assistantshipship but paid for the rest with loans. to compound the problem her husband, another university of illinois graduate student in education also has student loans. together, she and her hurricanes now that they've completed their grease, have a debt of $150,000. one wants to be a social worker. the other wants to be a teacher. now she worries about how her family will be able to cope with debt three times what any annual salary will be that she might receive as a social worker. the irony is chai even as a college degree becomes harder to afford for the middle class, it is more important than ever that people get educated and trained for workers. if you don't go the college route, your chances of success are diminished dramatically. that's why we want to address these serious issues. this bill that i'm talking about -- the one that'll be introduced tomorrow -- will give students

with college student loan debt who are current on their loans an opportunity to refinance. i talked to mbenti and other students that meant for her that her interest rate would come down from 6.8% to 3.8%. if you've ever gone out to get a mortgage, they'll explain to you that 3% of your interest rate is a big deal. if can you get your interest rate reduced 3weu%, your chances of paying off the principal are going to be a lot better. -- the principle are going to be a lot better. this bill that i cosponsored is called banklands emergency refinancing act. it will help the refinancing of loans into these lower interest rates. under the warren bill, those are private loarntion many of which

are have sky-high interest rates rand facing collection agencies, request refinance into federal loans with lower rates, stronger consumer protection. refinancing incidentally is fully pad for. this is a point i want to make because this is where we lose the other side of the aisle. this is where we can't find bipartisan cosponsorship for refinancing college loans. here is how we pay for it. most of us are familiar with the name -- i ask for two additional minutes, without objection. the presiding officer: without objection. mr. durbin: most of us have heard the name warren buffett, one of the wealthiest men in america. he raised a question a few years ago. why in america is my income tax rate as multimillionaire lower than my secretary's income tax rate? well, there is an slangs in the tax code but it isn't a very good one. he said, i should be paying more than she is paying. and so we've come up with something called the busts rule

which says if you're in the multimillionaire category, you're going to pay a higher interest tax rate than your secretary. what a radical idea that is. i'm just kiddie. the problem is that we go to the other side of the aisle and say we want to refinance college loans, we'll put in the buffett rule so that millionaires pay more in their income taxes. they say, we don't want any part of it. we will not increase taxes on anybody. by taking that position, they're sticking 44 million americans with college loan debts at higher interest rates and all the problems the they nen rate. what's better? that millionaires pay a little more so that working families across america have a fair shot at paying off their college loans? or just saying, we're not going to cut the tax code for any reason whatsoever and isn't it a darn shame for these students and their families? well, it is pretty obvious to me what we should be doing.

i met cheyenne pishard last week at illinois state university. she graduated with a teaching degree and about $30,000 in student debt. she has got a job, will be teaching at the public schools in eureka, illinois usm a first-year teachingal is were i an upcoming wedding, her student debt will be a burden. if she is allowed to refinance their loan, which she took out as 6.8%, she could cut her interest rate obama in half. tomorrow when this legislation is introduced, i hope anyone who has a family, whether they borrowed money for college, who has a son or daughter deep in debt, contact your senator or your congressman and ask them, are you going to part of this college student refinance effort? i hope they'll say yes. i. wmr. president, i yield the floor.

the presiding officer: under the previous order, there are two minutes of debate prior to a vote on confirmation. mr. durbin: i ask consent to yield back all time on the pending nomination. the presiding officer: without objection. question is on the nomination. a senator: i ask for the yeas and nays. the presiding officer: the yeas and nays have been called for. is there a second? there appears to be a second. the clerk will call the roll. vote:

vote:

vote:

the presiding officer: the senior senator from michigan. mr. levin: on this vote, i have

a pair with the senator from new jersey, mr. booker. if he were voting, he would vote aye. i would vote nay. i therefore withhold my vote.

vote:

the presiding officer: are there any senators wishing to vote or change their vote? if not, on this confirmation, the vote is 48 ayes, 46 nays. the nomination is confirmed. the clerk will report the motion to invoke cloture. the clerk: we, the asinine undersigned, in accordance with the provisions of rule 22 of the standing rules of the senate, hereby move to bring to a close the debate on the nomination of mark g.mastroianni of massachusetts to be united states district judge for the district of massachusetts, signed by 17 senators.

