other than the fact that we have a tremendous amount of kits that we just need to figure out the best way to get it done, because i think that everybody is on the same page in wanting to get it done. it's just that we've got to figure out a way to get it done. >> i think that's good advice to us. we need to figure out how to do this correctly. .. >> senator sessions, actually,

they could have had the hit three months after -- three months after she was murdered. that's when he was arrested for burglary. but we didn't have the law at that time. it was three years, three-and-a-half years after she was murdered that he was ultimately convicted and incarcerated. the law didn't go into effect until about a month after the hit was made. but we've had tremendous success since we've had the law go into effect in new mexico. >> but the point -- one of the points we should all remember is that this individual is not was not arrested for another rape. he was arrested for burglary and that is what told the tale and mr. redding, you solved a case in which -- when you got a hit on a person who was arrested for dwi, which is unrelated. based on your experience and you've been at this for a number

of years, do you think that the 20 states who now currently, i understand, test on arrest that that is good public policy? >> i do think that's good public policy. i think that the larger you can get the convicted offender database as well as the larger that you can get the database which contains evidence from crimes the more hits you're going to get so i think that's good public policy. i see no constitutional barrier to that being enacted into law in other states. and i know that the trend is in that direction. again, that will cause significant uptick in the number of samples which are submitted to go into the database. but i think that that can be handled and i think that it should be handled. >> ms. howley, with regard to assault victims, you made reference to it, several of you

did, rape victims, even if they know the person who attacked them, it seems to me that either upon that person's arrest or -- from the dna itself a test should be run because maybe the victim may not know that this person has a tendency -- you know, is likely to assault someone else. how would you -- discuss the value of even testing and entering this information based on a case where you know, the victim? >> when the offender is known to the victim -- we know that so many sex offenders are repeat offenders. and your ability to upload that person's sample will depend on their being convicted or in many states arrested.

at this point if you were to run a rape kit on a known defendant, that information would not be uploaded into codis. >> is that right? >> because you have a known defendant. >> that would be a policy error, would it not? >> well, when we're talking about greatly expanding our demand on codis, i think we do have to be careful going forward. again, that sample -- if he is arrested in about half of the states would go into codis. and if he is later convicted, we would get it into codis. there you're right we could start to see patterns. >> i see. one quick question, miss stoiloff, do you have to do multiple dna checks to make sure

that you're getting good information? in other words, how many actual readings and how much dna do you have to gather per victim? >> when the victim responds to the rape center there's a standard protocol that's followed for collection. there's a standard number of swabs and slides, et cetera, that are taken at the time. when we analyze the evidence in-house, we analyze it once unless it's required to be retested for court purposes, either the original analyst is not there or for whatever reason, the analysis is done country. -- once. >> there could be multiple swabs. >> correct. >> and you analyze each swab. >> we would analyze each swab, correct. >> and if you knew if the person was arrested and you did it, you'd only have to have one swab or specimen of that person's dna

to put it into the -- to the database; is that right? >> well, i think, if i'm understanding you correctly, the information, if it's obtained -- like if we were to obtain a male profile from one of the item of evidence we wouldn't need to test multiple items to put that profile in. however, we do test the rape kist we do test multiple items but the sample -- the profile is only entered once. does that satisfy your question? >> i think so. i just think -- if you identify the victim -- the perpetrator, you know the perpetrator, i think it could be put in and might not cost quite as much as if you are having to obtain the sample from the rape victim. >> well, we need -- we need the sample from the victim to compare against -- in the interpretation to know whether, you know, what information is there. sometimes every case is different. sometimes it's the details of

the case necessitate comparison to the victims. we always take the victim's standard as part of the rape treatment kit. i can tell you every experience we work -- even if the subject is known, we still work it. obviously, for prosecution reasons. but in florida we put the standard in. so i would take the subject standard and that would go into the database. and we don't know when he's arrested in the laboratory setting. we don't have any knowledge of the disposition unless we happen to testify. >> thank you. >> thank you very much, senator sessions. again, thank you for your moving testimony and thank you for coming forward. ms. smith you mentioned in your written testimony and in your story about the need for well-trained nurses and how critical that is for collecting the evidence and making sure that victims don't feel revictimized when the evidence is collected.

do you have any thoughts about what we could do to better train these nurses in this area as well as get more medical students, nursing students to go into this area and be trained? >> yes. there is a wonderful program, sexual assault nurse examiners that are trained specifically to take this exam. in my case, my doctor was actually reading the instructions as we went along. that's not real reassuring when you're going through an exam like this. but the sexual assault nurse examiners are not only trained how to deal -- how to get information that the average, you know, doctor may not even think about, but she's also trained to know how to do those first emotional needs of her patient. in a very good sexual assault nurse program you'll have rooms that are set aside so that the

victim can go into a room. the sexual assault nurse examiners, that is all they are there for. there's not -- it's a one-on-one examination. it's not -- with me i had three different nurses asking me questions and then a separate doctor. >> that builds trust to just have one. >> exactly. plus you have all the confusion that just -- she knows how -- she's trained to know or he is trained to know how exactly what questions to ask, how to ask them. i can't tell you the difference that that can make. >> thank you. speaking of that kind of coordination and efficiency, mr. redding, you talked about there needs to be better cooperation and coordination with prosecutors and law enforcement with these labs. that the labs don't just serve the police. they also serve prosecutors. you want to talk about why that's important and if you think there's something that we can do to enhance that cooperation?

>> that is very important as i've indicated, not just in cold dna cases but anytime that a prosecutor and the police cooperate during the investigation and the precharging aspect of a case, uniformly that case turns out to be better and we have better results from that case. one of the things that happens and that i've -- i realize needed to be corrected was that the only person who was being advised of a hit was the police officers. and i received a call some years ago from our lab saying what happened to these 25 cases of homicides and rapes? and i didn't know anything about most of them. so i contacted the police we began together to investigate those crimes and we were able to charge and convict a number of those people. so i have now set up in our jurisdiction contemporaneous notice from the laboratory to me as well as the police department

and that enables me to get involved immediately if that case -- if it's important. and it's important because prosecutors can teach and are teaching across the country interrogation techniques for police officers which are different in cold cases than they are in the regular investigation. and if they're investigated differently and if the interrogation goes differently, we have a much greater chance of success. >> and again, along these lines of efficiency, getting better results, we all want to get these rape kits tested, there's no doubt about that. some of the previous hearings we had on this issue. and we also want to get you more funding to do that. at the same time i know as a local prosecutor there's nothing worse than a mandate without the funding, leave the money behind, right. so what i would like to hear, from you mr. wedding and miss stoiloff, explain to me how we can best use these resources. if we give you more resources.

are there certain kits that you would argue shouldn't be tested or should they all be tested? what are the criteria you think that we should look at as we go forward? mr. redding? >> well, in sexual assault cases, i agree that there is some value to testing acquaintance rape kits. obviously, laboratories have to prioritize and they must prioritize and almost all laboratories do. our laboratories certainly do. >> it's not just dna, right, there's even more evidence, other kinds of evidence. there's more than dna? >> yes, yes, there are many types of other evidence. in the laboratories and prosecutors, of course, have to deal with the statute of limitations questions and those kinds of things that arise. but i do think that as we -- that as we move forward, we're going to discover and we're going to be able to ascertain what the value is of whether or not we should test every sexual assault kit. in the grant that i'm working on now, we're evolving that opinion as we go along.

our grant expires in june. we are looking now to see whether or not in acquaintance rape cases that man who is identified by the victim is, in fact, in the offender database. if he's in the database, then there is not the significant reason to test that case or that kit because if he's in the database, his case or his profile would have already hit to an unsolved case so we don't need to do that. that eliminates a significant number of the acquaintance rape cases that we would think that need -- there's value in testing. >> okay, ms. stoiloff, you want to add to that. >> i would say i agree with what steve said. the prioritization needs to be any stranger rape case and as i said earlier, when you have a written prioritization policy, that's clear that's what's going to happen when the case comes into the laboratory. the issue becomes if a stranger rape comes in and it's not

addressed, that's what should be, you know, handled by each laboratory correctly if you will. and the point that steve made about getting the profile in the database, i mean, we even in our laboratory, in our experience, if the case is negative, we will still, meaning there's no malprofile obtained we'll work the standard that's submitted of the subject and put that in the database. so we will do everything we can to get the profile in there. and, you know, sometimes it means that there's no evidence to test. but they'll submit the standard and we'll put that in as well. >> so to summarize, you want those tests. you want the kit done, but once they get there and you want them preserved and there to use but there may be an argument for prioritizing some of them while testing clearly in all the stranger rape cases. is that fair to say? >> yes, that's correct. >> okay. thank you very much. senator grassley? >> thank you, madam chairman. and thanks to all of you for your testimony. i'm just going to ask a few

questions of ms. howley. i've had the opportunity to work with her before off dorgan's bill on the restitution of victims of crime. i thank you for working on that. i was glad to have senator franken ask me if i would join him as a lead cosponsor of this justice for survivors of sexual assault act because i think that this would cut down on backlog of untested rape cases. now, you seem to raise the question as you discussed in your testimony the need to know more about the backlog of untested kits before you would have a concrete recommendation to address the problem. i understand your concerns that we test dna samples efficiently and effectively. so a few questions along that line. do you believe a requirement that state and local governments

provide statistics to federal government on untested rape kits on the backlog thereof would be useful? >> i think having that information would definitely be useful. my concern is i'm not sure how difficult it is to require states to provide that. nij and others have been trying to quantify precisely the existing dna database for many years. and so i would just want to be sure that we understand what the barriers have been to getting precise figures before we demand that of states. i certainly agree we need that information and we need to figure out how we can best get it. i think part of the problem has been, as, i believe, ms. stoiloff has said earlier, sometimes you have kits that are in the local law enforcement or local sheriff's office and you have other kits that are in a lab. it might be a local lab, it

might be a state lab or private lab. one of the problems has been identifying all those locations, maybe some are still kept at the hospital and haven't been forwarded. so identifying what exactly do we want to count as part of the backlog and where exactly can we get those numbers? you know, we've had problems before where -- i know many of -- many lawmakers have tried to get precise figures from their state. they might be told by the state lab we have no backlog. well, that may be true at the lab level but if you were to ask or go around to all of the local law enforcement, you might find there are quite a few samples that haven't been forwarded. so that's my concern. not that we definitely need the information, but we should figure out how realistic can we be that we'll have a precise number. >> or will the annual reporting requirements assist in reducing and eliminating the backlog by

do you think essentially shaming jurisdictions into testing more rape kits? >> i think anytime we can use real numbers to draw attention to a problem and then have real numbers to measure the effectiveness in agencies in addressing that backlog, that's clearly an important step. >> what do you recommend for information, the sort of information required of the states or from the states? >> i'm sorry. can you restate? >> what sort of information should be required from the states that we're trying to get the statistics on? >> i think states should be given clear guidance as to what should be considered part of the dna backlog. and then urged to measure that backlog. so states should be given guidance that we want not only the backlog that exists at your state level labs and your local labs but your private labs.

we want not only the number of samples that are in your major cities but also your smaller jurisdiction law enforcement offices. >> i'm going to move on to another question. in some states, rape victims are required to pay for their own rape kits and seek reimbursement after the kit has been processed. my judgment is rape victims should never have to pay for the cost of the kit. evidence-collection is obviously an important part of the examination. this is an important provision. do you think that the current law allowing for reimbursement of rape kit costs by states as opposed to full payment upfront

has caused any rape victims to avoid having a rape kit collected? >> while i am not aware of any cases where that has happened, that would likely be a result. most states do not require victims to pay for the rape kit and then seek reimbursement. most states pay for it up front and often through their crime victim compensation program. under the compensation program, the very fact of requesting a forensic exam counts as reporting for purposes of having the costs of that exam reimbursed. in most states the victim will never see a bill for the forensic exam. the hospital will send it directly to the compensation program or the other government payment source. >> see, i thought -- maybe i've got it wrong, but i thought -- there was more requirement to pay and it was holding people back so if it's not a problem, i think we have a problem in getting word out that that's not the case.

