the mobile health and mobile application market is expected to exceed $26 billion by 2017. while the u.s. mobile apps economy is responsible for nearly 500,000 new american jobs. a report from health data management anticipates 23% annual growth in this sector over the next five years. the f.d.a. highlights on their web site that $500 million smart phone users worldwide will be using health apps by 2015. the mobile annual itics platform which monitors more than 20,000 apps has seen a 19% increase in new health and fitness apps in 2013 from the year prior. that's really amazing. but what's even more impressive,

mr. president, is the health i.t.'s ability to protect people. consider the example of a young man named xavier jones whose basketball coach downloaded a $1.99 mobile application that gave him a refresher course how to properly administer c.p.r. it was a skill that came in handy the very next day when xavier collapsed in the middle of practice. in 2012, the departments of defense and veterans' affairs partnered to release a free apple and android app called the posttraumatic coach. ptsd app has been downloaded in 24 countries. it provides reliable information on ptsd's on users' smart

phones. other types of health yits such as -- i.t.'s such as low-rank clinical decision soft marry can improve outcomes. some of these technologies have the power to disseminate new information about effective treatments and recent clinical trials. patients want their doctors to have access to these cutting-edge therapies. protecting low-risk health i.t. is about empowering people with access to information. we need to protect that kind of innovation because innovation is an equalizer for consumers, and these technical -- technological benefits, they don't stop at our borders. think about this statistic --

one estimate shows mobile health deployments in africa could save as many as one million lives by 21st by -- by 2017. reminding pharmacists to refill their stock or even tracking emerging malaria epidemic, mobile health is already transforming the landscape of the developing world in very dramatic ways. these stories only scratch the surface of where this technology is going. it's important how we treat innovation here in the united states. other countries around the world are looking at how our government will regulate and soafer see these -- oversee these low-risk technologies. our bill makes it so low-risk, highly innovated clinical and

health software technologies and the potential they have to empower people are not undercut by these burdensome regulations. f.d.a.'s promise to use its enforcement discretion over low-risk health i.t. only serves to create confusion and uncertainty in the marketplace. regulatory discretion by its very nature is something that can easily change over time. and discretion can be misused or abused. clear rules should be set, because the current f.d.a. regulatory model for medical devices is not well suited for low-risk health information technologies. in a house energy and commerce can committee hearing last year, the f.d.a. submitted a letter to the committee that

said -- quote -- "for 2011 and 2012, the average time for f.d.a. review of medical device submissions that were identified as containing a mobile medical app was 67 days, and the average total time from submission to f.d.a. decision was 110 days"-- unquote. when regulatory days turn into months, problems are going to persist. and that's not something that we should leave to discretion. the regulatory timeline for risky devices shouldn't be the same for these low-risk software that gets released every 60 days, has major updates every month, and sees regular changes every week. having an approval process that takes longer than the shelf life of the average device operating

system, well, you know, it stifles opportunity and it stifles innovation. innovators, regulators and consumers need clarity and certainty into how these regulations are going to be enforced. since mobile wellness apps and most clinical decisions support technologies pose little risk to patients, they should not be subject to the same costly, painstaking processes as medical devices. the answer is the common sense, risk-based regulatory approach that the protect act provides. it protects innovation, it protects jobs here in the united states, and it proablghts jobs -- protects jobs in this u.s.-based job sector.

most importantly, it protects patient safety by giving the f.d.a. continued authority and oversight over health i.t. that is risky, and by creating an appropriate regulatory framework for that which is lower risk. with the introduction of the protect act, i would also like to acknowledge the great work of senator lamar alexander of tennessee, senator orrin hatch of utah, senator michael bennet of colorado, and others who have undertaken this in the past. these senators have helped to lay the groundwork for the development of a risk-based framework for health are i.t. -- health i.t. the ideas included in the protect act would not be possible without the progress that they secured in previous congresses and in the f.d.a.'s

safety and innovation act. i'm committed to working with anyone on these issues to exchange views, to exchange ideas so we can get the right policy balance our country needs and deserves. and, again, i thank my friends, senator king from maine and senator rubio from florida, for joining me in this important effort. together, we can achieve our shared vision of protecting patient safety, protecting innovation, and protecting u.s. economic jobs growth and opportunity. thank you, mr. president. i yield the floor. a senator: mr. president? the presiding officer: the senator from maine. mr. king: before joining senator fisher, i'd like to ask

unanimous consent that chris schweitzer in the office of senator pryor be granted floor privileges for the duration of the remainder of the calendar year. the presiding officer: without objection. mr. king: it's a pleasure to join the gentle pleasure of nebraska, i love the idea of the surf and turf caucus as reaching across the country to find commonsense solutions. i often think about legislation and what we're attempting to do and this an attempt to codify common sense, to try to bring to the regulatory process as it deals with medical devices a little more thoughtfulness and cautiousness as it affects health information technology. the first part of the bill actually sets up a process whereby we can examine in a thoughtful kind of way some of these issues to reduce the

regulatory burdens at the same time foster innovation and very importantly, protect patient safety. sets up a process involving the national institutes of -- the senate tiewt -- national institute of standards and technology and other parts of the administration so the regulatory process in this area can be rationalized across agencies and better coordinated. the heart of the bill, however, as the senator just outlined, is our eampt to differentiate between medical software that has a direct impact upon patient health and software which is more peripheral and can range from the app i have on my iphone which is a pedometer which tells me how much i walked each day or the kind of software being developed across the country to assist medical practices in their billing and in their -- in the operational part of the medical business. and i think one of the most important points is as the

senator pointed out, software evolves almost overnight and if you can go through this regulatory process, whether it's 60 days, 120 days or a year, get your software approved and then you find there's a bug and have you to fix it, that could restart the whole regulatory process. and i think this is a bit of -- i think we should acknowledge that this is a bit of preemptive legislation because the f.d.a. thus far has not intruded very deeply into this process but we believe this is important in order to define the areas where regulation and the protection of patient safety is important, but software that manages the billing process of a medical practice should not fall into that category and should not be subject to that level of regulation. that's what we're really talking

about here. as the senator mentioned this law goes back to 1976 and in thinking about 1976, jerry ford was president, and software was a mink coat. we weren't really thinking about what we're doing today and of course the legislation did not anticipate the kind of intense innovation and new thinking that's going on that's able to protect people's health just by giving them information about themselves. i have no doubt that the time will come when a smart phone will be able to do blood pressure or temperature or certainly heart rate. and that's information that we should have ourselves not necessarily regulated by the federal government. so i'm delighted to join the senator from nebraska and the senator from florida to introduce this piece of legislation, i think it's important, i think it's part of a larger project to try to bring our federal regulatory process

into the 21st century. where time is of the essence, innovation is at the speed of light, and that we can't burden our people who are doing those innovations with a lengthy and, yes, expensive process that has a tendency to discriminate against smaller entrepreneurs and business people. so i compliment the senator from nebraska for bringing this piece of legislation forward, i'm absolutely delighted to join her in its sponsorship and i look forward to moving it through the legislative process. there's a companion piece of legislation in the house and i think this, as i said at the beginning, is an effort to get as close as we can to legislating common sense in this area and i think it will make a difference for businesses, for people, for patients, and for the health care system in america. i thank the president.

a senator: mr. president? the presiding officer: the senator from alabama. mr. sessions: mr. president, we find ourselves today considering legislation to fix a problem that congress and the president created only two short months ago. we knew from the ryan murray spending deal that it cut military pensions and yet this senate passed the bill anyway over my objections and those of many of my republican colleagues. congressional democrats insisted on keeping the military pension cuts in the ryan-murray deal and would not accept change. every single democrat supported majority leader reid and rejected amendments to stop the cuts and voted for the final passage. so they ignored the warnings that i and others issued and

virtually every senate democrat voted to keep these cuts, rather than close clear federal tax loopholes that allow illegal aliens to gain money improperly. so what happens? constituents back home are outraged, and now senate democrats are trying to claim credit for fixing the very problem they created, which in itself is not bad, but unfortunately instead of doing this in a good-faith way consistent with our spending priorities and limgz under the murray-ryan bill, the prior bill that's before us now authorizes more spending, unpaid for in direct violation of the spending limits set out in the ryan-murray legislation passed just a few weeks ago. so we passed legislation, we set

limits on spending, and here we are blithely walking in again. so i'm at a loss to see why my colleagues continue to resist replacing these cuts, cuts to veterans who have earned it, who have been drawing these benefits and not replacing them by closing the tax credit loophole for illegal immigrants. it was recommended this cut, this closing of the loophole by the inspector general of president obama's own treasury department. why are there those who continue to be determined to protect billions of dollars in tax fraud and allow it to continue? would it not be in the national interest to close this loophole, restore these pensions for our veterans and maintain the savings we promise to the american people? indeed, the savings would be -- would more than pay for the

replacement of the veteran retirement provision. it would help reduce our huge deficits in addition. so let's review how we got here. in august of 2011, as we approach the statutory borrowing limit, the debt ceiling, congress passed the budget control act which congress agreed to immediately increase the debt limit by $2.1 trillion, allow us to borrow another $2.1 trillion, but congress promised to reduce the projected growth of spending from $10 trillion over the next ten years to $8 trillion over the next ten years. that was said to be a spending cut but really a reduction in the growth of spending. so this 2011 legislation passed into law, signed by the president promised to reduce the growth of spending by $2.1 trillion. now, i did not support that act. i thought we could have gone more and hope to do more, and of

course i recognize that it hit, endangered our military in a disproportionate way, although we hoped it would ultimately be avoided, but it was not. but once that legislation was passed, i felt and i think most of us in congress believe that we should honor the agreement we made to the american people. but almost immediately many of our colleagues begin saying that even those spending reductions were too much. at every turn, the senate passed or attempted to pass legislation that broke the spending caps, and i raised a number of budget objections. i'm the ranking member on the senate budget committee, and i'm aware when spending violates the spending limits that we have, i have on a number of occasions raised objections or budget points of order, and it takes 60 votes to spend more than the

budget allows us to spend. so it gives us a check on spending. many of my objections were sustained almost entirely with republican votes, i will add, but in plain fact, our colleagues were unwilling to save the money they promised the american people. that's what it is. we agreed to save a certain amount of money. we promised to do so. and when things get tight and their political groups want more, we tend to spend more and make excuses and violate the budget. and that, of course, is why we're in this deep, deep financial adverse situation we're in. so chairman murray and chairman ryan entered into a negotiation to ease the budget control act spending cuts, the sequester.

