[Congressional Record Volume 152, Number 55 (Tuesday, May 9, 2006)]
[Senate]
[Pages S4177-S4205]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  HEALTH INSURANCE MARKETPLACE MODERNIZATION AND AFFORDABILITY ACT OF 
                   2006--MOTION TO PROCEED--Continued

  The PRESIDING OFFICER. Under the previous order, the time until 2:30 
shall be equally divided.
  The Senator from North Carolina.
  Mr. BURR. Mr. President, I am going to be here numerous times this 
week. This legislation is too important to have it shortcut. There is 
not enough time in the debate to say it all at one time.
  Last night, this body had the opportunity to vote on proceeding to 
changes to the liability crisis that exists in health care today, but 
the minority denied us the ability to move forward. They denied the 
ability of the American people to hear an honest debate, to consider 
thoughtful amendments, and then to judge up or down on the content of 
the legislation.
  They had two opportunities: liability that was reform for all medical 
professionals; and, then, liability that was only changed for those who 
are OB/GYNs--that next generation of medical professionals who are 
going to deliver our grandchildren and our great-grandchildren, that 
profession that is going to regenerate the population of this country 
and, in fact, is suffering today because of the high rate of liability 
costs for the premiums they have to have.
  Now we are here. We are in debate--30 hours of debate--to see if we 
can proceed on a bill to bring small business group health insurance 
reforms into law, to enable small businesses in America to be able to 
price insurance for their employees in the same way large corporations 
are able to produce products for their employees.
  Today, small businesses' choice is between nothing and nothing. It is 
not something and something. It is nothing and nothing. And what will 
we do? We will debate, for 30 hours, whether we should proceed. Some 
don't believe this is important enough or, if it is important enough, 
that there ought to be all sorts of changes to it that are unrelated to 
these millions of Americans for whom their employer cannot afford to 
provide health care. Why? Because they are not big. The marketplace 
discriminates because they are small.
  Let me give you some statistics about North Carolina. In North 
Carolina, 98 percent of firms with employees are small businesses. 
Ninety-eight percent of my employers are shut out of the ability to 
negotiate a reasonable cost of health care for their employees. Because 
of that, their employees have a choice between nothing and nothing.
  We will have 30 hours of debate to see if we are going to proceed in 
this body to provide something versus nothing--not something and 
something. How can anybody object to providing a choice of something 
for those who do not have an option today?
  Additionally, in North Carolina, we have 1.3 million uninsured 
individuals. And 898,000--almost 900,000--North Carolinians are 
uninsured individuals in families or on their own with one full-time 
worker. Those are all individuals who potentially could be covered 
under an individual or a family plan.
  Of the 1.3 million who are uninsured in North Carolina, 900,000 could 
be affected with this one piece of legislation in the Senate. But for 
the next 30 hours, we will debate whether we proceed or never get to 
the process of an up-or-down vote; in other words, it is a choice as to 
whether we keep them with nothing and nothing and the uninsured numbers 
stay at 1.3 million or, in fact, we are going to provide something for 
North Carolina--900,000 people who today have nothing provided for 
them.
  Later today, I am going to come to this floor, and I am going to read 
for my colleagues real letters, handwritten letters--handwritten 
letters--from people who live in North Carolina, whose choice is 
nothing and nothing. These are individuals who have the same health 
needs, individuals who would like to have health insurance but whose 
employers cannot afford it today, who want the opportunity in employer-
based health care, but because of the way the system is designed today, 
it is not achievable because it is not affordable for them.
  We are here today and tomorrow, and we ought to be here as long as it 
takes to make sure Americans at all levels have choices between 
something and something. These 30 hours will determine, in fact, 
whether this historic institution will provide that for the American 
people or we will walk away; whereby, once again, the American people 
will be denied because some in this body do not believe there is a 
responsibility to move to a point where there is an up-or-down vote. 
Truly, people can look and say: You have my future in your hands. My 
health security is in the hands of the Senate, the Members of the 
Senate, and whether they are going to, in fact, respond to that.
  Well, I think people in North Carolina desperately want choice. I 
think they desperately want this bill. They want their employers to 
have the opportunity to be able to look at health insurance and to find 
it affordable. Why? Because that is their security. That is their 
ability to have coverage.
  My hope today is that the outcome of this legislation will not be a 
quick death such as last night with medical liability reform. We all 
agree health care is too expensive. We disagree on what the solutions 
are. But to end up with nothing, to deny the ability to move forward, 
to deny the ability for the American people's voice to be heard through 
the amendment process on this floor is disgraceful.
  My hope is after these 30 hours we will proceed, we will have a 
robust debate on the amendments, and, at the end of the day, the 
American people will have an opportunity for an up-or-down vote in the 
Senate.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from New Jersey.
  Mr. MENENDEZ. Mr. President, today we are here in the middle of what 
is being called Health Week in the Senate. But rather than debating 
important lifesaving, life-enhancing

[[Page S4178]]

legislation that has bipartisan support and could actually deliver hope 
and promise to millions of Americans, the Republican leadership in the 
Senate has, instead, decided to continue their political posturing, 
business-as-usual approach to governing.
  It is no wonder the American people have become disillusioned with 
the leadership in Washington. Instead of debating and passing stem cell 
legislation that will end suffering and extend lives, we are again 
focusing on a partisan proposal to limit patient options, even when 
they are harmed, for example, through medical malpractice.
  Instead of passing stem cell legislation that will provide new 
treatments and cures for debilitating diseases, such as Alzheimer's, 
juvenile diabetes, spinal cord injuries or cancer, we are debating a 
bill that would actually eliminate--eliminate--the health coverage that 
many States currently provide to cover some of these very diseases, 
that will cherry-pick, pitting the healthy versus older workers or 
those who have some chronic disease or illness. And where there is no 
insurance regulation, prices go up, insurance companies pick the 
healthy, and they discriminate against older workers and those who are 
less healthy.
  And they can deny coverage that States have thought important to have 
to meet the challenges of their individual States, sometimes very 
uniquely so.
  So instead of wasting an entire week debating legislation that I 
believe ultimately has no chance of passing, we owe it to the American 
people--to the millions of Americans and their families suffering from 
life-altering disabilities and diseases--to demonstrate our Nation's 
full commitment to finding a cure and doing all we can to help their 
hopes and dreams come true.
  It has been almost 1 year since the House of Representatives passed 
the Stem Cell Enhancement Act, and yet the Senate still has not passed 
this vital legislation. I rise to urge the majority leader to do the 
same and bring this important legislation to a vote in the Senate.
  I was fortunate to have had the opportunity to vote in favor of the 
bill as a Member of the House, where we had broad bipartisan support 
for the proposal. I believe that same bipartisan support exists in the 
Senate, which makes it even more difficult to understand why we cannot 
come together and do something meaningful for those who are suffering.
  My support of stem cell research is partially a reflection of my home 
State's commitment to innovation and discovery. In 2004, New Jersey 
became the second State in the Nation to enact a law that specifically 
permits embryonic stem cell research. We know that embryonic stem cells 
have the unique ability to develop into virtually every cell and tissue 
in the body. And we know that numerous frozen embryos in fertility 
clinics remain unused by couples at the completion of their fertility 
treatments. Why shouldn't they be allowed to donate those embryos to 
Federal research to save lives? We allow people to donate organs to 
save lives. Why couldn't a couple, if they so chose, donate their 
frozen embryos instead of simply discarding them?
  The great State of New Jersey offers more scientists, engineers, and 
technicians per capita than any other State, and I am proud to 
represent the innovation and research taking place in New Jersey. Our 
State is not only known as the Garden State but also as America's 
``Medicine Chest.'' But for our State and our country to continue to 
compete globally with health care breakthroughs, it is going to take 
more than private and State support. It is going to take the support of 
our Nation. It is going to take leadership that looks beyond politics.
  But, to me, similar to countless Americans and New Jerseyans, this 
issue is about more than our ability to compete as a nation. The 
promise of stem cell research is painfully personal. It means hope and 
promise--hope that people such as my mother who suffer from advanced 
Alzheimer's disease might one day be cured from the loneliness and 
confusion caused by this horrible disease and the promise that future 
generations of families will not have to see their loved ones enter 
into a world of dementia that robs them of the best years of their 
lives.
  We hold the key to unlock that door. It is shameful that we have let 
partisan politics stand in the way of medical progress. We owe it to 
our parents, to our children, and our grandchildren to unlock that 
door.
  Diabetes, Alzheimer's, cancer, Parkinson's--none of these diseases 
boast a party affiliation. And we cannot let ours keep us from doing 
what is right.
  Today we have an opportunity to do what is right. But it is clear to 
me that the majority will again let that opportunity pass them by. I 
will continue to fight, along with many of my colleagues, to see that 
this bipartisan bill is debated on the Senate floor and becomes law. We 
can no longer afford to delay this bill when it holds the key to curing 
some of the most devastating and debilitating diseases of our day. As 
the bill waits in the wings of the Capitol, children and adults alike 
wait for the cure they have been praying for.
  This is Health Week. What could better demonstrate our commitment to 
the health of this country than full Federal support for embryonic stem 
cell research? This bill has the potential to make a profound and 
positive impact on the health of millions of Americans. All we need is 
the leadership to bring the bill to the floor for a vote for the 
humanity of our Nation and for the mothers, fathers, brothers, sisters, 
sons, and daughters across this country who are suffering or watching a 
loved one suffer.

  This bill means so much more than ending restrictions placed on stem 
cell research. This bill means hope and promise to countless Americans.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Kansas.
  Mr. ROBERTS. Mr. President, like many of my colleagues, I rise today 
in support of S. 1955, the Health Insurance Marketplace Modernization 
Act. As a member of the Health, Education, Labor, and Pensions 
Committee, I am proud to have worked on this legislation and to lend my 
support as a cosponsor.
  First and foremost, I thank Chairman Enzi and Senator Ben Nelson, who 
have worked so hard on this legislation. The chairman and Senator 
Nelson did what many thought was impossible: they got the health 
insurers, State insurance commissioners, and the small business 
community to sit down together and work to find a compromise for small 
businesses. After over 10 years of deadlock, the Senate is finally 
considering a solution that will provide real relief to small 
businesses. This is truly a milestone. It has been said before, I am 
sure many times, that the House has passed this eight times, and we 
have yet to find a solution. Now is the time.
  Like many rural States, the Kansas economy is built on thousands of 
small businesses. Whether it is the farm implement store or the local 
pharmacy, the beauty salon or the downtown coffee shop, these small 
businesses and their employees are the backbone of our communities. 
They are what we are all about. But one nagging problem for virtually 
every small business owner is the high cost of providing health 
insurance. Most small businesses can't even afford to offer health 
insurance to their employees, forcing many to go without health 
coverage.
  In Kansas, only about 41 percent--not even 50 percent, not even 
half--of our small businesses offer any health insurance coverage. This 
is in stark contrast to the 97 percent of our larger businesses that 
offer health insurance to their employees. Without such health 
insurance coverage, employees are vulnerable to huge health care debts 
of their own, and it is harder for small employers to attract a good 
worker. I have literally heard from hundreds of Kansas small business 
owners and entrepreneurs, local Chamber of Commerce members over the 
years who say they are forced to choose between staying in business or 
providing the health care they deserve to their hard-working employees.
  Take for example Kimberly Smith of Andover, KS. Kimberly has three 
children, including a 3-year-old with a mild heart condition. She is 
self-employed. She is a realtor. She is a good realtor. Like many, she 
does not have access to affordable health insurance. Because of this, 
Kimberly and her family have been forced to go without health insurance 
coverage, and now she must pay all of her medical costs out of her 
pocket.

[[Page S4179]]

  Denise Breason from Lawrence, KS, is also facing the same crunch to 
find affordable health care. Even though Denise is a hard-working small 
business employee, she has been without health insurance for over a 
year and a half and had to stop taking all of her medications because 
she could no longer afford them without health insurance.
  Denise Hulse and her husband went without health insurance for their 
family for years. They prayed their children would remain healthy so 
they would not have to make a visit to the doctor or the emergency 
room. In the end, her husband was forced to let his small business go 
and take a low-paying job, just because it came with health insurance. 
To quote Denise:

       It is sometimes very hard just making it in the small 
     business community, and very few small business owners are 
     rich enough to be able to afford the high costs of health 
     insurance for their families.

  Another small business owner in Kansas told me he is paying over 
$2,000 a month each month in premiums alone for health insurance for 
his family. This is more than his house payment, more than his utility 
bills and grocery expenses, all combined.
  These stories go on and on, not limited to my home State of Kansas. I 
heard these stories when I had the privilege of serving in the House of 
Representatives. Eight times we approached this issue. Eight times we 
passed a bill. Now it is our turn in the Senate, and it is long 
overdue. I hear these stories from small business owners and employees 
across the country. Small businesses all share one main concern: 
finding affordable health care insurance.
  This is why I am asking my colleagues today to support and pass the 
Health Insurance Marketplace Modernization Act. The real question is, 
Do we take it up? Do we vote for cloture? Or do we let the House pass 
the bill the ninth time while we sit in the Senate and do nothing for 
those who cannot afford health insurance? I cannot imagine us doing 
that at this particular time.
  This legislation allows small businesses to pool together through an 
association and offer health insurance. Everything has to have an 
acronym in Washington. This one does, too. It is SBHP. I won't venture 
into what that acronym will be called, but it stands for small business 
health care plan. It is going to give small businesses an affordable 
choice for health care.
  The legislation is built on the fact that small businesses, unlike 
large companies such as Microsoft or others, or unions, do not have the 
power to negotiate affordable prices for health care.
  The concept of small business pooling together is not new. I 
supported legislation when I served in the House. In fact, the 
association health plan legislation has passed the House numerous times 
over the years without any action in the Senate. Now we finally have a 
solution that will provide meaningful relief to small businesses across 
Kansas and the country. We all know small businesses face many 
pressures in running the businesses. I believe we must enact 
commonsense policies to overcome these hurdles. We should allow the 
local farm implement dealer to pool together with other dealers in 
Kansas and across the Nation to purchase affordable care.
  Kimberly Smith should no longer have to worry about finding 
affordable health insurance for her children. Denise Breason should not 
have to stop taking her medications just because she works for a small 
business and cannot afford her care. Denise Hulse and her husband 
should not have been forced to let go of their small business, their 
dream they loved, just to find affordable health coverage. Instead, we 
need to find these hard-working folks affordable options that allow 
them to continue to contribute to our small communities, rural and 
smalltown America. This is why I support the legislation.
  As I stand before my colleagues today, I know there have been strong 
concerns expressed about this and previous association plan proposals. 
However, the small business health plans that are created under this 
bill have the necessary protections in place to address these concerns. 
I would like my colleagues who have concerns to please pay attention.
  The small business health plans will be regulated by the States, not 
the Federal Government. The small business plans will have to play by 
the same set of rules as other small group health plans. They must 
purchase their insurance through the regular insurance market. They 
cannot self-insure. Finally, the SBHPs may offer coverage that varies 
from State benefit mandates, but they must also offer an alternative 
plan that provides comprehensive coverage. This gives the consumer a 
choice in choosing a health plan that best fits their needs, and that 
is the key.
  I have heard concerns from organizations and individuals who fear 
this bill will take away their coverage for cancer screenings, mental 
health benefits, or any other mandates required by State law. However, 
I stress that this is simply not true. Small business, under this bill, 
will have access to a more comprehensive plan which will cover 
screenings, mental health services, or numerous other benefits. 
However, it is up to the small businesses to decide whether such a 
comprehensive plan is right for them.
  The purpose of this language is to give small businesses the option 
of choosing comprehensive benefits but not requiring them to buy such a 
rich package or a package they cannot afford. Simply put, this 
legislation trusts small businesses to choose a health care plan that 
best fits their needs and puts these small businesses, not health 
insurers or the Government, in the driver's seat when choosing their 
health care coverage. If a small employer wants to choose a more 
affordable plan for himself, his family, and his employees, he should 
have that option. Under this legislation, he has that option. However, 
he should not be forced by law to buy benefits that may be beyond what 
he can afford or beyond what he and his employees really need.
  I want to put the problem of mandating coverage in perspective. While 
small employers want to provide affordable health insurance for their 
employees, expensive and burdensome benefit mandates make doing so very 
difficult. Small firms and self-employed people have almost no leverage 
with insurance companies. In addition, they have to deal with an 
enormous array of State-level health insurance regulations. I don't 
think you read them; I think you weigh them. All of the benefit 
mandates, all of these regulations add to the cost and the complexity 
of the coverage.
  In contrast, however, big businesses generally don't have to deal 
with burdensome regulations. Federal law lets large companies, such as 
Microsoft and GM, and unions bypass expensive State benefit mandates to 
provide affordable comprehensive coverage for their workers. I ask my 
colleagues, why shouldn't small businesses be able to enjoy these same 
opportunities?
  Today, there are more than 1,800 State mandates, making it nearly 
impossible for associations to offer uniform and affordable benefit 
packages on a regional or national basis. Taken together, these benefit 
mandates create a confusing web, an unfunded mandate that prices many 
Americans out of the health insurance market. The Congressional Budget 
Office and the Government Accountability Office and others have found 
that State-imposed benefit mandates raise the cost of health insurance 
anywhere from 5 to 22 percent. In addition, CBO estimates that every 1-
percent increase in insurance costs results in 200,000 to 300,000 more 
uninsured Americans. In reality, benefit mandates represent an unfunded 
mandate on employers because insurance companies simply pass the cost 
of each mandate along. When the cost goes up, the coverage goes down. 
You have more uninsured.
  The legislation we are debating today simply provides an opportunity 
for a small business health plan to relax these burdensome mandates to 
offer affordable health insurance to small businesses on a regional or 
national basis, just like the big businesses and unions currently do. 
We should not be forcing small businesses to choose between staying in 
business or offering health insurance to their employees. Boy, that is 
a Hobson's choice. Instead, we need to give them more affordable health 
insurance choices and be willing to trust them to choose the option 
that makes the most sense for themselves, their families, their 
employees, and the future of their businesses.

[[Page S4180]]

  I know this bill is not perfect. Seldom do we or the other body pass 
a bill that is perfect. I have long said that we usually achieve the 
best possible bill, but sometimes must settle for the best bill 
possible.
  I appreciate the concerns that have been expressed with this 
legislation. However, I express to my colleagues that I think this bill 
is the best opportunity we have for easing the burden on our small 
businesses and allowing them to finally offer affordable health care 
insurance to their employees. I am proud to support this legislation. I 
urge my colleagues to do the same and vote for cloture. Eight times in 
the House, zero in the Senate. That should not be a moment of pride for 
this body. Let us vote for cloture and let us support this bill.
  I yield back my time.
  The PRESIDING OFFICER. The Senator from New Hampshire is recognized.
  Mr. GREGG. Mr. President, I rise to associate myself with the remarks 
of the Senator from Kansas, and especially with the efforts of the 
Senator from Wyoming who brought this bill to the floor of the Senate. 
This is a very significant piece of legislation in our efforts to try 
to make sure more Americans have the opportunity to get fair, 
affordable, and good health care insurance. It is a piece of 
legislation about people. It is directed at people who work in what is 
termed ``small business.'' That is the person who works as a cook in a 
local family restaurant or a person who works as a mechanic in a garage 
or a person who runs a mom-and-pop real estate agency.
  Literally, there are tens of thousands, millions of these small 
entrepreneurial centers throughout this country. Most of these folks 
don't make a great deal of money. They work very hard. They are taking 
care of their families. One of their biggest concerns is whether they 
can get health insurance so if somebody should get sick who works with 
them or should somebody in their family get sick, they will be able to 
have adequate care. But too many of them are not able to afford health 
insurance. Approximately 22 million people who are in these small 
businesses, these small retail businesses, small manufacturing 
businesses, small entrepreneurial shops, don't have insurance. Another 
5 million people, who are sole proprietors and work by themselves, do 
not have a number of employees working with them, also don't have 
insurance. That is 27 million people who fall into this category. So 
Senator Enzi has brought forward a bill to try to address that problem. 
It is going to try to make it possible for these people who work so 
hard and who would like to have insurance policies that are affordable 
to get them. By allowing them to band together in trade groups, so 
realtors can come together, as well as automobile dealers, garage 
owners, restaurant associations, and hotel associations can come 
together and form a large enough group so that they can create enough 
of a mass of interest and buying power so that they can go out and 
purchase insurance. That is something they cannot do today as 
individuals. This bill allows them to do that.
  It is hard to understand how anybody could oppose this concept. But 
people do oppose it, and I think most of the opposition comes from 
folks who either misunderstand the bill or who are using the bill as a 
way to energize their constituencies with information that is at the 
margin of believable, to be kind. The biggest opposition today to this 
bill, other than insurance companies who might see this as a 
competitor, comes from these groups that represent various different 
diseases and have compelling stories to tell about their diseases. They 
have gone to the State legislatures and they have gotten them to put in 
place what is known as mandates so any policy sold in that State has to 
cover that disease.
  As was pointed out by the Senator from Kansas, every time that 
happens that increases the cost of the insurance in that State. For 
every 1 percent increase in the cost of insurance--and some of these 
specific mandates are expensive enough so they by themselves represent 
a 1-percent increase in insurance premiums. But there are 200,000 to 
300,000 people who cannot afford insurance because the insurance bills 
go up and 200,000 or 300,000 people fall off the rolls.
  What this bill tries to do is address the issue of the person who has 
fallen off the rolls, the person who hasn't been able to get the 
insurance, by giving them an option that they can buy, which they feel 
is adequate to their needs--it may not have a specific mandate in it 
because maybe they don't need those mandates to be covered, but at 
least it gives them the basic coverage they need in order to get 
through their health insurance risks.
  The flip side of this coin, which isn't talked about much but which 
is fairly obvious, is that these people have no insurance at all. When 
these mandate groups argue, if you pass this bill, you are going to 
undermine the capacity of people to get insurance for this disease 
group, that is a totally misleading presentation because the people 
this is focused on don't have insurance to begin with. You cannot take 
something away from somebody who doesn't have it. If a person doesn't 
have an insurance policy, he doesn't have the mandates that the 
insurance policy requires.
  If a cook working in a restaurant or a garage attendant working at a 
gas station or a realtor working in a small mom-and-pop real estate 
agency doesn't have any health insurance, you cannot take away from 
them mandated coverage for health insurance because they don't have it 
to begin with.
  What this bill tries to do is allow that individual to participate in 
a group where they will have health insurance as an option. And if they 
have that option of health insurance, without mandates, they also have 
to have--that group, that restaurant, that real estate agency, that 
garage the option to purchase a fully mandated policy. In other words, 
it is a policy that is, for lack of better terms, a higher option 
policy, where you have everything covered. It has to track the five 
States in this country which have the most mandates on their insured. 
So the bill is balanced in that area of mandates.

  A second opposition to this bill has been the fact that it moves from 
community rating to a banding system. What does that mean? It 
essentially means that on a community rating you basically force 
everybody to be rated the same, no matter their health risk or age 
group or occupation. With a rating system, you adjust marginally for 
what health experience it may be or what age it is. Adjustments can be 
made, but they are limited by the State. If you have a community-rated 
system, you inevitably have a much higher cost going in for a lot of 
those people who are banding together in groups, who maybe don't have 
as much risk as others. But if you have a rating system, some people 
are going to be lower in insurance costs and some people will be 
higher. They are going to be within a relatively narrow band.
  So this bill allows these policies to be offered with a rating 
system, with a band. In New Hampshire--and this has been referred to on 
the floor by the Senator from Massachusetts--they had a very bad 
experience because, regrettably, New Hampshire did it the wrong way. We 
had a community rating system and then we went to a band rating system 
because we recognized that was better policy. I congratulate the State 
for that, but they didn't go to it correctly. They went sort of cold 
turkey. The practical effect was that one day people got one type of 
bill, and the next day they got a different type of bill. For some 
people it went up, for some people it went down, and it was a rather 
startling event for them. We looked at that experience in committee and 
said we don't want to emulate what happened in New Hampshire. We want 
to make this a much more responsible approach. We put into place a 
glidepath, 5-year phasing, so there will be plenty of time to adjust 
and to be able to handle this.
  That type of opposition to this bill, clearly, in my opinion, has 
been addressed. It has been addressed specifically because of the New 
Hampshire experience. So it is a misrepresentation to say that 
continues to be a major issue with this bill. As a practical matter, 
there are about 85 million people in this country who work in small 
businesses. That is a huge number. They deserve the opportunity to have 
this type of insurance made available to them. They should have the 
same opportunity as big businesses--the IBMs,

[[Page S4181]]

the Microsofts, the major manufacturers--in our country, if for no 
other reason than they happen to be the engine of economic activity in 
this country. Most of the new jobs are created by small businesses, the 
moms and pops who are willing to build that restaurant, take on that 
exciting opportunity, start small and grow. When they do that, they 
ought to have the opportunity to also have an insurance option 
available. But many of them don't because it is not affordable, because 
of the way the States work the system, and because of that these small 
groups, as individuals, have no buying power. So this bill has 
addressed that need.
  It is not the answer. This isn't a magic wand, but it is another 
opportunity put on, let's say, the cafeteria line of insurance that 
gives a small businessperson the chance to go down that cafeteria line 
and say: Yes, this plan works for the five people who work for me, and 
I am going to buy into the plan because I can afford it. Today, most 
people who walk down that cafeteria line, if they are small 
businesspeople, don't choose anything because they cannot afford the 
price of anything, or many of them are in that capacity, that 22 
million. This will take a fairly significant number of those folks and 
give them the opportunity to purchase health insurance.
  So it will take people from a noninsurance status to an insured 
status, from a situation where if they get sick, they don't know how 
they are going to pay for it, to a situation where if they get sick, 
they will have coverage. It is very important financially to most 
people and, obviously, it is important psychologically to everybody. So 
it is a good bill, something we should support.
  I do think much of the opposition to it is misguided because it 
doesn't recognize that the basic goal is to take people who don't have 
insurance today and get them insurance. Therefore, the arguments around 
mandates are irrelevant to that group of people and the argument of 
community rating as I think we will address.
  I congratulate the Senator from Wyoming for bringing this bill 
forward. I look forward to working with him on this bill.
  I want to speak on another matter briefly because there is a lot 
going on that is very good in this country relative to the economy, and 
it is not being highlighted.
  Today, there was an editorial in the New York Times that said we 
should not extend the tax cuts put into place in 2003. They say those 
tax cuts should not be extended in the areas of capital gains and 
dividends. That argument is good in 1930s economics. It is the old left 
theory of tax policy, which is that you increase revenues by constantly 
increasing taxes on people. It has been proven wrong this year, last 
year, and the year before. It was proven wrong by John Kennedy when he 
put in place the first tax cut. It was proven wrong by Ronald Reagan 
when he put in place the tax cut of 1980. And it has been proven wrong 
again.