the presiding officer: there are now two minutes of debate equally divided prior to the vote. who yields time? is there objection? without objection, all time is yielded back. by unanimous consent, the mandatory quorum call has been waived. the question is, is it the sense of the senate that debate on the nomination of mark g. mastroianni of massachusetts to be united states district judge for the district of massachusetts shall be brought to a close. the yeas and nays are mandatory under the rule. the clerk will call the roll. vote:

vote:

the presiding officer: are there any senators wishing to vote or change their vote? if not on the motion for cloture we have 56 aye, 39 nay, the motion is agreed to. the clerk will report the noxghts. the clerk: nomination, mark t.

mastroianni of massachusetts to be united states district judge for the district of massachusetts. the presiding officer: 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 nomination of bruce howe hendricks of south carolina to be united states district judge for the district of south carolina signed by 17 senators. the presiding officer: there are now two minutes of debate on the cloture of the nominee. yield back the time, without objection. by unanimous consent the mandatory quorum call has been waived. the question is: is it the sense that debate on the nomination of house howe hendricks of south carolina to be united states district judge for the district of south carolina shall be brought to a close? the yeas and nays are mandatory under the rule. the clerk will call the roll.

vote:

vote:

the presiding officer: are there any senators in the chamber wishing to vote or change their vote? if not, the ayes are 59, the nays are 35. the motion is agreed to. the clerk will report the nomination. the clerk: bruce howe hendricks of south carolina to be united states district judge. the presiding officer: the clerk will report the noings voke cloture. the clerk: cloture motion: we, the undersigned senators, in accordance with the provisions of rule 22 of the standing rules of the senate, do hereby move to bring to a close debate on the nomination of tanya s. chutkan of the district of columbia to be united states district judge for the district of columbia, signed by 17 senators.

mr. reid: i yield back that time. the presiding officer: without objection. mr. reid: madam president, i can't hear. the presiding officer: order. mr. reid: i now ask consent that following the cloture vote on calendar number 733, chutkan, the senate proceed to consideration of calendar number 752, 753, and 754, and the senate proceed to vote on confirmation of the nominations in the order listed. further, that if confirmed, the motion to reconsider be laid on the table, with no intervening action or debate, that further motions be in order to the nominations and any statemented be printed in the record and the president be immediately notified of the senate's action. the presiding officer: is there objection? without objection. mr. reid: madam president, we hope and expect these three nominations to be confirmed by voice, so we expect the next roll call vote to be a final roll call vote of the day. that should get started in just a few seconded. the next series of roll call votes will occur tomorrow

morning at about 11 qulook a.m. -- at about 11:00 a.m. the presiding officer: by unanimous consent, the mandatory quorum has been waived. is it the sense of the senate that debate on the nomination of tanya s. chutkan to be united states district judge for the district of columbia shall be brought to a close? the yeas and nays are mandatory under the rule. the clerk will call the roll. vote:

vote:

vote:

the presiding officer: any senator wishing to vote or wishing to change their vote? if not, the ayes are 54, the nays are 40. the motion is agreed to. the clerk will report the nomination. the clerk: tonya s. chutcan of the district of columbia to be united states judge for the district of columbia. the presiding officer: under the previous order, the senate will proceed to the -- consider the following nominations en bloc. the clerk: commodity futures

trading commission, timothy g. massad of connecticut to be a commissioner of the commodities future trading commission. timothy j. massad of connecticut to be a chairman. j. christopher giancarlo of new jersey to be a commissioner. the presiding officer: under the previous order, the question is on the massad nomination. all those in favor say aye. all those opposed say nay. the ayes appear to have it. the ayes do have it. the nomination is confirmed. under the previous order, the question is on the massad as chair nomination. all those in favor say aye. all those opposed say nay. the ayes appear to have it. the ayes do have it. the nomination is confirmed. under the previous order, the

question is on the giancarlo nomination. all those in favor say yea. all those opposed say nay. the ayes appear to have it. the ayes do have it. the nomination is confirmed. under the previous order, with respect to those nominations confirmed, the motions to reconsider be considered made and laid upon the table and the president will be immediately notified of the senate's action. mr. sanders: madam president? the presiding officer: the senator from vermont. mr. sanders: thank you, madam president. madam president, as chair of the senate committee on veterans' affairs, i rise today to introduce the insuring veterans access to care of 2014, and i want to thank the 16 cosponsors of this legislation, and they are senators rockefeller, begich, shaheen, kaine, reed,

