asking us about a bill because they were already talking about health care reform, and any one of us told him that it would increase taxes, it would increase premiums of health insurance, that it wouldn't do anything about decreasing inflation of health care, in other words, costs are going to go up yet and we're going to take $464 billion out of medicare, a program that's already in distress, to setup a whole brand-new government program, you know what every one of those people around the table would say? well, that doesn't sound like health care reform to me. so let's not denigrate the word "reform." i ask unanimous consent, along with my last remarks, to put a

letter from the afl-cio in the -- in the record. i yield the floor. the presiding officer: without objection. the clerk will call the roll. quorum call:

a senator: mr. president? the presiding officer: the senator from alabama. mr. sessions: i would ask that the quorum call be dispensed with. the presiding officer: without objection. mr. sessions: mr. president, the vote that we had earlier this morning moving forward to the omnibus spending bill that's before us is a stunning statement that we are not listening to the american people, that we are unaware or indifferent to the level of spending that's occurring in this country, and that it is unlike what has occurred before. many have complained that president bush overspent -- on some occasions he did. one expert told me recently that they compared president bush's misdemeanors to felony murder

when you look at the seriousness of the spending levels that we are now undertaking in the base line budgets of the various federal agencies. this is different from the stimulus package that's already out there to spend $800 billion in stimulus spending that's been poured into this economy on top of the base line budget spending items. and so not only are we having this unprecedented stimulus package, the largest single spending bill in the history of the american republic, not only did we do that earlier this year, we are now moving forward with the base line budget items that have increases that are stunning, unjustified, and irresponsible and put us on a pathway to double domestic spending in far less than ten

years. this is just unthinkable. and i -- i have to go back to the core threat that we are facing as more and more experts and economists are reminding us of it. this is based on the congressional budget office study. it's based on the budget presented by the president of the united states. over the ten years earlier this year, he presented us a budget, and what did it show? it showed that our total american debt in 2008 was was $5.8 trillion. that is a tremendous amount of money. that's what the total debt from the founding of the american republic was, $5.8 trillion. they project by 2013, that debt will increase to $11.8 trillion, doubling in five years and increasing to $17.3 trillion in the tenth year of the

president's budget. tripling the national debt. now, they say well, we have an economic recession. well, we have had recessions before. we have a recession more often than every decade. hopefully we thought maybe we could figure a way to avoid them, but we haven't done it yet. i guess blame can go around to a lot of different people. i would just say that this does not project another recession in the ten years that we're tripling the debt. mr. president, i see the democratic assistant leader and the whip here, so i would be pleased to yield the floor whenever he is prepared to go forward. mr. mcconnell: i would thank my friend from alabama. the presiding officer: the republican leader. mr. mcconnell: mr. president? the presiding officer: the republican leader. mr. mcconnell: mr. president, we had indicated to senator reid and senator durbin that we

wanted to see if there were not a way to develop some path forward on the health care bill, and i'd like to at this point propound a consent agreement that might well give us a way to move forward on some of the amendments that have been pending for quite some time, some of which are both supported and opposed on each side. having said that, i ask consent that after the vote on the adoption of the pending conference report, the senate resume consideration of h.r. 3590 under the following order -- two hours of debate equally divided between the two leaders or their designees, and following the use or yielding back of that time, the senate proceed to a series of stacked votes in relation to the following amendments or motions -- a baucus sense of the senate amendment related to taxes, the pending crapo amendment, which i might add parenthetically has been out

there since last tuesday, the crapo motion to commit the bill related to taxes. then the dorgan amendment which is on the drug importation issue, number 2793, and then a mccain amendment number 3200 on the same subject. i ask -- further ask consent that the above referenced amendments be subject to an affirmative 60-vote threshold and that if they achieve that threshold that they be agreed to. further, if they do not achieve that threshold, that they be withdrawn. finally, i ask that no amendments be in order to any of the mentioned amendments in motion. and before the chair rules, i would just like to make a quick point. the majority leader has been proposing a series of votes which regretfully has not held to our pattern of alternating back and forth. we have many people interested in the pending amendments and under the agreement i just put forward, each side would get two votes, as we have tried to offer it throughout the health care

