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tv   Book TV  CSPAN  December 20, 2009 5:30pm-7:30pm EST

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toward a combination -- a common ground on what's right. nobody's totally right. you know, each of us are here to serve in good faith we want to do what's best for our people in our home states. we're trying each state, different perspectives and different point of view. we're going to  get a better solution to health care reform if we talk together in good faith and give the whole story, not just part of it. mr. kyl: mr. president? the presiding officer: the republican whip. mr. kyl: thank you, mr. president. i appreciate the comments that my colleague from montana just made. i think the point that my colleague was earlier trying to make was that we just got the bill yesterday and have not gotten a full c.b.o. or final c.b.o. score that the correction simply revealed the fact that there is a lot there to digest, and we really ought to have more
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time to understand exactly how the interrelated pieces of the bill were, how all of the c.b.o. scoring relates and so on, and that when c.b.o. can make about a $600 billion error as i understand, that's a big error, so there is probably more, and there is probably a lot that we don't understand. it would really be helpful if we had more time to be able to understand all of this and understand how it works. i think that was the point that my colleague was making. i do appreciate my colleague pointing out it is better that we work in good faith here. for the most part, i certainly recall the long conversations that the ranking republican senator grassley and the chairman of the committee had. i know they worked in good faith and it would be best if we did that. it's to that end that i want to speak to some comments that a colleague earlier made today, and i don't know whether it's frustration or maybe just the lens through which partisans view things and their opponents, unfortunately, that spawned the remarks earlier today from one of our democratic colleagues.
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but in either event, his characterization of his republican colleagues i think requires response, mr. president. he began by talking about the malignant and vindictive passions that have descended on the senate. here's what he said. and i'm quoting -- "too many colleagues are embarked on a desperate no holds barred mission of propaganda, obstruction, and fear. history cautions us of the excesses to which these malignant, vindictive passions can ultimately lead. can rolled through taunting crowds, broken glass has sparkled in darkened street, strange fruit has hung from southern trees." now, i wouldn't believe my ears these references to one of the first and most vicious attacks on the jews by the nazis, hanging of blacks. the majority leader's remarks last week comparing the
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republicans' position on health care to the pro-slavery movement were largely ignored as the clumsy offhand ram buildings of a partisan, but the references earlier today appeared to be not off the cuff mistakes but prepared text deliberately delivered by one of the brighter minds of the senate. our colleague went on to acknowledge, and i quote again -- that in the heat of those vindictive passions, some people earnestly believed they were justified. such is the human capacity for intoxication by those malignant and vindictive political passions." well, yes, republican senators do believe our position is justified and, in fact, correct. there are honorable people on both sides of the aisle who obviously have to agree to disagree. but our colleague attributes no good motive to republicans whose passions are simply malignant and vindictive. he adduces evidence to support his claim. first, an unnamed editor of "the
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manchester enquirer" who wrote that the g.o.p., and i'm quoting -- "has gone crazy. an unnamed economist who believes that our party has been taken over by the irrational right. "a philadelphia jerusalemist talked about lunacy on the republican right. and i'm quoting now -- "it has gone crazy. it is more and more dominated by the lunatic fringe and has poisoned itself with hate." i wonder if my colleagues really believe that our position is animated by hatred. why else would we oppose this legislation? well, he answers that question, too. it's because he says, first of all, -- "it's to break the momentum of our new young president. they are desperate to break this
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president, he says. they have ardent supporters who are nearly hysterical at the very election of president barack obama, the birthers, fanatics, running around right-wing militias and support groups. that is one powerful reason, not the only one." well, talk about vindictive passions. does my colleague really believe that this is why i oppose the legislation, or my colleague john mccain? i hate to disappoint some folks, but i really don't care about the political fortunes of the president. at least not right now. i may three years from now. i don't like this bill. that's why i oppose it. my colleague says there is another reason. he says it's the insurance industry, which he proceeded to demonize. now, i'm not one to defend the insurance industry, but it's strange to see it so demonized
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by my colleague whose party brags of getting another 30 million people insured by who? the insurance industry. why subject these folks to such awful torture? but the real irony here is that the legislation which we oppose, the insurance industry supported. it made a deal with the obama administration and key senate democrats. you mandate that every american would have to buy one of our policies, and we'll support your bill. there was a deal all right, but it was between the insurance industry and key democrats. the insurance industry obviously didn't dictate the republican position which largely opposes the individual mandate. well, finally our colleague also accused republicans of engaging in something else. he said we were engaging in a campaign of falsehood about death panels and cuts to medicare benefits and benefits
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for illegal aliens and bureaucrats to be parachuted in between you and your doctor. our colleagues, he said, terrified the public that this parade of imagined horrors would whip up concerns and so on and then tell us the public is concerned about the bill. so the reason the public is opposed to the bill is because of the power of republican senators to terrify our constituents about imagined horrors. let's just look at the examples again. i don't know of any republican senator who has characterized the health care rationing as coming from death panels. i heard that phrase in another context. we tried to discuss the provisions of the bill that we believe do result in rationing. the chairman of the committee and i have had a lot of debate on this subject. i wish that senator roberts and i could offer a couple of the amendments that we wanted to offer to make sure that there is no rationing in the bill. i think it's a real problem and should be debated on its merits.
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the benefits for illegal aliens, i expect he was referring there to the house debate, but it is still the case that there are completely inadequate provisions in the bill to verify eligibility for benefits. you can even apply by telephone so just about anybody could apply for some of the benefits. and third, the matter of medicare benefits. i don't think that we're terrorizing our constituents about medicare benefits unless they understand the facts, and the facts are that medicare benefits are going to be cut. the congressional budget office says that the medicare advantage benefits are going to be reduced from a monthly actuarial value of $135 down to $49 a month. now, that's c.b.o. saying there is going to be a reduction in the benefits for those who have the private medicare -- medicare
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advantage policies. that includes dental vision, hearing, vision care, fitness, and a variety of other programs. we have had a semantic debate in this chamber between those who say well, the fundamental benefits of the medicare law are not specifically eliminated or reduced in the legislative language of the bill, that's true. what is also true is that the additional benefits in medicare advantage are being reduced. that's unassailable. and it's also true -- and c.m.s., for example, refers to this, that enrollment is going to be reduced because of these reductions in benefits. they talked about the lower benchmarks and say when it's fully phased in and enrollment and medicare advantage plans would decrease by 33%. so this is not some kind of fantasy. this is taken from the
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congressional budget office and from the c.m.s. actuary. and finally, in addition to the medicare advantage, the actuary says simulations by the office of the actuary suggest that roughly 20% of party providers -- and that's hospitals, nursing homes, home health care, would be unprofitable within the ten-year projection period as a result of productivity adjustments, meaning they would go out of business. obviously, seniors' care is going to be affected by this legislation, and we believe negatively so. that's an honest debate to have, and it's one which we would like to have. but finally, my colleague turned the world upside-down by arguing about the only reason that we're here the week before christmas is because of republican bad behavior, that we ruined the holidays for the professional staff because we followed the procedures of the senate that require the reading of the bill. now, it's true that that requirement is usually waived, but then we usually have plenty of time to know what's in a
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bill. usually a bill works its way through committee. both parties know fully what's in it. we both help to write the bill. it's transparent. it's usually printed long before the bill comes to the senate floor and we know what's in it. the reason it's read is so our staff would in fact have time to read it, to advise us. we didn't all have time to read it ourselves, and to advise the public, our constituents, of what's in it. again, we received it yesterday. we're voting on it tonight. that's very little time to know everything that's in there. and the more we learn about what's in there, the angrier a lot of people get. the special deals for one state, for example, that are simply wrong. that's why you take time to see what's in it. the majority of the public, according to opinion polls, want us to take more time to understand what's in this bill. and a final point on this -- i just have to say the majority leader dictates the schedule in the united states senate. all senators are pretty much
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equal, but the majority leader has two things that he can do and only he can do. has the right of first recognition and has the right to set the schedule. by the schedule, we mean when he files a cloture position, that's what brings this bill to the floor, this amendment to the floor. when he files the cloture position, that's when he determines when the vote will be. he determines when to bring the senate back in session and under the rules an hour after he brings us back in session, the cloture petition ripens and we have a vote. he can set that time any time. he can say that tomorrow morning at 9:00 a.m., the senate will come back in session and we will vote at 10:00 a.m. the leader could do that. that's his right, and he is the only one who has a right to do that. but instead, he says we will come in at one minute past midnight tonight, and therefore the vote will be one minute past 1:00 a.m. tomorrow morning. it's his right to do that. we didn't do that.
