to the west coast. the government needs to do away with the perimeter rule, just like it did with the regulation of aviation system long ago. dulles is now an international airport and can easily compete with national or any other airport in the country. the federal transportation policy should be based on competition and consumer need, but the existing prisonment -- perimeter rule is denying consumers choice in air travel and frustrating market forces that could accommodate these consumers. consumer choices in the markets should govern the schedules and flights out of reagan national, not the federal government. i would ask unanimous consent that my remarks regarding reagan national airport and my forthcoming remarks on health care policy appear as two distinct sections in the record. the presiding officer: without objection. mr. demint: thank you, mr. president.

this week, president obama gave a speech about health care, or actually i guess it was last week now. the speech was at a fancy hotel near washington, and he told jokes to make everyone laugh and sad stories to endear his audience further to his cause. the president said, as he has many times before, his law will lower the cost of health care. president obama knows how to give a good speech and he also knows how to tell it like it isn't. while president obama was busy selling his policies on the stump, others were busy analyzing the real effects of his health care law. it's not limiting cost. now, we heard some of the figures given by the democrats here from the congressional budget office but we have to expose that they're really playing with numbers. if you tell the congressional budget office to take $500 billion from medicare that's already bankrupt and can't pay

doctors to see patients, but you take $ 500 billion and call that savings that are created by obama-care -- that's part of where they get their money. the other part is to raise taxes on a lot of health care products and services and call that new revenue created by obama-care. any thinking american knows that you can't create a trillion-dollar new health care entitlement and it actually saves us money. when the congressional budget office looks at our whole health care spending at the federal level, it tells us, without all these funny assumptions, that the federal spending on health care is going to double over the next ten years. that's not saving us money. and this is the same office that found without these funny assumptions that o obama-care would cause premiums to rise an average of $2,100 per year for families in the individual market. that's telling it like it is.

it wasn't that long ago that some of the country's largest insurance carriers sent a letter to their enrollees warning them that obama-care was going to drive up the cost of premiums. they told it like it is. the obama administration didn't want this information to get out so the department of health and human services sent a letter back to the insurance carriers saying their claims were not true. and h.h.s. would have zero tolerance for this type of misinformation. they want to keep on telling it like it isn't. richard foster, the chief actuary for medicare and independent economic expert, recently testified before the house budget committee. he was asked if it was true or false that obama's health care bill would lower cost. just a true or false question. he said, i would say false more than true. he told it like it is. false more than true is a very

polite way of saying no, it won't lower health care costs. that claim is false. president obama also promised that if you would like to keep your health care plan, you can keep it. richard foster was also asked if those who like their health care plans would be able to keep their coverage. he said, not true in all cases. it certainly isn't true if you live in one of the 34 states where health insurance -- health insurers stopped selling child-only policies, and it's not true if you live in colorado and have aetna insurance. "politico" reported monday evening that the health insurance carrier was pulling out of the individual markets. and many americans will lose their health plans with obama-care. but you can keep your health care plan if your union or company got one of the 733 obama-care waivers so far. the waivers cover almost 2.2 million people.

you can get your health care or you can keep it if you're a member of the six chapters of the service employees international union who got waivers and whose political action committee spent more than $27 million helping barack obama get elected. or if you're one of the 8,000 members of the united food and commercial workers union that got waivers. their package spent millions -- their pac spent millions in helping obama and democrats get elected. these are unions who supported cramming obama-care down the throat of the rest of americans. even though labor unions represent less than 7% of the private work force, they have received 40% of the waivers. they don't want the health care, they want other americans to have to ack -- they don't want the health care they want other americans have to accept. most americans don't play these political games. they don't have lobbyists and pacs. but i think they should all get a waiver too. i think we should name this

repeal bill that we will vote on today "the great american waiv waiver." every republican in the senate is committed to repealing this bill. every american gets a waiver when we repeal this bill. soon we will have a vote to repeal obama-care here in the senate. i strongly urge my colleagues to follow the house in repealing it and returning it to the sender in the white house. i'm aware the president currently in the white house might want to veto our repeal. there is, however, going to be a presidential election in 2012 and this health care bill, this health care law is going to be a defining issue in that election. 2012 is two years before the law will fully be implemented. we can get a supermajority to overturn his veto in the next election or we can get a new president who will support its repeal. i think both outcomes are possible. let us all go on record now

showing where we stand. i suspect there's some democrats who might want to repeal this law before voters repeal them. the question is, do they have the courage to break with their party? for now, the president would like us to think his law can be fixed by modifying it slightly. it can't be fixed. trying to fix it with a few good ideas is like pouring a few glasses of fresh water into a polluted river. obama-care cannot be fixed by tinkering with its provisions because the basic premise is flawed. this law is actively creating a government-controlled system that relies on high taxes, less choices, and bureaucrats making health care decisions for americans. this is exactly what we are opposed to and why we insist on a full repeal. a recent analysis by the center for health transformation found it will give the secretary of health and human services 1,968

new powers. last year, the joint economic committee found that obama-care created 159 new federal programs and bureaucracies to make decisions that should be made between patients and their doctors. if the democrats and federal bureaucrats are permitted to control our health care system, our tax code will look simple by comparison. worst of all, in the rush to pass this legislation, none of its proponents cared if it was unconstitutional or not. they weren't going to let the constitution get in the way of their health care takeover. even now, when asked about the constitutionality of the bill, secretary of health and human services has said, "i'm leaving those arguments to our legal team from the department of justice." so far, their legal team is losing. two judges have told it like it is.

obama-care has been ruled unconstitutional by judges in virginia and florida. the virginia court held that the individual mandate requiring every american to purchase government-approved health insurance was unconstitutional. the florida court ruled the entire bill was unconstitutional because of the individual mandate included in it. in his decision handed down on monday, florida's district judge roger vinson compared the law to a finally crafted watch in which one of the pieces is defective and must be removed. but what happens to obama-care when you remove that one piece, which is clearly unconstitutional? the rest of the law falls to pieces. as the judge might say, the watch won't work. vinson wrote, "i must conclude that the individual mandate and the remaining provisions are all

inextricably bound together in purpose and must stand or fall in a single unit. an unconstitutional law that touches the most important personal decisions americans ever make must not stand. we must repeal the bill in its entirety. because at the very heart of it, which makes all the other parts work, that very heart, that individual mandate, violates the highest law of our land. and it's already failing americans. health care costs and premiums are going up despite the false assumptions we hear on the other side. choices in consumer control over the health care system are going down. by continuing to follow a failing plan, the government is planning to allow our health care system to fail. obama's broken promises are going to create a broken future for our country. if we do not fully repeal this bill, it's going to add nearly half a trillion dollars in new health care taxes and raise the

federal budget deficit by more than $500 billion in the next ten years and nearly $1.5 trillion in the next decade. yet the president -- the president says that this is going to save us money. we know this so-called affordable health care act for america does not live up to its label. we must repeal this bill and implement commonsense solutions that will lower the cost of health care for consumers and make health insurance available to everyone, even with preexisting conditions. we should allow americans to choose affordable plans across state lines, and we should end frivolous lawsuits that drive us costs and give equitable tax treatment to those who don't get insurance from their employer. obama-care does none of this. the facts and figures tell it like it is. president obama tells it like it isn't. it's time for congress to tell

it like it is and repeal obama-care. thank you, mr. president. i yield the floor. the presiding officer: the senator from nebraska. mr. johanns: mr. president, thank you. i had an opportunity during the comments of my colleague, senator demint, to sit here and listen to those and i would like to start my comments today by complimenting senator demint. those were very, very thoughtful comments. mr. president, many of my friends on the other side of the aisle are now acknowledging the problems with the health care law. it was a fascinating process last september and october as we were leading up to the november elections to see members running, to be on the other side of the aisle and saying, well, i would have done this different and if i get there, i'll do that different.

we've already seen one such provision designated for repair is my legislation to repeal the 1099 reporting mandate that is in the legislation. now, mr. president, just to be clear, i've never argued that that was the start of the unraveling of the health care bill. i don't believe that for a moment. what i would say is this, that provision should have never been in the health care law. and i'm very, very pleased to report today that that legislation, after two attempts to try to get it repealed, now has the support, bipartisan support, of 61 senators and the president mentioned repealing this provision in the state of the union address. while there is bipartisan agreement on this provision, that it needs to be taken out and repealed, the rest of the

2,700-page bill is bursting at the seams with flawed provision after flawed provision. months and months ago, as this bill was making its way forward, each one of us individual senators had an opportunity to decide, can this bill be changed enough to be saved. and the conclusion i reached is that there were no amendments that could change this bill enough that i could ever support it. it's fatally flawed and you just can't repair the problems. the catch phrase these days, the catchy slogan is that we will repair this bill. well, this bill is beyond repair. we can't tinker around the edges. you can't just kick the tires and put some air in them. a good detailing job on this bill won't save it.

even a major overhaul cannot get this bill back on the road. it needs to go back to the factory, mr. president. this bill is a lemon. it's simply beyond repair. that is why it's important for all of us to support senator mcconnell's amendment to repeal the health care bill in its entirety. let me just start out and say what courts are now acknowledging. this is an unconstitutional piece of legislation. the underlying foundation of the health care law is predicated on a false premise that the constitution somehow allows us -- us, here in congress -- to

demand of every private citizen that they buy a government-approved product or face penalty. let me repeat that. the premise of this legislation, the false premise, the constitutional premise, is that somehow we, as elected representatives, possess the constitutional power to force every individual in america to buy a government-mandated and approved product or face a fine. and that is an unconstitutional premise. recently this fundamental flaw was exposed by court rulings in virginia and florida. as a larks i've read both of -- as a lawyer, i've read both of them first word to last word. i just finished reading the florida decision yesterday. these courts in thoughtful

opinions found that this so-called individual mandate was simply unconstitutional. judge vinson said this, "if congress can penalize a passive individual for failing to engage in commerce, the enumeration of powers in the constitution would have been in vain, for it would be difficult to perceive any limitation on federal power and we would have a constitution in name only." unquote. you see, according to judge vinson's ruling, the entire health care law is unconstitutional because it is predicated upon the individual mandate. president obama has argued that,

members have argued that on the floor, and now there's this attempt to extricate from that argument, and it just won't work. the law will continue to be debated in other courtrooms, but i believe we are looking forward to a day when the supreme court of the united states says to congress, you went too far. you went beyond the constitution of this great nation. however, the health care law is flawed even beyond this congressional overreach, this unprecedented congressional overreach. the health care law double-counts dollars, threatens the health care infrastructure of this great nation, and adds more individuals to a system that i'm very familiar with as a former governor -- the broken

medicaid system. there isn't a governor in america that would come before any hearing of congress and argue that the medicaid system is anything but broken. this bill is also paid for by over $500 billion in tax increases and over $500 billion in real cuts to medicare. now, regardless of the claims to the contrary, medicare cuts simply can't be counted twice. they cannot simultaneously reduce the deficit, extend the solvency of medicare, and then pay for this open-ended entitlement. we will, i'm sure any american out there would see the fallacy of trying to say to them, we will, you can spend the same

dollar twice. you can, on the one hand, pay for your mortgage, and, on the other hand, use the same dollar to make the car payment. you know, no american would believe that. you see, only in washington could you get away with such enron-type accounting. it is simply budget hocus-pocus. even the administration's own c.m.s. concludes that the law's medicare cuts -- quote -- "cannot be simultaneously used to finance other federal outlays and to extend the trust fund" -- unquote. i've long made the assertion that if congress makes reductions in the medicare program, then those dollars need to stay in the medicare program to shore up a program that is running out of money, not to pay for a new health care entitlement.

instead, here's what we end up with. these cuts to medicare are going to have long-term consequences to seniors' access to physician and health care services. let me focus on my own state, for a moment. nebraska home health agencies, under this bill, in just five short years two-thirds of our home health agencies will be operating in the red. nebraska nursing facilities, already stretched to the limit, will have to endure $93 million in cuts. anyone want to argue that isn't going to force the closing of nursing homes in nebraska? of course it will. hospitals and hospice, major reductions in funding. 35,000 nebraskans who like and

receive the advantages of medicare advantage are going to see reductions to their benefits. if nebraskans are going to endure these cuts and others across the country do the same, they should have at least the security of knowing that the sacrifice they are being asked to endure is going going to impe the medicare program. if all the tax increases and all the medicare cuts weren't enough, the law's projected costs completely ignores the $115 billion it will cost to implement this legislation. now, around here, billions of dollars are thrown around. we all of a sudden in the last two years added new words to our vocabulary -- trillions. you know, a program just isn't big enough unless it's got a $1

trillion price tag anymore. we will, let us remind our -- we will, let us remind ourselves that those are hard-earned dollars by somebody out there trying to make a living. this isn't about funding trillion dollar programs. this is about poor individuals in this nation who are struggling to get by. nearly 20% of which are underemployed or completely unemployed. all these hidden costs will drive up the price tag even more of this very ill-advised statute. however, one of the most troubling aspects of this so-called reform is its massive -- massive -- expansion of medicaid. it simply heaps more unfund funded mandates onto state budgets. and as a former governor, i don't know how governors are doing it these days. they are in a financial meltdown

with few exceptions. and here we are simply heaping more u unfunded mandates onto state budgets that are already crumb ling. it puts -- get this -- it puts 16 million more people on the most broken part of the health care system -- medicaid. i can attest to the challenge of trying to provide quality health services for those on medicaid today, not even -- not even addressing the millions to be added. even now our offices are flooded with frustrated individuals completely unable to find someone to provide health care services to them due to the lack of participation in the medicaid program. you see, the story here is this: 40% of doctors don't take medicaid patients. why?

they can't afford to. ask any doctor, any hospital administrator in america, could you keep your office or your hospital open on medicaid reimbursement? and they would laugh at you. they would say, absolutely not. we would go broke. and so what's the government's solution to that problem? at $16 million on a broken system -- add $16 million on a broken s it is not because they don't want to treat these pishts, you see. they do. but the exphaid reimbursement rates would drive them into bankruptcy. so instead of dealing with that problem, a very serious problem in terms of access for poor people, what do we do? we burden our states with additional costs with this legislation, we saddle them with little flexibility through maintenance of effort mandates,

and totally disregard the big question of how all these new eligible individual individualsa chance of finding care. according to a recent study, the medicaid expansion is going to cost nebraska between $458 million and $691 million over ten years. depending upon participation rates. more shocking is that almost one in five nebraskans would not be forced on medicaid, a system where we can't find them care. and we're not unique. this is the true story in every state in the united states. the impact on this medicaid expansion could be profound to many hospitals, because medicaid-eligible individuals who are unable to find primary

care -- and there will be millions of them -- will turn to the emergency ward for their care. recently the centers for disease control reported detailed statistics on nationwide emergency room usage. while only 14.1% of all hospitals in the u.s. had medicaid coverage, medicaid patients compromised -- comprised more than a quarter -- 25.2% -- of all e.r. visits nationwide. this preliminary may c.d.c. report confirmed that the uninsured don't visit the e.r. most often, contrary to the arguments made on the very floor that i am standing on. this preliminary may c.d.c. report confirmed that the uninsured don't visit the e.r.

the most often. patients with medicaid do. specifically, more than 30% of medicaid patients under 65 visited the e.r. at least once compared to fewer thank 20% of uninsured -- fewer than 20% of uninsured and those are private insurance. an e.r. physician put it best: quote -- "high utilization of the e.r. is no surprise. many patients have difficulty finding primary care providers who take medicaid, so the e.r. is the only alternative." unquote. and so what is this new law -- and so what does this new law do to solve this problem? nothing t exacerbates and exaggerates and compounds the problem. and i could go on and on because the flaws in the law are so abundant and so severe that it

can't operate. mr. president, let me wrap up with this thought. the people of america deserve better than this effort. the people of america deserve something better than an unconstitutional attempt to say the federal government knows better than you. no mechanic could get this jalopy running again. they'd just scratched their head and say, haul it to the junkyard. this health care bill is so fatally flawed, it can't be fixed. the only option, contrary to what happened a year ago, is to go back and in a bipartisan way work to build solutions to the health care challenges a step at

a time, for once and for all, instead of compounding problems, solve them. mr. president, i yield the floor. the presiding officer: the senator from new jersey. mr. lautenberg: i hear the requests of people who are on the other side of the political aisle here to repeal the health reform bill that has been put in place, received majority support in the house and the senate when developed, and now what we are

witness to is that within -- within a bill that's planned for the continued support for the f.a.a. takes care of the conditions which are aviation structure works, that there's a bill -- there's an amendment put in here that says that we want to repeal -- recall the health care bill, the health reform bill that was signed into law by the president of the united states. and we've heard that there are challenges in court. but we hear also that there are cases in the court that say this bill does -- this act does appear to be constitutionally

sound. i'm listening here. my vantage point, mr. president, is that i grew up in a very poor working-class family with all of the ills that follow poverty. and i see america through that kind of a prism. and i see an america whose intention is to be fair, to take care of our citizens, to provide them with services, to make sure that we have military forces to protect us from enemies, to make sure that we have labor standards that try to make conditions healthy for working people so their health is protected as they perform their

tasks. there is an implicit promise that says we're going to educate those in the early years for sure with a reasonable education. in other words, there's a distribution of the assets that this country of ours holds that -- to which almost everyone is entitled to. we're not talking about differences in income or differences in personal material: housing, et cetera, that some have that others don't have. i'm not talking about that. i'm a capitalist. i came up the capitalist ladder, working hard. i'm going to talk about that in a minute. so when i listen to the rhetoric that's delivered here on a continuing basis about

government interference and keeping people alive, and keeping people healthy. why should the government interfere with people's chance to be overcome by illness or injury? shia consider it an outrage that some of our colleagues want to repeal -- i consider it an outrage that some of our colleagues want to repeal a law that's improved the lives of millions of americans. the push to repeal health care reform, i think, is the worst kind of hypocrisy coming from this place and at the other end of the capitol. here we're 100. the other side has 435 people. there are those who have voted not to have this health care reform in the first place. and now those who are jumping on

the opportunity to repeal a law that is designed to help people health, to help kids grow healthfully, to help families be able to maintain a degree of functioning when illness strikes their family, to provide services that increase longevity to our people and i, for one, speak well for that effort. it's so hypocritical to me because the senators who are advocating repeal have access to the best health plan in our country. they get to walk down the hall here, there's a clinic, half a dozen doctors, competent, skilled people. there are health care aides who work there, professionals.

and all you have to do is go in there and say, "doc, i feel something here, or i feel something here, or i've got this swelling here," and you get care. and we pay for it; not a lot but we pay for it. but it's available. it's available. it's a kind of perk i'll call it, that people across this country would be astonished to see how well we treat those who make the laws in this country, those who have the responsibility of taking care of our people, our constituents. they'd be astonished to see how easy it is. you go into the clinic.

we'll take you. you need some surgery, and we'll get you over to the hospital in short form, and we're going to take care of this before your disease gets the better of you. when people here -- senators, congressmen, staff people -- get sick, they just have to walk down the hall to the senate physician's office. don't have to get in a car or anything like that. they don't know the worry or understand the worry that comes if medical bills overtake the opportunity to buy food or housing or even force people into bankruptcy. again, let me say this isn't simple rhetoric for me. i lived through these conditions. and yet, these people who are up

for repeal are fighting to take away the lifeline, the health care reform law has given to families in need. i know what -- i know firsthand what it's like when your family doesn't have access to basic health care. i grew up in a family of modest means in paterson, new jersey. my -- it's a mill town. it was typically a city that received immigrants on a regular basis. my father spent his short life working in local silk mills, and he died of cancer at 37 years of age, when i was still a teenager. he was -- i'm sorry. my dad was 43. my mother was 37 when she became a widow. i joined the army.

