affordable health care is a right and not a privilege, this is a great victory. so now i see that some in the house have now scheduled a vote to repeal it after we get back from the fourth of july break. well, they've already voted to repeal it. i guess they'll vote to repeal it again. they are on the wrong side of history. and, you know, i call upon my republican friends in the house and in the senate, it's over. this is constitutional. now let's work together to make it so it's implemented, that it works for everyone. i say to my republican friends, i've never said that the affordable care act is like the ten commandments chiseled in stone for all eternity. i've often likened it to a starter home which could add some additions, make some improvements as we go along. but at least that starter home

has put a roof over our heads. a roof that will get quality affordable health care insurance to every american. so say -- i say to my republican friends, bring your tool kits. bring your tool kits if you want to make it better and improve it, give -- bring your dool kits. don't bring a sledgehammer. don't bring a sledge hammer break it down and try to repeal it. that's a nonstarter. so let's work together, put politics behind us and make this -- make this bill work for everyone. make it work for every, every american. the justices have spoken. now it's time for to us get back to work to build a reformed health care system that works not just for the healthy and the wealthy but for all americans. this is a victory. it is not a victory for president obama. it is not a victory for my committee or anyone else around

here. what this is, it's a victory to make sure that no one, no one in the future is ever denied health care coverage because he or she got cancer. make sure that no one in the future will be denied quality affordable health care coverage because you had diabetes. it's a victory for families who have had a child that needed intensive, very expensive health care coverage, to make sure that that child would live and grow and able to take full part in our society, though sometimes those costs are extremely high. in the past, there have been annual limits, annual limits. if you go above that, you got to pay out of pocket.

or lifetime caps. how many women have i met in the past who have had breast cancer and had had to have intensive treatments for a period of time, but they bumped up against a lifetime cap and they couldn't pay above that, they had to pay out of their own pocket. so this is whoates victory for. it's a victory for families. so that they don't face lifetime caps and annual caps. it's a victory for every family in america to ensure that every child can stay on their family's policy until their age 26. that's who wins here. ordinary, hard-working families in america. it's a victory for hard-working families to make sure that insurance companies have to -- have to, have to, have to --

provide, have to provide cost-effective lifesaving preventative care at no cost, to get to people early on, to keep them healthy in the first place. it is a victory for working families so no longer do they have to choose between paying for health insurance or other critical family needs. like food, shelter, transportation, education. that's what this is about. that's what this victory is all about. not one person, it is a victory for america's families. and i say to those who now want to repeal it, who are going to start to make a political issue out of this, you're on the

wrong side of history. the american people, the american people will now begin to take a look at this bill in a new light, that it is constitutional, it will be implemented and what's in it for us, and i just went through what's in it for every american family. and the american people will not want to go backward. they will not want to we peel this law. there may be improvements we can make as we go along. that's fine. but i say woe to those who vote to repeal this bill. the american people will hold you accountable for being on the wrong side of history, the wrong side of progress, the wrong side of ensuring that every american family has quality affordable health care in america. madam president, i yield the floor and i note the absence of a quorum. the presiding officer: the clerk will call the roll.

quorum call: mr. harkin: madam president, i ask further proceedingsened und the quorum call be dispense with. the presiding officer: without objection. mr. harkin: i ask that chris ladu e be granted floor privileges for the remained are of today's session. the presiding officer: without objection. mr. harkin: i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

quorum call:

mr. vitter: madam president? the presiding officer: the senator from louisiana. mr. vitter: thank you, madam president. madam president, if next i ask unanimous consent to vitiate any quorum call. the presiding officer: without objection. mr. vitter: tugs madam president. madam president, i come to the floor, aes many of our colleagues have done, to talk about this very significant and for me at least really stunning u.s. supreme court decision on obamacare. first of all, i use the word

"stunning" not particularly because of the outcome; i really wouldn't have been shocked at either outcome, upholding the law or striking down the law. i really considered both of those clear possibilities. i am stunned and shocked, somewhat confused, by the decision, by the nature of the decision, by the nature of the majority, and by the reasoning. i'm not going to dwell on that. it's not my or other senators' role to second-guess it or to claim we have some authority to rewrite it. but i do find that doing backflips beyond the significant power of the court to completely recharacteristickize the individual mandate and parts of the law associated with it as attacks. it was never proposed as attacks. it was never debated as ait was

never written as a taxes it was never meant as a tax in any part of the obamacare debate or legislative action. so i certainly agree with justice kennedy, who said out loud from the bench, which i think is significant, that to read it, quote, unquote, as a tax is not just reading the law a certain way; it's rewriting the law, and judicial rewriting of tax policy, judicial writing of the law to create a tax is particularly worrisome. i absolutely agree with that. so i really do think the majority led tragically by chief justice roberts did backflips to rewrite the law in order to uphold it. i think that's very unfortunate. what it also means for the country and for the policy

debate and for us in the congress is at least two things, which i think are also very, very important. number one, it means that if this is a tax, this is a massive tax increase on the middle class, which stands full square against the clear and repeated campaign promises of president obama. so this is a huge tax increase now that it's a tax, completely against everything he ran on and what he said over and over and over campaigning for office. it also means something separate that's very significant. it means that this is all about taxes and spending, it means a different congress next year, hopefully led by a different president, can repeal all of that, including with a simple majority of votes in the senate

through reconciliation. if this is all about a tax, if it's all taxes and spending, then it can all be undone through the reconciliation process. and, of course, that's significant for one reason and one reason only, because here in the senate, it means that lowers the requirement from 60 votes to a simple majority with a republican president. that would be 50 votes plus the vice president as the tie breaker. so, madam president, my bottom line is simple. it was my bottom line yesterday before the opinion, it was my bottom line for over the last severa w mtt ne the day after congress passed obamacare and the president signed it into law. it may be ruled constitutional. it's still a bad idea that is making things worse. it's putting an all-powerful

federal government between the patient and his or her doctor, and it's costing us an enormous amount of money as individuals, as citizens, as a society, as a government that we clearly cannot afford. many of us made those arguments during the original debate, but i think all of those arguments have been validated and are clearly more true and compelling in the months since obamacare was passed. in particular, costs have been going through the roof, and the suggestion that this was going to save us money and not cost us extra money, even the suggestion, the argument has gone out the window. it's clear the opposite is true. individual premiums have gone up as a result. family premiums have gone up as a result. cost to the federal government and society have gone up as a result. it's made the already staggering

problem of health care costs worse and worse and worse. it's made health care for everyday americans less and less affordable. and because of that, i certainly renew my commitment to work with others to fully repeal obamacare, lock, stock and barrel, and under the supreme court's decision today, again i restate, i think it's very significant since it's all about a tax, since it's all about taxes and spending, that can be done early next year with a simple majority in the united states senate if there is a president romney and a republican congress to do it. thank you, madam president. i yield back the floor. the presiding officer: the clerk will call the roll. quorum call:

mr. whitehouse: madam president? the presiding officer: the senator from rhode island. mr. whitehouse: madam president, in light of the -- first of all, may i ask permission that the pending quorum call be lifted? the presiding officer: without objection. mr. whitehouse: madam president, i wanted to, in light of the supreme court's decision on the affordable care act, come to the floor today to bring just a few rhode island voices into the

discussion that is taking place. one is a man in providence, rhode island, named greg who has a 16-year-old son. his son is named will. will has cystic fibrosis. that requires will to spend several hours every day undergoing the treatment that that dreadful disease requires. he sees a specialist four times a year to monitor the disease. he has daily prescriptions and treatments, and will and his father without this bill were looking at two problems. one, denial of coverage because will's cystic fibrosis was a preexisting condition, and two, lifetime caps. for people like will all around the country, this has been a real blessing because lifetime

caps are forbidden and kids with preexisting conditions must be covered notwithstanding the preexisting condition. so from greg, the father in providence, and his son, will, i wanted their voices to be heard today, in not so much celebration as relief that what they have been provided by the health care law is still in place. another voice to bring to the floor is olive. olive is a senior citizen. she lives in winsockett, rhode island. her husband has fairly serious alzheimer's disease and requires several medications to treat it. until the affordable care act came along, olive and her husband fell into the doughnut hole and they had to pay 100 cents on the dollar for the husband's alzheimer's medications while they were in the doughnut hole. when i ran for this office, one of the things i pledged to do was work my heart out to close

that doughnut hole. in the affordable care act, we do close it. it closes over time. right now there is a 50% discount for olive and her husband on her husband's alzheimer's drugs when they are in the doughnut hole, and to them that 50% discount meant $2,400, which for senior citizens counting on social security in winsockett is a very, very significant difference in the quality of their lives. overall in rhode island, it's up to $13.9 million in doughnut hole discounts for seniors and people with disabilities as a result of this bill. that makes a big difference in every single one of those lives, just like olive and her husband. a third voice i'd like to bring is brianne who is a 22-year-old graduate of the university of rhode island. she is out. she is working part time as a physical therapist but her job does not provide health insurance. she would be going without entirely, hanging her fortunes on chance as the president

recently said if it were not for the affordable care act. she and 7,500 young adults in rhode island have achieved coverage as a result of this bill by being able to get on their parents' policies. danny is also a recent college graduate living in providence, having graduated from brown university. he is passionate about renewable energy planning but couldn't make the health insurance work. because of the affordable care act like brianne, he is able to be on his parents' health insurance coverage and have that peace of mind. the last story i'll tell is of a small business owner named jeff in providence who provides health care insurance for his employees because he believes it's the right thing to do. he qualified for the law's small business health care tax credit, and so he has seen significant advantage to his small business from this provision. so i think it's a relief to try

to put this quarrel behind us, to try to move on and deal with the economic issues that we face, but as we do, i wanted to make sure that greg and olive and brianne and jeff and danny were all heard here on the floor today because they are rhode islanders in whose lives this bill has made a real and practical difference. thank the presiding officer, i yield the floor and i note the -- i will not note the absence of a quorum because i see the distinguished senator from wyoming ready to take the floor. mr. enzi: madam president? the presiding officer: the senator from wyoming. mr. enzi: thank you, madam president. it is disappointing that the supreme court has upheld the constitutionality of the new health care law. just because it's constitutional doesn't mean it's the best policy, perfect policy or even good policy. and just because the court upheld the law does not change the fact that the american people have overwhelming

concerns about it. not all of it but a lot of it. in fact, the court affirmed that the new health care law is a massive tax increase on the american people. congress must get serious about fixing our broken health care system. we can start by changing this misguided health care law that has divided the american people and failed to address rising health care costs. congress should work together to make commonsense, step-by-step health reforms that can truly lower the cost of health care. i was pleased to see that the supreme court narrowed the medicaid expansion because states can't afford them. hardworking americans are still struggling in this anemic economy and need real action to make health care more affordab affordable. reforms do not have to start here in washington. our nation-states are laboratories of democracy and can play a significant role in addressing the health care crisis in america. governors are in a special

position to understand the unique problems facing their states and fixing health care. like most problems facing our nation, there cannot be a one-size-fits-all solution. efforts underway by indiana governor mitch daniels provide a great example of what different states are working on. he's moving forward with healthy indiana initiative, which is an affordable insurance program for uninsured state adults aged 19-64. outside washington, some health insurance companies have already stated that they will adopt several reasonable provisions to lower health care costs. these include allowing young adults to be covered until age 26 while on their parents' plan, not charging patients co-pays for certain care, not imposing lifetime limits and not implementing retroactive cancellation of health care coverage. and they said they would do that regardless of how the supreme court case came out. one of the most effective ways congress can address the rising