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he did that. he's the only one that has the right to set that schedule. and if he wanted to set a schedule that was a little bit more convenient for all of the members, including our dear friend, the senator from west virginia, who is ill and indeed does have to get out of bed to come in a wheelchair to this chamber, the majority leader has it within his power to say we'll do it at a more convenient time. why would he do it in this way? because he's deliberately decided -- and all majority leaders have not done quite this but have done similar things. they set a recess and then they worked us up against the recess so that we'll have an incentive to finish, and it's usually a pretty good incentive. certainly, going home for christmas is a big incentive. and so the majority leader figures that if he can schedule this bill and the various votes in such a way that we end up voting on it on christmas eve,
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that maybe then we'll hurry up and try to do it and hurry up because, as one democratic staffer is quoted as saying, "we need to hurry up and pass this bill because the longer it hangs around, the more -- the longer it hangs around, the longer it will be," meaning to pass it. and that's true. the more the public finds out about it, the less they like it. so the majority leader is trying to get it done as quickly as he can, and as quickly as he can means scheduling us for a vote one hour after we come in, and since it has to be the -- there has to be an intervening day, today is the intervening day. so tonight at one minute after midnight, we reconvene the next day and then have the vote at 1:00 a.m. it's purely the majority leader's decision to do it that way. republicans have nothing to do with it. if i had my way, we would vote at 10:00 in the morning, but that's not the way it's going to be.
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so please don't say that it's republican bad behavior that results in having to vote on this bill late at night. the process is determined by the majority leader. now, i guess i'm going to conclude by saying that i think think -- i really don't believe that this bill can be sold on its merits, and i think that's another reason why we have to hurry up and do it before the public really figures out what's in it. the public opposes this bill not for the reasons imagined by my khraoerbgs but because -- my colleague, but because it will cut medicare benefits, it really will raise taxes, put the government in charge of too much. it will cost trillions of dollars. and it will result in the delay and denial of care. that's why the majority of americans want us to start over and address the problems on a step-by-step basis. i was amused by the democratic
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whip saying the republicans offered four amendments. i think it was seven, but say it's four. guess who determines how many amendments the republicans get to offer? the majority leader. he sets that schedule as well. he says it's our turn to offer an amendment. then it's your turn. the way he did the schedule, we only got to offer four or five amendments. we've got 2 hundred amendments pending. we'd loved to get as many of these pending and voted on as possible. believe me it is not republicans who don't want to vote on our amendments. the majority leader has set the schedule. this is why we oppose the bill. it's why we don't like the process. we respect what our constituents are telling us. we believe this bill will be bad for them and it will be bad for our country. our democratic colleagues have a different position. neither their position nor ours is malignant, nor should they be
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expressed vindictively. mr. grassley: mr. president? the presiding officer: the senator from iowa is recognized. mr. grassley: mr. president, we've all been waiting for many weeks while the democratic leadershipship worked behind closed doors out of public view to write this new health care reform bill. and this is, of course, this process is very much contrary to what the president promised during the campaign, that negotiations on the health care reform bill would even be on c-span so that everybody in the country could see it. so now a very secretly put together bill is out for our consideration, with just a few days to consider it. last week they were considering expanding medicare to people between 55 and 64 years of age, also increasing medicare to
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cover people up to 150% of poverty, and thirdly having a government-run plan run by the office of personnel management. now we have something entirely different. we have the reid amendment, and it's chock-full of special deals, and it does nothing to fix the fatal flaws in the 2,074-page bill that we started with. and now we have a bill that's probably 400 pages long than just 2,074 pages. what kind of changes does this new amendment make to the original reid amendment? well, one tax disappears. it was a tax on cosmetic surgery. in its place, we have a new tax, a tax on tanning bed services. the dial on the medicare payroll tax is turned up. so, the first time marriage penalty in a medicare tax, one
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that hits about half of the two-earner couples, that tax is enhanced. well over a million couples get to look forward to that tax just -- can you believe it -- just for being married. so the old marriage penalty is back here. the dial on the insurance fee is also turned up on the back end of the bill. but with respect to a few favored insurance companies, the fee is turned off. the very limited small business tax credit is expanded. over a half a trillion dollars in new taxes, according to the official congressional scorekeepers. what kind of tax changes stay the same? basically the manager's amendment, the underlying reid amendment still imposes new taxes, new taxes on everything from tanning beds to insurance
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companies to wages to heart valves, to drugs, and even more. contrary to what has been said on the floor this very day, the tax burden still rests on many middle-class folks. as has been said, there is a sizable subsidy that 12 million tax-filing families and individuals would receive. we don't dispute that. but what the other side doesn't want to acknowledge is this: there are 42 million tax-filing middle-class families and individuals who will pay higher taxes under this 2,000-plus page bill. for every middle-class tax-filing family that receives an insurance subsidy, three middle-class families will pay higher taxes. so i ask unanimous consent to
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insert in the record a copy of a corrected version of an article on congressional daily dated december 18 this year. the presiding officer: is there objection? without objection, so ordered. mr. grassley: now this new compromise does not fix any of the core problems in this original 2,074-page reid bill. it still is that long of a bill. it's still a $2.5 trillion massive bill as far as cost is concerned. the reid amendment actually adds 400 more pages. these closed-door negotiations didn't produce a better product. quite the opposite, it still taxes middle-class families, seniors and veterans. millions of people still won't be able to keep what they have as the president promised in the
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last campaign. and a lot of people who were hoping to pay less as a result of the word "reform" still end up paying more. and i'm not just talking about the young and the healthy. it still imposes higher premiums for prescription drug coverage on seniors and the disabled. it still permanently cuts all annual medicare provider payment updates based on productivity gains outside of health care. these cuts still go into effect even if it means that providers will get a negative payment update. and these -- and these permanent cuts still threaten medicare access to care. the bill still cuts $120 billion from medicare advantage, cuts
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that will reduce medicare benefits for 11 million beneficiaries. contrary to what the president told us in his speech in september, nobody's going to get cut from medicare. this bill still creates a new body of unelected officials with broad authority to make further cuts in medicare beyond the $460-some billion that are in this bill. this bill still unwisely makes the board permanent. this still requires -- the bill still requires this board to continue making even more cuts in medicare and to do that forever into the future. the damage this group of unelected people could do to medicare at this state is unknown. but we certainly do know how
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impossible it will be to undo any damage that that unelected board does if congress decides that we ought to undo it because whatever cuts they make, we have to offset, and stirring up that money is very difficult for offsets. this bill passes a $26 billion unfunded mandate under the states because the reid amendment even made this problem worse by adding $1 billion to that unfunded mandate for states under medicaid. these increased costs will cause states to raise taxes or maybe cut education, maybe cut transportation, maybe cut law enforcement. but it's still money that the states have to dig up. this bill still has the class
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act in it, even though the administration's own health and human service's chief actuary says it runs a risk, a great risk of being unsustainable. it still has a special carveout for committee and leadership staff from having to use the health insurance exchanges. this is a cute move on the part of somebody in these closed-door offices. i got an amendment through the senate finance committee on a unanimous basis that if the people of this country have to use the exchange, employees and congressmen on capitol hill ought to use it. but, no, when you get to the secrecy behind doored, just the congressmen and their personal staffs, but not the thousands of people that serve on leadership staff or committee staff. they still got the deal they have today, so they aren't going
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to know what the american people are going through by using the exchange. this bill still has special deals for brand name drugmakers that will reduce access to generic drugs, making drug costs even higher for everyone. what this process has shown is that there is a clear and significant philosophical difference between this side of the aisle versus that side of the aisle. those differences are still there, and the lines between us on this specific piece of legislation become brighter still even though maybe on 90% of the legislation going before this body, there is bicameral -- i mean, bipartisan cooperation. but on this one, restructuring
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one-sixth of the economy, health care being a life-or-death issue for 306 million americans, this is different than anything this body has tried before. so on something like this, maybe there's legitimate reasons for being differences. republicans tried to reduce the overall cost. they said "no," and they increased the spending in the bill. republicans tried to reduce the pervasive role of government. they said "no," and they increased the role of government. republicans tried to make it harder for illegal immigrants to get benefits. they said "no" and that still has not been fixed. republicans tried to guarantee that federal funding for abortions wouldn't be allowed under this bill.
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you know why? because that's been the federal policy since 1976. that's even had bipartisan support, ever since the hyde amendment was put in place that year. but they said, "no," they wouldn't agree to apply that policy here. that still has not been fixed. republicans tried to allow alternatives to the individual mandate and the harsh penalties associated with it. they said no. and they have been -- and they've subjected even more people to the mandate, and they've raised the penalties. republicans tried to raise medical malpractice reform. they said "no," and a real lawsuit reform is still not in this bill. we have watched for -- we have watched while the other side has
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expanded government coverage since this process began, the other side has been working hard to move millions, millions of people from private coverage to government-subsidized coverage. the bill creates new government programs that covers family making close to $100,000 a year. when we hear about that in rural america, in the midwest part of the united states, they think we've gone bananas in this body by subsidizing families that are making $100,000. and at the end of the day, after raising billions in new taxes, cutting about half a trillion dollars from medicare, imposing stiff new penalties for people who don't buy insurance and increasing costs for those that do, you know what? still 23 million people will not have health insurance.