i enlisted in the army. i attended college under the g.i. bill. i was a soldier; served in europe in world war ii. and as a consequence of the opportunity that i had to get an education, i was able to join a couple of friends and start a company that is known across the globe. the company is called a.d.p. we have more than 40,000 people working around the world in more than 20 countries. three of us from poor families. two of them are brothers, and their father was a mill worker also. and because of the success i had in business, all my family had to do was worry about their good

health and not backbreaking medical bills. but i never forgot what it was like to see my mother working so hard behind the counter of a store to pay the doctors, the pharmacies, the hospitals, to keep my father comfortable for the 13 months he was in bed with cancer robbing him of his life on a daily basis. and that's why i was proud to vote for the historic health reform law which is holding insurers more accountable and making our system more sustainable. i looked at the history of the health insurers because we see the health care bills constantly taking more of the g.d.p.

but you wonder why the -- you wonder where the health care cost increases take place. but i looked at some of the companies. for instance, i took the year 2009. it was a tough year, tough year for lots of people, lots of bankruptcies, lots of foreclosures, lots of jobs lost in 2009 cidna did -- cigna, the company's c.e.o. got $18 million worth of salary providing service. humana went from $270 billion worth of revenues to $1.3 billion. the c.e.o. there got $66.5

million. united healthcare, they had a heck of a five-year period. they started off with $2.4 billion worth of revenues in 2004. and in 2009, it went to $3.8 billion. from $2.4 billion to $3.8 billion. and the c.e.o. got $9 million salary, but he got big kickers at the end of the year. a company called well point, in 2004 they did $960 million worth of sales, we've news. -- saerblgs revenues. five years later they did $4.7 billion. the c.e.o. got $13 million. and i look at that. as we ponder where the money has gone to pay for health care in

this country. so, i see one place that a lot of it goes, and that is to the insurance companies. and now some of our colleagues want to recall this bill, remove the health care protection from 30 million americans. 30 million people across this country. almost 10% of our population will lose health insurance care if we repeal the bill that's in the works that,'s now in place, the law. the fact is repealing the health reform law would be enormous step backwards for our country. it would hurt seniors. it would hurt children, small businesses. and our deficit would balloon, grow larger. repealing this law would raise

drug costs for seniors by removing from them a 50ing% discount on drugs that they purchase when they're in the period of the doughnut hole and which also will, by the way, this law will help prevent us -- the removal will help prevent us from totally closing that doughnut hole. seniors across the country, listen. listen to the truth about what's being said. the doughnut hole is going to be closed. it's roughly a $4,500 element in people's income, or costs rather. this repeal would also give the biggest insurance companies more power over their patients to charge outrageous fees than ever

before. it means the insurers could once again reduce benefits, stop coverage during a person's illness and refuse to care for children, individuals and children stricken with preexisting conditions. repealing health reform would also hurt young adults who would no longer be able to stay on their parents' health plans until age 26. for young adults, especially new college graduates facing a tough job market, staying on a parent's health insurance is the only reasonable price insurance option available.. if health reform is repealed, small businesses will lose tax credits for up to 35% of health insurance premium costs. it would jeopardize the recent growth in the number of small businesses offering health insurance coverage to their

employees. and this repeal effort is fiscally irresponsible because any health reform would increase the deficit by at least $1 trillion, increasing the deficit. we're all now here looking at the deficit and wondering what we can do to bring it under control but we can't do it with the costs that we have now scheduled for health care. mr. mccain: would the senator provide how much longer he would be on speaking? mr. lautenberg: about three minutes. mr. mccain: thank you. mr. lautenberg lautenberg: as a, how could we repeal this law and look at our children and grandchildren, look them in the eyes? we should be focused on getting this critical jobs bill signed into law, not refighting last year's partisan battles. make no mistakes, democrats are willing and eager to fix the parts of the health reform law

that might need adjustment. i, for one, would salute that kind of a -- a review. but to repeal the entire law is an example of outrageous overreach. instead of meeting us halfway, our colleagues on the republican -- republican side are engaging in i think misguided political battles. it's wrong. we can't allow repeal of this law which is proving the lives of millions of americans. and i thank my colleague from arizona for permitting me courteous extension of the time that i had. i yield the floor. mr. mccain: mr. president? the presiding officer: the senator from arizona. mr. mccain: thank you. i thank the senator from new jersey and i ask unanimous consent to engage in a colloquy with the senator from wyoming, senator barrasso. the presiding officer: without objection. mr. mccain: thank you. mr. president, obviously we rise in support of the amendment put forward by the republican leader

for repeal of the bill -- of the health care bill. as we know, the house of representatives has already acted in overwhelming fashion. and neither the senator from wyoming or i intend to go through all of the arguments that we went through for nearly a year here on the floor of the senate. i -- the years that i've been here, i have never spent that much time on any single issue by far than on the health care issue on the -- on the floor of the senate. but one of the most important parts of this debate has been the overall cost either savings or lost if this legislation is repealed. and, of course, the highly regarded congressional budget office has determined that there

would be an overall increase of health care in america if the bill were repealed. and i think it's very important for us to recognize the valuable work that the congressional budget office does. they are really one of the most important parts of the decisions that we make on legislation. but i think it's also very important to point out that the congressional budget office makes decisions directly related to the input and the parameters and the details of legislation and how they're sent. the congressional budget office most appropriately does not decide on policy. they are simply there as a budget office. so what i'm saying is, garbage in, garbage out. if you are given certain data base to make judgments of cost

on, then, of course, you are going to come out with basically predetermined results and analysis. so one of the numerous aspects or parts of the legislation that was not taken into consideration by the congressional budget office because of the way the legislation was written is the so-called doc fix. now, the doc fix, as we all kn know, is in compliance with a reduction in medicare payments to doctors which was mandated several years ago. and then we found out that doctors would stop treating medicare patients if they were deprived of the medicare payments that they needed in order to make up for the costs of the treatment that they provided to medicare enrollees.

so here we have taken out of -- and we know that every single year we have had to quote, as we call it the doc fix, which has not allowed the previously legislated reductions in medicaid payments to physicians. so that's an additional $208 billion over ten years that. -- that alone, $208 billion. nowhere is that put into the equation. then we have, of course, the so-called class act, a poorly designed federal long-term care program and it was inserted at a point in the debate that was never in the original bill which was passed through the "help" committee. and it raises taxes by over -- i'd ask my colleague, it is a program for long-term care that

people pay into the system in order to be eligible for long-term care benefits, but over time, that money comes back out, not in the time frame that was given to the congressional budget office. now, there are a number of other provisions that i'd ask my colleague from wyoming about what his assessment of the costs were taking into consideration the doc fix, the class act, the envisioned medicare cuts by $500 billion and others, which simply are not going to happen. and i would be interested in -- in your total of the costs that actually would be saved by the repeal of this legislation. mr. barrasso: because what we're trying to do, what we're trying to do is actually provide people with the care that they need, the doctors that they want at a cost they can afford, and yet when we look at this health care law that, remember, was written

behind closed doors, in spite of promises. i mean, that's why people were so offended by this and why people are still opposed to this. written behind closed doors, votes in the middle of the night, all sorts of different special deals cut for senators to get to that 60th vote. and then, and what i hear most about as i travel around my home state, are the cuts to medicare, the proposed cuts to medicare. as you mentioned, $500 billion. you talk about the president having a -- a mission, a commission to look at the debt -- a commission, a commission to look at the debt. what that commission said is, if you're going to take money from medicare -- which this law does, takes $500 billion from our seniors on medicare -- it doesn't do it to help strengthen medicare or lengthen the life and the vitality of medicare, it does it to start a whole new government program. so it's $155 billion from hospitals, $202 billion from the 11 million seniors on medicare advantage, it takes $15 billion from nursing homes, $40 billion

from home health agencies, $7 billion from hospices. and -- and as my colleague from arizona said, he gets to the class act, which has been called a ponzi scheme that bernie madoff would be proud of, the president's own debt commission says repeal that. because there is no way with the way that that is set up in terms of taking the money in first so they can count that as coming in but the obligations to the country ten years and beyond will bankrupt this country. everyone on both sides of the aisle realizes that. the bipartisan president's dealt commission -- debt commission realized that to point where they actually put it in one of their recommendations. but now to hear our colleagues and the last speaker talk about the fact that this may actually help with the deficit and with the debt? anyone who looks at this over the long term and the nature of our country knows that this is going to bankrupt the country.

i worry about the jobs in this country. 9.4% unemployment. as a senator, i know both of us as senators are working to try to find ways to make it easier and cheaper to create private-sector jobs in america. this health care law makes it more expensive and harder to create private-sector jobs in this country. mr. mccain: nowhere during the debate, i'd ask my friend, did i understand that there would be a -- really a very large use of -- quote -- "waivers" to different companies, unions, businesses, et cetera. and already we've had well over 700 waivers granted to unions and others who have sought relief from this legislation. now, i'm told that that only

entails about 1% of america's economy, but isn't that quite a remarkable repudiation of this legislation? i would have liked to have heard during the debate. and, by the way, the secretary of health and human services is going to have to give well over 700 waivers for people so they won't have to comply with this law and, obviously, the only reason why you give a waiver is because the law -- the implementation of the law would be harmful to them. i'm very interested in hearing my colleague's comments about this so-called waiver business. and along with that, the governor of my state has aske asked -- written to the secretary of health and human services, to give her, to give the state of arizona a waiver. i hope that since the secretary of health and human services is in that business, that she will grant it to my home state. mr. barrasso: i'd like to see every citizen in this country have a waiver. i'd like to have every state

have an opportunity to have waivers. because just last week, the secretary of health and human services gave another 500 new waivers. the total now, 729 waivers. you can find them on the health and human service web site. this covers 2.2 million people. now, it's interesting, because in this debate before this bill was passed through in the middle of the night, after being written behind closed doors, labor unions publicly supported this health care law. well, now there are 166 union benefit funds who are exempt, they got the waivers. they got the waivers. unions now have 860,000 of the waivers of the 2.2 million waivers. so unions now have 40% of all the waivers even though there are only 7% of the private-sector work force in this country. so my question to my colleague is, if this law is so good, why do so many people who supported it in the first place now say i don't want it to apply to me?

is it, as nancy pelosi said when she was speaker of the house before the election, before the election that repudiated this health care law and the way it was crammed down the throats of the american public, didn't speaker pelosi say, well, first you have to pass it before you get to find out what's in it? it seems to me, and i'd ask my colleague from arizona, that as people know more and more about what's in this law, it is less popular on a daily basis to the point that yesterday, 58% of americans in a rus rasmussen pol said they would like to have it repealed and the numbers of people that thought all of us ought to be able to get waivers was even higher than that. mr. mccain: well, i want to thank my colleague for his enormous contribution to this debate and his knowledge and background in the medical profession. there's just one other issue very quickly i'd like to mention and that, of course, is that i was very pleased to hear the president of the united states at the state of the union message say that he -- that we ought to look at the issue of medical malpractice reform.

i can't tell the number of times we've tried on this floor to have at least a beginning of some kind of meaningful or any kind of medical malpractice reform, and i said to the secretary of health and human services at a hearing the other day that i hope that she would be making some proposals to us, to the congress, to -- so that we could obtain some kind of medical malpractice reform. as we all know, sometimes as much as 20% to 30% of the cost of health care is accrued because of the physicians' prescription of unneeded, unwanted and unnecessary tests for fear of finding that -- the physician finding him or herself in court trying to defend a treatment of a patient. and that, of course, is a huge portion of the addition of costs

in health care in america today. so i was very pleased to hear the president of the united states say that he wanted to examine and visit the issue of medical malpractice reform. and i know we stand -- my colleague stands ready to work with him on that issue. mr. barrasso: the president said the same thing in june of 2009 when he visited and spoke at the american medical association. so when this issue didn't really come to the floor, as a number of us would have liked it in this health care law that was written behind closed doors, they asked howard dean, who had been chairman of the democratic national committee, why they didn't include it. he said, we will, we just can't stand up to the trial lawyers who have such a remarkable influence over that -- over the party on the other side of the aisle. so i'm hoping that the president in his statement in the state of the union is sincere because it clearly didn't follow through what he said in june of 2009 when he met with doctors from all across the country.

mr. mccain: i thank my colleagues. i thank the senator from maryland for her patience. and i yield the floor. ms. mikulski: mr. president? the presiding officer: the senator from maryland is recognized. ms. mikulski: mr. president, i rise today in very strong opposition to any attempt to repeal the health care reform bill. the republican leadership has offered an amendment to repeal the affordable health care act. now, mr. president, they're only keeping half of their promise. they went out there and campaigned and the tea party had a teapot boiling oarvetion and they said, we're going to offer a bill to repeal and to replace. we will, guess what they're doing here today? one more hollow, symbolic pan pr to the masses amendment.

their amendment offers a repeal, but it does not offer a plan or strategy to replace, because you know why? they have no ideas. they just want to pander to the crowd. now, i want you to know, i am emphatically and unabashedly against the repeal of health care reform. but i'm going to say to my colleagues, as i listened to this colloquy, every senator has the right to rewrite legislation, but they do not have the right to rewrite history or to rewrite the facts. i heard c.b.o. criticized and be dismissed, but yet it was the republican party that said we couldn't move anything, bring up anything, even go get a clean exwithout getting -- even go get a kleenex without getting a

c.b.o. score. you can't say you want a c.b.o. score one day and then make fun of it the next, garbage in, garbage out. second, oh, they rewrote the bill. sweetheart deals, whatever. i was on the "help" committee. i chaired the tax force on quality. i went to several hearings in an open, public forum to get the best ideas to produce the best bill, and many of those instan instances, very few of the other party even bothered to show up. so i'm not real excited about their criticism. then we went into a markup of the bill, four weeks in the "help" committee. open public markups on -- in full view and on c-span. over 300 amendments were dealt with, 300 amendments. how is that secret? how is that behind closed doors? how is that in the middle of the

night? we worked in the middle of the night because there were so many amendments. fine. that's democracy. that's the way the legislative process works. but don't say -- don't retry -- try to rewrite history. don't try to rewrite facts. and if you want to rewrite the bill, keep your promise, republican party, that if you want to repeal, then let's go to replace. and i want to hear their ideas for replacement. i challenge them right here, right now, today on this amendment. come in with other amendments on your ideas for replacement. i want to know what it is they want to dovment i want to know, which parts of the health care reform do they want to repeal and replace? what is it that they want to repeal and replace? how about this: that no longer big insurance can deny coverage to a child with a preexisting condition? do they want to repeal that and

what are they going to replace it with? do they want to repeal the part where we allow young people to stay on their parents' plans until they're 26? do they want to repeal that and what do they want to replace it with? we eliminated the caps on health care -- a cap on what an insurance could pay out. do they want to repeal that cap? if you have cancer, if you needed heart surgery, and what are they going to replace it with? i'm proud of what we did in health care. it's answer lent bill. we accomplished four goals. first, we strengthened medicare and we ended those punitive practices of insurance companies. we expanded universal access and, guess what? we came up with quality and prevention measures that save lives and save money. this is what people wanted in

health care refomplet i heard it all over maryland and heard it at hearings. i had round tables, hearings, i was in diners, i held online town hall meetings, phone calls, letters, and was unt was unoncet the straight information about what we did, they liked it. last year -- let's go to medicare. we extended the sol have en for a decade. we closed the doughnut hole that's been so hard to swallow. last year more than 32 maryland seniors received a $250 rebate check to help pay for prescription drugs. that's in the health care reform bill. if we repeal it, do i have to call up 32,000 marylanders and say, gave it back? gave it back, we repealed. we will, i bet that's going to go over. these same seniors now get 50% off of their brand-name drugs when they hit the prescription

drug coverage cap. are we going to reneal? and what are we going to replace it with? but also one of my favorite parts of this bill was ending the punitive practices of insurance companies. seeing a child denied coverage because of chronic conditions like asthma or juvenile diabetes. i also fought very long and hard, as everyone knows, for women. did you know, mr. president, that when we began our hearings on the bill, we found out that in many instances insurance companies charge women 25% to 40% more in their premiums, simply because they were a woman, more than guys with the same age and the same health statistic us? are we going to repeal that and bring back gender discrimination? also, we needed the despicable practices of just being a woman, being treated as a preexisting

condition. another thing that my hearing un-- disclosed, in seven states and the district of columbia, women were denied coverage for simply being a victim of domestic violence. they were abused by their partner and they were then abused by the insurance company. are we going to abuse them once again by repealing that provision? not -- not if i can help it. then there were other issues, also particularly related to the whole issue of prevention. there were parts of this bill -- we offered a prevention amendment. when they tried take our mammograms away from us, the women duke to the floor, the democratic women took to the floor, good guys supported this bill, and we passed preventive measures at no cost and no deductible in order to make sure we not only had our mammograms but that there were other

preventive services. bill after bill after bill. are we going to go back to that? i hope not. so if they're going to repeal -- that's what they're repealing. they're really repealing the way we ended the punitive practices of insurance companies. they're really repealing our attempt to make sure medicare was solvent and close the doughnut hole for prescription drugs for seniors. and also get them a better health evaluation. we also did other things. remain a so proud of this. we said to the insurance companies, 80% of what you collect has to go into health care. it can't go into administrative costs. it can't buy you another armani suit or a set of gucci shoes or aanother oregon third or fourth home or a $1,000 bottle of wine when you have those conferences where you think about price-fixing.

you have to put it back into health care. i don't want to repeal that. i want that 80% collective to go back into health care. i think that's a good idea. you know, in our bill, one of the things i'm proud is that we stop big insurance from putting lifetime dollar caps on benefits. i heard from a woman in columbia who told me her husband had reached his life tile limit. when he needed an e.k.g. to deal with a longtimecard backproblem, thoad pay for it out of pocket. even with health insurance, their health care costs still topped $17,000 a year, but their annual income was at $60,000. bu by lifting that cap, the man can get his e.k.g. and prevent other kinds of problems. i could go case example after case example. now, let's go to something called "quality and prevention." i know that's often ridiculed. oh, those gush. you know, that's not like giving

-- that's not like real medicine. but i just want to tell the story of a brilliant and talented physician at johns hopkins, dr. pronovost. he developed a checklist to lower -- something that lowers infections that are caught in hospitals, which takes lives, takes money, and then stays. in the health care reform, we improve safety patient and help prevent medical errors. the checklist which we allow to occur in the bill has now, we found out, reduced in michigan patient deaths by 10% and it's nearly had over an 85% effective rate at eliminating blood stream infections. the cost savings to both public

and private insurance in michigan has been stunning. do we really want to repeal these measures that are saving lives and saving money? you know, mr. president, i don't want to repeal this bill. we did a lot of good things in it. and if the republicans have ideas, then i don't think they should vote to repeal unless they've got a better idea to replace what i outlined here today. so i challenge them. if you want to repeal, keep the other half of your campaign promise: replace. let's put those replacement ideas out into the light of day. let's put them out for debate and discussion and then votes. i'm up to the task. i wonder if they are. mr. president, i yield the floor. mr. chambliss: mr. president?

the presiding officer: the senator from georgia. mr. chambliss: i rise today to urge my colleagues to rethis highly unpopular health care bill. here's what repealing this health care bill will mean to georgians. the federal government will not be required to spend $8,470 on health care for every single georgian every year. 176,000 georgia seniors who are today enrolled in medicare advantage will not have their benefits reduced, and the $500 billion in medicare cuts will not be used to pay for new programs under this law. around $2.1 -- around 2.1 million georgia households making less than $200,000 will not have to pay higher taxes to fund this monstrous bill. 70% of small employer purchases will not face higher premiums.

