that it deems necessary because of this deal. so yes, i am concerned about it. i agree with you that the bunning amendment could have gone a long way to fix this. . . i just wonder if we're not pushing this to the point where we're not getting what we ought to get. i guess we ought to finish this process before the cbo can literally do the scoring for the

whole process. i hope that once we are finished in this market up, the committee will allow the cbo to score this before it comes up in committee. we do not know what we're voting on and we do not know what the costs are. frankly, i am really concerned about it. i have been thinking about this all dead -- i have been thinking about this all day. i think the cbo has been under tremendous pressure by all of us. i think they do a great job. there never afraid to tell us if they think they do not have it right. but this morning, it was almost more than i thought could happen in this process. once we get through this conceptual markup, i hope that

we all have enough time to give the cbo enough time to look at this and tell us what the final economics of the matter really are going to be. i do not think we are doing what is right for the population at large, and i do not think we are doing what is right for ourselves if we did not get that kind of information. i wanted to just bring up while we were doing this amendment, because he raised it this morning. i thought it was a very important thing. i also said, the mistake that was made on that was 100 million, it was actually 600 million. these and not inconsequential things. i'm just very concerned about it. >> senator, we have discussed this many times. let me said, as i have said many

times, as in particular with the discussions with the senator from north dakota many times, it is my intention that we will get this on the bill. that may take a few days until we finally wrap up we agree to hear, at least the majority agreed to, and then send that to cbo and get the score for the final vote. it is my intention to make sure that we get the score before we have the final vote. senator cornyn? >> senator, let me ask a question. you are aware of the news stories on this. i'm just wondering, do you think there's any additional legislative a mandate for change in your mark that needs to be done to effectuate the policy that you intended? if not, with the cbo simply --

what assumption with the cbo be using with respect to this car for out -- with this carve-out so they could take with the authors of the mark intended? they will use their objective, neutral, unbiased -- fair and balanced analysis. there will read the language. >> and it would be your view there is nothing necessary by way of an amendment to further clarify? >> that is right, because somebody could go back and find some ambiguity someplace. i think it is wise to let the cbo work with what they have. >> will be done on a consensual bill?

>> it will be conceptual first. as i recall, at one point, he said we can get the record and confirm it and it will take two weeks to score. i did not know if we have two weeks to wait around. but we will give him time, several days to score this bill. as we customarily have in the past. although i must say we're going to give him sufficient time for the preliminary analysis, and my guess is that it will be based on the language. but let's be honest and open about all of this. we have to merge the bills, too, and i think we will be working on the score while we

are merging the bills. but we will have a vote after the cbo scores the modified mark, as amendment, probably three days. then after three days, they will vote the bill. >> based on the story this morning, about this hospital carve-out, was a clear, or not clear? why was there a question by cbo with regard to that? was it clear from our standpoint? i think that is important here. i think it is a good example of the problems that we could

potentially face, and i remember this summer we had errors are miscalculations are under estimations of more than $70 billion, so i think it is important that we learn from this experience and the specific instances. >> i think there was ultimately a bit of confusion that we realized ultimately after the mark was released. we talked about how to handle this issue, and we were going back and forth on it. ultimately we made the decision that a language does result in a carve-out, but i think cbo was left with the impression that what we said it clearly indicated. much after the fact, we realize

that maybe it did not reflect it, and from their perspective there are still looking at it. >> there has got to be clarity in these policies. >> that is my intention. we are working with cbo to achieve that clarity. >> we will -- will we have the opportunity as a committed to respond to some of these issues before the final vote? >> i have no doubt it will be fair about this. this is one sixth of the american economy. if we do not get it right, i cannot tell you the repercussions we are born to have in the future. -- we are going to have in the future. i do not see any reason to

overly rush this, and i agree, i guess you have to meld it somehow with the health bill. having lived through that marked as well, i think it is really important to give cto enough time to really be able to tell us what is going on here, and hopefully in a competent manner so that we did not have to keep coming back to it and revisiting yet again and again. this is an important issue, and had we agreed to the bunning amendment, we would be a lot farther down the line and we would have a lot more confidence in what is going on here. i know you intend to do a good job here, but i do not see how you can expect cbo -- all of the language we have and we have