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i don't think this is what the american people had in mind when we promised to fix health care. the reid bill imposes a $2.5 trillion tab on americans. it kills jobs with taxes and fees that go into effect four years -- four years -- before the benefits of the bill take hold. it kills job with that employer mandate. it imposes a half a trillion dollars in higher taxes on premiums on medical devices, on prescription drugs and yet more. it jeopardizes access to care with massive medicare cuts. it imposes higher costs. it raises premiums. it bends the cost curve in the wrong way because people would expect you to bend inflation down.
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but this bill takes it up. this is not what people have in mind when they think about health care reform. we've been hearing repeatedly, mr. president, from the majority whip from illinois that the republican side has offered only four amendments. now, i found this to be rather astonishing. the majority whip should know because they're filed at the desk, that republicans have put forth 214 amendments. in addition to striking some of the bad ideas in the reid bill, these amendments also contain republican proposals that are improvements over the reid bill. but in this rush to get it done, the majority has decided that they don't want to consider any
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more of the 440 amendments that are filed before the desk. and let's gets clear that we keep them so people can have access to them any time they want to, the 440 amendments that have been filed that we're accused of not offering any suggestions, improvements. right here in these three binders, any one of the bills you want, any one of the amendments you want to know they are. so since this happens to be the case, i'd like to take them up on their interest in considering additional amendments. the majority leader and my friend, the senator from montana, have both said that they want this bill to fill the doughnut hole in the medicare part-d program. i share my colleagues' desire to even more protection than the seniors get under medicare.
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i filed an amendment that's in this binder here, amendment 31 3182, i filed an amendment that wiewz ththatwould use savings fl liability reform, which happens to be about the second or third thing that always comes up at my town meeting, that the people of this country feel we ought to be working on if you're going to make real the world reform. and i would put that $50 billion into savings towards eliminating the doughnut hole. the amendment puts the needs of 27 million seniors ahead of the needs of trial lawyers. i can't speak for my colleagues but that seems like a pretty easy decision. so to my good friend from -- from montana only have one unanimous consent request, i would ask unanimous consent to set aside the pending -- the
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pending amendment in order to offer amendment 3182, which is at the desk. the presiding officer: is there objection? mr. baucus: mr. president, reserving the right to object. the doughnut hole will be fill filled. i've made that promise. senator reid's made that promise. the white house has made that promise. and finally the bill presented to the president's desk, the doughnut hole will be filled, but not in the way suggested by my good friend from iowa. and i must say, that he's one of my best friends on the senate floor and it's with pain that i must object. the presiding officer: objection is heard. mr. grassley: i find it very disappointing that this opportunity to forego $50 billion in savings that could make prescription drugs more affordable for 27 million seniors, but i would also add that even though they say and my friends just said that they're filling the doughnut hole, i would quickly say that it's being filled in a way so that
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the big pharmaceutical companies are going to make sure that they're selling prescription drugs -- prescribed drugs for a long period of time and not have the savings that ought to come from using generics to a greater extent. and this $50 billion -- actually $54 billion that c.b.o. says you'd save with -- with medical malpractice reform would be a better way of filling that doughnut hole. i have a parliamentary inquiry. of the chair. the presiding officer: the senator will state his inquiry. mr. grassley: i want to make a parliamentary inquiry about the pending managers' amendment. my inquiry will be whether the pending amendment, which everyone agrees is critical to the health care reform legislation before us, complies with senate rule 44. senate rule 44 was adopted as part of a major ethics in
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government reform legislation. it was passed in 2007. its title was "honest leadership and open government act." the democratic leadership made it the first bill introduced when they took over the majority in 2007. it enjoyed broad bipartisan support. i wish the reform had been tougher but part of the legislation that became senate rule 44 dealt with the transparency of earmarks. they're technically defined as limited tax benefits, quote, unquote, limited tax benefits and quote, unquote, congressionally directed spending items. rule 44 applies to floor amendments like the pending managers' amendment. rule 44 requires the sponsor of the amendment, in case senator reid -- in this case, senator reid, to provide a list of these narrow provisions.
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senator reid has not provided the list. we just received the several hundred page amendment yesterday morning. republican staff have performed a preliminary review. that review finds that some items that might -- and i repeat might -- be limited tax benefi benefits. there are press reports about narrowly crafted exceptions to the insurance fee. and i would ask unanimous consent to insert in the record a copy of the dow jones article dated december 19, 2009. without objection. mr. grassley: likewise, the single state medicaid provision might determined to be congressionally directed spending items under rule 44. the determinations are not made by the minority staff in order to ensure transparency of narrow provisions, the burden is on the sponsor to provide the list. so, this is a parliamentary
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inquiry: does rule 44 of the standing rules of the senate require that if a senator proposes an amendment containing congressionally directed spending or a limited tax benefit, that the sponsors of those provisions and the names of the senators requesting them be printed in the record? the presiding officer: paragraph 4-a of rule 44 requires that a senator proposing an amendment containing congressionally directed spending item ensure as soon as practicable that a list of such items be printed in the "congressional record." mr. grassley: has the majority leader provided a list of these special deals and of the members who requested them for the record, as required by the senate rules? the presiding officer: the chair is not aware whether that's occurred at this time. mr. grassley: so what is the situation as far as the rule being provided as long as the senate has not been made aware of this?
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the presiding officer: this part of rule 44 simply requires that the senator mentioned make a good-faith effort to comply with paragraph 4-a. mr. grassley: well, we'll have to wait and see -- the presiding officer: it does not impose a condition that would precede the amendment that it could not be heard. mr. grassley grassley: i yield . the presiding officer: the minority whip. mr. kyl: thank you, mr. president. mr. president, a lot of attention has been paid to the position of the senior senator from nebraska on this legislation. page 98 of the bill -- or of the amendment, i should say, provides that the state of nebraska is carved out from being responsible for paying for additional medicaid patients added under the bill. it's the only state explicitly
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carved out from this requirement. mr. president, and i address this as well to the chairman of the committee, i ask unanimous consent that the pending amendment be set aside and it be in order to offer an amendment to extend to all states the same benefit that provides 100% federal funding to the state of nebraska for their expanded medicaid program. this would give the same treatment to other states that currently only nebraska would enjoy under this bill, and i would say that if the bill is a good thing for all state, then teams to me it should be aequally to all states. the presiding officer: is there objection? mr. baucus: i object. the presiding officer: objection is heard.the senator from wyoming is recognized. mr. enzi: since that was the broader context of that intent, there are other states that are hurting as well and so i would ask unanimous consent that the pending amendment be set aside in order to offer an amendment to the extent that colorado and montana and virginia would get
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the same benefit that provides 100% federal funding to the state of nebraska forever for their expanded medicaid program, which would give the same treatment to the other -- these other states that i mentioned that currently only nebraska would enjoy under the bill. the presiding officer: is there objection? mr. baucus: mr. president, reserving the right to object. as enticing as that might sound, i object. the presiding officer: objection is heard 78. a senator: mr. president? the presiding officer: the senator from alabama is recognized. mr. sessions: following up on that, i happened to see governor schwartzenegger on television today and he said he had initially been inclined to support this legislation but that when he realized what it would do to his budget and the medicaid budget in california, they would -- it would cost them $3 billion. they did not have that $3 billion. indeed, they didn't have the money necessary to meet their current obligations under medicare. therefore, i would ask unanimous consent that the pending
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amendment be set aside and it be in order to offer an amendment to extend to the state of california the same benefit that provides 100% federal funding to the state of nebraska for their expanded medicaid program. this would give the same treatment to california as nebraska would obtain. the presiding officer: is there objection? mr. baucus: i object. the presiding officer: objection is heard. mr. sessions: well, mr. president, i think i would be remiss if i didn't ask that -- unanimous consent that the amendment be set aside and that the -- the -- to extend to my state of alabama, which is also in a serious condition financially, and whose governor has absolutely expressed unequivocal opposition to the burdens under the state medicaid
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program that passing this legislation would impose on the state. so, therefore, i would ask that the same benefit that provides 100% federal funding to the state of nebraska for their expanded medicaid program apply to the state of alabama. the presiding officer: is there objection? mr. baucus: mr. president, i object. the presiding officer: objection is heard. mr. sessions: well, mr. president, i would just ask a little bit here, why are we here and voting tonight at 1:00 a.m., and probably voting all the way to christmas eve? and i think the answer fundamentally is on the health care matter, that after much talk about a bipartisan health reform effort and some work toward that end, the president and the democratic leadership in the congress that they had the majorities in the house and the senate and that they would use those majorities to pass the
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legislation they wanted, without republican input. and i know that has happened on occasion around this senate but i don't believe it's ever happened on a matter of such significance. these major kind of policy matters have historically been bipartisan or had substantial bipartisan support. we're talking about health care involving every american. we're talking about raiding, not strengthening, medicare, a program that's already in deep trouble. and we're talking about a major governmental intervention into one-sixth or one-seventh of the american economy, something that's pretty substantial, i think, pretty big issues, those. even more significant, our democratic colleagues i think are concerned that the american people, who, by their consistent majorities, reject this plan and they're fearful of that. so they want to move it forward
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now, sooner, faster, quicker with less discussion and less debate. so instead of working together to improve a broken health care system, the decision has been reached to railroad this bill through before christmas. they say the president promised reform. he was elected and we will just ram it through no matter what you or the american people, for that matter, think. just, for example, a recent cnn poll -- i don't think that's a right-wing entity -- 61% opposed the senate bill. only 36% support. just a little more than one-third support and over 60% oppose. that's lower numbers than president bush received for his plan to reform social security.
