bringing down the deficit. beginning to turn those costs downward rather than keeping them going upward in such an under controllable way. and saving medicare. making sure that medicare is stronger out into the future, that our seniors have more help paying for their prescription drugs and preventative services as well. when you get through all of it, mr. president, we know it's -- it's hard to change the status quo. those who benefit from the current system don't want it changed. the presiding officer: the senator's time has expired. ms. stabenow: but we do. thank you, mr. president. the presiding officer: the democratic block of time has expired. the senator from utah, senator hatch. mr. hatch: mr. president, i thank you. after weeks of closed door

clandestine negotiations, senator reid finally emerged with a 383-page manager's amendment yesterday to the 2,074-page, $2.5 trillion tax and spend washington takeover of our health care system. now, despite all the promises of ushering in a new era of accountability and transparency into washington by the president and the democratic party, the reid amendment represents everything that americans hate about washington right now. chicago-style back room buyoffs at the expense of the american taxpayers. at yesterday's press conference when democrats were asked about the nebraska earmark for medicaid funding, the majority leader simply replied, quote -- "a number of states are treated differently than other states. that's what legislation is all about. that's compromise." regardless of whether or not these actions were constitutional. or should i say unconstitutional. so in addition to the medicare advantage deal to grandfather

only florida's seniors and the the $300 million giveaway known as the louisiana purchase, we now know that the democrats' version of compromise really looks like. in the reid amendment released yesterday, vermont gets a 2.2% increase for six years in its medicaid federal match rate while massachusetts gets a 0.5% increase for three years for its entire program. the deal for the state -- but the deal for the state of nebraska takes the cake. now, we all know that any one congress can't bind future congresses, but somehow nebraska will receive a special carveout that will have the federal government pay for every dollar of its medicaid expansion. the total cost of these medicaid special deals -- deals -- $1.2 trillion -- $1.2 b illion, excuse me. so the next logical question is pretty straightforward. who will pay for these special deals? well, the answer is simple --

every other state in the union, including my home state of utah, who are collectively facing facing $200 billion in deficits and are cutting jobs and education services to survive. our states will now pay to support these special deals for nebraska, massachusetts, and vermont. according to the congressional budget office, the medicaid expansion in the reid bill alone creates a $26 billion unfunded mandate on our cash-strapped states. coincidentally, only one state avoids this unfunded mandate, and that's nebraska. now, let me focus my attention on over half a trillion dollars worth of new taxes, fees, and penalties on individuals, families, and businesses imposed by the reid bill. the new fees begin in 2010, while the major coverage provisions do not start until 2014. almost $57 billion in new taxes are collected before any american sees the major benefits

of this bill which are largely delayed until 2014. it's no wonder why this budget gimmickry creates an illusion of the bill reducing our national deficit. based on data from the joint committee on taxation, the nonpartisan congressional scorekeeper, this bill would break president obama's campaign promise by increasing taxes on 42 million individuals and families making less than than $250,000 a year. this is even after taking into account the government subsidies provided to low and certain middle-class families and individuals. the reid bill not only increases payroll taxes by nearly nearly $87 billion, but also imposes $28 billion of new taxes on employers who do not provide government-approved health plans. these new taxes will ultimately be paid by american workers in the form of reduced wages and

lost jobs. according to a recent study of similar proposals by the heritage foundation, these new job-killing taxes will place approximately 5.2 million low-income workers at risk of losing their jobs or having their hours reduced, an additional 10.2 million workers could see lower wages and reduced benefits. so with nearly half a trillion dollars in medicare cuts, and more than half a trillion dollars in new taxes, does the reid bill actually do anything to control our nation's skyrocketing health care costs? the answer, according to the congressional budget office, is a resounding no. in fact, it will actually increase our national health care spending. i quote -- "under the legislation, federal outlays for health care would increase during the 2010-2019 period as with the federal budgetary

commitment to health care. the net increase would be about about $200 billion over that ten-year period." unquote. so what's the bottom line? more taxes, more spending, and bigger government. let me take a moment to talk about the so-called abortion compromise in this bill. the language to prevent taxpayer dollars from being used to fund elective abortions in the reid amendment is completely unacceptable. the new abortion provisions are significantly weaker than the amendment i introduced with senator ben nelson of nebraska to ensure that the hyde amendment which prohibits federal dollars from paying for elective abortions also applies to any new federal health programs created by congress. the hyde amendment has been public law since 1976. the nelson-hatch-casey amendment which is almost identical to the stupak amendment in the house,

was included in the house-passed health reform bill in early november by a vote of 240-194. it is important to note that it was supported by 64 house democrats. let me repeat that. the stupak amendment was supported by 64 house democrats, and despite that vote and the support of seven senate democrats, the majority decided not to include this language in the reid bill or the reid manager's amendment. now, i find that absolutely outrageous. moreover, the reid conscience protections are much weaker than those included in the house-passed health reform bill. the house bill included the hyde-weldon conscience protections that have been included in the h.h.s. appropriations bills since 2004. the reid health reform legislation does not. the hyde-weldon language ensures that strong conscience protections are in place for medical providers who oppose

abortion. these strong protections which are currently federal law, currently federal law should also apply to the new programs created through the reid manager's package. the so-called abortion compromise does not stop there. the reid amendment also creates a state optout charade. as noted by cardinal daniel dinardo, the archbishop of galveston, houston, and the u.s. conference of the committee on pro-life activities, allowing, quote -- "individuals to opt out of abortion coverage actually underscores how radically the underlying senate bill would change abortion policy." excluding elective abortions from overall health plans is not a privilege that individuals should have to seek as an exception to the norm. in all other federal health programs, excluding abortion is the norm. and numerous opinion polls show that the great majority of

americans do not want abortion coverage." unquote. additionally, this provision does nothing to prevent one state's tax dollars from being used to fund abortions in other states. in other words, tax dollars from nebraska or utah could be paying for abortions in california or new york. the reid amendment also creates a new public option that will be run by the office of personnel management, o.p.m., and for the first time creates a federally funded and managed plan that will cover elective abortions. should this election -- should this legislation be signed into law, the federal government will be funding elective abortions for the first time in over 30 years. against the will of the vast

majority of americans. for these reasons, i believe that the senate health reform legislation is far inferior to the house-passed bill when it comes to protecting the sanctity of life. it should come as no surprise to anyone that pro-life organizations from the u.s. conference of catholic bishops to the national right to life committee and family research council have expressed their strong opposition to this so-called compromise. finally, let me take a moment to talk about the individual mandate tax which has almost doubled from $8 billion to $15 billion in the reid amendment. i have long argued that forcing americans to either buy a washington-defined level of coverage or face a tax penalty collected through the internal revenue service is institutional. -- is unconstitutional. the constitution empowers congress to do many things for the american people. just as important, however, is that the constitution also sets limits on our power. we cannot take advantage of the power without recognizing the limits. we hear a lot about how senators

