significant differences of two points. one is i want to%g@ @ @ @ @ @å we had a president not particularly stronger pro- consumer, and we know the senate did not lend itself to a stronger bill, so for many of us it was thought as the best we could do to keep prices down, saving money for employers, saving money out of pocket for people, saving money for taxpayers, and when you did hatched-waxman and the terrific work you did on that, you can look at the difference in cost of chemical pharmaceuticals and living organisms reckon the

1990's it was considered outrageously expensive. . that was considered outrageously expensive and the pharmaceutical that in those days cost $4,000, maybe it was $4,000 today, it was a pharmaceutical that cost $4,000. that was a high cost having a generic competing having a great difference there. we're talking about cancer drugs, and now it was 40,000. so without any kind of follow on biologic without any generic, we biologic without any generic, we don' where we need to get to to save consumers money. the 12ear agreement, and that 12 years doesn't lend itself to innovation. you look at hatch waxman on market exclusivity and compare market exclusivity followed on biologics. it was a 5-3-1-tiered approach similar to a bill that senator

bingaman and i also co sponsors and senator martinez and senator viter, and i'm leaving out another republican when were introduced. and that legislation really is better for competitiveness the 5-3-1 tier mem imiimicking hatc waxman. there has only been one non-industry analysis of the 12 to 14-year issue, 12 to 14-year bill and one other point, i apologize, on the 12-year agreement from last year we also didn't work out the issue of what do you do with evergreening and there was a difference of opinion after we passed it out of committee. never went to the floor because there were differences on to the evergreen 12 plus 12 plus 12. >> we've been working on that, as you know. i know we're working on it, but i would like to see your proposal because my

understanding is you want an evergreen 12 plus 12 and more 12s than that, we can certainly talk about that, but the last point, the only real study and the only real analysis done outside of the industry, not by the industry was the ftc report about the innovation issue, and we concede on those of us that want a stronger follow-on conserve nothing and certainly pro-consumer were pro taxpayer, pro employer and pro bringing in dollars for the health care system, but our side is also pro-innovation. the ftc report with the potential harm is that firms will direct scarce rnd dollars for low-risk drug products rather than to new inventions to address medical records. thus a new 12 to 14-year exclusivity period imperils the efficiency benefits of the follow-on approval process in the first place. this will mean a longer, maybe

counterintuitive, but a longer period of -- a longer period of exclusivity means less innovation, less investment in going down a new road. it means, as the ftc said, it means plowing and doing well plowing and well-tilled areas where you don't need much plowing and instead of what we really want to aim at. so that's why this 12-year doesn't work for, i think, most of us on this committee and we need to look at something different. chairman, we'll get to this debate on biologics. i promise we'll provide more than adequate time, and we did some last evening, but let me also encourage my colleagues here. again to try and see if there's some accommodation we could reach on this issue that would satisfy both the consumer interest and the innovation that we've been talking about, and i'd urge my colleagues to continue that effort so we can avoid what would end up being a non-result if we go down a path

with no answer and being able to merge on this committee. >> i'll be short. >> look, this was not just a gentleman's agreement. this was an agreement that the original hatch waxman has called the very priced competition term restoration bill. we had to balance both sides, the needs of the generics and the needs of the innovator companies and by all measure, we did that pretty well. now, in this particular case you've got a much more difficult situation because it's much more difficult to arrive and much more expensive to arrive on follow-on biologics success, and not only that, we had agreed. it wasn't easy to get to 12 years from where a lot of people in my side were, and frankly, we worked that down to 12 years.

the administration's budget has it at seven. of course, to keep in mind, without the innovator investments and work, the generics will have nothing. and it was not in their best interest if we had a bill that would not amount to the investments that are necessary in order to arrive at these -- at these solutions. i might add that these, you know, the average time to develop a follow-on biologic is extensive. i know companies that are in their 15th year and still getting private investment to keep going with no real absolute guarantee that they'll arrive at a treatment or cure that may be life saving to so many people. this is not a political issue to me. this is a very, very important, scientific issue, and frankly,

some on the generic side take the position to heck with them, and consumers aren't going benefit unless we get this right, and i'm convinced that to do it as well as we did on hatch waxman which was by no means easy, we had the same arguments back then to do it, it's going to take a minimum of 12 years and frankly, you know, if i'm wrong, i'd be surprised. >> thank you, senator. >> senator? >> well, first of all, i agree with senator brown and senator hatch in which we need to continue really these breakthrough innovations, but have to be enormously sensitive to both costs and yet the promotion of innovation. i'm puzzled about the regulatory process. in reading the medicare payment advisory commission which i know

is a bit controversial these days. they talk about medicare payments systems on to biologics. one of the things they do say is that biologics now account for $13 billion in medicare spending. they also go on to say that over time the product -- the price has not fallen, but there is no regulatory pathway to an expedited approval process on follow-on biologics. so while we argue, 12 years, nine years, seven years and sound like an auctioneer, one of my questions when we debate is what will -- what is the regulatory process here? what is the approval for the original biologic. it seems that there's no approval for a follow-on biologic. i'm puzzled by exactly what that means and the consequences and then the impact on the delivery of patient care and on cost, but

we could fool around with time and yet have no sound regulatory process to be able to do an appropriate regulatory process on the follow-on biologic. see what i mean? >> good point. so i'm not making this up while we're looking at the ftc report. if we look at the people who look at the funding for medicare. so but all of us want to have a biologic or pharmaceutical when we need it and you have to have people who invented and bring it to the marketplace. thank you, senator, very much. >> we need to have an innovation from the government. >> thank you, senator. senator gregg. >> thank you, mr. chairman. just a brief comment on new scoring by cbo.

i think both senator enzi and senator made this point. it is incomplete. if you're going to claim 97% coverage and therefore that you picked up this uninsured, the scoring is inaccurate because it does not have medicaid expansion costs in it. this bill as it's before us now has $34 million uninsured and it costs to the cbo 600 and some odd billion dollars. if those -- if you use your assumption as the chairman said at the beginning that the proposal would have 97% insured, people covered, so the $34 million would be reduced to 34 million. then you have to include the cost of medicaid expansion which

takes the cost of this bill well over $ 1 trillion and puts on the state and unfunded mandate of close to half a trillion dollars and those are big numbers and they don't meet the test that the president set out in my opinion. so i think it's important to make that clear. in the area of the class act, the cbo has said this is insolvent in its present form. we know it's insolvent in its present form. the fact that we're working with a ten-year window allows the score to represent a 50 million -- billion dollar plus window. we know when you get outside the ten-year window and people take advantage of the long-term care coverage that you immediately flip and you end up in a insolvency situation which represents by outside calculations $2 trillion.

cbo's calculation may be less than that. they didn't give us a 75-year number, but we know it's big even on the cbo numbers because cbo said for this thing to be solvent you have to start with a premium of $85, not $65 and then it would have to be adjusted upward. the $2 trillion numbers reached assuming a $65 billion number. so why would we start with a program which we know on the face of it creates a $2 trillion -- potentially $2 trillion hole or a hole close to that number in the out year cost. we can't afford that as a country. we've got -- i've got a chart here. we've got -- we've got $70 trillion of unfunded, just on

three spending, medicare, medical and social security. $70 trillion is already on the books that we're passing on to our kids that they'll have to pay for. there's no way they can pay for that. this healthcare reform should be about bringing this number down not taking it up another $2 trillion by adding a program that on its face is insolvent, which is what the class act is. it's -- my staff got carried away with the title, it's harsh, i think, in the next ten years this thing makes money, but over ten years it's a $2 trillion unfunded liability. $2 trillion. that's -- that's totally the opposite direction that we should be going through, going here as a committee. the chairman makes the comment, well, we have language in here that the secretary must adjust

and make it solvent. why would you start off with a program that's insolvent? and then tell the secretary oh, you've got to adjust for solvency. let's start up front with solvency and make the program sol vent to begin with. i'm offering amendment if it's an amendment at this time. i would offer amendment number six. my amendment number six. >> amendment number six. >> which essentially says that that takes out the number that's in here, the $65 premium and just simply directs that the secretary shall set a premium that causes the program to be solvent over 75 years. why 75 years? because that's what we score social security, medicare and medicaid on and when you start reducing below 75 years we're basically playing games with the number, and so an accurate act rarial approach to this to give

us reasonable numbers and to remain consistent with the scoring of that is of served. it is an attempt to gain the numbers. that is all this language does. it says, let us strike the number. but this make the program solvent there seems to be a solvent -- a consistent the there should be a solid program. but said they solvent program. it will probably between $85.100 dollars. it to be adjusted. that' is the estimate i have heard. the outside actuaries came in at $100. i am presuming it is somewhere in between. >> that of the secretary's job?

-- will be the secretary's job. shall be given a job. that'll be a number that she said. simply trying to fill that. program solvent. it's simply trying to fill the -- i guess it was senator hagan who asked this information from cbo simply trying to addrs the fact that we shouldn't be playing a shell game here, that we should actually start this program on the solvency footing and shouldn't start it off as an insolvent program, and we certainly shouldn't be adding $2 trillion to our debt on top of all of the other things we've got around here that we're doing to our children. >> let me -- it's always nice to start with a point of agreement and the last thing i want to be doing here is adding $2 trillion to the debt here. that would be highly irresponsible and so what we're

trying to do here is one, encourage people to enter the program because it makes sense for people to start assuming responsibility for their long-term health care needs and not be dependent upon the federal treasury to do so. how do we get people to start taking money, in the case of a student $5 a month and people older than that that want only talked about the $65 a month to contribute over five years before -- so they can participate in long-term care. the numbers are certainly the disability community, you talk about 100 million and the younger people who will hopefully live longer and will have potentially more productive lives and will face health care needs as they get older. to what extent do we want to encourage them now? not 75 years from now when the costs could be staggering, but today to participate in their own long-term healthcare needs and what cbo has told us is if you add a premium at the level that everyone is talking about, you will have the opposite effect according to cbo of

encouraging people to start participating in long-term health, but we also recognize as you get down the road here in time and the cbo letter to senator hagan, an important paragraph from this letter and let me ask that the letter be included in the record. joe, can i get a cope of this letter from senator hagan? >> on page 2 of the letter and it makes the point that senator gregg is making, although outcomes in the not too distant future are uncertain, the cbo expects that the actions by the secretary to reduce all benefits to the real daily minimum of $50 and raise the monthly premium from new enrollees to $ 5 after 2019 would be adequate to ensure that the program would pay benefits through 2050. in a letter to senator harken -- to senator hagen, rather, makes

that same point. and so you're striking a balance here. obviously, this is not public money. it's individual, private money, it's voluntary and if people don't participate then the program never works, in a sense, so the number is the right number to get people in than if you added up too high a number then you have people not getting in and the program fails. so it's striking a balance. >> that's the point, judd. >> it's not a balance though. it's not a balance to encourage people to come into a program that will have an insolvency of $2 trillion. that's not balance. that's bait and switch. i mean, that really is, my staff is right because basically what you're saying is somebody is you can come into this program at a cheap price today and in the out years we're going to adjust it, your benefits down and your premium up at a radical rate or at a dramatic rate and that's

what cbo says here, they're going to have to change the premium and they'll have to change the benefits. so why wouldn't we start out in the beginning by the honest cost of their insurance to purchase the policy because you know what's going to happen in the out years? these adjustments aren't going to be made because we won't have the political courage to enforce that adjustment and we'll tell the secretary to not make that adjustment and we're going to end up with the $2 trillion of added debt that will come out of the general fund. this is the way part b premiums started. part b was going to be totally covered by the premium and it's down to 75% of the premium. this is the exact same situation where we understate what the cost is and change the benefit structure and we don't have the courage to do that. let's just say that they have to have a solvent program right up front.

>> we're saying that and we're also saying those are new enrollees who pay the 85 and the premium. it's not necessarily increasing the benefits. new enrollees down the road. you're making those assessments. in many ways, we had other legislation dealing with other entitlement program which is did not involve necessarily the kind of sole part its pagz by the individual. here you might make a case that it might have been better off that we had a requirement of the law that the program be solvent. this legislation says it must remain solvent. what it doesn't say is absolutely it's how you get there except requiring the benefits and premiums to adjust it to keep it solvent. that's what the law says. that's the first time we've ever done anything like that. it's totally private money and totally voluntary. the cost of long-term care will not go away. they'll be staggering and the idea of giving people an opportunity to have independent living and not people going to medicaid and we all know what happens, they sell everything

off and put their parents in that situation or family member and they qualify for title 19, and this is the only program we have in this bill that actually brings down medicaid costs. the only one, and we all know what those impacts are. $2.5 billion reduction in medicaid costs. that's not huge, but it's a step in the right direction. we've all heard about our states complaining about it. the law we're asking you to endorse and support here is than program must be solvent. >> it says, how you do it. >> it starts off as an insolvent program and tells the secretary to be solvent. no one enters the program and it's not going to work. and i hate to refer to another committee here, but i think the banking committee just stopped credit card companies from doing this, you know? where you put a teaser rate out and then you change the rate. that's exactly what's happening. we're putting the teaser rate out and then we'll change the

rate. mr. chairman, mr. chairman. is there any provision in this class act that says if the payments aren't enough you don't qualify for medicaid, because under the arrangements if you look at this ten years from now, everybody will still be eligible for medicaid. they're here today to keep you eligible. unless you're absolutely excluded in the class act and i didn't find that it was then you're not going get any savings from medicaid unless you exclude their ability to file for medicaid if, in fact, they have this program. so those savings are not real, they're not going to happen because they're still going have inflation. we know seven or eight years from now we'll have hyperinflation from this country from the debt we're doing right now. sooty want to make a couple of points. i have never been at a mark-up for a section of the bill that has such lack of integrity. it's not the integrity of the

desire of when you're wanting to accomplish, but there is a lack of honesty about what the numbers mean. go back and look when medicare was written and what the cbo projections were and how it was going to be great and now we have this tremendous. i've looked it up and i've read the data, i've read what the medicare trustees report said at first. i've read all that and it's the exact same thing. this is a point and there was no cbo. but the point is that the estimates and budget estimates on medicare was and it was going to be fine, and the point is i'm also disappointed in aarp. this is generational theft again. we'll let the older people in this country. we say 200 million people will take this is what you're trying to do, but we know it's not going get funded. we know it's not going to be viable and we know it's not going to be solvent and the

reason we know is the second it goes to propose the rate we will pass a law saying it can't. we will tell you no you can't because the political pressure will be allowed to do it. that's request it got slashed, slashed, slashed. why are we lying to ourselves. if we want to create a long-term care program let's throw it out there and see what the real numbers are and put the real numbers on the table. let's not play the game with cbo. whatever the actuaries tell us, and we need to do, then let's just do it and let the premiums fall where they are, but let's don't play this lack of integrity of saying we're playing a game and saying we've got numbers when in fact we don't have numbers and to me it's disappointing. we've had a fairly good mark-up where we disagree and we've been straightforward. this is a charade as far as the cost, the benefits and who will participate in it and whether or not people will still get medicaid because they will. ten years from now, $50 isn't

going to mean squat in terms of taking care of you and the long-term care at home. it's not going to help you at all. we'll raise the level at which title 19 is available. and we're playing a game that i don't believe is up to the level of the integrity of this committee and i really object. i find it disheartening that we would go down this road and play a game on numbers and knowing that we're not going to accomplish what we want. ten years from now you'll look back and say, that wasn't what we intended at all. and it's not what we intend. we see the numbers and see where it's going so i would ask that maybe additional consideration to go back and throw the numbers out and let them fall where they are. that's a realistic expectation about what's going to happen. if we want to create a class act, let's do something that we're not charging, we're already strangling them, the generations that are following us and why would we do it again and why would we do it more?

this is a repeat of the fundamental mistakes that we've made on major programs by not ensuring that they're solvent. i just think it's beneath us the way we're doing the numbers on this. let me remind my colleague, first of all, this is not a mandatory program, it's a voluntary program. you don't have to participate if you don't want to. it's a modest amount to ask people to contribute. the idea is to not replace medicaid, but to delay people going into it. if we can do that, then obviously there are savings involved. $50 a day may not seem like much, but the people with a bit of assistance can make that difference over a period of time and they can stay in their own independent living situation going out. it's voluntary, completely voluntary and a worthwhile element of all of this. it's a program where trying to determine absolute solvency this many years out is hard. he would have to change the law, you could do that, you're right, you're correct.

i think people again recognize the cost of long-term care, here allowing something in place where the individuals themselves have participated in this if they want to. if they want to. they may decide not to. >> so what happens when she raises the fees and everybody drops out and now who's responsible? who is responsible for the liability of everybody that's been there and paid up. i don't thk that will be the case according to cbo. if that happens, say they raise the fees to $100. who will come in? ultimately, our kids are going to be responsible for the unfunded liabilities of this, because if they do raise it enough, they will discourage new people from coming in. that's what's wrong with this game. senator hagan. mr. chairman, did we let private industry do this? we did, yes.

the idea was to get them involved and in a way we think this will actually enhance the ability because this doesn't cover, obviously, the nursing home cost and so forth. the idea being that this would be a platform for people to have the kind of program so people that started into this, there's a likelihood that people will move into long-term care issues. >> my question is is there a company from an actuarial standpoint that will actually do this? that's my concern that the premium coming in with the outlay going out, that's what my concern is -- sort of what big a hole, and private industry will actually look at this and say from an actuarial standpoint that they're willing to get into this business and left the solvency happen there because what really concerns me is i don't -- i worry about $50 a

day. just the transportation costs of doing an hour treatment or two hours of treatment is going to surpass, i think, the $50. that's what concerns me. one of the issues -- >> in answer to your question -- >> yeah. the companies, i'm told, by staff would -- are insisting that this be a mandatory program for this to participate. i'm sorry. the companies were insisting that this be a mandatory program for them to participate, and i don't think -- maybe others want to, but i think a mandatory program would be a mistake in my view, but that's what they're looking for in order for them to participate in response to your first question. >> i'm sure we couldn't mandate people do this. one of the concerns is the

budget chairman in north carolina, we have a wonderful program called the community alternatives program that hopefully helps disabled adults stay in their homes and not go into a nursing home, but the average cost is $46,000 a person per year and not onthat only se 8,000 recipients and we have another program that serve 10,000 and that costs about $250 million a year program combined, these two programs have about 600 million just in north carolina for about 18,000 people and there's a wait list that's over two years' long. what i'm concerned with is the numbers with the premium coming in with the promise of the payment five years out that we are not being accurate with

these calculations, that's my concern. it is a new medicaid program and that is not the model that we're using here for this. >> the intent is to keep people -- the intent is to keep people and not go to nursing homes and long-term care. >> that's yet savings of cbo reported the savings. what concerns me is the $50 a day is, i think, would be hard to actually make it work. mr. chairman, the senator from north carolina raised an excellent point to pursue this. if you compare a private sector long-term care policy with this policy, the private sector long-term care policy which averages $200 a day in benefit

for a married person with a spouse. >> can i ask what you're reading from? i can have that? it's compared to the average private policy. >> i can get a copy or for anybody else who wants a copy. the senator from north carolina is making the valid point that at $50 a day you're probably creating a benefit that will be overwhelmed by the cost, but what my point is that you're not even funding the $50 a day cost. at a premium of $65 you can't do this. so, why not start out the solvency. if you're going to have $50 as a base benefit, at least make it a paid-for benefit. my language is really very simple.

it just says beginning with the first year of the class program for each year thereafter, the secretary shall establish all premiums to be paid by enrollees for the year based on an actuarial analysis of the 75-year cost of the program that ensures solvency through t 75 years. why not start there? i mean, your position is well, if we start there people won't enroll. if we don't start there and people will enroll down the road we'll end up with the taxpayer having to pick up the policies. >> my colleague keeps on saying so. this program is a solvent program and that's what the cbo letter tells us. the cbo letter doesn't say that. what the cbo letter says is if you adjust the premium and you adjust the benefits in the out years and you assume that's going to occur and then you can get to solvency, and they think that the premium should be $85, down the road and that's been the problem. why not have an actuarial. why not have the secretary have

the actuaries come in and say, okay, maybe it's $65, maybe it's $ 5 you but at least have it done at least have solvency rather than from day one knowing we have insolvency. >> they require the secretary to do exactly that. >> it's solvent today and it's solvent for the next ten years and you set up a system. >> no, the bill is only solvent in the next ten years because it scores in a ten-year window. >> that's what they do. >> as soon as we get outside of the ten-year window if you use the 75-year life, because that's what we use in medicare, medicaid and social security, it is immediately insolvent and the -- >> and the law requires the secretary to step up and make the at juddmedjustments to make solvent. >> you than from day one. once you get out of the window.

>> we're talking in circles on this thing. >> mr. chairman? >> senator casey? >> these discussions are helpful, but i think sometimes when they are extensive we lose a couple of facts that should be on the table or we should re-introduce some facts. the earlier discussion about the congressional budget office and new scoring it was not by this congressional. it was by the budget office. it wasn't something that was invented on this side of the table. secondly, with regard to the discussion about the class act just so the record is very clear, this is the july 6th congressional budget office letter this is paragraph 5, and i quote, the congressional

budget office estimates that the proposals on that effect on the federal budget would be to reduce the budget deficit by about $5 billion during the 2010 to 2019 period. that's fact number one that we should re-introduce. now i'm going to page 2. the congressional budget office letter not the letter from a bunch of democrats. the second full paragraph on page 2, the middle of the second full paragraph, and i quote. although outcomes in the not too distant future are very uncertain, the congressional budget office expects that actions by the secretary to reduce all benefits to the real daily minimum of $50 and raise the real average monthly premium for new enrollees to $85 some time after the decade by 2019

would be adequate and i'll frommed again, would be adequate to ensure that the program could pay benefits through 2050, unquote. we can debate about what's going to happen after 2019, what a secretary will do or not do, but the fact of the matter is you have part of this health care reform bill which is backed up by, i think, a pretty unambiguous letter from the congressional budget office, and i think that's very important to put on the record because people reviewing the record and people watching sometimes we can not emphasize that enough. we're talk pg the budget office, not one point of view or one party. >> the second to last paragraph because there is significant ambiguity in the budget analysis

because overall, cbo estimates that if the secretary did not modify the program to insurance actuarial soundness, the program would add to the budget deficits in a large and growing fashion, beginning a few years beyond the ten-year budget window. if the secretary did not -- did act to ensure this program solvency, the program and its effect on spending and medicare might or might not add to future budget deficits depending on the specific actions that were taken. so the point here is that we have a historical context that's part b premium and we're now in a situation where the part b premium is running massive amounts, multiple trillions of unfunded liability even though it was started by a program that was supposed to be covered by the premium. we've started this program

starting that it doesn't fully cover the premium. we know that this program will have to be significantly adjusted once you get past the ten-year window. in that adjustment you know congress has a tendency not to accept ver well because you heard from their constituencies that they don't want to pay a high premium. it's illogical to start a premium that's insolvent on its face. i agree 100%. the cbo said that this bill is now $650 billion out of whack. that's fine, but they didn't say that they covered 97% of the people with insurance. there are still $34 million people uninsured. so it's really a $1.6 trillion. the cbo said 611 -- the cost was 611 over ten years. there were 34 million people uninsured. >> they didn't say 650. that's point number one. point number two is with regard

to this question with what the secretary does in the future, last time i checked, the congress plays a role there. we provide oversight. that's something the congress has a responsibility to discharge and that's going to be our obligation to do that. >> our track record remains extraordinarily weak in that area when it comes to adjusting premium s premiums on it. >> mr. chairman? listening to the discussion what we're actually proposing is a loss leader. grocery stores do that over time. they have loss leaders, but they know that when people come in and buy those things that they've got the loss leaders, that they're going to see other things that they'll be inspired to get and those will have a higher mark-up and they will make money, if they go out of

business -- and we don't have any other product that can pick up the slack. we than it's a loss leader and this class act premium would be $65. the private sector in order to do the same thing has to charge $175 to $250. of course, they say that if it were mandatory it would be less and that then they don't have to do the loss leaders, but they would be able to do volume and volume will make a difference and what we're saying with the $65 one is that volume will make a difference, but that is already estimated to be $85. my dad always talked about a couple of farmers who took the product and hauled it to another state and sold it and took their truck and hauled it over there and sold it and they never could get as much as it cost them to

do that and now what they concluded to do is get the bigger truck. well, that won't work and that's what we're saying here. we know our truck's too small and we'll do this loss leader and we'll get more to pilot truck, but we're selling a product at a loss that we know has to be made up, and in social security we had an opportunity back in the '90s that would make insignificant changes that would change social security. i took a look the other day. most of those options are gone. if we put this loss leader in at this time, in ten years most of the option will be gone. you have to price the stuff right to begin with. it's still a bargain at 85 bucks or 110 bucks, it's still a bargain. and it's the obligation of whoever runs this program to point out that it's a bargain

and sign people up, not to cut the price below cost. so i hope you'll accept this amendment. >> senator markey? >> thank you very much, mr. chair. a few points that i think are relevant to this debate just so we're talking apples and apples. the bill page 13 notes annual establishment of premium for new enrollees after the first year of the program. the secretary shall annually establish the monthly premium for enrollment in the class program for any year after the first year after the program has an effect under this title. the re-establishment of new premiums kicks in very early in a year after the first year in which the program is in effect, and it then notesas it goes on, the calculated premium required for program solvency and says the secretary determines based on the most recent report of the

board of trustees on the class fund and the advice and the independence advisory council or other information that the secretary deems appropriate that the monthly premiums and income for europe projected to be -- if they're projected to be insufficient with respect to the 20-year period with the enrollment class program as necessary. essentially what we have in this bill right now and i'm just trying to make sure we're all talking about the same features of this bill is essentially a 20-year actuarial study and it's certainly legitimate to get into the details, but if one does get into those details, one finds that the report, and this is on page 47 on the version i have, the report provided shall include a statement of assets, so on and so forth and it is expected with disbursements will be made and it proceeds to talk about each of the next two

fiscal years as projected over a 75-year period beginning with the current fiscal year, and it notes an actual opinion by the social security administration certifying the techniques and methodologies, so on and so forth. so we have in here earlier on a 20-year projection. we have instructions related to a 75-year period. i certainly haven't had the time to take all these pieces and say how they compare to the points my colleagues are making, but there is -- i'm interested in this discussion. i do think it is very important that we set up a program in which there is a board with reports adopted from an actuary that proceeds to adjust the premiums and yet all that seems to be in here, and i certainly think it merits retrue see if,

in fact, it's missing, but i just want to make sure that we're all aware that many elements being discuss side important are in this bill as it stands right now. i also want to note that when we're talking about costs, often the discussion really focuses on the cost to the public side and that is, indeed, important because we're responsible for that balance of income and outflow, but it's also important to understand that we have huge costs driven in our health care system by the fact that folks with some modest assistance will be able to stay in their home and end up in incredibly expensive nursing homes and that's why my state of oregon has been immersed in this issue trying to find ways to assist people to stay in their home and so there is an overall savings to the health care system, if in fact, and not to mention the savings of the system, but a phenomenal increase in the quality of life if seniors are able to stay in their home, so

there is a public benefit and there is a reduction in cost to other sectors in the healthcare world because the citizens are not having to spend money on the public side and there was a lot of actuarial driven adjustments to the premiums in this bill as written. >> mr. chairman, if i could respond to the senator because i think he's made excellent points on his last point. we all understand that the importance of long-term care, health insurance is really a plus for the system, but it also needs to be a solvent -- a solvent long-term care health insurance, and there's no question that if people have long-term care health insurance that benefits the government significantly and the taxpayer as long as the system is a solvent one. on this last point which was to go through the language of the present bill, that's the problem with the present bill. on i mean, on the face of it using a 20-year score for your

actuarial soundness is inherently flawed. you're selling these policies to people who were 25, 35, 45 years old. they're not going to retire for 30, 40 years. they're not going to need this policy for 30 or 40 years. the reason you're able to sell it to them at a premium is because over the period of years they obviously accumulate massive amounts of money that can then be used to benefit them, but to use a 20-year window is absurd on its face for scoring this policy. and the soundness of this. the senator from oklahoma is right. this is outrageous gimmickry to use a 20-year soundness rule. i mean, 75 years is what we traditionally used around here on these programs. that's what the actuaries used. that's what should be used in this because it is the window

when you collect the benefits and the people take advantage and collect the premiums and the people take advantage of the benefits. that's the window you're dealing with. >> especially with the age of our population. we know the largest demographic group in our country, which is the fastest growing demographic and that will increase significantly. if i'm to understand my colleague, say for the purpose of discussion here, to talk about working out a number here that would at least project that kind of solvence they my colleague from new hampshire would then support this plan. >> that's what i do here. with the plan with a 75-year, people offer amendments and they've been voting. i'm curious. this action of the -- section of the bill. >> well, if it's a 75-year score. i'm proud to support the language. >> how about my colleague from oklahoma. >> if you're scoring if you're trying to get a score out, it's

what we tried to do. we're not trying to be disingenuous, looking ahead, and i know you disagree with this point, but just to make it again and by having the insolvency number present, with the score, it's a difficult time scoring beyond that period of time obviously and we set up the mechanisms before you heard me say, sorry for repeating myself, but by requiring the cbo or -- requiring the secretary, rather, to determine on a yearly basis what would be required in order to make this solvent. >> we wouldn't start with a premium. you would just have a 75-year score. >> i'm just saying what the bill does now. i realize there's a disagreement about this. >> if you'll accept my amendment, i'll support the language. that's basically -- >> my point is we're trying to achieve the same result. nobody wants to be writing something that he believes is vulnerable. obviously with the exposure that's been articulated. we think we've solved that, my

colleagues disagree with that and i'm trying to determine whether there's a determination to be supportive of this program. this amounts to over $1,000 a month and $50 a day. it's not insignificant. >> it's a pretty good contribution for a small amount of money to contribute to the long-term care needs. that's much more expensive, but it allows people to stay in their homes and get the kind of care they may need for a couple hours a day and whatever else it may mean. that's not insignificant. we're debating about it and none of us argue about the solvency issue. we have to answer that. we've answered it one way here. my colleague from new hampshire suggested another way of achieving the solvency question. so i'm trying to determine whether or not we can do that and achieve the same results here. obviously, there will be less savings and that have been reported by cbo than we're talking about $58 billion. you'll save more. no, you'll save more. you'll get a lot higher number. >> can i respond to the chairman

for a minute? let me do this. i want to accept this amendment. i want to ask my colleagues to do so. this is a point we all agree on. the last thing i want to do is sit here and create a situation that we're all debating whether or not we have this trillion dollar or whatever the question is for 75 years. i think it's a great idea. i think it's something we ought to include in our bill and it's a major gap in healthcare. you end up with the people living longer, having good quality of lives and liking a choice of not being pushed into a nursing home. none of us want to see the medicaid cost and we all know what happens. families do it every day, whether there's impoverished someone at home and that put costs on our state. this is the only program i know of in any of our bills that actually brings down potentially medicaid costs and tom is correct on this. obviously, it's not mandatory, and we think it will delay it anyway with people rushing to that window, if it does that, that's a savings worthwhile. i'm prepared to accept this

amendment and as senator enzi said, it's a bargain. if we're talking at $85, i'd like to do the student cap on this to have a cap on students to get them in. i'd like to bring students in. i hope it doesn't pose difficulties for people, but let's accept the amendment. let me hear from the this. any objection to that? although in favor of the greg amendment say aye. congratulations, senator. >> i appreciate your willingness. >> we'll go to final passage of the bill. thought i would take a chance and don't want to miss an opportunity. >> i want to second your comments, it could have a very positive impact and get people to buy long-term insurance is -- >> it is voluntary, not mandatory, its your own money putting up.

it's not government money -- except management -- >> could i share? i agree with the philosophy, we need to create something to fill this. i have a mother that i have people with all of the time. significantly expensive process. what happens if it doesn't float. in other words if we do the 75-year and look back and say what the premiums are, what cbo said, she has the legislation presently crafted -- but i'm saying down the road if it's not working. >> going to be minimum 110, $120. >> or can terminate the amount of enroll ees coming in. >> let's say we terminate the program. who has the liability for the unfunded -- >> the reason she's doing that is because we're not going to be able to meet those obligations, that's why we empower the secretary to do that.

if we do, so what we're saying s. the programs terminated. what about the obligation for people continuing -- >> because what you've done is allowed those people, made a determination that there's -- this is going to run into a deficit and therefore you terminate new enroll ees but have enough coming in, as i assume the case -- correct? enough there to pay out act wearily the responses to those in the program. >> any additional amendments in this section? if not, that's a good piece of work. i thank you. i enjoy working with you. you made a good case. let's move to -- what's the next

section? senator coburn, i suspect you may have an amendment or two.

mr. chairman, i'm not going to offer an amendment. >> sorry. >> i have no amendments to offer. i knew it would bring a smile to your face. >> i enjoy the conversations, you've been very constructive in these debates. >> where are we going, next section? >> i was going to ask everybody to take a look at my amendment, number 34. which talks about the burden this places on the social

security administration. and i'm not going to offer -- and withdraw it, but i would like people to take a look at it. it brings up some of the points of in addition to the solvency where we're shifting the burden to social security administration to make a lot of these determinations. i'm not sure they have the manpower to do that and it's something we'll with to take care of in other bills. >> what we probably ought to do is when we look at something like this. this may be -- i think we included as the number -- 1.2 billion over ten years in the bill, if i'm not mistaken on chart was included administrative cost of the program over ten years. >> i had a question about that. where did we get $125 million a year to manage this program? where's the data that backs up

$125 million? >> why that number particularly? let me ask. >> where why do not you introduce yourself? >> what we found was, this is not much of the treasury better what they assumed it said it was 1.2 billion over 10 and for costs. that was in terms of being able to collect the money into the trust fund. >> that is the cbo number. >> ride. >> i wanted to know where it came from. >> we felt it did that go forward, we will have to deal with this we dealt with the finance committee. . . with this at the finance committee, who are

asking to actually certify by records you would bring that you have a functional limitation, to areas of problems is going to be the dd centers in the local areas. states use them for state operated functions as well as for social security determinations and redeterminations, which are very complicated. it's a five-step process. that's who we left it with right now. do they need more money to hire more people? we need to continue to talk when it comes to finance. we know we need to have the people to do that work. >> thank you, very much. additional amendments and -- what's the next area we're going to? >> we've got left over issues. what is it 12? why don't we recess.

we've done a pretty good morning to deal with this section, a pretty good accomplishment. so i'm going to declare it a victorious morning and we'll come back at 2:30. we have the swearing in ceremony of our new colleague, senator al franken of minnesota. we'll stand in recession until 2:30.ñ#ñ# [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009]

>> day nine of the senate health committee's work on health care legislation continues tomorrow morning with a closed session beginning at 10:00 a.m. eastern. our live coverage will begin whether the committee opens their meeting to cameras. congressional committees are now working on five separate health care bills. we'll hear republican and democratic senators talk about health care legislation next on c-span. after that, senate judiciaryly -- judiciary chairman patrick leahy and senator mitch mcconnell talk about supreme court nominee sonia sotomayor. and later, testimony on climate change. >> how is c-span funded?

>> the u.s. government? >> i don't know. i think some of it's government raised. >> it's not public funding. >> probably donations? >> i want to say from me, my tax dollars. >> how is c-span funded? 30 years ago, america's cable companies created c-span as a public service. a private business initiative. no government money. senate leaders clashed on the subject of health care following their weekly lunches. harry reid said he plans to meet with four republicans wednesday to suss it. this is about 20 minutes the >> let me begin by talking

about what is clearly the biggest issue and that's health care. we've seen the themes of this administration. thear -- they're running banks, automobile companies, student loans and now if you look at what the administration would like to get on health care you are inevitably led to the conclusion that they also want to be running the nation's health care. there is overwhelming opposition in the country to the government being in charge of our 45e89 care -- health care. everybody is concerned about cost but republicans uniformly feel the cost issue can be addressed without having the cost take over health care. we have already two examples of government health care now, medicare and medicaid. both we know are on uns -- unsustainabling paths with enormous unfunded liblingts. yet the administration is trying to fund at least part of their health care evident by additional medicare and medicaid cuts, not to sustain

those programs which are already unsustainable, but to try to pay for a government program that expands care even further. wee -- we feel this is very wrong-headed. if you are looking for a pattern, think about the stimulus pattern the rush and spend, rush and spend. don't read the fine print, just get it done yesterday. >> -- you saw that with the prediction it would hold unemployment to 8%. now it's going to 10 and now they're wanting to rush and spend on health care when frankly nobody's had a chance to read the details. i think it's a significant move in the wrong decision. with that i want to call on senator cobb. >> thank you, leader. all of us having gone home this weekend and talk to our constituents came back with

stories about what our folks are saying to us. they are scared to death that what they have -- and remember about 85% of the folks have insurance -- they're scared to death that they're going to lose coverage, that somebody's going to get in between them and their doctor. using the medical analogy here, doctors of course are first admonished to do no harm in treating a patient. we think we should do the same thing with health care reform. let's take the time to do it right and especially for all of the americans who are already covered by either a government program or private insurance, don't do any harm to their coverage. if they like what they have, let them keep it and don't cut programs like medicare in order to fund this program. that's what seniors back in arizona are ral frayed of. we just -- really afraid of. we just got the word that the health committee, it's a new version of the bill now, it's gotten the score down to about

$600 billion but part of the reason is they took out a title that's going to add that same amount of money to add to medicaid. so, part of this is going to be a shell game to try to make it look like it doesn't cost as much as it really does by simply deferring to later additional spending that will have to occur. it's another reason why we want to take our time to do this right for the saving the american people. >> republicans want health care this year and we want to begin with the 250 americans who already have insurance and make sure those americans can afford their health care insurance. but we also want to look to low income americans and make sure we are fair to them. one of my greatest concerns is about the proposal to dump millions more americans in a failed health care program

called mid -- medicaid. two problems with medicaid -- first is the massive new cost to state governments. i've suggested to my senate colleagues that any of them who hote -- vote to increase medicaid coverage in the way that's in these bills ought to be sentenced to go home and be governor for eight years and try to work to pay for it. it would literally bankrupt the states the it would at -- did -- add an amount of money that equals to a new 10% state income tax. the second part is the proposal doesn't serve the americans who deserve to be served. 40% of the doctors won't serve medicaid patients. it would be like giving somebody a bus ticket without any buses on which to ride. so the medicaid proposals coming up in the democratic

proposal are simply an attempt to shift costs from washington because we have already spent all that anyone can imagine up here, back to the states and it will put them in the same situation. >> i think one of the messages that came across loud and clear at least during my travels during last week's break was what i think are common sense arguments the american people are really picking up un -- on the one is you can't spend money you don't have and second is when you borrow money you have to pay it back. the realization across america is that we are continuing to spend and bore our -- borrow here in washington, d.c. and that bears on 45e89 -- health care. health care is going to be a trillion-dollar new entitlement. one of the things i heard repeatedly over the break, most of it came up unsolicited, people talked the -- about the billions of new taxes

associated with energy. they -- it is a message they're going to start delivering to the politicians in washington, d.c. and i hope that we can successfully defeat the cap and trade legislation that was passed in a hurried way through the house last week and that we can at least slow this health care don't down to where we can get to the fundamental issue that most americans are struggling with and that is the cost issue and do it in a way that doesn't add trill yons of dollars to future generations. >> the folks in texas don't want another government-run health care program because they've seen the flaws of the ones we have already. one called medicare where we already know that it's fiscally unsustainable. tens of trill yons of dollars in unfunded liabilities. so to -- do our democratic friends really propose to

create another fiscally unsustainable government run program on top of the munns -- ones we have now? we also know medicare is riddled with fraud. $60 billion a year lost not in providing care to seniors but rather to people cheating and stealing from the american taxpayer. finally, because we know medicare like medicaid, pays below market rates to physicians, in my state 42% of physicians will not see a new medicare patient. in travis county, only 17% of physicians will see a new medicare patient. so medicare as currently constituted is not a model for another broken health care plan on top of two layers of broken government health care plans. we need real reforms, which means addressing coftsdz and people who don't have -- costs and people who don't have insurance now. >> is there a concern that you

are potentially -- >> if you couldn't hear the question, the hearings for judge sotomayor obviously take precedence. this is a lifetime appointment. i expect republicans, republican senators will be there for this hearing as democratic senators will be regardless of what other assignments they must have. i think that clearly comes first for next week. this is no small matter, the hearings over a supreme court nominee to the most important court in the land for a lifetime tenure. did you hear the question? about a second stimulus. down in my home state they say

there's no education in the second kick of a mule. why in the world there would be any conclusion about looking at that is mind-boggling. a second stimulus is an even worse idea than the first stimulus, which has been brove -- proven to have failed. we're spending $12 00 -- $$100 million a day on the interest for the stimulus. rush and spend is what this administration is about. rush and spend. this needs to stop for the future of our country, our children and our grandchildren. >> does this change the way you approach conflicts on the other side of the aisle? >> i would say our democratic friends now have their long-sought 60 votes. the american people will fully understand that they own the government, the executive branch, the house and senate and they're waiting to see the results of their programs.

>> senator franken gave me a list of jokes, but i didn't like them so i'm not going to do it. here's a list of those who know

we need to address health care. doctors, hospital. the middle class. president obama, who has made it his top priority. democrats in congress. and at the top of the list are the american people. 9 of 10 believe high costs are hurting their families. here's a list of those who believe we should maintain the status quo. republican leaders in congress. that's it. it's pretty lonely i guess on that side. maybe that's why they basically refuse to negotiate. maybe that's why they don't want to have a debate on the issue the maybe that's why they're committed to doing everything they can to stand in the way and maintain the status quo. it was just a couple of weeks ago the republican leader in

the house said the following and i quote. "i think we all understand that we've got the best health care system in the world." so that's the difference in this debate. republican leaders think the present health care system is the best in the world. and those of us who believe that we should change it. doctors, hospitals, pharmaceuticals, governors, and on and on. status quo simply is not where america is. they know that also -- unless we act, rising costs will only continue to get worse. they know that the current path is dead end and we need to head in a different direction. that's the choice. it's a clear choice. that's why we're going to get health care done.

you're getting good. your lips don't even move anymore the >> can you hear me in >> it was great. like edgar bergen. what -- who a lot of people wouldn't remember. >> it's going to be a renewed push to keep democrats together on procedural votes. i wonder how hard you're going to push democrats on that, whether it's realistic to keep people together on health care and climate change and big items like that. >> we want to work with the republicans. this year we've had a tremendously productive year. democrats haven't done it alone. we've had republicans work with us. a handful. we got three on the stimulus and we could go through the whole list where they -- we got just a few votes. we really need more help from the republicans. we don't want to do this alone. we want to work with them and what's as -- that's what we offer but we can't allow the

status quo to be the order of the day. so we're going to work as we have all year long, democrats, to stay together. >> sob open to a second stimulus. >> who said that? >> steny hoyer. if necessary. do you agree with that? >> first of all, for those of you who couldn't hear the question, i understand he said steny hoyer said we should be open for another stimulus. is that what you told me? ok. first of all. just slightly over 10% of the stimulus money has been given out for the places it goes. so a little less than 90% still needs to be put out to the american people and we're in the process be doing that. it's going to move more quickly now. as far as i'm concerned, there's no showing to me that another stimulus is needed.

things as bernanke said, the crops have been planted, the shoots are now appearing above the ground. and that's certainly evidence based on the fact that slightly over 10% of the dollars are out among the people. >> can we talk about the chance of keeping all 60 of the democrats together for a final product? clearly there are differing views. >> the question is this. how difficult will it be, i'm paraphrasing, to keep all 60 democratic senators together on health care in i repeat we want to get some help from the republicans. on procedural votes we'll keep the democrats together. we've down -- done that in the past, we'll do it in the future. i would hope the republicans understand that they should be part of this game here and i am

having a meeting tomorrow with a number of republicans. strictly will not -- strictly on the issue of health care who i've been told they want to do business on health care. it's four republican senators. i look forward to that meeting. and so i think that we don't want to do it alone is what i'm saying. we'll just do what we have to do. >> how confident are you that you will be able to get the 60 votes needed for a climate bill? >> we're moving forward on the climate bill. i'm having a meeting tomorrow with all my chairs. i've got six of them. they have -- we have a timetable we've laid out, all agreed on that and we hope to get to climate change sometime in the middle of september or at the latest the first part of october. >> how confident are you for 60 votes? >> well, we have to see what the product is first. but i feel that with our still

importing 70% of the oil we use that it's more important now than ever to do a good energy bill, which we already have one reported out of the energy committee which is a good bill. boxer's moving forward on it. i met with her last night. we're doing quite well. we have a number of steps. first of all we have to get the bill out of the committees and then join that in a bill. then we have to get something off the floor. the house is going to move. they've already moved quickly on this so they have a bill so we have something to confer with them. it's at least a three step or more process. >> and may be surprised to see

him in that new role. i'm just curious what do you think he names -- brings to the table? why did you put him on that committee? >> when i was a member of the assassinate -- state legislature, i served on the judiciary committee. very, very good committee. i liked it very much. we have a tremendous judiciary committee. some disagree with me. i personally feel that we should -- it's not necessary to have all lawiers on the committee. we have, of course senator feinstein. no one can ever question her involvement in that committee. she has been a stalwart. herb kohl is ranked right under senator leahy. he's a nonlawyer. al franken is extremely smart. just a little side note for some of you. we were in my office yesterday getting ready to come out here

to introduce him to all of you and he said "is there going to be a podium out there?" i said sure. he said, "well, i didn't know so i memorized what i was going to say." al franken is very smart. he didn't say that. he wasn't boasting, just making a comment. he's extremely smart. he's harvard educated. he has written volumes, books for -- in fact for christmas this past year i gave my nevada counterpart john ensign all of his books. [laughter] and now that he's in the senate i'm going to get him to sign them. >> is there a need to go back in and retool and redirect some of the money that's been earmarked that way? >> city -- at this stage, no. we're doing fine. i was reading nevada clips

today. douglas county, they just said they're going to spend $417,000 in that small county on a stimulus money to do some highway work. that's going to put dozens of people to work. that's happening all over the country. the money's starting to come out. so i feel comfortable with that. thank you, everybody. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009]

>> hoyer said that next week the three house commlts with jurisdictions over those bills are going to mark it up and it will be ready for the floor of. house the end of the month. >> has the bill itself been crafted? if so what's in it? >> that's a scre good question. a couple weeks ago they came out with a summary and some changes they're going to make to medicare and medicaid. what they haven't come out with is how to pay for it. everybody expects it to cost a trillion dollars at a minimum. which means they're going to have to find a lot of budget cuts and some tax increases to pay for it. >> the senate has been working on its own bill for some time. how is that going and when

might it be ready to come to the senate floor? >> well, i've learned never to make too strong a prediction about what might happen in the senate at any point. but i will say the health committee today, as you mentioned, they're continuing their part of the markup of the by. it took two weeks to get through the so-called noncontroversial parts of the bill and now they're moving into the areas that generate a lot more motion, especially what kind of government-run public insurance plan will be in health reform to compete with private insurance companies, what the responsibilities of employers will be to provide benefits to their workers, what people's responsibilities will be to obtain insurance and finally there's an issue about prescription drugs that tied up the markup a little bit today. i know senator chris dodd, who is overseeing the committee now while senator kennedy is recovering from his cancer, would like to have that markup finished by the end of the

week. it remains to be seen whether that can happen. >> compare what you know about what's going to come out of the house and senate and how will those bills be the same or different? >> i'll focus on the differences first because it's easier to point them out. with the house hill -- bill, and it's one bill, not three bills, that all three committees will work on and the bill coming out of the health committee, they're actually quite similar in terms of the insurance regulation and the public health option being there and the mandates. the finance committee, the third player in all this, is much more uncertain. they haven't put out their proposal yet and the expectation is that since chairman max baucus is trying to get republicans to supor the package, that it will have some pretty key differences from either the senate or the house bill. starting with the fact that

there will be no public plan in his legislation. >> what do you see them doing as it works through the bill? >> i'm of the mind that taxes are going to be one of the biggest questions facing this bill for the rest of the year the all the lay -- lawmakers say they want to find as much sabrings in the budget on health care especially, medicare, medicaid, things like that but the hard truth they're facing right now is that they're going to have to raise more money to sure that this bill doesn't add to the deficit over 10 years and that means raising somebody's taxes. >> senator patrick leahy held a news conference in support of supreme court nominee sonia sotomayor. judge sotomayor's confirmation hearing is scheduled to begin monday. this is 25 minutes.

>> as many of the law enforcement leaders here can attest, judge sotomayor's work on and off the bench is exemplary. from her years in the district attorney's office and then the trial bench and the appellate court she has an extraordinary record of following, upholding and defending the rule of law. i want to release the results of a comprehensive study released that speaks to judge

sotomayor's record of being tough on crime. we reviewed more than 800 criminal cases. it can be said with confidence that judge sotomayor is unquestionably a quones -- consensus judge on criminal justice issues. her record proves she's a moderate judge whose decisions in criminal cases rarely differ from those of our colleagues on the federal bench the in more than 400 criminal cases she decided this same as the republican judges. they agreed with mer -- her more than 77% of the time. i say this because she treats criminal cases not as a partisan matter but as a nonpartisan matter. judge sotomayor affirmed criminal convictions 92% of the time and reversed only 22% of

the time. she was particularly consistent in upholding convincings -- convictions involving the most violent crimes. she affirmed convictions 98% of the time in significant cases involving terrorism. and she gained practical eerns in the real world challenges that prosecutors and police officers deal with every day. she learned about the pain and sense of frustration and violation that crime victims experience. she worked with the police officers as a prosecutor and worked side by side with crime victims in her quest for justice for these ordinary americans. it's no surprise to me she has a strong record of being fair to the police in criminal cases. the -- when the country hears

from her next week in her confirmation hearing i have no doubt it will adepree with these groups did, the fraternal order of police, the national organization of police organizations, the national sheriff's associations, the national district attorney's association where i had the honor to serve once as the vice president, the national association of black law enforcement zutives, the federal law enforcement officers association, the national latino peace officers association, the major city chiefs association and the police executive research forum. they're all represented here. all say she's an impressive, qualified nominee to serve on the nation's highest court. one last thing i should mention -- just this morning the american bar association announced that they gave her a unanimous well qualified rating for judge sotomayor.

that is is it the highest rating that the american bar association can give any judge. they did it unanimously. it's a confidential peer-reviewed valuation of her professional qualifications, her integrate -- integrity, and judicial tem rament resulted in the highest rating possibility now we'll be hearing from david heller, the national vice president of the fraternal order of police. at some point i will slip out because we go into session at 12:00. they've asked all senators to be there. they're swearing in a new senator, which happens every so often. i think all senators, republicans and democrats alike, will want to be there. david? yes? >> legal defense fund, senator sessions has raised some

concerns about? >> they can raise the concerns they want. this is a mainstream civil rights organization just like mayor bloomberg and others, i'm proud of what they've tun. it seems to me some people seem to worry that if you have somebody who actually represents people who may be minorities that somehow that's suspicious. i don't feel that way at all. >> thank you, senator. my name is dave hiller. i'm the national vice president for the fratern order of police. i'm here due to the illness of our national president, chuck canterbury, who did -- could not be here today due to illness. we are here to pledge the f.o.b.'s highest confidence in

the nomination of sonia sotomayor to the supreme court. i think it says a lot about her character that a young, fresh lawyer out of yale decides to begin her legal career as a prosecutor in the district of manhattan at a time when crime in our urban areas was running rampant. in the five years she was at that office she put a lot of bad guys in jail and forged a genuine respect for the men and women working the beat in manhattan 79 in 1992 she was nominated by president george h.w. bush to the united states district court for the southern district of new york and two years later named to the u.s. appeals court by president bill clinton. she's proven herself to be a sharp, fact-based jurist, weighing the merits before

rendering a decision the having reviewed numerous rulings she's made which touched on law enforcement officers i can say that this is a judge any beat officer can and will support. the board unanimously voted to endorse her for the united states supreme court. i am proud to be here this morning and we as an organization stand ready to assist in her confirmation. thank you. >> good morning. i'm bill john, executive director of the national organization of police organizations. we represent 241,000 sworn law enforcement officers primarily in the largest cities of the u.s. on behalf of our organization i would like to thank you for all you have done to support the the nation law enforcement officers. we stand here to support the

nomination of sonia sotomayor to the supreme court. throughout her distinguished career judge sotomayor has work at almost every level of our judicial system, giving her a did. that will be invaluable on the supreme court. she was a prosecutor and litigator before her appointment to the district court. through her years of trial experience as an assistant district attorney, judge sotomayor gained an understanding of what law enforcement officers go through day in and day out on their jobs. her support of police in cases dealing with criminal procedure and qualified i'm unte -- immunity is evidence in the rulings she has issued. she has shown she has a keen awareness of the real world implycations of judicial rulings when it comes to aspects of law enforcement officers and keeping officers

and the communities they serve safe. she -- the knowledge she has gained as a prosecutor and judge will serve our nation well. therefore we join our colleagues in urging the senate to approve her nomination to the united states supreme court. >> good morning. my name is joseph mcmillan. i'm the national president for the national association of black law enforcement executives. i'd like to begin by thanking chairman leahy for allowing noble to participate in this event and express our support of judge sonia sotomayor as the 111th supreme court justice. noble strongly supports the selection of sonia sotomayor as the first nominee for the supreme court. she has shown that she has the tenacity, intelligence, and

legal prowess needed to serve as a supreme court justice. her record reflects that she thoughly prepared and investigates all angles of a matter and provided -- provides balanced opinions that are consistent with the letter of the law the judge sotomayor's experience will be an asset to the supreme court. noble is certain that judge sotomayor will bring the experience ands -- and lessons learned as a prosecutor and jurist to the cases heard by the supreme court. the law enforcement community appreciates when members of the highest court have experience with matters faced every day by members of law enforcement across the nation. noble is pleased to provide its support for judge sotomayor's nomination as the 111th justice of the supreme court of the united states. >> good morning. national president of the national latino police officers

association and chief of police of austin, texas. i stand here before my colleagues to stongly endorse the nomination and confirmation of the justice. we're not here because we're latinos and we're not supporting her because she's a latina. we're supporting her first and foremost because she's very qualified. she has the experience, education and temperament to be an outstanding justice. i'm excited an we're excited that we're going to have a supreme court justice who has worked in the front lines of american law enforcement, keeping our communities safe and we believe that perspective from the front line will serve the american public well and serve law enforcement well. as for more? sessions, the comments up brought up, i believe in this nation, a nation of laws and a democracy all views have the right to aggressive representation and advocacy and i believe that to question

question somebody's qualifications based on her advocacy for whatever the view may be is not part of this equation. that would be like saying someone that was a defense attorney that defended criminals or rapists or murders -- murderers were somehow disqualified from the bench. we in law enforcement support people not based on their advocacy in the past but on their temple rament and qualifications. when you take a look at her record it is clear as you can see from the unity of law enforcement that she is qualified and we look forward to seeing her confirmed. thank you. >> good morning. i'm john adler, national president for the federal law enforcement officers association. i'd like to thank chairman leahy as well as of all partner organizations here standing together in support of judge sonia sotomayor.

as the national president of the federal law enforcement officers oh, i stand ready to support president obama's nomination of judge sonia sotomayor to the supreme court. judge sotomayor possessions the requisite intellect, experience and character that an associate justice of the supreme court should embodiment federal law enforcement officers and all law enforcement officers strive to enforce the law oubt live -- oibtively and i expect judge sotomayor will do the same as she interprets the law. we're not looking for reassurance she would be pro-law enforcement in all her decisions. instead we only ask and fully expect that she remain loyal to the rule of law. when the judiciary committee begins its hearings next week i hope all the members support chairman leahy and endorse the

spirit of the plain view doctrine -- seize upon what's readily apparent to the objective mind and support her as our country's next associate justice of the supreme court. thank you. >> thank you. thank you. >> i'm joe casserly. i am an elected state's attorney for maryland and i am the president of the national district attorney's association and we are here, we have early on voted to support the confirmation of judge sotomayor. we also as part of our examination pulled a number of her cases, reviewed the cases, specifically looking for her rationale, her reasoning, what she saw and how she approached the cases. as prosecutors, as front line prosecutors we rement the victims of crime.

we represent law enforcement and the perspective of law enforcement. but we also represent the defendants because we look for making sure that those people who should not be prosecuted are not prrd. and we think -- prosecutored -- prosecuted. and we think that judge sotomayor has that background of looking at all the facts and the lawsuit and applying that both to prosecute the guilty but to protect the innocent and to save them from an unjust trial. we believe that it's very important on the supreme court to have someone with a perspective of understanding how complicated legal issues that are handed down by the supreme court have to be applied on a day to day basis by law enforcement officers and prosecutors. and we think that they are background in this area makes her very qualified to understand the impact of the rulings that she will participate in. therefore national district attorneys association, the

oldest and largest organization representing state and local prosecutors, would urge her confirmation. thank you. >> thank you very much. as i said, i only made it to vice president of the national district attorneys association so mr. president, i'm glad you're here. thank you. >> thank you. i'm tom manger. i'm the chief of police in montgomery county, maryland >> i'm here on behalf of the major city chiefs association, representing the 56 largest police departments in the united states. we're here to support the nomination of judge sonia sotomayor to the supreme court of the united states. we applaud her distinguished career in public service, a record of achievement that began with her work as a prosecuting attorney. during those early years as an assistant district attorney, judge sotomayor earned high marks from law enforcement. she's been praised by those who

worked at her side on criminal cases as well as officials who have taken cases to her courtroom in later years. her record as a prosecutor and a judge show a commitment to public safety and i -- a sensitivity to the needs of the community. she's made decisions both touch and compassionate. her cases show respect for the law. we support judge sotomayor's nomination and urge her confirm akse -- confirmation. >> good morning. i am sheriff david goad and the immediate past president of the national sheriffs association and we're here today representing that association. chairman leahy, thank you very much for this wunt -- opportunity. the national sheriffs association support the nomination of sonia sotomayor to be associate justice of the united states supreme court and

turgeds urges her confirmation without delay. i am pleased to be standing here with our partners in law enforcement in a strong, unified voice today. judge sotomayor is a real-world prosecutor who pursued justice tore victims of slilent crimes with unassailable integrity and it makes her an ideal nominee to serve on the supreme court. we believe her judicial philosophy and view of criminal justice to be sound. judge centimeter has the qualificationcations, judicial philosophy and commitment to interpreting the united states us -- constitution with an abiding sense of fairness. we urge the united states senate to confirm judge sotomayor as associate justice for the supreme court and thank you for this opportunity to speak with you here today. thank you very much. >> do we have everybody? oh, i'm sorry. >> good morning. i'm jerry murphy with the

police executive research forum many which is a membership association of approximately 350 chiefs and sheriffs from the nation's largest jurisdictions. i'd like to read part of a letter from our president, john tim oin e -- timony, who is not able to be here today. i am writing in support of the nomination of judge sonia sotomayor to be serve as associate justice of the united states. i believe justice sotomayor's inspiring life story and especially as a prosecutor in new york city where i have spent most of my career, demonstrate a strength of character that will serve her well on our nation's largest court. judge sotomayor group in a housing project in the south bronx. i patroled the streets of the south bronx in the 1970's and know what a tough district that was. i have spoken to several of my colleagues who did work with

her and they give nothing but rave reviews. they were impressed with her intelligence, strong work ethic and her fierce determination to prosecute criminals. like many others i have been inspired by judge sotomayor's personal story. through hard work and determination she earned degrees from princeton and the yale law tool dosh school. she could have cashed in on a blue chip law firm but chose instead to take a low-paying position in the man hatan district trorne's office where she gained real world experience as a prosecutor. she went out of her way to stand shoulder to shoulder with thoives us in public safety at a time when new york city needed strong, tough, and fair prosecutors. i'm confident she will continue to bring honor to herself and now to this supreme court when she is confirmed for this critically important position.

thank you. >> thank you. we've had everyone, everybody has spoken and i pressure this sfrong -- strong support from law enforcement. many of us in the senate as i did had the privilege of serving in law enforcement before we came here. we know the importance -- importance of having somebody on the bench who understands law enforcement. they follow the rule of law but they know what law enforcement goes through. i think that's extremely important and we don't have that enough on the court. i think judge sotomayor will be the only member of the supreme court who serves as a trial judge. she will have served longer on the federal court than near -- anybody in nearly 100 years, being nominated first by. george h.w. bush for one

federal judgeship, then by president clinton as another judge. this is a pretty remarkable cat. are there any questions of any of these in >> mr. chairman, how testy do you expect the hearings to if -- to be? >> i hope they wouldn't be testy. it's not just judge sotomayor who has been watched by the american public here. but the united states senate. i think that we have, every senator has a right and a responsibility to ask questions, good questions, tough questions. if they disagree with a response of the nominee they have an absolute right to say so. but it should be done respectfully. we're a nation of 300 million people. only 101 people get the final say on who's going to be on the supreme court, the highest court in our land.

first and foremost the president of the united states that makes the nomination as president obama did. and then the 100 senators who vote for or against that person. we stand as the conscience of the nation in doing that. it should be the conscience of the nation and it should be respectful of the nation. not to score political points, not to do things we think may just be popular for the moment, but to make the right judgment on behalf of all americans. i think most americans, certainly all the americans i spoke with in my home state of vermont last week as i was around the state, whether they agreed or disagree with the nomination they said we hope it will be a respectful hearing because at a time when we have seen disrespect for some of our federal courts, it damages the rule of law. and we are an amazing nation in following our rule of law. we are an amazing nation in

having and -- an independent federal judiciary and we should revel in that. ask the questions, yes, but show respect to the third branch of our government. >> senator, you said you reviewed more than 800 of judge sotomayor's -- >> yeah, and wee give that you breakdown here. >> judge sotomayor's cases do you agree or disagree with her ruling that the, in new york, the second amendment does not apply to the states? >> she wrote the same as some very conservative courts of appeals judges, as you know. in other states that's a question to be asked and it will be asked of her. >> some republicans are talking about using procedural tactics to delay the hearings. i was wondering what you thought about that? >> that we don't do. the most recent example, chief justice roberts. i've tried to follow almost precisely the schedule for the

hearings which chief justice roberts. i felt that that was an appropriate schedule for him. it should be an appropriate schedule for her. and we're following that. i also agreed during that time not to do any procedural delays and did not. did not do the usual put-overs, stuff like that. senators can use their rights in the senate, but i have a feeling the american public would say what are you afraid of? why don't you vote? vote for her or vote against her. don't try a procedural things so you don't have to vote. we're elected and paid well to come here and vote up or down. thank you. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009]

>> senator leahy will chair the judiciary committee hearings for supreme court nominee sonia sotomayor starting monday morning and the c-span networks will have live coverage. now, remarks from minority leader mitch mcconnell on jouge sotomayor from the senate floor. this is 10 minutes. >> last week the supreme court decided the case of richie vess destefano in which it decided the city of new haven, connecticut, unlawfully discriminated against a group of mostly white firefighters by towing -- throwing out a

standardized promotion test because some minority firefighters had not performed as well as they had. in this case the supreme court was correct in my view. the government should not be allowed to discriminate egg intentionally on the basis of race on the grounds that a race-neutral test administered in a race-neutral fashion results in some races not performing as well as others. yet regardless of where one comes out on this question there are at least two aspects of how all nine justices handled this very important case that stand in stark contrast to how judge sotomayor and her colleagues on the second circuit handled it. first, this case involves complex questions of federal employment law, namely the tension between the law's protection from intentional discrimination known as dispairate treatment

discrimination and the law's protection from less overt forms of discrimination, known as dispairate impact discrimination. it also involves important executional questions such as why the government, consistent with the fourteenth amendment's guarantee of equal protection under the law, may intentionally discriminate against some of its citizens in the name of avoiding possible scrimtory results against other of -- discriminatory results against other of its citizens. ever case involved in this case agreed it involved complex rules that warranted further treatment every judge exempt sonia sotomayor. the district court which took up the case spent 63 pages wrestling with this issue. by contrast, judge sotomayor's

panel dismissed the firefighters' claims in just six sentences. a treatment that her colleague and fellow clinton appointee, jose cabrenas, called remarkable, perfunctory, and not worthy of the way the issues presented by the firefighters appealed. -- of the weighty issues presented by the firefighters' appeal. it would be one thing if the richie case presented simple issues that were answered simply by applying clear pess -- precedent but the supreme court doesn't take simple cases and at any rate no one buys that this case was squarely governed by precedent, not even judge sotomayor. we know this because in perfunctoryly dismissing the firefighters' claims, judge sotomayor didn't even cite a precedent.

more over, she herself joined an en banc opinion of the second circuit that said the issues in the case were, quote, difficult, so to quote "the national journal," stewart taylor, the way judge sotomayor handled the important legal issues involved in this case was peculiar to say the least and it makes one wonder why her treatment of these weighty issues differed so markedly from the way every other court has treated them and whether her legal judgment was unduly affected by her personal or political beliefs. . sotomayor got the law wrong. she ruled that the government can intentionally discriminate against one group on the basis of race if it dislikes the outcome of a race-neutral exam and claims another group may sue it. or as judge cabranas put it,

under her approach, employers or as judge cabranas put it, under her approach, employers can reject employment examination when the no one on the supreme court thought that was a correct reading of the law. justice kennedy's majority opinion said they discriminated on the basis of race and employment matters and that the government have a strong basis that they could boost a lawsuit by disgruntled parties claiming that the discriminatory effects of an employment decision. even if justice ginsburg said that before it intentionally discriminate the government must have a good cause to believe that it could use a lawsuit by a disgruntled party. not judge sotomayor. she believes the statistics alone allow the government to discriminate against one group

it claims to fear a lawsuit. stuart taylor notes of why this is problematic. as he put it, the sotomayor approach would put into an engine of overt discrimination against high-scoring groups across the country and allow racial politics to masquerade a compliance with the law. under such a regime, he noted no employer could ever say the proceed with promotions based on any test on which minorities fare better. it is one thing to get the law wrong. judge sotomayor got the law really wrong. the new haven firefighter suffered for it. to add insult to injury, the perfunctory way in which she treated the case indicate that she either did i care about the claims were that she lets her own experiences affect your

judgment. as has been reported, the four issues on the bench, she was in a leadership position with a legal defense group for over one decade. she monitored the group's lawsuit and was described as a supporter of its litigation projects. one was to sue cities based on civil service exams. she is been credited with helping develop the group's policies of hunting these types of standardized tests. she treated the firefighters -- obama said he wants judges to get empathizes certain groups. is this why she said it is could be impartial even in those cases? it is a troubling philosophy for

any judge, let alone one nominated to our highest court. the decision is the attempt of a judge sotomayor's case. we reviewed 10 of her cases. it is the ninth time out of 10 that the supreme court has disagreed with her. she is the 0-34 the supreme court last term. only five cases that judges do really matter. i dunno if those are right. -- i do not know if those are right to do they only did a small number cases. it only takes cases that matter. she has been 990% of the time. -- wrong a 90% of the time. she was so wrong in interpreting the laws that all nine justices disagreed with her.

as he considers the as to consider the nomination, we should consider ourselves if she is allowing her post -- personal political agenda to cover her judgment in favor one group of individuals over another regardless of what the law says? i yield the floor. >> the senate judiciary committee begins confirmation hearings for judge that my are on monday. today, al franken joins united states senate. the minnesota democrat swore -- swearing him in march the end of eight months of legal challenges with norm coleman who narrowly lost the race. here is the swearing in ceremony with joe biden. officer the majority leader. mr. reid: i ask unanimous consent that the call of the quorum be terminated. the presiding officer: without objection. the chair lays before the senate the certificate of election for

a >> for the representation of the state of minnesota. the certificate is in the form suggested by the senate. if there is no objection, the reading of the certificate will be weighed and it will be printed in full in the record. if he will present himself at the desk, the chair will add to the street the oath of office as required by the constitution. >> please, raise your right hand. do you solemnly swear that to

support and defend the constitution against all enemies foreign and domestic? that you will bear -- get to take this obligation freely without any reservation or purpose of evasion and that you will well and faithfully discharge the beauty of the office upon which you are about to enter, so help you god? >> i do. >> congratulations. [applause]

[captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> palace c-span funded? >> the u.s. government. >> i do not know. >> it is not public funding. >> probably donations. >> i want to say from my tax dollars. >> 30 years ago, america's cable

companies created c-span as a public service, a private business initiative, no government mandate or money. >> now to the senate health education and labor committee as members discuss health care legislation. this market session began last month with the committee now considering amendments to the bill. president obama has urged congress to pass health care legislation before its august recess. they continue -- ted kennedy is still in right now. this is about an hour and 40 minutes. we want to welcome our guests here to this historic room.

i hope everyone had a good fourth of july. i would like to briefly describe where we are as of this morning. then we will have some opening comments about the next session of the bill that we will get to predic. then we will move on to various sections of the bill. i want to thank everyone for the work. we made some good progress over the last several weeks. today we are meeting to work on focusing on subtitle h and 1, the class act, which some have already addressed to some degree. we will have the debate on this this morning. i want to thank everyone again, particularly our staffs. wally and not reach agreement, this is a first step in a long

process. it has been tremendously crawford. that is not always reflected in the public debate, it is important that people know there is a lot of cooperation it goes on to try to resolve matters as we have. there's a lot of cooperation that goes on. we hope the process will continue. i had a chance to speak with senator kennedy on the phone. he extends his best wishes to everybody on the committee. we all wish him the very, very best under these circumstances. our goal this week is to try to finish the subtitle. to clear out any other amendments that we can. i know some are still outstanding.

we would like to go back and work on some of these matters. we'll try to do that as we go along. over the last three weeks we've accepted or voted on 87 amendments as we count them offered by colleagues on the other side. all of my colleagues on the minority side are more familiar tw the difltty of dealing with that than people here are. having dealt with that. trying to get numbers. i appreciate the hard work they do. it is hard. it wasn't until the middle of last week we were able to get numbers backing on the public option and the employer responsibility section. i appreciate the work they did.

i felt it was urgent enough to delay the filing for the health care system they analyzed our language that gave us the numbers. the jct concluded that provisions of title one, the coverage taken together with provisions already marked up by the committee would result in a net score of $611 billion over the next ten years. there's roughly $400 billion left in the cbo score for an earlier version of the proposal. under the jct analysis 120 million people would be uninsured. ha good news as the eme)@@@@@@å2

we will dramatically reduce the number of uninsured, 90% will have coverage. that is very good news as we move forward. i am very pleased to report that we have some extensive support then what we have achieved so far. i hope we can achieve a bipartisan bill. i know that is the goal of all of us. i know we are not there yet. that is not uncommon. that's the goal of all of us to put that together. i know we're not there yet. that's not uncommon. you have to start some place as you move forward. we're doing that with a very good bill, a comprehensive bill. as a reminder to my colleagues,

tonight is filing deadline for title one and title 6 amendments. senator kennedy does. senator brown had a deep interest. other members of the kplee do. my hope is to find some common point of interest. i know it's an important matter to all of us here. the reason we left it blank. i would like to do that if we can. it may not be possible. i don't know where we're end up in the process. ipd to make sure that i'm not going to live rigidly by the rules under the committee.

so we're not working in a straight jacket. mike, let me stop there. i would like to make a few brief comments on the class act. >> that sounds like a good process. i want to express our condolences on the death of your sister. that was quick. those are always painful and leave a tremendous hole. we're just sorry that that happened. we'll keep your and your family and her family and her grand kids in our prayers. you made comments about the scoring and the process. i also want to make comments. many claims were made based on the new estimates from the

congressional budget office as the only accountant in the senate i believe we need to focus on what the numbers indicate instead of the hopes and claims of the supporters of the bill. the numbers are clear. this bill spends more than $600 billion and leaves 34 million americans without health insurance. the schar man ef the committee claim this is approach will provide health insurance for 97% of americans. we take credit for the new coverage. don't take accounted for the costs associated with those expansions. i serve on the finance committee. i worked closely with grassley and their efforts to craft a bipartisan bill. i know a medicaid expansion will cost several hundred billion additional dollars and will increase the cost of the total bill to well over $1 trillion. we need to be up front about

what the bill will truly cost. at the time when california is literally writing ious because they're going bankrupt and states across the country are facing the worst financial crisis in a generation. why are the estimates lower than the numbers we saw? because the bill has a new tact on employers who did not aur health insurance to employees. this will cause employers to reduce the number of employees. most economists agree the effect will fall disproportionately on low income and minority populations. we should be finding new ways. the bill will always reduce the cost estimate by violating one of president obama's campaign pledges from last year. president obama promise that had

he would not increase taxes on families who made less than $250,000. but that is what this bill does. it taxes american who is do not have health insurance. under this bill they'll have to pay $36 bill every the next ten years. the american people should understand and the administration should understand that this bill breaks that campaign pledge on taxes. the bil uses a budget gimmick to hide the true cost of the bill. the bill assumes $58 billion in new rev new from a payroll tax. made by families making less than $250,000 a year. what will happen when more people become eligible for the program outside the ten-year

window. it will then become an unfunded liability that will cost the taxpayers $2 trillion. i've never seening in as bold as this. only in washington could someone develop a policy that cost the taxpayers $2 trillion and call that a savings and use it to pay for more federal spending. according to cbo the new government-run health care plan did not have a substantial effect in reducing the score of the bill. they say it would drive down health care costs. according to cbo those claims are wrong. this bill does too little to reduce health care cost. it reflects any logical desi to design a health care plan

that falls outside mainstream thinking and bares no connection to what we can afford. our best hope is most of the proo visions in the bill are discoursed. they committed to pay for policy changes. i appreciate the chairman's comments about flexibility in doing the amendments. as i heard earlier the biological piece is going to be filed at 5:00. that was going to be same time as the deadlines. hard to do amements when you haven't seen the bill. i would mention that these parts that were left blank to begin with, we've had flexibility in allowing them to be filed at

this point in time. so we're trying to work on these things, get them done as quickly as possible and wind up with a result. so we need to negotiate the bill in good faith. we appreciate the consideration that you've been giving. we need to have some time only the pieces as well in order to do it. so, again, we appreciate the consideration you're giving. and hope there will be more flexibility. we hope, of course, that a few more pieces of what we're suggesting be included in the bill. >> thank you very much, senator. i'm going to move to the class act. we mentioned on our work on the employer shared responsibility section.

i want to thank senator binghamton. the free writer proposal was discussed as well as just having some open ended process that would have cost a tremendous amount of money. to keep people in the employer based programs as well as the smaller businesses that did not want to. that's $750 for a full time employee. $370 for a part time employee. those numbers will be enough to provide for the insurance coverage of people, keeping people in the employer based program and getting the numbers up. we all rely on the ceo. far better. we looked at the free writer

proposal. those were $5,000 per employee. that was a staggering amount. i think that concern was a very warranted concern. so we looked around for other ideas. i think it's a reasonable number. $2 a day i realize can be a burden. but a much more reduced burden than would otherwise be the case if we're going to end up with the comprehensive proposal we're talking about. i was pleased with the numbers. on the class act proposal here. and before beginning there's a little of 100 different groups and so forth that have supported

this as well as from secretary sebelius and supporting for this title as well as aarp in support of this provision as well. let me take a few minutes to drip in this provision. it is something new but exciting and could contribute to reducing costs. we know about the 46 to 50 million people who are uninsured and how those numbers break down. all of us who have dealt with the issue personally or otherwise know how expensive long-term care can be for people. given the ability that people have longer life spans, higher quality of life, nonetheless need support in the process. this is going to become a growing issue and a growing demand. you can rely on medicaid.

but in doing so we know that adds tremendous costs, tremendous burdens. this is the only program, i think, according to kent conrad, chairman of the budget committee, that actually has a reduction in medicaid costs. it's a voluntary program. there's no mandates required. it's entirely optional. we're told the cost could be in excess of a billion dollars. it's not intended to pay for nursing homes but rather to support people who need some help in their retiring years and decide to give them such without

encouraging people to move into that medicaid window. unemployment rate from all the other economic factors that pressures on the medicaid can grow tremendously. as we attempt to reduce costs and provide affordable coverage for all americans we have to begin long-term care needs. the number does come out to around $200 people when you add the younger people. it forces americans with disabilities who need additional help caring for themselves prematurely to institutions because help is unaffordable. it fails to support families to provide realistic opportunities.

it would provide seniors and people with disabilities with the support and services they need to maintain their health, retain their independence, and remain active in their communities. urntly people with limited options when it comes to providing for long term care, support and services are the case. it can be a disincentive for people to work and to lead productive lives. this section, based on the class act, shows a voluntary insurance program that provides beneficiaries a daily cash payment of lease $50 a day. these types of voucher payment avoid bureaucracy and empower consumers by enabling them to control what services they get and how and where and from home. it to be clear that this benefit is not designed to pay for

nursing homes but to help people who can live independently. the beneficiary would have to show they are unable to perform two or more activities of daily living. they must pay monthly premiums for of these five years. they had to work for three of those five years as well. they would be paid through voluntary payroll deductions. premiums would be capped at $5 a month. younger participants will pay less than older participants. this is a simple insurance modeled the old facility planning for disability and help keep people off medicaid. it will increase in defense for millions of americans. disability. help keep people off medicaid an increase in dependence for millions of americans. the legislation does not eliminate the private insurer. actually, it probably helps by

providing a platform for them to sell long-term health care insurance that currently sell very poorly. such benefits we think will go a long way to meeting the needs of baby boomers, as i mentioned earlier. the congressional budget office has told us this would result in a $57.8 billion safings over a shorter term. the ceo told us over the long run the secretary of hhs will have to make adjustments to premiums and benefit in order to keep this program solvent. this act requires under law the future secretaries to make the determinations. used examples of earlier programs where the law never required the. it will be a requirement to

adjust this program to increase the premiums or adjust benefits. so we don't end up in the insolvent situation. that's a real problem. i don't disagree with that. that's an issue beyond the ten years. if you require by law the secretary to acquire it here, this program could be a very good program. it's private dollars. no public money involved. it's totally voluntary. you don't have to be in the program if you don't want to ft it enkurjs younger people to get involved to criminal intent the shared responsibility of contributing to the longer term needs. those are staggering. we see people today. how difficult it is to get long-term health care coverage. whether affordable or available. it's tremendously expensive. people living longer, not wanting to go into nursing care facilities, loving their own independence, the ability to contribute help with that as much as 75 or $80 a day may not seem like much, but that could be the difference between rushing off to medicaid and a

title 19 window or going to a nursing care facility and providing help for them. we think it has benefits for years and years to come. whether or not those secretaries will do what the law required. it's hard believing this is a law saying a mandate that you must adjust. that office would disobey the law. it's a leap of judgment that i don't think we ought to be necessarily making. each year review the long term solvency of the program and to make adjustments to the programs that will be insolvent for 20 years.

it will help many people get the assistance they need to return to work, help the elderly to stay if their homes longer and bring down the costs of med case. $57 billion savings. both uses reduce public costs and improve quality of life for people. with regard to the long term supports and services, there were 38 amendments filed by the colleagues. kennedy's amendment number one is modified to include mike enzy's. number 77 is modified and has been accepted. number 16, 17, 18, 20, 21, 22, 2

26, 27 is modified. as well as number 7 and senator isa isaacson's number one. to try to work on as many of the provigs as we can on this subsection of the bill. we still have amendments to consider with the title. private dollars going on. entirely optional for people. a mandate that future secretaries must adjust the program on a yearly basis to make sure the solvency will be there. by raising premium or adjusting benefits. i think it's a creative program and one that will make a significant contribution to people to keep them independent, contribute to the long-term

support and acquiring in a sense for those who want to participate an opportunity to share the responsibility. so with those points i open up the floor for amendments. >> mr. chairman, i have a few things i would like to say. first of all the follow-up by a logics bill is supposed to be followed by 5:00 tonight. you've given us an hour and a half. >> okay. >> now secondly i thought we had a deal here put together by senator kennedy, senator clinton, even senator schumer agreed at the time. i thought senator brown had agreed. maybe i'm mistaken there. we have no idea what you're filing. i hope it's consistent with what we all agreed to on the

committee. there's a lot of playing around. i'm very concerned about it. if we can keep them where it was, you will have an explosion in investments. that will lead us to more treatments and cures. if you play around with the day today exclusivity part, and i've spent a lot of time oon this and helped bring it down from where it was and force ad lot of companies to get off their kick and get down to that point. if we keep playing around with that, we're going to deter or even defer, i guess, an awful lot of treatments or cures that will be beneficial to mankind.

12 years is about equivalent to what we did. now we're talking large molecule drugs that are not even drugs but entities that are very, very difficult to duplicate. i would hope we can stick with what we came up with. 108 cosponsors of the bill which is somewhat similar to what we agreed to here. having said that, if the chairman will forebear with me for a while, the last week the democrats in the hud committee start ad letter they reduced the try costs of the bill for more than a trillion to a little more than $600 billion. that's fiction.

let me tell you why. the distinguished senator from wyoming i thought made a very interesting and good statement. here are the facts. the misleading lower spending and higher numbers based on -- i don't think anybody could decide otherwise. let's talk about the quote assumed unquote medical expansi expansion. the health democrats or staffers claim they cover almost 97% of the uninsured. now the truth according to the cbo letter is that it leaves more than 34 million americans uninsured. 97% number based on a massive expansion to 150% of the federal poverty level that would cost anywhere between $500 and $800 billion or more. this is a time when states are faced with $200 billion in

deficits. they simply assume the expansion without spelling out the policy. claiming jurisdictional concerns. now take neez taxes on american families and businesses. the revised title one of the bill includes an hon rous mandate to raise $36 billion in additional tax revenues. now families, that is if families fail to get the level of insurance that's defined by the federal government. this is a time when american families are struggling to pay their bills and keep their homes. as the distinguished ranking member said of president obama's own commitment to not raise taxes on 95% of americans. it includes a job killing mandate that's going to tax american businesses by almost

$52 billion. this is going to lead to lower wages and more job losses at a time when our national unemployment rate is almost 10% and rising. although the class act raises $58 billion or reports to do that. new rev news in the first ten years. what it doesn't mention is the long-term costs of the programs which according to the experts at the american council of life insurers will be almost $2 trillion. $2 trillion. this is a time when major government programs like medicare face long term deficits of almost $39 trillion. and to meet the target of fully paying for health reform in the first ten years, those who are arguing on using the budgetary gimmicks have lowered the score by pushing back the most expensive items of the ten-year

budgetary window. for example, the subsidies did not even get going until 2013. i mean, this is manipulating the budget to try to get to a lower figure and lower cost on this bill and the cost, if this bill was passed. despite the claims of reduced spending, the real ten-year cost of the fully implemented policy of this bill would easily exceed $ 1.5 trillion. we're asking american families to be honest about their spending and their budget in these tough economic times, i think we should take their advice as well on this important issue. these are important points, and as you know, i'd like to get a new health care reform bill. i'd like to be able to work diligently with that. i know the distinguished member leading us would like to do that.

i have a distinguished committee chairman and i've got to say that we're all just blown away by the blind way they think some have ignored these facts. you can't ignore them and play this game of $600 billion and everybody knows that it's going to be drill otrillions of dolla. >> i appreciate that. >> i'm sincere about this, and i have to say that i think senator kennedy, if he were here as well, he'd be tremendously concerned about this, and i feel really badly that he's not here, and that you have this responsibility that's got to be the most miserable sponsibility that you've had in a long time is all i can say, but we've got to get real on this stuff. if we're not going to get real we're basically pledging our country and our country's assets

and its futures on the our something that we're, you know, i'm not telling the truth about. so i'm really concerned about it, and i think this is too staff driven. let me say briefly to my colleague, the status quo is unacceptable. 18% of the gdp jumping to 25% is unacceptable. it's as if the costs are going to go down if we don't act. 14,000 people a day losing health insurance in this country is unacceptable. they can be in a free-fall for the 62% of bankruptcy, 50% of foreclosures. we recognize that we are trying to find members. the president wants is to be deficit neutral. we went to keep people in employer based programs. think about long-term needs for aging people that won

independence. this program does not change anything. if you like what you have, you keep what you can. you can make this affordable and quality. it is not an easy task. others have tried for 65 years and failed. we do not have the choice of feeling in my view. we have only one choice, to get this done. it will have some cost associated with it. the numbers we saw a month ago had sticker shock on it to all of us. costs down and the numbers we saw a month and a half a month ago where it had sticker shock on them to all of us. so we've tried to come back and figure out how do you do this and get numbers that are realistic and the numbers that we've come back with, cbo has come back with, not their number, our number, puts us in the ballpark of achieving the president's goals andi having a proposal. you i think we're on the right track with this proposal.

we'll work on that as a committee to try and solve the issue if we can to the satisfaction about bringing down costs as well and certainly the cost of pharmaceutical drugs whether they be bile odjick and chemical. they'll have some ability to manipulate while simultaneously have creativity and i've listened to you over the years and i agree with you. we do need to encourage the investments that occur in that area, they're essential. we have to have some restraint on costs. so we try to balance those interests. >> mr. chairman, with all due respect, i would rather fail than sad them country with an unsustainable -- >> none of us want to do that. >> well, i don't know how you will do that if you do this bill. >> mr. chairman -- >> you allowed me to make general opening statements which i did. for the class act, what i

intended to do was have the budget ranking member make some comments on that. let me turn to senator brown. >> i just want to speak for a moment with biologics, and i watched with great admiration. senator hatch's legislative skills and that i admire his work of more than two decades ago and one of the greatest consumer pieces of legislation that this body has passed in the last half century, probably. there are -- there are significant differences of two points. one is i want to mention the deal that was made a year or so ago on this committee of the 12 years. a couple of things are different today. one is that agreement was made with the understanding that we had a president who was not particularly supportive of a stronger pro-consumer side and also was stronger pro innovation, and we knew a

majority of 5149 in the senate didn't lend to a stronger bill. it was the best for innovation we could do and the best we could do to keep prices down saving money for employers, and saving money for taxpayers. when you did hatch waxman in the terrific work that you and you can look at the difference in cost of chemical pharmaceuticals and living organism biologics. back in the 1990s tax all that was considered outrageously expensive and the pharmaceutical that in those days cost $4,000, maybe it was $4,000 today, it was a pharmaceutical that cost $4,000. that was a high cost having a generic competing having a great difference there. we're talking about cancer drugs, and now it was 40,000.

so without any kind of follow on biologic without any generic, we don't get to where we need to get to to save consumers money. the 12-year agreement, and that 12 years doesn't lend itself to innovation. you look at hatch waxman on market exclusivity and compare market exclusivity followed on biologics. it was a 5-3-1-tiered approach similar to a bill that senator bingaman and i also co sponsors and senator martinez and senator viter, and i'm leaving out another republican when were introduced. and that legislation really is better for competitiveness the 5-3-1 tier mem imiimicking hatc

waxman. there has only been one non-industry analysis of the 12 to 14-year issue, 12 to 14-year bill and one other point, i apologize, on the 12-year agreement from last year we also didn't work out the issue of what do you do with evergreening and there was a difference of opinion after we passed it out of committee. never went to the floor because there were differences on to the evergreen 12 plus 12 plus 12. >> we've been working on that, as you know. i know we're working on it, but i would like to see your proposal because my understanding is you want an evergreen 12 plus 12 and more 12s than that, we can certainly talk about that, but the last point, the only real study and the only real analysis done outside of the industry, not by the industry was the ftc report about the innovation issue, and we concede on those of us that want a stronger follow-on conserve nothing and certainly pro-consumer were pro taxpayer, pro employer and pro bringing in

dollars for the health care system, but our side is also pro-innovation. the ftc report with the potential harm is that firms will direct scarce rnd dollars for low-risk drug products rather than to new inventions to address medical records. thus a new 12 to 14-year exclusivity period imperils the efficiency benefits of the follow-on approval process in the first place. this will mean a longer, maybe counterintuitive, but a longer peri of -- a longer period of exclusivity means less innovation, less investment in going down a new road. it means, as the ftc said, it means plowing and doing well plowing and well-tilled areas where you don't need much plowing and instead of what we really want to aim at. so that's why this 12-year doesn't work for, i think, most of us on this committee and we

need to look at something different. chairman, we'll get to this debate on biologics. i promise we'll provide more than adequate time, and we did some last evening, but let me also encourage my colleagues here. again to try and see if there's some accommodation we could reach on this issue that would satisfy both the consumer interest and the innovation that we've been talking about, and i'd urge my colleagues to continue that effort so we can avoid what would end up being a non-result if we go down a path with no answer and being able to merge on this committee. >> i'll be short. >> look, this was not just a gentleman's agreement. this was an agreement that the original hatch waxman has called the very priced competition term restoration bill. we had to balance both sides, the needs of the generics and the needs of the innovator companies and by all measure, we did that pretty well.

now, in this particular case you've got a much more difficult situation because it's much more difficult to arrive and much more expensive to arrive on follow-on biologics success, and not only that, we had agreed. it wasn't easy to get to 12 years from where a lot of people in my side were, and frankly, we worked that down to 12 years. the administration's budget has it at seven. of course, to keep in mind, without the innovator investments and work, the generics will have nothing. and it was not in their best interest if we had a bill that would not amount to the investments that are necessary in order to arrive at these --

at these solutions. i might add that these, you know, the average time to develop a follow-on biologic is extensive. i know companies that are in their 15th year and still getting private investment to keep going with no real absolute guarantee that they'll arrive at a treatment or cure that may be life saving to so many people. this is not a political issue to me. this is a very, very important, scientific issue, and frankly, some on the generic side take the position to heck with them, and consumers aren't going benefit unless we get this right, and i'm convinced that to do it as well as we did on hatch waxman which was by no means easy, we had the same arguments back then to do it, it's going to take a minimum of 12 years and frankly, you know, if i'm

wrong, i'd be surprised. >> thank you, senator. >> senator? >> well, first of all, i agree with senator brown and senator hatch in which we need to continue really these breakthrough innovations, but have to be enormously sensitive to both costs and yet the promotion of innovation. i'm puzzled about the regulatory process. in reading the medicare payment advisory commission which i know is a bit controversial these days. they talk about medicare payments systems on to biologics. one of the things they do say is that biologics now account for $13 billion in medicare spending. they also go on to say that over time the product -- the price has not fallen, but there is no regulatory pathway to an expedited approval process on

follow-on biologics. so while we argue, 12 years, nine years, seven years and sound like an auctioneer, one of my questions when we debate is what will -- what is the regulatory process here? what is the approval for the original biologic. it seems that there's no approval for a follow-on biologic. i'm puzzled by exactly what that means and the consequences and then the impact on the delivery of patient care and on cost, but we could fool around with time and yet have no sound regulatory process to be able to do an appropriate regulatory process on the follow-on biologic. see what i mean? >> good point. so i'm not making this up while we're looking at the ftc report. if we look at the people who look at the funding for

medicare. so but all of us want to have a biologic or pharmaceutical when we need it and you have to have people who invented and bring it to the marketplace. thank you, senator, very much. >> we need to have an innovation from the government. >> thank you, senator. senator gregg. >> thank you, mr. chairman. just a brief comment on new scoring by cbo. i think both senator enzi and senator made this point. it is incomplete. if you're going to claim 97% coverage and therefore that you picked up this uninsured, the scoring is inaccurate because it does not have medicaid expansion

costs in it. this bill as it's before us now has $34 million uninsured and it costs to the cbo 600 and some odd billion dollars. if those -- if you use your assumption as the chairman said at the beginning that the proposal would have 97% insured, people covered, so the $34 million would be reduced to 34 million. then you have to include the cost of medicaid expansion which takes the cost of this bill well over $ 1 trillion and puts on the state and unfunded mandate of close to half a trillion dollars and those are big numbers and they don't meet the test that the president set out in my opinion. so i think it's important to make that clear. in the area of the class act, the cbo has said this is insolvent in its present form.

we know it's insolvent in its present form. the fact that we're working with a ten-year window allows the score to represent a 50 million -- billion dollar plus window. we know when you get outside the ten-year window and people take it represents $2 trillion. cbo's calculation may be less than that. they did not give is a 75 year number. we know it is a debate. the cbo said for this to be solvent. yet said. start with a premium of $85. -- you have to start with a premium of $85. why would we start with a program which we know on the face of it create a $2