[Congressional Record Volume 153, Number 167 (Wednesday, October 31, 2007)]
[Senate]
[Pages S13598-S13611]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




CHILDREN'S HEALTH INSURANCE PROGRAM REAUTHORIZATION ACT OF 2007--MOTION 
                               TO PROCEED

  The PRESIDING OFFICER. Under the previous order, the Senate will 
resume consideration of the motion to proceed to H.R. 3963, which the 
clerk will report.
  The legislative clerk read as follows:

       A motion to proceed to the bill (H.R. 3963) to amend title 
     XXI of the Social Security Act to extend and improve the 
     Children's Health Insurance Program, and for other purposes.

  The PRESIDING OFFICER. The Senator from North Dakota.
  Mr. DORGAN. Mr. President, I ask unanimous consent that the cloture 
vote on the motion to proceed to the children's health insurance bill, 
H.R. 3963, occur at 3:45 p.m. today, and that if cloture is invoked it 
be considered invoked as if the vote had occurred at 6:30 p.m. today 
and concluded at 6:50 p.m., with the time following the conclusion of 
morning business prior to the vote equally divided between the two 
leaders or their designees.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. DORGAN. Mr. President, I wish to yield to myself 30 minutes, and 
I also ask unanimous consent that Senator Kennedy be yielded 30 minutes 
of the majority's time.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from North Dakota is recognized.
  Mr. DORGAN. Mr. President, I am going to talk about a couple subjects 
this afternoon. I am going to begin, however, talking about the issue 
of children's health insurance.
  The Children's Health Insurance Program will be the subject of the 
cloture vote later this afternoon, and it is a very important issue. We 
have a lot of children in this country who do not have health insurance 
coverage. Ten years ago, we put together a piece of legislation called 
the Children's Health Insurance Program. It has worked. It has been 
very successful. Millions of children who otherwise would not have had 
health insurance coverage now have health insurance coverage.
  The President, when he campaigned for office a couple of years ago, 
said he supported and wanted to expand the Children's Health Insurance 
Program to cover more children. The Congress, on a bipartisan basis, 
has now passed the Children's Health Insurance Program reauthorization 
that would provide additional coverage for nearly 4 million additional 
children in this country--3.8 million additional children, to be exact. 
The President vetoed it--this after he campaigned saying he supported 
expanding the program. In fact, not only did he veto the expansion of 
the program--that was done on a bipartisan basis in the Congress, and 
fully paid for, I might say--but he sent Congress a budget that left 21 
States without enough money to continue to cover the existing kids in 
the program.
  So this administration has it wrong. That is not just me saying it, 
it is a bipartisan group of Members of Congress who believe very 
strongly we need to do what is right to try to get health insurance to 
children. We should try to make sure every American has health 
insurance. That is very important. But it seems to me if you do not 
have legislation that does that, at least start with the children.
  I have said before, I do not know what is in second or third or 
fourth place in most people's lives in terms of what is important, but 
I know what is in first place in the lives of most people. It is their 
children and their children's health. If this is not a priority, if it 
is not a priority at the White House--it passed the Senate with a wide 
margin, passed the House with a wide margin, but we did not have 67 
percent of the votes in the House to override the veto--if it is not a 
priority at the White House, I ask what is a priority? If providing 
health care for an additional 3.8 million children is not a priority, 
what are the priorities at the White House? What is more important?
  Once again, this may be unfamiliar territory to the President because 
this is a piece of legislation that is fully paid for, unlike much of 
what we get from the White House these days. I am going to talk about 
that in a bit. But before us here in Congress, the President has two 
requests. In addition to his regular budget, the President has said to 
us: I want another $196 billion for the purposes of continuing the war 
in Iraq and Afghanistan. And he said: I want the $196 billion declared 
an emergency. I do not propose we pay for it. I propose we put it all 
on top of the debt. That will take us to almost two-thirds of a 
trillion dollars the President has asked for--none of it paid for, all 
of it requested by the President as an emergency.
  Contrast that, by the way, a $196 billion emergency request--none of 
it paid for--with a bipartisan group in the Congress that says: We 
believe the priority is our children. We propose to cover 3.8 million 
additional kids with health insurance coverage, and we fully pay for 
it. That is a very significant departure from what we hear at the White 
House these days.
  Now the President gases up Air Force One, flies all over the country, 
and flew

[[Page S13599]]

down to Arkansas not many days ago and said: I am the fiscal policy 
President. I am going to get tough. I am vetoing bills. Interestingly, 
he did not veto a bill in the 6 years his party controlled both 
branches of Congress. He did not veto bills in the 6 years in which, in 
nearly every case, the appropriations coming out of the Congress 
exceeded his request or at least were dramatically changed from his 
request.
  It is now, only in the shadows, the evening hours of his Presidency 
he decides he wants to be a fiscal policy President, tough on fiscal 
policy. The problem is, it is not so much what you say that matters, it 
is what you do that matters, and he has before us one more 
demonstration of the reckless fiscal policy we have seen now for some 
years, turning a very significant budget surplus, when he took office--
and, yes, we had a budget surplus of about $240 billion in that year--
turning that into a stream of fiscal policy budget deficits, adding $3 
trillion to the Federal debt, and asking us, once again: Please give me 
another $196 billion above all the regular appropriations.

  By the way, even as he asks for the additional $196 billion, he says 
we cannot afford providing insurance coverage for 3.8 million kids whom 
we fully pay for in a bipartisan bill.
  I am telling you, I think the President is wrong. I admire the fact 
this is a bipartisan bill. We did it the right way. The President will 
have a second opportunity to have a bill on his desk. My hope is he 
will understand the good faith and goodwill of bipartisan Members of 
Congress who have the right priorities, saying our children come first 
and children's health insurance is very important.


                   Indian Health Care Improvement Act

  Mr. President, that leads me to talk about a health insurance issue 
that includes the Children's Health Insurance Program but is much more 
than that. It is a bill that is going to come to the floor of the 
Senate soon, and thanks to the commitment by Senator Reid, the majority 
leader, it is the reauthorization of the Indian Health Care Improvement 
Act.
  It has been 8 years since Congress should have reauthorized the 
Indian Health Care Improvement Act--8 years--long past due, long past 
the time for us to have done this. The fact is, in this country we have 
2 million of the first Americans--they were here greeting the folks who 
came to this country--American Indians, and many of them live in Third 
World conditions, and many of them experience health care rationing, 
which I think is a scandal.
  It is not written much about these days, unfortunately. But there is 
a full-blown scandal, in my judgment, with respect to health care that 
is not available to American Indians--health care that was promised, 
health care that was committed, and health care that is our trust 
responsibility as a government to American Indians. We made that 
commitment, and we are not keeping it.
  Indian children will benefit from children's health insurance as 
well. But also, Indian children live--and in some cases die--with the 
results of the Indian health care system.
  This young lady shown in this picture is a 5-year-old beautiful young 
girl--sparkling eyes, with a beautiful dress, dancing in the 
traditional Indian dress--5 years old. Her grandmother, who testified 
at the Crow Indian Reservation, at a hearing I headed with Senator 
Tester, held this picture up. Her name is Ta'shon Rain Littlelight--5 
years old.
  Ta'shon died. Her grandmother brought her photograph to the hearing 
and held it high. She talked about her granddaughter. She said Ta'shon 
lived the last 3 months of her life in unmedicated pain, and died of 
terminal cancer. She was taken and taken and taken again to the Indian 
Health Service, was diagnosed with depression, and treated for 
depression. Ultimately, it was discovered she had terminal cancer--not 
depression, terminal cancer.
  She was flown to Billings, MT, and then to Denver, CO, and this young 
5-year-old is gone. Her grandmother asks the question: Would better 
health care have saved her? Should she have been diagnosed in a 
different manner? I don't know the answer to that. I do know this: 
There are too many children like Ta'shon Rain Littlelight who do not 
have the same health care as others have, and Ta'shon lost her life.
  It is not just this beautiful little girl. This is the photograph of 
a young girl whose photograph I have shown my colleagues before. Her 
name is Avis Littlewind. Avis Littlewind is also dead--14 years old. 
She took her own life. Her sister took her own life. Her father died at 
his own hand. She was in a fetal position in bed in her bedroom for 90 
days at age 14, and somehow no one quite figured out this young lady 
desperately needed mental health treatment. So she took her life.
  I went to that Indian reservation. I talked to the school officials. 
I talked to Avis Littlewind's classmates. I talked to the tribal 
officials to try to understand: How does a 14-year-old child fall 
through the cracks?
  Well, there was not mental health treatment available in any 
significant way for this young child. The people who would get her 
health care would have to beg and borrow a car to drive her someplace. 
But she is gone. This young girl apparently felt hopeless and helpless 
and took her own life.
  The question I ask with respect to the mental health treatment she 
should have gotten--with respect to so many other kinds of health care 
that should be available to American Indians--the question I ask is: 
When? When will they get the health treatment they deserve?
  This is a picture of a woman from the Fort Berthold Indian 
Reservation. I have described her situation to my colleagues previously 
as well. Suspected of having a heart attack, she was put in an 
ambulance and driven to a hospital--the nearest hospital off the Indian 
reservation. Arriving at the hospital, as they were carrying her into 
the hospital, transferring her to a hospital gurney, they discovered at 
the hospital something taped to her thigh with an ordinary piece of 
tape.
  Here, as shown on this chart, is what was taped to this woman's 
thigh, as she was taken into the hospital off of a gurney, suspected of 
having a heart attack. What they found taped to her thigh was a letter 
from the Department of Health and Human Services, and it described that 
this woman was not going to be eligible for contract health funding 
because they were out of money: So if you admit this woman to your 
hospital, understand, you are on your own. Financially, you are on your 
own. We are warning you.
  That is what the letter taped to this woman's thigh said. That is 
health care today in modern America on Indian reservations.
  Now let me describe why there is an urgency to pass Indian health 
care legislation, to reauthorize the Act that should have been 
reauthorized 8 years ago.
  We spend twice as much money per person on health care for Federal 
prisoners incarcerated in our Federal prisons as we do for American 
Indians, and we have a responsibility, a trust responsibility, for 
health care for American Indians. This is not being generous. This is 
meeting a promise America made to Indians. This country made the 
promise over and over again that we would provide for their health 
care. But we have not met that promise.
  If you take a look at what we spend per capita for American Indians, 
what you will discover is, we spend half as much per person for 
American Indians as we do for Federal prisoners. We have a 
responsibility for health care for those we incarcerate. I understand. 
If you stick someone in a Federal prison, you have to take care of 
them, provide for their health care.
  Why do we spend twice as much for a Federal prisoner's health care as 
we did for Ta'shon Rain Littlelight's or Avis Littlewind's or, in per 
capita expenditures, we do for American Indians? We spend $6,700 a 
year, per capita, on Medicare expenditures, veterans, $4,600; Medicaid, 
$4,300; Federal prisoners, $3,200; Indian health program; $2,100 per 
capita. We have to do better than that. We have significant 
responsibilities, significant problems, and regrettably, full-scale 
health care rationing on many of America's Indian reservations, and I 
think it is a scandal and an outrage and we have to fix it.

