leaders and includeshaes aimed at getting support of the law with the president signed yesterday. now the senate. almighty and eternal god, in whose keeping are the destinies of galaxies, here at this altar of supplication we lift our hearts to you. today, crown the deliberations of our lawmakers with civility and respect as well as passionate sympathy for humanity. facing questions and issues

quicken in our senators every noble impulse, transforming each task into a throne of service. take away any desire to put off until tomorrow the things they should accomplish today. lord, make them brave and steadfast until right becomes victorious might. we pray in your great name. amen. the presiding officer: please join me in reciting the pledge of allegiance to the flag. i pledge allegiance to the flag of the united states of america

and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. the presiding officer: the clerk will read a communication to the senate. the clerk: washington d.c., march 24, 2010. 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. reide :esiding officer: the majority leader is recognized. mr. reid: today the senate will resume consideration of the health care and education reconciliation act. roll call votes are expected to occur throughout the day. the vote-a-rama, as it's become known, will begin sometime this afternoon. mr. president, it's my understanding that s. 3158 is at

the desk and due for second reading. the presiding officer: the clerk will report. the clerk: s. 3158, a bill to require congress to lead by example and freeze its own pay and fully offset the cost of the extension of unemployment benefits and other federal aid. the presiding officer: the majority leader. mr. reid: i would object to any further proceedings with respect to the bill. the presiding officer: objection is heard. the bill will be placed on the calendar. under the previous order, the leadership time is reserved. under the previous order, the senate will resume consideration of h.r. 4872, which the c will report. the clerk: calendar number 331, h.r. 4872, an act to provide for reconciliation pursuant to title 2 of the concurrent resolution on the budget for fiscal year 2010, s. con res. 13. mr. reid: mr. president, would the chair report how much time is left on general debate on the

bill. the presiding officer: the majority has 7 hours and 32 minutes. the minority has 8 hours and 30 minutes. mr. reid: mr. president, i would now yield back all time on the bill on the majority's side. the presiding officer: the leader has that right. the time is yielded back.

mr. alexander: mr. president? the presiding officer: the senator from tennessee is recognized. mr. alexander: thank you. i ask unanimous consent to temporarily set aside the pending motion so i may offer a motion to commit which is at the desk. the presiding officer: without objection, so ordered. the clerk will report. the clerk will report. the clerk: the senator from

tennessee, mr. alexander, moves to commit the bill h.r. 4872 to the committee on health, education, labor, and pensions of the senate with instructions to report the same back to the senate within one day, with changes to reduce the interest paid by student borrowers by 1.5 percentage points and to add an offset. idinofficer: the senator from montana is recognized. mr. baucus: mr. president, i wonder if the senator from tennessee would agree to modify his request so that the amendment be set aside -- earlier amendments be set aside until a time designated by the leaders, and that this amendment then be taken up at a time decided by the leaders. mr. alexander: reserving the right to -- mr. baucus: which is the customary practice we've been utilizing on previous amenents.

mr. alexander: mr. president, with respect to the -- i wonder if the senator from montana would permit me to consider that request and then respond -- mr. baucus: i'm sorry? mr. alexander: i wonder if the senator from montana would allow me to consider that request and respond to him in a few minutes. mr. baucus: withdraw your request and make the request later? mr. alexander: if i may consult with senator gregg, then respond; if you'll make the request later, i would be grateful. mr. baucus: okay. mr. alexander: thank you very much. mr. president? the presiding officer: the senator from tennessee is recognized. mr. alexander: mr. president, this is an amendment that 19 million american families -- in which 19 million american families will be interested because it's an amendment to reduce the cost of student loans which 19 million americans have. this is the season of the year when a great many students have been admitted to a college or a community college or making their plans, and they're looking for where they're going to get their money. and what this amendment will do

is reduce the interest rate on 19 million student loans from 6.8% to 5.3%, or on the average loan of about $25,000 a year, it would save that student $1,700 or $1,800 over that period of time. more specifically, it would prevent -- it would not only help the student but it would help -- it would prevent the federal government from overcharging 19 million american college students on their student loans to help pay for the health care bill and other government programs. now one may ask: wait a minute, i thought we were debating the health care bill. how did we get to student loans? that's a very good question, because it just came up over the weekend. of course, we talked about student loans. there have been proposals, but no hearing in the senate, no consideration in the senate committee of which i'm a member. but over the weekend the

democratic majority decided, well, look, while we're at it, let's have another washington takeover. let's take over the federal student loan program. and let's take a program which is working very well, in which 15 million american students have voted with their feet to say we would prefer to get a regular private loan backed by the government which we get our college campuses, through awe community bank, through a nonprofit institution, even though we have an option for a private loan, many students have said we prefer the student loan through private lender. yet, over the weekend the democratic majority has said while we're at it, let's take over the federal student loan program, which means that starting july 1, students have no choice. you go to the federal government to get your student loan -- all 19 million of you, which is a new experience for 15 million of

the 19 million -- and the way you're going to do it -- and this is all going to be shet up in a -- set up in a short period of time -- you're going to go to four call centers on the internet. instead of going to your local lender or nonprofit institution who can encourage you as you make your plans for college, welcome to the new government loan program. you have no choice; that's what you're going to do. what are the other aspects of this? well, one is, other than denying choice to 19 million students on more than 2,000 campuses who prefer the federal loan program, the federal government is going to have to borrow another half a trillion dollars in order to make these loans. let's think about this for a moment. what is the number-one issue that most americans worry about today? it's that we have too much debt. and so what did this weekend takeover do? it adds about a half a trillion

dollars to the federal debt in order to make sthaoupbt loans at the -- student loans at the rate of $90 billion. these are a lot of loans, and so we have a lot of people in these organizations like ed sougtd -- ed south in my state. all of these lenders are out of business. we have one big bank -- the federal government. the education secretary is the new banker of the year. he's a very good education secretary. i don't know how good a banker he's going to be. we lose 31,000 jobs, but here's the rub. here is what my amendment is about. the federal government will be borrowing money at 2.8% and loaning it to students at 6.8% and take the difference and spend it on new government programs, including the health care bill. so we're going to be

overcharging 19 million students to help pay for the health care bill, according to the most recent congressional budget office estimates, it's about $8.7 billion of the overcharged money is going to go to pay for the health care bill. now, my friends on the other side have gotten up. they've already spent the money, of course. they've announced to everybody we're going to spend it on this, we're going to spend it on that, but what they don't tell you is where they get the money, and where they get the money is overcharging students. these aren't wall street tp-pbers we're -- financiers we're overcharging. this might be a single mom going to school in tennessee who has a job, who wants a better job. sheened borrows some money -- she borrows some money to go to the community college, and the federal government overcharges her to pay for some government program. she might not like that. in fact, i think there will be about 19 million student loan holders across the country who will go to school next year and

say wait a minute here, you mean you're overcharging me on my student loan to pay for this health care bill and to pay for other government programs? and the answer will be, yes, that's what we're doing unless you vote for this amendment. now, the estimate by our friends on the other side is that their federal takeover of the student loan enterprise will save $61 billion. if they're correct, let's give it to the students. let's reduce their interest rate. $1,700 or $1,800 per student over ten years, which is a lot of savings, is a lot of money. it may not seem like a lot of money to congressmen or senators in washington but to the single mom borrowing the money, $1,700 or $1,800 is a lot of money. in addition to the higher premiums, higher taxes, medicare cuts, the new cost to states, we're going to be overcharging on student loans. let me use a specific example from tennessee, if i may.

i was at the university of tennessee earlier this week. this is the university of which i used to be president. the university of tennessee has 30,000 students. 37% of them or 11,251 have federal private loans today. the average student debt is about $20,000. after july 1, all 11,000 students at the university of tennessee, with these federal private loans are going to have to switch to the government loans, and the government is going to overcharge 11,000 students who go to the university of tennessee at knoxville and use that overcharge money to pay for new government programs, including the health care bill. they're going to do the same thing to the university of tennessee at martin. there they choose to use the private loan program. they like it better than the government loan program. they think it's more convenient for the students. they've chosen it. 3,600 students at u.t. martin

have federal private loans. they're going to be out of those loans by july 1. they're going to have government loans, and the government is going to overcharge them to help pay for the health care program. a college at which i'll be saturday, they'll switch from private loans to government loans. they'll have no choice after july 16789 i know a lot of these students. they come from modest families in most cases. they're not going to be happy to learn when they switch to a government loan after july 1, and if they have an average loan, that over ten years they're going to pay $1700 to pay for the health care program. at east tennessee state university, it is 8,187 students. in all of tennessee, 200,000 students who are going to be -- who have student loans who are

going to be overcharged an average of $1,700 or $1,800 a year to help pay for the health care program or some other government program. if we're going to take over the student loan program, we're not going to overcharge the students and use it for the health care program. we're going to give the money back to the students. the point of my amendment is very simple. we're going to reduce the interest rate we charge on 19 million student loans from 6.8% to 5.3% and let the students have the saving instead of letting the government have the savings. that's what the other side hasn't told people about the soont loans. now, if -- student loans. if we had ample opportunity to debate this in the senate, if we had a committee hearing on it, if we had taken it through the regular process, we could have pointed it out. no, we did it over the weekend, send it over here, jam it through with breast beating and

look at what we've done count. i'm accustomed to that. i used to be a governor. i remember lots of members of congress who would say, i did a great thing in washington, and then send the bill to me to pay. and then the governor, the health care bill would do the same thing, it would send to governors in the states new costs our governor estimates that it is $1.1 billion to $1.5 billion new costs that state taxpayers will have to pay and as the medicaid kotses goes up -- costs go up, we'll get the second blow to the students of tennessee because either the state is going to have to reduce funding for public higher education, which i believe this health care bill will help permanently damage or they're going to have to raise taxes or they're going to have to raise tuition, or they're going to have to all three. if i'm a student at carson newman or the the university of tennessee, first this health care bill will overcharge me on

my student loan to help pay for it, second it will send such big new costs to the government that the governor will have to reduce covering the college or the university and my tuition will go up. all those students protesting the raise in tuition will they probably don't realize why that's happening. the main reason is that because over the years the federal government has so regulated the medicaid program that state pace a third of, that the state budges have grown and grown and grown, and the governors, such as governor schwarzenegger has had no choice but to cut other programs. and governors know when you get down through the process in state it comes down to medicaid or higher education and so a great the university like the the university of california is on its knees an even hope to -- and to even hope to keep its quality, it raises tuition 34%. my amendment won't help that problem. the law that the president

signed yesterday already will transfer to states these huge new costs that will permanently damage higher education and raise tuition. but what my amendment will do is say we're not going to in addition causing a raise in tuition overcharge 200,000 students in tennessee for their loans an use $800 billion to help pay for health care. sometimes i think, mr. president, the motto of the obama administration is, if you can find it in the yellow pages, government ought to be doing it. i mean, this is really breathtaking. while we're taking over cars, banks, insurance companies, while we're taking over more of health care, we'll just also take over the student loan program. add a half trillion dollars to the federal debt, overcharge 19 million students, cause 31,000 people to lose their jobs and say it's all in a day's work. that's what happened last weekend. just over the weekend that's the decision that they did. and then over here bragging

about how much they're going to do for everybody. well, we're going to do more for everybody if we have a chance to vote on this amendment because you can go home and say, either, i voted to cut your interest rate on your student loan from 6.8% to 5.3% and give you the savings or i voted to overcharge you $1,700 to $1,800 a year and give the money to the government to help pay for the health care bill. mr. president, i would like to include in the record following my remarks a few communications i received from tennessee. here is a letter from vanderbilt the university to congressman kupper, who said that our overarching concern with this proposal is it forces institutionings, including -- institution sincere that it forces to switch -- this is one of the top the universities in the world, they have chosen --

they believe it's best for their students and their campus to have the private loans. and, well, we know better, of course, than vanderbilt the university what's best for the campus an best for the students. we say, no, no, july 1, only the government. vanderbilt opposes the elimination of the ffel program, we encourage congress to carefully study the many alternate proposals including the high level of services, products and debt management we believe would come with this switch. we're very concerned that the proposed time frame is unreasonable and they also -- so vanderbilt opposes that. so does the baptist college of health sciences, so does merryville college, so does diresberg state community college. i ask unanimous consent, mr.

president, to include these remarks in the record and an article i wrote in "the washington post" that was posted on monday, march 7, about the student loan takeover. the presiding officer: without objection, so ordered. the senator from new hampshire is recognized. mr. gregg: thank you, mr. president. i am recognized, right? the presiding officer: that's correct. mr. gregg: thank you, mr. president. i would ask unanimous consent at this time to withdraw the amendment of the senator from -- on behalf of the senator from tennessee i would ask to withdraw the amendment. the presiding officer: is there objection? mr. baucus: mr. president? the presiding officer: without objection, the amendment is withdrawn. mr. baucus: reserving the right to object. the presiding officer: the senator from montana. mr. baucus: mr. president -- the presiding officer: objection is heard. a senator: mr. president? the presiding officer: the senator from tennessee is recognized.

mr. alexander: mr. president, i withdraw my motion. the presiding officer: the motion is withdrawn. the senator from new hampshire is recognized. mr. gregg: mr. president, at this time i yield such time as he may take off the bill -- [inaudible] -- a senator: mr. president? the presiding officer: the senator from tennessee is recognized. [inaudible] the presiding officer: is there objection? mr. baucus: reserving the right to object. what is the parliamentary situation at the moment? the presiding officer: there's a grassley amendment pending. mr. baucus: mr. president, who has the floor? the presiding officer: the senator from new hampshire has yielded time off the bill. the senator from tennessee has been recognized.