>> we definitely do have a problem getting word out. and part of this is because this system has been evolving in many years. so it could be previous victims or previous advocates have not -- are not aware of the change in procedures. states have made a real effort especially through mandates under the violence against women act to change the way that they are reimbursing or to change the way they are paying for forensic exams. but a lot of that change is recent. >> thank you. thank you, madam chairman. >> thank you very much, senator grassley. senator franken? >> thank you, madam chair. and i want to thank you and chairman leahy in your leadership on this issue. i want to thank each of our witnesses, ms. smith for your courage and your strength and mr. redding and ms. stoiloff for

your expertise and professionalism and ms. howley, for your advocacy. last month i introduced a bill joined my colleague, senator grassley and senator hatch and senator feinstein that would create financial incentives for jurisdiction to process the rape kit backlogs and to make sure that processing then continues to remain prompt. the truth is, i think that this is one of the issues -- those issues in congress where we all can agree on the big picture. rape is a heinous crime and we need to provide our law enforcement agencies with everything they need to prevent it. and bring perpetrator it is to justice. i just want to ask a few questions on this front. mr. redding, in your testimony you need there's a need for improved infrastructure and lab

capabilities so that dna evidence can be processed as quickly as possible. the national institute of justice study revealed that 6 out of 10 police departments surveyed lacked computerized evidence tracking systems. they rely on paper-tracking systems. and it's no surprise that when some police departments review their inventories they discover stores of untested kit. this happened in detroit and in los angeles. mr. redding and ms. stoiloff, how do your departments track dna evidence? and what kinds of federal resources are available to help police departments set up tracking, the kind of tracking systems that they require? >> well, again, as i mentioned in my county there are 46 different jurisdictions, different law enforcement jurisdictions. and that ability to track

information and inventories. and minneapolis has a good system that i can access from my office and my paralegal can access and so we're able to look at those issues and look at what's there when we want to try to ascertain, is that case that we can do something with or is the evidence never been submitted or never been inventoried? so i have good access there. i don't have the same kind of access in some of the other smaller suburbs. i think there needs to be a uniformed best practices recommended to jurisdictions for how long they hold onto to evidence and how long they old on to police departments. i mean, even some places, police reports are being destroyed in seven years and that's trouble to me when we expanded the statute of limitations as we have in minnesota yet we have a situation where we can go back to 1991 to prosecute these cases but the police reports have been destroyed.

so we do need a best practices for jurisdictions about how long they keep evidence, how they keep track of that evidence and how long they keep even something as basic as police reports. it's very important. and it's crucial. >> okay. well, i can -- aside from the police department we also have 35 municipalities in miami-dade county so i can only address for what happens in our agency and i have no idea to be honest what the laboratory -- you know, how they track evidence in the other agencies. we do have an in-house limb system if you will which is a laboratory information management system. however, what that does is actually track -- we know what we have in-house. as far as what's in the property room, even i don't know that what's actually there from years ago. we are, however, as i said -- we've been doing cold cases since 2001. reviewing cold sexual assaults

and cold homicides so we've pretty much covered everything within our own agency as far as what's been collected and stored. but, unfortunately, i agree with what steve said. there are issues that need to be addressed so that there's uniformed best practice with other agencies, too. >> thank you. i want to go -- move on to highlight the experiences some of the jurisdictions that have chosen as a default to test all or nearly all rape kits. these jurisdictions have seen their arrest rates for rape increase by as much as 30 percentage points and have had thousands of cold hits. our national -- or average national rape arrest rate is 26% jurisdictions that have implemented a test-all kits policy have seen them climbed up to 70%, more than 3 times than the national average. ms. howley, what in your mind is keeping all jurisdictions from moving toward this model. >> i believe that there are

three barriers as i outlined in my testimony. and the nij report indicated a big one is that local law enforcement agencies don't always understand the evidentiary value of dna evidence. that it can be used to solve crimes. so many law enforcement agencies in that nij survey indicated they were not forwarding kits for testing where there was not already a suspect. so that indicates one problem. another, of course, is -- is funding. if a local law enforcement agency has heard that the lab is overloaded or already knows that it will take more than a year to get something back from a lab, they may not be affording information because they know they can't get it in a timely fashion. and that would be directly related to funding to increase the capacity and reduce the lag time. but a third issue could be a lack of will.

we know in too many places, law enforcement agencies make a judgment as to the importance or value or credibility of the victim based on what they think a rape victim ought to act like. when talking to our members about the problems that they see, many of them highlighted the need to train law enforcement about sensitive response to victims of sexual assault. so that they can better understand why a rape victim may be presenting with what's called a flat affect. no emotion. she's no longer hysterical. that law enforcement needs to be trained to know that does not necessarily mean she was not a victim. so i would prioritize that as well. >> thank you. i've run out of time. i just want to make one little point on the reimbursement issue. i just want to highlight that we have heard from advocates like

human rights watch that people are slipping through the cracks and that some women pay for their kits up front. and that some of them are never repaid the full costs and my bill on this would close those loopholes. thank you, madam chair. >> thank you very much. senator whitehouse? >> thank you, madam chair. thank you, ms. smith for your extremely powerful testimony and your voice for victims around the country and thank you ms. stoiloff and mr. redding for your service in law enforcement. clearly the science of dna has sped far, far ahead. my first realization of it was a murder case where we were able to get dna off a beer bottle that the perpetrator of the crime had taken a swig out of during the course of his time in the home of the murder victim.

and i suspect it's rocketed forward in the your since then. -- in the years since then. so i think it's a very valuable tool. and i assume that all of you would support mandatory dna testing of violent criminals. >> yes, i certainly would, senator. any way that we can get the dna from a person who's committed crimes and who has been arrested, as i said, get that in the database, a larger databases of convicted offenders as long as with a larger database of crime which have been tested. when those databases are searched against each other, we get more hits, the bigger they are. ...

>> at least from my experience, the problem is not prioritization at the lab. i think the labs i deal with are properly prioritizing. i think the problem is the prioritization within the police department to some degree within the prosecutor's office. but i don't want to, you know, fault the police department too much, but i think -- >> that's the area where the prioritization -- >> that's the area. and when we have changed that prioritization and we get more

kits, we do, we do get better results. and i want to just briefly comment on police making that determination about b whether a victim's credible or not. many victims are most vulnerable victims are homeless, they have a chemical dependency problem or they have some other problem, possibly mentally ill problem. so they're preyed on. and we need to get those victims' dna results into our database as well. they can be linked to other cases, and we've done that on a number of occasions and been able to prosecute cases where we've gotten multiple hits. >> i have just a minute or so left and two more questions. one is do any of you fear that a broader regime of mandatory dna testing would test the capacity of the private laboratories to run the dna, or is there not

that kind of a capacity problem? >> there is definitely a capacity problem. all laboratories nationwide have a capacity problem. if there's a mandate that we have to do every single kit. even without mandating every single kit, the prioritization still allows you to -- >> mandatory testing of every single violent criminal? >> as far as the offender. >> the offender testing? >> it's actually done, it's separate. there's convicted offender laboratories for each state, and then there's local and state labs that process evidence. so it wouldn't necessarily be different, but the money mandated would be allocated by the state. >> so the additional burden of processing offender data would not impede the evaluation of dna evidence in current inactive cases? >> not -- they're separate

laboratories. so the forensic laboratory would have the capacity to do the evidence cases and the convicted offender database lab would have the capacity. but any time you mandate any kind of testing like that, the funding has to go with it. as the senator stated earlier, you know, we've had quite a few unfunded mandates even in florida that now they've learned to add right in. if it's not funded, it can't happen. >> and last question just to the law enforcement representatives just for the sake of the record, the effects of delay in processing evidence in an ongoing investigation are often more than just loss of time. could you each briefly comment on some of the collateral damage that takes place in an investigation when the investigation can't move rapidly forward and doesn't have timely access to key evidence. >> that can be devastating to

victims. it's devastating to wait years and then to get a call from a police officer or victim witness advocate in my office and say, you know, that thing you've been trying to put behind you and you've been trying to figure for all these year -- forget for all these years, we're going to reopen that wound for you. for good reason, of course, but that's very painful. it's not an easy call to make, it's not a call that we ever want to make, so i'd like to see the system take care of that and contemporaneously process sexual assault kits and other evidence kits -- >> but from a prosecutive point of view you also lose witnesses, lose recollection, raise cross-examination issues. i mean, setting aside for the moment the effect on the victim, the effect on the case itself is often significant beyond the simple delay, is it not? >> yes, it is. it can be severely compromised.

evidence, you know, goes away. it's lost, memories change, memories -- we've had a number of cases where important witnesses are deceased by the time that we get the dna result. and so that compromises our case. we're looking at some of those cases now in an attempt to see if we can work around that problem, but it certainly is a problem. >> [inaudible] >> thank you very much. i just had just a few follow ups here. i wanted to just go at this issue again, mr. redding, about -- and senator whitehouse touched on it -- this national databases and how comprehensive they are. i know in your written testimony you talked about how wisconsin discovered that it had 12,000 convicted offenders who were, nevertheless, not in the convicted offender database. and this, i don't think, was an issue of the testing as much as the data wasn't thumped in, right? >> that's correct.

again, my understanding is that some of this is reaction to an unfunded mandate. some of the lowalties are -- localities are required, of course, to collect kits from all the particular offenders in a county. and i'm aware that that costs money to the counties, and it's somewhat of a burden to counties which are strapped. and as a result, those counties are not as vigorous as they should be in collecting that data. so i'm sure that wisconsin is not alone in this, that there is a problem of uncollected -- >> so you're not just picking on them because of the packers. >> i'm not picking on them because of the packers. [laughter] >> you say you believe this happens in other states and that the actual, physical entry of the data. >> i do, i would be shocked if it didn't, yes. >> do you know if we have that going on in minnesota? >> there is a problem with it in minnesota that we're attempting to correct right now but, yes, it is an issue. >> uh-huh. ms. stoiloff, i was just thinking how sort of the

nitty-gritty testimony today makes us realize that with the miami police department not every day is like miami vice, right? and that there is a lot of hard work done in the labs every day to catch these perpetrators. do you want to comment about what mr. redding just noted, this lag in getting the information actually in the database? >> well, i can tell you for the most part, the prioritization helps with the lag, if you will. on the high priority cases, especially in cases where in homicides where you have so much evidence that's collected at a seam that we actually have -- scene that we actually have meetings in-house as soon as of as soon as possible with the detective and the prosecutor to resoft some of these -- resolve some of these issues. so it's a matter of a it's a short turn around on current cases. now, for cold cases it's a different story, so you have the technology to solve the crimes, but then you have a problem finding witnesses, etc., etc.

so it's sort of twofold. but i think as long as we adopt a best practice in addressing these issues immediately, you know, as soon as the cases are submitted, that should help some of those. and, no, we don't drive hummers. [laughter] >> all right. i'll remember that. the other thing that you mentioned in your testimony was just which i've heard before from our lab directors is just this forensic scientist and that the amount of money that's put into train them by the government and to get them up to speed, and then what i've heard -- now, i don't know if this was in your testimony, but then a lot of times they may leave and go somewhere else, maybe to the private sector, maybe to another lab that pays a little more, and it becomes like a bidding war. and i've certainly heard this in our state. do you want to comment on that? >> we have the same issue. and, unfortunately, as nice as miami looks on tv, we do have a problem that, you know, these analysts want to come -- forensic science is the hot

thing, it's the hot place to go, and they want to come and be trained wherever they can get a job. >> where do they go? >> usually home, like wherever they came from -- >> they go to other labs? >> other labs. >> government labs. >> it's not a situation, though, where they are seeking a job anywhere else, so i don't want to portray that miami-dade police lab is bad in any way, but they are going to where they came from and where their families are. so that becomes a problem because it is a two-year training process for dna. so from the date of hire which is, you know, a whole different issue, to get them hired in-house and then it's two years training, it's effectively two years -- i may have zero vacancies but essentially carry them as non-dna analysts for two years. >> does anyone else want to comment on that? >> i'd just like to echo that that is a tremendous issue, as you know, senator. we can hire a prosecutor, an experienced prosecutor and throw

him right into the courtroom. you can't do that with a dna analyst. you have to wait for them to complete the training, and it's a long training. so when you lose an analyst like we lose in the minnesota bca or miami, you can't throw somebody else in there right away, so it's a significant problem. >> okay. anything more anyone wants to adhere? well, i just want to thank you for your testimony today, for taking the time to be here. as you can see, we're very devoted to working on this problem. we know there have been improvements made, and the improvements have been made because of the willingness of people like you to come forward and tell your stories. we know there's clearly a backlog issue, and we want to be smart about how we tackle that. anyone who's worked on the front line as a prosecutor understands this unfunded mandate issue, and we have to figure out how to be smart to get the right rape kits tested and to get them tested, that we also have to do better

with training of everything from the nurses to the forensic scientists, and i was interested in some of mr. redding's points about the coordination with the police and prosecutors on the lab and improvements that can be made there. so those are the things that we're working on right now. and just for me and my former job which i love very much, especially i think back very lovingly to that job after what we've been going through the last month in washington, but i just have these memories that are ever etched in my mind about how we were able to use this science to, you know, not just convict horrendous murdersers and rapists, but i'll never forget that case -- and maybe steve remembers this -- we had someone come up from north carolina, i think that was the state, who had identified who she thought was her rapist many years before, and he had served something like six years, a decade in prison, and then the dna test, in fact, showed that it wasn't him. and he got out of prison, and

the two of them actually became friends. the the real person was already in jail and had been convicted, and they went around the country talking about the eyewitness id and improvements that had to be made to that. i remember a remarkable case we had and maybe again remember this one, steve, where we had a burglary, and the burglar had broken some glass and got his blood on the glass chart, and then that -- chart, and then that dna matched dna in another burglary in another state, and we were able to charge him as number 34546 because we didn't know who he was, we just had the record. i don't know if anything's ever come of that state, but it was a memory i have of the improvements we've made in this technology and the tool that it is, as you pointed out, for any kind of case. so i'm actually optimistic of the work that can be done here, the place that science has taken us, and all of you in your respective roles have been such a big part of that. so thank you very much, and we

look forward to working with you on the reauthorization of the violence against women act and all the work we'll be doing in this area. thank you very much. we will keep the record open for one week for any additional submissions, and the hearing is adjourned. thank you. [inaudible conversations] >> still in time for the holidays, american icons on dvd, the iconic homes of the three

branches of american government. the special three-disc collection is only $24.95 plus shipping and handling. visit c-span.org/store. >> the u.s. senate about to gavel in for another day of work on health care. yesterday afternoon leaders from both parties agreed to a final passage vote tomorrow at 8 a.m. eastern. of course, there is still one procedural hurdle to clear, and that's scheduled for today at 2:15 eastern. sixty votes will be needed for that. also today a vote on senator ensign's point of order that the bill itself violates the constitution. we expect that vote around 2:15 as well. now live senate coverage here on c-span2. senate will come to order. the cap chaplain, dr. barry bla, will lead the senate in prayer.