merkley, casey, whitehouse, blumenthal, heinrich, udall of new mexico, schatz, baldwin, wyden, hirono and leahy. madam president, it is safe to say that there is broad bipartisan agreement among all of us that every veteran in this country who enters the v.a. health care system deserves high-quality care and deserves that care in a timely manner. overall, talking to veterans in vermont and in fact throughout this country, talking to the veterans' service organizations who represent their interests and reading independent studies, they all confirm that by and large, once veterans get into the v.a. health care system, the system is, in fact, quite good. however, it has become clear

that all of us are aware of what has happened in the last month, it has become clear that while quality is generally good, there are too many veterans throughout this country waiting too long to access this care. in recent years, v.a. has seen a huge increase in its patient load. in fact, in the last four years, two million new veterans have come in into the system, many of them with very complicated health care cases, including posttraumatic stress disorder and many of the problems that older people, veterans generally have. despite this fact, it is still absolutely unacceptable that some veterans are forced onto long waiting lists for care, and it is totally intolerable, it is reprehensible that any v.a.

employee could be manipulating data in phoenix or anyplace else to hide how long veterans have been on waiting lists to see doctors. this is an issue that must be dealt with and must be dealt with rapidly and strongly. madam president, these problems are real, and they have to be addressed, but they should not be an excuse to walk away from a system that serves 6.5 million veterans every single year and 230,000 veterans every single day. this is a system that we must fix, not a system that we should ditch. we must focus on the underlying problems and work to transform the v.a., and i think in general what our legislation does is

three basic -- works in three basic areas. number one, we give greater authority to the secretary to fire incompetent senior officials. number two, we take very significant steps to shorten the wait times that many veterans are now experiencing. and three, we address the long-term health care needs of the v.a. in terms of a shortage of staff, doctors, nurses that currently exist in various locations around the country. let me just go through some of those issues right now. several weeks ago, my republican colleague from florida requested a vote on legislation that would allow v.a. secretaries to immediately remove senior executives due to poor performance, so let us be clear. i strongly support the effort to

make sure that we get rid of incompetent or worse senior executives at the v.a. there is no debate about that. but hears what the debate is about. i do not think it is a good idea to give the secretary of an institution, of an agency that has some 300,000 employees the ability to simply fire without any due process. what i worry about, madam president, is that you can move toward a situation where the v.a. health care system is politicized in a way that it should not be. let me give you an example. a new president comes in with a new secretary, the new secretary says, whether it's a democratic president or republican president, i want to get rid of them, 300 senior level

appointees, bring in 300 new people. four years later, another president comes in, different party. we're going to get rid of those 300 people, bring in 300 more people. i do not think that that provides the kind of stability that a -- that the largest integrated health care system in america needs or deserves. i worry about the politicalization. second of all, i worry about an instance where a whistle-blower stands up who is critical of this or that aspect of the v.a. that person could be fired without due process. i worry that there may be a situation where somebody is fired not because of bad performance or maybe they are a woman. somebody doesn't like a woman in that position. maybe they are gay. maybe they are black. maybe they are whatever. and that person does not have any ability to appeal that decision. i think that's wrong. i think that's bad policy. on the other hand, what i do believe is that person should be

taken out of his or her job immediately and that person must have the right to have an expedited appeal. what our legislation does is give the person a week to bring forth the appeal and gives the appropriate appeal body three weeks to make a decision. now, you're dealing with people who are m.d.'s, ph.d., high-level people whose professionalism is on the line, and i just don't think you can fire people willy-nilly without giving them a chance in an expedited manner to express their point of view. so that is one difference that i have with my colleague from florida on his proposal. now, let me talk a little bit about the major concern that i have, and that is how do we shorten wait times? how do we make certain that in those areas of the country where there are long waiting periods

or where veterans may be geographically a long distance away from a facility, how do we make sure that they get timely care? the legislation that i have offered takes immediate action to provide timely act assess for care for our veterans. first, this legislation would standardize v.a.'s process for providing non-v.a. care when the department is unable to provide care to the veterans within its stated goal. as d.a.v., the disabled american veterans, pointed out in a release today, v.a. must continue to be responsible for coordinating their care amongst various v.a. and non-v.a. providers. this legislation accomplishes that goal by providing a framework for consistent decisionmaking regarding non-v.a. care. under this legislation v.a.