  Senator Murkowski and I, as chairman and ranking member of the Indian 
Affairs Committee, have written in our committee a piece of legislation 
called the Indian Health Care Improvement Act. We are ready to bring 
that to the

[[Page S13600]]

floor of the Senate at last, at long last. Lives will be saved if we 
can pass this piece of legislation. Senator Reid has given us a 
commitment that we will have this piece of legislation on the floor of 
the Senate, and when we do, I think it will be a day of some 
celebration for American Indians who have been promised health care 
and, regrettably, have not received the benefit of the promises that 
were made. I am not suggesting there aren't some talented men and women 
who work in the Indian health care system and who work in public 
health. I am not suggesting there aren't some very talented people out 
there. But I can tell horror stories that are almost unbelievable.
  A woman goes to the doctor on an Indian reservation, and she has a 
knee that is unbelievably painful--bone on bone. It is the kind of knee 
that if it belonged to a Member of the Senate or one of the Senator's 
families, they would go and get a knee replacement. Bone on bone, 
unbelievably painful.
  This woman is told: Wrap your knee in cabbage leaves for 4 days, and 
it will be fine. Well, that is not fine, and that is not medicine. That 
isn't what we should expect in terms of meeting our responsibilities in 
this country to the first Americans.
  Again, I asked the grandmother of Ta'Shon Rain Littlelight if I could 
use her image, and I do so respectfully and I do so understanding the 
delicacy of it. But when the grandmother came to the hearing and held 
up the picture of this beautiful young girl with the sparkling eyes, 
and said: My granddaughter died, and here is how she died. In 3 months 
of unmedicated pain after her terminal cancer had not been diagnosed 
for months and months and months.
  I think it is important for us to ask the question: Does this matter? 
Do we care? I hope the answer is yes, it does matter and, yes, this 
Congress does care and, yes, this Congress is going to meet its 
responsibility. I hope in the coming weeks that certainly will be the 
case, starting here in the Senate.
  Mr. President, I yield the floor, and I make a point of order that a 
quorum is not present.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. DORGAN. 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. DORGAN. Mr. President, how much time remains?
  The PRESIDING OFFICER. There is 13 minutes remaining.


                             Fiscal Policy

  Mr. DORGAN. Mr. President, I wanted to speak about the subject I 
referenced briefly, and that is fiscal policy and this President. It 
gives me no joy to come and be critical of the President's fiscal 
policy. But it should give the American people no joy either to 
understand the consequences of a fiscal policy that turned very large 
budget surpluses, which took us a long time to begin to see, into very 
long-term Federal budget deficits and three trillion dollars of 
additional debt. That is a reckless fiscal policy and one that has to 
be fixed.
  When he recently asked the Congress for an additional $196 billion--
none of it paid for, all emergency--the President said: Now we will see 
whether the Congress supports the troops. Well, the fact is, not all 
that money goes to the troops in Iraq and Afghanistan. A substantial 
portion of that money goes to contractors.
  I wanted to go through with my colleagues some examples of what we 
are finding with respect to the spending of taxpayers' money for 
contractors. I believe I have held 17 hearings over the recent 4 years 
as chairman of the Policy Committee on these issues.
  Let me put up a couple of charts to describe where we are headed.
  This is a Congressional Budget Office estimate of October of this 
year. The U.S. wars in Iraq and Afghanistan could cost taxpayers a 
total of $2.4 trillion by 2017 when you count the very large interest 
costs because this is being financed with borrowed money. Again, a 
President who says he is a conservative borrowing all of this money, 
insisting it be borrowed and not paid for, and we end up in this 
country paying a fortune for the war costs.
  So the question is, is this money for the troops? Well, let me 
describe what we have. Last month, military officials said contracts 
worth $6 billion to provide essential supplies to American troops in 
Kuwait, Iraq, and Afghanistan--including food, water, and shelter--were 
under review by criminal investigators. In addition, $88 billion in 
contracts and programs, including those for body armor for soldiers and 
material for Iraqi and Afghan security forces, are being audited for 
financial irregularities.
  Think of that: $88 billion; $6 billion under criminal investigation; 
$88 billion, financial irregularities by these contractors.
  Once again, under this President, last month the Army reported that 
it had 78 cases of fraud and corruption under investigation, had 
obtained 20 criminal indictments, and had uncovered over $15 million in 
bribes.
  Another $196 billion, while those who prance around this money have a 
field day. It doesn't seem like conservatism to me.
  Again, in August, 2 months ago, the New York Times reported:

       The enormous expenditures of American and Iraqi money on 
     the Iraq reconstruction program, at least $40 billion over 
     all, have been criticized for reasons that go well beyond the 
     corruption cases that have been uncovered so far. Weak 
     oversight, poor planning, and endless security problems have 
     contributed to many of the program failures.

  So we ante up money from the United States Congress--billions and 
billions of dollars. We are going to provide health care clinics for 
the Iraqis. We are going to build 142 health care clinics. We hire the 
contractor. The money is gone, but the clinics aren't there. An Iraqi 
doctor--a very courageous Iraqi doctor--testified at one of my 
hearings. He said: I went to the Health Minister in Iraq and said: You 
know, we had these contracts with an American contracting company that 
was going to do these 142 health care clinics in Iraq. I would like to 
visit them. The Iraqi Health Minister said to this physician: You don't 
understand. Most of those are imaginary clinics.

  Well, the American taxpayer got fleeced. The money is gone. The 
contractor got the money. The clinics don't exist.
  We can't even keep track of the guns that are being sent to Iraq. We 
sent Iraq 185,000 AK-47s, and at this point we know where 75,000 of 
them are; 110,000 are gone and unaccounted for. We sent them 170,000 
pistols, 90,000 of them we can't account for. Are some of these AK-47s 
and pistols being aimed at American troops? Of course they are. How is 
it that we fund with American taxpayers' money the shipment of massive 
quantities of weapons to Iraq and don't keep track of where they are? 
Again, there are 110,000 AK-47s, we don't know where they are, and 
80,000 pistols, we don't know where they are. This is almost staggering 
incompetence, in my judgment.
  Saddam Hussein is dead. He was hanged by the neck. The Iraqi people 
no longer have Saddam Hussein in their lives. The Iraqi people voted 
for their own new constitution, and they voted for a new government. 
All that is left for the Iraqi people is to provide for their own 
security. The question is, when will the Iraqi people demonstrate the 
will to provide for their own security?
  We have trained 360,000 Iraqis in the interior forces and defense 
forces, soldiers and police men and women--360,000 have been trained, 
and they can't provide for their own defense, for their own security. 
Is there not a will in this country in which Saddam Hussein is gone, a 
new constitution, a new government exists, and they have 360,000 people 
trained, and that training was paid for by this country--is there not a 
will, then, to provide for security? If they can't, we can't. We are 
not going to provide security in Iraq for the next 5 or 10 years. We 
should not be going door to door in Baghdad in the middle of a civil 
war with U.S. soldiers.
  But it seems to me we should reasonably ask the question: If we have 
trained 360,000 for security in Iraq, and they can't provide for their 
own security, where are they? We are now told that up to 50 percent of 
those we have trained are probably not on the job anymore. We don't 
know where they are.
  I also just saw information a couple of days ago that the number of 
people

[[Page S13601]]

we are training has dropped by two-thirds. I mean, everyone talks 
about--including the President--the way out of Iraq is to train the 
Iraqis for their own security. We have trained a third of a million of 
them and now we have reduced the amount of training by two-thirds and 
now we have a surge of American soldiers going door to door in Baghdad 
in the middle of a civil war. I am just saying I don't think that adds 
up in the context of what this administration is asking of this 
Congress.
  Between April 2003 and June of 2004, $12 billion in U.S. currency, 
much of it in one-hundred-dollar bills, was dispersed by the Coalition 
Provisional Authority. That is us. We airlifted billions of dollars in 
C-130s. Some of it was shoveled out the back of pickup trucks in 
Baghdad. You think that doesn't attract flies and people who want to 
cheat and steal? It does. What happened? About $9 billion has gone 
missing, unaccounted for, in a frenzy of mismanagement and greed, it is 
said.
  ADM David Oliver, who was a senior official of the Coalition 
Provisional Authority was asked by a reporter about what happened to 
the cash that was airlifted to Baghdad. Our official said:

       I have no idea. I can't tell you whether the money went to 
     the right things or didn't. Nor do I actually think it's 
     important.

  Oh, really? You don't think it is important whether billions of 
dollars was used for the proper purpose?
  An independent oversight agency reported this month that it could not 
complete an audit of a $1.2 billion contract to train Iraqi police 
because records kept by the State Department and by DynCorps 
International, the contractor, were inaccurate and in disarray, 
documents not sufficient to do any kind of an audit.
  The State Department paid $43.8 million for manufacturing and 
temporary storage of a residential camp that has never been used. They 
paid $36.4 million for weapons and equipment, including body armor, 
armored vehicles, and communications equipment that couldn't be 
accounted for.
  Among the problems identified before an audit--this is a New York 
Times story of this month--were duplicate payments, the purchase of a 
never-used $1.8 million x-ray scanner, and payments of $387,000 to 
house DynCorps officials in hotels rather than other available 
accommodations.
  My colleagues get my point. I could show 100 charts which would all 
show in my judgment massive, staggering incompetence and lack of 
oversight of these contracts.
  The President says: I want $196 billion in emergency funding, none of 
it paid for, and by the way, if you don't support that, you are not 
supporting the troops. Well, a substantial amount of this money is 
supporting contractors, not troops, and there is substantial evidence 
that there is dramatic waste, fraud, and abuse of these contracts, and 
no one seems to care. No one seems to be watching the store. That goes 
for the Defense Department, the Secretary of State, and many others, 
including the White House.
  Finally, when we vote on the issue of whether we should provide 
additional emergency funding for the President, and yes, for the 
troops, and also for these contractors, I am going to suggest something 
very different. Some things are habit forming, and one of them, it 
seems to me, is to ask the Congress to increase spending substantially 
and not pay for it. This President has done this now to the tune of 
two-thirds of $1 trillion for the war in Iraq and Afghanistan.
  Aside from the fact that I think it is wrong because it doesn't have 
the country going to war with the soldiers--it seems to me if you send 
soldiers to war, you also ought to ask the country to be with those 
soldiers, not just with their thoughts and prayers but also to pay for 
the cost, rather than charge it to some future generation and have the 
soldiers fight the battle, and then come back to our country and pay 
the bills for those battles.
  So I have said to my colleagues, and I would say to the President, 
when we consider this issue of additional funding, I am going to offer 
this time some ways to pay for a portion of it, and I am going to give 
some examples. I have used many of these before, but this time, we will 
have a chance to vote on them. Maybe I will win, maybe I will lose, I 
don't know. But it seems to me we ought to do some things that are 
thoughtful and patriotic, even as we decide that we are going to 
provide support to our troops.
  Let me give an example.
  Let me give you an example. I have used this many times. This is a 
five-story white building in the Cayman Islands. A very enterprising 
reporter from Bloomberg named David Evans went to that building. It is 
on Church Street. That five-story white building is home to 12,748 
corporations. They are not actually there, of course; it is legal 
fiction that was created by smart lawyers to give corporations an 
address in the Cayman Islands so they can avoid paying U.S. taxes. I 
have legislation that says it doesn't matter if you are living in this 
building, you are not going to be able to avoid taxes by doing that; if 
your operations are not there, you cannot attempt to ``move'' your 
operations there to avoid paying U.S. taxes. I will attempt to close 
that.
  This is one of the most egregious. Wachovia Bank in the United States 
is one of the most prominent companies to do this. They purchased a 
sewage system in Bochum, Germany. It is not because they have a special 
interest in sewage systems. They don't want a sewage system. They 
bought it and immediately leased it back to the German city, which 
never lost it, and the Wachovia Bank never got it. They just had a 
financial transaction that gave an American bank a $175 million tax 
writeoff for the sham of buying a sewer system in Germany.
  Mr. President, only a portion of this practice has been shut down. I 
will give my colleagues a chance to shut that down and also raise 
revenue to begin to pay for some of the costs of the war as well.
  This one is a streetcar in Dortmund, Germany. We had First Union Bank 
lease streetcars there--not for the purpose of running a streetcar 
system; they wanted to avoid paying U.S. taxes. That is a scandal.
  I will also offer a piece of legislation that will shut down the tax 
scam that says if you fire your workers, close your plant, and move 
your jobs overseas, as Huffy Bicycles did, we will give you a tax cut. 
It is unbelievable that we provide that tax cut in this country. If you 
get rid of your American workers, shut down your plant, move overseas, 
and then ship the product back here, you get a tax deferral. Huffy is 
now a Chinese bike company. All the workers in Ohio got fired, and the 
American tax system gave a reward to this company for moving to China.
  We have had a chance--four times--to vote on this, and a majority in 
the Senate supported that tax break. One of these days, it will get 
closed. We will vote on that in the context of paying for some of the 
costs the President is asking us to pay for.
  Finally, just two more.
  This is, as you know, a picture of the dancing grapes from Fruit of 
the Loom. We have seen the television commercials. I don't know why 
someone would dress up as a grape and dance, but they made an imprint 
for Fruit of the Loom underwear before they left America. I assume they 
are still dancing, but I assume those who lost their jobs when Fruit of 
the Loom went to Mexico and other countries are not dancing. It is not 
that people stopped wearing underwear, but they are not making them in 
the United States.
  Finally, the little red wagon--Radio Flyer, a Chicago company for 
over a century--is now made in China. It was for the same purpose: tax 
cuts and low wages in China. I am going to close that loophole with 
respect to the description I have just given of moving your company to 
China and getting a tax cut.
  The point is, the President wants $196 billion in emergency funding. 
I don't know whether the Congress will do that. When the President asks 
for funding in the future, saying he wants to charge this, leave 
office, and then somebody else can pay the bill, we in Congress ought 
to say that there are easy baby steps to at least begin raising some 
funding. I have named three of them. We can stop American companies 
from benefitting from buying sewage systems or streetcars in other 
countries, stop paying an incentive for people to move American jobs 
overseas, and stop allowing companies to set up sham offices on Church 
Street in the Cayman Islands to avoid paying U.S. taxes.