they unveiled a plan which increased spending above the b.c.a. levels in exchange for increased tax collections and some spending cuts. they say it was paid for, the new increases in spending. so the increases in spending happened in two years. promised cuts were over a long period of time in the future, but it did in fact balance as they described it at the time. but immediately my staff alerted me to a provision in the bill that proposed cutting military retirement benefits by $6 billion, not for future recipients but for current soldiers and retirees. some service members would see a lifetime reduction of $120,000 or more, some $60,000. this was a cost of living reduction of more than 60%. so this i felt was unacceptable.

there were a lot of other things we ought to be cutting before we cut earned, promised retirement benefits to our veterans who served 20 years. only those who have a 20-year service record would qualify for this. i thought it was unacceptable. and pointed it out. of course, no one seemed to know where it came from, this provision. the department of defense said they weren't consulted. this was not surprising since the legislation was produced by secret behind closed doors, not something i think is good process. the traditional legislative conference committee process was abandoned. well, the good news is that it was caught before it came to the floor, and when the bill came up, some of us offered proposals to fix this problem while staying within the spending caps. so to not cut the veterans

$6 billion, we needed to find some other place to cut $6 billion and put it in place of that, else that would at least have kept the promises of the bill's sponsors of ryan-murray within their promise. so military retirement cuts were a significant part of paying for this new spending level. so in that spirit, i proposed, i thought, a reasonable alternative. for over two years now, i have been trying to close a massive tax loophole. in july of 2011, the treasury department -- the united states treasury department, part of president obama's administration, reported that illegal aliens received more than $4 billion in free child

tax credits in just 2010 alone. in some cases, households received tens of thousands of dollars year after year, in many cases claiming as dependents people who don't even live in the united states. a number of these filers had no tax liability. that is, they were paying no tax at all, but they were getting tax credit checks from the federal government. the inspector general of the treasury department asked congress to act and close this clear abuse, and it is dramatic really. what we found was in 2005, credits claimed under this provision amounted to $924 million, but the inspector general reported that by 2010, it was $4.2 billion. gone up four times in what?

five, six years. surging program, as word got out that all you had to do was make these claims. nobody checked if the children were in the united states or if there were children at all. and there is no way to check. this is what the inspector general of the treasury department reported in its 2009 report. it's made at least three reports on this subject and pointed out the problems we face. it is not accurate to say that we somehow want to abuse children and deny them support. we're talking about plain fraud, waste, and abuse in this system. so this is what the inspector general said in march of 2009. legislation should be considered to require a social security number in order to be eligible for the additional child tax credit, and that's basically what the amendment i offered,

the amendment that senator ayotte is now offering and our cosponsor -- and i cosponsor with her would do. just require you to have a social security number before you claim a big check from the united states treasury. this would be consistent with the requirements that i.g. said -- quote -- "for the earned income tax credit." so americans who file an earned income tax credit have to have a social security number. that's the earned income tax credit. that's for people who work and receive a low income. the inspector general goes on. "as it now stands, the payment of federal funds through this tax benefit appears to provide an additional incentive for aliens to enter, reside and work in the united states without authorization."

by the way, he said this would be an additional incentive for people to illegally enter the country, because you can come in unlawfully here, claim credit for children that do not even exist, and if they do, they might be in a foreign country, and it's now running up at the rate of $4 billion-plus a year. remember, over ten years, the costs of the cut to veterans is only $6 billion. this would more than pay for that closing this loophole. the inspector general goes on to say as far back as 2007, i.r.s. employees responsible for resolving errors on tax returns, including those filed by individuals with an i-10 -- that's a substitute for a social security number -- raised concerns to i.r.s. management about its policies for handling errors in i-10 tax returns.

these employees stated that management did not take any subsequent action to address their concerns. so the i.g. said employees complained to management but management wouldn't do anything about it. so a former complaint, the inspector general declares, was subsequently filed, and it goes on to say in its 2009 report in december, some six or nine months later, this -- the volumes of i-10's are growing, increasing the risk that fraudulent tax returns using i- 10's could be submitted. i-10's were issued, the inspector general says, quote, without sufficient support

documentation. a statistical sample of 658 forms, selected from 1.5 million applications, submitted from january 1-november 1, 2008, showed that 78% contained errors , close quote. the inspector general goes on to say there are no controls to prevent an i-10 from being used by more than one taxpayer on multiple tax returns. nobody's checking if he used the same i-10 number again, apparently, so they just can file multiple returns. he goes on to say -- quote -- "more than 60,000 i-10's were assigned and used on multiple tax returns processed in calendar year 2008." so more than 60,000 of these numbers issued to individuals were used on more than one tax

return. they shouldn't be using them but on one. it goes on to say -- quote -- "in addition, more than 55,000 i-10's were used multiple times on approximately 102,000 tax returns with refunds totaling more than $202 million." these are just the ones that used the number on more than one return, and the report goes on. 97% of supporting identification documents were missing or ill legible. 23% of signatures were missing and 5% had incorrect birthdays. then he goes on. one of the things that's pretty interesting is the news media has dug into this a bit. nbc affiliate in indianapolis in april of 2012 reported this.

an undocumented worker in southern indiana told channel 13 investigates just how easy it truly is. he said four other illegal immigrants filed tax returns using his address even though none of them actually lives there, and he said this year those four workers filed tax returns claiming 20 children live inside his small trailer home. as a result, the i.r.s. sent the illegal immigrants tax refunds totaling more than $29,000. but none of the 20 children listed as dependents on the tax returns lives in indiana or even in the united states. no, they don't live here, admitted the undocumented work worker. the other kids are in their country of origin, which is

mexico. on july of 2012, they further reported about an i.r.s. officer who complained in south caroli carolina. this is what they reported. "for example, howard," the i.r.s. officer, "received a stack of i-10 applications for dozens of children attending the same school in south carolina. when he researched that school, he discovered it didn't even exist. when howard reported the scam to his bosses, he claims his managers ordered him to approve the applications anyway." inspector general looked into that also. that complaint. well, this is not good. the taxpayers don't need to be subjected to this kind of fraud and abuse, and we absolutely

don't need to be cutting veterans' earned retirement benefits while refusing to take action against such fraud and abuse as identified by our own treasury department. so i offered the amendment to save the soldiers' pensions and pay for it by closing this tax loophole but the majority lead leader, supported by his caucus, including the authors of this legislation, i believe, for the most part, blocked the effort. not once but twice. so let me make it clear, this bill before us today, because our colleagues are refusing to utilize this possible fraud closing mechanism to save enough

money to more than pay for it, will be asking us to violate the fundamental principle of the ryan-murray act. the ryan-murray act promises -- promised, yes, we'd spend some more but that new spending would be paid for by taxes and spending cuts. and one of the spending cuts were the cuts to the veterans. so if you take out the cuts to the veterans, where are you going to get the money to make sure the bill is paid for as promised? that's the question. and we've offered a perfectly reasonable, actually essential loophole closing mechanism to pay for that and pay even more than that. so let me make it clear, the bill before us today is placing us in a position to choose from allowing an illegality to continue or cutting benefits

earned by our veterans. so what we're seeing in an astonishingly cynical move really -- think about it -- today is that we would restore the pensions to veterans without paying for it, without admitting a mistake was made and not living up to the plain promises made in the ryan-murray bill, which reinforced and re-passed spending limitations. congress passed spending caps in 2011. ryan-murray spent more but established higher but clear spending caps also. it reestablished spending cutsinspendingcuts -- spending . now the prior legislation busts the in-law ryan-murray caps. this is not acceptable of the are we blithel blithely ignorinn spending limits passed into law just a few weeks ago? is there no shame, no

embarrassment at such a dramatic breach of expleel budgetary spending -- legal and budgetary spending limits, plain law? closing the i-10 tax credit loophole is a no-brainer. let's stop this abuse and not cut current retirements of our veterans. i hope that we can move forward with the legislation today. i -- i'm uneasy, i'm worried, but let's move forward, let's bring the bill to the floor. but maybe a compromise that's accessible can be reached. i certainly think that senator ayotte's proposal, the one i'm supporting, is a perfectly reasonable compromise that ought to have overwhelming support in this body. but if such an amendment of this nature is not accepted to pay for this change, i think the

legislation is not going to pass in its current form. it would be a plain violation of the promises we made to limit spending just a few weeks ago. it's the kind of erosion of integrity that leads this country to financial disaster. we're running up too much debt. the congressional budget office director will testify before the budget committee tomorrow and the presiding officer will be there, i trust. he's an excellent member of that committee. he's going to tell us that interest on the debt of the united states, which will increase every year for the next 10 years and begin to surge upward in the outer years, the interest on that -- interest on that debt in the 10th year alone would be $890 billion.

that is stunning. the defense department is just $500 billion. right now interest on the debt is about $250 billion. it's going to $900 billion in 10 years. the first money this government will have to pay is the money we pay on our interest on the debt we've run up, $17 trillion, and we're going to add another $7 trillion over the next 10 years, according to c.b.o. so that -- that will be $24 trillion that we have to pay interest on. and he told us if interest rates go up 1%, it will add $1.5 trillion to the amount of interest we pay over the next 10 years. and most people tell us our interest rates are going up. so i guess what i'm saying, colleagues, is we know we face a financial challenge.

we know we've got to get spending under control. ryan-murray was designed to ease this year's cuts in the budget control act and the sequester, and this was the tightest, toughest year of all, so they eased that and they said they paid for it with tax increases and spending reductions. we've eliminated the bil -- thel before us would eliminate one of the pay-fors and substitute nothing else, which would mean we'd add another $6 trillion -- $6 billion to the deficit. that's the path to fiscal irresponsibility and financial danger and we need to get off of it. i would thank the chair and yield the floor. mr. president, i would note the absence of a quorum. the presiding officer: the clerk will call throlewill call the r.

