>> these complex demonstrating very good parameters of releasing drop of the industry as a whole but the whole industrial complex is growing, growing by 3.7%. on the whole this is quite a good index, but there are very many problems remaining. as you noticed we are now engaged in working by analyzing the state of the defense production industrial. missile equipment and the navy and so then. -- and so on. the air defense, air defenses -- there are many problems that are connected with the need for technological renovation of our leading enterprises because dating back we are able to produce combat equipment so as to ensure our defense security.

all these can be resolved and we are resolving and shall resolve these. the purchase or sale of equipment, the volume of sale of weaponry in the world, we're in second place. and, of course, to ensure our defense security, we do not need to purchase aroundments abroad but in order to work effectively on foreign markets, many of our arms are being produced within the standard of nato because it's easy to sell them. and our defense enterprises are keeping track of the different markets and in a given case we're speaking about mistrial. this decision has not yet been made. but before such a decision is made, we, of course, will think about this very deeply and we'll

speak about -- and examine our own possibilities in this area. and our defense enterprise must understand, of course, while determining the price of the end product, they have a competitor but without a doubt, the stakes on solving this question defense sufficiency, defense capability of the russian state will, of course, be made on russian defense industry. >> thank you. we have a very important question here. it has directly to do with what you talked about today. you often go to different places and you listen to the requests of common people. you always react to acute situations and solve many issues on the spot. so our officials cannot solve issues on their own.

>> the officials can resolve this and do resolve many problems especially my colleagues in the government of russia. they're working a great deal. they are very efficient people. they're professional people. they have become actually experts in those branches with what they're working. they've been working a great deal. and i would like to take advantage of this opportunity. we have meetings -- conference and meetings with them. i speak mostly critical but now i would like to thank them publicly for their joint work because they are doing a lot and have accomplished a lot so the country has passed through this very difficult period of time. perhaps the very most difficult period during the past decade with minimal losses. now what concerns my meetings

with labor collectives there, they are useful for myself and for the whole government because this is meeting people face-to-face with the people -- their problems. and during the preparation for today's meeting together with you to yesterday we spoke together with colleagues until late into the evening and looked at those questions coming in through the internet. coming through the sms channels. approximately, you know, the interest of the people, we know about the volume of questions that we received during the past few days but when we examine together with them and prepare for this meeting, of course, i prepared for this meeting and my colleagues -- they helped me with this. some of them said very correcting, how useful it is to look at all these.

this is the kind of feedback with the people, with the people with real problems. the citizens -- there have been trips and there shall be trips of this kind in the future, no doubt. >> we broke some traditions of hot lines, i would still like to give one. usually you select questions for the last round. >> yes, indeed. i've just mentioned about sms questions coming through internet. some of them i've selected a few questions. i've seen people raising their hands quite actively and not all of them -- this young lady there, please. we have time on air. there are certain limitations. be very brief, i ask you. [speaking in native tongue] >> translator: good day. my name is natalie and i study

at moscow university of physics. how the government plans to solve the issue of -- the problem of lack of qualified teachers? >> of course, interested people should come to these villages. they know their way. the labor resources especially highly skilled personnel to remove them there. they should be concentrated where they have the best conditions to apply their potential needs and resolving housing and increasing salaries for teachers. these are the main vectors. we have a program, a federal program for self-development in the countryside and in many regions there are programs for supporting purchasing housing for young families. and there are two young specialists including teachers as well. we'll be expanding this sector.

>> higher up in that sector, please. [speaking in native tongue] >> translator: i'd like to express my thanks and thanks from the team of russian social university. thank you for the attention you paid to develop the social sphere. you know about our university. i would like to offer you to get a closer look at it. we invite you to visit our university. i would like to pay your attention to one more problem. the year of youth is the year of 2009 and we know that the place that we have students is being illegally approximate being taken away from us. i know that we're trying to figure out the way out.

and i would like to ask you to have a look at it because -- >> thank you very much. i cannot comment on this one because i don't know the specific situation but by all means we'll examine the situation. >> please be quick. we don't really have time. >> i work for the emergency ministry. we have a law about military people and the prices of real estate in different regions and different people in the family are not taking into account. is it possible to give military people to remain in the old system or move on to the new system. >> you're quite right here. and indeed, we do not take into account also the composition of the family in allocating for housing. i think it's for 56 square meters and that's all and the

legislators thought it was a minimal floor space that they would receive from the state and if he wants to increase additional or higher class housing, larger floor space, he must think about this by himself ahead of time. but on the whole, in general, it's possible to correct here. this, of course, connected with great expenditures from the federal budget. when i was in the st. petersburg recently we discussed the housing problem and once again i would like to call together the governors in st. petersburg of those regions and parts of the russian federation where we are intending to build housing for servicemen in 2010 to provide them more permanent housing for those who have the right in 2010. and incidentally in 2011, 2012, those who are being discharged from the army, they will be in this system and must receive housing according to this

system. all those who are going into the mortgage system shall be receiving housing within the framework of the military mortgage. i would like to draw your attention and all those present here and the entire country, of course, that the mortgage savings for servicemen shall be fully financed from the federal budget of the state. in st. petersburg i came across the idea of additional stimulating -- stimulating demographic process among the servicemen. those families have second and third generation. we can give them a housing bonus also within the framework of the mortgage system. it's not a question of square meters but additional financing and we should count this up and that's what we should be doing. [speaking in native tongue] >> translator: let's -- the center of the house. those who are -- let's have the

last question from the auditorium here, the final question. [speaking in native tongue] >> translator: good day. i work in the innovation center of moscow university. we're planning to have innovations in the education process and will the state support the initiatives of sorts? >> yes, we're already supporting it. a contest that was held in september of this year and now we're summing up the results of 14 innovative institutes. they will be receiving support, financial support precisely for the innovation programs of training. they will get about 11.8 billion rubles over a period of five years purchasing additional equipment and working at those innovation programs which you just mentioned. thank you.

let's go over to the questions i have singled out. >> we've been going on for more than three hours. >> that i think god. -- thank god. >> let's have a question from alexander petrov. i consider it an important question and i'll read it to you. they're increasing pensions to all categories from november and he wants to know what the valorization means and i want to know what will happen to pensioners, sergeants, ncos and other ministry. my pension is 3,610 rubles. what's going to happen? i'm going to tell you what's going to happen and all those who may affect one way or the other. in 2010, there should not be in the russian federation

pensioners who are receiving pensions lower than the maximum minimum living level. if the pension is lower than the living standard in the region, these people shall be receiving additional -- either from the regional budget or from the federal budget. there are differences, but they will be supplemented. now what concerns military service discharge servicemen pensions, it's not a very simple question. this question -- it's there but it can be resolved. there are certain servicemen who had served the armed forces. for a certain period of time. who were discharged and received additional seniority and working in the civilian field. if this seniority is no less than five years, then this person has a right and a choice and make a choice.

if it's to his advantage, he can make the choice by himself. he can remain receiving servicemen's pensions which on the whole which the country above the general medium pension. >> yes, here is a question concerning -- we would like the ministers who would also act as your humbled servant the minister transportation go through the course. they have been on the roads and clinics. if you think this is not enough, we shall intensify their movements around the country. the main thing that it should be beneficial to the country. a very important question.

you promised that enough people who are without legs should be not examined. i refuse to receive prosthetics for this. the first groups of invalidity for life. so this is not to pass the constitution. this decision has been made in april 2007. it was a government decision. invalids who have lost this or that function should no longer pass the expertise commission. going through this, this is against the law. all leadership government decision has to be carried out in full. true. there is one nuance. if this enter a medical

commission to determine connection with the prosthetics, then that's another question. but no one has to send you to commissions to determine your ability or disability. why doesn't the state introduce a monopoly on alcoholic beverages? experts who are working in this area consider the monopoly on alcoholic products, this will not solve problems of all the citizens and the state as a whole. now, we're working on the decision, a main tax, an excise tax, will be shifted to the distilleries who produce alcohol or spirits and this at the first stage will be establishing all the excise taxes that the state has intended. this will make it possible to

avoid the production of counter-facts, alcoholic beverages. why are officials being reduced and why are they getting -- they are growing a greater number? the demographic process is being developed quite rapidly. this probably officially concerns the officials as well. this problem is indeed a large one. and officialdom is being growing at great rates in spite of the fact of our efforts to reduce different official levels and duplicating structures in regional or federal level. incidentally, we're going to continue this work in reducing

the number of officials. i would like to physical education of children in schools. the school once again i'd like to repeat it's the responsibility of the regional municipality officials although i do agree with you that not enough attention is being devoted to this. at the federal level we can adopt recommendations. we can put more pressure in this area. but in spite of the fact the objections of our financial authorities we should not doctor up the regions and giving them assistance from the federal budget but nonetheless in certain vectors this should be done in certain cases, in certain respect to healthcare and education. we shall think about this by all means. you consider the activity of stalin positive or negative in general?

i think that i know there's much discussion in this society about this. and i see ambushes. if you say positive, you say people being dissatisfied and saying negative and other people is dissatisfied and stalinism is being discussed then -- i think as i see it giving valid assessments that i think since 1924 to 1953 the country at that time was headed by stalin. the country has changed radically. from an agrarian country it became an industrial but there are no peasants left. we all remember all those problems. the problems concerning agriculture. the accused for food products. this have no positive influence

on the rural areas. but industrialization actually did take place. we won the great patriotic war and no matter what -- who says what, the victory was won. even if we speak about losses, casualties. no one can throw a stone at those who organized, who organized instead of the victory. but if we had lost that war, that consequences would have been much more catastrophic. it would be difficult to even imagine. but all the positive aspects of it was there, it was done at an unacceptable price. repression actually took place. there's a fact that no one can deny millions of our citizens, countrymen suffer from it.

and such a method of running -- of governing a country is unacceptable to govern a country that way. and without a doubt, in that period we came across not only with the cult of the individual mass crimes against their own people. this is a fact. and we must not forget about this. any historical facts must be analyzed all together. that's what i wanted to say. what in your opinion is obstructs the development of russia? here we go discuss. in the mental sphere this, of course, concerns the socialized consciousness. expectations that the state must resolve all questions, all problems completely.

and this, of course -- this, of course, limits personal initiative inside a person of himself. now we have just spoken about the soviet period. well, you know, in the first stage much -- there was much positive revolutionary enthusiasm. there was a revolutionary sign. no one will deliver us, necessity the god, the czar or a hero but we will achieve it. we'll do everything with our own hands. that slogan was lost, unfortunately, and the soviet times, people were deprived of any initiative and even though this mentality still lies there. everyone is still expecting the state to do everything for them. but nonetheless, we must promote the potential of each and every person as an individual. but what concerns the economy, the economy, the main problem is

the structure of the economy that has developed within the framework of so-called planned logic. planned economy. you know, that it's possibly like -- like an egyptian pyramid. it's powerful, but it's very cumbersome, very awkward. and very inert for necessary changes to be made, sometimes it's easy to build absolutely new enterprises and a new place in the field and it will be competitive and efficient and modern than to reconstruct everything that we have inherited from the past. although this has to be done, too. can you remember the most happiest day? yes, dasha is 16 years. i think the fact that we are alive. we are happy given to us by the almighty we're always forgetting there's an interlife and we

remember this then we will understand it. every life that has been is a happy life. do your subordinates tell you jokes about yourself? no they don't. my subordinates are my friends. they don't tell me any jokes. casinos and one-armed bandits have been closed but instead we have internet cafes with the same one-armed bandits and people are losing their last rubles. on behalf of many thousands of our country, close this evil once and for all. you know, these loopholes that are being used by those who are working in this area of business -- i mean, loopholes in legislation, these loopholes are ephemeral. if one follows theóz law by the

letter, all these casinos should be closed. the corrupted local authorities and the law enforcement agencies. we shall take up this issue separately. how do you view the situation in the northern caucuses, the situation with the apprehension? there's no signs and the situation is complicated, true. it is dictated by certain components. and, of course, we see different armed illegal gangs feel there are strong extremist groups too. this is a fact that cannot be denied.

we can combat this mercilessly until they are completely wiped out at the same time we should devote more attention to questions, social and economic nature. we should create new, high -- high-paying jobs, combat corruptions and, unfortunately, in the caucuses corruption is rampant and no less than it's throughout the country and in certain cases even more. i mean, the level of corruption. and we should combat the clan aspects.j=b these traditions connected with certain historical phenomenon but this should not -- this should not prevent us from resolving social aspects. we working in all these directions, we shall be achieve positive results. whereas there's enmity and

russia and ukraine, why does ukraine hate us? that's not true.éç we can't say that ukraine hates us. i myself love ukraine. i'm quite sure. millions of citizens in russia take this same attitude toward ukraine. what is ukraine. what is russia? these are people first of all. they are people. that's what the country is made of. these are not territories, not the national wealth where we're connected by ukraine by so many threads and bombs in the past, present and the future, i'm quite sure. i think the relationship with that country, certain subjects who are speculating on the problems and complications of the past and present. they're doing this[fb exclusive for their own personal, political self considerations.'u they will not succeed to destro.