the chaplain: let us pray. ear tern god, the source of peace on earth, goodwill toward humanity, we feel delight because you are sovereign causing all things to work together for good to those who love you, who are called according to your purpose. help our lawmakers to see that each difficulty is an opportunity to see you work and that in your time you will bring them to a place of abundance. may they face waiting tasks and

challenges with your gifts of understanding, kindness, civility, and self-control. lord, astound them with new insight and fresh vision they could not conceive without your blessings. give them the faith to believe that if they listen to you, you will give them answers they can't find themselves -- find by themselves. we pray in powerful name. amen. the presiding officer: please

join me in reciting the pledge of allegiance. i pledge allegiance to the flag of the united states of america and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. the presiding officer: the clerk will read a communication to the senate. the clerk: washington, d.c, december 23, 2009, to the senate: under the provisions of rule 1, paragraph 3, of the standing rules of the senate, i hereby appoint the honorable tom udall, a senator from the state of new mexico, to perform the duties of the chair. signed: robert c. byrd, presidet pro tempore. mr. reid: mr. president, following leader remarks -- the presiding officer: the majority leader is recognized. mr. reid: i'm so sorry. sorry about that, mr. president. i just got a little ahead of myself, which is easy to do sometimes. following leader remarks the senate will resume consideration of the health reform ltion. the time until 10:00 is divided between the two leaders or

designees. at 9:00 until 2:00 p.m. there will be an hour of alternating blocks of time with the majority controlling the first hour. the time between 2:00 and 2:15 will be equally divided between the two leaders with the majority leader controlling the final half, there will then be five or six roll call votes in relation to the hc bill. -- in relation to the health care bill. note the absence of a quorum, mr. president.

the presiding officer: without objection, so ordered. [no audio] the presiding officer: the clerk will call the roll.

mr. sessions: mr. president? the presiding officer: the senator from alabama is recognized. mr. sessions: mr. president, i ask that the quorum call be dispensed with. the presiding officer: without objection, so ordered. under the previous order, the

leadership time is reserved. under the previous order the senate will resume consideration of h.r. 3590, which the clerk will report. the clerk: calendar 175, h.r. 3590, an act to amend the internal revenue code of 1986 to modify the first-time home buyers credit in the case of the arld forces anker is other employees and for other purposes. the presiding officer: until 10:00 a.m. the time between the two leaders will be divided. the senator from alabama is recognized. mr. sessions: i just received this morning and i'm sure it's on the c.b.o. website, congressional budget office, an- an analysis of the health care bill that we're considering today. that analysis is crystal clear and confirms what c.m.s. has told us, and that is the

proponents of the legislation before us have been double counting -- double counting the savings from medicare and, as a result, it cannot be said that this bill is going to create a surplus in the treasury, but, in fact, will put us in a deficit and i think every member of this body needs to read this communication before they cast their vote. i know a lot of members of the senate who voted for the bill did so under the belief that it would be deficit-neutral. they've said so publicly. the president has repeatedly stated, and he did to the joint session of congress, that not one dime will be added to the national debt, and that is not so. i would just reveal what we were told by c.b.o. this morning, and

their report. this is what the c.b.o. said to us. and it's very simple. it's actually stunning that we have been confused about this issue when we're talking about hundreds of billions of dollars. it's absolutely an amazing event that the united states congress can't get their act together when we talk about hundreds of billions of dollars. they say this: the key point -- and i'm quoting, the savings to the h.i. trust fund, talking about medicare, under the ppaca, that's the health care bill that we're considering, would be received by the government only once. so they cannot be set aside to pay for future medicare spending and at the same time pay for current spending on other parts of the legislation or on other

programs. close quote. and that's exactly what this bill proposes to do. the president just two days ago at this press conference, said, "medicare will be stronger and its solvency extended by nearly a decade." close quote. then he goes on to say this -- quote -- "the congressional budget office now reports that this bill will reduce our deficit by $132 billion over the first decade." that is counting the money twice. it cannot be done. that's wrong. and it must not be allowed to occur. and senator gregg, a chairman -- a former chairman of the budget committee and ranking republican on it proposed an amendment.

saying, okay, any savings in medicare stays in medicare and our colleagues voted it down. senator harkin said that you have to vote it down, to our colleagues, in his speech on the floor, you have to vote it down because it will kill the bill. why would it kill the bill? because they're planning to use the money both ways. and it cannot be done and ought not to be done. and this is very much consistent -- entirely consistent with the communication from th the center from medicare and medicaid services, c.m.s., richard s. foster, the chief actuary. mr. foster laid it out. we should have seen this back on december 10th. it's really what piqued my interest in this whole matter because i'm wondering how this could be done. it didn't make sense to me and i read his letter and he says

this: the combination of lower part-a costs, and that's part-a of medicare, the hospital part, and higher tax revenues result in a lower deficit based on budget accounting rules. and he goes on to say: however, trust fund accounting considers the same lower expenditures an additional revenues as extending the exhaustion date of the part-a trust fund. they're running out of money. and if you cut the cost to part-a, you would extend, according to the trust fund accounting, the lifetime of the trust fund before it goes broke. in practice, though, he adds, the improved part-a financing

cannot be simultaneously used to extend the trust fund to -- excuse me. cannot be simultaneously used to finance other federal outlays. and then he put it in parenthesis, such as the expanding of the ppaca, which is the health care bill. and to extend the trust fund. despite the appearance of this result from the respected accounting conventions. so the two different accountings, one from c.m.s. says one thing and one from c.b.o., which has a unified budget accounting, a different process of accounting for federal expenditures. both say good things, but both can't be accurate. both members say, c.b.o. says you can't count it twice. c.m.s. says you can't count it twice. this is not a little matter.

so i would just urge my colleagues to -- the presiding officer: the senator's time has expired. mr. sessions: i thank the chair and urge my colleagues to access this information on the c.b.o. website and my website if they would like. the presiding officer: under the previous order, the time until 2:00 p.m. will be controlled in alternating one-hour blocks of time, with the majority controlling the first hour. the presiding officer: the senator from montana is recognized. mr. baucus: mr. president, it's been nearly five weeks since the majority leader moved to proceed to the health care reform bill before us today, and it has been more than two months since the finance committee reported its bill, a great deal of which is reflected in the bill before us today. it has been three months since the finance committee publicly posted the 564 amendments that senators filed for consideration in the committee, and it has

been seven months since the finance committee convened three bipartisan roundtable discussions on each of the three major areas of reform. delivery system reform, insurance coverage, and options for financing reform. it has been seven months since the finance committee issued three bipartisan policy papers detailing the options from which their committee chose to craft its bill, and 18 months since the finance committee convened a bipartisan day-long health care summit at the library of congress. it has been 19 months since the finance committee began holding open hearings to prepare for the -- to prepare the bill for us today, and it has been more than 15 long years since the last time that the senate took up this fight to enact comprehensive health care reform. it has been 38 years since our late colleague ted kennedy proposed a plan to extend health insurance coverage for all. it has been 44 years since congress created medicare, providing health care for america's seniors and medicaid providing health care for the poorest among us.

it has been 64 years since president harry truman asked the congress to enact a national insurance program, quote -- "to assure the right to adequate medical care for the protection from the economic fears of sickness." end quote. it has been 97 years since president teddy roosevelt ran on a platform that called for, quote -- "the protection of home life against the hazards of sickness through the adoption of a system of social insurance adapted to american use." end quote. and, mr. president, it is now only hours until this senate will pass meaningful health care reform. it will not be long now, mr. president, until the law will prohibit insurance companies from canceling insurance policies when people get sick. it will not be long now until people with pre-existing conditions will have access to health care. it will not be long now until the law will prohibit insurance companies from imposing lifetime or annual limits on benefits. it will not be long now until parents will be able to include their children up to aged 26 on

their insurance policies. it will not be long now until the law will require insurance companies to report on the share of premium dollars that go to pay medical care and the share that doesn't. it will not be long now until consumers will be able to shop for quality insurance and new internet websites where insurance companies will compete for their business. it will not be too long now until millions of uninsured americans will be able to buy insurance on new exchanges with tax credits to help make it affordable. it will not be too long now until the law will prohibit insurance companies from discriminating against women and setting premiums. it will not be too long now until the law will limit insurance companies and how much more they can charge when people get older. it will not be too long now until more than 30 million americans who otherwise would not have health coverage will finally get that peace of mind. it will not be too long now until more than 30 million americans will have a better chance to live longer, healthier , less pain-ridden

lives. it will not be too long now until more than 30 million americans will be able to share their family christmas free of the fears of medical bankruptcy. it will not be long now, mr. president, and, mr. president, it has been a long time coming. i thank god that i have lived to see this day. i thank god for sustaining us and for enabling us to reach this time. let us now at long last pass this historic legislation. mr. president, i'll yield 20 minutes to the senator from maryland. the presiding officer: the senator from maryland is recognized. mr. cardin: first let me say it won't be long now until we achieve universal health coverage, affordable care for all americans, and i want to thank senator baucus for making this moment possible. i know how hard he's worked for so many weeks, so many months so that we could bring very different views together, but all focused on the goal of achieving affordable health care for every american, and senator

baucus never lost sight of that goal. as a result, we are now just hours away from the last procedural hurdle until we'll have a chance in the senate to vote on a bill that for the 23 years that i have been in congress, i've told the people first of the third congressional district of maryland, then the people of maryland that i'm going to fight to change our health care system so that every american has access to affordable, quality health care. and we're going to take a giant step forward to reaching that goal in the legislation that we have before us today. so senator baucus, through the chair, i want to thank you very much for your extraordinary patience and leadership to bring us to this moment. you know, mr. president, there is a lot of discussion here on both sides as to what the facts of the bill are, so i'm going to use the congressional budget office because that's what we agreed to. that's the objective scorekeeper. they are not partisan.

i think everyone agrees to that as to what this bill does. the congressional budget office tells us that from the under 65 group, we're going to increase the number of insured from 83% to 94%, and for all americans, we're going to have 98% covered by insurance. that's universal. we're going to have a framework so that at long last america joins every other industrial nation in the world with a health care system where everyone is included. to me, this is a moral issue. it is an issue of whether health care is a privilege or a right. well, i -- i believe that the values of america teach us that health care should be a right for all americans, and the bill that we will be voting on will take us very much to achieving that goal. today in america, too many people fall through the cracks. too many people, families are literally destroyed because they can't afford access to health

care and therefore they don't get the tests that they need, and perhaps a disease that could have been caught earlier, prevented is lost and the person has to go through tremendous health care treatment, perhaps even losing their life. we have seen too many families go through bankruptcy because they can't afford the health care that they need. we see too many people literally cutting their roll call pills in half in hopes to be able to keep medicine for a longer period of time because they can't afford it, knowing full well that they are compromising their health. and many times, i have mentioned the case of damonte driver which could me is representative of so many tragedies in our community that could be avoided. damonte driver, a 12-year-old who lived in prince george's county, maryland, seven miles from here who had a tooth ache, whose mom tried to get him to a dentist, had no insurance, couldn't find a dentist, went to

a social worker, made dozens of calls, still couldn't find a dentist. he was complaining of severe headaches. after weeks of not being able to get to a dentist went to the emergency room, the only option that was still available. found out that the tooth had become abscessed, went into his brain, had emergency surgery, and he lost his life. because our health care system didn't provide access to affordable quality care for all americans. well, that's about to change. that's about to change. and i'm proud to be part of that. i have been asked by many in recent days as to what's in it for the people of maryland? what are they going to get out of this? well, let me tell you, the people of maryland are going to get a national health care system that makes a lot more sense, a rational system for care in america. the current system, too many people are being left out. small employers have a hard time

finding an affordable product. i have gotten many letters from my constituents. we have read over the course of the last several months many letters that we received, but i must tell you the letter i received from a small business owner in montgomery county about the fact that she and her husband had to take out two separate policies to cover their family of four because the private insurance companies discriminate and say that each have pre-existing conditions, and the only way they can get full coverage is to have two policies with two separate deductibles that the family cannot afford, two separate premiums that the family cannot afford, because there is not competition to provide coverage to small businesses in america. well, the people of maryland want to have -- small businesses in maryland want to have the opportunity to cover their employees, and they know the competition will work and this bill provides for a lot more competition. this bill will help those who are losing coverage today. so many people in maryland are losing their health coverage.