had to discuss back-and-forth, and we are hardly denting the conceptual language that is brought here. we are giving them almost an impossible job, and you say you are just going to give them a few days to be able to come up with some sort of answer before we vote in committee. >> i will wait until you finish. >> i will just take another couple of sentences. look, i think cbo has a very, very difficult job. i do not think we have been all let helpful to cbo with some of the things we voted upon, positive and negatively. i have a desire to help them be able to have every ability they can exercise to get this job

done right. the way i have interpreted what you have said, we will finish the conceptual market. they will then score that within a certain number of days, and then because of the health committee bill, there'll be some work to resolve the conflicts between the two bills, and then hopefully, that will come up with the final legislative language, which cbo says will take them at least two weeks to do this, and it may take them two weeks or longer to do the final statutory language. i just want to make sure i understand this process, because i am very concerned about that. we can hardly say we are rushing this, but i think we can be too concerned about not giving enough time.

>> actually, senator, that is not what i said. i said that when we finish the bill, we will then give the bill to cbo. >> the conceptual bill. >> the conceptual bill to cbo, which the committee has done for more years than -- i might add, this is along this markup in 15 years. cbo has told me that they need about three days, and that will give us their preliminary score. we then vote on the bill. it may be that the preliminary score is not deficit neutral over 10 years, as is required by budget legislation. that is the case, we will have

to modify it. there will be modifying amendment. i am not quite certain how long it will take the cbo to then score that. my hope is that if they tell us where up out of balance, that they can tell us how and why, so it can be remedied very quickly. that would then give us a ruling that we are deficit neutral. then we have to merge the bills, after we vote. i want to vote on this bill first, before there is any merger. in talking to the leader, he would like to move this bill after we get a score. i talked to him about that just a few hours ago. after we get the score from cbo, not before. he therefore expects us to vote

on this bill sometime this week. he then begins the process of merging the bills together. to be honest, i do not quite know what he has in mind. i know he has been talking to cto and has for some time to try to work with two committees to get a score on the bill before is brought up on the floor of the senate. it is my view that we need to have a ruling by the cbo before we go. it is also my view that we need a cto ruling before we go to the floor on the first bill. -- on the merged bill. to be candid, he may not like this, but i do not think we can wait around for two weeks.

if there is a problem later on -- i do not expect it will be that different. on a more narrow issue, working with cto on the medpack issue to get the scoring that we hope to get on the division, if it turns out that cbo says we have to come back to get the scoring and savings would want to get on the amendment. it is in hands of the cbo at this point, and we just have to do our best to be totally open and transparent. >> mr. chairman, i have served

on this committee a lot of years and on the budget committee my entire time in the senate, and i know there is a concern. i have talked to some colleagues, both sides of the aisle, about what happens if there is a discrepancy between the bill as written in plain english, which is the way this committee considers legislation, and the legislative language which is to follow. i was in conversations with cbo, as was the chairman, in which they said they would need two or three days once we are done here to provide us a score. that would be before they take the legislative language and prepare another score. the concern i picked up from a

number of colleagues is, what if there is a discrepancy between the bill as written in plain english, so all of us can understand it and our constituents can understand it when it is on the website, and the legislative language? my experience has been, and i would ask the chairman if it is not his intention, that if there is a discrepancy between the score on the bill written in plain english, which is what we would vote on, and a score provided by cbo, and a subsequent score based on the legislative language, that if there is a discrepancy, my experience has always been in this committee that the chairman addresses that in a manager's amendment to recapture the intention of the committee and they pass the bill. is that the chairman's experience?

>> absolutely. it is almost amazing to me how all that has worked in good faith. every chairman i have served under has done that. it makes no difference, and in good faith we always distrust each other. -- trust each other. that is exactly right. it has always work seamlessly. i have never seen anything even close to being characterized as heavy-handed. it is always transparent and in good faith. how does want to praise you. i just want to say something nice about you. i do not think anyone would

doubt that you act in total good faith. but the fact of the matter is that there will be a subsequent bill when you work with the help committee which is an entirely different matter. they do not do it this way. they do it, as i recall when i was chairman, they do it on a full score legislative language way. you can see why i am concerned about the process here of how we handle this. i don't think the one doubts that it is in a very good faith manner. i want to raise these procedural issues because they are tough issues. will the general public and everybody be given at least three days on the internet to read it and look at it and see if there are any mistakes that we can come up with?