we have three computers in our class, in our school. could you add a certain money, a. . >> i will provide a computer to every pupil to each and every one of your school. this is a full campaign of computerizations throughout the country.ojñ in certain schools and certain educational establishments so far this program has not been carried out to the full. only in computer classes, not every pupil has a computer. but since you reached me, i considered my duty to responsibility to your question. why do great people go through depression? i do not consider myself to be in the category of great people and that is why i do not have problems of depression.

you said we are -- everything will come out all right. you didn't mention how we're going to do it. you didn't listen to me tentatively. i spoke at the congress about the ways how to cope with the problems. we have a program developing russia to 2012. here we're speaking about modernization of the economy, innovation course of developing the country. development of different branches of the economy, agriculture, restructuring the economy as a whole. we'll speak about social development, about education and so then, reform of the pension system and so then. all this is written down. this, of course, requires additional corrections about the present day realities but we are not turning our backs on this and now this following report is right in line with what i've been saying.

x and together with our people, we'll cope with everything. >> translator: we have many relationships with it. it's one of the most important

partners, and the world economy is connected with invisible threads with the economy of the united states, and to wish someone certain problems -- to any country, in fact -- we'd be better if we were in a favorable world than in a world of catastrophes. >> translator: i'm 35 years. dear tatiana and nikolai, i congratulate you on your 55th birthday and wish you success. [applause] and all the people in the studio support me in my congratulations. i have worked at a factory, and they are just wishes.

i'll leave them outside the program. >> [speaking in native tongue] >> translator: one more question connected with the invalids who have lost their function. i've spoken about this, i will not repeat this. that should be covered by officials. and no one has the right to send invalids to be reassessed. why in our countries, why not all labor party people are working? i agree with that because their wages, the gap between those large incomes and those who have minimal incomes is very great. that is one of the great problems in the economy. and so to reduce the gap between the wealthy and the poor we have a special program to combat poverty.

the crisis had gotten moving, but without a doubt, it shall be carried out in the future. we shall be working in this direction. furthermore, we shall -- the pensions should be, then, 50% of the salaries, i mean, the average salary. >> [speaking in native tongue] >> translator: in european countries this percentage is about 40%. 40%. this so-called recommission of remission with respect to the pension and ratio to the previous salary. after the pension shall be increased by 46% in 2010. and this coefficient shall be 39.9, almost 40%. we're coming close to that figure. >>

[speaking in native tongue] >> translator: what does conversation with these citizens of russia -- i've already spoken with my colleagues. we are studying great, massive questions, requests, proposals, simply information, and ?ebtally -- incidentally, this information seems to indicate very many people in our country are living in a very complicated situation. and all of us face great questions, so those problem questions we should try to reduce their number. here a question of another nature. stupid questions, this is a question i received -- we are coming together to discuss serious problems, that is why i would like to say to the author

of this question what category he regards this question that he placed before me. dear vladimir, would you like to live as much as you would like, as long as you want? if you like to go into eternity eternity -- [inaudible] >> [speaking in native tongue] >> translator: i am proud, proud that i'm a citizen of the the russian federation. this is quite enough for me, thank you very much. [applause] >> translator: last question. you watched a special program, we worked for over four hours, and i hope that in a year we can get together in the studio again and continue our talk. thank you, thank the viewers,

the audience, those who sent questions and who gathered together. thank you. [applause] >> the senate comes in at the top of the hour for work on health care. >> alex wayne is with congressional quarterly. debate over abortion funding in the senate is underway, who are the key players? >> right. senator ben nelson of nebraska and senator orrin hatch of utah. they've introduced the amendment, they hope it's going to pass, but i think i can pretty confidently say it's not going to pass. >> what would senator knell szob's abortion -- nelson's abortion amendment do? >> it would restrict abortion coverage by insurers who operate

in these new exchanges the bill would create across the nation. it would also forbid the government-run insurance plan from covering abortions altogether, the only ones would be related to rape, incest or where the pregnant si threatens the mother's life. >> what took so long? >> yeah. senator nelson and democratic leaders wanted to get rid of it last week. i shouldn't say senator nelson wanted to get rid of it, but democratic senators did want to get rid of it. senator hatch on jekylled to that -- objected to that, so now it's ready to go. >> can you name democrats who have indicated they may vote for this amendment? >> there's two of them, i believe. senator nelson and senator bob casey. i think possibly byron dorgan, maybe kent con regard, but -- conrad, but i'm not sure about them. >> how about republicans?

>> most of them. the only two i think won't will olympia snowe and susan collins. they like the language as it is. >> what are the possible implications of this amendment passes, and then i'll ask the same question about it failing. >> sure. if it passes, it's likelier that democrats will have senator nelson's vote on the bill. if i can just go ahead and answer your other question, if it does not pass, senator nelson will not support the bill unless more restrictive abortion language is added to it. >> are you getting any sense of the mood of senator as they continue working on this bill? >> yeah. we've been staking out these meetings they have been having almost every night, and when the more liberal senators come out of those meetings, they always seem to be in a good mood. senator chuck schumer of new york says he thinks things are moving along well, but then we talk to moderates, and they're

not so sure. they don't think they're that close to a deal on any of the major issues, most importantly the public option. >> how is it looking for getting it done by christmas? >> iffy, i'd say. we have heard that senator reid is trying to pull together what they call a managers amendment. he's doing that now, and his spokesman told us yesterday that they hope to, they hope to start filing cloture petitions. these are procedural moves to end debate on the bill. they hope to start filing those by the end of the we'll. >> alex wayne with congressional quarterly, we thank you. >> thank you. >> madam president? >> the senator from nebraska. >> madam president, my co-sponsor, lead co-sponsor senator hatch, will appear sometime later and speak in favor of amendment 2962. he's unable to be here at the moment. before thanksgiving break i

voted with a number, a majority actually, of my colleagues in favor of beginning this debate. debate is essential in our democracy. it keeps our country resilient and strong through changing times. before that vote some argued here on the senate floor that we shouldn't hold this open and full debate. they seem to suggest that obstruction was better than action. some also argued here on the floor that the november 21st vote was really about abortion. they were wrong. that vote was just whether to begin a debate on an issue that has consumed the american public. now is the time to start debating the issue of abortion as we're addressing many other issues in health care reform. madam president, i'd like to discuss the amendment that i propose along with a bipartisan group of colleagues who include senators hatch, casey, brownback, thune, coburn,

johanns, visitor and barrasso. the amendment that we offer today mirrors the stupak language added to the house health care bill. madam president, for more than three decades taxpayers' money has not been used for elective abortions, and it shouldn't under any new health reform legislation either. some suggest that the stupak language imposes new restrictions on abortion. i disagree. we're seeking to just apply the same standards on abortion to the senate health care bill that already exist for many federal health programs. they include those covering veterans, all federal employees, native americans and active-duty service members and others. madam president, i note that the senate health care bill, if enacted, would, indeed, chart new ground.

it covers abortions. the language in the bill goes around the federal standard disallowing public funding of abortion. a clear majority of americans including my constituents in nebraska support this prohibition against using public money to cover abortion. our amendment formally extends that standard to this health care, this health reform bill. the united states supreme court has held that government may regulate abortion and may disallow public funds being used for elective abortions. beginning in 1976 with the hyde amendment, congress has prohibited public funding for elective abortion in all significant health-related bills. exceptions have been preserved for when the life of the mother is endangered or in the case of rape or incest. and except for those exceptions, public funds may not be used for any health care benefits package

that covers abortion. some have now cited the federal employees health benefits program. fehp as a possible model for health care reform. the fehp helps pay premiums for many different private health insurance plans. that way federal employees may choose the insurance plan that best suits their budget and personal needs. so it's important to note that none of the benefits packages offered to federal employees provides health insurance coverage for abortion. i repeat, none of the benefits packages offered to federal employees provides coverage for abortion. nor do benefits packages that are offered to individuals in other federal programs such as the children's health insurance program, medicare, medicaid, indian health services, veterans' health and military health care programs.

madam president, some have argued that the stupak language imposes tougher restrictions than in current law. that's not the case. our amendment mirror aims to extend the current standard to this new legislation. and on another point under federal law, states are allowed to set their own policies concerning abortion. many states oppose the use of public funds for abortion. many states also have passed laws that regulate abortion by requiring informed consent and waiting periods, requiring parental involvement in cases where minors seek abortions and protecting the rights of health care providers who refuse as a matter of conscious to assist in abortions. and perhaps most importantly, there is no federal law, nor is will any state -- there any state law that includes abortion coverage. so, madam president, i believe that the current health care reform we're debating should not be used to open a new avenue for

public funding of abortion. we should preserve the current policies prohibiting the use of taxpayer money for abortion that have existed for more than three decades. a number of polls this year have, again, shown that the most, that most americans do not support using taxpayer money for abortion. the senate bill as proposed goes against that majority public opinion. the bill says that the secretary of health and human services may allow elective abortion coverage in the public option if the secretary believes there is sufficient segregation of funds to insure federal tax credits are not used to purchase that portion of the coverage. the bill would also require that at least one insurance plan covers abortion, and one that does not cover abortion be offered on every state insurance exchange. federal regulation -- federal

legislation establishing a public option that provides abortion coverage and federal legislation allowing states to opt out of the public option that provides abortion coverage eases the restrictions established by the hyde amendment. our amendment would prohibit federal funds from being used for elective abortion services in the public option and also prohibit individuals who receive tax credits from purchasing a plan that provides elective aboargses. abortions. madam president, i've always been pro-life, and i have a strong record opposing abortion. as governor or nebraska in the 1990s, i signed into law the parental notification law and the ban against partial-birth abortion. in the senate i've co-sponsored and voted for legislation that prohibits taking minors across state lines and voted for legislation creating a separate offense for harming or killing an unborn child in utero during the commission of specified violent crimes.

aside from my personal views, however, i think most americans would prefer that the health care reform we are working on remain neutral on abortion. public polls suggest so. so does the fact that over the last 30-plus years congress has passed new federal laws that have not provided public funding for abortions. so the question has been settled. most americans, even some who support abortion, do not want taxpayer money to be used for abortions. we should not break with precedent on this bill. and finally, as president obama has said this is a health care reform bill, it's not an abortion bill. it's time to simply extend the standard disallowing public funding of abortion. which has stood the test of time to new proposed federal legislation. i look forward to debating this and other issues in the health reform bill as we work to address solutions to our

troubled health care system. today it just costs too much and delivers too little to the people of my state and to most americans. madam president, i yield the floor. >> madam president? >> the senator from california. >> madam president, it's an honor to be here in the senate at a time when we're working on one of the major issues of our time. we know that generations of leaders in both parties have tried to solve the health care crisis, and they've done it bit by bit. we read history, we know that leaders struggle with social security, democrats were in the forefront, the republicans fought us every step of the way, and franklin roosevelt took the lead on that. and we had john kennedy and lyndon johnson take the lead on medicare, and the republicans fought us every inch of the way on that.

we have some cooperation from certain senators and certain members of congress, but overall it was very difficult. and this fight is very difficult. to make sure that we turn things around. if we live in a society where if we don't step in to the breach here, we are told by nonpartisan surveys -- if senator grassley wouldn't mind, it's hard for me to concentrate. thank you. we are told if we do nothing -- and this is important -- premiums for our average families in california will be 41% of income. 41% of income. in states like pennsylvania, it will be 50% of income. well, we know what that means. people will not have health insurance. so we could pull the covers over our head and say, it's too hard, it's too tough. we could turn our backs to the fact that 66% of bankruptcies

are related to a health care crisis. we could turn our back on that. we could turn our back on the fact that infant mortality in america, 29 out of 30 nations, that's what we come out. this is america, the greatest country in the world. something is wrong when so many people don't have access to insurance and even if they do, when they need it most, it's gone. so how proud am i to be here at this time? very proud. how grateful am i to the people of my state for sending me back here three times so i could stand here and be a voice for them? i can't tell you, madam president, how proud i am. and when we started this health care debate, we knew it was important to the people we represent. and we knew it was important to the economy of this country. and senator cornyn has gotten up and said that this bill is terrible for the economy. well, let me tell you this, $27 billion of tax cuts in this bill -- let me repeat that, $27 billion of tax cuts for small

business. there are billions of dollars of tax breaks for individuals. so for people to stand up and say this isn't good for our economy, i just don't think they understand or get it. if we continue with the status quo, that's when we're in trouble. now, the women of the senate have been very involved, very involved, the democratic women. we have worked together to make sure this package meets the needs of all of our families including the women of this country. and senator mccull sky is on the floor, made sure we corrected a problem that was in the bill, a problem which basically was unclear as to who was going to set the benefits. and we wanted to make sure that women can get mammograms after 40 every year.