debate, and then we would move forward. the presiding officer: is there objection? mr. durbin: mr. president, reserving the right to object. the presiding officer: the senator from illinois. mr. durbin: mr. president, if i might engage in a colloquy with the minority leader, perhaps there would be a better understanding of his unanimous consent request before i make my final decision. i don't know. i have to ask unanimous consent. the presiding officer: without objection. mr. durbin: i'd like to ask if the -- as i understand it now, when it comes -- let's set aside crapo and baucus and assume that there is commonlyity on that. as i understand it now, the dorgan amendment which would allow for the importation of pharmaceuticals and drugs into the united states has been offered on our side as well as a lautenberg amendment which has some history in the senate. it was previously offered by senator cochran of mississippi and establishes a standard for certification of safety of the drugs coming in. now, could the senator from kentucky describe to me what the

new amendment, mccain amendment 3200 does? mr. mcconnell: fortunately, senator mccain is on the floor at this time, and i would like to ask him to describe -- mr. mccain: i'd like to say to my colleague, first of all, as is well known, the side-by-sides have been one side of the aisle and the other side of the aisle. if the lautenberg amendment were in order on the dorgan amendment as a side-by-side, that would obviously be a change from what we have been doing. basically, what my amendment does -- i think it makes some perfecting changes to the underlying -- the dorgan amendment. i think it makes a sense of the -- it has sense of the senate provisions. it has several other provisions which i think would help make it more effective. and i have to be very honest with my friend from illinois, it doesn't undermine the dorgan amendment. i think it supplements to the dorgan amendment just as the bennet amendment to medicare

costs supplemented the position that we had that medicare benefits wouldn't be cut. so side-by-side amendments aren't necessarily in contrast with each other. sometimes they perfect, and i think that my amendment makes it a better amendment -- better proposal, the dorgan amendment a better proposal. mr. durbin: i would ask the chair to expand the colloquy to include senator mccain. the presiding officer: without objection. mr. durbin: i ask senator mccain does your amendment 3200 include the existing language of the dorgan amendment? mr. mccain: yes, plus some perfecting language as far as the senate is concerned, about other procedures that would entail expediting the -- the dorgan amendment as well. mr. durbin: is the senator from arizona prepared to offer the lautenberg language in his amendment? mr. mccain: no, obviously not because i don't agree with -- with the lautenberg language in

my amendment, as you know. but what we are trying to do is, obviously, make the dorgan amendment better, just as other amendments in the side-by-side have tried to make the amendments better, don't necessarily cancel them out but make them better. mr. durbin: is the senator from arizona a cosponsor of the dorgan amendment? mr. mccain: yes, a proud cosponsor. mr. durbin: would the senator from arizona consider offering whatever is different in 3200 as a separate amendment to the dorgan amendment? mr. mccain: i guess what i -- i'm not sure if i understand my friend, but i'm just offering the amendment as a side-by-side in order to improve -- in my view, improve the dorgan amendment, but again in all candor not to undermine it but to make it better. mr. durbin: mr. president, i have an obligation to -- not only to my leader but also to senator lautenberg who is being dealt out of the picture here with this unanimous consent

request, and he has been offering an amendment which is well known and has been offered previously by senator cochran of mississippi, republican, and at this point senator lautenberg is offering it. i -- i think at this point i'm constrained to object based on this new mccain amendment, and i will discuss it with the senate leadership as to whether or not there is a way we can find a path through this. this is the third day we have been struggling with this. it appears that there is a lot of credence put in the belief that we have to have exactly the same number of republican and democratic amendments, and i understand it from the minority point of view. mr. mcconnell: i have a solution to the problem. it actually involves my side agreeing to a procedure we have not followed throughout this bill, but let me suggest the following that i think would get us out of this conundrum that we

seem to be in. and that would be that even though we have alternated from side to side, we agree to both dorgan and lautenberg in conjunction right after crapo and baucus, and then we get in the queue our affection -- our next two, which i believe you already are familiar with because they have been discussed on the floor, the hutchison-thune amendment and then a snowe amendment. mr. mccain: and i withdraw with great reluctance and great anger withdraw my amendment because i think the lautenberg amendment would be in violation of what we have agreed to. mr. mcconnell: in other words, mr. president, putting it another way, we're basically conceding to what you had

earlier proffered as a way to get moving on the bill, and then we would get back into our process of going side to side, and we are offering -- just wanted you to know that our next two -- we have been letting each side know what the other side was going to offer. our next two would be the snowe amendment and the hutchison-thune amendment. mr. durbin: i -- let me suggest this. i will formally object to the original unanimous consent request, and i will then take what i consider to be a good-faith offer from your side as to the next two amendments to the majority leader, we will review the amendments, and i hope even today that we will be back to you and suggest whether or not that is a path out of this -- mr. mccain: could i be clear with the senator from illinois that what this means is we will move forward with the side-by-side, dorgan and lautenberg, we would agree to, and then we would also expect agreement on following amendments so that we could lock those in for debate and votes?