small businesses employing 50 or more people and 8,000 georgia construction companies with five or more employees will not have to pay higher health care costs or be subjected to new penalties due to government mandates. under this law, hundreds of thousands of additional low-income georgians will become eligible for medicaid in 2014. that's going to result in an estimated $1 billion in new expenses for my state to fund that program. now, how are we going to fund that $1 billion? here we are -- we are a state that has to have a balanced budget every year, and we are struggling right now making the government -- the governor and the legislature are making really tough and hard decisions, cutting expenses to balance the budget this year. and under this bill, they're

going to have to come up with another $1 billion, or they are going to have to raise taxes, raise tuition costs at our universities? where are they going to get it? we don't know the answer to that but that's what this bill would require. while states work to prepare balanced budgets, they will not be given the flexibility to make prudent market-based decisions to improve their fiscal outlook. the governor of georgia has put forward proposals like ending medicaid coverage of dental, vision and podiatry treatments for adults. these are painful decisions that states are being forced to make, but the health care law requires states to maintain eligibility levels for beneficiaries in order to keep their federal medicaid dollars. reimbursement from medicaid is already so low that a majority of doctors will not see medicaid patients. states are left with little options other than further

reducing payments to providers or raising co-payments for beneficiaries. the federal government should not be hindering states' flexibility in dealing with their individual budget issues. this is not an area where the federal government should be impeding on the sovereignty of our states. america's deficit is the single-biggest issue facing our country today. repealing the health care bill means that our deficit will not increase by an estimated $2.6 trillion when this bill is fully implemented over a ten-year period, and it would also prevent that same $500 billion cuts coming from medicare to pay for entitlements that would do nothing but exacerbate our budgetary woes. my constituents in georgia and citizens all across this country made it clear that they want congress to repeal this legislation and work to lower health care costs and ensure

americans include commonsense solutions that aren't negotiated behind closed doors. we need a law that replaces this law and that actually reduces health care costs and enacts insurance reforms immediately. americans should be allowed to buy insurance policies across state lines, allow small businesses to pool resources and offer more affordable insurance to workers. and also we need to limit baseless lawsuits against doctors and expand health savings accounts. furthermore, in light of recent judicial decisions in v.a. and florida -- in virginia and florida it appears the law may not be upheld in the courts. i applaud the judges that congress does not have the authority to force americans to either purchase health insurance or pay a penalty for not doing so. that provision of law obviously is ultimately going to be decided by the united states supreme court. i plan to vote on repealing this

law and working with my colleagues on both sides of the aisle to start the process over and to make sure that next time we do it in the open and not behind closed doors, and that we get it right. with that, mr. president, i would yield the floor and suggest the absence of a quorum. the presiding officer: the clerk will call the roll.

a senator: mr. president? the presiding officer: the senator from arkansas is recognized. a senator: mr. president, are we in a quorum call right now? the presiding officer: we are. mr. pryor: i would ask that be dispensed with. the presiding officer: without objection, so ordered. mr. pryor: mr. president, thank you. i want to thank my colleague from oklahoma because he's been gracious to allow me to speak

before him because my speech today hopefully will be fairly short. but i do want to raise something that i think is of critical importance to the country. we know that we need to focus on cutting our spending. we know that we need to focus on the tax reform effort. i think everybody generally agrees on that. they may distkpwraoe on what the particular -- they may disagree on what the particulars may be. the third thing we also must do is we must focus on the economy and jobs. and this is something we have seen in this country over the last two and a half years. we've gone through a very harsh, very difficult recession. we've seen an unemployment number that stays stubbornly high. we've seen a lot of topsy-turvy economic numbers over the last two and a half years. and we, i believe in the congress, in the house and

senate and at the white house, we need to set the table for job creation and economic growth in this country, and we need to do it in a very smart way. so, mr. president, today i am here to talk about the angel investment tax credit bill that i am introducing. i want to encourage my colleagues to consider reading the bill and consider becoming cosponsors. i would love to be working on this over the next few weeks and try to get a broad base of support on this and try to get as much emphasis on this effort right now. i think it's one of many pieces of job-creating legislation that i'm interested in in this congress, but i'd hraof to get as -- i'd love to get as many colleagues as possible interested now to look at this to see if this is something we could pass sooner rather than later around here.

the angel investment tax credit is modeled after the new market tax credit, and it would provide a 25% federal income tax credit for investing in qualified early-stage small businesses. the focus will be on advanced manufacturing, aerospace, biotechnology, clean energy, and transportation. the bill would provide that up to $2 million per year in tax credit-eligible cash equity investments could be made. a total of $10 million per small company could be made. and the goal would be that for every dollar we put in, there would be $4 of private-sector stimulus. this really is the private sector getting back on its feet with a little bit of grease provided by the government to get things going in the right direction through the tax code.

the bill that i've written would authorize $500 million per year for five years for these tax credits. and like i said, the funding would -- or this proposal is expected to stimulate $2 billion per year in new capital formation. let me give you one quick example on how this can work. there's a company here, j.b. hunt. all these companies that are on this chart here started with angel investment to get over the hump. what happens is someone will have a good idea. they think they can innovate. they think they can produce. they think they can have value in the marketplace. but they can't get the capital in order to get established. they can't quite get over the hump. j.b. hunt company is now a $5

billion company. it employs 14,500 people and has 400 facilities in 48 states. in 1961, j.b. hunt had an idea, and he went to five poultry company executives with his hat in his hand asking for money. they gave him $25,000 in seed money, and that's what he's done with that company throughout the course of his lifetime. there are lots of examples of folks like that. h.p. -- there's a company in arkansas called nanomech and blue in green. many of these companies are household names: tpaeub, google, ebay, apple. all of these companies started with angel investment to get them through what they call the valley of death. the valley of death is usually that period where it's gone from the idea stage to the marketplace, and they usually

need somewhere between $1 million and $4 million to really get their ideas to market. our bill is designed to bridge that gap and cross that valley of death so that we can see a lot of start-up companies come into the marketplace. we're looking for the next j.b. hunt. we're looking for the next apple, next amazon. we're trying to find the next h.p., whoever is out there, who has great ideas, who wants to come in and invest. angel investment led to the creation of 250,000 jobs in 2009. 2009 wasn't a great year, but angel investment led to the creation of 250,000 jobs. this represented about 5% of all the new jobs in the u.s. so this can have a measurable impact. this can really move the needle in the right direction. i think that the time is now for us to work on this.

again, i encourage my colleagues on both sides of the aisle to read the legislation if they're interested. i'd love to visit with you about it. i'd love to get the bill moving through the system as quickly as possible. mr. president, with that, i yield the floor. thank you. the presiding officer: the senator from oklahoma is recognized. mr. inhofe: mr. president, there's been some confusion moving around of time, so while i was supposed to be earlier, let me just ask unanimous consent that i be allowed to speak as if in morning business for such time as i would consume. the presiding officer: without t objection, so ordered. mr. inhofe: i would say to my friend from arkansas, who just spoke, that i know a little bit about the program you have. in fact, you're fully aware -- the senator is fully aware that my daughter molly is a marketing professor at the university of arkansas, who has talked about this very concept. i don't know what -- why all of the successes have gravitated to northwest arkansas but it seems like they have. maybe this has something to do with it. but i'll look forward to following through with you on these such -- this program.

mr. president, i was -- i want to mention a couple of things that i -- i've been wanting to talk about but i'm here actually to describe two amendments that i have to the f.a.a. bill. the first thing i'd like to say, though, is i'd like to say publicly how proud i am of the new attorney general, scott prewitt, that we have in the state of oklahoma. he is now taking the leadership in suing to determine the constitutionality of the government-run health care. we are doing that currently in the state of oklahoma. i'm looking for some great results from that. i just -- i look at this sometimes and sometimes you have to ask the -- the very basic questions. you know, if you're talking about a government-run system and it doesn't work in sweden, it doesn't work in denmark, it doesn't work in the u.k., it doesn't work in canada, why would it work here when we have all these members of parliament coming over and saying why are you insisting on moving to something that has been a dismal

failure at the same time that we are moving toward a much more successful health delivery system, the model for the whole world and that's what we have here in the united states. and i would have to say also, mr. president, that when i look at the -- and listen to people talking about the -- the debt and the deficit and the problems that we have, i just think it's ludicrous that we can go back and try to act like bush had these great deficits when if you'll take the deficits during the eight bush years, add them all up and divide by eight, it came out to $247 billion each year. and now we have a president who has in just two years accumulated almost $3 trillion, six times the deficits that were there under the bush administration. and i -- i think that when people keep saying something over and over again that isn't true, they assume people will event ually -- eventually believe it. in this case, i believe the american people are so concerned

about the spending, the unprecedented spending, the unsustainable spending of this administration, this president and his majority in both houses, that they are up on this issue. now, before i get to my two amendments, i want to mention one other thing, that i was going to have as an amendment to the f.a.a. bill. and, unfortunately, there wasn't time to put it together and so i will be doing this sometime this summer but i want to serve notice. i have the distinction, i guess you'd say, since the retirement of senator john glenn, i am now i believe the only, the last remaining active commercial pilot in the united states senate. so when i look at the f.a.a. bill, i have a lot of interest in it. i had an incident, though, that occurred to me back in october, it was october 20 of this past year, when i was flying my twin-engine airplane into a field in south texas. it was called cameron county airport, a noncontrolled field. and i experienced something that is going to make me go back and

revisit to see if perhaps what happened to me, if it happens to someone else, that people in the f.a.a. would be just as generous as they were with me. i have to say before i tell you what happened that the f.a.a. could not have been better, they could not have been more cooperative. i sat down and i talked to them about the incident, but i'm going to tell you what happened. i was flying some passengers in one of my planes, a twin-engine plane, into cameron county airport. this happened to be a nice day. it was a v.f.r., the visual flight rules is what that means, so i didn't have to have control with the -- with the controllers on the way down. however, as a precautionary measure, what i always do, i talk to them anyway. so when you go down, straight south from tulsa, oklahoma, to cameron county airport, you -- you flight right over corpus christi. corpus christi is about 120 miles north of cameron county airport. so because they have a lot of training down there, they have the navy guys with the -- with

the -- the training that takes place, that it's always safer when you get -- when you're flying around down there with a lot of kids who may only have maybe 30 or 40 hours and to get on a control so they're watching you. and when you get on a control, they are -- in this case it's an approach control -- they give you a squawk so that you know they know who you are, where you are, how fast you're going, how you relate to other traffic in the area. so i got on corpus christi approach and i said, this is twin cessna, 115 echo alpha. i'll be coming south to v.f.r. and descending through 15,500. to go to the cameron county airport. halfway down, they handed me off, this is the term molg that is used -- terminology that is used, to the f.a.a. controller down there in the valley. this is way down south. a lot of the people back east here don't understand that texas, when you get down to the southern tip, that's as -- that's further south than miami,

florida, is so it's way, way down there. and so we went down to the -- down and they handed me off to what they called valley approach. valley approach took me all the way down to cameron county airport, turned me loose and i'm trying to get the recording so i know exactly what it was, to land at cameron county airport. this is the f.a.a. now, the problem is, when i -- when i went ahead and landed, by the time i got everything in landing configure rare, it was too late to go around, we're going below the blue line, as the saying is, and so i had to land while there were workers on the runway. now, the way, i say to my friend from iowa, that they normally preclude something from happening, is, as he well knows, is that they -- that they -- they have you on the -- their radar. they know that you're there but they publish notams, nosams, note to airmen. before you fly into any place, you check the notams to see if

there's construction on the runway, any projects, and we checked and there were none for cameron county airport. but there were people work on the runway. the other problem -- and so i want to have legislation -- i will include in the legislation a requirement that notams are published where they can be found by the pilot. in this case, the notice -- the notam that came out that there was someone working on the airport didn't come out to november 2 and this was october 20. so i had no control over it. and i'm not blaming anyone. i'm saying that they need to be in a conspicuous place where that can happen. the second problem that i see there that affects general aviation is that we have the -- the -- everything we do when we talk to a controller is recorded and the public should have access to those recor recording. i know that it's a difficult thing. i have requested this now since way back in october, have not received it yet so i'm going to try to set up a system where that is available to everyone. and then lastly, because even

though no action was really taken, i didn't violate anything and everything turned out fine, i did study procedures and all of that, but the bottom line, is all during that process, someo someone, a bureaucrat, could have taken away my license. here i've got more hours than most american airlines pilots. i fly an average of probably four hours a week still to this day, and that would be taking away a major part of my life. and that's how serious it is. many years ago, about ten years ago, the greatest pilot in america, his name is bob hoover. bob hoover is -- was a tremendous pilot and he's up in years, actually considered to be holder than i am. and they actually took away his license -- and this is called an emergency revocation -- i passed a law to require a -- a type of a -- an appeal, appellate process. we passed it and i think a similar thing should be afforded to all members. so, again, i -- i want to say that the f.a.a. could not have been more cooperative and more thorough but i think we need to

change the rules. we probably have to do it legislatively. i plan to do that during the summer. now, my two amendments. the first one is -- is one that i think most people when they understand will appreciate and that is that they are attempting to, it's my understanding right now there's a rule that is pending -- now, it's not really a part of this legislation directly but in a way it is, because with my amendment, we would be able to keep, preclude this from happening. the air carriers are scheduled airlines and unscheduled. the unschedules, they're called charter airlines, other types of airlines, and they -- they're under a different f.a.r., that's the federal aviation regulation, part 121, but there's a sub-part s. sub-part s says that if you're an unscheduled airline, you are not restricted to the same problems of crew rest restrictions that they have for a scheduled airline. now, there's a reason for this and the reason is this. a scheduled airline, they're out there every day and they adjust

their schedules for crew rest time. a charter airline does not have that opportunity, so they may go a long time, maybe three or four times what the crew rest would be, then have to take a longer flight. this does affect our military. right now the military, if you're taking -- flying blood, for example, into afghanistan, it's flown in by charter airli airlines. these airlines will take it down to cutter and then the cutter, it will go in usually on a -- probably on a c-17. now, to go from -- from rhyme stan down to cutter and back is longer than they can take without crew rest. or if they take it into afghanistan, that charter flight would have to do crew rest actually in afghanistan, maybe in kabul. well, obviously they can't leave so they enplane there and -- under some of those conditions. so the only choice then is that we would have to use some of our lift capacity, the c-17's, to do

that, and the problem we're having right now, our c-17's are so overworked, our crews are overworked, and so i believe that that exemption should continue to take place and we'll be trying to pass this amendme amendment. i'm going to try to get it in the queue. this is actual our amendment number 7 -- actually our amendment number 7. the other amendment i have i'm very sensitive to because i've participated in these programs. in the -- the -- there are a lot of voluntary organizations, volunteer pilots -- i've done it at my own expense, taken care of -- helping heart patients get around different places, flying in to help people out. and a lot of pilots are very generous with their equipment and their time and their money and they do this. and what i wanted to do is give them a -- a release from some of the liability that you would otherwise be exposed to. in other words, these people are doing this at their own expense, on their own time frame but they

are also -- they are also exposing themselves to major lawsuits. so these are the two amendments. that happens to be amendment number 6. i will be trying to get that in the queue after tonight's votes so that perhaps we'll be voting on it sometime between now and tuesday. with that, i appreciate the patience of my friend from iowa, and i yield the floor. a senator: i suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

mr. harkin: mr. president? the presiding officer: the senator from iowa is recognized. mr. harkin: i ask that further proceedings under the quorum call be dispensed with. the presiding officer: without objection. mr. harkin: and, mr. president, i ask unanimous consent that steven brenner and kirsten able of my staff be granted floor privileges for the duration of today's senate. the presiding officer: without objection. mr. harkin: mr. president, if there's one clear message that voters sent in the last electi election, it's that they want democrats and republicans in congress to cut out the bickering and the partisanship and to focus like a laser beam on boosting the economy, creating jobs, and reducing the deficit. so i find it absolutely astonishing that the republicans' number-one priority -- indeed, their obsession almost -- in these opening weeks of the new congress is to launch bitter, new partisan attacks on the new health reform law in an

attempt to repeal it in its entirety, something that would cost hundreds of thousands of jobs and add $240 billion to the deficit just in the next ten years. it would be sufficient to oppose this reckless amendment strictly on budgetary grounds. it would add $240 billion in to the deficit in the first decade and nearly $1 trillion would be added to the deficit in the second decade if we repeal the affordable care act. now, the sponsors of the repeal amendment have proposed no offsets whatsoever. so for all of the republicans' crocodile tears over big budget deficits, their first action in the new congress is to propose adding nearly a quarter trillion dollars to the deficits over the next ten years, and over $1 trillion in the second ten years.

now, the congressional budget office is our only objective, nonpartisan referee when it comes to budget projections. c.b.o. has told us in no uncertain terms that the mcconnell amendment, the repeal amendment, will add $240 billion to the deficit this decade. now, the republicans' response is to attack the credibility of c.b.o., the congressional budget office, and to claim that the hundreds of billions in budget savings, thanks to new health reform law, are based on -- quote -- "gimmicks." we will, that is complete nonsense. the budget savings in this new law are are real. if anything, c.b.o. has underestimated the savings that will come about, especially as a result of the robust wellness and prevention provisions in the new law, provisions that will keep americans healthy and out of the hospital in the first place. i would simply add that if the

savings in the new law were based on gimmicks, then those gimmicks would certainly show up by the second decade of the law's implementation. that's the nature of gimmicks. they eventually get exposed. but the savings in the new law actually skyrocket in the second decade to nearly $1 trillion, so to wildly assert that the savings in the new health reform law are based on gimmicks is flat wrong. it is irresponsible. so let's be clear. the republicans' obsession with repealing the new health reform law is not based on budgetary considerations; it is based strictly on ideology. they oppose the law's crackdown on abuses by health insurance companies and they oppose any serious effort by the federal government to secure health insurance coverage for tens of millions of americans who currently have none. we all remember william

buckley's conservative motto, sort of the father of the -- i would say the modern conservative movement, william buckley said once that the role of conservatives is to -- quote -- "stand athwart history yelling 'stop'." we will, in 1935 franklin rose develop passed social security. the republicans fought it bitterly and 75 years later they're still trying to undo it and privatize it. in 1965, president johnson and the congress passed medicare ensuring seniors access to decent health care. the republicans fought it bitterly and 45 years later they're still trying to you undt and privatize it t we will, to quote another famous republican president, "here they go again."

by the way, ntsz that the republicans are no longer -- notice that the republicans are no longer even pretending to offer a realistic comprehensive alternative. they used to talk about repeal and replace. now they're just talking about repeal. as always, the republican approach to health reform can be summed up in five words: pray you don't get sick. so make no mistake. the fight to provide access to quality, affordable health care for all americans has only just begun, it looks like. the same ideologues who came up with the big lies about death panels and pulling the plug on grandma are rolling out their latest campaign of misinformation. we will, the good news is that this time around, the dynamics of the debate have shifted. just as i long predicted, as people learn more about the great things in the affordable care act, the benefits and protections that are now guaranteed by law, support for

health care reform is growing steadily. as time goes by and people learn more about what's in it, a year ago we were bogged down in a messy, frustrating politics of passing a bill. this time around the law is the law, and what's at stake is crystal clear. are we going to put the health insurance companies back into the driver's seat, once again free to discriminate based on preexisting conditions? free to cancel your policy if you get sick? free to cut off payments? are we going to revoke access to health insurance for more than 40 million americans? are we going to add hundreds of billions of dollars to the deficit by wiping out all of the savings of the affordable care act? are we going to impose higher taxes on up to 4 million small businesses that are eligible for

health care tax credits, thanks to this new health reform law? mr. president, i also want to rebut the extreme ideological tags on the individual mandate in the new law. the republicans claim that this is somehow an assault on freedom. well, let's look at it another way. it's certainly an assault on individual americans' freedoms, when someone goes without insurance and they show up in the emergency room and they stick other americans with their emergency room bill. how about that freedom? shouldn't i be free, shouldn't you be free from having to pay for someone because they didn't have insurance and they show up in the emergency room, which is the most expensive form of health care, and now we got to pay the bill? what about that freedom? the individual mandate is just common sense, and that's why so

many republicans supported it in the past. senator john chafee's reform bill in the early 1990's included an individual mandate. it was supported by a number of republicans, some of whom are still here, republican senators grassley, my colleague from iowa, senator hatch, senator lugar -- all supported that individual mandate. more recently, the original wyden-bennett bill -- that is, senator bennett, the republican from utah, included an individual mandate. it was supported by senators alexander, crapo, corker, graham, and grassley. and, as we all know, the individual mandate was a critical piece of republican governor mitt romney's health reform in massachusetts. as i said, it's just common sense. by eliminating free riders and putting everyone in the risk pool, we keep rates down for

everyone. and it's the only way that people with preexisting conditions are not left out in the cold. so it comes down in this, mr. president: as we learned -- i was just watching over the last few weeks the h.b.o. series that's now on d.v.d. about john adams. and what the early colonists finally realized is that they would have more freedom if they stuck together, if they worked together, if they joined tots. the same is true here in health reform. when everyone is covered and no one is left out, we enhance individual liberty. so health reform is all about freedom, freedom from the fear that if you get sick you won't able to afford a doctor, freedom from the fear that a major

illness will lead to financial ruin. these are the practical freedoms that really matter to americans. mr. president, i can't tell you how many people have come up to me and thank me and other sponsors for passing the affordable care act. they tell me how it has personally affected their families in profoundly positive ways. so let me first tell you about sarah p posekany of cedar falls, iowa. she was diagnosed with chrohn's disease. she ran into complications from chrohn's which forced her to drop class in order to heal from multiple surgeries. because she was no longer a full-time student, her parents' health insurance terme terminatr coverage. four years later she found herself $180,000 in debt and was fourseforced to file for bankru.