[[Page S13602]]

  It doesn't take a giant step or a lot of courage to decide to shut 
down those tax scams and those wrongheaded, perverse economic 
incentives. Doing that will raise money and allow us to offset some of 
these war costs. And I hope that perhaps--I know better than to say 
this. I was going to say that perhaps the President will support this. 
But this administration opposes most of the proposals I have described 
that would raise funding by shutting down some of these terrible 
loopholes.
  This issue of if the President asks the Congress for $196 billion--
which he has now done in emergency money, with none of it paid for, and 
says: Now we will see whether the Congress supports the troops, I want 
my colleagues to understand that a substantial portion of this money is 
not going to troops, but it is going to contractors. I think this is 
the most substantial waste, fraud, and abuse that has existed in the 
history of this country, with respect to what is going on with the 
contractors. That is something we should be considering or a portion of 
what we should consider as well as we react to the President's 
proposal. Who is minding the store? Who is providing real oversight? 
Why have we allowed this to happen? Those represent the hard questions 
I believe Congress has a responsibility to ask.
  We all want the right thing for this country. I think we all want to 
be able to extract ourselves from a war in the Middle East, to be 
successful in the fight against terrorism, to expand opportunities with 
an economy that provides jobs and expand the middle class in this 
country. We all want to fix the health care system and provide 
solutions to our energy needs so that we are not so unbelievably 
dependent on foreign sources of energy. We all want that. I hope in the 
coming weeks, particularly as we end this year, we can find ways to 
decide to work together. There ought to be common purpose and a common 
set of goals for us to advance the interests of this country.
  Mr. President, I yield the floor and suggest the absence of a quorum 
and ask unanimous consent that the time be equally charged to both 
sides.
  The PRESIDING OFFICER (Mr. Cardin). Without objection, it is so 
ordered.
  The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. DURBIN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Chair advises the Senator--no one else is on the floor--the 
majority has 24 minutes remaining. Senator Kennedy had reserved 30 
minutes.
  Mr. DURBIN. Mr. President, I ask unanimous consent to be recognized 
for 10 minutes to speak as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                     Congressional Approval Ratings

  Mr. DURBIN. Mr. President, there are reports in the newspaper about 
the approval ratings of politicians and political institutions. 
Certainly, the President has had some problems, has had better days. 
His numbers are low. The numbers for Congress, in many respects, as an 
institution, are even lower.
  Those of us who serve in the Congress are asked from time to time: 
What does this all mean? Why are the American people so critical of 
Congress, and what is it doing?
  I think it reflects several points. First, the last election, which 
changed control of Congress from Republicans to Democrats, many people 
believed would be a watershed, a real change in direction. They have 
looked and haven't seen it, particularly when it comes to the war in 
Iraq. Despite our best efforts in the Democratic majority in the 
Senate, with only 51 out of 100 Members, we sent the President an 
opportunity to change the direction of his policy and start bringing 
American troops home. The President used his power in the Constitution 
to veto that legislation.
  We tried over and over, with all-night sessions, long debates, a 
variety of amendments and have not been able to break through and come 
up with a solid enough, strong enough bipartisan majority to change the 
policies in Iraq.
  It is frustrating--frustrating, I am sure, to the American people, 
frustrating to us in Congress, for some who voted against the war and 
now believe this war has no end in sight and should be ended soon in a 
responsible way.
  I think that is an indication of one of the reasons why the 
disapproval numbers for Congress are what they are today.
  We tried, however, when it comes to our budget and spending in the 
Congress, to focus resources on the needs of America. We have a chance 
to do that. But, unfortunately, we face another veto threat from 
President Bush.
  Our budget that we passed includes a lot of spending that will make a 
big difference--more Border Patrol agents to protect America, 
explosives detection machines in airports, research into cancer, 
diabetes, heart disease, other major killers of Americans, a much 
stronger food safety inspection system, an issue near and dear to me, 
energy efficiency and renewable energy projects and tax cuts for 
middle-class families.
  The total difference between our spending and what the President 
requested is $22 billion out of a national budget that borders on 
passing a trillion, depending on how one counts. That is eight-tenths 
of 1 percent of the Federal budget, the difference between the 
President's request and what we are appropriating. That is less than we 
spend in 2 months on the war in Iraq. The money we want to spend in 
America is less than 2 months of the war in Iraq. It is less than half 
of what the President wants to spend next year for tax breaks for the 
wealthiest Americans.
  We have passed a lot of appropriations bills to meet long-needed, 
long-neglected wants of middle-class and working families. 
Unfortunately, the President's priorities are different. There is no 
clearer contrast in our priorities and the President's priorities than 
the issue of children's health insurance.
  Senator Kennedy has come to the floor, and I am going to yield to him 
in a moment. He has been a national leader, certainly a Senate leader 
when it comes to the issue of children's health insurance. Think about 
this: A great and good and prosperous Nation, America, with 300 million 
people, has 15 million people without health insurance.
  Ten years ago, we said: Let's move forward and do something about it. 
A Republican Congress passed the Children's Health Insurance Program, 
and we managed to find coverage for 6.6 million of those kids. Now with 
a Democratic Congress, we want to continue the program and expand it to 
cover more children. So we set a goal of 10 million children. That 
still leaves 5 million uninsured. But 10 million would be insured over 
the next 5 years. The cost? An additional $35 billion. The way we pay 
for it is direct: an increase in the Federal tobacco tax with proceeds 
going to insure children.
  We believe this is sensible, keeping in mind the kids we are talking 
about are not the poorest kids in America. The poorest kids in America 
are covered by Medicaid. They get help, and I am glad they do. It says 
something good about our Nation. The kids who are well off, with 
parents in jobs that have health insurance, have no concern. How about 
those kids right in the middle? Mom and Dad go to work every single day 
and don't have the benefit of health insurance. They may make minimum 
wage or a little better. They don't have any benefits and the kids have 
no protection.
  A child without health insurance is less likely to have a regular 
doctor, regular checkups, regular immunizations, and less likely to 
have detected in their early lives medical problems which, if left 
untreated, become very serious and very expensive.
  We wanted to help those kids. So we put a bill together with the 
support of 18 Republican Senators, all 51 Democrats. We had 69 Senators 
committed to it. We sent it to the President, and he vetoed it. He said 
it was socialized medicine. I am not sure what that term means today. 
Forty years ago, it was the suggestion of too much Government.
  What the President doesn't tell us, and should, is this program is 
not about a government health insurance program. Overwhelmingly, the 
health insurance for these kids will be provided by private companies 
that will receive some subsidies, some incentive from the Government to 
provide this

[[Page S13603]]