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why do they do this? well, because they think they know better. because they want to make history. and if you object, as the senator from rhode island said this morning, you and those who disagree with us, you're mean-spirited, cold-hearted, whatever those words were. you are just like those great unwashed that you represent. so i think there is an unusual amount of -- of disdain here for any political and substantive disagreement about this incredibly important legislation, and i think there is a disdain for the concerns of the american people as represented in rallies, in tea parties, in polling data. is this all just fear?
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illogic? are they totally irresponsible to worry about the future financial condition of their children? senator mccain had this great cartoon that showed the man standing by state laws and said -- by santa claus, and i think it was president obama. they had health care. this little boy was in santa's lap. he said what did i get? santa said you get the bill. well, the people know this is a significant issue for the future direction of our country, and i think they are saying -- and they didn't intend this in the last campaign. i remember this defining moment, do you not, when joe the plumber accosted president obama and they discussed spreading the
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wealth around and what an effort there was to suggest that president obama didn't really believe in that and he believed in freedom and individual responsibility and wasn't going to tax the average person and those kind of things, and so the campaign survived that little dustup. but i think the american people are saying fool me once during the campaign, shame on you. fool me twice, shame on me. and so they're not happy with this. polls show the tea parties are more popular than the republican or the democratic parties. so i think this use of raw power, we're going to get it done before christmas and we'll pay any price necessary to get the votes to do it is not good, and i'm amazed that people would criticize those of us who don't
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agree with this legislation, and i'll talk -- i'm prepared to talk at some length about the substantive reasons about it, that we're somehow obstruction ists because we would like to have more than one day, really, to consider a 300-page amendment and see what all was placed in it. so my colleagues are saying that the people are misinformed, and they have been subjected to lies and misinformation. well, just a few days ago, i heard the president declare that if you don't pass this legislation, your premiums are going to go up, your insurance premiums are going to go up, which is not untrue, but what he didn't convey -- and i think most people understand already, however -- is that even if the bill passes, premiums will go
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up. some double digits, more than it would have gone up if the bill hadn't passed. and a few people will see a modest less than 1%, maybe some over 1% reduction in the rate of increase in the -- in their insurance premium, but a lot of people are going to see double-digit increases in their premium, particularly the people who are not in group plans, and those are the ones that are having the most unfair and getting rooked the most in insurance and we ought to be taking care of. because they are not in group plans and they are not in companies that subsidize it. they don't work for the government who subsidizes their health care. but the president has the bully pulpit. he lectured the whole congress. he hauled us out and talked about it. he got $150 million from the big pharma drug companies for advertisements, it's been reported. robert reich, great liberal,
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secretary of labor under president clinton, scathingly condemned that deal over the doughnut hole and contribution for advertising. and i would just have to say it appears the majority has found no price too high, no debt too low in order to get that 60th vote so they can go forward. and we have got to get it done now, pass this manager's amendment that the majority leader has plopped down, the one that was written in secret, and we just saw yesterday morning at 7:00 or 8:00. and well, i would just say, mr. president, how should we judge the overall merits of the bill? how should we decide whether or not to vote for it or against it? i would say one good way is to judge it by its own promises, to
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judge it by what was -- what the american people have been told the bill will do, how much it will cost and those kind of things. well, there are some facts and some fictions here, and we just need to be frank about it. fiction number one. we have been told that the total cost of the legislation is is $871 billion. that's a lot of money, money, $871 billion. but what are the facts? when the new programs created by this bill are fully implemented, the bill will actually cost over the first ten years of full implementation $2.5 trillion, three times as much. now, who is giving the best numbers here? since we know that most of the benefits don't start until five years from now, they score the
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first ten years of the budget, the cost of the bill, and say it costs $871 billion. but if you take it from the first ten years of the bill like we would normally score a piece of legislation, $2.5 trillion, $2,5 00,000,000,000. that's a stunning difference. it just shows what a massive piece of legislation this bill is. and according to the bill, medicaid will be expanded up to 133% of the poverty level, but that won't happen until 2014. the insurance subsidies funded by the bill don't begin until 2014. so this is how they manipulated the numbers. so they said it was was $871 billion. not so. in fact, the manager's amendment increases federal spending on health care to $200 billion
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rather than $160 billion projected under the original bill that came forward. so we currently spend 1/6 of our g.d.p. on health care. how much more can we afford to pay, and wasn't the original intent to rein in health care spending to reduce the percentage of g.d.p. going to health care? mr. president, how much time is left on this side? the presiding officer: the senator from alabama has six minutes remaining. mr. sessions: so we -- the business community and others were expressing concern about that, and so i thought the goal, and i think most americans thought the goal of the legislation was to figure ways to contain the growing costs of this health care in america without reducing our quality and the magnificent scientific care that so many americans get on a
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daily basis. but it doesn't do that. in fact, the numbers show that independent -- independent accountants show that the percentage of our national wealth, the g.d.p. that will go to health care once this bill is passed, if it is, will be greater than if it's not passed. i think we should -- we can wrestle with those issues and do better. what about another fiction? the president has promised -- you've heard other leaders on this floor have said this bill will not add one dime to the nation's surging debt, but by any fair analysis, the bill increases spending and debt. first, i have just got to say when you pass 70 new government programs, expand medicaid, create millions of dollars in new subsidies, how can that not reduce -- not increase spending? but the bill is -- is -- is
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structured in an odd way, really, so it doesn't add to the debt. why not? well, it's got taxes of of $519 billion. well, if you raise taxes, you can make anything come out to a balance. they call some of these taxes fees, but it's still taxes and increased costs. there is a $6 billion annual tax on the insurance industry as a whole. the people we want to reduce premiums, we raise taxes on them them $6 billion. $2.3 billion annual tax on the pharmaceutical industry. we would like to see less cost for drugs, not more. taxes on medical device companies, $28 billion on employers that don't provide enough coverage, according to the new standards, and a 40% tax on employers that provide too much coverage.
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and $43 billion total taxes raised through penalties on employers. all in all, you're taxed if you sell insurance, taxed if you buy it at the wrong level and taxed if you don't buy it at all. and yet, contrary to promises, the bill does not lower individual family premiums, and for many their out-of-pocket costs will increase. so this is not the kind of reform we were promised. but one more thing. always a part of health care reform was the acknowledged necessity to do something about the reductions in premiums -- in payments, reimbursements to doctors. this bill proposes cutting physicians' pay 21% for ten years. that's what it does.