costs of health care is to focus on the way it's delivered as part of the nation's current cost-driven and ineffective patient care system. america's broken fee-for-service structure is driving our nation's health care system further downward and tackling this issue is a good start to reining in the rising health care costs. what is fee-for-service? this method of payment encourages providers to see as many patients and prescribe as many treatments as possible but does nothing to reward providers who help keep patients healthy. these misaligned incentives drive up costs and hurt patient care. the new health care law championed by president obama and congressional democrats did very little to address these problems. the legislation instead relied on a massive expansion of unsustainable government price controls found in that fee-for-service program, especially in medicare. if we want to address the threat posed by out-of-control

entitlement spending, we need to restructure medicare to better align incentives for providers and beneficiaries. this will not only lower health care costs, it will also improve the quality of care for millions of americans. in the health care bill, we took half a trillion dollars, $500 billion, out of medicare and put it into new programs and then we appointed an unelected board to suggest cuts that can be made. and the only place we left for cuts are providers, hospitals, home health care, nursing homes and hospice. i don't think that's where we want to be cutting medicare. shifting the health care delivery system from one that pays and delivers services based on volume to one that pays and delivers services based on value is an idea that unites both republicans and democrats. we have been mentioning a number of simple steps that can be taken while congress weighs the larger fixes needed for medica

medicare. we can encourage insurers to offer plans that focus on delivering health care services by reducing co-pays for high-value services and increasing co-pays for low-value or excessive services. consumer-directed health plans provide another avenue for linking financial and delivery system incentives and have the potential to reduce health care spending by $57 billion a year. bundled payments will support more efficient and integrated care. all these options have already been utilized by a number of private-sector firms with great success. the federal government should be willing to support viable reforms where it's needed but also refrain from handcuffing innovative private-sector designs with excessive regulations or narrow political interests. our nation has made great strides in improving the quality of life for all americans and we need to remember that every major legislative initiative

that's helped transform our country was forged in the spirit of compromise and cooperation. these qualities are essential to the success and longevity of crucial programs such as medicare and medicaid. but when it comes to health care decisions being made in washington lately, the only thing the government is doing is increasing partisanship and legislative gridlock. i'd like to leave the senate with some words of wisdom from one of our departed members and that's senator daniel patrick moynihan, a democrat from new york, who served in this body. he said in 2001, shortly before he retired, "never pass major legislation that affects most americans without real bipartisan support. it opens the door to all kinds of political trouble." senator moynihan correctly noted that the party that didn't vote for it will criticize the resulting program whenever things go wrong. more importantly, he predicted

the measure's very legitimacy will be constantly questioned by a large segment of the population who will never accept it unless it's shown to be a huge success. that's a quote from daniel patrick moynihan, former senat senator. truer words were never spoken. we've seen each of these scenarios play out over the past two years as the new health care law polarized the nation. i hope this distinguished body has the courage to learn from our mistakes because our nation needs health care reform. but it has to be done right way. providing americans with access to high-quality, affordable health care is something i'm confident democrats and republicans should be able to agree on. but 2 1/2 years ago, a democrat president teamed up with a democrat-led congress with only democrat votes to force a piece of legislation on the american people that they never asked for and that's turned out to be just as disastrous as predicted.

how so? amid economic recession, a spiraling federal debt and accelerating increases in government health spending, they proposed a bill that's made the problems worse. americans were promised lower health care costs. they're going up. americans were promised lower premiums. they're going up. most americans were promised their taxes wouldn't change. they're going up. seniors were promised medicare would be protected. it was raided to pay for the new entitlement instead. americans were promised it would create jobs. the c.b.o. predicts that it will lead to nearly one million fewer jobs. americans were promised they could keep their plan if they liked it, yet millions have learned that they can't. and the president of the united states himself promised up and down that this bill was not a tax. that was one of the democrats' top selling points, because they knew it would never get passed if they said it was a tax.

the supreme court spoke today. it said it's a tax. this law was sold to the american people on a deception, but it's not just that the promises about the law weren't kept, it's that it made the problem that it was meant to solve even worse. the supposed cure was proved to be worse than the disease. so it's not just that the promises about the law weren't kept, it's that it has made the problems it was meant to solve even worse. the supposed cure has proved to be worse than the disease. now, we do pass plenty of terrible laws around here that the court finds constitutional. we need to do some commonsense, step-by-step reforms that protect americans' access to the care they need, from the doctor they choose, and at a lower cost. and that's precisely what i'm committed to doing. the american people weren't waiting on the supreme court to tell them whether they supported this law. that question was settled 2 1/2 years ago.

the more the american people have learned about this law, the less they've liked it. so now that the court has ruled, it's time to move beyond the constitutional debate and focus on the primary flaws, because of the colossal damage that it's doing and has already done to the health care system and to the economy and to the job market needs to be turned around. there are things that need to be done and can be done. i yield the floor. and suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

quorum call:

quorum call:

quorum call:

the presiding officer: madam president?

mr. durbin: madam president? the presiding officer: the senator from illinois. mr. durbin: ask consent to speak in morning business. the presiding officer: without objection. mr. durbin: i can't remember another day when so many americans were waiting for the supreme court to rule. today was one of those days. everyone understood that a decision just across that street by nine members of the supreme court was historic and politically significant. this morning, the supreme court handed down this decision, 193 pages with all of the major opinions and dissenting and concurring opinions included in the national federation of independent business versus sebelius. we all know this was the case to decide the constitutionality of the affordable care act. the affordable care act, of course, was one of president obama's first legislative undertakings when he was elected

president. many of us who were part of the senate and house during this debate will never forget it. i've been lucky enough to represent my great state of illinois for quite some time in the house and senate, but there's never been a more historic and exhausting debate than the one that proceeded the final vote on the affordable care act. the last vote in the senate occurred literally on christmas eve and we hurried away from here to be with our families, knowing that we had done something of great historic import. behind this decision was the human experience that most every one of us has had at one time or another. i can recall in my own family experience that moment when i was a brand-new dad and a law student, not exactly a great combination in planning, but that was my life, and our daughter was born with a serious

problem. we were near washington, d.c. and we were uninsured. no health insurance. brand-new baby. and i'm a law student. and i can remember leaving up georgetown law school just a few blocks away from here to go over to children's memorial hospital to sit in a room with all of the other parents who had no health insurance. it was a humbling experience, waiting for your number to be called for a brand-new doctor that you'd never seen before to sit down and ask you again for the hundredth time the history of your child. you never feel more helpless as a parent in that circumstance to have no health insurance and to hope, just to pray that you're still doing the best for your child. that experience is -- is one that literally millions of americans have every single day. with no health insurance, praying that they'll get through

the day without an accident, a diagnosis, or something that's going to require medical care. but we -- what we tried to do with the affordable care act was twofold. first, to expand the reach of health insurance coverage to more families, and second, to make health insurance itself more affordable and more reasonable. let me start with this question of affordable and reasonable health insurance. like my family, many families have children with a problem. a baby born with asthma, diabetes, cancer, heart issues. these are children which need special care, and many times families when they turn and ask for health insurance were turned away. well, that's not fair, and it's not what we need in america. we need health insurance to protect those families, and that's one of the major provisions in the affordable

care act. secondly, many people don't realize until it's too late that their old health insurance policies had lifetime limits, there was only so much money that the health insurance would pay. and people got into challenging medical situations with expensive health care needed, only to learn in the midst of their chemotherapy their health insurance was finished, walked away. we changed that in affordable health care. we eliminated the lifetime limits toker that very reason -- limits for that very reason. we also said that the health care companies should be entitled to a profit and of course should charge a premium to cover the cost of their administration of health care. but we started drawing limits to what they could ask. 85% of the money collected in premiums needed to be paid into actual health care. the other 15% is available for marketing, for administration,

for executive compensation. but 85% had to go into actual cost of health care, hoping to keep premiums from rising too fast. that was in the affordable health care act. we went on to say that when it came to coverage, we detected a problem. too many families had their sons and daughters graduating from college, looking for jobs and not finding full-time jobs with health insurance. so we expanded family health care coverage to include children -- young men and women -- through the age of 25. we said, we should be able to keep them under the family health care plan while they're getting their lives together and looking for work. that was one of the basics that was included in the affordable health care act. all of those things, i think, made health insurance -- make it more affordable and more reasonable for the families that need it. then came the question of what to do about those people who have no health insurance. some people don't have health

insurance because they work at a time job that -- at a job that doesn't provide it and they can't afford it. others have an opportunity to get it but they say they're going to wait. you hear that particularly from young people who think they're invincible. so the question was, how do we expand the reach of health insurance coverage? and we did it in this bill. we set a standard and said, you should not have to pay anything more than 8% of your income for health insurance premiums, and if you're in the lower-income categories, we will help you, help with tax credits and treatment in the tax code to pay for your health insurance. for your employer, the business you work forks we'll give them additional -- the business you work for, we'll give them additional tax credits, hoping to expand that pool of insured people inmark. for the poorest of poor, we said ultimately you'll be covered by

medicaid, a government health insurance plan, and for at least the first several years, the federal government will pay the entire cost -- the expanded cost of that coverage. the notion is to get more and more people under the tent, under the umbrella of coverage. that not only gives them peace of mind, but it also means for many hospitals and providers across america, there will be fewer charity patients. let's be honest about it. even people without health insurance get sick, and when they do, they come to a hospital, and they are treated, and when they can't pay their bills, they're passed on to all the rest of us. my hometown of springfield, illinois, memorial medical center, the c.e.o. said, if you just everybody walking through our front door at least paying medicaid, we'll be fine. do that, senator. and that's what this bill sets out to do. now, there were some people who objected to the part which said, if you can afford to buy health insurance and don't, you're going to pay a penalty. some people called it a mandate. others -- i -- call it personal

responsibility. if you can afford to buy health insurance, you should buy it, because 60% of the folks who don't buy it end up getting sick, and the rest of us pay for it and that's not fair to the system. it's estimated to cost those with private health insurance $1,000 a year just to pay for those who don't buy it when the can. that was one of the issues being debated before the supreme court. so, madam president, this bill, which ultimately passed, was signed by president obama, has been debated back and forth every since, became a major topic in this year's presidential campaign. i don't think there was a single republican presidential candidate who didn't stand up and say, i'll get rid of it on the first day of office. governor romney has said that. and yet when you look at all the provisions of protection in there the expansion of coverage even expanding medicare part-d drug coverage for seniors, to think we would eliminate that? think about the hardship that

would create across our country. we all waited expectantly for this day, this day at the end of the october term of 2011 for the u.s. supreme court. and the decision today was that the affordable care act that president obama signed into law is constitutional. and now we can move forward. some people have said, well, is it perfect? the answer of course is no. i say, half-jokingly, the only perfect law was carried down the side of a mountain on clay tablets by senator moses. all the other effort laws are ot human efforts. but the good news is this: today the supreme court found that the president's affordable care act is constitutional. there was, of course, some question of one provision or another, but the bottom line is, chief justice robert os -- not

considered a liberal by any standards -- led the decision that found this law constitutional. and the important part of that is that it means that for a lot of families there's going to be help. through this law, in i will last year, 1.3 million people on medicare and 2.4 million people with private insurance received preventive health care at no cost. that was a provision that was found constitutional today. that means that mammograms and other preventive treatment will help save lives. the law provides help for states with that prevention programs, programs to help our children stay strong with immunizations, programs that detect and prevent diabetes, heart disease, arthritis. another reason this law is so important is because of lifetime limits, as i mentioned.