mr. durbin: may i asked the two amendments that you voted, thune and hutchison and the other amendment, snowe, we would allowed to have side-by-sides to those? mr. mcconnell: of course. if you chose to, of course. mr. durbin: if you would be kind enough to review that proposal, i promise you i will get back to you. mr. mcconnell: i appreciate that because i understand capitulation when we do it. and basically we've essentially said to the majority, we'll go along with what you had earlier requested and we'd like to -- for you to take "yes" for an answer and for us to wrap this up and be -- have a sense of where we're going from here. mr. durbin: and i promise that we will get back in a timely fashion. i thank the minority leader. the presiding officer: there is objection to the initial request. mr. durbin: i object to the initial request. i yield the floor. the presiding officer: yes, the objection is noted.

the senator from alabama. mr. sessions: mr. president, i would ask unanimous consent that my remarks appear without interruption in the record. the presiding officer: without objection. so, mr. president, just to restate, we're on an unprecedented course of spending that's never been seen in our country brsm th before. the only thing like it was during world war ii and we were in a life-and-death struggle, fighting wars in both the pacific and atlantic and africa and around the world. virtually every able-bodied person was either in the military or building ships and airplanes and weaponry to send to our soldiers. the whole country was mobilized. so we never did this to our deficit then, and we did it in a

way that commenced a paydown of those debts after it was over. so i wanted to emphasize -- what i wanted to emphasize was, many of my colleagues have heard it stated, people seem to all admit it, we're on an unsustainable path. this is not a sustainable spending schedule that we are on. well, how do we get off of it? when do we get off it, if it's unsustainable? is it by producing a bill that we just voted on that increases spending at 12%, a rate of spending that would double those six discretionary spending bil bills -- accounts in, what, five, six, seven years, we double it? is that -- is that the way to get spending under control? i don't think so. and remember, i'm not counting in this 12% increase the stimulus package that was passed.

so this is stunning. and i would also note that under the budget that the president submitted and the deficits in the out-years are not going down. there's no projection in those ten years that we'd have a recession, but there's also no projection that the deficits would be falling. and, in fact, the deficit in one year, in 2019, would be over a trillion dollars, around a trillion dollars. so this is just stunning numbe numbers. the highest deficit we've ever had was last year at $450 billion, year before last. this year we just concluded in september 30 of this year, $1.4 trillion. next year will be $1.5 trillion, and there will be -- should be some dip we hope for a few years and then it's going back up on an unsustainable path. it's just stunning. we cannot do this.

that's one of the big things that is occurring in the streets of america with the tea parties and others. people are saying to congress, what is the matter with you? don't you understand you're mortgaging our children's futu future, you're devaluing the dollar, you're placing our economy at risk, as virtually every expert economist you talk to says, including mr. bernanke? not very aggressively, in my view, but he said that recently. so this is a bad path. what does that mean about when you have a big debt, the debt goes up? where does -- how do you get the money? where does the money come from? well, you have to borrow it. we put on the market treasury bills and notes and we ask people to loan us the money so we can spend, spend, spend,

spend more than we take in year after year. now, some say, well, it's the entitlements that are causing this and entitlements are growing. that's our social security and our medicare. one reason those are going, frankly, it's a very serious reason, is we have more seniors and they're living longer. so they've been going up 6%, 7% a year. and we're troubled by that. but the truth is that social security and medicare have been in surplus. and what has happened to the surplus? it's been spent on discretionary spending. we're spending the social security surplus and medicare surplus but it's going kaput. medicare is fading fast, and by 2017, it will be in deficit. so we're not going to have a

surplus to spend there, so you borrow the money. this is what you do. and in 2009, we paid interest on the money that people loaned us, much of it from china and oil-rich states, many of whom are not friendly to us, we're paying them huge amounts of interest, $170 billion. how much is that? that's a lot of money. my state of alabama is about an average size state. we're a frugal state. we don't -- we don't have huge government and we've got some pretty good economic growth i think as a result of that, but we have a $2 billion annual general fund budget. $2 billion. this, we paid $170 billion in the united states of america in interest alone in 2009. and look what c.b.o. says our -r objective budget office. it's under the control, really,

