look at the state of connecticut, there is a story in "the new york times" just last month about the impact of this law that my colleague and friend has voted for that has now been changed over two dozen times where they're interviewing a superintendent of schools in mariden, connecticut. we've just heard a story of somebody helped by the law. now let's look at the superintendent of schools in mariden, connecticut. he's also an soefrpblt he said in an interview. the new health care law was having unintended consequences. let's see what happened to school systems across the country. maybe they have children in school. i don't know. in connecticut, it says, as in many states, significant numbers of part-time school employees work more than 30 hours a week and do not receive health benefits.

well, you know the health care law, mr. president, defines a workweek as anything above 30 hours. so they have people that are working part time but more than 30 hours, so according to the health care law, those are full-time employees. so they work more than 30, do not receive health benefits. and he says are we supposed to lay off full-time teachers so that we can provide insurance coverage to part-time employees? that's a question asked by the superintendent of schools in a town in central connecticut. he asks, if we have to cut five reading teachers to pay for the benefits for substitute teachers, i'm not sure that would be best for our students. so the impact of this health care law and the mandate and the costs go way beyond the health care of an individual or a family or a community. it goes to so many other things,

including the education of our young people. and that are the trade-offs and unintended consequences of the health care law when we passed 2,700 page law. whether or not they allow more people to sign up, my concern as a doctor is what kind of care are they going to get? are they going to be able to keep their doctor which the president promised? the deadline date is less important than the kind of care people can get for the health care they are mandated to buy and pay a lot more than they would have paid had the law had not been passed? will they be able to keep their doctor? will they be able to see their doctor. we know there is a shortage of 90,000 physicians, half specialists coming in the next five or six years. we know the things happening along those lines with not enough nurses, not enough

physician assistants, not enough paramedics across the board, not enough people to take care of the people in this country. having insurance isn't enough to provide care, and the president made promises that are not being kept. and that's the concern i have when i hear that the deadline is extended. my concern is what happens after they sign up. will they be able to get the care they need? the associated press last week reported that, polled all these different cancer hospitals -- my wife is a cancer survivor. i know how important it is for people to be able to have the peace of mind to get the care they need. of the 19 hospitals that responded, only four of them, only four of the 19, to the associated press, said they won't be able to accept all the plans for the people who are signing up on the web site in those states where those hospitals are located. so it's not just a matter of keeping your own doctor. it's getting the doctor you need at a time of family crisis,

personal family concern, the times when people are most vulnerable. and yet, the fact that they have some coverage bought through a web site, will that actually help them get the care they need? and will the doctor who happens to see them, even if they are able to keep their own doctor, be able to spend the time interacting with the patient or with all the additional paperwork and time consumption activities? will the doctor have to cut the visit short, spend time looking more at the computer screen than looking at the patient? and there are complaints in every state of the union, mr. president, i will tell you, from patients who are complaining either to their doctors or the nurse in the office or at the checkout area of the office to say, you know, i would have liked to have the doctor look more at me and not look so much at the computer screen. there are so many components of this health care law that are harmful to health care delivery and to patient care in this country. so the president decides to

unilaterally delay a part of the law that this last week or the week before the secretary of health and human services says will not be done. this is the deadline. this is it. when is the law not the law anymore? when is it just swiss cheese? when do you trust somebody, take them at their word? words have meanings and it's time for this president and this administration to actually realize that the american people see what's happening, and each time they do a delay or do a change or do this or that, that has a huge impact on people's lives as they try to decide what to do and what matters and what doesn't matter under this administration. people are very, i think, disappointed as a result of the health care law, those who are looking for something better, they haven't found it. we still don't know how many people actually have paid for insurance. we may know how many went to the web site. we don't know how many of those

who bought insurance through the web site actually had their own -- got one of those letters, the five million people that got letters of cancellation, how many of those were canceled and how many were uninsured. it looks like the web site doesn't even want to look into that. on the paper application there is actually a box to check off. it says, you know, i didn't have insurance but now i'm going to get it. the web site left that off. i don't know if that was left off or if it fell through the cracks in the disastrous rollout. i don't know, but it wasn't there. so the administration which said our goal is 30 million people of people did not have insurance, getting them insured, the administration will never know the answer to that. and then the question, how many of these are really -- who are these folks in terms of young or old, sick or not sick, and we know of those eligible only about one in ten has signed up. and the big concern, regardless of some of these things that the president is doing to delay this