before this law, literally, insurance companies would say, sorry, you hit your limit. we can't pay for any more chemotherapy. but because of the affordable care act, found constitutional today by the court, 4.6 million people in my state of illinois alone receive the care they needed last year without having to worry about insurance companies' lifetime limits. it is prohibited by the affordable care act. in these tough economic times, as i mentioned, when young people are looking for work, the fact that you can now have health insurance through your family plan up to the age of is a sensible policy. two and a half million young americans receive protection under the affordable care act because of this singles provision. 102,000 of them live you -- over $61 million has been

rebated to those are health insurance policies and 300,000 people in illinois are included, in the form of a rebate because of what we term "the medical loss ratio." for seniors it will be a helping hand to pay for riggs prescription drugs. they will be able to help fill the so-called doughnut hole and have less money come out of their savings to pray for the drugs they need to keep them -- to pay for the drugs they need and keep them alive. it also means being able to get the annual checkup so problems can be detected before it gets serious. from the business side, the affordable care act found constitutional today by the supreme court is going to help small businesses pay for health insurance. the new health care law provides a tax break for small businesses that do the right thing and buy health insurance for their employees. so far more than 228,000 businesses across america have taken advantage of this new tax credit and they've saved $278 million.

when this is all implemented, this affordable care act, 30 million more people will have health insurance across america. by 2019, 15 million of these will be in medicaid and the rest will be in the exchanges and in private health insurance. let me just say, another provision in here that's important was the expansion of community health care clinics. senator bernie sanders of vermont, a good friend and great leader, really pushed hard on this. i've been to these community health care clinics across my statement they are wonderful. primary care in the small towns, in the neighborhoods that really help people along the way. madam president, today the president of the united states went to the cameras after the supreme court decision and talked about this decision by the court and this law, and he said for those who believe that the affordable care act was just politics as usual, it was a

political risk, and he knew it. there were close friends and advisors to the president who basically counseled him, don't try to take this on. this issue has stopped president after president. i tried to help president clinton and then-first lady -- clinton when they were passing health care reform and they couldn't get it done. but president obama stuck with it. even though there was precious little help from the other side of the aisle, he stuck with it and got the bill passed. they then challenged him in court at every level and today at the highest court in our land, it was found constitutional. the president said, it is not only good in its substance -- and i have described it -- but its also a new challenge for us, democrats and republicans, to make it work. the american people want us to come together to help make health insurance affordable and

available, to incentivize quality care and to make certain that america, the richest nation on earth, has the best and most affordable health care on earth. it took the supreme court 193 pages to say it today, and now it's up to us, both democrats and republicans, to work together. maybe put the swords aside and sit down at a table and make this law even better across america. i think the american people are counting on us. i think the supreme court today in finding president obama's affordable care act constitutional made it clear that now it's up to us to put the policies in place that'll make it successful and help families, businesses, individuals all across america. madam president, i yield the floor. the presiding officer: the senator from texas.

mrs. hutchison: madam president, we have had a monumental decision from the supreme court of the united states, and i have to say, i am disappointed because, while the opinion is not very clear in many respects, the result is clear. and that is that we are getting ready to see one of the largest tax increases in the history of our country. because we're all talking about the fact that the supreme court has declared the obama health care plan constitutional, but let's look at how it was declared unconstitutional. it was not based on the commerce powers of the united states congress and the constitution;

it was based, instead, on taxing capabilities, the taxing power of the united states congress. now, i want to read an excerpt from an interview that george stephanopoulos did with president obama. under this mandate, stephanopoulos says, the government is forcing people to spend money, fining you if you don't. how is that not a tax? president obama replies "no, that's not true, george. for us to say that you've got to take a responsibility to get health insurance is absolutely not a tax increase." stephanopoulos goes on later to say, "but you reject that it is a tax increase?" president obama replies, "i absolutely reject that notion." and yet the court today said,

this is constitutional because of congress's power to tax. so we're going to see the tax increase go forward, and the small businesses and the businesses that are looking at this, the individuals, are going to have a whopping increase in the cost of doing business. at a time when i certainly don't have to point out that we are in an economic downturn, when the private sector is not hiring, when we have an over 8% unemployment rate. yet now we see more costs on top of what we already have in this country, and i don't think that is the recipe for getting this country going again and hiring people to work. i'd like to read a few quotes

from employers on the impact of the obama health care plan on their businesses. scott walmick, president and owner of wammick strawns restaurants is an ihop franchise gee. this will cost my company more than we make. grady payne, the c.e.o. of conner industries, very interesting because conner industries is headquartered in my home state of texas with plants in eight different states. conner industries started in 1981 with five people and one location. today, they have grown to 450 employees and 11 plant locations. they offer health coverage toker employees and the company pays over half of the total premium cost.

in 2014, the company will have to choose how to comply with this law that is now on the books officially as constitutional, they will have to either buy a more expensive government-approved health care benefit or drop health coverage completely and pay the $2,000 fine for each of their employees. thus, mr. payne has stated that the impact of this law will cost them over $1 million no matter what option they choose. medical devices -- the c.e.o.'s of medical devices tax hinders innovation in an op-ed -- i'm sorry. excuse me, it's the chairman and c.e.o. of nuvasive a medical device company in san diego said

provisions of the affordable care act are destroying jobs, hindering jobs and slowing economic recovery. 230 to offset the medical device tax increase, we will be forced to reduce investments in research and development and cut up to 200 planned new jobs next year. so what we have seen today is a validation of what many of us were concerned about when this law was going through congress, and that is the enormous increase in the tax, the fine, and the overall burdens to the businesses of this country would do several things that are not good for the people of our country. it will increase costs to american consumers. it will inject the government into doctor-patient relationships. it will most certainly add new burdens on business. in an environment in which we

have over 8% unemployment. and i think it is very clear that though the president promised that you will be able to keep your health care coverage as you know it, that health care coverage is not going to be there because so many companies are going to drop the health care coverage that they have been offering because it is too expensive to comply with the government conscription of the plan that is required in order to avoid the $2,000 fine. so i think what the court said is insightful in this respect, and that is that while they said this law is constitutional based on the taxing power of congress, they are not ruling on the wisdom nor the fairness of the policy.

well, i think it's going to come down, mr. president, to the people of our country. because the election this year is going to determine the ultimate fate of this bill. the republican nominee, governor mitt romney, has said very clearly on the first day that he is sworn into office, he will ask for the repeal of this health care law. i think it will become an issue in every contested congressional race and every senate race. are you going to vote to keep this law that has been ruled constitutional based on the fact that it is a taxing power of congress, and the people will be able to decide. do they want this jolt on their health care, do they want the extra costs, do they want the

intrusion on the patient-doctor relationship, and do they want to possibly lose the coverage that they have and be taxed to go into another plan. a government plan. we are going to see the erosion of the quality of health care in this country if we are not able to repeal this law and start all over. now, i will say that the purpose of health care reform is to provide more options for people to get affordable health care coverage. i think that is a worthy goal. i think we should go for that goal in a way that does not burden the economy of our

country, stop employers from employing people, in a way that preserves the doctor-patient relationship and doesn't intrude on the people who do have coverage that they want to keep. that should be our goal. mr. president, there are several months before the election. i hope that we will be able to do something in this congress to start a new process of providing affordable health care options for the people of our country, and not continue on this path of enormous tax increases which have been validated by the court, as well as an intrusion on the quality of our health care, and something that in the bigger picture is going to keep our businesses from hiring more

people to get the economy jump-started that should be every one of our goals. i hope that we can work on this in a productive way before the election, but i also, mr. president, hope that the people will make the final decision in the election. if congress has not acted before, that we will have a decisive election that will say we can do better. we, the people of the strongest country on earth, can do better than a health care system that will be eventually turned over to the government if we go down this path. thank you, mr. president. and i yield the floor. mr. president, i suggest the absence of a quorum. the presiding officer: the clerk will call the roll.

quorum call:

a senator: mr. president? the presiding officer: the senator from louisiana. ms. landrieu: i ask unanimous consent to dispense with the roll call. the presiding officer: without objection. ms. landrieu: there are so many things going on in washington today it's hard to know what to speak on first but i'm going to

take this opportunity to talk about flood insurance. one of the reasons is because there are three states in the union that carry the most policies relative to our population. and that would be -- well, and maybe the most policies regardless of our population. that would be florida, number one, texas, number two, louisiana, number three, and of course california, number four. so while this bill affects everyone in the country, the four states that it affects the most and by far are the four states that i mentioned, and louisiana happens to be one. so the people of my state pay a lot of attention to flood insurance. we always have. and we always will have to. and, mr. president, i'm sorry to say that just within the last few hours with so many things changing around here at the last minute, that i just was given the information that the flood insurance bill which we have not

even debated on the floor of the senate is now going to be put into an omnibus package which includes many other important things. the transportation bill, the restore act, which is also important for the gulf coast, parts of it that were accepted by the house, and there were a few important parts that were, unfortunately, left on the cutting room floor over in the house, and now the flood insurance bill. and i want to make it clear that if i was called on to vote on the flood insurance bill that is now going to be a part of this package, i would vote no. because there are some very important provisions that i was going to offer as amendments to the bill that i think are crucial to not just my state but to the state of florida, potentially to the state of california, and potentially to texas as well, and i'm not sure

that their senators are in complete agreement or understand some of the challenges here, but i want to point a few of them out. unfortunately, i'm not going to get chance to vote no because i'm going to have to either vote for the whole package, which i intend to do, although this flood insurance bill is not in the position that i would support. and let me give you three reasons. one, there's a provision of the bill -- and i'm going to need the staff to come help -- there is a provision of the bill that talks about v-zones. it's called velocity zones. and right now with fema, fema basically says, if you are in a velocity zone, you can't rebuild. well, mr. president, i've got

st. bernard parish, taravone parish, cameron parish and large sections of tw three other paris that as you can see are designated v-zones. this means likely to be flooded, not just based on their elevations but the way that -- the historical patterns of storms coming out of the gulf affects them. and i understand that we have to be very, very careful in these areas, so i had an amendment to say, no, you can rebuild, but you have to build up to the right elevation. or you have to rebuild according to you know, the highest standards. if we don't fix this and this bill passes, which it looks like it will, there are going to be grave concerns or questions, if not a downright prohibition, on building in these areas regardless of whether you pay insurance or not. this is not right.