of the democratic majority but they take pride in giving us numbers that are valid and reliable and i think they do that, for the most part. look at this. they say by 2019, the interest that we will be paying on the debt won't be $170 billion but $799 billion because we can't stop spending. it's just unthinkable and it's -- and people say oh, we've got to do better. we can't -- this is unsustainable. we need to do something. when? we just voted this morning for a bill -- i yield th i don't haven that but i'll just read the numbers to you. it increases spending on six of the 13 appropriations bills. we try to pass them individual individually, 13 appropriations bills that fund the federal

government. well, when you get to the end and people don't want -- it's easier sometime for the leadership just to cobble all six of them together in a big package and put them out there and say vote up or down. so that's what we've done. that's not a good policy. we need to do better about that. we really need two-year budgeting and then we'd have time to bring up these bills one by one and give them the scrutiny they deserve. but if you look at the overall spending in these six bills, six of the 13 have been put noticing a package -- have been put together in a package, it shows that the percentage of growth and spending on the baseline level is 12%. that's a stunning figure when you think about it. what is the inflation rate today? zero. we don't have inflation. some say we have deflation. i think the last number may have been a .2% decline in inflation.

.2% deflation. so the economy is -- the average family is containing their spending. the average city -- ask about your mayor and all. aren't they trying to contain spending and be more efficient and -- and be leaner and more effective? what about our state governmen governments, the same thing? they're facing real problems and they're trying to contain the growth of spending, and we increase it by 12%? what about foreign aid and -- and state department and foreign operations, what kind of increase did they get, what kind of increase did the average working american get in their salary? probably zero. lucky to hold it. if they had been getting overtime, they're probably not getting overtime today. maybe in the family two people were working, maybe now only one

is working. but what did state and foreign operations get? a 33% increase in spending. 33%. most of which i assume will be spent around the world somewhere. what about transportation and h.u.d.? i think i have a chart on that. i just have the last two years since our colleagues have been in the majority leader. last year it was a 12.3% increase, a stunning increase. and look at this year, 2010, 23% increase on h.u.d. -- housing and urban development and transportation. 23% on top of 12%. this is the kind of spending

that would double the h.u.d. budget in three to four years. and the foreign op ps, i just mentioned that the rate of increase we have, it would double in two to three years. the whole budget would double in two to three years. and well let's talk about transportation-h.u.d. did they get any money out of the stimulus package? so you're counting that in here, aren't you, sessions, the money that transportation-h.u.d. got out of it? no, i'm not. this is baseline spending. what did they get? the total transportation-h.u.d. budget -- i hope that my colleagues will think about these numbers -- is $68 billion this year. $68 billion. so remember, i just noted that interest on -- in 2019 would be $800 billion. so it gives some perspective on

the level of spending we've got. but again, that's just the baseline spending and it does not count the $62 billion in spending that came out of the stimulus package according to this chart. and remember, the -- only a small percentage of the stimulus package went to highways. they said it was for bridges and infrastructure and highways, and i think about 4% of the overall amount went to highways. so now they claim we don't have enough money for highways and they talk about another stimulus bill of another couple a hundred billion dollars. just another hundred or $200 billion. remember, a hundred billion dollars, the entire transportation-h.u.d. expenditures this year is $68 billion. i'm just trying to -- remember, i don't think that this is any kind of exaggeration.

i don't believe that i am an alarmist here but i am alarmed because i'm telling the truth about these numbers. and what have we done on previous spending bills that have come through the -- the senate? two other bills have already come through the senate and had stunning increases in them. look at this. this is interior and the environment for expenditures. department of interior and the environment -- environment, e.p.a. basically, look at that, 16.6% increase in one year? it had a tight budget last year. it had a 16% increase this year.

and the e.p.a., the environmental protection agency, which now is claiming the ability to regulate co2, they got a 33% increase in spending. e.p.a. got a 33% increasing in spending. we've never seen those kind of numbers before. look. look at these expenditure growth items over the last number of years. you know, when president bush was in, everybody said, he was a spend thrift. president bush put us in debt. democrats said we're not doing anything. this is just the way bush, it's all his fault. he was a big spender. i criticized him some for overspending. a lot of republicans have. look at the interior, environment and appropriations. averaging over from 2001 to