quorum call:

quorum call:

the presiding officer: the senator from arkansas. mr. pryor: i understand that war-- that beer in a quorum cal. the presiding officer: that is correct. mr. pryor: i ask that the quorum call be suspend. the presiding officer: without objection. mr. pryor: i rise in support of the military pay restoration act. last year the senate passed the

bipartisan budget act, a bipartisan and bicameral greement that funded our government, provided stability for our economy, and reduced our deficit by over $22 billion. i think my colleagues and the american people will agree that last year was tough. we saw the delay of the farm bill, the government shutdown, the debt ceiling. needless to say, this budget agreement was a positive step afford. but i'll be the first to admit -- and i think i was maybe the first to admit possibly dhas pot this wasn't perfect especially when it came to the harmful budget cuts made at the expense of our men and women in uniform. there is no question that we need to cut our spending. i think almost everyone in this chamber agrees with that, and i think so many americans agree with that. but we must do it responsibly. we can do things that we all talk about, we can cut waste and

fraud and abuse, we can eliminate unnecessary -- we can be smart and eliminate things that, again, once we think about and roll up our sleeves and do the hard work we recognize we should do, like eliminate unnecessary government property purchases and maintenance and things like that and we can also cut out-of-date and inefficient programs. i mean, all those things should be done, but we cannot balance the budget -- we cannot balance the budget on the backs of our hardworking military members and their families. you know, we are a free nation today because of the sacrifices that our men and women in uniform have made. they made those sacrifices for all of us. they've made them for the nation and the world. they lay their lives on the line for us, oftentimes in faraway places from their homes and their families. so we can live at peace right here at home.

ashley, a soldier's wife from alma, arkansas, recently wrote me. l she said, "my husband signed up to serve so those who don't want to go wouldn't have to. we've made a commitmenclose quo. we've made a commitment to our service members and we need to honor that commitment today but ensuring that they receive the benefits that they've earned. when erin of lake stirks arkansas,, signed up for the army, he counted on those earned benefits to provide for him and his family. as he wrote me, he said, "i held up my end of the contract, and i believe the government should uphold their end." i agree with aaron. singling out our brave service members isn't just fair, it's wrong. duane in drasco, arkansas, who served in the air force, said, "i've been to iraq and

afghanistan many times. i left my wife and three kids that depended on me. i fulfilled my obligation." the government must right this wrong and fulfill our obligation to servicemen and women -- service members like duane. i've introduced the military retirement pay restoration bill. twha does is it repeals section 403 of the budget agreement that unfairly reduces the cost-of-living adjustment benefits for our military retirees under the age of 62 by 1%. and it ensures that our future military retirees receive their full military pay. unfortunately, i've heard a lot of back-and-forth here in the senate and on the senate floor about this provision. instead of working against each other, let's work together to get this done. as president john f. kennedy said, "let us not seek the republican answer or the democratic answer but the right

answer. let us not seek to fix the blame for the past. let us accept our own responsibility for the future." we can fix this. and today we'll take an important step afford in fixing this. i'm proposing a responsible solution here. this bill is something that everyone on this floor should be able to support. in fact, i've even heard speaker boehner down the hall here urging his colleagues over in the house to consider supporting legislation that would repeal section 403 of the budget agreement, just like mine does. just like ours does. supporting our men and women in uniform is not a partisan issue. it's an american issue. we've seen 30 of the major veterans groups urge us to fix this. the air force association, the marine corps league, the enlisted association of the national guard of the u.s., the association of the u.s. navy,

the military officers association of america, just to name a few. there's 30 of these organizations who urged us to fix this. they told us -- quote -- "this provision breaks faith with each individual who has faithfully served our nation for over two decades in uniform. so let's fix it. let's restore america's faith in congress by doing the right thing today. let's give our soldiers and their families the unwavering support they've given us. let's put the partisanship aside and let's pass this bill. our military members and their families are counting on us. madam president, with that, 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:

a senator: madam president? the presiding officer: the senator from connecticut. mr. murphy: are we in a quorum call? the presiding officer: yes, we are. mr. murphy: i ask that we dispense with the quorum call. the presiding officer: without objection. mr. murphy: thank you, madam president. i try to come down to the floor of the senate every week or so to give voices to the victims of gun violence. across this country, every day,

every week, dozens, hundreds, thousands of americans are gunned down on our streets and in our homes, in part because the united states congress does absolutely nothing -- has done absolutely nothing over the course of the past several years, over the course of the past decade to try to curb this scourge of destruction that plagues virtually every corner of our society. 86 people a day die at the hands of guns. 2,639 people, approximately, every month. we lose 31,000 people every year. there is not another first-world country in the world that can come close to the level of gun violence that we have here in the united states. and on top of these numbers are the horrific trend lines on mass shootings. over the course of january, we sue a school shooting essentially every two days the school was in session.

luckily is not the word to ascribe to this sentence, but luckily in each one of those instances, the damage was relatively minor to the potential damage that will unfortunately one day come when a shooter walks into one of these schools and is able to perpetrate the kind of violence that adam lanza did in newtown, connecticut. and we are sending a message of complicity when the united states senate and the house of representatives stands absolutely silenced in the face of this violence. i have come down to the floor almost every week, and i hope almost every time i arrive at the floor, i let my colleagues know that i don't expect that any law that we pass is going to reduce 31,000 or 2,600 or 86--- 86 to zero.

i understand the reality is there is no law that we can pass that will end all incidences of gun violence, that there is no panacea to this problem that congress can offer, but we send a pretty clear message when we do nothing, when the senate does not act, when the house does not act. we tell people in this country that we must be okay with the numbers that continue to accrue and move upward. i know that that isn't the case. i know that my republican colleagues are just as sickened as i am at 86 people dying every day from guns. i know that supporters of the n.r.a., gun owners themselves can't stand that this number is so high at 31,000 a year. but if the stats don't do it, then hopefully the voices of these victims will. and so i offer you four more recent victims.

these all from the streets of our cities in connecticut. bernard hall was killed just a few days ago in new haven, connecticut, january 31. he was shot and killed on the corner of east pearl street and pierpont street in new haven. emergency personnel were dispatched shortly after 10:00 p.m. and they found hall lying on the ground unresponsive with a gunshot wound to his head. he was pronounced dead at the scene. he was the third homicide victim of the year, third homicide victim of the year, 31 days into january. a couple days later, about 60 people gathered at the corner where hall was shot. he had a lot of family. he had a lot of friends. they mourned together. his family members and friends remind -- remember him as a very kind person. the family says we don't want retaliation. we want justice. i need people to stop being afraid, said his sister renee

evans. i need people to stop being afraid to say what they see. if you see it, say it. you don't need to give your name. anyone who knows something should just call the police. he was a well-liked person all across the neighborhood. bernard hall shot dead, 33 years old. derrell patrick law was killed ten days earlier in new haven. he had just started attending church regularly, the faith revival temple church in west haven. he had gone to one of his first services on january 19, and he didn't make it to the next service. not by choice but because he was shot dead on eastern street on january 20. this was the city's first homicide of 2014. mourners packed that church that he was new a new parishioner of to mourn him. they said that he was a good man who liked to goof around, especially with his many family members. derrell leaves behind a

1-year-old son. he was really active in sports in high school. he was only 20 years old. in high school, he had participated in football and track. justin mariano was 29 years old when just before the new year, he was killed in bridgeport, connecticut. he was shot on the evening of november 9. police responded to bridgeport hospital where mariano later died from his injuries. he had just started working at a barber shop called sharp cuts, and he was remembered by both the people that worked with him as well as the folks who trained him at a local cosmetology school as talented, bright and energetic. jerome copeland was 22 years old when he was killed on the streets of hartford. he was the 16th homicide victim in hartford when he was killed in the late summer of

2013. a woman who knew him said that he was a young father. he was struggling. he was trying to make ends meet. he leaves behind a son, a brother, two sisters and a loving girlfriend who described him as an energetic man who loved music. when i was at central high school in bridgeport a few weeks ago, i was sitting down with a group of kids who wanted to see what they could do to end the violence on the streets of their city to feel a little bit safer when they walked to school in the morning, and i asked them all how many of you know someone, a close relative or friend who has been killed by guns? and they looked at me strangely, in part because every single one of them raised their hands. at central high school, you just accept that at some point before you reach the age of 18, you're going to know somebody, a close friend or relative who has been killed by guns in that city.

at a similar meeting of high school students in hartford, connecticut, one young girl said the sounds of police sirens at night were her lullaby growing up, that she just knew there was a pretty good chance on any given night that somebody was going to get killed in her neighborhood and she had come to accept the signs of crisis response as just the pitter-pat of raindrops outside. to these kids, they look at their lives in which they fear for their safety when they walk to school, in which they accept the inevitable fact that they will lose someone close to them over the course of their teenage years and they don't understand the complacency of the united states senate. a recent study of cooke county hospitals in and around chicago showed that of all of the people that they treated for episodes of violence, nearly half of them displayed signs of ptsd.

the fact is, is that in these neighborhoods, ptsd is a reality in the same way that it is for our troops who serve for us overseas because they witness horrific acts of violence in neighborhoods that are supposed to be safe for our kids. we shouldn't have to compare the levels of ptsd in the neighborhoods that our kids transit in the same way that we look at ptsd on the field of battle. it's time that we did something. whether it's an investment in new mental health resources or beefed-up background checks to make sure criminals aren't buying guns or a recognition that there are some weapons that probably deserve to be in the hands of the military rather than in the hands of everyday citizens, it's time for us to have an answer. 31,000,2,600, 68 are too high.

and if the states don't do it, then hopefu hopefully over timee voices of victims will. i yield back. a senator: madam president? the presiding officer: the senator from north dakota. ms. heitkamp: most of the country watched with i think a great deal of interest right before the new year when we, unfortunately, had a train derailment in castleton, north dakota. what was unique about this train derailment was that the train that derailed subsequently derailed another train and resulted in a fairly large explosion which sent shock waves i think again through the rest of the country as we started to address the issue of how do we maintain safety on the raivment. so we've been having a lot of discussions about what is the appropriate level of regulation,

we've been having a lot of discussion about tank cars. the u.s. department of transportation has been meeting with the railroad industry as well as the oil and gas industry trying to assure that whatever decisions are made enhance the safety. but i want to talk about and that's not about government regulation and it's not about kind of long-term strategies except to the point that it is about the heroics and the importance of first responders. and so i rise today to honor the heroics of jeff anderson, an engineer in training for burlington northern santa fe railroad, whose bravery following the recent train derailment near castleton prevented the dangerous explosions from the crash from spreading even further. for many of us in the senate, the castleton derailment has trained our focus on our efforts to improve safety for the rail shipment of crude oil. from increased track inspections to updated tanker car standards to the consideration of new

routing options for crude shipments, all angles for improving the safety of crude rail shipments are being considered. what we should not overlook in our efforts, however, is the importance of skillful and well-trained railmen on the lines. railmen, like jeff anderson, are the backbone of that industry, and when one goes above and beyond the call of duty to prevent a disaster from spreading, they deserve to be recognized. on december 30, a grain car carrying soybeans to the pacific northwest derailed near castleton, north dakota. an axle broke on the car near the middle of the train, forcing the car off the rails and on to the tracks of the adjacent line carrying trains in the opposite direction. conductor bruce anderson and road foreman of engineers paul douglas radioed the emergency to the oncoming train on the opposite track. but there was insufficient time to slow down that train headed their way. in the brief moments following