the other amendment that i was prepared to offer is an affordability amendment. people may not realize this -- and i hope that the members will be listening -- again, this bill affects all the states, affects all of the states. but in the underlying bill, there is a provision that allows these rates for everyone in the country to be increased by 15% a year. now, people are really struggl struggling to pay flood insurance now. i think that's very steep. people that are arguing for the 15% a year increase say that it is important to get this program actuarially sound. it is currently running a $20 billion deficit. i am well- aware of the need to get this program in line, but i

was going to offer an amendment that simply created and expanded a short -- a small but important affordability provision of $10 million that the department would have to help people on fixed incomes or lower, middle-income families that of course are working along the gulf coast and in some of these coastal areas. they're not sunbeiging, not -- sunbathing, not vacationing. this is not about secondary homes. this is about primary homes. they have generations living near the coast, either fishermen, et cetera. this is a very important issue. flood insurance is not just about business and commerce. it is about culture, it is about a way of life, it is about preserving coastal communities, it is about being resilient in storms. and, yes, louisiana wants to pay

its fair share. florida must pay its fair share. texas must pay its fair share. we have no problem, and have been for years. some members are now waking up and saying, oh, my goodness, now you're telling us -- people in other parts of the country -- we have to buy flood insurance? but we have a levee. you telling us we have to buy flood insurance? well, yes. we've had levees in louisiana for 200 years. unfortunately, they break sometimes when the federal government doesn't build them correctly. they disintegrate and our people get flooded. and, yes, we have levees, we pay to have the levees and we pay for the insurance and we're not as protected as we could be and we're not sunbathing on the coast. we're running the largest port system in north america and we drain 40% of the continent. now, florida has a little

different situation. they do do a great deal of tourism, and they do do a great deal of sunbeiging and other things. and i'm happy for florida and their economies. but the people i represent are not running huge vacation operations. this is not an optional place for us to live. it's not option l for you not appears optional for the nation and not optional for the world. and we have to find an affordable and safe way to live here. so i had an amendment to try to make this more affordable. that amendment is not going to be offered. the only positive thing that i can say about the bill -- and there are some positive things -- and this is important i know to the realtors -- i support them almost 100%, a the homebuilders -- they've got a very good record with the realtors and homebuilders, and i believe in what they do and

they're right when they say we have to have a permanent extension because we can't close deals. we can't -- people can't sell their homes. we have to have this insurance program, and they are correct. and so, like a lot of things up here, it's a balance. with the amendments that i was going to put on the bill and actually had worked out to do so, on balance, the bill would have been better, and i was prepared to vote for it on the floor. now that it's being stuck into this package without the debate on the floor and without the amendments, i must go on record to say that i would vote against the bill in its current form, even though i know we need lon long-term flood insurance. because of the increased rates, the lack of the affordability, and the lack of the fix to the v-zones, i think that it justice the balance against the bill

generally. there's nothing i can do about it. that's the way it's going to a but i wanted to submit my comments for the record. and i can promise the members of this senate, after this bill goes into effect, you're going to hear a lot of complaints from your constituents, and i am certain that we will be back here within the year, after the elections, regardless of who wins and to loses, fixing some provisions that should have been fixed. but because there's not going to be a debate on the senate floor will not be. and i know that this bill came out of the banking committee in the senate with bipartisan support. i am well-aware of that. but i think there was some correction or some perfections that could have been done on the senate floor. we're not going to get that opportunity and i thank the chair, reserve -- suggest the absence of a quorum, and put my other statement into the record. the presiding officer: without objection. the clerk will call the roll.

ms. landrieu: mr. president, let me erase the absence of a worry and ask if john belarnos can come to the floor, please -- i ask unanimous consent. the presiding officer: without objection. ms. landrieu: i suggest the absence of a quorum. the presiding officer: will the senator renew her request for floor privileges? ms. landrieu: john belarnos. the presiding officer: without objection. quorum call:

ms. landrieu: i suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

quorum call:

a senator: mr. president? the presiding officer: the senator from florida. mr. rubio: thank you, mr. president. i ask unanimous consent that i be allowed to speak as if in morning business. the presiding officer: the senate is in a quorum call. mr. rubio: i ask unanimous consent the quorum call be suspended and i be recognized to speak as if in morning business. the presiding officer: without objection.

mr. rubio: thank you, mr. president, for this opportunity to speak. as we know, the supreme court ruled today on the health care law. we have gotten a lot of phone calls and emails. people want to know what this means. in washington, everything is analyzed over what does this mean for the elections, what does this mean for the republicans or the democrats. so what i hope to do today by coming to the floor of the senate is respond to some of my constituents from florida and folks from around the country that have called as well to find out what this means in real life and what my position is towards it moving forward. so that's what i hope to do here today in the few minutes that i have while the senate waits on the pending matter. let's first begin by understanding what's happened today. the supreme court -- what the supreme court does is it doesn't decide whether something is a good idea or a bad idea. the supreme court's job is to decide whether something is constitutional, and today by a vote of 5-4 -- four of them disagreed, but five of the justices, including the chief justice, decided that at least a key component of the health care law that passed here before i was elected was constitutional, but it was constitutional, they

said, because it was under the taxing powers of the congress. in essence, they said that this mandate, this requirement is constitutional because it is a tax. now, that's curious, of course, because the president denied it was a tax. i looked it up. remember, the specific interview that he gave a few months while this was being debated where he was asked by george stephanopoulos on abc wasn't this a tax, and he denied it. he denied it and said there was no way this was a tax. in fact, if i could find the right wrote in here -- quote in here just to make sure i'm not misquoting anybody in this day and age of fact checking, the president specifically said that the notion of a tax was wrong. so -- but months later when this appeared before the supreme court of the united states of the united states, his lawyers argued that, no, this is constitutional because this falls within the power of the government to tax. so that's important because that's the reason why this law still stands on the books today. let's reminded ourselves when we

talk about a mandate, this is not a mandate that the government provides you insurance. this is a mandate that you find insurance yourself. and for a mandate to work -- and this is by admissions of anyone who has ever been for a mandate, they will admit this to you, that for the mandate to work, the penalty for not buying insurance has to be severe enough so that you will decide to buy the insurance. otherwise, people will just pay the fine and not get the insurance. so what does this mean in the real world? well, first of all, what it means in the lives -- i found a blog post from 2009. the numbers may have changed a little bit, i'm not 100% sure, but this is what when the house was deliberating at the time an economist took this up on july 14, 2009, and he actually used a couple of real-world examples. this may be very similar to you, so listen carefully. the first example he used is of a gentleman, single, earns about $50,000 a year, which is four times the federal poverty level,

so he wouldn't qualify for the subsidies under the bill. now, he's single, 50-year-old nonsmoker, small business employee. that means he works for a small business that doesn't provide health insurance and isn't required to because the law requires businesses to have 50 -- that have more than 50 employees to provide insurance. let's say he works at a place that has five employees. they are not required to offer you health insurance. so he is 50 years old, he works at a small business that is not required to offer you insurance, he makes $50,000 a year before taxes. he doesn't have insurance. now, he cannot afford a bare-bones policy. this economist went through e e-health insurance.com and he found that the cheapest policy he could find was about $1,600 a year. $50,000, when you take out taxes, depending on where you live, all these sorts of things, it doesn't add up to a lot of money. this is middle class. he can't afford a 1,600-dollar a year policy. so instead he would have to pay

a $1,150 fine, which is a tax. that's what he would have to pay. guess what? even after paying the $1,100, he still doesn't have insurance. this is the real-world impact of the mandate. here's another example. this one actually uses my home state so i picked this one. a married couple, two kids. they have a small business, they run a tourist shop in orlando, florida. i'm not sure if this is a real person or a hypothetical, but i like the fact that they picked orlando, florida, so let's use that. small tourist shop in orlando, florida. their small business, husband and wife, $90,000 a year. that's what it makes. again, before taxes. you have a small business, $90,000, between all the expenses you have and all the other tax components that come up. it's middle class. this is middle class, okay? two employees. but their wages exceed the amounts that would qualify for the small business tax credit. so because their business is so small, there would be no financial penalty for the business that only has two

employees, but as individuals they still have to buy health insurance for themselves and for their families. so here they are, husband and wife, 40 years old, two kids, they own the small tourist shop, they are the only employees making $90,000 a year together. they can't find the cheapest -- the cheapest insurance they can get is a high-deductible plan, about $6,000 a year of annual deductible. that cost them about $3,800 a year. the fine is $2,000 a year. so that's probably what they end up having to do now. this is a $2,000 increase in their taxes through a fine, and they still don't have insurance to show for it. this is a third example i want to give you, and this one is not part of the analysis, but i pointed out to you the fact that the law now requires any business with 50 -- more than 50 employees, full-time employees to offer health insurance. now, offering health insurance is a good thing. we should try to encourage that and provide opportunities for business to do it, but imagine

if you're one of these businesses now and you're asking yourself i wonder if i should hire the 51st employee or the 55th employee? should i grow my business? well, as a result of this new mandate, maybe you decide not to now. how much will this cost us? it's $2,000 per employee if we don't comply. how much will this -- over 30. how much will this cost us? maybe this is not the year to add a few jobs. even worse, maybe they will decide you know what? maybe we should become a part-time business. you know where i hear a lot about this? i heard a lot about it in my campaign, franchises. the taco bells and mcdonald's. those aren't necessarily owned by taco bell or mcdonald's. they are owned by a small business owner who maybe has one or two of these businesses. they're going to decide to make everybody part time because they can't afford to pay the fine and they can't afford to provide the insurance. so this would be a bad idea no matter what the economy is, because now you're discouraging them from growing their business. no matter what our economy looked like, this would be a bad

idea. but let me tell you why it's worse. number one, guess who gets to enforce all this stuff? guess who you have to answer to. guess who you have to prove to that you have insurance. your neighborhood friendly i.r.s. that's who is in charge of enforcing this. millions of americans now have an i.r.s. problem because they don't have health insurance. and this idea that they don't have health insurance -- because if you read some of these statements in these interviews that the president gave when he said it wasn't a tax, it makes it sound like some of these people, they don't want to buy insurance, they want to use the money for something else, that they are irresponsible. they're not irresponsible. they can't afford it. there isn't a vibrant, private market for them to buy insurance, because they can only buy insurance from their state. so they live in florida and there is some company in california that wants to sell them insurance, too bad, you can't buy it. ridiculous. that's what we should be changing here. these people aren't doing it because they don't want to be responsible. they can't afford it. their house is upside-down.

they're making half as much and working twice as long. their kids want to go to college. everything's gotten more expensive, gas, milk, their water bill, the electricity bill. and on top of that, we're going to hit them with this? we just got a report today, the economy barely grew in the first three months of this year, less than 2%. our economy is not growing. when it's not growing, the debt gets worse, the unemployment gets worse, everything gets worse. we shouldn't be doing anything in washington that makes it harder for people to grow this economy. why would we do something like this to people? why would we pit the owner of a tourist shop with a $2,000-a-year tax or else the i.r.s. is going to chase you around? why would we hit this guy who's 50 years old trying to make a living in the world working for a install business, would y would we hit him with a $1,000-a-year tax if we're trying to grow our economy. look, health insurance is a real

problem, it is. i wish more americans could get their health insurance the way congress gets it. do you know how we get it? it's very simple. we get to choose, depending on which state you're from, eight to ten companies. and you can decide, you want a higher co-payment, you pay less premium and vice versa. you get to choose. most americans don't have that choice. they get their insurance from their job and their job tells them, this is our insurance plan, pick a doctor out of this book. that's the kinds of things we should be working on. and so apart from everything else, this is a terrible idea because it hurts our ability to grow our economy. this is the real-life impact of this bill. this is the impact this is going to have. and you're going to see it. you're going to see it in a further downturn in our economy and more slowing in economic growth. this is going to have a real impact. this is a big deal. people across this county and across florida have -- country and across florida have every right and every reason to be worried about the impact this is going to have on them. my friends, this is a middle-class tax increase and millions of americans now have

an i.r.s. problem. you will now have to for the first time in american history prove that you have health insurance or you're going to have to deal with the i.r.s. i guarantee you, that's not good for small business. i guarantee you, that's not good for the middle class. i guarantee you, that's not good for economic growth. that's where we're at today. and if there's anything i hope we can do here -- i wasn't here when the health care bill passed, but i hope some of my colleagues month voted for this will think to themselves -- who voted for this will think to themselves, this is never what we intended. we want to help people who are uninsured bunt like this. this is never what we wanted to do. i hope that enough reasonable minds will come together to either suspend or repeal this and let's start from scratch. let's come up with a real plan to deal with the health insurance crisis in america. thank you, mr. president. i yield the floor. a senator: mr. president? the presiding officer: the senator from nebraska. mr. johanns: thank you, mr. president. mr. president, today marks one

of the most historic and certainly highly anticipated supreme court decisions in a long time. i would be less than candid if i didn't say that i'm enormously disappointed that the court upheld the law in its individual -- and its individual mandate which requires all americans -- all americans -- to purchase government-approved insurance whether they choose to or don't choose to. i believe it is fundamentally wrong for the united states government to intervene in the lives of americans in this very, very direct way. however, the supreme court's role within our system of government is to interpret the constitution and they have spoken. so with the ruling now officially out, what's really important is where we go from here. now, the court did not decide