sarah was able to complete one semester to hawk i would community college but could not continue because of her earlier bankruptcy. every bank turned her down for student loans. with the new health law, people like sarah will be able to stay on their parents' health insurance until they are age 26. this is a real person. this is a real story. these are real people. so, they want to repeal this? they want to tell sarah, sorry, sarah, can't help you any, and we can't help any young people like you stay on their parents' policy until they're 26. or we could consider the case of eleanor pierce, also of cedar falls, iowa, when her job request a local company was eliminated, she lost her health

insurance. now she had the option of purchasing the cobra insurance, but it was completely unaffordable. so she searched for coverage on the private individual market, was almost unanimously denyinged access because of a preexisting condition of high blood pressure. the only plans that would cover her came with premiums she could never hope to afford without an income. so eleanor, at age 62, suffering from high blood pressure, had no choice but to go without insurance. and hope for the best. mr. president, hope for the best is no substitute for regular medical care. one year later, eleanor suffered a massive heart attack and when all was said and done, she had wracked up $60,000 in medical debt. so, mr. president, real people -- real problems -- and real solutions. we need to get beyond the id logical obsessions and listen to ordinary americans, victims of

the old broken sick-care system. americans have a clear message: the new law has important new benefits and protections; don't take those protections away. nearly half of nonelderly americans have some type of preexisting condition like high blood pressure, arnlg right -- arthritis, heart disease. the new law outlaws the denial of coverage based on preexisting conditions. the mcconnell amendment on repeal takes that away. the largest health insurer in california used technicalities to cancel the policies of women who got breast cancer. the new law outlaws the practice of canceling policies when people get sick. the mcconnell amendment takes away that protection and restores the right of health insurers to return to that

despicable practice. the new a law prohibits insurers from imposing lifetime limits on benefits. the mcconnell amendment sweeps that away. the law allows parents to keep adult children under their policy until age 26. the mcconnell amendment takes that away. mr. president, i want to briefly mention the destructive impacts the mcconnell amendment would have on my state of iowa. one, it would raise taxes on more than 260,000 iowans by taking away tax credits to help them purchase health care coverage. more than 8,300 young adults in iowa would lose their insurance coverage through their parents' health plans. tens of thousands of eye qua with a seniors would face higher prescription drug prices and once again would have to pay a co-pay for preventive services. such as colonoscopies and

mammograms, which now they can get without a co-pay. and of course, the 1.9 million iowans with private coverage would once again be vulnerable to a whole range of abuses and discriminatory practices by the health insurance industry. like cutting you off if you get breast cancer. or putting a lifetime cap on it, or an annual cap. in addition, mr. president, i want to mention that the new health reform law remedies the discrimination against iowa -- my state -- and a number of other states in terms of medicare reimbursement. a little background: under a very complicated medicare formula, doctors in iowa and a number of states were paid less for their services than their colleagues elsewhere for the same service. under the formula, for example, iowa physicians are reimbursed less than doctors in louisiana for the same procedure.

as part of the new health reform bill, i joined with congressman bruce braley, congressman leonard boswell on the house side to negotiate a compromise that provides an immediate $800 million to address geographic disparities for both doctors and hospitals as well as written guarantees from health and human services secretary sebelius for further action to reform medicare reimbursement rates. this great achievement is wiped out with if the mcconnell amendt passes. in addition, thanks to the new lawmakers mid-sized hospitals in iowa -- we call them the so-called tweeners. they're not big enough to have economies of scale. they're not small enough to be put into the small-hospital category. they're sort of in between.

but they are important providers of health care to so many communities in iowa and other states around the nation. well, thanks to the new law, we'll see greater medicare reimbursement to these mid-sized hospitals in iowa and other states. the two-year fix will cover fiscal years 2011 and 2012. it will aid these low-volume hospitals, some of which have struggled to keep their doors open. the fix was included in the new health reform lawmakers the affordable care act. at the heart of the reform mission was an effort to decrease the number of uninsured and increase access, access to affordable care. the law does just that and will ensure kwraefr iowan access to quality health care which these mid-sized community hospitals provide. again, that goes away. that goes away if the mcconnell amendment prevails.

we fought very hard to get that compromise in to protect these tweener hospitals. wiped out by the mcconnell amendment. finally, mr. president, i want to mention the many millions of americans who will be denied health coverage if the mcconnell amendment passes. the republicans apparently reckoned that middle-class americans who already have health insurance don't care about those who are not so fortunate. i couldn't disagree more strongly. i believe americans do care about the uninsured and they are well aware of the devastating human cost of repeal. nearly 45,000 americans die each year in part because they don't have health insurance. with this landmark law, we are ensuring at long last that every member of our american family has access to quality,

affordable health care as a right and not a privilege. as a right and not a privilege. i believe the american people, even those that have good private coverage, understand -- understand -- deep down that it is not right in our society for 30 million americans to go without health insurance coverage. and the devastating effects it has on those individuals and their families when they don't have that health insurance coverage. mr. president, the american people are not going to allow the republicans to take away this great humanitarian achievement. humanitarian achievement. so i urge my colleagues to oppose the mcconnell amendment. it blows a huge hole in the

budget deficit. it destroys hundreds of thousands of jobs. it repeals the patients' bill of rights, allowing health insurers to return to the same old abusive and discriminatory practices. it revokes health insurance coverage for tens of millions of americans. instead let us listen to those voices of the american people who have cried out for so long, for so long for health reform. let's get rid of the ideological obsessions. if there are things that need to be fixed, we can fix them. i've said many times the health reform law, this is not the ten commandments written in stone for all eternity. it's a law. we pass laws. no laws are perfect. sometimes you've got to make changes. we make changes in laws all the time. we're about to make a change in part of the health reform law now dealing with small businesses. fine. these things need to be adjusted

and worked on as we go ahead. they should be done in a nonideological and hopefully bipartisan fashion. but, if you propose that we repeal everything, everything, repeal it, it makes no sense. so let us move forward to build a reform health care system that works not only for the healthy and the wealthy, but for all americans. mr. president, i mentioned in my remarks about how we changed the law for medicare reimbursement to benefit certain iowa hospitals. and because of that, many of the hospitals in iowa were going to get a bump up in their payments this year. and i just -- i have a chart here. i didn't have time to get it put on a poster.

but, for example, saint luke's hospital in cedar rapids will get an additional payment this year of $7 # 4,-- $794,841 this year. that will be taken away by the mcconnell amendment, by the way. trinity regional medical center, webster county, going to get $434,913 additional this year, taken away by the mcconnell amendment. mercy medical center will get $584,833 in iowa city; taken away by the mcconnell amendment. we worked hard to get these payments to help these hospitals that are under duress and not able to serve people in their communities.

we were able to get this additional money to help them survive. and yet, the mcconnell amendment would take it all away. mr. president, i'd ask consent to put an article by james q. lynch that was in the "cedar rapids gazette" and also a chart showing the reimbursement to iowa hospitals under our new medicare rules for 2011. i'd ask that those be printed at the end of my remarks in the record. the presiding officer: without objection, so ordered. mr. harkin: finally, i'd just say, mr. president, for those of us in iowa, in a small rural state with a lot of mid-sized hospitals, with a lot of people uninsured, and quite frankly, we're not in the upper echelons of income in the united states, that for us this health care

law, this health care law provides immediate protections, immediate benefits and promises even more benefits as we get to 2014 and beyond. it would be a devastating blow to my constituents in iowa to have this health reform bill repealed. that's why i so strenuously urge all my colleagues to oppose the mcconnell amendment. mr. president, i yield the floor. a senator: mr. president? the presiding officer: the senator from kentucky. a senator: i ask unanimous consent that senator isakson be recognized to speak following my remarks. the presiding officer: is there objection? without objection. mr. paul:today we will vote on repealing president obama's

federal takeover of health care. this vote will be not only to repeal the specifics of this legislation, but to reassert that we operate under constitutional restraint. when this bill first came up, many on the other side sniffed and were incredulous that we would mention the constitution. many on the other side said the constitution, you know, they really had not even comprehended that the question would be asked where do you get the authority under the constitution to do this? well, interestingly, we do still operate in a society with constitutional restraint, and the courts have now decided that the commerce clause does not mean that you can do anything. mr. paul: the commerce clause, though, for the last 70 years has gotten larger and larger. i used to joke that you can drive a truck through it now it's so big. i also used to joke if my shoes were made in tennessee, they

could regulate my walking in kentucky. the commerce clause, the ask expansive definition and understanding of it has been supplying no restraint to this body. but i think this court case and i think this bill is about so much more than health care, it's about whether or not we live and operate with constitutional restraint of government. this has been going on for a long time. it started with wicker v. philburn in the 1940's where they told a farmer that he couldn't grow as much wheat as he wanted to. he wanted to grow 20 acres of wheat and the government said you can only grow 10 acres of wheat. he said well why? they said because of the interstate commerce clause, we can tell you how much you can grow. he said i'm not going to sell it to anybody. how am i engaged in commerce? i'm just going to feed it to my livestock. they told him by not selling it that he could indirectly affect the price of wheat between the states. it was a ludicrous argument then

and it's a ludicrous argument now. my hope is out of this case, as it moves forward to the supreme court, that maybe we will see a court that takes a step towards overturning wicker v. philburn. that would be the most important case i think in the last 70 years in the supreme court if we do it. will we get there? i don't know. listen to what the founding fathers said about this. many people say the general welfare clause says we can do this or the commerce clause says we can do this. madison wrote that we would not have enumerated these specifics powers and given them to the federal government if we intended for there to be no restraint. recently in the two federal court decisions, the judges made a point of saying that if you can regulate inactivity, basically the nonact of not buying insurance, then there is no aspect to our life that would be left free from government regulation and intrusion. so i think this court case is

incredibly important, more important even than the specifics of the health care bill. there are many reasons why we should have opposed the health care bill and still should. but really number one among them is we need to have a government that operates under the constitution and operates under a commerce clause that was intended to promote free trade between the states and was never intended to allow our government to grow so large and so invasive that it could intrude into every nook and cranny of our economic lives. with regard to the specifics of the health care bill, there were some problems in health care. as a physician, i've seen some of the problems. you know what the number-one complaint i got? was the expense of health insurance, the rising expenses. the federal takeover of health care did nothing to that; in fact has increased expenses to those. you see premiums rising. when you see problems there are two directions to go. we had problems in health care.

you could say do we need more government or less government? from my perspective as a physician, i saw that we already had too much government involvement in health care. i saw that what we had going on limited competition. you need more competition in health care if you want to drive prices down. you need to allow insurance to be sold across state lines. you need to allow competition in prices. one of the surgeries that i did was lasic surgery where you correct someone's eyes so they don't have to wear glasses. no insurance covers it. you think maybe this body will get together and force people to buy insurance for lasic surgery. you know what? without government getting involved competition drove the prices down on lasic. the prices were driven down because the consumer was involved. the same way with contact lenses. you can buy a contact lens for $4, maybe $3. it used to be $20 or $30.

competition works. what we should have asked ourselves when we looked at this health care debate, yes, there are problems. we can agree affordability is a problem. we can agree preexisting conditions is a problem. we should have said do these problems exist because there is too much capitalism or too little capitalism? i would argue there is very little capitalism at all. i do cataract surgery also. you know what? i charge the exact same price as every other doctor in my town, every other doctor in the state and every other doctor in the country because the prices are set in washington by a central committee. that is not capitalism and that's why health care is broken. we need to get back to the fundamentals and we need to say, why does capitalism work in 99% of the economy and doesn't work in health care? well, maybe it's because we're not allowing capitalism to operate under health care. today's vote is very important to repeal. there is great symbolism to this because we have to say yes, we operate as a body under the

restraint of the constitution, but there's also a message here about economic system. the american economic system is capitalism. we should be proud of it. we should try to inject capitalism into more enterprises and not let can't -- not less capitalism. we should not have such great faith in government that government has all the answers because government is notoriously inept and inefficient at most of the things they do. i rise today to support the repeal of the president's takeover of health care. i hope the democrats will reconsider. i understand some of them are reconsidering. and i yield back the remainder of my time. the presiding officer: the senator from georgia is recognized. mr. isakson: mr. president, i commend the senator from kentucky on his remarks, particularly his reference to the constitution. when i read the remarks of judge vinson, it read a lot like the

"congressional record" of christmas eve last year when we were debating whether or not to pass the affordable care act. and judge vinson was clear and precise both in his ruling on the commerce clause as well as recognizing the necessary and proper clause nor the general welfare clause could substantiate the american people to make the decision that the health care bill requires. now, i'm going to vote for the amendment by senator mcconnell to repeal the affordable care act. and i want to repeat the reasons that i stated a year and a half ago on the floor of the senate as to why i believe that. first of all, it has little or nothing to do with affordable care, in my judgment, and we have seen in the 13 months since its passage and the nine months since its signing increase after increase in costs both in terms of insurance premiums as well as the application of the law to the practice of medicine. so it's not about affordable care. it's about care going up in its cost. secondly, if you look at the way in which the bill ostensibly claimed it paid for itself, it shot big holes in america's

health care future, taking $500 billion out of medicare to begin with. reducing the reimbursement almost in its entirety for home health care, which in a state like georgia, with many rural people, is the primary way in which health care is delivered to them. and the assessment of taxes, whether it be on hearing aids and medical devices or the 3.8% sur placed on income -- surtax placed on income or earned income for families making over $250,000. it is appropriate to start over, but by starting over it doesn't mean we delay dealing with the problems americans face with their health care. it may mean we, in fact, accelerate it beyond what this bill would have done if it's carried out to its entirety. when we had the debate at the blair house a year and a half ago in the middle of the health care debate, when the president and the democratic leadership sat down across the table from the republican leadership and for four hours engaged in discourse over the differences in the two ideas, it became

quite clear what the majority wanted to do. they wanted to change the paradigm and put the government in charge of health care in america. and that's why every provision of the bill from the fines for not buying insurance to the provisions of reimbursement drive government to be the decision-maker and the control. just as the senator from kentucky talked about the price of health care today. the price of health care begins and ends with the assessment of reimbursement made in washington, d.c. so, number one, we do need to change the paradigm and get back to a capitalistic-type system and a competitive system. for example, repeal the barrier on interstate sales of health insurance and have a national marketplace. allow affiliated groups or similar groups to adjoin together and compete across state lines as a larger risk pool, like independent contractors, like the profession that i came from, real estate agents, who are not employees, not -- that don't have the benefits of erisa coverage, but bound together could compete with i.b.m. or 3m or any other

company in buying insurance as a group with large enough risk pool to reduce the costs of their premiums and raise the area of their coverage. it is very important that we realize that the real solution to health care, both in terms of its costs as well as america in the future is the way we practice wellness and disease management. and those are the types of programs we can begin to incentivize now to raise them in their practice and lower in the out-years the cost of health care and begin to get our arms around what is right now a spiraling contributor to the deficit and to the debt. but most importantly of all, the fact that over 70 waivers had to have been issued by health and human services already is proof the bill is flawed and is proof its continuation up until its beginning in 2014 is going to be nothing more than making other exceptions for other groups to try and make a bill that's designed to fail work. it won't happen. it should be repealed. and i commend the leader on his amendment, and i will vote for it this afternoon on the floor of the senate. and i yield back my time.

the presiding officer: mr. president? the presiding officer: the senator from indiana. mr. coats: mr. president, it was my understanding to -- that i was going to speak but there was someone else waiting to speak but i will deliver my prefntle mr. president, as a candidate for the senate this past year, i met with many hoosier families, small business owners as well as health care providers, patients, doctors, those involved with concerns about where this health care process was going to go. everywhere i went, from lake county to fort wayne to indianapolis, muncie, evansville, all across the state i heard a resounding plea to overturn the costly and intruesive health care law that was passed by this last congress

and signed into law by the president. mr. president, the issue for these people was not whether or not we needed to address issues of health care, whether it was quality, cost-effectiveness, access. the issue for them was -- were two things. one, they resented the process which forced through a bill which many did not fully understand or grasp the implications of, which was enacted and passed here in these chambers literally days -- hours before christmas. rather than the rules were bent to try and move this through the process, and it became a policy which was not supported in a bipartisan basis but yet a policy that affected virtually every american. and if experience tells us anything, it's that massive changes in policy need bipartisan support to be acceptable if they're going to be effective.

the agreement was, therefore, among the majority of the people that i talked to that the health care plan that is now in place is fatally flawed and needs to be repealed so that we can start over with a much more cost-effective, efficient, affordable health care plan. those who have listened to the people, expressed their views on this particular issue have come to the conclusion that their voices were not heard as they expressed throughout the deliberation of this that congress wasn't hearing what they were saying. the results of november, i think, with this issue being central to the ratified that. i ask that -- a health care law that raises taxes, penalizes businesses, straps states with

costly mandates and increases premiums for american families. recent polls show a significant majority of americans want the president's health care law to be repealed and they want congress to start over and put together a plan which doesn't eliminate every part and parcel of the law that passed. there are some good provisions in there, but overall, the provisions add up to a flawed policy that will not -- that will cost the taxpayer a lot of money and will not provide the access and the care and the quality that americans are looking for. we know that more than half the states, including my state of indiana, have joined in lawsuits challenging provisions of the constitutionality of the law that will be settled by the supreme court in due time. but i believe we must take this opportunity now to overturn the law and start over. let me just address some of the consequences to my state of indiana and to hoosiers if we do not repeal the current health care law. hoosier families will clearly

face higher premiums. the nonpartisan budget experts from the congressional budget office reported that individual health insurance premiums will increase by $2,100 per family as a result of this new law. if we do not repeal the health care law, 50,000 low-income hoosiers will be dropped from the healthy indiana plan. this was a plan implemented by our governor and our state representatives and senators, an innovative plan that addressed a real problem of low-income hoosiers not qualifying for other support. this plan put in place a proposal for health savings accounts. the program has been so popular that it now includes more than 50,000 participants. unfortunately, as a result of the health care law, the state will need to terminate the healthy indiana plan and place its participants into medicaid. this is just one example of a

provision of law enacted at a federal level that denies units of government -- states, localities, and others -- from innovating and bringing about sensible, market-based solutions to programs that they face and needs that they need to address. but as i said, unfortunately, the one-size-fits-all federal law basically says to those states and those innovators, no, we know better, we'll tell you what to do, regardless of what the cost is or regardless of how effective your program is. our governor had negotiated a savings of $400 million over a ten-year period of time in prescription drugs for low-income recipients. that plan has to be overturne overturned -- is overturned by this law and no longer will be in effect. therefore, costing not only the state the savings that are lost in this but also the recipients of the prescription drugs.