care with the State governments. So it is not socialism, if that is the 
President's concern.
  Secondly, he worried about whether it is fiscally responsible. We pay 
for it. The President and his war of $169 billion a year is unpaid for. 
He heaps it on our children and their children by adding to the 
national debt. We pay for this program.
  Finally, this notion that somehow we are going to discourage private 
insurance for these kids, if the private insurance market was so 
anxious to cover these kids, they would have been there long ago. These 
kids have gone months and years without coverage. Now is the time to 
change it.
  The President used his veto pen four times since he was elected 7 
years ago--once to veto a change in the war in Iraq, two other times to 
veto bipartisan-passed stem cell research, and now in vetoing the 
Children's Health Insurance Program.
  Senator Reid, the majority leader, came to the floor yesterday and 
said: We will give you a little more time to work out our differences 
with the Republicans, we will have an effort at compromise. They 
objected to being given a little more time to work this out.
  We have tried. We have had good bipartisan support for this bill. We 
want to bring it across the line. We want to pass a bill either the 
President will sign or we override his veto, and we are trying to do 
that.
  In closing, because I see Senator Kennedy is here and prepared to 
speak, it will not be long now, maybe a matter of days, before this 
President asks for $196 billion for the war in Iraq. Some of us who 
voted against it are troubled that we continue to see the cost of this 
war go up in human terms, with almost 3,900 Americans killed, with tens 
of thousands injured, and who knows how many innocent Iraqis lost their 
lives, and the war continues to go on.
  The good news from Iraq? Oh, they like to tell us the administration 
has all sorts of good news. The good news is the death rate is down. We 
have seen ethnic cleansing in neighborhoods and now the vacant 
neighborhoods where 4 million Iraqis have become refugees. These empty 
neighborhoods don't have as much fighting. Is that a victory? I am not 
sure it is.
  We need to be more honest with the American people. If the President 
believes he can ask with a straight face for $196 billion for the war 
in Iraq, if he can ask for that kind of money to help the people of 
Iraq, he ought to step back and sign a bill that helps the children of 
America.
  A strong America begins at home. It begins with strong American 
citizens, strong families, strong neighborhoods, strong communities, 
and a strong Nation. The President can move us in that direction.
  I hope my colleagues in the Senate this week will join us. Let's pass 
this Children's Health Insurance Program. Let's send it back to the 
President. Let's hope, as he considers $196 billion unpaid for his war 
in Iraq, he can find $35 billion paid for the children of America.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Massachusetts. The Chair 
advises the Senator that 15\1/2\ minutes remain.
  Mr. KENNEDY. I ask if the Chair will let me know when there is 2 
minutes remaining.
   Mr. President, I wish to first of all thank our friend and colleague 
from Illinois, Senator Durbin, for again making an excellent statement 
about the Nation's priorities, the priorities we have before us in 
terms of making a judgment about the Children's Health Insurance 
Program. He has spoken frequently, eloquently, and passionately about 
the issue. He and I are hopeful that across the country Americans are 
able to take a few minutes and really absorb the arguments that are 
made in the case that is before the Senate and also understand the 
judgments many of us have made on this side of the aisle--virtually all 
of us on this side of the aisle, and some very courageous Republicans--
about what our responsibilities should be to the future of our country. 
It is a future that expects, that demands, and that requires us to give 
attention and assistance, when we can, to our children. This is the 
right thing to do not only from a health point of view, as has been 
pointed out so many times, but it also is imperative in terms of 
getting a handle on health care costs in the future by having a 
healthier generation, and, importantly, it is imperative as we are 
looking to the education of this generation.
   We have made the case time and time again, and we are making 
different points this afternoon, but the fact is if a child can't see 
the blackboard or hear the teacher or is unable to read the assignment 
because they are in need of glasses, that child is not going to be able 
to learn, that child has a better chance of dropping out, and that 
child has a better chance of living a life that is not constructive, 
productive, or useful in so many ways. So this case has been made time 
and again, and it is important.
   We hope, those of us who are supporting this legislation, that we 
will be able to garner the votes that are essential to getting this 
legislation into law. So I thank those who have spoken and spoken so 
well on this issue.
   Mr. President, as I and others have mentioned, this is really an 
issue of priorities. Nothing points out the issue of priorities more 
clearly than the choice we have between investing in our children--
Americas's children here at home, the sons and daughters of working 
families--and investing in the war in Iraq. This point is made 
frequently but can never be made enough: 41 days of conflict in Iraq at 
$12 billion is 10 million children who could be insured for virtually 1 
year. That points to the difference in the choice. On the one hand, we 
have a President and administration that virtually gives open-endedness 
to the number of days we are going to continue to be in Iraq. Yet, when 
it comes to the question of these 10 million children for the year, he 
says: Absolutely no. There is no way. We will not permit it, we will 
not accept it, and we will veto any proposal that comes our way that 
recommends and suggests it.
   The administration is quick to highlight their achievements on 
health care for children in Iraq, but they won't show the same 
commitment to the health of our own children. In Iraq, American money 
has renovated 52 primary care clinics and re-equipped 600 others, but 
in America, children are denied essential medical services in the name 
of fiscal discipline; in Iraq, we have provided 30 million doses of 
children's vaccines, but in America we are told we cannot afford basic 
preventive care for 10 million children.
   The Web site of the U.S. Agency for International Development 
proudly notes the remarkable accomplishment--and I commend them for 
it--that they have successfully vaccinated 98 percent of all Iraqi 
children against measles, mumps, and rubella. If only we could do as 
much. If only we could do as much for our own children. According to 
the Centers for Disease Control, only 91 percent of American children 
have received the same vaccine by the recommended age. The 
administration should be as concerned that children growing up in 
Boston or Birmingham get their recommended vaccines as they are about 
the children in Baghdad and Basra.
   The same Web site proudly notes that the USAID has improved the 
health of vulnerable populations in Iraq by increasing access to high-
quality, community-based primary health care. That is just what we are 
trying to do in America with this bill. In Iraq, it is an 
accomplishment; in America, it is a veto.
   A bipartisan majority in Congress has made a judgment too. Our 
judgment is that we must make room for decent health care for America's 
children. We must stand up to the empty rhetoric and hollow slogans of 
the White House and give all children in America the healthy start in 
life they deserve. We need to know who is for working families across 
America and who will stand in their way to getting quality, affordable 
health care.
  We need to know who is for families such as the Vega family in 
Greenfield, MA. CHIP helps Flora Vega, a working mother, buy an extra 
inhaler for her 5-year-old daughter so she can have one at school and 
the other at home. CHIP also helped her afford a nebulizer--the small, 
portable device that pumps the asthma medicine into her lungs when an 
inhaler isn't effective. That means her daughter doesn't face sudden 
dangerous attacks of asthma that require her to go to an emergency 
room.

[[Page S13604]]

   We need to know who is for families such as the Lewis family in 
Springfield, MA. I met Dedra Lewis and her daughter, Alexsiana, when 
they came to talk about the difference CHIP has made in their lives. 
Alexsiana has a rare eye disease that requires expensive drops every 
hour of each day. To take care of her daughter, Dedra had to cut back 
on her hours at work and lost her insurance. Without CHIP, she would be 
choosing between paying the mortgage for their home and paying for the 
medicine the child needs to keep her vision.
  Family after family, from coast to coast, can tell similar stories. 
That is why families across America are calling on Congress to renew 
the promise of CHIP. The task has not been easy, but we will not be 
deterred or deflected. When Medicare was first proposed in the 1960s to 
allow the Nation's senior citizens to live their retirement years in 
dignity, its supporters were attacked with much the same harsh rhetoric 
as we hear about CHIP--it is socialized medicine, it is a Government 
takeover. But Congress rejected that absurd rhetoric, and hundreds of 
millions of senior citizens have benefited immensely ever since. 
America's families face real challenges--higher mortgages, soaring gas 
prices, the ever-increasing cost of health care, and many other 
burdens. They deserve real solutions, but the White House offers only 
hollow slogans.

  Our opponents failed to stop Medicare, and they won't stop CHIP now. 
Medicare didn't pass on the first attempt, but its supporters came back 
again and again with the force of the American people behind them to 
ask--to demand--that Congress act. And the 1964 election made it all 
possible. That is just what we will do with CHIP, even if it takes the 
2008 election to do it. We will keep at it until the children of 
America get the health care they need and deserve and that the American 
people are demanding.
  As we have pointed out, at the time we saw this legislation 
developed, when it was initially proposed, it was a compromise between 
Republicans and Democrats. Those of us who wanted to give attention to 
the uninsured sons and daughters of working families recognized that we 
had a unique situation in America: We had resources as a result of the 
tobacco settlement, which provided hundreds of billions of dollars as a 
bonus to America, and we could decide how we were going to expend those 
resources. I saw in my own State of Massachusetts, the determination to 
use those resources to provide a health insurance program for the sons 
and daughters of working families.
  That was a very important model that was replicated here over 10 
years ago in the Senate, where we used much of the resources that were 
allocated to us to be able to develop the Children's Health Insurance 
Program. There were Republicans on that side who said: Look, we don't 
want to just extend Medicaid; we want a separate program that will be 
resolved in the States. There were those of us on this side saying: 
Medicaid provides very good health assistance for children; the 
preventive programs are model programs, and they do an enormous amount 
in providing quality health care for children in a wide variety of 
areas and functions. No, our Republicans said, we want the States to be 
able to develop those; we will take guidelines, but we will let the 
States do it. A compromise was reached between Republicans and 
Democrats, and that was acceptable.
  Secondly, it was determined that the States would have the ability to 
make judgments and decisions about deductibles and copays. We said: No, 
we want a standard way to make sure all working families are going to 
be able to acquire it. But, no, we worked out that program, and again 
it was a compromise. It was a judgment and decision of the sponsors of 
that legislation that we were going to use the private insurance 
companies--private insurance companies--to make sure of the delivery 
system. Many of us thought it would take a long time to get this 
program up if we went that route, but nonetheless it was a compromise. 
It was a compromise. Democrats and Republicans came together in this 
compromise program. Very important compromises were made at that time. 
It reflected the best judgment of the Members of the Senate and the 
House of Representatives, and that legislation has been an 
extraordinary success.
  The area where it has not been successful is that we have not reached 
all the children out there who are eligible and should be able to 
receive it. If we are looking for legislation that really reflects the 
best of Republicans and Democrats, if we are looking for legislation 
that basically reflects the best in terms of our priorities, this is 
that legislation, and now is the time to move ahead.
  We have a budget of $2.9 trillion. The question is, Can we afford--
can we afford--the few billion dollars to provide the type of health 
coverage in this legislation? We are not even taking the resources from 
the existing budget. We are saying: What is going to be the result of 
that, by increasing the cost per package, the 61 cents? The result of 
that is going to be more children are going to stop smoking. That is 
the result.
  If you take the increase in the cost of a pack of cigarettes, we have 
the real opportunity to see a very important public health 
achievement--discouraging children, the 3,000 children who start 
smoking every single day, the thousand who become effectively addicted 
from their earliest contacts with it. We discourage them from moving 
down that pathway. So this is a positive health development both in 
terms of the resources and in terms of the outcome. Unique. Unique.
  Just to finalize here, we are enacting new legislation--those of us 
who believe in it--to address some of the real challenges and make this 
a fairer and more equitable country. We have the example of the 
existing program in place now. It works. It works. It is successful. 
Parents need it, and parents want it. The only issue--the only issue, 
the only issue--is whether we have the willingness and the will to 
implement it and to make it achievable for families in this country. We 
are talking about those working families, those mothers who hear a sick 
child cry in the night and wonder whether that child is $423 sick, 
because that is the average cost of going to the emergency room; those 
families who pray their child, who has an earache or a throat ache, 
will be better in the morning. How do you put a cost on that? How do 
you put a cost on that? Well, we recognize that as a real value, and we 
are not prepared to let parents make that kind of judgment call and 
feel that kind of pain and that kind of fear and that kind of anguish.
  This legislation does the job, and it is important that we get a 
strong, overwhelming vote this afternoon that really reflects the good 
judgment of the American people, who say children should be first in 
this Nation. That has been a founding value of our Nation since the 
Pilgrims settled up in my part of the country, and I believe it is a 
value that is shared today. We will have an opportunity to vote on this 
in a short time. Hopefully, it will be accepted overwhelmingly in the 
Senate.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from New Jersey.
  Mr. MENENDEZ. Mr. President, what is the parliamentary situation in 
which the Senate finds itself at this moment?
  The PRESIDING OFFICER. The time of the majority has expired. The 
Republicans have 59\1/2\ minutes.
  Mr. MENENDEZ. Mr. President, I ask unanimous consent to speak for 10 
minutes. Should a Member of the Republican side of the aisle seek the 
floor, I will be happy to yield at that time.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from New Jersey is recognized.
  Mr. MENENDEZ. Mr. President, I wish to talk about the reauthorization 
of the Children's Health Insurance Program and why those who are 
opposing the bill are making this a nightmare for children. When I 
first came to the floor in support of the bill on July 31, I knew there 
were those who did not share my support, but I thought they would 
merely be a road bump to reauthorization. Now it seems we have a 
roadblock to children getting critical care they need.
  How many times can you veto or vote against children receiving health 
care and not raise a question as to your role as a representative of 
the people? How many times can you veto or vote against children 
receiving health care and then turn around and take pictures with 
babies and families back in your