mr. baucus: mr. president? the presiding officer: the senator from new hampshire cannot reserve his right to the floor. mr. baucus: mr. president, again, might i ask who has the floor? the presiding officer: the senator from tennessee has the floor. mr. baucus: i thank the chair. mr. alexander: thank you, mr. president. mr. president, could you let me know when 10 more minutes have expired, please? the presiding officer: the chair will do so. mr. alexander: thank you very much. mr. president, i have a little history with the student loan program. i see the distinguished senator from utah is here. when he was the ranking republican on the senate health and education committee 20 years ago, i was the united states education secretary. he helped me with my

confirmation process, which i have been grateful for. he and i worked together during that time when the question of having a government loan program or a direct loan program came up and it was widely discussed we had a republican president then and a democratic congress. and we came to a compromise. and the compromise was to say, let's have both. we'll give students the option and help them stay on -- and keep the organizations on their -- on their toes. so if you're a student at the the university of tennessee, the university of utah, you've got a choice. you can either say, i don't want to fool with all of these private lenders or the local bank or the nonprofit organization in my state, ed south, for the state organization. i want to go straight to the governor. so all students have that. that's 19 million students, and only one-fourth of them choose that. now, in the united states of america, where choice and competition is an important part of our culture, that usually

teaches us a lesson. that would suggest to us that most campuses, most students, by overwhelming majority, prefer being in the private market than lining up to the government, otherwise we'd have the government grocery store or government car program. we're beginning to sound like that. we'd have the government insurance company and all banks would be government banks. everything would be in the government. we used to have a system like that in the soviet union and ours did a little better over time. and generally our motto has been, if you can find it in the yellow pages, the government shouldn't be doing it. what's happening in this administration is the reverse, if you can find in the yellow pages, government should be doing it. here's the situation that developed over the last 20 years. the roughly 6,000 institutions of higher education in this country. many people say, well, all higher education is like the the university of tennessee or harvard or california. but there are many kinds of colleges an the universities,

for profit, nonprofit, private, public, historically black colleges, many different kinds of institutions. and the genius of our system is that we give -- we let federal dollars either through pell grants or through loans follow the student to the institution of their choice. choice and competition in our system of higher education has given us -- has given us, by far far, the best education in the world of those 6,000 institutions, last year, 2008, 4,121, chose to use the regular student loan program. that's three out of four. one out of four used the government loan, the direct loan program, the one that everybody's going to use now. currently there are 2,000 lenders that participate in the student loan program, they're banks and and nonprofit institutions like ed south in tennessee. last year nearly $100 billion in

student loans were made. let's keep in mind as the government takes this over, we go from a system where we have government-backed loan, which cost the taxpayers very little to government loans at rate o of $100 billion a year, which means we're going to have to run up a half trillion dollars more in debt at a time when our debt is ridiculously out of control. that's this weekend washington takeover that -- that just occurred. there's not definitive evidence to suggest that the federal government can make these loans better than lenders can make these loans. i don't think the department of education has the manpower to do it. i think by july 1 there will be consster nation from all over the country from families who applied for student loans and are applying through their federal call center or through their -- or through the internet. ed south, a nonprofit provider in tennessee, for example, has

provide regional outreach counselors who provide career training. they made 443 presentations at tennessee schools to help students understand. remember, we have 200,000 of these students in tennessee to help them understand their options. they worked with 12,000 students to help them understand what they could do. they worked with 1,000 school counselors. well, the u.s. department of education soon be providing all of these services. so senator gregg, earlier, had written the congressional budget office asking how much money this federal takeover would save. they came back with an explanation that it's no not $67 billion or $61 billion which is the current number being used today, but more lik like $47 billion. my own suspicion, and i can't prove it, but my own suspicion, having been a the university president, having been secretary of education and having watched

this program for 20 years is that they're in the real world the federal government is not going to make these 19 million loans more convenient for students. it's not going to be able to do it any cheaper. it's just going to deny people choice, run up the debt, throw 31,000 people out of jobs, and the icing on the cake, and it is a sour tasting icing is that the 19 million students who have student loans after july 1, are going to be overcharged by the federal government, who will be borrowing money at 2.8%, loaning it at 6.8% and using the money to help pay for the health care bill and other programs. our friends on the other side, they'll be saying they like to blame everything on the bankers or lenders. the lenders are charging too much money. if they're charging too much money, reduce what they get. reduce what they get. you're saying there is a $61 billion savings, much of which comes from the fact that the

federal government can borrow money more cheaply than private lenders can. but then you're saying we're going to take the savings and we're going to spend it. we're going to overcharge these students. i can't believe the brazenness of this. and neither will i believe 19 million students understand it. so, mr. president, i'm glad to come here today and talk about my amendment, which i'll be glad to introduce at the appropriate time. no senate bill has been introduced. our committee has held no hearings. we've not had a markup of this bill. this is just a wonderous washington takeover over the weekend. we stick into the health care bill another washington takeover, this time of 19 million student loans. and on top of it, congratulations mr. and mrs.s work student. you're going to get to be overcharged on your loan to help pay for the health care bill and other government programs. i hope my friends in the senate on both sides of the

aisle will see the injustice in this and say okay, you're right, senator alexander. if we're going to take it over and create $61 billion in savings, at least let's give the students the savings. let's not give it to the government let's not overcharge the students on an average $25,000 loan, $1,700 or $1,800 over ten years. if we do, we need a truth in lending stamp that goes on every student loan starting in july saying warning your government is overcharging you in order to help pay for other government programs. we'll let the single mom who has got a job, who is going to school to help improve her circumstance, see what she thinks about the idea of her being overcharged to help pay for other government programs. so my amendment, when it's voted on, will do a very simple thing. it will say to the 19 million students in the country, we're going to reduce your tr-t on your student -- interest rate on your student loan from a typical

6.8% to 5.3%. that's going to save you $1,700 or $1,800 on an average loan. and it says, mr. president, we're not going to overcharge 19 million students to help pay for the health care bill. mr. president, before i yield the floor, i'd like to -- i see my friend from new hampshire is engaged in conversation. i wonder if i could address the senator from new hampshire through the chair. before i yield the floor, i wanted to ask through the chair whether that is what i should do to the senator from new hampshire. mr. gregg: mr. president, i'd like to ask the senator from tennessee a question on the substance of his proposal because i do think it's an important propose. as i understand it, what the senator is saying is that they put this baggage on this train, which is the nationalization of

all the student loans in this country. the government is going to take them all over, which will be the fourth major nationalization event that this administration has undertaken. first they nationalized the auto industry. now they're in the process of kwau -- quasi nationalizing the health care industry. if the house reform bill passes they'll be nationalizing the finance industry. my question to you is they threw this proposal on the train, nationalizing the student loan industry. in order to use student loan money to finance the health care bill because this bill would have violated the budget rules if it didn't have the student loan money basically paying for it? mr. alexander: mr. president, i'm afraid the senator from new hampshire is exactly right. according to the congressional

budget office's updated estimates, $8.7 billion of this money that's being overcharged students will be used to help pay for the health care bill. the other money, except for a small part, will be used for other government programs. so you're right. on both counts. just one washington takeover after another. that's why i'm saying i think we ought to hide the yellow pages from these fellows. they find something in there being done in the private sector, they're going to say we can cut out the profit. we can cut out the business. why doesn't the government do it? second, this is an astonishing thing to me. these are wall street financiers going to the community colleges in new hampshire and tennessee. these are people with jobs who are trying to improve their life. their student loan levels are already too high. we're all worried about that. so we're going to take another $1,700 or $1,800 on a $25,000

average loan over ten years and say we're going to overcharge you and we're going to use that in the government. the answer is yes to your question, senator. $8.7 billion of the money taken from students by overcharging them on their student loans will go to help pay for the health care bill. mr. gregg: if i can ask a further question of the senator. f. they didn't have that $8.7 billion money of student loan money being used to finance the health care bill, this reconciliation would fall, would it not, because it would not meet the budget instructions of having $1 billion of savings? mr. alexander: the senator is correct. mr. baucus: mr. president? mr. president? mr. gregg: the senator had a further question about whether the floor could be used. we're in the middle of a unanimous consent agreement. mr. baucus: i would like to ask the senator from tennessee a question. mr. alexander: i'll be glad to have a question. mr. baucus: isn't it true, senator, that the congressional budget office stated march 20,

commenting on the bills in a letter to the speaker, on page 13, states "so the title as a whole" -- referring to the education title. states "the title as a whole would reduce budget deficits in both the ten-year projection period and subsequent years." isn't that true that the congressional budget office reaches that conclusion, so states the letter of march 20? mr. alexander: mr. president, i don't have that letter in front of me, and i don't know what that has to do with my amendment. what i'm saying is that the democratic majority is deliberately overcharging 19 million students to help pay for the health care bill. those are congressional budget office figures, not mine. mr. gregg: mr. president?

mr. alexander: mr. president, i still have the floor, and i will ask through the chair to the senator from new hampshire whether i should at this point yield the floor. mr. gregg: i appreciate the senator from tennessee's courtesy. and at this time we are ready to go forward with the unanimous consent request. mr. alexander: i thank the senator, and i yield the floor. mr. baucus: mr. president? the presiding officer: the senator from montana is recognized. mr. baucus: mr. president, i want to propose a unanimous consent request. following that, i'll state my intention on the order of votes, of which i have yet to clear with the leader's office. the proposed consent is i ask consent that the total time on the bill be divided equally between the majority and minority leaders or their designees and that the offering of amendments not add additional claims to the time. the presiding officer: is there objection? mr. gregg: the next amendment on our side will be offered by senator hatch. the presiding officer: is there objection?

without objection, so ordered. mr. gregg: mr. president, i would ask further unanimous consent -- pwau mr. president, i just want -- pwau mr. president, i just want -- mr. baucus: mr. president, i want to finish up that business. mr. president, i might say my intention, i'm not asking for a consent agreement. it is my intention that the order of amendments would be the gregg amendment, beginning with the gregg amendment medicare, mccain target provisions, then the the crapo amendment on taxes, the enzi motion to committee regarding employer mandate, the barrasso amendment regarding premiums, next the grassley amendment regarding executive personnel should be in the exchange. mr. gregg: what the senator is asking is that the voting order be in the order that they were offered? mr. baucus: that is correct. that's my intention, but there's

no request at this time. mr. president? mr. president? the presiding officer: the senator from montana is recognized. mr. baucus: mr. president, i yield ten minutes to -- mr. gregg: may i just make a point? i spoke inappropriately. i believe the senator from tennessee will want to submit his amendment back for the record. he had withdrawn it. could we do that? i would ask unanimous consent that the pending amendment be the senator from tennessee's amendment. mr. baucus: mr. president? the presiding officer: is there objection? mr. baucus: reserving the right to object. mr. president, i might ask if the understanding be that the motion -- earlier amendments, that this motion be set aside until a time to be determined by the leaders. mr. gregg: why don't we make that on every amendment that we offer? mr. baucus: that would be fine. that would be fine. the presiding officer: is there objection? without objection, so ordered. mr. baucus: mr. president?

the presiding officer: the alexander motion is pending. pwau mr. president? the presiding officer: -- mr. baucus: mr. president? the presiding officer: the senator from montana is recognized. mr. baucus: mr. president, i yield 15 minutes to the senator from michigan. the presiding officer: the senator from michigan is recognized. mr. levin: mr. president, the debate which will come to a close this week has in one sense been going on for a year, but in another sense it's been going on for a century. in 1912, theodore roosevelt campaigned on the promise of a national health insurance program. workers, theodore roosevelt said, are entitled to a basic standard of protection from injury and illness -- quote -- "wherever such standards are not met by given establishments or given industries are unprovided for by a legislature or balked by courts, the workers are in skwr-pd. the progressive -- are in

jeopardy. the progressive employer is penalized and the community pays a heavy cost in lessened efficiency and misery." since teddy roosevelt said that, presidents and members of congress from both parties, seeing the same costs that theodore roosevelt saw in the failure to assure health care for all, have grappled with this issue. these attempts at reform have largely fallen short. they floundered for many years. health care is personal and complex. the timing was wrong or the politics were difficult. leaders on all sides failed to find the compromises that would have enabled them to move forward. but the recurring theme is that time and time again reformers have failed to overcome the enormous obstacles that those who profit from the status quo have been able to erect. and because we have fallen short in the past, americans today face a health care system that

costs too much and too often delivers too little. in our united states today, mothers and fathers wonder what else tech cut from the family budget to afford yet another increase in their health care premiums. parents file for bankruptcy because their insurance fell thousands of dollars short of providing for a child's lifesaving treatment. nearly two-thirds of the bankruptcies in this country involve medical costs. and more than half of those involve people who had insurance. small business owners eliminate health coverage for employees because they can't afford another year of massive premium increases. and thousands of americans who woke up this morning with health care insurance will go to bed tonight without it. despite those tragic facts,

entrenched interests have sought again to prevent reform, to consign our nation to an unsustainable status quo because what's good for the american people will not necessarily profit some company. the health insurance industry is dominated health care decisions in this country for too long. how often have constituents come to us with stories of insurance companies that deny them coverage of necessary treatment? how often have our constituents told us of an insurance company that denied coverage because of preexisting conditions or canceled coverage because of minor inaccuracies that the company conveniently discovered just after diagnosis of a serious and costly illness? it is time to end the unhealthy dominance of the health insurance industry. and so i'll cast my vote again against those entrenched interests. and my vote will be for health

care reform. and i hope our colleagues will do the same. we have the opportunity to finish the task of overcoming the entrenched opposition to, do what so many presidents and so many members of this body have fought for for decades to accomplish. the months of debate have been difficult. they have too often been filled with too much heat and too little light, with exaggeration, half-truth, untruth, with innuendo, designed to obscure rather than to inform. that's no different in many way from previous debates on major reforms. when congress approved social security in 1935, a republican senator warned that it would -- quote -- "end the progress of a great country." when medicaid was debated in 1965, one critic charged that cooperateing with the plan would be com evil.

now we get more scare tactics, a number of our republican colleagues continue to claim that this is a big government takeover of health care. well, the american medical association supports this health care plan. surely the american medical association is not a supporter of government takeover of health care. then we're told that this will hurt medicare. and, yet, the association that represents more seniors than any other, aarp, endorses this health care plan. so the scare tactics are coming at it again, but there's a difference. that while scare tactics were able to derail health care reform in the past, scare tactics are just not working this time.