if we do not repeal the health care law, hoosier taxpayers will bear a heavy burden. the law will force indiana to expand medicaid, enrolling approximately one in every four citizens in the program. according to an actuarial analysis by the indianapolis-based milimmin inc., a nonprofit, nonpartisan group, indiana will have to absorb an estimated $3.6 billion in new costs over the next decade if the 1.5 million eligible hoosiers enroll in medicaid, which they would under this plan. that burden is passed on to hoosier taxpayers, and our state, frankly, cannot afford to do that. the report also predicts that indiana would have to spend more than $300 million on new administrative costs alone. so with states already facing budget cuts, there's no doubt that these costs will be -- will either be passed on to taxpayers or the state will opt out of the plan and turn the people over to

the exchanges and to the control of the federal government. if we don't repeal the health care law, hoosiers will see a decrease in the quality of service of care. i met with physicians, health care providers, hospital administrators at sites all across the state. i heard a very common concern -- the new law will jeopardize the quality of care for patients. health care plan cuts reimbursement dollars for hospitals and providers at a time when they can least afford it. these cuts simply exacerbate the dire shortage of doctors and nurses and will result in less advanced care for people in need, less personal attention from providers, and fewer choices for patients. if we do not repeal the health care law, hoosier businesses will suffer. the president's health care overhaul hits our job creators

with harmful mandates and regulations, mountains of paperwork and countless taxes. the new law requires businesses with 50 or more people on staff to pay a $2,000 tax per worker if the employer does not offer an acceptable health insurance plan for its employees. mr. president, if i heard one thing more than any other thing from business owners it was that this law will drive them to make employment decisions that are adverse to the benefit of those seeking employment. companies that were in the 45-50 range of employees or even less have basically said, if the choice comes to -- whether to hire new employees or whether to outsource, whether to use technology to replace those employees, if i have to go over 50, i will do that rather than hire new employees.

it's just -- an arbitrary line drawn at 50 basically puts the job creators of this country -- the small- and medium-sized businesses -- in a position of having to decide whether to take on the mandated tax burden of the federal government or whether or not they will -- or simply not go forward and hire over that particular limit and find other ways to produce their product without added employment. at a time when we're facing 9-plus, 10% unimroiment, putting legislation in place that discourages businesses from hiring is the wrong thing to do. many businesses may find it cost-effective to drop workers from their health insurance plan and pay the fine instead. a shuttle maker in new paris, indiana be, found that dropping

health insurance coverage for new employees and paying the penalty would generate savings in the six-figure range for the company. that is a story repeated over and over and over. it is the law -- the law dictates a financial benefit to the company to drop their insurance plans and shift the coverage over to the federal taxpayer. in fact, the administration's own estimates reveal that the more than 6,000 pages of regulations mandated by the law could force half of all employers to give up their current health care coverage within the next two years. now, one burdensome regulation is the 1099 provision i believe we're going to have a vote on that amendment, and i theep it passes. this is one of the many egregious, unexpected consequences of pushing a law through without fully understanding the law or the implications of the law, and rather than begin a piecemeal

approach to deconstructing this 2,100-page or more bill, i believe it's expeditious for us to repeal and start over. the medical device tax particularly impacts my state. it adds a 2.3% sales tax on medical devices. this is an industry in the state of inthat inprobably -- in the state of indiana that probably is one of our top manufacturers, making a profit, hiring people, and yet arbitrarily taxed as a way of helping to pay for the cost of the health care bill. cook medical, a medical device company in bloomington, expects the new health care law will cost the company $15 million to $20 million per year, and this is a company, along with biomed, zimmer, and other medical companies, that simply had the deep pockets because they were producing pockets that the world wanted to buy, they were one of

our export leaders rs and because they were making profits at a time when the federal government wag looking for money to pay for other aspects of the health care plan, they simply added a 2.3% sales tax on their devices, a total of about $20b the health care law devastates indiana businesses. one out of every ten individuals today in ink inis looking for a job. congress should be focused on ways of encouraging those individuals and encourage private-sector growth and job creation, not stifling it. our health care system in america has problems, but restructuring it with a one-size-fits-all government-run plan that increases taxes, raises premiums, and hits businesses with penalties is not the right fix. congress needs to repeal the current law and start over by a step-by-step approach that reduces the sky-rocketing cost

of health care. listening to hoosiers over this past year, i created a list that i believe congress should focus on when we do start over. one, allow competition across state lines. we need to improve being a ssess to the quality of care by increasing competition and allowing scriewrmallowing consue health insurance across state lines. encourage innovation, and i talked about the innovation that's taken away from our state by this law. eliminate frivolous lawsuits and include liability of reform. how this bill could have passed without liability reform as a part of it, when all of us know that defensive medicine is forced upon doctors and providers and hospitals through frivolous lawsuits, without a process -- sensible process of providing for those who clearly are victims of malpractice, but taking away the egregious steps that have been taken and egregious awards that have been made for honest mistakes.

without that being a part of the health care bill, it undermines the credibility of what congress was trying to do and what the american people and health care providers were looking for. improving medicaid and the exphip program, allowing for the immediate creation of association plans for small businesses, incentivizing and rewarding healthy lifestyles, expanding health savings accounts, not reducing them, advancing the use of electronic medical records, increasing cost transparency and retaining our promises to our military personnel, veterans, and their eligible family members are all components of the more detailed plan that i outlined this past year in indiana. most importantly, i believe the underlying principles to ensure our health care system is one that preserves personal freedoms and put puts individuals contron health care decisions is critical to addressing the next bill we take up. so let's take this opportunity

now. let's listen to the patients. let's listen to the health care providers and physicians. let's listen to the job creators and small business owners and then let's listen to the american people who sent us here to represent them. let's rhee repeal this law and -- let's repeal this law and let's start oamplet mr. president, i yield the floor. mr. nelson: mr. president? the presiding officer: the senator from florida is h recognized. mr. nelson: thank you, mr. president. mr. president, it seems to me that what we ought to be doing with regard to this law is we ought to be fixing it instead of repealing it. we ought to be focusing on fixing it instead of focusing on repeal. already unanimously it seems that people have embraced

different parts of this law as certainly necessary. i mean, you could go down the list. 26-year-old can now stay on their parents' health insurance policies. health insurance companies can't go off spending all kinds of money on all kinds of jet airplanes and vacations. they have to deliver 80 -- on large group insurance policies, they have to deliver 85 cents of health care without of the dollar of premium paid. 85%. and then of course you can't have a health insurance company cancel you in the middle of your coverage. i mean, who in the world would not embrace this in the law, that you can't have some silly kind of reason that you're not going to give health insurance to a patient because they had a preexisting condition when in

fact they had a skin rash, and that's an excuse? there's a lot in this law n.a. t is good, not the least of which is that there are 35 million people out of the 45 million that are uninsured in this country that come 2014 will have private insurance, private exchanges called health insurance exchanges, in each state of which they can go and shop for health insurance. and if they can't afford it, because they're somewhere between the rate at which they're eligible for medicaid, which they get the health care, or they're up to 400% of the poverty level for a family of four, they will have some assistance from the federal government so that they can

purchase that private enterprise -- free private enterprise exchange insurance. and you know what happens if you can bring 35 million people into the health insurance system? what happens to them? then if they have health insurance, they start getting preventive care. that means you avoid what happens now is they don't have health insurance, they avoid going to the doctor because they can't afford it, they wait until the health problem turns into an emergency. where do they end up you? they end up in the emergency room, which is the most expensive place now with a full-blown emergency, and the laws of the 50 states require the emergency rooms to treat those people, and guess what? who pays?

all the rest of us pay. so if you can bring 35 million people out of the 40-some million uninsured americans into the health insurance system, you bring down the per-unit cost that all the rest of us pay, which is tacked on to the health insurance premiums that we pay. because when the hospital picks up the tab, who do you think ultimately pays? it's distributed right out to the health insurance system, and the rest of us end up paying. so there's a lot of good in here. what we ought to do is fix it. we shouldn't repeal it. now, there is another issue that has arisen, and this great debate that we are having that is of historic proportions on

what's going to happen to this law that was passed in this body by a 60-vote margin, what's happened is there's been a lot of lawsuits filed. and in two cases federal district judges have ruled that the law is constitutional. and in two other cases, federal district judges -- this is the lower court of the federal court system -- they have ruled that it is not constitutional. now, of course, we have had action by the legislative branch, the other house, the house of representatives has voted to repeal the law, and now here we are with the issue in front of us, of which we're going to vote later today. well, doesn't anybody conclude

that this matter is going to the supreme court to decide if this law is constitutional or not? when the supreme court decides, regardless of what we've done here or what we haven't done, the supreme court decision is going to discard political and partisan interests. and so isn't it in our interest if -- isn't it in the commonsense interest if we would come here and join together in a resolution to petition the supreme court to have an expedited review of this case? now, typically what happens with these two for and two against --

that's going to work its way up through the court of appeals and that's going to take another year, year and a half, and then it'll get to the supreme court, and that'll take another year, year and a half. why don't we just expedite the matter? and why don't we express our intent to have an expedited review by the supreme court? wwell, i have filed such a sense of the congress, a resolution, and its passage might prevent people from arguing back and forth over this law for the next several years, and everybody in this country that's going to be affected would have an answer, and they deserve an answer. and, therefore, i would urge the senate to consider adopting the resolution asking the supreme

court to step in and to decide quickly whether the current law meets the constitutional test. my preference is that we fix the lawyer, that we not throw it out. i don't want to go back to the days of the insurance companies dropping people because they get sick or depriving seniors of help getting their prescription drugs. but, because the matter ultimately is going to be resolved by the nation's highest court, i think we ought to take a commonsense approach of this resolution, and i would urge my colleagues to adopt it. now, mr. president, i see no one else is on the floor seeking recognition. i would just add that another commonsense thing in this law

that certainly means don't repeal it is the assistance that is given to senior citizens. that assistance is in the form of help with the cost of their prescription drugs. the congress passed, and it was signed into law years ago, a prescription drug benefit, but that benefit was only partially assisted by the federal government. and senior citizens had to pick up a big part of the tab. this law closes a lot of that gap, what is commonly referred to as the doughnut hole. we don't want to take that away from senior citizens. and i certainly think that's going to stand the constitutional muster. there's another part of this law that is so beneficial as well,

and that is that aren't we concerned about the deficit? aren't we concerned about how we're going to get our country back on a road toward balance of our deficit so that we have a balanced budget? well, what this law does, which seems to me common sense that you don't want to repeal it, it saves the federal government. according to the congressional budget office, a nonpartisan highly technical economic teeth it, saves the federal government $250 billion over the next ten years. and in the second ten-year period would save up to $1.2 trillion to the federal government. there's plenty of reasons that we ought to fix it instead of repealing it. and i would urge my colleagues -- and i see my dear

friend from the state of nevada came in. before he came in, i had urged us to consider a sense of the congress resolution to have an expedited appeal to the u.s. supreme court. mr. president, i yield the floor. the presiding officer: the clerk will call the roll of the senate. quorum call:

the presiding officer: the senator from nevada. mr. ensign: mr. president, i ask that the quorum call be dispensed with. the presiding officer: without objection. the senator from nevada is recognized. mr. ensign: mr. president, i rise today in support of the amendment offered by the republican leader to repeal what i believe is the unconstitutional government takeover of our health care system. make no mistake, we all want to improve access to affordable

health insurance for all americans, including those individuals with preexisting conditions. but unfortunately, this health reform bill that was signed into law last year is not the right prescription. over the past year i have spoken with tens of thousands of nevadans about this bill. they were very clear when they said that this law is not the cure for our broken health care system. this law imposes new burdens on most nevadans and most americans. it requires that every american citizen purchase health insurance coverage. those who fail to buy health insurance that meets the minimum requirements are subject to financial penalties. just two weeks ago i received an e-mail message from tommy phelps who is a boy scout in las vegas.

this is a picture of tommy, just ten years of age. he attends mulasky junior high school and is working to earn his citizenship in the national merit badge. tommy e-mail stated that i'm really concerned that the bill will damage our country. i think it is unconstitutional for the government to force citizens to buy health coverage. also i believe that the hidden costs in this bill will drive our country much deeper into debt. my dad says that this bill will lead to the elimination of senior dimensions and medicare advantage plans for our seniors. well, i wish that more than half of my colleagues would heed the words of this young 12-year-old. i couldn't agree with tommy more. i am also concerned that this health reform law will destroy our health care system in this country. i'm also concerned about the unprecedented overreach of the government's demand that every

american purchase health insurance just because they live in america. the judge, as we've all heard, in florida ruled that this bill is unconstitutional. let's ask the question st-rbgs really -- is it really constitutional for the government to tell all americans that they must buy health insurance? what's next? what personal liberty or property will the congress seek to take away from americans next? will the government mandate what cars we're allowed to drive or what food that we feed our children? mr. president, where do we draw the line, or will we even draw one at all? after all, the constitution is about enumerated powers, specific powers given to the congress. this bill blows the lid off of those enumerated powers. i've spoken at length about the

unconstitutional provision and even raised a constitutional point of order before the senate voted to pass this reform bill. as i mentioned earlier this week, the florida judge ruled the individual mandate unconstitutional and even went so far as to say that the whole bill is unconstitutional because it cannot be separated out. in december 2010, a federal judge in virginia also struck down the individual mandate as unconstitutional. now we know it could take several years for this case to reach the supreme court of the united states. my good friend from florida, senator nelson talked about expedited that procedure. i think that makes a lot of sense, so that we don't have to wait several years for the supreme court to reach its decision. the administration should ask for that, and the administration has the right to bypass the

court of appeals and go directly to the supreme court. but in the meantime, because it may take that long, several years, we should act to repeal this law before we begin to suffer under its tyranny. now going back to tommy, his e-mail address is significant costs associated with this health reform bill. tommy has every right to be concerned. in fact, every american should be concerned. spending in this country has continued to spiral out of control. the health reform law is only adding to our financial demise. unless repealed, the law will further exacerbate the cost of health care, explode our deficit and debt and forever alter the relationship between the government and the american people. now we hear from the other side that this is going to reduce the deficit -- that this bill is --

because there were $500 billion in cuts in medicare, increased taxes. those cuts in medicare, by the way, congress could repeal and often does. they also used fuzzy math when this bill was being debated. a lot of the savings in medicare were counted twice, and that's why the budget committee on the republican side that did the study said that this bill will actually increase the deficit in the first ten years by $700 billion. i mean, let's just take some common sense. do you think you can increase the medicaid rolls by 16 million people in america and actually cut costs? does that make any sense to anybody? increase medicaid rolls, which are paid by the federal government and the states, and we're actually going to decrease the deficit? that just defies common sense. many small business owners in my

state are already seeing a dramatic increase in their health insurance premiums. this bill was supposed to bring down cost. it's doing exactly the opposite. i've met with at least -- well, with many companies across our state, but with three large companies that i met with, they actually tell me that they're considering, because of a cost standpoint, tkropbg their health insurance, paying the -- dropping their health insurance, paying the fine for employee because it makes common sense to them. they can pay their employees a little stipend. they can put their employees on the government system and their money ahead. well, with businesses struggling just to make it today, people are actually looking. this could be the difference between staying in business and not. so they are looking at huge increases in their premiums or paying the fine and putting

people on the government system. that's one of the reasons that i think that this bill is going to massively increase the federal debt. this law does not help the typical nevada family who purchases insurance in the individual market either. in fact, traveling the state, i met with nevadans who are already seeing increases in their premiums. the estimates are for individuals is 10% to 13% increase in their premiums because of this bill. but small businesses that i've talked with, the increase is already, that they're seeing this year, is somewhere from 15% to 30%, a few of them around 8% or 9%. but most of them are between the 15% and 30% range. in my state, unfortunately, about 70% of all businesses, their health plans won't qualify for the minimum plans in this government -- that this government is going to mandate

starting in 2014. well, in tommy's e-mail to me, he also mentioned medicare advantage. there are more than 100,000 nevada seniors who choose a medicare advantage plan. these nevadans are not better off because of this reform. their extra benefits actually will be reduced by more than half. this bill doesn't help middle-income workers in nevada either. our hardworking hotel housekeepers, casino workers, airline workers, teachers, police officers look forward to sharing the burden of the $200 billion tax on health insurance holders. many american workers will pay for new taxes and penalties with reduced wages and lost jobs. oh, and by the way, there's also new taxes on prescription drugs, clinical lab work and medical devices that will also get passed on to the american

people. simply put, i believe that this health care bill is the job killer. my state cannot afford to lose more jobs. we have 14.5% unemployment in my state, 9.6%, 4%, something like that across the nation. we can't afford to lose more jobs. i'm sure thafpl us have heard -- many of us have heard the phrase that the devil's in the details. truer words cannot be spoken when talking about this health care reform bill. we know when democrats pass this legislation that they were given enormous discretion to the secretary of health and human services, but i don't think any of us could be fathomed that the 2,000 page bill would generate potentially up to 20,000 new pages of regulations.

i've printed off many of the regulations in the bill here before us today. look at the size of this thing, and they're not even close to being done writing the regulations. i challenge anybody with any company or any american to try to understand this bill and its regulations. it's virtually impossible. it takes a team of lawyers and health care experts to even come close to understanding all the implications of this bill. according to my staff's calculations, so far about 6,200 tphaeupblgs regulations. as -- 6,200 pages in regulations. this could go to at least 26,000 pages. i think it is safe to say the devil really is in the details with this health bill. the american people are going to learn more about its unintended consequences of this legislation as more and more of these regulations roll out. remember last year when nancy pelosi said we have to pass the bill; now we can find out what's in it.

we may be able to find out what's in it if you can understand it when you get through all of this. i wonder how many people in this body have actually read not only the legislation, but the regulations. it's absolutely daunting. this health care reform bill with all of its new taxes, funding cuts for programs that they rely on and raise premiums, which is why we should be repealing this bill. instead of doing so, however, this administration is granting special waivers to various provisions in this law. these waivers are basically exceptions to the rules and they allow organizations to circumvent the standards required in this health reform law. so if waivers are needed, isn't that proof that the health care reform bill is problematic? isn't it proof that this health care reform bill isn't working or are special interest waivers

a greater priority than the plight of the american people? it's interesting to me that some of the biggest supporters of this law have been working behind-the-scenes so they can obtain special waivers so they get out of complying with this law. they won't be held to the same standards as businesses in nevada. nevadans are not behind this bill. american people are not behind this bill. but there is no doubt that we need to improve health care in the united states. what's the primary problem with health care in the united states? the senator -- the new senator from kentucky said it best. it's too expensive to buy health insurance in the united states. this bill does nothing but make that problem worse. the people of this country did not sign up for the kind of change that brings with it

billions of dollars of new taxes and a potentially -- and potentially a loss of their insurance coverage or a choice to decide which coverage that they have the american people don't want a bureaucrat coming between them and their doctor. now, turning my attention back to taxes just for a moment. this bill alone ensures that hard-working americans hand over even more of their paycheck each month to government. it's funny how reforming health care means more money for uncle sam. there's a new surtax on investment income which, yes, does include a gain on home sales, which has many nevadans infuriated. there are new limits on the limits of flexible spending accounts, which i've heard from many nevadans on. many people use these flexible spending accounts to fund

exceptional medical costs even though president obama promised people could keep their current health care plans. excuse me. there's also a new tax on certain employer-provided health care. the so-called cadillac plans much there's taxes on drug companies, medical devices, in-door tanning services and the onerous 1099 reporting requirements for small businesses that apparently even president obama opposes now. he said in the state of the union address that we need to fix parts of the bill that need fixing and move forward. well, i believe this whole bill needs fixing, so let's repeal it and replace it with real health care reform that actually attacks the cost, which is the number one problem in health

care in the united states. we can go back to the drawing board. take the best ideas from both sides of the aisle. put together health reform bill that will take us into future. republicans have come up with many ideas on ways to fix the nation's broken health care system. the answer is not unbearable taxes, unsustainable growth of the government or paying for a brand-new entitlement program. those aren't the qualities of comprehensive health reform. they're the qualities of terrible policy that will lead to devastating results for americans and our health care system, which is the best in the world. there is a better way. it will take time, but if we can change the way that americans think about health care, then we can create a better system. imagine a system where americans get to keep their choices in health care and were allowed to buy insurance across statelines. imagine a system where there's

transparency, where you know how much your doctor's visit will cost and how much your surgery will be. ask yourself, when was the last time you went to a doctor's office and got a written estimate? this third-party payer system that we have, somebody else is paying the bill, you're receiving the service, doctors don't care what you think of the cost. so there is no transparency in today's system. we need to have a system that's transparent where you can shop around for the best value for your money. imagine a system that rewards individuals for engaging in healthy behaviors. imagine a system where you're not punished for having a preexisting condition. imagine a system that allows small businesses to pool their purchasing power together to provide health insurance to their employees through small business health plans. imagine a system where doctors can practice medicine to heal patients instead of practicing medicine with the goal of not