2009, 1%. he was holding the line. he had some 5% years, 5.6, 5.6. but some negative years too. so the average was a modest 1%. a 16% growth in spending at a time when inflation is zero. another example of that, let's just take the ag, agriculture bill, i believe in agriculture. i tried to support most of these bills. i worried sometimes we were spending too much in agriculture. but i can't vote for this. we've already moved this legislation through the senate. the ag appropriations discretionary spending. zero in 2005, zero in 2006, .0% in 2007, 1.1% in 2008 and now

15% and 14.5% increase. how can we say we're responsible? we had deficits in these years. we've never seen deficits of $1 trillion a year, which is basically what's going to occur under president obama's budget. i wish it been so. i wish i didn't have to make this speech because it's dangerous to the american economy. so -- now these numbers remain here are just stunning numbers. only one that got a modest increase, our men and women in uniform, the defense department. but state and foreign ops,

32.8%, interior 16.6%, commerce, justice, state, 12.3%, transportation and h.u.d., 23%, agriculture, 14.5%; defense 4.1%. that should tell us something about maybe where the priorities are around here. it's troubling to me. but -- so what do the american people think about this? i've heard a lot of my colleagues say, well, you know, we have a recession and we have this war that's going on and we just got to spend more, the american people understand that. and they're -- it's all right. we just want to do this and let's do it. look at this poll that came out recently. actually november last month cnn poll, the question is: which of

the following comes closer to your view of the budget deficit -- the government should run a deficit if necessary when the country is in a recession and at war, or the government should balance the budget even when the country is in a recession and is at war? 67% say balance the budget. balance the budget, please. because this -- first of all, i know this isn't world war ii. we've got a very expensive war. we need to make sure our men and women are well funded. but it is not the driving factor in the deficits that we're having today. only 30% said run a deficit. 4% had no opinion. 67% said we ought to have -- balance the budget even at a time of war and recession.

so -- so there -- there are other problems that -- all this -- that has ramfications that arise from this kind of reckless spending. it's been a catchline for a number of our colleagues who supporting this health care bill that it would reduce the deficit. well, past history with entitlements has shown that that is not so. first, estimates don't prove to be accurate, number one. number two, there are gimmicks in this health care bill that hide its true costs. i will just mention one of them for this moment. because we do not -- one of them -- one of the big ones is that we don't pay the doctors. the doctors are projected after this next year for nine years

under this budget scheme to take a 23% cut in their payments for the work they do for medicare and medicaid. a 23% cut. many doctors already are leaving medicare and medicaid because they're not paid enough. they're paid substantially less by the u.s. government for medicare and medicaid in private insurance -- and private insurance companies pay for them the work that they do. so we can -- that was part of the plan to fix medicare was to fix permanently the payments for our physicians. when the numbers didn't add up, and if you pay the physicians what you're supposed to pay them, it would cost $250 billion over 10 years. instead of doing that, they attempted to take the doc-fix payments and put in a separate bill and pass it, every penny of it going to the debt, and saying

our health care bill is deficit-neutral. the health care bill is deficit-neutral, my good friends and constituents back home. i'm voting for a bill that's not going to impact the debt. well, when you move a $250 billion hold out of your bill and put it over here, that's one way to hide -- hide what you're doing. if you count that, we hav have $120 billion deficit. and the bill, by the scoring our own colleagues. they just took that out. because they didn't -- the numbers wouldn't add up if it were in. and it's wrong. and it's the kind of gimmicks and manipulation that the american people are getting tired of and some people are going to pay at the ballot box for continuing this kind of thing. let me just give some examples how even the estimates of these

bills fundamentally turn out to be wrong. in 1967, the estimate for how much medicare would cost in 1990 was $12 billion. so in 1967 they projected how much medicare would cost in 1990. what was the actual cost in 1990? it was $98 billion, no not $12 billion. that means the estimates were off by a factor of eight. in 1987, congress estimated that medicaid payments to hospitals would cost $1 billion in 1992. that was just five years out. a five-year projection was medicaid payments to hospitals would be $1 billion. what was the actual cost? $17 billion. meaning the estimate was off by a factor of 17 in only five years. so this kind of recklessness

does jeopardize our economy. i don't think this spending is helping our economy because i think what is occuring is that people who invest in the future and -- and hundreds of millions, maybe billions of dollars in big factories and things, they're worried about our recklessness. they're worried about future economic stability and they're not as willing to invest because we're not acting responsibly. stanford university economist, michael boskin, stated in a recent editorial in "the wall street journal," -- quote -- "explosion of spending deficits and debt foreshadows even higher prospective taxes on work, saving, investment, and employment. that not only will damage our economic future, but it is harming jobs and growth now." close quote.