>> as i said, when the cbo gives the store, then we will have an opportunity to vote. >> i just want to bring to the chairman's attention that the help bill, and i went down and talk with the ranking member, passed the committee on july 15 with three titles not in legislative language, and no score. the bill was sent to the floor of the u.s. senate on september 17 with legislative language, and still no full score. so they never got a final score

prior to voting on the bill. i just want to make sure that this committee does not try to do that, and then after its final passage, the merger of the two bills, we cannot have one conceptual and one in legislative language to get a final score on a merged bill. so what is the chairman's intention at that time? >> first ball -- first of all, we can only control what we can control. there are certain areas we cannot control. we can control to some degree our committee. it is difficult to control other committees.

we will do our very best to get the score. we are not going to vote on the final bill until we get the score from the cbo. then the next debt is to merge this bill with the help committee bill. that is up to the leader. i do not know what his plans or intentions are, by suspect he wants to move without too much delay. >> could you give us some assurance that we are at least going to see a final, merged bill before we vote on it? >> i cannot give a total insurance, but that would be my wish. >> a quick question. will we have decision time to review the mark after it has been scored?

>> it will certainly have time to be the mark walt cbo is reviewing the mark. -- while cbo is reviewing the mark. >> i hope we do not get it at 9:00 and then we are voting at 10:00. >> that would not be in good faith. >> i think you have answered the question i was going to ask, but i want to be clear. i was going to ask in the process you describe, whether we would have bill language at the time the health bill and the finance bill are merged, and i understood you to answer that question by saying that you would expect that that should be the way we should do it, but you could not control it. >> that is right. i cannot control the health committee. -- the help committee. >> as chairman of the finance committee, if we work for a year to vote a bill out, we ought to be able to see the product that we produced.

if you are telling me that we might not see a statutory legal language in the product, then i think, what are we wasting our time here for? so we ought to have to products, one from the health committee, one from this committee, and at that point, somebody in the senate above us decides how it is going to be done. >> senator conrad is recognized. >> i had not concluded my thought. my point was that, from the answer you gave, it sounded to me like there was the

possibility that we could yet again after this committee had concluded its work be facing a circumstance when, after the two bills were merged, that we had been converging -- we had been merging eight -- we would still not have an opportunity for the members of the senate at that point to be able to observe that legislative language. i just wanted to make a point that the circumstances that came up today with regard to the cbo score on the pedpack language is an example of the concern, namely that the conceptual language led cto to believe that a hospital deal was not included, but the hospital deal was supposed to be included, and when it cbo figure that out from the conceptual language, they indicated they had a $10 million mistake. my point is to say that that is

an example of what many of us are concerned about happening, and that is one of the reasons why we like to get some kind of certainty with regard to when there will be statutory language. >> let's go to the amendment. i intend to operate entirely good faith, all the way around. to be honest, i do not know if we can wait two weeks for the legislative language. in fact, it might take longer, given the experience of cbo, but we will operate in total good faith. we will get the cbo's corp. after we complete our business here, we will look at the score, and we will operate in good faith. i will do all i can to make sure that we get the score on but merged bill -- on the

merged bill, so that people have an opportunity to see what is in the product and what is not in the product. >> we are a democracy. we are an imperfect institutions. we try our best. we work hard, but the real clue here -- the real glue here is to operate in good faith. if both sides operate in good faith, and we are doing our business, the senators can vote any way they wish to vote. all i am saying is we will do our very best to operate in good faith and give the centers the opportunity to review the bill. >> isn't the case that when