every day, hundreds of people lose their health insurance in my state today. by the way, we live in the wealthiest nation in the world and maryland is the wealthiest state, and we're losing health coverage today. our medicare beneficiaries are finding their program under attack. they want to have the stability of knowing that medicare will be there, not just this year but for the decades to come. this bill starts to reform medicare by reforming health care so that we can sustain it and to fill in the prescription drug doughnut hole which so many seniors are finding it very difficult to afford their medicines. so for the people of maryland, this bill is a bill that's going to provide a rational way in which they could maintain their existing coverage, find it more affordable, and certainly sustain coverage for our medicare population and provide competition for small business owners to find affordable health care. it also brings down the health care costs. and marylanders are very interested in that. now, again, let me use the

congressional budget office, the objective scorekeepers, and what they say is that for the overwhelming majority of americans, their health premiums will go down, will go down, because health care costs are coming down. this legislation invests in prevention and wellness, and we know that prevention and wellness works. we know that if you can detect a disease early, you can not only save lives, you can save health care costs because the preventative services cost a couple hundred dollars, an operation that you avoid are tens of thousands of dollars. screening and early detection work. management of diseases work. we know that most of our health care costs in america are spent on the leading diseases, on cardiac care and on diabetes. we know that we spend a lot of money, but if we can manage those diseases more effectively, we can save a lot of money, and this bill takes us down that

path. we know we can save money by investing in health information technology. think about that. think about how much -- think about how much paper we receive every year from our health care system. think about our own medical records and how that could be used to help us each manage our own health care and take more responsibility, and we're not doing that today. we know that we could use a card to go anywhere in the world, and they can track our financial records, but for health care, that's not true today. by investing in health information technology, we can reduce a significant amount of the administrative costs of health care, and yet better manage each of our own health care needs. that's what this bill does. this bill will cover 31 million more americans, 31 million more will be insured. that's not what i'm saying as a democratic senator from maryland.

that's what the congressional budget office is saying that this bill will achieve, 31 million more americans that won't have to go to an emergency room to get their primary care needs met. think about how much that costs each one of us when that person, whose only option is basically to go to an emergency room, how much does that cost us because you see many of those individuals can't afford those hospital charges so it becomes uncompensated care, and it's added to the rates of hospitals that you and i pay, mr. president, those of us who have health insurance. and for the people of maryland who have health insurance, they have a hidden tax every year of of $1,100. it's not only a waste of money that we have to pay, it's not the efficient way we should work our system. there should be -- there should be facilities available so that everyone who has can get their care in a much more cost-effective way. well, this bill moves us towards those goals, provides competition so that we can bring down the cost of health

insurance through the local exchanges. and, mr. president, another provision in this bill that i'm very excited about is that we can cross state lines for competition so that if you're an employer in maryland and you hire workers in maryland and virginia and pennsylvania, you're able to get the regional and national competition so you have more choice on the health insurance companies. that that will also bring down cost and quality. this bill will help to reduce the federal deficit. how many of us have talked about that? i know that people who watch us say, gee, i hear a republican senator and then a democratic senator, is this the same bill they're talking about? well, let's talk about the congressional budget office. the objective scorekeeper. the congressional budget office says that this bill will reduce the federal deficit b

by $132 billion. billion, that's a "b," billion. that's quite an accomplishment when you realize that to get everyone covered, the federal government is providing subsidies which will cost us an additional investments. -- investments to make sure that the small businesses can afford it, we provide tax credits. that costs revenues. more people insured, they have tax preferences. yet, the congressional budget office has confirmed that this bill brings down the deficit b by $132 billion in the first 10 years. look at the second 10 years. a lot of us want to look at long-term impact. in the congressional budget office the objective score keepers tell us that it will reduce the deficit by .5% of 1% of the g.d.p. or $1.3 trillion. mr. president, that's quite an accomplishment to get everybody covered and reduce the deficit and have that confirmed by the

congressional budget office. that helps the people of maryland. and that's why the people of maryland benefit from this bill as do the citizens of every state in the nation. i want to talk about protecting consumers. the -- the -- senator baucus talked about. this i want to make sure you understand that people understand what's involved here. senator baucus mentioned a lot of the provisions in the bill about preexisting conditions and the pediatric for children take effect immediately. the caps that we bring in, the lifetime caps that we deal with covering children under the age of 26, the reinsurance program for 55 to 64-year-olds, the lost ratios to make sure that the insurance companies are using your premium dollars to pay for benefits. the independent review of -- of a decision made by an insurance company whether to cover a charge or not. i want to talk about the patients bill of rights. because i think the people of this nation would be surprised

to find out that we haven't yet enacted the patients bill of rights. it was 1997 that we started talking about a patients bill of rights. about enacting -- that we had national protection against the arbitrary practices of insurance companies in 1998 president clinton by executive order applied the patients bill of rights to the government insurance companies. but there is not one for -- i'm pleased that the managers' amendment added four important provisions -- very important provision that's i authored by amendment that i've been working with democrats and republicans over the last decade to get in federal law. access to emergency care. let's talk about that for a moment. because today there are people that live in new mexico and live in montana and live in maryland who go to their emergency rooms

and they read the fine print of their insurance plan. they say, well, before you go to an insurance room, you've got to call for preauthorization. or you need to go to the emergency that's in network. or we may second guess whether you really needed to go to that emergency room if, in fact, your final diagnosis was that you didn't have an emergency need or condition. you may have been sweating, the traditional chest pains, the traditional symptoms for a heart attack, you did exactly what a prudent lay person would do, get to the emergency room as quickly as possible and find out it wasn't a heart attack. and they, the insurance companies, can second guess your coverage. thanks to the managers' amendment that senator baucus helped us put together, we now are going to cover access to emergency care as a requirement for every private insurance company. prudent lay persons standards; no preauthorizations.

get to the closest emergency room as quickly as you can. that's an important protection to get into federal law. and then to be able to choose your primary care doctor your primary care doctor is a person you have to have confidence in if you're a woman and you want it to be ob/gyn, you should have that right. if you're a parent and want a pediatrician, you should have a pediatrician. this legislation will make sure that those protections are in law. so for all of those reasons i'm pleased and i know that the people of maryland will be pleased to know that at long last we get the patients bill of rights protected. there are a lot of groups who supported this over the years. wanted to acknowledge the long list of people, long list of groups, bipartisan groups that have worked from aarp to the consumers union, to the and the

list goes on that have supported the patients bill of rights against private insurance companies that at long last we have the ability with the passage of this bill on the senate floor to move it one step closer to passage and to be the law of the land. i want to talk about minority health. the reason i want to talk about minority health is for two reasons. first, i know my colleagues are interested to know that the amendment that is currently pend that the leader filed, technically on my behalf, which establishes the minority health protections within the different federal agencies, i just want to assure my colleagues that it's in the underlying bill. it's in the package. it's in the managers' package which has been adopted. so i'm going to suggest to the -- to the body that we either withdraw the amendment because we don't need it to pass. it's in the underlying bill. this is the original amendment that i had submitted. i wanted to explain that. the amendment that i filed that

i established at the minority health office at the department of human, health services and n.i.h. will be in the underlying bill and in the managers' package. this is an important moment. today there's huge disparities in our health care delivery system in america bringing about huge disparities among different ethnic communities. african-americans, for example, their life expectancy is 5.3 years lower than whites. when we look at diabetes in america, the incidents of diabetes is two times greater among minorities than the general population much we need to have a strategy to deal with it. how can we reach out to minority communities to deal with their special needs? unless you have a focus within the department of health and human services, unless you have a focus within n.i.h. and other agencies, you won't deal with it as effectively as we should. i want to, again, thank senator

baucus and senator dodd who understood this, and senator reid, because we can develop a national strategy to help deal with the issues of the minorities. and i also mentioned heart disease, african-americans 33% more death rates due to heart disease. the list goes on and on and on. that's why this bill codifies the office of minority health in the office of the secretary of health and human services, establishes minority for health, health resources and services administration, substance abuse and mental health services administration, agency for health care research and quality, food and drug administration, centers for medicare and medicaid services and elevates the center on minority health and health disparities at n.i.h. to an institute. i want to, again, thank those

who helped me get this into the managers' package and it's now in the bill that we'll be taking up for a vote tomorrow. i also want to compliment senator sanders. i've done this before on the community health centers. as we deal with the disparities of health care in america, one of the problems is, yes, we have to get people health insurance, we have to get people the financial wherewithal to have health care, you need to have the facilities in place to deal with the health care needs. it's one thing to say we'll cover the costs, it's another thing to say that we'll have the doctors available to you. i met with one of the leaders at johns hopkins university located in the urban part of baltimore city. they said, look, we need help. we need more community health centers, we need more primary care doctors, we need more nurses. we need help with those seeking

care through traditional channels rather than emergency rooms, that's great news, with them being able to afford it, that's great news. let's have the facilities. there are many underserved areas around the nation and in maryland that just need facilities. and thanks to the sanders amendment, which i'm proud to be a cosponsor, worked with him, that's in this bill, we will see $10 million to expand community health centers. 25 million more americans will get access to care through the community health centers. that's good news. and we invest in creating more primary care doctors which is a valuable part of this bill, and i applaud all of those. mr. president, let me point out, this bill will help. this bill will help families in america. you know, the choice is whether we pass this bill, which sets up the framework for america to finally become a nation that provides universal coverage or we maintain the status quo. let me tell you what happens if we maintain the status quo.

these are the numbers. right now the average cost for a family for health insurance i is $13,244. if we don't take action by 2016, that's not too many years away, it will be $24,291. the presiding officer: the senator has consumed 20 minutes. mr. cardin: can i have two more minutes? is that snob thank you. -- is that possible? thank you. if people are able to maintain their existing coverage, we have to act. that's why the american medical association supports the bill. this bill will help the medicare population much it strengthens medicare, as i pointed before. that's why the aarp supports it. it will provide annual physicals for our seniors. this bill is important for our business owners an will no longer be discriminated by paying 20% more than the

comparable large companies pay for an insurance product. mr. president, this bill is good for marylanders. it's -- it's good for every american. it moves us toward universal coverage. the bill is not perfect. there are things -- i'm disappointed by some of the things that are in the bill, some of the things that didn't make it into the bill. but, mr. president, this bill establishes the framework for universal, afordable quality care for every american. it speaks to the values of our nation. i'm proud to support this legislation and i know that we will look back that the day as being one of the bright moments for america where we said to the people of our nation, that, indeed, we will provide affordable, quality health care for every american. with that, mr. president, i would yield the floor. the presiding officer: the senator from montana is recognized. mr. baucus: mr. president, i yield 15 minutes to the senator from delaware, mr. kaufman --

mr. kaufman. the presiding officer: the senator from delaware is recognized. mr. kaufman: i thank the manager for making this bill a possibility. it is a historic transformational. it is -- and to is a large degree because of his hard work. i appreciate that. i yield him 30 minutes my postcloture time. thank you, mr. president. i rise today once again to express my support for historic health care legislation that we have before us. after more than a year of debate and months and months of negotiation, i welcome the extraordinary opportunity to enact meaningful health care reform. and, yes, i mean years and months. since this reform effort has been a long and deliberative process. not the rush job that opponents of this -- job have been claiming. i must admit, however, there were times during this debate

when i wasn't sure we would reach this point. in fact, i was convinced we would not. i found in my life when you think things are never going to happen, every important thing that i've ever done, you will reach a point where you think this will never happen. for the bogus charge of health panels, death panels, polyfaxcom lie of the year. there were some long days where it was hard to see where we would reach the end point. thanks to the hard work of the majority leader, as well as senators baucus, dodd, and harkin, and their staffs, we are finally here. as many of you know, i've worked in and around the congress more than 36 years. i think i've learned quite a bit about how things operate here in the senate. the senate is commonly referred to as the most deliberative body in the world. but such stipulations are not

always pretty. sometimes tempers flair, sometimes the debate doesn't reach the level that we aspire to or the american people deserve. sometimes the most important legislation is actually to get the votes necessary to pass. we all know what happened to health care reform the last time we attempted an overhaul 15 years ago when president clinton tried to pass his version of health care reform, the debate was just as passionate. because of because of the coarseness of that debate, because of the seemingly intractable opposition to health care reform, congress has been wary in the intervening 15 years to take up this cause again, and it's understandable. but over the past 15 years, our health care system has gotten more expensive. rising medical costs, skyrocketing premiums, increasing numbers of the uninsured and the strain on both business and providers have brought the critical need for health reform back to the senate

this year. and make no mistake, we need health care reform now. the status quo, what i call the present health care system, is simply unsustainable. medical costs account for 1/6 of domestic spending and are headed upward. in 1979, we spent approximately approximately $220 billion as a nation on health care. in 1992, we spent close to to $850 billion. and in 2009, we will spend spend $2.5 trillion on health care. $220 billion in 1979. $850 billion in 1992. $2.5 trillion in 2009. how can anyone argue it is not time to deal with health care reform and the need is urgent? the projection on our national health care expenditures is out of control. in addition, one of the biggest if not biggest forces behind our

federal deficits which we hear so much about on this floor are skyrocketing costs of medicare and medicaid. in 1966, medicare and medicaid accounted for only 1% of all government expenditures. they now account for 20%. if we do nothing to start bending the cost curve down for medicare and medicaid, we will eventually spend more on these two programs than on all other federal programs combined. we must slow the level of growth in the medicare and medicaid programs if we're ever to get our budget situation under control. in addition to the fiscal pressures crushing our federal and state governments, the present health care system is also handcuffing families and workers. just look at the rise in insurance premiums in my home state of delaware. in 2000, the average premium for family health coverage in delaware was just over $7,500. that's $7,500. by 2008, the number had jumped to $14,900.