today that this law is good policy. in fact, chief justice roberts went out of his way to clarify this point. it's clear in my mind that we must do everything we can to repeal this flawed law because it is enormously bad policy. while we've waited over two years for the final decision about this law's constitutionality, we haven't had to wait that long to learn why the law is bad for america. the law was a train wreck from the very beginning. back-room deals, empty promises, political tactics that epitomize what disgusts americans about their government. some of the law's leading

supporters even admitted that they hadn't read the 2,700-page bill. the speaker acknowledged that we're going to have to pass the law to see what's in it. my colleagues across the aisle hastily passed the bill on the notion that there were some gold nuggets in there tucked inside the law and that maybe americans were -- would think that they were lucky enough to cash in. well, we've come to know that nothing, nothing could be further from the truth. after more than two years, there's been a lot of rain but not a single rainbow and certainly no pot of gold when it comes to this legislation. instead, what we have seen is one broken promise after anoth another. just last week, the

administration's own medicare actuary reported national health spending will increase at an average of more than 50% over the next decade. the same analysis estimated in 2014 the increase in private health insurance premiums is expected to accelerate to 7.9%. but the startling fact is that's more than twice the increase americans would have faced in the absence of the health care law. this is just one of many studies that indicate the law does not bend the cost curve down as the president promised. it begs the basic question: why would, why would congress pass a

massive overhaul of our country's health care system that actually increases the cost of care? it's so ironic that the majority decided to call this health care law "the affordable care act." you can hardly argue that more people will receive better care under a plan that drives costs upward and also puts medicare on an unsustainable path. the medicare actuary asserted in the most recent trustee's report that the law could lead to significant access issues for beneficiaries under medicare, and medicare itself is estimated to be insolvent by 2024. due to the cuts to medicare in the health care law, he said -- and i am quoting -- "the prices paid by medicare for health

services are very likely to fall increasingly short of the cost of providing those services." he goes on to say -- and again i'm quoting -- "severe problems with beneficiary access to care" will occur. well, that's just another way of saying, to put it very directly and simply, our seniors are going to find it harder and harder to find a doctor or a hospital that will accept them as patients. to put it simply, our seniors are going to have difficulty accessing medical care under this law. the health care law perpetuates the problems within this very, very difficult system.

it is clear heavy-handed government solutions aren't the answer, but that's exactly what this law creates. in this law, there are 159 new boards, over 13,000 pages of new regulations, and it gives the secretary of health and human services more than 1,700 new or expanded powers. no one will convince me that that isn't a seizure of our government, of our health care system and putting it under the power of government. americans don't want government bureaucrats diagnosing and prescribing their care. they want the freedom to choose an insurance plan that covers their needs and to just simply see the doctor of their choice.

it seems the president even manipulated this sentiment which is why he said no fewer than 47 different times -- quote -- "if you like your plan, you can keep it." well, he knew that that pledge would help him gain support for his law but, sadly, the american public was misled and his promise can't be kept. the nonpartisan congressional budget office estimates up to 20 million americans -- 20 million americans -- could lose the insurance they get through work, the insurance that they like and want to keep because of this health care law. and families in 17 states, including my own state of nebraska, no longer -- no longer have access to the child-only

health insurance because of the mandates of this misguided legislation. and that's not the only way the law will hurt hardworking american families. the director of the c.b.o. testified that the new law will mean 800,000 fewer jobs over the next decade. the american people deserve more than a laundry list of flawed policies and empty pledges. americans deserve step-by-step reform instead of rushed policy. transparent reforms, not a 2,700-pain entangled mess. and an open debate, not a closed-door discussion and the back-room deals that were so necessary to get this flawed piece of legislation passed. more than anything, they deserve

sound policy that delivers on the promises. i will do everything i can to continue to push to repeal this misguided law and to push for policies that set us on a right course. because the path we pave will define our future as a nation. there is no disputing that medicare and medicaid are two of the biggest drivers of our nation's $15 trillion debt. so if we want to secure a sound future for our children and our grandchildren, we have to fundamentally reform these government programs, not double down on policies that will bankrupt them. in that same vain, we can't ignore our struggling economy. instead, we need policies that promote business growth and job

creation. you see, i believe we can pass step-by-step reforms that confront these tough issues and policies that depart from a top-down, one-size-fits-all approach. the issue of health care touches all of us at the deepest level. whether it's a new life entering into our world, a tough diagnosis, a lifesaving surgery or care for a loved one in their final days, health care decisions should not be dictated by washington. families and the physician that they trust need to be at the heart of the decisions that impact their health. the supreme court has spoken definitively about the constitutionality of this law, but americans have spoken loud and clear when it comes to the sensibility of this -- of this

process and of this policy. it's time to repeal it and put in place sensible reforms that truly do bring down costs. madam president, i yield the floor. i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

quorum call:

quorum call:

mr. lee: madam president, i ask unanimous consent that the quorum call be suspended. the presiding officer: without objection. mr. lee: madam president, i rise today to speak about the supreme court's ruling this morning in the case involving the constitutionality of the affordable care act's individual mandate. in that case, the supreme court rendered a decision that may be perceived by many as a victory for the proponents of the

controversial individual mandate contained within the affordable care act. i submit today, however, madam president, that this victory, if it is to be called that, will prove to be not only hollow but also short-lived. i say that because, significantly, the supreme court was able to uphold the constitutionality of the mandate only by a series of gymnastics that allowed the court to find that this was a tax. first, the court addressed the issue and concluded for only the third time in the last 75 years -- only the third time since 1937 -- that congress had in fact exceeded its power as asserted under the commerce clause of the u.s. constitution. having concluded that congress lacks the authority to compel commerce, the creation of commerce, so that it could then regulate commerce, the supreme

court went on to shoehorn this individual mandate provision into the supreme court's conception of congress's taxing power. this awkward construction is one that exposes many of the true flaws of the individual mandate. the mandate itself, we must remember, was not wildly popular among the american people at the time it was enacted. it has become even less popular as the american people have come to understand it. a recent poll revealed that roughly 74% of americans don't like the individual mandate. this is easily for us to understand when you think about the path tha fact that we, as a, were born as free people. it offends our most basic sense of freedom to have one of the most personal decisions made for us by government, particularly by the impersonal, distant government that's based in washington, d.c.

these kinds of decisions should be made by individuals and families in constitutiona consuh their doctors, not by government bureaucrats in washington, d.c.,. so the fact that it's unpopular doesn't surprise us. and given the fact that the supreme court was able to uphold the individual mandate, only by calling it a tax, is significant. it's especially significant given the fact that it was pitched to the american people as something other than a tax. the president promised us he would not raise our taxes. he promised us that the individual mandate did not amount to a tax increase. he promised us all along that he would never raise the taxes of any american earning less than $250,000 a year. well, those who participated in congress, who voted for this provision, also promised us that this would not amount to a tax

increase. they did so for one simple reason: they knew it couldn't pass. they knew it wouldn't be able to get the number of votes necessary to make it become law if they called it a tax. so they didn't. they went to great lengths to make sure that it wasn't described or characterized or structured as a tax within the text of the statute itself. now, after the fact, the supreme court has taken the step of shoehorning this regulation into congress's taxing authority, and it's calling it a tax, effectively insulting those members of -- effectively insulating those members of congress who voted for it. it's not just any tax contrary, but a tax increase that the joint tax that will be borne by

hardworking, middle-income workers. they've concluded that over 75% of the burden associated with this thing that has now been deemed a tax will be paid by those earning less than $250,000 a year. it was unpopular before we were told it would be deemed a tax. now that it's a tax, we can't expect that its status as a tax will enhance its popularity. if anything, we can expect that it will become even less popular with the american people. for that reason, i'm -- i'm absolutely convinced that for those who call this a victory for the individual mandate, it will prove to be anything but a victory. it will prove to be something that will result in a groundswell of people contacting their members of congress, telling them that they don't want their taxes raised, telling them that members of congress who voted for this promised them that it wouldn't be a tax

increase, asking them, for instance, to vote on it, to decide once and for all whether they're willing now to call it a tax, give than that was the only way it could be upheld as a valid exercise of congress's power. now, as we move forward to the november elections, we're going to hear a lot about what people don't want out of their national government. we'll continue to hear a lot from those people who are offended by this notion that the government can tell them where to go to the doctor and how to pay for it, who are offended by the notion that government would step in and tell americans, you have to buy health insurance, not just any health insurance, but that health insurance which congress in its infinite wisdom has deemed necessary for every american to purchase. and if you don't, you're going to be penalized, if you don't, you're going to be taxed. people are going to be upset about this. they're going to complain to

congress and to candidates for congress. they're going to complain to the president and to other candidates for the presidency. this is not the kind of government that they want. after they do that, they'll proceed and they'll start talking about what kind of government they do want. that's where we have to move, away from the kind of government we don't want toward the kind of government that we do want, the kind of government that we do want -- the kind of government that we do want is the kind of government that we as americans have always wanted, ever since our founding. the kind of government that recognizes limits to its power, when it acts, it does so without affecting our individual liberty, and it does so at the expense of our state governments.

this is not simply a technicality upon which we are involved in a discussion. this is a very important part of the political process. it's essential that any time we raise taxes we do so in a way that is clear to the people that we stand accountable for raising taxes to the people. the courts don't have the expertise to do that, and yet they exercised that power today. as the majority opinion today reminded, the court -- the supreme court of the united states possesses neither the expertise nor the prerogative to make policy judgments. those decisions are entrusted to our nation's elected leaders who can be thrown out of office if the people disagree with them. this reminds me of one of my favorite quotes from our country's greatest founding father, george washington, who said something very similar way back in 1789 when he explained,

"the power under the constitution will always be in the people. it is entrusted for certain defined purposes and for a limited period to the representatives of their own choosing, and whenever it is executed contrary to their interest or not agreeable to their wishes, their servants can and undoubtedly will be recalled." this reminds us of the fact that we, as americans, are in control of our own destiny as a nation. we, as americans, are here and have the prerogative to explain what we want and what we don't want out of our government. the government exists to serve the people and not the other way around. the decision rendered by the supreme court today, while something i disagree with in many respects, is one that i predict will usher in a new era of robust debate and discussion over issues of federalism and

individual freedom. that debate, i'm convinced, will lead inexorably to the result that we as americans will become more free, less captive to a government that tells us where to go to the doctor and how to pay 0 for it, that we as a people will prosper as we regain our god-given right to constitutionally limited government. thank you, madam president. ms. mikulski: madam president? the presiding officer: the senator from maryland. ms. mikulski: madam president, i rise to speak on the affordable careage oact. madam president, today i am so relieved that the supreme court has upheld the affordable care act as constitutional. with this ruling, our nation's highest court has made it clear that no matter who you are, a man or a woman, a senior facing cancer, a child with juvenile diabetes, you will have health

care that's available, reliable, and undeniable. health care reform has achieved many goals that the american people wanted us to do. one, expanding universal access. now 32 million people will have health care that they didn't have before. second, it breaks the stranglehold of insurance companies, ending their punitive practices, particularly in those areas of preexisting conditions where they denied health care because a child might have autism or asthma or for we women they had a particular approach where they charged us more, 30% more, and then they simply treated a woman as being a preexisting condition. packers sometimes for thsometimf

domestic violence was considered a preexisting condition. we ended that program we also saved and strengthened medicare and we exercised prevention, early detection and screening that will saving lives, improve lives and also save money. i'm proud of what we did in congress with the universal coverage. for the first time in our history, we are committed to covering every single american with health care. and it helps young families, families be able to look out for their children. it helps young adults -- recently graduated from college -- some looking for a job, some working in start-ups where there's no health insurance, because of health care reform, 52,000 young adults in maryland will have coverage on their parents' policy while they go back to school, look for a job, or get that entrepreneurial spirit going. then there's these punitive

practices of the insurance company. much is being said about how we interfere with your right to see the doctor, your doctor of your choice or get health care. that's what insurance companies have been forge years, people in pinstripes i think ising in boardrooms made decisions on who could get health care and who couldn't. so we've stopped them from denying family health insurance. we stopped insurance companies from denying children's coverage and congress ended, as i said, the discrimination against womn -- women. i remember when they tried to take our mammograms away, and i just said no and organized the preventative health care amendment, but when we fought for -- we women fought to have access to mammograms and other things related to our particular life needs, the fact is that we wanted it for the men, too.