on this side of the aisle are supposedly defending the big, evil insurance companies while those on the other side of the aisle are defenders of the american families. this insurance mandate exposes such partisan hypocrisy. let me ask one simple question -- who would benefit the most from this unprecedented mandate to purchase insurance or face a penalty enforced by our friends at the internal revenue service? the answer is simple. there are two clear winners, two clear winners under this draconian policy, and neither is the american family. the first winner is the federal government, which could easily use this authority to increase the penalty or impose similar ones to create new streams of revenue to fund more out-of-control spending. second, the insurance companies are the most direct winners under this insurance mandate because it would force millions of americans who would not otherwise do so to become their customers. i have heard them say 30 million

americans would be forced to buy insurance. now, if you don't believe me, then just look at the stock prices of the insurance companies that have recently shot to their 52-week highs. right now, states are responsible for determining policies that best meet the particular demographic needs and challenges of their own residents. massachusetts, for example, has decided to implement a health insurance mandate while utah has decided not to do so. this bill would eliminate the state flexibility so that the federal government may impose yet another one-size-fits-all mandate on all 50 states and on every american. i cannot think of anything more at odds with the system of federalism that america's founders established, a system designed to limit government and protect liberty. as i have said all year long, ensuring access to affordable and quality care for americans is not a republican or democrat issue. it is an american issue. unfortunately, the majority's

arrogance of power has forced us down a path where ideology has trumped policy and big government has trumped american families. town hall after town hall and poll after poll tells us that americans want us to step back, start over, and reform our health care system in a step-by-step, fiscally responsible manner. this is a moment for courage and leadership. all we need is one democrat to listen to a growing chorus of concerns from americans across this great nation and stand up against this bill. i'm going to do everything possible to make sure that the voice of utahans and americans everywhere will be heard loud and clear in the senate chamber. a vote to move this bill forward will be one of the most important votes this body has ever taken. a vote that is bigger than our parties or our ideologies. a vote that will fundamentally change the american landscape for generations to come and

restructure 1/6 of our american economy. a vote that will determine if we give our future generations the same opportunities and the same sets of pride that has been our privilege. make no mistake, our actions on this vote will not be without consequences. history in our future generations will judge us on this vote. despite the harsh realities of skyrocketing deficits and exploding national debt, the majority's insatiable appetite to spend has not changed. last weekend was a perfect example. at a time when we are already debating a $2.5 trillion tax and spend washington takeover of our health care system, the majority jammed through a $1.1 trillion appropriations bill with a 12% year over year increase in federal spending. but this is only the tip of the iceberg. there is already talk of raising our nation's debt limit by almost $2 trillion to accommodate washington's out-of-control spending habits.

enough is enough. it's time to stand up and do what's right, and there is no better time to do it than to vote against moving forward on this health care bill. the time for courage is now. the historic blizzard in washington yesterday was a perfect symbol of anger and frustration brewing in the hearts of the american people against this bill. i urge the stkwrort once again listen to the voices -- the majority to once again listen to the voices of the american people. there is still time to step back and start over. now, mr. president, one last thing. when you have one-sixth of the american economy involved, it really deserves a bipartisan vote. and to be honest with you, almost every major reform we've ever passed -- in fact every one that i can think of -- had a huge bipartisan vote. in this particular case, i don't know of one republican who is going to vote for this. if you can't get 75 to 80 votes

on something that is this important, for this much reform, we should start over and do it on a step-by-basis and do it the right way. i yield the floor. mr. bennett: mr. president? the presiding officer: the senator from utah. mr. bennett: i've been interested in the conversation going on this afternoon and this evening, and i heard once again the statement made on the floor about the number of people who die every year because they don't have insurance, and how that is an absolutely essential reason why we have to pass this bill and indeed pass it now. we have to pass it before christmas. we have to pass it immediately, because there are tens of thousands of people who are dying because they don't have insurance. and we have to pass this bill so that it will provide insurance for them in january of 2014. we have to pass this bill because people are dying right

now, but we're not going to have any of the things that will take care of them available to them for four years. so we can't take an extra week. we can't take an extra ten days, because people are dying. but we can take an extra four years before we give them anything. i have had a very hard time understanding that logic. that mathematics doesn't add up for me. delaying everything for four years, why? well, we know why. the reason they're delaying the implementation of this bill for four years has nothing whatever to do with people's health or the fact that some people are dying. the reason that the implementation date of this bill is delayed four years is entirely due to the computers in the congressional budget office which say if you started this

program immediately, it would bankrupt the united states of america. it would blow the budget right out of the water. oh, how do we make it look as if this thing is budget-neutral? well, the way we make it look as if it's budget-neutral is tell the computers, who cannot think -- they can only add -- we will start the revenues that are in this bill, we will start the taxes that are in this bill, we will started increased premiums that are in this bill right away. but we don't start spending any of the things that we're giving to people to save their lives for four years. so the computers will say, all right, you'll accumulate revenue for four years, and that will be a big pot of money. and then in the remaining six years of the ten-year term, which is all the computers are allowed to look at, you will have enough money over a ten-year period to pay for six years worth of benefits.

and i will grant that. actually it isn't six years worth of benefits because the money coming in won't be enough. so in order to make it look even better, they'll project and the computers who don't think just add and say, yes, this is right. we will project, taking roughly half a trillion dollars out of medicare and putting into the same pot of money that's coming in in the four-year period when nothing's going out. wait a minute, if we have four years of money coming in and nothing going out and we take hafrts dollars out of -- take half a trillion dollars out of medicare and put it in the same pot of money, the computers can add that really well and say this is going to be revenue neutral. mr. president, anybody who thinks this is going to be revenue neutral does not understand reality. and certainly does not understand history.

let's look at the c.b.o. record of projecting health care costs. i remember when the congress passed medicare and there were very firm costs associated with medicare. it's going to cost so much. we look back on medicare; it has cost 20 times what was projected. in the first year it cost more than was projected. and this is in constant dollars. this is not in inflation-adjusted dollars. constant dollars medicare cost 20 times than what we were told. i remember in debate, 1994, joe califano, a member of the white house staff who wroted bill, wrote an op-ed piece in "the washington post." he said, congress, pay attention to our experience with medicare. he said we put medicare together. we got the cost projections. we put the whole thing together. and he said we knew within

months after it had passed that we were wrong. we knew within months after we had passed that the costs were going to go way out of sight. and we went to the congress and told them, and at that point it was too late. this thing had taken root. it had its followers. it had people who were solidly behind it. and it was too late to fix it. and it's ended up costing us 20 times. let's look ahead. let's look ahead and see what we're doing if we pass this bill. number one, we're doing nothing for those people who need coverage for a four-year period, but we are locking into the federal budget situation a brand-new entitlement. now that's a word we use here in washington, and many of my constituents don't understand what it means. so let me do my very tpwoeft try to -- my very best to try to