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this they claim to save save $250 billion, and they will use that for the new programs. the doctors were promised from the beginning that their payment reimbursements would be fixed. they can't sustain a 21% reduction in pay. doctors will quit practicing doing medicare work all over the country if that occurs. a senator: will the senator yield? mr. sessions: i will be glad to. a senator: so let me ask you, from what i understand about the doctors, the so-called doctors fix, it's around a $250 billion cost to that. mr. ensign: in this bill, there is no fix to that, from what i understand, is that correct? mr. sessions: that is correct. mr. ensign: now, so the bill is either dishonest as far as the deficit is concerned, because if you put the doctors fix in there, this thing actually hurts the deficit or we're actually seriously hurting doctors when this bill will require a lot
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more doctors for the country to take care of those new people who now have health insurance in the country, is that correct? mr. sessions: exactly correct. what we are doing, i think you can say fairly, boil it down to this, we are raising taxes almost $500 billion. we're cutting medicare medicare $500 billion, almost a trillion dollars total, and we're using none of that money to fix the doctor payment deficit that we know has to be fixed. we cannot cut the doctors 21%. congress says fill that money in and i assume we have got to fill it in in the future. and any good health care reform would do what it promised to do from the beginning, was to eliminate this cut. now, one proposal has been to do it simply by adding to the debt. mr. ensign: so would you describe this almost as a shell
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game? mr. sessions: absolutely. mr. ensign: the doctors fix would be the pea. where are they hiding the pea? because we know this is going to be fixed. it is always fixed. every year we fix the doctors. and yet to hide the true costs of the bill then, the doctors fix is really the pea in that little shell game, and they are just hiding it, is that correct? mr. sessions: exactly. the president looked the american people in the eye and said this legislation will not add one dime. the presiding officer: this block of the minority's time has expired. mr. sessions: if i could ask 30 minutes to wrap-up, milwaukee? 30 seconds. the presiding officer: without objection. mr. sessions: so the president promised that. and the doctors coming up every year to try to make sure they don't get cut 21% and he has not
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done it. it does not add up. this bill, when you add the doctor fix, clearly adds to the debt and it's got to be added as part of the reform. i have a number of reasons to pose the legislation. i urge my colleagues to do so. a senator: mr. president? the presiding officer: the senator from iowa. mr. harkin: i understand now the democratic side has one hour from 6:30 until 7:30. the presiding officer: the senator from iowa is correct. mr. harkin: i yield myself time from 6:30 until 7:00. mr. president, i was in my office a little bit ago. i was watching the comments made by the distinguished minority whip, the senator from arizona, senator kyl. and he went on at some length about how, really, this vote at 1:00 a.m. that we're going to be taking is really tough on some members. he mentioned specifically our distinguished colleague, senator robert byrd. that -- who is not -- not up and
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about at those hours. that they would have to drag him out of bed and bring him down here for this vote. and then mr. kyl, he felt very sorry for mr. byrd that we would do that at 1:00 a.m. and he said that the majority leader has the power to put this vote back. we could do it at 9:00 a.m. in the morning. well, he's absolutely right. we could do it at 9:00 a.m. in the morning. but because of the intransigence of the republican side. because they are not willing to let us have these votes without expending the 30 hours under the rules -- under the rules, the cloture petitions have been filed. and, of course, the republicans, which is their right, they can burn up 30 hours. well, after the first vote at 1:00 a.m., the clock starts ticking on the next 30 hours for the underlying substitute.
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then after that 30 hours, there's the underlying bill itself. and that gets 30 hours. so if the republicans really want, they can burn up 90 hours. i ask to what end? to what end we have the 60 votes. no one doubts that. there are 60 votes now to pass this bill. so to drag this out and to cause people to come in at 1:00 a.m. in the morning, it's not on the democrats' side, it's on the republican side. when i heard the distinguished senator from arizona pleading to put the vote off, i thought to myself, well, if that's what the republicans would like to do, there's a simple way to do that. you simply move the vote that we're going to have at 1:00 a.m., move it back to 9:00 a.m. tomorrow morning. then you have the intervening hours from 1:00 until 9:00 count towards the 30 hours towards the
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next vote. simple. very simple. so i took that to heart. and i asked our -- our staff to type up the unanimous consent and they have given a copy to the other side. and so that's what my unanimous consent will do. it will ask that the vote occur at 9:00 a.m. tomorrow morning. but that the intervening hours from 1:00 to 9:00 would count toward the 30 hours for the junt lying substitute. so, mr. president, i ask unanimous consent, that the cloture vote scheduled to occur at 1:00 a.m., monday, december 21st, occur at 9:00 a.m. monday, december 2 1-s, and that if -- 21st and it cloture is invoked the postcloture time to be considered to begin at 1:00 a.m. the presiding officer: is there objection? mr. enzi: reserving the right to object. we're not the party that spent eight weeks to delay everything. we're not party to put this
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together we're trying to do without any input from the republicans and we're trying to have time to review this and let america know what's happening. we know that the democrats have kept people from going home now for three weeks so they wouldn't have to listen to the voters at home. we would agree to the request if the senator would strike the retroactive cloture time. we want the time. mr. harkin: my initial request stands, mr. president. the presiding officer: is there objection? mr. harkin: i object. the presiding officer: objection is heard. mr. harkin: mr. president, there they go again. they want to delay. delay, delay, delay. ofobjectthey want to delay it. they would be happy to delay this to christmas, new year an january and february. why, they'd be happy to delay this bill for 10 years or more. you know, because they don't
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want it to happen. that's really what's going on. i say to my good friend from wyoming, he's a good friend, a great senator. we had a good -- we did it in our committee. we got the bill through, open, above board. i think the reason that we're here at this time is because we democrats bent over backwards to -- to accommodate the minority. we did in our committee. and i can say that senator baucus went the extra mile. no, he went the extra 10 miles. he went the extra 100 miles on the finance committee to involve and to get the minority side involved and the last only one -- at last only one republican would vote for it and we know who that was, the senator from maine. so we could have, mr. president, we could have emulated the republicans. we could have emulated what they did when they were in the majority in 2001.
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i was here. i terror well. when they -- i remember it well. when they came up with a crazy tax package that cut taxes for the wealthiest in our country. stole the surplus that we had built up under president clinton by the year 2000, when we were looking at surpluses on into the future. and they came up with all of these big tax cuts for the wealth which. and guess -- wealthy. and guess with a they did? they did reconciliation where they only needed 51 votes. under reconciliation, as the president knows there is no filibuster. you cannot filibuster a reconciliation bill under the rules. so if they had done their tax bill in 2001, like we're doing this, you know, we could have delayed. we could have had some input into that. but they said, no. they just went right to reconciliation. we could have done that with this bill. we could have done that with
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this bill. i remember having discussions with members of the -- of our caucus and others saying, no, no. and the president. president obama wanted to do this as much bipartisan as possible to involve the minority in a constructive process. and so that's what we decided to do. to do it in a very constructive, open, process. and what it's gotten us is total -- total objec delay by the min. but we will persevere. we will start -- we started this open process and we will finish this open process. the dye has cast. we will have a vote at 1:00 a.m. i would like 9:00 a.m., but you heard the republicans object to that. i asked that the intervening hours be counted toward the next 30 hours and they wouldn't even do that.
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so the reason we're here is not because of democrats. we're here because the republicans simply don't want this bill to pass. that's really the reason. so we're going to vote. we're going to vote at 1:00 a.m. on the face of it it is really a technical, procedural vote. it is really more than that. with that vote at 1:00 a.m. on the managers' package, cloture on the managers' package, we will have reached a pivotal point, 1:00 a.m., pivotal point in the decades long request to pass comprehensive health care reform. we reached a crossroads, a point in time just like this senate did in 1935 when we passed social security or in 1965 when we passed the medicare bill. each of those bills was a giant step forward for the american people. but each was bitterly opposed in this body by defenders of the
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status quo. the republicans. in each case, senate opponents weighed a strident campaign of fear, warning that the passage of the bill would lead to socialism. socialism. that's what senator robert taft from ohio called it, socialism. we're going to sovietize america. you can read it in your history books. but in the end, mr. president, a critical mass of senators rose to the historic occasion. senators ignored the dark warnings and the demagogue rich they voted their hopes and not their fears. they passed laws that transferred america -- transformed america in profoundly positive way. the senate has arrived at another one of those rare, historic moments. this time we're attempting to pass comprehensive health reform. a goal that as eluded congresses and administrations going back to roosevelt.