senator mccull sky fixed it by making sure that the head of health and human services is going to be the one to decide what is covered. and women's prevention has now gone way up to the top of the list because of the senator and the women who worked with her on this. we're very proud of that. well, there's one thing that was taken care of in the rebill that we didn't think we've we'd have an argument about, and that is we thought we had an understanding that we were not going to bring up the issue of abortion, that it wasn't necessary to do it because we weren't doing anything in the bill. senator reid doesn't do anything in the bill that changes the current agreement. and let me say because i started in the house in the '80s, i was part of that agreement. i offered the amendment that said, yes, it's true, no federal funds could be used unless the the life of the woman was at stake for abortion, and through

my amendment we added rape and incest. and those are the only three exceptions. no federal funds could be used for abortion except to save the life of the woman or if she's a victim of rape or incest. and that agreement has held for three decades. now, it's fair to say neither side is thrilled with it. but the fact is the agreement has held. and the fact is that senator reid has crafted a bill, which is the underlying bill, that preserves that three-decades-long agreement. but over on the house side they passed a radical stupak amendment which strikes at the heart of this delicate compromise by preventing women from using their own private funds, madam president, for their legal reproductive health care. now, that's a big shock because

women have been able to utilize their own private funds in order to get a legal procedure, legal procedure, and never has anyone, to my knowledge, on either side of the aisle said that she couldn't get access to insurance to cover the whole range of legal reproductive health care if she uses her own funds. this amendment takes us way back. now, here's what's really interesting. the people who bring us this, and mostly it's going to be the men who speak on this, i think -- we'll see if that's right or wrong, but i think i predict that -- the men who have brought us this don't single out a procedure that's used by a man or a drug that is used by a man that involves his reproductive health care and say they have to get a special writer. there's nothing in this amendment that says if a man

someday wants to buy viagra, for example, that his pharmaceutical coverage cannot cover it, that he has to buy a rider. i wouldn't support that, and they shouldn't support going after a woman using her own private funds for her reproductive health care. is it fair to say to a man, you're going to have to buy a rider to buy viagra, and this will be public information to be accessed? no. i don't support that. i support a man's privacy just as i support a woman's privacy. so it's very clear to me that this amendment would be the biggest rollback to a woman's right to choose in decades. we didn't ask for this fight, madam president. we didn't plan for this fight. we don't want this fight. we simply want to insure that

this three-decades-long agreement is kept in place, and that's what senator reid does in the underlying bill. it's very clear that in the underlying bill there is a firewall, madam president, a firewall between federal funds and private funds. and all we are saying is, please, leave it alone. we believe it is discriminatory to single out a procedure that only women can utilize and say to the women of this nation, oh, by the way, yes, this is a legal procedure, but you can't use your own private funds. senator reid is very clear. he puts into place, as i said, a firewall between the federal funds and the private funds. so roe v. wade is still the law of the land. i know a lot of my colleagues

don't support it, they'd like to see it overturned, they'd like to make abortion illegal at the earliest stages, they'd like to criminalize it, they'd like to put doctors in jail, they'd like to put women in jail. the fact is roe v. wade is the law of the land, and at the early stages of a pregnancy, a woman has a right to choose. that's the law. later on she can't do it. there are restrictions for her. hurdles for her. that's what roe does. so there are many people, particularly on the other side of the aisle -- more than on our side, for sure -- who want to make roe, they want p to overturn roe. well, they know they can't do it because the vast majority of the people in this country support a woman's right to choose at the early stages of a pregnancy. so what can they do? they can make it impossible for her to access, access the doctor for this procedure. and in this bill they go after

her insurance. it's, it's very surprising to me. that such an amendment could pass the house, but it did. and i am asking my colleagues, women and men both sides of the aisle, to, please, please, stand up for equality in this country. please don't single out women. what have women done to deserve this? there are mothers, there are daughters, there are grandmas, they serve in the military with dignity. why punish them this way? why have such a lack of respect for them? that they can't even get reproductive health care with their own private funds? it is really, to me, such a rollback of women's rights. and i believe we will defeat this here in the senate, and i believe senator reid deserves a lot of credit because what he did in the underlying bill is

preserve the status quo. no federal funds for abortion, not a dollar. but a woman can use her own private funds to buy health insurance. thank you very much, madam president, and i yield the floor. >> american icons, three original documentaries from c-span now available on dvd. a unique journey through the iconic homes of the three branches of american government. see the exquisite detail of the supreme court through the eyes of the justices. go beyond the velvet ropes of public tours into those rarely-seen spaces of the white house, america's most famous home. and explore the history, art and architecture of the capitol, one of america's most symbolic structures. american icons, a three-disc dvd set. it's $24.95 plus shipping and handling. order online at c-span.org/store.

>> and next the senate starts day nine of debate on the health care bill. two issues are pending, an abortion coverage amendment by a bipartisan group of senators headed by nebraska democrat ben nelson. it would stop the government-run health insurance program called the public option from offering insurance coverage, and republican senator john mccain has offered a motion to send the bill to committee for changes in the medicare advantage provisions. the bill exempts some states from benefit cuts in the bill. that mccain motion would extend the protection to all medicare advantage participants. senate plans to recess between 12:30 and 2:15 eastern for their weekly policy lunches. no votes are scheduled at this time, but they could pop up throughout the day as senators agree on vote times. off the ooh floor, negotiations continue over the public option. live coverage of the u.s. senate now here on c-span2. the chaplain: let us pray.

god of wonder, beyond all majesty, may our lives and our world be awakened by your grace. open our eyes to your works and our ears to your words of life. stir within our lawmakers a desire to please you. enable them to hear with objectivity and respond with integrity, as they comprehend their individual and collective responsibilities. lord, make them exemplary models of the highest and finest in faithful, loyal, and dedicated leadership.

give them wisdom, strength, and clarity to meet today's daunting challenges. we pray in your great name. amen. the presiding officer: please join me in reciting the pledge of allegiance to the flag. i pledge allegiance to the flag of the united states of america and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. the presiding officer: the clerk will read a communication to the senate. the clerk: washington, d.c, december 8, 2009. to the senate: under the provisions of rule 1, paragraph 3, of the standing rules of the senate, i hereby appoint the honorable roland w.

burris, a senator from the state of illinois, to perform the duties of the chair. signed: robert c. byrd, president pro tempore. mr. reid: snrp. the presiding officer: the majority leader is recognized ment. mr. reid: following leader remarks the senate will resume consideration of the health reform legislation. following the leader remarks the time until 12:30 will be for debate only. the majority will control the first half of the time that's allotted until 12:30. the republicans will control the next half. the remaining time will be equally divided and controlled between the two leaders or their designees. the senate will recess from 12:30 until 2:15 p.m. to allow for the weekly caucus luncheons. there are two amendments now pending. one is the nelson of nebraska amendment of the other is the mccain amendment, motion to commit. senators should expect votes after the recess in relation to the pending amendments. should i say, amendment and motion. mr. president, we have scheduled this morning -- as soon as the

leader time is used -- a group of senators, democrats senators. these are all new senators. i hope those people that are watching understand the quality of the people who are now going to make a presentation before this body. the states that will be represented here today will be state of oregon, the state of delaware. we of course have new hampshire, colorado. we have two colorado senators who are going to speak, a new senator from massachusetts, new mexico, virginia, illinois, alaska, and the opening will be by senator merkley and the closing by senator merkley. such quality individuals, mr. president, we're so fortunate to have in the senate. and i am grateful for the time that they've taken to speak on this issue. much of what they have done is

set the tone for this debate on our side of the aisle. it's been constructive, it's been positive, and it's been very, very lucid, and it all -- we're all successful individuals -- and they were all successful individuals before they came to the senate. and certainly that is so acknowledged every time we hear them say a word here on the senate floor. the presiding officer: under the previous order, the leadership time is reserved. under the previous order, the senate resume consideration of h.r. 3590, which the clerk will report. the clerk: calendar number 175, h.r. 3590, an act to amend the internal revenue code of 1986 to modify the first-time home buyer's credit in the case of members of the armed forces and certain other federal employees, and for other purposes. the presiding officer: under

the previous order, the time until 12:30 p.m. will be for debate only, with the time equally divided and controlled between the two leaders or their designees, with senators permitted to speak for up to 10 minutes each, with the majority controlling the first hour and the republicans controlling the next hour. mr. mcconnell: mr. president? the presiding officer: the republican leader is recognized. mr. mcconnell: over the past several days, americans have seen in vivid detail what supporters of this plan plan to do to the medicare program for seniors. they plan to use it as a giant piggy bank to pay for an

entirely new government program, and yesterday we heard floated for the very first time that they want to radically expand medicare. so what's becoming abundantly clear is that the majority will make any deal, agree to any terms, sign any dotted line that brings them closer to final passage of this terrible bill. they entertain adding new experiments without any assessment of the impact that the deal making will have on the american people or our economy. they are, for lack of a better term, winging it on one of the most consequential pieces of legislation affecting our country in memory. well, let me suggest to the majority, americans would much rather we get it right than scurry around, scurrying around throwing around untested last-minute experiments in order to get 60 votes before christmas. let me just say that again.

americans would much rather we get it right than scurry around, throwing together untested last-minute experiments in order to get 60 votes before christmas. over the past several days, our friends on the other side repeatedly voted to preserve nearly half a trillion dollars in medicare cuts to finance their vision of reform. a vision that includes cutting nearly $8 billion from hospice care, $40 billion in cuts to home health agencies, $120 billion in cuts to medicare advantage, $135 billion in cuts to hospitals that serve medicare patients, and nearly $15 billion in cuts to nursing homes. well, these cuts really illustrate what these -- what these cuts really illustrate is a lack of vision, because cutting one troubled government program in order to create

another is a mistake. i'll say it again. had a a trillion dollars in cuts to medicare for seniors is not reform. but medicare cuts are just one leg of the stool holding up this misguided vision of reform. let's take a look at another. let's look at how this bill punishes not only seniors but how it kills jobs at a time when one in ten working americans is looking for one. this bill doesn't just punish seniors, it punishes job creators, too. that's the message we got yesterday from small businesses across the country. they sent us a letter opposing this bill because it doesn't do the things proponents of this bill promised it would. it doesn't lower cost. it doesn't help create jobs. and it doesn't help the economy. here are just some of the groups that signed that letter: the associated builders and contractors, the associated general contractors, the

international food service distributors association, the national association of manufacturers, the national association of wholesale distributors, the national retail federation, small business and entrepreneurship council, the u.s. chamber of commerce, and here's what these groups had to say about this bill. i'm reading now from their letter dated december the 7th, 2009, a letter that was addressed to every member of the senate. quote -- "in order to finance part of its $2.5 trillion price tag, h.r. 3590 imposes new taxes, fees, and penalties totaling nearly half a trillion dollars. this financial burden falls disproportionately on the backs of small business, small firms are in desperate need of this precious capital for job creation, investment, business

expansion, and survival. " the letter goes on to detail all the ways in which this bill punishes small businesses, thus making it harder for them to retain or hire workers. these groups point out that under this bill, small business in the u.s. would see major cost increase as a result of new taxes on health benefits and health insurance. costs that will be passed on to employees and which would make health insurance more expensive, not less. under this bill, self-employed business owners who buy coverage for themselves could see a double-digit jump in their insurance premiums. for other small businesses, the bill won't lead to a significant decrease in cost, something they were promised as a result of the bill. under this bill, jobs would be lost and wages would be pressed as a result of a new law that would require businesses either to buy snrurns for their

employees or to pay -- insurance for their employees or to pay a fine. needless to say, this is not the kind of legislation the american worker needs or wants at a moment of double-digit unemployment. and perhaps that's the reason that poll after poll -- poll after poll public opinion shows that the american worker opposes this bill. some business groups may have supported this plan earlier in the year because they thought it was inevitable. they didn't want to be critical of a bill they thought they had no power to stop. but something happened between then and now. the american people realized what this bill meant for them. they realize what had it would mean for seniors, for business owners, for the economy, for our future as a country, and americans stood up -- americans stood up. they made their voices heard, and now the tide has turned. the american people oppose this

bill. they want us to start over. they want us to make common sense, step-by-step reforms that everyone can support, not some backroom deal to have the government take over the health insurance system that's then forced on the american people without discussion. our friends on the other side can read the writing on the wall. they know the american people oppose this bill. but they've apparently made a calculation to force it through congress over the next several days before the american people even have a chance to absorb the details. the only thing that can stop them is the realization by democrats themselves that this plan would be a tragic mistake for seniors, for the economy, and for our country. and that a better path would be the kind of step-by-step reforms that americans have been asking of us, reforms americans really want. americans don't think reform should come at the expense of seniors, and they don't think it should come at the expense of

jobs. they don't think it should make current problems worse. now, on another matter, mr. president, we're now hearing talk that the administration is thinking of using the bank bailout tarp money that taxpayers reluctantly handed over during last year's credit crisis on another spending spree like the stimulus, which they said would stop unemployment at 8% but hasn't. $1 trillion later, unemployment is now at 10%. this is not only irresponsible, since the purpose of these emergency funds was to prop up the credit system in the midst of a crisis, it also violates both current law and the pledge we made that every dollar we got back would be returned to the taxpayer to reduce the national debt. that's the pledge we made when we passed the tarp proposal. this proposal out of the administration is completely wrongheaded, but it's perfectly illustrative of the way democrats in congress have been dealing with taxpayer money all