[[Page S13605]]

home State? How many times can you veto or vote against children 
receiving health care and then still argue that you care about the 
well-being of children other than your own?
  I don't understand how we have gotten to this point, but let me make 
this very simple. The bill at its core provides health care for poor 
children. Yet there are those in Congress and the White House who are 
missing that bottom line. More important, their votes are hurting our 
Nation's children.
  There are 9 million children in America who suffer in silence because 
they do not have health care; 6 million of them are eligible for the 
Children's Health Insurance Program or Medicaid, but they are not 
enrolled.
  That keeps me up at night. I hope it keeps up at night others who 
have to cast a vote soon as well.
  I want to be sure we know the families and children we are talking 
about. The families we seek to cover work every day at some of the 
toughest jobs in America--some of them jobs none of us would want to 
do, but they work at it every day. They work at jobs that offer no 
health care coverage whatsoever and they do not make enough money from 
their employment to afford private coverage. It is the children in 
these families we are trying to cover. So let's talk about the reasons 
why there are those who continue to vote to bar children from health 
care.
  That is strong language, but I have had enough of sugar-coating this 
issue. The new bill includes substantial revisions to try to reach out 
to colleagues who have raised issues and directly addresses a number of 
the concerns they have talked about. According to the Congressional 
Budget Office, the new bill would continue to cover nearly 4 million 
uninsured children by 2012, at a cost of about $35 billion over 5 
years. That is a fraction of what we spend in Iraq. That is in addition 
to the over 6 million children already covered by this program.
  Those opposed to this bill have been shouting about how the bill 
needs to cover more low-income children. Good news, the new bill would 
further increase our focus on covering the lowest income uninsured 
children. The new bill would prohibit any coverage above 300 percent of 
the poverty line, except for some who have already been grandfathered 
in. Limiting new coverage to 300 percent is a harder line than the 
original bill, and it is a concrete ceiling for new coverage. It also 
changes the financial incentives States receive to enroll more 
children, and it ensured we are targeting the enrollment of low-income 
children.
  The new bill only provides these incentives to States when they 
enroll Medicaid-eligible children and no longer includes incentives for 
enrolling SCHIP children, as was in the original bill.
  In fact, this new bill will cover an additional 100,000 children as 
compared to the original bill, for a grand total of 3.9 million 
children gaining coverage under the bill on which we will be voting 
cloture. Of these children, essentially half are Medicaid eligible. 
These children are the low-income children many of our colleagues are 
talking about. This new bill brings in 200,000 more Medicaid-eligible 
children than the first bill.
  We have listened and we have made changes. But compromising on 
children's health can only go so far. The second issue I have heard, 
and it makes my blood boil, is the argument that undocumented 
immigrants would gain coverage under this bill. I know it is Halloween 
so we are going to scare the American people as best we can, but this 
is a tactic that cannot stand. Let's make it clear: Undocumented 
immigrants are not eligible for Medicaid and CHIP, they have never 
been, and nothing in this bill changes that. Nothing in this bill 
changes that. It is a shame there are Members who still come on the 
floor using that argument.
  In fact, the new bill tightens citizenship requirements. States will 
seek to verify names and Social Security numbers but also have to 
verify citizenship with information from the Social Security 
Administration. The Social Security Administration will check the 
information received from the States to determine that the information 
matches and also check to see if the database shows that the applicant 
is a citizen. If they can confirm--great. We have another citizen with 
health care. If not, the State has to require original documents to 
prove citizenship. This is in no way an open door, and in no way should 
we allow this to continue to be used as a false reason to not give 
health care to children in this country.

  I ask my colleagues to stop tying up this issue, trying to make 
children's health care an immigration debate so we can have it every 
night on the nightly news being about immigration. Oh, it is about 
immigration. It is not about immigration. It is about children's health 
care; children who do not have it, cannot afford it, and will not have 
it unless this Congress acts.
  Some have also raised the question about adults. The reality is we 
cover some parents. This administration gave us waivers to do it 
because they said it is a good thing: Let's cover parents who are also 
in these jobs, working hard, not able to afford health care, not 
getting it at work--because we are getting more children involved 
through their parents. By the way, we happen to cover more Americans--
isn't that a terrible thing? We happen to cover more Americans, of the 
47 million who have no health care coverage whatsoever. It is a 
terrible thing.
  I think it is quite a good thing. I have seen it succeed in my home 
State of New Jersey. We have found a strong correlation between 
enrollment of parents and enrollment of children.
  Finally, if values match our actions, this bill needs to be supported 
by all Members in the House and Senate and signed into law by the 
president. It is time for President Bush to stop making his fiscal 
conservative bones on the health care of children. It is time for the 
President to put away the veto pen and allow doctors to take out their 
stethoscopes to make our children healthier. It is time to give the 
children of America what the President and every Member of the Senate 
and Congress has, health care coverage, health care for America's most 
precious asset but also its most vulnerable asset--our children.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Sanders). The Senator from Oklahoma is 
recognized.
  Mr. COBURN. Mr. President, I wish to spend a few minutes of time 
speaking about the ``revised'' SCHIP bill and what it means to the 
American people. The rhetoric associated with the bill is that we want 
to cover children. That is a laudable goal. But that is not what this 
bill is about. If that were what this bill is about, what we would be 
doing is having a bill on the floor that expands the current payments 
of $5 billion a year to $7 billion a year, which is what is required by 
the CBO to truly cover the kids whose parents make $41,000 a year or 
less. That is not what this bill is about.
  The bill is about having the American taxpayers, and especially the 
poor American taxpayers, pay $133 billion over the next 10 years to 
cover families presently with insurance.
  What does the Congressional Budget Office say about this bill? First 
of all, it spends $400,000 more than the bill the President vetoed; it 
covers 500,000 fewer kids. It still maintains that 10 percent of the 
people in 2012 on SCHIP will be adults. It gives exemptions for the 
State of New Jersey--a family of five earning $89,00 a year, they will 
still be covered. It creates loopholes where rural hospitals get paid 
the same as metropolitan hospitals, as a favor or an ``earmark'' to 
certain Members of Congress.
  What it does not do is solve the problem. What is going on here? 
There is not anybody in America who does not think we corporately 
should be helping poor children with their health care. But this isn't 
a bill about helping poor children with their health care; otherwise, 
we would not be taking 1.2 million middle-income kids and putting them 
on SCHIP, at the same time the only increase we see on the poor kids, 
families making under $40,000, is $800,000. So what is going on? What 
is going on is this is a political campaign. It is a political campaign 
that, under the guise of helping children, what we want to do is start 
the march toward single-payer, government-run health care. That is OK 
if you believe that and you want to put that out. But this idea of, we 
are going to wink and nod to the American public under the name of poor 
children when, in fact, this bill will cover not poor children and 10 
percent of the people covered will be

[[Page S13606]]

adults 5 years from now and we are going to take kids off their 
parents' insurance.
  One of the things people will not talk about is in 35 States, the 
SCHIP program is Medicaid. Of those 35 States, over 50 percent of the 
doctors will not see a Medicaid child. Why is that? Because Medicaid 
will not pay a rate at which the doctor can pay their overhead and 
still see the child. So what we are going to do is we are going to take 
the parents' right away to choose the doctor they want for their kids, 
and we are not going to lower their insurance premium at all by taking 
the kids off--the ones who have insurance, the 1.2 million who the CBO 
says will come off private insurance--and then we are going to take 
away the parents' right to pick the doctor to care for their kid.
  What this is, is moving to single-payer, government-run health care. 
What I would say is, if that is what we want to do, let's call it that. 
But that is not what we are calling this. We are claiming we want to 
help poor children.
  President Bush got it right. Before we expand to families of $60,000 
or $80,000 a year who have insurance and put them on a Government 
program, shouldn't we make sure the program we have now has enough 
money to cover the kids whose families make under $41,000 a year? And 
shouldn't we make sure that, when we say we are giving you coverage, we 
are giving you coverage?
  The other thing we ought to ask is: Why aren't the American people 
going to get value out of this? The cost in this program, to buy $2,300 
worth of insurance--and that is the highest level at which the average 
kids cost, the average is probably around $1,700--why would we be 
spending $4,000 in this bill to buy $2,300 worth of insurance? The 
American people have to look at that and say: What is wrong with this 
picture?
  The other side of it is we are going to get all the money, we say, by 
taxing tobacco. Who pays tobacco taxes? Who are the majority of people 
in this country who pay tobacco taxes? I will tell you who they are, 
they are disproportionately poor. They are disproportionately the 
disadvantaged. They are disproportionately those people who can least 
afford to pay a tax. So it is no wonder the CBO, in this evaluation of 
this program, said: This is the most regressive tax we have seen in 
years. It is going to hurt the very people we say we want to cover. 
Does the Senator have a question?
  Mrs. McCASKILL. Will the Senator yield for a couple of questions?
  Mr. COBURN. Absolutely.
  Mrs. McCASKILL. You know, the Senator from Oklahoma and I agree about 
an awful lot when it comes to fiscal discipline, but I am having a 
little trouble. I am hoping he can help me with this problem I am 
having. I am willing to bet the Senator from Oklahoma may have been one 
of the Senators who said no to Medicare Part D. I am guessing. I would 
have to check the vote.
  Mr. COBURN. I wasn't in the Senate or the Congress.
  Mrs. McCASKILL. I forget the Senator is a newcomer. I would be 
curious. This is where I don't understand the Senator's concerns about 
political gamesmanship and trying to make this about the children, and 
so forth.
  On the other hand, I am trying to figure out the President's 
position, and maybe the Senator can explain to me why no means testing. 
You know, $170 billion and basically no way to pay for it was not a 
problem for the President of the United States with Medicare Part D. 
They were jumping up and taking credit for it then. There was 
absolutely no means testing, and it was much more expensive than this 
program.
  The question is, what is the difference? Why is it that the President 
has a problem with this program, when Medicare Part D, with no means 
testing, no way to pay for it, was just fine?
  Mr. COBURN. I would be remiss if I thought I could speak for the 
President. But I will tell you what this Senator thinks. Medicare Part 
D hung on the shoulders of our children $8.3 trillion worth of unfunded 
liabilities.
  So today we are giving prescription drugs to seniors, and we are 
taking away future opportunity from our kids. Had I been here, I would 
not have voted for Medicare Part D. In fact, I lobbied a lot of my 
former friends from the House to vote against Part D. That is not what 
we are talking about today.
  What we are talking about today is, if we are going to have a program 
for poor children, which I support, we at least ought to cover up to 95 
percent of the kids who are eligible before we expand the eligibility. 
That is where the $7.8 billion over the next 5 years needs to be added 
to this program, and then with the caveat that says: States, you cannot 
go to the higher income until you cover the poor.
  This is a typical example of what Washington does and America rejects 
all the time. We do not measure what we are doing to see if we are 
accomplishing things. What we do know about SCHIP is that in many 
places it has been a valuable lifesaving tool for the poor people in 
this country. But, in fact, the States have done a poor job of 
enrolling many of those kids.
  What we also know about SCHIP is that 35 of the States put their kids 
on SCHIP into Medicare. Now, what does that mean? Since you get no 
choice of half the doctors who are out there who are eligible to care 
for the kids, what we have said is, we are going to give you care, but 
you get no choice. You get care, but you get no choice. You get no 
freedom when the Government helps you with who your child is going to 
see.
  So I do not doubt that there are inconsistencies in any President's 
position. I can debate Medicare Part D all day. I am with you. I am on 
your side. But the point is, this debate is not about helping kids. 
This debate is about changing the underlying structure of our health 
care and starting to build a Medicare from the ground up, and we have a 
Medicare here and merging them in the middle.
  I am willing to debate that, too, but I want us to be honest about 
what we are debating; otherwise, we would not have a family of five in 
New Jersey making $89,000 a year eligible under this program, someone 
who already has insurance.
  So here is the question for the American people: Do you want to pay 
taxes to buy health insurance for 1.2 million kids, for parents who 
already have it, and give them a program that is subpar to what they 
already have with no decrease in the insurance cost to parents for the 
insurance they are covering now? That is the question.
  And do we have a way of covering poor kids that would be better? I 
would propose to the Senator from Missouri that a refundable tax credit 
to poor children, allowing their parents to have enough money to buy a 
policy, which the average is truly $1,700 per year, per kid, a 
refundable tax credit that gives them the freedom to choose any doctor 
they want, that does not put a Medicaid on their forehead, that 
automatically excludes 50 percent of the physicians in this country, is 
a far better way to do it and a more equitable way to do it.
  If we did that, that would pay for itself without raising taxes 
anywhere because you would eliminate the cost shifting that goes on in 
the health care industry for the kids who do not have care today. And 
we will not raise taxes on the poorest of the poor because that is who 
is going to be paying for this.
  Plus, we all know, 21 million new Americans are not going to start 
smoking. We all know that. But yet that is how we chose to meet the 
requirements of pay-go here, through a false claim that we will have 
enough revenue to pay for it by raising the tax on cigarettes.
  So I am all for having a debate on national health care. Senator 
Wyden and I and Senator Bennett and Congressman Conyers and myself and 
Senator Burr had that debate in New York this week at the New School. 
That is a good debate to have. But this is a slight. This is a slight 
about what we are doing. And the question to the American people has to 
be: Do you really think, if you are making $45,000 a year or $65,000 a 
year, that your taxes ought to go up to pay for somebody who is making 
61,000 or less, and at the same time limit the availability of those 
same children to have the physician of their choice? That is what we 
are talking about. I believe we ought to cover poor children. I think 
that the SCHIP program now ought to be held accountable to cover the 
poor children. If we are going to pay for it, I am willing to

