking about here. we're not talking about some government program that we're going to create that no one knows what the results will be. we know exactly what this will do for millions of americans. let me make a couple of points before i turn again to our chairman, senator harkin. first of all, there have been a lot of arguments made on the other side that we don't need this. i haven't heard an alternative, which is true in a lot of the debates in the last couple of days. we hear a lot of criticisms an critiques. some of them grossly inaccurate.

but i'm still waiting -- still waiting to hear an alternative. another idea. we don't hear much about that. but the other side made a lot of points about -- about costs and the budget and how you pay for programs like this. well, let's just turn to the first chart on my left. medicaid pays for a majority of long-term care in the united states of america. medicaid pays 40% of -- 40% of medicaid is for -- i'm sorry. for long-term care, 40% of it is paid for by medicaid. now, a lot of people think of the medicaid program, which, i guess, covers about 60 million americans, roughly, we should think about long-term care. people don't often think about medicaid as being connected directly to long-term care for older citizens those who fought our wars, who worked in our

factories, who -- who raised our families, who gave us life and love and all they asked for in the twilight years of their life is a little help with their health care. now, plenty of them are -- are given skilled care in nursing homes. and for many of those who are in nursing homes, they have skilled care and they have a good experience. for some it's not so good. they'd rather be able to stay at home. they'd rather have opportunities to be provided some help at home. so they want the kind of dignity that i spoke about earlier. the same is true of those who might be a lot younger, but who have disabilities, and they want to continue working. they want to continue working. here's another way to look at this. projected medicaid spending on long-term services and supports is unsustainable the because if nothing's done, medicaid services for -- for older

citizens in america, alone, will rise by 500% by 2045. you don't have to be a -- and i'm certainly not a -- a -- a -- an expert on how these costs are going up. but you don't have to be an expert to know that if in the year 2000 you're at this level, and by the year 2045, not that far into future, you're going to be over above -- above 200. so medicaid long-term services and support spending for those who happen to be aged 65 or older, $200 billion by 2045. so this is going up. this is what -- this is when you -- you don't do anything to -- to meet a health care challenge. if we want to just keep this number going up, we'll listen to the other side and just not enact any kind of a program. let me do one more chart and then i'll turn to senator

harkin. for a -- to senator harkin for a discussion about this. we hear a lot about spending and savings and how we're going to pay for health care. well, if we want to pay for a part of this health care bill and a big part of the challenge, we should enact the class act. because medicaid savings from this act, you can see it here here, $1.6 billion just over the first four years.