year. by throwing it at one problem after another without much regard for the consequences. whether it's the stimulus, cash for clunkers, or the bill currently on the floor, americans are running out of patience with politicians who promise jobs but deliver nothing more than debt, higher taxes and longer unemployment lines. mr. president, i yield the floor. the presiding officer: the senator from montana. mr. baucus: mr. president, for the benefit of all senators, i'd like to take a moment to lay out today's program. it's been more than two and a half weeks since the majority leader moved to proceed to health care reform. this is the ninth day of debate on it. the senate has considered 18 amendments and motions. we conducted 14 roll call votes. today the senate will debate the amendment by the senator from nebraska, senator nelson, on the women's right to choose. at the same time we'll debate

the motion by senator mccain on medicare advantage. the time between now and caucus lunches is for debate only. the majority will control the first hour of debate this morning. republicans will volume the second hour. we are hopeful the senate will be able to conduct votes on or in relation to the nelson amendment, a side-by-side amendment to the mccain motion and the mccain motion sometime this afternoon. thereafter we expect to turn to another amendment, likely to be an amendment from senator dorgan on drug re-importation. i hope that the pending mccain motion is the -- excuse me. i note that the pending mccain motion is the third such effort by the republicans to defend the private insurance companies who run the program called medicare advantage. that's the same so-called medicare advantage program that

the nonpartisan medpac says is overpaid, overpaid by 14% compared to traditional medicare, which does the same thing. that's the same so-called medicare advantage program, with overpayments at $90 to medicare premiums to a typical retired couple even though that cum gets nothing in exchange. that is the same so-called medicare advantage program that has been the major source of profits for private insurance companies to receive these overpayments. that is the same so-called medicare advantage program that helps the private insurance companies to pay their c.e.o.'s $8 million a year, $9 million a year and in one instance more than $20 million a year in compensation. that's the same so-called medicare advantage program that in our view needs a healthy dose of competition. that's all our bill would do. our bill would move to competitive bidding in the private insurance market. it's high time we do so. this morning we're going to have

a colloquy among many new stphorbgs a group of senators elected last year is a very active group. i've met with them many times. they are very thoughtful, they are active and they have a lot to say. mr. dodd: mr. president? the presiding officer: the senator from connecticut is recognized. mr. dodd: i'll be very brief because we want to have time to hear from our colleagues. a number of them served on the health, education, labor, and pensions committee, which helped us craft the legislation we now have before us in this compromise melded bill. i listened to the minority leader this morning and i'll talk more about this later. you'd phr-pl believe that 300 days proposal arrived as president of the united states and all these problems emerged. the fact of the matter is under the previous eight years we watched the nation accumulate debt and one administration, more so than all prior 43 administrations combined, the situation we find ourselves in economic did not happen overnight. it happened over a number of

years of carelessness, a lack of regulation, a lack of enforcement of regulation that existed. we have been grappling with these problems. in december of last year more than 700,000 people lost their jobs in that one month alone. in january almost 700,000 again. and the same true in march. almost 3 million jobs were lost before the ink on the inauguration papers was dry. we're now finding ourselves, while still too high in the unemployment rate, vastly improving the economic condition of this country. much more needs to be done. yet, we hear the same sort of chicken little arguments about just say no every time to an idea that might make a difference in this country. certainly decisions made a year ago to provide the stabilization of major financial institutions contributed directly to the benefits we're seeing today. and certainly the efforts of taking some of these resources that have gone to bail out major financial institutions now being used to try and create jobs in the country is i think something to be welcomed by the american

people, not rejected by members of congress who seem only to be interested in whether or not we're going to take care of those large firms who got us into the mess in the first place. i welcome the president's ideas in this area and we welcome particularly this effort on health care, to make a difference not only for individuals but for our economy. to reduce those costs, reduce those premiums, make those insurance products available to all americans who worry every night about whether or not they're going to fall into that abusiness because of a health care -- into that abyss because of the a health care crisis that befalls them or a loved one. we're going to hear from the colleagues whose new membership is a wonderful addition to the united states senate. i yield the floor and allow them to take over and discuss their ideas. the first being, i believe our new senator from delaware, senator kaufman. mr. kaufman: mr. president? the presiding officer: the senator from delaware is recognized. mr. kaufman: i want to start by agreeing as to how we got to

where we are and why it's important we do something about it. he's right. the chairman of the finance committee is right too. the freshman senators who come from all over this country got together and, frankly, with the leadership of senator warner from virginia, put together a package which i think is a very constructive package for the health care reform act that we have to pass. and i really appreciate the opportunity to join with the other freshmen, including the senator in the chair, to discuss the unique opportunity we have to finally enact meaningful health care reform. and make no mistake, we need health care reform now. when you look out there and you see the rising premiums, everything from rising premiums to insurers denying coverage to people with preexisting conditions, the health care system is failing individual americans. there is no doubt about that. not only is it doing that, it's

threatening the fiscal solvency of our country. medicare and medicaid swallowing up more and more of our federal spending. if we don't act soon to become the largest contributor to the deficit. the time for reform is now. we can't wait any longer. as the senator from connecticut said, this isn't something that just came out of nowhere. it's been there for a long time. we have to act now. thanks to the hard work of senators reid, baucus, dodd, harkin and their staffs, we have a bill before us that can finally reform our health care system. it is a good bill. it is a bill that truly protects what works in our system, at the same time fixing what's broken. no longer will americans be denied coverage on the basis of preexisting conditions. no longer will their coverage be revoked when they get sick and need it the most.

this bill will help protect seniors by offering new preventive and wellness benefits and extend the solvency of the medicare trust fund by an additional five years. it will also help our economy by significantly cutting health care costs and reducing the nation's deficit by $130 billion. you hear a lot of numbers, you see a lot of numbers, you read about it in the newspaper, especially on the other side of the aisle, this will cut the deficit for the next ten years by $130 billion for the first ten years and maybe up to $650 billion in the second ten. this will truly bend the curve, which we have to do if we're not going to go into insolvency. it's interesting when the other side talks about deficits, deficits, deficits. the thing that's really driving the deficit is health care costs, because what drives medicare and medicaid costs is health care costs. this bill makes quality, affordable health care within reach of all americans.

but there's always more we can do, and that's why i'm pleased in joining my other freshmen members with a very promising amendment to the bill. so much of what has broken our health care system revolves around basic inefficiencies that drive up costs while simultaneously driving down quality. that's right, costs go up, quality goes down. that's not the way we want to have it. we want costs go down, quality goes up. even worse, inefficiencies in the system often give way to the waste, fraud, and abuse that drains somewhere between $72 billion and $220 billion annually from doctors, patients, private surers and the state and federal government, this is significantly increasing health care costs for americans. these are inefficiencies that can and will be curbed. by seeking innovative ways to lower health care costs across the country, this amendment

complements the underlying health care bill. it adopts the full spectrum of 21st century technologies and innovative methods of delivery to further cut through the red tape that continues to plague our system and stifle innovation. it provides commonsense, practical solutions that help contain costs, improve quality and increase value. it increases penalties for health care fraud and enhances enforcements against medical crooks and utilizes the most sophisticated technology to better detect and deter fraud in the health care system. it quickens the implementation of uniform administrative standards, allowing for more efficient exchange of information among patients, doctors, and insurers. it provides more flexibility to establishing accountable care organizations that realign financial incentives and help insure americans receive high-quality care.

it provides greater incentives to insurers in the exchange to reduce health care disparities along racial lines. these are just a few examples of the provisions in the amendment that i believe will mesh well with the patient protection and affordable care act. as i've said before, it is time to gather our collective will and do the right thing during this historic opportunity by passing health care reform now. i think this amendment can help us reach that goal. we can't afford to wait any longer. we need to act now. we can do no less. the american people deserve no less. thank you, mr. president. a senator: mr. president? the presiding officer: the senator from virginia is recognized. mr. warner: thank you, mr. president. i want to thank my colleague, the senator from delaware, for his comments and his leadership on this issue. i want to also thank all of the

fresh ph*erpb. this is, i think -- all the freshmen. this is, i think, the seventh time the freshmen have come to the floor on this issue. i think our colleagues have had to endure over 65 speeches from the freshmen on the subject of health care. before i get into my remarks, i want to personally thank senator baucus and senator dodd and the majority leader, and particularly their staffs for working with the 11 freshmen members who have come together to unveil a package of health care amendments around the issue of cost containment. we've been working on this for now close to three months. later today we'll have a formal press conference. let me say at the outset, i'm proud of the enormous broad-based support we're receiving for this package of amendments. we're going to be having a business round table come in an endorse the amendments that we have in companies like wal-mart and intel and target and quad

graphics endorse this package. we're going to have groups like the aarp and the a.f.l. we're going to have important think tanks like new american foundation and actually mark mcclellan, who was the head of c.m.s. under president bush, is endorsing our package. the notion here being that while the merged bill has -- starts to move this enormous ship of health care spending in the right direction, what we're trying to do with this package is put a few afterburners on that movement as we really try to move away from our current system that, let's face it, doesn't make much good business sense, doesn't make much good financial sense, that basically rewards volume over quality, that has the absurd situation in this country where a hospital that has a higher readmission rate gets paid more than a hospital that has a low readmission rate. we're taking all of the various aspects of the bill around payment reform, around greater accountability, around data

mining, around administrative simplification and saying how can we take the tools that have been put in these bills and accelerate them, give the secretary, as we move forward the ability to take pilot programs and broaden their approach and broaden their appeal. if it works, let's bring that reform to our whole system. one of the things that we have also focused on -- and while we anticipate a very good score from the c.b.o. in terms of overall lowering health care costs, what we're trying to do in this package is not just look at health care reform in the context of those government-related programs: medicare, medicaid, what have you. but also how we partner with those in the private sector. one of the reasons why the business round table is so supportive is the fact that we have to recognize that well over half of the american public still receives their health care through private insurance or through their health care they receive in conjunction with their employers. how do we take the best of the

private sector? how do we take the lessons learned from the private sector, bring those into the health care reforms that i hope this body will soon pass in the coming weeks. the necessity -- my friend the senator from delaware has raised this point, what's good about this bill. there are still issues to be resolved. i still have concerns, particularly around the public option portion. but i know that in a good-faith effort we'll get those issues resolved. and one thing that needs to be reaffirmed time and time again is what happens if we don't do health care reform, because not acting is a policy choice. not acting is every bit as much a policy choice as moving forward on this bill. if we fail to act, our federal deficits will continue to explode because the largest driver of our federal deficit is not education funding, it's not transportation funding, it's not even the tarp or the stimulus much the largest driver of our

federal deficit is health care spending. if we fail to act, medicare, which protects the health care of millions -- countless millions of senior citizens -- will go bankrupt in the next eight years f we fail to act, families in virginia -- an average virginia family and i would imagine an average family -- my good friend from connecticut, the families of connecticut, they will see health care insurance eat up 40% of their income. business understands that if we can't drive down our overall health care costs, then the ability for america to come out of this recession and remain competitive will be seriously undermined because as long as american business has to pay twice as much% person, as much as $3,000 to $4,000 per employee more for their health care costs

than any of our competitors around the world, then no matter how competitive the american workforce is, american businesses won't be able to compete as well. our amendment package -- and i know my colleagues will go through in some more details -- and i see some of my other colleagues are here on the floor, so i'll yield my time and be happy to come back and go through some more of these provisions -- it is complex. it is a bit dense. it is about 30-odd different provisions here that take very good part that are already in the combined bill and as indicated move them quicker, move them faster, try to make sure that we have what i think all of us want -- more price transparency in our pricing around health care, more ability to take programs and pilots at work and roll them out on a rage -- on a wider basis. my good friend from colorado has been working hard on the administrative reform portion. this is a good package of amendments. i was asked yesterday from

somebody from the press what it is like. i would sum up because some of this stuff gets fairly dense, but sum up two things this package of amendments is trying to do. i think we all remember years back when you -- when you were in the travel area and you called up and tried to get an airline reservation and depending on who you called an what time you called, you might get a total different price on your airline ticket. well, what this package of amendments is trying to do is trying to do to health care what travelocity did to the airline business. how did we bring some true pricing competition? it won't get us there, but it'll move us down the line. i say to my good friend, i see the chairman of the "help" committee, who's worked so hard and so long on this issue, but

as he knows, i was lucky enough in the old days to fall into the cell phone industry. i managed to eeo eke out a small living in that industry. if we took -- if we thought this amendment -- if we thought the original bill was basically creating the cell phone of the 20th century, what is our package of amendments is, it's basically the iphone version to your motorola flip phone version of the bill. i have to kind of work on that a little bit better before the press conference. but you kind of get where i'm going. we provide dozens of applications 0 an good framework that's provided on this merged bill. i'm very proud of the work that all of these freshmen senators have done over the last few

months. i thank the majority and their staffs for helping us work through this amendment package. i look forward to its adoption and i look forward to later today all of th coming to endorr efforts. and with that, i yield to the junior senator from colorado, who is next up on the agenda. thank you, mr. president. mr. bennet: mr. president? the presiding officer: the senator from colorado is recognized. mr. bennet: thank you. i'd like to thank our colleague from virginia, senator warner, for his extraordinary leadership throughout this process of the freshmen coming together to see what we can do to move this legislation forward, to improve it. i think a lot has been said about how the bill, as drafted by the "help" committee, the finance committee now by the majority leader is directally correct in its efforts to get a handle on thighs skyrocketing costs. i think this amendment package will move us much further in the direction of trying to hold down costs for our working families

and small businesses across the country. throughout this entire debate and going back to the very beginning, what i've said is that no matter where you are on many of the issues here, there can't really be any disagreement that the current system with respect to cost is completely insane. our families in colorado face double-digit cost increases every yeemplet over the last decade their median family income has actually gone down by 97%. gone down by $300, the cost of health care up by 97% over that same periods of time. our small businesses are paying 18% more than large businesses for health care just because they're small. we are spending as a country more than twice what almost any other industrialized country in the world is spending as a percentage of our gross domestic product on health care. we're spend roughly 18%, going to 20% in the blink of an eye.