  In fact, in the first 6 months of this year, tax revenues jumped 11 
percent, $134 billion, and a large percentage of that is the increase 
in tax revenues from capital gains and the fact that we have reduced 
the rate on capital gains which causes people to free up assets. Over 
the last 3 years, revenues have jumped dramatically--in fact, last year 
by 14 percent, and the year before by 7 percent, and next year they are 
projected to jump again. Why is that? It is because we are seeing an 
economic boom which has created 5.3 million new jobs since those tax 
cuts were put into place. There have been more jobs added in the United 
States in that period than Europe and Japan combined have created. And 
those jobs have led to economic activity and, in turn, have led to 
revenues to the Federal Government.
  Revenues to the Federal Government are dramatically increasing 
because the economy is growing, and the economy is growing because the 
burden on those people who go out and are willing to take risks through 
capital investment, dividend activity, through income tax activity--
those people are taking risks and creating economic activity and, as a 
result, creating jobs which, in turn, create taxpayers, which, in turn, 
increases the Federal revenues.
  The numbers don't lie. They are huge, significant, and they confirm, 
once again, that John Kennedy was right, Ronald Reagan was right, and 
George Bush was right. By making tax rates fair, especially on capital 
formation, you energize economic activity and, in turn, you create 
massive increases in Federal revenues. Regrettably, I must say the New 
York Times is wrong.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Arkansas is recognized.
  Mrs. LINCOLN. Mr. President, I am so happy to come to the floor today 
because the Senate is finally debating how we can help small businesses 
across our country afford health care for their employees. Just as 
Senator Gregg has mentioned how important it is to provide benefits to 
groups who want to invest, and to individuals and companies who want to 
invest and grow the economy, so too it is critically important that we 
provide small businesses the ability to invest in themselves. That is 
what I want to talk about today.

  Small businesses are critical to this country. They are critical to 
rural States such as mine in Arkansas, but they are the engine of our 
economy in this great Nation. They are the No. 1 employers. That is why 
it is so important that we get this right, that we provide them with a 
tool that will allow them to reinvest in themselves and their employees 
and their communities, so that we can keep that engine going.
  I applaud my colleague from Wyoming, Senator Enzi, for all he has 
done in bringing about this debate. He has worked hard and genuinely on 
this issue, and I appreciate very much what he has put into this. He 
has helped us make sure this is not a debate about whether this is a 
critical issue.
  This reminds me of something I was taught by my father who said: If 
it is worth doing, it is worth doing right. It is worth doing 
correctly. That is what we are here to talk about today.
  I believe very strongly that our small businesses are so important to 
us--our self-employed individuals in this country have the greatest 
spirit in the world--and it is so important that we should not offer 
them a second-rate opportunity. We should offer them the same 
opportunity we have as Federal employees and Members of Congress: The 
opportunity to build a pool that will offer them greater access, 
greater choice at a lower cost, by pooling all of themselves together 
across this great country, while maintaining the quality, which is what 
we do for ourselves. We maintain the quality of the product of the 
health insurance we receive or have access to as Federal employees and 
Members of Congress, and we should do no less for the small businesses 
and the self-employed individuals in this great country.
  So I hope, as we continue this debate, we will remember those hard-
working American families who are depending on us not just to do 
something, but to do what is right and fair, and offering what we see 
as fair tax policy and offering what we see as fair access to the same 
quality product of health care and health insurance that we as Members 
of Congress get.
  The small business health care crisis is undoubtedly one of the 
issues I hear the most about when I return home to Arkansas. In fact, 
in every community in our Nation, as well as millions of working 
families across this country, we are seeing the difficulty of having 
access to quality health care and health insurance and the ability to 
pay for that.
  There are approximately 46 million Americans currently without health 
insurance, including 456,000 Arkansans whom I am responsible for in 
terms of producing a product that is worthy of those individuals. Small 
businesses are the No. 1 source of our jobs in Arkansas. Yet only 26 
percent of the businesses with fewer than 50 employees offer health 
insurance coverage. Workers at these businesses, which again are the 
engine of our economy, are most likely to be uninsured. In fact, 20 
percent of working-age adults are uninsured in Arkansas. This number is 
alarming, and addressing this problem should be a national priority, 
and we should approach it as if we are going to do the best job that we 
are capable of doing. That is why we are here today, to talk about 
that.
  Mr. President, 224 major organizations are opposed to the proposal 
that

[[Page S4182]]

Senator Enzi has brought before us. Two hundred-and-twenty-four is a 
huge number: everywhere from diabetes to mental illness to hospital 
federations. These individuals understand how important the years have 
been in allowing State insurance commissioners to be able to set 
mandates in order to cover what is important to individuals in their 
States, and what is important to small businesses and everyone in those 
States. Those States have the right and the ability to figure out what 
is important to them, and the majority of them have agreed on many of 
these major issues.
  Those who lack health insurance do not get access to timely and 
appropriate health care. We know that, and we see it. We see it in the 
cost of Medicare when people don't get health care for 20 or 25 years 
when they are in the working marketplace as a small business owner or 
employee, and then they become more costly to us when they hit Medicare 
age because they haven't received the screenings, the timely visits to 
the doctor, and they haven't been getting the kind of health care they 
truly need. They have less access to these important screenings. They 
don't have access to the state-of-the-art technology that exists or 
prescription drugs, which is another piece of what can help keep down 
the cost of health care.
  Working families need help with this problem. The Institute of 
Medicine has reported that 18,000 people die each year because they are 
uninsured. The fact is, being insured does matter. It makes a big 
difference. It makes a difference in our health care costs. It makes a 
difference in whether you are going to survive--longevity, the ability 
to care for your family. It makes a big difference. We have reached a 
juncture where we are going to debate how we deal with those who are 
uninsured, whether we are going to give them substandard coverage or 
whether we are going to give them the coverage that we have.

  Again, I commend my colleagues, Senator Enzi from Wyoming and Senator 
Nelson from Nebraska, for their leadership. I appreciate their hard 
work on this issue. But I do disagree, because I believe that the devil 
is in the details on this issue, and I am deeply concerned about the 
very harsh and unintended consequences that will occur if S. 1955 were 
to become law.
  Senator Durbin and myself have been working together for several 
years to come up with what we believe is a better health care plan for 
America's small businesses. What we have done is looked to a 40-year-
old tested delivery system, and it is the one that we ourselves use. It 
is a Federal plan that takes the best of what Government can do and 
combines it with the best of what private industry can do. The private 
marketplace and the competition that it can create allows the 
Government to pool all of its Federal employees and use that pool as a 
negotiating tool to bring us greater choice at a lower cost.
  About 3 years ago, I suppose it was, my staff and I were discussing 
the way we could help small businesses, and I thought about the way my 
Senate office operates. It operates much like a small business in my 
home State and here. As I looked at my employees, I saw that I had two 
employees, one with 26 years with the Federal Government, another with 
30 years with the Federal Government. I had two women who had delivered 
babies and were on maternity leave. I had some, such as myself, with 
small children and a husband that is on my plan, and then I had a host 
of young, healthy staffers who were single. But I had a whole array of 
different individuals who needed a tailor-made insurance plan for their 
needs. While there are similarities in our Senate office and small 
businesses, there are also some obvious differences. One of the most 
glaring contrasts is access to affordable and quality health care. I 
saw what my office went through and realized that is what small 
businesses are going through. I knew we could do better. I knew we 
could take the plan of what we have and apply it to small businesses.
  Last year, more than 8 million people were banded together in the 
Federal employees purchasing pool, and that gave us choices among 10 
national health insurance plans and a variety of local insurance plans, 
and a total of 278 private insurance plans from the private 
marketplace. Not government-run--not government-run health care at 
all--but health care from the private industry, health insurance from 
the private industry that was created by competition of the multiple 
Federal employees across the country. It offered us greater access, 
greater choices at a lower cost.
  So I am here to ask this question: Why don't we try to give small 
businesses access to that same type of private health insurance option 
that Members of Congress and Federal employees enjoy today? Rather than 
reinvent the wheel, why don't we create a program for small businesses 
that is based on our Federal Employees Health Benefit Plan, through the 
FEHBP, by pooling them, the small businesses, together in one 
nationwide pool. That is exactly what Senator Durbin and I have 
proposed in our Small Employers Health Benefit Program. By pooling 
small businesses across America into one risk and purchasing pool 
similar to the FEHBP, our program will allow employers to reap the 
benefit of group purchasing power and streamline administrative costs 
as well as access to more plan choices. The SEHBP, as we have 
introduced, lowers costs for small businesses in two key ways: It pools 
them into one national pool across the country, therefore spreading the 
risk between the healthy and the sick, the young, the old, those who 
live and work in the remotest parts of this great land and those who 
work in the most urban areas. Second, our plan significantly lowers 
administrative costs for small businesses.
  Two economists have estimated that SEHBP would save small businesses 
between 27 and 37 percent annually, even if they don't take advantage 
of the tax cut that we offset costs with by insuring lower income 
workers. We provide a tax cut to small businesses, and for the life of 
me, I can't figure out why those on the other side of the aisle, for 
the first time I have ever noticed, will fight a tax cut for small 
businesses. Providing small business a tax cut to be able to engage in 
what is such an important tool in getting themselves and their 
employees insured makes good sense. What a great investment.
  Senator Gregg was talking about balancing all of that and the 
economy. What a great way to balance what corporate America gets and 
their ability to deduct health insurance costs that they have and small 
business getting a tax cut for investing in their employees and health 
benefits for them. Under our bill, employers will receive an annual tax 
credit for contributions made on behalf of their workers who make 
$25,000 per year or less. And if the employer contributes 60 percent or 
more to the health insurance premium of an employee making $25,000 or 
less, the employer will receive a 25-percent tax credit. And the tax 
credits increase with the number of people covered and the proportion 
of premium the employer chooses to cover. Also, the employer receives a 
bonus tax credit for signing up in the first year of the program, 
because we know from the example of the Federal employees that the more 
employees who are in the pool, the greater advantage to everyone 
concerned. Small businesses will save thousands of dollars--even more--
under our plan.
  Segmenting the market into different association pools, as S. 1955 
does under Senator Enzi's bill, will not achieve these savings that 
would be created by instituting one large pool with all of those small 
businesses and self-employed individuals. Each association will be 
administering to a separate group with a different administrative 
structure and different costs, obviously. More funds would be going to 
administrative costs as opposed to serving the people with a quality 
health plan. Our SEHBP would have one administrative structure and 
could pool approximately 53 million workers together, therefore 
balancing the risk of sick and healthy, young and old, rural and urban, 
for affordable rates for everybody. Why wouldn't we want to make our 
pool as big as it possibly could be, as we do with the Federal workers?
  I believe our plan takes a real moderate and balanced approach that 
combines the best of what Government can do with the best of what the 
private sector can do, and preserving important coverage for preventive 
health

[[Page S4183]]

care treatment such as diabetes supplies, mammograms, prostate 
screening, maternity and well-baby care, immunization, things that 
States themselves have decided are important enough to mandate coverage 
for and ensure that the people of their State are going to get the safe 
and important coverage of illnesses that are critical to them in their 
State.
  Like the FEHB Plan, our program does not promote Government-run 
health care, but it harnesses the power of market competition to bring 
down health insurance costs using a proven Government negotiator in the 
Office of Personnel Management, OPM, which is the negotiator for our 
plan. We, once a year, as Federal employees, can choose among 270-plus 
plans. We are able to actually benefit from that proven Government 
negotiator and the harnessing of that power.
  Our legislation, S. 2510, has been endorsed by many organizations--
the National Association of Women Business Owners, Small Business 
Majority, the American Medical Society, the American Diabetes 
Association, the National Mental Health Association, the Cancer 
Society, and many more that have realized how important it is to use a 
proven example, a proven structure that maintains quality but helps by 
pooling and bringing down those costs.
  The Mental Health Liaison Group, representing over 35 national mental 
health organizations, wrote to us and said about our bill:

       S. 2510 does not sacrifice quality of coverage for 
     affordability or allow the offering of second class health 
     insurance to small businesses. Within the FEHBP program, 
     small business owners, employees and their family members 
     would be covered by all the consumer protections in their 
     home states--including hard-won state mental health parity 
     laws and mandated benefit laws.

  The American Academy of Pediatrics, writing to us on behalf of over 
60,000 primary care pediatricians and pediatric specialists, wrote:

       Through the benefits of pooling small businesses and 
     providing tax cuts to small employers, small pediatric 
     practices will be assisted in the health insurance market 
     without sacrificing health care services for children.

  The American Diabetes Association wrote to us and said:

       While other proposals seeking to provide health benefits 
     for small businesses . . . have exempted or eliminated 
     coverage for important diabetes care protections, [our bill,] 
     S. 2510, will allow individuals with diabetes to receive the 
     important health care coverage they require to remain healthy 
     and productive members of the workforce.

  This is not just about quality of life, although many of us believe 
that is very important. We as Members of Congress enjoy a quality of 
life because of the very healthy health insurance program we are 
offered. We want our small businesses that are vital to our economy to 
enjoy that same opportunity. But it is also about economics. It is 
about making sure we keep our workforce, particularly our small 
businesses and their workforce, healthy and thriving and productive and 
in the workplace. It is about making sure America's working individuals 
and working families get the health care they need before they reach 
65. When they hit 65 in the Medicare Program, then they are going to be 
more costly to Government because they are not going to have gotten the 
health care they needed and deserved in their working years.
  I believe our plan is better in so many ways. I am proud we are 
having this debate, and I hope so many people will realize we can do 
better. We can do better and make sure we truly elevate small 
businesses and self-employed people to the same level we hold 
ourselves, in providing them the access to the same quality type of 
health care.
  Our SEHBP bill offers tax cuts for small employers. Senator Enzi's 
bill does not. SEHBP relies on a proven program. It is based on the 
successful Federal Employees Health Benefit Program which has 
efficiently and effectively provided extensive benefit choices at 
affordable prices to Members of Congress and Federal employees for 
decades. For decades, we have had a proven program out there that 
proves you can harness the competitive nature of the marketplace, and 
with the oversight of Government and the State mandates, you can 
actually provide that quality of health insurance at a lower cost. By 
pooling small businesses together and allowing OPM to negotiate with 
private health insurance companies on their behalf, they, too, could 
have access to this wide variety.
  On the other hand, Senator Enzi and Senator Nelson's bill establishes 
a new set of responsibilities at the U.S. Department of Labor, to 
administer an untried and an untested program. We don't reinvent the 
wheel. What we do is use what already exists. To invent a new section 
of the Department of Labor to administer Senator Enzi's bill is going 
to take time and money. We are not going to know how it needs to be 
administered through the Department of Labor. They have never done it 
before. Even the Department of Labor employees currently enjoy benefits 
from the health insurance program that is negotiated by the Office of 
Personnel Management. So it is hard to believe they are going to want 
to go to another system.
  SEHBP offers individual self-employed workers the same access to 
health insurance that is offered to group businesses. SEHBP defines 
small businesses as groups of 1 to 100, so an individual self-employed 
person will be treated exactly as a business with 2 or more people. Any 
business with 1 to 100 employees is eligible to participate in what we 
are trying to do.
  Under Senator Enzi's bill, the self-employed people are not pooled 
with the small businesses, unless they are mandated by State law. And 
there are not that many State laws that actually mandate that. But the 
self-employed people in 36 States, including Arkansas, will not have 
access to the same negotiated rates of businesses with 2 or more 
people. They will be pulled out of that pool and rated on their own. 
That means, if they are younger women of childbearing years or perhaps 
they are older workers at 50 or 55 and are diabetic, they will be rated 
completely separate from the pool, which means they will be segregated 
and treated differently. They don't get to enjoy the benefit of a 
larger risk pool which could bring down their costs and offer them 
greater choice.
  Our bill also ensures access to health care specialists. Many States 
have passed laws requiring insurers to cover certain health care 
providers, including dentists or psychologists or chiropractors. All 
three of these and many more are required by our State of Arkansas law. 
I know the people of my State enjoy the assurance they have of knowing 
that their State regulator, their State insurance commissioner, is 
looking out for their needs. They can do that better on a State level. 
That is why we have always left those types of regulatory issues up to 
our State--because they know and can work.
  Can you imagine being a small business, or better yet an employee of 
a small business, having to call some big, huge, Federal bureaucratic 
office to request or to complain or to have your concerns heard about 
what is not covered under your insurance plan? No, they call the State 
insurance commissioner today, and that is the way it should be. The 
State insurance commissioner can then respond to the concerns of their 
constituency and has done so very well over many years.

  The coverage for diabetes supplies, mammography, and other important 
screenings are mandated by State law which would be preempted by what 
Senator Enzi is trying to do. Many States have passed laws requiring 
health insurance companies to cover these benefits because insurers 
simply were not doing it. It did not happen because the insurance 
commissioners just decided on a whim to do it; it is because the 
insurers were not covering it. Why do we have to go back and relearn 
that lesson?
  For 40 years, the Federal Government has used the effectiveness of 
the pool of the 8 million Federal employees and been able to enjoy the 
protections that are there, guided by State insurance commissioners.
  Our bill also prevents unfair rating on gender and health status. 
Under our bill, health insurers will be prohibited from ratings based 
on health status--whether you happen to be diabetic, whether you happen 
to have eating disorders--your gender, or the type of industry in which 
the employees are working. Under Senator Enzi's rules, that will be all 
preempted, even for the 15 States that don't allow ratings on these 
factors.
  Our bill also frees employers to focus on running their businesses. 
They don't

[[Page S4184]]

have to go and negotiate these plans through their association or with 
their association. They are going to get sent a booklet just as we do, 
once a year, to review all that is available to them, and choices, and 
then figure out what is best for them. My employees--each of them picks 
something different. I pick coverage for a family with children. Some 
of them pick a PPO or an HMO. Some of them pick all different kinds of 
State plans and others that are offered to them in that process.
  Mr. CARPER. Will the Senator yield?
  Mrs. LINCOLN. Absolutely.
  Mr. CARPER. Mr. President, how much time is left on our side during 
this period of debate?
  The PRESIDING OFFICER. There is 5 minutes remaining.
  Mr. CARPER. How much longer does the Senator expect to speak?
  Mrs. LINCOLN. How about if I just go ahead and yield to the Senator 
from Delaware because as a former Governor, he has some incredible 
stories to tell, and I think they really add to this debate. I will 
simply say to my colleagues that I hope they follow this debate very 
closely and certainly appreciate how important this is to the working 
families of all of our States.
  Mr. CARPER. I thank my colleague for yielding. I ask if she would 
stay on the floor.
  I commend Senator Lincoln for actually coming up with this idea. It 
is an idea for which she and Senator Durbin share credit. When you 
think of some of our options, the options basically are do nothing, 
maintain the status quo, continue to make the cost of insurance very 
steep and rising for small businesses or to adopt the proposal of our 
colleagues, Senator Enzi and Senator Nelson, whom I believe are two of 
the most thoughtful Members of the Senate. They have worked hard to try 
to make a not very good idea--the original association health plan--a 
better idea. But between doing nothing and the modified HP legislation 
from Senators Enzi and Nelson is a third way. The third way has already 
been outlined here by Senator Lincoln.
  I wish to ask my colleagues to think about it. I don't care whether 
it is a Democratic idea or Republican idea. It is actually an 
opportunity to take the best from what the Government, the public 
sector, can bring and to take maybe the best the private sector can 
bring.
  One of the common values that are shared by the Enzi-Nelson 
legislation and the Lincoln-Durbin legislation is the notion that we 
have a lot of smaller employers, they have a lot of employees, and 
together is there some way we could pool their purchasing power? Maybe 
we could increase the number of health insurance options available to 
them and maybe we could bring down the cost of those options. They 
propose to do it in one particular way which, as Senator Lincoln 
pointed out, has a number of problems, one of which affects us 
negatively in Delaware.
  We have had a very high rate of cancer mortality. Finally, we have 
brought it down over the last 10 years or so, in part by having 
mandatory cancer screening--mammography, for cervical cancer, prostate 
screening, for colorectal cancers--and that has helped to bring down 
our cancer mortality rate. From the top in the country, we have finally 
now dropped to the top five. We are moving in the right direction. I 
will talk about that tomorrow, and I will even bring some charts to 
rival the chart of my colleague, I hope.
  But I suggest to my colleagues, think about this. We have all these 
disparate Federal agencies across the country. Collectively, we have a 
couple of million employees, family members, and retirees, and all we 
do through the Federal health benefit plan is we pool our collective 
purchasing power. It doesn't matter if you work for the VA or Homeland 
Security or some other Federal agency--EPA--basically we could come 
together and use our collective might to negotiate better rates and, 
frankly, better coverage than would otherwise be the case if we were 
just negotiating for ourselves. We do it all through the Office of 
Personnel Management.
  What Senator Lincoln is suggesting is it works great for us, provides 
reasonably good coverage for Federal employees, including us as U.S. 
Senators. We have to pay our portion. It is not that we get it for 
free. We have to pay our share. But it works pretty darn well. She has 
come up with a way where we take that Government idea and transpose it 
and transfer it to the private sector. She would have the Office of 
Personnel Management effectively provide the service or play the role 
in the private sector that it currently plays in the public sector, to 
allow a lot of employees, whether you work for the local hardware store 
or restaurant or small manufacturer or technology company, to say: We 
would like our employees to be able to pull together from Arkansas, 
from Delaware, even from Minnesota, in order to get a chance to buy 
better insurance products, have more variety, and bring down our costs 
to our small business employees.
  It has worked. It is proven. It is time tested, and I believe it is 
worth trying. The worst thing that I think could happen, coming out of 
this week, is for us to do nothing.
  It is a big problem. It is a big problem for small employers, and it 
is a big problem for large employers. It is a big problem for America.
  I think what would be the worst thing that could happen, and what 
would basically ensure that we do nothing is for our Republican friends 
to basically allow no amendments to the Enzi-Nelson legislation. I 
think that would be awful. That would be a huge mistake. It would 
pretty much basically ensure we end up not getting this bill done or 
some variation and not even having a chance for debate and vote on the 
Lincoln-Durbin legislation. We can do better than that.
  Frankly, the Senate deserves a lot better than that.
  I say to my colleague from Arkansas, who has been good enough to 
relinquish her time, I thank her on behalf of all us for pointing out a 
different course, a third way in this regard. I thank her.
  Mrs. LINCOLN. Mr. President, I thank my colleague from Delaware.
  The PRESIDING OFFICER. Minority time has expired.
  Mrs. LINCOLN. Thank you, Mr. President.
  I ask unanimous consent to continue until other Members arrive.
  The PRESIDING OFFICER. Is there objection? Without objection, it is 
so ordered.
  Mrs. LINCOLN. Thank you, Mr. President.
  I will be glad to yield the floor when others are ready to speak.
  I would like to add that the experience of many of our colleagues, 
whether they are former insurance commissioners, former Governors and 
others, brings to this table the understanding what the American people 
want, what our working families want. I think the debate is that small 
businesses definitely want more affordable health care. They also want 
to make sure that what they are providing for themselves and their 
families and their employees is quality service, quality coverage. That 
is what they deserve. That is what they want.
  Even for those who feel so young and invincible, we also know that 
they may be one car accident or one diagnosis away from needing more 
comprehensive health insurance for the rest of their lives.
  That is why we want to make sure--as I said in the beginning--that 
whatever we do is right, that we don't move forward on something that 
is going to be less productive and in the long run, unfortunately, put 
more people at risk.
  My goal is to help small businesses while not jeopardizing the 
quality of health care for the 68 million Americans in State-regulated 
group plans that are already out there. We don't want to do harm there.
  The fact is if we move forward on what Senator Enzi wants to do, 
which is preempting those State regulations and State mandates, we 
could do tremendous harm for those who are currently insured and the 
16.5 million Americans with individual health insurance coverage who 
would probably lose some quality of coverage which they have.
  If it is good enough for Federal employees, and if it good enough for 
Members of Congress, I think it should be good enough for millions of 
small business employees who are the economic backbone of communities 
throughout this Nation.
  I applaud my colleagues for coming to the floor for this debate, and 
I hope we will have a serious debate so we can

[[Page S4185]]

move forward and actually do what is right for the American people.
  Mr. CARPER. Mr. President, will the Senator yield once again?
  Mrs. LINCOLN. Yes, absolutely.
  Mr. CARPER. Mr. President, we do not often think of the Federal 
Government in the way we are trying to harness market forces and 
competition and put them to work. We try to hold down Federal outlays. 
That is what we do with respect to the Federal. It is literally what we 
do with respect to the Federal Employee Health Benefit Plan. What we 
are trying to do, with respect to what the Senator has outlined, is 
harness market forces and competition and put them to work for small 
businesses as well.
  Mr. ENZI. Mr. President, reclaiming our time, I didn't realize they 
would be allowed to use part of it.
  It would be helpful if the other side would actually share the 
details of their amendment with us so that we can take a look at it. 
The details of our bill have been through the committee, out here, and 
had hearings. We don't know what is going to be in there. The last time 
I looked at it, there was, I think, $9 billion of cost in it each year, 
and the huge bureaucracy that would be built up. I make that request to 
the other side--that we sure would like to take a look at their bill. 
It is hard to do until we have a copy.
  The PRESIDING OFFICER. The Senator from Alaska is recognized.
  Mr. STEVENS. Mr. President, I thank the Chair.