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some think that i'm talking about franklin roosevelt, i'm talking about theodore roosevelt. the filibuster we have seen here now and it's been going on for weeks it about defenders of the status quo. each must make a choice in this body, fear or hope. stick with the broken status quo or embrace bold change with all of its uncertainties. now the other side's saying, well, what about this? and what's going to happe happe? you know, mr. president, i keep talking about this bill we're as iaswe'repassing. it's not like the 10 commandments written in stone. so there are uncertainties in the future. the future is uncertain. but what we can do is lay down a
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good start towards bringing people into a health insurance system. stopping some of the most horrible practices of the health insurance industry. moving us towards a more health care system rather than a sick care system. so, yeah, there are uncertainties. but we know one thing, the certainty of the status quo leads to too many people not having any kind of health care whatsoever. leads to people dying younger than they should because they don't go in for their checkups or their screenings, children, others. well, we know the other side made it clear, some time ago, that they wanted to obstruct and delay and filibuster and kill this bill. as far as my friends on the other side of the aisle are concerned, this floor debate is not about offering amendments to imrove the bill, it's not about
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allowing more time to fully read it and understand the bill, that's nonsense. it's not about playing a constructive role to pass a better bill. all the other side wants to do is kill this bill. period. all this wrac yacking going on s morning. i was watching c-span, i thought, people are getting ready for christmas, and feeling good and we're yacking back and forth, back and forth, back and forth. people have tuned us out. they really have. it's christmas time and people have tuned us out. and, yet, we're here. but we're here for a good reason. we're here because we are determined to pass meaningful health reform for america. and we mean to do it before christmas. well, again, in the defense of the broken system and status
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quo, the republicans joined at the hip with the health insurance companies. they used the same talking points. the same distortions, the same bogus, cooked up studies. the same outrageous stories about death panels an pulling the -- and pulling the plug on grandma. we heard that from the other side week after week, month after month. every step, i said, we on this side have acted in good faith. we did not go the reconciliation route. in our futile quest -- futile quest for bipartisanship, we have repeatedly given the republicans more time. in the senate health committee, under the great leadership of senator dodd, we spent nearly three weeks marking up the bill. no amendments were denied. the republicans could offer any amendment they wanted. it took 13 days, a total of 54 hours of meetings. we went out of our way to accommodate our republican
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colleagues. we accepted 161 of their amendments. either by vote or just by accepting them. after all that time, all that good will on our side accepting 61 of their amendments, everyone on that committee voted -- every republican on that committee voted against the bill. every time that i told this story in iowa or wherever i've been, people said, they offered 61 amendments, surely they must have been happy about that. they would have voted for the bill. they don't understand it. in the finance committee, deliberation on the bill stretched out for months solely to accommodate the wishes of the republican members of the committee. despite the fact that he bent over backwards to accommodate the minority's requests, all but
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one republican on the committee voted against the bill. and now today republican senators say they are opposing the cloture petition because they need more time. they say we're rushing things. rushing things. there's a big rush going on here. good grief, this bill's been on the floor for 21 days. we've been deliberating health reform almost the entire day. congress has been trying to get this done since theodore roosevelt. so republican colleagues say "slow down, you're moving too fast." that's absurd and disingenuous. you have to ask yourself: are our republican friends going to be more constructive, more willing to act in good faith after the christmas or new year break? of course not because their aim, understand it, is not to improve the bill or to even understand it. it's to kill health reform,
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period. that's all it is. they just want to kill it. and now because they don't have enough votes to kill it outright, they've opted for, of course, delay and obstruction and filibuster. let's be clear, mr. president, they're not only delaying and obstructing the senate, they're delaying and obstructing the millions of americans who desperately need the reforms in this bill. they're delaying and obstructing the 31 million americans who will finally get health coverage. they're delaying and obstructing the underinsured, millions of americans who know they're one ep society a -- episode away from bankruptcy. they're delaying and obstructing women in this country who face systematic discrimination by insurance companies. they're delaying and obstructing americans who fear that if they get cancer or heart disease, their health insurance company will canceling their coverage.
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mr. president, let's be clear. republicans, again, are not only trying to kill health reform in doing so, but are killing the hope for millions of americans who are desperate for reform of the current broken system. too many americans are literally dying because they do not have health care and proper access to a doctor. all told, nearly 45,000 americans die each year -- each year -- pwau they lack meaning -- because they lack meaningful health insurance. a johns hopkins study found that children without health insurance who are hospitalized are 60% more likely to die than those with insurance. why? obvious. because kids without health insurance are much less likely to get preventive care or to be taken to a doctor in the early stage of their illness.
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60% more. think about it again. children without health insurance who are hospitalized are 60% more likely to die than children who have health insurance. so that's the real cost of delay and obstruction here on the floor of the senate. this is our job. we're mere and we're going to finish this job. but it's a tragic human cost, and these victims can be found in every one of our cities, our towns, our farms, our rural communities. mr. president, i refuse to allow any obstacle to stand in the way of the senate addressing the needs of these americans. i have, along with my friends on this side, opposed the republicans' filibuster. likewise, i have been willing to disappoint many whose views i respect by agreeing to painful compromises in order to keep this bill on track. i agreed to those compromises not because i lack passion or
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fight. i think my colleagues who know me know well enough that i can fight. i did so because of the harsh but unavoidable reality that because of the republicans' obstructionists, we need 60 votes to pass this bill and the only pass to secure 60 votes was by making necessary compromises. i would add that's also the way our predecessors in this body were able to get the votes po pass social security and medicare, both of which had big gaps in coverage when they were first enacted. what they did was they passed bills that were sort of half a loaf. then they came back for the remainder of the loaf in following years. but despite these compromises, mr. president, make no mistake, this remains a profoundly progressive bill.
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one analyst put it this way. he said this legislation will be -- quote -- "the most important social equality achievement since the great society." that is why the right wing in this country is pulling out the stops to kill it. this bill will usher in three huge reforms. first, this bill will be the biggest expansion of health coverage since the creation of medicare. some 31 million americans who do not have health insurance now will get it thanks to this bill. this is a monumental achievement. now we do this by expanding medicaid and by providing subsidies to low-income, modest-income families. in addition, if you're a small business owner, this bill will offer tax credits of 35% of employer contributions toward premiums in order to make it more affordable for small businesses and their employees to have health insurance, and
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that 35% will go up to 50%. the 35% starts next year. that why i've said many times in my state of iowa and around, actually the biggest winners under this bill, aside from the totally uninsured, the biggest winners are small businesses and the self-employed. small businesses and the self-employed are the big winners in this bill. what's more, our bill will end the discriminatory practice of jacking up premiums because the eurpbs holder is older -- insurance holder. through these health insurance exchanges people without access to coverage will be able to shop and choose from a menu of quality health plans much in the same way that members of congress do. mr. president, this bill does much more than extend health coverage. the second great reform in this bill is an array of provisions
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cracking down on pervasive outrageous abuses by the health insurance companies, abuse that is currently leave most americans one serious illness away from financial catastrophe. right now the health insurance business in this country is extraordinarily profitable, but these profits come at a staggering human cost. think about it, when americans get a diagnosis, let's say, of cancer or some other grave illness, they fear two things. first, they fear the illness. second, they fear the health insurance company. they wonder is my company going to authorize treatment and pay the bills? or will i have to go to war to prevent it from steufg me -- stiffing me or rescinding my policy? i always tell phaoepl, look at your policy. is there a rescission clause in there. so many people say what is a rescission clause? i say it's a little clause in there. it says when your policy is up
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for renewal, the insurance company can terminate you. they don't have to renew your policy. and this is what happens. someone comes down, they get a very serious long-term illness like cancer, heart disease. their policy is up for renewal, the insurance company says no, they will not renew your policy. now you're out in the cold. with a preexisting condition, now you can't get insurance anywhere. well, this bill will end that practice. health insurance companies now employ a whole army of claims adjustors just to deny requests. in fact, the health insurance companies give bonuses -- bonuses -- reward people for denying claims, saying "no" to policyholders. in the state of california, the largest insurers deny more than one out of every five requests for medical claims, even when recommended by the patient's doctor. one large insurer, pacific care, denies medical claims nearly 40%
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of the time. think about that, almost one of two. significant in a denies claims -- cigna denies claims 33% of the time. now, republican senators give us all this scare talk about a government bureaucrat standing between you and your doctor. right now we have corporate bureaucrats standing between you and your doctor. and they earn good evaluations and bonuses and money for denying you coverage. i can remember at a town meeting i had in mason city in august, one of those famous town meetings. towards the end of it -- it was okay. there was a lot of contention there and people voicing their concerns, as they ought to and they have a right to do. but at the end there was a man sitting out in front. i thought, well, this will be my last one. i called on him. he stood up and he said, you know, i've been a doctor here, i've been a doctor here for over
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40 years in mason city. 40 years. he said i can tell, i can say honestly during those 40 years, i have never once had a government bureaucrat come between me and my patient on medicare or medicaid. he said, however, i can't tell you how many times during those 40 years i have had insurance bureaucrats come between me and my patient. this is the doctor who practiced 40 years. nearly 62% of bankruptcies in the united states are linked to medical bills. and here's the real kirk: 80 -- here's the real kicker, 80% of those are people who had health insurance. when's the last time you ever heard of a health insurance executive claiming bankruptcy?
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i'd like to find one someplace. mr. president, the american people have lived in fear and under the heavy hand of these health insurance companies long enough, but help is on the way. let me mention just a few of the ways that this bill immediately cracks down on abuses by health insurance industry. first, you know if you're uninsured with a preexisting condition, the bill would give you access to affordable coverage without discrimination. our bill immediately bends those rescissions that i talked about, where the insurance company can rescind your policy. we stopped that right away. we prohibited insurers from imposing lifetime limits on benefits, and we restrict the use of annual limits. our bill ends discrimination against women. as i said, currently pay as much as 48% more for the same coverage as a man has. our bill requires insurers right
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away -- next year -- to let children stay on family policies until they are age 26. those are just a few of the things. but there is one-third area in this bill that i have championed for many, many years. and in my way of thinking, in many ways, i think it may be the most profound part of the bill. and that is a whole array of provisions promoting wellness and prevention, turning america into a genuine wellness society. on the clinical level, the bill requires reimbursement for proven cost-effective preventive services such as cancer screenings, nutrition counseling, smoking cessation programs. this means that health professionals will be able to offer these services to you before you get diabetes or cancer or etch see ma. -- emphysema. for annual physicals, no co-pays, no deductibles.