there is a merged bill, it comes to the floor, by definition, it will have to be in legislative language? >> that is correct. but so what we have is what we have always had. maybe it is because other members have not been in chairmanship's or not gone through the hoops here, but the path here is one well-traveled. this is not something new. the pattern is very clear. you have the bill that is recorded here in plain english. it scored by cbo. the chairman has said very clearly will not vote until there is a score. then the plain english is translated into legislative language. that will be several weeks before cbo has a score on that. by definition, the bill that goes to the floor that is a

merged bill between the two committees of jurisdiction has to be in legislative language. it has to be. and so that will be the bill for all to see, for all to read, for all to evaluate, and that will be scored. that will be scored. >> my concern -- it is like cool hand luke, we have a failure to communicate. my concern is obviously in reconciling the scoring and we have the legislative language and all that that has been talked about with my colleagues. i guess i did -- i just did not get it until i read the press articles about this. here we have the assertion that the american hospital association made a deal, if that is the way to put it, or at least to agree to $150 billion worth of cuts, and then made an additional deal with

somebody and said but, we are not going to take any additional cuts -- i do not know if that is the first year after this or the next year. i do not know how this figure was reached, $11 billion separate that would be recommended by the medicare commission that senator rockefeller spoke so strongly for, that would be immune to this kind of deal. it would mean that the medicare commission has already succumbed to the hospital lobby, saying we gave $150 billion up front, we are not going to give any more to the tune of $11 billion, and that that is really responsible for the carveout efficiency, and that is the case, it speaks to what senator rockefeller was trying to do, and it speaks to the fact that deals can still be made, because obviously if it is the aha or

anybody else, how they can come here and lobby and still, despite senator rockefeller's efforts, by past that. i would like to know if that, in fact, is correct, and who is responsible for the carveout for $11 billion? >> ok, let's go to the amendment. >> i have been patiently waiting. holding west virginia up as an example, i think that is unfortunate. our governor is a democrat. i happen to disagree with him on his approach to stay that both he and i know very well. we are not a rich state. we have a lot of people that do not have automobiles, doctors, insurance, do not know where they can get health care. if they want to go to the

emergency room, they have no idea where it is or how to get there, having no transportation. to me, he applied for the first medicaid waiver. i never liked that program. i never did like that program because it allows governors to cut medicaid and, in my case, cut children's health insurance program, which is exactly what happened in west virginia when he took this personal responsibility, you have to sign the pledge of rule. i think it is condescending. i think it is government doing what i think i have been hearing all of you folks say you do not think government should be saying, telling people what they have to do in order to get health care services.

it is a lot easier for people who have education and experience and have means, etcetera, to exercise that. but the whole concept of doing this, senator cornyn, i admire you greatly, it would require all medicare beneficiaries to sign a member agreement. it is not a country club, that is personal responsibility club, similar to the one used by the west virginia medicaid program, and that was a disaster. but it was a disaster. i was governor there eight years. it was a disaster. it would not have worked with most of the medicaid community. we have all of for west virginia people who are not capable of knowing how to make decisions, even though preventive care, out well this is such a high order of business, and we all know that.

but i have to recognize that these are human beings and i have to recognize the people factor. yes, it would work for some, but it would not work for a lot, and it would backfire. in fact, it has backfired under the medicaid waiver or they had to do that at the senator from texas refers to. medicaid has been caught and the number of children on the children's health insurance program has dropped greatly. i would oppose the amendment. >> mr. chairman? mr. chairman, let me agree with senator rockefeller and opposing the amendment. it seems to me that we have heard speech after speech the last six, eight days about how we were not being fair to medicaid recipients and that we were allowing medicaid to be a second-class health care system and that physicians would not take medicaid patients and that

we ought to increase reimbursement and medicaid and on and on. to me, this amendment drives home the point that we think medicaid is a second-class medicare -- medical system and it is demeaning to the people who have to be presented with this so-called personal responsibility agreement. it is demeaning to require them to sign it. i think it is ironic that the last statement and it is, "i will be treated fairly and with respect." in my view, giving somebody this type of agreement and saying that you have to sign this if you want to participate in medicaid is not treating a person with respect. we would never think of doing that with veterans. we would never think of doing that with medicare beneficiaries. we would never think of doing that with other participants.