would coordinate non-v.a. care by taking into account wait times for care, the health of the veteran, the distance the veteran would be required to travel, as well as the veteran's choice. this bill also addresses v.a. systemwide health care provider shortages. but in terms of the wait list, what we say in english is if there is an unacceptable wait time or if a veteran is a long distance away from a provider, we are going to allow and we must allow that veteran to get health care through a private provider, through a federally qualified community health center, through a department of defense military base if that's available, through an indian health service if that's available and that exists now in alaska and that might not be expanded. so bottom line here is if there are waiting lists beyond what is reasonable, the veterans in this country should be able to

get into non-v. health care in a timely manner and this bill does that. but importantly, madam president, this bill also addresses a very significant issue that i think we cannot ignore. and that is that it appears to me that in many parts of this country we simply don't have the doctors and nurses that we need when an influx of veterans are coming into the system. i just was talking to some very knowledgeable people today who are telling me about burnout, primary care physicians, psychiatrists are seeing more and more patients and turnover rates are much too high. the last thing we want to do is to see rapid turnover because people are burnt out and just don't have the time to do the quality work they want to do. let me quote if i can, madam president, an article that appeared in "the new york times" on may 29 which addresses this issue. this is what it says -- and i

quote -- "dr. phyllis hollen beck, a primary care physician took jock at the veterans affairs medical center in jackson, mississippi expecting fulfilling work and a lighter patient load than she had had in private practice. what she found was quite different. 13-hour workdays fueled by large patient loads that kept growing as colleagues quit and were not replaced. appalled by what she saw, dr. helenbeck filed a whistle-blower complaint and changed jobs. a subsequent investigation by the department of veterans' affairs concluded last fall indeed the jackson hospital did not have enough primary care doctors resulting in nurse practitioners handling far too many complex cases and numerous complaints from veterans about the late care. it was unethical to put us in that position, dr. hollenbeck

said of the unit in jackson. your heart gets good broken, end of quote. here we had a physician that wanted to do the right thing, wanted to spend the appropriate amounts of time with a patient. she was unable to do that. what we're hearing is in many parts of this country primary care physicians are just saying we can't do it. too many people are coming in. i think this is an issue that has to be addressed and our legislation does that. our legislation gives the v.a. the ability to rapidly hire new doctors, nurses and other health care providers in areas with identified shortages. it also enables v.a.'s ability to recruit qualified health providers by enhancing scholarship and loan repayment opportunities. madam president, as i know you well know because you're on the committee that deals with this issue, we have a crisis in this country in terms of the lack of primary care practitioners. this is a very serious problem.

there are experts who tell us, in fact, that we need 50,000 new primary care physicians in the next ten to 15 years. and this is a national problem, it is a problem within the v.a., and what this legislation proposes is that the v.a. work with the national health service corps in order to provide debt forgiveness, scholarships to medical school students so when they graduate they could get into the v.a. and practice the quality medicine that we need there. this bill also in addition to that addresses another issue that has been discussed a lot, i think there's widespread bipartisan support for that, support in the house as well and that is the authorization of some 27 major medical facility leases. in many instances these leases would improve access to care closer to home, it would

increase the availability of specialty care services in those locations. in addition, these would allow v.a. to decompress overutilized v.a. facilities. this is an important issue. i believe there is bipartisan support for it. that is in this legislation. furthermore, madam president, this bill would require the president to create a commission to look at v.a. health care access issues and recommend actions to bolster capacity. in the last couple of days i have heard a lot of good ideas out there about how we can deal with the issue, but we need a high-level commission of some of the most knowledgeable people in this country appointed by the president to report within 90 days some ideas about how the v.a. can proceed. so, madam president, i want to thank the 16 or so cosponsors that we have, i look forward to working with my republican

colleagues. we've got a problem, we have to address that problem, and i hope that we can do it in a bipartisan way. with that, madam president, i would yield the floor. a senator: madam president? the presiding officer: the senator from connecticut. mr. blumenthal: thank you, madam president. i am pleased to follow my friend and colleague from vermont, senator sanders, and i want to begin by thanking him for his leadership, his persistence and his perseverance in the face of resistance that should not exist. this cause ought to be one that galvanizes the nation and