the derailment, an eastbound train carrying crude oil collided with the soybean car lying over the tracks and that eastbound train exploded. following the crash, jeff and the entire crew of the westbound grain train sprang into action. immediately following the derailment, conductor bruce anderson went back and pulled approximately 50 cars away from the fire, recognizing the fire would soon spread to the remaining cars, jeff worked with assistant fire chief adrian kiefer to hatch a plan to couple back on to the remaining oil cars and unhook the tanker cars and pull them to safety. jeff, a former civilian firefighter for the grand forks air force base, borrowed two radios and fire protection gear from the castleton fire department. his engineer and trainer to come crooks jumped into -- cooks jumped into the rear engine of the train to reverse the locomotive towards the fire and

connected the train to the tanker cars in danger of exploding. jeff, armed in fire protection gear, walked towards the fire to connect the train to the cars. he then walked even closer to the fire to pull the pin on the closest tanker car within a safe distance, getting 25 more cars away from the fire. now, remember, these are cars filled with crude oil. once the pin is pulled, jeff radios to tom to pull the cars away. because of jeff's heroics, the danger from the derailment were minimized and the explosions were isolated to the tanker cars adjacent to the derailment. had it not been for jeff, this disaster would have been much worse. i'd like to take this time to thank not only jeff anderson but all those involved in the response, including engineer tom cooks, conductor bruce anderson, road foreman of engineers, paul douglas, castleton fire chief

tim mclean, and castleton assistant fire chief adrian kiefer for their presence of mind and their decisive action following the crash to minimize the danger of this derailment. and i rise with some awareness of what firemen do. as attorney general for the state of north dakota, i had the pleasure of also being responsible for the fire marshal's office. as somebody in charge of the fire marshal's office, i spent a great deal of time travel across north dakota visiting not only with full-time sphier men but the wonderful volunteer -- firemen but the wonderful volunteer fire offices that we have all across north dakota. i have a special spot in my heart for firemen. my dad was chief of the fire department in matador, north dakota, for years and years and took that effort quite serious seriously, took the training quite seriously. and as we move forward in this discussion of guaranteeing the

safety of crude moving on the rails, i would ask this body to consider a third prong not beyond -- beyond simply looking at routing decisions and prevention of derailment and then in the unfortunate incidents, containment of the consequences of derailment, i ask everyone to consider the importance of training, the importance of doing everything that we can to provide the equipment and to provide the training and the resources to our first responders. anyone who doubts the commitment of those first responders to put their life in -- in harm's way need only look to the 9/11 responders and realize if you've worked with firemen, they all knew when they walked into that building that their chances of returning were virtually nonexistent but yet they walked into that building in an effort that we can only shake our head at the heroics of that effort. and you take a look at the heroics of jeff anderson and his

colleagues in -- in doing everything that they could to promote public safety and to guarantee public safety. let's respond with appropriate public policy and appropriate training and appropriate resources for our first responders. madam 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:

nor senator madam president? the presiding officer: the senator from alaska. mr. begich: are we in a quorum call? the presiding officer: yes. mr. begich: i ask that the quorum call be vacated until the time the complete my you comments. the presiding officer: without objection. mr. begich: madam president, i rise today because i am one of

the sponsors of the bill pending before the senate at this moment. the bill is about as simple as you can get around this place. a one-sentence measure to real estate store the fairness to america's military retirees. the bill will repeal the cola cut congress gave to working-age military retirees when we passed the budget just before christmas. the bill -- that budget bill had a lot of good provisions, and it pass with large bipartisan support on both sized of the capitol. it avoided another government shutdown and alaska's delegation was unified in passing that budget bill. it provided another round of budget cuts to the defense department and other agencies. it showed the american people that republicans and democrats can really work together. but it wasn't much of a christmas present for our veterans. the brave americans who made a career out of serving their country and in many cases

putting their lives on the line. that budget deal says working-age military retirees will see their pension, cola adjustments reduced by 1% annually. for many of them, that's a hit totaling tens of thousands of dollars over years. for some, the total reduction of their lifetime is upwards to $80,000. it's completely unacceptable. that's why many of us only supported the budget deal because we had already committed to rolling back the cola cut once the deal was completed. madam president, the bill before us right now will take care of the problem. -- once and for all. the chief sponsors are senator hagan and senator pryor and senator shaheen and myself. many others are coming on board. in fact, i don't know of a single member of this chamber who opposes making sure our military retirees continue to receive their full cola. it's the right thing tovment to. with these heroes signed up and

to serve and made military service their career, it was what they were promised. they should expect no less now. i have been around the block a few times. i know what's coming. many of our colleagues on the other side of the aisle are going to come to this floor and talk a good game. they're going to pledge their loyalty to the troops. they're going to wrap themselves in the flag, and then they're going to pivot. they're going to start qualifying things. they're going to say the sky is falling and they're going to say we can only pass this bill if we pay pour it. -- pay for it. we've already been down that road. many of us in this chamber tried to fix the military cola last month. our effort efforts failed in a t over what's known around here as a paivment and honestly, i'll sick of t the bill before us right now, the bill i proudly sponsor, has no pay-for. why? why is that, people ask? it's because the mism our armed services have paid, paid up on

their end of the deal and now it is fipple time for us to pay our part. unfortunately, too many of them have made the ultimate sacrifice -- with their lives. all of them, even those who served, who survived and were lucky enough to retire, had agreed to put their lives on the line. that's the deal when you signed up to serve this country. so to my colleagues i say, don't come down to this floor, don't lecture me about paying for in -- for this bill, because it a simple thing to do. i have got a list here of alaskan soldiers who died in the battles of iraq and afghanistan, the wars that weren't paid for. there are 2 name 2 names here. a small populated state, so every one of of these losses hit us hard. in ology, nearly 6,800 american soldiers have died amidst two wars. half of all these fallen soldiers were between the age of

18 and 24 years old. madam president, with per mirks i'm going to read just a few of these names of fallen alaskans. tec sergeant lesley williams, air force, age 36, june know. p.f.c.ardar cleveland, age 19, anchorage. sergeant curtis arkela, army, age 22. mike alaski, marine reserves, age 22. sterling. 22 alaskans have paid the price. granted, we'll never know if these brave soldiers would have chosen to make a full crie caret of the military. we'll never know if they would have collected a pension from a country they served. but this much we do know: every american troop who is serving right now, especially the career soldiers, signed up with a promise from the rest of us that in return for their sacrifice,

their government would take care of them. it's time for those of us in congress to step up and do that. both sides of this aisle on both sides of the aisle, it's time for us to pass this bill and to make good once again on the end of the deal. let me make one point. our actions so far on this issue are not theatrical. this isn't about ideological policy debate. by voting to reduce the cola adjustments we have already impacted real people, real families and created uncertainty in their future. here are just two examples of alaska constituents. a soldier from anchorage wrote to me and said this:, "i myself am on active duty, just over 18 years of service. maybe i made a mistake by devoting my life from the age of 19 to now to the air force. he said he has moved six time, has two failed marriages, two children, one who is disabled. he says, "we changed the rules

of the game now and he wonders what would happen if he had chosen a college instead of the military. his letter say, "i can't undo 18 years of service. i can't change my career path. it seems very unfair to me to be changing our retirement like this." another family wrote to me from north pole, up near fairbanks. p the husband served 20 years in the air force and their daughter is currently major in the air force. they were promised benefits for life like good health care and retirement benefits with a cola adjustment. the husband could have left sooner and started another creerks but he chose to stay because of the benefits. their message to me is very simple. to vote to reduce the cola breaks faith with them. with those already retired and with everyone who has chosen a military career. what about those bright, young people who are deciding right now whether to join up and sign

up, perhaps make a career out of the military? what are they thinking about their congress and their future? we need to fix this and fix it right now, starting with our vote this evening -- not next month, not later this spring, not next fall but right now. madam president, i know there's going to be a lot of debate. hopefully tonight we'll see the cloture vote and we'll move to the gaivment i know there will be a list of pay-fors. as i said earlier, the people who this protects and ensures that they have a cola and retirement they can depend on are people who served this country. they put their lives on the line. we have an obligation, an obligation today, tonight, and tomorrow to finish this up and put their cola back in place. i know we'll hear the arguments about the deficit and all these explanations. but i can't say enough about the payment that's already been made by our military, by the people who served not only on the front

lines but served throughout our military, throughout this world in serving and protecting our country. madam president, i hope that we put aside our political debates, our politicking, and get on with doing what's right. when you put this in perspective about the 6,800 people who perished in the two unpaid for wars, this is a $6 million issue over the next ten years. a small amount to make sure we solve this problem. i would hope that my colleagues -- and i can tell you there is broad support. when you look at the military coalition, an incredible organization of many of our military organizations around the country who've sent a letter today supporting s.b.1963. this is the bill we have up today -- tonight. so i would hope again members of both sides, especially the members on the other side, put aside this whole argument on the

pay-for. let's get on with doing what's right for our retirees. they have paid the price. they have servinged this country and it is our time to pay the price and pay the bill and that is voting for this piece of legislation tonight and voting to close it in cloture and moving on to feignal passage. madam president, i appreciate the time. i luke afford to the debate. i yield the floor and notice the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

quorum call: the presiding officer: the senator from mississippi. the presiding officer: do i understand we are in a quorum call? the presiding officer: yes. mr. wicker: i ask unanimous consent that the quorum call be vitiated. the presiding officer: without objection. mr. wicker: and i wish to speak as if in morning business. the presiding officer: without objection. mr. wicker: madam president, i

see on the calendar s. 1963, a bill to repeal certain reductions made by the bipartisan budget act of 2013. i didn't vote for the bipartisan budget act of 2013, and my "no" vote was cast for one reason. it is this so-called c.p.i. minus one in justice that was done to military retirees. those military retirees under the age of 62, under this newly passed bipartisan budget bill that has been signed by the president, will not be able to keep up with the cost of living because their annual cost-of-living adjustment, or cola, would be reduced each year by 1%. i think we have clearly pointed out to the american people the injustice of this provision in the budget act. over time an enlisted person would lose some $80,000 lifetime out of his or her pocket.