there is no reason we ought to be thinking about doing it with medicaid. >> mr. chairman? if i could close, mr. chairman, my friend, the senator from west virginia seems to suggest that medicaid benefits would be contingent on signing the pledge. that is not what my amendment proposes. under no circumstances would it affect someone's right to receive medicaid if they otherwise qualify. i would just read the words again, because i have yet to understand what it is about this that people disagree with. number one, i will do my best to stay healthy. i think that was what the amendment was about that was embraced by broad margins. second, i will show up on time for my appointments. as i indicated, doctors and texas have said one reason they did not take medicaid is because many medicaid patients because

they do not pay anything, they did not show up for appointments on time. encouraging them to show up on a point this on time to get the treatment that they need -- encouraging them to show up for appointments on time to get the treatment they need seems to be common sense. third, i will use the emergency room only for emergencies. getting people treatment in a clinical setting rather the emergency room seems to me to be a good objective. and the last two, a right to decide things about my health care and health care of my children and i will be treated fairly and with respect. i just do not see how that could possibly be demeaning. it is an affirmation of the fact they have a right to decide about their health care and be treated fairly and with respect. i think there is any thing that has happened here that sort of insurance as second-class status of medicaid beneficiaries it is the votes that we have had which

have given them no choice, with limited access to doctors because of low reimbursement rates and the kind of arguments we have been trying to make on this side but which have apparently fallen on deaf ears. >> the senate finance committee is back for more work on health- care legislation tomorrow morning at 10:30 eastern. live coverage is on c-span 3. ward debate now from the senate finance market. the committee agreed to amendment by senator nelson on senior citizen tax exemptions. debate on the amendment is 45 minutes. >> senior citizens, that is 65 and older, and their spouses would be eligible to claim the section 213 deduction if their medical expenses exceed 7.5% of

adjusted gross income. this amendment would apply in the years beginning in 2012, and it would end before january of 2017. it has been a joint effort putting this together, and i want to thank the chairman and the staff. we made several changes. one of those changes was in thei underlying bill, a new provision to raise the income floor for the medical expense deduction. the medical expense deduction provides relief for taxpayers that experience extraordinary

out-of-pocket medical costs during the year. it has been at 7.5% of adjusted gross income, and taxpayers may deduct their medical expenses. but to the extent that they exceed 7.5% of their adjusted gross income in current law. but what we find is that more than 80% of the taxpayers climbed a medical expense deduction also have a fairly low incomes. in comes under 75,000. this deduction was designed in the tax code to exclude predictable, recurring expenses , as well as the surprise, the extreme medical hardship beyond

an individual's control, such as major surgery, severe chronic disease, catastrophic illness. and so from the 1950's, until 1982, the income floor on this medical expense deduction was 3%. that was increased to 5% in 1983, and to the present 7.5% in 1987. now, under the chairman's mark, the income floor would rise to 10%. it and because it is that much less deductible from taxable income, it is going to raise $22 billion in the german's mark perry -- in the chairman's mark.

well, you peel back the pages, and you find more than half of this benefit goes to senior citizens. those same senior citizens tend to live on fixed incomes, and they are the ones that are more likely to experience the extraordinary medical costs. as a result, their medical expenses exceed the income floor of 7.5% more often than others. there was a time when seniors will fully exempt from the income for, and that was back in 1951 -- from the income floor, and that was back in 1951 until 1966. well, the purpose of this amendment, which has been jointly worked out with the chairman is that we should not

raise taxes on the seniors to pay for health reform, particularly in this case, seniors suffering extreme medical hardships. and so, the new out-of-pocket limits will apply and other parts of the bill to private insurance offered in the exchange. however, these same out-of- pocket limits -- remember, this is the limit that we went from 2% to 12%, that premiums cannot be 2 2beto 12% of income. we put limits on that. -- they cannot be 2% to 12% of income. that does not apply to medicare beneficiaries. now we're back to the seniors. as a result, many seniors will

continue to rely on this medical expense deductions to offset a high impact of high medical costs if they get a surprise in a particular year or recurring. in working with the chairman's staff, with this amendment does would be carved out seniors from the 10% and come floor, individuals 65 and older would continue to deduct their medical expenses, but deduct them as they do under current law those in excess of 7.5% of adjusted gross income. what that means in dollar terms in the pockets of senior citizens is $7 billion. ok, we have a revenue offset.