and let others are sign up or not sign up for a bit of a time, my concern is what kind of care are they going to get when, whether they were insured through the web site this week, next week, the week after that, what kind of care is going to be available to them when they find the costs of the care for so many people i hear from in wyoming is much, much higher than they were paying before, if they had a policy that they liked or are still finding they didn't have insurance, that for many of them they still think that the rates are unaffordable. thank you, mr. president. i yield the floor. i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

quorum call: a senator: mr. chairman? the presiding officer: the senator from louisiana. mr. vitter: thank you, mr. chairman. i ask unanimous consent to speak for up to ten minutes. the presiding officer: the senate is in a quorum call at the moment. mr. vitter: excuse me, mr. chairman. in that case, i ask unanimous consent to end that quorum call. the presiding officer: without objection. mr. vitter: and to be recognized for up to ten minutes. the presiding officer: without objection. mr. vitter: thank you, mr. chairman. mr. chairman, i come to the floor again to try to move

forward on a bill with near unanimous support. in fact, with regard to the actual substance of the bill within the four corners of the bill, it has unanimous support, because it would advance 27 community-based health care clinics for veterans in the v.a. system immediately. 27 around the country would serve hundreds of thousands of veterans in communities that absolutely need this type of expanded community-based clinic. two are in my state, one in lafayette, one in lake charles, louisiana. now, all of these community-based clinics, including the one in lafayette, including the one in lake charles, have been fully authorized by the v.a. and throughout the process. they have been on the books. we have been planning on them and moving forward with them for some time, but they have hit a series of bureaucratic glitches.

for the lafayette and lake charles facility in particular, first they hit a big v.a. glitch when the v.a. screwed up, and that's their words, not mine, just screwed up in the letting process to put out contracts to locate land and to build or lease these facilities, and because of that bureaucratic mistake, the v.a. lost a whole year in the process in terms of moving forward with these clinics which are fully approved, fully authorized. then during that year of delay, then out of the blue, c.b.o. decided to score how these clinics are financed differently than it ever did before. i won't go into the weeds, but, mr. president, suffice it to say that under this new scoring method, it created a scoring issue which it never did before. well, then that was an additional hurdle, an additional

point of delay that we had to respond to. we overcame that, mr. president, with a proposal that ensures that the v.a. funds and handles this correctly so that there is no scoring issue, and that bill passed the house nearly unanimously. in fact, that vote in the house was 346-1. now, mr. president, as you know, not many things pass either body near unanimously. that did. very, very widespread bipartisan support, 346-1, and that is the bill that has come over here to get final approval. with the addition of an amendment to help pay for any costs associated with that bill, and that amendment has been fully vetted. it's supported in a bipartisan way. with the addition of that amendment, we have no opposition here in the senate on the actual

substance of my proposal, on moving forward with these 27 important v.a. clinics around the country, two of which are in louisiana. unfortunately, the only objection that appears to reside here in the senate is from the senator from vermont, senator sanders, who does not object to this bill as amended, who does not object to the substance within the four corners of this bill, who simply wants his much bigger, much broader v.a. bill passed. well, i applaud his passion to advocate for that, but there is significant concern with that much, much bigger, much, much more complicated proposal. there are 43 senators, including myself, who have very significant concerns about that proposal, and i think it's really unfortunate for him to block something where there are

no concerns, it's been vetted, it has bipartisan support. every conceivable substantive issue has been worked out. simply to hold that as hostage for a much broader bill that has concerns and poogz for almost half of the senate, 43 senators. and so i hope we can avoid that, mr. president. i come to the floor to ask for that unanimous consent. i think the american people want us to work together. i think the american people want us to agree on things we can agree on. there is lots to fight about, there is lots to wrestle with, there is lots to disagree about, and we should work on that stuff, too, toward an agreement, and i'm open to doing that with senator sanders, but in the meantime, i firmly believe that the american people want us to agree where we do agree. don't create disagreements that don't exist. they want us to move forward where we can move forward.