these are military members who fulfilled every part of their bargain. and the government comes along and tells them after they've done their share, after they've subjected themselves to worldwide duty, after they have been in a war zone perhaps any number of times, the government comes along in the form of this bill and says we've changed our minds. we're not going to give you your full cost of living. we're going to take a percent from that each year. for officers it is even more than the $80,000 lifetime. and i think most americans now realize that it was a mistake to do this, that it needs to be corrected and we need to go back to keeping our promise to military retirees. we have an obligation to military retirees to do this. at the same time, madam president, we have an obligation to future generations not to go back on the budget

savings that were so hard fought in this budget act. i supported the level of budget savings. i just didn't like the way they were done. and time and time again senator ayotte, senator graham and i and others came to the senate floor pointing out that there are other ways to pay for the savings that need to be made in the budget. there are better ways than taking it out of the hides of the people who volunteered to serve their country in the military. so we have a bill that we will be considering, s. 1963, and it's authored by mr. pryor, mrs. hagan, mrs. shaheen and mr. begich. i like the idea of addressing the problem. there's only one fault in the bill, and that is it does not have a pay-for.

so of the budget savings that were made last december, some $6 billion of that would simply go away. we would be spending that $6 billion that we were wanting to save. our obligation needs to be to the military people and also to future generations. why do we need to cut $6 billion? why do we need to stay with the $6 billion in budget savings? because we have an obligation to do something about the debt. that's the whole reason for the budget bill last december, is we are drowning in a sea of debt to the tune of $17 trillion-plus and growing every day. and so, we need to rectify the wrong done to military people. at the same time we need to find the budget savings elsewhere. today i will vote to proceed to

the bill. i will do so in the hope that republicans and conservatives will be allowed to offer amendments in the regular order to pay for this bill, to find the $6 billion in savings needed over a ten-year period to pay for this bill. now there is legislation, there's a proposal by senator ayotte, senator graham and i that would use an obama administration pay-for to pay for the cost of rectifying the wrong to the military retirees. it is a closing of a loophole in the united states tax code, a loophole that allows people improperly to claim an additional child credit. the joint committee on taxation

has estimated that this change could save approximately $20 billion over the next decade. this was an issue identified by the obama administration's treasury department and by the inspector general there. so we're not taking a republican -- we're not taking something from the heritage foundation. this is something from the treasury department of the obama administration and from their inspector general. and i would simply submit to my colleagues, let's rectify the wrong done to the military retirees, but let's admit also we have an obligation to future generations to not add to the debt any more than this congress has already done. we can fulfill both of these obligations today. but the way to do is to vote for cloture on the motion to proceed, which i will do -- and i think many of my republican colleagues will do so. we ask in return for regular

order on this important bill. allow amendments. allow pay-fors. perhaps the ayotte-graham-wicker pay-for. perhaps others. if there are members on the other side of the aisle among my democrat friends about a better pay-for, bring that to the floor, offer it, let the sun shine shine on these suggestions and let the american people know where we stand on righting the wrong and also protecting future taxpayers. so, vote -- i would say to my colleagues, vote "yes" on cloture on the motion to proceed. but i would say to the leadership, don't lock it down this time like you usually do. don't fill up the amendment tree. allow -- allow republicans, allow democrats who have other ideas about how to protect our future generations from a sea of

debt to bring those ideas to the floor, vote on them, and let the american people see that we can correct this wrong to the military without adding $6 billion to the debt. so, thank you, madam president. i hope that we can have a bipartisan consensus and begin this new year with regular order and with allowing the elected representatives of the states to work their will rather than having deals cut behind closed doors. thank you, madam president. i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

quorum call:

mr. nelson: madam president? the presiding officer: the senator from florida. mr. nelson: i ask consent the quorum call be lifted. the presiding officer: without objection. the clerk will report the motion to invoke cloture. the clerk: cloture motion, we the undersigned senators in

accordance with rule 22 of the standing rules of the senate hereby move to bring to a close the debate on the motion to proceed to calendar number 298, s. 196 , a bill to repeal section 403 of the bipartisan budget act of 2013 signed by 17 senators. the presiding officer: by unanimous consent the mandatory quorum under rule 22 has been waived. the question is, is it the sense of the senate that debate on the motion to proceed to s. 1963, a bill to repeal section 403 of the bipartisan budget act of 2013, shall be brought to a close. the yeas and nays are mandatory under the rule. the clerk will call the roll. vote:

vote:

votevote:

the presiding officer: are think senators wishing to vote or wishing to change their vote? on this vote, the yeas are 94, the nays are 0. three-fifths of the senators duly chosen and sworn having voted in the affirmative, the motion is agreed to. the presiding officer: the senator from north carolina. a senator: thank you, mr. president. i rise today to speak in support of senate bill 1963 and i also ask unanimous consent that after my remarks, that senator brown from ohio follow me for a time not to exceed 10 minutes. the presiding officer: without objection. mrs. hagan: mr. president, this bill is a bill that senator pryor and i have introduced to repeal the harmful cuts to military retirement pay in the recent bipartisan budget act. as a senator from the most military-friendly state in the nation, i am pleased that we have just voted to advance this

important legislation that will affect so many brave men and women from north dakota and around the country who serve our nation in the military. these harmful cuts to military retirement pay were included in the recent bipartisan budget that passed the house and senate with bipartisan support. and while i supported the murray-ryan budget because it rolled back across-the-board sequestration cuts that threaten our military capabilities and the safety of our troops, i am opposed to the provisions -- the presiding officer: the senate will be in order. the senator from north carolina. mrs. hagan: mr. president, this budget rolled back across-the-board sequestration cuts that really threaten our military capabilities and the safety of our troops and i'm opposed to the provision that reduces these cost-of-living adjustments for military men and women who have served our country with honor and

distinction. without action, these cost-of-living cuts will take effect in december of 2015. by passing this legislation this week, we can keep our promise to our service members and veterans who do not deserve to have their retirement benefits cut. the proposed cuts would affect our current and future retirees still serving our country on active duty. if allowed to remain, the cost-of-living cuts would cost a typical retiree over $80,000. in my state of north carolina, close to 90,000 retirees as well as thousands of service members still on active duty would bear the brunt of these cuts. i recently heard from a veteran from apax, north carolina, who served in the military for 21 years, including two tours in afghanistan, one in saudi arab arabia, one in korea. he said the cost-of-living cuts

change the promise made to his family after moving 12 times in 21 years. his family made these decisions on where to live, what house to purchase, what job to take, and how to save for his son's education based on this pension income. i also heard from a woman whose husband is an active-duty marine stationed at camp lejeune in jacksonville, north carolina. she wrote, "my husband has served 16 years in the marines, four tours in iraq and is preparing to deploy to afghanistan soon. he has kept his promise to the u.s. and earned his benefits in full. we have lived with long-term separations, uncertainty and financial stress. please do not add to that. the money may not sound like a lot to some people but it means a whole lot to us."

once again, that woman's husband, active-duty marine. this is unacceptable. we've made a commitment to these brave men and women, many of whom have deployed multiple times to combat zones overseas. we must keep our promises to our service members after they've sacrificed so much for us. these cost-of-living cuts would negatively affect not only individual service members but also the military as a whole. i serve on the armed services committee and two weeks ago military leaders testified that retirement benefits are an integral part of a service member's decision to remain in the military or to further reenlist. we cannot overlook the consequences these cuts would have on the retention of service members, particularly mid-grade officers and noncommissioned officers who are considering the length of their future service. nor can we overlook the effects they would have on the

military's long-term readiness. i am pleased that we have acted to prevent the cost-of-living cuts for the most severely wounded military retirees and their survivor benefit plan recipients, but our bill would go further and this would repeal these cost-of-living adjustment cuts for all military retirees. yes, it is true that our country faces difficult fiscal challenges. however, we can never balance the budget on the backs of those who have answered the call to duty. we must keep the promises we've need our veterans who have put their lives on the line to protect us. i urge my colleagues to support our legislation that will ensure current and future veterans receive the benefits they have earned. mr. president, i yield the flo floor. mr. brown: mr. president? the presiding officer: the senator from ohio.

mr. brown: thank you, mr. president. i appreciate the words of senator hagan, who has been a leader for our veterans, for their health care and camp wille jeune and so many other way, looking out for pensions and health care for those who have earned it, sacrificed for us. she, like i, believe that it is an honor to honor those who have sacrificed for us. so thanks to senatorre senator r her remarks. today i was in a c.v.s. drugstore in ohio west of cleveland, thankin thanking th a decision they made last week that they would stop selling tobacco products and they would invest in a national smoking-cessation campaign designed to help people quit smoking. c.v.s. c.e.o. said the right thing to do for our customers and company is to help people on their path to better health.

the sale of too long is inconsistent with this purpose. that's good news. in my state one in every five deaths is connected to tobacco. ohio ranks sixth in adult smoking, 16,900 people in ohio -- children in ohio under 18 start smoking each year. you know what we know about tobacco, mr. president? we know that 480,000 people every year in the united states of america die of tobacco-related illnesses. you know what else we know, mr. president? because 480,000 americans die from tobacco-related illness, we know that big tobacco companies' executives know they have got to find 480,000 new customers every year to buy their product. you know, mr. president -- nothing in particular about your age or mine -- but they don't aim at people like us, people in their 40's, 50's, 60's, to get them to replace the 480,000

people who have passed away. they aim at the age of the pages sitting in our quhaim. joining me at c.v.s. today were two young women who both smoke and are both working to quit smoking. both are doing very well, as they've -- as they quit smoking. they both started smoking, they told us, as teenagers. and they are work -- c.v.s. is working with them on their smoking cessation campaign. we're also joined with michael roroizen from the cleveland clinic, he is a heart doctor, and has done so well in various kinds of care to help people quit smoking, to help people lose weight, to prevent diabetes and all the preventive care he's

worked on. we're also joined by two nurse practitioners, lauren and molly, who are part of the c.v.s. clinic that have helped people do better managing their health. but the point, mr. president, is this: that c.v.s. has made this decision. this isn't earth-shaking. it is -- half of cigarettes are bought today at gas station. that's not going to change much. cigarettes are going to be available. it is a legal product. people should have -- in fact should have the right to buy cigarettes if they choose to. but the point is, tobacco companies shouldn't be able to target young people the way they do. and we've seen major progress. 50 years ago -- 50 years ago the surgeon general issued a groundbreaking report on the health effects of tobacco use. and look at the progress we've made. 42% of american adults smoke cigarettes in 1965. today 18% of american are are s smoke cigarettes. so it has been a huge public