the revenue offset would make payments under the employer a fair share provision non- deductible as a business expense. ok, what do i mean by that? and the underlying chairman's remarks, for example, there is a complicated formula that an employer is going to have to make it his employee goes into the exchange. but there is an overall cap. remember $400 per employee times the number of employees is the cap. that the employer would ever make in his fair share contribution. well, the offset here is instead of that being a deductible expense, that it would be

nondeductible expense. this track some the other things that are expenses that are also non deductible. such as taxes on mutual funds. real-estate investment trusts. certain of their expenses are nondeductible, and likewise taxes on tax-exempt foundations are nondeductible. and so in order to meet the requirement of the revenue neutrality, the amendment is going to sunset in 2017. now, of course, what i would like is as we get closer to the floor is to continue to work with you so that that carve-out for the seniors would be

extended to cover the last three years of the budget window. but for purposes of this amendment, it goes until just 2017. that is the amendment, mr. chairman. >> mr. chairman? >>. right ahead. >> thank you. i have a couple of questions i like to ask about this amendment from the chairman's staff at the table. from the joint tax committee. for the chairman's staff, let me say someone in the exchange becomes severely disabled and has long-term care expenses from being in a nursing home. with these people with disabilities be protected from a tax increase under the nelson amendment for the catastrophic long-term care expenses? >> catastrophic long-term care

expenses would qualify for medicare expenses. sorry, catastrophic long-term expenses would be qualified expenses which any taxpayer could deduct, so the extent to which the chairman has modified by center in nelson's amendment. it it would depend upon their rage. senator nelson's amendment has one threshold if you are 65 or older and a higher threshold has modified if you are under age 65. >> also, 70 million people will be uninsured. let's say a child is one of those uninsured families, as stricken by cancer. will this family be protected by a tax increase on catastrophic expenses under the nelson amendment? >> again, senator, senator

nelson's amendment keys off at age of the taxpayer or the taxpayer's spouse. it >> are you saying they would be covered? >> in your case, i am presuming the child's parents are probably under age 65. if that were the case, then it would test for the itemized deductions relative to the higher 10%. >> that uninsured family with a child with cancer may also have to pay a penalty tax for being uninsured. would that penalty tax be considered a medicare -- medical expense for the purpose of the medical expense deduction that the chairman is limiting? in other words, is it possible this uninsured family will be paying higher taxes because the chairman is raising the threshold for the catastrophic medical expense deduction, and on top of this, they would have to pay a penalty tax that would

not count as one of the catastrophic medical expenses? >> the deduction under present law -- remember, the only thing that is being amendment -- amended is the threshold. the deduction the deductionlaw is for medical care received, health insurance, prescription drugs and the like. the police tax that you discussed would not fall into that -- the penalty tax that you discussed would not fall into that. >> last question, is it fair to say that people who take this medical expense deduction, especially those who are not seniors, tend to be sicker than the rest of the population? >> do you mean on a year-to-year basis? i could not actually say on a year-to-year basis. i am sure that there would be some people claiming to have

chronic diseases. i do not know if people with chronic diseases are more highly represented in those who claim itemized deduction. it is certainly true, as senator nelson explained, in any one year, if someone has an unusually high medical expenses, which could relate to some sort of health problem, that that increases the probability with which one is able to claim itemized deduction. >> is that a yes? >> it is a sort of yes. it is sort of because i did not know if people know if-- >> do we have that? >> i do not have that with me. i can check with my colleague. >> thank you very much. >> would the senator yield for a question? >> certainly. >> if i follow the line of your questioning, what you are

arguing for is not increasing the deduction limit from 7.5% to & -- >> i want to know who is covered. >> what i am trying to do is just carve out seniors from that increase. am i am trying to point out the fact that some people are not covered and some people are covered. i was trying to extrapolate from our staff out there who is and who is not covered. thank you. >> mr. chairman, did senator grassley want to speak? if not -- >> thank you very much. first of all, i want to thank senator nelson for this excellent amendment. i like very much to be added as a co-sponsor. i think this is exactly right when we're talking about seniors