[[Page S13607]]

put the money and find offsets somewhere else to pay for it, if we do 
not do a tax credit.
  Mrs. McCASKILL. Mr. President, if the Senator would yield for a 
second, as he well knows, I voted with him. I voted with the Senator 
from Oklahoma to try to pull some of the earmarks out of the bill, to 
pull all of that money out of children's health insurance. I think he 
and I both agree on the goal.
  The problem is, the question I wanted to ask--and he is not in a 
position to answer it because, unfortunately, he is not someone who was 
here who voted for Medicare Part D, but the inconsistency as to what I 
hear from the White House and what I think people in this Chamber are 
hearing from the Senators who voted for Medicare Part D is, every 
argument they are using for SCHIP is true but exponentially higher in 
Medicare Part D.
  By the way, the only difference is in Medicare Part D the people who 
are making the money are the pharmaceutical companies and the insurance 
companies, and it is not funded and multimillionaires and billionaires 
get it. So it is so unfair to say that the President is taking a 
principled stand because if it were a principle, it would have been 
consistent for both SCHIP and Medicare Part D. That is the question 
that you are unable to answer, and I have yet to hear anybody answer 
that question.
  Mr. COBURN. Mr. President, I reclaim my time to say the following: I 
think the Senator from Missouri makes a good point on consistency. I 
think they are finally awakened to what the American people want at the 
White House. I think they are finally starting to pay attention that 
being efficient in the Federal Government is important.

  But having not been, maybe, efficient with Medicare Part D, I applaud 
the President for now taking a stand on something that is common sense 
that would say: If we are going to have a program for poor children, 
let's make sure it covers poor children. Let's make sure it covers poor 
children. Right now it does not. Right now it does not.
  Rather than expand the program that is not meeting what it is 
supposed to do and raise taxes on the poorest of the poor, I think the 
President's response and the CBO's score, which is $7.8 billion more 
over the next 5 years instead of $35 billion more over the next 5 
years, is a reasonable response to really cover poor children.
  And what we know, by what CBO says, is that will do it. Now, let's 
talk about the difference in what we are going to be having the cloture 
vote on now versus the bill that the President just vetoed. This bill 
covers 400,000 less kids; it spends $500 million more. So we are not at 
$4,000 anymore, we are at about $4,200 to buy $2,300 worth of health 
insurance. It does not fix the fast lane for illegal immigrants as the 
authors claim. It does not fix adults on the SCHIP program.
  CBO says in 2012, at least at a minimum, 10 percent of the enrollees 
will still be adults. It does not fix the crowdout issue. This bill 
will cause 2 million people to lose private insurance coverage and come 
in a government-run program, crowding them out of the private insurance 
market. Despite a fix for the problem of enrolling more higher income 
kids than currently eligible kids in SCHIP, the CBO still projects only 
800,000 currently eligible, currently eligible SCHIP kids, will get 
enrolled.
  But 1.2 million kids of families making more than $60,000 will get 
enrolled. So for every two kids we enroll who are poor, we are going to 
take three kids out of the private sector. We have talked about what 
kids lose when they go to the Medicaid Program.
  What are the other problems? In this bill are earmarks for specific 
hospitals to violate CMS payment rules to pay those hospitals more than 
what the rules say because some Congressman or Senator thinks they 
should not have to live within the rules. I would love to be able to 
tell that to people in a community in Oklahoma who just had to shut 
down their hospital because they could not make it under what CMS rules 
pay.
  So what we have is about seven of those in here, where we are going 
to take care of the little hospitals of seven Members of Congress, but 
we are going to ignore all of the rest of the community hospitals in 
this country that are struggling under a payment system that does not 
pay for the care of people they are supposed to be caring for.
  There is still an income disregard loophole, which means it does not 
matter what you said because we have a loophole that says if States 
want to, they do not have to follow the income guidelines. You can 
still enroll families making more than $100,000 a year in the SCHIP 
program.
  Well, that is in there by design because the desire and design of 
this bill is to move to single-payer, national health care.
  I think the Presiding Officer sitting in the chair right now probably 
believes that is where we should go. I do not have any problem debating 
that. But the incrementalism and the real effort of this bill is to 
expand SCHIP to a point where Americans who have insurance are going to 
pay higher taxes so everybody can get covered. If you look at the mess 
that is trying to be created by these five or six hospitals in here 
right now, how are we going to solve that problem when everything is 
Medicare?
  Some say we are going to take the profit motive out of medicine. We 
are going to take the profit motive out of the drug industry. We are 
going to have a 220,000-physician shortage in 15 areas in this country. 
The applications for enrollment at medical school are diving. Why are 
they diving? Because they cannot afford the education and then have an 
income to pay off their student loan, let alone pay for housing and 
income to feed their kids.
  How did that come about? It could have been Medicare creating that. 
It could have been that we were not willing to pay. What else is going 
to happen? Eighty percent of all innovation in health care in the world 
comes from this country. Eight out of every ten new ideas that are 
lifesaving, eight out of ten of every new treatments, eight of ten new 
devices are developed in this country.
  Why are they developed? Because we still have 48 percent of the 
health care system that is not run by some government program. And 
through there, there is enough risk taken, based on the reward that can 
be gained, to invest in capital and research to develop these 
lifesaving treatments.
  We say we want to move SCHIP in the name of kids, but what we really 
want to do is to have national health care. Well, we better think about 
that hard and long because here are the statistics on cancer treatment 
in this country compared to everywhere else in the world. It does not 
matter what cancer you get in this country, you have a 50-percent 
greater chance of living 5 years than anywhere else in the world.
  Why is that? Is it those big, bad pharmaceutical companies that have 
to spend a billion dollars just to get through the maze at FDA? Is that 
what it is? Is that why? I am a two-time cancer survivor. I am so 
thankful for the pharmaceutical industry. I would not be here without 
them. Two times they have developed, researched, and made drugs that 
have saved my life.
  I do not disagree that we have some excesses in corporations in this 
country. But the pharmaceutical industry, with all the negatives that 
are out there, still leads one of the most positive responses we have 
ever seen in this country to solving real problems for real 
Americans. So we can beat them up and we can beat the President up and 
say Medicare Part D. I do regularly on Medicare Part D. I don't think 
we ought to steal from our children to have drugs paid for. But this 
bill steals from everybody. It also steals from the poorest. It steals 
from the poor, blue-collar, low-income worker who has the benefit of a 
lot of other programs. It says: We are going to raise your taxes 
because you happen to be addicted to nicotine. We are going to steal 
from you to pay for somebody who is making $61,000 a year who already 
has insurance. Do we want to do that? Do we want to steal from the 
people who are working, barely getting by, so we can pay for people who 
already have insurance? Is that what we are doing? That is what we are 
doing.

  I have listened to the debate. I offered some ways to change this. 
Senator Burr and I offered an amendment. We didn't get a vote on it. It 
solves through tax credits a way to insure, not go into a Medicaid 
program but insure with choice, so you take the stigma of Medicaid off 
patients' foreheads.

[[Page S13608]]