that's $14,900, almost doubling in just eight years. if we fail to enact pending health care reform legislation, the same premium for family coverage is expected in delaware to reach $29,000 in 2016. let me repeat that. $29,000 for family coverage in delaware in 2016 if we don't pass health care reform now. states around the country will see similar increases which are simply unaffordable. too many people are going bankrupt paying for their medical care. today the inability to pay for skyrocketing medical bills accounts for more than 60% of u.s. personal bankruptcies, a rate of one and a half times what it was just six years ago. and keep this in mind. more than 75% of families entering bankruptcy due to health care costs actually have health insurance.

let me repeat this because it's a critical point. three quarters of all americans filing for bankruptcy because of medical bills already have insurance. we also need reform to stop the worst abuses in the health industry, insurance industry. in my year as serving as a senator from delaware, i have heard from far too many constituents who have been refused an insurance policy because they have a pre-existing condition. i have heard from fathers who are denied family insurance coverage because they were told their children had pre-existing conditions too expensive to cover. much to my shock, i have received letters from women that i have talked about on the senate floor who have been turned down for coverage because their pregnancy was considered a pre-existing condition. pregnancy a pre-existing condition? that's simply intolerable. even worse, however, if that is possible is the practice of rescission where insurance companies drop coverage for individuals the moment they get sick and need their insurance the most. being denied coverage after you

already paid your premiums is just plain cruel. for all these reasons and more, we must reform the present health care system. thankfully, we now have the opportunity to bring about meaningful health care reform to the patient protection and affordable care act. mr. president, i'd like to take just a couple more minutes to discuss why this legislation has earned my support. first off, it's fiscally responsible. president obama laid down a marker that any health care reform legislation that landed on his desk could not add to our nation's debt. i'm happy to say this legislation passes this test. according to the congressional budget office, the patient protection and affordable care act would reduce the deficit by by $132 billion over the first ten years. this bill is fully paid for. second, it helps stabilize medicare and medicaid programs. the absence of this legislation

on the medicare trust fund is expected to go bankrupt in 2017. according to the head actuary at the centers for medicare and medicaid services, passing this bill would extend the solvency of the trust fund for an additional nine years. nine years. medicare is a sacred trust, with americans and this bill ensures that this trust is preserved. in addition to reducing the deficit and shoring up the medicare program, this bill contains numerous provisions that will help americans afford their premiums and prevent them from filing for bankruptcy protection. starting next year, insurers will no longer be able to place lifetime caps on health care benefits. for the next several years, insurance will also be restricted in the annual limits they can place on benefits, and then these will be eliminated altogether in 2014. these are huge changes for people with debilitating diseases and those who experience unexpected catastrophic events costing millions of dollars in treatment. in addition, premium subsidies

for families with incomes under 400% of the poverty level or $88,000 for a family of four will be available to help them afford their premiums once the new insurance exchange is up and running. it will also be annual limits on out-of-pocket costs for individuals and dependents will be able to be covered under their parents' insurance policies until age 26. all of these are meaningful reforms that will dramatically lower the rate of bankruptcies associated with medical costs. the bill also contains some other great consumer protections that don't currently exist in our present health care system. i already highlighted the problems in the current system with insurers denying coverage for people with pre-existing conditions and rescinding coverage when people get sick. under this bill, americans will finally be freed from the shackles of pre-existing condition clauses that have kept so many from attaining much-needed health insurance. starting next year, insurers

will no longer be able to deny coverage to children with pre-existing medical conditions. this ban on not covering pre-existing conditions will be extended to all americans in 2014. the bill also forbids insurers from rescinding health insurance after americans have already paid their premiums. americans will no longer lose their coverage when they get sick and need it most. in addition, the bill dramatically expands coverage of prevention and wellness services. it provides incentives for employers to implement wellness programs and offers a new annual wellness checkup for seniors enrolled in medicare. these are all good, positive reforms to our health care system. now that we are close to finishing this debate, the media has focused its attention on particular deals that benefit certain senators and specific states, but i want to point out that all the benefits i have talked about, all of them are available to every american in every state. most every senator has brought

something to this debate and to this bill. i'm very pleased that the manager's package includes the health care fraud froarmt -- enforcement amendment which i introduced. i along with senators leahy, klobuchar, schumer. again this provision benefits not just delawareans but all americans. the national health care antitrust association conservativively estimates that 3% of all health care spending, some $72 billion, is lost to health care fraud in both public and private health care plans. $72 billion lost in health care fraud in both public and private health care plans. other estimates place the figure as high as 10%, over over $220 billion. fraud hits every one of us in every corner of our nation where we can least afford it, our health care premiums, while

simultaneously driving down the quality of and our trust in our health care system. this amendment increases funding to fighting fraud in public programs. it improves screening of providers and suppliers and requires implementation of meaningful compliance programs. this section tightens requirements for claim submissions and provides new tools to deter fraud and abuse in the private insurance market. it also strengthens criminal investigations and prosecution. today, outdated laws and punishments insufficient to provide effective deterrents hamper prosecutors and agents. this is incredible. but many criminals have told law enforcement officers that they switched to health care fraud from the drug trade because the reward to risk ratio is so much higher. can you believe that? there is actually an incentive for crooks in the present health care system to commit health care fraud. the antifraud amendment can begin to reverse this trend.

significantly reducing costs attributed to fraud will go a long way toward benning the cost curve down. what this bill does, it has -- increases the sentencing requirements for people who commit health care fraud to make it much less attractive for them to get into the health care fraud business and then gives us the prosecutors and the agents we need, just like we did under the financial regulatory reform, to go after these folks and catch them, then put them in jail, and with the new sentencing guidelines, put them there for a longer time, discouraging people from getting into the health care fraud business to begin with. in addition, the package of amendments i cosponsored with my fellow freshman democrats would also improve the bill and benefit all americans. i am lucky to be a member of a dynamic freshman class, including the presiding officer, and have enjoyed teaming up with them in our morning speech in the colloquies to push the health care reform effort forward. i am pleased that our amendment package was accepted by the

bill's managers and that it provides commonsense, practical solutions that help further contain costs, improve value, and increase quality. for example, it quickens the implementation of the uniform and administrative standards, allowing for more efficient exchange of information among patients, doctors, and insurers. it provides more flexibility and establishes accountable care organizations that realign financial incentives and help ensure that americans receive high-quality care. and it provides greater incentives to insurers in exchange to reduce health care disparities affecting underserved minority communities. for all the reasons listed above, from the original text to the additions added to the manager's package, this bill should and must be passed. it brings quality, affordable health care within reach of all americans, including more than 30 million americans who are currently uninsured. it strengthens the medicare program, extending its solvency

for nine years. it helps restore fiscal order by reducing the deficit by approximately $132 billion over ten years and over $1 trillion over 20 years, and it offers much-needed consumer protections that provide stable coverage at an affordable cost. in closing, i again want to acknowledge the hard work of senators baucus, reid, dodd, and harkin, as well as their staffs, especially their staffs. the staff has done an incredible work on this piece of legislation, and they have enabled us to reach this historic legislative moment. i have ended many a speech by noting that it's time to gather our collective will and do the right thing during this historic opportunity by passing health care reform. i think we may have finally reached that goal. we certainly can't afford to wait any longer. we need to act now. we can do no less. the american people deserve no less. thank you, mr. president, and i

yield the floor. the presiding officer: the senator from montana. mr. baucus: mr. president, i yield the balance of the time that we have in our hour to the senator from north dakota, senator conrad. mr. conrad: mr. president? the presiding officer: the senator from north dakota. mr. conrad: mr. president, i rise this morning not to talk about health care but to talk about the other critical matter that faces this body before we leave this session for the holidays, and that is the matter of extending the debt limit of the united states. let me start by saying it is

imperative that we extend the debt limit. if we did not, the united states would default on its debt. the consequences for this country and the global economy would be nothing short of catastrophic. if you think about the problems created -- created in world markets by the fact that dubai defaulted on $40 billion of debt, think of what it would mean to global markets if the united states were to default on on $12 trillion of debt. for those who say, well, this is obama's fault, no. this is not obama's fault. he has been in office 11 months. and i would remind everyone that he walked into the biggest mess

in 70 years. deficits and debt exploding, economic growth plummeting. all of that was happening before barak obama became president of the united states. he did not create the economic mess. he inherited it. he did not create the fiscal mess. he inherited it. those are things that he had to take on as the new president. there were record deficits and a doubling of the national debt. there was the worse recession of since the great depression, financial market and housing crises. ongoing wars in the iraq -- in iraq and afganistan. an unsustainable long-term outlook. when president obama came in,

this is what was happening to deficits before -- before he took office. the deficits were skyrocketing. in fact, we have never held presidents responsible for their first year in office for the fiscal affairs. -- affairs under their -- under their te term of office, because everybody here knows that they inherit the budget from the previous president for the first year. that is not barak obama's responsibility. that is the responsibility of the previous administration. for those who say, well, he made things worse, no, he didn't make things worse. he made things better. yes, he added short-term to the deficit about $300 billion in 2009 because of the economic recovery package. but i would remind people the difference the economic recovery package has made. we've gone from joblessness that was running at $700,000 a month

when he came in. this is january of 2009. the month he came in jobless numbers were increasing by 749,000 a month. and look at trend, because of the recovery package and other measures that were put in place, the changes in private, nonfarm payrolls have improved dramatically from losses of over 700,000 a month to losses of 18,000 a month. and we now believe in the first-quarter of next year, the job situation will become positive. the same thing happened on economic growth. economic growth was sharply negative when he came into office in th. in the last quarter we know that the economy actually grew at a

rate of 2.2%. that is a dramatic change. so the fact is he made things better. he inherited a disaster. and he went to work to get america back on track. let's just look for a moment at the debt. this is what happened under the previous administration. the gross debt of the united states skyrocketed, more than doubled under the previous administration. and so this is what the current president inherited. he did not create it. he wasn't the architect of it. he didn't produce these deficits and debt. he inherited them. it is true that we are still on a course for long-term debt that is unsustainable. this was the cover of "newsweek" on december 7th, pearl harbor

day. and the "newsweek" cover said this, "how great powers fall." steep debt, slow growth, and high spending kill empires and america could be next. when you went inside the story, it said this. this is how empires decline. it begins with a debt explosion. it ends with an inexorable reduction in the resources available for the army, navy, an air force. if the united states doesn't come up soon with a credible plan to restore the federal budget to balance over the next five to 10 years, the danger is very real that a debt crisis could lead to a major weakening of american power. mr. president, i don't know what could be more clear. here's what's happened since 2001. and, again, most of this is on the -- the shoulders, the responsibility of the previous administration.

because the debt absolutely skyrocketed under their watch. but it is continuing to grow. and it must be faced up to. mr. president, what's more alarming is the longer-term outlook on the trend that we're on the debt which will reach over 100% of the gross domestic product by 2019 is scheduled to hit 400% of gross domestic product by 2050. that's the trend line that we are on. that's the trend line we've been on since 2001. a trend line of massively growing debt. and the question is, can we face up to it? -- face up to it? do we have the strength? do we have the will to take on the burgeoning debt? mr. president, this is what the

national journal wrote on november 7th of this year. "the debt problem is worse than you think. simply put even alarmists may be underestimating the size of the debt problem. how quickly it will become unbearable and how poorly prepared our political system is to deal with it." mr. president, the reality that we confront tomorrow morning is whether or not we will extend the debt limit of the united states. we have no choice. if we would fail to pay the debts we have already accrued, the united states and other markets around the world would collapse. that's just the fact. we cannot permit that to happen. how we got in this position, to me, is very clear. the previous administration put

forward a fiscal policy that doubled the debt of the united states and put us on track to continue to double it every eight years. the current administration has taken action to get the economy moving and growing again. had they not taken those steps, which add to the deficit in the short term, the long-term debt outlook would be even worse. mr. president, that doesn't take a way from the -- away from the fact that we've got to deal with the reality that confronts us now. that reality is we're on a trend line that is absolutely unsustainable. for those who say, well, if you deal with the debt, you're going to have to do something about social security and medicare and revenue. yeah, that's true. you're going to have to do something about all of those. for those who say dealing with the debt means facing up to the

hard reality that confronts this country and the fact that we are on a course that is unsustainable, yes, that is true. we're going to have to make changes in the entitlement programs. we're going to have to make changes in the revenue system. and when i say that, i don't mean by that the first thing we do is raise taxes. the first thing we ought to do is collect the taxes that already owed that are not being paid because of these offshore tax havens, these abusive tax shelters and all the rest. mr. president, we can get more revenue we don't need to raise taxes to get more revenue. we need to collect the revenue that's currently owed and we need to get it from the people who are cheating all the rest of us by engaging in these tax schemes -- offshore tax havens, a i brewsive tax shelt -- abusive tax shelters. we have companies now who are leasing sewer systems, buying

them from european cities in order to depreciate them on the books in the united states to reduce their taxes here. then they lease the sewer systems back to the european cities that bought them in the first place. that's happening right now. and if you doubt that we're losing money to offshore tax havens, just go google offshore tax havens, see how many hits you get. you get over one million. and they will describe a life of luxury living offshore tax free on income received in this country where taxes are owed in this country and no taxes are being paid. that's the kind of thing that's got to be stopped. mr. president, how much time do i have remaining? the presiding officer: 5 1/2 minutes. mr. conrad: mr. president, let me talk just a minute about -- senator gregg and i have proposed a bipartisan commission to deal with this long-term debt

threat. it has 35 cosponsors now. and the idea is to give a group of our colleagues and members of the administration a responsibility to come up with a plan. and that plan, if it enjoyed a super majority among the group of 18 who would be given the responsibility to come up with a plan, if 14 of the 18 could agree on a plan, it would come here for a vote. it would come here for a vote. every senator would retain their rights to vote up or down. every senator would retain their rights. and it would require 60 votes in the united states senate to pass. it would require 60% of the house to pass. the president would be able to veto it if he didn't like it. but i think it's clear that we have a real challenge facing us

as a country. and it's going to take some special process to deal with it. what we have outlined is putting everything on the table with 18 members, 10 democrats, two from the administration and eight republicans. all task force members must be currently serving in congress or the administration. if 14 of the 18 can agree, that report would come to the congress for a vote. the report would be submitted after the 2010 election. and there would be fast-track consideration in the senate and the house. and there would be a final vote before the 111th congress adjourned. for those who say, well, that's going to shred social security an medicare, -- and medicare, no, no, no. what is threatening social security an medicare is to do -- and medicare is to do nothing. both of them are already cash negative. the trustees of medicare tell us it is going to go insolvent by 2017.