help people understand what an entitlement mean. as the word implies, the people who are receiving the money under an entitlement are entitled to it whether we have the money to give it to them or not. they are entitled to it, whether they need it or not. they are entitled to it whether it makes any sense for them to get it or not. it is an entitlement that they will receive this money. when medicare was passed, the only entitlement we had was social security. now we have social security, medicare and medicaid. and along with the other entitlements that are built into the federal budget, how much of the federal budget goes out in entitlements? mr. president, if we look at the budget for 2010, here is the cautionary lesson for us. the budget in 2010 that we voted on here in this body -- i didn't vote for it -- it listed the

projections out of the congressional budget office as to how much revenue the federal government was going to have in 2010. and the answer was $2.2 trillion. that's a lot of money. and then it said, next line, entitlement spending or mandatory spending $2.2 trillion, which meant that in 2010, with the economy on its back and the revenue coming down as a result, every single dime we received out of the economy in 2010 was already committed. so people would say to me, senator, why don't you balance the budget? and i'd say how am i going to balance the budget? how am i going to balance the budget with every dime that's coming in already committed and going out as an entitlement and outside of the appropriations process. oh, vote against an earmark. pardon me?

the entire government of the united states, all of the embassies overseas, the defense department, transportation, education, national parks, name it, whatever it is, every dime to keep the government going had to be borrowed not because we didn't have any revenue -- we had $2.2 trillion worth of revenue which by itself would have covered the cost of keeping the government open. but we couldn't touch a single dime of that $2.2 trillion because all of it was tied up with entitlements sofplt what are we doing in the face of that experience? we are creating a new entitlement to add to those that we already have. now the realities of federal budgeting are these -- and they're not unlike the realities of running a business. i have run a business, and i understand how the very best projections, the very best forecasts can go awry.

you can have a new product. you think it's going to do really well, and you forecast "x" millions of dollars in revenue from this new product, and you look at what are the product's going to cost you, and you forecast that cost, and you put the two together and you say, all right, we're going to have "x" in revenue, we're going to have "y" in costs. and as a result we're going to have "z" in profit. you go out and you build the product, you commit for the raw materials, you pay the people in your factory to produce it, and you put it on the shelves. now you're at the mercy of the customer because if the customer decides he doesn't like the product, your projections of the amount of revenue will not save you from the enormous loss that will come. and, yes, you're right on the "y" that you're spending but you were wrong on the "x" that you

thought you would get in and instead of getting the "z" that you thought would come in as profit, you've got a huge loss on your hands. conversely, i've had this happen to me too. i've done my forecasting, laid down the plan for how much of the product we're going to produce. i've done my forecasting of how many will sell, and the product went crazy, jumped off the shells. and all of a sudden i was stuck with empty shelves and had to scramble to produce more and more and more in order to meet the demand. well, in the federal government, we don't have a product, but we have -- we have expenses, just the same as doing a manufacturing operation. and we don't have sales, but we have taxes. and our taxes are dependent upon the viability of the economy. and the one fundamental lesson we all should learn around here is this: we can accurately

predict the expenditures that are going out, just like in the business i could predict what it would cost me to produce the product. but we cannot accurately predict the revenue that will come in, just like i can't accurately be sure of what the sales will be. we did a spending pattern based on revenue when the economy was strong, and suddenly the economy turned weak and the revenue dropped off to $2.2 trillion, and we were stuck. so, does it make any sense in the face of that reality, we can determine the spending but we can't determine the revenue? does it make any sense in the face of that reality to build in increased spending in the form of another entitlement?

in the hope that the revenue will be there? and the only way the majority leader is able to make this bill look as if the revenue will be there is with a series of budget gimmicks, the likes of which i've never seen, some of which i've already discussed. the first budget gimmick is to say the revenue will be there because we'll have ten years of it and only six years of expenditure. the revenue will be there because we'll be able to find half a trillion dollars worth of waste, fraud and abuse in kphaeufrplt i will stipulate -- in medicare. i will stipulate there's probably half a trillion dollars worth of waste, fraud and abuse in medicare over the period of time we've been talking about this bill. we've been looking for it for more than ten years and have been unable to find it. this bill, instead of trying to take a scalpel to medicare and cut out the areas of waste, fraud and abuse that are there,

using a sledgehammer to smash medicare and say we're going to knock half a trillion dollars out of it and hope that in the process of doing that, we're going to hit the waste, fraud and abuse without hitting anything else. mr. president, we've got four years on the timetable laid down by the majority in which to get this right. the majority has decided that if indeed people are dying because they don't have health care, they can continue to die because they don't have health care for four years more. i think in the face of the smoke and mirrors that we're seeing with respect to this budget, we can afford during that four-year period, at the front end of that four-year period to take a few more weeks to do this right. and that's why i'm here, and that's why my republican colleagues are here. not because we don't say there's

a problem. not because we don't have any ideas as to how to deal with the problem. not because we don't want to join hands with our friends across the aisle to solve the problem. but because we know this bill is the wrong solution, and are constituents are pleading with us. they know this bill is the wrong solution. every poll shows that. and they are pleading with us, don't let it happen. don't let it happen. no matter what you have to do, don't let it happen. may well be that all of our efforts are in vain. it may be that we're washed aside in a tide of 60 votes. but we will not be washed aside by complacency or the desire to get along. because the stakes are too high. i conclude with this one last analogy. there was another very large organization that handed out a

large series of entitlements to people with whom it was connected. these entitlements were not directly involved with the business of that organization, but they got bigger and bigger and bigger. and ultimately this organization suddenly discovered that it could not function because of the financial drain of the entitlements that it faced. the organization is now owned by the federal government. it's called general motors. they discovered that they could no longer be a car company because they were buried by the kind of entitlements they had built into their own situation. let us take a lesson from general motors. we don't want the federal government to go bankrupt the way that company did. and if we do, there is no other organization to bail us out the way the u.s. government ultimately felt forced to bail out general motors. it's a cautionary tale that we all need to hear -- heed.