                 Cape Wind Facility in Nantucket Sound

  Mr. President, I am here to discuss the provision in the Coast Guard 
and Maritime Transportation Act of 2006 and the provision which allows 
the State of Massachusetts to have a say in the siting of a 24-square-
mile, 130-wind turbine energy facility.
  I have a chart I want to use and describe.
  First, let me say why the Senator from Alaska is involved in this 
issue. What I am trying to say is that this is a tremendous precedent.
  We have a series of areas of various States where there is a gap in 
State jurisdiction and where Federal waters are adjacent to and 
sometimes almost surrounding State waters. That is particularly true in 
my State. With the Cook Inlet on either side of Kalgin Island, there 
are gaps of Federal waters surrounded by the mainland of Alaska going 
down the inlet.
  The Minerals Management Service tells us there are roughly 2.5 
million acres of Federal waters going down that inlet that could be 
used for projects such as I am going to discuss today.
  A similar situation exists with Chandeleur Island, LA; the Channel 
Islands in California; the Farallon Islands in California; the Hawaiian 
Islands in many instances; and in Puerto Rico.
  What I am here to talk about is the precedent that would be 
established by locating this facility in Nantucket Sound, less than 2 
miles beyond the State of Massachusetts' jurisdiction.
  If we look at this chart, you can see very clearly the area with the 
darkest color on the chart, which is the proposed site of this power 
facility. It is 9 miles from one part of Massachusetts, 13.8 miles from 
the other side, and 6 miles from the other direction.
  When you look at the situation, we realize the State has jurisdiction 
over at least 3 miles in that area.
  This is very close to the area of Massachusetts where people have a 
right to be concerned over this project. Before the Federal Government 
claimed ownership of this area, there was a judicial dispute over which 
government had jurisdiction over it. I am informed that the State of 
Massachusetts had established a marine park in this area. As a matter 
of fact, it was listed as part of a proposed marine sanctuary, even in 
the Federal listings. It is now the proposed site for the largest and 
most expansive offshore wind energy project ever undertaken in the 
world.
  This facility would include turbines that stand 417 feet tall.
  This is a chart that describes it. Those windmills would be 417 feet 
tall, taller than the Statue of Liberty. The one little point at the 
bottom shows a 30-foot sailboat. You can see the size of it. People 
sail their boats that size on Nantucket Bay, and the Great Point 
Lighthouse is supposed to keep sailors and mariners warned about the 
area. It is only 73 feet tall.
  When you look this area, it is 24 miles across, more than half the 
size of Boston Harbor itself. It is going to be the site of this 
enormous facility.
  As I said, it is larger than any similar kind of wind energy project 
in the world.
  It is a very small area of Federal jurisdiction, completely 
surrounded by the mainland and islands of Massachusetts.
  Some in the media have insinuated that by including this provision in 
the Coast Guard and Maritime Transportation Act, I am doing it as an 
old friend to Senator Ted Kennedy. He is an old friend. It is true that 
Senator Kennedy and the Governor of Massachusetts support the provision 
in the Coast Guard bill, but this is my amendment. They have agreed 
with me. I didn't seek their agreement. It is not an issue based on 
friendship or on past favors or future favors. It is strictly a 
provision based upon my long-held belief that States should have the 
final say on projects which will directly impact their lands, 
resources, and constituents.
  Some in the press have claimed this provision is embedded in 
``obscure legislation to be passed in the dead of the night.'' We hear 
this all the time. But the Coast Guard authorization bill is hardly 
obscure legislation, and there is nothing secretive about this bill.
  The version of this bill that passed the House of Representatives 
included a provision related to offshore wind farms. It was in the 
House-passed bill to start with. The House and the Senate, in a 
bicameral, bipartisan group of Members of a conference committee, 
discussed and negotiated language to provide the State of Massachusetts 
a greater voice in the siting of this windmill farm in Nantucket Sound.
  This bicameral, bipartisan group also negotiated language requiring 
the Coast Guard to assess the potential navigational impacts of the 
proposed offshore powerplant.
  This is the normal legislative process for passing legislation of 
this type through the Congress.
  Again, let me point out this chart. I don't live in this area, but I 
have studied it very well. This is the path the ferries take coming out 
of these areas and going through this sound, and it is the path which 
the commercial traffic, steamships, and cargo ships use going into that 
port.
  As a consequence of this location, this line demonstrates the State's 
jurisdiction and how close it is to the State's jurisdiction. As a 
matter of fact, the area that is has been lined shows the previous plan 
which would have gone partially into the State's jurisdiction. The 
project was amended, so it does not touch the State waters or State 
jurisdiction areas at all.
  It is this area of solid brown on this chart.
  By the way, this is the very shallow portion of this area. There is 
no question about it. Nantucket Island is out here. But there are 
equally shallow portions outside of the sound that could have been 
used. But, of course, it is deeper going in there, and that access to 
this interior part of this sound I think is strictly a financial 
decision.
  At the heart of the debate on the issue is States' rights. The fact 
is this project will be located entirely in the sound--in this small 
doughnut hole of the Federal water surrounded by islands and mainland 
of the State of Massachusetts.
  The debate over this project is similar to the fights those of us in 
Alaska have been engaged in for decades. Our State lands are surrounded 
by Federal lands, and we often don't have any decision regarding the 
development of our resources or projects which will be located in our 
State.
  This is one of those situations where Congress ought to listen to the 
Governor. They ought to listen to the senior Senator, in my opinion.
  Those in Massachusetts have raised legitimate concerns about the 
impact of this wind farm and what its impact will be on maritime 
navigation, aviation, and radar installations critical to our homeland 
security.
  This proposed site is an area already known for its treacherous 
flight conditions, and this facility could make those conditions much 
worse. According to the National Air Traffic Controllers Association, 
this facility will be located in the flight path of thousands

[[Page S4186]]

of small planes. Both the Barnstable and Nantucket Airport Commissions 
are opposed to the construction of this facility, as are the major 
ferry lines that operate in Nantucket Sound.
  As the chart I have described shows, ferry routes pass within a mile 
of the proposed location for this project on two sides. The 24-square-
mile footprint for this facility is nearly half the size of Boston 
Harbor, a 471-foot wind farm.
  Again, those windmills are larger than this building. Those windmills 
are larger than the Capitol.
  You have to get the specter of this size being built in the center of 
this sound. It is a 24-square-mile footprint for this facility. As I 
have said, it is half the size of Boston Harbor and has shipping and 
ferry channels bordering on three sides.
  There is not a single local fishing group from Massachusetts that 
supports this project, I am informed. It would effectively close a 24-
mile-square-mile footprint of many kinds of fishing that has taken 
place in this sound for generations. Horseshoe Shoal, where the 
facility will be built, is one of the most productive fishing grounds 
in the area. That means this area produces offspring. This is where the 
fish spawn.

  The impact of the shoal will be significant. The piling for each one 
of these windmills--there are 130 of them--are 16 feet in diameter and 
will be bored down into the shoal to a depth of about 80 feet. This 
productive area will be littered with 130 drilled holes. Each piling 
will occupy 2 acres of productive fishing ground. Navigating in and 
around 130 turbines will make fishing and fishing reproduction in this 
area nearly impossible.
  In addition, these turbines will make Coast Guard search and rescue 
missions much more difficult in this area, already known for severe 
weather and sea conditions in parts of the year.
  Those in Massachusetts raise another important point. Developing a 
wind farm of this size and scale offshore has never been done before, 
let alone in an environment as extreme as the waters of the North 
Atlantic.
  To put this challenge in perspective, it helps to compare the 
Massachusetts project to the wind farm currently operating in Palm 
Springs, CA. I know a little bit about this. I have gone into that town 
several times by air. That facility stands 150 feet at the tallest 
point. The blades are half the length of a football field, but they are 
one-third of this size. Even on dry land and a relatively calm desert 
climate, the Palm Springs wind farm has been plagued by serious 
maintenance complications. Many of the turbines require constant 
maintenance and repair.
  Put that in the Massachusetts Sound. They require maintenance and 
repair constantly. This Massachusetts project would require maintenance 
and repair to take place in icy waters of Nantucket Sound. The size of 
the windmills for this facility would dwarf the existing land-based 
wind projects. The windmills in Nantucket Sound would stand nearly 
three times as tall as those in Palm Springs, with wind blades over a 
football field in length. Just the blade is a football field in length.
  Now, given the legitimate issues raised by the people of 
Massachusetts and their representative, I believe it is only fair to 
allow the State to have an equal voice in the debate over the siting of 
this project. Nantucket Sound, as I have said, is not the only place 
where a project of this kind can be built. In Europe, deepwater wind 
energy technologies are currently being developed as far out as 15 
miles in 138 feet of water. Placing wind energy facilities further from 
their shore reduces their impact on maritime navigation.
  If this 24-square-mile wind farm is built further away from shore, 
there would be a number of benefits. It would be removed from boating, 
fishing, ferrying, shipping channels, reducing the risk of collision 
and reducing the potential impact on the navigation which we have asked 
the Coast Guard to look into.
  I do support America's use of alternative energy sources, including 
wind farms and wind power. I have supported wind projects in the past 
during my time as chairman of the Senate Committee on Appropriations. 
Our committee appropriated over $105 million for wind projects in 
fiscal year 2002 to fiscal year 2006. There was even one in my State 
around Kotzebue.
  It is the right of a State to determine if this type of project is 
consistent with its efforts to protect its resources. I believe 
Congress should defer to the judgment of the Massachusetts 
congressional delegation, the Governor of Massachusetts, and the people 
of Massachusetts on this matter. States should have a say in the 
activities taking place in the waters adjacent to their shores. This 
location, in particular, deserves special consideration due to the 
geographic peculiarities of the region.
  California blocked oil platforms, Oregon and Washington blocked them 
before they were even built.
  We now have a dispute before the Congress over a potential 
development of gas resources 170 miles off the State of Florida. This 
is 3 miles. This is within a sound that is one of the--I have only been 
there two or three times, but it is a place if you ever go to it you 
would not forget. It is not a place that deserves to have this impact. 
The residents of Massachusetts will have to live with the impact of 
this project. They must have a greater role in determining the fate of 
this treasured area.
  This bill, H.R. 889, as agreed to by the conference committee, 
rightly awards the State of Massachusetts this greater authority in the 
decisions regarding this project. So I am here today to urge the House 
and the Senate to listen to the people of Massachusetts and 
particularly to listen to their senior Senator.
  I am pleased to yield whatever time I have remaining. I think I have 
only another 10 minutes or so. I yield to the Senator from 
Massachusetts.
  I think we have 30 minutes on this side and 30 minutes on that side, 
is that correct?
  The PRESIDING OFFICER. There is 14 minutes remaining on the majority 
side.
  Mr. STEVENS. Is there time on the Democratic side for the Senator 
from Massachusetts?
  Mr. KENNEDY. We are rotating back and forth. I am happy to work that 
out.
  Mr. STEVENS. We will work that out.
  Mr. KENNEDY. We will stay on the subject matter.
  Mr. ENZI. We had some latitude here to allow 20 minutes on this and 
we were 5 minutes late from that one.
  Mr. STEVENS. I talked too long.
  Mr. ENZI. And Senator Thune does not have the time for his speech.
  Mr. THUNE. Mr. President, I cannot yield, but if the Senator from 
Massachusetts requests time and wants to use the Democratic time for 
that, we have 14 minutes on the majority side I would like to use to 
talk about the small business health plan. But if the Senator from 
Massachusetts wants to use Democratic time, that is fine.
  Mr. KENNEDY. I ask to be yielded 8 minutes on the Democratic time.
  The PRESIDING OFFICER. Without objection, it is so ordered.

  The Senator from Massachusetts.
  Mr. KENNEDY. Mr. President, I thank my friend and colleague, the 
Senator from Alaska.
  I hope to have an opportunity to get into this in greater detail than 
I will for the few minutes I have this afternoon.
  There are certain points I want to make. That is, the waters around 
the area described by the Senator from Alaska, the Nantucket-Martha's 
Vineyard-Cape Cod area, has been designated a state ocean sanctuary and 
it is an unreplaceable asset to the people of Massachusetts. Up to 
1986, it was generally recognized to be under the jurisdiction of the 
Commonwealth. In the 1970s, Massachusetts was concerned about potential 
development threats and made the entire area a protected state ocean 
sanctuary--where no structures could be built on the seabed and where 
no offshore electricity generation facilities could be constructed.
  The legislation was passed easily through the State House. And the 
specific part of Nantucket Sound that is no longer protected by the 
state laws, because of a Supreme Court decision, is under consideration 
for national marine sanctuary status.
  My second point, Mr. President, is that I am for wind energy. We all 
know we need it to meet our future needs, and we've seen the successes 
that onshore wind energy farms can be. We ought to have offshore wind 
energy, but we need to get it right.

[[Page S4187]]

  The problem in Massachusetts is that we have a developer who's 
basically staked a claim to 24 square miles of Nantucket Sound back 
when there were no rules on offshore wind development, and then got the 
project written into the new law so the new rules won't apply to this 
project.
  And the practical effect is that there will be no competition for the 
developer and that his application is being reviewed and processed 
before the Department of the Interior can even complete a national 
policy.
  In the Energy bill, section 388 says:

        . . . the Secretary shall issue a lease, easement or 
     right-of-way under paragraph (1) on a competitive basis 
     unless the Secretary after public notice of a proposed lease, 
     easement or right-of-way that there is no competitive 
     interest.

  The next provision says:

       Nothing in the amendment made by subsection (a) requires 
     the resubmittal of any document that was previously submitted 
     or the reauthorization of any action that was previously 
     authorized with respect to a project for which, before the 
     date of enactment of this Act--
       (1) an offshore test facility has been constructed;

  Well, where in the country was there a project that had an offshore 
test facility?--only in Nantucket Sound. So this was a real special 
interest provision.
  Because of this ``savings provision,'' the developers are pushing 
Interior to complete this review before the rules of the game are even 
established and before the ocean is zoned.
  So while Interior is setting a uniform program--and deciding which 
sites should be used--this project is on the fast track. The developer 
and the developer alone picked the site.
  And this is a serious problem. Look at what the EPA said about this 
project's draft environmental impact statement. They called it 
``inadequate.'' That's from the EPA, the agency charged with protecting 
the environment.
  And the EPA wasn't alone. Look at what the US Geological Survey said 
about Cape Wind's draft environmental impact statement:

        . . . the DEIS is at best incomplete, and too often 
     inaccurate and misleading.

  Inadequate--Incomplete--and too often inaccurate and/or misleading. 
Does this sound like project that should be on the fast track?
  But because they've been written into the law, the interests of our 
state have been basically submerged to a special interest developer.
  They complain about the provision in this bill that Senator Stevens 
negotiated with the House. He's right. He's trying to at least bring 
this back up for review under the sunlight and ensure that the 
interests of the state for safety and for environmental protection 
aren't run roughshod over.
  The project's developer is the one that got the special interest 
legislation. This Coast Guard provision is designed to check that and 
preserve the public interest.
  The provision Senator Stevens crafted tries to remedy an injustice 
the developer created, and at least let the people of our State be 
heard.
  We wish this provision wasn't necessary, and it wouldn't be if the 
developer was content with following the rules that apply to everyone 
else.
  That would have been satisfactory, but no, we are denied that equal 
treatment. We are prohibited from that. That is not right.
  Our State went out and created the Cape and Islands Ocean Sanctuary 
as a protected area. Then the Supreme Court cut a hole in those 
protections, and now the interests of the State to preserve the 
fisheries and environment of the whole region is being undermined. It 
is being handed off to private interests. It's not right. We deserve to 
have at least a little fairness in this.
  I will not take the time to list the various national marine 
sanctuaries, including the Channel Islands, all the Florida Keys, and 
other national treasures, like Stellwagen Bank outside of Boston, which 
I am so happy we have protected into the future.
  The law says you can't build energy facilities in those sanctuaries 
and we shouldn't--and Nantucket Sound is just as important as those.
  For 400 years the Sound was considered Massachusetts waters, and it 
was a protected by the people of our state.
  In preparation for the 1986 Supreme Court decision that would specify 
that this narrow area would be carved out as Federal land, we took 
special care to get on the national marine sanctuary site evaluation 
list. We didn't want to take any chances then, and we're still on the 
list. At a minimum, no industrial project should be built there until 
we can resolve that status.
  And now we have a developer who wants complete control over 24 miles 
in the middle of the Sound, even though no government agency has zoned 
it for energy development yet.
  We know that the U.S. Commission on Ocean Policy called for a 
comprehensive siting policy, and that Interior is now working on it. We 
endorse that approach completely, but this developer is undermining 
that.
  And the American people should know just what this developer is 
getting for this no-bid, no-compete contract. There will be at least 
$28 million a year in federal tax benefits available to the developer 
that's $280 million over 10 years.
  And in Massachusetts, the developer will be eligible for between $37 
million and $82 million a year in price subsidies under the renewable 
energy credit program. That's $370 million to $820 million in price 
subsidies over 10 years.
  Then there's the fact that the company will be able to write off the 
$800 million cost of this project off in just 5 years.
  This is a boondoggle, and it's an outrage the developer's getting a 
no-bid contract to a public resource. We've seen what no-bid contracts 
can do, Mr. President.
  Who pays when we talk about subsidies? It comes out of the taxpayers' 
pockets when we talk about subsidies.
  It is a great deal for this developer. It is a great deal for his 
investors. It is a great deal for the venture capitalists. They will 
get so much money they will not be able to count it. But it shouldn't 
be done without the voice, without the consideration, and without the 
interest of the State, let alone the many groups that oppose this 
project and fear that it will undermine the safety, environment, and 
economic interests of the region for years to come.
  I thank the Senator from Alaska for his hard work on this bill and 
this provision.
  Let me ask the Senator--and I know the time is up--I understand if 
this proposal were for an LNG facility in Nantucket Sound, the Governor 
of Massachusetts would have the same authority under the Deepwater Port 
Act that we're seeking here for this project. Am I correct?
  Mr. STEVENS. That is right.
  Mr. KENNEDY. We need LNG and we need more energy sources, but if they 
had decided here to do an LNG on this site, the Governor would have a 
voice in that, am I correct?
  Mr. STEVENS. I believe the Senator is correct.
  Mr. KENNEDY. So this idea about having a voice on this makes a good 
deal of sense.
  I thank the Senator from Alaska.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Martinez). The Senator from South Dakota.
  Mr. THUNE. Mr. President, how much time is remaining on this side?
  The PRESIDING OFFICER. Ten minutes remains.
  Mr. THUNE. Mr. President, I ask unanimous consent, if necessary, that 
I have a couple of additional minutes beyond that. I believe the other 
side was granted a little bit of extra time when they were addressing 
this issue as well.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered. The Senator will have an 
additional 2 minutes.
  Mr. THUNE. Mr. President, last week the Robert Wood Johnson 
Foundation sponsored ``Cover the Uninsured'' week, a call for this 
country to wake up and address a huge and growing problem in our 
Nation. In 2004, approximately 19.1 percent of nonelderly Americans did 
not have health insurance. That number is growing.
  Why do we have this problem in one of the wealthiest nations in the 
world? It is because nearly one-half of the 45 million uninsured 
individuals in the United States are either employees of small firms or 
family members of small business employees.
  The primary reason cited by small businesses themselves for not 
offering health benefits is simply the high cost of health insurance. 
We can do something about that beginning today. We

[[Page S4188]]

also have this problem because Congress has repeatedly failed to do its 
job in the past. We can also do something about that, beginning today.
  Today the Senate voted on a motion to proceed to S. 1955, which is a 
bipartisan bill addressing the issue of the working uninsured. This 
legislation allows the creation of small business health plans to help 
lower the cost of health care for small business owners and their 
employees.
  Our colleagues on the other side have also offered some legislation 
today to address this issue. Senators Durbin and Lincoln have talked 
about their particular proposal, which is a Government approach. In 
fact, they say it saves money, but it shifts the costs over to the 
taxpayers, to the tune of $73 billion over a 10-year period. Why would 
we ask for taxpayers to foot the bill before we have allowed the small 
businesses of this country to take advantage of a market-based approach 
and to use the market forces that exist out there in a way that would 
drive health care costs down for them and their employees? It is very 
simply a difference of philosophy.
  Our philosophy--the approach contemplated under S. 1955--deals with a 
market-based solution to this issue. The proposal, S. 2510, by our 
colleagues on the other side is a Federal Government solution to this 
issue, at a great cost, I might add, to the taxpayers of $73 billion 
over a 10-year period.
  S. 1955, the Enzi bill, which, as I said earlier, we were able to 
move to proceed to today, would lower the cost of care for employers 
and employees. In addition, the Congressional Budget Office estimates 
S. 1955 would reduce net Federal spending for Medicaid by about $790 
million over the next 10 years. It would also save the States of this 
country about $600 million in the cost of Medicaid over a 10-year 
period. That is in addition, as I said, to the savings that would be 
achieved for small businesses.
  The Congressional Budget Office has analyzed this particular piece of 
legislation and concluded it would save somewhere between 2 and 3 
percent for small firms in this country on the cost of their health 
insurance. What is significant about this, as well, in contrast to the 
proposal by our colleagues on the other side, which would cost an 
additional $73 billion over the course of the next 10 years, is the 
Congressional Budget Office said that the Enzi bill, S. 1955, would 
increase tax revenues coming into the Government by $3.3 billion over 
10 years because lower spending on health insurance would increase the 
share of employee compensation paid in taxable wages and salaries 
versus tax-excluded health benefits. In other words, lower spending on 
health insurance would translate into higher wages and salaries and 
actually would also generate more revenue for the Federal Government 
rather than less, which is what would happen under the proposal by the 
Democrats, which would cost the taxpayers $73 billion, according to the 
Congressional Budget Office, over a 10-year period.
  So I believe it is important we move forward and we vote to send S. 
1955 out of the Senate to conference with the House. As a Member of the 
House of Representatives, I voted for the creation of small business 
health plans numerous times. In fact, that particular proposal has been 
voted on no fewer than eight times in the House of Representatives.
  Every time I voted when I was a Member of the House, and every time 
it has been passed by the House of Representatives, it has come to the 
Senate and has been unable to be voted on because it has been 
filibustered, obstructed by the other side. I would say, that is in 
spite of the fact that if it were allowed an up-or-down vote in the 
Senate, I believe there would be a decisive bipartisan majority in 
favor of this legislation.
  Unfortunately, due to obstructionism, the Senate, until today, has 
never voted on legislation creating small business health plans. As a 
Congressman and now Senator, I have listened to many accusations about 
the harm that S. 1955 or similar legislation would do if it were 
enacted.
  What harm would be caused by decreasing the cost of health care for 
small employers by 12 percent and increasing the coverage of the 
working uninsured by 8 percent? Lower cost and more coverage for those 
who are currently uninsured: That is not harm. That is exactly what we 
ought to be accomplishing here by enacting legislation that would make 
health care coverage more affordable and more available to more 
Americans.
  South Dakota has an estimated 72,949 small businesses as of 2004, 
which is an increase of 2.4 percent from the previous year in 2003. 
South Dakota also had an estimated 90,000 uninsured individuals or 12 
percent of our population in the year 2004. Fifty-two percent of South 
Dakotans had employer-based health insurance, 8 percent below the 
national average.
  Small businesses are the backbone of South Dakota's, as well as our 
Nation's, economy. It is time these businesses were placed on a level 
playing field and allowed to pool together to purchase health 
insurance, like large employers and unions.
  I have heard from many provider groups in my State of South Dakota 
concerned about coverage for their specific services. S. 1955 allows 
small business health plans to offer a basic benefit plan that would be 
exempt from State mandates as long as the small business health plan 
also offers an enhanced benefits option that includes at least those 
covered benefits and providers that are covered by a State employee 
health benefit plan in one of the five most populated States in this 
country.