the american people have expressed their disapproval of wild, inaccurate claims in many ways, including personal conversations with most of us. it is true that because health care is so complex, because changes must be phased in and transition periods are often necessary, many of the benefits of this bill will not take effect for some time. but improvement in health care for millions of americans will take place almost immediately. after president obama signed this bill into law, small businesses immediately get a tax cut to help defray the costs of providing insurance to their employees. within three months of the signing yesterday the bill will allow people with preexisting conditions to access a special fund to help cover the gap until insurance exchanges where they can obtain coverage become

operational. and retirees will be able to qualify for an insurance plan to help lower costs. in october the federal government will help states setup agencies to help consumers choose new health plans or to challenge unfair decisions by their current insurance plan. eventually those agencies will help consumers enroll in insurance exchanges that will help millions of people find dependable coverage that meets minimum quality standards at a price that they are more likely to afford. and within six months of the president's signature yesterday, insurance reforms will begin to take hold. new health plans will be required to let women see an afternoon g/gyn without insurance company approval, they will be prohibited from denying coverage to children based on preexisting conditions, and require to allow children to allow on -- remain on their

parents' policy until age 26. they will have to, those insurance companies, to provide preventive care without co-pays or deductibles and they will be barred from setting lifetime coverage limits. those are historic improvements in our health care system will take place in the first six months after enactment of this legislation. more sweeping changes will come with full implementation of this bill's provision. we will protect all americans of all ages of denial of coverage based on preexisting condition, from exorbitant out-of-pocket costs an confusing and opaque language that disguises the cost or scope of coverage. we will require insurers to give their customers a rebate if these insurers done spend enough of their revenue on patient care and we will fill medicare prescription drug doughnut hole that hurts so many seniors. so at its heart, mr. president,

this bill and its improvements in this reconciliation effort aims to tackle the central problems of our health care system. rising costs and the insecurity that many americans rightly feel about the lack of dependability of their insurance. the cost of health care already exceeds the ability of many american families to pay will price more and more families out of the system if it continues to rise. and will present enormous problems for the federal budget if not contained. we can and we will make the health insurance system work for those who already have coverage by holding down those unsustainable increases in premiums and in ways large and small we attempt to tame this beast that threatens to swallow our family budgets and our federal budget. how are we going to do this? and i would ask the chair how many minutes do i have remaining? the presiding officer: the

senator has 5 1/2 minutes. mr. levin: i thank the presiding officer. even though health care experts believe that these measures are going to help lower costs for families and the government, the congressional budget office that is not even taking into account the savings which will come to exist by ending wasteful subsidies to insurance companies using medicare advantage, by requiring medicare advantage to spend at least 8% of revenue on ben -- 85% of revenue on benefits and other kinds of benefits. some of those savings cannot be figured out precisely by the congressional budget office. they are prudent. they don't take those savings into account. but what they do obviously take into account and do count are the reductions which will lead the savings -- the savings which will lead to $140 billion in savings for the federal budget in the first 10 years an

and $1 trillion over the next decade. those savings are real savings. those are savings which they can figure out in cost and including we are going to subject investment income of the nation's wealthiest families with incomes over $250,000 to the medicare tax. we're going to impose a moderate medicare tax increase on those that have that kind of earned income over a quart -- $250,000. this bill cracks down on artificial financial structures. and i commend the finance committee for this. senator baucus and his colleagues, they are cracking down on artificial financial structures with no economic substance whose only purpose is to allow their users to avoid taxes. the finance committee has strug wld that issue for years. they -- struggled with that issue for years. they have succeeded in doing this. we pick up an awful lot of revenue that is owed to uncle

sam by ending this kind of loophole which has allowed wealthy individuals to avoid paying taxes through the use of artificial financial structures that have no economic substance, whose only purpose is to avoid paying income taxes. and so, mr. president, we'll take an enormous step with the passage of this reconciliation bill joined with the bill which the president signed just yesterday. leaders of our country, from franklin roosevelt to harry truman, richard nixon, ted kennedy have fought so hard for these kind of reforms. we are finally going to provide health insurance to millions of americans who do not now have it. and we're going to protect those workers which teddy roosevelt warned nearly 100 years ago were in jeopardy unless every american had health insurance. the opponents of reform are vocal, they're strident.

we're going to hear amendment after amendment being offered in an attempt to derail this effort. i hope our colleagues will answer history's call and make real and lasting changes that these bills provide and will improve the lives of our citizens in ways that we've been struggling to do in this senate for decades and long before many of us got here. for to this who continue to oppose reform, let me ask some questions, isn't it long overdue to end discrimination based on preexisting conditions? the american people believe we should. so do i. isn't it longover due, i ask, to end the insurance industry practice of rescissions, the denial of coverage to those who paid for it? well, the american people believe that we should and so do i. shouldn't we do something about the thousands of americans forced into bankruptcy because of health expenses even though though have insurance that they thought would protect them is

this? -- protect them? the american people believe they should and so do i. shouldn't we take steps to rein enormous health care expenses, expenses that could put health care out of reach for more and more americans. the american people think we should and so should i. shouldn't we clear the way for 32 million americans who do not now have health insurance to obtain it? the american peep. believe we should and so do i. i hope we join together this week and do what so many before us have tried and unable to do, to reform a system that leaves so many of our fellow citizens in jeopardy. and i urge the approval of this bill, this essential reconciliation bill that has been passed by the house as a part of a package of historic legislation and to finish the task of bringing landmark change to american health care. i yield the floor.

the presiding officer: the senator from montana is recognized. mr. baucus: mr. president, i ask consent that senators warner, udall, tom udall, and mark udall and shaheen and senator merkley be allowed to engage in a colloquy for up to 25 minutes. the presiding officer: without objection, so ordered. a senator: mr. president? mr. president? the presiding officer: the senator from virginia is recognized. mr. warner: mr. president, as we approach the end of this long journey, or at least the end of the first step of this long journey, i and a number of my other freshmen colleagues are going to come down one more time to the floor to engage in a conversation for a few moments about what this health care bill

will mean to our constituents and to the people of the united states. i'm going to talk about some of the causes of how we got here and some of the consequences of what would happen if we don't act and at the end i'm going to add some comments about how we make sure that we implement this bill in appropriate fashion. recognizing that the hour is late and colleagues have got other items, i'd like to, first of all, ask my good friend, the senator from illinois, senator burris, if he would like to give a brief recap of why he has been a firm supporter of this legislation and why he thinks this bill is so important not only to the people of illinois, but to the people of the united states. mr. burris? mr. burris: thank you very much, senator warner. senator warner, i want to compliment you for keeping us freshmen engaged and involved and making sure that we get the message out to the american people. this piece of legislation, which

was signed yesterday by president obama is historic. and i am so proud and -- and appreciative that i had -- an opportunity to play a part in this. as you know, my position was a very, very strong public option. i say that those issues are in there when we deal with cost and accountability and for the insurance companies and, therefore, it is a major piece of legislation which we want the public to really and you can re. we want the public to understand that there will be benefits that they will get tax credit right away. and these tax credits can total as much as 35% of tote. premiums. secondly, for our children who have no elimination for preexisting conditions, within the next 90 days these provisions will kick in on behalf of children. so there are a lot of good things in this bill that's going to benefit all of us in america.

that's been trying to do this over 97 years. i say to my colleagues on the other side, the reconciliation bill is certainly important to make some -- some corrections and the battle that they're waging. not from a standpoint of policy, but strictly from a standpoint of politics. seeking to make failure out of this issue is not fair to the american peep. the mis -- people. the misinformation is not fair. not only do we get immediate benefits, but the long-term benefits of this legislation is also very helpful. the situation of dealing with preexisting conditions in 2014 when that kicks in -- i remember when my daughter was changing jobs and she needed to get insurance because she had a headache problem, they wouldn't even insure her. i had to battle to get some insurance for my daughter. so it's good. it's good legislation much it's history, and i just want the american people to know that it's in the books and we're going to make the corrections

and the people will go forward. thank you, mr. chairman. it's my pleasure to join in the colloquy. mr. warner: thank you, mr. burris. i know how hard you fought for this legislation since day one. this legislation is going to have wide ranging effect for people all across the nation. but i -- i now know my colleague, the senator from north carolina, north carolina and virginia are neighbors. we both share a number of small businesses. we have a vibrant entrepreneurial flavor in virginia and north carolina. i know senator hagan has been concerned not only on the overall effects of health care but particularly how it will affect small businessness her state. i would like to ask senator hagan to tell us how this bill will affect small businesses in her state of north carolina.

mrs. hagan: the bill that was signed into law yesterday is getting us on that track. the new and historic law combined with the bill we're considering in the senate now is going to reform our health care system to reduce the cost and improve patient care for those families in north carolina and in virginia and families across america. in 1996, the average premium in north carolina for a family of four was $6,000. today that's $12,000. it's projected in 2016 to be $24,000. people cannot afford that. that's why we need to have change. after decades of working to fix a broken health care system, this law controls the exploding costs, increases access to care and reduces our long-term deficit, which i know we're very concerned about, by as much as $1.2 trillion over the next 24 years. health care reform will improve

access and the quality of health care for millions of americans. in north we have 1.7 million people without insurance. they will now have access to a family doctor. this bill provides immediate benefit to small businesses, middle-class families and seniors in north carolina. the small business owners that i talk to, they want to provide coverage for their employees, but the costs are prohibitive. this month i received an e-mail from a small chiropractic practice in eastern north carolina that had to drop its health plan for its employees because the rates doubled over the last two years. but starting today 112,000 north carolina small businesses will be eligible for tax credits to provide health care to their employees. within the next six months, hard-working middle-class families will be able to add their children up to the age of 26 on to their health care plans. this will benefit about 870,000

young adults in my state. this year insurance companies will no longer be able to deny coverage to a child for a preexisting condition such as asthma and diabetes. and that means insurance companies will no longer be able to drop your coverage because you get sick or because you filed too many claims n. north carolina, 1.4 million seniors will receive preventive services with no additional costs, 250,000 seniors will have their drug costs in the doughnut hole immediately reduce and eventually eliminated. i'm proud of these immediate benefits in our effort to reform the health care system over the long term. the health care reform effort would not have been possible without the work of tenacious capitol hill staffers. i personally want to thank two incredible health care staffers on my team: michelle adams and tracy sevinich who worked

countless hours for reform in our country. thank you, senator warner. mr. warner: thank you, senator hagan. appreciate your leadership on this issue. i again also appreciate your recognition of not only the members who have been struggling with this bill for almost a year, but the staff members who help us put together the facts, put together the case studies, help us crunch the numbers as we try to make sure we get this right. i now want to call on my friend, the senator from alaska. one of the things that the freshmen have always said, mr. president, as we've come to the floor over these months, we've pointed out that the price of doing nothing is extraordinarily high to our economy, to our families, to our businesses, and that the status quo is just not sustain afpblt i know, senator -- sustainable. i know, senator begich, this is a theme you've echoed on the floor. as we come to the closing hours, if you could share with us one

more time why you think the status quo is not acceptable. what is the cost of doing nothing and how this will affect the great state of alaska. mr. begich: thank you or your leadership especially as we worked on the cost containment piece of the legislation. over the next few days we're focusing on making a bill better; a good bill a little bit better. the president signed yesterday landmark legislation moving health care reform into law. over the next few days, again, we're going to work on making that bill a little bit better. you're going to see clearly the differences. you're going to see our side of the equation has worked hard on this legislation, who voted for health care reform, who are on the side of american families, not on the side of the insurance industry. we're on the side of seniors who will see lower prescription drug costs, because reform is going to work in that direction. and not on the side of big drug companies. we're on the side of american small business, not business as

usual. i was truly proud to pass and vote for that legislation last december. as mentioned already this morning, there are many benefits that occur right now, this year. this year, for example, there is help for small businesses, as you've just heard. immediately firms with fewer than ten workers get a tax credit worth 35% of what they will spend now on health insurance. it will eventually ramp up to 50% tax credit and firms up to 25 workers will get partial credit. small business is truly the backbone of alaska, the business community and this country's business community. that is immediate benefit today. coverage for preexisting conditions: within three months people with preexisting conditions and no insurance will get help. a $5 billion fund is being set up to provide them with affordable coverage. coverage for dependent children -- within six months parents will be able to extend their policies to cover their

dependent children up to the age of 26. some of these points you've already heard, as i've said this morning, but it's important to receive it because i think in the noise over the last year and a half a lot of it got lost. another and a very important one -- free preventive care. within six months all insurance plans must provide free checkups. this includes seniors on medicare. and there is much, much more when you look at this legislation. for my own state, the bill addresses many specific concerns that i've heard in alaska. they include several of my amendments, including a panel to improve federal health care in alaska. increased loan forgiveness for thousands of new primary care providers and adding funding for community hospitals. we also as a team here, as freshmen, have a cost containment amendment which increases value and innovation in the health care system. as mentioned earlier, let's not forget it is a deficit reduceer. in the first ten years $143 billion.

in the next ten years $1.3 trillion in deficit reduction. and this bill is paid for. paid for. these are many of the improvements. again, these improvements will save lives, add 32 million people, those uninsured, making sure they have coverage, save seniors prescription drug costs by closing the doughnut hole. save families by providing relief by helping them afford health care. it has been an enormous time in this last year and a half working on this. i also want to say the next three days will be also tedious and confusing, i think, to the public. because what you will see on the other side is every imaginable amendment that we would love to see. many of them we probably would love to vote for. i'm not voting for any of them because the whole tactic is just to delay this delivery to ensure that people who want a family doctor won't get it, to protect the insurance companies instead of what we're trying to do, make sure people get a fair shake from their companies. so you're going to see that over the next three days.