the answer cannot be to do nothing. i believe this is a challenge that requires us to come together, republicans and democrats, house, senate, the administration as we've dealt with fiscal crises in the past. the social security commission in the 1980's, the andrew air force base summit in the 1990's. those were special procedures to deal with a special challenge, and that is what is required now. we are on a course that is absolutely and utterly unsustainable. mr. president, let me go back to the vote tomorrow. because a group of us have said we're not going to vote for any long-term extension of the debt without consideration of a special process to deal with the debt. but we are also prepared to extend the debt on a short o oft term basis -- short-term basis.

that is through thely essential. that is -- essential -- that is absolutely essential. that is the responsible thing to do. a failure to extend the debt tomorrow would send a message to markets around the globe that the united states is not going to pay its debt. if the united states reneged on the dz 12-donthe $12 trillion o. the united states has never, never defawtd on its debt and it never -- defaulted on its debt and it never can without grave consequences without our economy and the world economy. mr. president, let me again say, as clearly as i can. for those who want to blame

president obama, that won't wash. he has been in office only 11 months. he walked into the biggest mess in 70 years. deficit and debt exploding, joblessness skyrocketing, economic growth plummeting. he didn't create that economic mess. he inherited it. he did not create the fiscal mess. he inherited it. mr. president, tomorrow will be a key vote for this country. those of us who are concerned about the growing debt and are willing to take it on must also be responsible about making certain that the united states does not default on its already accrued debt. that would be a disaster for

this country. i thank the chair and yield the floor. how much time do i have remaining? the presiding officer: ten seconds. mr. conrad: perfect. merry christmas. mr. corker: mr. president? the presiding officer: the senator from tennessee. mr. corker: mr. president, i would like to inquire as to how much time is allotted for me? the presiding officer: the minority has 60 minutes. mr. corker: i have ten minutes, i think. i wonder if the president might let me know when i have two minutes left? the presiding officer: the chair will do so. mr. corker: okay. mr. president, i thank you. i -- i have watched this body over the last period of time as we discussed health care, and the body itself has been -- the

integrity has been challenged of this body. i have watched as individuals have challenged each other's integrity as it relates to this bill. mr. president, i choose not to do that today, and i want to state as i state constantly back home in my state that i am -- i consider it a privilege to wake up each day and come to work in this body. obviously, things don't always go as one might expect, but i do consider it a privilege, and i thank -- i thank the folks back home for allowing me to serve in this body and to deal with these important issues. mr. president, i don't think i will ever quite understand why this bill is -- was put together the way that it was, and i certainly understand there are differences of opinion and differences of interest, but i -- i don't think i will ever understand why medicare moneys of an insolvent program are used

to fund a new entitlement. finally, c.b.o. has come out this morning very clearly and stated what we have been saying for over six months in this body, that the fact is that taking medicare savings and using it to create another entitlement does not work. it takes away from the solvency of medicare itself. it's kind of late. i'm glad that c.b.o. has actually come out and said today finally after months of debate what we have been saying from day one, that you could not take medicare savings and use it to create a new entitlement without challenging the solvency of medicare itself. i will never understand, mr. president, why that building block, a flawed building block, was used to create this bill. and i think that everybody knows that it was that use of inappropriate funding that really began this whole partisan

divide. my guess is we might -- my guess is we might have ended up with a bill that would stand the test of time had we not utilized that basic flawed building block in this bill. there has been another one, though, mr. president, that i have found equally problematic, and that is the whole issue of creating an unfunded mandates for the state -- an unfunded mandate for the state of tennessee and all across the country. as a matter of fact, i think the challenges to people's personal integrity has been centered more around this issue than anything else, as various senators trying to protect their states from an unfunded mandate have been challenged in that regard. many of the people who serve in this body used to be mayors. they used to be governors. they used to be people who had to deal with budgets and their own states, and so years ago in a bipartisan effort, a bill was passed to ensure that we here in

washington didn't pass laws that increased costs for cities. i was a mayor of a city. for states. i was commissioner of finance for a state. and there was nothing, nothing that was more offensive than for the federal government to pass a law and to send down a mandate to a city or a state that costs money and yet not send the money that went with it. there was nothing more infuriating because we had to actually balance our budgets. we didn't have the ability to borrow money from qoafers -- from overseas and to continue to operate in the red. so, mr. president, back in 1995, a law was passed, a law was passed called the unfunded mandates reform act, and it was done to do away with the arrogance that existed up until that time and unfortunately continues to exist where the federal government would create laws that would increase costs on cities and states. it was passed in a bipartisan

way. as a matter of fact, 15 members from the other side of the aisle supported this law, voted for this law, and put this law in place. as a matter of fact, many of the people who made this bill, created this bill participated. the chairman of our finance committee voted for this law. the majority leader voted for this law. the distinguished chairman of the budget committee who just spoke voted for this law. the chairman of the "help" committee, the health, education, labor and pension committee that drafted a big part of this bill voted for this law, and what this law said was that we could not pass legislation out of this body, out of congress that placed an unfunded mandate on states, on cities, and calls them to have to do things that raised expenses by laws that we created without sending the money themselves.

our governor, the governor of the state of tennessee, is a democrat. he is on the other side of the aisle. we have worked closely on numbers of economic development issues. i have talked with him all the way through this process. he actually had hoped to work with this administration on health care and on health care legislation. he has been involved in health care all of his life. he has managed our state well. he has dealt with many challenging health care issues in the state of tennessee. much has been documented about the travails that our state has had as it relates to medicaid and our ability -- our desire to try to fix that. mr. president, he has called this bill, which appears to be readying to pass this body, he has called this bill to be the mother of unfunded mandates. he has talked about the the $750 million in costs that this bill is going to cost the

state of tennessee, to deal with at a time, by the way, when they are hoping that their state's revenues will be at 2008 levels by the year 2014. so, mr. president, again, i'll never understand why we have raided an insolvent entitlement to create a new entitlement weakening medicare. i'll never understand why we have done that to create this bill. and, mr. president, i will never understand why this body chose to create such a large unfunded mandate for states around this country through the provisions that we put in place as it relates to medicaid, telling states that they have to raise the levels at which they insure citizens across their state from 100% to 133%. mr. president, there is no question that this bill violates

violates -- okay. okay. mr. president, there is no question that this bill violates the law that was put in place in 1995. mr. -- the presiding officer: the senator has two minutes remaining. mr. corker: two minutes left. i thank you. that's perfect timing, mr. president. and for that reason, mr. president -- and again, i talk about the fact that it is a privilege, a privilege to serve in this body. i think generally speaking people try to live up to the standards that this body has set for all of us and that our citizens across this country expect us to live up to. for that reason, mr. president, i am going to raise a budget poured because there is no question per what c.b.o. has said. the fact is that this bill is going to cause cities and states to pay more for the health insurance of their employees. c.b.o. has stated that clearly,

and there is no question that this bill is going to cause states to have to utilize dollars that otherwise might be used for tuition. so for that reason, mr. president, i raise a budget poured -- point of order for section 425-a-2 of the congressional budget act of 1974, makes it out of order to consider any legislation that contains an unfunded intergovernmental mandate in excess of the statutory limit unless the bill provides new direct spending authority or includes an authorization for appropriations in the amount equal to or exceeding the direct cost of such mandate in the senate. the pending bill includes an unfunded intergovernmental mandate in excess of the annual statutory limit of $69 million within the next five years. therefore, i raise a point of order against the bill pursuant to section 425-a-2 of the congressional budget act of

1974. i raise a point of order against the pending substitute amendment, pursuant to section 425-a-2 of the congressional budget act. mr. baucus: mr. president? the presiding officer: the senator from montana. mr. baucus: mr. president, i move to waive the point of order for the consideration of the pending legislation. and ask for the yeas and nays. the presiding officer: is there a sufficient second? there appears to be. the yeas and nays are ordered. mr. grassary:. mr. grassley: mr. president? the presiding officer: the senator from iowa. mr. grassley: i would ask my friend from montana, senator baucus, to be alert because i have a similar request to set aside, but before i do that, i want to explain why i'm doing

this. i worked for six years to pass the congressional accountability act which was signed into law by president clinton in 1995. i worked so hard because i strongly believe that there should only be two sets of laws in this country -- one set of laws in this country. prior to 1995, there were two sets of laws, one for capitol hill and the rest for the rest of the country because congress exempted itself, so that's why following on that practice of 1995 i offered an amendment during the finance committee markup to require that members of congress and congressional staff get their employer-based health insurance through the same exchanges as our constituents. that's something i also heard complaints from the grassroots of iowa during my town meetings. now, i did offer that amendment and it was adopted without objection, but then, you know, after careful consideration and

examination of the bill that senator reid put together -- and this was done by the congressional research service -- it was revealed that my amendment was changed under this closed door merger process. so something cute happened. under the bill we now have before us, this requirement would not apply to staff for committees of the congress or leadership offices. it would apply to our personal members and our personal staff, but not leadership, so that's a real cute thing to give exemptions for some people on capitol hill but not for others. so at this point, senator baucus, i would ask consent to insert -- no. i ask of the president, i ask consent to insert an analysis from the congressional research service into the record.

the presiding officer: without objection. mr. grassley: this carveout creates a double standard and is totally unacceptable. this amendment goes beyond just going where my original amendment went to cover all people on capitol hill. the amendment that i am asking consent for would also include the president, vice president, political appointees, and senior level staff of the executive branch. it's only fair that if this bill becomes law, these leaders should themselves be subject to the reforms that makes our constituents go through the exchange, so i ask consent to set aside the pending amendment in order to offer amendment numbered 3178 which is at the desk. mr. baucus: i object. the presiding officer: is there objection? mr. baucus: i object. the presiding officer: objection is heard. mr. grassley: democratic leadership and the white house have spent months talking about

accountability, and with this objection, i think the majority will not even consider an amendment to make sure that the white house and all members of of -- employed on capitol hill, not just those in our personal office, live under the same new health care system the rest of the country lives under. that sure doesn't sound like accountability to me. there's widespread agreement that the health care system in this country has serious problems. cost are raising three times the rate of inflation. many americans are uninsured. millions more fear losing their insurance in a weak economy and -- because of preexisting conditions. doctors are ready to close their doors over high malpractice costs and lower government reimbursement and we don't do anything in this bill about high malpractice costs. something has to be done.

everyone seems to agree. but tomorrow the senate will vote on a bill that makes a bad situation worse. it's unfortunate that we're voting on a bill that a significant majority, 61% of americans oppose. the american people, providers, advocacy groups, as well, are reacting to the fact that this bill slipped down the slippery slope to more and more government control of health care. it contains the biggest expansion of medicaid since 1965. it creates a long-term care insurance program called the class act that the c.m.s. actuary says runs a significant risk of being unsustainable and one of the most significant members of this body referred to it as a ponzi scheme similar to

the madoff, what he did. it imposes an unprecedented federal mandate for coverage backed by enforcement authority of the internal revenue service. it increases the size of government by $2.5 trillion when fully implemented. it creates dozens of new federal buicbureaucracies and programs o increase the scope of the federal government role in health care. that's a lot of power over people's lives concentrated in the federal government. and there are 1,697 delegations of authority to the secretary of h.h.s. to do things beyond authorities specifically given in this legislation. and the excesses of this bill appear willfully ignorant of what's going on in the rest of

the economy outside of the health care of these excesses make it far worse than doing nothing. at this point in our nation's history, we're facing very challenging economic times. we've seen the auto industry go into bankruptcy. we've seen banks shut their doors. the chart behind me shows how the federal debt has increased by $1.4 trillion since inauguration. the chart also shows the growing amount of debt that the federal government is taking on. just the amount of increased debt added just since inauguration puts on each household $11,000 more of debt. and that total debt now exceed exceeds $12 trillion for the first time in history. you know, at the beginning of this debate, one of the key

promises of health care reform was that it would bring down health care costs. this needs to be done before health spending sinks the federal budget an settles the -- and settles the taxpayers. so i have a chart that ill states the upward expenditures of health care costs b by $160 billion over the next decade. and that comes from this bill. the red area on this chart is a net additional federal health spending according to not this senator, but the congressional budget office. americans have rightly lost faith when in the face of the current economic crisis congress thinks this $2.5 trillion restructuring of the health care system is a good idea. from rationing care to

infringing on the doctor-patient relationship, this government-run system will guarantee u.s. taxpayers a staggering tax burden for generations to come. when the debate began last year, interested legislators of both parties set forth benchmarks that were at the time no brainers and still are. but this bill doesn't conform. health care reform should lower the costs of premiums. it should reduce the deficit. now, this bill does over the 10-year window. but if you look when the program really starts four years from now, look ahead at 10 years from that time, you'll find that it does not. it should bend the cost curve of health care right way. but it doesn't do that. the reid bill doesn't do any of these things that we set out to do at the beginning of the debate.