so when we organized for the prevention amendment so that we could limb the need on co-pays for this, it was so we women could have access to mammograms, so that the men could have access to screening for prostate cancer, so all americans could get that screening for the dreaded c words like colon cancer, how about diabetes and heart disease? these are the kinds of things that if you can have early detection and early screening will save lives and also save the spread or the disease getting worse. it detects the terrible situation of diabetes. undetected, uncontrolled and unmanaged, diabetes can result in the loss of an eye, the loss of a kidney, the loss of a leg all because you have lost your health insurance. but because of what we've done

in the affordable health care act, not only will you have health care but you will have the preventative services where early on you will be able to examine exactly where you are, have access to a diabetic educator, have the kind of monitoring, coaching that you need, and hopefully diabetes comes under control, and guess what? our health care costs comes under control. you know, that's what we did in this bill, and i'm really, really proud of it. i travel my state a lot, and as i went from diner to diner, out there in the community where i could just talk to the people unfettered, unprogrammed, unchoreographed, you know what they said to me was barb, i not only worry about losing my job but i worry about losing my health insurance. i don't know what will happen to my family. i fear that i am one health care

catastrophe away from family bankruptcy. i want to make sure that my family is taken care of. i talk to small business. how could they afford that? they need predictability. they need understanding. they need to have access through something called the health care exchange where it would be like an economic mall where they will be able to go to the health exchange and see the whole lineup of private health insurance companies and the benefit that they offer so small business will be able to navigate that and see what do they need, what can they afford for the benefits for their workers? this is the american way. this does use market techniques but at the same time we don't use free market to endanger the people in terms of universal access and some of these others.

there are many things in this bill, and one of the others that i like so much is we insist that 80% of the premium you pay goes into health care, not into the executives' pockets for perks, privilege or profits. now, i believe in the free enterprise system and i believe in profit, but i don't believe in profiteering, so we said 20% goes into administrative costs, and if you can control those, you will make a bigger profit, but 80% has to actually go, rewarding providers for the health care that they do, for their education, for their training. i just think it's terrific. and this august, this part of the bill has already kicked in. my constituents in maryland will see over $5 million returned to them because we insisted on this provision. so we are for providers getting what they nd in terms of

reimbursement, but at the same time looking -- making sure it goes into the health care that they need. so today we have had the ruling of the court. i was out there on the steps of the supreme court and i loved every minute of it. madam president, as you know, i got into politics as a neighborhood protestor. i fought a highway and i fought the downtown establishment and i fought the political bosses. and what i have said is i have talked to young people around the world, particularly those who have aspirations in autocratic or dictatorial environments. you know, in america, when you're a protestor, they don't put you in jail. they send you to the senate. i'm here because of the first amendment of the constitution. free speech, freedom of assembly. but when i was out there on the steps today and heard the roar of the crowd, whether it was the

tea party who had access to a microphone, whether it was me who had access to a microphone, that the founders' vision of america worked. what did they do? they believed in limited government. they believed in no -- they believed in checks and balances. no president should have unlimited power, no congress should have unbridled power, and the supreme court would have an independent judiciary to act as the referee. president obama proposed the bill. we duked it out in the congress. we passed it and sent it out to the land, but there have been legal challenges. it went to the supreme court. the supreme court looked at the bill, not for utility or even desirability. they looked at it for constitutionality. and today they ruled that the bill was constitutional. i'm sure somewhere there is tom jefferson, john adams and his wife abigail who said they lived

the constitution and in that health care bill, by the way, john, they didn't forget the ladies. madam president, i yield the floor. i note 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 maryland. mr. cardin: i ask unanimous consent that the quorum call be dispensed with. the presiding officer: without objection. mr. cardin: madam president, i ask unanimous consent to speak as if in morning business. the presiding officer: without objection. mr. cardin: madam president, i take this time to comment on the supreme court decision on the affordable care act. i think this was a good day for the american people. it allows us to move forward with providing universal health care coverage for all americans, affordable, quality health care.

i want to quote from a former member of this body when he said for me, this is a season of hope, new hope for a justice and fair prosperity for the many and not just the few, new hope, and this is the cause of my life, new hope that will break the old gridlock and guarantee that every american, north, south, east, west, young, old, will have decent quality health care as a fundamental right, not a privilege. that was a statement from our former colleague, the late senator ted kennedy, on august 26, 2008. this congress acted and did what was right to move this nation forward, to join all the other industrial nations in the world to say health care is a right, not a privilege. and the supreme court today recognized that it was congress' responsibility and that congress had the legal authority to move forward. as a result of that decision, we're going to find that

$10.7 billion has been recovered already today by dealing with waste, fraud and abuse in the medicare system. we'll be able to continue with those programs that make our health care system more affordable. we'll be able to continue health care coverage for those between the ages of 19-25 that are now on their parents' health insurance policy. 3.1 million young adults have benefited from that provision of the affordable care act that was upheld by the supreme court today. 17 million children with preexisting conditions can no longer be denied coverage by their insurers. that provision is now safe as a result of the supreme court decision. 5.3 million americans on medicare saved on average $600 on their prescription drugs. madam president, as you know, we worked in this affordable care act to close the coverage gap, the so-called doughnut hole on prescription drug coverage for

our seniors. in upholding the affordable care act, the supreme court allows us to continue to make sure that that coverage gap is eliminated. 70,000 americans with preexisting conditions now have the security to know that their coverage is safe. in addition, in 2011, 32.5 million seniors received one or more free preventative services. so far in 2012, 14 million seniors have already received these services. the expansion of benefits in medicare that was under the affordable care act, providing the wellness exam, eliminating the co-payments on preventative health services, that will also now be safe and our seniors will continue to be able to enjoy those benefits. on the doughnut hole that i already mentioned, the coverage gap on prescription drugs will save $3.7 billion for 5.2 million seniors for an average of $651. this is real money. this is the difference between some seniors being able to take their medicines or having to leave them on the pharmacist's

desk. that is now also protected. insurance companies will provide almost 13 million americans with over a billion dollars in rebates in 2012. we put into the health care reform proposals protections against excessive premiums by private insurance companies. well, that's going to save the consumers in america over a billion dollars. 105 million americans no longer will have lifetime limits on their coverage. insurance should be there that protects you. before the affordable care act, we had limits that may not have covered your extraordinary costs, your catastrophic costs. we now have that protection as a result of the affordable care act and the supreme court upholding that decision today. it's also important for small businesses, small businesses, 360,000, took advantage of the tax credit that helps small companies afford to buy health insurance for their employees, and when we fully implement this

bill in 2014, small companies will enjoy the same larger pools and lower premiums that larger companies enjoy today in covering their employees. that today is helping cover around two million workers. we already made a significant amount of progress as a result of the affordable care act and the supreme court upholding that law today. i'd like to just talk a minute about the patients' bill of rights. one of the major parts of the bill was to take on the abusive practices of private insurance companies. we all know that that was at risk if the supreme court did not uphold the actions of congress. as a result of upholding the actions of congress, we now find, for example, access to emergency care, a provision that i worked on, that says that it is prudent for you to go to an emergency room. let's say that you're having shortness of breath and you have chest pains and the right thing for you to do is to go to an

emergency room, that your insurance company is going to pay for that visit. you can't go by your final diagnosis. it may not be a heart attack. if you get your bill and it's not paid for by your insurance company, you might have a heart attack. this bill protects us to make sure the insurance companies do not use abusive practices against you. the access of women's health care is guaranteed under the patients' bill of rights. access to pediatric care, choice of health care professionals as your primary care. all of that is in the -- what we call the patients' bill of rights that protects you against abusive practices of private insurance companies. clinical trial coverage is also in here. the provision i worked on, health disparities. we know that we pay a heavy cost in america because of health disparities. in minority issues and genders issues. we now have a national institute for minority health and health disparities at the national institutes of health. that will help us understand why we have these disparities in our system and what we can do to

reduce those disparities for t the -- because it's the right policy for america and will also save us money. that law now is protected. that -- that institute is protected and is no longer in jeopardy as a result of the supreme court upholding the -- the affordable care act. and let me talk about oral health care. we talked frequently on the floor here about monte driver, the 12-year-old in maryland in 2007 had no health insurance and could not get access to dental care, lost his life. we -- we said that's not going to happen again in our state or any place in the nation. and we're proud that -- that children's access to pediatric health care, dental care is protected under the essential benefit provisions in the affordable care act that was upheld by the supreme court today. i also just want to comment on the importance of the legal decision beyond health care. to me, it shows that the supreme court was able to find a way to

advance the rule of law and to follow the precedent that we've seen in upholding programs such as social security and medicare, which are mandatory insurance programs. it's the right decision on the rule of law. it's the right legacy for this court to find a way in a -- in a snrac has nine different justices -- in a supreme court that has nine different justices with different views, they were able to come together with an opinion that upheld the authority of congress to act on a major national problem. madam president, now it's time for us to move forward. this issue's been litigated. the supreme court is the final arbiter of this decision. it is constitutional. i urge my colleagues, both democrats and republicans, let's work together to implement this bill in the best manner for the people of this nation. we know that we're saving money. we know that the congressional budget office says that the implementation of the affordable care act will save hundreds of billions of dollars over the

first ten years and then trillions of dollars beyond that in our health care system. let's work together to make sure it works. let's work together in the interests of the american people. let's put our partisan fights aside, let's accept what the supreme court has done and now let's move forward to get this law implemented in the most cost-effective way so that we can, indeed, achieve the goal that senator kennedy was talking about, that every american should have access to affordable, quality care in the richest nation in the world. and with that, madam president, i would suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

mr. lautenberg lautenberg: mada? the presiding officer: the senator from new jersey. mr. lautenberg: thank you, madam president. the presiding officer: the senate is in a quorum call. mr. lautenberg: i ask unanimous consent that further calling of the roll be dispensed with. the presiding officer: without objection. mr. lautenberg: thank you, madam president. today, june 28, 2012, 30 million american people gave thanks and it's because the supreme court this morning upheld the health care law that

will provide those 30 million people with access to affordable health insurance. today is a proud day for america, and for the values that we cherish, because on this day our nation's highest court has reaffirmed that america is a country that works for everybody, not just a privileged few. we fought for these values for many years, and this victory is just the latest in america's long struggle for a fairer and more equal country. we took the first step 77 years ago when president franklin roosevelt signed social security into law, ensuring that in this country, no senior would go

hungry. 30 years later, president lyndon johnson helped america take the next step when he created medicare and medicaid, ensuring that our seniors and the most vulnerable among us would always have access to health care. and today our efforts to ensure that every american has access to quality health care has been given the stamp of approval by our supreme court. today we establish our belief in america, the wealthiest nation on earth, that it's our moral duty to make sure that everyone can keep themselves and their families healthy. madam president, a little more than two years ago we heard the