and i think what's important for us is to remind americans, alaskans in my state why this bill is important. it helps small business, families, seniors. it does it now. it's important. it's important for us to get it done. but don't be fooled by the next three days of what goes on on this floor. we have passed health care reform. all we're doing now is making this bill better and a good bill better. thank you, mr. warner. mr. warner: thank you, senator begich. thank you for your comments. thank you for your leadership, particularly on the series of freshmen amendments that dealt with cost containment. if time kpweufts after my colleagues -- exists after my colleagues speak, i want to go back to that issue. i want to ask my good friend from oregon a question. no one has come to this body with more passion about making sure that working families get a fair break not only in health care, but in the world of financial reform and issues that cut across the spectrum. i know that one of the issues that senator merkley, you have worked on tirelessly throughout

this whole conversation is how to make sure that oregon families get that fair break, get that fair shot. how do we make sure that health care is affordable. i'd like to you share with our colleagues and those americans who are home watching what this health care bill does to help those middle-class americans, middle-class oregonians, make sure they get that fair shot, fair break in health care reform. mr. merkley: thank you, senator warner. it is a pleasure to join my colleagues on the floor. i know when all of my colleagues go home they hear stories from their constituents about our broken health care system. and that's certainly what i hear. i hear it in my town halls. i hear it on the street as people stop me to share their story. and i certainly hear it in my mail. these are just a few of the stories that citizens in oregon have sent to me. and just give you a sense of the type of frustration that we're hearing. last year, don writes, "my premium went up 65% even though

i made no significant claim against my policy." or we can turn to jane who says, "we are subject to being turned down for health insurance because i have a chronic illness." or to adrian who observes that the medical debt was crushing, and we were forced to file for bankruptcy. or to amanda who says, "my daughter cut her finger. i took her to emergency. the hospital is a network provider. the e.r. physician said she needed surgery. okay, what do i know? they are the experts. it turns out the surgeon was not a network provider. she billed me over $9,000. i have little hope. do i file for bankruptcy?" or art, who says, "in less than five years i had to change my health insurance five times. it was never a matter of choice. i simply had to take whatever plan my employer decided to

offer." or dagney who observes, "when i started to fill out my insurance, i had questions such as 'have you ever had? for instance, i had asthma," and goes on to describe his challenges. the list goes on and on and on. and that's why we're in this health care dialogue. because we need to fix a health care system that is broken for working americans. now, the bill that we have passed and the president has signed has three terrific things: it creates state-based markets for health care policies where consumers can shop for the best policy. and these markets will increase choice and competition. second, the bill ends insurance company practices that victimize our working families, practices like turning people down for preexisting conditions or dumping them off of their policies when they're injured or

when they have a disease. and, third, it invests in our provider workforce to counter the rapid retirement of baby boomers. out in oregon, we're going to lose 20% of our primary care physicians in the next five years, while many of us as baby boomers ourselves, are going to need more health care. so those things are huge challenges. this bill takes a stride that's very significant. and this week we will work to pass an up-down vote on an up-down vote pass a bill that will make further improvements to the bill that the president signed just yesterday. i'm pleased to join my colleagues in this fight to repair a broken health care system that just isn't working for our working citizens. thank you. mr. warner: thank you, senator merkley. thank you for sharing also those stories from real folks who are dealing with the current broken health care system, the enormous stress, challenge and burdens

that our current system places on those families. i think we take a giant step forward -- the president already has -- by signing into law the bill yesterday. we will continue that step with passing this reconciliation bill later this week. i'd now like to call on another one of my colleagues, senator tom udall from new mexico. senator udall has, again, along with all the other freshmen colleagues, been a leader in this fight. he's particularly taken on the issue of prevention and the fact that we have a health care system in this country that's more a sick care system than it is a wellness and prevention system. i'd like to hear from him, from senator udall about how this bill is going to affect the good folks of new mexico. senator udall. mr. udall: mr. president, and thank you, senator warner. thank you for leading us so much and pulling us together in this freshmen effort. it's been a pleasure to work with all my fellow freshmen senators here on the floor again and to join them right now. last fall we gathered regularly

in this chamber to fight for health care reform. as a group, we helped lead the charge to make quality, affordable health care accessible to all americans. yesterday the change we have been fighting for became a reality with president obama's signature, health care reform is now the law of the land. this moment has been a long time coming. teddy roosevelt first called for health care reform nearly a century ago. his banner was taken up by a long and distinguished list of man and women who advocated for change. for too many years new nextians, like americans -- new mexicans, like americans across the country, have struggled to find health insurance. they struggled to hang on to policies to get more expensive and restrictive every day. with this reform all of that begins to change. no longer will insurance companies be able to

discriminate based on preexisting conditions. no longer will they be able to dramatically increase rates without public scrutiny. no longer will 32 million americans worry every day about what would happen to their families if they get sick or are in an accident. i'm proud to have fought for and voted in favor of this historic legislation. yesterday we began taking back control of our own health care. today the journey continues. and i pledge to continue fighting every day to ensure new mexico families and small businesses have the security and stability that comes with access to quality, affordable health care. the reason i fought so hard for reform is simple. for my constituents, the status quo is not an option. so it's the people of new mexico i'd like to talk about today. they are the reason i stand up every day and fight for comprehensive reform.

people like katherine. katherine lives in clayton, new mexico. we met last year when we attended one of my health care town halls. katherine worked hard all of her life. she had affordable insurance through her employer, but since she retired, katherine's health insurance premiums have risen dramatically from $110 a month when she was working to more than $800 a month today. katherine's insurer recently denied a claim for a treatment she received. now on the top of skyrocketing monthly premiums, she also owes about $4,000 in medical bills. that's more money than she receives from five months of pension payments. as katherine, herself said, it's unsustainable for me and i know i'm not the only one. i'm just looking for some relief not just for me, but for all

those people coming behind me. to folks like katheryn, i say relief is coming. this reform will make health insurance more affordable by placing caps on out-of-pocket medical expenses. it would make it more affordable by providing premium assistance through tax credits for low and moderate income families. i'm fighting for new mexicans like kathryn, and i'm also fighting for new mexico small business and for entrepreneur like arvind. arvind has owned a small business in albuquerque for more than a decade. as a boss, he made a priority to provide his employees with good benefits. for years he paid 100% of his employees' health care premiums. but he's not sure how much longer he'll be able to do that and stay afloat. you see, for the past few years arvind's insurer has increased his company's health care

premiums by between 30% and 40% every year. and there's nothing arvind can do about it. as arvind said, we've got no bargaining power. we've got no leverage. i'm insuring maybe a dozen people at my company here. it's very hard. the insurance companies give you a 30% or 40% increase and that's what you get. it's too big a bite. to small business owners like arvind and their employees, i say relief is coming. this reform will help small businesses by making it more affordable for them to offer coverage for their employees. we do this by providing tax credits for up to 50% of premiums and by creating small business health exchanges to build a larger employee pool. in new mexico the vast majority of our insured are employed, but

they and their employers can't afford coverage. these new tax credits will help our small businesses provide insurance for their employees at a cost that they can afford. and with that, i would ask unanimous consent to include remaining remarks at this point in the record and yield back any time that -- to senator warner. mr. warner: thank you, senator udall. i know our time is running out. just a final comment i'd like to make is that -- as many of my colleagues know, i hon of serving as governor of virginia before becoming senator. and one of the differences, i think, between an executive and legislator as a former executive, i realize that passing the bill is just the first step. what really happens is going to be the implementation afterwards. and the appeal i'd make, particularly to my colleagues on the other side, is i agree with some of their points we don't go far enough on cost coin trainment. that there's -- containment. that there's a lot of things in

this bill to grant the secretary to start experimentallal programs on cost containment and bundling payments. how this bill is implemented is where the rubber hits the road. i believe there is more we can do with cost containment. i hope in the coming weeks and months that rather than appeal, they will come together with us to make this legislation work. i yield president? the presiding officer: the senator from montana. mr. baucus: i would like senators to know that we intend to alternate blocks of time, roughly half-hour each time. i ask consent that the next half-hour be under the control of the republicans and the half-hour thereafter be under e control of the majority. the presiding officer: is there objection? without objection, so ordered. a senator: mr. president? the presiding officer: the senator from florida. mr. lemieux: mr. president, i ask unanimous consent to temporarily set aside the pending motions and amendments so i may offer an amendment at the desk. the presiding officer: is there

objection? without objection, so ordered. the clerk will report the amendment. the clerk: the senator from florida, mr. lemieux, proposes the amendment number 3586. mr. lemieux: mr. president, i k to dispense with the reading of the amendment. the presiding officer: without objection. mr. lemieux: mr. president, i rise in support of the amendment that i'm filing today. i want to thank my colleague from virginia who asked us to think about the practical aspects of this health care reform. i just listened to my freshmen colleagues on the democratic side talk about all of the good things in their opinion that this bill is going to do. and, you know, there's one i didn't hear them speak about. i didn't hear them speak about the fact that half of the new people who are going to be covered by health care in this country, some 16 million of the 30-some million who have the opportunity for health care under this law are going into medicaid. and the practical impact that my friend from virginia asked us to think about is that our states

right now are finding themselves in bankruptcy, realistically, because of the obligations of medicaid. our states, unlike the federal government, have to balance the budget. medicaid is a program that the states pay some 50% of. and they can't make it work. we're finding out in florida right now that this program -- this new law will cost florida $1 billion in the text 10 years. and because they balanced their budget and because they can't print money, that means the dollars will go away from teachers, away from students and away from police. but the point i want to make sheer and the amendment that i'm offering is this, several times, mr. president, as i've been on the floor, and heard from my democratic colleagues, they have made this point: why shouldn't the american people have the same health care that we in the congress enjoy? why shouldn't they, like all federal employees, be able to

pick from a comprehensive and rich plan of benefits in order to take care of their health and the health of their family? well, mr. president, that's a good point. but what's going to happen to these 16 million new americans? they're going to go on medicaid. that's not the plan we have. that is not the rich benefits that the members of congress enjoy. medicaid, health care for the poor, which will now have some 50 million americans in it after these 16 million join it, is a program in crisis. it's a program that is failing. and let me give you some real-world examples. right now we know that patients on medicaid can't find doctors who will treat them. we know in california, for example, 49% of family physicians do not participate in medicaid. i entered this document into the record last year, "the seattle times" on march 17th reports,

that walgreens will no longer take new medicaid patients in the state of seattle. "the new york times," on march 15th, reports about mrs. volet, she's in flint, michigan, she has cancer. for two years she's been receiving treatment, but now her doctor is dropping her from medicaid. he says, after a while you realize that we're really losing money on seeing these patients. not even breaking even. we're starting to lose more and more money month after month. all across america health care providers are dumping medicaid. and we're about to put 16 million new people. so i'm going to take a page from my friends on the other side. because they say the american people should have the same rich benefits that we should have. what i'm proposing today in this amendment is that 535 members of

congress should have the same benefits as these 16 million new people and thesemillioredent, us amendment the members of congress will go into medicaid. if it's good enough for 50 million americans, it should be good enough for us. so i've offered amendment 3586, it will require that the benefits that are paid for health care by the federal government for the 535 members of congress go to the state medicaid agencies. and then we all can enjoy this program that 50 million people in america are struggling with. if it's good enough for 50 million americans, it's good enough for the members of congress. and i'd like to call upon my distinguished colleague from arizona, who i know wants to speak on this issue as well. mr. mccain: mr. president, i ask unanimous consent in engaging in a colloquy with the senator from oklahoma, the senator from florida, an myself. the presiding officer: without objection. mr. mccain: mr. president, i strongly support the amendment. let me also, just for a moment,

point out where we are here. where are we now that all of the champagne has been drunk and all of the celebration has gone on on the inside the beltway entitlement and the adoring need aiment we have a deficit o of $1.4 trillion. we have a 9.7% unemployment. we've got beginning right away half a trillion dollars worth of medicare cuts will take place over the next 10 years. a half a trillion dollars beginning right away. a half a trillion dollars worth of tax increases over the next 10 years. beginning in four years years, $2.5 trillion in new health care entitlement spending begin. the plan still puts government in control, it still mandates that every american must purchase a government-designed and approved health policy, it still mandates that employers have to provide health insurance or pay a fee. and 330,000 medicare advantage

members in my state are going to be exposed to drastic cuts. fortunately, we took out one of the sweetheart deals that now a least the 800,000 that were carved out before in florida will be subject to the same cuts. and no one -- no one -- no one believes that the so-called doc fix, that there will be a 21% cut in physicians' payment for treatment of medicare patients is going to happen. this is a -- you can put lipstick on a pig, mr. president, but this is still a pig. and the fact is i noticed the senator from illinois came to the floor this morning and said well, how great this is and how there's going to be really reductions in the deficit as a result of this legislation. i wonder what he is responded to one of the biggest corporations in the state of illinois, caterpillar, who sent him a letter saying -- quote --"in our

fragile economy we can ill afford increases that place us at a disadvantage v. global competitors that are not similarly burdened. and they state elements of the legislation would drive up caterpillar's health care costs by more than 20%, ove over $100 million." the senator from illinois is sponsoring legislation that increases costs for one of the largest manufacturers and exporters in america that's going to increase their cost by $100 million. i wonder when he's going to go out and visit headquarters out there in peoria. i hope it's soon. the fact is that there are things in this legislation that are wrong and there are things that are left out of this legislation that are wrong. including $100 billion a year that could be saved by medical malpractice reform. is there anything in those 2,733 pages that have anything to do with medical malpractice reform? that's the little dirty secret

here. the dirty little secret is that the trial lawyers control the agenda certainly as far as this legislation is concerned. we have the state of texas that has reduced costs, reduced premiums, increased the number of people who have been able to lawsuit filings are down, defensive medicine increases, annual costs by 10%. physician recruitment is up. the largest malpractice insurance company in state has slashed its premiums by 35%. saving doctors some $217 million in four kwraoefrs in the state -- years in the state of texas. i would like to ask my friend from oklahoma why in the world we would not enact medical malpractice reform if we're truly interested in reducing costs of health care in america. and he -- and our other doctor, barrasso, from wyoming, can testify because of their experience to practice defensive

medicine which could be as much as $100 billion a year. here we are looking at dramatic increases in costs -- and, by the way, we need to discuss more. the president's going around the country saying that insurance premiums will go down. individual premiums will go up between 10% and 13%. facts are stubborn things. i'd ask my friend from oklahoma if he might talk a little bit not only about what's in this bill, but what's not in this bill. and medical malpractice reform is certainly something that anyone would logically assume would be part of any real reform if you're interested in reducing costs. now, if you're interested in increasing government bureaucracy -- and i hear that this could mean the employment or hiring of 16,500 i.r.s., new i.r.s. agents. we're trying to track down the facts behind that.