We offered a way that every kid could get covered. It is called a 
refundable tax credit. It can only be spent on health insurance or 
health care. But people don't want to do that. Why would those who are 
more progressive in thought not want to do that? Because they offered 
the original income tax credit. Why would they not want to do that? It 
is because the agenda is different than we say it is. The agenda is to 
start toward a nationalized, single-payer, government-run, no-choice 
health care system that will eliminate that 80 percent of innovation in 
the world made by American ingenuity, American capitalism, American 
idea that ``I will invest some of mine to see if I can come up with an 
idea that will help somebody else and, by the way, I will profit from 
it.''
  What we are saying is, we don't want markets to work. We want the 
Government to run it. If you think about everything else we have today, 
everything with the exception of health care and primary and secondary 
education, we believe in markets. They have been very good to us. They 
have given us the highest standard of living of any society ever in the 
history of the world. They have advanced causes in terms of treatment 
of disease more than any advancement ever in the history of the world. 
What this bill is about is saying: We don't believe markets ought to 
apply.
  Myself, Richard Burr, and five others have a bill called the Health 
Care Quality and Choice Act. It creates a tax credit for everybody to 
buy their health care. We treat everybody the same. Everybody gets the 
same amount. Everybody gets to buy a private health insurance plan. We 
create a market so the insurance industry doesn't steal 25 percent of 
the cost of that. We set up a way to create markets. The Every Child 
Insured Act, legislation offered by Richard Burr, creates a way where 
every kid is covered. Senator Martinez and Senator Voinovich have a 
bill that covers up to 300 percent with tax credits of all the kids in 
the country who don't presently have health insurance. This bill isn't 
about covering kids. This bill is about putting the Government in 
control of the last 48 percent of health care. As P.J. O'Rourke says, 
if you think health care is expensive now, wait until it is free.
  A couple other things the American people should know is that England 
is pouring billions of dollars into their national health care system 
now. Why? Because on average when you get cancer in England, up until 
18 months ago, once you were diagnosed, you waited at least 12 months 
before treatment started. They have a goal by 2010 to get to 3 months 
to start your treatment. Do you know what the average length of time, 
insured or uninsured, in this country is from the time you have a 
diagnosis of cancer until you start getting treated? It is 3 weeks and 
2 days. Why do you think we are doing better than they are on these 
things?
  We are about to go into a system that destroys innovation, destroys 
quality. I agree, there is plenty wrong in health care. I have a bill 
that changes us toward prevention. I am all for working on the problems 
we have in health care. But the question the American people ought to 
ask is, do we want to tax ourselves to pay for care for kids who are 
already covered in the name of not doing a good job under the SCHIP 
bill now, and should we have the kids who need to be covered covered 
before we start reaching beyond those who already have care? They are 
not going to answer that question. Because the real debate is, the 
first step is to get away from your choice of choosing a doctor, your 
choice of what facility you will go to, your choice in getting to 
choose what drugs you will take and what options you will have, because 
the Government bureaucrats are going to decide all that for you.
  If you believe that is not true, look at what Medicare is doing right 
now for women who have osteoporosis. They get diagnosed with a DEXA-
scan. They get treatment. But because doctors in this country have 
ordered too many DEXA-scans, according to the bureaucracy in Washington 
known as the Center for Medicare Services, we have now limited 
physicians. You can't check to see if the medicine you are giving is 
working and maybe change the medicine to give them one that might be 
working, because a bureaucrat has decided we are doing too many tests. 
That is called rationing. That is why health care costs are lower 
around the world, because they let people die from cancer. They let 
people die with a broken hip. They let people die with congestive heart 
failure.
  We don't. We value individual lives and we are willing to put the 
resources in for the best, longest, and best quality life. Don't be 
fooled about what this bill is about. This bill is the first step 
toward national health care. This bill fails to address the problems in 
SCHIP as they are today. This bill raises taxes on the poorest of the 
people in the country--all in the name of having a political issue in 
2008 to say those people who oppose this don't care about kids. I have 
spent my whole life delivering babies, 4,000 of them now. That is a 
false claim. If you care about these kids, you will balance the budget, 
pay for the war by the expensive, duplicative, wasteful programs we 
could eliminate. We would have a balanced budget, and we wouldn't be 
charging the very thing we are getting ready to pass on to our kids, 
which is a $300 billion deficit this year alone. Caring about kids 
means you will make the tough choices, that means you go against the 
interest groups to do what is right for the future, not what is best 
for the next election.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. CASEY. Mr. President, I believe on the Democratic side we may be 
out of time. On the Republican side, there is time left. I ask 
unanimous consent to borrow some of the Republican time.
  Mr. COBURN. There is no objection.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CASEY. I thank the Senator from Oklahoma.
  I have a limited amount of time, but I want to highlight a couple of 
things about the State Children's Health Insurance Program legislation. 
All of America knows about it. We have been debating this for weeks, 
and we will continue. Obviously, there are differences of opinion about 
what to do about health care generally. I will focus on one argument 
that has been made against this, that somehow if the Federal Government 
continues the State Children's Health Insurance Program and adds 
funding--we had an overwhelming vote here in the Senate, and we will 
have that again today, a veto-proof endorsement of the program and the 
dollars to back it up by an increase in the cigarette tax--what has 
been debated back and forth is the coverage and who gets covered and 
who doesn't.
  People across America have heard a lot about 200 percent of poverty, 
300 percent of poverty. These numbers get thrown around. Two hundred 
percent of poverty means a family of four is making $41,300. Most of 
the families covered by this program and that would continue to be 
covered or would be added to the coverage are in that range and below 
200 percent of poverty. I want to put up a chart that walks through 
this in terms of a family. If we look at 32 States, we have about 32 
States that set the income eligibility for the Children's Health 
Insurance Program at 200 percent of poverty, $41,300. Of course, 201 
percent would be 1 percentage point above that. So let's say a State 
doesn't allow and the Federal Government won't allow States to go above 
200 percent of poverty. Here is what families are facing, getting by on 
$41,507, for an example, in a rural county in Pennsylvania. If you look 
at a family of four with two children, take-home income is $2,893; 
housing, $726; childcare, $1,129--even if you got a child credit, it 
would still be a big number; $609 for food; $446 for transportation; 
phone service, $45; total $2,955. That is their expenses. Then you add 
in the number from up top, the income level, the monthly income, the 
differential between the income and the expenses, you get a minus of 
$62. Let's say that is off by a couple hundred dollars. Let's say those 
numbers are off by a few hundred dollars give or take. It doesn't 
matter. Because either way you cut it, if a family is faced with the 
basic necessities of life, not factoring in school supplies, not 
factoring in an emergency for a child hospitalization, not factoring in 
other things that families have to deal with every day, whether it is 
an extra rent payment or an increase in rent, whether it is a pair of 
shoes or sneakers for a child, none of that is

[[Page S13609]]

factored in there, this family is still behind at 201 percent of the 
poverty level.
  I have been hearing for weeks from the President--we have all heard 
from him when he makes public pronouncements--that somehow this program 
is going to families who don't need it; their incomes are too high; it 
will go above that. Yet now you have Senate and House negotiators who 
have worked out an agreement where they put a ceiling at 300 percent 
because of objections that were raised. I don't know what more we can 
do. The President apparently thinks this program works. He says he 
supports it. His measly increase would actually lead to a reduction of 
the number of American children who are covered. But he says he 
supports the program. He says he wants to increase it. He said, when 
campaigning, that we should add millions more. Yet he is the roadblock 
in front of progress on this issue.
  This illustration is right on target in terms of what a real family 
faces. One more point about this. Think about what it costs; even if 
you have a family who has coverage through their employer, that family 
may have to deal with a similar situation. We all know that the average 
monthly premium for family coverage is about $300. In either scenario, 
they are up against a lot paying for children's health insurance, and 
this is at a fairly low income level for a family of four. That 
argument makes no sense.
  I will conclude with one other argument. There were representations 
made over many weeks now by the President. He kept pointing to States 
such as New York and New Jersey as examples of how these numbers would 
get too high and the income levels would get too high. I can debate him 
on that point, but I will put that aside for a moment. What he didn't 
talk about and what some of his allies have not talked about is the 
fact that this isn't just about what happens to children in urban 
areas. We know from history, from 10 years of evidence, this program 
not only works generally, but it works particularly well for poor kids. 
It works particularly well for African-American children. We have cut 
that rate of uninsured a lot. It works particularly well for urban 
children who happen to be Hispanic. But what the President doesn't want 
to admit is that it also helps a lot for rural children.
  Today in America one-third of all rural children--we have a lot in 
Pennsylvania, a lot of children who live in rural communities--get 
Medicaid or SCHIP. Thank God we have those programs for rural kids and 
for urban kids and all the rest.

  I will give you two examples, and then I will conclude. Pennsylvania 
has a broad middle. We have a lot of smaller counties, many of them 
rural. To give you two examples: Clarion County and Huntingdon County--
one is in the middle of Pennsylvania toward the southwest and one, 
Clarion, is up almost in the northwestern part of our State.
  Under the Bush plan, if the President were to get his way, under his 
children's health insurance proposal, here is what would happen in 
Clarion County, PA. Between fiscal year 2008 and fiscal year 2012, it 
is estimated 146 children would lose coverage. OK. Go a couple counties 
away to Huntingdon County--a small rural county--and in that same time 
period of 2008 to 2012, 129 kids would lose their coverage.
  Now, I think it is a tragedy for 1 kid or 5 kids or 10 kids to lose 
coverage, but now you are talking about hundreds of kids in two small 
counties in terms of population.
  What is the comparison to the bipartisan children's health insurance 
proposal? Clarion County would gain 278 children, Huntingdon County 
would gain 247. So instead of losing about 130 to 150 in each of those 
small counties, we gain 250 children or more, maybe as high as 280 
children.
  So that is the difference. We can talk all we want about percents of 
income in all the States. I am looking at two counties in Pennsylvania 
that happen to be smaller in population and that happen to be largely 
rural, and I know hundreds of children who get coverage now will not 
get that coverage in those two counties; and hundreds of children would 
get coverage under the bipartisan children's health insurance 
legislation.
  I do not know what more the Senate and the House can do on both sides 
of the aisle to plead with the President to go along with what the 
American people have told us overwhelmingly. There are a lot of things 
we disagree about in the Senate and across the country, but very few 
Americans now disagree that investing in children in the dawn of their 
lives is a good idea for that child, for his or her community, and for 
our economy long term.
  So we will continue to make the case up until and through the vote 
today. But I think this is critically important for the children of 
America, all the children of America--urban, suburban, rural or any 
other way we classify where our children live. For their sake, and for 
the sake of the long-term economic future of the country, I believe the 
State children's health insurance legislation is urgently needed.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. GRASSLEY. 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. GRASSLEY. Mr. President, to quote Yogi Berra: It feels like deja 
vu all over again.
  Here we are again debating the State children's health insurance 
bill, or SCHIP as we all know it by. I know colleagues are tired of 
this issue and frustrated by the process.
  I do think, though, we have an opportunity to move forward and to 
bring this issue to closure. I think my colleagues should be aware of 
many of the improvements that have been made to the bill that has 
passed the Senate twice. These improvements were negotiated in a 
bipartisan manner with the Senate and the House in order to help 
persuade Members who have indicated a willingness to support the SCHIP 
bill.
  A lot has been said about who is or is not negotiating the bill. Some 
have been critical because they have not been part of those 
discussions. To them I would say: Stop trying to kill the bill if you 
want to be a part of the negotiations. It makes no sense to negotiate 
with Members who have said they are never going to vote for the bill.
  So we have been trying to figure out a way to make the bill better. 
Here is where we are so far:
  There is more of an emphasis upon poor kids. Everybody has been 
saying: We ought to emphasize getting kids under 200 percent of poverty 
into the program. We have rewritten the bill to make that more certain. 
It is probably still not satisfactory to some people so far, but we 
will continue to work on that.
  Then there is the whole New York $83,000 red herring issue, and that 
was in the President's veto address. But remember, it was not in our 
bill. But somehow somebody told the President it was in the bill, and 
then the President, in his veto message, referred to a reason for 
vetoing the bill was the $83,000 issue with New York. That has been in 
the law for 10 years. What we did--so the President could not say that 
anymore--is we made clear this was not going to happen in any State.
  Then we took care of the childless adult issue. In the original bill, 
you remember, we phased out childless adults covered by the SCHIP 
legislation, and we phased them out in that bill over a 2-year period 
of time. We now have that down to a 1-year period of time.
  Premium assistance is strengthened. A technical clarification to the 
citizenship documentation provision in the bill has been made. That is 
not all. More work yet this morning--with Senator Baucus and me and 
some House Members--more work is underway trying to work with those who 
are sincerely wanting to vote for a children's health insurance bill.
  We are working on a potential amendment to this bill that will go 
further to address putting kids under 200 percent of poverty first, 
strengthening the private coverage options, and further clarifying that 
no illegals can get onto the program.
  Now, you understand, all these things are what our intention is. But 
somehow, through statutory language, we have not been able to make it 
clear enough. So we are going back and trying to make it more clear as 
a practical matter, maybe doing in a real

[[Page S13610]]

way what we intended to do that maybe when we wrote the language 
unintentionally was not accomplished.
  Now, to the point of illegals, Members who are working to kill this 
bill have tried to make it seem like this bill opens the floodgates to 
people who are in our country illegally getting onto the health 
programs. To keep asserting this is as responsible as yelling ``fire'' 
in a crowded movie theater.
  The latest assault is being leveled at the provision based on a bill 
authored by no other than Senator Lugar. It is a provision called 
ExpressLane, which allows States the option--just the option--to 
establish income eligibility based on eligibility for other means-
tested programs. ``ExpressLane'' is the new poster child now for those 
who scream ``illegals'' as a way to kill the bill.

  I ask unanimous consent to speak for 1 more minute.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. GRASSLEY. Mr. President, the ``ExpressLane'' option in the bill 
clearly requires a State to confirm the citizenship of applicants. I 
want to make that clear. The ``ExpressLane'' makes sure you have to be 
a citizen of the United States.
  Since some Members clearly are not reading the bill, let me read from 
those provisions:

       Verification of citizenship or Nationality status: The 
     State shall satisfy the requirements of section 1902(a) 
     (460)(B) or section 2105(c)(10), as applicable for 
     verifications of citizenship or nationality status.

  I don't know how much more clear it can be, and I hope it puts to 
rest a very sad mischaracterization of the bill.
  To sum up, the bill before us now is an improvement on the bill that 
passed the Senate. It strengthens the number of provisions that 
Republicans have been concerned about. I hope with the amendment I am 
working on with Chairman Baucus, Senator Hatch, Senator Rockefeller, 
and Members of both parties from the House of Representatives, that we 
will be able to increase the number of Republicans who vote to support 
this bill here in the Senate.
  I support cloture in the vote just coming up and I ask my colleagues 
to do it so we can proceed on this bill. I urge my colleagues to vote 
the same way.
  I yield the floor.