health vick trivment and it be a huge public health victory in small and large steps. first, the report was so important. we remember as kids that you could smoke almost anywhere in our society. state governments then began to prohibit smoking in public buildings. then began to prohibit smoking in other publicly owned buildings, government buildings. and then people couldn't smoke in public places in many places, many stated around the country. we remember people used to smoke ons airplanes. and then over time smoking was restricted to, if i remember, aisles 18 to 35 or something. but then -- so you could smoke if you were in one of those aisles but not a seat in front of that or behind that, whatever it was. and now smoking is banned on all flights. so we've seen major progress made. c.v.s. is one step in that. we have sent -- a group of us, led by senator harkin, senator blumenthal has been involved, a number of others, asking the

other major drugstore chains -- walgreens and rite aid to do the same, to quit selling cigarettes there. but ssh so we've seen progress, but it's still a major public health problem. one of the places that it is particularly a problem -- i said that 480,000 people in america die from tobacco-related illnesses every year, heart disease, cancer, a whole host of illnesses that are based -- connected to smoking or chewing tobacco. so they aim at children for sure with their targeted campaigns. but they also go overseas and they -- tobacco companies are trying to undermine public health laws, particularly in poor countries around the world. if you are a health care -- if you are a public health official in india, you've got to worry about cholera, you've got to worry about h.b., h.i.v. a.i.d.es, child diarrhea, you've got to worry about all the

things that kill people prematurely. when the tobacco companies come in, whether they are american companies or companies from any other country, they don't have much defense against that. that's why -- i know the presiding officer from indiana has been a real leader in opposing bad trade policy for our quun. but one of the elements of a bad trade policy is giving u.s. tobacco companies too much power to go into far too many of these countries and co joel and threaten and -- cajole and threaten and even undermine public health laws. in fact, we have seen in more than one country which is thought -- a poor country that's not -- that not too many people don't have many public resources -- people are pretty poor -- we've seen tobacco companies threaten those countries that are about to enact a new health care law and that country backs off because they don't have the dollars and the resources to fight the tobacco companies' efforts. so -- in court. we have a lot of work tovmentd i just wanted to share what

happened today in lakewood, ohio, with thig my colleagues, w important it is what a huge public health victory. i want to emphasize how successful these efforts to curb the use of, too the greater killer in the country, how successful we've been. more than 40% of people smoked in 1965. today fewer than 20%. that's because of a partnership among government, local officials, public health officials, american cancer society, american heart association, so many of these organizations have really stepped up in a way that really has mattered -- the american lung association and others -- to protect the public interest, especially to protect children. i applaud the efforts of that company and so many of my colleagues that have been working on it. mr. president, i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

quorum call:

mr. begich: mr. president? the presiding officer: the senator from alaska. mr. begich: i'd like to move that we vacate the quorum call. the presiding officer: without objection. mr. begich: i ask unanimous consent the is that the proceed to a period of morning business with senators permitted to speak up to ten minutes each. the presiding officer: without objection. mr. begich: mr. president, i ask -- the presiding officer: the chair lays before the senate the letter of resignation of senator max baucus of montana dated thursday, february 6, 2014. without objection, the letter is deemed read and spread upon the journal. the senator from alaska. mr. begich: mr. president, i ask unanimous consent that the letter relating to the resignation of the senator from montana, max baucus, be printed in the record. the presiding officer: without objection. mr. begich: i ask unanimous consent that the finance committee be discharged from further consideration of

s. 1954, the senate proceed to the immediate consideration. the presiding officer: the clerk will report. the clerk: s. 1954, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services and critical access in small rural hospitals through 2014. the presiding officer: without objection, the committee is discharged and the senate will proceed to the measure. mr. begich: i ask unanimous consent that the bill be read for the third time and pafpbd the motion to reconsider -- and passed and the motion to reconsider be laid on the table. the presiding officer: without objection. mr. begich: i ask unanimous consent the help committee be discharged from s. res. 339 and the senate proceed to immediate consideration. the presiding officer: the clerk will report. the clerk: s. res. 339 commemorating the 150th anniversary of mayo clinic. the presiding officer: without objection the committee is discharged and the senate will proceed to the measure. mr. begich: i further ask that the resolution be agreed to, the preamble be agreed to, the motion to reconsider be

considered, made and laid upon the table with no intervening action or debate. the presiding officer: without objection. mr. begich: i ask unanimous consent that not withstanding the resolution of the senate of january 24 -- 1901, that the traditional reading of washington's farewell reading tack place on monday, february 24, and that senator king be recognized to deliver the address. the presiding officer: without objection. mr. begich: mr. president, i ask unanimous consent that the appointment at the desk appear separately in the record as made by the chair. the presiding officer: without objection. mr. begich: mr. president, i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

the presiding officer: the senator from alaska. mr. begich: i ask that the quorum be vacated. the presiding officer: without objection. mr. begich: i ask unanimous consent that when the senate completes its business today it adjourn until 10:00 a.m., tuesday, february 11, 2014, that following the prayer and pledge, the morning hour deemed expired, the journal of proceedings journal of proceedings be approved to date and the time for the two leaders be reserved for their use later in the day. that following leader remarks the senate resume consideration of the motion to proceed of s. 1963, the military retirement restoration bill and that the senate recess from 12:30 p.m. until 2:15 and the time be considered postcloture. the presiding officer: without objection. mr. begich: senator-designate walsh from montana will be sworn in tomorrow. if there is no further proceedings to com

scott.dings to com >> i guess my first question to the audience is, where is senator demint from? i was just wondering. s well there's a line of separation between the two of you guys. it is good to be with you all. thank you for the opportunity to talk about my choice act and to

talk about an issue to me that is really about freedom. the power of choice to me in education is truly the power of freed freedom. i think to myself when goy to church on sundays, a friend of mine and beautiful wife have a beautiful little girl born with down syndrome and when i see them at church, on sundays i often think to myself about what we're doing in the education space to make sure that every person has the opportunity to maximize their potential. and then i read a story about a little girl named rachel lewis and i connected the dots to my friend scott and little rachel lewis. rachel lewis also was born with down sip droem and her parents fought to get her into the right school and successfully were able to get her in school and did well and when they moved the new school system simply was not very welcoming to rachel.

and so her parents fought for a year to give rachel the same mainstream opportunity we once for every kid. unfortunately, they had to fight and fight and fight. little over a year later, they were able to get rachel back in a mainstream classroom. unfortunately what they realized along the way was that they were going to now ask the system that fought to keep her out of these mainstream classes, to now educate little rachel. that's a tall order. that's a tough task. and so they decided to send rachel to a different school. a school called hidden treasure. where rachel could realize her potential. now rachel's about 20 years old. she's graduated from high school. she doesn't have a job. she has two jobs.

and i look around my church and i see my friends and i say to myself, perhaps the choice act will be the path to seeing more kids realize more of their potential. as i think through the opportunity component of the choice act creating hope and opportunity for individuals an opportunities through education, i think about the dismal numbers in the d.c. area, so many kids trapped in failing schools. as a matter of fact, they're trying so hard there are 21 -- 22,000 students on waiting lists, 15 schools closed, and yet, with a graduation of 56%, there is some conflict, some challenge to the notion that we should provide more opportunity scholarships to more kids. let me explain how that works. how many of you guys would like to have better outcomes for less

money? raise your hands. i figured -- i see your hand in the air as well. would you rather pay $20,000 for 56% high school graduation rate or if i gave you door number two, would you choose $8500 for a 9 % graduation rate? how many of you would go with the 9 %. where are you from, sir? your hand is not in the air. i'll come back to you in al will bit. and that is the difference here with the d.c. opportunity scholarship. we're talking about the 6,000 kids over the last ten years who finished school here in the d.c. area, have a 97% graduation rate. more importantly, 91% of the students go on to a two-year or four-year college.

if, in fact, choice, the power of choice, is the power of freedom, we ought to take a serious look at the outcome of education right here at place where we can have a true challenge, $20,000, for 56% of the kids to be able to go on to a two-year or four-year education or $8500 for the kids 97 out of 100 times graduating. 91 out of a hundred times goes on to get a two or four year education and 94 out of 100 times the parents are completely satisfied with their education. these are remarkable numbers. i will tell you as i close here, that as a kid growing up, who did not do well in school -- i think my story has been told a couple times -- but to refresh your memory, i was that kid.

you see, 90% of those kids that come from underperforming schools. too many of those kid, 86% of the kids are african-american, 14% are hispanic. too often we write off these kids as at risk kids that will never perform. i would rather have seen the results of the 6,000 kids that have gone through the opportunity scholarship, i would rather call the kids high potential children. with a great future, an amazing platform and paths that are filled with prosperity because we know if you look at the results of education, we can see the results of employment. and let me finalize with this. as we study the numbers and we have this great debate on issues over the next at least nine or ten months before an election i would like for us to have a

debate even after the election, other side would like to participate, i'll show up anywhere, any time, any day to have that debate because what we're talking about is the quality of life that americans will experience for a very long time to come. if you have a college education, your unemployment rate is under 4% today. if you graduate from high school, it's around 7.7%. those who do not graduate from high school, which in my county back at home in south carolina, 56% of the african-american males aren't finishing high school. the unemployment rate is 10%. but here's where the rubber meets the road. after age 25, those who have not graduated from high school, only 50% of them are actually in the labor force. so think about that 10% unemployment rate, compounded by the fact that only half are in

the work force. if you want to have a serious debate about people, let's have a debate about the foundation on which they stand. let's have a serious debate not about how to make more republicans or make more democrats or have political conversations, i want to have a conversation about the future of a country based on our education and to the extent that we provide equal access to the best education system in the world, spending over $600 billion collectively with the states, we can have a serious conversation about prosperity and i hope that we have that debate for a lot longer than a year. i will tell you that having had the privilege of a life that was going down the wrong direction, have you ever noticed that you always drift in the wrong direction? all drifting does not go in the right direction. i tried it.

i'll just tell you that the results of drifting is bad. the results of focus is good and i look forward to having an opportunity to talk about the issue "

continues. host: welcome back. our guest for this segment is sam baker from medicare advantage program." thank you for being here. we are talking about the medicare advantage program. explain what that is. guest: medicare advantage program, a subset of medicare. instead of the traditional medicare program, these are private plans that you can buy. they can have wraparound coverage in addition to the traditional benefits. they are reimbursed by the federal government. host: how is it affected by the

affordable care act? guest: it cuts medicare advantage program rather significantly. one of the bigger cuts in the law. this is a program democrats have paying insurance companies more to provide the same service the government was already providing. and insurancear companies are afraid we will see additional cuts on top of the cuts in affordable care act. host: we have a chart. what does that mean for a person involved in this program? guest: to some extent we are still figuring this out. sayrance companies will there's no way to make those cuts without us passing that on.