then we are now embarked on one of the greatest expansions of government in the history of this country. coburn i thank the senator -- mr. coburn: i thank the senator for his question. if you look at thompson roeurts, the estimate -- reuters, the estimate for defensive medicine costs are $200 billion a year. it's not just that we order tests that protect us from frivolous lawsuits, those tests have consequences. some of those tests actually hurt patients or expose them to radiation or in fact limit our ability to do what's best for the patient because we're more interested in protecting ourselves. but -- mr. mccain: could i ask the opinion of the senator from oklahoma. why do you think there is no address of medical malpractice reform whatsoever in this legislation that has the lightest impact on reducing -- the slightest impact on reducing

health care costs? mr. coburn: two reasons. the doctors' only defense is to order tests that they need that the patient doesn't necessarily need. the second is because they couldn't get, or wouldn't put it in the bill because they knew it would pass and the american people would agree with it. it's beyond me. let me go to the point of this current amendment because i think a lot of people -- i delivered almost 4,000, somewhere over 4,000 babies. 2,000 of those were medicaid babies. over half the babies i've delivered in my life i've cared for through medicaid. the state of oklahoma in march or april -- february, i mean, cut medicaid reimbursements 3%. they're going to cut it another 8%. 40% of the primary care doctors don't see medicaid patients because the price that is paid

for the coverage doesn't cover the costs, let alone any margin, doesn't cover the costs of the nurses, the rent, the malpractice. the second point is of the specialists that are available, 65% of the specialists in this country won't see. when i'm taking care of medicaid patients, i have trouble finding better than me in a specialized area to care for my patient. what's the the other thing we know about medicaid? even if you normalize for social factors, their outcomes are worse. the cost in terms of number procedures, failure of therapeutics, all are worse. so why is this a good idea? it's not just a political stunt. if members of congress are enrolled in medicaid, the first thing that's going to happen is medicaid reimbursements are going to go up, so that the availability of the finest and the best and the brightest in

this country are available to members in this congress. so it's not just a stunt to say we put our membership in medicaid. it is a very important you willr motive to improve medicaid. think about if you're one of the 16 million people that are going to get medicaid supposedly under this bill, and i doubt that seriously because we're going to see a marked decrease to 50% or 60% of the doctors won't see them, think about what's going to happen. they're not going to be able to find a doctor. you've got coverage, but up can't get anybody to care for you. now, is that coverage? is that care? is that prevention? is that management of chronic disease? no, none of that will happen. so the whole idea between placing us in a leadership position into a medicaid program is so that we'll lead and fix it and make it what it should be. there's only one health care

system worse in america than medicaid and that's indian health care service. there's only one worse. everything else outside of those two programs is better. so why would we consign 16 million americans to a health care program that's failing today? and so the way to fix that is to put us into it. and i guarantee you the self-interest of the members of congress will fix medicaid and make it what it should be. with that, i yield back to the original author of the amendment. mr. lemieux: i thank my friend and colleague from oklahoma. how could anyone in this body not vote for this amendment? why should we have better health care than the 16 million people that we're going to put into medicaid and now will be 50 million americans? why should we have it better? why should we have a gold-plated premium health care plan? look, i've got a family of five. we're going to have a baby any day -- could be today -- and have a family of six. i pay $400 a month on the

government program. $5,000 a year. could i get that in the marketplace? of course i could. there is a doctor right here in the capitol, whole staff of them. any time i want to see a doctor, i get fantastic health care as a member of congress. why shouldn't we have the same health care that we're subjecting 16 million new americans to and 50 million americans in total? like my friend from oklahoma says, certainly won't that make the point to us that this health care is failing? what's going to happen when a member of congress tries to find a doctor and can't find a doctor that will take him? what's going to happen when they try to find a specialist and no specialist will take him? you don't hear our friends on the other side talking about the fact that half of the people who are going to get coverage under this legislation are going into a failing system. that's not one of their talking points. but it's the truth. so i challenge my friends who say that they should walk among the least of us to vote for this amendment. and i just want to turn again to my colleague from arizona.

he and i have expressed our distress about this bill for one -- for lots of reasons, but a specific reason is we both represent states with lots of seniors. we have this medicare advantage program that's going to get $200 billion cut out of it. it's going to really affect our two states. i wonder and would ask my colleague, the distinguished senator from arizona, to speak on that issue. how is this going to affect seniors in arizona when we're raiding medicare to start this new program? mr. mccain: i thank my opinion friend from florida. the fact is that medicare advantage is a program that provides seniors with choices. that's one of the reasons why it's a major target for the other side because it doesn't fit in with the government mandates that this whole bill embodies. and so i'm worried about 11 million americans who have the medicare advantage program. i'd just like to refer my colleagues to a article -- i know the senator from utah is

waiting. if he'd just give me another minute or so here. today in the "wall street journal" entitled "now can we have health care reform." i quote from the part of it that says "health insurers and indeed corporate america as a whole are like monkeys, cut by staking a glass jar to the ground. they won't let go so they can't get their hands out of the jar. the trinket in the jar is the ruinous $250 billion tax benefit for employer-provided insurance." that's the elephant in the room. corporate america isn't brave enough to argue against a direct subsidy to an employment cost no matter how perversities impact of insulating consumers from the true cost of health care choices. insurers aren't brave enough to say give us a tax code that lets us go back to being insurers rather than a tax laundromat for the middle class' health care

spending. almost any bill that would have been worth having that fundamentally fixed this tax distortion regardless of its other elements. we say this because any bill, including the one signed by the president yesterday, will be revisited many times in the future. millions of pages of rules will be written by regulators before we see how it really works. congress itself will return in predictable ways. it will reverse the proposed medicare cuts that created obama care's illusion of fiscal probity. it will tighten the mandate that requires insurers to cover the sick at favorable prices. it will not tighten the requirement that the young and healthy buy insurance at prices that subsidize the old and unhealthy. more and more tax money will have to be found to keep the jalopy on the road. more and more administrative controls on medicine will attempt family from keeping the

jalopy. under the law insurers have more incentive to lavish on their high-end employees. mr. president, i ask unanimous consent that the entire piece be included in the record. the presiding officer: without objection. mr. mccain: mr. president, i thank -- i thank my friend from utah for his indulgence. going around the country right now telling the american people things that simply are not correct. including the fact that these budget projections we know are patently false not because c.b.o. gave these false numbers but because assumptions were wrong. one of the biggest assumptions is the so-called doc fix. is there anyone who believes that we're going to have a 21% cut in medicare physician payments this fall? i would ask my friend, the senator from utah, who is very familiar with this issue. i know he has an amendment.

this is one of the reasons why americans are so angry. they know they're not going to cut doctors tpraeuplts medicare by 21 -- payments from medicare by 21%. it's a sham perpetrated on the american people. so, i'd say to my friend from florida and my friend from utah, we'll be back on the floor probably this fall sometime or littler next year and we'll be talking about the fact that this doc fix was obviously, that the doctors payments for provision of health care for medicare enrollees was not cut 21%, as the other side is telling the american people that it would be. it's not fair to the american people i'd say to my friend from utah. mr. hatch: i agree with my friend. mr. president? the presiding officer: the senator from utah. mr. hatch: i ask unanimous consent to set aside the pending motion to offer a motion to commit. i send that motion to the floor.

the presiding officer: without objection, the clerk will report. the clerk: the senator from utah, mr. hatch, moves to commit the bill. mr. hatch: i ask the reading be dispensed with. the presiding officer: without objection. mr. hatch: mr. president, before i discuss my motion to commit to protect the medicare for more than 10 million seniors, i'd like to discuss the broader issue of health care reform. we've never seen anything like the country faces now. we're at a pivotal point in the nation. the line between private businesses and public government has never been so blurred. government effectively owns several of our nation's financial institutions, insurance companies and auto manufacturers. krefplt's have been fired -- c.e.o.'s have been fired by government bureaucrats and washington is now in the business of running our health care system more than ever before. our fiscal outlook is bleaker than ever. according to the recent ten-year outlook by the congressional

budget office, the current administration's policies would add $8.5 trillion to our already record national debt. the report also confirmed that we would be facing a record deficit of $1.5 trillion this year along with a dire prediction of our deficits only getting worse after 2015 and beyond. now let me put this in perspective. our deficit this year is the largest yearly deficit since 1945. it is 10% of our entire economy. our national debt is on a path to double in the next five years and triple in the next ten years. according to c.b.o., our national debt will explode to $20.3 trillion by 2020 or 90% of our g.d.p. we are literally drowning the future of this nation and the future of our kids and grandkids in a sea of red ink. i deliver these remarks with a heavy heart because what could have been a strong bipartisan bill reflecting our collective and genuine desire for responsible health care reform turned out to be an extremely

partisan exercise resulting in one of the largest big government spending bills being signed into law yesterday. now we are jamming through another 153-page edition of new taxes and spending. recent polls show a majority of americans remain concerned and skeptical about all the promises of reduced deficits and lower costs under this legislation. why? because they know there is no such thing as a free lunch especially when washington is the one inviting you over. according to the administration's actuary at the center for medicare and medicaid services the bill signed by president obama yesterday will raise our total health care spending by $222 billion over the next 20 years and that doesn't include the doc fix, which is as much as $371 billion more. the most cynical joke played by washington on the american people in this entire exercise

has been the promise of this $2.5 trillion tax and spend bill actually reducing our deficit. nobody believes that. the biggest bait-and-switch on the american people about the bill's impact on the deficit is a simple math trick. if something is too expensive to do for a full ten-year period, just do it for five or six yea years. most of the major spending provisions in the bill do not go into effect until 2014 or later. coincidentally, after the 2012 presidential elections. so what we are seeing is not a full ten-year score but, rather, a six-year score. according to the senate budget committee, the full ten-year score of the senate bill would approach $2.5 trillion. we're already spending $2.4 trillion. more importantly, let me also clarify what the congressional budget office has said on the nearly $500 billion in medicare cuts which my friends on the other side argue will magically not only extend medicare solvency but also pay for the large part of this bill.

this is like telling american families that they can spend the same magical dollar to not only pay their mortgage but also their credit cards. it is nonsensical. here's what the experts at c.b.o. said. "the key point is that the savings to medicare trust fund will be received by 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." by the way, did i mention that at a time when major government programs, like medicare and medicaid, are already on a path to fiscal insolvency, it is interesting to note that more than half of the newly covered lives, 16 million out of the 32 million are simply being pushed into the medicaid program. and if anyone thinks that states who are facing more than $200 billion in deficits will not be left holding the bag in the future, then i have a bridge to sell you. i've said all along that this is not a fight between republicans

and democrats but a fight between democrats and a majority of americans who do not want this bill. in town hall after town hall, in poll after poll, in election after election, americans begged washington to listen to their voices, but washington ignored them and used every means necessary, from backroom deals to procedural trickery to get this bill passed. we need to remember the real implication of these -- implications of these policies, not simply in terms of political legacies and ideological holy grails, but in terms of its impact on the future of our children and grandchildren. we need to ensure that they have the same opportunities to prosper that we've all been blessed with. let me just say a few minutes about a motion to commit that i will be offering. my motion to commit states that if the actuary of the department of health and human services certifies that 1 million medicare advantage beneficiaries lose their coverage or benefits, the cuts to the medicare advantage program will not go into effect.

it is that simple. it is important to point out that the bill the president signed into law yesterday would slash $120 billion from the medicare advantage program. this reconciliation bill would cut the program by an additional $66 billion for a grand total of $202 billion. before the health care reform bill was signed into law, c.b.o. projected that medicare advantage enrollment would have increased from 10.9 million in 2010 to 13.9 million in 2019. now, medicare advantage enrollment will be 4.8 million less, numbers of people, in 2019 due to the passage of the new health bill or almost 2 million less than today. c.b.o. also projected that rebates for additional benefits and reduced cost sharing offered through medicare advantage would be reduced by 50%, from $135 per member/per month to $67 per member/per month in 2019. these lost benefits include

lower premiums, lower co-payments, and lower deductibles. it will also impact everything from hearing aids to dental and vision benefits. most importantly, it would violate president obama's on pledge to -- quote -- "if you like what you have, you may keep it." medicare advantage works. every medicare beneficiary has access to a medicare advantage plan. almost 90% of medicare beneficiaries participating in the program are satisfied with their health coverage. it is time for to us stand up for more than 10 million seniors and ensure that this program is not used as a piggy bank to finance washington's big-government plans. i appreciate my colleagues allowing me to go maybe a minute longer than i should have, but i urge my colleagues to support my motion to commit this bill. the presiding officer: who

yields time? the senator from montana. mr. baucus: mr. president, have the republicans used up their time? the presiding officer: the republicans have one minute remaining. mr. baucus: i don't mean to be picky but i assume that they'll yield back that minute, not consume it. okay. mr. president, i yield 15 minutes to the senator from maryland. the presiding officer: the senator from maryland. ms. mikulski: mr. president, this is, indeed, a great day because we're passing real health care reform for american families, for american workers, for american small business, for seniors, and our communities. health care reform will save lives. no longer will dreams and lives be endangered because people lost their health care insurance when they either got sick, lost a job, or had an accident. now, mr. president, i listened to the other side, who says that

they listen to the people. well, you know, you heard the old saying, "men are from mars, women are from venus"? i think that party is from mars and we're from planet earth. i think they've been out in our orbit. the planet earth that i'm on tells me to pass health insurance. one of the reasons i'm voting for this bill is all, and the main reason i'm voting for this bill is the story of the lives that i heard from my constituents in maryland. round-tables, town halls, hearings, lots of letters, phone calls, e-mails. they told me about the situation in their lives where they were terrified that one big health care incident could lead them into bankruptcy. they were terrified that if they changed a job in one of our new high-tech communities that could have offered great opportunity for them, they didn't take it