  According to the Council for Affordable Health Insurance, all of 
these States--all of these States--require coverage for alcoholism, 
breast reconstruction, diabetes self-management, diabetic supplies, 
emergency services, mammograms, mastectomy stays, maternity stays, 
general mental health, chiropractors, optometrists, podiatrists, 
psychologists, and social workers.
  Small business owners want to give their employees the best health 
coverage possible under their budgets to recruit and retrain their 
workforce. Facts suggest self-insured large company health plans, 
currently exempt from State mandates, generally cover services 
important to their employees.
  This legislation would create new options for small businesses and 
the potential for a choice in health plans for their employees. Today, 
only 10 percent of firms with 50 or fewer employees offer their 
workforce a choice of more than one health plan. Lowering the 
administrative costs of health insurance plans will give small firms 
new and better coverage choices for their workers.
  Additionally, the GAO found that the added cost of mandates to a 
typical plan is between 5 and 22 percent. CBO estimates that every 1-
percent increase in insurance costs results in 200,000 to 300,000 more 
uninsured Americans. When the cost of health insurance goes up, 
coverage and access go down.
  The concept behind S. 1955 is very simple: to provide health 
insurance to small businesses that is both affordable and accessible. 
Small businesses not only in my State of South Dakota but across the 
Nation have been fighting for the creation of small business health 
plans for over 10 years. It is high time that the obstruction end in 
the Senate, that the Senate step aside and allow an up-and-down vote on 
this very important legislation.
  As I said before, it is legislation that, if you look at just the 
Congressional Budget Office findings, would cover nearly a million more 
people, would allow three out of every four small business employees to 
pay lower premiums than they currently pay under current law, and would 
see small firms' premium costs decline by 2 to 3 percent. The average 
decrease per firm would likely be greater, since the CBO estimate is a 
total that factors in the costs of other benefits added by firms in 
response to the reduction in premiums.
  It would also allow annual spending on employer-sponsored health 
insurance to be reduced by about $2 billion in a 5-year period. As I 
said earlier, it would increase Federal tax revenues by $3.3 billion 
over 10 years because lower spending on health insurance would increase 
the share of employee compensation paid in taxable wages and salaries 
versus tax-excluded health benefits--more coverage; lower costs; more 
revenue to the Federal Treasury, not less. The alternative offered by 
our colleagues on the other side, as I said earlier, comes at a high 
cost to the taxpayers: $73 billion over a 5-year period.

[[Page S4189]]

  We can do better. We can allow the market forces of this country to 
be used. We can take a market-based approach to this issue and do 
something that has been done a long time ago, something that has, as I 
said, been voted on repeatedly in the House of Representatives, never 
to have been voted on here in the Senate, because it has been blocked.
  It is high time for the small businesses of this country, for their 
employees, for families who lack coverage today, to have another tool 
at their disposal, a tool that takes into account and takes full 
advantage of market forces, by allowing small businesses to group 
together to leverage their size, to drive down the rates they pay for 
health insurance and, thereby, cover more of their employees.
  That, again, is in stark contrast to the model and the proposal that 
is being offered by our colleagues on the other side, which consists of 
a government-based solution, that comes at a very high cost to the 
taxpayers, that calls for more bureaucracy and redtape, and does 
nothing in the end to bring down the cost of health care for small 
businesses in this country.
  It is long overdue. I hope, as we have the chance to debate this now 
in the Senate, once that debate is concluded, we will be able to 
proceed to a vote because the one thing that has always been missed 
here in the Senate, despite action on eight different occasions in the 
House, is an actual up-and-down vote in the Senate that would allow the 
Senate to speak on the issue of whether we want to do something 
meaningful to reduce the cost of health care for small businesses in 
this country, to provide more coverage for those who are currently 
uninsured, and also to do something that would reduce the cost to the 
Government, the cost of Medicaid, as well as the other costs that are 
associated, as I said earlier, by increasing the amount that would come 
into the Treasury.
  For those reasons, Mr. President, I ask my colleagues to support this 
legislation.
  I yield back the remainder of my time.
  The PRESIDING OFFICER. The time until 4:30 is controlled by the 
minority.
  The Senator from Iowa.
  Mr. HARKIN. Mr. President, here we are on day 2 of Health Week, and 
there are still no plans to bring up H.R. 810, the stem cell research 
bill.
  This bill was passed by the House of Representatives 351 days ago--
almost a year ago now--with still no action here in the Senate. Yet the 
majority of Senators are for it. I do not understand how in the world 
we can have a Health Week in the Senate and not vote on the American 
public's No. 1 health research priority: lifting the President's 
restriction on embryonic stem cell research.
  That seems to be what we are doing. We are wasting our time on bills 
that everyone knows are not going to pass. We are passing up a golden 
opportunity to promote one of the most promising areas of research in 
our lifetimes.
  Most people by now have heard of the enormous potential of embryonic 
stem cells. These cells have the remarkable ability to turn into every 
other type of cell in the human body--brain cells that could replace 
those lost in Parkinson's disease, islet cells to replace those lost in 
type 1 diabetes, and on and on. Adult stem cells don't have that power, 
only embryonic stem cells. That is why the world's best scientists 
think embryonic stem cell research has so much promise to save lives 
and ease human suffering. It is also why they are so frustrated by the 
President's arbitrary restrictions on stem cell research.

  Under the President's guidelines, Federal funding can be used for 
research only on those stem cell lines that were created before August 
9, 2001, at 9 p.m. Where did that date come from? Out of thin air? If 
the stem cell lines were created at 8:30 p.m., they are fine, they are 
moral, they are OK. If they were created at 9:30 p.m., all of a sudden 
they missed the cutoff. It is totally arbitrary.
  Shortly after the President announced his policy, he said 78 stem 
cell lines were eligible under his guidelines. It turns out that only 
22 are. In fact, it is even worse. Only a handful of those are even 
healthy enough and readily available. More importantly, all of the 22 
lines that are available have been contaminated by mouse cells. They 
have been grown in a mouse feeder cell environment. It is unlikely they 
will ever be used for any kind of human intervention, which is supposed 
to be the whole point of the research anyway.
  Dozens more stem cell lines have been created since August 9, 2001. 
They are healthier. Many have never been contaminated with mouse cells. 
But thanks to President Bush, they are off limits to our best 
scientists.
  Yet opponents of H.R. 810 sometimes argue that embryonic stem cell 
research has no potential. Last week, Senator Brownback presented a 
list of diseases that are being treated with adult stem cells and asked 
why that hasn't happened yet with embryonic stem cells. Let me address 
that directly. Scientists have been doing research on adult stem cells 
for over 30 years. There are no arbitrary restrictions on research with 
adult stem cells. Scientists and private companies don't have to be 
skittish about doing this research. They don't have to worry that all 
of a sudden the Federal Government is going to ban it or limit it.
  Let's compare that situation with human embryonic stem cells. 
Scientists didn't even know how to derive them until 1998. The first 
Federal grant for these stem cells wasn't awarded until 2002. Even now, 
only a tiny fraction of the total Federal budget for stem cell research 
is used for embryonic stem cells. The vast majority goes for adult stem 
cell research, and every scientist who enters this field is taking a 
risk that Congress will pass a law to shut down the lab. They also risk 
that they won't get any 1 of the 22 lines contaminated by mouse feeder 
cells which they will then not be able to use for human therapy. So it 
is no wonder that more diseases are being treated today with adult stem 
cells. Adult stem cell research had a 30-year head start. Meanwhile, 
scientists have been studying embryonic stem cells for just 5 years 
with one arm tied behind their back.
  The fact is, it doesn't matter what I think about the potential of 
embryonic stem cell research. It doesn't matter what Senator Brownback 
thinks either. What matters is what the scientists think. And I defy 
anyone to find a single reputable biomedical scientist whose doesn't 
believe we should pursue embryonic stem cell research.
  I have a letter from Dr. J. Michael Bishop who won the Nobel Prize in 
medicine in 1989. He writes:

       The vast majority of the biomedical research community 
     believes that human embryonic stem cells are likely to be the 
     source of key discoveries related to many debilitating 
     diseases. . . . In fact, some of the strongest advocates for 
     human embryonic stem cell research are those scientists who 
     have devoted their careers to the study of adult stem cells.

  A letter from Dr. Alfred G. Gilman, who won the Nobel Prize for 
medicine in 1994:

       It has become obvious, however, that the number of stem 
     cell lines actually available under current policy is too 
     small and is controlled by a limited monopoly, which has made 
     it significantly more difficult and expensive for research to 
     be conducted. These limits have hindered the important search 
     for new understanding and treatment of devastating diseases.

  I have similar letters from Dr. Ferid Murad, who won the Nobel Prize 
for medicine in 1998; Dr. Arthur Kornberg, who won the Nobel Prize in 
medicine in 1959; and dozens more of our Nation's top researchers--all 
of whom believe in the potential of embryonic stem cell research. I ask 
my friend from Kansas, in response to his speech of late last week: Are 
there any Nobel Prize winners in medicine who oppose embryonic stem 
cell research? Name one.
  In fact, I challenge him further: Are there any reputable biomedical 
researchers at all who think we should be studying adult stem cells 
only and not embryonic stem cells? Name one.
  I don't think he will find one. Every scientist I have spoken to says 
stem cell research should not be an either/or endeavor. We should not 
be talking about stem cell research or embryonic stem cell research. We 
should study both. We should open all doors in the pursuit of therapies 
that can save lives and ease human suffering. The breakthroughs are 
coming, but they take time. To clamp down on embryonic stem cell 
research before it even has a chance to start shows a total lack of 
understanding about how science

[[Page S4190]]

works. More importantly, it denies hope to millions of Americans who 
suffer from Parkinson's, ALS, juvenile diabetes, spinal cord injuries, 
and dozens of other terrible diseases and conditions.

  We are rapidly approaching the 1-year anniversary of the vote in the 
House on H.R. 810. It has been 351 days since the House passed it on a 
strong bipartisan vote. If the Senate were allowed to vote on H.R. 810, 
we would win here, too. We have the votes. We would pass this bill and 
send it on to the President. Regrettably, however, the Republican 
leadership has not let that happen. So here we are, we are going 
through this farce--it is farcical--comedy, gimmickry of a so-called 
Health Week without taking up the American public's No. 1 health 
research priority.
  It is Tuesday. Health Week lasts for 3 more days. We could pass H.R. 
810 in a matter of hours. I urge the majority leader, take up the bill. 
Let the Senate have a quantified amount of time to debate it. We will 
pass it, and we will give millions of Americans who are suffering from 
diseases the hope they deserve.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from California.
  Mrs. BOXER. Mr. President, before he leaves the floor, I say to my 
colleague from Iowa, Senator Harkin, how much I appreciate his 
leadership in the area of health care. His analysis of where we stand 
on the stem cell issue is so appropriate, and he is so right. Here we 
have a whole area of scientific research that is waiting to take off. 
We have States, such as mine and others, that are taking the lead 
instead of following the lead of the Federal Government.
  I say to my friend, does he ever remember a time in history when this 
country was plagued by disease that the Federal Government didn't step 
to the plate, whether there was a Republican President or a Democratic 
President? Isn't it shocking that as we face these epidemics of 
Alzheimer's and Parkinson's and cancer and heart disease and all the 
others my friend mentioned, isn't it amazing--I am sure it is to him as 
well as to me--that we have a lack of leadership in Washington?
  Mr. HARKIN. I say to the Senator from California, it is not just 
amazing, it is shameful. It is shameful what is happening now with the 
lack of support for biomedical research, especially embryonic stem cell 
research. As I said, every Nobel Prize winner in medicine, all the 
reputable scientists say we should be on it and we should be on it 
strongly. Yet the President, through this arbitrary cutoff, is denying 
this for scientists, denying it to people who are suffering. I say to 
my friend from California, God bless California. They took the lead out 
there. Her State has taken the lead. They are forging ahead. Other 
States are following their lead. If only we could get the Federal 
Government to follow their lead.
  Mrs. BOXER. As my friend pointed out in his statement, we have the 
votes for stem cell research, even with the President's opposition. If 
we asked for a show of hands in any roomful of people: Have you been 
touched by cancer, have you not personally or someone you know been 
touched by heart disease, by stroke, by Alzheimer's, Parkinson's, 
paralysis, all these things, we know how many hands would go up.
  Mr. HARKIN. Juvenile diabetes.
  Mrs. BOXER. That is clearly one. And I have met with juvenile 
diabetics. I have met with the children, the parents and the families. 
They are counting on us. Here we are in Health Week, as my friend 
points out. We have the votes. Yet what do they bring up? A bill that 
is actually going to take away health care from people, the Enzi bill.
  Mr. HARKIN. Exactly. I appreciate my colleague from California. She 
is right on target. I know my friend from California, the distinguished 
Senator, has been in the forefront of fighting for the things that will 
help people have better lives, especially in health care, and to ease 
the pain and suffering of people, especially juvenile diabetics.
  As the Senator knows, the families tell us that perhaps one of the 
first therapies that could come from embryonic stem cell research would 
be for these kids suffering from juvenile diabetes. What a great day 
that would be.
  I thank the Senator for her comments and strong leadership in all the 
areas of health care, and I thank California, through her, for the 
leadership they have shown.
  Mrs. BOXER. I am very proud of my State.
  In my State the gentleman who took the lead in putting the stem cell 
research initiative on the ballot has a child with juvenile diabetes. 
Watching that child suffer and struggle motivated him. He ignited this 
wonderful movement in our State. Shockingly, here we are in Health Week 
and this thing is nowhere to be seen. It is another example of why we 
need change around this place. I thank my friend.
  This Health Week Republican style is really fascinating when you look 
at the bills that have come before us. The first two bills would have 
hurt patients who were injured by malpractice, patients who might have 
been made infertile or harmed in many ways. Those two bills took away 
the rights of patients.
  The PRESIDING OFFICER. The minority's time has expired.
  Mrs. BOXER. I ask unanimous consent to speak another 15 minutes.
  The PRESIDING OFFICER. Is there objection?
  Mr. ENZI. I object.
  The PRESIDING OFFICER. Objection is heard.
  Mrs. BOXER. I ask unanimous consent to suggest a quorum call.
  Mr. ENZI. Mr. President, under the unanimous consent agreement, we 
are alternating every 30 minutes.
  The PRESIDING OFFICER. Under the precedents of the Senate, the 
Senator must control at least 10 minutes in order to suggest the 
absence of a quorum.
  Mrs. BOXER. I ask unanimous consent that at 5 o'clock I be given the 
floor for 10 minutes.
  The PRESIDING OFFICER. Is there objection?
  Mr. ENZI. Mr. President, reserving the right to object, the Senator's 
side controls the time at that time. So if they want to give the 
Senator the 10 minutes, there would be no objection to that. It would 
come out of the Democratic time.
  Mrs. BOXER. I thank the Chair.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Wyoming.
  Mr. ENZI. Mr. President, first, I apologize for the confusion over 
the unanimous consent that we had. It was designed early this morning 
to make sure each side had an opportunity to have an equal amount of 
say on the 30 hours that we are working on in order to actually get to 
amendments on this bill. Now that we have had cloture and everybody has 
agreed, or almost everybody, that we needed to proceed on the bill, we 
are talking about an issue that is huge to small businesses out there 
and wanting to find some kind of solution. We even suggested that 
perhaps they would like to reduce the number of hours of debate about 
the right to proceed so that we could actually get to offering 
amendments. But we have a 30-hour time requirement. That could be 
reduced by unanimous consent, or even eliminated by unanimous consent. 
But it has not been, so we will try to keep on a half-hour rotating 
basis so that as many people as possible can have something to say on 
the bill.
  I am going to take a few minutes at this point to talk about this 
issue. We have been talking about health care. One advantage of having 
this 30 hours is to have some additional health care debate. I need to 
talk a little bit about prescription drugs Part D. That is not part of 
the motion to proceed, but it has been talked about a number of times 
on the Senate floor today. There are some confusing things out there 
for seniors that I would like to clear up.
  I have been taking the last two recesses to travel across Wyoming and 
hold meetings with senior citizens to explain the prescription drug 
plan to get them signed up so they can get the benefit. There is some 
confusion out there. When we were designing the plan, we were worried 
that there would not be any plan interested in our small population in 
Wyoming. We have less than 500,000 people in our State. Our biggest 
city has 52,000 people. So we have a little bit of trouble finding a 
big enough pool for anything and to encourage interest. So I asked that 
there be kind of a Federal backup plan on it, and that was put in the 
bill.
  But when the time came around for companies to offer plans in 
Wyoming, obviously, they were even excited about 500,000 people because 
we had 41

[[Page S4191]]

plans respond. That is competition. That competition brought the prices 
down by 25 percent before the people even applied for the benefit. A 
huge decrease in cost; that is cost by competition. The downside is 
that 41 plans create confusion. If you have ever tried to buy insurance 
and talk to a number of different insurance salesmen, every package is 
designed slightly different to make it a little bit more confusing so 
that their plan looks better, but it is also harder for you to make 
comparisons.
  There is an easy way to make comparisons. Medicare saw that coming 
and set up a computer analyzation so that all you have to know is what 
your prescriptions are and what the doses are. You can put them in over 
the Internet or you can talk to somebody live by an 800 number or there 
are a lot of volunteers across America who are helping to get this 
information out. It lets Medicare do the math. They will present you 
with three or four plans that meet your prescription, your doses, and 
your criteria for where you want to buy it. You can look at these line 
by line. All the lines match up and you can compare them and find the 
best one for you. It has been a tremendous help.
  My mother asked me to help her on her decision. There are kids across 
the United States--kids like me--who need to be helping their moms on 
these kinds of decisions. I was happy to do it because it gave me an 
opportunity to try out the telephone method, the Internet method, and I 
talked to a number of volunteers and the local pharmacist. We owe the 
local pharmacist a great deal of thanks for the way this is working and 
the difficulties that they have had doing a new program. We have not 
had a big change in the program in decades. When we first had Medicare, 
there were problems. They got worked out. When we started this one, 
there were problems, and I think they have mostly been worked out.
  Occasionally, at these hearings, somebody was having a problem. A 
hour and a half was the longest it took us to straighten out any 
problem for anybody. I ran this process and came up with these four 
best at the least cost for my mom.
  One of the things that people raise in those sections is they say: I 
don't need any drugs so I should not have to do this. I should not have 
to pay a penalty later.
  The way insurance works is that you buy into the plan usually before 
you get sick. You pay a premium and when you get sick, then you have 
the coverage for the things that can happen to you in the future.
  Medicare prescription Part D is completely different because you can 
already have a huge medical problem and a lot of prescriptions and you 
can sign up for this now and have a maximum guaranteed cost. I know of 
people who are actually saving thousands of dollars because they signed 
up. If you don't have anything the matter with you and you don't want 
to buy into a big plan, you run the evaluation and you can find a small 
plan you can buy into.

  One in Wyoming is $1.87 a month. What if the $1.87 a month doesn't 
cover me if I have something really bad happen to me? Well, every 
November 15 to December 31 you can change your mind. You can change 
your company, and they cannot stop you. Tell me where else insurance 
works like that. Every November 15 to December 31, you can change your 
mind and sign up for a plan that has new kinds of benefits for you that 
match new illnesses that you might have.
  This is working for the people who have paid attention. It is easy to 
have Medicare do the math. So everybody out there who hasn't signed up 
needs to talk to the volunteers, probably at their senior citizen 
center or call the 1-800 number or get on the Medicare Internet site 
and have that plan figured out for you. It takes a few minutes and you 
can be set so that you, first of all, won't have any penalties, but, 
secondly, you will have some tremendous benefits as you need the 
medication. It has made a huge difference.
  Some people have talked about negotiating the price. When I was doing 
these hearings, I had some difficulty with people who showed up and 
said: You know, there are some medications I really want to have, that 
I am supposed to have, and I cannot get them. Well, when I checked, 
those were the veterans, and the veterans' prices are negotiated, and 
when they negotiate prices, they pick a similar drug and get the best 
price by kind of fixing the price on it and driving the price down 
through this bidding war. But it eliminates medications. Yes, there are 
medications you can take. It may not be the medication your doctor 
thinks is absolutely the best. But that is what happens with negotiated 
prices.
  So what we relied on in the Medicare prescription Part D was 
competition, and competition has happened. Prices came down 25 percent, 
and then people who signed up for the program who are using medications 
found out that they are also saving another 25 percent as the least 
amount, or 37 percent as the average amount, and some people are 
getting 83 percent--I say some people. I know some people who are 
getting several thousand times more than what they are paying in 
because they are into the catastrophic care. I wasn't even listing the 
catastrophic care.
  The important thing is that we need to tell people and help people to 
sign up by May 15. It is a tremendous benefit. We have had more people 
sign up than we had anticipated signing up. That means, again, a bigger 
market; that means lower costs. So it works for all of us when people 
sign up. Remember, there are plans out there. If they have them for 
$1.87 a month in Wyoming, I bet they have that at $1.87 or less every 
place in the country. Look at those if you are not using any 
medication.
  So that is what competition does. That is the purpose of the bill 
that we are talking about and that we have actually had the motion to 
proceed on, not the ones that fall under other committees' 
jurisdictions, such as Medicare or stem cells or some of the other 
things that have been talked about here. Those are things that 
actually--this falls under the jurisdiction of the Health, Education, 
Labor and Pensions Committee. We took the bill through committee that 
has never been through the Senate before. The House passed a bill that 
is considerably more liberal and difficult than the one that we passed. 
They passed it eight times over there in a very bipartisan way. If we 
have the same Democratic Senators over here vote for it that had 
Democrats in the House vote for it, we will pass this bill easily. Even 
if there is a filibuster, we will pass it because it is a concept that 
small businesses have been asking for. This is the first opportunity we 
have had to provide it for them.
  We did it by being very conservative in the approach and going to a 
situation where we could work across State borders, so that 
associations could build a big enough pool that they could effectively 
work with their insurance companies to get these multiple competition 
bids. We are certain that it will work. One of the reasons we are 
certain that it will work is because it has been tried within States. 
But those who have tried it within States have found that it works very 
well, and they know it would work even better if they could go across 
State borders. So even those who are doing it are asking to do it on a 
wider scale than what they have been. For a lot of the States that have 
less population, yes, they want to be able to do it at all. They don't 
have big enough pools within their States to do it, so they want to be 
able to go across the State borders.
  I want to discuss a little bit why we need to pass S. 1955 and allow 
for the creation of these small business health plans. First of all, 
the concept of allowing small businesses to join together to find 
better prices for health insurance is not new, as I mentioned. Many 
organizations have offered nationwide health plans to members in the 
past. But States continued to add mandated benefits and other 
regulations to their insurance markets during the 1980s and 1990s, and 
the administrative hassles and costs associated with the mandates and 
regulations became too much of a burden for existing plans that could 
no longer offer an affordable benefit on a national basis. So they 
discontinued the plans.
  The Associated Builders and Contractors organization, known as ABC, 
is an unfortunate example of this problem. Their insurance carrier 
refused to continue doing business with the ABC insurance trust in the 
late 1990s because

[[Page S4192]]

the panoply of 50 different State regulations and excessive benefit 
mandates made it impractical and unattractive for the insurance company 
to continue the program. ABC was unable to find another carrier to pick 
up their business.
  This chart kind of shows how health care costs have gone. I don't 
think there is any argument on either side of the aisle that this is 
what has happened. There has been a rapid escalation, and compared to 
what it used to be, there has been a rapid escalation for a long time, 
oddly enough. We are up to a national average cost per employee of 
about $8,000 a year. That doesn't include the part the individuals are 
paying, which brings it up to about $11,000 a year. That is the amount 
we have been talking about on both sides of the aisle today.
  What is truly unfortunate is that workers at ABC's member companies 
were benefiting from this program, and the companies were saving money 
on their health care expenses. The health plan sponsored by ABC for 
nearly 45 years had total administrative expenses of about 13 cents for 
every dollar in premium. These costs included all marketing 
administration, insurance company risk, claim payment expenses, and 
State premium taxes. Compare this to the small business employers who 
purchase coverage directly from an insurance company. The total 
expenses for most small businesses today can approach 35 cents for 
every dollar of premium. So saving nearly 25 cents on a dollar is real 
money, especially in today's health insurance prices.
  The other benefit to ABC's member companies and employees is that any 
profit generated by their health plan stays in the plan. This also 
helped keep costs down. So the idea isn't new, and it has worked 
before.