we can't hope to compete in this global economy if we're devoting a fifth of our economy to health care and everyone else in the world is devoting less than half than that. as the senator from virginia also said, if you have any cornerabout these deficits that ware facing here in washington, which have become completely untenable, the biggest driver of those are medicaid and medicare costs. my view has been from the start that no matter what your entry point was into this debate, the cost was the central question for our work families and for our small businesses and we have stressed the need over and over here for health care reform. that's why i think the senate needs to adopt freshmen amendment package which would cut costs, save the taxpayers money and make our health care system function more efficiently. this package of amendments will help strengthen the reform

proposal's ability to deliver affordable, quality health care to all americans, whether they are in private plans or whether they're in public plans. these provisions will remove much of the red tape that for so long as slowed the delivery of care. doctors from all over colorado have told me time and time again that their medical practices are mired in paperwork and that their staffs spend far too much time and money jumping through administrative hoop after hoop. the thyme our doctors and nurses spend on unnecessary paperwork is time they can't spend becoming better professionals and, most important, providing quality care to their patients. this amendment will require the secretary of health and human services to adopt and regularly update a single national standard for some of the most basic electronic transactions that occur between insurers and providers, and meeting these standards will be enforceable by penalties if insurers and providers don't take steps to comply. my provision will make sure that we implement health reform -- that as we implement health

reform, we are consistently identifying and implementing new standards. there are also terrible infinish sis in the way we pay health care providers and allow them to deliver care to patients. this package helps eliminate bottlenext so that baishts are -- this package helps eliminate bottlenecks so that patients -- to better craft strategies for medicare and medicaid and private-sector plans to improve care. in the current system doctors are forced into requesting a multitude of tests to confirm a diagnosis they've already made. this creates unnecessary work for doctors and administrative staffs, lab technicians and so on. it is time we create a system that empowers doctors to practice medicine and do their jobs efficiently. and under the current broken system, doctors have to endure needless hurdles to even set up a practice. it is no wonder the number of

primary care doctors has been steadily declining for sometime now. this package of amendments would create an environment that attracts doctors back to the field rather than making it more difficult for them to provide care. along with the savings this bill already creates, this amendment will help doctors remove the red tape to help patients in a timely manner. we cannot go on allowing the middle class to absorb the rising cost of our nation's health care system. we need health care reform that will control costs and put us back on a path toward fiscal responsibility this. package of amendments will help us do just that. mr. president, i want to again say thank you to my colleagues here from the freshmen class for their work. this sometimes has seemed teed yurks it sometimes is hard to describe, but these amendments are very critical if we are going to get ahold of costs as we go forward and that's the thing that working families in this country need more than anything else in order to have

stability in their lives. we have got to get ahold of our rising health care costs. with that, mr. president, i yield the floor. mr. kirk: mr. president? the presiding officer: the senator from massachusetts is recognized. mr. kirk: thank you, mr. president. with great joy and enthusiasm, i can say that today we are closer than ever to guaranteeing that all americans, at long last, will have full access to quality, affordable health care. the patient protection and affordable care act, which our colleague and our fres in our f, senator merkley of oregon, suggests, as senator kennedy from mass would have subscribed to, that this is the health care

bill of rights. it will help fix the health care system that is failing to meet the needs of the american people. and i am extremely proud to join with majority leader reid, with senator baucus, my good friend senator dodd of connecticut, and with my fellow freshmen senators. i want to single out, if i may, the senator from virginia, mark warner, one of the more enlightened business leaders of our time who brought his wisdom and innovation, skills, and practices of the private sector to help improve the important challenge we have here in the public sector. and i thank the senator for his leadership on this effort. in contributing to legislation

that will mark an historic stride forward for the american people. i want to say just a word as well, a particular word about the chairman of the "help" committee, who has enormous responsibilities in the senate of the united states, chairing the effort to reform our financial regulations and financial system so that the american people will understand that we are one country with one important financial system and they're not somehow a second-tier, unrelated and unconnected to the decisions that are made on wall street and elsewhere. when senator kennedy of massachusetts was stricken, senator dodd of massachusetts -- not only because senator kenzi y is a very close friend, but because the senator from

connecticut understood the enormity of the challenge and important effort that is being made here today in the united states senate. and i want to salute him for sharing his wisdom and his strength and his leadership, not only in the areas of financial reform but in this important area as well. as i said, this is nothing less than a bill of rights for the american people on the issues of health care. with this legislation, all americans finally will be guaranteed access to the affor affordable health care coverage they deserve. families who need a helping hand to care for an aging relative will be protected. insurance companies will be prohibited from arbitrarily refusing coverage and from stopping benefits just when they are needed most.

doctors will be given the support they need to practice the best medicine possible. that's why they took their oath. and with the help of the measures in this total legislation and some of the particular reforms suggested by our freshmen colleagues, that best medicine will be practiced. and the american economy will be protected from the skyrocketing costs of health care with which every american family is now afflicted. over the past month i've had the privilege of working with my fellow freshmen colleagues on a series of amendments we're discussing here this morning to make this health care bill of rights even stronger. these amendments plant the seeds for an innovative 21st century health care system that offers what american families want most: better results for lower costs. it's as simple as that. these amendments focus on the root causes of our skyrocketing

health care costs. they provide medicare the support it needs to become a leader in moving away from the reimbursement model that increase costs without improving care. public-private arrangements will be established to smoother reform and prevent private insurers from shifting costs on to public plans. the red tape with which we're all familiar weighs down the current health care system in both the public and private sectors will be reduced. all of this will contribute to lower costs and higher quality in our health care system. one focus that is of particular interest and importance to me is the delivery system reform. we must move toward a system of paying hospitals and doctors for the quality care they provide rather than the quantity of tests and procedure they

perform. our amendments reward providers of medicare who give high-quality care rather than high-volume procedures. we will also allow medicare to test promising new models to reduce costs, increase quality and improve patient health. we must make these changes for the sake of our patients and for the sake of our economy. in short, our amendments, mr. president, strengthen the reforms of the patient protection and affordable care act. i urge all of my colleagues to support these amendments and take these important steps with us to bring america's health care system into the 21st century. once again i thank the leadership. i thank the senator from virginia and my freshmen colleagues for their good work on this historic health care bill of rights. and, mr. president, i thank you

and i yield the floor. a senator: mr. president? the presiding officer: the senator from colorado is recognized. mr. udall: mr. president, my freshmen colleagues and i have come to the floor on a regular basis over these past months to make clear to both sides of the aisle how critical it is to reforming our health care system. right now too many americans lack the freedom to move to a new job, further their education, start a small business because doing so would ko* put them at risk of losing their health care coverage for their family. mr. president, you think about it, freedom is, after all, about choices. what motivates me and i know motivates all of my freshmen colleagues is the desire to preserve and enhance the freedom of those who live in our states. this legislation we've been debating and amending over the past few weeks can and should be a vehicle we use to enhance freedom for all of our american citizens. we're going to repair and

modernize our broken health care system. and if we fail to do so, we perpetuate anant kwaeupted status quo -- an antiquated system that keeps stability out of the reach of millions of american families. the package of amendments we present here today is designed to inject more cost containment into in bill, cut down on bureaucratic red tape and push us more aggressively towards a reformed health care system that rewards better patient care more than simply more care. in developing these ideas my fellow freshmen and i relied on the input of people back home. and through my discussions with constituents, health care providers, businessmen from all over colorado, a common theme has emerged. they want a health care system that tackles cost while keeping the focus on patients and quality. while i believe we've helped to accomplish that with our freshmen proposal because more

than 30 groups, mr. president, have come out in the past few days to support our efforts. and this is a wide-ranging number of groups including consumer champions like the aarp, business leaders from the business round table, and health providers like my home state denver health. now, my freshmen colleagues have spoken about individual pieces of this effort that combine to make the whole, and i'd like to single out a section that i think has particularly strong influence in the future of our health reform efforts. senator rockefeller authored an important provision that creates the independent medicare advisory board. the board would be tasked with keeping down the costs in the medicare system by issuing proposals to cut spending and increase the quality of care for beneficiaries. i applaud this contribution to the bill, but i've wondered why we can't take it a step further by look at the whole health care system and not just medicare in isolation. if we're going to tackle spiraling health care costs across the country we need to

push each area to be smarter and more efficient in dealing with cost growth. one of my contributions to the package is to expand the scope of the medicare advisory board to examine not just medicare but the entire health care system and tax that board with ways to slow down the costs of health care across the country. this would include providing recommendations on the step the private sector could take to make our delivery system more efficient. mr. president, health care leaders and economists agree that such an approach can help our system toward a more streamlined and coordinated way of delivering care to all americans. so in sum, let me wrap up, i want to thank the senator from virginia for his leadership; the senatorell, mr. merkley; senator shaheen from new hampshire. it's been a delight to work with my fellow 11 senators. i think this is a bold contribution to the package i know we're going to pass out of this senate. we come from varying parts of the country. we have spre political out--

very political outlooks and background. this is a winning addition to health care reform, and i encourage all senators to support our efforts. mr. president, i yield the floor. a senator: mr. president? the presiding officer: the senator from new hampshire is recognized. mrs. shaheen: thank you, mr. president. i'm so pleased this morning to join my freshmen colleagues in introducing our innovation and value package. for the last several months the freshmen in the senate have been coming to the floor to help make the case for health care reform, to tell our colleagues and the public about what we've heard from our constituents and to come together as one voice in support of reform. today we back up that rhetoric with action. today we propose something concrete. we've talked about the importance of reforming the way we deliver care, about how we need to slow down the skyrocketing costs of health care while improving quality and about the need to provide incentives to make the changes

happen. today we deliver on that talk. our proposals are about containing costs. they're about looking into the future, thinking about our delivery system and finding ways to make small but very important changes that will make a difference. throughout this debate, i've been talking about the importance of increasing the quality of care while reducing the cost. this amendment package does just that, and this amendment package matters. it matters to all the health care consumers who are interested in reducing costs and increasing the value in our health care system. and it especially matters to business. the high cost of health care and insurance coverage eats away at the bottom line for businesses. and if we can reduce waste and inefficiencies, attack fraud and simplify our system, we can reduce costs. the innovations in this package

attract business because business understands that we need to take steps in our public and private health care systems to lower costs and deliver value. now, i'm proud that with this amendment we're able to promote the good work of elliot fisher and his colleagues at the darthmouth institute for health policy and clinical practice and to recognize the work that they've done on accountable care organizations. accountable care organizations are about coordinating care among providers. hospitals, primary care physicians, specialists and other medical professionals. these accountable care organizations make decisions with patients, and i think that's the operative phrase. they make decisions with patients about what steps they can take together to improve care. and when these efforts result in cost and quality improvements, providers and consumers can share in the savings. this is the essence of true

reform. we must demand peformance, quality, and value from our health care system. and this package makes great strides. i want to close, mr. president, by thanking all of my fellow freshmen. i'm so proud to be part of this freshmen class and all the great work they've done. i especially want to recognize senator warner, who's really been the driving force behind this health care package. i'm not sure i agree with his cell phone analogy, but i certainly agree with the leadership that he's shown in developing this package. also i want to recognize the, our senior colleagues in the senate: senator dodd, senator baucus and reid and harkin, for the leadership that they've shown in getting us to this point. and finally, i want to recognize all of the staffs of all of us freshmen senators, many of whom are here today who have worked so hard to get us to this point, and especially single out my

assistants allison mcdonald and dr. manny for all the work they've done on this effort. i'm so pleased thob here with my fellow -- to be here with my fellow freshmen and i ask all of our colleagues to join us in this effort. thank you very much, mr. president. a senator: mr. president? the presiding officer: the senator from north carolina is recognized. mrs. hagan: thank you. i rise in support of the freshmen value and innovation package which builds on efforts to provide quality affordable health care at a lower cost to families. and i too applaud our colleague, senator mark warner, for helping to initiate this package. i want to take a moment to talk about two provisions in this package which i included: curbing fraud and abuse with 21st century technology and medication therapy management. today medicare spends about $430 billion annually. medicaid approximately $340

billion and the state children's health insurance program an additional $5 billion, for a total of $775 billion. in medicare alone, annual waste amounts to between $23 billion and $78 billion. yet, despite the sky-high numbers, investigations are pursued only after payment has been made, which means that government fraud investigators have to recover funds that have already been paid. as a result, it's estimated that only about 10% of possible fraud is ever detected. and of that amount, only about 3% is ever actually recovered. this means the government recovers at best about $130 million in medicare waste, fraud, and abuse. when estimates are between $23 billion and $78 billion, we're only recovering $130 million. doctor shopping is an example

that was pro"no child left behind" in a recent -- that was profiled in a recent "usa today" report. this involves a patient receiving multiple prescriptions from numerous doctors in a short period of time without getting caught. and each of the claims gets paid by medicare, medicaid, or even private health insurers. but current technology exists today to assess in realtime if a claim warrants further investigation. and this technology will praoufpbt -- prevent fraudulent claims from being paid on the front end. a software company in kerry, north carolina, sass, developed this technology. this amendment will require the department of health and human resources to put in place systems that will detect patterns of fraud and abuse before any money leaves our federal coffers. another source of waste in the system is people not sticking to their medication regiment.