i think there's too much truth in that. brian riddil at the heritage foundation on october 6th, in "the washington times", did an op-ed that said that the estimates on the size of the deficits that i've just given you are likely to be wildly optimistic. by the way, when i said the debt triples from $5.8 trillion t to $17.3 trillion, i am not including -- and those numbers do not include health care. because it hadn't passed. that's not current law, they didn't count that in the numbers when they were scoring it up. so he notes that the president assumed that spending would only increase at the rate of inflation for nine years after 2010. after he concluded an 8% increase for spending in 2010. the president's deficit

estimates also assume interest rates lower than those in the 1980's or 1990's. now once all the factors in mr. riddel's analysis is added up, he projects a total deficit for the next 10 years to b be $13 trillion, an unsustainable level, for sure, and well above what c.b.o. has scored. because he's projecting higher interest rates on the debt because so much money would be borrowed worldwide, how do you induce people to loan you money? you have to offer them higher interest rates to get them to loan you money. they're not going to loan you money at the low interest rates that we have today because of the economic slowdown. the interest rates are going up. c.b.o. acknowledges that in his score, the heritage scholar there said it's going to go up higher than c.b.o. has scored. october 14th, "new york times"

article, said that "reason we are not pressing china to appreciate its currency and stop devaluing its currency against our is because we rely on them to purchase our debt." don tial, an economist at credit swiss was -- suise, -- to get them to pay the bills. in other words, to get them to keep buying our treasury bills. so we can keep borrowing money. small manufacturers all over the country, including alabama, have suffered from china's undervalued currency. we continue -- they not only have a wage advantage over us to a significant degree, they also don't have the environmental laws we have. and they also devalue their

currency, all of which makes them more able to undercut american companies manufacturing and adversely compete against them. i'm constantly hearing about it from my state. i know others are hearing the same thing. however, china and other countries may not be able to keep financing -- to keep financing our debt in the future. professor allen meltzer, a well-known scholar on the federal reserve -- federal reserve, and monetary policy scholar noted in a column in "the wall street journal," that our current and projected deficits are too large relative to current and perspective world saving to rely on other countries being able to finance them for the next 10 years. we just can't -- we can't expect to be able to have that much wealth out there either in terms of our own citizens saving money

to buy the treasury bills and debt of the united states, but other countries are not going to have it either. in a budget committee hearing on budget reform, november 10, former controller of the currency, and g.a.o. head, david walker, testified that by 2014, -- 2040, time flies faster than we like to admit, we will have to double taxes to keep current with our commitments. this is the former controller general of the united states, the head of g.a.o., the government accountability office, and he knows these numbers and he's been very concerned about our reckless spending for quite a number of years, and resigned now, and basically committing himself to try to get this country on a sound financial track. mr. walker stated that in 12 years interest will be the single biggest line item in the budget. the interest on the debt even assuming interest rates don't

change from today's low rates. interest rates are going to go up. at least some. he also said that debt and deficits are the public's largest concern by 20 points in the opinion polls. that's what i'm hearing back from my constituents. they want some leadership up here. they want us to say look, we'd like to be able to provide more for this, that, and the other, but we simply have got to get our house in order and in the long run if we hold the line now, we can get this house back into order. and i believe we can, but we can't on the path that we are today. in a "financial times" editorial in may of this year, mr. walker warned that the u.s. is in danger of losing its aaa financial credit rating. well, is that possible? the united states of america wouldn't have the highest credit rating in the world? mr. walker said it's possible.

he made that comment in may of this year. and, of course, if you don't have the highest credit rating, you have to pay higher interest rates to get people to buy your debt, to loan you money. so if you want to loan two people money and one is rock solid, you might loan it to them for 4%, but if another person is risky, you may want 5%, 6%, 7%, 8%, 9% from them. so moody's rates people to see how reliable they are in paying their debt back with dollars worth the same as you loaned them. and mr. walker warned that our reckless spending was putting us in a path so we would no longer have our aaa credit rating. well, sure enough, in a report just this week, the big rating service moody's state -- stated that the u.s. is in danger of losing its aaa credit rating.