they will have to exclude certain expensive doctors from their networks. the argument that insurers make is that every cut gets transferred over to seniors. host: our guest this our is sam baker medicare advantage program from. if you want to join the conversation, for republicans, 202-585-3881. democrats, 202-585-3880. .ndependents, 202-585-3882 explain why these cuts are happening. inst: the cuts were included the affordable care act were included for two reasons. people thought the program was overpaying and people needed savings. an administration is trying to expand coverage and pay for that

expansion and trying to make cuts. insurers were able to turn their proposed pay cut into a pay increase. it is one of these administrative cuts that was going to be layered on top. that is why you are seeing it. it is a very lean time across the board. host: peter on our line for democrats. earlieri was calling an to raise taxes on this rich to get this country back going again. they are so far out. we had 137,000 billionaires last year. you want to pay the debt down. medicare advantage should not have been in there.

they took it away. it needs to be brought back and give medicare back up where it is supposed to be. $1000 up tog $50,000, i do not think they should be taxed. the poor people are paying all the taxes. if you raise the taxes on the rich -- we have to bring the cost down. they do not want to pay the tax. let's get this country back in shape. thank you. guest: you see this debate playing out in congress. do you raise taxes or do you cut? wants to cut our entitlement programs like medicare. you'll probably see some balance between them.

these were some of the cuts back during the presidential campaign. there was a to do over romney and ryan attacking president obama for some medicare cuts. that includes these medicare advantage cuts. ken is on our line for republicans. sam baker said the government is able to pay for it. i am 64 years old. i have been around. 70's andthe late 19 we have been paying this, not the government. the seniors have been forced back into below poverty levels

stealing the money. stealing money from the social security trust fund. it has got to stop. stop saying it is an entitlement. we put into the funds themselves. for every dollar we put in, our employer matches that fund. there is twice as much money but they have never shown the other dollar for every dollar we put in. when you use the word "entitlement," it sounds like a welfare program. we have been working all of our lives. some baby boomers have died and their money is absorbed into the system. i think it is time everybody starts investigating into what is theirs.

very simple to do. simple math. i like to see where we belong and what is ours. it is pitiful one senior citizens have to eat dog food to make up the difference between their rent and their electric and since 2009 they did away with the cost of living thestment by taking out utility courses and the food costs. and to bring the cost of living adjustment down. these people worked all their lives. guest: the caller mentioned the trust funds, which gives back to the inherent tension. nobody likes to take a pay cut.

not any of the stakeholders in the health care system. because of some of the cuts in the affordable care act, the trustees have projected the length of the medicare trust fund, the program will be solvent for an additional 12 years. it is that trade-off. you want a program to last longer. host: i want to go to an ad that talks about medicare advantage. [video clip] >> medicare advantage makes our medical care affordable. >> i feel there's been enough damage already without cutting more. advantage, idicare do not know what i would do. >> i am not sure. >> we will talk and spread the

word. no work cuts to medicare advantage. vote. add being run an by the insurance agency for lawmakers to see. is wrapping up because it is time for the medicare program to set up payment rates for medicare advantage. these are the same ads that worked last year. a very similar ad campaign started running. lawmakers sent letters saying you have to reconsider the form of to reconsider this cut. there is precedent for these working. florida on our

line for democrats. caller: good morning. i am a nurse and a long-term care provider. , thef the best things medicare advantage program benefits the insurance companies and not necessarily the senior citizens. senior citizens need the long-term care and there is restraint with such limited amount of services that could be provided through the program. basically the medicare advantage program, the insurance providers profit, not necessarily the seniors, who need the assistance and there care to maintain their daily living. they were going to eliminate that. we did very well prior to medicare advantage coming on the scene. they do give a certain amount of

care. it is all about profit. i applaud the obama administration for trying to eliminate the medicare advantage program. thank you. guest: i think the obama administration would be happy but they are trying to roll it back and a lot of they are very much trying to roll it back and truly a lot of them do feel like it's a giveaway to their insurance companies especially the way it's structured now and that's part of the reason they are seeing a lot of cut that are currently taking effect. the other side of that the argument that insurance companies make is that even on traditional medicare seniors generally have a lot of supplemental coverage. they buy additional coverage outside of medicare to help pay for certain other benefits that the program doesn't cover. medicare advantage often

includes the -- that's that so am i, higher price but at least sometimes you get her coverage for that price. >> host: a question from twitter. david larsen writes please explain how medicare advantage had a subsidy increase last year. my plan has no premium and some co-pays went down for 2014. >> guest: it's a program that has been staying pretty affordable. medicare part d. the privately administered section has as well. that's prescription drug coverage of course so you are not necessarily seeing these cuts translate into benefit cuts for seniors just yet which the administration can point to and argue well this means you can absorb another cut or two before we start and seniors. >> host: next up state college pennsylvania galas on our republican's line this morning. >> caller: hi good morning. i am also have a degree in health care administration. i see huge problems with the

health care act taking place. i think basically the bottom line is a kickback to the insurance companies however physicians aren't going to florida to get the best treatment that they possibly can to a patient when they won't get reimbursed for that particular type of care. therefore what we have done in my opinion is we have decreased our level of care. we are sorry you can't have this because we can't afford it. we can't pay you and therefore it's not covered underinsurance so we are just not going to do it. the doctor is going to guesstimate the problem. that is my main concern with basically the health care in general right now. as we are decreasing the kick back to everybody involved our

hairs -- health care is becoming more of a third world health care. it's a huge concern. thank you. >> guest: this is something else that the affordable care act tries to take steps in this direction and there's a broader push within congress to change the way that medicare pays doctors, hospitals and other providers and to shift away right now you get paid if you are a doctor or a hospital freight service that you provide so one test to get paid for that and another test to get paid for that. that is i think what the caller is referring to and there is a shift to try to say say this isn't a good way to have our payment structure set up. maybe it would make more sense to pay based on the health of the patient so together as a team of providers appear patient is healthy at get paid a little bit more and if you're patient comes in with some particular problem rather than paying for

the x-ray in the consultation and then for the drug we are just going to pay you one lump sum to make that patient healthy. >> host: sam baker "national journal" we are hearing doctors are being dropped from his program. why is that? >> guest: that is a step insurance companies are taking as they see their payments from the federal government come down they are pushing out providers and doctors who cost them more so it's a way for them to sort of absorb a payment cut on there and without directly cutting the benefits that they offer seniors. you are seeing some doctors suing trying to get back into medicare advantage networks so a doctor and should -- suing an insurance company even though they are protesting the same thing. >> host: let's go to pompano beach florida where stephen is on the line for democrats. >> caller: okay.

>> host: go right ahead you're on with sam baker from "national journal." >> caller: yes, thank you. i'm wondering and i think that this was already answered when do these cuts actually take place? have they taken place already? >> guest: so they are phased in over a number of years and some have taken effect and some have yet to take effect. what you are seeing insurance companies lobby on right now are possible cuts that could take effect soon for next year. this is sort of the time of the year when the medicare agency decides what its payment rates are going to be irrespective of the cuts included in the affordable care act so that is what you are seeing. >> host: let's take another call. next up is brenda. she is in tallahassee, florida on our lines for republicans. >> caller: yes, i'm a senior citizen and i'm on medicare advantage and i can tell you that from day one when obama got

in 20081 of his first speeches was i'm going to get rid of medicare advantage. i will tell you why. because it's a good deal for the people. it's a good deal for senior citizens and obama wants to make sure that retirees have to work right on into their 80s. this provides more income for all the welfare clients, okay? but i want to tell you taipei $130 a month for medicare for my medicare advantage. i have had my heart worked on. my heart was worked on prior to being on medicare advantage. i was under -- prior to medicare advantage. that was $97,000 work of -- worth of work done on my heart. and then a year ago i was diagnosed with breast cancer and

that was under the medicare advantage. the medicare advantage my treatments without insurance for $700 for the radiation. after all was said and done what i owed, the total amount that was due for me was $3200 which i paid. that was the out-of-pocket that i was made to pay. but i think that obama and pelosi and harry reid would like to see all the senior citizens just work right up to their death so that we continue paying in through fica taxes for all the welfare clients they get free medicaid and free food stamps and free housing and help on their electric bills.

this is where our obama stands. >> guest: you are hearing partially the point that insurance companies are making which are people that medicare advantage generally like it. it is a very popular program. seniors who get their coverage through medicare advantage generally rate the program pretty well and at the point that insurers are making these ads like the one we saw before is that if you cut this program enough those cuts will trickle down to seniors so i think that is with the callers getting at. out. >> host: geraldine is on our line for democrats. >> caller: hi. >> host: hi there. >> caller: hi. i am calling about. hi. i was calling in about the affordable care act. i tried to apply for it a couple of weeks ago and they told me

that i had to make at least $11,000 before i could even apply for it. now i was one of those that i was -- unemployment shut down. i have worked for 36 years. i am 59 years old now and i have been out to look for a job. i just cannot find one. i tried to get food stamps and i was told that i can only get it teen dollars for a whole month. i just want to know, i mean i have no income now and i just sit and wait to see if they are going to put our unemployment back. after working 36 years you would think that i could get unemployment at least for a year. thank you. >> guest: on the health care

part of that, this is a real problem with a lot of people of cross the country running into because of the supreme court's decision upholding the affordable care act there is at big discrepancy among the states about whether they are expanding their medicaid program. so you are having some states expand medicaid and obamacare subsidies kick in on top of that but in the states that don't expand medicaid you have this gap of people who truly are being told that they are too poor to qualify for subsidies intended for low income people. so this is the administration's argument in trying to persuade more governors to take up to, to accept the affordable care act medicaid expansion is up for the argument has been somewhat successful. i believe the expansion has been expanded in 25 states but there's obviously a lot of work to do in real people do fall into that gap. >> host: we have had a lot of seniors colin and i'm curious we think the overall impact the aca

has been on seniors specifically with population. >> guest: is probably a little bit too early to tell. there are some reductions in medicare advantage but there are also new benefits added to medicare. the doughnut hole that we have heard so much about her so many years and prescription drug coverage is being closed. there is a new benefit for preventive care that has been added and the lifespan of the program has been extended as we said earlier. so right now i would say it looks like a plus again there is an argument to be made that as you reduce these payments your doctors will want to provide fewer services. >> host: the next caller is johnny and albany georgia on our line for democrats. >> caller: yes, i just wanted to call and talk about medicare. in my point of view medicare advantage is another form of welfare and that's all it is because i am 79 years old.