because they weren't going to have health insurance. when i listened to people, i think about the lady in cumberland who works full time but her employer doesn't provide health insurance and she's terrified that she's one sickness away from a catastrophic situation. or from karen in kensington, whose father had to quit work because he had crohn's disease. when he was making payment on his insurance, he was two pennies short and they canceled his insurance, and it took him six months to try to get it ba back. he lost his coverage and he was only 59 years old when he passed away. and then there were the breast cancer survivors, the wonderful women and the nanny they loved who are -- women -- the wonderful women and the men that they loved who are out there racing for the cure. but even in a prosperous community like annapolis, a woman told me how she lost her job and with it, her family's health insurance, and when her

insurance ran out, she was terrified if she would lose her cancer treatment. walking around the diners -- and i love diner -- i see myself as a diner democrat -- in every diner, it's usually multigenerational people. and what do they tell me? "barb, don't forget the old people." senator barb, no matter what, keep medicare stable. if you're 50 years old, you're terrified that your parents could lose their medicare and it's going to fall on you. the sandwiches they're eating also affected the sandwich generation. right about the old-timer's health care, worried about keeping their own and then trying to figure out how they were going to pay for college. medicare has multigenerational implications. this is why in this bill i'm so proud of the fact that we're going to stabilize medicare for another ten years and do very

important reforms in medicare. i'm also very pleased to respond to the people who said, no matter what, make health care available and affordable. for every parent who's ever worried about covering a child with a chronic illness, whether it's autism or cerebral palsy or juvenile diabetes, they will always be able to get health insurance. for the small business owner, like my own father who once had a grocery store, or my grandmother, who had the best baker shop, worried about how they were going to provide health care for themselves. well, this generation, they won't be able to worry about that. i think this bill is really an exceptional one. we save and strengthen medicare, expand the solvency for anothe another -- nearly a decade, we end the punitive practices of insurance companies, we expand universal access, and we pay for it with an emphasis on wellness and quality, saying goodbye to

quantity medicine and emphasizing quality medicine. goodbye to volume medicine and getting value for our dollar. for our seniors -- for our seniors, one of the most important things we'll do is close that doughnut hole. the doughnut hole has been hard to swallow ever since this bill was passed, and we're going to provide a $250 rebate to seniors who hit the gap in the prescription drug benefit and also offer a better discount on prescription drugs. but where i'm also very excited and honored is because the role that i played in making sure that we ended the punitive practices of insurance companies towards women. for too long, in too many ways,

they treated simply being a woman as a preexisting condition. so, first of all, they charged us 30% to 40% more just simply to be able to get insurance. then they would have the punitive practices of denying us health insurance for a preexisting condition. in eight states, domestic violence was viewed as a preexisting condition. you talk about being abused, you were abused by your husband, then you were abused by your insurance company. well, we're not going to be battered any more by these companies. we've ended that in this. and then there was the hearing that shocked and chilled me, when a hearing on gender discrimination in insurance, a woman told a compelling story -- peggy from colorado -- that after she had had a c-section and a premature baby, the costs

were high and lost her health insurance. and when she went to apply, they told her, in order to get health insurance, because she had a premature baby, because she had a c-section, they would not give her health insurance unless she was sterilized. i couldn't believe it. that's what fascist countries do. that's what authoritarian regimes would be. it wasn't the taliban in afghanistan. it was an insurance company in colorado. well, we took that fight and we end those abusive practices in this bill. never again will a woman be able to deny -- be denied health insurance because of any preexisting condition. we end the gender discrimination in charging women more. but then, as the debate went forward, they wanted to take our mammograms away from us and they didn't want to put mammogram and preventive services for women in the bill. they said it cost too much mon

money. well, i didn't want to hear th that, and i asked the women to suit up and come to the floor and we offered an amendment. the good men of the senate also joined us. many remember we wore pink that day, and today we're in the pink as well. and we offered our amendment to ensure preventive services for women so that if you -- if your doctor says you need a mammogram, you're going to get one. if you need screening for cervical cancer or a pap smear, you're going to get one and you're not going to have to pay a co-pay and a deductible. but we, like the old song "bread and roses," we fight not only for women but we fight for men too, because it is for us, it's not about gender, it is about the agenda. and the biggest agenda is to make sure we provide health care to as many americans we can in the most affordable way, with value, quality and prevention as

our underpinnings. so we were able to make significant changes in this bi bill. but affordability is an issue, and i believe that we did that by emphasizing quality. at senator kennedy's request, i led the quality task force, and because of prudent ways that we're going to be able to offer these initiatives, we are going to be able to increase the affordability of this bill. to make people healthier, we want to prevent disease an manage chronic disease. by the emphasis on the management of chronic disease, we're going to save lives an save money. first of all, we're getting more value for the dollar. yes, we will be looking at comparative effectiveness. so when you go for a treatment or you buy a drug, you know that we're getting value for the dollar. the other is that we're going to emphasize reduction of medical

errors and also medical infections in hospitals by introducing quality initiatives that reward hospitals for being able to do that. but you know i also listen to the providers. i represent iconic institutions, johns hopkins medical institution an the university of -- and the the university of maryland. and i listened to my primary care physicians as well, and they said, senator barb, please, reduce the hassle factor, too much paperwork and not enough time to be with patients, too many contradictory rules from yish companies and not -- from insurance companies and not enough after clear path on how to help people. we made sure that we're going to save money by reducing the hassle factor. by simplifying administrative costs by emphasizing medical

health technology. we're going to promote the medicine through this comparative effectiveness research and we're going to also reward following the recommendations of the finance committee the -- really the encouragement of medical homes in order to be able to manage chronic disease. these are the many reforms that are in this bill and that i'm very, very proud of them. and i'm also, as the daughter of a small business, really excited about how we're going to be able to help small business be able to provide health care to their employees. the fact that we're going to offer tax breaks for small business and be able to have health exchanges that they can buy those health care bills at a better cost are, indeed, important. so, again, the other party might be mars, but i'm glad that my feet were planted in planet

earth by listening to the people that i represent, by listening to their concerns, and then listening to the excellent ideas that came from both the people themselves and, i must say, the people who are the providers that could help us lead the way. mr. president, i'm going to vote for this bill, and i know there's much to reform it in the years ahead. but this is more than a beginning. this is a leap into the future. and it's a leap that we can take with confidence that when this bill passes with reconciliation, we will have done a major historic advance for the american people. our job is about creating opportunity, an opportunity to have health care is one of the greatest opportunities we can provide. mr. president, i yield the floor. mr. baucus: mr. president? the presiding officer: the senator from montana is recognized. mr. baucus: mr. president, i ask consent that the committee on homeland security governmental affairs be authorized to meet

during the session of the senate on monday, to consider the nomination of robert jonathan harding to be the assistant secretary of the department of homeland security. the presiding officer: without objection, so ordered. mr. baucus: i ask unanimous consent that at the conclusion of this half-hour at majority's control that the republicans control the next half-hour and the majority control the half-hour after that starting at about 11:51. the presiding officer: is there objection? without objection, so ordered. mr. baucus: mr. president, i'd just like to take a couple of moments to speak on two amendments. one offered by -- i think it's senator -- senator hatch with respect to medicare advantage. off the topic, it's important to remember that health care reform will reduce excessive overpayments to medicare

advantage plans while at the same time rewarding high-quality efficient plans for providing care to seniors. medicare advantage plans that achieve high-quality rankings under this legislation that save -- for regular checkouts for blood pressure, diabetes, will receive increase in payments. that's very important. because today medicare advantage plans are paid the same amount regard less of the quality of care they provide. so for the first time under this legislation payments to plans would be based on performance. something that all seniors would prefer. that makes this medicare advantage plan more fair, more reasonable. it will enable plans to participate everywhere in the country both urban and rural while eliminating overplaiments that plans -- overpayments that plans receive today. according to medpac, it is a bipartisan commission that

advises congress on medicare payments. that organization says that medicare plans are paid 13% more than traditional payments. they strongly recommend that we reduce that overpayment because it causes a great inefficiencies. i might also say that today because of the overpayment all seniors on medicare -- i'm talking now especially about seniors who -- who take a fee-for-service. all seniors on medicare pay for these overpayments. even if they're not on medicare advantage plans. how? basically because every senior pays $3 more per month on part-b premiums. what so seniors paying paying for the overpayment for medicare advantage plans. medicare advantage overpayments drain resources from the medicare trust fund. if they're overpaid, that means they're draining excessive resources from the medicare trust fund. in fact, the -- the -- the

government estimates that medicare advantage overpayments speed up insolvency of the medicare trust fund by 18 months. after that, there's no evidence that overpayments to medicare advantage plans -- don't forget these are private insurance plans, even though they say medicare, they're private insurance plans, there's no evidence that overpayments to them lead to better quality to medicare beneficiaries. in fact seniors can spend more out-of-pocket dollars under medicare advantage plans than under traditional medicare even if they have certain conditions. the bill eliminates these overpayments by decreasing the statutory rates on rates today and giving quality performance increases to high-ranking plans. we're paying more than we do today to high-ranking plans. no senior in medicare advantage will lose access to any of their

medicare benefits under this proposal. there are all of these false claims across the aisle that these cuts which cause more efficiency, prevent waste, prevent overpayments are going to cut beneficiaries, medicare advantage beneficiaries payments. that's not true. it's misleading. plans will not be allowed to lower or drop their basic medicare benefits that seniors are entitled to under medicare program. so there's no cut in basic medicare benefits. in fact, they're guaranteed. the reforms in this bill will ensure that the dollars for medicare trust fund go toward improving the quality of care for seniors rather than to support the operations of private insurers. i think that's something the vast majority of seniors would prefer. i want to make that clear. because some of the statements made on the other side of the aisle i find quite misleading. which leads me to another point, mr. president. americans probably are a little concerned about what's in the health care reform. they hear all kinds of claims, both sides.

now the health care reform has passed. the president signed the bill yesterday. this is just sort of a help, fixer upper around the edges a little bit. now americans can look for themselves as to who's telling the truth. they can -- they will want to look more closely than they have in the past because now it's law. now it affects people. so people are going to ask: gee, how's it going to affect me? i better find out. when people start to find out, they're going to learn, i say this somewhat presumptuously -- but they will find out that those claiming all the bad things that will happen, all the bad things about this bill are basically not true. and they're also going to start to realize that all of the good things in this bill that a lot of the proponents have been mentioning from the president on down, the good things are true. once people are thinking closely and separate it, they'll realize not only are the medicare

charges are not -- are false and some of the other charges are also false and i say, again, somewhat presumptuously, i think the provisions are good and help seniors are basically accurate. the senator from florida offered an amendment basically requiring all members of congress to enroll in medicaid. now, i ask you, mr. president, i clear -- that clearly is not a serious amendment. medicaid's a very vital program for vulnerable americans. it should be treated very seriously and should not be used for political games. mr. president, i now yield the balance of our time in this half-hour to the senator from rhode island. mr. reed: thank you, mr. chairman -- the presiding officer: the senator from rhode island is recognized. mr. reed: thank you, mr. president. i first want to begin by recognizing the extraordinary leadership of the majority

leader, harry reid, chairman baucus, chairman dodd, and chairman harkin, to get it to this point. mr. president, common sense and cost-effective health care is now the law of the land. the question before the senate now is whether we will make some important improvements to that reform or whether we'll respond to the wishes of the insurance industry and others who want to preserve a broken status quo of higher premiums and dwindling coverage for middle-class families. yesterday president obama signed into law a health insurance reform bill that will cut the deficit by $143 billion over the next 10 years, ensure that health insurance companies actually provide americans with the coverage that they pay for, and preserve medicare for our senior citizens. that is no small achievement and it would be a tragedy if the other side of the aisle persists in its efforts to defeat health care reform by seeking to delay

and upend the package of improvements in the bill that we are now debating. it sometimes gets lost in the heated rhetoric of the other side, but under the status quo, the healthier are faced with ever increasing costs and they are denied care, dropped coverage or prevented from purchasing coverage. the new health insurance reforms will provide relief for every american. indeed, under the law just signed by president obama, these five reforms will take place by the fall of next year. no child will be denied coverage because of a preexisting condition. small businesses will receive a 35% tax credit to purchase insurance for their employees starting this year. seniors on moyer who confront the -- on medicare who confront the doughnut hole will have additional assistance. -- there will be less to administrative costs or profits or else they must pay a rebate

to their policyholders. our states community health care centers will receive a boost in federal resources. rhode islanders will particularly welcome this relief. just last week rhode islanders learned that health premiums in the state will go up 10% this year. in the same week they also received news that as many as 21% of the individuals in the state will be without insurance sometime during this year. this is double the rate of the uninsured just 10 years ago. in rhode island these two headlines coupled with an unemployment rate of nearly 13% have caused a perfect storm. as the economy took jobs away from rhode island, it also took away health insurance for the employees. the healthy hope not to get sick, the sick started showing up at hospital emergency rooms, and those who still had access to insurance stopped being able to afford it. hospitals in rhode island can no

longer shoulder the burden of the uninsured. community health centers in rhode island can no longer shoulder the burden of the uninsured. indeed, the economy can no longer shoulder the burden of the uninsured. today we are considering a bill that makes further improvements to the health insurance reform law. indeed, these are changes that americans have consistently said they want. and that is why we should support this bill. it is also why i intend to oppose the legislative maneuvers from the other side of the aisle. they are interested in overturning the reform of our health care system. reforms which have replaced the costly status quo with a system based on more competitive markets. they are in favor of a system where the whim of insurance companies rule. they are in favor of a health care system in which costs continue to rise at astronomical rates each year for families and for businesses.