they want us to make progress where we can and keep working on the rest. and so, mr. president, i ask unanimous consent in that spirit that the veterans' affairs committee be discharged from further consideration of my bill, h.r. 3521, and the senate proceed to its immediate consideration, that my amendment which is at the desk be agreed to and that the bill as amended be read a third time and passed, the motion to reconsider be laid upon the table. the presiding officer: is there objection? mr. sanders: reserving the right to object. the presiding officer: the senator from vermont. mr. sanders: mr. president, i appreciate the interest that my colleague from louisiana has on this, in fact, very important issue, and i agree with him that we want to expand v.a. health

care, that we have run into a bureaucratic morass. there are 27 facilities in 18 states that can and should be approved, and if the senator from louisiana is prepared to join with me, we can pass his concern today or within the next couple of weeks, along with many, many other provisions that the veterans' community is deeply, deeply concerned about. mr. president, during the last government shutdown, it's not widely known but the truth is that we were seven to ten days away from a situation where veterans, disabled veterans, veterans who have pensions were not going to get their benefits.

the comprehensive bipartisan legislation that received 56 votes here on the floor, unfortunately not the vote for my colleague from louisiana but 56 votes, and we are working to get the 60 votes we need to overcome a republican point of order, and we are going to get those 60 votes, make sure that we do have advanced appropriations, so that no disabled veteran will not get a check in the event of another government shutdown. my colleague from louisiana may or may not think that's an important issue, i don't know. i think it's an important issue, and i can tell that the reason that the legislation that i introduced has the support of the american legion -- and by the way, 500 of them were here this morning at a very interesting hearing. it has the support of the v.f.w., of the d.a.v., of the vietnam veterans of america, of

the vague-afghanistan -- iraq, afghan veterans of america. virtually every veterans organization because they understand that the veterans community has very serious problems that we have got to address. my friend from louisiana may or may not have concerns about making sure that every veteran gets their benefits in an expedited way, that we don't have this backlog. our legislation addresses that. my friend from louisiana may or may not be concerned that there are veterans who want to take advantage of the post-9/11 g.i. bill, of which over a million people are now taking advantage of, are having problems not being able to get in-state tuition. our legislation addresses that. our legislation for the first time makes sure that dental care will be part of v.a. health

care. our legislation addresses the reprehensible situation faced by many women and men in the military who have to deal with sexual assault. we think they should get the care that they need. and on and on and on. so we have a comprehensive piece of legislation supported by virtually every veterans' organization in this country. we received 56 votes. one person was absent who would have voted for it, 57 votes, and we are now working with some of our republican colleagues to make sure that we get the 60 votes. and i say to my colleague from louisiana, work with us. bring some of your other colleagues aboard. please don't tell me that this is too expensive. if it's too expensive to take care of our veterans, then let's not go to war in the first place. so i -- mr. president, i would

give my colleague from louisiana the opportunity now to do something really extraordinary, to do something that the veterans' committee wants. and, mr. president, with that, i object to my colleague from louisiana's proposal, and in its place i ask unanimous consent that the senate proceed to the consideration of calendar number 297, s. 1950, that a sanders substitute amendment, the text of s. 1982, the comprehensive veterans' health and benefits and military retirement pay restoration act be agreed to, the bill as amended be read a third time and passed, and the motions to reconsider be considered made and laid upon the table with no intervening action or debate. we pass this right now, we deal with the senator's concerns and a lot of other concerns. the presiding officer: the objection is heard to the request of the senator from louisiana. is there objection to the request from the senator from vermont? mr. vitter: yes, mr. president. i object on behalf of 43

senators, including myself, and so reclaiming the floor and reclaiming my time, mr. president, you see we all want to work very hard to help veterans. we all acknowledge that these health care and claim backlog issues are extremely important. that's why i am very involved in all of those issues across the board. that's why, for instance, i'm an active member of the claim backlogs working group that's working with the v.a. to improve that situation and proposing focused legislation. we all care very much about that. but right now, senator sanders' comprehensive bill has significant concerns and opposition. 43 u.s. senators, over 40% of the whole body. i do object on behalf of myself and the rest of those folks. i do commit to continue to working on those issues, but i

also stress real regret that when this body is very divided on the important details of that bill -- and the details do matter, that we don't come together on something we agree on. we can't accomplish a few important steps at a time. now, perhaps senator sanders thinks if we do this, somehow it takes away momentum for his larger bill. i think that's nonsense. these 27 clinics in 18 states, they are important, but they are a trivial part of that broader bill. they are a trivial part of all of the proposals in that broader bill. i don't think it takes away any momentum in any way, shape or form for that broader bill. i'll continue to be just as committed and just as interested to v.a. health care issues and working down the claims backlog and everything else.