the presiding officer: the senator from louisiana. mr. vitter: thank you, mr. president. mr. president, i, too, rise to voice me very strong concerns about this latest version of so-called comprehensive health care reform. and i'll speak of my strong concerns starting with the process we're in the midst of, because i'm still guy guesting thdigesting theparticulars of ta bill. as you know, mr. president, it was just divulged yesterday, a 383-page amendment to the underlying bill. the amendment references another bill which is 286 pages. the underlying bill is 2,074 pages. it makes for the seventh -- count them, the seventh version of so-called comprehensive health care reform, obama-care

for short, in a few weeks, that totals -- grand total would be 2,733 pages. so certainly i'm still digesting this littes latest version. my taf is helping me. staff is helping me. but i wanted to rise to begin to express my concern. and, mr. president, the first concern is what i just referenced, this process we're in the midst of. mr. president, when i went around louisiana, when i continue to go around louisiana, have town hall meetings, of course health care comes up first and often. and the themes i hear over and over is this is too important to rush. this is too important to have some arbitrary deadline, whether it was last summer or christmas. but we need to get it right and not have arbitrary deadlines and you need to know what you're voting for or against. that's what i hear about the right process to use over and

over and over. well, unfortunately, mr. president, clearly this process we're in the midst of does not honor those wishes of louisiana citizens, of american citizens. before this latest mega health care bill was unveiled everyone it seems, including members of the majority party, who at least were involved in the negotiations, unlike republica republicans, were in the dark. let me mention a few statements that democratic senators made over the last week or so before yesterday's unveiling. senator durbin, in the leadership, said -- quote -- "i would say to the senator from arizona that i'm in the dark almost as much as he is and i'm in the leadership." senator schumer of new york, also in the leadership -- quote -- "i can't say what there is because we're not allowed to talk about what's submitted to

c.b.o.." senator bayh of indiana -- quote -- "we're all being urged to vote for something and we don't know the details of what's in it." senator bill nelson of florida -- quote -- "i don't know what the deal is." my colleague, senator landrieu of louisiana -- quote -- "there's no specific compromise. there were discussions. until the package that was sent is scored, we really don't even know what's in it." senator casey of pennsylvania -- quote -- "any big agreement is progress even if we do not know any of the details." senator feinstein of california referred to a meeting on the majority side recently -- quote -- "there was no explanation. it was just sort of 'go, team, go.'." and senator ben nelson of nebraska talking about a similar majority meeting -- quote --

"general concepts but nothing very specific at all." then at least yesterday, mr. president, this new mega bill, this 383-page amendment referencing another 286-page bill, attached to an underlying underlying2,074-page bill -- so that finally happened yesterday morning. but, mr. president, i'm afraid it's not progress enough, it's "time" enougtime enough considee set to vote on this new mega bill in just a few hours, starting at 1:00 a.m. tomorrow morning. and, mr. president, listening to american citizens all over the country, several senators, including myself, have advocated we need at least 72 hours of final bill text on the internet

before we take any votes about this sort of major legislation. we need at least 72 hours of the official congressional budget office cost estimate being on the internet before we start any of those votes. i've certainly advocated that. many of my colleagues here on the republican side have advocated that. listening to respond to american citizens who say no arbitrary deadlines, know what you're voting on, get it right. perhaps even more importantly than my advocating or other republicans advocating is, at least eight democrats have specifically demanded the same thing. back on october 6 of this year, eight democrats wrote a very clear strongly-worded letter to the majority, senator reid, and

they demanded exactly the same thing. 72 hours of final legislative language on the internet before any vote on the matter. a full congressional budget office cost estimate on the internet for at least 72 hours before any vote on the matter. and i applaud these senators for demanding that, senators lincoln and landrieu, mccaskill, pryor, bayh, lieberman, senator ben nelson, and senator webb. but again, mr. president, this process we're in the midst of certainly does not honor that minimal demand. we're set to vote on this in just a few hours, and when we do, we will have only had the final legislative language for about 40 hours. we will have only had the full congressional budget office cost estimate for about 37 hours.

that's 56% or less of this minimum time frame that so many of us, including eight democra democrats, have demanded. so again, mr. president, this rush to judgment, this rush to beat an arbitrary christmas deadline is clearly ignoring the common sense of the american people, the common sense that i heard in my dozens of town halls all across louisiana, know arbitrarnoarbitrary deadlines, t you're voting on, get it right, don't rush to judgment. so, mr. president, i have strong, strong concerns about this process. where are the 72 hours? where is the opportunity for members and the american people to really know what's in this latest version of a mega bill on so-called comprehensive health care reform? where's the 72 hours of notice

of a congressional budget office cost estimate. mr. president, given that rush to judgment and arbitrary time line, i'm rushing to digest this latest version of the bill. i have other very strong, substantive concerns. i'll be coming back to the floor within the next few days to more precisely outline those concerns as i digest more of the details of this latest mega bill. but let me mention at least six of the big louisiana-based questions that i'm focused on in terms of this latest megabill, this latest so-called comprehensive health care reform or obama-care. number one is the impact on the louisiana state budget. mr. president, there's been a lot of discussion about that

because of the particular language included in the bill pertaining to louisiana that apparently gives louisiana $300 million benefit. the problem from the louisiana perspective, mr. president, is that in the medicaid system and that $300 million is directly related to medicaid, in medicaid, there's a much greater additional burden put on all states, including louisiana, and in louisiana's case, apparently that's going to far surpass $300 million. so i'm really concerned about the overall, the net impact on the louisiana state budget, particularly because of the dramatic expansion of medicaid. medicaid is the health care program for the poor. it's dramatically expanded in this bill. and every state, except, perhaps, nebraska, because of

special language put in for nebraska, every state pays a match for both existing medicaid and medicaid expansion. that's going to put a big extra burden on the louisiana state budget, and that big extra burden is apparently going to be much more than the $300 million of benefit that has been so widely talked about. and i'm looking right now at the details of that. mr. president, my second big louisiana-based concern has to do with louisiana's seniors. louisiana seniors who've paid into medicare, the health care system for retirees, for years and have assumed it would be there for them as they paid in, as they followed the rules every step of the way. mr. president, i know from the study i've done already that this new latest version of the megabill, so-called comprehensive health care refo

reform, involves a $464.6 billion cut to medicare. and that's going to impact every louisiana senior and it's going to impact tens of thousands of louisiana seniors on medicare advantage particularly onerously. mr. president, my third big louisiana-based concern is the louisiana taxpayer, because this bill contains massive tax increases to pay for all of these new entitlements. apparently the total figure of tax increases in the bill is $518 billion, over half a trillion dollars, more tax increases than in any of the six previous megabills, the six previous versions of obama-care. and a lot of these taxes, mr. president, are clearly going on individuals who earn less

than $200,000 per year, families who earn less than $250,000 per year. a lot of louisiana taxpayers are going to be hit. that's a big concern. fourth, mr. president, i'm concerned about louisianans who have health care now and who pay premiums, because those premiums by all accounts, by all independent estimates, are going to go up because of the taxes and fees and other burdens in this bill. fifth, mr. president, what about louisiana's small businesses, businesses that are struggling right now in a serious recession, the most serious recession since the great depression? we're in the midst of an extremely serious recession and we're putting new mandates, new burdens, and new taxes on louisiana small business. by all accounts, that's going to cost jobs, pure and simple, as we're in the midst of a very

serious recession. and i'm really concerned about that impact on louisiana small business. and sixth and finally, mr. president, louisiana defenders of life. i'm very proud to say louisiana is one of the most pro-life states in the nation. vep strong values which hold up -- very strong values which hold up life in all of its forms. this bill has taxpayer funding of abortion, really, the first time ever in federal legislation, breaking tradition from the hyde amendment, which has been the law since early 1977. i'm very concerned about that radical, truly radical departure from the past, mr. president. so in closing, mr. president, i hope that we can adopt a different process, one that reflects the common sense of the