as much as one half of all patients in our country do not follow their doctor's orders regarding their medications. the new england health care institute estimates that the overall cost of people not following directions is as much as $290 billion per year. this waste can be eliminated with medication therapy management. that's a program where seniors bring all of their prescriptions in a little brown bag, their over-the- counter medications, their vitamin supplements to the pharmacy to be thoroughly reviewed in a one-on-one session. the pharmacist follows up and educates the patient about his or her medication regimen. north has has successful medication therapy management programs already in place. in 2007, the north carolina health and wellness trust fund launched an innovative statewide program. we've called it check meds n.c. to provide medication therapy

management services to our seniors. during the program's first year, more than 15,000 seniors and 285 pharmacists participated. just this small program saved an estimated $10 million and countless health problems were avoided for our seniors. this amendment takes this successful north carolina model and implements it nationally, permitting pharmacies and other health care providers to spend considerable time and resources evaluating a person's drug routine and educating them on proper usage. madam president, i urge passage of this freshmen amendment package which will further reduce health care costs for american families. thank you. a senator: madam president, i seek recognition. the presiding officer: the senator from new mexico. mr. udall: madam president, thank you very much. this package today is the result of collaboration that began

pont months ago when the senate -- that began months ago when the senate's freshmen class joined together for health care reform, when we united in the belief that the status quo is not an option. the health care status quo doesn't work for americans, and iit doesn't work for america either. if we fail to act, every person, every institution, every small business in this country will pay the price. achieving true reform means making insurance available and affordable to all americans. it also means reining in out-of-control spending. for some, those two goals seem diametrically opposed. they ask, how can you contain costs when you're expanding access to millions of additional people? one of our country's great economic thinkers, paul krugman, recently challenged this hypothesis. first, he said, the majority of americans uninsured are young

and healthy. covering them wouldn't increase costs very much. second, noted that this reform links coverage expansion to serious cost control measures. these goals are two sides of the same coin. without one, we can't have the other. as mr. krugman said, "the path to cost control runs through universality, and we can only tackle out-of-coal cos costs as- tackle out-of-control costs as part of a deal that guaranteed health care." we take additional steps to transform our delivery system, to contain cost costs. with these amendments we encourage a faster transition to a 21st century system that is more efficient costs less, and

holds providers and insurers accountable. i am proud to sign on to all of the amendments in this package. but there is one proposal that is particularly important to the people of new mexico. in my state, 30 of 33 counties are classified as medically underserved. residents of these highly rural counties are more likely to be uninsured. they're more likely to have higher rates of disease. and because of a shortage in health care providers, they're often forced to travel long distances for care. this amendment would help us take the first steps towards alleviating the growing shortage of primary care physicians in new mexico and across the country. by 2025, there will be a shortage of at least 35,000 primary care physicians in the united states. and as this shortage grows, our rural areas will be hardest hit.

in this amendment we call for expert recommendations on how to encourage providers to choose primary care and to establish their practices in medically underserved areas. these experts would analyze things like compensation and work environment. they would recommend ways to increase interest in primary care as a career. madam president, we are closer than ever to providing all americans with access to quality, affordable health care. i'm proud to be a part of a group of freshmen who refuse to sit on the back bench and watch this reform develop from the sidelines. i'm proud to be part of a group that from the beginning refused to accept the status quo as an option. and i want to thank the staff of all these fine senators and thank personally my staff members fern goodhard and benet

thanson, and i look forward to continuing the work this outstanding group as we debate a bill that will improve our health care system for generations to come. madam president, i yield the floor. mr. burris: madam president? the presiding officer: the senator from l i wil i will fro. mr. burris: it is my privilege to stand with these senators and give recognition to those distinguished senators who have put so much heart into drafting this important legislation, to our leader reid and to senator baucus and to senator dodd and to all of the individuals. it is a pleasure for me to be a part of this freshmen colloquy on this major package. over the past several months, my freshmen colleagues and i have taken the floor many times to speak about the need for comprehensive health care reform.

so i'm pleased to join them today as we discuss our cost-containment package. this set of provisions will hep reduce efficiency and reduce disparities in our health care system. our amendment will improve the principle of high value, low-cost care that is central to the patient protection and affordable care afnlgt madam president, our amendment will strengthen medicare's ability to act as a payment innovator, paying for value and not for volume. speeding this process, our amendment gives medicare more after resource that is needed to gather data, expand programs that works and reach the neediest patients. so we also work to strengthen waste, fraud, and abuse provisions in the patient protection and affordable care act.

make sure that the department of health and human services has the tools not to only punish offenders but prevent fraud from happening in the first place. this is not just about our public program. we also promote private public data sharing to get a better picture of our whole medical system. our amendment further takes aim at administrative costs, another barrier often cited for getting the most effective care by encouraging private-public collaboration, to create uniform standards, and reduce the mountain of paperwork that makes doctors spend more time -- takes doctors' time away from their patients. finally, madam president, we put pressure on private insurers to change the way that they pay, by encourage insurers to reward programs that produce -- to reduce disparities. providers will increasingly

focus attention on population that need it most. by proactive targeting these needy folks through culturally competitive training, language service, and community outreach. our amendment will increase wellness and reduce the use of costly emergency room care. my colleagues and i are supportive -- supported by top business groups, consumer groups and providers because they all know that we have to transform the way care is delivered in this country. businesses know that without the reduced cost of care and promoting transparency, the cost of premiums will continue to rise, putting a stranglehold on wages increasing and making them less competitive. consumer groups want to ensure that patients get more dollar for their dollar.

not just get more care, but they get the type of coordinated, effective care that will keep them healthy and out of the emergency rooms and out of the health care system. those providers who focus on targeted care to get the best patient outcome want to be rewarded for doing so. the the evidenc evidence could e clearer that the patient protection and affordable care act will lower costs for ordinary americans. so i call upon my colleagues to take an honest look at what we're doing, and i defy them to say that health care reform will not reduce costs and improve the functioning of our health care system. the debate on health care reform cannot be about scoring political points. it must be about the health and well-being of the american people. all of our great work will bear

fruit and we will reform our nation's health system because there is no other option. our citizens demand it, and they deserve no less. madam president, i want to thank our distinguished colleagues and i yield the floor. and i'm happy to be a part of this freshmen cooing colloquy and presenting such an important issue at this time in history ands in this great country of ours. i yield the floor, madam president. a senator: madam president? the presiding officer: the senator from alaska. beg thank you very much, madam president. i -- a mr. begich: at the very much, madam president. i seek the floor to talk about this package. i'm proud to join them in introducing this amendment today. the technical work in this package is complex and complicated. but the themes it addresses are simple and straightforward, which i know our colleagues on the other side will appreciate and we hope support.

value, innovation, quality, transparency, and cost containment. the full legislation now under debate in the senate makes wonderful strides in fixing what is broken in america's current health care system. under the leadership of senators baucus, dodd, harkin, and our majority leader reid, the committees have done incredible work. what the freshmen are saying today is we believe our package can help. we can go further. we can do better. our goal is a health care system that is more efficient and more affordable. in just a few moments, we will stand together at a news conference with all my freshmen to formally announce this package. what i most appreciate is that we will do so with the support of consumer and business groups. while the language of this amendment promotes efficiency and encourages innovation within the health delivery system, what it really is about is helping individual americans and

businesses get a better deal on health care. i'm proud of that, especially when we know the cos that cost containment is the number-one priority of small business owners in this health reform debate. insurance premiums alone just in the last ten years for small business have risen 113%. and it was just reported in the media that small businesses in this country face another 15% increase in the health premiums in the coming year. what about families, our friends, and our neighbors? health insurance premiums prosecute eating up ever-growing chunks of the family budget. nationwide, family health insurance purchased through an employer at the start of this decade cost about $6,700, almost 14% of the family income. last year the same premium cost $13,000, 21% of the family income. if we do nothing, if we don't

reform the system, and don't contain costs, this country will be in big trouble. by 2016, the same family health insurance will cost more than $24,000, because health costs are skyrocketing when compared to wages from that $24,000 will represent 45% of the family budget. madam president, enough is enough. and the package we are introducing today will help. i want to focus very briefly on a small but significant piece of the package that addresses rural health care. it will help hospitals in several states including alaska, my home state. by extending the rural community hospital demonstration project, we are building on known success. the program is small. even with this amendment, the number of eligible hospitals nationwide will expand from 15 to 30. 20 rural states will be eligible to participate instead of the

current 10. part of what we are saying in this package is this: if something is working to provide better health care access and value, for goodness sakes, let's keep it going and do what we can to improve on it. my thanks go to senator ben nelson, who has been a champion of this program, and also pushing for its extension. madam president, as i conclude, i want to stress one -- once again how proud i am to stand with my freshmen colleagues. the cost-containment package we are proposing today will help all americans, and i hope it will help move the senate that much closer to an historic vote on a landmark piece of legislation buffs today. i yield the floor, madam president. mr. warner: madam president? the presiding officer: the senator from virginia. mr. warner: i know our time is about to expire. i want to begin to close by thanking all my freshmen colleagues for the great work they've done on this and their staffs. i see a number of my colleagues

from the other side. this is an amendment package that brings greater accountability, great efficiency and greater innovation, supported by the business round table, supported by businesses and health care systems around the country. i'd ask their consideration. i thank again the chair, senator dodd, for his -- the fact that he allowed to us lay out this peafnlg amendments. i think it will add an important component to this bill on trying to rein in costs, not just on the governmental side, but systemwide. thank you, i yield the floor. mr. dodd: madam president, i want to commend 10 of the 11 freshmen khroegz have spoken -- colleagues have spoken with great passion on this issue. we owe them a debt of gratitude for putting together what i think to be a fine package. i want to particularly thank senator warner who led this effort. but as he pointed out this only happened because of the

cooperation of ideas each member brought on cost containment. all americans owe them a deep debt of gratitude. you can feel pretty good about the future of our country with this fine group of freshmen senators. the presiding officer: the snort now has 60 minutes. mr. baucus: -- the presiding officer: the minority has 60 minutes. mr. baucus: madam president, i join my good friend from connecticut in thanking them -- i don't want to call them freshmen. they're pretty wise. our colleagues act like they have been here for years and they know their subject extremely well. but delivery system reform is always something i've been pushing for. i'm happy to see that's part of your package. also additional emphasis on rural areas and indian

reservations. we clearly need more of that. more transparency -- i firmly believe that's going to help in the long run, help us get costs down and get the quality of care up. and work on the independent medicare advisory board is really great too. to be honest, these are all ideas, the next step of ideas that are pretty much in the bill. but they are the proper next steps, next steps that i firmly believe should be taken. i compliment you on what you're doing very much. and i thank my friend from arizona. the presiding officer: the senator from arizona. mr. mccain: madam president, i'd also like to add my words of congratulations to the new members for their eloquence, their passion, their well-informed arguments, although they're badly misguided. but i do congratulate them for being -- taking part in this spirited debate. we welcome it, and i hope that someday we'll be able to agree

on both sides for us to engage in real colloquy between us back and forth. i think the american people and all members are well informed. madam president, i ask unanimous consent for the next 30 minutes to engage in colloquy with my colleagues. the presiding officer: without objection. mr. mccain: i talk a lot about c-span. i'm a great admirer of c-span and how the president when he was running also talked about c-span. and he said c-span would be in the running. it was quoted right now a group of senators is meeting behind closed doors to try to hash out a compromise on the public option. reporters waiting for the meeting to break were shunted around the corner make it go harder for the press to catch senators as they leave. c-span, this is not.