these clinics are a tiny part of that. so he doesn't lose any advantage. he doesn't lose any momentum. but we could move forward on something we do agree on and build from there, and i think that is more reasonable, and i think that is more constructive. there is literally no disagreement among any of us in this body about these clinics. i have worked hard with several other colleagues to address every question and every concern out there. the amendment at the desk erases some of those concerns. we have covered the waterfront on this clinic's issue in particular, and i am really disappointed that we can't move forward as a first step and agree on what we agree on. we disagree on enough. let's agree on what we agree on.

let's move forward on what we agree on and pass these 27 clinics and start that progress and certainly continue to work on an important compromise on the much bigger piece represented by the sanders bill. thank you, mr. president. i yield the floor. the presiding officerz the majority leader. mr. reid:, mr. president, the junior senator from wyoming has come to the floor several times recently talking about the fact that examples that he and other republicans have given dealing with obamacare, examples that they think are bad, i've called lies. mr. president, that is simply untrue. i have never come to the floor to my recollection, i never said a word about any of the examples that republicans have given regarding obamacare and how it's not very good. but i have come to the floor and

i think my friend, the junior senator from wyoming must be getting mixed up, what i've said about the koch brothers and what they've done regarding health care. but it's easy to get mixed up because i think it's hard to separate the koch brothers from the republican caucus anyway. now, mr. president, i've asserted and i'll continue to assert that the koch brothers are trying to buy america. and they're doing it in a number of different ways. they don't believe in social security, they don't believe in minimum wage, they don't believe in benefits. unemployment benefits. they don't believe in environmental laws. as you know, read in the paper they have a chemical plant, they were fined $100,000 over the last week or ten days in order to pay $50 million to bring it up to standard because it was deleterious to people's health in the area. the koch brothers are running

false and misleading ads all around the country against democratic senators dealing with health care. do they care about making health care better? of course not. these are false and misleading ads and they have gone so far to have actors pretending they're from the states and they not only have done that in one state, they use the same actor in different states. so the record should be very clear, yes, i have called many if not most of the anti-obama ads by the koch brothers false and misleading, because they are. i have 12 requests for committees to meet during today's session of the senate, they have the approval of me and senator mcconnell. i ask these requests be agreed to and printed in the record. the presiding officer: without objection. under the previous order, there are now two minutes of debate equally divided prior to a vote on the cooper nomination.

all time is yielded back. is there a sufficient second? there appears to be. the clerk will call the roll. vote:

vote:

vote:

the presiding officer: are there any senators in the chamber wishing to vote or change their vote? if not, the yeas are 100, the nays are zero. the nomination is confirmed. under the previous order, there are now two minutes of debate equally divided prior to a vote on the harpool nomination. mr. leahy: madam president? the presiding officer: the senator from vermont. mr. leahy: i yield back all time. the presiding officer: without objection, all time is yielded back. the question is on the nomination. is there a sufficient second? there appears to be. the yeas and nays are ordered. the clerk will call the roll.

vote:

vote:

the presiding officer: any senators wishing to vote or to change their vote? seeing none, on the matter the yeas are 93, the nays are 5. the nomination is confirmed. under the previous order there are two minutes of debate equally divided prior to a vote on the mchugh nomination. without objection, all time is yielded back. is there a sufficient second?

there appears to be. there is. the clerk will call the roll. the yeas and nays have been ordered. votes:

vote:

the presiding officer: does any senator wish to vote or to change his or her vote? if not, the yeas are 59, the nays are 41. the nomination is confirmed. under the previous order, there are now two minutes of debate equally divided prior to a vote on the smith nomination. who yields time? is there a sufficient second? there is. the yeas and nays are ordered.

who yields time? without objection. all time is yielded back. the clerk will call the roll. vote:

vote: