otherwise it just becomes a part of the department of transportation. and their existing finance program. we need to be thinking bigger. and if ever there was a time to start thinking big, it would be now. .

been performance and opportunity are all built on the platform of investments -- innovative public investment. every great american president has come up with a great investment project. from the rear can now -- eerie canal to others. the chapters of our american success story have always been written in stone and mortar and iron and steel, granite, and fiber-optic cable. we must come together to write the next chapter in infrastructure investment for our nation. i look forward to working with you. we can do this. we need to have the courage and

the will and the foresight and the vision to move forward on this plan. you can play an incredible significant role in raising the profile of this and of letting your colleagues and members of congress to take your clout and use it to put pressure on the institution i am serving to make this happen. thank you for letting me be here today. thank you. [applause] >> thank you so much for being with us. our chairman is no longer on the phone any longer. he passed along a question for you. the administration has proposed certain things. the question in view of justice

-- how can we work together and be helpful? that is the question. >> i think there is an appetite to move forward on this. speaker pelosi is very interested in this and has spoken out about it. what we cannot do is limit our vision to just making this part of the department of agriculture. i share the subcommittee on agriculture. i'm always thinking about it. it cannot be just a part of the department of transportation or make it in another piece of that agency. its strength and independence as a bank -- as i concluded, we

need your help. we need your voices. i am happy to sit down at any time or place to discuss this with people. we need your voice and your aggressive advocacy of this concept. we need -- this is a tough time. we are dealing with energy legislation, health care, a difficult economy. this has to be part of the national discourse on what happens with our economy. we are facing a very difficult time. it does not lessen what you need to get done with other entities to try to move forward. in that context, i believe that with the kind of capitalization we can talk about that will require congress to move on it that you can help us get there.

you can help yourself and do the kinds of things you want to do to create a solid economic base in your own state. >> i think your proposal is a very good one. if you could explain, how would it work in an instance of -- there is a high-speed rail effort by the administration. 11 corridors have been selected. we in the west are trying to have a corridor from el paso to denver. there are federal and state matches. other your -- under your bank, could states apply? how would it work? >> let me go back to the

concept. this is not to supplant the already existing mechanism that is there to finance the project. this would be another avenue of revenue. with such a project, the state could request, apply for funding to the bank in order to be able to get this financed. what we are looking at is locally you have dealt with municipal bonds which are usually smaller projects. projects of national significance and regional in scope that would look at how you can take traffic off the road and lessen congestion. you can look at the environmental benefits the deal with job creation. that is the purpose that is set

up for states to be able to get funding from this bank. >> he said the house is going to move forward on a highway bill. i read in the paper today -- i may not have all of my facts, but this highway bill may be delayed. >> you are talking about the reauthorization of the transportation. the senate last week -- the highway trust fund is about $8 billion short. they are trying to address that shortfall. to do that before the august recess is important. the senate already acted and they extended it for 18 months.

i suspect that is what will happen in the house as well. it is being worked out. that is what is going to happen. we have seen an extension by several months. it makes it very difficult to try to get anything done with that short time frame. they are trying to sort out how to fund the entire record relation. one person is masterful in what he is doing. there is a determination to deal with the $8 billion shortfall in the highway trust fund. >> we have a lot of projects in the states ready to go.

i hope you succeed. >> thank you very much. [applause] >> an important topic. we are running over. we need to get to a couple of other items. we will move right along. i want to thank our special guests for being here for this important discussion on infrastructure. thank you all. [applause] i would like to ask my colleagues to be as expeditious as possible in their presentations while still doing justice to the topic over the next few minutes. first of all, and want to call on gov. patrick who is going to be our host a year from now.

, appear and tell us what we are going to enjoy next year. >> thank you. i am proudly wearing the colors of red sox nation. you are about to get your own callers to where rigid colors to wear. we are honored to host the meeting -- you're all colors to wear. we're honored to host the meeting next year in boston. we are planning meetings that will be productive and fun. look for it to the fungicide to showing you wear american democracy was invented, our historical attractions. we want to expose you to our cultural and history community. we want to show you the

beautiful landscape, the mountains, valleys, and coastline. plan to come early. plan to stay late. we will have some version of a concert services that will help you plan your family vacation around that time as low. we are looking forward to having you. i want to thank everyone for their leadership and the honor of giving us this opportunity. thank you. [applause] >> there is a massachusetts display here at the convention center. stop buying get more information. now i want to talk about a program called child help. >> i can speak from here. this is an opportunity for me to

talk to you about something that is near and dear to my heart. our headquarters are in phoenix, arizona. it is an organization that i got involved with. two dynamic women who work entertainers in the young girl like decided they would put aside their career and to reach out and help those abused children that we all have in our state. five children die every day in the united states and due to java beans. these children are in your states as well as mine. i will like some people to stand up. please the knowledge of them. [applause] they have been fighting child

abuse for 50 years. we just celebrated our 50th anniversary. some marvelous things. today you may have noticed that there is a bus outside -- it is a bus tour to raise attention about child abuse. it includes the national hot line. on the table, you have a piece of paper that explains this. we want you to know that they will be in your community. i hope you have the of virginity to welcome them and to participate with them to raise that awareness. they are out there and they are

focused on encouraging and providing support and resources for families and care givers around the country. today i have a child help resolution. what we are hoping is that we can get all of the governors throughout the state to sign on to say that the day as governors of their state want to prevent child abuse and they want to help those families that are victims of child abuse. it is a worthy cause. i will like you to come by here before we leave to sign up with it. i have cut my presentation down. i asked you to take the sheet of

paper, and make this issue something that we can collectively do in each of our states and make a difference. children are hurting out there. thank you. [applause] >> we thank the people from chao help for being here as well. this awards program gives governors the opportunity to recognize some of the most bible citizens and servants. they have made inviable contributions to public service and state governments. i am honored to commend these extraordinary individuals for their commitment to improve their communities, their state, and our great country. all the nominees for outstanding this year.

the selection committee had to fulfil its responsibility to make these choices. i want to thank one person from pennsylvania research on the selection committee. i think barbour is here. -- barbara is here. thank you very much. awards are in several categories. as i announced each winner, i would like you to come forward along with your governor if he or she is here. i want the governor's to come up here and make remarks about each winner. our first when there is the former secretary of this up the cargo -- of south dakota fishing

in gaming deparle in. [applause] >> thank you, mr. chairman. ladies and gentlemen, john cooper served as the secretary of game fishing parts in south dakota for two different governors. before that, he served as a u.s. fish and wildlife officer for a number of years. before that, he served two terms of duty in vietnam. he is a gentleman that has been responsible for improving the quality of life for people who live in south dakota but also for hunters and fishermen who enjoy the hunting season. he has been actively involved

with clean water issues and promoting an negotiating changes in the missouri river water resource plan. he has been an active member with the state and other states. it is my pleasure to introduce you a gentleman who has done a marvelous work over a long career. mr. john cooper. [applause] >> thank you. next in the private citizen category, from virginia. a lie to and by the governor to come forward.

>> -- i would like the governor to come forward. >> terry dickinson would have been a good nomination in the year. he served as a dentist. he came to virginia where he became the chair of the virginia dental association. he noticed that many americans do not have access to dental care. he started something in virginia called the mission of mercy which organized private sector dentists to provide free dental care around our state. he organized nearly 40 mission centers. he has been responsible for providing free dental care for these organizations. the work that he has done has spread through other states that have tried to emulate the work.

he dealt with people hurt by hurricane katrina. the centerpiece takes place next weekend in virginia county. i have served their and i will be working with volunteers with my wife. people lined up and drive from all over the eastern part of the united states. it is all kinds of medical care not just a dental. you'll save vehicles from florida and oklahoma coming to get free dental and medical care. it is a very humbling and setting thing tuesday. the work that he has done to bring people together is very inspiring. his model is, it is not about the care, it is about the caring. i look forward to being with him

next week to continue his wonderful work. [applause] >> congratulations dr. dickinson. now in the arts category. i like to invite governor a mallet to come forward. -- o'malley to come forward. >> thank you for your hospitality and pulling us together. she is one of the recipients of the distinguished service award. it has been written that americans are living in the present that is shaped by visions of the future. her dream of the future in maryland was a place where every

child have the ability to receive quality arts education that would unleash their own creative potential and ability to think in creative waves. -- creative ways. maryland has the best public school system in the u.s. that is in part due to her leadership. she understands that if our children are to attain higher levels in reading and math that the arts and music are critical to that. she worked with the maryland state department of education. it resulted in the adoption of a voluntary state curriculum in fine arts. we are setting up objective criteria that says this is true arts education. putting kids on a bus to visit a museum once a month after school

is not arts education. she has been a tremendous leader. she is a true champion for arts education. because of her efforts, we are seeing tremendous progress in education in our state. her leadership has improved the quality of life for our kids and their outcome. we are proud of you. he make maryland a better place. thank you for your leadership. [applause] >> our final award winner is in the artistic production category. it represents the state of florida. i like to tell you about james. he is a resident from florida. he was born there. he began selling his paintings out of the trunk of this car

for $20 years ago. he has planted more than 10,000 florida landscapes. he has been commissioned by two governors of the state. he has expertise and has spent time in many projects. he volunteers for our education programs as well as other programs that benefit children as well as crime prevention programs. he participates in charitable events. extensive artistic contribution captures the beauty of this state. he is generous with his time, talent which brings a greater understanding on the importance of art to the public. congratulations to james. [applause]

of want to take a moment to recognize the corporate fellows that are planned such an important role in the activities of nga. this program was founded in 1988. they can share the unique experience is an expertise through our research and development arm. corporate fellows demonstrate a commitment to improving cooperation in understanding state government and industry and help us develop a bipartisan resolution is to the problems of our nation. many of the top companies in our nation have corporate fellows.

blue cross blue shield, ibm, johnson & johnson, and others are a part of this. they have been a member for 20 years. on behalf of all the governors of america, i would like to thank all of these companies and our corporate fellows for their contributions to our organization. [applause] now they bittersweet moment when we say farewell to a colleague who is moving on after his service to this association but to his state. a lot to as one governor to return to the podium. he is serving as governor of the commonwealth of of virginia. he is turning over the keys to his successor next year. really appreciate him for what he has done for his state and his hard work here.

he has served on important committees and task forces of this association. he has been involved in public office for about 15 years serving on the richmond city council. he has served as governor of virginia during the last term. he has done so much in different areas such as transportation infrastructure, land use planning, education. they all have been priorities for him while he was governor of the state. sometimes things happen. the ticket -- difficult challenges that we need to confront. we talked about mississippi and what happened in the gulf coast and out others have responded to this diversity -- adversity. there was a real tragedy in

virginia check -- tech with a mass shooting. many students and families were affected. in the wake of a tragic, he came up with an executive order to prevent those with mental illnesses from purchasing firearms. that was a tough time. he rose to the occasion however. we are proud of what he has done for the people of this commonwealth. we will miss you. we appreciate all that you have done. we hope that you will keep in touch and value the friendships that you have made here at this association. best wishes. [applause] >> thank you very much.

no, no. thank you. you are very kind. [applause] please have a seat. in virginia, we are the only state where you can serve one term. the title is your excellency not your honorable. there is a consolation there. it has been a great honor of my life to serve here. i want to say, of being governor right now is the toughest jobs in the united states right now. everyone of you and us is making and will make very painful and difficult decisions. not many people understand how difficult they are. i understand. i applaud you for your cap -- courage.

a look forward to working with you together when we do public- service together. thank you very much. [applause] >> the framed picture that i just gave him where he said he did not recognize himself, it is a pitcher with teddy roosevelt and the governors' association several years ago. i am sorry we went late. thank you all for your patience. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009]

>> tomorrow we will continue our annual coverage of their conference. live coverage starts at 3:30

eastern on c-span. the senate health education and labor pynchon's health committee voted on a health-care bill. -- pensions health committee voted on health care bill is triggered this is half an hour. >> we welcome all of our colleagues here this morning.

many important humans have occurred here. in this room, and the mccarthy hearings were held. the watergate hearings were held. in this very room, john fitzgerald kennedy as a junior senator from massachusetts announced his candidacy for the precious -- for the presidency. his brother did the same. we have at dinners as members of the senate. we come here twice a year to enjoy it each other's company. this room has had a lot of pleasant and a dramatic moment in our history. i think all of you for the

tremendous effort and work it you had engaged in over the last few days. it has been a tremendous undertaking. i am very grateful to all of you. i want to turn to my colleague and friend from wyoming for a statement he has this morning. i will then make a brief statement as well. the statement from senator kennedy of want to put in the record and include it. we just got off the phone with vicki kennedy. senator kennedy wishes he could be here. you can proceed. >> thank you, mr. chairman. i want to thank the chairman and all the members of the committee from both sides of the aisle and the staff for all the work that everyone has put in on this bill and other bills that we have worked on. a lot of people do not know

about the weekend work that has been done both by members and by staff. staff has stayed around in the evenings after we left to work out details. this state through their lunch hours and dinner hours to work out details. it has been an all they all week effort for them. -- all-day, all-week effort for them. what did take everyone for being civil to each other. as far as markups on a very difficult bill, there has been another of patients. i really appreciate that. -- patience. i really appreciate that.

i had high hopes that this would be the years that members of the committee would work together to provide health insurance for every american. i urge my colleagues to start with a blank piece of paper to the -- to develop a bipartisan bill that members of the senate can support. that is an absolute criteria. this cannot be a bill put together by one side if america is going to believe what we are doing. there must be support and input from both sides. if one side has the votes and can write the bill and when, america will not win. -- write the bill and win, america will not be win. we have had the same vote that has appeared on almost every amendment that has been blocked here.

we had a 45 roll-call votes. to prevail. -- two prevailed. president obama wants a health care bill that will reduce costs and every american can get access to adequate and quality health care. a bill that will not increase the deficit. republicans strongly support those goals. this bill does not meet them. they do not meet the goals. the bill has some all solutions for the problems that are not stated. i wonder what president obama's reaction in the campaign trail would have been had this bill passed last summer rather than this summer. i wonder how the former senator from illinois had voted given the stark differences between

this bill and his campaign proposal calls. the bill before this committee fails on all of those counts. it breaks the promises of the president'. it does not reach the common goals that the president and congress shares. it as $1 trillion to the deficit. -- it adds $1 trillion to the deficit. we had news net -- last week that the federal budget deficit was around $1 trillion. iraq asked and instructed to been to the cop -- we were asked and instructed it to bend the cost curve and down.

it would increase the total spending on health care. the first word in the title of the bill is affordable. but it is not affordable. most people insured now will pay more. this bill breaks the president promised that if you like the care you have now, you can keep it. the bill would force millions of americans to lose the health care plans they have been like now. this bill kills jobs and cut wages. it will result in lower wages and higher unemployment. these job and wage cuts would hit low-income workers, minorities, and women the hardest. if you look at the front page of today's wall street journal, you will read the ominous title referring to the house proposal.

small businesses face big bites. employers will be penalized for not providing insurance. americans are facing the highest unemployment rate in 26 years. we are trying to impose new taxes on small employers that will eliminate jobs for low income and minority workers. this bill raises taxes at the worst possible time despite several offers from the republican party. the bill would impose a new tax on people without health insurance. it will allow washington bureaucrat to ration care. it lays the groundwork for government takeover of health care giving them the power to prevent patients from seeing the

doctor they choose. this bill traps' low-income americans with the second tier health-care program. medicare patients to labs have the access to attract all the health care. they refused to give low-income americans a chance to get out of the worst health program in the country. instead of giving the lowest income america's the choice to enroll in private inch -- private insurance, -- the care they would receive is worse than what they would in private health care. this bill spends billions of taxpayer dollars.

this bill preserves the costly dangerous medical malpractice system. it fails to reduce medical losses which drive up health- care costs and force doctors to order wasteful tests to cover liabilities. it provides fewer medical students with financial system -- assistance working in underserved areas. this bill breaks the record for the largest markup and the most amendments filed. that is because republicans were

shut out of the drawing process. we were forced to do hundreds of amendments to get the corrections that we thought should be in there. i appreciate the flexibility of the majority. we reciprocated the flexibility by the way that we were able to do the second half of the bill. there were not in the second degree mms which were not allowed. i appreciate -- -- there were not any second degree amendments which were not allowed. we got to tinker around the edges. all the bright idea of limits suffered. i hope between now and the merging of the finance and going

to the floor we can correct some of these things. i have a lot of hope for that. i know there are a lot of ideas that have been suggested here and on the finance committee which i am on. i think we have a bright future for health-care reform in america. it cannot be this bill. it can have parts of this bill. i want to reform the health-care system to improve quality, reduce costs, increase access, and i like the goal that if you like the insurance you have now, you can keep it. this legislation fails lows and the six the american people with a bill that we cannot afford. i understand the finance committee is supposed to take care of financing it. we see an increase costs which would make it difficult for them.

we have a chance to merge the two bills and come up with a bill that will meet the president's goals and all of our goals. for the reasons i have mentioned, i ask my colleagues to oppose this bill. i thank the chairman. >> thank you. i appreciate your participation and cooperation of the next -- over the weeks. the list is long. the staff members have been here during the markup. did they have been here every weekend that we have been involved in the process. all lights, emails back-and- forth trying to resolve -- long nights, and emails back and forth trying to resolve this.

i am going to submit the names of all these people from the staff of senate the -- senator kennedy. we are careful to all of them for the time and effort they have put in to get us to the place where we have the first bill coming either body of the united states congress to grapple with the issue that has defied several presidents. we have not crafted the perfect legislation. we have put on the table something that will serve as a basis for addressing this crippling issue of a health care reform in our country. i thank all of the staff. i want to recognize our colleague from the white house. he will be leaving us after the vote here today.

he has made a significant contribution to our process. he was very instrumental in crafting a very creative proposal in this area as well as other suggestions in the process. we thank you for your participation. we look forward to working with your in the years ahead on these issues. i put these blue bristles on the prices -- blue bristles on the table here. -- below bracelets on the table here. -- blue bracelets on the table here.

senator kennedy is happy about the effort we are about to endorse which is to send this bill out of the committee and work with others to put together legislation that we hope we all can embrace and indoors. i hope that is a goal that all of us have. we begin this process with a blank sheet of paper and a mandate from our fellow citizens around the country. the american people demanded legislation to protect their choice of doctors, hospitals, insurance plans, cut costs for families and businesses for the federal government. they once everyone to have access to affordable and quality health care. that was the charge we all received. with a smarter and more efficient health-care system that would eliminate waste, fraud, and abuses. it would focus on keeping people

well and set of just taking care of them when they are sick. we want to improve outcomes for every citizen. the american people ask us to recognize the urgency of this moment and the effect that the health care crisis is having on them and businesses around the nation. the american people wanted us to act. to set aside politics and find the solutions that have been looted presences and congresses for more than six decades. -- deludeeluded presidents and c ongresses for more than six decades. this committee is ready to take the first, a giant step towards america where our health-care system lives up to the lofty standards set up by our talented

professionals. it is about patients not profits. no parent should lay awake at night hoping their child's fever goes down because there is no money to take the child to see a position. we want an american where grandmothers are able to afford prescriptions so they can stay healthy. we do not want anyone to fail or fall in a bankruptcy because they get sick and their insurance will not cover their bills. we won a health care system where doctors and patients determine their health care plans and not bureaucrats. we want an american where people do not have to live in fear if they lose their jobs and make -- and may lose the insurance they rely on or it may be taken away

by an insurance company when they needed the most. this bill stops insurance companies from denying coverage based on pre-existing coverages. it makes quality care affordable and accessible to every american family. if you have health insurance and you worry about how you can afford the care you need, this bill as for you. it eliminates lifetime caps on coverage. it stops insurance companies from increasing insurance premiums. if you have health insurance that works well for you and your families, this bill is for you. . coverage is not good covered unless it is stable coverage that cannot be taken away and is

not eat up your family budget. it guarantees that you are able to get the treatment of the doctors you choose. this bill -- we have been waiting in fighting for this bill for a long time. i am proud that it has come from this committee. it is a bill that americans have waited 60 years for. ted kennedy has fought for this bill for decades. i spoke with them this morning. he is very excited about the prospects of this moving forward. he asked me to cheer these hearings. i decided that i will not let us failure. we would listen to each other and engage where we could to get the contributions of each member to this effort. every single member of this committee has played a role in this bill. provisions have been included in this legislation because of the

contributions of all 22 of your around this table. we have come to a resolution on the solvency issues of long-term care. we are encouraging people to take responsibility for their own behavior. we'll talk about medicaid issues. the cost of this bill and a lettuce -- let decisions people have to make are taken into account because of some of you here. you have spoken of small business concerns. we have listened as a result.

there's been many ideas offered an amendment made in in this area. todd, we thank you for your work on the small-business issues as well. in other person has worked on the prevention issues of this bill. quality and extended a debate on those issues and how we can improve quality has been discussed by one of these colleagues here. pat robertson roberts -- pat roberts has also done extensive work on this. we've been trying to make sure every american is covered. we thank you for your contributions.

jack reed made a lot of contributions to get japan. we have been working with or national many issues as well. bernie sanders aboutalked aboute penalties on those engaged in fraud and abuse. this process will go forward. i am confident we will reach a, -- the compromise. you have made significant contributions. you're involved earlier in putting together how we deal with airplay issues as well as other issues for part-time workers and making sure they do not discriminate against smaller employers, we appreciate thank

you for the support that we have received. the work that you have provided dealing with liability questions -- every member of this committee has made it a significant contribution. many amendments were adopted in this committee. i think they added value to the product. ozzy quarter of us has been engaged for almost 60 hours in a discussion about this critical issue. this is a better bill. even if you do not vote for it, you many significant country region. the process is not completed. it goes forward to work with others to try to fashion this. there is a reason what every other administration has failed at this. it is hard. it is still under an acceptable

but unsustainable. -- unacceptable and unsustainable. we have to come up with a common answer. it is difficult. but based on the determination have seen around this table, we can achieve that result in the coming weeks. our president is deeply committed to this. he is prepared to spend every bit of political capital he has in order to achieve a reform of our health care system in this country. that is an incredible commitment by an american president. i am grateful to all of you for the us regions u.s.-made and the responsibility you have dealt with at a late hour. i'd appreciate you being determined to sit around this table does but other obligations

you have with other companies. thank you of an as have this. our goal is to write a good bill. if it is a bipartisan bill, and is even better. in has to be a good bill. i know the differences here. vmi is uneven progress. we have crested a good film dealing with preventive measures. this is less expensive than the predictions earlier. my thanks to all of you for allowing us to come to this phone. we love it some of a and -- we are trying to relieve the burdens and years the people have in our country because they

worry about the ability to take care of themselves. i am prepared to stay around after the vote. i want to move along because of the obligations that other people have. >> there is one member that as an expression of thanks. you stepped in for an enormous job. we want to thank you. you have been under significant stress. you are chairman of the banking committee which is a 36 hour day. with your usual loyalty to the institution and a fringe of what senator kennedy, you have stepped in with enormous skill and a self sacrifice.

on behalf of all of us on both sides of the aisle, we would like to thank you for the leadership you provided. you provided an open forum and given us the opportunity to offer ideas. du provided leadership. you have created a state of mind. we had a big job to do. we want to thank you for your leadership.

>> senator roberts. >> no.

>> who for all the obvious reasons, here in spirit -- knowing >> >> i moved to report the bill as amended. [applause] >> thank you, everybody. the onward and upward. i was going to invite members to come up here and get a photograph of this committee. we will not meet again on this issue as a committee. lamarck, before you run off, let's take one photograph.

>> i ask unanimous consent to make a tackle performance changes. [laughter] >> without objection, if so ordered. [laughter] >> ok. ok, everybody, thank you again.

one more? hold on. come to the center here. ok, very good. the meeting stands adjourned.

>> in the senate health committee has approved legislation, 13-10, along party lines. remarks now from senate democrats on health care bill, this is just over 15 minutes. >> first of all, we consider 500 amendments bee. even though this was not a bipartisan vote, this was a

bipartisan effort. every member of the committee hoped to make a contribution to this product. i want to thank them. particularly, i want to thank senator harkins and, senator murray, and as for the direction an invitation of senator kennedy which to on the responsibility of crafting their ideas dealing with prevention, quality, coverage, and workforce issues. we miss a ted kennedy. he was here in spirit. this morning, i talked to him during his was very excited that his committee would be the first committee to mark up a bill and send it to the floor. obviously, we need to have the finance committee effort. most importantly, beyond the sense that we feel of having achieved this, for many of our fellow citizens, those who have

no coverage, it too high deductible, or out of pocket expenses, those who are worried about whether or not they will have coverage, they deserve better. in a country of this great affluence and the credibility, with the professional class that we have in the health-care area, we ought to be able to do a lot better than we have been doing. this bill, because of what we have done, we think it will increase access. it is going to reduce cost to individuals. and it is going to improve the quality of health care in our country. we will have to make some investments to achieve those results, but we are prepared to do that. this is an important moment. we may never get a better chance to do it. is no longer acceptable, -- it is no longer in acceptable, the health-care system. it is no longer sustainable.

that makes a string together the synergy of opportunity to do what every other congress and every other it ministration has been unable to achieve for almost seven decades. we are determined to not let that happen on our watch. >> first of all, mr. chairman, thank you for your leadership on getting is over the finish line. it has been a long slog, but will work hard and stuck together we now have a bill that does four things. it reduces costs. it protect choice. it ensures coverage for all americans. and it also begins to change your system to the health care system rather than a sick care unit. as president obama said many times, the prevention and

wellness and public health is the one where we are to change the system so that we can keep costs down in the future. in this bill, we have made great strides forward in putting more emphasis on prevention, keeping people healthy in the first was in keeping them out of the hospital. i think this is a good bill for america. it is the right construction for what ails the contrary now. i want to thank my colleagues for all the great work they did, sitting here to all these long marriage, and drafting a bill that i believe has garnered a lot of support. i believe it will cross the finish line sometime this fall. we will have it on the president's desk sometime early this fall. >> today, we meet our responsibility to the american people. we now provide universal health- care coverage to all americans.

it is health care coverage that is available, undeniable, and a portable, available to all without any discrimination on the basis of a previous condition, no discrimination on the basis of gender, and it means that, if you're a father and you lose your job, your children will not lose their health care. if you are a mother, dealing with an autistic child, you will be will have the doctors that you need when you needed and no one can deny that care. -- when you need it and no one can deny that care. [unintelligible] we can save over $500 billion in our health-care system. and we guarantee that, if you'll let what you got, you can keep it.

if you need something new, you will be able to go to a new gateway and find something that is affordable and personalized to your family. we did it because, we democrats, worked together. we gave them hours of debate and opportunities to offer unlimited amendments and to be able to speak their minds, though there will, at the end of the day, they did not want to support universal health coverage for all americans. it is a question of whose side are you? we stand here on the side of the american people we stand here on the side of american providers. we want to get rid of their household so that they can do value-based care. we stand here on the side of history that says that we, the democrats, no had to provide a social contract with a safety net in terms of the health care they need.

i want to thank senator chris dodd for the leadership provided. he stepped in when needed. he provided good leadership that was called for. and he provided the skill and openness and transparency in the debate that truly honors this committee. chris, thank you. i think my colleagues for all their hard work and all their contributions. >> i want to join everybody in congratulating senator don on his leadership and success -- senator dodd on his leadership and success. we have had to make tough decisions on the key design elements in the health care reform bill. that includes the design of a public auction. it includes what kind of irresponsibility we will put on individuals, what kind of responsibility we will put on employers, what will the impact

be on small employers, all of which have been made very well in this legislation. this is one piece of legislation that will now compete with others that are working through their way through the committee process in the senate and the house. i think that when their college look at the different places you can count on in these issues, they will find -- i think that when our colleagues looked at the different places you can come out on these issues, they will find that this is a fair one an. >> first, let me thank senator dodd for the tremendous work he has done over the last month, putting this bill together, and bringing together every raise ideas about health care reform. i know he did it with senator

kennedy sitting on his shoulder and weigh to litigate for the great job you have done. a few months ago, health care reform was a bunch of different ideas and bills. today, this committee has put together and includes a bill that focuses on the needs of our families out there, from prevention to quality care to coverage to the work force, to make sure that our families that are out there today who do not have access to health care, who cannot pay for it when they do, or do not feel they have a choice about the personal debt -- personal decisions they make about their own health, this is a major step forward. i was very proud to work on the work force side of this. providing access is critical. but without the doctors and nurses and health care providers to ride that health care, we will never achieve access. this is a major component to make sure that all americans have access to the health care work force that they're going to need. we move forward year from today, look forward to see what the finance committee does, and to get to the floor of the united states senate, and finally tell

our friends and neighbors and the people that we represent across the country that the united states senate and congress is dealing with the most important issue of the day, making sure that people in our states have access to health care. today i stand here and think about a boy that i mentioned at the very beginning of this market. his mother got sick. she had a job. she lost her job because she was sick. she lost her health care because she lost her job. she cannot see a doctor. and this young boy lost his mother. today, we are a step closer to make sure that young boys like this and families everywhere will not be denied health care coverage in the united states of america. >> anyone else? any questions? >> can you give us an example of what the republicans --

>> there were many of them. there was a solvency issue of long-term care. tom harkin worked very hard to see to it that there would be rewards for employees who took on the responsibility of reducing exposure to health care problems. orrin hatch prevailed with his ideas on biologics. there have been numerous contributions in may, not just technical amendments, that our -- contributions made, not just technical amendments, that our republican counterparts offered. this is where we are starting from. i still believe that we can achieve bipartisanship. the important issue is a good bill.

getting a bipartisan bill that does not do anything for the people who are depending upon his will not be warmly received. a good bill that is by parts and has a chance of succeeding and also being -- a good bill that is bipartisan and has a chance of succeeding. we'll have a great health care plan good as members of the united states congress, we have very good health care. but for the millions of their fellow citizens across this country, are losing jobs, losing homes, going into bankruptcy because of the health-care crisis. they are the ones we're working for. >> do you see bringing this bill to the floor and [unintelligible] >> i am confident that he will get a bill.

he has a tough job ahead in the finance committee pare. i have a lot of confidence that max will get the job done. we dealt with the major structural questions of health care. we worked with the finance committee on some overlapping issues. >> [unintelligible] >> i don't think it will be necessary. i think max will get his bill out and we will support him. >> where he or his staff given any indication of what they will be doing in the coming weeks? >> i will be leaving here and going down again. [no audio]

i have listened to him over and over again say what this means to work country. [no audio] we have 60 votes. the ideal thing is to have all of us working together on this. that is certainly my goal. i am not opposed to that idea at all. i do not want to lose sight of our most important objective, which is to get a good bill passed. it is meant to be better if we have bipartisan support. i am certainly going to try to achieve that. i have made every effort to

accommodate where we could their ideas. two hundred 60 two minutes of the 500 amendments we considered -- 161 amendments of the 500 amendments we considered were included. the ideal goal is a good bill that has bipartisan support. >> [unintelligible] >> i think we addressed it in the committee. we like the idea that people

have choices. the law of the land permits people to make those choices. we respect that. we're going to pursue that. we do not want to discriminate people have more convictions or religious convictions. we want to make sure that people are protected. in the case of an emergency, we do not want someone to be denied health care. i think we handled the issue well. >> is there any particular area where the committee would adopt it as it stands? >> i do not know. i have not had that conversation yet. i am confident, given what we have done with it, there is no reason why a good part, if not all of the bill, should be adopted by the finance committee. >> [unintelligible] >> that is the responsibility of these committees.

we have to find a way to pay for all of this. we have to deal with the waste and fraud issues and the provision issues and find ways to bring down costs. we will have to look at all the funding mechanisms for it. i will be heading the committee that has the responsibility to do that. we have finished our job. our job is not to come up with that answer. and ultimately, we have to engage in it. i would do not want to preclude any idea. thank you all very much. >> up next, we have comments on senate republicans about the approval of the health care

bill. this is about 35 minutes. >> as you know, the bill on health care just passed in committee along party lines. the president set some goals. he said that everyone should be covered. if you like we'll have, you can keep it. we need to drive down the cost of health care. and that it should be paid for. that bill gets uandan f. -- that bill gets an f. it does not cover any of those things. it affects every single american and affects every single business. it affects every single provider.

this is the most comprehensive thing we have never addressed in the united states senate. we never had anything that affected everybody. it is important that we get it right. that bill got it wrong. we tried, through a long process of amendments, to get it right. the democrats drafted the bill. that is not bipartisan. the only way that we have any input was to do amendments and we did a bunch of amendments to point out the flaws in the bill. i hope the people take a look at that and we will talk about that some this morning during this bill will not meet any of the presidential goals. we have had speed in the drafting process. we allowed the bill to come to committee with only half of its drafted. later, we got the other raft. the reason the other half did not come biis because it would

raise costs even more of. it will cover less people. it is a travesty for small business. we have people here that will cover a number of these issues. the bill fills what it was set out to do. i hope there is still a chance to correct it for the sake of americans. they need to have insurance. they need to have portability. we have five republican bills that entered all the things that the president said, all of the goals that we set out, and we had to do those through amendments. they were virtually turned down. the impression we got was that, if it was trees -- if it was suggested by republican, it had to be bad. that is bad for america. >> thank you for your leadership during these last few weeks as we marked up this bill. the president, from the first pitch last night -- the

president throughout the first pitch last night in the all-star game. but we set up three standards, that all americans be covered this least 34 million people uncovered. second, the cost curve should be in bed, that we should get under control the cost of health care. this bill does not do that either. it adds about $3 trillion to the debt of the united states. thirdly, he said that nobody should lose their health care if it wanted to keep it. this bill does not reach that issue either. in fact, people will lose their insurance under this. there will also lose their job. small business will be massively impacted. there are ways we can accomplish with the president wants to do. i have proposals. we can cover all americans,

banned the cost of hair-care -- we can cover all americans, bend the cost of health care, it was regrettable that, when we offered amendments, many instances failed because they came from our side of the aisle. >> the president stated very clearly at the start of this process that health care was unsustainable on its current path. today, it is 17% now our gross domestic product. we believe, with the president, that is unsustainable today. [unintelligible]

we have anything but that today. tom coburn and nine offered a complete substitute to the bill, one that checked all the boxes that senator gregg just talked about. it assured that every american was covered. it ensured that direct investment was made for wellness, prevention, and disease management. and it passes the test of being financially sustainable well into the future. not only does the bill that was passed out of the health committee today fall 34 million americans short of full coverage, it is unsustainable financially. it will actually penalize americans that have insurance today that they are happy with and doctors that they want to go to that will affect them in the future on the cost of their health care and possibly on who

their provider of choice may be. we are headed in the wrong direction. unfortunately, there are only two numbers you need to remember from the entire market process. that is 13 and 10. when it was a republican amendment, it was defeated 13- 10. when it was an american amended, it was passed 13-10. -- when it was aaid democrat amendment, it was passed 13-10. >> the president stated fully at the beginning that, one of the things he wanted to accomplish, was to level the curve and began a downward turn on the costs. in terms of cost, one of the contributing factors is defensive medicine, frivolous lawsuits, and the tort issue. on four different occasions in the committee, we talk about or

offer amendments that dealt with frivolous lawsuits and runaway verdict. not to keep someone to be rewarded the full extent of damages if they were injured, but to give the judge the authority to lift caps only if the evidence in court proves that there were damages. there's no chance to even bring that up or talk about it. one of the most significant contributors to cost was rejected unanimously. >> senator mccain. >> you always have to defer to the seniority level. as we look at the process that we just went through in this health committee, it is important to recognize what happened and what did not happen. we are having competing press

conferences this morning. on the democratic side, they are saying that this was a bipartisan process, that many republican amendments were accepted. while the vote may have been 13- 10, there was a level of fairness throughout. let me just give you an example of the amendments that were accepted from myself. we had about 20 amendments accepted. that is pretty impressive for republicans. but they were all technical amendments, making sure that the language within this legislation allowed for indian tribes in the participants. we had gone through the draft and ensured that there was level of equity provided for our tribes across the country.

each one of those was counted as accepting a republican amendment and now this is a fair process, a bipartisan process. some of the other points that need to be raised through this legislation and my colleagues have done a good job of outlining them -- when we talk about the impact of small business, i think it is important to recognize that things can go on on one side of the hill and then, through the laws of unintended consequences, we can really foul things up on the other side. the administration recognizes that where this economy is going is having a very painful impact on small businesses around this nation, the businesses that keep this country going. they're looking at and possibly using tarp funds to provide for bailouts. whether you think that is right or wrong, that is one of the considerations. but in this committee, we said,

small businesses, we are going to assess a pretty substantial tax to you. if you are an employer with less than 25 employees, you are ok. but if you're a small business that has 50 employees, you're going to be taxed an additional $20,000. we are going to give you a temporary bailout, but we will impose on you to the long-term a tax to our small businesses. where are our small businesses when to go with a canopy that. they will shut the restores and we will lose those jobs. one thing i have been bringing out repeatedly throughout this market is the access issue in rural america. the 17% of individuals and this country have limited access to primary health care provider. they are not there. what we're doing through this legislation is squeezing it

down. we are saying that the reimbursement rates under the government-run plan may be even less than what the medicare rates are paying you now. my doctors in alaska are saying that we cannot participate in a plan like that. we will not be participating further in medicare. where do our people go for care? we might be giving you a card that says that you are covered. he did not have a provided that can see you address your medical needs, we have not provided any thing for americans. >> all of us our -- all of us republicans are committed to the prospect of reforming health care in america. but our fundamental belief is that health care has to be available and affordable. the problem with health care is of the quality of health care in america. if it is the cost of health care. let me point out that this legislation has not one single provision that is aimed at reducing the cost of health care.

glaring in its absence is any medical liability reform. there's not one provision. everybody knows that one of the major contributors to the increasing cost of health care is the requirement of doctors and defensive medicine for fear of appearing in court and having her legal bills and the cost of their health insurance. there's not one provision in this bill that reduces the cost of health care in america. we have to consider what we have just done, by the way, when the committee passed this bill without scoring or knowing the cost of billions and billions of dollars in provisions that we passed by a 13-10 vote. so here we are with the highest deficit in the history of this country in peacetime with a bill

that is going to talk over $1 trillion with no way of paying for it. the bill has an employer mandate that will tax small businesses who cannot afford to pay more and will lead to job losses. the employer mandate could reduce the hiring of low-wage workers. the bill includes a government plan that the cbo says will force millions of americans out of their current coverage, out of the coverage that they now want and believe in and into the government plan. that is not keeping what you have if you like it. it will also leave millions of americans uninsured. elections have consequences. this is a glaring example of that. we have now, again, committed another act of generational theft, of laying an unsustainable fiscal burden on future generations of americans. the whole process that we had

just been through it is one of the most bizarre that i have been involved in in my years in the united states senate. >> senator hatch. >> i think my colleagues have some this a pretty good. but let me show you a copy of a letter from the head of era congressional budget office. it is an interesting letter. i will now read the whole thing. i will read a part of one paragraph. i think it backs up senator mccain 100% cou. cbo has not had time to study the costs. but preliminary analysis says

that it could increase several spending for medicaid by an amount that could very in a broad range around $500 billion over 10 years. that is what they have not told you. they tried to get it down to $600 billion using budgetary gimmicks. they want to go with the medicaid expansion that will cost $500 billion more or even more than that. along with that increase in federal spending would come a substantial increase in medicaid enrollment. such an expansion of medicaid would also have some impact on the number of people paying coverage from other sources, including employers. all told, the number of undulate -- of on elderly people who remain uninsured would decline by about 50 million to 20 million. -- by about 15 million to 20 million.

absent any expansion of medicaid, about 33 million people would remain uninsured if it were to be enacted. i do not care who you are, but you have to realize that they're spending too much. they are taxing too much to get us there. and they are writing legislation that is totally partisan that is not going to work to. -- not going to work. you're talking about moving people into a government plan like medicaid or medicare. medicaid alone is estimated at $33 trillion in unfunded debt. it is $33 trillion to $39 trillion. even the president said that medicaid, medicare, and social security are unsustainable in the current form. and yet they're adding more of a burden to those costs. let me tell you, this is not a

republican making this point. it happens thato be the head of cbo, frank suitter. from the start of the health- care debate, democrats have completely said us out -- have completely set us out of the process. when we turn our efforts to offer valuable so some 10 amendments, -- offer valuable substantive amendments, they went with a straight party-line vote. our national debt will triple in the next decade. with 50 cents of every federal dollar being deficit finance, if we're lucky, it will require

taxpayer money that is already overpriced. medicare, right now, as a future class of $39 million. this bill creates another washington-run bureaucracy. to make matters worse, the employer mandate would kill jobs at a time when our unemployment rates are approaching 10%. i am extremely disappointed and sad to say that it was not the people on the stage that will be hurt by this. it will be all americans. if this bill becomes law, americans will not only see a government. step in between them and their doctors, they will see their health care costs rise. there's a strong possibility that they could lose their current coverage. i am just as disappointed to hear recent reports that they had given up on a bipartisan

solution, too. while the administration says that this issue is a party for the president, he may not roll up his sleeves. i think it is high time that he does, make suggestions, and work with us on a bipartisan solution. i believe we can achieve a bipartisan bill to ensure quality coverage for american families. my amendment on biologics protects innovation while creating a pathway for affordable life-saving drugs and it is a great example of bipartisan accomplishment when we put our differences aside. let's not just get it done. let's get it done right.

>> senator alexander. >> this is getting to be an unfortunate and familiar refrain, more washington dead and another washington takeover. week, republicans, have several proposals on the table, including a bipartisan proposal, that would have gone in a completely different direction. our goal is to reduce the cost of health care for every american. when we're finished, it is also to give them a government that they can afford. this bill does not do that. it is a great proposal. it is a bipartisan proposal. it would have created dollars for low-income americans to get the same insurance the most of us by. it would not add to the government debt and would not create a government program.

that was rejected. [unintelligible] the medicaid proposals that senator hatch talked about will bankrupt states if fully implemented. the idea's going to be to dump another fifth team million to 20 million americans into a failed medicaid program. the amount of dollars that that will cost in tennessee about equals a 10% income-tax. in other states, it would be similar. that will be discovered as time goes along. the president has said that we need to watch our entitlement spending. in early june, he said that we need to pay as you go. he said a few weeks ago, let's make sure that health care is paid for. for us to know exactly what

these provisions cost will take several weeks and careful work by the congressional budget office. if we follow the president's advice, we will move ahead. we know exactly what all of these programs cost -- if we follow the president's advice, we will not move ahead until we know exactly what all of these programs cost. >> one success that we had was an interesting point from the budget committee. there was a long-term care provision in this. it is when to provide $59 billion in extra revenue for a spirit that is pretty exciting. -- for us. that is pretty exciting. but no one could use it until after the budget window closed. at the end of the closure of the

budget window, there is a $2 trillion cost. we had an amendment that we were successful on because they were a man -- i think because they were members not to pass it. but the premiums have to be higher on the front end to cover the $2 trillion cost. that is just one example of the things better in this bill that drive the cost up. this does not have a downward curve spiral to it. there is a provision in there for and health care prevention. you can call it that if you really stretch things. it provides a slush fund mandatory each year of $10 billion. that money can be used for sidewalks and jungle gyms and buying farmers' markets. i guess that could be health care. it is something that has been dreamed of it in near march for a long time and will be instituted in this bill. -- dreamed of in your marcearmaa

long time and will be instituted in this bill. it is worked the way i spit -- i suspect it will be, everyone will be forced into the government option if that continues to exist. there's also the clinical effectiveness research. that is health care rationing. that is cost effectiveness, not clinical effectiveness. the united kingdom has a system with quality of life here. it means, the older you are, less care you get. people died. that is not the system that we will buy an american pit we cannot go to that kind of a system. we will not so for older people

dying. we will not settle for a long waiting times. it is culturally impossible. that is just a few of the things that this bill does. there is a long process yet. we hope there will be some corrections. i mentioned that there were five republican plans. any one of them would have met those criteria. it would have driven the cost to keep spiral down. it would have covered everybody. several senators had proposals. all of the meet the president's criteria. none of them were used. we appreciate this opportunity to bring your case to the nation. who knows if the american people

already understands. their understanding and a greater rate every day. -- they are understanding that a greater rate every day. have you any questions? >> senator hatch, you are now and bipartisan negotiations with the finance committee. would you like to comment on president obama praising the new tax on wealthier americans yesterday? >> there are a lot of proposals being thrown out. we have some criteria on how that has to work. it cannot be at the expense of medicaid and medicare. it does have to be paid for. that is always a difficult task. we want it paid for out of

health care items, not out of the general tax of the people. that is a good possibility if we do not keep it to health care. again, there are a lot of ideas there. we will try to negotiate those through this kind of a situation. i am hopeful that, in the finance committee, we will have better luck than we had in the health care committee. >> [unintelligible] word is 3% of $500,000? unfortunately, a lot of the people who have that money are small business people. they use that money to expand their businesses and create more jobs. in the end, they will lose more jobs.

it will cost a lot of small business disruptions. there are so many things wrong with what they're proposing. we do have a number of republican plans that have not received the notoriety that these two committees have in their efforts, but which would of been much less expensive and would keep the current parental live and running. i agree with the distinguished chairman of this committee. this will taxes right into oblivion if we allow them to pass this type of a bill. they will continue to oppose new taxes.

they are hiding a lot of the costs. they are hiding those costs with budget gimmickry. it is not fair. this medicaid expansion is going to be left to the states. the federal government cannot afford to keep it going once they implement it. the states will be stuck with it and it will bankrupt almost every state in the union. that is not good governance. that is not good legislation. we want to work with their colleagues on the aside, but, when you keep talking about the central point of this is that a government plan will dictate a one-size-fits-all promotion, we know that we will not have innovative and great ideas that will have a great health care system. >> [unintelligible]

>> i could not hear you. >> [unintelligible] >> oh, yes. >> [unintelligible] >> the way the bill is written right now, they can ignore the high command. it has been ignored since 1976. almost everybody has at least said it is where it should be. the language of this bill is a way of circumventing the law. i don't care who you are. that is not the right policy. let me tell you, if we start down that route, the bipartisanship will be even less.

in the end, we will have less effective health care. some have said that it does not affect a the [unintelligible] of course it doesn'. i think is a terrible mistake. we have been able to get along because it says that taxpayers should not have to pay for abortions for those who do. one poll shows that the majority is opposed to abortion in this country. i do know that it has been narrowing. people are getting awfully tired of the slaughter of innocent children. what brought that to most people's attention was the partial birth abortion debates.

a fully grown infant that is capable of living of said of a mother's womb, they ran scissors into the back of the head and extract the brain and pull that child out and say that it is not a living human being. that is just immoral. it brought home to everybody how brittle some of these approaches are. >> senator, how confident are you that there is a bill that republicans can sign onto? is reconciliation the only avenue to democrats? >> i do not think that reconciliation is an avid accused at all. it would leave holders biggest

swiss cheese if they try to use that approach. i hope that the finance committee bill will be more bipartisan. i appreciate senator baucus has taken the time to make it right. i do not think -- i don't know if you will be allowed to take the time to make it bipartisan. if he does not, then the health bill will be the bill. i am concerned about how twthe merger of the two bills will work out. when we did that, it took the approval of both the two chairmen and the two ranking members before a bill could be put together i do not know if that will be the case in this one. i suspect it will not considering what occurred in the health committee.

if this is going to be bipartisan, the american people will be convinced that it will work. it needs to be bipartisan. and is to have the support of 80 people. that will show that we covered the loopholes, that we met the goals, and that it will work if it winds up 60 votes or 61 votes, it will be the most liberal bill that this country has ever seen. it may do things that we may never be able to correct. thank you. >> our coverage of the health care bill continues. harry waxman of california is the committee chair. this is about one hour and 25

minutes. . . the amendment has what is called the class act.

could you tell us what that is? it is a great name. >> it is a classy act, mr. chairman. no, i am kidding. basically, what this is, the people who now have to get health services, chronic people with disabilities who now have to get services through institutional is asian -- hospital, nursing home, whatever -- would be able to pay into a system, a voluntary payroll deduction, and after a certain number of years, if their health becomes in danger, they become chronically disabled, there would be able to tap that and get those services that would normally be provided by hospital or nursing home in a community setting. it is a way of having people

finance over their life, if you will, -- >> not long term care? >> it is a long-term care system for people with a voluntary checkoff so it is paid for through their payroll. there is no cost to the government. >> but it helps people who voluntarily pay into this fund to be able to use that fund? >> right, and this is a major issue, mr. chairman, with the disabilities committee that approached me. many times, they approached mr. dingell. sometimes they were aggressive about it, needless to say. and it is something that mr. kennedy has sponsored and the senate and is in the health bill. not that i want to mention the senate, god forbid. >> it is an issue that senator kennedy has championed, and it is very much wanted and needed.

there are other provisions in the bill that seem unrelated, but they'll have a common provision -- they all have a common provision that you and the staff have worked out that are not the controversy of. the manual labeling is something that has been agreed to buy all the stakeholders, restaurants and consumer groups and others, so people can get information when they eat in a restaurant. there is emergency trauma care provisions, school based immunization, tel-health reauthorization, which is planning more of a role in giving people the ability to have assistance from health-care providers not in front of them but who can evaluate the medical situation and revise -- advise patients and their health care providers.

providers. the painter and management, there is a federal tort claims act for chc volunteers. is this to allow -- as i understand -- those people who volunteer at a community center to be put under the same provisions as employees at a community health center. they would be covered by the federal tort claim law so they wouldn't be barred from volunteering and be required to get medical malpractice health care coverage for their volunteer period. i strongly support the amendment. it has a lot of good features in it. and i would hope members have had a chance to look at the amendment and would feel likewise. i want to recognize the gentleman from georgia, mr. gingrey. >> mr. chairman, thank you. i want to ask the author of the

amendment, mr. pallone, going to page seven of his amendment, subtitle nurse health management centers. i had to read pretty quickly through this. i didn't see anything in their regarding medical dr. max supervision in any way, shape, were formed in regard to these nurse management centers. could you give a little bit more explanation about that? is there any physician supervision over the centers, or do i -- am i correct in assuming that this is just albeit well-trained, advanced practice nurses pretty much practicing medicine at these centers free and independent of any other supervision? >> i'm going to defer to ms. capps since it was her bill. >> i appreciate the interest in this.

the advance practice in areas where there are clinics there are provisions in the regulations that advanced practice nurses have the ability to supervise and carry at this kind of decisions made in primary care. >> the gentleman would yield to me again so i can ask -- >> on a yield to the gentleman. >> and i thank the gentleman and i appreciate ms. capps's comments on that. i don't know what the law is in california but i sure it varies from state to state -- >> yes, it would. >> mr. pallone nor ms. capps, with this provision be a federal preemption of all the state laws -- >> no, of course not. that is why it is set up the way it is, as a voluntary or applicable in areas where these kind of provisions can be made. >> and bayh thank the gentlelady

and mr. pallone for that response. >> i yield back mr. chairman. >> mr. deal, you wish to be recognized. >> yes mr. chairman, thank you. as i look over the 75 page amendment, i think i have counted as many as 13 separate pieces of legislation, which i think all of them have in one form or another been introduced as separate pieces of legislation. now, some of these i feel very strongly in support of. in fact, and a co-sponsor in some of the individual pieces of legislation comprise this amendment. some i have reservations about. i was glad to hear the chairman say everybody that fell under the menu and came to the agreement. i was under the impression after reading it the only way you could get out from under it was to have a blue plate special that didn't last longer than 30

days or 60 days and that was the only way you are going to be able to state the provision but may be those who would be affected by it have looked at it more carefully than i have. but i have a procedural question of the chairman. mr. chairman, as i understand this amendment, the pallone amendment, is a second-degree amendment and therefore would not be subject to an amendment to wait in order to extract portions of it that might otherwise be considered objectionable. am i correct this amendment is not subject to being amended -- >> the gentleman is correct. >> i appreciate the response and i personally would have preferred, even though it may have taken a little more time, for us to be able to deal with these individual pieces of legislation separately so people could express their opinions on them individually rather than collectively. but i appreciate the gentleman putting forward many of these proposals encompassed within this amendment, and i yield back

my time. thank you. >> let me -- if the gentleman from georgia, mr. deal, if you want to decide the question on these different parts of the amendment, i think that what be an appropriate request. do you want to take out something for separate consideration? >> mr. chairman, i have heard expression from some of our members, perhaps an indication that they would prefer to do that. i'm afraid time wise we haven't had the chance to get a collective judgment on that at this point. >> iowa c. well, the amendment as it was proposed -- >> mr. chairman in light of your apparent offering on that, i would like to request the menu labelling portion of the amendment be separated for separate vote. >> without objection we will put

the unanimous consent that the section of the amendment dealing with menu labeling be put aside and the amendment without that would be put under consideration. hearing no objection will be the order. are we ready to vote? >> mr. chairman? >> yes, gentlemen for morgan. >> thank you, mr. chairman. i am just now able to produce this amendment that came out at 9:09 last night. has this been scored or do we know how much money we are talking about? is there any data on the cost? >> the gentleman will yield these are authorizations of appropriations. we don't have a score on authorizations. the score would be on appropriations. >> is there a grand total for the amount we are authorizing? >> let me ask counsel of there's

a grand total for the amount. >> are there totals for each bill? perhaps i could direct to the council mr. chair, could you show me what page for each of these i understand there are 18 -- >> if you yield to me often authorizations spell-out a specific amount and related to the appropriations committee how much is needed after the examine the request but we would authorize a program and the appropriations committee would make those decisions. >> i appreciate that, mr. chairman. i know oftentimes congress is held accountable for not fully funding what's been authorized. clearly that was the case of the no child left behind legislation for many years there were arguments made a large sum was authorized and then i was never fully funded so council, can you direct me to where the authorizations are in this bill, in this 75 page amendment?

>> put your mic on. >> i'm quickly scanning. all of these or appropriations for discretionary spending. so in my quick scan, the number of christ is on page 24. >> page 24 is the only place >> so far that is the lummis -- part and? >> and again on page 24 there is $10 million authorized for telemedicine incentive grants, and then again on page 35 there is $100 million authorized. >> well, now, on page -- okey, 24 it says $10 million for fiscal year 2010 and such sums as may be necessary for the fiscal year 2011 through 2014 so that is an open-ended operation? >> yes, sir. there are many programs enacted as some may be necessary. >> are there other authorizations -- >> on page 48 --

>> if i may, page 35, line four. there are authorized appropriations -- >> and that's $100 million for 2010 and in its open after that? okay, thank you. >> page 44 there are authorized $12 million. >> and then such sums as may be necessary? >> no search. >> that's for each fiscal year. >> each fiscal year. in page $48,500,000 for each of two fiscal years. page 48, mauney 11. and again on page 56. line 19 and 20. $2 million for fiscal 2010, and 4 million each for 2012.

page 59, again such sums as may be necessary, no specified total page 59. on page 65, such sums as may be necessary. and finally, page 75 for the extension of the wise woman program for screening preventative health screening for women, $70 million, 73.5, 77, 81, and 85 and succeeding years. those are the totals. i'm sorry, sir, i do not have the courage appropriation levels for the programs. >> mr. chairman and we have the appropriation levels somewhere to try to get in perspective what's being authorized? >> with >> the committee is meeting this morning to mark up theirs. >> du have them from last year,

the fiscal year? >> i could find them, but i do not have them with me now. >> ok. thank you. mr. chairman, i realize my time has expired. >> any further discussion? any on the democratic side? if not, we go to mr. bartlett. >> i will yield some of my time, but i will insist on a point of order. i will use the same role and the same logic that mr. polo and used on mr. burgess' liability. ty. in his long term health care section, there is clearly an item on page three, line ten established mechanisms for collecting and distributing payments. that is clearly jurisdictional lee, totally within the ways and means committee. so if dr. burgess liability language was not germane by some

jurisdictional total within the judiciary committee this section is not germane because it is totally within jurisdiction of the ways and means committee. so, you know, what's good for the goose is good for the gander, mr. chairman. and i would, i would yield to mr. shadegg or mr. buyer because they have concerns -- >> with the gentleman yield to me? >> sure, i will yield to mr. pallone before i yield to mr. shadegg. >> i just want to say very briefly that this was written specifically to avoid the problem that you are raising by saying that the program does not go into effect until and unless the secretary sets up this, you know, voluntary payroll deduction. so it's written to specifically avoid the jurisdiction of the ways and means committee and that's my understanding that

that's reclaiming dr. burgess amendment was written to give the hhs secretary that same discretion and was ruled john germaine. i mean -- non-germane. >> it says the program doesn't go into effect until a statute is passed that does that. that establishes the voluntarily payroll deductions we have to actually have legislation to accomplish that. that's how it avoids the problem that you're suggesting. >> i'm going to yield to mr. shadegg. >> i thank the gentleman. i'm going to seek time on my own because i have a deep concern about the germane of this particular amendment. if you go to page four it talks about liability protection for volunteers or volunteer practitioners. as i understood mr. burgess amendment it dealt with liability. we were told that was in the jurisdiction of the judiciary committee and i quite frankly

have for years wanted to extend federal liability protections to surgeons working in emergency rooms performing procedures for doctors performing in emergency rooms compelled and i assume if we rule disasters fictional we can in fact have this amendment i certainly intend to offer amendments that to deal with immunity. this is clearer grant immunity to practitioners and quite frankly i probably on the substance agree with it but i don't and can't agree with a structure where a republican amendment on liability is not germane but democratic amendment on liability is germane. with that i will yield back to the gentleman from texas. >> on a yield to mr. buyer if i have the time. i think i do. >> i thank the gentleman for yielding. my great concern, mr. chairman, is we remain consistent. the purpose of the chair is to be impartial in your rulings.

impartiality is one of the most important attributes of leadership. so you can not be capricious or arbitrary and impartial rulings. so if in fact dr. burgess' amendment was out of order you can't now claim and say that this amendment is in order. so if you would like -- my suggestion, mr. chairman, if you would like to make this amendment in order then we should reconsider dr. burgess' amendment on medical malpractice reform. we can't -- we can't pick and choose and that is my great concern. the other, just on feet subject itself with regard to the community assisted living services and support is that cbo has already spoken on this issue that the question whether its actuarial sound over the long term and whether premiums will be insufficient to support the goal for which you're seeking to achieve. so, really bothered here at the

moment that the chairman of the health subcommittee at a markup whereby we were given a 1,018 page build in the first amendment out of the box is a 75 page amendment and it could be a bill in and of itself. i'm bothered both on two grounds, mr. chairman. one on substance and the other on procedure. so i will rest to the gentleman's point of order and ask that the chair be impartial in his ruling. >> i yield back, mr. chairman. >> the chair is ready to rule. the gentleman from georgia wish to speak on a point of order? the gentleman is recognized. >> i did have a question not pertaining to the rule of the chair. i wanted to ask either the council or mr. pallone on page 74 the subtitle of our extension of the wise woman program. i am not completely familiar

with the wise woman program. i have some idea of what it's about. but could either one of you explain what that program does? there's a good little bit of money involved, that 70 million in fiscal year 2010, 73.5, 77 million all the way up to 85 million in 2014, so over a five-year period we are talking about a lot of money -- >> would the gentleman yield? >> of course. >> i will ask ms. capps -- why don't i just feel to you if you like, ms. capps debate >> i don't mean to preempt the discussion because other people know about the wise woman program. cdc set this up as a pilot in 20 states and has been remarkable in the way that older women have become aware of their prevalence to work heart disease and the

steps that can be taken to recognize symptoms to get to medical care it actually helps to educate some of the providers that have not become aware, too, of the information available recently. it thus some data collection. we just want to expand it to all states if they choose to incorporate. it's already been approved. it's a part of cdc. .. >> the gentleman wants to stipulate that all women are wise. we did not want to debate that. >> i am glad that you made that comment. i wanted to ask one simple question from the gentle woman from california, is part of this program paying for cooking

glasses? >> no, it is screening, actually. it provides screening for older women who are not covered in any other way so they can become aware of symptoms they might have. it is a way to get women into treatment more quickly than to wait until some costly treatment is perhaps needed later. later. >> well, reclaiming -- >> all the nutrition education may be part of the average programs. >> asking for a yield of time. as you described the program, of course, it sounds good, which is be spending money teaching cooking glasses and that is why i wanted to make sure. >> thank you, this is been verified in which it was initiated and is only based on the positive outcomes in those states that is now being recommended by the cdc to be applicable to other states as well.

>> i think the gentle lady and i yield. >> mr. chairman, we have before us a point of order and i would like to deal of the point of order before we get into further discussion on the amendment itself. anybody wish to be recognized on a point of order itself? the chair is ready to rule. the point of order has been asserted that this amendment is not germane for two reasons -- primarily that it passes a provision that would be in the jurisdiction of the ways and means committee. on page for the effective date says that the public health service act provision which is in our jurisdiction shall take effect on the effective date of a statute establishing a voluntary payroll deduction under the internal revenue code of 1986 to support the program authorized by such title. and had read legislated an

effective statute of the payroll deduction, that would be outside the jurisdictions of our committee. what we do in this particular provision is established the program, but the program which is under the public health service act would not take effect until the ways and means committee establishes the tax. the second assertion of non germane is backed community health centers provision giving liability protection would not be in our jurisdiction. it this amendment to allow volunteers at the community health centers to be covered under the liability protections under this act is under the act in the public health programs. the community health centers are under the public health act and a parliamentarian in the past

has always referred such bills dealing with anything, anything pertaining to the health centers to us including liability protection so the chair ruled that the point of order is not sustained. i want to call for further discussion of the amendment before we proce to a vote on the pending amendment. >> mr. chairman. >> who seeks recognition? >> i won't take all my five minutes or whatever because i know most of the speakers on the other side are concerned about laying out vendors amendment and of the staff could explain to us because as you like being on this committee for a number of years i remember the same thing happening having a bill coming to the committee markup on a regular vacation even when the majority was a republicans have a huge manager's amendment laid out for our consideration. it is that not correct? >> will the gentleman yield on

that point? >> i'd be glad to yield but i would like to stay and recognize -- remind me of a previous times where we see advantage amendment of x number of pages. >> it is not unusual in this committee for there to be a manager's amendment of substantial size. >> i'd be glad to yield to my friend joe. >> i agree with what the council said, the difference is at least when i was chairman when we did manager's amendment, the amendment was published and both sides had a chance to look at it before it went to markup for a number of days. it we never strong so to speak a manager's amendment and i don't remember ever having a manager's amendment the nature of a substitute and having the first a majority amendment be in essence an addendum to the manager's amendment. i don't recall that ever. >> well, i have seen 2003 and it you weren't sure but i know the some of that was laid out last

night at 10:00 o'clock. my staff was able to look at it and so let's argue about not the process because i get calls all the time about you didn't read the bill and i said that is our problem but there are 233 years been able to get congress to be bills. but if you want to complain about the process that is one thing, but if you want to complain about the issues better in a the amendment that is separately and we might move along quicker and be able to deal with it, but that's mr. chairman, i yield and return my time to you. >> thank you, mr. chairman. i have a question of mr. palone, i don't see mr. rush year, but on page 57 subtitle postpartum depression, we have dealt with this issue in the two previous congresses and adopted compromise language bipartisan

leyna. language regarding a longitudinal study of relative mental health consequences for women resolving a pregnancy. and in various ways they may have resolved a pregnancy including carrying the pregnancy to term, parenting and child, placing the child up for adoption, miscarriage, having an abortion, so we have a compromise legislation that included postpartum depression on the issue of abortion. i was just wondering why the compromise language that we passed in the two previous congresses wasn't included in this language. in could you -- i think this is very important because increase research on post abortion depression would lead to greater awareness of the issue and the development of compassion about reaching counseling programs to help close abortion women so i

think it is important and i just wonder if you can explain why that is not included. >> we have brought the same concerns, and it had compromised language regarding the longitudinal study. guarding and resolving a pregnancy. with your acceptance, we will put that language in and make sure it is clear. we are willing to do it, we just did not get it in time. with your acceptance? >> the concession language, yes, i would accept that. it is a appropriate i would ask unanimous consent. >> the gentleman from michigan seeks recognition for unanimous consent request, would you stay here unanimous consent request? >> i ask that section one of two, regarding longitudinal study of rental medal hauls consequences for women resolving a privacy would be included in

this amendment and a purpose section in. >> is there objection. >> out like to reserve the right. >> the women from colorado. >> i'm not going to object, i would just like to say that i think this compromise language is good and i think we should look to the results. in the past mr. stupak end and mr. pitts had a disagreement but i think there can be mental health issues resulting from pregnancies and i think this is good compromise language and with that i will withdraw my reservation. >> mr. chairman, one more time and i will shut up. okay. we have operated on both sides in reasonably good faith on health care issue. and you have been more than accommodating this week in requesting the schedule. this particular amendment in my opinion is in very bad play.

it was posted on the g drive at 10:28 p.m. last night. i don't know about other members and apparently mr. green staff sits by the g drive all night long. i want to commend him for that. >> you want to make sure we read it all. >> well, i commend you but i was adjusted to withdraw this amendment. there are some good things in it, there's obviously some good things in it. but it is a little unusual for the majority for their first amendment to be an omnibus amendment that was not readily accessible under normal conditions before the market began. i would be happy to yield. >> if you feel so strongly about it, i thank you may case that you ought to have more time to look at it. i join you in asking the gentleman from new jersey to a straw has amended without prejudice and and be permitted to offer it again.

we are throwing the whole on this amendment. >> i would withdraw without reservation to bring it up. >> and i would like to request -- just a minute, i would like to request that we be able to deal with this amendment before we leave today if that is acceptable. >> sure, we've got a series of 13 votes, about 12:30 p.m. so we're probably facing 50 minutes before we end for the day. because these next series of votes of the last those of the day and will take until two or 2:30 p.m. and by previous agreement we agreed to end up at 2:00 o'clock so we're actually saying about about 45 minutes at most, it would be better to just pull this one off and bring it up first thing next week if you want to do that. but if you found -- and you're

bound and determined to have it today i can stop you give my parliamentary inquiry? i would decide to get a clarification of terms because i'm trying to fall on the ball game here. this i understood was the bill. this i anderson was member's amendment, but we have been talking about and mr. green referred to this as a manager's amendment. >> isn't the amendment to the manager's amendment to a mezzo is the an amendment by the chairman of the subcommittee to the manager's amendment caltech that is, correct. >> i thought council was asked whether managers amendments are, and i did not hear council asked if managers eminence to managers amendments are common. >> the chair will announce a parliamentary inquiry. if you find any rule that says this can be done please raise it, otherwise we have a request from mr. barton t with shaw the amendment, the gentleman from new jersey has with john and i

will take the recommendation that the gentleman from texas this be put over until next monday and we will do that. >> i would try to clarify things, i was not objecting to simply try to find out what we were talking about. >> mr. chairman, over here on our side. parliamentary inquiry -- what happened to the request regarding section one of what every language? >> it adopted? >> no. >> because it was pending so do we have to -- >> we put the whole thing aside and i am to stand somebody wanted to look to that language as well to be sure so the whole matter is put aside including the separate issue with the palone amendment involving labeling. >> thank you mr. chairman. >> parliamentary question.

when that mr. palone introduces or arrange to the amendment back, it is my understanding based on our colloquy it will include a section one of two language that we have passed the previous congress? >> i would hope that that could be worked out, but he will be recognized to offer the amendment he made it, offer a different amendment and may offer in endeavor way but as seem to me that we were pretty clear that it was going to be unanimous consent for the language you had suggested. >> thank you mr. chairman. >> would you want to complete the unanimous consent now? let's all not get tied down. the palone amendment has been withdrawn. so we will go for another amendment at this time.

ms. harman, you have recognition for an amendment at the desk. >> let me ask you some questions was it submitted within to our time for review? >> as it was mr. chairman. >> the clerk will report. >> it is harman a 36. >> wasn't it our turn? >> amendment of california and mr. sarbanes of maryland, the end of title five of deficiency adds the following: subtitle, assisting veterans with military emergency medical training to become a state licensed or certified emergency medical technicians. section blank, assisting veterans with military emergency medical training to become state licensed or certified emergency

medical technicians. >> mr. chairman, i would like to ask unanimous consent that the reading be dispensed. >> without objection, the reading of the amendment will be discussed with the gentle lady of california recognize to explain and someone wants to reserve a point of order? >> thank you, mr. chairman para did mr. chairman, this amendment was worked out with mr. sarbanes and your excellent staff of, and also is part of legislation that i have offered with two colleagues, melissa bean, it would bolster the safety and security of our communities by enhancing the surge capacity of local medical facility is end at the same time it would help returning veterans transition

into civilian live. the amendment authorizes grant funding to create a fast track for military medics to become emergency responders. and also commissions to the gao studied identify in obstacles keeping former military medical profession from entering civilian medical fields. in the mr. chairman, everyone here understands their extraordinary service performed by military medics on the battlefields and iraq and afghanistan they are the true mashed champions of our work efforts in those places and a gain invaluable experience responding to ied attacks and other catastrophic emergency is on the battlefield. however, when they return home, the unemployment rate of returning veterans is about 30% and may have to start at the

bottom getting training to become civilian emt. we think this makes no sense and their experience should be embraced and they should be fast track for service that is absolutely critical in air local hospitals and other facilities. many hospitals and emergency medical services throughout the country now operates at or near capacity and obviously in the event of a terrorist attack major natural disaster are other casualty incident the resulting surge of patience would overwhelm these facilities. correct in this requires having a large -- >> will the gentle lady yield before mr. barton please? >> mr. chairman, i would love to yield to my old friend mr. buyer of first. >> here's what i'm going to ask of you, jane. i think you're doing here is

right in his noble, we voice had a real challenge trying to link the soldiers to that which can be done in the real world and what i'd like to do with you, ms. harman, is would you please withdraw this, work with me and let me go to my veterans affairs committee and also work with dod. i agree can even make this better and we bring this back on monday. i did not know about this, ms. harman, out of love to do that and that is just my only request. >> reclaiming my time, we did contact your staff specifically given your experience in this area. we received a very positive reactions. >> i said i liked it and i read the amendment for the first time. what i want to do is shot through we have some and educational programs with v.a. and working with dod, can i bet that, ms. harman? >> will yield? this is an amendment that i

think mr. burton was going to except that i certainly want to congratulate you and mr. sarbanes. i think it is a well thought the amendment and doesn't preclude mr. by year as the ranking member from looking at further changes to it. but i don't want us to keep on picking up amendments and putting them aside. we back to close on some issues and this one is so reasonable and so right that i would hope it does go for the. >> thank you mr. chairman, reclaiming my time, i take your offer. i appreciate your good faith offer, however, we did work with a veterans committee member, stephanie sandlin, on this and we have been exploring how to solve this huge problem in the most effective way and we have come to this proposal and worked with mr. sarbanes and apply to yield to him for a minute. a form of this that would fit well in the health care bill. i do agree with the chairman

that this is ready. i would offer to you after i yield to mr. sarbanes to work with you on some additional initiatives when i take to help our returning vets and out like to yield to mr. sarbanes. >> further discussion of the amendments? >> mr. chairman, i did. i was going to say we would excepted, but i want to support mr. buyer, he is a former of the chairman's letter to committee so i personally think is an acceptable amendment but i yield to congressman buyer general. >> i personally do not oppose this but that does not make, i am only speaking individually and don't have the expertise that chairman buyer has a knack for the recognition on the amendment, mr. sarbanes. >> want to thank the committee for working on this amendment, i want to thank ms. harmon as

well. to put this in context there is a significant set of provisions within the underlying bill that addressed the workforce shortage is and we have attempted in that respect to design pipelines and that will produce more medical professionals over time. but there's also a recognition that we need to do something in the immediate term and the phrase i like to use to describe this kind of an initiative is rapid deployment. we have to see where we can rapidly deploy care givers even as we are developing these pipelines over time. ms. harman is focused i think rightly on the tremendous potential in terms of it the emt profession to transition and is returning veterans two that kind of work and to do it in a timely

basis. i'm also attracted to another portion of this amendment, which asks that the gaoo@/g#á@ @ @ @ -- which asked the gao to look into other possibilities for transitioning to veterans. this on the one hand it is addressing the workforce shortage that we are very concerned about. under other hand -- on the other hand, is keeping with other initiatives that we have undertaken in this congress already to focus on that particular issue. again, i think miss harmon for her work on this and i would urge everybody on the committee to support this amendment and i yelled back my time. -- i yield back my time. >> i speak specifically to your eminence. number one a complement to, they

also are tying into exactly where their favorite wins are. so i have no objection it, mr. chairman, if you're willing to accept this amendment with the caveat made to the vet to this. you have worked with stephanie but also at michael brink, to buildings the way, is the experts so let me over the weekend that this and if it's good two go this wonderful, if not the gentle lady i have worked with you on many years and of their recommendations or tweaks will circle back to the committee and i think that's the best way. >> will you yield to make? i think which you are suggesting is that week accepted this amendment assuming the committee is willing to do it and if we can't find some improvements in the next several days, we would have unanimous consent to add to this amendment to make it even better? is that what you're proposing? >> i believe chairman waxman would be amenable along with mr. and -- mr. burton.

should this amendment be adopted the gentleman from indiana, mr. buyer, would be permitted to offer further amendment caltech perfecting amendments. >> without objection, that will be the order. mr. murphy. >> thank you mr. chairman, the gentle lady from california, do we have a dollar value for with these grants would be? >> no, we have not. >> my understanding as i read this is not bypass any certifications of lessening law of any state. >> we were careful but it is to create a fast track. there are specifically created hardships for these trained medics to come back and have to start at the bottom and a lot of the courses they have to take our way to basic for them and yet they have to pay large registration fees which means many of them are deterred from even becoming emt. this is a huge loss for our country and a loss for them. >> this would be a way that states could find out they are the went to the training

acidification and one other question -- other in the states who are already reviewing this, and the models it already in existence that we might know of? >> i understand that kansas and maryland are already doing this. >> i thank you so much and yelled back my time the mr. chairman. >> anyone else seek recognition? if not we will proceed to a vote on the harman amendment. all those in favor and a post? the amendment is agreed to. we are now looking to the republican side for an amendment. mr. sullivan. >> you have an amendment that has been out for two hours and copies at the desk it is two this title? >> and i reserve a point of order to make the gentle lady from colorado, the amendment qualifies of the clerk will report the amendment.

>> amendment offered by mr. sullivan, at the end of title five of division c. add the following. >> without objection the amendment will be considered as read. >> mr. chairman, i say to reserve a point of order on the amendment caltech we already have so there are two reservations point of order. mr. sullivan, you're recognized for five minutes. >> thank you mr. chairman. i have an amendment to the mammoth and the nature of substitutes. mr. chairman, i have a common-sense good government of yemen today that is important ever to stop boys will and inefficient government spending in our health care programs. my amendment would require the health and human services secretary to conduct a study on you and all programs affected by this legislation to determine if there's any program duplication. under my amendment the secretary must write a report on the study within a year of enactment of this bill. after writing that report the

secretary will have duplicative programs within six months. i'm particularly concerned with a number of new government programs created in this bill and this legislation is adding at least 31 new federal programs, agencies, grant programs, commissions and and gates. with the nations experiencing regular levels of debt, we need to be taking a hard look at ways to duplication on our current programs. especially when adding to them as this bill does. also with the cbo stating yesterday that this legislation will increase not reduce public spending on health care we need to find an spears savings where we can. just this week it was reported that our budget deficit is already topped $1 trillion for the. was on pace to grow 2 trillion by the fall. i think we can all agree that in efficiency, duplication and waste will spending are having devastating consequences for the fiscal health of our country. my amendment would help stop an rasul or duplicative spending in

this legislation. i believe that we are all going to keep putting new spending programs on the table that we absolutely must have a mechanism to take old things off. my amendment provides the mechanism to do just that. again all my comments into amendment does is require simple study on duplication of federal programs in this bill and allow the secretary to take action on inefficient programs. i think everyone can agree to this especially in light of the deficits we're facing this country and i yield back to met the gentleman yields back. >> can i withdraw my reservation? >> i am certainly sympathetic to what you're suggesting that we make a wise investments and not have duplicative efforts. but i am worried about this amendment. the underlying bill requires the secretary to develop a national prevention and wellness strategy which i think what address your concern. that strategy requires a secretary to inventory current

prevention and wellness activities. it requires her to identify specific national goals and objectives and set priorities for future initiatives. and the secretary must also develop a plan for addressing these priorities, take into account on answered research questions and unmet prevention and wellness needs and this report is to be submitted to congress no later than one year after enactment of this provision. what difference is your amendment which would require a study which we also have a but then authorizes the secretary to terminate programs as she deems appropriate without further action by the congress. and i feel that the congress ought to be able to use its own judgment before programs that we've authorized are terminated by anybody in the executive branch. i am ready to terminate any program that is unnecessary and

redundant and not cost-effective, but i want the congress to do it. i don't think it's a proper to delegate that authority to the secretary and for that reason i would oppose the amendment. mr. barton. >> mr. chairman, i rise in support of the soul of an amendment. we thought this was the single most innocuous good government amendment that we could offer in good faith to show we were going to try to work to improve the bill without destroying any of the underlying principles that the majority is embedded in a. this amendment is fairly simple. it says that the secretary of health and human services who by the way is appointed by president obama within a year has to look at all the new programs coming in this division day of the bill, so we are trying to stay within the scope of the procedure of the chairman

has organized. and send a report to the congress and then if in that study the secretary determines some of the programs are duplicative and we even change to this zero bits, we said to the maximum extent a proper determination of the federal programs within this division so we even give all little leeway there. if you look good your underlying bell and you create a brand new commissioner, who can terminate people's individual health insurance without any congressional act, i would thank you could except that and hhs secretary under this division of your new program, your new bill, good to some extent terminates duplicative and grant programs. duplicative. especially through my blue dog friends who tried to do a little cost containment in the bill,

this does not guarantee cost-containment but in at least direct the secretary and gives the secretary authority if you have duplicative programs under this division to try to save some money. i think it is an innocuous amendment and it to be unanimously supported. >> will the gentleman yield? i just point out that both sides have misjudged the acceptability of the respective amendments. a first volume in a statement i don't think is accurate -- we don't give authority to the secretary to tim in anyone's insurance whatsoever. >> well it you create a new health commissioner that has that authority. >> this amendment -- i'm not sure that that is accurate. i doubt but we can look good that. >> wiccan checketts. >> i don't think we ought to give the secretary this kind of power, any kind of secretary and you pointed out the secretary at the present time has been appointed by president obama. if you're willing to say that it

would not, the secretary would not have the ability to terminate the programs but ask congress to terminate i have no problem with that. i don't think the amendment is even necessary because we have that in our underlying bill, but what bothers me is why i can support this amendment is authorizing the secretary even using her best judgment to replays of the judgment of members of congress to authorize the program to terminate these various efforts. the recommendation would carry a great deal of weight, but of all the congress ought to give that kind of authorization to the executive branch. >> reclaiming my time, i appreciate that but we have fundamental difference of opinion about separation of powers of the constitution. the congress legislates the executive branch and administers and what you're saying is you don't trust president obama's own appointees to the minister

the programs that to put into place. you want to micromanage. i mean, secretaries have the authority right now to terminate programs and presidents have the authority would one congress appropriates not to spend those funds if they don't agree with the intent of the congress. and so we are just trying to prevent duplicative programs. this is a massive change of the health care system as we know it and we thought this amendment was fairly straightforward. it inadvertently, let's give the benefit of the doubt that you are not intending to agree duplicative programs, just in and ridley you give some explicit authority to the secretary to pick and choose and try to eliminate duplication. i don't think that as partisan. i think that is good management and good sense but obviously we have a difference of opinion so

i would support the sullivan amendment and i yield back. >> for the discussion on the sullivan a man and? >> mr. chairman, i will be brave, but i simply want to raise the issue that i think mr.. -- which is what authority there is to do away with plans and whether the commissioner has the authority to do so. i believe on page 16 grace. employment based health plans, the bill by language says that a plan can it exist for employer provided health care may continue to exist for five years without meeting their requirements. the minimum requirements prescribed by the health care benefits advisory committee for that five years and at the end of that if it does not meet those requirements it goes away so as i understand the commissioner does have the

authority to wipe out all existing plans at that point in time and i believe that's what mr. burton was referring to. it's not something we need to go intoow, we can go into at a later point and i'd be happy to ask for clarification and a later point. with that i would be happy to yield to mr. rogers of michigan. >> thank you. you point to the huge problem of dropping a 1200 page bill or a thing nobody has read the bill clearly and maybe mr. chairman you haven't gone to page 44 under section b of that page, suspension of enrollment of individuals on such plan after the data commissioner nullifies the entity of determination. not only can you do a whole plan which is in a later section in the bill, under this bridge that can go to an individual and throw you off a plan. so it is clearly under -- under this bill, you have given the secretary and the commission this. if you are concerned they can do

that, mr. chairman, maybe we ought to postpone this hearing and go through this bill and find those instances where you have an power the federal government to throw individuals of their bill. by the way, there is nothing in here that says you have to notify them. that is dangerous stuff, and i am in agreement with chairman waxman this is a concern. we ought to work together. >> will the gentleman yield? >> i would be happy. >> i just want to follow-up with my colleague from michigan. are you saying that this unelected commission can do something to throw people out of their insurance plans without notification, perhaps? >> under the bill that is written and has been presented to this yesterday, that is exactly what they can do, suspension of enrollment of individuals under any plan after the commissioner at notifies the entity. >> they can do that.

the amendment before us simply says there are duplicative grant programs, that the secretary should try to eliminate that duplication, right? >> that is correct, sir. . be allowed, that is two much of a delegation of authority by get in the bill to kickeople off a plan without -- can that not only to come off but under the second paragraph it can also suspend payment to the entity under health insurance without notification. >> will the gentleman yield to me? >> and be happy to yield to the chairman. >> i think what is being raised >> i think what is being raised is a red herring and the me t we allow the commission to look at the insurance plans to be sure that they meet the requirements under the law that this bill would promote. for example of an insurance plan would discriminate against people based on pre-existing condition and they refuse to make a change in that plan, that plan would not be qualified to

be operated. that is the power that is given, not to say the individuals that they can no longer get insurance. no one would be for that. but we're not like about the section of the bill, talking of a difference section can add the chairman has unlimited time and what time i have loved and on the past been criticized for consuming all the time given. let me say i appreciate the explanation but that does not appear to be the words of the bill. the words seem to indicate that plans must go out of existence by a ruling of the commissioner at a certain point in time and that seems to be in the commissioners' discussion and the language raised by mr. rogers is a pretty clear at least from the wording in the bill and all i can do mr. chairman given the circumstances of not having been in the process of drafting the bill is to read from the bill. and i think the gentleman from michigan has adequately pointed out that this allows the suspension of the enrollment of an individual under such plans. that is the wording appears 44

at line 16 and 17. i'd be happy to yield to mr. rogers. >> thank you mr. chairman and not only is it under the individual but they've also done this with later on in the bill and i don't have the session before me that says the secretary can do it for an entire plan and the entire company with consultation with the health choices commission. but they can actually eliminate full plans under the company as well as as you stated out. >> i appreciate the gentlemans indulgence. mr. pallone, uc recognition. >> would you yield to me? >> the chairman does not have unlimited time. the chairman has to abide by the same rules as everybody else. let me just say that i disagree with the strained reading that is being offered to a section of the bell that is being used for a different interpretation that

what i think the clear reading of it entails. the revenue is described in the paragraph with respect to what qualified health benefits offered by qualified health benefit plan is they can have civil money penalties or they can suspended enrollment of individuals under such a plan after the date the commissioner notifies the entity of a determination under paragraph one that the plan does not qualify. that is a way to enforce the requirement that the plans be quified, but let me just say even if you read it differently the issue before us and i will review your interpretation because i wouldn't want to give secretary or anyone and given such enormous power, but the amendment that is pending before us by mr. sullivan gives the

secretary the power to terminate authorize programs that may already be appropriations of funds. i think congress would want to have a strong recommendations and terminate those programs, we don't disagree about that, what we disagree about in this instance in the soul of an amendment is whether the secretary should have that power. we may disagree on that but i just want to make clear my reason for authorization. >> with the gentleman yield? the soul of an amendment only gives the secretary the authority to eliminate duplicative programs established by this division. if it is an existing program from a prior congress that is not new created in this long, this amendment does not apply. >> the gentleman from new jersey. i would ask counsel if you would

permit. >> i mean. >> what does the secretary under the sullivan eminent be able to terminate issue found it was duplicative in her opinion? wouldn't that applied to programs with the public health service act that addressed prevention in? >> it requires the secretary to review both the new programs and existing programs and then authorize the secretary to terminate such other federal grant programs which i would understand to mean that the programs but those currently in existence. >> in any case, mr. chairman and fi can reclaim my time, i think between what counsel just read it and other provisions of the bell with the secretary supposed to report back to us about these various programs, i think ample opportunity in the legislation now to have either her or the congress subsequently terminated

duplicative programs so i just don't see the need for the soul of an amendment. i just think it is unnecessary given what the underlying bill says. but i feel to the chairman. >> i have nothing further to add. gentleman yield back his time? >> yes. >> any further discussion? if not will proceed to a vote on the sullivan amendment. all those in favor say aye, opposed know. i'm going to ask for a recorded vote and let's proceed to a recorded vote. >> [roll call]

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[roll call] have all members responded to the roll call? and eight members wish to change their vote? if not, the clerk will tally the votes. just a minute two. >> mr. chairman, and i recorded? >> mr. buyer it is recorded as voting ayes. >> mr. stone's anyone else wish to be recognized? if not, the clerk will tally the role.

on that boat, mr. chairman, the ayes or 29, the nos or 27. >> the amendment is adopted. [applause] now we will recognize members

for further amendments. >> i have an amendment at the desk and i like to ask unanimous consent. >> if the gentleman will withhold, we are trying to clear in number of amendments to gather. >> i know, i was going to ask unanimous consent to do and block between altman number one, and green 02. >> mr. chairman, i received -- reserve a point of order. >> let's be sure we have put unanimous consent. [inaudible conversations]

if the gentleman from texas would modify his unanimous consent to do the green and baldwin amendment. >> we have no objection to my republican side has no objection to that. >> green 002, baldwin 01. >> we will accept those. >> without objection, the amendments will be considered it and the bloc. without objection both amendments will be considered as read. and the gentleman from texas recognized for five minutes to explain. >> thank you mr. chairman and i will be brief, i know miss baldwin want to discuss her amendment. i have an amendment i have worked on for behavioral health trading grants, not only myself

but mr. murphy of pennsylvania. >> we will accept both amendments. a voice vote, we will accept them. >> okay, we want to end up on a positive note. >> i accept that and withdraw my -- >> we will accept to show you that we are good guys and let's vote and come back monday and start over. >> i want to make sure the good guys on the record before, -- >> i am trying to be helpful,. >> and mr. green would yield, on the baldwin amendment we're still working on clarification language. i think we all agree in principle and what we're doing with the bald one amendment and want clarification language on possible euthanasia language on this amendment. miss baldwin, if she wants to clarify that i'm going to go give as understanding. >> absolutely. mr. stupak and i have had a significant discussion about an

amendment to the baldwin the amendment. i think we are in agreement and as we move toward we will incorporate that, but i know we're trying to get this through quickly on a voice vote. i would ask unanimous consent to insert on page three line five the language, any grants awarded under this act shall not go to any government or nongovernment organization that promotes suicide assistance or the active hastening of death, in the previous clause shall not prohibit a relative or hospice care. >> without objection that will be the order. >> reserving the right to object. tonight the gentleman recognized on this reservation. >> i'm curious i just barely heard what she wanted unanimous consent for it related to suicide, right? >> it is a right to live -- acceptable to the right-to-life community which you just said. >> i would just like

clarification on that. i actually come from us did that twice has voted to allow suicide so i'm not an advocate of that but i'm trying to figure out the implications of what you're asking for in the legislation on my state of war again. >> will the gentleman yield? >> absolutely. >> i apologize, i was trying to get this through quickly but i'm happy to explain. mr. stupak raised with me and i've worked on this amendment with mr. burgess concerning the public information program and outrage that will go on in the amendment, that the grants to do this not to be made available to those organizations that are sort of promoting it assisted suicide in but rather are conducted by governmental or non-governmental organizations that are there to provide information about all the options available.

what happens -- i never actually explain the original amendment. what happens is in way too many cases in america people experience and of life medical care that is misaligned or absolutely contrary to their wishes and this is an amendment that is helped -- is there to help people understand what their options and express those an advance directives and other vehicles. >> i have no problem with that, i'd just like to know the implications. for example, -- >> does the gentleman of jack? >> as the only way i can get discussion to get answers. we are in a marked up here. >> we are relying on both republican and democratic staff to discuss these things. do you object? >> the gentleman of jacks. >> in this is not something that would be objectionable. >> at like to know that, like to know the implications.

we have a thousand page bill with all these amendments line, we have a rush to vote and i can't even find out if you're cutting off funds to agencies in my state that may have nothing to do with this only by some connection could get honda. that is all i'm asking for. .. let us ask if that is the intent to the amendment. >> this amendment creates a new outreach and information clearing house. to help promote better communication about end of life options, advanced directives, other legal tools where people can express their wishes for and of life care. i would be happy to yield to dr. burgess with whom i worked very hard on this amendment.

>> i think the gentle lady for the recognition. the concept was to allow for end of life planning before you got to that point in the care of a patient. of the care of a patient. and really this was only to deal with the ability to establish grants between the recipient of the care, and wouldn't involve the states. >> with the gentleman yield? >> yes. >> isn't it true though the language that mr. stupak and mrs. baldwin agreed with appear to be pro-life language in other words, if you are a pro-life member the unanimous consent request improves the bill in that respect; is that not a true statement? >> of course i am pro-life member and the statement is correct. >> i would ask my friend from oregon to not object to this.

this actually improves the bill -- >> if you will allow -- if you have the time, doesn't this promote with the people of oregon voted for? to provide information about in of life alternatives? it doesn't conflict, as i understand it -- with your policy. >> it is just to find out what in the devil it does or doesn't do. and what i'm told is basically the quiet, don't ask questions, we've got to go. it's been agreed by others who've negotiated. that's great. i would just like to know from my state's perspective who wins and who loses and then i can make an informed decision. >> as the gentlelady offering the amendment have an answer? >> i take you all that your wertheim just trying to get the answers. >> it is to have better communication on end of life

issues. we are all going to die but we hate talking about it and in fact the medical profession has not been great about communicating options especially when these issues are not imminent. we want to, through a clearinghouse of information, let people start thinking about type of medical interventions one would want and express those where possible in things like advanced directives and other legal tools available and that's what this amendment achieves. >> the gentleman joins the objection to the unanimous request? >> i will withdraw my objection. >> we have less than three minutes on the floor, so let us take the vote if the gentleman would permit -- >> mr. chairman, give me 30 seconds. i wholeheartedly support the gentleman's amendment. i have a bill pending that

addresses the same issue and when we talk about ending the growth curve in regard to end of life care, which a lot of people don't want, but you have to give it because you don't know i think is a very important amendment and i supported and yelled back. >> the unanimous consent request to make the change is now agreed to. the vote now occurs on the two amendments in block. all of those in favor of the green and gold when the amendments say aye. opposed, say no. the ayes have it. the amendment is agreed to. we will recess and i don't think we will be able to return given there are 18 votes on the house floor and given the time we agreed

>> and now president obama on the emergency for passing a comprehensive health-care bill that will reduce costs and not add to the deficit. he spoke after passage of health legislation by two key house committees. this is about 10 minutes. >> good afternoon. i realize that all washington has focused on the 24 hour news cycle. i know there is a good deal going on right now when it comes to health care. i want everybody to step back for a moment and look at the unprecedented progress that we have already made on reform that will finally lower-cost, guaranteed coverage, and provide more choice. we have provided consensus that we have never seen her for --

never seen before in this country. in may, we were able to bring together health care providers around an agreement to do their part to increase the annual rate of health care by 1.5 percentage points manually which will save us 2 trillion dollars or more over the next decade on costs for all of us. years later, we got the pharmaceutical industry to agree to $80 billion in spending reductions over the next decade. reductions that will make prescription drugs more affordable for seniors. that is partly why the aarp has endorsed our efforts. last week, we reached an agreement with hospitals to bring down the costs by another $155 billion. test this past week, both associations representing millions of nurses and doctors across the nation who know our

health-care system best announced their support for what we're trying to do. in these past weeks, we have built censuses around specific reforms on which there has not been consensus before. i will list some of those. i want to applaud the efforts of the committees in the house and senate who have worked long and hard to make this progress. we're now at a point where most everyone agrees that we need to invest in preventive and wellness programs that can help lead healthier lives. we have an agreement on the need to simplify insurance forms that patients have to fill out every time they go to a hospital or see a doctor. we have an agreement on the need to reform our health insurance system so that if you lose your job, change your job, you can still get affordable health insurance. we have an agreement to deny

coverage to americans -- to provide coverage for americans. and the marketplace where people can choose a plan that best suits their needs. this is what health insurance reform will mean for the average american. it will be low cost, more choices, and coverage you can count on. it will save you and your family money. he did not have to worry about being priced out of the market. he did not need to worry about your family. americans who do not have health insurance can get affordable, quality options. these are areas where we agree right now. this has brought us closer to the goal of health insurance

reform than ever before. now we have to get over the finish line. part of this process is figuring out how to pay for it. health insurance reform can be done over the next decade. health insurance reform cannot add to our deficit over the next decade. and i mean it. already, congress has increased our proposal to cut hundreds of billions of dollars in unnecessary spending and a warrant to giveaways to entrench companies, medicare, and medicaid. we believe that about 2/3 of the costs could be achieved through these savings alone. that leaves 1/3 of the costs for us to cover all americans that are still going to have defined a way to pay for it. the key committees in congress

are working diligently with the white house to see if we can come up with an agreement on that remaining one-third. the bill i signed will also slow the growth of health-care costs over the long run. this is a separate issue. it is an issue of how we pay for health-care reform immediately in a way that is deficit neutral, but how do we also that the cost curve so that we are not seeing huge health care inflation over the long term that would not only make health care reform package is more expensive 50 or 20 years out, but we also want to make sure that people who have nothing to do with the government programs like medicare and medicaid, how do we make sure that their costs are under control as well? i realize that there is going to be a lot of debate and disagreement on how to best achieve these long-term savings.

our proposals will change incentives so that providers will give patients the best care, not just the most -- and not just the most expensive care. that will mean big savings over time. that is what we mean when we say we need system reform. i have proposed to congress, and i am confident that it will adopt these proposals, that an independent group of doctors and medical experts will oversee long-term cost savings measures. every year, there is a new report that details how much waste and inefficiency there is in medicare. how best practices are not always used, and how many billions of dollars could be saved. unfortunately, this report ends up sitting on a shelf. what we want to do is force congress to make sure that they are acting on these recommendations to bend of the cost curve each and every year.

we will reduce cost for families and for taxpayers. we need an independent group that is empowered to make lease changes. that is up that we have proposed. i am confident that if we work with the experts in the field, we can find a way to eliminate waste, slow the growth of health care, and provide families more security in the long term. i realize that the last few miles any race are the hardest to run. i have to say that now is not the time to slow down. now certainly not the time to lose zero. make no mistake. we are consigning our children and to skyrocketing premiums and crushing deficits. there is no argument about that.

we cannot control the cost of medicare and medicaid, and we cannot control our long-term debt and our long-term deficits -- that is not indisputable. if we cannot get health care reform done. you will see premiums go up at astronomical rates, and people who lose their jobs over pre- existing medical condition -- a medical condition will find themselves in a position where they cannot get health care. that is not a position i except for the united states of america. we're going to get this done. it will happen this year.

i am absolutely convinced of that. members of congress are prepared to work as hard as it is going to take to make this happen. i am grateful for the work we have already done. there will be a lot more sleepless nights. eventually, this is going to happen. thank you very much. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> tomorrow on c-span, president obama's speech at the one hundredth anniversary of the naacp in new york, at dealing with the relevancy of the naacp in post-racial america.

coming up next on c-span, the house republicans news conference to discuss the economy and health care. and today's national governors' association opening news conference from mississippi. a little bit later, interviews with attendees of this year's digital media conference in north virginia. >> apollo 11 astronaut buzz aldrin takes your calls on sunday's "washington journal." we talk about the fortieth anniversary of the first moonwalk. >> tomorrow on c-span, a house hearing with former treasury secretary henry paulson, testified about the government's role of the bank of america merger with merrill lynch.

a group of house republicans held a press conference to discuss the economy, jobs, and health care. they opposed the economic stimulus package earlier this year, this is about 20 minutes. >> we are here today to talk about all the things swirling around here and be very aggressive agenda that the administration is trying to push through this congress and on to the american people. from the very beginning of this congress, we have been focused on one thing. that is job creation. in fact, people across this country are continuing to wonder, where are the jobs? as we see, the ambitious agenda with one program after the other

coming down the pike, the other question is, who is paying for all of what is trying to be pushed? i just walked out of the ways and means health care markup that is just beginning. it is extraordinary, the breadth of the bill that is being pushed through and the costs associated with it. ultimately, the cost is going to be borne by the people of this country, the middle class, the wealthy, those who can least afford it. all of us are going to be paying astronomical cost at time where we just cannot afford it. i want to it quote a letter that was sent to the speaker by the blue dogs. at the bottom, it says, we cannot support a bill that further exacerbates the challenges faced by small businesses. in fact, the blue dogs got a right. we should be about job creation.

we should be about making sure american workers get back to work. that is our concern with what is going on in the health-care bill. that is our concern with what went on in the cap at a trade bill. that is our concern with the lack of success as far as the stimulus is concerned. with me today are some colleagues that will come after me. i want to turn it over to the chairman of the republican study committee, the gentleman from georgia, dr. tom price. >> what is an effort to try to bring focus to the number one issue across this land as the economy and jobs. this morning, we learned that 522,000 more americans were led down by the economic policies of this president and to this speaker. if we pass the stimulus, it

would immediately create jobs. immediately create jobs. five months later -- the white house reworks their math formulas to show the jobs saved. real people are hurting. people are mad, they want their money back, and they want their change back. america has learned a costly lesson. it only consumes it. after 2 million jobs lost, is this what the speaker had in mind? when they put their trust in this president, it is not too late. we can return billions of dollars in failed stimulus so we

can move forward with real economic stimulus. before the president ever unveiled his spending spree, the committee offered a solution that will put money back in the hands and pockets of those who earned it, reduce economic burdens on businesses, and cut spending. america has overcome every single challenge that it has ever faced, and it remains the greatest nation in the history of the world. american economic recovery will come, but it will be in spite of, not because of the failed policies of this majority. i am joined with my colleagues and 522,000 new americans in asking, where are the jobs? what we have asked to happen this morning is for new faces in our conference to join us and talk about the economy and their perspective from their states from the seats they have in congress now on this issue.

first, the gentleman from new york. mr. lee has created literally hundreds of jobs in western new york as a successful small business owner. he knows what it means to sign the front side of a paycheck. >> i want to touch on a couple of key points. the rest -- i represent the city's of buffalo and rochester. both of these cities are struggling. what frustrates me is you look at washington and realize how out of touch we are. this is one of the only cities that are growing, because we're filling it with federal bureaucrats. we can't afford to pay them, but 1.8 trillion dollars -- but there is a $1.80 trillion deficit. i have people calling the day in and day out about the spending in this stimulus. the latest example if you

haven't heard, is that we are spending over a million dollars on temporary road signs to tout what we're doing with the stimulus laws. these are temporary road signs that we will have to throw out in 2011. a million dollars. i would rather give that back to the taxpayers in my district. we have a very out of touch administration that doesn't realize the fiscal mess we're putting it -- they are putting us into. the people in my district are extremely frustrated and want us to stop this reckless spending. with that, i will turn over -- >> thank you very much. when individual that has been a rising star at our conference in the new freshman class, before she came to congress, she worked as kansas state treasurer.

>> good morning. as congressman price mentioned, i am a cpa by profession. i am also a mother of two. i looked at financial issues with a close eye on how they will affect my kids. our nation is facing very real challenges, but we cannot address any of them by continuing to pass unsustainable levels of debt on the future generations. since january, this congress and the administration have taken us in the wrong direction. it has gone on an unprecedented spending spree from -- with your tax dollars. kansans are saying, enough is enough. we have pushed up $1 trillion to our kids that could grow to nearly $2 trillion by fall. rather than slowing down and

thinking, the majority party is turning a blind eye and announcing plans for a government takeover of health care. any policy passed today will have long-lasting effects. i don't know how we can look our children in the eye and say we are not responsible for paying for the things that we are enjoying today, and we will send them the bill. this congress has selfishly burdened our children with add that they should not have to pay. the out of control spending increases taxes on families and small businesses, and borrowing from future generations has got to stop. we have a responsibility to provide relief with -- relief for americans. i will get kansans and all americans back to work. thank you. >> the breadth of experience is

remarkable. the freshman class brings all sorts of great talent. mr. paulson has 16 years of business experience working as an analyst for major american employers. the >> i america paulson from minnesota. i can tell you that one of the greatest failures of congressional leadership over the past six months has been a lack of focus and attention on helping small businesses. all we ever hear about is too big to fail, and this is mind- boggling when you think of seven out of every 10 jobs coming from small businesses. saying you want to a grow jobs without taking action is like saying you want to mow a long while starting the lawn mower. the budget has raised taxes on the backs of small businesses, and house leadership has told us that they want to tax nearly

every small business to fund a massive government takeover of the health-care system. in my home state, we're feeling the effects of these misguided policies. just last week, it was reported that exports plummeted nine. -- 19.4% in the first quarter. the debt and the deficit continued to rise. i liked ask the speaker how it is going to help create jobs. if we are going to recover, small business needs to lead the way as it has with every other recession. it is past time for congress and the administration to make it easier, not harder for job creators. thank you very much. i think you notice the common denominator is their response

-- the remarkable experience in the job sector. steve? >> thank you, chairman price. it is good to be with you today. we're looking at a situation where the american people are hurting. millions of americans are out of work. each day, -- the democrats promise that their stimulus would create jobs immediately, and employment -- on and won it would not rise above 8%. unemployment is at the highest levels that has been, at peak above 9%. in my state alone, we have seen unemployment at the highest it's

been in recent history, pushing 10.5% across our state. i have a family at home. i have three boys at home that did not come to washington to rack up massive debt. my background is that of financial adviser before i got into the legislature. i serve on the budget committee. as i saw these massive spending bills come through our committee and we heard testimony on them, i saw the infusion of spending and an expansion of government. the concern i had is that we were creating a tremendous amount of debt. historic amounts of debt. we're at the point tuileries are borrowing 50 cents of every dollar -- where we are borrowing 50 cents of every dollar. could you imagine borrowing 50% of the money that you spend? we do it here in government.

i am the oldest of nine children. my father was an immigrant to this country, became a legal citizen, worked hard, went on to become a doctor with health care reform coming up. it is an important issue to me, personally. my father worked hard to make our future better for his children. when i see the amount of that we are accumulating right now, and this is that we have passed on to our children and grandchildren for years to come. i can't imagine we're making the world a better place for them and improving their futures. we have to continue to work hard. what i went home over the fourth of july break, ito had a chance to listen, because i did. i did not hear my constituents coming up to me and saying,

thank you for putting more government in our lives. i did not hear that. i heard the opposite. it gives us a chance. families are struggling -- give us a chance, families are struggling. we have 900,000 businesses in ohio alone. it is the economic engine across this country, and small businesses are struggling. they are struggling to keep the benefits, and we continue to penalize and hurt small businesses. the stimulus bill is not targeted on small businesses like it should have been. the cat-and-trade bill that we passed. the state that i live in -- it is bad.

manufacturing and agriculture are the to the top industries in the state of ohio. other companies will be less competitive internationally against companies like china, india, the same companies that are buying our debt right now. that is going to cost jobs. our energy is nearly -- 90% of energy in ohio comes from coal. what is is an energy tax. it will cost more jobs and increase the cost of energy. anyone who turns on electricity, who uses natural gas or gasoline, the cost will go up. families are struggling to make it from paycheck to paycheck. unemployment is at the highest level that has been. now we have a health care reform

bill that is going to cost more jobs. we're putting the burden on the back of small businesses. we found out there is a provision in one of the plans that would penalize employers if their employees decided to take a health plan somewhere else. maybe their spouse works for the government and has a better plan. that employee decides to take the spells's plan. the proposal that i looked at -- at the end of the day, the bottom line is that i stand up here with my colleagues. we believe that the american people, the taxpayers, they know best how to spend and invest in jobs, create jobs, and

sustain jobs in the long run. unfortunately, what we're seeing with this democratic leadership in this administration is that they have it backwards. they believe the government can come in and take your hard- earned tax dollars and a better tell you have to spend those or tell you that is that those tax dollars. they're going to spend those dollars as they see fit. that is a problem. what i hear from my constituents is that they expect better from congress, they deserve better, and we have had some alternative plans. we can do better. >> congressman, it joe biden is traveling to your district today. what is your response? >> i can't explain his schedule. i do not blame him for wanting to go to richmond, va. and talk to the great people there.

we have had a continuing dialogue about the effectiveness of the stimulus plan. the stimulus plan has been a flop. it is president obama's economy. >> in your opening remark, he said the cost is going to be more to the middle class and the wealthy. i understand the economic concerns have with the trickle- down theory, but regardless of what you think about raising taxes in an economic downturn, is in this people who could foot the bill? >> i am not arguing about the impact on wealthy people. 50% of the people impacted by

the tax hikes, the surtax, this bill we are marking up right now, are individuals who drive at least 26% of their income from small business sources. what that means is, these are the job creators. if the first priority is getting people back to work, how can you think making it more expensive for people to hire people is a way to do that? it doesn't make any sense? if the president says he owns the economy, let's do the right thing and get people back to work. let's stop this flow of trillions of dollars out the door without being targeted to small businesses and those actually hire people. were questions? thank you. -- more questions? thank you.

>> the nation goes the governors are in mississippi this weekend for their annual meeting to address issues impacting their states. this opening news conferences about 30 minutes. >> we're very glad and honored to be hosting this year's national governors' conference. this is the first time we have hosted the national governors' conference. i might call to your attention -- if you look out the window, you see the old hotel building. that is where the 1935 governors conference was held. now it is an office building. water got into it during katrina. everything you see from here was devastated by katrina.

this building, which was almost brand new, had water through the first floor, the courts, the justice officials were out of the building for a year while it was being pre -- repared. -- repaired. the storm surge in mississippi, the first little town east of the eye of the storm was 38 feet deep. the national weather service said it was the greatest storm surge ever recorded in the history of urology. -- in the history of meteorology. all of this area was devastated. as you can see, a tremendous comeback has been made. we are very glad that the governors' association chose our state to have this conference so

that the people of the united states and their elected leaders could see the progress that has been made. they can see there is still a lot to do. i have been struck by how many governors have mentioned to me, i was here a year ago or two years ago, i can't believe the difference in the way the place looks now. our conference theme this year is infrastructure. we thought it would be appropriate to have this conference here, where you can see one of the big transportation infrastructure enterprises. it was absolutely obliterated by the hurricane. everything was lost, and hundreds of containers that were parked on the land side of the appears that you see were carried out as far as 11 miles away. .

>> the mississippi gulf coast is coming back bigger and better than ever. people in the united states have been incredibly generous to us in so many ways, including congress giving us $5.4 billion of community development block grant funds that we have used to restore housing, for economic development, community read dollarization, and everyone of you will be given one of these. this is the most recent report on how that $5.4 billion has

been spent and is allocated to be spent. the taxpayers were generous and gave us latitude in how to spend it. we thought we had you here, we would make our report about what we have done. with that, i am glad to be joined here by leaders of the national governors' association. some of you have been told that governor ed rendell who is our chairman is not here because of issues that they are working on in pennsylvania. our incoming chairman, jim douglas, is here to stand in for governor rendell. it is my pleasure to introduce to you the governor as west virginia. >> thank you, and i do appreciate you and your wife for all the hard work and all volunteers in the beautiful

state of mississippi that have made this possible. ed rendell could not be here, so i am standing in as the vice chair. the in g8 is probably the most -- the nga is the most bipartisan group of policy makers you will find anywhere. we work across party lines trying to find solutions, because we both had the same challenges. i have been appreciative to have the french ship and working relations i do with governors around the country -- to have the friendships i do. i appreciate the work they have done to continue to bring these real solutions to real problems. also to the hotel and convention staff here in biloxi.

he school bus well. -- he schooled us well. it has been a spectacular kickoff. the excitement that all our families have to travel with us and our staff. that we talk a little bit about the stimulus recovery act earlier this year and how it is affecting all of us in our respective states. i can speak for west virginia. we have been very fortunate. we have been able to dodge the bullet, if you will, but we will not go unscathed. we will be affected as every other state. with that being said, we are looking toward the 2013-2014 budget. we are all plant -- trying to plan our seltzer. the economic challenges the governors are facing are real.

just to give you some statistics, for the first quarter of the year, governors collectively across the u.s. witnessed a 24% decline in revenues. during 2009, we saw 42 states forced to reduce their it enacted budgets by millions of dollars. it brought spending down 2.2% below what 2008 was. we have never been allowed to record those drastic changes in the health and well-being of state government since they have been keeping data. states also had to recommend $24 billion in tax increases for the 2010 fiscal year. and now -- i don't know what it would have done without the of recovery act. even those of us who have weathered fairly well to this point, and some have been more challenge, collectively, i did

not know what would have done with the amount of hardship that has been placed on citizens and our respective states that would have had to endure deeper cuts. a lot of this was able to be prevented by the stimulus act. about $135 billion of that was medicaid and education that was used to fulfill the drastic cuts that would happen if it had not been for this money. you will see a lot of the money -- you have been hearing people talk about infrastructure. ed rendell took this as his charge when he became chairman of the nga. he has done a terrific job of working through this. i think you will start seeing a lot of this money starts flowing now for our infrastructure in all our states. the show already projects we talked about will start to flow -- that it shovelled ready projects. despite all the assistance we

have had from the federal government, we are projecting shortfalls collectively in the next several years of more than $200 billion that will be facing, even with the assistance we receive. there has to be a correction that will go on among each state. we will have to find the adjustments that need to be made, looking at our past policies and benefit packages, and looking at how we operate our states to be able to live within our means. this is where the rubber hits the road. governors make those decisions, and make them for the best interest, not just for today but for future generations. i think you'll see a lot of changes and adjustments being made. with changes come opportunities. i do not think we will ever have another correction such as the one we work will be going through that will not provide a lot of opportunities for states

to hit their stride. that is what we are positioning ourselves for. we can see what mississippi has done through adverse hardships like katrina. is just overpowering, the devastation that went on here. the mississippi people rolled up their sleeves, got to work, and they are back stronger than ever, because they believe in each other. if there is any other place that can be done, i do not know where it can be, other than america, coming back from the economic hardship that we are all facing right now. governor rendell has been a terrific leader. we appreciate his leadership and foresight into infrastructure. without the proper roads, bridges, water, sewer, and the new infrastructure is it the broadband high speed. we have to be able to connect with the rest of the world, no matter how will our states may be. we are working to make sure all our states have the necessary infrastructure to do that.

i just want to thank haleigh, our host, for doing the job that he has done. i am confident this will be one of the most beneficial nga meetings that we have ever had. we have more challenges now than we have ever had. we are facing more economic challenges and more opportunities, so we are going to work together, as the nga has always done, to make this very successful, and hopefully go back home with solutions to a lot of the challenges we have. with that, i will introduce our current buys chair and incoming chairman of the nga, our dear friend, jim douglas from vermont. >> thank you for being here. haley, great job as usual.

governor barbour has shown great leadership in leading the state that. years ago, looking back at the response led by governor barbara to make sure that mississippi came through very difficult challenging time. congratulations on that effort, and thank you so much for being our gracious host this week. thanks to march as well for her hard work and hospitality. this is the 101st annual meeting of the national governors' association. it was formed at the suggestion of the roosevelt who is a former chief executive of the state of new york. he thought it was a good idea for governors to come together every now and in and talk about issues of importance to the states. we have been doing it for more than a century. twice now in mississippi, and we hope that these meetings will continue to be a forum for bipartisan discussions, solutions, and confronting the

challenges that america is facing. we have a lot of hard work ahead of us over the next couple of days. our committees have full agendas. we have several plenary sessions that we will be talking about with some important topics and installing it leaders for the coming year. i talked with ed rendell the other night. he regrets having to pass on this annual meeting because of the fiscal crisis his state is facing, but we will carry on under his leadership nonetheless. we will have a plenary session later today focusing on infrastructure, which is governor rendell's top priority. we have some very distinguished guest, including the vice governor of a province of 100 million people in china. he has a lot of experience and infrastructure and will talk

about china's strategy, including the role of private investment in the infrastructure needs of that country. we will be joined by charles mormon, who will talk about the role of freight rail infrastructure to transport raw materials and products. i have congressman rose of the laura of connecticut'. our committees will be active in talking about the long-term economic prospects for the states in our country. the education, early childhood, and work force committee will talk about increasing education and training opportunities for workers in this new and transforming economy. health and human services committee will focus on health- care reform. the national resources committee will talk about barriers to american energy security and independence. we will participate in a plenary session focused on emergency

preparedness, certainly a timely inappropriate topic given our venue here on the golf course -- on the gulf coast. secretary napolitano will be here and deliver the keynote address. we'll have some panelists, the ceo of motorola and travelers, brian mcdonald, partner and director in the disaster of and compliance division, and credit few great -- craig fugate. their specific topic will be coordinating efforts between the federal and state governments when these challenges occur, to make sure we have comparability of our emergency management strategies. our final plenary session will focus on energy and the economy. we'll have speakers from the public and private sector including the ceo of the u.s.

chamber of commerce institute for 21st century energy, a founding partner of paragon partners, chairman and ceo of newcor. we have a lot on our plate over the next couple of days. as my colleagues have suggested, there is no more critical time in the fiscal and economic lives of states than now. so many state shortfalls that are mounting. so many of our constituents are out of work and facing losses of income with family struggling to put food on the table and eat every day needs of people in america. there is no more important time for governors to come together and talk about the challenges of the people of this great country. i look forward to the next couple of days with my friends and colleagues. we are going to do