as we end this debate, i urge my colleagues to listen to the american people. the reid bill is the wrong direction. i yield the floor. i ask unanimous consent to add some other remarks i was going to make that i don't have time to make at this point. the presiding officer: without objection. a senator: mr. president? the presiding officer: the senator from new hampshire. mr. gregg: i want to associate myself with the comments of the senator from iowa. in fact, i'd like to incorporate them by reference in my conference because they were on point in terms of what this bill does do and does not do. the bill does not accomplish what we set out to do, which was to cover all americans, which is to bend the cost care down, let you keep your insurance are if you have it. it's a dz 2.3 trillion increase in health care spending. that's how much it grows the government. health care costs go up by ove over $230 billion in the first 10 years. we know premiums are going up.

and now we have this interesting issue involving medicare. we've heard a lot of talk from the other side of the aisle about how medicare's not being cut and if it is being cut, it's just being used to help a new entitlement and therefore it should be counted as part of the basic effort to bring fiscal responsibility to this bill. well, that's hokum. compare is cut by $500 billion over the first 10 years, dz 1 trillion -- $1 trillion over the first 10 years of implementation, and then the money's being spent. not to make medicare more solvent, not to make medicare stronger so it doesn't have a huge funded liability. it is being created to create a new entitlement. an entitlement that is going to massively expand the size of government by $2.3 trillion. the american people understand this doesn't work. common sense kicks in. they know from common sense you

can't cut medicare b by $2.3 trillion and have a new entitlement and claim that medicare is better off for it. they don't have to know it through common sense, all they have to do is listen to the c.b.o. let me quote from the letter. it's a devastating letter. i wish this bill would be on the floor long enough for it to be actually open to public view and have sunshine ton. it's rushed through before christmas so no one can see what's in it. here's what c.b.o. says, the key point is that the savings to the medicare trust fund under the bill -- they use the acronym for it, would be received by the government only once so they cannot be set aside to pay for future medicare spending and at the same time pay for current spending on other parts of the legislation or on other programs. exactly what this bill does. it spends the medicare money on other programs. they go on to say, and this is c.b.o. speaking, not me.

to describe the full amount of the medicare trust fund, again they use h.i. trust fund, savings as both providing the government's ability to pay for future medicare benefits an financing new spending outside of medicare would essentially double count -- i repeat -- double count a large share of those savings and thus overstate the improvement in the government's fiscal position. the simple fact is that what's happening here is a scam. pure and simple scam on the american people and especially on the seniors. on the seniors in this country. because medicare's being cut by billions of dollars in order to create a new entitlement and it's going have massively negative effect on the fiscal health of this nation. because we know that new entitlement won't be fully funded and we know that medicare has $35 trillion of unfunded liability out there. and if you're going to cut medicare by $3 trillion as the other side of the aisle is

proposing, if you're going to eliminate medicare advantage for a large number of seniors, except those who live in southern florida, then that money ought to be used to reduce the debt so that the medicare system becomes more solvent. it's that simple in the long run. it's not being done here. c.b.o. has pulled the curtain back from this game and made it very clear it's not going to be done. nobody will learn this. they will pass this bill through here before anybody can figure it out an listen to c.b.o. you know, it's just an outrage the way this bill was put together. we all know that. dark of night, back rooms, deals everywhere. only a few people in the room. those people that really drafted the bill, a very small crowd. nobody else was allow in. no cameras, no information about what was going on. and then you bring in a senator here and there and say, what do you need to get -- what do you need to get the vote? and then the bill arrived here. now it's not unusual to have

earmarks and bills. if it was in the budget and the budget is reasonable, i've even asked for earmarks. but this goes beyond the concept of earmarks, this bill. this bill fundamentally changes policy. that's never happened around here for one part of the sunt v. another part of the country -- country v. another part of the country. all american seniors will have to live by massive cuts in medicare advantage. that's a pretty good health insurance program for a lot of seniors, i think there are 11 million seniors in that program. all of america has to live by that policy except for three counties in southern florida. all of america has to live by a an insurance situation where insurance companies are taxed at a certain rate except insurance companies in nebraska. all of america has to live by medicaid reimbursement rates, which are going to cost the states billions of dollars. new hampshire $120 million over

10 years. except for vermont and massachusetts. and then there's a special exemption in here for -- for new york and a couple of other states. louisiana. $300 million. that's a total corruption of the concept of policy. policy in america's supposed to cover everyone. when the federal government acts, it's supposed to be a policy that affects everyone equally. you're not supposed to have codries of exceptions. this bill has been called historic. historic. excuse me. historic by my colleagues on the other side of the aisle. the most historic thing about this bill is the fundamental damage it has done to the consent of open, thorough and public debate that was at the heart of the thought process of adams and madison, our founding fathers when they created the checks and balance system with the senate at the center.

the senate was supposed to be the place where bills come to the floor, they're open to debate, there's amendments, and you have a process where things get aired and there's sunshine. no sunshine here. no, not at all. this is not majority rule as conceived by our founding fathers in fill fi. this is close -- in philadelphia. this is closer to the single-state system that we've seen in europe. the minority is ignored and there are no checks in this process on the autocratic rule of the majority. and the irony, of course, is that the bill never went through the public's consideration. never went through committee and was drafted behind closed doors and it has been on the floor for less than 72 hours. as a result, we delivered a health care bill that's been corrupted by special interests, especially on the issue of policy, that is extraordinarily expensive.

and has massive expansion in the federal bureaucracy to which if you applied the word reform, you would have to call bernie madoff honest. the terms simp -- just simply don't apply here. unfortunately this bill in its present form, i believe, will lead to fundamental harm to the fiscal health of this nation. there is no question in my mind but that if we load another $2.3 trillion of costs on to our government, expand our government in this manner, that our children are going to be passed a nation where they have less opportunity than our generation had. and, further, i don't think it's going to help the nation's people relative -- our people relative to their -- to their health care. i think it will lead to a significant contraction of the quality of health care, emfor seniors. -- especially for seniors, but for all americans as we lose the innovation, the energy

innovation and the resources for innovation. and, as a result, this bill, in my opinion, should be sent back to the drawing boards and should be reconsidered. mr. president, i yield the floor. mr. cornyn: mr. president? the presiding officer: the senator from texas. mr. cornyn: mr. president, over the last few days, we have learned as we have dug into this bill and the process by which it was written behind closed doors, we have discovered that the bill is chock-full of sweetheart deals. when americans voted to change washington last year, they didn't think it would be politics as usual here, but unfortunately it's sunk to a whole new level. it's painful to me to read the editorials in hometown newspapers back in texas and elsewhere around the country to see what editorial opinion and other opinion leaders are saying about the process by which this

bill was written, but let me just read you a couple of lines from the "fort worth star telegram." it says -- "the tawdry use of earmarks to bury the doubts of recalcitrant moderate democrats was a cynical display of end justifies the means horse trading that president obama campaigned against as a senator and a candidate. this was an administration that was elected on the campaign slowing an qod change you can believe in." when david axelrod, one of the masterminds of the campaign, one of the advisors of the president, was asked about that, he said well, this is just the way it is. this is the way washington works. well, i for one want to stand up and say this is not the way it should work. i know presidents campaign for office saying they're going to change washington, but the truth

is the hardest fight is to keep washington from changing you. and unfortunately, it seems like that's what's happened here. rather than listening to the american people, the creators of this health care bill started with the special interests first. that's where the meetings behind closed doors started with the pharmaceutical industry, to cut a deal with them, with the insurance industry, to cut a deal with them. the insurance industry will get get $476 billion worth of tax credit from this bill alone, and the hospital industry and the list goes on and on. colleagues will stand up and tout the endorsement of things like aarp that's backed nearly half a trillion dollars in cuts out of medicare because, as it turns out, they are in the insurance business and they can sell more medigap policies when they cut medicare advantage, as this bill does.

in order to get to 60 votes for cloture on the motion to proceed, you didn't hear a high-minded and idealistic debates about what is the right policy for this country when it comes to reforming our health care system. if this bill could have passed or mustered 60 votes because it was such great policy, because the american people were embracing it, you wouldn't need to make all the sweetheart deals that were made behind closed doors to induce recalcitrant senators to vote for cloture, not because they think it's the right policy but because their state got a special deal. we know well about what happened in louisiana and now in nebraska, but of course there were deals, special deals for vermont that included included $600 million in the manager's package. we know that in california, the so-called bo tax has been

replaced by another tax on tanning beds. at the instances of one of the businesses named allergen out in california who led a lobbying campaign to defeat the cosmetic surgery tax. we've heard -- we've heard this is all about keeping insurance companies honest, but the fact of the matter is there were special deals here for insurance companies in nebraska, what has been coined the omaha prime cuts, the carveout. new fees for mutual of omaha and other insurance companies doing business in nebraska that no other insurance company in the nation is going to benefit from. and then there is the so-called gatorade special deal for insurance companies in florida. there is a $100 million hospital deal in connecticut, someone called uconn. of course there were deals for montana that were slipped in the bill, although, you know what? no one had the courage to actually messenger the name of the state. had you to start to dig into it, just like the louisiana deal.

at least the senator from nebraska was brazen enough to actually have nebraska listed by name. the rest of them you have to dig out by trying to figure out well, who benefits from this deal and who doesn't? well, i want to ask what about the other states? my state under this unfunded mandate in this legislation will have to pay the state taxpayers taxpayers $21 billion in unfunded mandate medicaid liabilities over the next ten years. we didn't make a sweetheart deal to vote for bad policy because my state could get some extra money, because i think that's unprinted. i wouldn't do it. but what about the other states that voted for the bill without getting the sweetheart money, like arkansas which faces an unfunded medicaid mandate of of $335 million. colorado $624 million.

california, $3.5 billion, a state that's already nearly bankrupt. this is going to make their situation enormously worse as governor schwarzenegger has acknowledged. now, i'm not saying that other states should somehow get the sweetheart geels that were negotiated for these other votes, but i'm saying this entire bill is a bad deal, and we need to kill it and start over, strip out all the earmarks and to bring the kind of transparency that the president campaigned on and that i think the american people have a right to expect. now, these sweetheart deals are egregious in and of themselves. what's worse -- and i have been on the telephone talking to constituents back in texas. there are some people who paint with such a broad brush, they say well, we think all of you are corrupt, because this verifies some of the most cynical suspicions that people

have about government. and i for one resent it. we have many honest and honorable people who serve in public life, and this taints us all with a broad brush and simply stated makes me furious. i resent it. i resent those who brought us to this position because i think it sullies the reputation of the united states senate. mr. president, in a moment, i'm going to offer a point of order, but let me first note that one of senator reid's first acts as majority leader was to pass the honest leadership and open government act. let me tell you the name of that again. it's called the honest leadership and open government act. in 2007, president obama, then senator, said to earn back the

trust to show people that we're working for them and looking out for their interests, we have to start acting like it. unfortunately, for the american people, washington has not yet started to act like it. this landmark ethics reform legislation required senators to publicly disclose earmarks, and who requested them? senator grassley and i have both made parliamentary inquiries about whether this provision has been complied with, which is now contained in rule 44 of the senate standing rules, and we found that the majority leader has not so far complied with these public disclosure rules that he himself championed. and since my friends on the other side of the aisle don't certainly seem to care a lot about this, we just have to -- we just have to insist that this provision be complied with. and in a moment, i will raise a point of order about this violation of the senate rules. we need to force the members of this body to be honest about who

is -- who has required special favors and earmarks, tax treatments and benefits in this bill. so, mr. president, i have a parliamentary inquiry. according to rule 44, paragraph 4-a of the standing rules of the senate which states -- "if during the consideration of a bill or joint resolution a senator proposes an amendment containing a congressionally directed spending item, limited tax benefit or limited tariff benefit which was not included in the bill or joint resolution as placed on the calendar or as reported by any committee, in a committee report or on such bill or joint resolution or a committee report of the senate on a companion measure, then as soon as practicable, the senator shall ensure that a list of such items and the name of any senator who submitted a request to the senator -- to the senate for each respective item

included in the list is printed in the congressional record." i would simply inquire of the chair, is the chair aware whether this list of congressionally directed spending items and their senate sponsors have been printed in the congressional record? the presiding officer: the chair is not aware if such a disclosure has been made. mr. cornyn: mr. president, under those circumstances, i raise a point of order that the amendment is not in order since it violates the provisions of senate rule 44, paragraph 4-a. the presiding officer: paragraph 4-a of rule 44 requires that the senator who proposes an amendment containing any congressionally directed spending item ensure as soon as practicable that the list of such items be printed in the congressional record. the provision is not enforceable and no point of order lies. mr. cornyn: mr. president, i appeal the ruling of the chair, and i ask for the yeas and nays. mr. baucus: mr. president? the presiding officer: the senator from montana. is there a sufficient second? there does not appear to be.