being sued. and imagine a patient-centered health care system, not an insurance-centered system and not a government-centered system, which is what we have today. these are all standards which we should work towards. we can't afford to settle for this bill -- this bill. this bill, i believe will bank rupt our country -- bankrupt our family, our country and our neighbors. we cannot survive with this sort of taxing and spending for our future. we can't survive it. we cannot afford it. so, mr. president, i believe we should repeal this bill. all of its pages, all of its regulations, all of the regulations to come and work together, not as republicans, not as democrats, but as americans to address the primary problem of health care in this country and that is the cost. it is critical for future competitiveness of american business. it's incredibly important for

the quality of health care for the future of our citizens as well. mr. president, i yield the floor. a senator: mr. president? mr. schumer: thank you, mr. president. i rise in strong, vehement opposition to the a amendment offered -- to the amendment offered by the minority leader to repeal the health care reform law. i would say to my good friend from nevada, yes, we would like to work together to further reduce costs. but this bill does reduce costs significantly. the c.b.o. has said in no uncertain terms that the appeal would balloon the deficit by more than a trillion in the second decade. the law smokes out a good deal of the waste, the inefficiency, the duplication that we all know is part of our system. and that is the place where we have to continue to work together. our country delivers the best

health care in the world, but it's also the most inefficient. we spend 17% of our g.d.p. on health care. the next highest spending country is only 10%. under the reform law, we will begin the first large step in keeping quality care, but getting the costs under control. now, if my colleagues on the other side of the aisle said, you know, you're right, we have to reduce costs. we have a better way. and they offered a bill on the floor, well, maybe we'd take a look at it. but they're silent. they're easy to sit there and say, repeal. what would you put in its place? and the reason this amendment will be so easily defeated today is because a budget point of order which says, if you're going to raise the defici deficit $230 billion in the first decade and a trillion dollars in the second, you

better find out where that money's coming from. and the other side is sliefnlt not a peep -- silent. not a peep about where that money would come from. that makes one feel this is sort of for show. let's wave the flag for some of our hardcore supporters who definitely want repeal. but there's nothing in its place. the old mantra that the other side seem to have some of them, repeal and replace is gone. it is now repeal and we have nothing to replace it with. that does not meet the favor of the american people. in fact, the numbers who are against repeal is growing. only about a fifth of those who say they want the law changed want a full repeal. only 20% of the public wants full repeal. if those numbers are correct, and i believe they are, that means that a majority of

republican voters don't want full repeal. the bottom line, mr. president, particularly in this area of health care, talking about deficit reduction is a lot easier than doing it. that fact is evidenced by the amendment my friend, the leader from kentucky, will offer. that is why a budget point of order is the appropriate response. and that is why this will be defeated rather handily. and in later days maybe my colleagues will come up with parts of the bill they wish to change. we will be open to it. senator stabenow today is offering an amendment to change the 1099 section of the law. she has worked with people on both sides of the aisle. i know that senator johanns has been a leader, the republican from nebraska. we're going to pass that today. so the idea that we're unwilling to change any part of this law is belied by what we're doing here on the floor. we want to work together.

but somehow when we get a repeal amendment -- repeal the whole thing, no substitute, no change -- no answer to how to deal with the debt, one wonders what this repeal is all about. and, furthermore, what is one of the reasons -- why is the american public becoming more favorable to this law as we go through this debate? that's what the polling data has shown. well, i'd give two reasons. first, many of the horrors that were bandied about as the law was being put together are proving not to be true. i'll never forget in the summer -- last summer someone came over to me, a gentleman from long island, he said, senator schumer, i'm a democrat, i voted for you in every election, but i'm not going to vote for you again. i said, why? he said, i hate the health care

law. i said, what do you hate about it? he said i'm going to lose my health benefits on labor day. i said, what's your profession, sir? he said i'm a new york city firefighter. he lived on long island, but he was a new york city firefighter. anyone who knows anything about the health care bill knows that a new york city firefighter will not lose their benefits on labor day or any time else under this provision. but this poor man had listened to some talk radio and they convinced him that he was going to lose his benefits. but that is all fading. i haven't spoken to the gentleman since. i don't know his name. i just met him at a summer start treaty fair. but he -- a summer street fair. he found that his benefits are just as good as they were before labor day. it's funny he would say repeal the law a year ago, but wouldn't say so today. but there's an important reason why this law is gaining support

as we learn about, and we owe some thanks to our republican colleagues. because they have given us a second chance to make a first impression. most who looked last year said the messaging, rightly or wrongly, falsely or truly, was done better by the opponents than the proponents of the law. now as people look at the law, they're learning so many good administration the bill. i dare say that most of my colleagues on the other side of the aisle want to keep those good things. i'd be quite certain that the vast majority of americans would want to keep those things and the polling data backs that up. so when you do repeal, when you just use a hatchet, not a scalpel you lose many of the good things that are in effect today. i ask my colleagues on the other side the aisle who support repeal, do you support increasing prescription drug costs for our seniors. thanks to this law, the

so-called doughnut hole, which was created in the prescription plan of 2003 under george bush, will be fixed. seniors in this doughnut hole, which says when your -- when you've paid about dz 2,500 - 2,500 -- $2,500 for drugs, government will help you no longer, will now get a 50% discount on their medications. this first year that will amount to the average senior savin saving $550. when you're a senior on a fixed income, $550 is a nice amount of change. and will help a whole lot of people. the discount keeps increasing every year until the last crumb of the doughnut hole is gone. i will admit that's a mixed medical for because a -- metifore, because a doughnut hole does not have any crumbs. but good try, staff. it sounded very good to me.

but in these times, these savings aren't exactly chicken feed. they will make a huge difference for seniors. the average senior when the doughnut hole is fully eliminated, crumbs and all, wil save more than $2,000 a year. how how about the provision that helps young people? every one of us knows of instances where young men and women get out of college or get out of high school and they go into the job market and oftentimes those new jobs that they're seeking doesn't provide health care. that happens quite often. it's a new job, it's a low-paying job, they are just starting out, but i know i've spoken to many young people like this and their parents. there is a lot of anguish. does that young person who maybe has a job that pays $25,000 or or $30,000 a year pay $1,000 a month for health care for him or herself? we can't afford that.

on the other hand, not to go with health care, yeah, they are young and healthy, but god forbid they have an accident, go to the hospital, come up with some unusual and rare and expensive disease. what are they going to do? this keeps lots of young people and their parents up at night. this new bill solves that problem because you can stay on your parents' health care should they have it until you're 26, and by then you're in the labor force a little bit longer, and the likelihood of your employer giving you health care is somewhat greater. do my colleagues on the other side of the aisle want to take that away? and if so, what are you going to put in its place? what are you going to tell the young people 22 and 23 and 24 and 25 and 26 what they're going to do? then there is another provision that's, i think, really worth keeping -- preventative

medicine. we all know that one of the big problems with our health care system as opposed to some of the others in some of the other western countries is we don't do enough prevention, and so instead of a disease being nipped in the bud, making the patient healthier and costing the system a whole lot less, it waits and waits and waits. well, those who put this health care -- those of us who put this health care bill together realize that and -- realized that and said early detection saves not only lives but billions of dollars. so now in this health care bill, medicare will provide a free wellness checkup once a year for every senior citizen. if there is a little bit of illness, they can nip it in the bud. we all know the earlier you detect cancer or heart disease or diabetes or emphysema, the better chance of curing and the less expensive to cure it. so this is going to save billions of dollars.

just giving certain tests at these wellness checkups will save people, themselves money but more importantly save the medicare system a lot of money. it's important to save the people to save their money, too, of course. and it makes a great deal of sense. a mammography can find breast cancer before it metastasizes. a simple blood test can provide prostate cancer before it spreads. one -- what are my colleagues on the other side of the aisle going to say to seniors? what are they going to say to the medicare system which is trying to get more effective by getting involved in early detection and prevention? forget it? that's what you're doing when you vote for repeal. you have nothing in its place. how about the small business tax credit? my dad was a small businessman. he had a little exterminating

business. i know how small business men struggle. my father truly didn't become happy until he left the business. now, praise god, he is 87, he is a much happier guy even at 87 than he was at 60 strug until that business. one of the dilemmas that small business people face is the high cost of health care for their most. they want to provide it. a, because they want their employees to be healthy. b, because they like most of their employees. and c, because they want to keep the employees from going somewhere else if they're good. but it costs so darn much. well, here is what's in the bill. if you're a small business that makes less than $1.2 million and you have fewer than 25 employees -- i think it's 25 or fewer employees -- you get a 35% credit, going up to 50% in 2014. huge help to small businesses

that are already providing health care for their workers and a great incentive for small businesses that are not already do so. hundreds of thousands of small businesses in my state alone will benefit from this. what, my friends, on the other side of the aisle are you saying to those small businesses? what are you saying to their workers? go at it alone because you want to repeal it, but you have nothing, nothing, nothing to replace it. and there's one more provision i want to speak of. there are so many good things in this bill, no matter how much you don't like some of the bad provisions. i know that's genuinely held by many of my colleagues. to just repeal it and get rid of all the good stuff makes no sense, in my judgment. we've all heard the horror stories of insurance companies when you go to them after you, your spouse, your kid has an

illness, and you say thank god i have insurance, and the insurance company deliberately or maybe not, but anyway, they say, mr. smith, you didn't check off that little box on page 17. you didn't dot that i or cross that t. you're not covered. we all know the intent was to cover. we all know that the insurance company was happy to take the premiums even without that dotted i or crossed t or checked box. when the family was healthy and money was coming in. but now all of a sudden they say bye-bye. this bill doesn't allow that to happen. the kinds of rescission that i just talked about are banned. what are we saying, not just to the families who have experienced this but to every american family with insurance that worries about this, what are we saying to them?

again, you have nothing in its place because you are repealing, not replacing, even though people had said early on that that's not what they're doing. so i'd say in conclusion or just one more point before i conclude, we are willing to work with you. the stabenow amendment on the floor of the senate shows just that. i would have drafted it a different way, and there will be a levin amendment that i would prefer, but either way, we're going to address the 1099 issue. many people on your side of the aisle, many people on our side, that was a mistake. not every bill is perfect, but we're not digging in and saying we have to have the bill exactly as written and exactly as drafted. but you're doing the inverse. you're saying we have to have no part of this bill, because if you wanted to retain parts of it, you would have had an amendment on the floor saying take these parts out and keep

these parts in, but you're not. why? well, your guess is as good as mine, but it's a lot easier. it's a lot easier to just tear down than create, as we learned when we did the health care bill. but you really have an obligation. unless you believe there shouldn't be a health care system or we ought to go back to the system without any changes in the law which we had, which nobody liked, it's not fair. so in conclusion, one, this bill reduces the deficit, the repeal increases the deficit, and there is no money there to make up for those funds that the bill would bring in by cost cutting and by fees. second, there are lots of good

things in the bill that probably my colleagues would support, but they just get rid of them with no replacement, nothing. nothing for the seniors, nothing for the 21-26-year-olds, nothing to the people who are treated poorly by their insurance companies. and third, we want to work with you. there are some changes that we could work together on in the bill, not only 1099 but further walking down the road of reducing the inefficiencies in the system, the high costs, the waste while still preserving good care for the people who get it. that's something that would lend itself, particularly in these times of high deficits, to bipartisan support and working together. but today, simple repeal, again, it may feed some red meat to the minority in this country. it's a small minority if you believe the polling who say just

repeal it, but the responsible job of a legislator, whether you agree with this bill or disagree with this bill, is not to repeal but to improve. that isn't happening today. mr. president, i yield the floor. the presiding officer: the senator from alabama. mr. sessions: mr. president, i rise in strong and vehement support of senator mcconnell's bill to repeal the health care reform law as now constituted and will support replacing it with reforms that truly provide americans with access to quality, affordable health care, reduce skyrocketing health care costs and put our nations on a more sustainable fiscal path. these good goals can be achieved, but this current bill does not do it.

i'm pleased to see my colleagues say they would accept some amendments, but the johanns amendment he made reference to was voted on twice last year, and when the democrats held a significant majority in this body, they voted it down. after seven new members have been added, many of them elected on a promise to repeal this -- every one, virtually, on a promise to repeal this bill, we now have the agreement to change the 1099, which is about .01 of what's significant about this legislation. indeed, if senator scott brown had been elected a month or so sooner, the bill wouldn't have passed as it did on december 24, the day before christmas. the american people have never supported this bill. polling numbers shows they still do not support this bill. the democratic health care

legislation was sold as a package that would reduce insurance premiums by $2,500 per family. we were told that repeatedly. it would trim the federal deficit, reduce the deficit and immediately create 400,000 new jobs. sadly, none of these promises have been met, they were all false. they were attacked on this floor by people who were sophisticated, and they pointed out how these matters were not going to be achieved and they have not. they were false then and they're false now. the new health care law will cause health care spending to rise over the next decade. americans will see dramatic increases in their premiums. that is a fact. the federal deficit will increase by an additional additional $700 billion. this bill does not reduce the

deficit, and the law's expensive mandates, penalties and tax hikes will lead to job losses and layoffs that will damage our economy. the last thing we need to do now is to have employers lay off people because of surging health care costs, as is happening. talk to small businesses in your communities. as our nation's reckless fiscal policy and surging debt brings us ever closer to a tipping point, a debt crisis that could damage our country substantially as it has others around the world. respected economists have stressed the need for congress to reduce federal spending and contain mounting health care losses, but rather than tackle these problems that threaten the long-term stability of our nation, new -- nation's new

health care law exacerbates a fiscal crisis by creating a new open-ended entitlement, a monumental new entitlement program. introducing $2.6 trillion in new spending. tell me how we can spend spend $2.6 trillion and not increase spending in our country. entitlements today are hammering our budget. they are surging our deficit. entitlements are dangerous things. the last thing we need to do is create a new entitlement that's not going to be contained in its spending. and according to the congressional budget office, our official analyst, the new health care law, our own group, the c.b.o., appointed by the democratic majority, says that the health care law will cause insurance premiums in the individual market to soar by

10-14%. for american families, translating it into a $2,100 increase in their costs for purchasing health care coverage by 2016. that's huge. another $2,100? that's a stunning development and is exactly opposite of the promises of the bill. c.b.o. scored that. total health care spending in the united states consumes already 17.3% of g.d.p. and we have felt that that was too high. it's the largest of any industrialized nation in the world. but under this new law, the national health care spending will approach 20% of g.d.p. by the end of this decade. this is the budget committee scoring chaired by the democratic majority in the -- in the congress. sadly, many supporters of the health care law continue to perpetuate the myth that

repealing this law would increase the deficit. my friend, senator schumer said, repeal the law and the deficit will go up. a thorough examination of the law pulls back the curtain to expose the deceptive budget gimmicks on how that is stated and reveal the true cost. the double counted -- first, our democratic colleagues double counted $398 billion in medicare costs and taxes, $29 billion in social security taxes, $70 billion in new long-term health care premiums to pay for the new health care spending. double counted money. it's the largest false accounting scheme i suppose in the history of the world. think i'm exaggerating? december 23, the night before this budget -- this health care bill was finally passed 60-40 --

60 democrats, 40 republicans "no" -- i called the congressional budget office, mr. elmendorf, selected by our democratic colleagues to be the budget director, and this is what he said. "the key point is that savings to the h.i." -- that's the hospital insurance trust fund of medicare under the health care bill "would be received by the government only once, so they cannot be set aside to pay for future medicare spending and at the same time pay for current spending on the other parts of the legislation or on other programs." this money it was cutting medicare benefits, raising medicare taxes, they didn't use the money to strengthen

medicare, which was heading to insolvency, they took the money and spent it on a new program. actually, they borrowed the money from medicare and that's how they got it. it wasn't the treasury's money to spend on a new program. and the way they scored it, it double counted the money. that's how -- it's this money that they're counting to say that this bill is -- actually creates a surplus. without this money, there's no surplus. since medicare is going into deficit, they are going to call their debt instruments, their bonds from the treasury as they go into deficit. by the way, the u.s. treasury pays medicare interest on the money they borrowed from them to start this new program. and soon that money is going to be gone and we're going to have to borrow money on the open market to fund this new entitlement. and the new entitlement's going to cost far more than is currently estimated.

over the ten-year budget window, the congressional budget office says the new law -- the congressional budget office reports point out how the law was doctored to start certain revenue enhancements, taxes and so forth now but only starting the expenditure programs in 20 2014. why is that important? well, they looked at -- they got a score from c.b.o. of what it would cost over ten years. so you get income for ten and you get expenditures for six, it looks pretty -- might look pretty good. that, plus the double counting of the money and several other gimmicks. that's how they say this is creating a surplus. it is not a surplus. as the ranking member on the budget committee, i am stunned

by how difficult and how challenging our current financial situation is. we've got to do something about it. we need the president to help us and lead. he's not doing so, so it looks like congress may be having to deal with it. but former director of the c.b.o., douglas hold douglas ho, cowrote an article in the "wall street journal" in january that eliminates any confusion about the law's impact. i'm disappointed that members of our senate are still coming down here to success -- to suggest that repeal of this law is going to adversely impact our deficit. i'm stunned that that would continue to be said. this is what mr. holtz-aiken, a highly respected individual said, in the "wall street journal" in january. the article is entitled, "health care repeal won't add to the

deficit." he says this -- quote -- "repeal is the logical first step toward restoring fiscal sanity." fiscal sanity. he goes on, how, then, does the affordable care -- he goes on, "how, then, does the affordable care act magically convert $1 trillion in new spending into painless deficit reduction? it's all about budget gimmicks, deceptive accounting, implausible assumptions used to create the false impression of fiscal discipline. repeal is not a budget buster. keeping the affordable care act is." closed quote, mr. holtz-aiken, former director of the congressional budget office. there's no question about that. holtand it's a stunning thing. a poll by the kaiser foundation and harvard university released last week revealed that the american people are seeing

through these ploys. they've heard these talk about before. they're not buying it. 60% of the country believes the health care law will increase the deficit over the next ten years while only 11% think it will lower the deficit so colleagues, give us a break, would you? the american people are not going to buy this argument. i wish it would not be repeated but the president continues to say it himself. clearly, the american people once again showed that they are wiser than our -- than their government leaders in many instances. and the final point i'd like to make about the health care law is its debilitating impact on jobs, the expensive mandates and penalties included in the health care law coupled with rising costs of insurance facing families and businesses are costing us jobs right now.