american people and louisianans when they say no arbitrary deadlines, no rush to judgment. know what you're voting on. also, mr. president, i hope that we will adopt a different approach that doesn't involve all of the downside that i mentioned in those six major categories. i'm still digesting this latest mega bill, mr. president. i'll return to the senate floor in the next few days to talk in more detail about those concerns that i've laid out. but i hope all of my colleagues, democrats and republicans, look hard at those with similar concerns look hard at the process an resolve to not just do this quick before christmas or an arbitrary deadline, but to do it right and to honor the american people and our work. thank you, mr. president. i yield the floor. the presiding officer: the

senator from florida. a senator: thank you, mr. president. i'm new to this colleague. as i listened to my distinguished colleagues speak to this bill and watching some of my other colleagues in my office on the television this evening, i can't help but think how fortunate i am to be here, to be part of this process. it makes me think back to the founders who put together this great constitutional system of democracy that we have in this country with the three branches of government, and here in the senate the sober reflective legislative body to think through the great issues of date and make sure we get them right for the american people. mr. lemieux in listening to this -- mr. lemieux: in listening about this great debate, i wonder what they would think about this here. because i'm new to this chamber, i think i still have fresh eyes as to what is normal and perhaps what is a little bit departed from normal.

would they think it was in their founders intention that we would be coming here to vote at 1:00 in the morning? do you think that it would be their intention on how things would work in the senate that we would get an amendment to the bill that's 400 pages long, we would get it yesterday, it would have just a little time to consider it before we try to vote on it? would it be what they intended that we would press this vote up against christmas and we would try to get it done quickly while most of the people in our country are off with their families and preparing for the holidays? would that be what they intended the process of this great, deliberative body, arguably, it is often said the greatest debating institution in the world, is that the way they'd want us to achieve policies that going to affect one-sixth of our economy? i don't think so. in fact, i don't think the american people think so either. that's why they're so bewildered

as to what we're doing here in the united states senate. why we ares, as my friend and colleague from louisiana said, rushing to judgment? why we muss get this done -- must get it this done before christmas. if it's such a good bill, why do we have to get it done so quickly? if it's such a good bill, why can't we take some more time to evaluate it? if it's such a good bill, why can't we offer more amendments to it? so i'm sure the american people, if they're home watching this and they're probably watching sunday night football, they would say that my senator from florida or the senator from the other states can now offer amendments to try to improve the bill. but that's not the case. because the leader of the distributic party, the majority leader, has done something called filling the tree. now, look, i'm new here too. so this is all new to me. it's a process by which no other amendments are allowed. so if we want to change the

bill, if we have ideas to improve it, that's not allowed. is that what the american people want from us? is that what our founders intended? i don't think so so we have this new amendment, it's some 400 pages long. it is the amendment to, i guess, fix the problems that were in the bill or at least to get 60 votes. and what do we know about this amendment? what does it do, for example to medicare cuts? we know that the previous bill before the amendment cut nearly a half a trillion dollars out of health care for seniors. what does this amendment do? well, it still cuts health care for seniors. it actually cuts it a little bit more. but it's still around that same number, a half a trillion dollars. we know also that it raises taxes. does -- does it raise taxes a half trillion dollars like the previous measure did? yes, it does, in fact, it raises taxes a little more. now it's $518 billion.

well, what about the questions that the most pressing question on the minds of most americans? the very reason, mr. president, that we are here, according to the president of the united states, which is to impact the cost of health insurance for most americans. what does it do about that? does the amendment do something about that is this we know that the underlying bill does nothing to impact the cost of health insurance for most americans. we are here about to change one-sixth of the united states economy and this bill does nothing to impact the cost of health insurance for folks who already have health insurance in this country. that's not me saying it. that's the congressional budget office. if you're one of the 170 million americans who already have health insurance, this bill is not going to lower your costs. in fact, for some americans it's going to increase your costs over the next 10 years. well, does this amendment fix it? no. so we're still in the same situation. cut a half trillion out of health care for seniors, raise

taxes, buy half a -- by half a trillion dollars with nothing really in it in terms for the cost of their health insurance. now how is this going to affect the american people? well, if you have medicare -- if you're a senior who's been paying into it -- it's going to affect you. now, my friends on the other side of the aisle will say, look, the nearly half trillion dollars that we're going to take out of medicare is just waste, fraud, and abuse. and we'll get that money out. well, the congressional budget office says that the measures in the bill will take out a billion and a half dollars worth of waste, fraud and abuse, not $5 trillion. will where the -- where will the rest come from? it will be decreased benefits, decreased access to doctors. mr. president, we know right now in medicare nearly 24% of medical health care providers,

your doctors, for example, won't take medicare anymore. 24%. one in four almost. in medicaid it's 40%. now, what's going to happen when you reduce the amount of money that you're paying into medicare? you're going to reduce the amount of money that's being paid to providers, which means that providers are not going to see their patients. if the doctor's not in, it's not health care reform. this impacts my state of florida. we have the highest number of seniors per capita. three million -- three million seniors on medicare. and they're going to be impacted. i'd like to read from a letter that was sent to me by a mr. richard malaney. i received it at the end of november. it says, dear me -- dear senator lemieux, i thought you would like to see this letter from my

cardiologist, it attaches it from the palm beach cardiovascular clinic in palm beach, florida. i'd ask unanimous consent that this letter be entered into the record. the presiding officer: without objection. mr. lemieux: it's an open letter to the patient and signed by seven doctors in the cardiovascular clinic practice. it says that drastic reduction in fees are seriously going to hamper our ability to continue to see you, our patients, as we do today. we feel the need to warn you that these reductions will translate into much longer waiting periods for you to schedule an appointment or procedure with your doctor. longer telephone response times to you. and not having the convenience of an in-office nuclear and echo diagnostic testing. the letter goes on, we may not be able to provide some of the services that patients have come to depend on and in the long run

if the current policy are not changed, we may force us to close our doors. so these are doctors, real doctors, and this is a letter from the real patient saying, if these -- if these cuts to reimbursements to doctors an providers aren't -- and providers aren't addressed, then we are going to have an inability for doctors to perform health care. that's real -- real world problems that are going to occur if this bill is passed. so this is no great shakes for seniors. this isn't health care improvement for seniors. those that we have in an entitlement program, those who paid into the program are going to have a cut in their benefits. and that's exactly what the chief actuary that we found out last week from the center for medicare and medicaid services said. he said that it's plausible, even probable, that there will be shortages for medicare and medicaid beneficiaries because

there's not going to be doctors who are available to see them. let's talk about the taxes. $518 billion in tax increases. what is that going to do to the cost of health care? we're going to tax medicine, we're going to tax lifesaving devices. those taxes, of course, will be passed along to you, the consumer. so for you, your cost of health care will go up. taxes on health insurance, almost $60 billion. taxes on medical devices devices, $19 billion; taxes on medicine, $22 billion. if you don't have health insurance now, and you don't get it, you'll be taxed. if you're a small business and you don't provide health insurance to your employees, you'll be taxed. i had a telephone town hall meeting this week, mr. president, and i talked to a