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they encourage people to do this so they won't have to pay a co-pay or deductible. we help businesses both large and small create workplace wellness programs for their employees. and one thing that i don't think has been mentioned before, our bill requires large chain restaurants to post basic nutrition information right on their menu. so consumers, when they're going out to eat can make healthy choices. what we're trying to do is change the paradigm from a sick-care system to a true health care system, one that keeps people healthy and out of the hospital in the first place. our aim is to re-create america as a wellness society focused on good nutrition, physical activity, preventing the chronic diseases that take such a toll. so, mr. president, as a proud progressive, i make no bones about my enthusiasm for the three great reforms in this bill: vastly expanding
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coverage, cracking down on the abuses by the health insurance companies, and making robust investments in wellness and disease prevention. today, we are closer than we've ever been making senator ted kennedy's dream of universal health insurance a reality. a reality. this bill has many authors. we've all been involved in it. but in a very real sense this, really is senator kennedy's bill. so i urge senators when the vote occurs at 1:00 a.m. to vote their hopes, not their fears. seize the moment. let's move ahead. let's vote for cloture. at long last, let's give every american access to the quality, affordable health care they need and they deserve. mr. president, with that, i yield the floor.
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6 ms. stabenow: mr. president? the presiding officer: the senator from michigan is recognized. ms. stabenow: thank you, mr. president. before my opinion friend from iowa, the distinguished chairman of the health committee, leaves the floor, i want to thank him for his wonderful leadership and friendship in so many capacities and passion for what we are doing now. we are all here together knowing that in the process of legislating, you don't always get every idea that you want, but you come together and you work for something that is good for the american people. and that's what we've done. and so i want to thank you very much for your leadership. mr. president, i want to take a few moments to talk about how we actually got to this point on a sunday evening. voting at 1:00 in the morning. and frankly, what has been happening all year. so i want to take a few minutes to talk about what has happened this entire year, the first year of president obama's presidency, our first year in the majority,
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with the majority that we have. and then speak a little bit as well about the very, very important legislation that's in front of us. but i do think that it's important that we take a moment to recognize and address a very unfortunate milestone, mr. president. look back on the year, what we've accomplished in spite of that milestone. in april, the media celebrated president obama's first 100 days in office, but here in the senate, we can measure our progress by something else. not a hundred days but a hundred objections from the minority party. actually, 101, as of yesterday. objections, filibusters, delays, stalling tactics designed to stop us from helping the american people who are hurting in these tough economic times. and, mr. president, that's more
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true in my state than any other place in this country. our people, the great people of michigan, have been hurting longer, have been hurting much more deeply than other places of the country because of the major economic transition as well as the recession that we're involved in. but there's good news, mr. president, because while the republicans were stalling and wasting time, we were working hard, doing what the people of america sent us to do. now, i want to talk about what we have done in spite of the stalling, but i also want to just take a brief moment to explain something hard to explain about senate rules, because it -- people i think look at us and say, well, they objected but why does that matter? why does that matter? well, mr. president, as you kn know, when there's an objection i,in order on ever eve to overcd it's called a filibuster -- it
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involves invoking petitions called cloture and it takes time. it just plain takes time. so 101 times we've either had to get -- we haven't been able to move forward because of an objection or we've had to go through long process that we're involved in right now. and i think it's important to just briefly explain it. because when the republicans object -- as they are now, as they have been on so many occasions -- our leader has to file what's called a cloture petition and then you wait two days. can't do other business for those two days. we have done that over and over and over again, wasting time while people in my state want us to be focused on jobs, on lowering their health care costs, on making sure that we are doing the things that matter to them every day. but we stop and we wait two days. then we vote on stopping the filibuster. and then we wait 30 hours, had h is what we're doing right now. then you vote on whether or not to proceed to the item.
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there's filibusters again. then you file a cloture motion on the amendments or the bill, you wait two more days. then you vote on closing a filibuster and the then you wai0 hours. and then you vote on the amendment, which we will do tonight, and then you have to wait another 30 hours. and in this case, another 30 hours. so it does matter when we say there have been 101 objections that have either stopped us or forced this process, it does matter. it matters because it has slowed down the ability to move, to be able to get things done. but, mr. president the good news is this. we've gotten things done anyway. we've gotten things done anyway because we are focused and committed to getting things done. we know the american people have waited too long, that the last
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eight years were about taking us in the wrong direction with things that didn't help most people, that put us in a huge deficit hole, that didn't address health care or health care costs or jobs or policies that made it worse. so we know that even though there have been 101 objections this year -- and there will be more, there will be more -- we are going to get things to be for thdone forthe american peop. it's amazing, mr. president, the stalling actually happened on the very first day of the 111th congress on january 6 when the republicans objected to moving forward with an important public lands bill, something that we had been trying to do for some time, to protect and preserve our national parks, forests and wilderness areas. but we passed that important bill anyway over their objections and three different
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filibusters, as the chart showed, three different times we had to wait -- wait two days, wait 30 hours, wait two days, wait 0 hours. but w30 hours. but we passed it. since then, nearly every single week we've been in session -- every single week but four out of 31 weeks -- we have had to go through this process or have had objections. they have found something to object to or something to filibuster. and as i said, today -- yesterday, actually, they objected for the 101st time. this time with a filibuster against providing affordable health insurance for over 30 million americans. they have misused long-standing senate rules and traditions to stall everything that might give this president and this congress a victory. i think it hurts all of us, mr. president, when the -- when the senate breaks down, as it
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has. everybody is hurt by that. to stall everything that would help get americans back to work or that would help 15.4 million americans who are looking for work. and now to stop us, as i said, from extending health insurance coverage to over 30 million americans. their objections aren't about policy, they're about politics. earlier this year, objection 74, they stalled the unemployment bill and their delaying tactics caused nearly 300,00 200,000 ams to lose their unemployment benefits just a couple of months before christmas. they objected to the bill twice. they filibustered, not once but three times, before they voted unanimously, they voted unanimously for the bill. so why would you filibuster
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something three times and then vote for it unanimously? not because you're concerned about the policy. the only explanation is that republicans were just trying to waste time. time that cost 200,000 americans their unemployment benefits. the difference between paying the mortgage, keeping the heat on, putting food on the table, and possibly trying to keep health care going with a cobra payment or in some other fashion. objection four was the republican filibuster of the lilly ledbetter fair act, to make sure women get equal pay for equal work. the republicans filibustered that bill but we passed it. we passed a very important equal pay for equal work bill, in spite of it. objection 6 was to the american
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recovery and reinvestment act, which has been absolutely critical to creating jobs, keeping our economy out of a depression. they filibustered that bill three times as well but we overcame the objections, passed the rove act an recovery act ane critical investigations in transportation, in our schools, in our police officers and in clean energy technology and manufacturing. and, yes, we are seeing the difference, mr. president, in michigan right now. $2 billion that was part of the recovery act. i'm pleased to say that we have received a large part of that in michigan to develop new battery technology, manufacturing. and we have at least six different firms that have announced and begun to develop manufacturing facilities for advanced battery development.