and they're doing -- will do so more in the future. i would just add, mr. president, i had meetings with small business groups in phoenix city, alabama, and jasper, alabama, 10 or 15 individuals. every one of them told me without question this health care law would cause them to reduce employment. we do not need to be reducing employment. we need to be increasing employment. this bill is a job killer. it's indisputable. over 6,000 pages of legislation and regulation regulations add . economic estimates indicate that repealing the law that threatens our economic recovery would save 700,000 jobs. it's imperative that congress does repeal this law. yes, we need to start and continue to work on things we had already agreed on, like

preexisting condition illness -- preexisting illness, interstate competition of health premiums, a lot of things that we all agreed on and could agree on to make health care better. let's do on those things. let's not have a massive federal entitlement program funded by dubious gimmicks imposed on the american people against their will, damaging to the american economy. we cannot do that. and it will be repealed, in my view. the -- so, mr. president, i know my time is up. i would just conclude by saying we had a new election. a lot of people took that issue to the american people. i think their voice was clear. they're not happy with congress who do not listen to them and passed the bill against their wishes, and they expect congress to reconsider it and change it

and limb mate it and start over with legislation -- eliminate it and start over with legislation that will work. their message is clear and that's what we need to do. i urge my colleagues to support senator mcconnell's legislation. i would yield the floor. mr. sanders: mr. president? the presiding officer: the senator from vermont. mr. sanders: mr. president, it is very hard for me to understand how anyone could be voting to repeal the entire health care bill, because when you do that, among other things, what you are saying is that we will continue the odious practice of denying health care by insurance companies to people who have preexisting conditions. now, for eight years under president bush, more and more people lost their health insurance, the cost of health care soared, and our republican

friends had virtually nothing to say on health care. now that a bill has been passed, which i am the first to agree is not the best bill that we could have passed -- and i will tell you why -- it has its share of problems which should be remedied. but to say right now, when 50 million americans have no health insurance, when states all over this country are wrestling with huge budget deficits which no doubt will result in millions more being thrown off of health insurance, to say we should retreat to where we were is beyond comprehension. second of all, for my republican friends to say let's repeal health care, there are millions of families that now are beginning to be able to include within their own health care

plans their sons and daughters up to the age of 26. goodbye to that. furthermore, in a nation which ends up spending more on health care -- almost double per person -- compared to any other nation on earth, we have put in the health care reform bill billions of dollars for disease prevention. we are as a nation very weak in terms of trying to keep people healthy, trying to keep them out of the hospital. we spend a fortune on people after they're sick. in this bill, we have made some significant steps forward in terms of disease prevention. wellness, which is very, very cost-effective in terms of health care dollars, not to mention -- not to mention human pain and suffering. in that regard, i'm proud to have worked with a number of

other senators in doubling in that bill the number of community health centers in america which was providing the most cost-effective primary health care that is provided in this country, keeping people out of emergency rooms, keeping people out of hospitals, giving them access to primary health care, dental care, low-cost prescription drugs, and mental health counseling. in the midst of an extraordinary crisis in terms of primary health care, where everybody recognizes we don't have enough primary health care doctors or nurses or teb nitions -- or technicians, we tripled funding for the national health service corps and it is already working effectively in getting doctors and dentists and nurses and other practitioners into underserved areas. all of that would be undone and i think that makes no sense whatsoever. now, to my mind, what we have to do is not to repeal this bill

but to make it a better bill, and i will give you one very specific suggestion that i have worked on now for over a year. senator wyden has worked on th this, others have worked on that and that is to say that if a state in this country, the state of vermont, the state of alaska, any other state, can maintain the high standards for quality health care and coverage, that the national health care bill did, then that state should be given significant flexibility to perhaps do it in their own way and do it more cost-effectively. and i should tell you, mr. president, that in the state of vermont, our new governor is a supporter of a medicare-for-all single payer program. there are other states that to want move in a different direction, maintaining high standards but doing it, perhaps, in a different way than has been

proposed by the national legislation. in my view, they should have that right. and if vermont is effective in doing what i believe we could -- providing health care to all of our people in a cost-effective way -- i suspect other states around the country can learn from vermont's experience. i think that is a positive step forward the beauty of our federalist system, 50 states, every state has a good idea. i think if we maintain standards that are high and give states flexibility, this can improve the health care reform bill that we passed last year. but killing this whole bill makes no sense to me at all. mr. president, i also wanted to say a word on an issue which is getting more and more attention, and that is social security. in my view, social security has proven itself to be the most successful social program in

american history. over a 75-year period -- and this is really extraordinary. we take it for granted but it is an extraordinary success story. in good times and in bad times, social security has paid out every nickel owed to every eligible american, and it does that in a minimal administrative cost. mr. president, despite its strong record of success over the last 75 years, social security now faces unprecedented attacks from wall street from many of my republican friends, from some democrats. and i have to be very clear that if the american people are not prepared to stand up and fight back, we could begin to see the dismantling of social security this very year. mr. president, let me just cite

the facts with regard to social security. i know when we watch tv tonight there will be some guy up there saying social security has gone bankrupt. social security is collapsing. and that is absolutely untrue. there has been a significant amount of misstatements regarding social security. here are the facts that nobody denies, nobody denies. number one, according to the latest report of the social security administration, social security will be able to pay out 100% of all benefits owed to every eligible american for the next 26 years. you tell me how a system is going bankrupt. we've got a lot of problems in this government, and our country faces enormous problems. but when you can pay out every benefit owed to every eligible american for the next 26 years, do not tell me this is a program in crisis or going bankrupt.

and after 2037, social security will be able to pay out 78% of promised benefits. do we have to deal with that over the next 26 years? yes, we do. but it is not crisis. and this senator will do everything that he can to oppose any effort toward privatization, any effort to raise the retirement age, any effort to lower benefits. second point: everybody is concerned about the deficit crisis that we face, $14 trillion national debt. and how much has social security crypted to the deficit and the -- contributed to the deficit and the national debt? how much? well, not one penny. not one half a penny. social security is funded by the payroll tax. social security has a $2.6 trillion surplus. that surplus will go up. and to attack social security because of the deficit crisis is

grossly unfair. you want to know why the deficit went up? we're in the middle of a recession. we fought two wars in afghanistan and iraq, forgot to pay for those wars. gave hundreds of billions of dollars in tax breaks to the wealthy, bailed out wall street, medicare part-d prescription drug program written by the insurance companies, all unfunded. those are the reasons why you have a deficit. social security has nothing to do with it. so i would suggest that in the midst of all of this financial instability that's out there, with the middle class shrinking and poverty increasing and people really worried about their retirement years, one of the most significant things that we as a congress can do is stand up and say we are there. we're going to protect social security. we ain't going to cut it and we're going to make it stronger so while it has done a great job

for the last 75 years, it will continue to do a good job for the next 75 years. with that, mr. president, i would yield the floor. mr. vitter: mr. president? the presiding officer: the senator from louisiana. mr. vitter: thank you, mr. president. i rise in strong support. mcconnell amendment 13 that would completely repeal president obama's, in my view, unconstitutional health care bill. of course i was an active participant in the debate in the last congress about obamacare and fought that tooth and nail. the day after it passed into law, i introduced a freestanding measure to repeal it completely. the first day of this new congress that i could file bills, i reintroduced that measure. and of course, for all those reasons, certainly support this amendment that accomplishes that important goal. let me begin by responding to my distinguished colleague from vermont's suggestion. everybody who wants to repeal this law, including me, we don't

want to do away with the idea that you shouldn't be shoved off insurance because of preexisting conditions. you shouldn't have portability. you shouldn't be able to meet those obligations. we don't think that at all. we are, however, for complete repeal for a very simple reason. what's wrong with this bill, what's wrong with obamacare isn't one detail here and one comma there. is isn't at the periphery of the plan. it's at the heart of the plan. it's the essentials. it's the core of the plan. we can and should and must pass significant reforms like protection for individuals with preexisting conditions. that's why we have introduced those measures. we have advocated those measures in a targeted way. that doesn't mean we can or should or must preserve the

whole of obamacare which has significant problems at the core of that tkpwar -- gargantuan bill. let me mention four of those core problems from my point of view. first is maybe most fundamental, most basic; that is there are important elements at the core of obamacare that are flat-out unconstitutional. and even if they weren't unconstitutional, they would be unwise because they are a dramatic expansion of the power and role and authority of the federal government. the most obvious is an absolute mandate in the bill. a mandate from your federal government that every man, woman, and child in the united states must buy health insurance. now this is unprecedented. there has never been a mandate like that from the federal government or any level of

government. there's never been this forced purchasing of a product in the private marketplace. some people bring up the comparison with car insurance, but that's not a close comparison at all. because at the state level, that's not a forced mandate. that is simply saying if you want the right, the privilege of driving a car, which is not some constitutional guaranteed right, then part of the deal is you have to cover the damages from any accident. so that's not a good comparison. so this absolute mandate that every man, woman and child in the united states go out and purchase health insurance, purchase a product in the private marketplace is unprecedented. and for that reason, it is unconstitutional. and it's an unprecedented expansion of the power and role and authority of the federal government. in the last few days there have

been hearings, quite late to the hour but there have been hearings in the senate in committees about the constutionality or unconstutionality of obamacare. of course this central question came up. i found the response of some of the witnesses at the hearings who favored obamacare, were advocates for obamacare pretty startling on this point. one senator in the committee asked them, well, if we can mandate constitutionally that every american man, woman and child buy health insurance, why can't we pass a law that says obesity is a real problem in this country, which it is? and, therefore, we're going to mandate that every man, woman, and child in america eat certain vegetables and certain healthy foods every day. you know what the response was from this advocate of obamacare?

well, i don't think you can mandate that they eat the food. you can only mandate that they buy the food. great. real reassuring. to me, that's not an argument for the constutionality of obamacare. that's a clear argument for the unconstutionality and danger of the obamacare federal power overreach. there are many other aspects of obama care which also pose serious constitutional problems. my point is that these are big problems, and they aren't minor details which we can tweak with amendments. they go to the heart of this gargantuan bill. similarly is the dramatic expansion of government and the cost of that expansion. instead of controlling and lowering health care costs, obamacare is expanding

government and expanding health care costs. the senate budget committee estimates the bill will cost $2.6 billion for the first ten years of full implementation of all of that new spending doesn't lower health care costs, and there are multiple sources affirming that. yet, president obama continues to claim that the act will -- quote -- "slow these rising costs." maybe he didn't see the c.m.s.'s chief actuary richard foster who said overall national health insurance -- excuse me. overall national health expenditures will increase by a total of $311 billion over the next ten years under the law. and when the c.m.s. actuary was asked directly if president obama's health care bill would hold down unsustainable medical costs, just last week that actuary replied -- quote -- "i would say false close quote.

last year the c.b.o. also confirmed our concerns about the bill's inability to contain costs, stating -- quote -- "in c.b.o.'s judgment, the health legislation enacted earlier this year does not substantially diminish that pressure." close quote. in addition, increased costs for the government and present and future taxpayers, health insurance premiums will increase for americans and their families. in fact, the c.b.o. estimated the premiums will increase by $2,100 even though at least candidate obama promised to lower premiums by $2,500 per family. so that big expansion of government and costs, and health care costs including taxes and partly cloudy premiums, is another -- taxes and health care premiums is another big problem. this isn't a minor detail which we can fix with a perfecting

amendment, a few tweaks to the bill. this goes to the core of the entire plan. another fundamental issue which goes to the core of the entire plan is the fact -- and i think it is a well-established fact -- that the obamacare plan will cost us not just money, not just increased taxes, not just increased health insurance premiums, will cost us jobs. that should also be worrisome, but it should be particularly worrisome as we stand here today and debate this in a horrible economy, as we're trying to come out of the worst recession since the great depression of the 1930's. again, this isn't just any period of time. this is a time of prolonged historic unemployment. and this bill costs us jobs. and this absolutely debt mates job create. the bill taxes jobs, places more

burdens on job creators. the national federation of independent businesses, representing thousands of american small businesses, including many in louisiana -- my home state -- said that -- quote -- "if new taxes, new mandates and government programs in ppaca -- that's the obamacare bill -- remain intact, the law will stifle the ability to hire, grow and invest." close quote. in addition to the often discussed 1099 paperwork nightmare for small business, the bill also includes a pay or play mandate on job creators. this complicated new tax penalty imposes a tax on businesses with more than 50 workers if they do not offer coverage or do offer coverage by workers elect to decline that benefit. again, this is a fundamental problem with the bill that goes

to the heart of the bill, not the periphery. now, this aspect of the bill will have many dire consequences. first, because the $2,000 penalty for not offering insurance is less than the 6,100 average employer benefit contribution, businesses are actually given an incentive to drop coverage, so there is a concrete money incentive, a major money incentive for businesses to drop coverage and actually push workers off good coverage. many have right now. second, businesses that are able to grow and hire more workers may choose not create jobs and to stay under the 50-employee threshold to avoid all of these disincentives and difficulties. because of all this the nonpartisan congressional budget office concluded that the bill -- quote -- "will encourage some

people to work fewer hours or to withdraw from the labor market" -- close quote, and it said -- quote -- "on net, it will reduce the amount of labor used in the economy" -- close quote. now, is that what we want to encourage in any economy?, but particularly in a horribly down comirks we're trying to come out of the worst recession since the great depression, and do we want to reduce labor opportunity in our economy? these are stunging conclusions that so many of us warned against during the debate, conclusions that the majority of americans feel. taxing american job creation, sticking business with more government compliance requirement and cost is absolutely the wrong approach, particularly in a down economy. finally, madam president, there

is another concern that i share with so many others in this body that, again, goes to the heart of the bill. it's not a minor detail. it's not something that we can solve with a perfecting amendment. it is not at the per river re, it is not changing a comma, changing a sentence. it is at the heart of the bill. and that is that the bill contains, at its heart, over $500 billion in medicare cuts. yes, over half a trillion dollar cut to medicare. and these cuts aren't invested back in medicare. they don't help medicare stay solvent. they don't help medicare survive solvent for longer. they don't help fix the looming medicare challenge. they're stolen from medicare to pay for brand-new stuff for other people in obama care.

these medicare cuts directly impact seniors, and one study shows that the massive cuts to medicare advantage will hit louisiana seniors particularly hard. a study by the heritage foundation shows that louisiana seniors enrolled in medicare advantage plans lose more than any other state in the nation because of the obama health bill. the report says that projected enrollment in medicare advantage will drop by over 125,000 louisianans, 62%. benefits will be cut by $5,000 per beneficiary. so this bill takes away benefits and choices for seniors, not to fix medicare, not to preserve medicare, not to preserve its solvency for longer, but steals it from medicare, steals it from seniors for brand-new purposes for other folks. and this directly contradicts the president's promise that --

quote -- "if you like what you had, you can keep it" -- close quote. no, you can't, mr. president. thousands of louisiana seniors can't. in fact, c.m.s.'s chief actuary also verified that the promise will be broken, confirming that americans may lose their current health care coverage regardless if they want to keep it or not. so, madam president, i respond directly to my friend and colleague from vermont by saying, we want full repeal of obama care for a very simple reason: the big problems with the bill, the big problems with the plan aren't at the margin, they're at the core. and the big problems can't be fixed with a perfecting amendment, the changing of a comma, changing punctuation, revising one or two or five or ten sentences. the big problems are at the core of the plan, starting with the

mandate from the federal government, unprecedented, that every man, woman, and child in america needs to go into the market and buy a particular product. that's why we demand repeal. that's why we'll continue to pursue repeal until it hangars and that's why -- until it happens, and that's why we'll replace this huge, burdensome bill with targeted reforms like protecting folks with preexisting conditions, like reimportation, generics reform and other measures to reduce prescription drug prices, like allowing american citizens to shop for health insurance across state lines and to pool together through their small businesses, through other means, through association health plans. thank you, madam chair. with that, i urge all of my colleagues to come together. let's repeal this really

problematic plan, and let's start anew with focused, targeted reforms that the american people have been asking for. madam president, i yield the floor. madam president, i suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

a senator: madam president? the presiding officer: the senator from mississippi. mr. wicker: i ask unanimous consent that the quorum call be dispensed with. officer without objection. mr. wicker: i rise today in support of the mcconnell amendment to the f.a.a. reauthorization bill. what we have this afternoon actually is an opportunity to show the american people that we are listening to them. the american people want the obama care law, the affordable health care law, as it's known, to be repealed and replaced with something less expensive and something workable. polls show this. the individuals that we talk to when we go home tell us this. and this vote will be an opportunity for us to show them

that we are listening. now, i've heard some of my colleagues come to the floor this week and suggest that this massive 2,000-page tax-increasing, job-killing bill is exactly just what we need. i would suggest that there are a number of facts that indicate otherwise. the other side would have you believe that without this health care law, this country is going to fall off the tracks, and the world will virtually come to an end p. end and they try to cite one or two popular proposals that are in this law, which of course could be enacted after repeal, practically by unanimous consent. and ignore the fatal flaws in the law.

the former speerveght house unanimous -- the former speaker of the house, nancy pelosi, during consideration of this act in the house and senate, fame us/told a grass-roots group that came to washington, d.c., tweerchedz hurry up and pass the bill so you can find out what's in it. we will, indeed, since the passage -- we will, indeed, since the passage and signing of the law by president obama, the american people are finding out something new that is in the bill that they don't like and as a matter of fact it turns out that members of the house and senate who voted for obama care also did not know precisely what was in the bill and certainly did not anticipate the ramifications of this massive, ill-advised law. under the new law, it is absolutely a fact -- and we know this -- that medicare will face

over $500 billion in cuts, and senior citizens will have a right to be concerned. future senior citizens variety to be concerned about these cuts. they include $15 billion from hospitals, $202 billion from medicare advantage, $15 billion from nursing homes, $40 billion from home health agencies, and $7 billion from hospice. cuts from these federal expenditures in medicare to pay for the new obama care legislation. everyone agrees that medicare needs to be made more solvent and we need to work on medicare, but these reckless cuts will only make medicare's problems worse. another thing americans have found out about this affordable health care law that is being

implemented even as we speak is that the law falls short of the president's goal of controlling runaway costs. and, in fact, raises projected spending. last week in his state of the union address, president obama said the health insurance law we passed last year will slow these rising costs. this is simply not true. and to support my assertation that it is not true, i would -- i would cite the president's own actuary. c.m.s. reports that, in fact, spending will be increased by about 1% over what it would have been over 10 years. that increase could get bigger, of course, the report points out, since the medicare cuts that i've already pointed out may be unrealistic and politically unsustainable, according to the report.

krrmt m.s. -- c.m.s. said that over all health expenditures under the health reform act would increase by $11 billion and health expenditures will be 21% of the cross domestic product by the year 2019. but it's not just the government bean counters that are worried. here's what the national federation of independent business said, small business owners everywhere are rightfully concerned that the unconstitutional new mandates, countless rules and new taxes in the health care law will devastate their business and their ability to create jobs. that's the national federation of independent business. national association of manufacturers says that manufacturers remain adamantly opposed to the employer mandates and to the medicare hospital insurance tax increases.

these employers are faced with incorporating the first round of health care changes and are grappling, having difficulty doing so with how to comply with the long list of new rules. these are not scare tactics. these are not unwarranted fears by a wooed public. these are people who work with health care every day and are telling us that this congress has made a mistake. in fact, there are already real consequences of this health care reform law. abbott laboratories said it is cutting about 1,090 jobs. that's -- 1,900 jobs much that's just a fact. the job cuts come -- quote -- "due to changes in the health care industry including health care reform and the changing regulatory environment. " unquote. that is simply a fact.

it's not conjecture. blue shield of california recently stunned individual policyholders with a huge rate increase effective march 1st, seeking cumulative hikes of as much as 59% in premiums for tens of thousands of their customers. this san francisco-based blue shield said that the increases were the result of fast-rising health care costs and other expenses relating to the new health care laws. again, just fact, madam president. it's also an absolute certainty that state taxes are going to go up and they're going to go up big time unless we repeal this health reform law. in my state of mississippi, the legislation will cost the stat state $1.7 billion over 10 years including $443 million in year

10 alone from fiscal year 2014 to fiscal year 2020, the massive expansion of medicaid will cost mississippi taxpayer taxpayers $225 million to $250 million extra each year. our governor, one of the staunchest opponents of tax hikes that i have ever heard of has stated that this law will certainly force the state of mississippi to increase their taxes unless it is repealed. again, these costs are simply facts. they result from the mandate. madam president, there's also bipartisan opposition to this law. we didn't see much bipartisan support for its repeal in the other body, and i was disappointed by that. but when you get out to the

public, when you get out off of capitol hill and out to individuals, it's not a republican issue, it's not a democrat issue, is it a bipartisan american opposition to this law. and i are have repeatedly quoted former governor phil bretison of tennessee, someone who ran as a democrat in his state successfully twice an ran as the standard bearer for his party three times, a loyal democrat, who, of course, called this law the mother of all unfunded mandates. but after the law was enacted, he -- he wrote an op-ed in "the wall street journal," october 21, 2010, and i ask at this point -- madam president, i'll ask that this op-ed be included in the record at this point. the presiding officer: without objection. mr. wicker: and, among other things, governor bretison, who

was still governor at the time said that our deficit is at unacceptable levels and our americans can ill afford another entitlement program that adds substantially to it. but our recent health reform has created a situation where there are strong economic incentives for employers to drop health care coverage all together. the consequence will be to drive many more people than projected and with them much greater costs into the reforms federally subsidized system. the democratic, elected -- democratic elected governorror of tennessee -- governor of tennessee criticizing this act and pointing out other facts that are wrong. and in his subsequent book on the subject, phil bretison also criticizes the health care law saying it will cause deficits to go up, costs to continue

increasing, employers to drop coverage, state costs to increase governments to grow and will make our current problems worse. obama care is not what the doctor ordered according to governor bretson. my time is limited. i could go on and and on members of -- of the senate and house could and will go on and on as we face this issue if we don't win it today. the facts are there. this is a terribly flawed piece of legislation. facts are stubborn things and the consequences have already started to mount up. opposition is strong, support for repeal is strong and bipartisan. and for those reasons i will vote in favor of the mcconnell amendment when we consider it later on today.