  But Congress needs to act before small business organizations can 
resurrect their defunct programs and before other organizations can 
start new ones. Congress considered fixing this problem during debate 
over the Health Insurance Portability and Accountability Act in 1996--
it is better known as HIPAA--but the small business affordability 
provisions in the House bill were dropped during the conference between 
the House and the Senate in the final bill. As a result, HIPAA only 
addressed access to health insurance and not affordability. So now 
everyone has access to health insurance policies, but the policies 
themselves are unaffordable to many. When I became chairman of the 
Committee on Health, Education, Labor, and Pensions last year, I 
announced that I would bring a health insurance affordability bill 
before the committee so we could finish the job we started 10 years 
ago--in other words, to make it possible for all Americans to have 
access to a health insurance policy that is affordable.
  Many were skeptical then, and some may still be skeptical now, but 
the time for more of the same is over. America's working families want 
change, and they are tired of excuses from Congress.
  Small businesses and working families are demanding relief from high 
health insurance costs. And it is no wonder. This year, employers are 
paying twice what they were paying in the year 2000 for health 
insurance. That is correct. What businesses paid for health insurance 
has doubled over the past 6 years. That is a pace we can't keep up.
  This cost squeeze hurts small businesses the most. The highest rates 
of uninsured workers can be found in businesses with 25 or fewer 
workers. Only 60 percent of the Nation's businesses are offering health 
insurance these days, down from nearly 75 percent just 5 years ago.
  Small businesses and working families are stuck on the escalator of 
rising health insurance costs, with no end in sight. And in a tight 
labor market, small business owners don't want to jump off this fast-
moving escalator because dropping health insurance puts them at a major 
disadvantage in competing for the best workers. We need to give them a 
safe place to get off this escalator of rising costs, somewhere where 
it is more affordable for themselves and working families, and the 
small business health plan will give them that option.
  Mr. President, I yield the floor to the Senator from North Carolina.
  The PRESIDING OFFICER. The Senator from North Carolina is recognized.
  Mr. BURR. Mr. President, the chairman has brought a carefully crafted 
piece of legislation to the Senate floor, one that took a tremendous 
amount of skill to negotiate and one that has incredible support--more 
support when the bill passed out of committee than it does today. Why? 
Because people now fear it might become law. People fear this might 
pass, and they never believed it would. What does it do? It brings 
additional competition to the marketplace, but more importantly, it 
brings health care coverage to Americans who have no coverage today.
  Why are we here today, on Tuesday afternoon at almost 5 o'clock? 
Because the Senate is in a 30-hour debate about whether we are going to 
be willing or able to proceed. We are not even on the bill yet; we are 
in a procedural mode which requires us to have a vote to proceed to 
consider whether we are going to have a debate on this bill, S. 1955, a 
bill that changes the choices of the uninsured population in America.
  The choices they have today are nothing and nothing. Under any 
scenario, you would have unanimous support to change that. But there 
are actually people who are against that up here, but not across the 
country. As a matter of fact, in this poll done by Public Opinion 
Strategies in March of this year, over 80 percent of the people polled 
overwhelmingly support small business health plans; in other words, 
they support this legislation--the effort to bring new choices of 
products that are affordable to small businesses, to employers, and, 
more importantly, to the employees they hire.
  In North Carolina, we have 671,000 small businesses. Ninety-eight 
percent of firms with employees are small businesses in North Carolina. 
Don't let anybody come to the floor and tell you that this bill does 
not have an effect except on a select group of people. It may be a 
select group of people, but it is 98 percent of the employers of North 
Carolina. Women-owned small businesses have increased 24 percent in 
North Carolina since 1997, Hispanic-owned small businesses have 
increased 24 percent since the same date, Black-owned small businesses 
have increased 31 percent since 1997, and Asian-owned small businesses 
have increased 74 percent since 1997. These are companies which benefit 
from this legislation. These are companies which today can't afford the 
premium costs of health insurance; therefore, their employee base goes 
without. They are in that category of uninsured that so many people 
come and talk about on this floor, but they talk about uninsured 
without the solution as to how to cover them.
  This is a population which in some cases today is on Medicaid. They 
work full-time. Their income level qualifies them for Medicaid. And 
what would be the incentive for them to get off of Medicaid? It would 
be if their employer has the option to offer them health care the way 
the majority of America is now provided health care: through their 
employer. But we are here in 30 hours of debate trying to decide 
whether we are going to allow Members to come to the floor and debate a 
bill and offer amendments which will allow us to switch from nothing 
and nothing to nothing and something, which will allow us to inject 
something, some ray of hope into the millions of Americans who don't 
have coverage today.
  Let me read a few letters. I think it is always helpful to hear from 
people whom this affects, the human face behind the issues that 
sometimes we lose on this floor simply because we don't want to talk 
about names or pictures.
  This is a woman from Sunbury, NC. She wrote me in mid-April of this 
year. I am just going to read some pieces. She says:

       Support SBHP legislation, S. 1955. I feel that this is very 
     important because I haven't had health insurance in many 
     years, because my employer doesn't have access to affordable 
     insurance to offer us.

  Some suggest on this Senate floor that is not the case, that 
everybody has the opportunity to have health insurance. ``I haven't had 
health insurance in many years.'' Why? ``Because my employer can't 
afford what is available.''
  Another letter received in April of this year from a young lady in 
Elizabeth City, NC:

       Please support Senate bill 1955, the Health Insurance 
     Marketplace Modernization and

[[Page S4193]]

     Affordability Act. My employer cannot afford health insurance 
     for their employees. My husband works for Ford. They are 
     closing his plant soon. We will have no insurance unless my 
     employer offers it. I have premature twins. They were born 3 
     months early. It costs me $2,000 a month to feed them. That 
     does not include any doctor's appointments we have to go to. 
     I feel that this is a great bill.

  What is America looking for? They are looking for hope. They are 
looking for us to produce a product out of this institution that 
actually fulfills their needs. I don't know how it can be any clearer.

       It is not offered to me today, because my employer can't 
     afford the options that are in our marketplace.

  What do we do? We create new options that are affordable. That is, in 
fact, what the chairman is trying to do with this bill.
  Here is a third letter, also from Elizabeth City but a different 
business. It says:

       Small businesses need help with insurance--

  In big bold letters--

       I am now paying $986 per month for my wife and myself. This 
     is for only 60 percent coverage and a $2,500 deductible. I 
     know people with group insurance who are paying $600 a month 
     for 80 percent coverage and a $250 deductible. Many of those 
     have dental insurance as well. My policy provides none. 
     Please vote for this bill. Allow small businesses to have 
     coverage equal to employers of other companies.

  That is all we are doing. We are using the scale of what people who 
have a tremendous amount of employees can do, and that is they can go 
to insurance carriers and they can negotiate for products based upon 
the volume of their employees. But how does a small business owner do 
that when he has five or six or seven employees? Well, it is real 
simple. We allow them to band together. We allow them to band together 
into a common association, and we allow that association to then market 
their entire association based upon the volume.
  Another letter that I received on April 6 says:

       As a small business owner, it is important to enable some 
     economy of scale in allowing franchises to obtain more 
     affordable health care coverage.

  The last one I am going to read is quite unique.

       As a professional photographer, I have seen firsthand the 
     difficulty that my fellow professional photographers face 
     when attempting to purchase health insurance on their own. S. 
     1955 would allow photographers and other independent business 
     owners to band together across State lines and purchase 
     health insurance. Having this as an option and choice will 
     improve our access to quality health care and help control 
     costs through competition.

  These letters are from people on the front lines. They are from 
employees whose employers can't offer coverage today because it is not 
affordable. They are from individuals who own businesses and would like 
to offer coverage to their employees. They are even from photographers, 
people whose lives are in their hands every day in a camera, but they 
cannot afford the individual costs of health insurance in today's 
marketplace.
  In North Carolina, we have 1.3 million uninsured North Carolinians. 
Of that 1.3 million, almost 900,000 uninsured individuals are in 
families or are on their own where one person at least works full-time. 
With the passage of this bill, 900,000 of the 1.3 million uninsured in 
North Carolina could potentially be offered health insurance. We can 
narrow it down from 1.3 million to 400,000 individuals who are 
uninsured in North Carolina with the passage of one simple bill, or at 
least they would have the option to be able to purchase it for once. 
Ninety-one percent of workers in large firms of 1,000 employees or more 
have health insurance, yet 66 percent of workers in small businesses 
defined as 10 employees or fewer have health insurance. Well, if you 
remember the North Carolina numbers, I said 98 percent of firms with 
employees were small businesses. Think of the millions of Americans who 
are going to be touched by the passage of this one piece of legislation 
that provides them choice. Where today their choice is between nothing 
and nothing, tomorrow their choice is between nothing and something.
  Why are we here? We are here for 30 hours of debate--not debate on 
the bill, not debate about the amendments, debate about whether we are 
going to move forward. We do that at a time when--I just went back and 
did a quick calculation on the back of my calendar--we have 76 
legislative days left between now and adjournment. That is assuming we 
have productive days on Fridays and Mondays, and as the chairman knows, 
Fridays and Mondays are not always productive in the Halls of Congress. 
People are either slow to get here or quick to leave. If you take out 
Fridays and Mondays, we are down to 45 days. But we are going to spend 
30 hours trying to decide whether we are going to move forward to 
debate this bill, and we will spend another 30 hours after we file 
cloture on the bill to get to a point where we can have an up-or-down 
vote, if, in fact, we get that far.
  Last night, we voted on two medical liability bills--medical 
liability that covers the entire medical professional world--and last 
night, we were denied the ability to proceed and to debate the 
legislation, much less amend it. The second bill is legislation in 
which--and I think the American people would be shocked at this--we 
were denied the ability to move forward to debate or amend legislation 
that limited the liability to OB/GYNs in America, a specialty we are 
losing specialists out of every day, where every year people aren't 
continuing to practice. But we will spend 30 hours debating whether we 
proceed to debate not necessarily the merits of the bill--and my hope 
is that the chairman will be successful, and I will be beside him 
arguing every step of the way, because without this, these Americans 
don't have hope of a choice of anything other than nothing and nothing.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER (Mr. Isakson). Under the previous order, the 
Senator from California is recognized.
  Mrs. BOXER. Mr. President, my understanding is that Senator Dorgan 
had time at 5 o'clock set aside, so if he wishes to take it now, then I 
will wait until his conclusion.
  I ask unanimous consent that at the conclusion of Senator Dorgan's 
remarks I be permitted to speak at that time. Since it is controlled by 
the Democrats, I can make that request by myself.
  The PRESIDING OFFICER. The Senator from North Dakota will be 
recognized, and at such time as he completes his statement, the Senator 
from California will be recognized.
  Mr. ENZI. That is assuming it comes within the 30-minute parameters?
  The PRESIDING OFFICER. The Senator is correct.
  Mr. DORGAN. Mr. President, I have listened to some of the debate 
today. It has been very interesting. The last speaker spoke about 
choice and choices. I want to talk about choices in health care a bit. 
This is Health Week, we are told. It is an opportunity, for a change, 
at long last to talk about some health care issues on the floor of the 
Senate.
  The intent, I believe, of the chairman who brings this bill to the 
floor is that we should speak only about and address only the issues 
dealing with small business health plans. However, he knows and I know 
there are many other health issues that have been long delayed by this 
Chamber and that need to be debated. I intend to offer a number of 
amendments. They are in order under the rules of the Senate. They are 
amendments that deal explicitly with health care issues.
  The issue before the Senate is not unimportant. The question of 
rising health care costs is very significant to everybody--individuals, 
businesses, governments. Everyone who is a consumer has to deal with 
increased costs of health care and we should, indeed, address the issue 
of health care costs for business associations and for small 
businesses. There is no question about that. I wish to be a part of the 
group that works on that in a bipartisan way, in a way that expands 
opportunity, not narrows opportunity; in a way that expands coverage, 
not narrows coverage; in a way that covers everyone, not just a few. I 
do not agree that we should make health care unaffordable for the older 
and sicker and then make profit out of insuring people who are younger 
and healthier. That is not the right way to do this.
  But having said all of that, let me describe some other things that 
have been long delayed on the floor of the Senate that need to be 
addressed. Let me talk about the first one. It is the

[[Page S4194]]

issue of reimportation of prescription drugs. A bipartisan piece of 
legislation has been long ago introduced and discussed here on the 
floor of the Senate, and we have not had the opportunity to vote on it.
  The reimportation of prescription drugs, why is that important? 
Because the American people are charged the highest prices in the world 
for prescription drugs; it is not even close--the highest prices in the 
world. Consumers in every other country are paying lower prices. Try to 
buy Lipitor and if you buy it in the United States you pay a higher 
price than in any country in the world--France, Germany, England, you 
name it. You pay the highest prices in the United States. Why should 
U.S. consumers be charged the highest prices?
  With consent, I want to show a couple of things on the floor of the 
Senate. Let me show, if I might, two bottles of Lipitor. I ask consent 
to show these on the floor of the Senate.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DORGAN. As you can see, they look identical: identical labels, 
identical pills in the same bottle made by the same company--shipped to 
two different places. One is shipped to Canada and one is shipped to 
the United States. The difference? One is half the price of the other. 
Guess which. It is the Canadian consumer who gets the benefit of paying 
half the price for the identical prescription drug.
  Let me also show a couple of containers of Prevacid. This is a drug 
that is widely used for ulcers. Once again, as you can see, it is 
essentially the same bottle, same pill, made by the same company, made 
in an FDA-approved plant and shipped to two different locations, one to 
Canada and one to the United States. The difference? This one costs 
twice as much. Who buys this one? The U.S. consumer; twice as much for 
the same pill.
  An old fellow sitting on a hay bale in North Dakota at a farm meeting 
said, my wife has been fighting breast cancer for 3 years. She took 
Tamoxifen for breast cancer. Every 3 months we drove to Canada to get 
Tamoxifen because it was the only way we could afford it, and we paid 
about 80 percent less than it would have cost us to buy that 
prescription drug to treat her breast cancer. We paid 80 percent less 
by driving to Canada to get it.

  The fact is, they allow a small amount of drugs to come across the 
border for personal use. But other than that, a U.S. consumer cannot 
access an FDA-approved prescription drug nor can a U.S. pharmacist 
access that same FDA-approved prescription drug. That is unbelievable. 
We have a bipartisan group of Members of the Senate who say consumers 
ought to be able to purchase FDA prescription drugs by reimporting them 
from other countries. That would put downward pressure on prescription 
drug prices in this country. A bipartisan group of Senators wants to do 
that, but we are prevented from doing it by current law. We want to 
change the law.
  Yet we are prevented from changing the law because the majority 
leader won't bring this legislation to the floor of the Senate. This is 
something we can offer as an amendment to the bill on the floor. It is 
well within the rules of the Senate, it deals with health care, and I 
am serving notice now that this is an amendment we will offer and vote 
on during the conduct of this discussion, providing we are allowed to 
offer amendments. I am hearing rumors that perhaps the majority leader 
will decide to fill the tree legislatively and allow no amendments. If 
that is the case, it will be a long week, but my hope is he will not do 
that. If amendments are allowed, I will offer this amendment and will 
get a vote.
  Let me go back to about midnight on the night of March 11, 2004. That 
is a little over 2 years ago--midnight. The reason I remember it was 
midnight, I was sitting right back here and I reached an agreement with 
the majority leader, Senator Frist. Here is what Senator Frist 
announced that evening after our negotiations, and after which I agreed 
to release the name of Dr. Mark McClellan to be promoted from the head 
of FDA to the Centers for Medicare and Medicaid Services. As a result 
of that, Senator Frist came to the floor and put this in the Record.

       I announce for the information of my colleagues that, with 
     consultation with the chairman of the Senate Committee on 
     Health, Education, Labor, Pensions, Senator Dorgan, Senator 
     Stabenow, Senator McCain, Senator Cochran, and other 
     interested Senators, the Senate will begin a process for 
     developing proposals that would allow for the safe 
     reimportation of FDA-approved prescription drugs.

  Two years later, nothing: No vote on the floor of the Senate, 
nothing. My colleague, Senator Vitter, sent a letter around a year ago. 
It says:

        . . . in the context of the Lester Crawford FDA 
     nomination, I obtained an agreement with Majority Leader 
     Frist regarding drug importation legislation. . . .The Senate 
     will probably hold some floor vote on a reimportation 
     amendment soon, probably on the Agriculture Appropriations 
     bill. Should that vote demonstrate that reimportation has 60-
     vote support on the floor, then Leader Frist will be open to 
     and work in good faith toward a floor debate and vote on a 
     reimportation bill. . . .

  What happened as a result of that? Nothing. No action, no votes, 
nothing.
  This bill on the floor of the Senate is amendable. This bipartisan 
amendment deals with health care. It has been long delayed--and no 
more. I intend to offer this amendment this week.
  Finally, at long last, perhaps the American consumers will no longer 
be charged the highest prices in the world for prescription drugs 
because they will be able to access FDA-approved drugs by reimporting 
them from virtually any other country in which the consumers are paying 
a lesser price for the identical prescription drug. That is unfair to 
the American people. The only reason we have not changed it yet is 
there are, regrettably, a few people in this Chamber who have blocked 
that opportunity, I assume on behalf of the pharmaceutical industry. 
But that blocking is about done. This week this bill is open for 
amendment. I intend to come and offer this as an amendment.
  That is one.
  Let me talk for a moment about another issue, once again long 
promised here to the Senate. We are told we are going to have an 
opportunity to do this--again and again and again--and we are not. We 
don't get the opportunity. It is called stem cell research. It is 
controversial; there is no question about that. I understand the 
controversy. But is it important? Yes, it is. We have all these people 
who talk about life. This is about life. This is about life-giving 
medical research, to find ways to unlock the mysteries and to cure some 
of the worst diseases known to people: Alzheimer's, diabetes, cancer, 
heart disease, Parkinson's. There is an unbelievable opportunity for 
medical research to unlock the cures for some of these diseases. But we 
need to proceed with stem cell research.
  We have been long promised the opportunity to have a vote on stem 
cell research on the floor of the Senate, and guess what. No such vote. 
On May 24, almost 1 year ago, the House of Representatives passed a 
bill on stem cell research. We are still waiting to have a vote on that 
here on the floor of the Senate--once again, a bill with bipartisan 
support.
  Let me describe, if I might, the importance of this in the eyes of a 
young woman. I met with this young girl about 2 weeks ago. It is not 
the first time I met her. She is a young lady, Camille Johnson, 13 
years old, diagnosed with type 1 diabetes at age 4. She is the one in 
the middle, playing the clarinet. She has had some very serious health 
problems, some very serious problems in her young life. She would like 
very much to live her life without diabetes. She would like diabetes to 
be cured for her and millions of others.
  In 2002, scientists at Stanford University used special chemicals to 
what is called transform undifferentiated embryonic stem cells of mice 
into cell masses that resemble islets found in the mouse pancreas. When 
this tissue is transplanted into the diabetic mice, it produces insulin 
in response to high glucose levels in animals. Wouldn't it be wonderful 
if, through this stem cell research, we cure diabetes; if we could tell 
this young woman your life is not going to be a life of diabetes. We 
can cure that disease.

  I have been involved in political campaigns recently and have been 
told by opponents that my proposal and my position on stem cell 
research is one that

[[Page S4195]]

murders embryos. Nothing could be further from the truth, nothing at 
all. Do you know there are 1 million people living among us, walking, 
breathing, talking--1 million people who were conceived through in 
vitro fertilization? One million people. When that in vitro 
fertilization takes place, the uniting of a sperm and an egg in a petri 
dish, more than a single embryo is created. A number of embryos are 
created in that process. Some are implanted into the uterus of a woman 
and some become a human being. Some are cryogenically frozen and stored 
in the event they should be used again if this did not result in a 
pregnancy.
  There are some 400,000 of those embryos frozen at in vitro clinics 
right now, 400,000 of them, and 8,000 to 11,000 are discarded, thrown 
away, every year. They become hospital waste.
  Should some perhaps be used for stem cell research with the hope of 
saving lives? The answer clearly is yes. This is not about murdering an 
embryo. If in fact this is the murder of an embryo, then the discarding 
of the embryos at the in vitro fertilization clinic, 8,000 to 11,000 a 
year, is also murder.
  We had one person testify at the Commerce Committee a couple of years 
ago who said those 1 million people who are here as a result of in 
vitro fertilization should not be here; it was wrong to create these 
people. Tell that to the parents who had those children; the childless 
parents who, through in vitro fertilization, discovered the miracle of 
having a child.
  The question of stem cell research is not about murdering an embryo, 
it is about an opportunity to cure some of the dreaded diseases.
  The other issue--and the reason I am talking about this is this is a 
big issue that we are not allowed to vote on in the Senate. This, too, 
should be an amendment on this bill. This, too, during Health Week is a 
very important issue dealing with health.
  The other side of this research is something called somatic cell 
nuclear transfer. Simply it is this: Let us assume a patient takes a 
skin cell from their own earlobe and that skin cell from their earlobe 
is then put in an evacuated egg and stimulated to become a blastocyst 
of a couple of hundred cells.
  That blastocyst now has predictor cells. They use the predictor cells 
for heart muscle, to inject back into the heart muscle to grow a 
stronger heart, to repair a heart attack.
  Some would say you have destroyed or murdered an embryo. There is no 
fertilized egg. There is only the skin cell from the person who had the 
heart attack whose cell is now being used, through somatic cell nuclear 
transfer, to save that person's life. This is about lifesaving. Yet we 
have so many here who said: Let's not worry about these diseases. Let's 
shut off this research because we think it is about murdering embryos.
  That is not what this is about. It is about this young girl and 
whether we decide we want this young girl to live her life as a 
diabetic, a life filled with hope at this point that Congress will 
finally do the right thing.
  The House of Representatives did it. The Senate needs to vote on it. 
Perhaps this week is as good a week as any. We have been promised. A 
year ago we were promised, just like drug reimportation. This Chamber 
is full of promises, but we never quite get to vote on important 
issues.
  I am not suggesting that when I talk about stem cell research that 
there are not ethical considerations, without serious concerns and 
serious issues to which we should be attentive. We should. I don't 
dismiss all the other concerns. But I do say this: If you have lost a 
child, if you have lost a loved one, and you have watched someone die 
from Parkinson's or cancer or heart disease, if you have been through 
that and then say to yourself: But I want to shut down promising 
research that could potentially cure diseases, then you have not been 
through it the way a number of people in this Chamber have been through 
it. I think it is so important for us to do the right thing and to 
continue this breathtaking research that can save lives.
  There are so many other issues. There are just a couple of minutes 
remaining. Then I will yield the time to my colleague from California.
  We passed recently in the Senate a piece of legislation that provides 
prescription drug benefits to senior citizens. But we did nothing to 
put downward pressure on drug prices. There is a special provision in 
the bill which my colleagues, Senators Wyden and Snowe, were talking 
about earlier today, that actually prevents the Federal Government from 
negotiating for lower prices with the pharmaceutical industry. That is 
unbelievably ignorant. A provision like that is unbelievably ignorant, 
and it ought to be repealed.
  All we need is a vote on that on the Senate floor. That, too, is a 
health issue. There is no excuse for this Congress to say: By the way, 
the Federal Government cannot negotiate for a lower price. We already 
do it in the VA. We end up with far lower prices as a result of the 
negotiations.
  In this case, with this bill, there is a provision that says: Don't 
you dare negotiate. It would be against the law for you to try to get 
lower prices and reduce Government spending. That, too, is a health 
issue. That, too, will be in order this week.
  I hope very much that we will have a vote on that. Yes, the 
underlying bill is important. We ought to find a bipartisan way to fix 
it. No, it doesn't work the way it is. It will restrict choice, in my 
judgement, increase prices for some, and make others completely 
uninsurable. We ought to fix it in a bipartisan way.
  But on the other three issues--reimportation of prescription drugs, 
stem cell research, repeal the law that prevents negotiation of lower 
prices with the pharmaceutical industry to save taxpayers money--
shouldn't we do all three of those? We ought to do all three of those 
this afternoon, right now. We have been blocked for far too long.
  If there is, in fact, an amendable vehicle--and I hope it will be; we 
will know that tomorrow morning--then I have just described three 
amendments that I believe should be offered, and when offered I believe 
will be approved in the coming days. If not, if this is a charade, and 
tomorrow we discover there is a legislative approach called ``filling 
the tree,'' which is simply setting up a little blocking device to say 
we are not going to allow anybody to offer anything, then I think the 
Senate will have sent a very strong message that this isn't Health 
Week. This is a week in which you want to trot out a little proposal of 
your own and avoid votes on serious issues that we should be taking in 
the Senate.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from California.
  Mrs. BOXER. Mr. President, I appreciate Senator Dorgan's remarks. I 
have been on the floor of the Senate a lot today waiting to get the 
time, and I have been fortunate to hear many colleagues. I thank him 
for very succinctly pointing out that in a real health care week you 
wouldn't close your eyes to hope--hope that we are going to find cures 
for the terrible diseases that plague our families--Parkinson's, 
Alzheimer's, diabetes, spinal cord injuries, stroke, heart attack, you 
just name them. The fact is, we know stem cell research is promising. 
We know a lot of States have gotten out ahead of the Federal Government 
because this President and this Congress have restricted the number of 
stem cell lines we can fund research on. And many of those stem cell 
lines are, frankly, no good at all because they have been impacted by 
mice cells. And they lack the diversity needed for robust research.
  I have talked to leaders in this field. I am not a scientist. I was 
educated in economics. But I have spoken to leading scientists, among 
whom is a gentleman named Dr. Peterson who worked at USFC in San 
Francisco. He is one of the leading pioneers in stem cell research who 
left to go to England because this President and this Congress put up a 
big stop sign in front of stem cell research. It is tragic.
  Our families need the hope of a cure. How many of us have met with 
these youngsters who have juvenile diabetes, and we have seen how 
difficult their lives are and how they suffer, even with the strides 
that have been made in this area. They are still in great danger.
  Health Week is here. We have a vehicle, as Senator Dorgan calls it, 
the Enzi bill, which tries to deal with the health insurance problems 
that small businesses face. I am going to talk about a better 
alternative to the Enzi

[[Page S4196]]

bill that will really do something. But we also have a chance to raise 
these issues during the debate on the Enzi bill.
  We have bipartisan support for drug importation from countries such 
as Canada, where drugs are sold at half the price of what drug 
companies charge in the U.S. We have bipartisan support for stem cell 
research, fixing the Medicare prescription drug issue so we could 
actually say to Medicare: You have the ability and the right just as 
the VA has to negotiate with the pharmaceutical companies for lower 
prices. But I have to say Health Care Week Republican style is really 
Insurance Company Week.