the beat goes on. could i just remind my colleagues of the amendment that we are discussing here is drafted to prevent drastic medicare advantage cuts from impacting all seniors under medicare advantage. i want -- this amendment says simply let's give seniors who are members of medicare, who enrolled in medicare advantage the same deal that senator nelson was able to get for the state of florida. at least most of the seniors who enrolled in the medicare advantage srapl. there are 1 -- medicare advantage program. this amendment would allow all 11 million to have the same benefits. there would be no carveouts for various groups of seniors just because of the influence of a member of this body. i just want to quote again "the new york times," my favorite source of information.

quote -- "senator tries to allay fears on health overhaul. mr. nelson, a democrat, has a big problem. a bill taken up this week by the committee would cut medicare payments. the program known as medicare advantage is popular." et cetera, et cetera. "it would be intolerable to ask senior citizens to give up substantial health benefits they are enjoying under medicare, said mr. nelson, who has been deluged with calls and complaints from constituents. i'm offering an amendment to shield seniors from those benefit cuts." i am offering an amendment to shield all senior citizens, the 11 million of them that are under medicare advantage, as the senator from florida said, to shield seniors from benefit cuts. that's what this amendment is all about. we should not carve out for some

seniors what other seniors are not entitled to. that's not america. that's not the way we should treat all of our citizens. and i hope that my colleagues will understand that this is simply in the name of fairness that this amendment is proposed. and i would ask the senator from tennessee and the senator from texas, large numbers of enrollees in the medicare advantage program, also how this would be unfair as well. mr. alexander: i thank the senator from arizona for his amendment, and i thank the senator from florida for his amendment because medicare advantage is very important to tennesseeans. we have 243,000 tennesseeans who have opted for medicare advantage. about one-fourth of all americans who are on medicare have chosen medicare advantage

because it provides the option for increased dental care, for vision care, for hearing coverage, for reduced hospital deductibles. this is especially helpful to low-income and minority americans. this is especially helpful to people in rural areas. and what the republicans have been arguing all week is that contrary to what our friends on the other side are saying, this bill cuts those medicare advantage benefits, and the director of the congressional budget office says that fully half -- fully half -- the benefits of medicare advantage for these 11 million americans will be cut. well, our democratic friends say no, that's not true. we're going to cut $1 trillion out of medicare over a fully implemented ten years as part of this bill, but nobody's going to be affected by it. well, the senator from florida apparently doesn't believe that. he says we have 900,000

floridians who don't want their medicare advantage cut. and we don't trust, he is saying in effect, we don't trust this democratic bill to protect these seniors' medicare advantage. so i would ask the senator from texas if the people from florida and the senator from florida don't trust the democratic bill to protect medicare advantage, why should 240,000 ten seeans trust the -- tennesseans trust the democratic bill to protect medicare advantage? mr. cornyn: what's good enough for the seniors in florida ought to be good enough for all seniors. in my state, the state of texas, we have 532,000 seniors on medicare advantage, and they like it for the reasons that the senator from tennessee mentioned. and they don't want us cutting those benefits. but i would ask the senator from arizona and tennessee, i seem to recall we had amendments earlier which would have protected everybody from cuts in their

medicare benefits. and now we have a targeted effort negotiated behind closed doors to protect states like florida and pennsylvania and others. and i wonder whether this, the nelson amendment to protect the seniors in florida would even be necessary if our colleagues across the aisle had agreed with us that no medicare benefits should be cut. mr. mccain: as the senator from texas points out, just a few days ago we, by 100-0 vote passed an amendment proposed by the senator from colorado, senator bennet that says -- quote -- "protecting guaranteed medicare benefits. protecting and improving guaranteed medicare benefits." nothing in the provision of or amendments made by this act shall result in the reduction of guaranteed benefits under title 18 of the social security act. is there any member on the other side that can guarantee seniors in his or her state in medicare advantage that they will not

lose a single benefit that they have today? not the guaranteed benefit that the other side goes to great pains to talk about. i think those who are enrolled in the medicare advantage system believe since they received those benefits that they are guaranteed benefits as well. and i'd ask my -- we have our two physicians here on the floor who both had the opportunity of dealing directly with the medicare advantage program. if you have a patient come in, you say, by the way, you're having your medicare advantage program cut, but don't worry. we are protecting your guaranteed medicare benefits, you think they understand that language? mr. coburn: i'd respond to the senator from arizona with the following: first of all, they won't understand that language. if you look at the law there's medicare-a, medicare-b, medicare-c, medicare-d.

they're all a law. what is guaranteed under the law is that if you want medicare advantage, srubg it. what's going to change is we're going to take away that guarantee. we're going to modify medicare part-c, which is medicare advantage. so we have this confusing state to say we're not taking away any of your guaranteed benefits, but medicare advantage is guaranteed to anybody who wants to sign up for it. it is duplicitous to say we're not cutting your benefits when in fact we are. i'll yield to my colleague, an orthopedic surgeon from wyoming. what is good about medicare advantage? we hear it's a money pot to pay for a new program for other people. here's what's good about it: as we get coordinated care for poor medicare folks, medicare advantage coordinates the care.

and when you coordinate care, what you do is you decrease the number of tests. you prevent hospitalizations. you get better outcomes. and consequently, you have healthier seniors. so when it's really looked at, medicare advantage doesn't cost more. it actually saves medicare money on an individual basis because if you forego the interest of a hospital where you really start incurring costs, what you've done is save the medicare trust fund. but aoufls given better -- you've also given better care. the second point is many people on medicare advantage cannot afford to buy a supplemental policy. 94% of the people in this country on medicare who are not medicare advantage are buying a supplemental policy. why is that? because the basic underlying benefit package of medicare is not adequate. and so here we have this group of people who get benefited

because they chose a guaranteed benefit of medicare part-c. and all of us we're saying time out, you don't get that anymore. mr. mccain: -- people who enroll in medicare advantage are low-income people and a lot of them are rural residents? mr. coburn: a lot of rural. i don't know the income levels. but i know there is a propensity, you actually get a savings because you don't have a to buy a supplemental policy if you're on medicare advantage. mr. barrasso: -l following on with my colleague from oklahoma, there is the coordinated care. that is one of the advantages of medicare advantage. there is also the preventive component of this. if we talk about ways to help people keep their health care costs down, it has to do with coordinating care and preventing illness. a senator: we just heard we want to put a new preventive package in the program by the freshmen on the other side. yet we want to take the

preventive care out of the package. interesting mix, isn't it? mr. barrasso: we want to keep our seniors healthy. that is one way they can stay out of the hospital, out of the nursing home. stay active. yet this cuts medicare advantage. the democrats have voted to do just that, cut all this money out of this program that seniors like. 11 million american seniors who depend upon medicare for their health care choose this because there is an advantage to them. as my colleague from oklahoma, the other physician in the senate, has talked as i have extensively about patient-centered health care. not insurance-centered, not government-centered. medicare advantage helps keep it patient-centered. so when i see about the deals that are being cut behind closed doors, they're cutting out people from all across the country, and it seems as if there is a sweetheart deal to help the seniors on medicare advantage in florida to try to encourage one member of the senate to vote a certain way. what about the seniors from the rest of the country, whether it's texas, oklahoma, tennessee,

arizona? a lot of seniors who have great concerns. and i would hope they would call up and say hey, this is wrong. we need to know what's going on and why is it that there's a sweetheart deal for one selected senator and one selected state when we want to have that same advantage? why are the democrats voting it eliminate to cut all of this medicare money? mr. cornyn: let me ask my colleagues a question, maybe starting with the senator from arizona, a related issue, which is, medicare advantage is a private-sector alternative or choice to medicare, which is a government-run program. and i'm deducting throughout all of this bill sort after bias against the private sector and wanting to eliminate choices that aren't government-run plans. am i reading too much into this, or do any of my colleagues see a dollar propensity in this bill?

mr. alexander: i would say to the senator from texas, i think he's exactly right. there's a lot of very appealing talk that we hear from the advocates of the so-called health reform bill. but when we get right down to it and we examine it chosely, we find basically a big increase in government-run programs, and what does that mean for low-income americans and what does it mean for seniors who depend upon our biggest government-run programs, that's medicare and medicaid? the risk that they may not have access to the doctor they want. the senator from wyoming mentioned on the floor of the roar day that the mayo clinic, widely cited by the president and others on the other side, as an example of controlling costs, is beginning to say we can't take patients from the government-run programs, in some cases, because -- because we're not reimbursed properly for them. so what's going to happen, you know, behind all of this happy talk we're hearing about health care, is that we're going to

find more and more low-income patients dumped into a program called medicaid where half the doctors won't see a new medicaid patient -- it's like giving someone a bus ticket to a bus line that runs half the time -- and medicare is going to increasingly find itself in the same shape, just as the mayo clinic and perhaps others will say, we can't afford to serve patients from the government-run program. so i think -- i think the senator from texas is exactly right. we don't have to -- we don't have to persuade the 11 million americans who've chosen medicare advantage. it is a good program. they like it. in rural areas between 2003 and 2007 more than 600,000 people signed up for it. they -- they like tment and i think, in a way, the senator from florida may have a sweetheart deal, but in a way he's done us a favor, because we've been trying to say all week that the democrats are cutting medicare.

they're saying, trust us. we'r not cutting medicare. the senator from florida is saying, floridians don't trust you. you're cutting their medicare advantage, and i want to have an amendment to protect them. and senator mccain is saying, let's protect all seniors' medicare advantage. mr. mccain: could i also point out to my colleagues and for the record, again, on september 20, 2003, there was a letter to the conferees in medicare urging them to include a meaningful increase in medicare advantage funding for fiscal years 2004, 2005, a group of 18 senators, including senators schumer, lautenberg, clinton, wyden, et cetera, including senator kerry, who now obviously wants to reduce the funding for medicare advantage, again perhaps he was for it before he was against it.

but, again, i would also like too point out as short -- i would also like to point out as short a time ago as september 2009, a group of senators including wyden, murray, specter, bennet, klobuchar, others wrote to mr. charles frizera, acting administrative for the centers for med cainders medicaid services, "we write to express our concerns regarding the proposed changes to medicare advantage rates for calendar year 2010. the advance notice has raised two important issues that if implemented would result in highly problematic premium increases and benefit reductions for medicare advantage enrollees across the country." so, again, as short a time ago as last april there was concern on the other side about cuts in medicare advantage program. mr. alexander: i wonder if the senator is aware, in alabama

there's 181,000 people who are going to get the cut. in california, 1,106,000 people, seniors, are going to have their benefits cut. mr. coburn: colorado, 19 l,000 that are going to have their benefits cut. georgia 176,000, illinois is 176,000, indiana 148,000, kentucky 110,000, louisiana 151,000, massachusetts 200,000, michigan, 406,000. that's exactly what michigan needs right now, isn't it? for their seniors to have their benefits cut. minute missouri 200,000, nevada, 400,000 of, state of new york, 853,000, ohio, 499,000, oregon 250,000, pennsylvania, maybe, maybe not, because they may have got the deal, 865,000; tennessee

233,000 according to my numbers; washington state 225,000; wisconsin 243,000. i'd ask unanimous consent the list of what the enrollment is by the c.m.s. on medicaid and medicare advantage enrollment as of august 2009 be placed in the record. the presiding officer: without objection. mr. mccain: and the point of all of this that the senator from florida, a member of the finance committee, felt so strongly that medicare advantage was at risk that he decided to carve out -- was able to get a majority on a party-line vote of the finance committee to carve out a special status for a group of seniors under medicare advantage in his state. this amendment simply says that everyone that the senator from oklahoma just made reference to has that same protection. that's all that this amendment is about.