it may be heartening for the other side to slow down reforms through a series of representative amendments, but i think rhode islanders and all americans want us to pass a bill because it contains straightforward proposals. first, this reconciliation bill, as it is noun, would -- known, would eliminate the so-called cornhusker kickback, which would have created an entirely inappropriate medicaid system exclusively for one state. going to other provisions that would have unfairly supported some states and not others. second, this bill begins -- also known as the doughnut hole. which requires seniors to pay more for their medications than they ordinarily would. this year's seniors would receive $250 when they enter the doughnut hole and pay less for drugs that they purchase once they enter this coverage gap. third, at a time when so many of

us are worried about government spending, this bill does more to reduce the budget deficit so that we can save up to $1.3 trillion in the next two decades. those are real savings, and i find it ironic that some on the other side would oppose them. fourth, the bill makes sure that the so-called cadillac tax, which was intended to affect the most expensive health care plans, is reduced by 80% so that it hits its intended targets, not middle-class families. fifth, the bill recognizes that we should do even more to help struggling families afford health insurance and so it provides new tax breaks to help make coverage more affordable. as i said earlier, in the next few days, my colleagues on the other side of the aisle are expected to file and attempt to offer numerous amendments to this bill. these are tactics i think that are truly dilatory and that is, again, another reason why i will

oppose the amendments. some of these amendments may seem like they're common sense, but each one is designed for a purpose of derailing this legislation, of sending it back to the house, of undercutting the most significant reform of health care in the last several decades. but there's another aspect of this legislation which is vitally important and that is the improvements to the student support systems for higher education in this country. it's the dream of every parent that their child will have a better life, and a big part of that dream is that they will have the opportunity to go on to college or even an advanced degree. this bill ends a student aid system that gives away billions in federal subsidies to private banks, including some that helped create the 2008 financial meltdown, and instead puts those taxpayer dollars directly in the hands of students to pay for their education. during this economic downturn,

paying for college has become all the more difficult for many families in rhode island and across the nation. like health care, one of the top concerns of families as they sit around their kitchen table during these difficult times is how they will pay for their child's education. the key to ensuring our nation's economic stability and progress is also providing access to education. it's the engine that moves people forward. it's what expands our capacity and our capabilities in a complex world. and now we have the opportunity so that we can, in fact, provide additional assistance through pell grants, and we can do it by saving money from bank subsidies and reinvesting that in pell grants. approximately $42 billion will be freed up, $35 million will be committed to pell grants. it will be expanded to additional recipients, and the maximum grant will increase

almost to $6,000. we'll also provide in rhode island $7.5 million for information so that families and students can locate the best arrangements for their college education, for their financial aid. this also will invest $2 million in community colleges which are becoming a central part of our education system, particularly for those people who are transitioning into the work force or through the work force. and just one final point. it's particularly fitting that we are investing in the pell grant, named after my predecessor, senator claiborne pell. his vision to give people the opportunity of higher education and then to stand back and watch them do great things has been legitimized and vindicated over 30 years. i don't think senator pell foresaw the internet. i don't know how much he used it, even when it arrived, but he knew if we gave people the skills and talents, they would

do great things. and we have done great things. and with this legislation, we'll do even more. and i yield the floor. the presiding officer: the senator from new hampshire is recognized. mr. gregg: how much time does the democratic side have on their half-hour which they're in? the presiding officermr. reed: d for a unanimous consent? mr. gregg: yes. mr. reed: thank you, very much. mr. president, i ask unanimous consent that the subcommittee on personnel of the committee on armed services be authorized to meet during the session of the senate on wednesday, march 24, 2010, at 10:00 a.m. in open session to receive testimony on military health system programs, policies, and initiatives and review of the defense authorization request for fiscal year 2011 and the future years defense program. the presiding officer: without objection, so ordered. mr. reed: thank you. i thank the senator. the presiding officer: the time has expired from the majority. mr. gregg: mr. president, a couple of comments were made on the other side of the aisle that i think need to be responded to because they're so patently inconsistent with the facts that

they -- they clearly should b be -- that fact -- that should be clearly reflected. it's almost as if somebody spent too much time at the movie "alice in wonderland" around here. the idea that by their own score when you cut medicare by $521 billion -- billion dollars, half a trillion-dollar cut out of med carry by their own score, which sin accurate, of course, because -- which is inaccurate, o of cours, because it doesn't cut the full ten years. if you cut the full ten years, it's a trillion dollars taken out of medicare. the idea that seniors aren't going to be affected by that type of a cut is absurd on its face. the claim, is oh, well, we don't affect senior benefits. well, that's nice. that's like telling somebody, you can have a car but there's no engine in it. i mean, the simple fact is that when you cut the providers of the seniors by as much as this bill cuts them, clearly it's going to be harder for a senior citizen to see a provider: a

doctor, a hospital group. or when you reduce the spending on medicare advantage, which is an insurance program that many seniors appreciate, c.b.o. scores the reduction as being so large that over 11 million seniors will be thrown off that system. that affects seniors. and so if they genuinely believe their language -- no, we don't do anything about medicare here, we don't do anything about seniors, even though the scores say they cut medicare by $500 billion, their own score, and the c.b.o. has said that medicare advantage will knock -- that over 11 million people will be knocked off medicare advantage, if they believe that, they believe their language, then they have to vote for my amendment. they have to vote for my amendment. which protects social -- which makes it clear that we protect medicare. then there was this other comment made that somebody was going to vote against our amendments not because they don't make sense but because

they're dilatory. they're dilatorymen dilatory. this from a leadership on the other side of the aisle that produced the largest piece of social engineering in our history -- 2,500 pages, $2.6 trillion of spending, a trillion dollars of cuts in medicare when fully implemented -- produced that bill behind -- in a closed room, behind a hidden room, behind a secret door somewhere on that side of the capitol, never open to the public, brought it to the floor of the senate on a saturday afternoon, filled up the tree, wouldn't allow any amendments, and within three days forced us to vote on it on christmas eve. then took it over to the house where they rewrote this trailer bill, again, in a secret room,

behind a closed door, and brought that bill to the floor and didn't allow anybody to amend that. but amendments are dilatory. you know, i guess -- why have an opposition party, you know? i mean, maybe we should just go to a cuban system? i mean, that seems to be the attitude of the other side of the aisle. the american people are an unfortunate inconvenience. the fact that they've elected a republican membership to this senate and to the house, they're an unfortunate inconvenience that should be ignored and not allowed to participate in the process. and when they come up with ideas like protecting the medicare system or like taking out the sweetheart deals or like suggesting that the president and his people and the staff of the majority leader should be under the laws that we're about to pass here or that suggest that we should live by the terms of the rhetoric, which is that if your premiums go up, you won't be impacted by this bill

or that says there won't be any taxes on people under $200,000 -- amendments which just fulfill the statements of the other side of the aisle on issues -- they're going to keep the bill clean, they're not going to tax people under $200,000 of income, people's premiums won't go up, medicare won't be affected, and everybody will be subject to this new law of the land, including the president of the united states and his people and the staff of the majority leader. when we offer amendments like that, they're dilatory, they're an inconvenience, they shouldn't be allowed, they shouldn't be voted on, not because they don't make sense but because, oh, get rid of them, they're the opposition. they're the american people speaking through their elected representatives and we ought to have a voice and they ought to be voted on and they ought to be given a vote based on the substance of the amendments, not on the fact that the other side of the aisle doesn't like opposition. it is just so arrogant, this attitude which pervades

washington now, that says, oh, american people, we know better than you how to live your lives. why do you get in our way? we in washington know how you should live. just stand back, let us make your decisions as to what you should do with your life, especially relative to health care, we will do a much better job for you. and certainly, don't countenance any opposition, don't countenance any dissent, and certainly don't hold us to our word, for example, when we say people under $200,000 won't be taxed or when we say premiums won't go up or when we say everybody will be covered by the bill or when we say medicare won't be -- recipients won't be impacted. don't countenance, don't make us hold to those words by voting on amendments. because those amendments are dilatory. the arrogance is palpable. palpable and inexcusable. and now we will hear from the senator from oklahoma, who has another amendment that i'm sure the other side will say is

dilatory and inappropriate, even though it makes a heck of a lot of sense to me. i yield the floor to the senator from oklahoma. mr. coburn: well, i thank the senator from new hampshire. the presiding officer: the senator from oklahoma is recognized. mr. coburn: thank you, mr. president. as i contemplate what's happening at 62 years of age and looking back through my life, this is undoubtedly the greatest assault on liberty this country has ever had. and it's not direct, it's indirect, but it's what the senator from new hampshire talked about. it's, we're going to decide for you what you get. what the american people still don't understand in this bill is there's three areas in this bill that in the next five years will put the government in charge of everybody's health care: what you can have, what you can't have and who can give it to you. that's what's coming in this bill. so if you're a caregiver out there or you're a patient, you

might think long and hard about the three provisions in this bill that are going to do that: the medicare advisory commissi commission, the cost-effectiveness, comparative effectiveness panel, and the u.s. preventive task force panel. all of those are going to carry the force of law, and it's not just going to apply to government-run plans. if you have private insurance with your employer today, you're going to be told what treatments you can have, because some group of bureaucracies in washington are going to decide that. that's what's in this bill. the senator from new hampshire mentioned several of the claims that have been made. i won't address them again. but i would ask unanimous consent to temporarily set aside the pending motions and -- and amendments so that i may offer an amendment which is at the desk number 3556. the presiding officer: is there objection? without objection, so order the clerk: the senator from objection, so ordered. mr. coburn: this is a oklahoma, mr. coburn, proposes constructive amendment that an amendment numbered 3556. saves millions and millions and millions of dollars in medicaid. mr. coburn: i ask unanimous consent that the amendment be

considered as read. the presinofcer: without the fraud in medicaid prescriptions is out of this world. it can be fixed. this amendment will prohibit prescriptions for recreational drugs for rapists and child molesters. nobody can disagree with that. it's not in the bill. it's the current state. but if this bill goes through without this amendment, your tax dollars are going to be paying for viagra for child molesters. that's what's going to happen. there is a executive order that this will override. the bill overrides the executive order. so there's no prohibition in the bill for this at this time. a government accountability audit of medicaid found 65,000 instances of improper prescriptions costing $65 million over the last two years.

thousands of prescriptions written for dead patients by people prescribing and posing as doctors. they focus on ten types of frequently abused prescription drugs in just five states, which means this audit, which is just over five states, multiply it by at least ten, and you got $650 million worth of fraudulent prescriptions in medicaid alone. we're not going to address that. 65 doctors or pharmacists were banned from medicaid for writing or filling prescriptions for illegally selling drugs. just in those five states. 1,800 prescriptions were written for dead patients and 1,200 prescriptions were written by dead doctors. just in those five states. the amendment would direct the centers for medicare and medicaid services to enact a g.a.o. recommendation to prevent and eliminate fraudulent prescriptions. it would direct c.m.s. to establish a fraud prevention system for medicaid program and issue guidance for states to

prevent the process in claims for prescription providers and pharmacies debarred or excluded from the medicare or medicaid program. ensure that utilization of drugs and review of that and restrictive recipient programs adequately identify and prevent doctor shopping and other abuses of controlled substances. develops a system to identify duplicate or death of medicaid beneficiaries and approval fraudulent claims. for years the the federal government has required states to provide prescriptions for viagra and other impotent drugs to medicaid patients, including convicted sex offenders, child molesters and rapists. states have provided the coverage based on a 1998 letter from the clinton administration. as a result of that, an executive order was issued in 2005 which this bill, if unamended, will reverse. 800 convicted sex offenders in

14 states receive medicaid-funded prescription drugs for erectile dysfunction. that's according to the 2005 survey. the predators of these victims have been as young as two years old. so we've got convicted sex offenders, rapists and child molesters that were taking federal tax dollars and buying them drugs so they can act again. florida, 218 case. new york, 198 cases. texas, 191 cases. and it goes down the list. this amendment would prohibit new health care exchanges from providing coverage for e.d. drugs to convicted child molesters and convicted rapists. it's pretty simple. the claims that are made on this

bill are outlandish. as somebody who's practiced medicine for 27 years, 50% of my patients were medicaid patients. what are you going to do if you don't fix some of the things in this bill? is destroy the best doctor-patient relationships in the world. that's what you're going to do. you're going to put 16 million people into a failing medicaid system that the states can't afford. almost every state is cutting medicaid reimbursement at the time only 40% of the doctors in the specialties will see medicaid patients. it's going to go to 20%. so we're going to put 16 million people in a system, and then they're not going to be able to find a doctor because the costs in my own state, we're going to

have an 11% net reduction in medicaid reimbursement which is already only 75% of medicare. what do you think is going to happen in all the states in the country when the medicaid reimbursement goes down and we add 16 million new people to medicaid? you're going to call it care. you're going to rub your shoulders, rub that medal on your shoulder and say we fixed health care. you're going to promise them that they're going to have care, but they're not going to have care. they're going to have a card, but they're going to have no care. we're going to have indian health service-type care in medicaid because nobody's going to be there to care for them. the claims under this bill keep me sleepless at night not because of washington. because of those 10,000 medicaid patients that i've taken care of through my career, that i know

you're going to destroy what care's left for them. you can claim otherwise, but the facts are going to prove you wrong. and we're seeing it in every state in the country right now. the cuts to medicaid reimbursements. so at least you ought to help save $650 million a year by getting rid of fraudulent prescriptions, eliminating prescriptions for convicted child molesters for erectile tkeus function and disdysfunction and recreational use for a drug such as viagra. and to vote against this amendment to, not fix something that's very obvious is criminal. it's not just not right. it's an active aid to help those who would hurt our children. i yield to the majority whip.