on medicare. the goal of this bill is to be adding to quality care, prevention, making sure that we are making prescription drugs affordable and so on. we did not want this provision that will particularly help seniors that are sick more frequently, have more severe health problems, we do not want them to be penalized by this cap. so i think it is the right amendment, and i strongly support it. i would go and asked, in response to senator bunning's question about others, would it not be fair to say that right now, those who have insurance, the only thing they have is the medical deduction. i should not say the only thing, but those who did not have insurance are the ones right now that we're trying to help in the exchange. the right now have a medical to

stop -- deduction, but under the bill, it will have amendments on out of pocket costs, limits on premiums, which i am going to continue to push to get down as far as we can. is it not true that for many people who now currently only have the medical deduction, they will instead have limits on out of pocket expenses and premiums and access to more affordable health care? >> senator, it would certainly be the case that if someone would have been claiming all itemized deduction by reason of a catastrophic medical expense, which they had no insurance and were drawing down their savings or funding from whatever source, if they now have insurance which covered that catastrophic illness, it would not be making those payments. so they may not qualify for the itemized deduction. >> so the hope -- i would just

say to my colleagues, the goal of this legislation is to make sure that we have fewer people using that deduction because they, in fact, have insurance that is affordable to them and their family. for many people, the majority of people who do not have insurance now, there would be limited in how much they would have to pay, cutting down on those catastrophic experiences that are terrible for families right now and often lead to bankruptcy's and so on. the goal is to make sure that we cannot put families in that particular situation. >> will yield? >> already have to. >> even under the chairman's remark, and god willing and passes, there will still be 17 million uninsured people. my question was to directly find out if they were going to have to get -- if they were going to be covered or not.

that is the question i asked. even knowing that there was going to be coverage for other people. >> i see. >> thank you. >> could i have the floor? >> sure. >> yesterday, we heard a lot of talk about medical bankruptcy's. for example, members on my side of the aisle were told that in order to provide medical bankruptcy's, -- medical bankruptcies the plants cannot be less than 65%. this was to allow hsa high deductible health care plans to meet the personal responsibility plan. we were also told how important was to have an out-of-pocket maximums in health insurance plans. senator and cynne introduced an amendment that was germane because it amendment -- it

amended the bankruptcy talk. with all the talk about preventing medical bankruptc ies, which we all want to prevent, and i do, i was surprised to see a proposal that would raise the 7.5% agi flor to that 10%. so because the medical expense deduction was put into the tax code to provide protection from catastrophic medical expenses, we all agree that catastrophic medical expenses lead to medical bankruptcy. last tuesday, i asked staff, cbo, and joint tax what taxpayers would be affected under the proposal to increase the 7.5% afi -- agi floor.

staff informed me that most taxpayers would not be affected. i was informed that the out of pocket minimum's would eliminate or mitigate any adverse effects on individuals or small business. staff also stated that most plants have an out-of-pocket maximums. so those with employer coverage would not be affected be there. i agree, with staff, that these protections will help individuals, but individuals below age 65. but what about individuals 65 and older? it seems that the german's mark forgets about them and it forgets -- it seems that the chairman's mark forgets about them and if it's there is no cost sharing expenses. then also forgets that medicare does not pay some of long-term care expenses. what does this mean? it means that the tax increase pulls most heavily on seniors. the proposal raises $21 billion.

guess where half of that revenue is coming from. it is coming from senior 65 or older. i hope you will not take my word for it. joint tax told us that about one-half of the revenue comes from seniors in 2013. this would increase to 53% by 2019, and the largest concentration of seniors affected are middle-income seniors earning between $50,000 and $75,000. seniors, then, are clearly exposed, yet the chairman's mark would take a tax benefit away from seniors. now, senator nelson has offered an amendment to exempt individual 65 and older from the proposed increase. his amendment allows seniors to continue using the 7.5% floor. i agree with the