mr. durbin: madam president? the presiding officer: the senator from illinois. mr. durbin: madam president, i can't say with any certainty anything about the critics of the government -- or the affordable health care plan except one thing, each of the critics on the republican side of the aisle of what they call government administered health care, government administered health insurance, every single senate republican critic is currently protecting his or her family with government administered health care. in other words, what's good enough for their family shouldn't be good enough for the rest of america. i think, as a show of good faith, that the republican senators should come to the floor today to say, not only are we going to vote for repeal of the health care reform, we're going to show our personal commitment of this by walking away from the federal health insurance program. i would admire them so much if

their actions as senators reflected their speeches on the floor. but they don't. they are denying to the rest of america what every single member of congress has available today to protect their families. that, to me, is indefensible. now, this week a judge in florida decided that this affordable health care act was unconstitutional. but before we get carried away with that decision, step back. this law has been challenged 16 times in federal courts. 16 times. 12 courts have dismissed the challenges on procedural grounds saying that the person who filed the suit didn't have a standing in court. four of the federal courts decided it on the merits. two of the federal courts decided it was a constitutional law. and two said it was unconstitutional. you say to yourself, wow, two federal district courts said this law was unconstitutional. aren't you worried? well, i don't take anything for

granted, but i do understand a little bit of history. what other laws in america were found unconstitutional by lower courts and then constitutional by the supreme court? anything significant? social security was found unconstitutional. then the supreme court said, no, it's constitutional. the federal minimum wage law was found unconstitutional by a lower court and the supreme court said it was constitutional. the civil rights act of 1964 was found unconstitutional by a lower court and the supreme court said it was constitutional. so let's not get carried away with lower court decisions clearly split on the issue the we had a hearing in the senate judiciary committee that i chaired. brought in constitutional experts from across the united states. it was a good, spirited hearing, lots of different opinions between the democrats and republicans. but i think the case is clear and strong that we have a power under article 1, section 8 under

the constitution to regulate commerce. is there anyone on the republican side who's going to stand here and argue that the health care industry, the health insurance industry, which represents 18% of the economy of america is not commerce? well, of course it is. and then, of course, we have the authority under that same section to pass laws necessary and proper to carry out the responsibilities and authority given us. well, here's what we're trying to do. we're trying to make sure that everyone in america has health insurance. we say to the 83% of americans who currently are insured, you don't have to worry about this argument. you already have health insurance. for the 17% uninsured, many of them are people who have preexisting conditions and have been denied coverage, can't afford it. some of them are people that, frankly, can't afford coverage even if they don't have a preexisting condition to family. this law moves us to the point

where more and more americans will be covered with health insurance. and we say at the end that those who can afford health insurance and don't buy it will pay a tax. because of the decision. now, is that heartless? is that a federal mandate on people who just want to be left alone? you know, if they were just being left alone, it's one thing, but i'll tell you what human experience teaches us. these people who want to go it alone, don't bother me i'm on my own, are going to get sick some day. and when they get sick and go to the hospital, they will be treated. and when they can't pay for their treatment, do you know who will pay? all the rest of us. everyone else paying health insurance premiums has to absorb the cost of those who are free loading on the system. it's not fair. it used to be the conservative republicans preached personal responsibility. when we put personal responsibility in this law, all of a sudden they don't like it. i think personal responsibility still counts and i believe it is clearly constitutional to

include it. i listened to some of the arguments about repealing this law. i heard the senator from mississippi say how bipartisan the support is for it. i would have liked to have asked him how he explains the fact that four out of five people in america, 80% of americans, oppose repeal. they don't think the law's perfect. many of them say, improve it, if you can. but 80% oppose repeal. the signature issue for the house republicans and now the senate republicans is the repeal of affordable health care, it would be devastating if we did. the first thing you'll notice if you read -- and it's only three pages -- the amendment filed by senator mcconnell, the republican leader, is that on the second page, he manages to include in here the statutory pay-as-you-go act of 2010 as passed and printed by the house

of representatives. unless you're a person who follows closely what's going on around here, you may not know what that says. what it says is senator mcconnell wants us to ignore the fact that the repeal of the health care act will ad add $230 billion to our national deficit over the next 10 years and more than $1 trillion in the decade after that. a party that comes to the floor every single day telling us their passionate determination to end our deficits and address our debt with the mcconnell amendment will add $230 billion to our national deficit over ten years and $1 trillion more in the next ten. this is a budget-buster amendment. this will add more to the deficit in one fell swoop than any single thing we have done in congress in the time that i have served, and it's being offered by the party of so-called fiscal

responsibility. i also want to say that when we talk about premium increases currently taking place under health insurance policies across america, i understand it. we have all lived through it. we've seen it. businesses see it all the time. there is a provision in our affordable health care act which addresses it that would be repealed by the mcconnell amendment. the provision is called medical loss ratio, and it says that a health insurance company has to spend 80%-85% of premium dollars on actual health care. they can't take it away in advertising, in administrative costs, in salaries and bonuses for their c.e.o.'s. so one of the things that will happen if the republicans have their way and repeal health care, the health insurance companies will be allowed to raise premiums at any level as quickly or as much as they want without being held to this medical loss ratio. that may not be the worst thing, though. any person in america who has been raised in a family where

someone in the family suffers from what's known as a pre-existing condition knows that you always live in fear that you won't have health insurance, and fear that if you have to go out and buy it on the open public market, you will never be able to afford it. this law that senator mcconnell and the republicans want to repeal today, this law says that no health insurance company in america can discriminate against anyone under the age of 18 who has a pre-existing condition. now, that's something that any parent would appreciate. you never know if that beautiful son or daughter of yours is going to have problems with asthma, diabetes, cancer, mental illness, and you certainly want that child, that love of your life to have health insurance coverage. senator mcconnell and the republicans want to repeal the protection for families that have children with pre-existing condition.

that's fact. it isn't as though they're offering exclusions and saying no, no, we'll keep that. they have eliminated the entire law with this three-page amendment. they have eliminated these protections. and how about the protection for those who, if diagnosed with a serious illness and find their health insurance companies cutting them off completely, putting a cap on the amount of money they'll spend to provide for medical services and treatment. saying at some point they're going to eliminate their policies altogether because they failed to make a disclosure on an application form. it happens too often. in my state of illinois, sadly, we lead the nation in what's known as rescissions. health care insurance companies that canceled coverage when people get seriously ill. how would you like to be in that predicament? how would you like to be facing a serious illness that keeps you awake at night tossing and turning about whether you're going to live or die and then fight a health insurance company during the daylight hours in the hopes that they'll cover the prescriptions and treatment you need to stay alive?

that is the reality, a reality that is addressed by the health care act, a reality that would be repealed by senator mcconnell and the republicans' efforts today. those are the real results of what they want to do. it isn't just about who ends the political debate and has the largest cheering section if it's over. it's about real-life changes. how about senior citizens, those under medicare. many of them struggle to pay for prescription drugs. even with the medicare prescription drug plan, there is a gap in governing called the doughnut hole. we start to close that gap and say to seniors if you have expensive prescription drugs, we're going to make sure ultimately that they are covered completely, from the first of the year until the end of the year. now there is a gap in coverage. the republicans and senator mcconnell want to repeal that provision of the health care act which provides for seniors, not only more coverage for their prescription drugs but also an

opportunity for an annual physical, and the kind of preventative care that they need to stay healthy and strong and independent in their homes for a longer period of time. that is what senator mcconnell and the republican senators want to do with the repeal of this law. and what about job creation? well, the senator from mississippi talked about one company cutting some employees. i'm not sure of the particulars in that company, but one of the things we did in this law was to take a look at tax subsidies to medical device and pharmaceutical companies and if they were duplicative or overly generous to make sure that they got closer to the reality of what a company needs to have incentives to grow. it's true, some of those tax subsidies were eliminated and some of the companies weren't happy about it, but the bottom line was we were trying to make sure that health care is affordable. we can't afford to provide massive subsidies to profitable companies on an unlimited basis. this bill that we're talking

about, the one the republicans want to appeal, will crack down on frowd and medicare and medicaid. it will simplify paperwork for private insurers. it invests in prevention, creates a pathway for generic biologic drugs and tests new ways to pay health care providers to reward value rather than volume. if the law is repealed, we'll have fewer jobs and higher costs for families and businesses. the number-one complaint of illinois small businesses across our state is the cost of health insurance. if the republicans have their way today and repeal it, this law that we have passed, the cost of health insurance will grow, the cost to businesses will grow, the number of employees will shrink. a 1% or 1.5% growth in health care costs above the rates under the new law will prevent employers from creating 2.5 million to four million jobs over the next ten years. talk about a job destroyer, the

republican repeal amendment does just that. repeal means going back to the same broken system we've had for so long with insurance companies once again free to overcharge families and businesses to protect their corporate profits and c.e.o. bonuses. the same broken system with workers seeing their paycheck shrink as more and more of their hard-earned wages are deducted to cover skyrocketing premiums. the same broken system with seniors being forced to shoulder the full cost of prescription drugs in the doughnut hole and the same broken system with small businesses closing their doors and laying off workers because they can't afford the crushing cost of health insurance. the republican claim that this health care bill is a job killer is just plain false. the economy has been gaining private sector jobs since president obama signed the bill a year ago after losing jobs for a long period of time before. since the president signed the bill, we've created more than

1.1 million private sector jobs, and in contrast in the ten years before we had lost 3.3 million private sector jobs. average real incomes for americans are back on the rise after years of being stalled under the old health care system. just this week, the commerce department reported that average real disposable income has risen 1.3% over the past year, after falling .1% in each of the previous two years. madam president, i will close by saying this: our hearing today before the senate judiciary committee on the constitutionality question makes it clear to me that the court, the supreme court, if it follows the clear precedents that have been handed down for decades, if supreme court justices who have spoken eloquently and directly on the commerce clause will view this health care act in the same context, they will find it constitutional. and then perhaps we could move on. perhaps at that point the republicans will stop beating this drum on repealing health

care, will join us in making it even a stronger bill and will focus on creating jobs instead of killing jobs, as this mcconnell amendment would do. madam president, i request unanimous consent that cody lynn hailla, a fellow on senator inouye's staff, be allowed floor privileges for the duration of the senate's consideration of s. 223, the airway modernization and improvement act. the presiding officer: without objection. mr. durbin: thank you, madam president, and i yield the floor. mr. kirk: madam president? the presiding officer: the senator from illinois. mr. kirk: madam president, i'd like to talk about two topics today, first on this health care bill and then on the situation in egypt. i rise today in support of the amendment to repeal the health care law. we made a mistake last year in passing this law, and a large majority of the american people know it. in the face of the largest debt in our history, it was the height of folly to create a new

spending program offering subsidized health care to 30 million americans. it's a promise that we cannot afford to keep and one that our lenders may force us to retract. before losing our credit rating or suffering the humiliation of foreign lenders denying us new loans, we should take the decisive action now to end this entitlement. the congress should replace this mistaken law with bipartisan reforms that prohibit the government from overriding the decisions you make with your doctor, that defend your right to buy insurance from any state in the union and to make lawsuit reforms to lower the costs of defensive medicine. the failed health care law now ruled as unconstitutional by two federal courts uses the commerce clause of the constitution to create an unlimited government that could require americans to

buy what they do not want. the very heart of the constitution was the creation of a limited government that could only accomplish its defined missions, leaving all else to the people and to the states. these courts are right. the law is unconstitutional, and it spends over $2.6 trillion. it hurts small businesses. it cuts senior health care under medicare and levies billions in new taxes against our economy in the teeth of the great recession. recently, i visited decatur memorial hospital in decatur, illinois. their president, ken smithmier, warned me that the medicare cuts required by the new health care law would cut $10 million annually from their hospital, resulting in the loss of over 200 jobs, and decatur is not alone in its troubles.

in nearly half of my state's counties, hospitals are among the top three employers. they are the backbone of our local economies, and their employment will be greatly harmed by this health care law. we made a promise to seniors who depend on medicare that we would take care of them. this law cuts medicare and hurts them. we should honor instead our promises to defend the nation, to support seniors on social security and who depend on medicare before making an extravagant promise that is irresponsible and cannot be kept under the health care law. i'd also like to take this time to speak on an entirely different subject, which is what is going on in egypt. i would entitle this discussion "the muslim brotherhood, its

leaders in their own words." mr. president, will -- will egypt follow poland or georgia to foster a new democratic government or will it follow iran's revolution converting egypt into a state sponsor of terror? while u.s. policy should support human rights and democracy, we face the risk that the muslim brotherhood, -- could seize power. who is part of the brotherhood and what are its political objectives? a detailed study shows why these questions should command the attention of the congress and the president. with so much at stake in the middle east, americans must be clear eyed about the muslim brotherhood and its radical islamic agenda where the pledge of jihad against the west and the state of israel. the muslim brotherhood is the largest islamist movement in the

middle east and is widely described as the most organized political force in egypt. its membership is estimated at over 600,000. although it claims to be nonviolent, this conservative organization, the muslim brotherhood, was profoundly influenced islamic terrorist organizations such as al qaeda, islamic jihad and hamas. one of its disciples was the prominent islamist thee low jaj siyaz katu who provided the underpinnings for al qaeda. as recently as 2004, the organization motto was as follows: allah is our objective, the prophet is our leader, the koran our law, jihad is our way, and dying in the way of allah is our highest hope.

the muslim brotherhood was founded in 1928 by hassan al-banna. banna is famously quoted as saying it is the nature of islamic to dominate, not to be dominated, to impose its law on all nations and to extend its power to the entire planet. the muslim brotherhood has a violent history. back in 1946, the u.s. army issued an intelligent report stating that the muslim brotherhood -- quote -- "maintains secret caches of arms." through the 1940's, the paramilitary branch of the unit carried out targeted bombings and assassinations. in 1948, the muslim brotherhood was implicated in the murder of mahmoud hamasi. in 1984, the group tried to's nature an dull nasser. the government banned the

brotherhood as a political party that very same year. the muslim brotherhood went underground only to -- mr. reid: madam president? the presiding officer: the majority leader. mr. reid: would my friend yield for a unanimous scoant request? a senator: i yield. mr. reid: thank you. you know that at 5:15 p.m. today, the senate proceed to votes in relation to the following amendments to s. 223, the f.a.a. authorization bill in the order listed below. levin amendment relative to repeal of 1099, the text of which is at the desk. stabenow amendment number 9, repeal of 109, and mcconnell amendment number 13, which is repeal of the health care reform. there are no other amendments, points of order or motions to be in order to these amendments prior to the votes except that a budget point of order, if applicable, remain in order to each of the amendments and if one is raised, the motion to waive the budget point of order be north. in order. that if the motion to waive is in order, the motion be agreed to and that the senate then -- shy that if the motion to swaif agreed to, the amendment be considered agreed to and the

senate then -- mr. reid: sorry, madam president. that if the motion -- i'll start over. following mcconnell amendment number 13, i say that no other amendments, points of order or motions be in order to those amendments prior to the votes except that a budget point of order, if applicable, remain in order to each these amendments and if one is raised, a motion to waive the budget point of order be in order, that if the motion to waive is agreed, the amendment -- the amendment be considered agreed to and the senate then proceed to vote in relation to the next amendment in the sequence. further, that the levin amendment be subject to a 60-vote threshold for its adoption and if it fails to

achieve 60 aimfive votes, the amendment be withdrawn. finally, there be two minutes of debate equally divided prior to each vote, that all votes after the first vote be limited to ten minutes. the presiding officer: is there objection? without objection, so ordered. mr. reid: madam president, i extend my appreciation to my friend from illinois. i apologize for the interruption but we've been trying to get to this agreement for most of the afternoon. i would ask that the record not appear -- that my friend's statement not be interrupted. the presiding officer: without objection. mr. kirk: i thank the majority leader. the presiding officer: the senator from illinois. mr. kirk: the muslim brotherhood went underground only to resurface during the 1980's. it claimed to disavow violence and attempted to win political power as a religious and social organization. it was increasingly successful with allied candidates, winning 17 seats in the parliament in 2000 and then a stunning 88 seats, or 20% of egypt's parliament, in 2005. the muslim brotherhood is not a monolithic organization but it

does maintain a leadership structure and a core set of beliefs. its leader is called the general guide. he has several deputy guides. below them is a guidance council comprised of 15 to 16 senior leaders as well as a broader body, the shura, comprised of roughly 100 members. mohammed badi is -- was elected as the eighth general guide of the muslim brotherhood in january of 2010. as noted by the u.s. government's open source center, badi is influenced by the writings of famous muslim brotherhood ideologues said katub and is known for his conservative views. in an april interview in 2010, mr. badi said, we will continue to raise the banner of jihad and the koran in our confrontation with the enemy of islam.

he went on to say -- quote -- "the muslim brotherhood still considers the zionists to be its main and only enemy. the jews who occupy palestine have their eyes set on egypt." two days ago, a leading member of the muslim brotherhood, mohammed ganlam, reported told al-alam radio news network that he would like to -- quote -- "like to see the egyptian people prepare for a war against isra israel." adding that the world should understand -- quote -- "the egyptian people are prepared for anything to get rid of this regime." he went on to say that the seuz canal should be -- quote -- "closed immediately" and that the flow of gas from egypt to israel should cease -- quote -- "in order to bring about the downfall of the mubarak regime." in 2007, the muslim brotherhood released a political platform which contained a number of indications on how this organization would govern egypt

if it came to power. according to the congressional research service, the platform called for -- quote -- "the establishment of a broad -- of a board of religious scholars whom the president and the legislature would have to consult before passing laws." as noted by mohammed al-manshawi, the editor in chief of the tarak washington, an arab insight -- quote -- -- "reminist of iran's guardian council, this unelected body could have the power vested by the state to veto any and all legislation passed by the egyptian parliament and approved by the president that is not compatible with islamic shah sharia law." the same document raises the important question of the muslim government's commitment to a pluralistic society. despite pledges to treat minorities and women as equals, the platform allows neither to hold high public office.

as stated in the platform -- quote -- "nonmuslims are excused from holding this mission." for women, the post of president or prime minister would -- quote -- "contradict her nature, social, and other humanitarian roles." the draft also cautions against -- quote -- "burdening women with the duties against their nature or role in the family." madam president, the people of egypt and apparently its army are mandating the fall of the mubarak regime. while we support human rights and democracy, we must heed the growing warnings about the muslim brotherhood, their leaders, and plans for taking egypt all the way back to the 13th century. we as americans have seen this movie before -- in iran, in lebanon and in gaza. to prevent a strategic reversal

on the scale of what happened in iran, the united states and our allies should do all that they can to support egypt's armies and secular leaders, ensuring no future for the muslim brotherhood. an egypt locked under sharia law and depressing women, christians and jews would be a catastrophic setback for progress in the middle east. such a state could renounce the camp david peace accords or even start yet another war with israel. decisive action and influence now will benefit the national security and economy of the united states later. the defeat of the muslim brotherhood and victory for egyptian secular nationalists would be the best way to avoid war and restore economic confidence in the middle east and the wider world. mr. president -- madam president, i ask unanimous consent my remarks be entered in the record as delivered without

interruption. and with that, i yield the floor. the presiding officer: without objection. mr. kirk: mr. president, i'd like to suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

the presiding officer: the senator from michigan. mr. levin: madam president, there is, i believe, overwhelming bipartisan support for repeal of the recent changes to the 1099 reporting -- i thank the presiding officer. madam president, i ask unanimous consent that further proceedings under the quorum call be dispensed with. the presiding officer: without objection. the senator from michigan. mr. levin: madam president, i was referring to the overwhelming bipartisan support for repeal of the recent changes to the 1099 reporting requirement. small businesses in my state and across the country have told us that the new reporting requirements they face under the affordable care act will create an unnecessary burden that could make already tough times even