call of americans struggling to pay for health care, parents who had to choose between keeping their children healthy and putting food on the table, and seniors who couldn't afford lifesaving medications. and so we passed and president obama signed into law the affordable care act. and already millions of americans are reaping the benefits of this law. thanks to health reform, insurers can no longer deny people coverage for a preexisting condition. if someone has cancer or some other longtime sickness, they can't deny people coverage if they are already sick from these conditions. up to 17 million children -- children -- with preexisting conditions are already benefiting from this condition,

from this provision. under the affordable care act insurance companies are prohibited from canceling coverage when people are sick, and more than -- more than three million people in my state, new jersey, no longer have a lifetime limit on their health insurance coverage. today, millions of seniors are already receiving free preventive health services and are saving an average of $600 a year on prescription drugs. it's not just seniors who are seeing lower costs. almost two million new jerseyans with private insurance now receive preventive health services at no additional cost. for women these service include cancer screenings like pap smears and mammograms, and

since the 1950's -- it's amazing -- cervical cancer screenings have cut mortality rates by more than 70%. think about that. 70%. of the people who are alive now who otherwise would have died if they didn't have the coverage. young people have benefited as well. more than 73,000 young adults in new jersey obtained health coverage last year through their parents' insurance plans. and this has brought their parents peace of mind knowing that their children who may have just graduated from school and are making their way in the world, will be covered with insurance if they need it. but, mr. president, even with our supreme court's decision, our friends the republicans continue to fight our efforts. they're again showing that they will stop at nothing to make

seniors have to pay more for medications, more families go bankrupt and more parents having to choose between feeding their children and taking them to the doctor. our colleagues across the aisle keep telling us they want to repeal and replace health reform, that they simply favor other solutions. but they have no proposals and no ideas on how to do that. instead, they just keep giving the american people the same message, give your benefits back, we can't afford it in this rich nation of ours. well, i have a message for them. for my friends here in this place, where care is so carefully given, that if you don't want americans, i say to colleagues here, to have

affordable health coverage, you ought to give yourself back. that's what i say. the republican hypocrisy is stunning, as members of congress these politicians have access, all of us, to world-class health care. but they're determined to take away the life line that health reform law offers to families who really need it. let's be clear. without this law, insuressers -- insurers could once again cancel coverage when people get sick and refuse care to -- coverage to people with preexisting conditions. the republicans want to return to the days when it was legal for an insurer to turn away sick children, to say sorry, you're not covered by insurance, no matter how sick you are, can't give you any help. and i say to my republican colleagues, stop attacking

americans -- america's health care. now the obama health care plan. start working with us to ensure a healthy and happy future for all of our children and grandchildren. americans don't want to relive the health care debates, the lies about death panels and socialize medicine. the american people want to us move forward and work together and lower costs to make sure no american gets left behind. that's what the american people deserve from us. they sent us here. in this place for six years at a time. and that's the america we must believe in. that's the america we fight for. and today we're one step closer to making that america a reality. i speak for myself,

mr. president, some years ago it was 18 years old, i signed up to serve my country in world war ii. 18 years old. it was a dark moment in our history. the war was at its height. my father was on his deathbed. he was just past 42 years of age. he had cancer, acquired like his brother and his father did, from working the mills in paterson, new jersey. my mother was a 37-year-old widow. things were tough. things were difficult. i had a little sister.

my father died, we all grieved, i was already -- already enlisted in the army, and they permitted me to stay home until my father passed on. but what happened was not only did my father leave grief, but he left bills. bills for hospitals, for pharmacists, for doctors. people shouldn't have to go through that, the coverage ought to be there that says we'll take care of you, you're an american citizen, be proud of that and don't let anybody fight to take away your rights to protect their rights. no, it's not a balance. so, mr. president, i yield the floor and note the absence of a quorum. the presiding officer: the clerk will call the roll.

quorum call:

quorum call:

mr. graham: there are observations i'd like to make about the supreme court today. number one is the legislative process. members of congress during the debate on obama health care had a very passionate, heated debate, which is part of democracy, and, as i recall the debate, when people on our side suggested that this is a tax increase, that all the fines and costs associated with the health care bill would be a massive tax increase, the friends -- our

friends on the other side, almost to a person, said, no, this is not a tax increase. and president obama assured the american people during the debate that the fine is not a tax. i think the reason that was so is because if we debated this bill and the only way you could pass the bill is using the power of congress to tax under the constitution, there would not have been ten votes for the legislation. nobody would have wanted to have gone home and say, i just increased your taxes by billions of dollars over the next ten years to fix health care, because i think most americans believe our health care in this country needs to be reformed and in many ways broken, needs to be fixed. but there are very few people in this country who believe we don't tax enough, and that's the

problem with health care. that's not the problem. the problem with health care is not the lack of how much we tax you; it's the lack of choices you have and the competition when it comes to purchasing health care. many of us want to give chance to buy health care -- a chance to buy health care outside the state in which you are live. many of us believe that reform will lower costs. i'd like to give individuals the same tax write-off as businesses have when it comes to purchasing health care, and i'm willing to help those who don't have the money to buy health care to be able to buy health care in the private sector. i'm willing to do a lot of things, but i'm not willing to impose a massive tax increase to fix health care. also i don't think it's fair for people in the body during the

debate on a bill to say, this is not a tax increase. vote for the bill and wind up having to be told by the court, the only way this is legal is for it to be a tax increase. so here's my challenge: to every member of the democratic party who shade this -- who said this wasn't a tax increase when we debated the bill, i'm asking you now if you did not want to increase taxes when we fixed health care, repeal this bill and work with me and others to find a way to fix health care. if after the supreme court ruling you're still okay with the legislation, just be honest enough to go back home and say, i raised your taxes to fix health care because i thought that was the right thing to do. and let's have a debate about whether or not that's the right thing to do. i can promise you, it is not the

right thing to have a debate where the president of the united states and the architects of the bill assure you that you're not having a tax increase when in fact that's the only way this bill can stand. so i believe we all owe it to the american people to be on record. if after today's ruling you're still for this legislation, have the courage to tell the american people i'm for it, even though i had to raise your taxes to make it happen. stand behind what you really believe. and if you really believed at the time this shouldn't be considered a tax increase and you're upset or you are worried that it is now being called a tax increase and you think that's wrong, have the courage to say, let's start over. nobody is going to hold it against a political leader who's

willing to change their mind if it makes sense. and i can't think of a better opportunity for congress to revisit an issue than this. if there is ever a bill that needed to be revisited, it is the obama health care bill. it needs to be revisited and we need to start over because it was passioned 0 an party-line vote, it was passed -- it was passed on a party-line vote, it was passed with statements being made that it was not a tax increase when it turned out to be. so i hope we have the which is come and courage to start over and get this thing right. now, th now, the second point i'd like to make is that no one in this country has suggested that health care needs to be fixed through a massive tax increase. let's find a better model to fix health care than hundreds of billions of dollars in new taxes. a final thought is how do we move forward? in november of 2012, every person who voted for obama

health care, telling their constituents this is not a tax, you owe it to your constituents to go back and say listen, the supreme court said this can only stand with it being a tax. i'm either okay with that or i'd like a second chance to fix it. president obama is a good man and sincerely believes that health care needs to be reformed in a certain way. i agree it needs to be reformed but not this way. owes it to the american people to correct his statement. when he assured us all this was not a tax increase, many americans found comfort in that. i have always believed that the court could uphold this law under one theory and one theory only. i never believed that the commerce clause was broad -- so broad that we in congress could

compel you to buy a product you did not want, and the court today said that the commerce clause cannot be used in such a fashion. so the bill was sold as a power within the commerce clause. the court said today the commerce clause will not allow congress to make the public buy a product. that's not commerce. that should make all of us feel better that there are some limits on the commerce clause vis-a-vis your congress. but the court did say that when it comes to the power of a tax to tax, the congress' discretion is broad, and that is constitutionally true and has always been so. the congress has the power to raise taxes to pay for a war even though you may disagree with the war. we have it in our power to say for the public good we're going to raise taxes to pay for a war.

congress also has the power, in my view, to say that the health care system is broken, we're going to raise taxes to fix it. i don't think that's the right answer but i think that is within our power. and what the court said today was that the fine is really a tax, and now that we know it's really a tax, what are we going to do about it? are we going to leave in place the largest tax increase in modern history to fix health care or are we going to be smart enough, wise enough and courageous enough to start over again? i hope we're wise enough, courageous enough and smart enough to start over and this time do it in a way where it will truly be bipartisan. the worst possible outcome for the american people is for the

congress to pass legislation that affects 1/5 or 1/6 of the economy, telling you that this is not a tax, and at the end of the day, that's the only way the law can stand is for it to be a tack. so i hope that between now and the election, we can have another debate about health care and all those who stand by this product, you need to tell your constituents i believe in this product and i'm willing to tax you in a large way to make it happen. if we had that debate to begin this, this bill would have never passed and we would have worked together. second chances are hard to get in life. congress now has a second chance. final thought about medicaid expansion. the congress said that we're going to expand medicaid dramatically under this proposal to ensure people not covered by

medicaid today. if you're 133% above poverty, you would be included in medicaid. in my state, 31% of the south carolinians would be eligible for medicaid under the obama health care formula. that would mean an additional billion dollars of a matching requirement by the state of south carolina to get the federal money. that means that my state would have to cut education, raise taxes or cut public safety to come up with the money to match medicaid expansion or the obama health care act. the supreme court said you can't do that to the states. you cannot expand dramatically medicaid which will bankrupt states and tell them if they don't agree with the expansion, they lose all the money under the current program. that's coercive. in september of last year with senator barrasso, i introduced legislation, the graham-barrasso bill, that would allow states to opt out of obama medicaid expansion and still receive the money they receive under the

current program. that is basically what the court said we should be doing. so i hope the republican leader will impress upon the democratic leader to bring the bill up we introduced last september and legislatively allow states to opt out of medicaid expansion under obamacare if they choose to. and i guarantee you there are going to be a bunch of red and blue states opting out of medicaid expansion under this bill because it will make them hopelessly bankrupt, and that's not the way to solve health care for the poor. that part of the bill needs to be addressed, too. so, mr. president, this is a historic ruling by the supreme court, but for it really to be historic in its fullest sense, congress should take this historic opportunity to revisit health care, get this right without a massive tax increase. i yield the floor.

the presiding officer: the clerk will call the roll. quorum call: the presiding officer: the senator from oklahoma. mr. inhofe: mr. president, i ask unanimous consent the quorum calling process be vitiated. the presiding officer: without objection. mr. inhofe: first of all, my friend from south carolina i think articulated it very well. what happened today with the supreme court, i -- i think we're going to see a lot of people -- it's going to be a wake-up call for a lot of people in america, and i think it will, as he suggested, it had a profound effect on the elections in november when people realize that the courts have ruled -- when the people who don't have coverage realize that they are going to be penalized by $695 -- that's per individual, by the way, and families who do have coverage will have to pay an additional about $2,100, and the

employers of america are going to be dealing with government exchange. people are going to be concerned about it. i think what they're going to want to do is send people to congress, both the house and the senate and in the white house, who are going to change this system. so i think -- i will stand here on the floor and say that's what i am predicting and we'll see what happens. i want to make one comment because we're waiting now -- we will be voting shortly on a very significant bill. it's the highway reauthorization bill. proud becauseese things that we -- we have been trying for a year and a half to do this. when we passed the last highway reauthorization bill, that was in 2005. at that time, i was the chairman of the environment and public works committee. we passed the bill. as i recall it was a $286.4 billion bill. it was for five years. of course, that expired in 2009.