there appears to be. mr. baucus: mr. president? the presiding officer: the senator from montana. mr. baucus: i move to table the appeal of the ruling of the chair. i ask the vote occur on the expiration of all postcloture time. the presiding officer: is there objection? without objection, so ordered. mr. baucus: i ask the yeas and nays on the motion to table. the presiding officer: is there a sufficient second? there appears to be. the yeas and nays are ordered. a senator: mr. president? the presiding officer: the senator from missouri. mr. bond: mr. president, last week i had a little fun with a holiday classic, "the night before christmas," which you can still find on youtube, by the way. while i meant this parity to bring some much-needed levity to the process, the points i made are very serious. for the american people, there is nothing more serious than the reform bill we're considering

today. the majority's so-called reform package will restructure 1/6 of our struggling economy, drive health care costs higher, force millions off their current plan, put health care decisions in the hands of bureaucrats, cut seniors' medicare, raise taxes, and hurt small businesses and cost jobs. there's nothing funny about this health care folly. americans faced with rising premiums ask for bipartisan reform to make health care costs affordable, but the democrat bill fails to give the american people what they want, which is why senator reid has written bill after bill behind closed doors, with no republicans. the majority party doesn't want americans to know they are getting a lump of coal for christmas until it's too late. but leader reid has really outdone himself on the latest deal he cut. this is chicago-style politics at its worst. a 2,700-page back room deal

written behind closed doors, full of political payoffs, vampire votes in the dead of night, all to pass a health care bill before christmas that the american people don't want, that will increase health care costs, raise taxes, and cut medicare for seniors. operating under an arbitrary deadline which seems designed to minimize transparency, understanding public involvement. but i want the american people to know that they are -- what they are getting from the majority this holiday season. i don't want my good friend from nevada to be known as hurry up and reid, so let's talk about what really is in this bill. under the majority's latest back room deal, americans are getting more taxes. this deal imposes about about $500 billion in fees and taxes on individuals, families, and small businesses. under the majority's latest back room deal, americans who own small businesses, the backbone of our economy, are getting more taxes and costly regulation.

for small businesses who employ a large number of those currently uninsured, this bill does nothing to help make insurance more affordable or accessible. the bill contains a costly employer mandate which destroys job creation opportunities. it doesn't take a rocket scientist or an economist to figure out that the multiple penalties small businesses will pay for full-time workers will result in these companies forcing workers from full time to part time and discouraging new hiring. companies are going to have to think twice before hiring new full time workers if it's going to cost them a pretty penny. at a time when the companies are trying to pinch pennies. there is also a paperwork mandate which is a new administrative burden on small business, which, according to the national federation of independent business, will impose a direct $17 billion burden on businesses. unfortunately for small businesses, unlike larger businesses or unions, the news gets even worse.

unlike large businesses, most small businesses can only find and purchase health insurance in the private insurance marketplace. that means to ensure their employees' small businesses have to go to the big insurance companies on which the reid bill is placing hefty new fees. most folks don't have a problem with putting more fees on insurance companies. it seems to be politically -- it seems to be 101 that these insurance companies will not suck up -- it up and swallow these new fees. and c.b.o. stated so explicitly. they will pass on to the fees and the small business that's will have no choice but to purchase their services. one of the gimmicks the majority's using to hide the cost of the bill is a weak tax credit that is supposed to help small businesses in purchasing health insurance. the hitch is that small businesses will only receive the full tax credit if they have less than 10 employees.

if you hire that 11th employee, the tax credit is reduced. in addition a small business can only get full credit if it pays employees an average of $25,000 a year or less. so no salary increases. no wage increases. in other words, what is already a horrible economic situation, where businesses are shuttering their doors an workers are laid off, we're going to punish small businesses for hiring new employees and paying workers more. this tax credit is a case of bait and switch. if your small business just happens to fit in the narrow qualifications, it is only temporary. after six years the credit goes away, but the mandate on small businesses stays. that's why the national federation of independent business and their strong opposition to the majority plan stated -- quote -- "it will not only fail to reduce and control the constantly climbing health care costs that small business

owners face. reform that was supposed to be all about small business has turned out to be more about big business and other late-night deal makers. all at the expense of our nation's job creators. close quotes. that's not the kind of reform that the small business can afford. under the majority's latest backroom deal americans are getting hundreds of millions of dollars in cuts to critical health care programs. like $118 billion in cuts to medicare advantage. as well as cuts to hospitals, nursing homes, home health agencies and hospices. when government forced through massive cuts for home health in the late 1990's, unintended consequences were costly and tragic. in my state of missouri, a significant number of agencies closed in missouri forcing patients into more expensive care. one example, a county in north missouri, the only home health agency closed, they had 40

patients served in home at a cost of $4 million a year. -- 400,000 a year. when those patients were cut off, 30 were forced into hospitals or nursing homes. the cost skyrocketed for these patients to a staggerin staggering $1.4 million on the government tab or a $1 million larger hit to taxpayers. we don't even know what happened to the other 10 patients who lost this critical care. this is not the kind of reform americans can afford. under the majority's latest backroom deal states are getting hit hard. for example, the majority's big plan is to expand medicaid. but their big plan for paying for it is to put the burden on the states. that is, unless you were able to cut a backroom deal like in nebraska, which leaves other states holding the bag for their costs. which brings me to my next point. under the majority's latest backroom deal, americans are forced to fund a number of political payoffs. there is such a large number of

political payoffs, the bill is started to be dubbed as cash for cloture. there's a carve out for the insurance industry in michigan and nebraska. there's the extra $300 medicare fund -- $300 million medicaid for louisiana known as the louisiana purchase. what was the mysterious $100 million for the health care facility, it turns out to be a hospital in connecticut this is not the entire list of sweetheart deals. that's not the kind of reform that americans want. with chicago politics and backroom deals like this, it's no surprise that poll after poll makes clear the american people are saying no to democrat proposals. the latest poll released by a university found that american voters mostly disapprove of the plan 53--- 53% to 36%. a recent abc-"washington post"

poll found that it -- the american public's absolutely right. americans don't want this bill. in the classic tale called "christmas carole" scrooge is given the opportunity to see the christmas past, present and future. while the democrats are trying to paint the g.o.p. as scrooge, they would do -- we don't want to wake up next christmas an having americans pay more than they are today for health care or being unable to get health care and losing their jobs, but under the majority's latest backroom deal, that is the future. next christmas we don't want to see small business that's still can't afford to offer health insurance to their employees or, worse, small businesses struggling to keep their doors open because the costly new burdens in this bill. but under the latest backroom deal, that is the future. a year from now we don't want to hear that seniors have lost

access to care. unfortunately, that is the christmas future we face -- if this bill passes. christmas future several years from now could look even worse. that's why in my night before christmas pairedy as it was -- it was not funny as it was scary and true, but i could not catch the holiday spirit myself, how far away from common sense we have been led, our kids and grandkids have their futures to dread. the last year my colleagues on the -- this side of the aisle watched with dismay as the wheel have come off federal spending. a trillion dollars in taxpayer money, a trillion there, got a problem? throw money at it. historians look back at the 111th congress and say this is where the decline of economic power began? i don't want that on my watch, mr. president. we can reform health care without spending trillions of our children and grandchildren's money. if the majority were to bring up a bill that made health insurance more affordable for small business owners to purchase for their employees

that eliminated frivolous lawsuits that emphasized wellness an prevention programs, it could go a long way to solve the problems of the uninsured and underinsured and they could get 80 or 90 truly bipartisan votes. what they really want, apparently, is to take over health care at a tremendous cost to individuals, families, and businesses and -- and increase the dependency on the federal government. that's not a christmas present i want and i don't want to give it to the american people. i thank the chair and i yield the floor. a senator: mr. president? the presiding officer: the senator from wyoming. mr. enzi: i want to thank the senator from missouri for his comments. he's been the chairman of small business committee. small business plays the biggest role in the economy of the united states. we could have and we should have spent the four weeks talking just about what needed to be done with small business. as it big issue. and it's important, and i appreciate the emphasis that you put on it through the years.

i want to talk about the whole bill, a quote that i ran into, is that absolute power corrupts absolutely. the democrats have absolute power right now. under the biggest requirements for votes, it only takes 60 in the senate. the democrats have 60 votes. in the house they have a clear majority of the votes and that's all that's required to pass a bill over there. they're under the impression that they won the election, they get to write the bills. never before has that happened on a major piece of legislation. everyone in this country should be upset when the majority refers to bills like ending slavery and civil rights and medicare and welfare reform and paints the republicans as the opposition. substantial numbers on both sides of the aisle made those bills possible. i'm pretty sure people remember that it was lincoln, the republican, who led the fight to abolish slavery.

leader mansfield gives dirksen from illinois that made the civil rights bill possible. in every incident except for now, republicans have had a leadership role in substantially participating and making and voting for those laws. in politics, that's how it has to work for our country to be successful. only one party, and especially one person, gains from this so-called health care reform bill. the president will be able to show how he was able to accomplish something against all odds. why against all odds? because the democrats of the senate wrote off the 40 votes of the republicans. that's right. we were written off from the start. oh, yes, we were allowed to participate to see if we couldn't be persuaded to take what the democrats wanted to write and foist on america. anything short of buying the whole democrat plan and we could be and would be thrown overboard because our votes aren't needed.

and we were thrown overboard with the excuse of phony time deadlines when it was really needing to do just the democratic ideas. senator kennedy and i were able to work through an incredible number of bills because we recognized that both sides had good ideas and both sides had bad ideas. the trick was it take as many of the good ideas as possible and have the courage to tell someone on both sides of the aisle that their idea wasn't ready for prime time. when even headed necessary and both leaders -- headedness and both leaders promoting the surviving ideas, both were unanimous. were there flaws? yes. no bill is perfect. on the simplest solutions, no one, particularly those who have never been involved in that business or that area can comprehend all of the unintended consequences. but when it's both parties acting in concert, when problems come up, solutions are sought.

when bills are done by one party, and no all encompassing bill has been done this singularly before, when a bill is done by one party, the flaws result in justified finger-pointing. you can't change such a basic part of the economy, something that affects every single person by ignoring many who have experience in the business and in the area and not expect major flaws. the american people even recognize the flaws already. of course, everyone has some knowledge of health care since it affects us all. when those flaws develop, and they will, in an avalanche, everyone will point to one party, the democratic party and say, why did you have to prove your power? why didn't you just work to get it right? why did you have to polarize the issue to show that you were the only ones concerned about people? the course the republicans will be compelled to pull out the proof that we warned about the

flaws, but were ignored. because the democrats were focused on proving that they won the election. normally there's plenty of blame to go around, but not on this one. so the republicans were thrown overboard. that only left the 60 votes needed to pass the bill. well, you can't get 60 people to agree on 100% of anything. you couldn't get 60 people to agree on a place to eat dinner. but all 60 had to agree. that's where you have to move away from legislating and into deal making. that's when you have to start playing games like, let's make a deal or the price is right. but i don't want to downplay how masterful the leader was. everyone has to be in awe of his ability to give much to a view and -- to a few and none to many and get 100% to stay on what they can see from the polls is a sinking ship. how can a person discriminate between members? discriminate between states?

usually we do earmarks in appropriations bills. now we're starting to do them in policy bills? why? just to buy votes. the leader is buying votes with taxpayer money for things that majority of the taxpayers will never benefit from. i don't have time to go into the way that groups have made hidden deals for this bill like with the american medical association and with big pharmaceuticals. i don't have time to talk about how taxes are going to go up or how premiums are going to go up. as an accountant in the senate you are going to be shocked by the numbers. but until it's too late. i don't even have time to explain to you how the democrats are planning to spend your money twice. the same money twice. and that's a pretty neat trick too. i don't have time to explain how the government is going to tell you that the minute -- what the minimum amount of insurance is. and it's more insurance that most americans have right now. and if you don't find a way to

buy this better package, there will be fines for you to pay. if the government can force you to buy insurance and force you to buy what washington thinks is the best insurance, what's next? will they be able to tell you what kind of a car to buy? remember, the government now owns a car company. i hope i have time to remind you that we all agree medicare is going broke. but this bill takes almos almost $500 billion of medicare money and uses it to do new programs. new programs outside of medicare that will go on forever. and need money for everyone -- forever. even after medicare is broke. they even recognized the problem and so they formed a commission to tell us where to cut medicare. that's so they can shift the blame to the commission. but the difficulty is they've made special deals that take away the commission's ability to make cuts