pierre calito, chief international economist at moody's stated that, unlike several years ago, -- "now the question of a potential downgrade of the u.s. is not inconceivable. "well, that would make the interest rate of $799 billion for one year, the interest payment in 2019 be low. if we get downgraded, that interest rate payment is going up. under the most pessimistic scenario put forward by moody's, the united states would lose its top rating in 2013. this is a great country. we have such a dynamic people and economy. they are willing to work, they are willing to compete, they are willing to save and all, but we need some leadership, and we need some leadership from congress, and we are oblivious to what the american people are

telling us, and we are oblivious to the massive debt increases that we are putting on the american people. and therefore this bill that passed today should not pass because having a 12% increase in spending, which would double that whole bill's financial spending in what? five or six, seven years, is unthinkable at this point in time. and i'm against it. i hate to be against it. there are a lot of things in there that i would like to be for, but i do not believe the republic is going to sink into the ocean if we would have a 1% or 2% increase in spending for these six bills. i don't believe that everything is going to collapse if we were to have a little frugality around here, give up some of our pork spending, give up some of our special projects and pro fuss on what is in the national

interest for a change and try to contain the surging growth of spending, and i don't know when it's going to occur. everybody says we've got to stop, so when? i say now. i say let's send this bill back. let's don't pass this bill. let's send it back to the conferees and the appropriators and say come back with a bill that's more responsible, and then we'll pass them. we're not going to not pass legislation to fund these things. don't let anybody say that, but the question is what kind of increases can we justify, and i'm worried about it. the american people are worried about it. we assume congress needs to get worried about it. if not, we're going to have some new people in congress and some new people are going to fix it because it can be fixed if we show determination. i thank the chair and would yield the floor. the presiding officer: the senator from pennsylvania. mr. casey: thank you, mr. president. mr. president, i rise this afternoon to speak about health care and the bill that is on the floor that we have been debating now for a number of days, the

patient protection and affordable care act. i wanted to provide first a brief overview, but in particular to focus on provisions that relate to our children and then get into some detail about -- about those provisions and the important programs that are contained within those parts of the bill. first of all, as we all know from the debate here, what this side of the aisle has been trying to do is not just to pass legislation but to do it in a way that meets the goals that we set forth many months ago and as well as what president obama indicated much earlier this year in terms of some basic goals. i will just cite a few of those. to make sure that when we're enacting legislation, that we don't add to the deficit, that we at least break even, so to speak, but the good news is on

the scoring done by the congressional budget office that the patient protection and affordable care act will actually lower, lower the deficit over ten years by some some $130 billion and then lower it even further over the course of the next ten years. by one estimate over over $600 billion. so that's good news about deficit reduction as it relates to this bill. even if we broke even, it would be significant. also we're obviously trying to cover tens of millions of americans who don't have coverage to the foundation, i should say, of the bill on that issue is that some 4% of the -- some 94% of the american people will be covered, adding some 30 million to 31 million in terms of coverage. that's also a goal and i think we're going to be able to meet that. and then a whole series of things that we have talked and talked about for years and have never done. we talk about how we have to enhance health care quality.

we haven't done much about it and we're going to be able to make changes in this bill to do that. certainly prevention. everyone knows that the studies on this are in a word irrefutable, that prevention is not only gd for a patient and good for his or her own family and good for the economy in the long term because you're going to have a healthier worker, but it's also a giant cost saver, sometimes in a way that you can't quantify and often get credit for from the congressional budget office. i have no doubt and i think i join a lot of other people who know a lot more about prevention than i do that this will be a huge cost saver in addition to being something that leads to better health oxygen. -- better health outcomes. so in terms of deficit reduction and coverage, it's a very strong bill. it's also a strong bill in terms of dealing with what we can call in two words consumer protections, and that doesn't even begin to describe what this