gentleman from central florida who had been laid off from his job in a restaurant. and he said to me, the reason why i got laid off is because the restaurant couldn't afford the health care benefits. so when health care benefits -- when health care benefits went up, the restaurant raised its prices for its food and people stopped coming to the restaurant and the restaurant went out of business and there wasn't health care for any of employees. you can't get blood from a stone. while the benefits of this plan laid out by my democratic colleagues may sound great, 33 million more americans who will have some kind of health insurance, you have to look at the details. how are you going to pay for it and what's the effect going to be? when you raid half a trillion dollars out of medicare, you're going to decline the quality of health care for our seniors. when you raise taxes by a half a trillion dollars, you're going to pass those costs along to consumers who already have health insurance and their

prices are going to go up. you're going to pass them along to small businesses who won't be able to afford them, who will let people go. we have 11.5% unemployment in florida. when small businesses can't afford this, they're going to let people go or, like that restaurant, close their doors. that's not good for a country that's fighting through the worst recession since the great depression. and now we find out, mr. president, that there's a bunch of special deals in this bill. we find out that the senator from nebraska, has been able to get a special fix for his state. see, another thing that this bill does is it takes and puts a big unfunded mandate on the states. what do i mean by that? an unfunded mandate is a requirement that the states must fulfill that they don't get paid for and this time it comes in the ford of medicaid which is health care for the poor. medicaid, under this proposal, is going to be increased.

we're going to put 15 million new americans into medicaid. you think that medicare recipients are having a tough time finding a doctor. in medicaid 49% of doctors won't take it, 50% of specialists won't take it now we're going to put 15 million more americans into it. what it does to the states is that in a state like florida, it's going to cost us in 10 years nearly $1 billion to accept this unfunded mandate. now the senator from nebraska apparently got a fix for this so his state won't have to pay the billion. now, florida would like that same fix. if it's good for nebraska, it's good for florida. i'm sure iowa would like that fix as well. i'm sure all the states would. so, mr. president, i ask unanimous consent that the pending amendment be set aside and it be in order to offer an amendment to extend to the state of florida the same benefits that provide 100% federal

funding to the state of nebraska for their expanded medicaid program. the presiding officer: is there an objection? mr. harkin: objection. the presiding officer: objection is heard. mr. lemieux: the reason why my distinguished colleague from iowa oh, jectd to this is this -- object to this, is that the deal won't go through. some states will get it better and some states will get less. that's not fair. but that's what this bill has been put together to cobble together 60 votes. may -- may i ask how much time i have remaining? the presiding officer: 15 seconds. mr. lemieux: at the end of the day, i have 15 seconds left. i will be back to the floor to speak about this again, but this is not a good bill for america. that's why my colleagues on this side of the aisle have been debating and showing our objections so that the american people can understand. i yield the floor. the presiding officer: the republican block of time has expired. the senator from massachusetts.

mr. kirk: thank you, mr. president. mr. president, let me acknowledge first the leadership of our colleague from the great state of iowa, senator tom harkin, who he and his staff have worked tirelessly to bring us to this point in our legislative process. i also want to commend my distinguished colleague, majority leader harry reid of nevada, senator ben nelson of nebraska, barbara boxer of california, bob casey of pennsylvania, and chuck schumer of new york. for the printed and practical compromise they reached on the difficult issue of abortion. their work allows the united states senate to now march with our house colleagues toward the forward edge of history and the enactment of the patient protection and affordable care act, and i congratulate them for that important contribution. mr. president, i would also like to commend my colleague, the assistant majority leader, dick

durbin, of illinois for bringing to the senate's attention during yesterday's debate an op-ed that appeared in "the washington post" this morning, written by our dear friend victoria reggie kennedy. it was entitled "the moment ted kennedy would not want to lose." vicki kennedy was senator kennedy's partner in all things, including his final efforts to move health reform forward, even as he valiantly fought his own battle with cancer. in more than 17 years of marriage, ted and vicki were inseparable, bonded by the love of friends, family, and most obviously by their love for one another. we remember vicki displayed inspirational grace in leading us all in our grief and in the memorial celebration of his life on the occasion of senator kennedy's death, and today she continues as his partner, paying

tribute to ted's legacy by respectfully urging his colleagues to move forward on the health reform he would have wanted. i feel certain that vicki's voice and his will make us more determined than ever to complete ted's work for the american people, and we thank you, vicki. mr. president, i would now like to respond to an argument made in another op-ed in thursday's "washington post" and in an interview on "meet the press" this morning by my friend, a former democratic party chairman howard dean. chairman dean said in his opinion piece, -- "if i were a senator, i would not vote for the current health care bill because it does not bring real reform." with all due respect, before anyone swallows howard's faulty prescription, as they say in the field of health care, it's time for a second opinion. as a former national chairman of

the democratic party myself, i'll take my equal time to offer my opinion and say i am a united states senator and i will vote for the current health care bill pro sighsly because it does bring real reform. now, is it all the reform for which our friend and colleague ted kennedy, the father of modern health care reform, fought so valiantly and tirelessly throughout his legislative career? no. is it all the reform for which i and many of my distinguished colleagues advocated so passionately here on the floor of this chamber throughout this intense debate? no. but is it a quantum leap forward that will bring real reform to a broken, discriminatory, bankrupting deficit-busting health care system that will only get worse without immediate action and passage of this legislation? the answer, mr. president, is

clearly yes. one of the reasons history will record that ted kennedy was the greatest legislator of our time was that he respected the need and the art of compromise, and he would argue that a choice between a solid, sound, significant and long overdue start at real reform of our health care system and the choice of leaving america's families to continue to fall behind because we refused to seize the historic moment before us is the easiest choice and perhaps the most historic vote we may ever cast as united states senators. does anyone in this chamber or in massachusetts or anywhere else, for that matter, doubt ted kennedy's commitment to legitimate, credible, real reform of our system in order to make affordable, quality health care accessible to the greatest number of americans?