mr. kyl: mr. president? the presiding officer: the senator from arizona. mr. kyl: we're fortunate to have a real doctor, a physician, dr. coburn of oklahoma, as one of our colleagues here in the united states senate to talk about the real impact of legislation like this as he sees it when he treats his patients. and i think his words deserve a lot of attention. i just wanted to briefly address this morning a couple of the claims that my democratic colleagues are making about this new legislation, claims that are simply false. the first one: there's a big tax cut. one of my colleagues said this is the biggest tax cut we've ever had. there is no tax cut for taxpayers in this bill. what they're touting as a tax cut is rather a direct payment to insurance companies. i find it very odd that that's called a tax cut. when i think of a tax cut, i

think of money remaining in the pockets of taxpayers. we're going to say you don't have to pay taxes that you've been paying in the past. that's not what's in this bill. what this bill does is to provide a subsidy to insurance companies to dispense government-mandated insurance. it's not a tax cut for taxpayers. instead, most of the so-called tax relief goes directly to the insurance companies. it never touches -- you never touch the money. it never touches the american families' pockets. the subsidies are delivered straight to the u.s. treasury. they're not extra dollars in people's pockets, as the chairman of the finance committee argued. they're, rather, advancable, refundable tax credits which is code for a new tax entaoeufplt in fact, that's exactly the way it's scored or recorded in the

federal budget. it's recorded as a spending program, the reason being that the people receiving these so-called refundable credits pay very little if any taxes. these are folks that don't pay taxes, and so they get what's called a refundable tax credit. even then, the money goes directly to the insurance company, not to them. i always thought you had to pay taxes to get a tax cut, but not in the rubric of this legislation. according to the joint committees on taxation, only about 8% of all taxpayers making under $200,000 a year would actually benefit from this government subsidy for health insurance. the remaining 92% would receive no tax benefit under the bill. and i have to say, when we're talking about tax cuts, you've got to at least put in a little bit of a word about the tax increases in the bill, because that's where the bill really focuses on taxes. it taxes many of those who have health insurance. it taxes you if you don't have health insurance. the taxes in the bill tkpw*et hit families, it hits seniors, it hits the chronically ill,

small businesses, those who have flexible spending accounts, those who use medical devices. all of those things create a tax that you pay. the vast majority of the people who pay these taxes are not high earners. and as the congressional budget office has said, whenever there's a tax on some other entity that delivers health services, that tax flows directly through to the taxpayers in virtually the same amount of money. in fact, in order to collect all of these taxes and especially the tax that's imposed on you if you don't buy this insurance, the internal revenue service estimates that it's going to have to have between $5 billion and $10 billion more just in order to collect the taxes. it's been estimated that this would require 16,500 new i.r.s. agents. welcome to your friendly new health care bill. the second thing my colleagues are talking a lot about the last

48 hours, the elimination of the problem of preexisting conditions in acquiring health insurance. the implication here is the republicans have not supported help for people who have preexisting conditions. that's not true. we've made that point clear. we made that point clear in the meeting we had with the president at the blair house. the argument is about the best way to do it. and as you'll see in just a moment, it turns out that this bill hasn't done it very well. republicans have suggested there are a lot of different ways to get to this problem: state reforms, risk pools, more competition, subsidization. all of these things can help with us this problem. but for all of the democrats' central planning in this bill, it looks like the problems are already arising as a result of their specific provision to deal with this problem. according to a brand-new associated press story of march 24, president obama's claims about preexisting coverage for

children are not what they seem. the article notes that the letter of the law which democrats took upon themselves to write behind closed doors -- i'm quoting now this article -- "provided a less than complete guarantee that kids with health problems would not be shut out of coverage." end of quote. in your rush to do these things behind closed doors without proper vetting, always voting "no" on any attempts to correct it, you end up with problems like this. and they're going to have to somehow go back and try to fix this. if this blunder is discovered on the first day that this law takes effect, how many more errors will be discovered in the next days and weeks as people pore over the 2,733 pages of this new health care law and the 150 pages of the reconciliation bill that's on the floor right now? if you can't draft a bill properly to protect children with preexisting conditions, which is the centerpiece of the bill's so call immediate deliverables, how are you going to be able to successfully make

one-sixth of the economy work through this new government-operated system? finally, mr. president, i've tpwaubgd two things that our democratic friends are -- i've talked about two things that our democratic friends are crowing about, neither one of which i think are worth crowing about, how about the things they aren't talking about, the things americans are very concerned about? democrats love to talk about people who are allegedly hurt by this -- helped by this legislation. how about the ones hurt by this bill? how about the seniors? seniors in my state of arizona are very worried about the medicare cuts. over a half a trillion dollars in medicare cuts in this bill. our democratic friends don't like to talk about that, but it's a reality. it's in the bill. the reconciliation bill slashes more than a half a trillion dollars from medicare and contains $202 billion reduction in veining. you don't -- in medicare

advantage. medicare advantage beneficiaries in my state like the health care they have right now. and it's not true that if you like your health care you get to keep it. it's false. this bill takes benefits away from seniors who are on medicare advantage. that is the truth. it may be an inconvenient truth for our colleagues who like to stress what they think is good about the bill but continually ignore things that are going to hurt their constituents and certainly are going to hurt my constituents. my senior citizens in arizona don't want the government taking away their health care, and they are very concerned as a result. a constituent from tucson -- and i'll close with this, mr. president -- wrote me a very short, very direct letter but it summarizes, i think, the point a lot of people feel. "i'm a senior citizen age 83. if i lose my medicare advantage coverage i'll lose my primary physician of 18 years. senator kyl, do not let them take away my medicare

advantage." end of quote. mr. president, all of us know physicians that are no longer taking new medicare patients. they can't afford to because we don't pay them enough. mayo clinic in arizona has already said it's not going to accept any more medicare patients at several of its facilities in the phoenix metropolitan area. this health care bill is asking a lot of the american people, a lot in terms of tax collection and a lot in terms of future debt that our children and grandchildren are going to have to pavement one group that ought to be very concerned and is are senior citizens who face nearly a half a trillion dollars in medicare cuts. small businesses will be hit with a litany of onerous new taxes and mandates and regulation, and probably worst of all, from my perspective, is that just as these costs inevitably escalate as time goes on, just as in the european countries that have had to deal with these same kind of health care issues, this legislation will ultimately lead to the

rationing of health care. and that is the cruelest result of all. mr. president, i'd like unanimous consent to put in the record at this point an op-ed piece by mr. bob robb, who writes for "the arizona republic." it's dated march 24. the last two sentences of this op-ed, i think, summarizes the point i made very well. he says "but it is impossible to treat health care as a public good without rate regulation and rationing. those are the inevitable next steps down the health care road the democrats have taken the country." the presiding officer: without objection, s ordered. mr. kyl: thank you, mr. president. mrs. hutchison: mr. president? the presiding officer: the senator from texas is recognized. mrs. hutchison: mr. president, i ask unanimous consent to temporarily set aside the pending motions and amendments so that i may offer an amendment which is at the desk. the presiding officer: is there

objection? without objection, it is so ordered. the clerk will report. the clerk: the senator from texas, mrs. hutchison, for herself and others, proposes an amendment numbered 3608. mrs. hchon mr. president, i ask unanimous consent that the reading of the amendment be dispensed with. the presiding officer: without objection, it is so ordered. mrs. hutchison: mr. president, the amendment that i offer today is to allow states to opt out of this health care bill. if he have there was an encroachment on the 10th amendment, this bill is it. we are hearing from state leaders all across the country asking congress to abandon this bill. it is an unconstitutional preemption of state innovation, state prerogative, and states' rights. they are guaranteed in the constitution by the 10th amendment. 13 states have now filed suit against this legislation because the leaders in those states know

the detrimental impact this broad, one-size-fits-all solution will have on their unique situations. states are the most well equipped to design and approval governmental programs to address the needs of their citizens. my amendment would restore the 10th amendment rights reserved to the states by allowing state legislatures to pass legislation that would allow them to opt out of this bill and the federal takeover of their health care system with its mandates, many of which are unfunded mandates. let's walk through the harmful provisions in this bill from which the states could opt out. taxes, the job-killing taxes. the bill imposes ten years of taxes, about half a trillion dollars on individuals and businesses as well as pharmaceutical companies, insurance companies, and medical

device manufacturers. some of these taxes will start almost immediately. more than $100 billion in taxes on prescription drug companies, medical device manufacturers, and insurance companies will begin to take effect before the actual supposed benefits of this bill would come into play. studies show that these taxes will be passed on to consumers. there is no doubt about it. of course they're going to be passed on to consumers. they're going to be collected for years before there are any supposed benefits. and then there are the taxes on those who can't afford, don't take insurance. the higher of $695 per individual or 2.5% of household income. employers will be hit with new taxes. the penalty could be as high as

$2,000 or $3,000 per employee. now, what is this going to do to the small businesses of our country, which creates 70% of the jobs? at a time when families are struggling, at a time when our businesses are struggling, at a time when our economy is at an all-time -- not all-time low but almost all-time low, certainly bad -- businesses aren't hiring. why aren't they hiring? they aren't because they have a fear of future. they don't know what to expect going forward. they are not going to start hiring people until there is a comfort level that the economy has stabilized and that we are in a real recovery mode. and yet when people feel that way, when small businesses feel that way, what is the biggest

deterrent to them being able to say, okay, things are getting better and i can hire new peop people? more taxes and more mandates and more burdens. that's what is going to keep them from taking that leap to hire more people. so it's like a revolving situation that we're not going to get out of as long as we are continuing to put on more taxes, more expenses, and more mandates. you know that premiums are going to go up. premiums are already going up, and our purpose in this bill should be to bring premiums down by lowering the cost of health care, not by increasing the co costs. that is so counterintuitive. it could only be thought of in washington, d.c. cuts to medicare.

the senate bill includes over half a trillion dollars in cuts to medicare. about $135 billion of those are in cuts to hospitals. mr. president, how much time is remaining? the presiding officer: 10 seconds remain on the republican side. mrs. hutchison: thank you. mr. president, i thank you. i will submit the rest of my statement for the record. the bottom line is, i hope that my colleagues will vote to support the states' rights so that we will be able to address high unemployment -- high unemployment as well as high uninsured rates in a way that will lower the costs and give more options. thank you, mr. president. and i yield the floor. mr. baucus: mr. president? the presiding officer: the senator from montana. mr. baucus: mr. president, i'd now like to yield very shortly to senator schumer from new york. mr. president, i ask consent that -- i know i've already

suggested -- i've already said we're going to divide back and forth a half-hour each. that's already been done. while we're waiting for future? schumer -- he is here. mr. president, i now yield ten minutes to the senator from new york, senator sniewrm. mrs. schumer: thank you. the presiding officer: the senator from new york is recognized. mr. schumer: thank you. and i thank the chairman of the finance committee, on which i'm proud to serve, for yielding time and also for the great work he has done. i want to commend senators dodd and harkin for the great work they have done in the help committee and all the members of the help committee as well as the finance committee and, of course of course, majority leader reid, who has been solid as a rock and steadfast, in his own quiet way. is he more responsible for this bill passing than just about anybody else, so i thank our leadership for that. and i rise today to talk about this historic accomplishment of health care reform. congratulate all of my colleagues for their hard work

and dedication. congratulate the president. he, too, was like a rock. he never budged. the day after the massachusetts election, when so many others were saying, we can't get this done, trim back, he was steadfast. i saw him, and his steadfastness, his internal gyroscope got us over the goal line. now, i'm going to today address where the future is in this bill in terms of average americans. we all know that the american people are still try to digest health care legislation we have just passed. that's understandable. it's a large and complex piece of legislation. and, of course, there's been a tremendous amount of misinformation out there about what it does and what it does not do. to tell the average american that this is truly historic legislation doesn't really get to them. they want to know how it's going to affect them. and i fervently believe that the

more the american people learn about this bill, the more they will like it. i believe it's for two reasons. first, people very quickly come to see that the myths and lies that some have put forward about this bill will not come true. because they're not in reality, and now we're in reality, we're in health care reality, because the first part of the bill has passed, the major part, and we will pass the second. second, there are so many good things in this bill that people like and need. as people learn the truth as to what those things are, many of which will improve their lives, some immediately and some in a few years, i'm confident they'll not only like health care reform but embrace it. when the crime bill was passed, mr. president, in 1994, the same thing that happened, there was a parade of horribles. but over the years, we saw that it reduced crime and made

america a better place, and it became a very popular piece of legislation. i believe the same thing will occur with this health care bill. so today i want to take the rest of my time to describe to average americans how this bill will affect them. and the number-one group, the largest group of average americans are those who are covered by their employer plan. first, you will keep your coverage. for people who've been scared into thinking that they might lose their health coverage or have the government telling them what to do, what treatments they could or could not receive, they're going to discover that there is very little change for them. i had a firefighter employed by the city of new york on long island last week say, "don't pass the bill, i'll lose my benefits." that firefighter will see that his benefits will stay as good

and as strong as they are now. in fact, it will get better for those folks who are already covered, because premiums to their employer won't go up and up and up and their employer will not continue to ask them, as they have now, to pay so much more and to get so much less back. we can't claim that premiums will not go up at all, but we know they will go up much less. and the likelihood of the employer calling the person, the average person, a worker in their company, and saying, "jim, mary, you're a great worker. i love you. i want you to stay in my company, but i am eliminating your health care benefits or i'm greatly cutting them back" will be greatly reduced over the years as this bill becomes law and works its way. beneficiaries, people on private

health care won't pay higher medicare taxes. their benefits will not change. their choice of doctors will not change. they will be much better off, and they will learn that. second, to small business owners who are trying to do the right thing and provide health insurance coverage to their workers and now find that costs are increasing and makes it more and more difficult every year to keep those employees on health care, they're going to find this year that there's a generous tax credit to make it more affordable to provide coverage for their employees. the average small business person is going to really like this bill, because the average small business owner wants their employees to have good health care coverage, but they can't do it alone. now they're going to get some help. and what about to the small

business owner who aches because he can't supply or she can't supply insurance because the employee had a preexisting condition or just because it's too expensive. they're going to find they will now be able to provide insurance for those folks. what about all those families with kids who are now in college and they worry once the kid gets out of college they're not going to have health care. they're going to find that they're covered up until their 26th birthday on their parents' plan. they have to be. and that's going to start this year. what a relief to millions of american families and millions of american students. i know this personally. my daughter's graduating from law school. when the bill passed at 1:00 a.m., she called me up -- she was watching when the house bill passed -- and said, "dad, i've been worried what i'm going to do about health insurance next year." she's out in the job market. "now i don't have to worry." that phone call will be repeated by hundreds of thousands and

millions of students to their parents in the next while. so it's great for them. what about retirees who are not yet eligible for medicare, the person who fears that because at the don't have their job or they're retiring at age 60 or 62, 61, what are they going to do? this bill will provide more assistance to bring down premiums. it will provide more choices to these retirees who right now have either no health insurance or one that's so expensive they can't afford it. what about average americans who worry, say they have early stages of diabetes and their health care doesn't cover prevention? averageme