  If you look at the bills that have been brought before us, they all 
help the insurance companies. They don't help average Americans. They 
do not help us.
  The first two bills said we are going to restrict the right of 
patients--whether they are very wealthy, whether they are middle 
income, whether they are poor--we are going to stop them from 
recovering damages if they are harmed by medical malpractice.
  I was very pleased that the Senate chose not to limit debate on those 
two bills which would have taken away the rights of patients while 
giving a gift to the insurance companies. And hopefully we can change 
the Enzi bill.
  I don't like bills that take away benefits from my people in 
California. I don't like bills that take away benefits from all 
Americans. That is why the Enzi bill is a bad bill. It does just that. 
I will go through with you the list of benefits that are taken away.
  Mr. President, the Republicans bring us Health Care Week. They bring 
us the Enzi bill. What they do not tell us and you don't find out until 
you look is that all the States' protections that have been put into 
place will be wiped out upon passage of the Enzi bill.
  Those are harsh words. What do I mean? What benefits will be taken 
away from my people in California? According to the report put together 
by Families U.S.A, ``The Enzi Bill, Bad Medicine for America,'' those 
benefits include AIDS vaccines, alcoholism treatment, blood lead 
screening. You know that is important because if you don't screen kids 
for lead in their blood they could have learning disabilities--bone 
density screening. We know about osteoporosis. In California we 
guarantee that your insurance will pay for that; no guarantee in the 
Enzi bill whatsoever. As a matter of fact, the Enzi bill overrides all 
of this--cervical cancer screening, clinical trials, colorectal 
screening, contraceptives, diabetic supplies and education.
  We just talked about how it is so important for diabetics to have 
their meds--drug abuse treatment, emergency services, home health care, 
hospice care, infertility treatment, mammography screening, maternity 
care, mental health parity.
  In my State, if you have a mental health problem and you need help, 
your insurance coverage will cover your treatment, just the same as if 
you had a physical problem. We know it works. The list goes on--
metabolic disorders, minimal mastectomy, off-label drug use. In 
California, we have a law that says you can't kick a woman out of a 
hospital the same day she has a mastectomy. What, you may say? This 
happens? It does--off-label drug use, orthotics, prosthetics, prostate 
cancer screening. We know that prostate cancer is a scourge--
reconstructive surgery, second medical surgery opinion.
  If somebody tells you you need serious surgery, you can get a second 
opinion in California. That is covered--special footwear, telemedicine, 
well child care, so that we prevent diseases. That is my State.
  Every single State in the Union gets overridden, whether it is 
Alabama, Colorado, Georgia, Idaho.
  I know my friend from Georgia would be interested because he is 
sitting in the Chair. These are the things that your State offers. It 
protects your consumers. It is as long a list as California, I am proud 
to say--alcoholism treatment, ambulatory surgery, bone density 
screening, bone marrow transplants are covered in the State of Georgia. 
Cervical cancer screening, contraceptives, dental anesthesia, diabetic 
supplies, drug abuse treatment, emergency services, heart transplants 
are covered in Georgia. Infertility treatment, mammography screening, 
mental health parity, minimal mastectomy stay, morbid obesity care--
which is very important now with the obesity epidemic--off-label drug 
use, ovarian cancer screening, telemedicine, and well child care. 
Georgia has a very inclusive and wonderful list of guaranteed 
protections for people.
  In the State of Georgia there are 2.347 million people affected by 
this who would not have those guarantees under the Enzi plan. The Enzi 
plan essentially says to insurance companies: You can choose. You have 
to offer one plan. What do they call that plan? One premium plan. You 
have to offer one premium plan based on a state plan of their choosing, 
but there is no guarantee at all that what is in that premium plan is 
what is in the Georgia plan or the California plan or the North Dakota 
plan.
  The fact is, all of the work that has been done in our States--and I 
find it somewhat amusing given this is a Republican debate, that the 
Republican bill preempts the States. What is wrong with this picture? I 
thought our Republican friends loved decisionmaking at the State 
level. No, not here in the Senate. They would prefer the insurance 
companies decide it rather than the States.

  This is why I call my colleagues' attention to a study done on the 
impact on all the States, with letters compiled from attorneys general 
from many of the States and Governors.
  From Oregon, they register their opposition, first their benefits are 
not guaranteed any longer. In addition, they are very worried about 
what happens to premiums. The Enzi bill disadvantages older people. As 
far as the research I have done, it disadvantages women. It certainly 
disadvantages people who come in with a preexisting condition such as 
high blood pressure. That includes a lot of Americans.
  The bottom line is, the Enzi bill, the star rollout production of the 
Republican Health Care Week, will make null and void all protections 
that our States have given their citizens and replace them with some 
kind of riverboat gamble where insurers will choose some plan, from 
some State, and apply it to my State. I don't want a so-called premium 
plan from another State.
  Here is a good example. In Connecticut, there is a terrible epidemic 
of Lyme disease. A tick bites your body and it can make a person very 
ill. We have some of that in California, but we do not have as much per 
capita as Connecticut. In Connecticut, the State legislature and the 
Governor say insurers have to cover Lyme disease because it is an 
epidemic in the State. In other States, it may not be necessary. 
However, we will wipe that Connecticut requirement off the books, and 
we will say, through the Enzi bill, insurance companies are going to 
decide.
  Something is wrong. This is not Health Care Week, this is ``insurance 
company week.'' That is not good for consumers.
  My own State has built a comprehensive State health insurance system 
that encourages affordable and equitable coverage for all, while 
ensuring consumers are protected and guaranteed benefits. The Enzi bill 
takes away a State's power to regulate health insurance. It is a gift 
to the insurers, as I said. It preempts benefits, as I said. It also is 
going to lead to way higher premiums for all in America who are covered 
by health insurance.
  Insurance companies, not the States, will now decide what benefits 
the consumers. That is why we have letter after letter after letter 
from Governors, from attorneys general, warning us not to pass the Enzi 
bill.
  There appears to be no limits on the cost shares an insurer can 
charge nor are there requirements that plans treat consumers equitably 
or offer comprehensive coverage.
  As I said, if you are a little older--maybe you have high blood 
pressure, maybe you have some other health problems--you are in 
trouble. You are not going to have an affordable plan and you will lose 
the benefits you have. You may be priced out of the market. It will be 
catastrophic.
  We have serious problems with the Enzi bill. Here is the great news. 
There is a wonderful alternative out there, the Durbin-Lincoln bill, of 
which I am a cosponsor. I thank my friends for working so hard on this.
  As I go around my State, people nod in agreement with the Durbin-
Lincoln bill's premise. Senators have very good

[[Page S4197]]

health insurance. We pay half of the premium and the Government matches 
the other half. There is a Federal Employee Health Benefits Program. 
There are basic benefits required and private companies come in and 
offer various plans. People such as me and my employees can choose from 
a broad array of plans. It works beautifully.
  I ask unanimous consent, at 5:45, the Senator from Oregon, Senator 
Murray, be recognized for 15 minutes, until 6 o'clock.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mrs. BOXER. Senators Durbin and Lincoln take this Federal plan and 
open it up to small businesses with 100 employees down to a single 
self-employed person.
  This plan will work because there will be a huge pool set up. 
Everyone can buy into it from any business in this country with less 
than 100 employees. It would be a very diverse pool of people. They 
will be insured. The pricing is going to be very fair and reasonable. 
The plan will be administered in the same way our Federal benefits are 
administered.
  I heard Senator Thune say: That is a government plan. No, it isn't. 
It is a plan that is administered by the Federal Employees Health 
Benefit Plan, but it is coverage provided by private insurers. Because 
the administrative costs are kept so low, this is going to be very 
affordable and will solve the problem.
  And guess what. This alternative, the Durbin-Lincoln alternative, 
does not take away the protections States have given all who live in 
those States. If you are in California, you still get the benefits. By 
law, you are protected. If you live in Washington State, you will get 
those benefits. The alternative that the Democrats are behind will cost 
less. It will protect benefits. It will work beautifully.
  I say to my colleagues, if it is good enough for you, it ought to be 
good enough for small businesses and their employees. This bill is a 
wonderful and practical alternative.
  In my concluding 6 or 7 minutes, I will say that this so-called 
Health Care Week is a major disappointment, unless we find out tomorrow 
we can amend the Enzi bill. If we can amend Enzi and pass stem cell 
research and prescription drug reimportation, if we can make sure there 
is hope for patients with Alzheimer's, diabetes, heart condition, 
stroke, cancer because we move ahead with science, then Health Care 
Week will have mattered. If we can offer the Durbin-Lincoln substitute, 
it will not preempt the protections of State law as the Enzi bill does. 
The Enzi bill has more opposition than any bill I remember. AARP is 
against it. The Cancer Foundation is against it. There are 224 
organizations against it.
  I ask unanimous consent to have printed in the Record those 
organizations opposed to the Enzi bill.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

       National Partnership for Women & Families, 9 to 5, 
     Association for Working Women, Action Alliance of Senior 
     Citizens of Greater Philadelphia, Alabama Psychological 
     Association, Alliance for Advancing Nonprofit Health Care, 
     Alliance for Justice, Alliance for the Status of Missouri 
     Women, American Academy of Child & Adolescent Psychiatry, 
     American Academy of HIV Medicine, American Academy of 
     Pediatrics.
       American Academy of Pediatrics--Nebraska Chapter, American 
     Academy of Physician Assistants, American Association for 
     Geriatric Psychiatry, American Association for Marriage and 
     Family Therapy, American Association of People with 
     Disabilities, American Association on Mental Retardation, 
     American Chiropractic Association, American College of Nurse-
     Midwives, American Counseling Association, American Diabetes 
     Association.
       American Federation of State, County and Municipal 
     Employees, American Federation of Teachers, American 
     Foundation for the Blind, American Nurses Association, 
     American Occupational Therapy Association, American 
     Optometric Association, American Pediatric Society, American 
     Podiatric Medical Association, American Psychiatric 
     Association, American Psychological Association.
       American Speech-Language-Hearing Association, Arizona 
     Action Network, Arizona Business and Professional Women, 
     Arizona Psychological Association, Asociacion de Psicologia 
     de Puerto Rico, Assistive Technology Law Center, Association 
     of Medical School Pediatric Department Chairs, Association of 
     University Centers on Disabilities, Association of Women's 
     Health, Obstetric and Neonatal Nurses, B'nai B'rith 
     International.
       Bazelon Center for Mental Health Law, C3: Colorectal Cancer 
     Coalition, California Coalition for PKU and Allied Disorders, 
     California Black Health Network, California Psychological 
     Association, Campaign for Better Health Care--Illinois, 
     Capital District Physician's Health Plan, Inc., Catholics for 
     a Free Choice, Center for Civil Justice, Center for Justice 
     and Democracy.
       Center for Women Policy Studies, Children's Alliance, 
     Citizen Action/Illinois, Citizen Action of New York, Clinical 
     Social Work Guild 49, OPEIU, Coalition on Human Needs, 
     Colorado Center on Law and Policy, Colorado Children's 
     Campaign, Colorado Progressive Action, Colorado Psychological 
     Association.
       Committee of Ten Thousand, Communications Workers of 
     America, Connecticut Citizen Action Group, Consumers for 
     Affordable Health Care, Delaware Alliance for Health Care, 
     Delaware Psychological Association, Department for 
     Professional Employees, AFL-CIO, Disability Rights Wisconsin, 
     District of Columbia Psychological Association, Easter Seals.
       Empire Justice Center, Epilepsy Foundation, Excellus Blue 
     Cross Blue Shield, Families USA, Families with PKU, Family 
     Planning Advocates of New York State, Florida Consumer 
     Action Network, Georgia Rural Urban Summit, Guttmacher 
     Institute, HIP Health Plan of New York.
       Hawaii Psychological Association, Health and Disability 
     Advocates, Hemophilia Federation of America, Idaho 
     Psychological Association, Illinois Alliance for Retired 
     Americans, Illinois Psychological Association, Indiana 
     Psychological Association, Institute for Reproductive Health 
     Access, International Association of Machinists & Aerospace 
     Workers, International Brotherhood of Electrical Workers.
       International Longshore & Warehouse Union, Iowa Citizen 
     Action Network, Iowa Psychological Association, Kansas 
     Psychological Association, Kentucky Task Force on Hunger, 
     League of Women Voters, Maine Children's Alliance, Maine 
     Dirigo Alliance, Maine People's Alliance, Maine Psychological 
     Association.
       Maine Women's Lobby, Massachusetts Psychological 
     Association, Maternal and Child Health Access, Mental Health 
     Association in Michigan, Mental Health Legal Advisors 
     Committee (Commonwealth of Massachusetts), Michigan 
     Association for Children with Emotional Disorders, Michigan 
     Campaign for Quality Care, Michigan Citizen Action, Minnesota 
     COACT, Minnesota Psychological Association.
       Missouri Association of Social Welfare, Missouri 
     Progressive Vote Coalition, Montana Psychological 
     Association, Montana Senior Citizens Association, Inc., 
     NAADAC--The Association for Addiction Professionals, NETWORK, 
     a National Catholic Social Justice Lobby, National Alliance 
     on Mental Illness, National Association for Children's 
     Behavioral Health, National Association of Anorexia Nervosa 
     and Associated Disorders, National Association of Social 
     Workers.
       National Association of Social Workers, Arizona Chapter, 
     National Association of County Behavioral Health and 
     Developmental Disability Directors, National Coalition for 
     Cancer Survivorship, National Consumers League, National 
     Council for Community Behavioral Health Care, National 
     Council of Jewish Women, National Council on Independent 
     Living, National Disability Rights Network, National Family 
     Planning and Reproductive Health Association, National Health 
     Care for the Homeless Council.
       National Health Law Program, National Hemophilia 
     Foundation, National Mental Health Association, National 
     Multiple Sclerosis Society, National Organization for Women, 
     National Rehabilitation Association, National Research Center 
     for Women & Families, National Urea Cycle Disorders 
     Foundation, National Women's Health Network, National Women's 
     Law Center.
       Nebraska Psychological Association, Nevada State 
     Psychological Association, New Hampshire Citizens Alliance, 
     New Jersey Citizen Action. New Jersey Psychological 
     Association, New Mexico PACE, New Mexico Psychological 
     Association, New York Civil Liberties Union Reproductive 
     Rights Project, New York State Health Care Campaign, New 
     York State Psychological Association.
       North Carolina Justice Center's Health Access Coalition, 
     North Carolina Psychological Association, North Dakota PKU 
     Organization, North Dakota Progressive Coalition, North 
     Dakota Psychological Association, Northwest Health Law 
     Advocates, Northwest Women's Law Center, Ohio Psychological 
     Association, Oklahoma Psychological Association, Oregon 
     Action.
       Oregon Advocacy Center, Oregon Psychological Association, 
     Organic Acidemia Association, Patient Services, Inc., 
     Pediatrix Medical Group, Pennsylvania Council of Churches, 
     Pennsylvania Psychological Association, Philadelphia Citizens 
     for Children and Youth, Philadelphia Coalition of Labor Union 
     Women, Planned Parenthood Federation of America.
       Planned Parenthood of New York City, Population Connection, 
     Progressive Maryland, Public Citizen, RESULTS, Religious 
     Coalition for Reproductive Choice, Reproductive Health 
     Technologies Project, Rhode Island Ocean State Action, Rhode 
     Island Psychological Association.
       Sargent Shriver National Center on Poverty Law, Save Babies 
     Through Screening Foundation, Senior Citizens' Law Office,

[[Page S4198]]

     Small Business Majority, Society for Pediatric Research, 
     South Dakota Psychological Association, Suicide Prevention 
     Action Network USA, Summit Health Institute for Research and 
     Education, Inc., Tennessee Citizen Action, Tennessee 
     Psychological Association.
       Texas Psychological Association, The Arc of the United 
     States, The Black Children's Institute of Tennessee, The 
     Disability Coalition of New Mexico, The Institute for 
     Reproductive Health Access, The Senior Citizens' Law Office, 
     The Virginia Academy of Clinical Psychologists, Triumph 
     Treatment Services, US Action, US Action Education Fund.
       U.S. PIRG (Public Interest Research Group), Union for 
     Reform Judaism, United Association of Journeymen and 
     Apprentices in the Plumbing and Pipe Fitting Industry, United 
     Cerebral Palsy, United Food and Commercial Workers, United 
     Senior Action of Indiana, United Steelworkers International 
     Union, United Vision for Idaho, Univera Healthcare, Universal 
     Health Care Action Network.
       Utah Health Policy Project, Vermont Coalition for 
     Disability Rights, Vermont Office of Health Care Ombudsman, 
     Voices for America's Children, Voices for Virginia's 
     Children, Washington Citizen Action, Washington State 
     Coalition on Women's Substance Abuse Issues, Washington State 
     Psychological Association, West Virginia Citizen Action 
     Group, West Virginia Psychological Association.
       Wisconsin Citizen Action, Wisconsin Psychological 
     Association, Women of Reform Judaism, WorId Institute on 
     Disability, Wyoming Psychological Association.

  Mrs. BOXER. Mr. President, this bill is going to hurt American health 
care by cancelling out all the hard-won State protections and by 
raising premiums so high they will price consumers out of the market. 
That is why across the board there is opposition. I have not seen this 
many organizations come out against a bill.
  By the way, this bill, when it was first presented, sounded 
reasonable. It was only when we looked at the small print that we 
realized how dangerous it is.
  Instead of working on this misguided bill, we could have done the 
alternative, we could have done the stem cell, we could have fixed the 
Medicare prescription drugs, we could have allowed drug importation.
  If we didn't want to do real health care reform, there are a lot of 
other things we could have done, such as raise the minimum wage. We 
could have finished the job on immigration reform, strengthening the 
enforcement at the border and stopping illegal immigration, but getting 
people on a path and out of the shadows.
  What about Superfund sites? We have some of the most polluted sites 
in the country still awaiting cleanup. We have one in four people in 
America, including 10 million children, living within 4 miles of a 
Superfund site.
  What about debating the war Iraq? That is on everyone's mind. There 
is still no exit strategy. There is still no plan. We see suffering on 
the ground there every single day.
  We have issues with a potential nuclear Iran. We should debate that. 
In Afghanistan, the situation is deteriorating and we have all but 
forgotten about it. We have not followed the recommendations of the 9/
11 Commission to this date. We have failed fiscal policies. We have 
debt as far as the eye can see. We ought to debate pay-as-you-go. If 
Members want to spend money, they should show how they going to pay for 
it instead of putting the burden on the backs of America's children.
  There are many other things we could do, but since we are on Health 
Care Week, let's fix our health care system. Let's not pass a bill that 
will not help people with serious diseases or fix the problems with the 
Medicare prescription drug program.
  We have so much work to do and this Enzi bill is masquerading as a 
bill that will help our citizens. When we read the fine print, we find 
out it is only going to make matters worse.
  I am proud to yield the floor to my friend from Washington.
  The PRESIDING OFFICER. The Senator from Washington is recognized for 
15 minutes.
  Mrs. MURRAY. Mr. President, I ask unanimous consent the next 
Democratic speakers in order be Senator Dayton, Senator Durbin, and 
Senator Akaka.
  The PRESIDING OFFICER (Mr. Chambliss). Without objection, it is so 
ordered.
  Mrs. MURRAY. Mr. President, at this hour, families are struggling 
with health care. Seniors are facing a critical deadline for drug 
coverage. Businesses are grappling with the high cost of insurance. And 
patients are being denied the cutting-edge research that could save 
their lives. Those are critical issues. And what is the Senate doing? 
We are dealing with a distraction instead of real solutions to make 
health care affordable, more accessible, and more innovative.

  I am on the Senate floor this evening to talk about what we should be 
doing to help families and businesses and communities meet their health 
care needs. I also want to talk this evening about why the Republican 
proposal, S. 1955, could do more harm than good.
  This is a bill which takes a good idea--pooling the risk in health 
insurance--and distorts it with a plan that will raise the cost of 
health care, strip away patient protections, and hurt many of our small 
businesses. But do not take my word for it. Attorneys general from 41 
States, including my own, have written to outline the serious problems 
with the Republican bill. I have heard from doctors with the Washington 
State Medical Association and from my own Governor about the damage 
this bill will inflict on patients and on our economy.
  Simply put, this proposal is a distraction. Instead of dealing with 
real solutions to real problems, the Republican leadership is wasting 
time on one narrow proposal that is only going to make things worse. We 
can do better. The truth is that patients and seniors, doctors and 
nurses, and all of our communities deserve better.
  If we were serious about reducing the cost of health care, helping to 
improve access, and driving innovation, we would be talking about the 
critical issues that the Republican leadership is trying to avoid. We 
should be focusing on everything from the Medicare drug program, to 
stem cell research, to community health care. Frankly, we do not have a 
day to waste.
  On Monday, millions of seniors and disabled will be hit with a 
deadline that means higher premiums for their prescription drugs. That 
May 15 deadline is just 6 days away. I am hearing from seniors that 
they are very worried about this deadline. They are worried they are 
going to pick the wrong plan, and they do not think it is fair to be 
punished if they need more time so they can make an informed choice.
  I have been traveling throughout my home State of Washington, meeting 
with seniors and holding roundtables with patients, with pharmacists, 
with advocates.
  Three weeks ago, I was in Chehalis, at the Twin Cities Senior Center. 
I can tell you, seniors are worried. They are angry. They are 
frustrated. They are frightened about this May 15 deadline, and that 
deadline is just one of the problems this flawed drug program is 
presenting.
  The week before that, I was in Silverdale, and I have held Medicare 
roundtables in Kent, Vancouver, Ballard, Shelton, Spokane, Anacortes, 
Bellevue, Aberdeen, Olympia, Lakewood, Seattle, and Everett. 
Everywhere, I have heard from seniors about just how bad the Medicare 
Part D Program is. I have heard their frustration about dealing with 
such a confusing system. I have heard their anger that this program 
does not meet their needs. And I have heard from many who just want to 
throw their hands up in the air and ignore the whole program.
  If we were serious about improving health care, we would be fixing 
the problems they have outlined. Instead, we are going to let an unfair 
deadline hurt our seniors even further. In just 6 days--in just 6 
days--they are going to have to pick a plan or face high penalties 
whenever they do enroll, and the penalties grow larger the longer they 
wait. To me, that is just not fair.
  Right now, this Senate could be extending the deadline so our seniors 
are not pressured into making the wrong choice in such a complicated 
system. Right now, we could be lifting the penalty so that seniors are 
not punished if they need more time to make the right choice. Right 
now, we could be providing help to millions of vulnerable Americans who 
have been mistreated by this flawed Republican plan. But, instead, this 
Congress is leaving seniors to fend for themselves. The Secretary of 
Health and Human Services has said he opposes extending the deadline or 
lifting the penalties, and this

[[Page S4199]]

Republican Congress seems to agree with him by a shameful lack of 
action.
  Seniors deserve better. The disabled deserve better. Our most 
vulnerable neighbors deserve better. If we really wanted to make health 
care more affordable and more accessible and more innovative, we would 
be on this floor fixing the Medicare drug program and helping seniors 
who are facing that unfair deadline.
  Now, that is just one example of what a real focus on health care on 
this floor would include.
  If we were serious about helping patients, we would be expanding 
lifesaving research. For patients who are living with diseases such as 
Parkinson's or multiple sclerosis or Alzheimer's or diabetes, stem cell 
research holds the potential to help us understand and to treat and 
someday perhaps cure those devastating diseases.

  Nearly a year ago, the House of Representatives passed legislation to 
lift the restrictions that hold back this promising research. The House 
of Representatives has acted, but for an entire year the Senate has 
not. My colleagues, Senator Specter and Senator Harkin, are well known 
for their leadership on this fight. They were promised a vote on stem 
cell research, and that vote has still not taken place. Every delay 
means missed opportunities for patients with devastating diseases.
  If this Senate is serious about health care and saving lives, we 
should be voting on stem cell legislation today. That is why, last 
week, I joined with 39 other Senators in writing to the majority leader 
urging him to bring up H.R. 810, the Stem Cell Research Enhancement 
Act. But instead of real solutions, the Senate is focusing on a 
distraction. Patients with life-threatening diseases deserve a lot 
better.
  If we were serious about improving health care, we would be investing 
in local efforts that boost access to health care.
  Two weeks ago, through the Johnson & Johnson Community Health Care 
Awards, I had a chance to honor leaders from across the country who are 
doing innovative work to break down the barriers to care. If we were 
serious about improving health care, we would be building more Federal 
support for their work. Instead, we are moving in the opposite 
direction.
  Perhaps the best example is the Bush administration's 5-year effort 
to kill the Healthy Communities Access Program, which is known as HCAP. 
This is a program which helps our local organizations coordinate care 
for the uninsured. I have seen it make a tremendous difference in my 
home State. Well, every year since taking office, this Bush 
administration has tried to kill that successful program. I have been 
out here on the floor leading the fight for our local communities every 
year, and most years we have won. But this past year, the White House 
and the Republican Congress ended the support for Healthy Communities 
and thus made health care less accessible for families from coast to 
coast.
  If we were serious about improving health care, we would be investing 
in local programs that make a difference. But, instead, the Republican 
leadership is focused on distractions. We can do better than that.
  So let me take a few minutes to turn to the specific problems with 
the bill that is before us, S. 1955, and explain why so many experts 
across this country are warning us that this bill will eliminate 
critical patient protections, it will lead to unfair premiums and 
insurance practices, and it will raise the cost of health care.
  First of all, this bill will eliminate many of the important 
protections that keep patients healthy and lower the cost of health 
care.
  In my home State of Washington, we have enacted a number of State 
patient protections that require health plans to cover services such as 
diabetic care, mental health services, breast and cervical cancer 
screening, emergency medical services, and dental procedures. But under 
this bill, small business health plans or association health plans 
would not be required to cover those important benefits. Allowing 
insurers to abandon mandated benefits, many of which are preventive and 
are diagnostic, will result in a sicker population and higher health 
costs for everyone.
  When this legislation was debated in the HELP Committee, I offered a 
number of amendments to provide for coverage of several important 
women's health benefits. Unfortunately, every one of those amendments 
was defeated. So now, here we are, and we have a bill on this floor 
that will strip away the protections on which our patients across this 
country rely.
  A new report by Families USA shows just how many families in my home 
State will be hurt by this bill. That report found that 1,861,000 
residents of Washington State may lose protections if this bill is 
passed. And what could they lose? Emergency services, home health care, 
drug and alcohol treatment, contraceptives, diabetic supplies and 
education, hospice care, mammography screening, maternity services, 
mental health care--the list goes on. I am not going to tell nearly 2 
million people in my home State whom I represent that we are going to 
take a gamble and risk losing those hard-won protections for a plan 
that will likely raise the cost of health care for many of our families 
and small businesses.
  Secondly, this bill will encourage insurance companies to charge 
higher premiums for less healthy consumers. This bill will preempt 
strong laws and protections in our State that limit the ability of 
insurers to vary premiums based on health status, age, gender, or 
geography. I am very concerned this will result in adverse selection or 
what we call cherry-picking, leading to higher premiums for less 
healthy consumers. In fact, rates will likely become unaffordable for 
those who need it the most, potentially increasing the number of 
uninsured Americans.
  Now, Mr. President, I would like to share some letters I have 
received from leaders in my home State who all speak against this 
flawed proposal. I ask unanimous consent that these two letters be 
printed in the Record following my remarks.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (See exhibit 1.)
  Mrs. MURRAY. Mr. President, recently I received a letter from the 
Governor, Governor Christine Gregoire of my home State of Washington, 
in which she expressed many of her concerns regarding this legislation 
and its impact on the people who live in my home State.
  This chart behind me contains the full text of the Governor's letter. 
As you can see, she has many serious concerns. I wish to highlight for 
the Senate some of the main points our Governor has raised with me.
  Governor Gregoire alludes to the harmful aspects of this bill, and 
she says:

       [S. 1955] stands to harm our small group insurance market, 
     which is a critical component of [Washington State's] current 
     health care system. . . .
       Instead of promoting more affordable health care, this 
     legislation would cause a serious increase in rates for 
     consumers--possibly two or three times over what they now 
     pay.

  Governor Gregoire also warns in her letter to me that:

       [this] bill threatens consumer protections that the state 
     of Washington strives to guarantee to [all of] our residents.

  The Governor also warns that this bill:

       would foster a proliferation of health plans that do not 
     cover preventive services that are absolutely vital to the 
     health and well-being of Washington residents. . . .

  Mr. President, I would also like to share a letter that I have 
received from the 9,000-member Washington State Medical Association 
that wrote to me in strong opposition to S. 1955.
  Now, this chart shows the full letter, and I want to read just a 
portion of it:

       This legislation will have a severe impact on all the 
     consumer health gains that have been made in Washington State 
     over the past decade.
       S. 1955 will:
       Undermine Washington State's many gains in advancing health 
     care quality;
       Pull people from existing insurance coverage rather than 
     attract the uninsured;
       Lead to higher costs for consumers;
       Strike down Washington's Mental Health Parity law, which 
     took eight years of work to be enacted;
       Eliminate other mandated benefits that help consumers such 
     as mammography services; and,
       Leave Washington's citizens at risk for unpaid medical 
     bills in the event of an AHP insolvency.

  That is from the head of the Washington State Medical Association, 
which has 9,000 members in my home

[[Page S4200]]

State. I think their words should be heeded by the Members of this 
Senate.
  Third, this proposal does nothing to address increasing health care 
costs.
  In fact, it builds on the sorry record of this administration and 
this Congress in not addressing the rising costs that Americans face. 
Because of the flaws I mentioned, this bill does nothing to contain 
those costs. In fact, it could dramatically increase costs for many 
businesses and families in Washington State. It could well mean that 
people in the State of Washington who have affordable coverage today 
could end up worse off than they are right now.
  I know my State has been a leader in working to expand access to 
affordable health insurance for working families and small businesses. 
Many of the reforms that worked to control costs in my State would be 
jeopardized if this legislation is enacted. Washington State has a 
proud tradition of strong consumer protections and integrated managed 
care that has improved health outcomes and controlled cost increases. 
We should not jeopardize what my State has fought hard for by dangerous 
Federal legislation.
  I do support the concept of pooling. I believe we can implement 
policies that provide stability in health insurance premiums. In fact, 
I am currently working with a number of my colleagues on legislation to 
create Federal and State catastrophic cost pools to spread out the 
risks and address what is driving health care costs. We can help spread 
the risk in ways that will lower costs and still protect patients. The 
legislation before us could raise costs for consumers and small 
businesses. We can do better than that.
  There are serious challenges facing our country when it comes to 
health care. This Senate needs to get serious. Instead of focusing on a 
distraction, we should be helping seniors with prescription drugs. We 
should be expanding lifesaving research, and we should be supporting 
community health care. Those are some of the things we should be 
working on to reduce the cost of health care and to improve access and 
to accelerate innovation. We can do all of those things, but we need 
the Republican leadership to get serious if we are going to provide 
serious solutions. We don't have a day to waste. I hope we can get to 
work on the real solutions that our American families deserve.

                               Exhibit 1

                                            Christine O. Gregoire,


                                       Office of the Governor,

                                      Olympia, WA, April 27, 2006.
     Hon. Patty Murray,
     U.S. Senate, Washington, DC.
       Dear Senator Murray: I am writing with great concern about 
     S. 1955, the Health Insurance Marketplace Modernization and 
     Affordability Act, and its potential to further erode our 
     ability to provide sound health coverage to citizens in 
     Washington State. This bill stands to harm our small group 
     insurance market, which is a critical component of our 
     current health care system. Furthermore, the bill threatens 
     consumer protections that the State of Washington strives to 
     guarantee to our residents. For these reasons, I ask that you 
     oppose the bill in its current form.
       When it comes to providing health care, the federal 
     government has been putting an ever-Increasing burden on the 
     states. The Deficit Reduction Act, alone, paves the way to 
     eliminate nearly $50 billion over the next five years for the 
     Medicaid program. Fresh on the heals of signing the Deficit 
     Reduction Act, the President unveiled his Fiscal Year 2007 
     budget proposal, which proposes eliminating $36 billion from 
     the Medicare program over the next five years. Additionally, 
     the implementation of the Medicare Part D prescription drug 
     program has had enormous impacts on the states. Nearly every 
     state in the Nation--Washington included--felt compelled to 
     step in to ensure that our most needy citizens, our dual 
     eligible population, continue to receive their medications 
     due to fundamental flaws in the Medicare Modernization Act. 
     Against this backdrop now comes S. 1955.
       If passed, S. 1955 would establish a small group rating 
     mechanism that would further erode the possibility of 
     pursuing reasonable health care costs in the states. Instead 
     of promoting more affordable health care, this legislation 
     would cause a serious increase in rates for consumers--
     possibly two or three times over what they now pay. At its 
     worst, the bill could result in the total collapse of our 
     small group insurance market, something we must fight to 
     prevent.
       Additionally, I am concerned that S. 1955 would foster a 
     proliferation of health plans that do not cover preventative 
     services that are absolutely vital to the health and well-
     being of Washington residents, such as mammography, 
     colonoscopies, diabetic care services, and newborn coverage. 
     In 2005, the Washington State Legislature passed, and I 
     signed, legislation providing mental health parity. If 
     Congress passes S. 1955, the bill could also fully abrogate 
     this effort to ensure mental health coverage in Washington 
     State.
       It is surprising to me that S. 1955 is moving forward, 
     given that it is patterned, in part, on a flawed National 
     Association of Insurance Commissioner's 1993 Model Rating 
     Law, actually adopted by the state of New Hampshire in 2003. 
     This proved to be an unfortunate experiment for the people of 
     New Hampshire. Just this year, that state's Legislature 
     repealed provisions of its 2003 law due to the astronomical 
     jump in rates that occurred in only a two-year period after 
     it was implemented. Given this history that he knows only too 
     well, my colleague, Governor John Lynch of New Hampshire, 
     recently registered his opposition to S. 1955 in a letter to 
     his federal delegation, dated March 28, 2006. New Hampshire's 
     experience is illustrative and a harbinger of what could come 
     to all states, should Congress adopt S. 1955.
       As Washington State's Attorney General from 1993-2005, I, 
     along with the majority of my colleagues within the National 
     Association of Attorneys General (NAAG), opposed several 
     precursor bills to S. 1955. Introduced in each of the last 
     several Congresses, these bills allow for the federal 
     regulation of association health plans (AHPs), and have 
     passed out of the U.S. House more than once. I appreciate 
     that S. 1955, in its current form, does away with one fatal 
     flaw of the earlier AHP bills--that being the wholesale 
     obliteration of state regulation over national AHPs. But, as 
     I have articulated, S. 1955 still goes too far in preempting 
     other basic consumer protections. It is heartening to see 
     that a majority of current members of NAAG, including 
     Washington State Attorney General Rob McKenna, have now 
     weighed in with their concerns and opposition to S. 1955.
       As a nation, we need innovative solutions that provide high 
     quality, sustainable and affordable health care access to our 
     un- and under-insured populations. With the help of the 
     Washington State Legislature, I have embarked on a five-point 
     strategy to promote evidence-based medicine; better manage 
     chronic diseases; increase prevention and wellness 
     initiatives; require data transparency; and expand the reach 
     of health information technology. These strategies invite 
     strong partnerships between states and the federal government 
     that I remain committed to pursuing with you. Unfortunately, 
     proposals like S. 1955, are counterintuitive to the notion of 
     forging such partnerships and I ask that you reject the bill.
           Sincerely,
                                            Christine O. Gregoire,
     Governor.
                                  ____

                                                  Washington State


                                          Medical Association,

                                                   April 25, 2006.
     Hon. Patty Murray,
     U.S. Senate, Washington, DC.
       Dear Senator Murray: On behalf of the 9,000 members of the 
     Washington State Medical Association, WSMA, I am writing to 
     ask that you vote no on S. 1955--Association Health Plans, 
     AHPs, when the bill comes to a vote in the U.S. Senate.
       The WSMA is very concerned about the negative effect of 
     this legislation on our State's citizens, purchasers, 
     providers and health plans.
       This legislation will have a severe impact on all the 
     consumer health gains that have been made in Washington State 
     over the past decade.
       S. 1955 will:
       Undermine Washington State's many gains in advancing health 
     care quality;
       Pull people from existing insurance coverage rather than 
     attract the uninsured;
       Lead to higher costs for consumers;
       Strike down Washington's Mental Health Parity law, which 
     took eight years of work to be enacted;
       Eliminate other mandated benefits that help consumers such 
     as mammography services; and,
       Leave Washington's citizens at risk for unpaid medical 
     bills in the event of an AHP insolvency
       The Washington State Medical Association works hard every 
     day to insure that Washington's citizens have access to the 
     finest medical care in the country. This legislation will 
     test our ability to continue in this endeavor.
       For more information, please do not hesitate to contact Len 
     Eddinger in our Olympia office.
           Very Truly yours,
                                              Peter J. Dunbar, MD,
                                                        President.

  The PRESIDING OFFICER (Mr. Smith). The Senator from Kansas.
  Mr. BROWNBACK. Mr. President, I rise to address some issues my 
colleagues have raised. I am appreciative of the debate and the chance 
to talk about health care. It is a critically important topic. It is 
one that we have to talk a lot more about, how we can provide as much 
health care as possible to everybody at the lowest price that we

[[Page S4201]]

can get it and get more people insured. That is at the root of what we 
are trying to get done with the proposal of Senator Enzi and others to 
get more health insurance, better coverage to more people across the 
United States. That is a worthy goal, something we need to do. We have 
far too many people uninsured. We need more people insured. That is 
central to us. It is central to the hospital and the provider community 
that we have people who are insured. Because of those who are not 
insured and then can't pay the price of their health care, that is 
spread across to other people, which is what we do today. That is what 
we need to do, but it would be better if we could get more people 
insured and have a direct system of payment.
  Others have said that what we need to be talking about is different 
than this, rather than expanding health insurance coverage. I respect 
that. Some of my colleagues have raised the stem cell issue. I want to 
address the concerns my colleagues have raised on stem cells. I want to 
report to my colleagues what a tremendous positive story we have to 
tell about stem cells, an exciting story of people receiving 
treatments, living longer and healthier lives because of stem cell 
treatments. These are not the controversial ones. This does not involve 
the destruction of a young human in the embryonic stage. This involves 
the use of adult stem cells, which the Presiding Officer and others, 
everybody in this room has in their body, adult stem cells. It also 
involves cord blood stem cells. These are the stem cells that are in 
the umbilical cord between the mother and child, while the mother is 
carrying the child.
  I want to show two charts to start off. I think it is best if we make 
this a personal debate. I challenge my colleagues who have challenged 
me about this topic to come forward with pictures of individuals who 
are being treated with embryonic stem cells. I would like to see the 
people who are being treated with embryonic stem cells. We have put 
nearly half a billion dollars of research money into embryonic stem 
cell research. We have known about embryonic stem cells for 20 years. I 
don't know of the people being treated by embryonic stem cells.
  I can show people who are being treated with adult stem cells or cord 
blood. This is Erik Haines. He is 13 years old. He was diagnosed with 
Krabbes disease, the first patient to receive cord blood for this rare, 
inherited metabolic disease. The date of transplant was 1994. He is 
alive today. He would be dead without this having taken place.
  Let me show you a picture of Keone Penn. I had him in to testify 
before a Commerce Committee hearing a couple years ago. He has sickle 
cell anemia. The date of transplant was December 11, 1998. He had been 
very sick. He wasn't expected to live. As a matter of fact, it says in 
a statement that he made: If it wasn't for cord blood, I would probably 
be dead by now. It is a good thing I found a match. It saved my life.
  We have now many more people being treated for sickle cell, a whole 
host of diseases. As a matter of fact, I want to read off a few of 
these. These are human clinical trials, real people getting real 
treatments, living longer lives, if not being cured, by the use of 
adult stem cells and cord blood stem cells in 69 different disease 
areas.
  My colleagues have heard this debate for a period of years. We have 
been debating stem cells for a number of years. We have been debating 
the controversial area of embryonic stem cells, which the Federal 
Government funds, which State governments fund, which private industry 
and the private sector is fully free to fund completely, every bit of 
the way that they want to do that. They can. They have been. And we 
have no human treatments from embryonic stem cells to date. We don't 
have any. They are funded globally. There is no prohibition against 
embryonic stem cell research in the United States.
  My colleagues seek more than the nearly $500 billion that we have put 
into embryonic stem cell research, an area that has not produced any 
human treatments to date. I want to be clear that that is what we are 
talking about. When we started this debate, my colleagues pushing 
embryonic stem cells, who in their hearts absolutely believe they are 
doing the right thing and this will lead to cures, listed cancer, 
sickle cell anemia, Lou Gehrig's disease. We are going to deal with all 
of these things. With the promise of embryonic stem cells, we will cure 
these things. That is what they said on their side when we started this 
debate 6 years ago. Six years later--I could be off a year or 2--where 
are the cures? I say we have them. They are in adult and cord blood 
stem cells.

  I ask unanimous consent to print in the Record at the end of my 
statement a sheet of human clinical applications using adult stem 
cells.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (See exhibit 1.)
  Mr. BROWNBACK. I want to read a few of the 69 from this document: 
Sickle cell anemia, aplastic anemia, chronic Epstein-Barr infection, 
lupus, Crohn's disease, rheumatoid arthritis, juvenile arthritis, 
multiple sclerosis, brain tumors, different cancers, lymphoma, non-
Hodgkins lymphoma, a number of solid tumors, cardiovascular. This is an 
exciting area that is taking place where we now have people with acute 
heart damage, chronic coronary artery disease being treated with adult 
stem cells. Primarily, this has been an adult stem cell treatment where 
they harvest stem cells out of their own body and inject them right 
back into the damaged heart tissue.
  Now we are seeing people who couldn't walk up a flight of steps going 
up eight flights, having hard tissue being regenerated with the use of 
their own adult stem cells. There is no rejection problem. This is 
their own cells. They take these adult stem cells from your body, which 
are repair cells, grow them outside of the body, put them back into the 
damaged heart tissue area, and now instead of congestive heart failure, 
without any ability to get enough blood throughout the body, the heart 
is pumping harder and better. It is actually working. They are 
regenerating the heart in these people. This is actually taking place 
in human clinical trials today. It is a beautiful issue.
  The list goes on: chronic liver failure, Parkinson's disease. I had a 
gentleman in to testify who had taken stem cells out of a part of his 
body, grew them, put them in the left part of the brain. The right side 
of the body started functioning without Parkinson's disease. Later it 
came back, after several years, but he had several years free and was 
starting to learn how better this can work with Parkinson's disease.
  Again, continuing from the list: spinal cord injury, stroke damage, 
limb gangrene, skull bone repair. We have recently had advances. For 
example, they took the stem cells out of a person's body. They had a 
form around which the bladder could be grown, outside a new bladder 
could be grown. They took the stem cells, put them around this form, 
and actually grew a bladder out of a person's own stem cells. These are 
marvelous, miraculous things that are taking place in 69 different 
areas of human clinical trials, adult and cord blood. I ask my 
colleagues from the other side, the ones who promised all of the cures 
from embryonic stem cells, as this debate moves forward, we will bring 
out statements that people made 5, 6 years ago about the cures that 
would come from embryonic stem cells. The cures have come from these 
noncontroversial areas. This is where we ought to be funding. This is 
what we ought to be doing. This is where we are getting treatments.
  I ask my colleagues from the other side, where are the treatments 
with embryonic stem cells? Colleagues on the other side, for whom I 
have great respect and I know in their hearts are doing what they 
believe is the right thing to do, asked about reputable scientists 
opposed to embryonic stem cells. I ask unanimous consent to print in 
the Record this letter at the conclusion of my statement.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (See exhibit 2.)
  Mr. BROWNBACK. It is dated October 27, 2004. It is to Senator John F. 
Kerry, running for President at the time, signed by 57 scientists who 
have a real problem with embryonic stem cell research.
  They say in this letter:

       As professionals trained in the life sciences we are 
     alarmed at these statements.

  They are referring to what Senator Kerry was saying, that this would 
be a

[[Page S4202]]

centerpiece issue for him in moving forward with science. This is in 
2004.

       First, your statement misrepresents science. In itself, 
     science is not a policy or a political program.
       Second, it is no mere ``ideology'' to be concerned about 
     the possible misuse of humans in scientific research.

  Here we come to the real rub of the issue on embryonic stem cell 
research. Is the embryo human life or isn't it? It is one or the other. 
It is either a human life or it isn't. It is alive. It is human in its 
genetic form. Is it a human life or not? If it is not a human life, do 
with it as you choose. If it is a human life, it deserves protection 
and respect. We do it for everybody in this room, no matter what your 
State is, your physical condition. Why wouldn't we do it while you are 
in the womb?
  I have a letter signed by 57 scientists with a real problem with 
embryonic stem cell research. My colleague asked me to produce 
scientists who are opposed to embryonic stem cell research. Here they 
are.
  I finally say to my colleagues on this topic, the promises they have 
made about embryonic stem cell research have not been realized to date, 
and reputable scientists question whether they will ever be realized. 
We are half a billion dollars later after investment from the Federal 
Government on embryonic stem cell research, animal and human. Now you 
are seeing--this is just the Federal Government, not about the private 
sector or other governments around the world. I will read to you what 
other scientists who support embryonic stem cell research are saying 
about the prospects of embryonic stem cell research. A British stem 
cell research expert, named Winston, warned colleagues that the 
political hype in support of human embryonic stem cells needs to be 
reined in. This is dated June 20, 2005, where he says this:

       One of the problems is that in order to persuade the public 
     that we must do this work, we often go rather too far in 
     promising what we might achieve. This is a real issue for the 
     scientists. I am not entirely convinced that embryonic stem 
     cells will, in my lifetime, and possibly anybody's lifetime, 
     for that matter, be holding quite the promise that we 
     desperately hope they will.

  Let's look at another researcher talking in this field. I want to get 
testimony in here from Jamie Thompson, the first scientist to grow 
human embryonic stem cells. This is the question posed to him:

       People who use nuclear transfer generally say that the 
     technique is optimized for producing stem cells rather than 
     making babies. They would not want to equate this with the 
     process that produces embryos that were fit for implantation, 
     and they argue that they are used in the reproductive process 
     differently.

  I am talking about the use of embryonic stem cell research in a 
cloning procedure, where you create a clone, take the embryonic stem 
cells from the clone.
  This is what Professor Thompson says:

       So you are trying to define it away and it doesn't work. If 
     you create an embryo by nuclear transfer and you give it to 
     somebody, you didn't know where it came from, there would be 
     no test you could do on that embryo to say where it came 
     from. It is what it is. It is an embryo. It is a young human 
     life. It's true that they have much lower probability of 
     giving rise to a child, but by any reasonable definition, at 
     least at some frequency, you are creating an embryo. If you 
     are trying to define it away, you are being disingenuous.

  My colleagues started to raise the issue that if you create an embryo 
by process of cloning, it is not really a young human life. But if you 
create an embryo that is a sheep, like Dolly, and grow it up to be 
Dolly the sheep, is Dolly not a sheep? Would that be the contention? 
That is simply not the case when they are creating a cloned individual 
or cloned human being, and that goes into the next step in this debate, 
to discuss human cloning. The other side calls it somatic nuclear cell 
transfer--the same process that created Dolly.
  My point is that that is the next step on this continuum. We are 
talking about embryonic stem cell research funding and the lack of 
production taking place there for human treatment. The next step is 
that we need to clone and then we need to clone the individual and not 
harvest it in a day or two, but we need to grow the fetus out several 
weeks so we have sort of fetal farming, which is a ghastly thing to 
even consider. Yet it is being talked about in some research circles.
  I conclude with the statement that if we want to be successful in 
this area and treat people, which I believe is the measure that we 
should go by--the treatment of individuals--our best bet, if my 
colleagues want human treatments to take place, they want to cure 
people, if that is what their effort is, let's fund what is working, 
which is adult cord blood. Let's move off of this politicized debate 
which is about the definition of young human life. Let's move off this 
debate and do something that is curing people. And we can.
  That is the way we ought to go in this debate. We ought to also pass 
the Enzi proposal that gets more people health insurance, which is 
where we should focus this debate now because that is what we are 
talking about, rather than a politicized issue of embryonic stem cell 
research, which has not worked and is not working.
  I yield the floor.