the answer is clearly no. is this a bill of real reform that ted kennedy would champion and vote for? absolutely yes. ted kennedy knew real reform when he saw it, and so do i. mr. president, here are the real health care reform measures of this senate bill, many of which senator kennedy himself helped to craft. think about this. it will save money and save lives, expand coverage and bring over 30 million uninsured americans into the community of the uninsured. it will control costs and lower premiums, stimulate competitive choices so consumers can choose the best policy at the most affordable price, relieve the costly health care burden on the small businesses of america through tax credits, provide a discount to countless seniors like my own sister maude who was

squeezed by the cost of prescription drugs under medicare d's so-called doughnut hole. the real reforms in this bill will strengthen medicare and medicaid, reduce the deficit by hundreds of billions of dollars, attack waste, fraud, and abuses, eliminate lifetime limits on needed care, reward wellness and preventative practices, increase transparency and insurance company accountability, promote flexibility, innovation, and best business practices, reward the quality and the value of care instead of the quantity and volume of procedures. this bill will eliminate unjust discrimination against women or those afflicted with pre-existing conditions. it will provide the elderly and the disabled a voluntary choice to self-fund a plan that will

provide financial security to purchase long-term services when they are needed most. it will require insurance companies to cover children and dependents up to age 26 and prohibit insurance companies from dropping coverage for americans who get sick, the very reason they buy health insurance in the first place. in these and many other ways, this senate bill is real reform. for a senior citizen who cannot afford the drugs she needs or the 31 million people who will now have the health insurance they deserve. for families who worry that hospital bills will wipe out their life savings for a system that presently fails to serve the needs of the american people, mr. president, this is real reform. for those well-meaning progressives who say they oppose this bill because it does not go

far enough, and to my colleagues on the other side of the aisle who want to defeat this bill and start over, i say they are both mistaken. we need to win this fight now, and we need to win this fight together. will there be more to do after its enactment? mark my words, there will always be more to do. but this historic piece of legislation will be a giant step forward toward a health care system that truly begins to serve the needs of the american people. president kennedy offered two profound observations that have helped me keep things in perspective throughout my life, and they have particular application at this moment in our time. he once said -- "wisdom requires

the long view." and on another occasion, he said -- "democracy is never a final achievement. it is a call to an untiring effort." john kennedy's words apply so well to the work of health care reform before us this evening and to the legislation that will pass this senate within the next several days. we are all called upon to exercise our wisdom and to take the long view of history. we must understand that passage of this legislation will not be a final achievement. it will be a compelling first call to an untiring effort, to continue with our responsibility to do what the american people deserve -- provide affordable, accessible, quality health care for them as a matter of right. i am old enough to recall the

civil rights act of 1960 and the civil rights act of 1964, and the civil rights act of 1968. with the passage of each of those laws, there was always more to do, but each began the march of progress toward equality under our laws, and each created a responsibility to ensure that our country's laws more aptly reflected our national character and our principle of equal justice. the same is true of this moment in our national history. the bill before this senate is not perfect, nor will it be a final product. make no mistake, however. it is real reform and it will provide enormous benefits to

america's workers, america's seniors, and america's families. i urge my republican colleagues not to be held hostage by the raw and divisive politics of the moment, not to be the captives of those who may threaten with some meaningless political litmus test scorecards, but to step back and to think about the positive difference these reforms will make in the lives of the millions of american families we represent. and finally, to reflect wisely upon the long view of history and decide that this is the moment to join the majority of this united states senate in moving toward history's enlightened edge by voting for this landmark legislation. mr. president, i yield the floor.

the presiding officer: who seeks time? the senator from connecticut. mr. dodd: mr. president, mr. president, before he leaves the floor, let me commend our colleague from massachusetts, paul kirk, who has only been with us a brief amount of time. under circumstances as he has said on numerous occasions over the last several weeks that he would much prefer to have avoided, but i want to commend him. in the brief time he has been here as a member. many of my colleagues know that paul kirk is no stranger to this institution, having worked as a member of the staff in senator kennedy's office for many years and has had a distinguished career in his own right in boston, and we welcomed him here under those very sad circumstances, but his remarks this evening are evidence of the value he has played in coming to this chamber and filling a gap here that -- and articulating i

think a view that our colleague from massachusetts would be expressing were he here tonight and these days. and said so well -- if it hasn't been introduced in the record, i will ask, mr. president, that an editorial piece written by senator kennedy's wife, vicki kennedy, be included in the record at this juncture. the presiding officer: without objection, so ordered. mr. dodd: because she said it very well as senator kirk has, that this is a far from perfect bill. we all know that. and it's far from a finished product in terms of health care. the presiding officer has spent a good part of his career as well working on this issue and would be the first to acknowledge as well that we have a lot more work to be done. congresses long after all of us who serve in this chamber tonight are gone will be grappling with these issues of how we can better deliver health care services, create greater access, and reduce the costs of health care while extending the quality of life for our fellow citizens and removing the fear that so many families fear --

feel, rather, when they discover that a loved one, a child, particularly, is suffering from some illness or disease that requires attention. and yet to be informed that the cost for providing that attention, that care is so prohibitive that they can't afford to do it, and wondering why they, because they lack the economic circumstances, can't take as good of care of their children as someone with greater access to economic power can. and that's really what we're trying to achieve here is to create that availability of a right. i don't know of anyone that disagrees with the statement that health care in america ought to be a right, not a privilege, and if it is a right, then just as other rights are extended to every citizen, regardless of their economic circumstances, their ethnicity, their background, their gender, certainly this right ought to be no different from that regard and available to all of our fellow citizens, regardless of their financial circumstances. that's what we're starting to do

here. it doesn't achieve that goal perfectly, but it puts us on that path to achieving that equity, that ability for families and individuals to take care of themselves and their families when afflicted by a medical crisis or a medical problem. so, mr. president, having been deeply involved in this issue now for not quite a year but almost a year since it became very difficult for my friend and colleague from massachusetts to conduct the kind of daily hourly efforts that he would have been involved in but for his health condition, we have come to a moment now to decide whether or not we go forward, whether or not we accept the responsibility as being members of this body to do the best we can when trying to design something written by 100 people, not to mention 435 in the other body, not to mention an administration and all of their interests, not to mention all of the stakeholders who are involved in this question of health care which is so voluminous that it would be

impossible even in the time remaining this evening to mention everyone who has a stake in the outcome of this discussion. taking all of those elements and trying to bring them together to fashion an idea or a set of ideas to go forward has defied, as i said so many occasions in this chamber, has defied every administration and every congress since this first challenge was posed by, well, going back to the days of theodore roosevelt. but more recently, since the time of harry truman. and every congress, republican and democrat, every president democrat and republican have at least thought about doing this. some actually tried. president nixon actually tried. president clinton actually tried to come forward. and as those who remember those days, for a variety of reasons some would seem more clear today than they did at the hour they were being debated, those efforts failed.