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and those manufacturing facilities are going to put thousands of people back to work. that was in the recovery act that was filibustered three times. objection 20 was to senator kennedy's serve america act which we passed despite their filibuster to help young people give back to their country through volunteerism and community service. objection 24 was to the fraud enforcement and recovery act which cracked down on predatory lending and abuses by banks and mortgage companies. that bill was held up for nearly a month. but we passed it, giving real relief to millions of american homeowners. we passed the credit card bill. republican objection number 32. we passed the helping families save their homes act -- republican objection number 33. we gave the f.d.a. the authority finally to regulate tobacco to help keep kids from smoking. that was republican objection
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38. we passed the travel promotion act which will help stimulate the suffering tourism industry across the country. that was objection number 45. we passed a troop funding bill to make sure our soldiers in iraq and afghanistan had the support they needed. despite having to file cloture to fight a filibuster. objection number 47. we passed the defense authorization bill that included a pay raise for our troops and other help for our military and their families. despite repeated filibusters and objections -- and these were objections number 54, 56, 57 and 58. can you imagine? this was a defense bill. we passed the veterans health care bill despite republican stalling to help caregivers of disabled veterans, women
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veterans, rural health improvements for veterans, mental health care for veterans and support for homeless veterans. this was republican objection number 89. and objection 98 was another filibuster against those pay raises for our troops. just nine days before christmas. and despite all of those objections, 101 now, we have been doing, mr. president, what we were sent here to do. we have focused on actions to help create jobs and strengthen our economy and focus on the things that families struggle with and care about every day, to make people's lives better. not just a few, not just the investment bankers on wall street, not just the wealthy folks that got the tax cuts in the last eight years, but middle-class families who every day are trying to figure out
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who's -- what about them, what about us. that's what we have been focused on. we passed an extension of the children's health insurance program to provide health and dental care to nearly 10 million children. we passed legislation to reform government contracting and protect taxpayer dollars. legislation to invest in health care and energy and education. we passed the cash for clunkerss bill, mr. president, as you know, i was proud to lead in the senate that moved over 650,000 fuel-efficient cars off dealer lots and brought thousands of laid-off manufacturing workers back to work. we passed legislation to support the growth of small businesses and to extend the first-time home buyers tax credit. and now, just a few days before
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christmas, we're working to pass this critical, historic health insurance reform legislation. and we are committed to getting it done. republican colleagues can object a hundred times or a thousand times, but we are not wavering in our commitment to do the right thing, even though inaccuracies abound, even though misinformation has been said over and over and over again about what this bill would do. we are committed to overcoming what has been the tidal wave of opposition from the special interests who control the status quo, who like it the way it is right now. we are determined to get beyond that and to do the right thing for american families. whether our republican colleagues work with us or not -- and we sincerely hope they do and we have spent a tremendous amount of time this
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year reaching out to get bipartisan support. whether they stall or object or not, our job is to do everything we can to move america forward and that will continue to be our focus. as the distinguished presiding officer knows, because we both sit on the finance committee, we have spent months reaching out with committees, with processes to get bipartisan support. but as my dad used to say, it takes two to tango. it takes both sides that have to want to work together. and, unfortunately, it appears that the strategy that was put in place back at the beginning of the year, the very first day of session, with the very first filibuster, the strategy that was put in place was just to
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stop us from being able to move america forward. to stop this great new president, to stop the majority in the congress -- congress. but we have moved despite that. i think often of what we could do if we hadn't had to deal with 101 filibusters, what we could have done in creating a clean energy bill that would create more jobs in my great state ordeal with other critical issues that we need to deal with. and we will deal with as we slog through filibuster after filibuster in the coming year. we will do that. but now we have the opportunity in front of us to pass historic health insurance reform that, frankly, people have talked about for 100 years. it's not perfect, but nothing ever is when you start out. but it's a great framework for
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putting in place the value, the principle that every american should be able to have affordable health insurance and that we are going to tackle the explosion of costs that have hit businesses large and small, have hit taxpayers and bring those costs down over. that's what we are involved in right now. and we're going to get it done. we could have voted much earlier rather than keeping our staff here until 1:00 a.m. we'll vote again after we run the next 30 hours. i believe it's tuesday morning. we could vote and be done with the final passage at that point. we know where the votes are. we have the votes to pass this. but it appears that we will be here until christmas eve.
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mr. president, i don't mind for myself. i, of course, want to be home with my family, as i know that you do. i think of my brother, he drives for u.p.s., he'll be working on christmas eve. a lot of americans will be working on christmas eve. and if we need to be here until christmas eve to do something that will positively affect every american, i'm willing to do that. i'm willing to do that if that's what we need to do. mr. president, let me just take a moment to talk about the bill in front of us. the bill in the front of us, literally, saves lives. saves money and saves medicare. and i'm very proud that in the managers' amendment, the amendment we'll be voting on at 1:00 a.m. today, we've made it even better. i'm very pleased to have helped to lead a section related to small business tax cuts, along
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with our chair, the small business committee, senator landrieu, and another strong advocate, senator lincoln, we have been working on provisions that will make sure that there are small business tax cuts that start immediately next year after the bill passes. $40 billion in tax cuts in total to help small businesses afford health insurance for themselves and for their workers. in our amendment we also provide even tougher are insurance re -- tougher insurance reform in the underlying bill we have a whole health care bill of rights. i remember coming here in the year 2000, and the patients bill of rights was the major thing that we were trying to get done. we were in the minority, the democratic minority, but we were working hard to do that. it was my first opportunity to work with senator kennedy. and we believe strongly that we needed to take insurance company
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bureaucrats out from the middle between doctors and patients. mr. president, that's in this bill. those kinds of reforms are in this bill. and one of only many things that are in this bill. but we've toughened it up so that if the insurance companies between now and when the new group insurance pool takes effect are raising their rates too high, spending too much on profit and administration, then taxpayers, rate payers will get a refund and we hope that will put pressure on them not to continue to raise rates or try to do what the credit card companies have done, before the bill takes effect, raise rates. so we put new protections in. other protections as well to make sure that the majority -- the vast majority of every dollar that a family puts into premiums actually goes for their medical care rather than for
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profits and administration. in total we have $430 billion in tax cuts to create affordability for families, for individuals to help them be able to afford to purchase health insurance. and with that, overall, this is a tax reduction, this bill is, for the american people. and it's a reduction for taxpayers because it lowers the deficit in the first 10 years and on into the future. mr. president, let -- i'm going to take just a moment to -- to give a sense of what is in the bill as it relates to new coverage. and the benefits. we know that the majority of -- the majority of us have health insurance already. in michigan it's about 60%. -- 60% of the people of michigan
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and in other places it's 50% or 55%. but we have what's called an employer-based health insurance system. and we've started with the basis that people should be able to keep what they have. and we've built on that. the majority of people have either employer-based insurance or they have medicare or medicaid or veterans services or other public services. so we started from the basis that we want to make current health insurance more secure, more stable. so the insurance reforms we're putting in place for those plans that take effect, new plans after this takes effect, will include no -- the elimination of preexisting conditions, the elimination of what's called rescissions or the ability to
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drop someone if they've gotten sick. the elimination of discrimination. one of the things that i was surprised about -- i was surprised to learn about in terms of -- its extensiveness as we went through this process is that women are paying on average 50% more for the same coverage in the individual insurance market. or maybe even less. less coverage. because being a woman, or being in child bearing years or being pregnant may be viewed as a preexisting condition, so that women can't find health insurance. so those who have insurance today, and as they reup, as they get new plans, they will be able to take advantage of all of the insurance protections, our health care insurance bill of rights in the bill. and this is very important. and also people with insurance today will actually over time --
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it will take some time for this to happen -- but as others who don't have health insurance now, be able tie for -- be able to ad insurance, there will be fewer people needing to use an emergency, there will be other people who end up coming back in terms of cost to all of us with insurance today. when someone walks into the emergency room sicker than they otherwise would be if they see a doctor, they get treated as they should, but then the hospital has to make up the cost so they put it on to people that have insurance today. it's estimated to be abou about $1,100 in hidden costs for individuals. and so we're going to see those kinds of costs go down. other kinds of changes in efficiency and quality that will help people with insurance today. so coupled with the insurance reforms, we'll see more stability and more quality for people who have insurance today.
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the major area of new coverage is in what's called the insurance exchange for the 15% to 20% of the people who can't find affordable insurance today and most of them, as our presiding officer knows, are small businesses or people who are self-employed. people who can't find insurance as well. may have lost their job and then lose their insurance. but for those individuals we set up a new group pool. a way for people to use the same leverage that a big business does or the federal government does, just as our insurance policy for members of congress uses a pool and then everyone can choose the insurance coverage they want within that pool and get a better deal, that's what we're setting up in the insurance exchange with help for tax cuts for families and for businesses and individuals in order for them to be able to help afford to purchase insurance.
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we also are giving a choice to states. if a state for lower income working people chooses to provide a basic health insurance plan rather than people getting their tax cuts to go into the exchange, they can setup their own basic health insurance plan and bring down costs as well through the state. for young workers, one of the things that i wish i had been around a couple of year -- i wish had been around a couple of years ago is the fact that we will be allowing parents who have children on their insurance going forward after the effective day of the act, to be able to keep their children on their insurance until age 26. giving young people a start in their first job or being able to know that they have insurance until age 26. and there are a number of other provisions for young people as well. or making medicaid as a safety net for low-income people, up to
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133% of poverty. we'll truly be able to say, if you lose your job, you won't lose your insurance. what an important thing to say in terms of taking away that fear of losing your job and having nowhere to turn. improving medicare. we are going to stop what have been overpayments to for-profit insurance companies and put that money back into closing the gap in prescription drug coverage under medicare. it's been called the doughnut hole. closing that. providing preventive care for seniors without out-of-pocket costs and lengthening the medicare trust fund so it's stronger for a longer period of time. and for early retirees, i'm very proud to have worked with senator kerry to develop a way to provide support and help for companies that pay for their health insurance for early
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retirees to lower their costs. so that, in fact, we will be able to help those who have retired voluntarily or involuntarily to be able to have the insurance they need until they can qualify for medicare. mr. president, let me just close by saying this: this legislation is very much about saving lives, 45,000 people lose their lives every year because they can't find health insurance that they can afford. 45,000 families will have one less person at the dinner table over the holidays because of lack of health insurance. surely we can do better than that in our great, great country. saving money for small businesses, for familie

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