                             Cloture Motion

  The PRESIDING OFFICER. Under the previous order, and pursuant to rule 
XXII, the Chair lays before the Senate the pending cloture motion, 
which the clerk will state.
  The legislative clerk read as follows:

                             Cloture Motion

       We, the undersigned Senators, in accordance with the 
     provisions of rule XXII of the Standing Rules of the Senate, 
     do hereby move to bring to a close debate on the motion to 
     proceed to Calendar No. 450, H.R. 3963, Children's Health 
     Insurance Program Reauthorization Act of 2007.
         Max Baucus, Harry Reid, Benjamin L. Cardin, S. 
           Whitehouse, Robert Menendez, Daniel K. Inouye, Jack 
           Reed, Barbara Boxer, Patrick J. Leahy, Bernard Sanders, 
           Ken Salazar, Kent Conrad, Ron Wyden, Byron L. Dorgan, 
           Debbie Stabenow, Bill Nelson, Robert P. Casey, Jr.

  The PRESIDING OFFICER. By unanimous consent, the mandatory quorum 
call is waived.
  The question is, Is it the sense of the Senate that debate on the 
motion to proceed to H.R. 3963 to amend title XXII of the Social 
Security Act to extend and improve the Children's Health Insurance 
Program shall be brought to a close?
  The yeas and nays are mandatory under the rule.
  The clerk will call the roll.
  The bill clerk called the roll.
  Mr. DURBIN. I announce that the Senator from Indiana (Mr. Bayh), the 
Senator from Delaware (Mr. Biden), the Senator from Illinois (Mr. 
Obama), and the Senator from Oregon (Mr. Wyden) are necessarily absent.
  I further announce that, if present and voting, the Senator from 
Delaware (Mr. Biden) would vote ``yea.''
  Mr. LOTT. The following Senator is necessarily absent: the Senator 
from Virginia (Mr. Warner).
  The PRESIDING OFFICER (Mrs. McCaskill). Are there any other Senators 
in the Chamber desiring to vote?
  The yeas and nays resulted--yeas 62, nays 33, as follows:

                      [Rollcall Vote No. 401 Leg.]

                                YEAS--62

     Akaka
     Alexander
     Baucus
     Bingaman
     Boxer
     Brown
     Byrd
     Cantwell
     Cardin
     Carper
     Casey
     Clinton
     Coleman
     Collins
     Conrad
     Corker
     Dodd
     Domenici
     Dorgan
     Durbin
     Feingold
     Feinstein
     Grassley
     Harkin
     Hatch
     Inouye
     Johnson
     Kennedy
     Kerry
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     Lugar
     McCaskill
     Menendez
     Mikulski
     Murkowski
     Murray
     Nelson (FL)
     Nelson (NE)
     Pryor
     Reed
     Reid
     Roberts
     Rockefeller
     Salazar
     Sanders
     Schumer
     Smith
     Snowe
     Specter
     Stabenow
     Stevens
     Sununu
     Tester
     Webb
     Whitehouse

                                NAYS--33

     Allard
     Barrasso
     Bennett
     Bond
     Brownback
     Bunning
     Burr
     Chambliss
     Coburn
     Cochran
     Cornyn
     Craig
     Crapo
     DeMint
     Dole
     Ensign
     Enzi
     Graham
     Gregg
     Hagel
     Hutchison
     Inhofe
     Isakson
     Kyl
     Lott
     Martinez
     McCain
     McConnell
     Sessions
     Shelby
     Thune
     Vitter
     Voinovich

                             NOT VOTING--5

     Bayh
     Biden
     Obama
     Warner
     Wyden
  The PRESIDING OFFICER. On this vote, the yeas are 62, the nays are 
33. Three-fifths of the Senators duly chosen and sworn having voted in 
the affirmative, the motion is agreed to.
  The majority leader is recognized.
  Mr. REID. Madam President, while everybody is here, there will be no 
more rollcall votes today. I am going to be meeting shortly with 
Senator McConnell to find out when the next vote will be. The next vote 
can only come about with a unanimous consent request. I will work with 
Senator McConnell to see if we can come up with an easier lift than 
what is required under the rules.
  Under the rules, we will vote at approximately 1 a.m. Friday morning 
on the next aspect of this procedure we have on the CHIP bill. We will 
visit in a short time to see if we can change that time in any way. 
Again, that would have to be done by unanimous consent. As we know, if 
any one person doesn't like it, it will not happen. Otherwise, the next 
vote will be likely at 1 a.m. Friday morning.
  As I said, I will do everything I can to see if we can make it more 
convenient for the Members, as I am sure Senator McConnell will. We 
have, on this most important issue, to make sure that the necessary 
parties are contacted and that everybody knows exactly what they are 
doing. So until further notice, the next vote will be at 1 a.m. Friday 
morning.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mrs. LINCOLN. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  Mr. McCONNELL. Reserving the right to object.
  The PRESIDING OFFICER. The Senator cannot reserve the right to 
object.
  Mr. McCONNELL. I object.
  The PRESIDING OFFICER. Objection is heard.
  Mr. McCONNELL. Madam President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. McCONNELL. Madam President, the Senate is now considering what is 
essentially a do-over bill. The majority seems to believe that what 
didn't pass muster the first time and was vetoed by the President can 
now be successful. Well, it can't be, and my friends on the other side 
of the aisle know that.
  The reason we have this do-over bill before us is because, I believe, 
this process has become more about scoring political points than making 
good policy. When the other Chamber passed this bill--and they rammed 
it through, in essentially 1 day--not only did they not pick up any 
votes, they actually lost one vote on the House side.
  Then the majority in this body bypassed the committee process where 
both parties would have had a chance to strengthen the bill and brought 
it directly to the floor.
  Last Friday, the majority filed cloture on the motion to proceed, 
forcing this vote today. It is the majority that wanted to vote on this 
do-over bill, not my side of the aisle.

[[Page S13611]]

  The majority is also expected to fill the amendment tree to prevent 
Republican Senators from offering amendments and closing loopholes in 
the bill. All of that suggests to me that this is about politics, 
really, and not policy.
  So the bill before us is almost like a sequel of the bill that was 
vetoed the last time. And like any sequel, it is even worse the second 
time around.
  According to the Congressional Budget Office estimates, this bill 
actually covers 400,000 fewer children than the original SCHIP bill. 
Yet it costs more--a half billion dollars more.
  Our friends on the other side argue that their do-over bill will 
serve low-income children first. But instead of requiring that low-
income children be served first before expanding the program to cover 
those beyond 200 percent of the Federal poverty level, this bill 
expands the program to cover families making as much as 300 percent of 
the Federal poverty level.
  This will repeal the requirement that the Secretary of Health and 
Human Services, Mike Leavitt, just recently put in place that States 
cover 95 percent of low-income kids before they expand.
  This bill also contains an ``income disregard loophole'' that would 
allow States to ignore thousands of dollars of income when determining 
SCHIP eligibility. States could essentially define a family's income at 
whatever level they see fit.
  Democrats also argue this do-over bill will only serve children, not 
adults. Even that is not the case. While this legislation would phase 
childless adults out of the program within 1 year, parents would still 
be eligible.
  Put it all together, and we have a bill born out of a process that is 
focused more on scoring political points than making good policy, and 
it is certainly not one I intend to support.
  I urge my colleagues to re-engage in communication and consultation 
with this side of the aisle. Together, we can craft a bill that keeps 
its focus on low-income children and can actually receive a 
Presidential signature. That is the way to accomplish real results for 
the American people. We Republicans stand ready and willing to do just 
that.
  Madam President, I yield the floor.
  The PRESIDING OFFICER. The Senator from West Virginia.
  Mr. BYRD. Madam President, what is the matter before the Senate?
  The PRESIDING OFFICER. The motion to proceed to the Children's Health 
Insurance Program.
  Mr. BYRD. I ask unanimous consent that I may speak as in morning 
business, and I speak out of order.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                                  Iran

  Mr. BYRD. Madam President, I commend and offer my wholehearted 
support for the resolution that Senator Durbin has submitted. His 
resolution, which I am proud to cosponsor, is a simple, clear statement 
of a fundamental constitutional principle; namely, that the Congress 
and only the Congress has the power to declare war. As this resolution 
states:

       Any offensive military action taken by the United States 
     against Iran must be explicitly approved by Congress before 
     such action may be initiated.

  The President is the Commander in Chief of the Armed Forces. But the 
President of the United States, although Commander in Chief of the 
Armed Forces, is not a dictator. The President is not an emperor. He is 
President, who, like all Presidents, takes an oath of fealty to the 
Constitution of the United States.
  It is the American people--the American people--who pay the price of 
war in blood and in treasure. And it is the American people, through 
their representatives in Congress--that means us--who must give their 
approval--the approval of the American people--for such a momentous 
decision. That is the system that George Washington recognized when he 
presented his resignation to the Continental Congress. That is the 
system that the wise Framers of the Constitution created when they 
drafted our most basic and sacred document. That is the system that 
every Senator takes an oath to defend.
  Today is a fitting day to discuss the issue of Iran. Today is All 
Hallows Eve--Halloween--a day when people don masks and costumes to 
frighten others. The White House has been busy unleashing its 
rhetorical ghosts and goblins to scare the American people with claims 
of an imminent nuclear threat in Iran, as they did with Iraq. But while 
few people doubt the desire of some in the Iranian regime to attain a 
nuclear bomb, there is little evidence that Iran is close to acquiring 
such a weapon. Fear, panic, and chest-pounding do not work well in the 
conduct of foreign policy. This is a time to put diplomacy to work. 
There is ample opportunity to coordinate with our allies to constrain 
Iran's ambitions. But instead of working with our partners, the Bush 
administration has unveiled new unilateral sanctions against Iran. 
Instead of direct diplomatic negotiations with Iran, the Bush 
administration continues to issue ultimatums and threats.
  We have been down that path already. We know where it leads. Vice 
President Cheney recently threatened ``serious consequences''--serious 
consequences--if Tehran does not acquiesce to U.S. demands--the exact 
phrase that he, the Vice President, used in the runup to the invasion 
of Iraq. The parallels are all too chilling. President Bush warned that 
those who wished to avoid World War III should seek to keep Iran from 
obtaining nuclear weapons. Secretary of Defense Gates has admitted in 
the press that the Pentagon has drafted plans for a military option in 
Iran. The President's $196 billion request for emergency war funding 
included a request for bunker buster bombs that have no immediate use 
in Iraq. Taking all of this together--the bellicose rhetoric, the 
needlessly confrontational unilateral sanctions, the provocative 
stationing of U.S. warships in the region, the operational war 
planning, and the request for munitions that seem designed for use in 
Iran--these are all reasons for deep concern that this administration 
is once again rushing headlong into another disastrous war in the 
Middle East.
  The Bush administration apparently believes it has the authority to 
wage preemptive war. It believes it can do so without prior 
Congressional approval. That is why the resolution of Senator Richard 
Durbin of Illinois is so critical--namely, the White House must be 
reminded of the constitutional powers entrusted to the people's 
branch--that is us, the House of Representatives and the Senate. I urge 
my colleagues to join Senator Durbin and me on this important 
resolution and halt--halt--this rush to another war. Let us not make 
the same disastrous mistake as we did with Iraq.
  Madam President, I yield the floor.
  Mr. WHITEHOUSE. Madam President, may I speak for 12 minutes as in 
morning business?
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________