we're now that third administration, that third effort that's come this far if you will. my hope is this evening and again in the ensuing few days here we'll complete our task in this body and continue the effort by working with the other body -- the house of representatives -- to fashion a final product for the signature of the president of the united states, to allow us to begin what will be a long journey to make sure that that right of health care is available to all of our citizens. many of us here may never see the benefits of that because of just life expectancy, i suppose. but to know that you're leaving a health care system in place for the coming generation where they can look back on these wintry days of the united states senate and be reminded there was a congress at the outset of the 21st century willing to face up to the challenges with all the accusations, all the barbs, all the arguments being hurled

at people and made an effort -- made an effort -- to right a wrong, to make a difference and improve the quality of life for all of our fellow citizens. that is something that i hope coming generations will recognize as a result of the efforts that we have made here. so, mr. president, let me just take a few minutes if i can to sort of at least wrap up for this part of the debate my views as to where we stand at this hour. when this body began, the process, of course, mr. president of writing health care reform over a year ago, we knew it would represent a mammoth understaking. and we knew it would get more difficult as we got closer to the goal line, as every major effort i've been involved in for three decades here has certainly evidenced. as you get closer to the goal line of major undertakings, it gets harder and harder to cross that finish line. this issue involves one-sixth of our economy, affects 100% of our fellow citizens and has been the center of american public policy

debate before many of us were even born. our path has been long and been winding and been difficult, but, mr. president, it has been illuminated by a torch lit long ago in the days of harry truman and those who even preceded him, and sustained for decades by very good people -- democrats, republicans and others who believe that in the nation founded on freedom and sustained by an imaginable prosperity, no one, no one in our country ought to ever have to go to sleep on a night like this feeling that if they got sick or if a loved one does they'd go broke or worse be unable to afford the care they or that loved one needs to get well. as i've said so many times before, the person who carried this torch has long and proudly as anyone since this debate began so many years ago is not with us tonight but he is in spirit and good conscience. i speak of course of our colleague from massachusetts, ted kennedy.

he never expected that he or we would cure all of our ills in one fell swoop, in one massive bill here that would once and for all right this problem of health care. progress, he would argue, is hard. and the simple mathematics of the senate make it harder all the time. i know that our republican leadership has basically advised their fellow members of their caucus not to vote for this bill no matter what's in it. i regret that. i think it's a sad moment indeed but one we have to grapple with. we can't quit because of that political conclusion. we have to move forward. in fact, they went so far as to write a play book on how to disrupt this issue. i know they don't like this or many parts of t. i also know that many like parts of it. they acknowledge that when they talk about greater access and cost reductions and quality of health care. as one who conducted the markup and hearings on health care over

the last year, i heard over and over again the members of that committee -- republicans and democrats -- speak of the very same goals that we all seek with health care reform. i know as a matter of fact, in fact many wrote major provisions of this bill, mr. president. this bill is not devoid of the involvement and participation of members of the minority party here this evening as we come close to votes on the final choice. but i regret that it's come to that. i think our best efforts do emerge when we work together as citizens of this great country regardless of the political label that we bear. my hope will be in the coming days those doors may open and participation may in fact flow and that we'll end up with a product coming back from conference that is even stronger than the one we're being asked to make a decision on this evening. someday i think we'll look back on this moment in our nation's history, and many of them who are not part of this decision will wish they had stood at the

arena instead of lobbing rhetorical grenades and cheap shots at a bill that deserves so much better. there is still time for my colleagues to stand up and do what's right. i hope they will before the process is over with. but as it is, our caucus had to work at finding a compromise language that we could all stand behind, and we've tried to do that over these days. the resulting bill isn't one that any one of us would have written on our own given that opportunity. that goes for me as well, as i know does the presiding officer. we fought for strong public option in our committee. i fought to have it included in the bill the majority leader brought to the floor. i would have happenably li been fighting for it -- i would have happily been fighting for it even today. it is always easy to envision the legislation that you want than it is -- than the legislation you can get. so, mr. president, preferred outcome of the republican

friends here we have in the senate, deadlocked within our caucus and resulting failure to pass a reform bill will result in for family bankruptcies, more deficits and sadly more debts that could have been prevented if everyone had access to decent health care. we do not have to let that happen. in fact, we will not let that happen. we have to be better than that. yesterday, mr. president, the majority leader introduced a manager's amendment to the original patient protection and affordable care act which we've been debating prior to thanksgiving. t-r toughens accountability policies for insurance companies, requires them to spend more on health care and less on administrative costs and profits, holding them k-lable for jacking -- accountable for jacking up premiums. it provides american families with more health care choices, guaranteeing that in addition to a variety of private-sector options, families can choose from at least two national plans similar to the ones we receive

right here in the united states senate, one of which will be a not-for-profit in the plan. it starts a tax credit for small businesses in 2010, giving families more information to shop for better deals and helping to spread cost-saving innovations across the country. it builds on the bill's protections for seniors, children, rural communities and other vulnerable populations. it preserves the bill's core commitments that no american should go broke because they get sick and no american should die because they can't afford the care they need to get well. mr. president, after more than a year of legislating and more than 60 years of hard work on the part of advocates across the nation, we have an unprecedented opportunity both later this evening as well as the remaining days of this week where standing on the floor of the nate with a chance to pass a piece of

legislation that puts our focus on preventing disease, not just treating it, a bill that ensures that 31 million of our fellow citizens who today lack any health insurance at all, a bill that guarantees that every american will have access to quality health care at lower costs. senator ted kennedy always believed that we'd someday have this chance, and i think he knew that this year might be the best and for our generation the last chance. these opportunities don't come around very often. we fought for reform in the 19 # os and failed. we fought for health care reform in the 1990's and failed as well. mr. president, if we fail this time, if we let partisanship triumph over progress, if we lose sight of the goal in the face of political gamesmanship, we who stand here today may never get that other chance. we came here to make this country a better place. i believe that every person who serves here, every person who

serves here believes that they came to the united states senate to make our country a stronger and better place. we have before us a bill that saves lives, lowers costs and frees tens of millions of our fellow americans from the fear that grips them as i address this chamber on this evening. let us do our jobs. let us pass this bill. let us make america stronger and a better place because this congress and this administration rose to the challenge to grapple with a magnificent issue that deserves our attention and our support. and i urge our colleagues to support this bill, and i yield the floor. the presiding officer: the senator from illinois. mr. durbin: mr. president, let me first acknowledge the senator from connecticut, who played a critical role in the, not only the inspiration but the preparation of this important landmark legislation.

senator dodd has been given so many tough assignments in his career. he's been handed some of the toughest, and this was one. his health, education, labor, and pensions committee met, i understand, for 54 hours if i'm not mistaken. i think that was said earlier on the floor -- considering hundreds of amendments to the notion that we could create a better, more effective health care system in america. i've yet to hear anyone criticize his chairing that committee. he was even handed and fair, entertained and accepted some 150 or 160 republican amendments to this bill in an effort to try to build some bipartisan support for it. he went the extra mile with extra hearings. his committee was weary at the end, but he proved that his experience here in the senate had taught him valuable lessons about what it took to be respectful of another side of an

issue. he was not rewarded with the final vote in the committee. not a single republican senator would vote for the bill, but it wasn't for lack of effort on the part of senator dodd. when this bill passes -- and this bill will pass -- he deserves special credit for it and i'm going to be one of the first to applaud him. he's included a provision in this bill near and dear to me on congenital heart research that will save lives and will spare suffering to families across america. and i will forever be indebted to him for that. mr. president, in just four hours in the early morning hours of monday, december 21, 2009, one of the most significant votes in the history of the united states senate will take place. it is hard for us in the midst of this debate, after all that has come before us and all that is likely to follow, to properly put this in historical context