                               Exhibit 1

                Adult & Non-Embryonic Stem Cell Research

                   Advances & Updates for April 2006


       HIGHLIGHT OF THE MONTH--STEM CELL HOPE FOR LIVER PATIENTS

       British doctors reported treatment of 5 patients with liver 
     failure with the patients' own adult stem cells. Four of the 
     5 patients showed improvement, and 2 patients regained near 
     normal liver function. The authors noted: ``Liver 
     transplantation is the only current therapeutic modality for 
     liver failure but it is available to only a small proportion 
     of patients due to the shortage of organ donors. Adult stem 
     cell therapy could solve the problem of degenerative 
     disorders, including liver disease, in which organ 
     transplantation is inappropriate or there is a shortage of 
     organ donors.''--Stem Cells Express, Mar. 30, 2006


         ADVANCES IN HUMAN TREATMENTS USING ADULT STEM CELLS--

       Buerger's Disease: Scientists in Korea using adult stem 
     cell treatments showed significant improvement in the limbs 
     of patients with Buergers disease, where blood vessels are 
     blocked and inflamed, eventually leading to tissue 
     destruction and gangrene in the limb. Out of 27 patients 
     there was a 79% positive response rate and improvement in the 
     limbs, including the healing of previously non-healing 
     ulcers.--Stem Cells Express, Jan. 26, 2006
       Bladder Disease: Doctors at Wake Forest constructed new 
     bladders for 7 patients with bladder disease, using the 
     patients' own progenitor cells grown on an artificial 
     framework in the laboratory. When implanted back into the 
     patients, the tissue-engineered bladders appeared to function 
     normally and improved the patients' conditions. ``This 
     suggests that tissue engineering may one day be a solution to 
     the shortage of donor organs in this country for those 
     needing transplants,'' said Dr. Anthony Atala, the lead 
     researcher.--The Lancet, Apr. 4, 2006; reported by the AP, 
     Apr. 4, 2006
       Lupus: Adult Stem Cell Transplant Offers Promise for Severe 
     Lupus--Dr. Richard Burt of Northwestern Memorial Hospital is 
     pioneering new research that uses a patient's own adult stem 
     cells to treat extremely severe cases of lupus and other 
     autoimmune diseases such as multiple sclerosis and rheumatoid 
     arthritis. In a recent study of 50 patients with lupus, the 
     treatment with the patients' adult stem cells resulted in 
     stabilization of the disease or even improvement of previous 
     organ damage, and greatly increased survival of patients. 
     ``We bring the patient in, and we give them chemo to destroy 
     their immune system,'' Dr. Burt said. ``And then right after 
     the chemotherapy, we infuse the stems cells to make a brand-
     new immune system.''--ABC News, Apr. 11, 2006; Journal of the 
     American Medical Assn, Feb. 1, 2006
       Cancer: Bush policy may help cure cancer--``Unlike 
     embryonic stem cells . . . cancer stem cells are mutated 
     forms of adult stem cells. . . . Interest in the [adult stem 
     cell] field is growing rapidly, thanks in part, 
     paradoxically, to President George W. Bush's restrictions on 
     embryonic-stem-cell research. Some of the federal funds that 
     might otherwise have gone to embryonic stem cells could be 
     finding their way into cancer [adult]-stem-cell studies.''--
     Time: Stem Cells that Kill, Apr. 17, 2006
       Heart: Adult stem cells may inhibit remodeling and make the 
     heart pump better and more efficiently.--Researchers in 
     Pittsburgh have shown that adding a patient's adult stem 
     cells along with bypass surgery can give significant 
     improvement for those with chronic heart failure. Ten 
     patients treated with their own bone marrow adult stem cells 
     improved well beyond patients who had only standard bypass 
     surgery. In addition, scientists in Arkansas and Boston 
     administered the protein G-CSF to advanced heart failure 
     patients, to activate the patients' bone marrow adult stem 
     cells, and found significant heart improvement 9 months after 
     the treatment.--Journal of Thoracic and Cardiovascular 
     Surgery, Dec., 2005; American Journal of Cardiology, Mar., 
     2006
       Stroke: Mobilizing adult stem cells helps stroke patients--
     Researchers in Taiwan have shown that mobilizing a stroke 
     patient's bone marrow adult stem cells can improve

[[Page S4203]]

     recovery. Seven stroke patients were given injections of a 
     protein--G-CSF--that encourages bone marrow stem cells to 
     leave the marrow and enter the bloodstream. From there, they 
     home in on damaged brain tissue and stimulate repair. The 7 
     patients showed significantly greater improvement after 
     stroke than patients receiving standard care.--Canadian 
     Medical Association Journal Mar. 3, 2006

     69 Current Human Clinical Applications Using Adult Stem Cells


                    Anemias & Other Blood Conditions

       Sickle cell anemia, Sideroblastic anemia, Aplastic anemia, 
     Red cell aplasia (failure of red blood cell development), 
     Amegakaryocytic thrombocytopenia, Thalassemia (genetic 
     [inherited] disorders all of which involve underproduction of 
     hemoglobin), Primary amyloidosis (A disorder of plasma 
     cells), Diamond blackfan anemia, Fanconi's anemia, Chronic 
     Epstein-Barr infection (similar to Mono).


                          Auto-Immune Diseases

       Systemic lupus (auto-immune condition that can affect skin, 
     heart, lungs, kidneys, joints, and nervous system), Sjogren's 
     syndrome (autoimmune disease w/symptoms similar to 
     arthritis), Myasthenia (An autoimmune neuromuscular 
     disorder), Autoimmune cytopenia, Scleromyxedema (skin 
     condition), Scleroderma (skin disorder), Crohn's disease 
     (chronic inflammatory disease of the intestines), Behcet's 
     disease, Rheumatoid arthritis, Juvenile arthritis, Multiple 
     sclerosis, Polychondritis (chronic disorder of the cartilage) 
     Systemic vasculitis (inflammation of the blood vessels), 
     Alopecia universalis, Buerger's disease (limb vessel 
     constriction, inflammation).


                                 Cancer

       Brain tumors--medulloblastoma and glioma, Retinoblastoma 
     (cancer), Ovarian cancer, Skin cancer: Merkel cell carcinoma, 
     Testicular cancer, Lymphoma, Non-Hodgkin's lymphoma, 
     Hodgkin's lymphoma, Acute lymphoblastic leukemia, Acute 
     myelogenous leukemia, Chronic myelogenous leukemia, Juvenile 
     myelomonocytic leukemia, Cancer of the lymph nodes: 
     Angioimmunoblastic lymphadenopathy, Multiple myeloma (cancer 
     affecting white blood cells of the immune system), 
     Myelodysplasia (bone marrow disorder), Breast cancer, 
     Neuroblastoma (childhood cancer of the nervous system), Renal 
     cell carcinoma (cancer of the kidney), Soft tissue sarcoma 
     (malignant tumor that begins in the muscle, fat, fibrous 
     tissue, blood vessels), Various solid tumors, Waldenstrom's 
     macroglobulinemia (type of lymphoma), Hemophagocytic 
     lymphohistiocyctosis, POEMS syndrome (osteosclerotic 
     myeloma), Myelofibrosis.


                             Cardiovascular

       Acute Heart damage, Chronic coronary artery disease.


                           Immunodeficiencies

       Severe combined immunodeficiency syndrome, X-linked 
     lymphoproliferative syndrome, X-linked hyper immunoglobulin M 
     syndrome.


                             Liver Disease

       Chronic liver failure.


                Neural Degenerative Diseases & Injuries

       Parkinson's disease, Spinal cord injury, Stroke damage.


                                 Ocular

       Corneal regeneration.


                           Wounds & Injuries

       Limb gangrene, Surface wound healing, Jawbone replacement, 
     Skull bone repair.


                       Other Metabolic Disorders

       Sandhoff disease (hereditary genetic disorder), Hurler's 
     syndrome (hereditary genetic disorder), Osteogenesis 
     imperfecta (bone/cartilage disorder), Krabbe Leukodystrophy 
     (hereditary genetic disorder), Osteopetrosis (genetic bone 
     disorder), Cerebral X-linked adrenoleukodystrophy.

                               Exhibit 2

                                                 October 27, 2004.
     Senator John F. Kerry,
     John Kerry for President,
     Washington, DC.
       Dear Senator Kerry: Recently you have made the promotion of 
     embryonic stem cell research, including the cloning of human 
     embryos for research purposes, into a centerpiece of your 
     campaign. You have said you will make such research a ``top 
     priority'' for government, academia and medicine (Los Angeles 
     Times, 10/17/04). You have even equated support for this 
     research with respect for ``science,'' and said that science 
     must be freed from ``ideology'' to produce miracle cures for 
     numerous diseases.
       As professionals trained in the life sciences we are 
     alarmed at these statements.
       First, your statements misrepresent science. In itself, 
     science is not a policy or a political program. Science is a 
     systematic method for developing and testing hypotheses about 
     the physical world. It does not ``promise'' miracle cures 
     based on scanty evidence. When scientists make such 
     assertions, they are acting as individuals, out of their own 
     personal faith and hopes, not as the voice of ``science''. If 
     such scientists allow their individual faith in the future of 
     embryonic stem cell research to be interpreted as a reliable 
     prediction of the outcome of this research, they are acting 
     irresponsibly.
       Second, it is no mere ``ideology'' to be concerned about 
     the possible misuse of humans in scientific research. Federal 
     bioethics advisory groups, serving under both Democratic and 
     Republican presidents, have affirmed that the human embryo is 
     a developing form of human life that deserves respect. Indeed 
     you have said that human life begins at conception, that 
     fertilization produces a ``human being.'' To equate concern 
     for these beings with mere ``ideology'' is to dismiss the 
     entire history of efforts to protect human subjects from 
     research abuse.
       Third, the statements you have made regarding the purported 
     medical applications of embryonic stem cells reach far beyond 
     any credible evidence, ignoring the limited state of our 
     knowledge about embryonic stem cells and the advances in 
     other areas of research that may render use of these cells 
     unnecessary for many applications. To make such exaggerated 
     claims, at this stage of our knowledge, is not only 
     scientifically irresponsible--it is deceptive and cruel to 
     millions of patients and their families who hope desperately 
     for cures and have come to rely on the scientific community 
     for accurate information.
       What does science tell us about embryonic stem cells? The 
     facts can be summed up as follows:
       At present these cells can be obtained only by destroying 
     live human embryos at the blastocyst (4-7 days old) stage. 
     They proliferate rapidly and are extremely versatile, 
     ultimately capable (in an embryonic environment) of forming 
     any kind of cell found in the developed human body. Yet 
     there is scant scientific evidence that embryonic stem 
     cells will form normal tissues in a culture dish, and the 
     very versatility of these cells is now known to be a 
     disadvantage as well--embryonic stem cells are difficult 
     to develop into a stable cell line, spontaneously 
     accumulate genetic abnormalities in culture, and are prone 
     to uncontrollable growth and tumor formation when placed 
     in animals.
       Almost 25 years of research using mouse embryonic stem 
     cells have produced limited indications of clinical benefit 
     in some animals, as well as indications of serious and 
     potentially lethal side-effects. Based on this evidence, 
     claims of a safe and reliable treatment for any disease in 
     humans are premature at best.
       Embryonic stem cells obtained by destroying cloned human 
     embryos pose an additional ethical issue--that of creating 
     human lives solely to destroy them for research--and may pose 
     added practical problems as well. The cloning process is now 
     known to produce many problems of chaotic gene expression, 
     and this may affect the usefulness and safety of these cells. 
     Nor is it proven that cloning will prevent all rejection of 
     embryonic stem cells, as even genetically matched stem cells 
     from cloning are sometimes rejected by animal hosts. Some 
     animal trials in research cloning have required placing 
     cloned embryos in a womb and developing them to the fetal 
     stage, then destroying them for their more developed tissues, 
     to provide clinical benefit--surely an approach that poses 
     horrific ethical issues if applied to humans.
       Non-embryonic stem cells have also received increasing 
     scientific attention. Here the trajectory has been very 
     different from that of embryonic stem cells: Instead of 
     developing these cells and deducing that they may someday 
     have a clinical use, researchers have discovered them 
     producing undoubted clinical benefits and then sought to 
     better understand how and why they work so they can be put to 
     more uses. Bone marrow transplants were benefiting patients 
     with various forms of cancer for many years before it was 
     understood that the active ingredients in these transplants 
     are stem cells. Non-embryonic stem cells have been discovered 
     in many unexpected tissues--in blood, nerve, fat, skin, 
     muscle, umbilical cord blood, placenta, even dental pulp--and 
     dozens of studies indicate that they are far more versatile 
     than once thought. Use of these cells poses no serious 
     ethical problem, and may avoid all problems of tissue 
     rejection if stem cells can be obtained from a patient for 
     use in that same patient. Clinical use of non-embryonic stem 
     cells has grown greatly in recent years. In contrast to 
     embryonic stem cells, adult stem cells are in established or 
     experimental use to treat human patients with several dozen 
     conditions, according to the National Institutes of Health 
     and the National Marrow Donor Program (Cong. Record, 
     September 9, 2004, pages H6956-7). They have been or are 
     being assessed in human trials for treatment of spinal cord 
     injury, Parkinson's disease, stroke, cardiac damage, multiple 
     sclerosis, and so on. The results of these experimental 
     trials will help us better assess the medical prospects for 
     stem cell therapies.
       In the case of many conditions, advances are likely to come 
     from sources other than any kind of stem cell. For example, 
     there is a strong scientific consensus that complex diseases 
     such as Alzheimer's are unlikely to be treated by any stem 
     cell therapy. When asked recently why so many people 
     nonetheless believe that embryonic stem cells will provide a 
     cure for Alzheimer's disease, NIH stem cell expert Ron McKay 
     commented that ``people need a fairy tale'' (Washington Post, 
     June 10, 2004, page A3). Similarly, autoimmune diseases like 
     juvenile diabetes, lupus and MS are unlikely to benefit from 
     simple addition of new cells unless the underlying problem--a 
     faulty immune system that attacks the body's own cells as 
     though they were foreign invaders--is corrected.
       In short, embryonic stem cells pose one especially 
     controversial avenue toward understanding and (perhaps) 
     someday treating various degenerative diseases. Based on the 
     available evidence, no one can predict with

[[Page S4204]]

     certainty whether they will ever produce clinical benefits--
     much less whether they will produce benefits unobtainable by 
     other, less ethically problematic means.
       Therefore, to turn this one approach into a political 
     campaign--even more, to declare that it will be a ``top 
     priority'' or receive any particular amount of federal 
     funding, regardless of future evidence or the usual 
     scientific peer review process--is, in our view, 
     irresponsible. It is, in fact, a subordination of science to 
     ideology.
       Because politicians, biotechnology interests and even some 
     scientists have publicly exaggerated the ``promise'' of 
     embryonic stem cells, public perceptions of this avenue have 
     become skewed and unrealistic. Politicians may hope to 
     benefit from these false hopes to win elections, knowing that 
     the collision of these hopes with reality will come only 
     after they win their races. The scientific and medical 
     professions have no such luxury. When desperate patients 
     discover that they have been subjected to a salesman's pitch 
     rather than an objective and candid assessment of 
     possibilities, we have reason to fear a public backlash 
     against the credibility of our professions. We urge you not 
     to exacerbate this problem now by repeating false promises 
     that exploit patients' hopes for political gain.
       Signed by 57 doctors.

  The PRESIDING OFFICER (Mr. CORNYN). The Senator from Minnesota is 
recognized.
  Mr. DAYTON. Mr. President, I ask unanimous consent to speak for 15 
minutes as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                      Report on Hurricane Katrina

  Mr. DAYTON. Mr. President, last week the Senate Committee on Homeland 
Security and Governmental Affairs, of which I am a member, approved its 
report titled ``Hurricane Katrina, A Nation Still Unprepared.'' The 
committee's distinguished chairman set today as the deadline for 
additional views.
  I reluctantly voted not to approve that draft of the report last week 
because it is seriously incomplete. While it is still lacking all of 
the information, documents, and testimony which President Bush and his 
subordinates denied the committee, last March 15 the ranking member 
asked the chairman to subpoena witnesses and documents that have been 
withheld by the White House. Regrettably, she declined to do so.
  Earlier this year, on January 12, the chairman and ranking member 
wrote the White House Chief of Staff, Mr. Andrew Card, regarding the 
information they had previously requested. Their letter stated, in 
part:

       This practice (of withholding information) must cease.

  It continued:

       We are willing to discuss claims of executive privilege 
     asserted by the White House, either directly or through a 
     Federal agency. But we will not stand for blanket 
     instructions to refuse answering any questions concerning any 
     communications with the EOP [Executive Office of the 
     President].

  Their insistence that either administration officials comply with 
this oversight committee's rightful demands or the President invoke his 
executive privilege not to do so was entirely appropriate. 
Unfortunately, when Mr. Card and his subordinates still refused to 
comply, the chairman denied the ranking member's request to issue 
subpoenas.
  Regrettably, at its markup of the draft report, the Senate committee 
failed to support my motion to subpoena those documents and witnesses, 
which were being withheld by the White House without claim to executive 
privilege, and which were being wrongfully denied by executive 
agencies.
  The administration's refusal to comply and cooperate with this 
investigation is deplorable, as is the Homeland Security Committee's 
failure to back the chairman and ranking member's proper insistence 
that the White House do so. That committee is charged by the full 
Senate with the responsibility to oversee the agencies, programs, and 
activities that are related to homeland security. The committee was 
expressly directed by the Senate majority leader to examine the Bush 
administration's failure to respond quickly or effectively to the 
disasters caused by Hurricane Katrina. This investigation is not 
complete without all of the information requested from the 
administration. Furthermore, the report's findings and conclusions can 
hardly be considered reliable if the White House has decided what 
information to provide and what information to withhold from the 
committee.
  This unfortunate acquiescence confirms the judgment of the Senate 
Democratic leader that an independent bipartisan commission was 
necessary to ensure complete and unbiased investigation into the failed 
Federal, State, and local responses to Hurricane Katrina. His request 
has been repeatedly denied by the majority, with the assurance that the 
Senate committee would fulfill those responsibilities. Tragically and 
reprehensibly, it has failed to do so. Thus, the committee failed the 
Senate's constitutional obligations to be an independent, coequal 
branch of Government from the executive. It also failed the long-
suffering victims of Hurricane Katrina, who deserve to know why their 
governments failed them, and all of the American people, who depend 
upon their elected representatives to protect their lives and their 
interests, without regard to partisan political considerations. That 
partisanship includes unjustified protection of an administration of 
the same political party, as much as undue criticism of one from 
another party.
  That partisan protectionism is especially unwarranted given 
widespread agreement about the urgent need to understand the failures 
during and after Hurricane Katrina and to remedy them before another 
large-scale disaster, God forbid, should occur.
  Now, 8 months after the hurricane, the lack of progress in cleanup, 
repair, and reconstruction in devastated areas provides further 
evidence of the Federal Government's continuing failure to respond 
efficiently or effectively. There is no time in which the helping hand 
of Government is more urgently needed and more surely deserved than 
during and after a disaster. Victims are damaged or devastated 
physically, emotionally, and financially.
  Local officials and their public services are overwhelmed, if not 
destroyed. They need a Federal emergency response organization 
comprised of experienced, dedicated professionals, who have the 
resources necessary to alleviate short-term suffering and commence 
long-term recovery, and also have the authority to expeditiously commit 
those resources.
  What the failed Federal response to Hurricane Katrina showed is the 
utter ineptitude of the Federal Emergency Management Agency, known as 
FEMA. Even worse, FEMA's indifference and incompetence in the aftermath 
of Katrina was not an isolated instance. In my direct experience with 
FEMA's disaster relief responses in Minnesota, the agency is too often 
a major obstruction to recovery projects rather than a principal ally.
  Thus, I agree with the report's recommendation to create a new, 
comprehensive emergency management organization, to prepare for and 
respond to all disasters and catastrophes. I remain openminded about 
whether this new entity should remain within the Department of Homeland 
Security, as this recommendation intends, or be established as a 
separate Federal agency. The challenge for the committee, for all of 
Congress, and for the administration will be to actually recreate an 
existing Federal agency which has become dysfunctional and 
nonfunctional. Merely ``reforming'' FEMA by rearranging some boxes and 
lines in its organizational chart, revising it, and giving its head a 
new title, will be woefully inadequate. The new organization must be 
more streamlined, centralized, and compact than its predecessor. It 
must be less bureaucratic, less consumed with regulatory minutiae, and 
less resistant to local recovery initiatives. It must spend less time 
creating complex plans and cumbersome procedures, and more time in 
training and perfecting action responses to emergency situations.
  History shows that ``if a student does not learn the lesson, the 
teacher reappears.'' This report describes some of the most important 
lessons from the failed response to Hurricane Katrina. The committee's 
and this Congress's subsequent actions to correct these serious 
deficiencies before the next catastrophe will indicate whether those 
lessons will be learned.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.

[[Page S4205]]

  Mr. AKAKA. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. AKAKA. Mr. President, I ask unanimous consent that I be allowed 
to speak for 10 minutes as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


         Native Hawaiian Government Reorganization Act of 2005

  Mr. AKAKA. Mr. President, I rise today to talk about bipartisan 
legislation that is of critical importance to the people of Hawaii. S. 
147, the Native Hawaiian Government Reorganization Act of 2005, would 
extend the Federal policy of self-governance and self-determination to 
Hawaii's indigenous peoples, Native Hawaiians, by authorizing a process 
for the reorganization of a Native Hawaiian governing entity for the 
purposes of a government-to-government relationship with the United 
States.
  Together with my senior Senator and the rest of Hawaii's 
congressional delegation, I first introduced this bill in 1999. The 
bill passed the House in 2000, but, unfortunately, the Senate adjourned 
before we could complete consideration of that bill.
  Since then, I have introduced a bill every Congress. In every 
Congress, the committees of jurisdiction--the Senate Committee on 
Indian Affairs and the House Committee on Resources--have favorably 
reported the bill and its companion measure.
  I thank the majority leader, the senior Senator from Tennessee, who 
is working to uphold his commitment to bring this bill to the Senate 
floor for a debate and rollcall vote. I must tell my colleagues that he 
did try to meet his commitment in September 2005 and did schedule it 
for the floor. But at that time, Katrina happened, and we took it off 
the calendar.
  I also appreciate the efforts of my colleague from Arizona who 
opposes the bill on substance, but has worked with me to uphold his 
promise to allow the bill to come to the floor for debate and rollcall 
vote.
  S. 147 does three things. First, it authorizes the Office of Native 
Hawaiian Relations in the Department of the Interior. The office is 
intended to serve as a liaison between Native Hawaiians and the United 
States. It is not intended to become another Bureau of Indian Affairs, 
as the current program for Native Hawaiians will remain with the 
agencies that currently administer those programs.
  Second, the bill establishes the Native Hawaiian interagency 
coordinating group. This is a Federal working group to be composed of 
representatives from Federal agencies who administer programs and 
services for Native Hawaiians. There is no statutory requirement for 
these agencies to work together. This working group can coordinate 
policies to ensure consistency and prevent unnecessary duplication in 
Federal policies impacting Native Hawaiians.
  Finally, the bill authorizes a process for the reorganization of the 
Native Hawaiian governing entity. And we ask: Why do we need to 
organize the entity? It is because the Native Hawaiian Government was 
overthrown with the assistance of U.S. agents in 1893. Rather than shed 
the blood of the people, our beloved queen, Queen Lili`uokalani, 
abdicated her throne after being arrested and imprisoned in her own 
home.
  Following the overthrow, a republic was formed. Any reformation of a 
native governing entity has been discouraged. Despite this fact, Native 
Hawaiians have established distinct communities and retained their 
language, culture, and traditions. They have done so in a way that also 
allows other cultures to flourish in Hawaii. Now their generosity is 
being used against them by opponents of this bill who claim that 
because Native Hawaiians do not have a governing entity, they cannot 
partake in the Federal policy of self-governance and self-determination 
that is offered to their native brethren in the United States.
  My bill authorizes a process for the reorganization of the Native 
Hawaiian governing entity for the purposes of a federally recognized 
government-to-government relationship. There are many checks and 
balances in this process which has the structure necessary to comply--
to comply--with Federal law and still maintains the flexibility for 
Native Hawaiians to determine the outcome of this process.
  Further, my bill includes a negotiations process between the Native 
Hawaiian governing entity, the State of Hawaii, and the United States 
to address issues such as lands, natural resources, assets, criminal 
and civil jurisdiction, and historical grievances. Nothing that is 
currently within the jurisdiction of another level of government can be 
conveyed to the Native Hawaiian Government without going through this 
negotiations process.
  I am proud of the fact that this bill respects the rights of Hawaii's 
indigenous peoples through a process that is consistent with Federal 
law and it provides the structured process for the people of Hawaii to 
address the longstanding issues which have plagued both Native 
Hawaiians and non-Native Hawaiians since the overthrow of the Kingdom 
of Hawaii.
  I want to reiterate to my colleagues that this bill is not race 
based. This bill is based on the Federal policies toward indigenous 
peoples. Those who characterize this bill as race based fail to 
understand the Federal policies toward indigenous peoples. Those who 
characterize this bill as race based fail to understand the legal and 
political relationship the United States had with the indigenous 
peoples and their governments preexisting the United States.

  Finally, those who characterize this bill as race based are saying 
that Native Hawaiians are not native enough. I find this offensive. And 
I ask that my colleagues join me in my efforts to bring parity to 
Native Hawaiians by enacting my bill.
  This effort will continue from day-to-day here. We will continue to 
bring forward the history of Hawaii and the reasons why we are trying 
to enact this bill, not only for the benefit of the indigenous people 
of Hawaii but for the benefit of the United States as well.
  Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. VOINOVICH. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Thune). Without objection, it is so 
ordered.

                          ____________________