perhaps it will since the nation has been appalled and astonished by reports of not only cooking the books but covering up that potential criminality, destruction of documents, falseification of records, secret waiting lists, delays that are unacceptable and untolerable for health care, basic, necessary health care that our veterans need. but these issues are long standing, decades old, in our veterans' affairs health administration. they are endemic to the system. in fact, they reflect systematic failing that are long standing in this system, and they need to be addressed with systemwide reform. i am strongly in support and proudly so in advocating the

ensuring veterans access to health care act that senator sanders has just introduced. it is a version of the omnibus bill and other measures that have been introduced. it has essential features that will provide better health care sooner, more accessibly to our veterans. it is necessary to pass. but it should have passed, these kinds of provisions, literally years ago. in fact, the very first piece of legislation i introduced in the senate, senate 1060, called honoring all veterans act, included a provision, for example, to deal with the shortage of doctors in this system. it included other health care-related measures to expand the availability and accessibility of health care. these problems, far from new, have been exist ebt -- existent for sometime, and the

cover-up, the lying and falseification of records is potentially now criminal, beyond a failure of public policy, it is a failure in integrity. i'm pleased to join senator sanders to make sure that the 9.3 million of the nation's 22 million who are enrolled in the v.a. health care system, which is up from about 2.5 million at the end of the first gulf war, have the kind of service they need and this bill will address some basic needs. it provides authority to remove senior executives based on poor job performance and preventing wholesale political firings. the legislation would provide veterans who can't get timely appointments access to private clinics and the option of going to community health care centers, military hospitals, or private doctors. and it would authorize the

veterans administration to lease 27 new health facilities in 18 states, including funds, for the enhanced lease for the community care center in west haven, connecticut which does profoundly important and excellent work. the legislation authorizes emergency funding to hire new doctors and nurses and other providers in order to address systemwide health care provider shortages and to take other necessary steps to ensure timely access to care. and it addresses the health care primary care shortage for the long term as well, by authorizing the national health service corps to award scholarships to medical school students and to forgive college loans for doctors and nurses who work at the v.a. these kinds of measures and others in the bill will act to fulfill our basic obligation to

our veterans, just as i did or attempted to do in the honoring all veterans act some years ago, and others have joined since in seeking to do, and my hope is that we can reach across the aisle. in fact, i'm working with senator mccain on a letter, a bipartisan letter to the attorney general urging all possible involvement and leadership in a criminal investigation. i hope the similar spirit of bipartisanship will enable us to work with senators mccain and burr and coburn on their veterans choice act and combine these measures, enlist them in supporting a bipartisan solution and join senator sanders in hoping for that bipartisan effort in this measure because there's no question the v.a. budget has grown, but simply has failed to keep pace with surging demands, especially in

mental health services and primary care. too many of our veterans coming home with serious mental health issues, including posttraumatic stress, traumatic brain injury, need the care that we owe them and we need accountability. part of it will be firing the officials who should be held responsible, but part of it may also be prosecuting them and that's the reason i have asked the attorney general to take the lead to assume much more immediate and significant involvement in any criminal investigation that may be necessary. in fact, there is credible and significant evidence of criminal wrongdoing here. the department of justice must be involved, and in my view, must take a leadership role, and that's the reason that senator mccain and i have joined in a letter that we are seeking support for our colleagues to send that would

request the attorney general to take such steps. only the attorney general has the resources, expertise, and authority along with the f.b.i. to do a prompt and effective criminal investigation. only the department of justice can convene a grandchildren and -- grand jury and take other necessary steps, only the f.b.i. can bring to bear the expertise as well as the resources. the inspector general of the veterans administration has only 165 investigators for the entire nation. this investigation now spans more than 40 centers where criminality has been alleged. of the 216 sites visited by the auditors recently, many were found to have issues of scheduling practice defects, and potential integrity

problems. so there is a reason for the v.a. inspector general to not only consult with the department of justice but also involve the department of justice in an active leadership role here and for the acting secretary the v.a. to request that involvement, which i hope he will do. i commend what he's done so far, but now is the time for the department of justice to be involved in leading. the audit of the facilities around the country ought to be made public, not just the overall results have been delivered to the president in a report last friday, but all the results, site-specific results for locations. for example, the two hospitals in connecticut, in west haven and newington as well as the six medical centers in connecticut. all those