bill will do in terms of helping at least one category of americans. we saw a study a couple of months ago that indicated over -- over a several year period of time -- my recollection serves me as three years, millions of americans, not thousands or tens of thousands, but millions of americans have been denied coverage because of a pre-existing condition. that's because we have allowed insurance companies to do it year after year and in some cases a lot longer than that. well, we don't need to just talk about it and decry it and condemn it. we need to make it illegal. but we also have to make sure that we don't just pass legislation, a lot of which has to be implemented down the road, and then say to those with pre-existing conditions we changed the law but you have got to wait several years. one of the immediate benefits under the patient protection and affordable care act relates to those americans who have pre-existing conditions. the act will provide $5 billion

in immediate federal support for a new program to provide affordable coverage to uninsured americans with pre-existing conditions. coverage under the program will continue until the new exchanges are operational. that's good news for millions of americans who have been denied coverage. i can't tell you and i think every senator in this chamber, both sides of the aisle, democrat, republican, independent, have received letters from americans, horrific , tragic stories in many instances where they have been denied coverage, sometimes leading to death, sometimes leading to -- even if it's not death, to the worst of health care outcomes. so that will -- that high risk pool as it's called for those with pre-existing conditions will be an immediate benefit under the bill. a couple of other things that will happen immediately and then i will move to the provisions on children. we hear a lot about business on this floor. arguments about who is stronger

or who is more of an advocate for small business especially. but what we don't say enough is this act, the patient protection and affordable care act, will offer tax credits to small businesses to make employee coverage more affordable and those tax credits will go up to 50% of premiums which will be available to firms that choose to offer coverage. that's another not just good reform, good for the small business, gad for the employee, and really good for our economy short term and long term, but it's one of those immediate benefits. and i'll cite one more and then i will move on. we -- this congress a couple of years ago passed medicare part-d as it's known, adding prescription drug coverage. and one of the adverse impacts from that legislation is an older citizen gets the benefit of that and is able to benefit from the prescription drug coverage, but then they fall

into the so-called doughnut hole. that's a very innocent-sounding phrase, doughnut hole. it doesn't sound that bad. it's a nightmare for someone. basically what it means is it means an older citizen has to carry the whole freight for a long, long time and pay a lot of money at a certain period of time within which they -- they fall within that category. the patient protection affordable care act will reduce the size of the so-called doughnut hole by raising the ceiling on the initial coverage period by $500 in 2010. another immediate benefit of the enactment of this -- of this bill. the act will also guarantee 50% price discounts on brand name drugs and biologics purchased by low income and middle-income beneficiaries up to the cap that's -- up to the coverage gap. another immediate benefit. so in terms of small business, in terms of covering those with

pre-existing conditions immediately, as well as helping older citizens deal with and manage the difficult doughnut hole problem that so many of them have been suffering from. let me go do a quick summary of -- i just want to keep that up for a moment. i haven't gotten that chart yet but i will. let me start with it, in fact. this is just a summary of some of the challenges of where we are now and what happens if we do nothing. the status quo is unacceptable and unsustainable. that's an understatement. the first bullet point on there. every week, 44,230 people are losing their health insurance coverage. so every week that goes by here, every day that goes by, we have americans losing their coverage. bad for the individual and their family and it's real bad for our economy. the second bullet point, between january 2008 and december december 2010 -- roughly, you're looking at there a three-year time period -- 178,520 individuals in pennsylvania are

projected to lose their health care coverage. there's no way to adequately describe the adverse impact that -- that projection and that data point has on the people of pennsylvania. you can't have a growing economy if people are losing their health coverage. the numbers are spiraling out of control, not only in pennsylvania but across the country. you can't sustain an economy long term. the third and final bullet point -- without reform, family coverage would cost $26,679 in 2016, just seven years from now, consuming 51.7% of projected pennsylvania family median income. the site is the new american foundation. now, that same number for the country -- in other words, the percent of median family income going to pay for health care, for health care, something so fundamental and basic in our

society. it's 51.7% in pennsylvania in 2016. the good news for the rest of the country is that the average nationally is only, only a little more than 45%. i haven't met a person in pennsylvania or anywhere else in this country, but i know i haven't met a person in pennsylvania who says you know what? don't worry about it. don't worry about passing any health care reform bill. don't worry about getting it done because in 2016, i'm -- i'm living in pennsylvania and i can come up with 51.7% of my income for health care. don't worry about it. i can handle it. we know no one can afford that. even a family of tremendous means might have trouble affording more than half their income, half their income to pay for health care. what if the -- what if the projection is wrong? what if it's off by ten percentage points? that's 40%. what if it's wrong even more? what if it's