every senior citizen pays the same amount into a social security program and the medicare program and those people who are on medicare advantage that is what they get, the advantage. they don't have to have a secondary to pay that 20% that medicare does not cover. myself, i have to have it because i'd wouldn't go around saying that i don't like welfare when i was except being welfare on medicare advantage. the lady from north carolina she is asking for welfare. it's just welfare and that is the way should explain it. it's welfare. >> guest: medicare certainly is you know in sort of the parlance of government reports and entitlement program.

it is something that seniors pay into and the government also funds so it's a publicly funded insurance program you know and i think one of the arguments against medicare advantage who are for medicare advantage cuts are a lot of them feel it is costing too much costing extra for pretty much the same care that it's you know in a sense welfare for insurance companies. obviously insurance would reject that assertion and as the caller said would point out that medicare advantage does offer a lot of benefits that traditional medicare doesn't create. >> host: sam your article focuses on something called risk corridors and you write those are part of a three-pronged safety net designed to stabilize the insurance marketing case the aca enrollment work so differently than expected. walk us through your piece and what you found. >> guest: this was i was then asked actively a flashpoint that has flared up over the

affordable care act in the past couple of weeks. risk corridors are part of what are called the 3r's including risk corridors. because the affordable care act created new insurance markets insurers sort of had to guess who is going to sign up when they said their premiums. we think people are going to be about this old and about this healthy you know, all these different factors that they take into account. risk corridors are there in case they guess wrong so if they were too conservative and they end up with a much better than expected experience in real life they pay into a fund. if their experience was worse than expected they take money out of e-fund so because of part of that equation to take money out of the fund we have seen several republicans led by senator marco rubio from florida calling this a bailout or insurance companies. it is now to appeal the risk

corridors even there was a similar program included in the medicare prescription drug benefit in all sorts of other previous forms of insurance that the federal government has undertaken. they have unexpectedly become controversial. >> host: let's take another one of your calls. in marion indiana. >> caller: good morning. my husband was disabled prior to age 65. in indiana he couldn't take a medicare supplement. it wasn't available. we weren't eligible for medicaid we can't go on the affordable care act exchange because we are eligible for medicare so our only option is medicare advantage. we do pay a premium for that plan. i mean there was nothing else available. if they were to do away with that i don't know where that leaves us. so that is my comment. >> guest: again that gets back to this point that medicare

advantage stepping back traditional medicare doesn't cover everything. almost every senior who is on traditional medicare needs some form of supplemental coverage and a lot of medicare advantage plans build of supplemental coverage into their plans so they do offer benefits which the other doesn't. >> host: a couple of questions from twitter. peg writes are insurance companies for medicare advantage limited by profit caps and aca? >> guest: that's a good question. the provisions of that question is referring to is something that doesn't direct recap insurance companies profit that of the premiums you bring in you have to spend 80% on medical care and that leaves only 20% ford ministry that costs and profit. >> host: another question. on the average american how much doomed medicaid advantage insurance companies get paid for each and raleigh and is that the

capitatiocapitatio n rate? >> guest: the actual dollar amount depends on a lot of things. in the past their payment rate has been, various studies have put at between 17117% of what we pay for traditional. >> host: next up incorporated eastport illinois at us on the line for independents. >> caller: yes, my question is if obama would have let's medicare alone instead of taking the money out of medicare to get obamacare going medicare would be as in better shape. i had medicare and i had my supplements. now i have been put with humana medicare and they have taken away my supplement. you tell me how the government can stick their noses in and try to run our people out. we have more sense than they have got. >> guest: well, if the

administradministr ation had left medicare alone the medicare trust fund which only funds part of the program according to the program's trustees would have become insolvent i believe in eight to 10 years sooner than it scheduled to now. some of these cuts have actually extended the life of the program. it's one of those things, medicare is very expensive and it's a big chunk of the federal budget so you can spend less money now and make the money last longer or spend more money now but it won't last as long. that is clearly the trade-off that policymakers have to make create. >> host: in orlando florida deborah's on the line for republicans. >> caller: hello? >> host: hello you are on "washington journal" with sam baker. >> caller: hi how are you guys doing today? >> host: we are all right. >> caller: okay, my father, my

grandfather was on medicare for a very very long time. he actually recently passed away now all those medical bills that he had medicare never covered. they never covered any of those bills. now i want to know because my mother, if my mother can be on this medicare advantage plan without any kind of deferment or anything like that and if it would affect her at all because he was on medicaid and yet none of the bills paid? >> guest: medicare advantage in gnome they sell different plans in different states so would depend on your particular circumstances but these are privately administered plans that are sold again as a supplement to traditional medicare. >> host: to new york next della is on the line for democrats. >> caller: yes, let me make

something clear. medicare is funded by the government. medicare advantage is funded by private insurance companies. medicare does not cover dental and does not cover eyewear, restriction eyeglasses. along comes the insurance companies like humana and others and they say let us take care of it. give the money to last and we will cover the glasses and we will cover the dental. so this is what is draining medicare. the medicare advantage program funds, you pay places like humana and they are supposed to cover the dental and eye care. medicare was never meant to cover it. medicare part a and b covers your business with the doctor in your hospitalization but does not cover i care and does not cover dental.

this is why i say to these people who are calling in saying that medicare benefits were cut, they were cut if you have a private insurance company who promised to cover what they were never meant to cover. >> guest: that's right very the point we have been making medicare advantage, one of the selling points that it has is that it covers traditional medicare -- what traditional medicare does not including dental and vision. again that's the point that insurance companies are making. you're hearing both sides of that here with the calls. seniors like the program. the program covers additional things and it is more expensive but people get more for it is the argument. >> host: let's go back to twitter period smith writes i have heard experts argue that we could raise revenue for medicare by lowering the age and getting more healthy adults. comment? >> guest: that idea was something that the president had

briefly looked at and congressional republicans had too. that's pretty much off the table now. the congressional budget office said the savings are doing that would be pretty negligible and it's unpopular enough and not worth the limited amount that would save. >> host: next up is jerry in rochester new york on the line for republicans. >> caller: good morning. this discussion has been very interesting. i have been following medicare advantage and i've been a medicare advantage member for 10 years now and i find it very very cost-effective. i guess my question is medicare always promotes a very low administrative rate in the single digits and i believe senator, -- tom coburn who said that doesn't cover the waste fraud and abuse in regular medicare. greg is medicare advantage is

run by insurance companies and they might have a higher administrative costs let's say 15% versus 5% for example. they probably have a rate close to zero for waste, fraud and abuse carried anyway just to finish this i live in rochester new york. about two-thirds of the seniors in rochester are covered by two very excellent medicare advantage programs run by quote unquote nonprofit insurance companies. i would just like to hear your comment about the cost effectiveness of medicare advantage and also the outcomes. are the outcomes better and is more cost-effective than regular medicare? thank you. >> guest: so this goes back to that same debate that insurers have been having with the federal government. it insures say we are providing better services and we are better able to prevent waste

fraud and abuse instead of just going after it after we think it has happened which is how medicare approaches things. the federal government says you are still providing pretty much the same service although you have a couple of additional things thrown in there. it's basically still medicare at its core. we are paying you more than the amount we have spent on medicare so i don't think that question has been definitively answered. >> host: matt in concord new hampshire is on our line for independents three at. >> caller: hello. i really enjoyed the segment. i am disabled and i've been disabled due to an industrial accident. i've been on disability long time and i'm currently 55. ever since i was disabled in my mid-40s i have had to pay a premium of 84 euros no matter what supplemensupplemen tal insurance i die. because i was disabled number one i take a lower percentage of

my social security in my monthly check. it reduces the amount because i was disabled before retirement and secondly every sure inside by, supplemental there are many kinds of supplemental just a medicare advantage. i have no deductibles and no co-pays and everything is paid with my medicare. i never get a bill so i'm happy with it. it cost me a little more but the one thing that most people lose and they lose this rapidly because they never see it, anybody who receives social security, social security disability, supplemental disability, they receive a check from the government. they pay $108 or $140 a month out of their check for medicare. not only if we paid into it our whole life we continue to pay for it. between my medicare payment which i never see because they take it before i get my check of

$140 in my 300-dollar a month premium for my type fmat plan so i have noticed a vileno co-pay but the thing everybody misses here all these broad differencey state has an insurance commissioner. those insurance commissioners are regulated and controlled by the state. this is why people have trouble selling insurance over state lines. i guess i would really like to hear more diversity and the plans that are available and as one caller questions, cost efficiencies, the efficiencies. all the different programs. but the one thing that nobody has ever answered because i am under 64 and on medicare and i have a supplemental wide-awake pay the rate of an 84-year-old? >> guest: welfare are a couple

of things. one to the caller's point about state insurance commissioners and insurance markets that is exactly right. that's something that the affordable care act attempts to get at. you built a new insurance exchange and this is for private insurance coverage not medicare, in each state. and the law tends to sort of create competition and increase competition by bringing more insurance companies and more plans and therefore more choices into each state. and at the same time it prohibits insurance companies from charging people more in coverage because of her pre-existing condition that they might've had whatever that is, general diabetes and that sort of thing and that's illegal now. >> host: we have joined by "national journal" sam baker.

thank you for joining us. >> guest: thank you. >> i've often said that when i'm traveling on amtrak that i run, not walk to the quiet car. but what this i believe and i know will provide for consumers and that already has on some airlines is more opportunity for data rich engagement. it will open up the market for more competitors to provide options so hopefully it will be over the long term less expensive for those engaged. when you look at the international ecosystem when it comes to this i have been told by those in the business at that 90% of engagements is data only. so a very small part of it is conversation and what is also great is it's up to the carrier, up to the airline to permit the type of conversation.

>> i think it's all an evolutionary process. you are never comfortable with your eyes pushing for change and growth not just in yourself with the issues that you care about. you have never done it so there's never a point in time we feel like there are, i am now here and i can do this the same way all the time. it's always changing. scotland will hold a referendum in september to decide whether or not it wants to separate in the united kingdom. ridge prime minister david cameron delivered a speech recently urging scotland to stay in the u.k.. he also took a few questions from the audience. this is about a half an hour. [applause]