mr. cornyn: if the senator would yield for a question, if this amendment does not pass, which protects all medicare advantage beneficiaries, all 11 million of them, 532,000 in my state, and as a result of not only these cuts but perhaps additional cuts to come in the future to medicare advantage, which makes it harder and harder to -- for medicare beneficiaries to get coverage, i would ask our colleagues, particularly our doctor colleagues, what's -- what's the impact on eliminating medicare advantage and leaving people with medicare fee-for-service, which is the, as i recall, the bennet amendment earlier, which is you have to parse the language closely. they talk about guaranteed benefits. but i think the senator from oklahoma makes a good point. right now medicaid -- medicar, e advantage are guaranteed benefits. but what's the consequence of being forced only on a medicare

fee-for-service program? mr. coburn: limited prevalence screening, no coordinated care, loss of access to certain drugs, accessory things like vision and hearing supplementals, but more importantly, what's going to be is poorer health outcomes sms that's what it's going to be. or a much smaller checkbook. one or the other. a smaller checkbook, because now the government isn't going to pay for it, you are; or poorer health outcome. if your checkbook is limited, the thing that's going to happen is you're going to get the poorer health outcome. mr. barrasso: the senator from arizona started talking about the closed-door meetings, secretly trying to come up with things. there was an article in the paper today that the democrats are turning to actually throw more people on the medicare rolls and medicaid rolls as they're trying to come up with

some compromise. the idea being it's going to be compromising the care of the people of america. they're trying to put more people onto medicaid rolls. and the senator from tennessee has said, you know, it's -- many iphysicians don't take those patients because the reimbursement is so poor, and it's putting more people into a boat that's already sinking. so they want to put more people on medicaid and more on medicare. but at the same time, they're cutting medicare by $464 billion. this is a program that we know is already going broke and yet they want to now put people aged 55 to 64, add those to the medicare rolls, which is a program o i have great concernsb so special deals for some, cutting out many others and now adding more people to the medicare rolls-to-. to me, this is not sustainable. yet these are the deals that are being cut less than 100 feet from here, of off of the floor f

the senate while we're out here debating for all of the american people to see the things that we think are important about health care. jobs are going to be lost in our economy as a result if this bill gets passed. people that have insurance, they're going to end up paying more in premiums in this bill is being passed. and people who depend on medicare for their health, whether it is medicare advantage or regular medicare are going to see their health care deteriorate as a result of this proposal. but i turn to the senator from arizona, who's been a special student of this. mr. mccain: so seniors, by losing medicare advantage, would then lose certain provisions that medicare advantage provides them and then they would be forced, if they can afford it, to -- which they're now paying zero because it's under medicare advantage, then they would have to buy medigap policies, right, medigap policies that would make up for the benefits they lost

when they lost medicare advantage. and guess who offers those medigap insurance policies? our friends at aarp, which average $175 a month. so we're telling people, who are in medicare advantage today, when they lose it, they will be -- can be guaranteed if they want to make up for those benefits they're losing, they would be paying $175 a month, minimum, for a medigap policy. a lot of american seniors cannot afford that. and that's just a fact. $2,000 a year. they can't afford it. mr. coburn: i would make one other point is over the next ten years, 15 million baby boomers are going to go into medicare. 15 million. and we're taking $465 billion out of medicare, and on a real ten-year picture, $1 there tri.

what do you think is going to happen to care for everybody in medicare? what do you think is going to happen? the ultimate is we're going to ration the care for seniors in this country. if this bill comes through. life expectancies will decline. the presiding officer: there's 35 minute minutes remaining. mr. mccain: in other words, five minutes for this -- the presiding officer: five minutes remaining for you. mr. mccain: dr. barrasso, have you treated people under medicare advantage? mr. barrasso: i have. the people of wyoming know there's an advantage to being in this program. that's why they sign up. that's why citizens all around the country have signed up for medicare advantage because they realize there's value in prevention. and there's value in coordinated cavecare. there is value in having eye care, dental care, hearing care. there is -- there are advantages to want to stay healthy, to keep down the cost of their care.

mr. mccain: even though it may cost more, the fact that you have a weller and fitter group of senior citizens, you in the long run reduce health care costs because they take advantage of the kind of care that over time would keep them from going into the hospital earlier or having to see a doctor more often. mr. barrasso: that's one of the reasons that medicare advantage was brought forth. i know a lot of senators from rural states supported it because it would allow people from small communities to be in a program like that. it would encourage doctors to go into those communities to keep those people well. the 11 million people who are on medicare advantage in this country, they know they're on complair advantage. they have chosen it. it is the fast he have-growing component because people realize the advantages of being on medicare advantage. if they want to stay independent, they want to stay healthy, they want to stay fit, then sign you for medicare

advantage. i would think people all acruels the country who are listening to this debate who are sorns medicare but are not on medicare advantage would want to say, hey, why didn't i know about this program? seniors talk about this at senior centers and i go to senior centers and have town meetings there and shift with folks, hear their concerns. they're converting over and joining, signing up for medicare advantage because they know there are advantages to it. and now for this senate and the democrats to say, no, i want to slash over $1 billion from medicare advantage, i think the people of america understand that this is at a great loss to them and at peril to their own health as they lose the coordinated care and the preventive nature of the care. caning caned a ask the senator from tennessee, do you -- mr. mccain: i'd ask the senator from tennessee, do you know of any economist, any expert on health care that believes that you can make these kinds of cuts in medicare advantage and still preserve the same benefits that the enrollees have today? mr. alexander: the answer to the senator from from arizona i.

i know of one senator at least who does not believe it and he is the senator from florida. and its u.a.e it's interesting l week we've been going back and forth. we've been say, you're cutting medicare benefits. they've been saying us to, oh, no we're not. the people at home must say, who's right about this well, the senator from florida who sits over there has said, i'm not willing to go back to florida and say to the people of florida that your benefits aren't going to be cut if you're on medicare advantage, so i want an amendment to protect you. and so does the senator from texas, and so do the senator from oklahoma, the senator from louisiana, and from tennessee. and so the senator from arizona is saying we believe you're cutting medicare advantage benefits for 11 million americans. the senator from florida doesn't trust your bill. we don't either. we want an amendment that protects 11 million seniors.

mr. cornyn: it seems like all of the discussion about health care reform is a bit about accountable care organizations coordinating care particularly in the latter part of life, avoiding chronic diseases and the like. when i was at kelsey sebold clinic, they told me it is medicare advantage which allows them to be able to coordinate care to hold down costs to keep people healthier longer. yet, the irony to me, it seems that by cutting medicare advantage benefits is we are going backward rather than forward when it comes to that kind of coordinated less expensive care. would you concur with that? mr. barrasso: i would concur this is taking a step backward. that is why the senator from florida demanded they make accommodations for people of florida. the people of america, 11 million americans who have

chosen the medicare advantage program because it does help coordinated care, it goes with preventive care, it keeps it more patient-centered as opposed to government-centered, that is the way for people to stay healthy, live longer lives. we've seen cuts across the board on home health care, whether it's hospice care, they're across, they're cutting. the seniors across the country do not deserve. they paid into the program for many years and deserve their benefits. mr. alexander: one other thing, we've talked a lot about our good friend, the senator from florida. now he's been so perceptive on noticing that his floridians with medicare advantage may lose their medicare benefits. i hope he's as perceptive -- the presiding officer: the senator's time has expired. mr. mccain: i ask for an additional 30 seconds. mr. alexander: i believe there are our medicare benefits likely to be cut. aren't there cuts to hospices?

aren't there cuts to hospitals? aren't there cuts to home health care that we talked about yesterday? if floridians don't trust the democratic bill, why should they trust the democratic bill to trust any of their medicare benefits? mr. mccain: i would like to point out what dr. coburn said, medicare part-c, which is medicare advantage, is part of the law and to treat it in any way as different because those on the other side don't particularly happen to like it i think is an abrogation of the responsibilities to to the senis of this country. i thank my colleague. i yield the floor at this time. mrs. hutchison: madam president? the presiding officer: the senator from texas. mrs. hutchison: madam president, i rise today to talk about another amendment that is pending, the nelson-hatch-casey amendment. and this is the amendment that i

think has been discussed in the last day as well that is the amendment that would assure that no federal funds are spent for abortion. that was unclear. it is unclear in the underlying bill. and i think it is very important that we talk about it, that we make sure that it is very clear exactly what the nelson-hatch-casey amendment does. and that is it would bar federal funding for abortion, which is basically applying the hyde amendment to the programs under this health care bill. since the hyde amendment was first passed in 1977, the senate has had to vote on this issue many, many times, probably just about every year. and i have consistently voted to prohibit federal funding for abortions, as i know my colleague and friend from utah has done, as well as the democratic sponsors of this amendment.

and yet, it seems that some members were on the floor last night misconstruing exactly what the hatch-casey-nelson amendment does. specifically, their claim was that the hyde language only bars direct funding for elective abortions while the nelson-hatch-casey package is unprecedented. so i would just like to ask the distinguished senator from utah what exactly did the hatch -- did the hyde language say? let's clarify what hyde was so we can then determine if your amendment is the same. mr. hatch: thank you so much. the current hyde language contained in fiscal year 2009 labor-h.h.s. appropriations act says the following: section 507-a. none of the funds appropriated in this act and none of the funds in any trust fund to which funds are appropriated in this act shall be expended for any

abortion. b, none of the funds appropriated in this act and none of the funds in any trust fund to which funds are appropriated in this act shall be expended for health benefits coverage that includes coverage of abortion. mrs. hutchison: so that is federal funds prohibited from being used in abortions for that particular pweufplt what about programs like chip? that was created in the balanced budget act, and in 2009 was reauthorized by congress and signed by the president earlier this year. so what about the chip program? mr. hatch: i know a little bit about kheufp. it was the hatch -- about chip. it was the hatch-kennedy bill. i insisted that the following language be included in the limited statute. in general, payments shall not be made to a state under this section for any amount expended under the state plan to pay for any abortion or to assist in the purchase in whole or in part of

health benefit coverage that includes coverage of abortion. b, exception: subparagraph a shall not apply to an abortion only if necessary to save the life of the mother or if the pregnancy is the result of an act of rape or insist. that is what the chip bill said, and that was the hatch-kennedy bill. mrs. hutchison: i assume you do know what is in that bill. what about the federal employees health benefit plan? what does it say? mrs. hutchison: the reason i mentioned senator kennedy is because he was the leading liberal in the senate at the time and yet he agreed to that language. the federal employee health benefit package, the following language appears in the financial services and general government appropriations act for fiscal year 2009: section 613. no funds appropriated by this act shall be available to pay for an abortion or the administrative expenses in connection with any health plan under the federal employees health benefits program which provides any benefits or coverage for abortions.

section 614. the provisions of section 613 shall not apply where the life of the mother would be endangered if the fetus were carried to term or the pregnancy is the result of an act of rape or incest. mrs. hutchison: isn't that the same as the language of the nelson-hatch-casey amendment? mr. hatch: you're right. let me read that language for you. in general, no funds authorized or appropriated by this act or an amendment made by this act may be used to pay for any abortion or to cover any part of the cost of any health plan that includes coverage of abortion. mrs. hutchison: based on what you've said, this is not new federal abortion policy? the hyde amendment currently applies to the plans discussed, including the plans that members of congress have, and the abortion protections for all of the federal health programs all

say exactly the same thing and that we should -- the amendment that we are going to vote on, that is the nelson-hatch-casey amendment, would preserve the three-decades long precedent. that's what your amendment does. and that we must pass it if we are going to guarantee that the bill that is on the floor is properly amended so that it is the same as our 30 years of abortion federal policy in this country? mr. hatch: the reason it's so critical that we pass the nelson-hatch-casey amendment is that it is the only way to guarantee that taxpayer dollars are not used by the insurance plans under the democrats' bill to pay for abortions. in other words, the hyde language is in the appropriations process. we have to do it every year rather than making it a solid

amendment. but this bill is not subject to appropriations. so this bill, if we leave the hyde language out of this bill and the language that we have in the amendment, the nelson-hatch-casey amendment, then we would be opening up a door for people who believe that abortion ought to be paid for by the federal government to do so. and we should close that door because that's been the rule since 1977. mrs. hutchison: i just thank you for the explanation. i thank the senator from utah, because i do think it's important that people know. there has been a lot of question raised about the bill and whether it would be a foot in the door for a -- for changing a policy that really has been the law of our country and accepted as such, whether it was a democratically controlled congress or republican-controlled congress.

i think everyone has agreed that this hyde amendment language has protected federal taxpayers who might have a very firm conviction against abortion would not have to be subsidizing this procedure. mr. hatch: i appreciate the distinguished senator from texas pointing this out. the current bill has language that looks like it is protected but it is not. and that's what we're trying to do, is close the loophole in that language and get it so that we live up to the hyde amendment which has been in law since 1977. and to be honest with you, i don't see how anybody could argue that the taxpayers ought to be called upon to foot the bill for abortions. let's just be brutally frank about it. the taxpayers should not be called upon to pay for abortions. the polls range from 61% of the american people, including many pro-choice people, do not

believe taxpayers should pay for abortion to 68%. the polls are from 61% to 68% do not believe that the taxpayers ought to be paying for abortions except to save the life of the mother or for rape or incest. and we provided for that -- for those approaches in this amendment. so anybody who argues otherwise is just plain not being accurate. mr. specter: madam president, would the senator from utah be willing to yield for a question? mr. hatch: sure. mr. specter: my question relates to the provisions of the pending bill, section 1303-2-b which specifies that the plan will not allow for any payments of abortion and where there is

as provided out of section 1303-2-a, there would be a segregation of funds. so that under the existing statute, there is no federal funding used for abortion. but an individual may bile additional funds -- may buy additional funds, a woman having the right to pay for her own abortion coverage. and with the status of medicaid, where the prohibition applies to anybody, any federal funds being used to pay for an abortion, there are 23 states which allow for payment for abortion coverage coming out of state

funds. so aren't the provisions of this statute which enable the woman to pay for abortion on her own exactly the same as what is now covered under medicaid without running against the violation provisions of the hyde amendment? mr. hatch: the way we view the current language in the bill is that there's a loophole there whereby they can even use federal funds to provide for abortion in this, under this segregation language. and that's what we're concerned about. want to close that loophole and make sure the federal funds are not used for abortion. like i say, there are millions of people who are pro-choice who agree with the hyde language. all we're doing is putting the hyde language into this bill in a way that we think it will work better. mr. specter: if the senator --