now, the problem we have had since 2009 is we have been operating on what they call extensions. mr. president, one of the things that most people are not aware of is when you operate on extensions, you're operating on -- with the same amount of money that you're spending out of the highway trust fund, you're getting about two-thirds of what you would get if it were a reauthorization, because, girl, they could only do it just in a very short period of time. there is not any planning, and they have already said that you lose about 30% to 33% of the spending power, money that should be spent on highways and bridges and on maintenance. well, anyway, that's -- it's kind of funny because i -- i happen to be -- have been ranked as the most conservative member of this body at different times. i'm always in the top three. and yet i consider this to be something -- i have always said, i may be the most conservative but i'm a big spender in two areas. one is national defense and one is the -- is infrastructure, and

that's what this is all about. i'm very proud that people understand -- i have had occasion to talk to a lot of the new members of the conference committee over in the house, and those -- and explain to them that the conservative position, the conservative vote on this is to vote for the highway reauthorization bill that's going to be coming up to us. hopefully it will be here tonight and it's going back and forth between the house and the senate. the conferees, i believe, have -- most of them already signed off on this bill, so it's coming up, it's been a long time in the making. i'm very excited about it. and let me also say that while i take the position that the conservative vote is to vote for the -- the authorization bill, for the highway bill, i'm not alone in this -- this feeling. i would like to submit for the record a statement by the chairman of the american conservative union. it's an op-ed by al cardinis who

is the chairman of the american conservative union. he presents a case, a very strong case as to why this is the conservative position that should be taken. so i ask unanimous consent at this point in the record i submit in the record the statement and the op-ed piece by the chairman of the american conservative union. the presiding officer: without objection. mr. inhofe: so i'm looking forward to having this. certainly my state of oklahoma, and the state of oklahoma is not the only state that has the -- that has bridges and road problems, and i'm looking forward to that. another good thing that's happening today, right now we're waiting and i feel very confident that we're going to be able to pass out of the senate the pilots bill of rights bill. right now we're in the process of hopefully getting that done. when that time comes, i'd like to be recognized to talk about some of the great extensions of justice to people who have been denied that justice heretofore just because they happen to be pilots. so with that, i would yield the

floor. i suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

a senator: mr. president? the presiding officer: the senator from indiana. a senator: mr. president, i ask unanimous consent that the quorum call be vitiated. the presiding officer: without objection. mr. coats: mr. president, i come to the floor today to speak about the supreme court ruling on health care. obviously, we were all glued to the television set this morning and watching this historic and momentous decision. i was deeply disappointed with the ruling. i respect the court and its

work, but i was disappointed the court failed to strike down this law, as many had anticipated that they would. i was disappointed because i believe that the law has been deeply and fatally flawed from the -- from the very beginning. it became a major issue, of course, in the 2010 election as people watched in 2010 this being passed through without bipartisan support. it was -- procedures were worked around and violated in order to pass it through. the stories are rampant about how, against really the will i think of the majority of the american people, this 2,700-page monstrosity, so infamously described by the speaker -- then-speaker of the house as

something that we'll learn about after we pass it. well, mr. president, we have learned about it. we've had two years to examine this and we've seen it, parts of it being played out with more to come. and what we've learned i think is that this bill is fatally flawed, that it ought to be repealed. it doesn't mean that we don't have health care issues that we should deal with but we need to deal with this in a bipartisan way that's better explained to the american people, that's cost affordable. it's labeled "the affordable care act" and it's anything but affordable. at a time of deep recession, at a time of over a period of the last two or three years of a stagnant economy, this is adding a burden of regulation and taxation that is working against our coming out of this -- this deep hole of economic distress. americans found out what was in this bill and it reaffirmed i

think many of their deep concerns about going forward with a plan that tries to wrap up the entire u.s. health care system in one big ball, 2,700 pages worth of rules and regulations and taxes and impositions and mandates and said that this is not -- we want reform of our healt health caree want to make it more affordable, we want to make it more accessible. but letting washington essentially decide how to go forward with that without giving flexible to the states and flexibility to -- flexibility to the states and flexibility to the private sector to initiate reforms clearly was what -- not what the american people, or at least the majority of the american people, were looking for. despite the promises that were made about the impact of this bill by those who authored it and by the president, middle-class americans have found that the health care law is -- is a massive tax. and, of course the court reaffirmed that today. this is not just a penalty, this

is a massive tax on working americans. and not just the rich. it's on the middle class and it's on every american taxpayer. the -- and this, even though the president has famously now on every yo youtube and every natin that's discussing the health care system, his quotes insisting that this was not a tax on the middle class or a tax on any americans. families have found out that their insurance peopl premiums e going up, not down, as was promised by those who supported this bill and authored this bill. seniors have found out that they may not be able to keep the insurance plan that they have and want and could lose access to medicare advantage. medicare advantage, a program that many seniors have enrolled in and found to be successful in addressing their health care needs at a reasonable cost.

business owners found out that they would be fined $2,000 per employee if they failed to provide workers with a health care insurance plan approved by uncle sam. i don't know how many business owners i've talked to in indiana this past couple of years who basically have said, i -- we have sat down with our employees and discussed with them how much we were able to do and still keep them as employees and not sink this company. and we have come to agreements. and different companies have different types of agreement with different types of plans based on their ability to provide the -- that kind of coverage, accepted by both the employees and the owners of the business. and now all these are wiped out because it's determined that washington will decide what the minimum level of the plan should be. and several business owners have told me that they simply can't run their business in this economy, on the low margins, if

any margins, that they're achieving and provide that kind of increase in insurance and pay for -- have to pay for that or opt out it was and pay this fine, $2,000 per employee. other businesses have said, you know, well, okay, there is a exemption for those under 50 employees, and other businesses have said, guess what, i've got 47. do you think i'm going to hire over 50? no way. no way am i going to push myself into the category where i have to pay a fine of $2,000 per employee if i don't comply or -- with the dictates out of washington, d.c., in terms of what my plan should look like. and so what we see is a lot of hiring of temporary workers, we see a lot of hiring -- payment of overtime for existing worke workers, but we don't see hiri hiring. we don't see the expansion of hiring, particularly in small business, because of the affordable -- so-called affordable care act. patients and doctors -- and i've

talked to them all over the state of indiana -- health care providers, insurance companies, hospital administrators, groups of doctors that are part of a group or those in individual -- in private practice,&all the other entities that are -- practice, and all the other entities that are engaged in health care. and to a group, they have major concerns with this. and to a group, they have opposed this affordable health care act, or so it's described. we have a dynamic medical device industry in indiana, as they do in several states across this country. it's one of the cutting-edge, leading industries in terms of our ability to provide new products, innovative products to make people's lives healthier and safer and -- and to prevent a number of unintended consequences from various medical procedures.

they learned after reading this act and finding out about this act that they were going to be subject to a tax just levied on them, a 2.3% tax on their gross receipts, levied on them because they were a pay-for for this. these companies, who make pacemakers, artificial joints, surgical tools, find this something that drives them to the point where they need to think about transferring their business overseas or part of their business overseas or not hiring the workers that they would like to hire. it is simply a tax imposed on one of our more dynamic and innovative industries that are -- is leading in our exports but no longer can compete under this tax with their competitors that are based overseas. now, just because this ruling

happened today and saying that the health care law is constitutional does not mean that it's the right policy for us to go forward. the law remains unpopular and unaffordable, and i want to state here today that i am committed to working with my colleagues to repeal the health care law and give our citizens the power and the flexibility to make their own decisions relative to their health care and to use though innovative -- to use those innovative ideas that are out there to put a much better package together withou without -- that addresses the real question of rising health care costs and access. the -- as i've traveled our state, as i've listened to all these providers, as i've asked the question of them, "if the health care law is struck down by the supreme court, what would you propose, because we have a problem here.

we have rising health care costs that have to be contained and yet we -- and we have an access problem and we have a number of other problems in terms of gaining access to coverage and payment for health care issues. what would you propose?" and i've got a long list of those, and i've talked about it here on the floor, i've talked about it during the campaign, i've talked about it across the state. things i have learned from listening to the people who are on the front line doing this business everyday. and there's all kinds of innovative solutions out there. there's all kinds of things that we ought to -- we ought to be looking at. i know awful of us are committed to -- i know all of us are committed to going forward, those who support the repeal of the current law, going forward, to bringing forward a sensible, affordable, cost-effective, quality effective solutions to our health care issues. so what the supreme court essentially has done is said, congress, it's yours. and congress represents the people and we need to be

representative of the people. and so what we need to do now is listen to the people. and it's the people who will decide the future of health care for this country. it's the people who will decide in this coming election, i believe, the people who will decide as to whether they want ever more washington, ever more taxing and spending, ever more deeply in debt, ever more federal mandates and regulations or whether or not they want to approach this in a different way that can reduce spending, empower individuals, give states greater flexibility and bring forward sensible, step-by-step, incremental, as it's affordable, tested, proven ways of addressing our rising health care costs. and so, perhaps rightfully so, the supreme court has turned it back, turned it back to us, and it's our responsibility now to go forward and represent all

those who were not listened to when this bill was run through this congress in a way that violated a lot of our procedur procedures, in a way that went against i believe a majority -- the majority will of the american people. so here we are and now it's back on us and we need now to stand up and take responsibility, those who voted for it will be defending it, of course, and those who voted against it or those of us who are here partly because it was an issue in the 2010 campaign, are here to not just simply say we don't like what's there but to offer also positive solutions to the problem. mr. president, with that, i yield the floor. a senator: mr. president? the presiding officer: the senator from rhode island. mr. reed: well, thank you, mr. president. today's supreme court ruling that the affordable care act is constitutional and is the law of the land is a victory i believe for rhode islanders and for all

americans. families will no longer fear financial ruin if a child becomes seriously ill or face denial of health coverage due to a child's preexisting condition. and they will no longer have to worry that the terms of their coverage will run out as they are being treated after a major medical emergency. indeed, tonight, rhode islanders and all americans can sleep a little easier knowing that they and their children will have access to quality, affordable health care. this is the type of security we want for our children and what this law will proivment indeed, for the -- law will provide. indeed, for the first time in our history, parents can, with some confidence, trust that whatever lies ahead, their child at least will have access to affordable health care. we couldn't say that with any confidence years ago, even two years ago when we undertook this legislative activity.

and this law has already benefited many people in rhode island. individuals, families and businesses. children up to age 26 are able to remain on their parents' health insurance plan. in rhode island, this has benefited an estimated 9,000 young adults and their families. over 15,000 rhode island seniors have saved a total of $14 million on prescription dr drugs since the law was enacted, an average to close to $600 annually. seniors will continue to save on their drug costs until the existing coverage gap is closed and will continue to have access to free preventive care, like annual wellness visits and screening. rhode islanders can now expect rebates if an insurance company spends too much on administrative costs and c.e.o. bonuses instead of on their health care. for too long, health care companies, health insurance companies got away with increasing premiums and decreasing coverage which resulted in higher costs and

unfair practices. beginning in 2014, rhode islanders will be able to purchase health insurance on a new exchange, a single point of entry where they can evaluate the cost and coverage of health insurance options. they will, indeed, for the first time for maniriers have a real choice -- for the first time for many rhode islanders have a real choice for the health care that they receive, the insurance that they purchase. and according to families u.s.a., 97,000 rhode islanders will have access to tax credits to make their coverage more affordable. a thousand more child adults will gain coverage through the medicaid program. now that the court has spoken, i hope we can work on a bipartisan basis to do what we must do and that's to create jobs and improve our economy. this health care decision was a landmark decision but the work now, the work of all of us should be to reinvigorate our

economy so that not only can people have the confidence that they'll have health care, but they can have the further and, indeed, very primary confidence that they will have meaningful work. in that respect, i'm glad that congress